Association of physical activity and sitting with metabolic syndrome and hyperglycemic clamp parameters in adolescents - BRAMS pediatric study.

Introduction: Obesity and metabolic syndrome (MetS) have immediate and long-term consequences on adolescent health and well-being. Among the available treatments for MetS in adolescents, behavioral interventions such as increasing physical activity (PA) are preferred. This study aimed to investigate the association of PA and sitting time with MetS and a complete set of metabolic health parameters. Methods: Data from the Pediatric Brazilian Metabolic Syndrome Study (BRAMS-P), a cross-sectional multicenter study conducted using a convenience sample of 448 Brazilian adolescents (10y-19y), were used. Sociodemographic and lifestyle information were collected using a standardized questionnaire. Daily PA and sitting time were estimated from the International PA Questionnaire. Anthropometric parameters, body composition, and blood pressure were measured by trained researchers. Blood lipids, uric acid, hepatic enzymes, creatinine, glycated hemoglobin, glucose, and insulin were measured in fasting blood samples, and the Homeostasis Model Assessment for Insulin Resistance was calculated. A subsample of 57 adolescents underwent the hyperglycemic clamp protocol. Results: The odds for metabolic syndrome were higher among adolescents who spent >8h sitting (OR (95%CI)=2.11 (1.02 - 4.38)), but not in those classified as active (OR (95%CI)=0.98 (0.42 - 2.26)). Adolescents who spent more time sitting had higher BMI, waist circumference, sagittal abdominal diameter, neck circumference, percentage of body fat, and worse blood lipid profile. The insulin sensitivity index was moderately and positively correlated with moderate-to-high PA in minutes per day (rho=0.29; p=0.047). Conclusion: Time spent sitting was associated with worse metabolic parameters and must be restricted in favor of adolescent health. Regular PA is associated with improved insulin sensitivity and may be encouraged not only in adolescents with obesity or metabolic disorders but also to prevent adverse metabolic outcomes in normal-weight adolescents.

Interpretação e aplicação das tecnologias do cuidado no cenário da atenção primária de saúde / Interpretation and implementation of care technologies in the setting of primary health care / Interpretación y aplicación de las tecnologías del cuidado en el escenario de la atención primaria de salud

Objetivo:analisar o uso das tecnologias do cuidado na Atenção Primária de Saúde. Método: estudo qualitativo, descritivo, de campo e transversal. Amostra composta por 20 enfermeiras das Estratégias Saúde da Família do município de Caruaru/PE/Brasil. A coleta de dados se deu por entrevistas semiestruturadas nos meses de junho e julho de 2013, após a emissão do parecer favorável doComitê de Ética em Pesquisa,sob o CAAE nº 14593513.0.0000.5203. Os dados foram analisados de acordo com a análise de conteúdo. Resultados: após análise dos dados, emergiu a categoria temática <>, a qual deu margem para duas subcategorias <> e <>. Conclusão: o domínio sobre o uso das tecnologias do cuidado é uma ferramenta capaz de facilitar a relação entre usuário e enfermeiro, recurso para diagnósticos e intervenções, demandando uma expressiva resolutividade.(AU)

Objective:to analyze the use of care technologies in Primary Health Care. Method:qualitative, descriptive, field and cross-sectional study. Sample composed of 20 nurses of family health strategies of Caruaru municipality/PE/Brazil. Data collection was carried out by semi-structured interviews in the period from June to July 2013 after obtaining a favorable opinion of the Ethics Committee, CAAE 14593513.0.0000.5203. Data were analyzed according to content analysis. Results:The thematic category <> emerged from the analysis of data and this gave rise to two subcategories: <> and <>. Conclusion:the domain on the use of care technology is a tool able to facilitate the relationship between user and nurse, resource for diagnostics and interventions, demanding a significant solving.(AU)

Objetivo:analizar el uso de las tecnologías del cuidado en la Atención Primaria de Salud. Método: estudio cualitativo, descriptivo, de campo y transversal. La muestra compuesta por 20 enfermeras de las Estrategias Salud de la Familia de la ciudad de Caruaru/PE/Brasil. La recolección de datos fue por entrevistas semi-estructuradas en los meses de junio y julio de 2013, después de la emisión del parecer favorable delComité de Ética en Investigación, sobreCAAE nº 14593513.0.0000.5203. Los datos fueron analizados de acuerdo con el análisis de contenido. Resultados: después del análisis de los datos, surgió la categoríatemática <>, la cual dio margen para dos subcategorías <> e <>. Conclusión: el dominio sobre el uso de las tecnologíasdel cuidado es una herramienta capaz de facilitar la relación entre usuario y enfermero, recurso para diagnósticos e intervenciones, demandando una expresiva resolutividad.(AU).