Background The World Health Organization estimates that 19 million deaths worldwide are attributable to physical inactivity Chronic diseases associated with physical inactivity include cancer, diabetes and coronary heart disease Objectives The purpose of this systematic review is to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents Search strategy The search strategy included searching several databases In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews Primary authors of included studies were contacted as needed for additional information Selection criteria To be included, the intervention had to be relevant to public health practice, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, report on outcomes for children and adolescents (aged 6 to 18 years), and use a prospective design with a control group Data collection and analysis Standardized tools were used by two independent reviewers to rate each studyﾒs methodological quality and for data extraction Where discrepancies existed discussion occurred until consensus was reached The results were summarized narratively due to wide variations in the populations, interventions evaluated and outcomes measured Main results 13,841 titles were identified and screened and 482 articles were retrieved Multiple publications on the same project were combined and counted as one project, resulting in 395 distinct project accounts (studies) Of the 395 studies 104 were deemed relevant and of those, four were assessed as having strong methodological quality, 22 were of moderate quality and 78 were considered weak In total 26 studies were included in the review There is good evidence that school-based physical activity interventions have a positive impact on four of the nine outcome measures Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol Generally school-based interventions had no effect on leisure time physical activity rates, systolic and diastolic blood pressure, body mass index, and pulse rate At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity result in positive effects Authors' conclusions Given that there are no harmful effects and that there is some evidence of positive effects on lifestyle behaviours and physical health status measures, ongoing physical activity promotion in schools is recommended at this time

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School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18.

Identifying the women at risk of antenatal anxiety and depression: A systematic review.

Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries.

Magnitude and risk factors for postpartum symptoms: a literature review.

Background: Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates, and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD, and a meta-regression to identify economic, health, social or policy factors associated with national PPD prevalence. Methods: We conducted a systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To test for country level predictors, we drew on data from UNICEF, WHO, and the World Bank. Random effects meta-regression was used to test national predictors of PPD prevalence. Findings: 308 studies of 304,449 women from 56 countries were identified. The global pooled prevalence of PPD was 17.5% (95% CI: 16.4% - 18.6%), with significant heterogeneity across nations (Q = 17,192, p = .000, I2 = 98%), ranging from 3.10% (0.01% - 10.87%) in Singapore to 37.78% (30.95% - 44.83%) in Chile. Nations with significantly higher rates of income inequality (R2=42.78%), maternal mortality (R2=25.54%) infant mortality (R2=12.23%), total fertility rates (R2=17.14%), or women of childbearing age working > 40 hours a week (R2=24.14%) have higher rates of PPD. Together, these factors explain 77.26%% of the national variation in PPD prevalence. Interpretation: The global prevalence of PPD is greater than previously thought and varies dramatically by nation. Disparities in wealth inequality and maternal-child-health factors explain much of the national variation in PPD prevalence.

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Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries.

Women’s attitudes and expectations regarding gynaecological examination

There are various factors related to postpartum depression. In this study we have aimed to determine the effect of mode of delivery on the risk of postpartum depression. A total of 318 women who applied for delivery were included in the study. Previously diagnosed fetal anomalies, preterm deliveries, stillbirths, and patients with need of intensive care unit were excluded from the study. Data about the patients were obtained during hospital stay. During the postpartum sixth week visit Edinburgh postnatal depression scale (EPDS) was applied. There was no significant difference between EPDS scores when compared according to age, education, gravidity, wanting the pregnancy, fear about birth, gender, family type, and income level (P > 0.05). Those who had experienced emesis during their pregnancy, had a history of depression, and were housewives had significantly higher EPDS scores (P < 0.05). Delivering by spontaneous vaginal birth, elective Cesarean section, or emergency Cesarean section had no effect on EPDS scores. In conclusion healthcare providers should be aware of postpartum depression risk in nonworking women with a history of emesis and depression and apply the EPDS to them for early detection of postpartum depression.

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Postpartum depression: is mode of delivery a risk factor?

AIM: The aim of the study was to explore the prevalence and characteristics of women with unplanned pregnancy (UP) and to examine the associations between pregnancy planning status and womens health practice and depression during pregnancy in Manisa Turkey. MATERIAL AND METHODS: The study was conducted with pregnant women (n=550) who attended a state hospital for antenatal care in Manisa Turkey. Health practices of women during pregnancy were assessed with the Health Practices Questionnaire (HPQ II) and depression was measured by the Beck Depression Inventory (BDI). RESULTS: Of the 550 pregnancies 149 (27.1%) were unplanned. Women whose pregnancies were planned were likely to be younger more educated employed to perceive more social support and to be more satisfied in marriage life than women whose pregnancies were unplanned. The number of pregnancies births and children was higher in women whose pregnancies were unplanned. Women with UP had significantly lower HPQ scores (mean 118.4 SD=13.5) than women with planned pregnancies (mean 124.0 SD=14.1). Women with UP also had a significantly higher score for BDI (mean 10.3 SD 6.9 vs mean 8.1 SD 5.8). CONCLUSIONS: Women with UP had engaged in fewer healthy practices and experienced more depressive symptoms during pregnancy. Health-care providers should screen for UP at an early stage and offer health education programs to help women to develop positive health practices and to improve their emotional health. (c) 2012 The Authors. Journal of Obstetrics and Gynaecology Research (c) 2012 Japan Society of Obstetrics and Gynecology.

Planned and unplanned pregnancy: effects on health practice and depression during pregnancy.

Objectives The aim of the study was to assess the symptoms of women and to describe the relationship between women's attitude towards menopause and quality of life.Methods This study was conducted from November 2010 to April 2011 at Celal Bayar University Faculty of Medicine and 494 women agreed to participate in the study. Women's attitudes towards menopause and quality of life were evaluated by Menopause-specific Quality of Life (MENQOL) questionnaires.Results Women with no education had the highest scores for vasomotor, psychosocial and physical cluster symptoms (4.1 ± 2.0, 3.1 ± 1.6, 3.2 ± 1.4, respectively). Vasomotor (4.0 ± 1.9) and physical quality-of-life scores (3.2 ± 1.40) were significantly higher among housewives. Psychosocial (3.6 ± 1.8) and physical scores (3.5 ± 1.5) of women who had no health insurance were found to be higher. The highest scores reported by the women were as follows: vasomotor, physical, psychosocial and sexual cluster (3.8 ± 1.9, 3.1 ± 1.4, 2.9 ± 1.6, 2.7 ± 1.8, respectiv...

Relationship between women's attitude towards menopause and quality of life

The purpose of this study was to estimate prevalence and risk groups of domestic violence during pregnancy in Manisa, Turkey, and to determine antenatal complications or health problems and health service use. This study was a population-based, cross-sectional, and household survey. The study universe included two primary health units situated in two different socioeconomic areas (rural and urban) in the city of Manisa, Turkey, from January to June 2004; the homes of 246 women were visited and the study sample included 217 women. A questionnaire was used that comprised sociodemographic and reproductive characteristics, and the Domestic Violence Against Women Determination Scale, developed by Yanikkerem in 2002 to measure the frequencies of type and severity of violence. The Statistical Package for the Social Sciences (SPSS, version 10.0 for Windows) was used to analyze the data. Student t test and Mann-Whitney U test were used to evaluate data. Results indicated that 9.7% of women were beaten by their partner during the pregnancy (17.3% in the rural area and 2.7% in the urban area) and 14.3% of women were beaten before pregnancy. A total of 10.6% of women said they had been slapped, 9.1% reported an object was thrown at them by their partner, and 6.5% admitted to having been kicked during pregnancy. A total of 36.4% of women reported experiencing forced sexual activity. Abused pregnant women were less educated, had lower income, were unmarried, were multiparous, had more children, had a longer duration of marriage, lived rural areas, were more likely to have unplanned pregnancies, had miscarriage, had an interpregnancy interval of 2 years or less, smoked more cigarettes, did not visit a health institution for control during pregnancy and did not know the sex or knew the fetus was female when compared with nonabused women. Abused women who live with various problems during pregnancy and are victims of violence tend to feel isolated, insecure, and depressed. Our results indicate that most pregnant women do not report that their prenatal care providers discussed violence with them. Healthcare provides have an important role in this issue. Antenatal care protocols should be modified to address domestic violence and contributing factors during pregnancy so that identified women can be counseled appropriately and attempts can be made to intervene to prevent further episodes of domestic violence in primary care settings.

Emre Yanikkerem

Papers

Women’s attitudes and expectations regarding gynaecological examination

Postpartum depression: is mode of delivery a risk factor?

Planned and unplanned pregnancy: effects on health practice and depression during pregnancy.

Relationship between women's attitude towards menopause and quality of life

Domestic violence during pregnancy in Turkey and responsibility of prenatal healthcare providers.