Baixos níveis de aptidão aeróbia em estudantes do ensino médio de uma cidade do sul do Brasil: associação com fatores sociodemográficos, estilo de vida e adiposidade corporal

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Desportos, Programa de Pós-Graduação em Educação Física, Florianópolis, 2015.Níveis inadequados de aptidão aeróbia são indicadores de diversos agravos à saúde e têm sido associados como um dos fatores de risco de mortalidade prematura por todas as causas de doenças. O objetivo geral do estudo foi estimar a prevalência de baixos níveis de aptidão aeróbia e analisar a associação entre baixos níveis de aptidão aeróbia e fatores sociodemográficos, de estilo de vida e adiposidade corporal em estudantes do ensino médio de São José ? SC/Brasil. Para identificar lacunas científicas do objeto de estudo, inicialmente foi realizada revisão sistemática nas bases de dados PubMed e SciELO. O estudo analítico transversal de base escolar foi desenvolvido com 879 alunos (14 a 19 anos) de escolas públicas de São José/SC. A aptidão aeróbia foi avaliada pelo teste Canadense modificado de Aptidão Aeróbia?mCAFT. As variáveis demográficas (cor da pele, sexo, idade), socioeconômicas (turno de estudo e nível econômico), e estilo de vida (hábitos alimentares, tempo de tela, nível de atividade física, tabagismo e consumo excessivo de bebida alcoólica) foram avaliadas por questionário autoadministrado. A adiposidade corporal foi mensurada por meio das dobras cutâneas do tríceps e subescapular. A maturação sexual foi usada como variável controle nas análises estatísticas. Aplicaram-se os teste U de Mann Whitney e qui-quadrado de heterogeneidade. Foram estimadas as razões de chances (OR) e intervalos de confiança (IC95%) na regressão logística. A menor e a maior prevalência de baixos níveis de aptidão aeróbia encontradas na revisão sistemática foi de 23% e 61,7%, respectivamente. Os fatores que estiveram associados ao baixo nível de aptidão aeróbia foram: sexo feminino, nível econômico baixo, baixo nível de atividade física, consumo de bebidas adoçadas, tempo de tela excessivo e excesso de adiposidade corporal. No estudo de base escolar, a prevalência de baixo nível de aptidão aeróbia foi de 87,5% (IC95%). As meninas com tempo de tela excessivo (OR:2,25; IC95%), que consumiam leite inadequadamente (OR:2,01; IC95%), as nãofumantes (OR:0,35; IC95%) e com excesso de adiposidade corporal (OR:6,13; IC95%) e os meninos de cor de pele branca (OR:0,55; IC95%) e que eram pouco ativos (OR:1,56; IC95%) tinham mais chances de ter baixo nível de aptidão aeróbia (pAbstract : Inadequate levels of aerobic fitness are indicators of various health problems and have been considered a risk factor for premature mortality from all causes. The overall aim of this study was to estimate the prevalence of low levels of aerobic fitness and to analyze the association between low levels of aerobic fitness and sociodemographic factors, lifestyle and body adiposity among high-school students of São José - SC / Brazil. To seek scientific gaps of the study object, a systematic review in PubMed and SciELO databases was initially performed. The analytical, school-based cross-sectional study was developed with 879 students (14-19 years) from public schools of São José / SC. Aerobic fitness was assessed by the modified Canadian Aerobic Fitness Test - mCAFT. Demographic variables (skin color, gender, age), socioeconomic (school shift and economic level) and lifestyle (eating habits, screen time, physical activity, smoking and excessive alcohol consumption) were evaluated by self-administered questionnaire. Body fat was measured by triceps and subscapularis skinfolds. Sexual maturity was used as a control variable in the statistical analysis. The Mann Whitney U and chi-square heterogeneity tests were applied. Odds ratios (OR) and confidence intervals (95%) were estimated in the logistic regression. The largest and lower prevalence of aerobic fitness levels found in systematic review was 23% and 61,7% respectively. The factors associated with low aerobic fitness were female, economic level low, little physically active, consumption of beverages sweetened, excessive screen time and excesso body fat. In the school-based, the prevalence of low levels of aerobic fitness was 87.5% (IC95%). Girls with excessive screen time (OR:2.25; IC95%), with inadequate milk consumption (OR:2.01; IC95%), non-smokers (OR:0.35; IC95%), with excess body fat (OR:6.13; IC95%) and the white skin color boys (OR:0.55; IC95%), little physically active white boys (OR:1.56; IC95%) were more likely to have low levels of aerobic fitness (p<0.05). The prevalence of lowlevels of aerobic fitness was high, which indicates the possibility of health damages. Some of the individual factors associated with the outcome are considered modifiable, which helps in carrying out actions to promote and maintain satisfactory levels of aerobic fitness

Prevalence and factors associated with low lumbar strength in adolescents

Introduction: Low back pain is a multifactorial disorder and is one of the most common musculoskeletal discomfort in adolescents and adults. Objective: To determine the prevalence and factors associated with low levels of lumbar force in adolescents.  Methods: This is a cross-sectional study involving 909 adolescents aged 14 to 16 years enrolled in public schools in São José, of Santa Catarina State – Southern Brazil. Lumbar force was analyzed by the lumbar extension test developed by a Canadian research group, which proposes different cutoffs according sex. Independent variables were sex, age, socioeconomic status, alcohol consumption, screen time, physical activity, aerobic fitness and mass body index. For data analysis, binary logistic regression was used, with significance level of 5%.  Results: The prevalence of low levels of lumbar force was 45.2%, being 36.2% for boys and 53.1% for girls. The population subgroups most likely to present low levels of lumbar force were females (OR: 1,99; CI95%: 1,52 to 2,60) and those adolescents with overweight (OR: 1,48; CI95%: 1,12 to 1,96). Conclusion: Almost half of the students had low levels of lumbar force. The girls, the adolescents with overweight and with excessive time in front of the screen most likely present low levels of lumbar force. The innovation of this study is  modifiable factors such as  the excessive time screen and overweight may be used to promote health  interventions to improve  levels of  lumbar strength of youth.Objetivo: Verificar a prevalência e fatores associados a baixos níveis de força lombar em adolescentes de 14 a 19 anos de idade.Método: Trata-se de um estudo transversal, com 909 adolescentes de 14 a 19 anos, estudantes de escolas públicas da cidade de São José, Santa Catarina – Brasil. Analisou-se a força lombar por meio do teste de extensão lombar proposto pela Canadian Physical Activity, Fitness and Lifestyle Approach (CPAFLA) que propõe pontos de corte distintos para os sexos. As variáveis independentes analisadas foram: sexo, idade, nível econômico, tempo de tela, atividade física, aptidão aeróbia e Indíce de Massa corporal. Para a análise dos dados utilizou-se a regressão logística binária com nível de significância de 5%.Resultados: A prevalência de baixos níveis de força lombar foi de 45,2%, sendo 36,2% para os meninos e 53,1% para as meninas. Os subgrupos populacionais com maiores chances de baixos níveis de força lombar foram o sexo feminino (OR: 1,99; IC95%: 1,52-2,60) e adolescentes com excesso de peso (OR: 1,48; IC95%: 1,12-1,96). Conclusão: Quase metade dos estudantes apresentaram baixos níveis de força lombar. As meninas e os adolescentes com excesso de peso estiveram mais propícios a ter baixos níveis de força lombar

Suicidal behaviour in adolescents: Characteristics and prevalence

Introduction: Suicide refers to the conscious desire to die, and suicidal behavior is divided into three stages (thinking, planning and attempted suicide). Objective: To estimate the prevalence of thinking, planning and suicide attempt and identify the sociodemographic characteristics and lifestyle among adolescents in southern Brazil. Methods: Cross-sectional study with 1,132 adolescents from public schools in São José, Santa Catarina, Brazil, aged 14-19 years. The thinking, planning and attempted suicide were evaluated by three different questions, taken from the questionnaire Youth Risk Behavior Survey (YRBS). The independent variables were gender, age, skin color, economic status, sleep quality, perception of body weight, level of physical activity and alcohol consumption. Results: The prevalence of thinking, planning and attempted suicide were respectively 13.8%, 10.5% and 5.5%. Neither crude nor adjusted analysis, the younger adolescents (14-16 years) had the characteristic of suicidal thinking. Teens who slept well had not characteristic they thought, planning and suicide attempt. Finally, adolescents with poor perception of body weight had the characteristic of suicidal thinking. Conclusion: Adolescents with suicidal thinking presented characteristic of being young and having inadequate body weight perception. One in ten teenagers thought and planned suicide. Regarding suicide attempt, the ratio was less than one. In addition, adolescents affected by thinking, planning and suicide attempt, had the characteristic not sleep well

Simultaneous Health Risk Behaviors in Adolescents Associated with Higher Economic Class in the Northeast of Brazil

Design. The social, cultural, and economic context can be an important variable in the perception and adoption of risk behaviors in adolescents. Objective. The purpose of this study was to identify the prevalence of simultaneous health risk behaviors and associated socioeconomic factors in adolescents living in the metropolitan region of Aracaju, State of Sergipe, Brazil. Methods. The sample consisted of 2,207 high school students aged 13–18 years. The risk behaviors measured were “low levels of physical activity,” “excessive daily TV time,” “high consumption of alcoholic beverages on a single occasion,” “involvement in fights,” “smoking cigarettes,” “carrying firearms,” and “marijuana consumption.” Information was obtained through self-administered questionnaire. Results. Considering the results, it was observed that female adolescents and those aged up to 16 years were less likely to have two or more health risk behaviors compared to males and those aged 17 years or more, respectively. It was also found that both high- and middle-income level adolescents had higher prevalence of having two or more health risk behaviors. Conclusions. It was concluded that male adolescents older than 16 years with better socioeconomic level were more exposed to the simultaneous presence of several health risk behaviors

Current perspectives of co-management in healthcare: experiences of the Humanization Working group on primary healthcare

O objetivo deste artigo é relatar a experiência da criação de um Grupo de Trabalho de Humanização (GTH) como dispositivo para a materialização e operacionalização de espaços de cogestão na atenção primária à saúde, baseado nos princípios da Política Nacional de Humanização. Trata-se de um estudo descritivo com abordagem qualitativa, envolvendo a observação participante abrangendo o Núcleo Integrado de Saúde Pinheiros (NIS-Pinheiros) da cidade de Maringá, PR. O NIS conta com sete Equipes de Saúde da Família, sendo referência para o atendimento de aproximadamente 35 mil usuários. A coleta dos dados foi realizada por meio da análise documental, utilizando-se os registros das atas das reuniões do GTH e atas das reuniões gerais, os registros da caixa de sugestões da unidade e os registros da observação participante do Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) do Ministério da Saúde, desenvolvido por meio da Universidade Estadual de Maringá (UEM) no NIS-Pinheiros. Os resultados constatados apontam que as reuniões do GTH e sua ampliação, intitulada de "Reunião Geral", passaram a ser dispositivos de participação e construção coletiva na cogestão do NIS-Pinheiros, além de conferir responsabilidade para todos os atores sociais envolvidos (trabalhadores, gestores e usuários), que passaram a participar do planejamento e organização da unidade, intervindo na melhoria dos processos de trabalho e na qualidade da produção de saúde na atenção primária.The aim of this article is to describe the experience of a Humanization Work Group (GTH) as a co-management apparatus on Primary Health Care. This group is based on the National Policy for Humanization (2004). It is a qualitative study, based on participant observation (Minayo, 2004), conducted at the Núcleo Integrado de Saúde Pinheiros (NIS-Pinheiros), a Primary Care Health Unit, in the city of Maringá, Paraná. The NIS houses seven Family Health Teams, which assist around 35.000 people. Data were collected using documental analysis of the GTH meetings records, the General Meeting records, the information from the suggestion box, the experience of the students who participated of PET-Saúde (Program of Education for Health Through Work, of Brazilian's Ministry of Health), from Universidade Estadual de Maringá (UEM). The project was conducted at NIS-Pinheiros. The results show that the GTH meetings and its extension, called "general meeting", were used as an apparatus for participation and collective construction of co-management at NIS-Pinheiros. Additionally, these apparatus shared responsibility among all the social actors involved (workers, managers and users), who could participate of the unit's planning and organization, improving the work processes and the quality of health production on primary care

Television Time among Brazilian Adolescents: Correlated Factors are Different between Boys and Girls

Objective. The aim of this study was to identify the prevalence of excess television time and verify correlated factors in adolescent males and females. Methods. This cross-sectional study included 2,105 adolescents aged from 13 to 18 years from the city of Aracaju, Northeastern Brazil. Television time was self-reported, corresponding to the time spent watching television in a typical week. Several correlates were examined including age, skin color, socioeconomic status, parent education, physical activity level, consumption of fruits and vegetables, smoking status, alcohol use, and sports team participation. Results. The prevalence excess television time (≥2 hours/day) in girls and boys was 70.9% and 66.2%, respectively. Girls with low socioeconomic status or inadequate consumption of fruits and vegetables were more likely to have excess television time. Among boys, those &gt;16 years of age or with black skin color were more likely to have excess television time. Conclusions. Excess television time was observed in more than two-thirds of adolescents, being more evident in girls. Correlated factors differed according to sex. Efforts to reduce television time among Brazilian adolescents, and replace with more active pursuits, may yield desirable public health benefits

Neurostimulation Combined With Cognitive Intervention in Alzheimer’s Disease (NeuroAD): Study Protocol of Double-Blind, Randomized, Factorial Clinical Trial

Despite advances in the treatment of Alzheimer’s disease (AD), there is currently no prospect of a cure, and evidence shows that multifactorial interventions can benefit patients. A promising therapeutic alternative is the use of transcranial direct current stimulation (tDCS) simultaneously with cognitive intervention. The combination of these non-pharmacological techniques is apparently a safe and accessible approach. This study protocol aims to compare the efficacy of tDCS and cognitive intervention in a double-blind, randomized and factorial clinical trial. One hundred participants diagnosed with mild-stage AD will be randomized to receive both tDCS and cognitive intervention, tDCS, cognitive intervention, or placebo. The treatment will last 8 weeks, with a 12-month follow-up. The primary outcome will be the improvement of global cognitive functions, evaluated by the AD Assessment Scale, cognitive subscale (ADAS-Cog). The secondary outcomes will include measures of functional, affective, and behavioral components, as well as a neurophysiological marker (Brain-derived neurotrophic factor, BDNF). This study will enable us to assess, both in the short and long term, whether tDCS is more effective than the placebo and to examine the effects of combined therapy (tDCS and cognitive intervention) and isolated treatments (tDCS vs. cognitive intervention) on patients with AD.Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02772185—May 5, 2016