Effect of School-Based Food and Nutrition Education Interventions on the Food Consumption of Adolescents: A Systematic Review and Meta-Analysis.

The school is a favorable environment for the development of interventions to prevent obesity. The objective of this systematic review is to evaluate the effects of school-based food and nutrition education interventions on adolescent food consumption. The literature search was conducted on databases: MEDLINE/PubMed, Embase, Scopus, ERIC, Science Direct, Web of Science, Cochrane, LILACS, and ADOLEC. The following research strategies were focused on: population (adolescents), intervention (food and nutrition education), outcome (food consumption), and study design (clinical trial). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement guidelines were followed and all stages of this review were performed by two researchers and, when necessary, a third researcher resolved discrepancies. Included studies are randomized clinical trials (RCT). A total of 24 articles were included for review and 11 articles in meta-analysis. In the evaluation of the general effects, there was a significant effect (mean difference (MD) for fruit consumption (MD = 0.09, CI 0.05, 0.14) in serving/day; and for vegetables (MD = 0.59, IC 0.15, 1.03) at times/week. In the consumption of FV (fruits and vegetables), there was no significant effect (standardized mean difference (SMD) of interventions in their consumption (SMD = 0.00, 95% C1 -0.11, 0.11). The evidence available in this review and meta-analysis concludes that food and nutrition education interventions in schools presented favorable results in the food consumption of adolescents. Registered on the PROSPERO database (CRD42019116520).

Desafios do profissional de educação física nos Núcleos Ampliados de Saúde da Família e Atenção Básica: uma revisão sistemática da literatura brasileira / Challenges of the physical education professional in the Extended Centers for Family Health and Primary Care: a systematic review of Brazilian literature

Resumo Introdução A inserção dos profissionais de educação física na atenção básica tem relevância devido aos trabalhos relacionados à promoção da saúde, porém alguns desafios são apresentados na literatura como barreiras para a atuação profissional. Objetivo Revisar na literatura os desafios encontrados por profissionais de educação física que atuam nos Núcleos Ampliados de Saúde da Família e Atenção Básica (NASF-AB). Método Uma busca utilizando os termos "educação física" e "Núcleo de Apoio à Saúde da Família" foi realizada na base de dados LILACS e no portal SciELO. Os critérios de inclusão foram: ser artigo original, estar publicado no idioma português, ter sido publicado a partir do ano de 2008 e ter avaliado a atuação de profissionais de educação física no NASF-AB. Resultados Dos 45 estudos encontrados na busca inicial, seis atenderam os critérios de inclusão. Além desses, outros dois artigos foram identificados nas referências, resultando em oito artigos incluídos na revisão. Entre os vários desafios relatados, os mais frequentes encontrados nos estudos foram a falta de infraestrutura física e material, a distância entre a formação acadêmica e a área de saúde coletiva e a instabilidade profissional. Conclusão Embora alguns desafios relatados não dependam apenas do profissional de educação física para serem resolvidos, os achados dessa revisão fornecem importantes informações para que futuros profissionais que desejam atuar no NASF-AB possam se preparar de forma mais objetiva e consigam realizar um trabalho com eficiência e qualidade.

Abstract Background The inclusion of physical education professionals in primary care is relevant due to work related to health promotion, but some challenges are presented in the literature as barriers to professional performance. Objective This study aimed to review in the literature the challenges faced by physical education professionals who work in the extended centers for family health and primary care (NASF-AB). Method A search using the terms "physical education" and "family health support centers" was performed in the LILACS and SciELO databases. The inclusion criteria were: be an original article, be published in the Portuguese language, be published from 2008 onwards, and have assessed the role of physical education professionals in the NASF-AB. Results From 45 studies identified in the initial search, six met the inclusion criteria. In addition to these, two other articles were identified in the references, resulting in eight articles included in the review. Among the several challenges reported, the most frequent ones in the different studies were the lack of physical and material infrastructure, the distance between academic formation and the collective health area, and also professional instability. Conclusion Although some of the challenges reported do not depend solely on the physical education professional to be solved, the findings of this review already provide important information for future professionals who wish to work in NASF-AB to prepare themselves more objectively and perform an efficient and quality work.

Is rituximab effective for systemic sclerosis? A systematic review and meta-analysis

Abstract Background: Systemic sclerosis (SSc) Is a clinically complex and challenging disease, that leads to skin fibrosis. Its most frequent complication is interstitial lung disease (ILD), which leads to a worse prognosis. In this situation, cyclophosphamide is considered the gold standard for its treatment, despite the controversies regarding its efficacy and toxicity. However, studies using rituximab (RTX) have shown that this drug may be a promising therapeutic option. Objectives: This paper objective was to analyze the scientific evidence on the RTX effects on SSc. Methods: A systematic review (SR) was performed including clinical trials (CTs) on the use of RTX in SSc, published up to May 2020. The studies were identified through systematic searches in bibliographic databases using a predefined search strategy. The following databases were used: PUBMED, SCOPUS, SCIELO, LILACS, SCIENCE DIRECT, WEB OF SCIENCE, COCHRANE, WHOLIS, PAHO and EMBASE. Also, a manual search was performed. The methodological quality of the studies was determined using Jadad scale, Risk of Bias Tool (RoB 2.0) and Risk of Bias in Non-Randomized Studies - of Interventions tool (ROBINS-I). A meta-analysis of the randomized CTs was performed, using Review Manager. Results: Ten CTs were included in this SR. Of these, three were randomized and seven were non-randomized. Five showed a statistically significant improvement in forced vital capacity (FVC) at some time during follow-up. Regarding the skin, eight studies showed statistically significant improvements according toa the modified Rodnan skin score. The meta-analysis found positive effects of RTX in SSc, with a statistical significance for lung disease. Conclusion: Rituximab is a promising strategy for the SSc-associated ILD and cutaneous fibrosis treatment. PROSPERO registration number: CRD42019132018.(AU)

Atividade física e saúde na adolescência: protocolo de uma intervenção baseada na escola / Physical activity and health in adolescence: protocol of a school-based intervention

A literatura indica que os adolescentes apresentam uma maior tendência na adoção de comportamentos de risco à saúde como inatividade física, comportamento sedentário e hábitos alimentares inadequados. Esses fatores apresentam-se como potenciais fatores de risco para as doenças crônicas em todo o mundo. Numa perspectiva voltada para Promoção da Saúde, tendo como referencial a abordagem das Escolas Promotoras de Saúde, as evidências apontam que as intervenções baseadas na escola surgem como estratégia promissora por produzirem efeitos positivos na saúde de crianças e adolescentes. Por isso, objetiva-se na presente tese, apresentar uma intervenção multicomponente baseada na escola voltada para a promoção da atividade física e saúde de adolescentes. Os métodos foram organizados em duas etapas: 1) primeira etapa: métodos e critérios de elegibilidade incorporados no protocolo de Revisão Sistemática (RS) e Metanálise (MA) em sequência os métodos desenvolvidos na RS e MA que abordou os mecanismos relacionados aos efeitos do exercício na cognição (níveis de BDNF) em adolescentes; 2) segunda etapa: a concepção, planejamento e os métodos descritos na intervenção do Programa Atitude, Movimento e Escolhas para uma vida saudável (AME). A intervenção multicomponente é composta por 4 componentes: (I) Formação de professores e planejamento de atividades relacionadas aos temas (promoção da atividade física, comportamento sedentário e educação alimentar e nutricional); (II) Treinamento e planejamento específico para os professores de educação física; (III) Disponibilização de materiais e estratégias que estimulem a adoção de hábitos saudáveis no ambiente escolar; e (IV) Educação em saúde na escola com palestras e ações dirigidas a alunos, pais e professores. Serão distribuídos folhetos informativos e uso das redes sociais, a fim de disseminar o conhecimento sobre os benefícios da prática regular de atividade física. O Programa AME apresenta-se como uma proposta articulada, integrada, sustentável e de baixo custo com grande potencial para produzir benefícios na saúde e cognição de adolescentes. Por fim, cabe ressaltar que os resultados do estudo fortalecerão a prática baseada em evidências no âmbito de pesquisas voltadas para a promoção da saúde no contexto escolar (AU).

The literature indicates that adolescents are more likely to adopt health risk behaviors such as physical inactivity, sedentary behavior and inappropriate eating habits. These factors are presented as potential risk factors for chronic diseases worldwide. From a perspective focused on Health Promotion, having as a reference the Health Promoting Schools approach, evidence indicates that school-based interventions emerge as a promising strategy for producing positive effects on the health of children and adolescents. Therefore, the objective of this thesis is to present a school-based multicomponent intervention aimed at promoting physical activity and health in adolescents. The methods were organized in two stages: 1) first stage: methods and eligibility criteria incorporated in the Systematic Review (SR) and Meta-analysis (MA) protocol following the methods developed in RS and MA that addressed the mechanisms related to the effects of exercise on cognition (BDNF levels) in adolescents; 2) second stage: the conception, planning and methods described in the intervention of the Program Attitude, Movement and Choices for a healthy life (AME). The multicomponent intervention consists of 4 components: (I) Teacher training and planning of activities related to the themes (promotion of physical activity, sedentary behavior and food and nutrition education); (II) Training and specific planning for physical education teachers; (III) Provision of materials and strategies that encourage the adoption of healthy habits in the school environment; and (IV) Health education at school with lectures and actions aimed at students, parents and teachers. Information leaflets and use of social networks will be distributed in order to disseminate knowledge about the benefits of regular physical activity. The AME Program presents itself as an articulated, integrated, sustainable and low-cost proposal with great potential to produce benefits in the health and cognition of adolescents. Finally, it is noteworthy that the results of the study will strengthen evidence-based practice in the context of research aimed at promoting health in the school context (AU).

The Effects of Exercise on BDNF Levels in Adolescents: A Systematic Review with Meta-Analysis.

The aim of this study was to analyze the evidence available in the literature about the effects of exercise on brain-derived neurotrophic factor levels in adolescents. The literature searches were conducted in PubMed, Embase, Scopus, ScienceDirect, Web of Science, SportDiscus, the Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL. Randomized controlled trials and non-randomized controlled trials performed with adolescents (10-19 years) who underwent different exercise programs and who evaluated BDNF levels before and after the intervention were included. We included six studies, four RCTs and two non-RCTs in the systematic review with a total of 407 adolescents. In two randomized trials and one non-RCT, the intervention groups showed significant improvements in BDNF levels compared with the control group. The results presented in the meta-analysis indicate that despite the positive effect in favor of the intervention, there were no significant differences (standardized mean difference 0.28 ng/mL, 95% confidence interval -0.28 to 0.85; p = 0.32, I² = 0%). The results presented in our review indicate that aerobic exercise programs practiced in moderate- or high-intensity are promising strategies to increase BDNF levels in adolescents. However, further studies are required to support this finding.

The Control and Prevention of COVID-19 Transmission in Children: A Protocol for Systematic Review and Meta-analysis.

BACKGROUND: The pandemic following the rapid spread of the new SARS-CoV-2 virus has hit all continents and caused thousands of deaths worldwide. Evidence has been published on epidemiological and clinical characteristics of population groups considered at risk; however, information for the other population groups, especially for the child population, is needed. In this context, this protocol describes a systematic review that will aim to identify the evidence on control and prevention of COVID-19 transmission among children and adolescents, as well as to describe the epidemiological profile and clinical and immunological characteristics of COVID-19 in this population. METHODS: This protocol will be developed in accordance with PRISMA-P. The searches will be conducted in PubMed, Web of Science, ScienceDirect, EMBASE, and Scopus, seeking clinical trials. Observational studies and case reports with Children and adolescents (≤19 years) infected with SARS-CoV-2 will be included whether they report information on the control of prevention and COVID-19 transmission. Two independent researchers will perform the selection of articles, removal of duplication, and screening by Rayyan QCRI application. Cochrane's RoB 2.0, ROBINS-I, and CASP tools will be used to assess the risk of bias. Meta-analysis, subgroup analyses, and/or descriptive analyses will be carried out based on the data conditions included. RESULTS: A high-quality synthesis of the available evidences on the epidemiological profile, the clinical and immunological characteristics involved in children, and adolescents diagnosed with COVID-19, as well as the participation of this population in the transmission dynamics of SARS-CoV-2 will be provided. CONCLUSION: This systematic review has an important relevance in the current context because it has a great potential to help the development of new control and prevention strategies in the pediatric population. RECORD OF SYSTEMATIC REVIEW: CRD42020179263.

Mechanisms of action of molecules with anti-TNF-alpha activity on intestinal barrier inflammation: A systematic review protocol.

BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha), among cytokines that mediate the inflammatory process, plays an important role in diseases involving the loss of intestinal barrier integrity. Several molecules with anti-TNF-alpha activity have been studied aiming to develop new therapies. The purpose of this paper is to describe the systematic review protocol of experimental studies that determine mechanisms of action of molecules with anti-TNF-alpha activity on intestinal barrier inflammation. METHODS: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Protocols (PRISMA-P). The databases to be searched are PubMed, EMBASE, Scopus, ScienceDirect, and Web of Science. Experimental studies in rats or mice that assessed the activity of anti-TNF-alpha molecules in models of intestinal barrier inflammation will be included in the systematic review. Studies characteristics, experimental model, and main results will be described and the bias risk assessment will be performed. Two independent reviewers will perform study selection, data extraction, and methodological quality assessment. A narrative synthesis will be made for the included studies. Also, if sufficient data is available, a meta-analysis will be conducted. I statistics will be used to assess heterogeneity. RESULTS: The present protocol will assist in producing a systematic review that identifies the mechanisms underlying the reduction of TNF-alpha in intestinal barrier inflammation models. CONCLUSION: The systematic review may contribute to the theoretical basis of research on new molecules with anti-TNF-alpha potential and, consequently, in the development of new therapies employed in humans. PROSPERO REGISTRATION NUMBER: CRD42019131862.

Rituximab in systemic sclerosis: A protocol for systematic review.

BACKGROUND: Systemic sclerosis (SSc) is a clinically complex and challenging disease, the most frequent complication of which is interstitial lung disease, which leads to a worse prognosis. In this situation, cyclophosphamide is considered the criterion standard for treatment, despite the controversies regarding its efficacy and toxicity. However, studies using rituximab (RTX) have shown that this drug may be a promising therapeutic option. The objective is to describe a protocol of a systematic review (SR) that analyzes the scientific evidence on the effects of RTX on SSc. METHODS: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases to be searched are PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, COCHRANE, WHOLIS, PAHO, and EMBASE. The studies that would be included in SR are clinical trials that evaluate the use of RTX in patients with SSc who meet the classification criteria for the disease according to American College of Rheumatology and European League Against Rheumatism (2013) and/or LeRoy criteria will be included in the SR. The data to be extracted are related to the characteristics of the studies: authors, year of publication, study location, type of study, sample size and age, patient characteristics, duration of intervention, therapeutic scheme, follow-up time, main variables, and main results. RESULTS: In our study, we hope to find articles presenting new evidence supporting treatment of SSc with RTX. CONCLUSIONS: The SR will present results of scientific evidence for the effects of RTX in SSc. We hope that the results could strengthen clinical decisions for the best treatment of SSc and guide future researches. PROSPERO REGISTRATION NUMBER: CRD42019132018.

Red meat consumption, risk of incidence of cardiovascular disease and cardiovascular mortality, and the dose-response effect: Protocol for a systematic review and meta-analysis of longitudinal cohort studies.

BACKGROUND: Red and (particularly) processed meats are high in cholesterol and saturated and solid fatty acids. Their consumption is considered one of the risk factors for metabolic disorders. Numerous studies demonstrated a possible association between red meat consumption and cardiovascular disease (CVD). In this protocol, we propose a systematic review of the literature to examine the associations of red meat consumption with CVD incidence and mortality, and explore the potential dose-response relationship. METHODS: We will search MEDLINE/PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, Cochrane (CENTRAL), WHOLIS, PAHO, and Embase. We will include prospective epidemiological studies (longitudinal cohort). Risk of bias will be assessed using the Newcastle-Ottawa scale (NOS). Four independent researchers will conduct all evaluations. Disagreements will be referred to a fifth reviewer. We will summarize our findings using a narrative approach and tables to describe the characteristics of the included studies. The heterogeneity between trial results will be evaluated using a standard chi-squared test with P < .05. We will conduct the study in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-analyses Protocols (PRISMA-P). RESULTS: This review will evaluate the association between red meat consumption and incidence of CVD and mortality (primary outcome measures). The secondary outcome measure will include the dose-response effect. CONCLUSION: The findings of this systematic review will summarize the latest evidence of the association between red meat consumption and incidence of CVD and mortality and the dose-response effect through a systematic review and meta-analysis. REGISTRATION: PROSPERO CRD42019100914.

Training programs in communication skills to improve self-efficacy for health personnel: Protocol for a systematic review and meta-analysis.

BACKGROUND: Patient-centered care should be the focus of health services, where improvements in the communication skills of health professionals promote excellent health and quality care. Thus, this study is a protocol for a systematic review and meta-analysis to evaluate the effectiveness of training programs in communication skills to promote self-efficacy in the communication of health personnel. METHODS: This systematic review protocol is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) statement guidelines and the Cochrane Handbook of Systematic Reviews of Interventions. The review should include studies carried out with health professionals who have undergone training in communication skills aimed at promoting their self-efficacy. Clinical trials (randomized, non-randomized), community trials, and quasi-experimental studies should be included. Therefore, the comprehensive search strategy will be conducted in the following databases: PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will conduct all study selection procedures, data extraction, and methodological evaluation, and disagreements will be referred to a third reviewer. RevMan 5.3 software will be used to gather data and perform the meta-analysis if possible. RESULTS: This systematic review will provide evidence on more effective programs for communication skills training and will consider information such as duration, educational strategies, assessment measures, and outcomes that promote health worker self-efficacy. DISCUSSION: This systematic review should provide evidence for effective communication skills training for health professionals in order to guide new strategies for quality care. DISSEMINATION AND ETHICS: The findings of this scoping review will be disseminated in print, at conferences, or via peer-reviewed journals. Ethical approval is not necessary as this paper does not involve patient data. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019129384.

Lifestyle and sleep patterns among people living with and without HIV/AIDS.

INTRODUCTION: Negative lifestyles affect the health and quality of sleep of those living with and without HIV/AIDS. METHODS: Individuals were divided into two groups based on whether or not they were living with HIV/AIDS. RESULTS: Among the 20 participants, 95% displayed a poor lifestyle, and both groups demonstrated low-quality sleep with significant differences between groups in the early sleep variables, total sleep time, and sleep patterns. CONCLUSIONS: Both groups demonstrated similar behavior with unsatisfactory lifestyles, poor sleep quality, and irregular sleep patterns.

Lifestyle and sleep patterns among people living with and without HIV/AIDS

Abstract INTRODUCTION: Negative lifestyles affect the health and quality of sleep of those living with and without HIV/AIDS. METHODS: Individuals were divided into two groups based on whether or not they were living with HIV/AIDS. RESULTS: Among the 20 participants, 95% displayed a poor lifestyle, and both groups demonstrated low-quality sleep with significant differences between groups in the early sleep variables, total sleep time, and sleep patterns. CONCLUSIONS: Both groups demonstrated similar behavior with unsatisfactory lifestyles, poor sleep quality, and irregular sleep patterns.