Change in the motivation pattern of adolescents before and after participation in a multidisciplinary health promotion program

Introduction: there is evidence that multidisciplinary interventions are an efficient approach to achieving weight loss and other health-related goals. However, dropout rates of these programs are high among adolescents. The suggestion is that understanding the motivation of individuals to participate in these projects is fundamental to developing strategies for permanence and, consequently, promoting better results.Objective: the main aim of this study was to describe the motivations of overweight adolescents participating in a multidisciplinary health promotion project.Methods: this qualitative study was conducted from March to July 2021 using the Bardin content analysis technique. The tool used for data collection was the semi-structured interview, analyzed means by the software QSR NVivo 11 by grouping the speech into clusters. These, in turn, were evaluated in three categories: (1) motivation, (2) food, and (3) physical exercise.Results: the age of the participants was 13.8 ± 2.4 years old, with body mass index of 31.8 ± 8.5 kg/m². Regarding family income, 41.66% had a monthly payment of 3 to 6 minimum wages. Regarding parents' educational level, 70.83% of mothers had completed higher education, while 29.16% had completed high school. According to the respondent's answers, weight loss was the greatest motivation to participate in a multidisciplinary obesity treatment program. In category 2, it was observed that adolescents associated the act of eating with feelings such as anxiety and nervousness. In category 3, the impact of the pandemic was found under the modalities of physical exercise practiced.Conclusion: the results describe the motivation of overweight adolescents to participate in a multidisciplinary program, in addition to elucidating participants' perception of their health and related habits, strategies for health promotion, and consequent improvement of the quality of life of these individuals.

Motivations of overweight adolescents participating in a multidisciplinary health promotion program / Motivações de adolescentes acima do peso participantes de um programa multidisciplinar de promoção da saúde

Introduction: the perception of individuals about their own health is a strong indicator of their real state, as well as their behaviors related to the prognosis in case of presence of pathologies, besides being proportional to their motivations to acquire healthy habits. Objective: to describe the motivations of overweight adolescents when participating in a multidisciplinary health promotion program and their perceptions about habits related to physical and emotional well-being. Methods: this is a qualitative study, using the Bardin content analysis technique. The tool used for data collection was the semi-structured interview, analyzed with the help of the software QSR NVivo 11 through grouping of the speech into clusters. These in turn were evaluated in three categories: (1) motivation; (2) food; and (3) physical exercise. Results: the average age of the participants was 13.8 ± 2.4, with an average body mass index of 31.8 ± 8.5 kg/m². Regarding family income, 41.66% had monthly income of 3 to 6 minimum wages. Regarding the educational level of parents, 70.83% of mothers had completed higher education, while 29.16% had completed high school. According to the respondents' answers, the greatest motivation to participate in a multidisciplinary obesity treatment program was weight loss. In category 2, it was observed that adolescents associated the act of eating with feelings such as anxiety and nervousness. In category 3, the impact of the pandemic was found under the modalities of physical exercise practiced. Conclusion: the results prove the importance of understanding the perception of adolescents about their own health and related habits, in order to elaborate effective strategies for health promotion and consequent improvement of the quality of life of these individuals.

Introdução: a percepção dos indivíduos a respeito da própria saúde é um forte indicador do seu real estado, bem como dos seus comportamentos relativos ao prognóstico em caso de presença de patologias, além de ser proporcional às suas motivações para adquirir hábitos saudáveis. Objetivo: descrever as motivações de adolescentes acima do peso ao participarem de um programa multidisciplinar de promoção da saúde e suas percepções a respeito de hábitos relacionados ao bem estar físico e emocional. Métodos: trata-se de estudo de abordagem qualitativa, com emprego da técnica de análise de conteúdo de Bardin. A ferramenta utilizada para coleta de dados foi a entrevista semiestruturada, analisada com auxílio do software QSR NVivo 11 através de agrupamento das falas em clusters. Esses por sua vez foram avaliados em três categorias: (1) motivação; (2) alimentação; e (3) exercício físico. Resultados: a idade média dos participantes foi de 13,8 ± 2,4, com índice de massa corporal médio de 31,8 kg/m² ± 8,5. Em relação à renda familiar, 41,66% apresentaram renda mensal de 3 a 6 salários mínimos. No que tange à escolaridade dos responsáveis, 70,83% das mães possuíam o ensino superior completo, enquanto 29,16% possuíam ensino médio completo. De acordo com as respostas dos entrevistados a maior motivação para participarem de um programa multidisciplinar de tratamento da obesidade foi o emagrecimento. Já na categoria 2 observou-se que os adolescentes associaram o ato de comer com sentimentos como a ansiedade e o nervosismo. Na categoria 3, constatou-se o impacto da pandemia sob as modalidades de exercício físico praticados. Conclusão: os resultados comprovam a importância de entender a percepção dos adolescentes a respeito da própria saúde e hábitos relacionados, a fim de elaborar de estratégias efetivas para promoção da saúde e consequente, melhoria da qualidade de vida desses indivíduos.

Efeitos deletérios do Lockdown frente à COVID-19 sobre respostas à saúde de adolescentes com obesidade: um estudo longitudinal / Deleterious effects of COVID-2019 Lockdown on health responses in adolescents with obesity: longitudinal study

Trata-se de um estudo longitudinal e observacional que investigou as consequências do lockdown em decorrência do coronavírus em 2020, na aptidão física relacionada à saúde e respostas bioquímicas de 16 adolescentes do sexo masculino com sobrepeso ou obesidade (idade 12,6 ± 1,8 anos). A antropometria, composição corporal, testes de aptidão física e medidas de biomarcadores sanguíneos (glicemia em jejum, colesterol total [CT], colesterol de lipoproteína de baixa densidade [LDL-c], triglicerídeos [TG], aspartato aminotransferase [AST] e alanina aminotransferase [ALT]) foram avaliados antes e após 8 meses de lockdown. Os resultados mostraram um aumento do peso corporal, massa livre de gordura e circunferência da cintura e do quadril (p<0,05) após 8 meses. A força isométrica máxima de preensão manual e a flexibilidade aumentaram, enquanto a resistência muscular diminuiu (p<0,05). A glicemia em jejum, CT, LDL-c, TG, TG/glicose, AST, ALT, TG/HDL-c, CT/HDL-c e LDL/HDL aumentaram (p<0,05), ao passo que os níveis de HDL-c diminuíram significativamente (p<0,05). Portanto, 8 meses de isolamento social promoveram efeitos deletérios sobre parâmetros morfológicos e aptidão física em adolescentes. No entanto, o pequeno tamanho da amostra impede a generalização desses achados.

This longitudinal and observational study investigated the consequences of the coronavirus disease 2019 lockdown on health-related physical fitness and biochemical responses in 16 overweight or obese male adolescents (aged 12.6±1.8 years). The anthropometry, body composition, physical fitness tests, and measures of blood biomarkers (fasting blood glucose, total cholesterol [TC], low-density lipoprotein cholesterol [LDL-c], triglycerides [TG], aspartate aminotransferase [AST], and alanine aminotransferase [ALT]) were evaluated before and after 8 months of lockdown. The results showed increased body weight, fat-free mass, and waist and hip circumference (p<0.05) after 8 months. Maximum isometric handgrip strength and flexibility increased, while muscle endurance decreased (p<0.05). Fasting blood glucose, TC, LDL-c, TG, TG/glucose, AST, ALT, TG/HDL-c, CT/HDL-c, and LDL/HDL increased (p<0.05), while the HDL-c levels decreased significantly (p<0.05). Therefore, eight months of social isolation promoted harmful effects on adolescents' morphological parameters and physical fitness. However, the small sample size prevents the generalization of these findings.

Efectos de dos programas de ejercicios resistidos en la aptitud física relacionada con la salud de mujeres obesas con síntomas de algia en las rodillas / Effects of two resistance exercise programs on the health-related fitness of obese women with pain symptoms in the knees

Introducción: El sobrepeso afecta negativamente al sistema cardiovascular y al osteomioarticular, favoreciendo el dolor en las articulaciones de las extremidades inferiores. Por lo tanto, se han aplicado estrategias para reducir el sobrepeso a través de cambios en el estilo de vida. Objetivo: investigar los efectos de dos programas de intervención multidisciplinares sobre la aptitud física relacionada con la salud de mujeres obesas con síntomas de dolor en las rodillas. Métodos: Se evaluó a mujeres entre 40 y 59 años con obesidad (n=59) en el tiempo pre y post intervención en antropometría, composición corporal, aptitud física, nivel de discapacidad en rodilla y cadera y calidad de vida relacionada con la salud. Se realizó un ensayo clínico aleatorizado de grupos paralelos, utilizando dos programas de ejercicio de resistencia y reeducación alimentaria, durante ocho semanas. Todos los participantes recibieron el mismo contenido de intervención nutricional y para ejercicios físicos se aleatorizaron en dos grupos, G1 siendo el "grupo de fuerza" utilizando máquinas (n=30), y G2 siendo el grupo de "entrenamiento funcional" (n=29). Veintiocho mujeres (G1=18 + G2=10) fueron incluidas en los análisis finales. Los grupos y el tiempo se evaluaron mediante análisis bidireccional de la varianza, con medidas repetidas. Se asumió una p < 0,05 para todos los análisis. Resultados: se identificó un efecto de tiempo, con valores más altos para la fuerza máxima de tracción lumbar isométrica (MILTS), luego del período de intervención en ambos grupos (p < 0.05). Sin embargo, para las otras variables investigadas, no se identificaron diferencias significativas (p > 0.05). Conclusión: La ausencia de resultados significativos para todas las variables, excepto FIMTL, puede estar justificada por la adherencia moderada de los participantes a las intervenciones (~ 59% a 66%) ya que el estudio se realizó durante el período de aislamiento social (COVID-19). Sin embargo, se cree que los modelos de intervención fueron positivos en el mantenimiento de las variables estudiadas.

Introduction: Overweight negatively impacts the cardiovascular system and osteomyoarticular, promoting pain in the joints of the lower limbs. Therefore, strategies have been applied to reduce overweight through lifestyle changes. Objective: to investigate the effects of two multidisciplinary intervention programs on the health-related physical fitness of obese women with pain symptoms in the knees. Methods: Women between 40 and 59 years of age with obesity (n=59) were evaluated in the pre- and post-intervention time regarding anthropometry, body composition, physical fitness, level of disability in the knee and hip, and health-related quality of life. A randomized clinical trial of parallel groups was conducted, using two resistance exercise programs and food re-education, for eight weeks. All participants received the same nutritional intervention content and for physical exercises were randomized into two groups, G1 being the "strength group" using machines (n=30), and G2 being the "functional training" group (n=29). Twenty-eight women (G1=18 + G2=10) were included in the final analyses. The groups and time were evaluated by two-way analysis of variance, with repeated measures. A p < 0.05 was assumed for all analyses. Results: a time effect was identified, with higher values for maximum isometric lumbar-traction strength (MILTS), after the intervention period in both groups (p < 0.05). However, for the other variables investigated, no significant differences were identified (p > 0.05). Conclusion: The absence of significant results for all variables, except FIMTL, may be justified by the moderate adherence of the participants to interventions (~59% to 66%) since the study was conducted during the period of social isolation (COVID-19). However, it is believed that the intervention models were positive in maintaining the variables studied.

Effects of a multi-professional approach on anthropometric variables and food profile of overweight or obese adolescents / Efeitos de uma abordagem multi-profissional sobre variáveis antropométricas e de perfil alimentar de adolescentes com sobrepeso ou obesidade

INTRODUCTION: Investigating the of overweight or obese adolescents' nutritional quality is substantial to guide healthy eating strategiesOBJECTIVE: To assess the effects of a multi-professional approach on anthropometric parameters, body composition, and the level of food processing in adolescentsMETHODS: Twelve overweight/obese male adolescents between 13-17 years old participated in a series of 12-week multi-professional interventions led by physical education, nutrition, and psychology professionals. The participants were assessed before the intervention as well as at 6 and 12 weeks. Anthropometric assessments were performed, including body weight, stature, and body mass index; body composition, with fat mass (FM), body fat (%BF), skeletal muscle mass, and resting metabolic rate (RMR), and by filling in a three-day food record, to assess the ingested foods by its level of processing: fresh, minimally processed, processed, and ultra-processedRESULTS: No differences were observed in anthropometric parameters performed at different stages (p>0.05). Reductions in FM and %BF and increases in SMM and RMR (p<0.05) were identified after, the 12-week intervention. There was an increase in the consumption of natural foods/g and increased the caloric consumption of processed foods/kcal after 12-week of intervention (p<0.05CONCLUSION: The model resulted in a decrease in fat mass and body fat percentage, an in skeletal muscle mass, resting metabolic rate, natural foods/g, and processed foods/kcal

INTRODUÇÃO: Investigar a qualidade nutricional de adolescentes com sobrepeso ou obesidade é substancial para orientar estratégias de alimentação saudávelOBJETIVO: Avaliar os efeitos de uma abordagem multiprofissional sobre os parâmetros antropométricos, de composição corporal e o nível de processamento de alimentos em adolescentesMÉTODO: Doze adolescentes do sexo masculino com sobrepeso/obesidade, entre 13-17 anos participaram de uma série de intervenções multiprofissionais ao longo de 12 semanas, que foram conduzidas por profissionais de educação física, nutricionistas e psicólogos. Os participantes foram avaliados antes da intervenção, após 6 e após 12 semanas. As avaliações antropométricas foram realizadas, incluindo o peso corporal, a estatura e o índice de massa corporal; para a composição corporal foram incluídas: a massa gorda (MG), percentual de gordura corporal (%G), massa muscular esquelética (MME) e taxa metabólica basal (TMB), bem como o preenchimento do registro alimentar de três dias, para avaliar os alimentos ingeridos, via nível de processamento: in natura, minimamente processado, processado e ultraprocessadoRESULTADOS: Não foram observadas diferenças significativas nos parâmetros antropométricos realizados nas diferentes etapas (p>0,05). Reduções na MG e %G e aumentos na MME e TMB (p<0,05) foram identificados após 12 semanas de intervenção. Houve um aumento do consumo de alimentos in natura/g e aumento do consumo calórico de alimentos industrializados/kcal, após 12 semanas de intervenção (p<0,05CONCLUSÃO: O modelo proposto resultou em uma diminuição da massa gorda e percentual de gordura corporal, aumento da massa muscular esquelética, taxa metabólica basal, consumo de alimentos naturais/g e alimentos processados/kcal

Transcranial magnetic stimulation of the medial prefrontal cortex for psychiatric disorders: a systematic review

Objective: The medial prefrontal cortex (mPFC) is a highly connected cortical region that acts as a hub in major large-scale brain networks. Its dysfunction is associated with a number of psychiatric disorders, such as schizophrenia, autism, depression, substance use disorder (SUD), obsessive-compulsive disorder (OCD), and anxiety disorders. Repetitive transcranial magnetic stimulation (rTMS) studies targeting the mPFC indicate that it may be a useful therapeutic resource in psychiatry due to its selective modulation of this area and connected regions. Methods: This review examines six mPFC rTMS trials selected from 697 initial search results. We discuss the main results, technical and methodological details, safety, tolerability, and localization strategies. Results: Six different protocols were identified, including inhibitory (1 Hz) and excitatory (5, 10, and 20 Hz) frequencies applied therapeutically to patient populations diagnosed with major depressive disorder, OCD, autistic spectrum disorder, SUD, specific phobia, and post-traumatic stress disorder (PTSD). In the OCD and acrophobia trials, rTMS significantly reduced symptoms compared to placebo. Conclusion: These protocols were considered safe and add interesting new evidence to the growing body of mPFC rTMS literature. However, the small number and low methodological quality of the studies indicate the need for further research.

Enthousiasmós - Entusiasmo / Enthousiasmós- Entusiasmo / Enthousiasmós - Enthusiasm

Este artigo pretende levantar algumas questões acerca do conceito de natureza humana. Este conceito esta voltado para a idéia de utilidade, implica em uma natureza cindida, natureza que deve controlar, dominar e sublimar seus instintos, desejos e paixôes. Isto afeta a economia fisio-psíquica do homem que trava uma batalha com sua própria natureza. A investigação do conceito de natureza humana passa e se aplica a arte, a filosofia, e a psicologia. A arte pensada como um impulso da natureza justifica seu fascínio e importância na existência humana, à criação artística pertence a natureza do homem; a filosofia enuncia o conceito de natureza humana; e a psicologia vai ser herdeira do paradigma filosófico. Acerca deste conceito devemos considerar estas ciências, e cabe à psicologia a tarefa de reivindicar o domínio do estudo da natureza humana

This paper aims to raise questions about the concept of human nature. The concept of human nature is associated with the idea of utility, and implies in a divided nature: a nature that must control, dominate, sublimate the desires and passions. This affects the human pshysio-psychological balance wich battles against its own nature are part of and apply to the fields of art, philosophy, and psychology. Understanding art as an impulse of nature justifies its fascination and relevance in the human existence, artistic creation belongs to the human nature: philosophy enunciates the concept of human nature; and psychology will inherit the philosophical paradigma. Althougt the concept of human nature is related with these sciences, psychlogy must claim to its domain the study of the human nature

Sindrome nefrotica em Pediatria / Syndrome nefrotic in Pediatrics

Os autores fazem um estudo retrospectivo sobre os princi-pais dasos clinicos observados no estudo de 46 criancas com nefrose lipoidica. Amaioria era do sexo masculino (29/46 ou 63%) e a media da idade no inicio do edema foi de 53,4 meses, com pico de incindencia entre tres e quatro anos. As medias do tempo de evolucao e do tempo de seguimento foram, respectivamente, 53,5 e 48,9 meses. Em 45 criancas foi possivel caracterizar a sensibilidade ao tratamento inicial com prednisona. Destes, 36 (80%) foram considerados cortico-sensiveis.A analise da frequencia de recaidas observadas durante o seguimento permitiu caracterizar a populacao cortico-sensivel em: de recaidas frequentes (16/36); e comrecaidas ocasionais (17/36). Da populacao com recaidas frequentes e que recebem ciclofosfamida, a maioria foi considerada ciclo-sensivel (14/15) assim como cinco das oito criancas cortico-resistentes. Houve perda de controle em 11/46 (24%) dos pacientes e a media do tempo de seguimento foi de 48,9 meses, situacao maisfavoravel do que a observada pelos autores em Londrina em 1977 quando foi verificada uma perda de controle de 47% dos pacientes e media de seguimento de 22 meses. A avaliacao da atividade da sindrome, refletida pela necessidade de tratamen-to "especifico" (prednisona ou ciclofosfamida e prednisona), revelou aumento progressivo de 7,1% ao ano da populacao G1, ou seja, a populacao sem tratamento .