Measurement-Based Care in Youth: An Opportunity for Better Clinical Outcomes?

Measurement-based care (MBC) is a procedure in which systematic and routine assessments are performed. Through this practice, clinicians can verify the progress of the symptomatology of the patient and adapt the appointments and the intervention to the current symptoms. Studies have reflected on the importance and the benefits of this type of procedure in the adult population, and have shown positive results. However, there is a lack of evidence concerning the remaining populations. Regarding youth, for instance, few articles have evaluated the benefits of using this procedure in clinical practice. However, research focused on this topic has revealed positive results, especially when clinicians were loyal to the MBC procedures. Still, further research is needed. This letter aims to share the methodology used by our multidisciplinary team, composed of psychologists and psychiatrists, in a clinical context at the Hospital Cruz Vermelha, Lisboa, applied to the adult population; the objective is to share and discuss some alterations that could be made to our evaluation protocol to enable the same to be used with the youth population. We believe that implementing MBC for youth is crucial for several reasons, including enhanced treatment efficacy, more personalized treatment, a reduced reliance on subjectivity, and empowerment not only of patients but also families.

The Effects of Physical Activity, Exercise, and Sports Programs on Depressive Symptoms in Individuals with Disabilities: A Systematic Review with Meta-Analysis.

Studies show that physical activity, exercise, or sport reduces depressive symptoms in the general population. However, little is known about its effects on individuals with disabilities. Thus, this systematic review with meta-analysis aims to verify the effects of this practice on depressive symptoms in individuals with disabilities. The Pubmed, Web of Science, Scopus, and SportDiscus databases were used, with several descriptors and Boolean operators. A total of 1509 studies were identified through searching the databases. Studies that met the eligibility criteria were subsequently assessed for their methodological quality (Downs and Black scale), and a meta-analysis was performed. The Z-values that were obtained to test the null hypothesis, which states that there is no difference in means, showed Z = -2.294 and a corresponding p-value = 0.022. We can, therefore, reject the null hypothesis in the sense that exercise seems to reduce depressive symptoms in individuals with disabilities. In sum, participants from the intervention group presented more probability of reducing depressive symptoms when compared to the control group (approximately -1.4 standard differences in means; 95% CI -2.602 to -0.204).

Physiotherapy students’ perceptions of ageing – Playing narratives as a pedagogical innovation / Percepciones de los estudiantes de fisioterapia sobre el envejecimiento - Narrativas lúdicas como como innovación pedagógica

Introduction and objectives: There is a considerable lack of structure in training health professionals in geriatrics. The narratives can promote a collaborative reflection on different topics and might be used as a pedagogic strategy for undergraduate health students. This study aimed to explore the adoption of new perspectives on ageing after the implementation of dynamic narratives in the first graduate year for physiotherapy students. Materials and methods: An exploratory qualitative study was performed. Participants were included if they were: ≥18 years old, physiotherapy students and agreed to participate. Physiotherapy students (n=44) were recruited from the School of Health Sciences, Polytechnic Institute of Leiria. Two gaming sessions were performed to help students, as narrators, express their visions and ways to deal with the geriatrics field. Students’ perspectives about ageing at baseline (T1) and after the narratives experience (T2) were collected by answering the following question: What is your perception regarding ageing? Two evaluators were involved in qualitative data analysis by performing: (i) an individual analysis of themes/subthemes and a discussion meeting to evaluate discrepancies and to reach a consensus. Results: Negative perceptions about ageing were referred 39 times at T1 (most of them related to restriction; deterioration subthemes). There were no negative perceptions registered at T2. Positive perceptions increased at T2, from n=39 to n=52, and three new subthemes emerged (beginning of something, fighting ageism, challenge). (AU)

Introducción y objetivos: Existe una considerable falta de estructura en la formación de los profesionales de la salud relacionados con el campo de la geriatría. Las narrativas son capaces de promover una reflexión colaborativa sobre diferentes temas, y podrían ser utilizadas como una estrategia pedagógica para los estudiantes de salud de pregrado. Este estudio tuvo como objetivo explorar la adopción de nuevas perspectivas sobre el envejecimiento después de la implementación de narrativas dinámicas en el primer año de posgrado para estudiantes de fisioterapia. Materiales y métodos: Se realizó un estudio cualitativo exploratorio. Los participantes fueron incluidos si tenían: más de 18 años de edad; estudiantes de fisioterapia que aceptaron participar voluntariamente. Los estudiantes de fisioterapia (n=44) fueron reclutados del Instituto Politécnico de Leiria. Se realizaron 2 sesiones de juego para ayudar a los estudiantes, como narradores, a expresar sus visiones y formas de lidiar con el campo de la geriatría. Las perspectivas de los estudiantes sobre el envejecimiento al inicio (T1) y después de la experiencia narrativa (T2) se recopilaron respondiendo a la siguiente pregunta: ¿Cuál es su percepción con respecto al envejecimiento? Dos evaluadores participaron en el análisis cualitativo de los datos, realizando: un análisis individual de los temas/subtemas; una reunión de debate para evaluar las discrepancias y llegar a un consenso. Resultados: Las percepciones negativas sobre el envejecimiento fueron referidas 39 veces en T1. No se registraron percepciones negativas en T2. Las percepciones positivas aumentaron después en T2, de n=39 a n=52 y surgieron 3 nuevos subtemas (comienzo de algo; lucha contra la discriminación por edad; desafío). (AU)

Physiotherapy students' perceptions of ageing - Playing narratives as a pedagogical innovation.

INTRODUCTION AND OBJECTIVES: There is a considerable lack of structure in training health professionals in geriatrics. The narratives can promote a collaborative reflection on different topics and might be used as a pedagogic strategy for undergraduate health students. This study aimed to explore the adoption of new perspectives on ageing after the implementation of dynamic narratives in the first graduate year for physiotherapy students. MATERIALS AND METHODS: An exploratory qualitative study was performed. Participants were included if they were: ≥18 years old, physiotherapy students and agreed to participate. Physiotherapy students (n=44) were recruited from the School of Health Sciences, Polytechnic Institute of Leiria. Two gaming sessions were performed to help students, as narrators, express their visions and ways to deal with the geriatrics field. Students' perspectives about ageing at baseline (T1) and after the narratives experience (T2) were collected by answering the following question: What is your perception regarding ageing? Two evaluators were involved in qualitative data analysis by performing: (i) an individual analysis of themes/subthemes and a discussion meeting to evaluate discrepancies and to reach a consensus. RESULTS: Negative perceptions about ageing were referred 39 times at T1 (most of them related to restriction; deterioration subthemes). There were no negative perceptions registered at T2. Positive perceptions increased at T2, from n=39 to n=52, and three new subthemes emerged (beginning of something, fighting ageism, challenge). CONCLUSION: This study demonstrated the potential of narrative-based experiences as a desirable pedagogic methodology (board games-oriented) for geriatric education in undergraduate health students.

The Practice of Physical Exercise and Sports in Portuguese Trans Youth: A Case Study.

The following case study aims to analyze the experience of a Portuguese trans individual regarding their practice of physical exercise (PE) and sports in Portuguese gyms and sports clubs. A 30-min interview was conducted through the Zoom platform. Before the interview, four questionnaires-Satisfaction with Life Scale (SWLS), Positive and Negative Affect Schedule (PANAS), Hospital Anxiety and Depression Scale (HADS), and EUROHIS-QOL 8-item index-were also applied, all in their Portuguese version. The interview was digitally video recorded after consent was obtained, transcribed verbatim, and subject to thematic analysis. Findings suggest positive values for satisfaction with life and quality of life. The values of positive affect were higher than those of negative affect, and there was an absence of depressive and anxious symptomatology. In the qualitative analysis, mental health was the main motive for the practice, while locker rooms separated by gender and university life were the main barriers mentioned. Mixed changing rooms were identified as facilitators of PE practice. This study highlights the importance of developing strategies for the creation of mixed changing rooms and sports teams in order to promote a comfortable and safe practice for all individuals.

“RespirArFundo”: Um programa de promoção de exercício físico em professores e funcionários em contexto escolar -Estudo quantitativo e qualitativo / “RespirArFundo”: Un programa para promover el ejercicio físico en profesores y personal en un contexto escolar -Estudio cuantitativo y cualitativo / “RespirArFundo”: A program to promote physical exercise for teachers and employees in the school context -Quantitative and qualitative study

O projeto RespirArFundo, através de uma metodologia mista quantitativa e qualitativa teve como objetivo avaliar o efeito de um programa de intervenção (22 “sessões teórico-práticas”), com realização de diferentes tipos de atividades, para melhorar os níveis de aptidão física, bem-estar e qualidade de vida (QdV) em professores e funcionários de uma escola secundária da região centro de Portugal. Pretendeu-se ainda avaliar os níveis de satisfação dos participantes com o projeto e identificar as principais barreiras e facilitadores à sua participação. A fase de intervenção deste projeto decorreu entre janeiro e junho de 2021. A amostra foi constituída por 26 profissionais da escola (19 professores e 7 funcionários não docentes), sendo na sua maioria (92.3%) do sexo feminino (53.7 ± 5.0 anos). Para a avaliação da aptidão física foram utilizados os testes “levantar e sentar da cadeira”, “levantar, percorrer 2.44m e sentar” e o “teste de preensão manual”. Para a avaliação do bem-estar recorreu-se às escalas PANAS, SWLS e SVS enquanto o WHOQOL-Bref foi utilizado para a avaliação da QdV. Foi ainda realizado um grupo focal. Apóso programa, verificou-se que os participantes melhoraram no teste “levantar e sentar na cadeira” (η2=0.51), em relação ao momento inicial. Para além disso, os participantes revelaram níveis elevados de satisfação com o programa e percecionaram a existência de benefícios físicos e de bem-estar associados ao projeto, adotando hábitos saudáveis. A importância do projeto foi reconhecida pela Direção da escola, tendo sido atribuídas horas específicas para que o projeto continuassea funcionar nos seguintes anos letivos. (AU)

The project RespirArFundo, through a mixed method (quantitative and qualitative), aimed to assess the effect of an intervention program (22 theoretical-practical sessions). It carried out different types of activities to improve physical fitness levels, well-being,and quality of life (QoL) in teachers and employees of a higher school in the centre region of Portugal. It was also intended to assess the satisfaction levels of the participants that participated in the project as well as to identify the main barriers and facilitators to their participation. The intervention phase of this project took place between January and June 2021. The sample consisted of 26 school professionals (19 teachers and 7 employees). The majority was female (92.3%) with a mean age of 53.7 (± 5.0 years old). In order to assess physical fitness we used the following tests “chair stand”, “8-Ft Up-&-Go” and “hand grip”. For the assessment of well-being, the PANAS, SWLS and SVS scales were used, while the WHOQOL-Bref was used to assess QoL. A focusgroup was also performed. After the program, it was found that participants improved on the test “chair stand” (η2=0.51), in relation to the initial moment. Moreover, participants revealed high levels of satisfaction with the program and perceived the existence of physical and well-being benefits associated with the project, adopting healthy habits. The importance of the project was recognized by the school's management, and specific hours were assigned so that the project continues to function in the following academic years. (AU)

El proyecto RespirArFundo, a través de una metodología mixta cuantitativa y cualitativa, tuvo como objetivo evaluar el efecto de un programa de intervención (22 "sesiones teórico-prácticas"), con diferentes tipos de actividades, para mejorar los niveles de aptitud física, el bienestar y la calidad de vida (CdV) en profesores y empleados de una escuela secundaria en la región central de Portugal. También queríamos evaluar el grado de satisfacción de los participantes con el proyecto e identificar los principales obstáculos y facilitadores de su participación. La fase de intervención de este proyecto tuvo lugar entre enero y junio de 2021. La muestra estaba compuesta por 26 profesionales (19 profesores y 7 personal no docente), siendo la mayoría (92.3%) mujeres (53.7 ± 5.0 años). Para la evaluación de la aptitud física se utilizaron las pruebas "levantarse y sentarse de una silla", "levantarse, caminar 2.44 m y sentarse" y la " fuerza de prensiónmanual ". Se utilizaron las escalas PANAS, SWLS y SVS para evaluar el bienestar, mientras que el WHOQOL-Bref se utilizó para evaluar la CdV. También se realizó un grupo de discusión. Tras el programa, se comprobó que los participantes mejoraron en la prueba "levantarse y sentarse en una silla” (η2=0.51). Además, los participantes revelaron altos niveles de satisfacción con el programa y percibieron la existencia de beneficios físicos y de bienestar asociados al proyecto, adoptando hábitos saludables. La dirección de la escuela reconoció la importancia del proyecto y le asignó horas específicas para que continuara en los años siguientes.

A narrative exploratory study on the perspectives about physical exercise practise in a sample of Portuguese elderly.

The overall prevalence of inactivity among individuals aged 55 or older in Portugal is the highest in Europe therefore it's important to develop effective strategies to increase adherence to structured exercise programs by older adults (Picorelli et al., 2014a). The purpose of this paper is to characterise different perspectives on barriers and facilitators to the practise of physical exercise in a sample of the Portuguese elderly. Two groups of enrolled and non-enrolled in a community exercise program were recruited. Each group had 6 participants that were included in the study if they were ≥ 60 years of age. Two focus groups were conducted via Zoom and lasted ≤ 60 min. Participants were asked about five domains regarding physical exercise. Data analysis occurred in three phases by 2 trained and experienced examiners. While the enrolled group highlighted benefits (n = 6) and facilitators (n = 6), and shared strategies to overcome some barriers (n = 2) the non-enrolled group focused on the barriers (n = 6) instead and shared more excuses to justify their non-practice of physical exercise (n = 3). To overcome the barriers considered by the participants in the non-enrolled group, some education strategies focused on physical literacy might be crucial. The high number of barriers felt by the less active older people makes it more complicated for them to adopt and maintain an exercise program. Narratives-based methodologies are interesting methodologies to collect patient-centred perspectives about exercise practise and therefore design adequate programs.

Development of an mHealth Platform for Adolescent Obesity Prevention: User-Centered Design Approach.

Obesity is a chronic condition that influences the quality of life of patients and families while increasing the economic burden for the world population. Multidisciplinary prevention programs are crucial to address it, allowing an early introduction of healthy behaviors into daily habits. Mobile health interventions provide adequate support for these programs, especially considering the gamification techniques used to promote users' engagement. TeenPower is a multidisciplinary mHealth intervention program conducted in Portugal during 2018 to empower adolescents, promoting healthy behaviors while preventing obesity. An agile software development process was applied to the development of the digital platform that holds a web-based application and a mobile application. We also propose a model for future developments based on the user-centered design approach adopted for this development and the assessment conducted in each phase. The user-centered design approach model proposed has three distinct phases: (1) design study; (2) pre-production usability tests; and (3) post-production data. Phase 1 allowed us to obtain the high-fidelity version of the graphical user interfaces (n = 5). Phase 2 showed a task completion success rate of 100% (n = 5). Phase 3 was derived from statistical analysis of the usage of the platform by real end users (n = 90). We achieved an average retention rate of 35% (31 out of 90 participants). Each technique has provided input for the continuous design and improvement of the platform. This allowed the creation of a tailored platform that could meet users' expectations. Nevertheless, the retention rate decreased significantly over a short period of time, revealing the need for further work in the improvement of the gamification experience.

Adapting the Short Grit Scale with Exploratory Structural Equation Modeling for Portuguese College Students.

The Short Grit Scale (Grit-S) is a self- and informant-report version of the longer Grit Scale, and it retains the 2-factor structure of the original scale. Our purpose in this research was to measure trait-level perseverance and passion for long-term goals by translating and validating the Grit-S for Portuguese respondents. Our participants were 572 college students (135 female, 437 male; age range 18-30 years, M age = 21.47, SD = 2.29 years) from twelve Portuguese universities. Our data confirmed the scale's two-factor structure ("consistency of interests" and "perseverance of effort") and demonstrated appropriate adjustment values (CFI = 0.999, TLI = 0.981, SRMR = 0.017, RMSEA = 0.001, CI90%= 0.000-0.041). We found the adapted scale to be invariant for sex. Use of the scale confirmed an association between grit and well-being. These results imply that other investigators and practitioners interested in this scale may now apply it with Portuguese young adults.

Exercise Dependence and Anxiety in Cross-Trainers, Bodybuilders and Gym Exercisers During COVID19.

The World Health Organization declared the COVID-19 pandemic an international public health emergency in January 2020, and, soon thereafter, a worldwide adoption of quarantine and physical isolation measures restricted regular practitioners of indoor group physical exercise from many of their usual practices. Some, with exercise dependence (ED), may have experienced exercise withdrawal symptoms that triggered unhealthy anxiety levels. In February 2021, during Portugal's second COVID-19 lockdown, we characterized and compared ED and anxiety levels among different groups of indoor exercise practitioners (cross trainers [CG], bodybuilders [BG] and gym practitioners [GG]). In this cross-sectional study, we recruited 234 adult participants through the internet. To assess participants' ED and anxiety levels, we used Portuguese versions of the ED Scale-21 (EDS-21) and the State-Trait Anxiety Inventory (STAI-State; STAI-Trait). ED symptoms were evident in all participant subgroups, and we found no gender differences in ED. Anxiety was higher among women than men in CG and GG groups, and there were significant differences in ED between groups such that BG practitioners showed higher ED than GG and CG practitioners (small effect size). Bodybuilders reported most ED behavior, followed by CG and regular gym exercisers, but on some criteria BG and CG groups had similar ED levels. Our results are in line with prior ED prevalence reports conducted before COVID-19 restrictions among regular GG, but these are the first data to report a higher ED prevalence among BG and CG, relative to GG.

Caring for patients with end-stage renal disease during COVID-19 lockdown: What (additional) challenges to family caregivers?

INTRODUCTION: Caring for a patient with end-stage renal disease undergoing in-centre haemodialysis can be a stressful experience, likely to involve significant burden. Within the context of the new coronavirus pandemic, these patients are highly vulnerable to infection by COVID-19, which might increase the care demands and burden of family caregivers. AIM: This study aimed to explore the subjective experiences of family caregivers of non-COVID-19 patients with end-stage renal disease undergoing in-centre haemodialysis during the COVID-19 lockdown. STUDY DESIGN: A qualitative study was performed with a purposive sample. METHODS: Semi-structured telephone interviews were conducted with 19 family caregivers (50.7 ± 14 years old) of patients undergoing in-centre haemodialysis in April 2020. FINDINGS: Four major themes were identified: (1) emotional distress; (2) changes in caregiving responsibilities; (3) educational and supportive needs; and (4) coping strategies to deal with the outbreak and with the lockdown. DISCUSSION: The findings suggest that family caregivers of patients undergoing in-centre haemodialysis have to manage several additional care responsibilities due to COVID-19 lockdown. The dialysis team should consider the development of educational and supportive interventions to meet family caregivers' needs, mitigate emotional distress, fears and concerns, and prevent caregiver burden during the COVID-19 pandemic.

"Together We Stand": A Pilot Study Exploring the Feasibility, Acceptability, and Preliminary Effects of a Family-Based Psychoeducational Intervention for Patients on Hemodialysis and Their Family Caregivers.

This pilot study aimed to assess the feasibility, acceptability, and preliminary effects of a family-based psychoeducational intervention for patients undergoing hemodialysis (HD) and their family members. This was a single-group (six dyads), six-week, pre-post pilot study, delivered in a multifamily group format. Feasibility was based on screening, eligibility, content, retention, completion, and intervention adherence rates. Acceptability was assessed at post-intervention through a focus group interview. Self-reported anxiety and depression and patients' inter-dialytic weight gain (IDWG) were also measured. The screening (93.5%), retention (85.7%), and completion (100%) rates were satisfactory, whereas eligibility (22.8%), consent (18.4%), and intervention adherence (range: 16.7-50%) rates were the most critical. Findings showed that participants appreciated the intervention and perceived several educational and emotional benefits. The results from the Wilcoxon Signed-Rank Test showed that a significant decrease in anxiety symptoms (p = 0.025, r = 0.646) was found, which was followed by medium to large within-group effect sizes for changes in depression symptoms (p = 0.261, r = 0.325) and patients' IDWG (p = 0.248, r = 0.472), respectively. Overall, the results indicated that this family-based psychoeducational intervention is likely to be feasible, acceptable, and effective for patients undergoing HD and their family caregivers; nonetheless, further considerations are needed on how to make the intervention more practical and easily implemented in routine dialysis care before proceeding to large-scale trials.

Depressive Symptoms and Burnout in Football Players: A Systematic Review.

The purpose of this article was to systematically review and organise the available literature devoted to the topic of depressive symptoms and burnout in football players. A systematic search was conducted in Web of Science, Scopus, SPORTdiscus, PubMed, and Psychinfo for articles published up to June 2020. The searches yielded 1589 articles, and after the screening process, a total of 18 studies met the eligibility criteria and were included for review. Playing position and conflicts with coach/management seems to have a direct influence on the prevalence of depressive symptoms in current players as do the injuries and life events of former players. During the pre-competition phase, most of the athletes displayed reduced rates, indicating burnout. An exploration of the mental health of football players will help to create models of care and guide professionals so that they may help players achieve better performance while also having better wellbeing. Understanding how to prevent and cope with the emotional wellbeing of football players will be possible to guide players and coaches.

Body image and well-being in dance practitioners: An exploratory study / Imagen corporal y bienestar en los practicantes de danza: Un estudio exploratorio / magem corporal e bem-estar em praticantes de dança: Um estudo exploratório

Literature has been concerned with the effect of dance practice on several variables, namely well-being and body image (BI). This study aimed to analyse the perception of dance practitioners on BI and subjective well-being (positive and negative affect and satisfaction with life), comparing adolescents and adults. A sample of 91 dancers (18.08±5.12 years) was recruited and divided into two groups (adolescents 11-17 years; adults 18-34 years). The group of adolescents presented a higher perception of satisfaction with life compared to adults (p=0.041; d=-0.44). Regarding the relationships between variables, when analysing separately each group, in the group of adolescents the positive affect is related to satisfaction with life (r=0.64; p≤0.001) and negative affect (r=-0.32; p=0.026), while the negative affect is related to the hours of weekly practice (r=0.46; p=0.001). In the group of adults, positive affect is related to satisfaction with life (r=0.36; p=0.017) and weekly hours of practice (r=0.39;p=0.010), while negative affect is related satisfaction with life (r=-0.45; p=0.003). With regard to (dis)satisfaction with BI, we found that, in the group of adolescents, it is related to the years of practice (r=0.33; p=0.023) and the weekly hours of practice (r=0.32; p=0.023), while in the adults' group, satisfaction with life (r=-0.42; p=0.005) and negative affect (r=0.59; p≤0.001) are related. Our results leave some indicators that should be explored in future studies, namely seeking to understand the factors that may be mediating the relationship between BI and well-being, as well as the effect of age on this relationship. (AU)

La literatura ha investigado el efecto de la práctica de la danza en variables como el bienestar y la imagen corporal (IC). El objetivo de este trabajo fue analizar la percepción de la IC y el bienestar subjetivo, comparando adolescentes y adultos. Se utilizó una muestra de 91 bailarines (18,08±5,12 años), divididos en dos grupos (adolescentes de 11 a 17 años; adultos de 18 a 34 años). Los resultados indican que el grupo de adolescentes tiene una mayor percepción de la satisfacciónde la vida (p=0,041; d=0,44). En el grupo de adolescentes, el afecto positivo está relacionado con la satisfacción con la vida (r=0,64; p≤0,001) y el afecto negativo (r=0,32; p=0,026), mientras que el afecto negativo está relacionado con las horas de práctica semanales (r=0,46; p≤0,001). En los adultos, el afecto positivo está relacionado con la satisfacción de la vida (r=0,36; p=0,017) y las horas de práctica semanales (r=0,39; p=0,010), mientras que el afecto negativo está relacionado con la satisfacción de la vida (r=0,45;p=0,003). En cuanto a la (in)satisfacción con la IC, en el grupo de adolescentes, esto está relacionado con los años de práctica (r=0,33; p=0,023) y las horas de práctica semanal (r=0,32; p=0,023). En el grupo de adultos, la satisfacción de la vida (r=0,42;p=0,05) y el afecto negativo (r=0,59; p≤0,001) están relacionados. Nuestros datos parecen dejar indicadores para explorar en el futuro, buscando una comprensión de los factores que pueden estar mediando la relación entre la IC y el bienestar. (AU)

A literatura tem-se preocupado com o efeito da prática de dança em variáveis como o bem-estar e a imagem corporal (IC). O objetivo deste trabalho foi analisar a perceção de IC e de bem-estar subjetivo, comparando adolescentes e adultos. Recorreu-se a uma amostra de 91 dançarinos (18.08±5.12 anos), divididos em dois grupos (adolescentes 11-17 anos; adultos 18-34 anos). Os resultados indicam-nos que o grupo dos adolescentes apresenta umaperceção superior de satisfação com a vida comparativamente com os adultos (p=0.041; d=-0.44). Verificamos que no grupo dos adolescentes, o afeto positivo se relaciona com a satisfação com a vida (r=0.64; p≤0.001) e com o afeto negativo (r=-0.32; p=0.026), enquanto o afeto negativo se relaciona com as horas de prática semanal (r=0.46; p=0.001). Já nos adultos, o afeto positivo relaciona-se com a satisfação com a vida (r=0.36; p=0.017) e com as horas de prática semanal (r=0.39; p=0.010), enquanto o afeto negativo se relaciona com a satisfação com a vida (r=-0.45; p=0.003). No que se refere à (in)satisfação com a IC, no grupo dos adolescentes esta relaciona-se com os anos de prática (r=0.33; p=0.023) e as horas de prática semanal (r=0.32; p=0.023). No grupo dos adultos relaciona-se a satisfação com a vida (r=-0.42; p=0.005) e com o afeto negativo (r=0.59; p≤0.001). Os nossos dados parecem deixar indicadores a explorar no futuro, procurando a compreensão dos fatores que podem estar a mediar arelação entre a IC e o bem-estar, bem como, o efeito da idade nesta relação. (AU)

Effects of Exercise Programs on Anxiety in Individuals with Disabilities: A Systematic Review with a Meta-Analysis.

Anxiety symptoms are increasingly prevalent in individuals and may affect their quality of life. Physical exercise (PE) has been shown to be an effective method for reducing anxiety symptoms in the general population. The present study aimed to identify if PE programs can be a good method to reduce anxiety symptoms in individuals with disabilities, through the methodology of a systematic review with a meta-analysis. The PubMed, Web of Science, Scopus, and SPORTDiscus databases were used, considering the period from 2001 to 2021. The descriptors used were: "cerebral palsy", "motor disability", "physical disability", "vision impairment", "visual impairment", "vision disability", "intellectual disability", "mental retardation", "intellectual disabilities", "hearing impairment", "hearing disability", "multiple disabilities", "physical activity", "exercise", "sport", "training", and "anxiety", with the Boolean operator "AND" or "OR". The systematic review with a meta-analysis was carried out in the period between May and June 2021. The Z values (Z-values) obtained to test the null hypothesis, according to which the difference between means is zero, demonstrated a Z = 2.957, and a corresponding p-value of 0.003. Thus, we can reject the null hypothesis, and affirm that PE promotes positive effects and can be a good method or methodology for the reduction of anxiety symptoms of individuals with disabilities.

Association Between Food Choices Motivators and Physical Activity in Body Image (dis)Satisfaction in Portuguese Adolescents.

Concerns about weight and body image are common among adolescents since they are particularly vulnerable to body-image dissatisfaction due to the normal physiological, social, and psychological changes they are going through. This study aims to analyse the relationship between food choice motivations and physical activity in body-image perception among adolescents. Twelve to sixteen years old adolescents were recruited from three school districts. The Portuguese version of the Food Choices Questionnaire (FCQ) was used to assess food choice motivators, and the Quantification de l'Activité Physique en Altitude Chez les Enfants was used to assess physical activity and to calculate daily energy expenditure (DEE). Body image perception was measured using Collins' sequence of seven silhouettes. Body image (dis)satisfaction was estimated by the present body shape minus the desired body shape. ANOVA and Kruskal-Wallis tests were performed to compare groups, and the post-hoc Bonferroni test was used to compare target groups. A multinominal logistic regression was performed to analyse the association between gender, age, hours of sport's competition, FCQ, and body dissatisfaction. All analyses were performed in IBM SPSS Statistics 26.0. The sample comprised 286 adolescents (51.4% females). Means of FCQ categories varied between 0.33 and 0.97 (range: -2 to 2). Regarding the categories of FCQ, statistically significant differences were found in the category of body satisfaction and weight control among the three groups (p = 0.004). A preventive effect was found of choosing food regarding body satisfaction and weight control, on body-image dissatisfaction.

Higher Physical Activity Levels May Help Buffer the Negative Psychological Consequences of Coronavirus Disease 2019 Pandemic.

This study explored the associations between physical activity (PA) anxiety levels, and the perception of satisfaction of basic psychological needs (BPN), during Coronavirus Disease 2019 (COVID-19) lockdown. Thus, 1,404 participants (977 women, 426 men, and one respondent preferred not to answer) ranging from 18 to 89 years old (36.4 ± 11.7 year-old) completed a questionnaire in the period between 1st and 15th April 2021. The survey included sociodemographic data and the following validated instruments: the International Physical Activity Questionnaire (IPAQ), the Basic Need General Satisfaction Scale and the State-Trait Anxiety Inventory. The Kruskal-Wallis test was performed to examine variation in anxiety levels and BPN satisfaction according to PA category (low, moderate, and high). Spearman's Rho correlations coefficients were used to determine the association between anxiety levels and psychological needs. Individuals presenting a higher level of PA revealed lower levels of anxiety-state (H = 20.14; p < 0.01). Differences between elements from different levels of PA were found for the autonomy (H = 23.52; p < 0.001), competence (H = 18.89; p < 0.001), and relatedness (H = 24.42; p < 0.001) psychological needs, suggesting that those who feel their BPN as more satisfied have higher levels of PA. The study found statistically significant correlations between anxiety-state and the satisfaction of the needs for autonomy (p = 0.01; r = -0.46), competence (p = 0.01; r = -0.40), and relatedness (p = 0.01; r = -0.21). These findings support the importance that PA has in the anxiety levels during social isolation, emphasizing the importance of multidisciplinary teams in an individual-based approach.

The Relationship Between Anxiety Levels, Sleep, and Physical Activity During COVID-19 Lockdown: An Exploratory Study.

Nowadays and worldwide, the attention is focused on coronavirus disease (COVID-19), and its consequences on mental health are yet to be fully understood. It is important to capture differences in anxiety levels among populations, groups, and the gender-related variation. Therefore, the present study had two main purposes: (1) to characterize the levels of state anxiety and trait anxiety by examining gender-related, sleep-related, and physical activity-related variations in a nonrepresentative sample of the Portuguese population during the first weeks of lockdown; and (2) to explore the possible relationship between trait anxiety and state anxiety and the possible role of gender as a moderator. This cross-sectional study comprised 1,332 Portuguese adults (aged 18-55 years old) recruited online during COVID-19 outbreak measures. Participants answered to sociodemographic data and the Portuguese version of the State-Trait Anxiety Inventory (STAI). Gender differences were found in both state anxiety (p = < 0.001; d = 0.385) and trait anxiety (p = < 0.001; d = 0.467) with females presenting higher values. People reporting doing more physical activity than usual during COVID-19 lockdown presented lower levels of state anxiety (p = < 0.001; d = 0.200). People reporting more satisfaction with the quality of sleep presented lower levels of both state anxiety (p = < 0.001; d = 0.701) and trait anxiety (p = < 0.001; d = 0.899). Variation associated with the physical activity level (low, moderate, and high) was significantly different among groups in both state anxiety (p = < 0.001) and trait anxiety (p = < 0.001). When analyzing in more detail separating the levels of physical activity, participants performing moderate and high physical activity showed lower values of state and trait anxiety compared to participants with low physical activity. Participants performing high physical activity also showed lower values of state anxiety compared to participants performing moderate physical activity. Higher levels of trait anxiety were related to higher levels of state anxiety, but this association was not moderated by gender. Interventions aiming to support people psychologically during this outbreak should consider anxiety as well as gender and possible behavioral changes in sleep and physical activity, for example. Health professionals should not only consider the anxiety related to the situation we are living but also address trait anxiety to help overcome COVID-19 psychological consequences.

Intradialytic exercise in end-stage renal disease: An umbrella review of systematic reviews and/or meta-analytical studies.

OBJECTIVES: This umbrella review aimed to understand the clinical benefits and adverse events associated with different modalities of intradialytic exercise in patients with end-stage renal disease undergoing hemodialysis. DATA SOURCES: The search was performed until September 10th, 2020 on Scopus, Web of Science, the Cochrane Database, CINAHL, and PubMed. METHODS: This umbrella review was conducted following the PRISMA guideline statement. The methodological quality of the reviews was assessed with the AMSTAR-2. Standardized mean differences with 95% confidence intervals were estimated. The I-squared statistic was used to assess heterogeneity and the Eggers' test was performed to test asymmetry/small-study effects. RESULTS: Eleven reviews were included and 48 unique meta-analyses were examined. Nine were supported by suggestive evidence (P < 0.05, small heterogeneity, absence of small-study effects, and excess significance bias). Clinical benefits were found for functional capacity associated with aerobic exercise (d = 0.81; k = 6), resistance training (d = 0.58; k = 6), neuromuscular electrical stimulation (d = 0.70; k = 5), and inspiratory muscle training (d = 1.13; k = 2), measured by the distance covered in the 6-minutes walking test. This outcome was also associated with aerobic exercise (d = 0.28; k = 7) and combined exercise, measured by VO2peak (d = 1.01; k = 5) and by the duration of the cardiopulmonary test (d = 1.07; k = 4). Isometric quadriceps muscle strength improved with neuromuscular electrical stimulation (d = 1.19; k = 7) while patients' perception of vitality improved with combined exercise (d = 0.60; k = 3). CONCLUSIONS: Suggestive evidence was found for the associations between various modalities of intradialytic exercise and functional capacity. Combined exercise was associated with improvements in physical and psychosocial variables. Few or no adverse events were reported.

"What do we fear the most?": Exploring fears and concerns of patients, family members and dyads in end-stage renal disease.

INTRODUCTION: End-stage renal disease (ESRD) and the need for haemodialysis (HD) treatment are increasing. The course of the disease and all the life readjustments needed may generate a multitude of fears in patients and families. AIM: This study aimed to explore the main fears and concerns of patients with ESRD undergoing HD and their family members. STUDY DESIGN: A qualitative study was performed. METHODS: Individual semi-structured interviews were conducted with three groups: 20 patients, 14 family caregivers and 15 patient-family dyads. Interviews were audiotaped, transcribed verbatim and submitted to thematic analysis. FINDINGS: Five major themes emerged: (i) fear of death (fear of earlier death, fear of a sudden death and fear of dying); (ii) fear of problems during HD (fears related to the vascular access, and fear of complications during HD); (iii) concerns related to the disease (fear of loss of autonomy, fears of getting worse, fears related to renal transplantation and concerns about dietary restrictions); (iv) fear about the future; and (v) absence of fears and concerns. DISCUSSION: Patients with ESRD undergoing HD and their family members expressed different fears related to the disease and the treatments required. Renal care staff must acknowledge and understand such concerns and help patients and families to cope. This is important to improving people's quality of life (QoL), the dialogue between health professionals, patients, and family members, and the care offered by the dialysis care settings. Moreover, this study highlights the impact this disease has at a familial level. Future family-based interventions should acknowledge possible fears and concerns of this population and integrate them into their programs.