Interprofessional collaboration in nursing homes (interprof): A grounded theory study of general practitioner experiences and strategies to perform nursing home visits

Background: Interprofessionalism, considered as collaboration between medical professionals, has gained prominence over recent decades and evidence for its impact has grown. The steadily increasing number of residents in nursing homes will challenge medical care and the interaction across professions, especially nurses and general practitioners (GPS). The nursing home visit, a key element of medical care, has been underrepresented in research. This study explores GP perspectives on interprofessional collaboration with a focus on their visits to nursing homes in order to understand their experiences and expectations. This research represents an aspect of the interprof study, which explores medical care needs as well as the perceived collaboration and communication by nursing home residents, their families, GPS and nurses. This paper focusses on GPS' views, investigating in particular their visits to nursing homes in order to understand their experiences. Methods: Open guideline-interviews covering interprofessional collaboration and the visit process were conducted with 30 GPS in three study centers and analyzed with grounded theory methodology. GPS were recruited via postal request and existing networks of the research partners. Results: Four different types of nursing home visits were found: visits on demand, periodical visits, nursing home rounds and ad-hoc-decision based visits. We identified the core category "productive performance" of home visits in nursing homes which stands for the balance of GPŚ individual efforts and rewards. GPS used different strategies to perform a productive home visit: preparing strategies, on-site strategies and investing strategies. Conclusion: We compiled a theory of GPS home visits in nursing homes in Germany. The findings will be useful for research, and scientific and management purposes to generate a deeper understanding of GP perspectives and thereby improve interprofessional collaboration to ensure a high quality of care.

Kompetensutveckling som konkurrensmedel : En kvalitativ intervjustudie med fokus på förskollärarstudenters och förskollärares uppfattning av kompetensutveckling som konkurrensmedel

Studiens syfte handlar om huruvida kompetensutveckling kan fungera som konkurrensmedel när en kommun har för avsikt att attrahera och behålla förskollärare. Bakgrunden inleds med vilka kompetenshöjande insatser kommunen arbetat med för att bli en attraktiv arbetsgivare. Det efterföljs av en teoretisk beskrivning om hur kompetensutveckling kan fungera som konkurrensmedel samt skolan som attraktiv arbetsgivare. Metoden som användes vid insamlandet av data var semistrukturerade intervjuer. Forskningsansatsen inspirerades av fenomenologin och styrde sedan arbetet med insamlandet av data samt val av analysmetod. Då urvalet innefattade två grupper; förskollärare och förskollärarstudenter skapades en intervjuguide för respektive grupp som utformades efter studiens syfte och frågeställningar. I studiens resultat framkommer samtliga intervjupersoners upplevelse av att kompetensutveckling är något positivt. Förskollärarna såg det som en avgörande faktor vid val av arbetsgivare medan förskollärarstudenterna värderade exempelvis lön som en faktor av större betydelse. I resultatet lyfts andra övergripande faktorer som exempelvis arbetsklimat, stöd från chef och storlek på barngrupper vilka även styr intervjupersonernas val av arbetsgivare. Det lyfts också möjliga kommunspecifika utvecklingsområden samt generellt för förskolor. 

Influence d'un incitatif financier destiné aux médecins de famille sur la gestion du diabète des Néo-Brunswickois

Résumé: Problématique : En réponse à la prévalence accrue de la maladie du diabète et au fardeau économique important que représente cette maladie sur le système de santé international, des programmes incitatifs pour les maladies chroniques furent instaurés à travers le monde. Ces programmes visent à inciter les médecins à appliquer les lignes directrices chez leurs patients avec besoin complexe en vue d’améliorer la santé des patients et par la suite de réduire les coûts incombés par le système de santé. Les programmes incitatifs étant nombreux et différents d’un pays à l’autre, les études actuelles ne semblent pas s’entendre sur les répercussions de tels programmes sur la santé des patients atteints de diabète. L’objectif de cette étude est d’évaluer les retombées d’un incitatif financier sur le contrôle glycémique de la population atteinte de diabète du Nouveau-Brunswick, au Canada. Méthodes : Cette étude transversale répétée et de cohorte a été menée grâce à des bases de données administratives du Nouveau-Brunswick contenant des données sur dix ans pour 83 580 patients adultes atteints de diabète et 583 médecins de famille éligibles. La santé des patients a été évaluée au niveau du contrôle glycémique, en mesurant les valeurs moyennes d’A1C annuelles à l’aide de régressions linéaires multivariées. Afin d’évaluer si les médecins changeaient leur pratique avec l’implantation du programme incitatif, nous regardions au niveau de la probabilité de recours annuel à au moins deux tests d’A1C en utilisant des régressions logistiques multivariées. Résultats : La probabilité de recours annuel à au moins deux tests d’A1C était plus élevée dans quatre sous-groupes étudiés : les patients nouvellement diagnostiqués après l’implantation du programme avaient des cotes plus élevées comparées aux nouveaux patients avant l’implantation du programme (OR=1.23 [1.18-1.28]); les patients pour lesquels un médecin avait réclamé l’incitatif comparés aux patients pour lesquels aucun médecin n’avait réclamé l’incitatif (OR=2.73 [2.64-2.81]); les patients pour lesquels un médecin avait réclamé l’incitatif avaient des cotes plus élevées après l’implantation du programme comparé à avant (OR=1.89 [1.80-1.98]); et finalement, les patients suivis par un médecin de famille qui a déjà réclamé l’incitatif avaient des cotes 24% plus élevées (OR=1.24 [1.15-1.34]). Il n’y avait pas de différence dans les valeurs d’A1C annuelles entre les 4 sous-groupes étudiés. Conclusion : L’implantation du programme incitatif a démontré que les médecins ont une meilleure probabilité de prescrire au moins deux tests d’A1C, ce qui suggère une meilleure prise en charge des patients. Cependant, le manque de changement au niveau du contrôle glycémique du patient suggère que l’étude des répercussions de l’incitatif devra être poursuivie afin de voir si elle mène à une amélioration d’issues cliniques chez les patients.

How much walking should be advocated for good health in adolescent girls?

Background: It is currently not known how much walking should be advocated for good health in adolescent girls. The aim of this study was therefore to recommend health referenced standards for step defined physical activity relating to appropriate health criterion/indicators in a group of adolescent girls. Method: Two hundred and thirty adolescent girls aged between 12-15years volunteered to take part in the study. Each participant undertook measurements (BMI, waist circumference, % body fat and blood pressure) to define health status. Activity data were collected by pedometer and used to assess daily step counts and accumulated daily activity time over seven consecutive days. Results: Individuals classified as ‘healthy’ did not take significantly more steps·day−1 nor spend more time in moderate intensity activity than individuals classified as at health risk or with poor health profiles. Conclusion: ‘Healthy’ adolescent girls do not walk significantly more in term of steps·day−1 or time spent in activity than girls classified as ‘unhealthy’. This could suggest that adolescent girls may not walk enough to stratify health and health related outcomes and as a result the data could not be used to inform an appropriate step guideline for this population.

Promoting oral health in adults with learning disability

Introduction: It is complex to define learning disabilities, there is no single universal definition used; there are different interpretations and definitions used for learning disabilities in different countries and communities. Primarily, the term “learning disability” sometimes used as “learning difficulties” is a term widely used in UK. There are various types and degree of severity of learning disabilities depending upon the extent of disorder. Though different definitions used all over the world, its types and classification coupled with their health and oral health needs are discussed in this review. Objectives:  To review the background literature on definitions of learning disabilities and health needs of this population.  To review literature on individual clinical preventive intervention to determine the effectiveness in promoting oral health amongst adults in learning disabilities.  To review literature in relation to community based preventive dental measures.  To determine the interventions in this areas are appropriate to support policy and practice and if these interventions establish good evidence to suggest that the oral health needs of adults with learning disabilities are met or not.  To make recommendations in implementing future preventive oral health interventions for adults with learning disabilities. Methodology: It was develop a comprehensive narrative synthesis of previously published literature from different sources and summarizes the whole research in a particular area identifying gap of knowledge. It provides a broad perspective of a subject and supports continuing education. It also is directed to inform policy and further research. It is a qualitative type of research with a broad question and critical analysis of literature published in books, article and journals. The research question evaluated on PICOS criteria is: Effectiveness of preventive dental interventions in adults with learning disabilities. The research question clearly defines the PICOS i.e. participants, interventions, comparison, outcome and study design. The Cochrane database of systematic reviews (CDSR), Database of Abstracts of Reviews of effects (DARE) through York University and National institute of Health and Clinical Excellence (NICE) was searched to identify need of this review. There was no literature review found on the preventive dental interventions found hence, justifying this review. The guidance used in this review is from York University and methods opted for search of literature is based on the following: Type of participants, interventions, outcome measure, studies and search. The review of literature; author search; systematic and narrative reviews, through the following electronic databases via UFP library services: Pub-Med, Medline, EMBASE, CINHAL, Google scholar; Science Direct; Social and Medicine. A comprehensive search of all available literature from 1990-2015, including systematic reviews, policy documents and some guideline documents was done. Internet resource used to access; Department of Health, World Health Organization, Disability World, Disability Rights Commission, the Stationery office, MENCAP, Australian Learning Disability Association. The literature search was carried out with single word, combined words and phrases, authors' names and the title of literature search. Results: It is primarily looking at the oral health interventions available for adults with learning disabilities in clinical settings and the community measures observed over a period of 25 years 1990-2015. There were 7of the clinical intervention studies and one community based intervention study was added in this review. Conclusion: There is a gap of knowledge identified in not having ample research in the area of preventive dental interventions in adults with learning or intellectual disabilities and there is a need of more research, studies need to be of a better quality and a special consideration is required in the community settings where maintenance of oral hygiene for this vulnerable group of society is hugely dependent on their caregivers. Though, the policy and guideline directs on the preventive dental interventions of adults with LD there still a gap evident in understanding and implication of the guidance in practice by the dental and care support team. Understanding learning disabilities and to identify their behavior, compliance and oral health needs is paramount for all professionals working with or for them at each level.

Moradia e meio ambiente: extensão universitária e compromisso social

This book’s guideline is a description of the activities developed during the University Extension project entitled "Housing and Environment: building dialogue over the urbanization of the settlement Ilha", located in the Metropolitan Region of Curitiba. This project was coordinated by professors from the Federal University of Technology - Paraná (UTFPR). The initial objectives of the extension project were to investigate ways of intervention on the scenario of poor conditions of housing and urbanization of the settlement Ilha, for their land regularization. The book tells the story of the extension project, showing how the initial goals have changed with time. In addition, this book describes the frustrations and the learning process along the way, from the view of professors and students of UTFPR who actively participated in this project. This book also intends to report the feelings that the villagers attributed to their place of residence; the joys, stumbling and learning by using a participatory methodology from what Paulo Freire says about popular education. Moreover, the book brings the confrontation between the technical and popular vision on the regularization of the area.

Rational Function Interpolation of Electromagnetic Transfer Functions of High-Speed Interconnect Systems from Discrete Time-Domain and Frequency-Domain Data

We present new methodologies to generate rational function approximations of broadband electromagnetic responses of linear and passive networks of high-speed interconnects, and to construct SPICE-compatible, equivalent circuit representations of the generated rational functions. These new methodologies are driven by the desire to improve the computational efficiency of the rational function fitting process, and to ensure enhanced accuracy of the generated rational function interpolation and its equivalent circuit representation. Toward this goal, we propose two new methodologies for rational function approximation of high-speed interconnect network responses. The first one relies on the use of both time-domain and frequency-domain data, obtained either through measurement or numerical simulation, to generate a rational function representation that extrapolates the input, early-time transient response data to late-time response while at the same time providing a means to both interpolate and extrapolate the used frequency-domain data. The aforementioned hybrid methodology can be considered as a generalization of the frequency-domain rational function fitting utilizing frequency-domain response data only, and the time-domain rational function fitting utilizing transient response data only. In this context, a guideline is proposed for estimating the order of the rational function approximation from transient data. The availability of such an estimate expedites the time-domain rational function fitting process. The second approach relies on the extraction of the delay associated with causal electromagnetic responses of interconnect systems to provide for a more stable rational function process utilizing a lower-order rational function interpolation. A distinctive feature of the proposed methodology is its utilization of scattering parameters. For both methodologies, the approach of fitting the electromagnetic network matrix one element at a time is applied. It is shown that, with regard to the computational cost of the rational function fitting process, such an element-by-element rational function fitting is more advantageous than full matrix fitting for systems with a large number of ports. Despite the disadvantage that different sets of poles are used in the rational function of different elements in the network matrix, such an approach provides for improved accuracy in the fitting of network matrices of systems characterized by both strongly coupled and weakly coupled ports. Finally, in order to provide a means for enforcing passivity in the adopted element-by-element rational function fitting approach, the methodology for passivity enforcement via quadratic programming is modified appropriately for this purpose and demonstrated in the context of element-by-element rational function fitting of the admittance matrix of an electromagnetic multiport.

Defining the Resolution of a Network for Transportation Analyses: a New Method to Improve Transportation Planning Decisions

Travel demand models are important tools used in the analysis of transportation plans, projects, and policies. The modeling results are useful for transportation planners making transportation decisions and for policy makers developing transportation policies. Defining the level of detail (i.e., the number of roads) of the transport network in consistency with the travel demand model’s zone system is crucial to the accuracy of modeling results. However, travel demand modelers have not had tools to determine how much detail is needed in a transport network for a travel demand model. This dissertation seeks to fill this knowledge gap by (1) providing methodology to define an appropriate level of detail for a transport network in a given travel demand model; (2) implementing this methodology in a travel demand model in the Baltimore area; and (3) identifying how this methodology improves the modeling accuracy. All analyses identify the spatial resolution of the transport network has great impacts on the modeling results. For example, when compared to the observed traffic data, a very detailed network underestimates traffic congestion in the Baltimore area, while a network developed by this dissertation provides a more accurate modeling result of the traffic conditions. Through the evaluation of the impacts a new transportation project has on both networks, the differences in their analysis results point out the importance of having an appropriate level of network detail for making improved planning decisions. The results corroborate a suggested guideline concerning the development of a transport network in consistency with the travel demand model’s zone system. To conclude this dissertation, limitations are identified in data sources and methodology, based on which a plan of future studies is laid out.

Avaliação do potencial cancerigénico de microcistinas (cianotoxinas)

Tese de doutoramento em Farmácia (Toxicologia), apresentada à Faculdade de Farmácia da Universidade de Lisboa, 2009.

O envelhecimento ativo na perspetiva de pessoas idosas que frequentam a Universidade Sénior de Águeda

O envelhecimento ativo é o processo de otimização das oportunidades de saúde, participação e segurança, a fim de melhorar a qualidade de vida das pessoas à medida que envelhecem. Permite que as pessoas realizem o seu potencial físico, social, mental e de bem-estar ao longo da vida, bem como de participação na sociedade, ao fornecer-lhes proteção, segurança e cuidados adequados quando eles precisam. Com o presente estudo pretendeu-se, globalmente, saber qual a perspetiva das pessoas idosas que frequentam a Universidade Sénior de Águeda sobre o Envelhecimento Ativo e como valorizam os seus determinantes básicos durante este processo. Trata-se de um estudo exploratório, de natureza descritiva, com uma abordagem qualitativa. Participaram vinte pessoas idosas, sendo quinze do género feminino e cinco do género masculino. Os participantes estavam inscritos na Universidade Sénior de Águeda, pelo menos desde o início do ano letivo. A técnica utilizada para a recolha de dados foi um guião de entrevista semiestruturada e para a análise destes dados foi utilizada a técnica de análise de conteúdo predominantemente indutiva. Relativamente aos resultados do nosso estudo, na perspetiva dos participantes, o conceito de envelhecimento ativo, circunscreve-se essencialmente a duas grandes áreas: a promoção da atividade e a necessidade de se manterem ocupados. Relativamente à primeira destacaram as suas componentes física e mental, as quais estão relacionadas com aspetos da saúde. Quanto à segunda área os participantes relacionaram-na com a participação social. Também nas entrevistas foi destacada a participação social como um determinante fundamental para o envelhecimento ativo, associada à convivência e à promoção de atividades por organizações de apoio social. Quanto à frequência da Universidade Sénior, as pessoas idosas referem que a frequentam pela promoção do envelhecimento ativo nomeadamente através das suas atividades nos diferentes domínios. Concluiu-se que as pessoas idosas participantes no estudo não têm conhecimentos acerca do conceito geral do envelhecimento ativo nem de todos os seus determinantes, é de salientar também o valor que as pessoas idosas dão à USEA. Em relação às implicações para a prática da gerontologia elas decorrem dos resultados, devido ao facto das pessoas valorizarem a importância da Universidade Sénior, é então necessário criar mais espaços que propiciem essas condições, pois não existem em todos os concelhos e por vezes situam-se nos centros das cidades, o que se torna de difícil acesso para as pessoas idosas que vivem nas periferias. Por outro lado, em relação à segurança, o determinante do envelhecimento ativo que não foi reconhecido pelas pessoas idosas, é necessário que exista formação acerca da segurança, tanto no ambiente doméstico de maneira a reduzir os riscos face a quedas e também em relação aos espaços públicos.

Avaliação da eficácia da radioterapia paliativa no controlo da dor em doentes com metástases ósseas

A Radioterapia é um dos tratamentos disponíveis para tratar o cancro seja com intuito curativo ou paliativo. O objectivo da radioterapia paliativa consiste em controlar os sintomas apresentados pelos doentes com doença avançada, como por exemplo a dor provocada pela presença de metástases ósseas, que é o sintoma em estudo neste trabalho. A Radioterapia deve causar o mínimo de efeitos secundários e o mínimo desconforto possível aos doentes, não devendo aumentar a morbilidade, mas antes proporcionar maior qualidade de vida aos doentes. Recentemente, vários estudos investigaram a utilização da radioterapia em fim de vida, proporcionando uma linha orientadora nesta área, a partir das condições clínicas dos doentes submetidos a radioterapia perto do final da vida. A escolha do tema deste trabalho resulta de uma inquietação sentida no dia-a-dia, aquando da realização dos tratamentos de radioterapia a doentes paliativos com dor óssea e com mau estado geral. Exigindo a radioterapia um posicionamento e imobilização precisos e rigorosos pode, por vezes, causar algum desconforto aos doentes. No caso dos doentes com necessidades paliativas, nomeadamente com dor moderada a forte, é importante inferir acerca do real benefício de um tratamento que ao invés de promover alívio, lhes pode provocar mais dor e desconforto, indo contra às boas práticas preconizadas em cuidados paliativos. Considera-se que o tema é relevante para a melhoria dos cuidados prestados ao doente oncológico a realizar tratamentos de radioterapia, na medida em que permite realizar uma reflexão acerca da eficácia deste tratamento em fim de vida e sua aplicabilidade quando estamos perante doentes com prognóstico de vida limitado. O estudo em causa é um estudo descritivo exploratório, tendo sido realizada uma análise sistemática da informação contida nos processos electrónicos dos doentes, disponíveis na rede hospitalar, de acordo com os critérios de inclusão estabelecidos, no sentido de averiguar a eficácia do tratamento de radioterapia no alívio da dor. O estudo permitiu concluir que a radioterapia é um tratamento eficaz no controlo da dor em doentes com metástases ósseas, não vindo alterar as conclusões avançadas por outros estudos e outros autores internacionais. No entanto, é importante a realização de um prognóstico mais preciso na tomada de decisão terapêutica para que doentes que não vão beneficiar do tratamento de radioterapia possam ser referenciados para cuidados paliativos mais precocemente. Quanto à escolha do esquema terapêutico, o esquema de fracção única deveria ser mais comummente utilizado pela sua demonstrada eficácia, como o comprovam os diversos estudos referenciados neste trabalho.

Exposure and risk assessment in occupational exposure to fungi: aspects to consider in highly contaminated settings

Although a clear correlation between levels of fungi in the air and health impacts has not been shown in epidemiological studies, fungi must be regarded as potential occupational health hazards. Fungi can have an impact on human health in four different ways: (1) they can infect humans, (2) they may act as allergens, (3) they can be toxigenic, or (4) they may cause inflammatory reactions. Fungi of concern in occupational hygiene are mostly non-pathogenic or facultative pathogenic (opportunistic) species, but are relevant as allergens and mycotoxins producers. It is known that the exclusive use of conventional methods for fungal quantification (fungal culture) may underestimate the results due to different reasons. The incubation temperature chosen will not be the most suitable for every fungal species, resulting in the inhibition of some species and the favouring of others. Differences in fungi growth rates may also result in data underestimation, since the fungal species with higher growth rates may inhibit others species’ growth. Finally, underestimated data can result from non-viable fungal particles that may have been collected or fungal species that do not grow in the culture media used, although these species may have clinical relevance in the context. Due to these constraints occupational exposure assessment, in setings with high fungal contamination levels, should follow these steps: Apply conventional methods to obtain fungal load information (air and surfaces) regarding the most critical scenario previously selected; Guideline comparation aplying or legal requirements or suggested limits by scientific and/or technical organizations. We should also compare our results with others from the same setting (if there is any); Select the most suitable indicators for each setting and apply conventional-culture methods and also molecular tools. These methodology will ensure a more real characterization of fungal burden in each setting and, consequently, permits to identify further measures regarding assessment of fungal metabolites, and also a more adequate workers health surveillance. The methodology applied to characterize fungal burden in several occupational environments, focused in Aspergillus spp. prevalence, will be present and discussed.

A rehabilitation intervention to promote physical recovery following intensive care: a detailed description of construct development, rationale and content together with proposed taxonomy to capture processes in a randomised controlled trial.

Background: increasing numbers of patients are surviving critical illness, but survival may be associated with a constellation of physical and psychological sequelae that can cause on going disability and reduced health-related quality of life. Limited evidence currently exists to guide the optimum structure, timing, and content of rehabilitation programmes. There is a need to both develop and evaluate interventions to support and expedite recovery during the post-ICU discharge period. This paper describes the construct development for a complex rehabilitation intervention intended to promote physical recovery following critical illness. The intervention is currently being evaluated in a randomised trial (ISRCTN09412438; funder Chief Scientists Office, Scotland). Methods: the intervention was developed using the Medical Research Council (MRC) framework for developing complex healthcare interventions. We ensured representation from a wide variety of stakeholders including content experts from multiple specialties, methodologists, and patient representation. The intervention construct was initially based on literature review, local observational and audit work, qualitative studies with ICU survivors, and brainstorming activities. Iterative refinement was aided by the publication of a National Institute for Health and Care Excellence guideline (No. 83), publicly available patient stories (Healthtalkonline), a stakeholder event in collaboration with the James Lind Alliance, and local piloting. Modelling and further work involved a feasibility trial and development of a novel generic rehabilitation assistant (GRA) role. Several rounds of external peer review during successive funding applications also contributed to development. Results: the final construct for the complex intervention involved a dedicated GRA trained to pre-defined competencies across multiple rehabilitation domains (physiotherapy, dietetics, occupational therapy, and speech/language therapy), with specific training in post-critical illness issues. The intervention was from ICU discharge to 3 months post-discharge, including inpatient and post-hospital discharge elements. Clear strategies to provide information to patients/families were included. A detailed taxonomy was developed to define and describe the processes undertaken, and capture them during the trial. The detailed process measure description, together with a range of patient, health service, and economic outcomes were successfully mapped on to the modified CONSORT recommendations for reporting non-pharmacologic trial interventions. Conclusions: the MRC complex intervention framework was an effective guide to developing a novel post-ICU rehabilitation intervention. Combining a clearly defined new healthcare role with a detailed taxonomy of process and activity enabled the intervention to be clearly described for the purpose of trial delivery and reporting. These data will be useful when interpreting the results of the randomised trial, will increase internal and external trial validity, and help others implement the intervention if the intervention proves clinically and cost effective.

Um olhar sobre a inclusão: conceções e práticas numa instituição educativa de natureza privada

Trabalho de Projeto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Ciências da Educação: área de especialização em Educação Especial realizado sob a orientação científica de Doutora Helena dos Anjos Serra Diogo Fernandes

Prevalence of physical activity in European adults — Compliance with the World Health Organization's physical activity guidelines

Background. Adults are recommended to engage in at least 150 min/week of moderate-to-vigorous physical activity (PA). Purpose. This study aimed to examine the level of compliance with PA recommendations among European adults. Methods. Using data from European Social Survey round 6, PA self-report data was collected from 52,936 European adults from 29 countries in 2012. Meeting PA guidelines was assessed usingWorld Health Organization criteria. Results. 61.47% (60.77% male, 62.05% female) of European adults reported to be engaged in moderate to vigorous PA at least 30 min on 5 or more days per week. The likelihood of achieving the PA recommended levels was higher among respondents older than 18–24. For those aged 45–64 years the likelihood increased 65% (OR = 1.65, 95% CI: 1.51–1.82, p b 0.001) and 112% (OR = 2.12, 95% CI: 1.94–2.32, p b 0.001) for males and females, respectively. Those who were high school graduates were more likely to report achieving the recommended PA levels than those with less than high school education (males: OR = 1.19, 95% CI: 1.12–1.27, p b 0.001; females: OR = 1.13, 95% CI: 1.06–1.20, p b 0.001). Conclusion. Although about 60% of European adults reported achieving the recommended levels of PA, there is much room for improvement among European adults, particularly among relatively inactive subgroups.