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BACKGROUND:  Waist-related measures are commonly used to classify central adiposity and related comorbidities. This classification may be essential among children, as it may identify the risk of future non-communicable diseases. METHODS:  A cross-sectional study was conducted in the Eastern Cape province, South Africa, among 459 primary school learners aged 9-14 years. Height, weight and waist circumference (WC) were measured using standardised techniques recommended by World Health Organization (WHO). The anthropometric measurements, including body mass index (BMI), WC, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were computed and evaluated. RESULTS:  Most participants were girls (57.70%) with an average age of 11.20 ± 1.60 years. The average weight was 38.81 kg ± 10.49 kg with an average height of 144.16 (standard deviation [s.d.] = 10.37) cm. The sample had a BMI of 18.41 kg/m2 (s.d. = 3.19). The results showed, on average, WC of 62.10 cm ± 8.12 cm, WHR of 0.82 ± 0.15 and WHtR of 0.44 ± 0.05. Girls reported significantly higher BMI, WC and WHtR. Based on WHtR, the results showed the acceptable ability to classify children according to abdominal obesity, thus identifying their risk for comorbidities. CONCLUSION:  Overall body fat indicated by BMI and central obesity shown by waist-related anthropometric measures can play a significant role in classifying children in terms of their risk of comorbidities.Contribution: To prevent the risks of metabolic diseases in childhood, it is necessary to detect abdominal obesity early using WC-based anthropometric measurements, especially WHtR, to identify those at risk.

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Background: Low levels of physical activity in high- to low-income countries, including South Africa, pose a great risk of cardiovascular-related diseases. Aim: This study aimed to assess and compare the physical fitness profile among children. Setting: The study setting comprised rural and urban primary school learners in the Eastern Cape province, South Africa. Methods: A cross-sectional study was adopted utilising a randomly selected sample of boys and girls aged 9-14 years. Physical fitness measures were assessed using the Euro-fit test battery. Some parametric tests were used for mean comparisons of the various anthropometric measurements and physical fitness characteristics across demographics. Results: The sample consisted of 870 primary school learners. The average weight and height of the sample were 39.29 ± 10.34 kg and 144.06 ± 10.81 cm, respectively, with a mean body mass index (BMI) of 18.80 ± 4.11 kg/m2. The results showed that boys reported significantly high levels of physical fitness. Sit-ups (p ≤ 0.001) and VO2 max (p ≤ 0.001) significantly increase with age, while all the physical fitness measures were significantly higher among rural-based learners. Conclusion: Rural-based learners and boys generally had better physical fitness performance than their peers. The effect of gender and place of residence should be considered when designing physical fitness interventions. Contribution: This study adds to the existing body of knowledge about the effect of demographic factors on the physical fitness profile of children, where boys and rural-based learners are reported to be more physically fit than their counterparts.

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Background: The level, direction or presence of the relationship between perceived physical activity (PA) participation and physical fitness (PF) in children may differ by gender and this will assist in designing gender-specific interventions to promote PA participation, which in turn improves PF levels. Aim: This study aimed to establish the moderating effect of gender on the relationship between perceived PA participation and PF. Method: A cross-sectional study was conducted with a cohort of 870 primary school children aged 9-14 years old. Perceived PA participation was measured using the PAQ-C questionnaire while PF levels were measured using cardiorespiratory endurance (i.e. VO2 max). Results: The results showed significant gender differences for perceived PA participation levels (t = -3.40, p ≤ 0.001) and PF (t = -11.59, p ≤ 0.001), with boys reporting higher levels than the girls. Perceived PA participation had a positive, weak and statistically significant correlation with PF (r = 0.251; p ≤ 0.001). Gender significantly moderates the relationship between perceived PA participation and PF (ß3 = 3.518; 95% confidence interval [CI]: 0.642 to 6.395; p = 0.017). Conclusion: The moderating effect of gender on the relationship between perceived PA participation and PF highlights the differences in physiology as well as the societal PA associated roles played by boys and girls. Contribution: The study has established that the relationship between perceived PA participation and PF is more pronounced among boys than girls.

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Background: Low physical activity (PA) participation levels and increasing non-communicable diseases in children are concerning in South Africa and globally. Objectives: We sought to assess the mediating role of perceived social support factors on the relationship between PA enjoyment and PA levels among rural, peri-urban and urban school children. Method: A cross-sectional study was adopted to assess peer, family and teacher encouragement as mediators on the relationship between perceived PA enjoyment and perceived physical activity participation among children, using the Physical Activity Questionnaire for Older Children (PAQ-C). The sample comprised a random sample of primary school learners aged 9-14 years. Results: The sample consisted of 870 primary school learners with a mean age of 11.0 ± 1.49 years. Most participants were girls (n = 519; 59.7%). The findings suggest low levels of perceived PA participation (mean = 2.33, standard deviation [s.d.]: 0.43). Peer (ß = 0.0187, 95% confidence interval [CI]: 0.0088, 0.0307), family (ß = 0.0280, 95% CI: 0.0155, 0.0425) and teacher (ß = 0.0242, 95% CI: 0.0127, 0.0378) encouragement partially mediates the relationship between perceived PA enjoyment and perceived PA participation. Family encouragement (ß = 0.0158, 95% CI: 0.0017, 0.0311) has the most considerable mediating effect, followed by teacher encouragement (ß = 0.0125, 95% CI: 0.0010, 0.0269). Conclusion: The findings demonstrated low levels of perceived PA participation in school learners. Therefore, we recommends including social factors as mediators in PA intervention programmes in primary schools. Clinical implications: Social support factors as mediators on the relationship between PA enjoyment and PA participation among children may improve children's PA participation levels and help prevent non-communicable diseases in future.

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AIMS AND OBJECTIVES: To examine underlying factor structure of the Critical Care Family Needs Inventory-Emergency Department across three countries to identify similarities and differences. BACKGROUND: Understanding family needs assists nurses to provide family-centred care to deliver optimal outcomes for critically ill patients and their families in Emergency Departments. DESIGN: Retrospective secondary analyses of data collected in three cross-sectional surveys. METHODS: Convenience samples involved recruitment of family members accompanying a critically ill relative into four Emergency Departments in Australia (2), South Africa (1) and Taiwan (1). Item-matched raw data from 374 responses to 40 items from the surveys were collated and analysed using confirmatory factor analysis methods. Reporting adhered to an adapted STROBE checklist. RESULTS: The factor structure of the 40-item Critical Care Family Needs Inventory-Emergency Department differed between countries. Analyses of the Australian data revealed a four-factor solution comprised of 18 items across four categories of family need (support, communication, participation and comfort); the Taiwanese data also demonstrated a four-factor solution comprised of 13 items (support, communication, participation and comfort); alternatively, the South African data revealed a two-factor solution comprised of nine items (communication and participation). Fifteen items did not match across the countries. However, loading for four items common across all three countries was related to family participation (3) and communication (1). CONCLUSIONS: The findings suggest family members from different countries responded to Critical Care Family Needs Inventory-Emergency Department items in different ways. Consistent with concepts of family-centred care, the study identified participation and communication needs that were common across the countries. The outcomes illustrate the challenge of providing appropriate care for family members during critical illness of a relative in the ED. RELEVANCE TO CLINICAL PRACTICE: Family perceptions of important needs during critical illness in the Emergency Department differ across countries; hence, the Critical Care Family Needs Inventory-Emergency Department has limited utility. Participation and communication needs emerged as common family needs.

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