Aerobic training with a self-selected or predetermined intensity on sleep parameters in adolescents with obesity: a randomized clinical trial

Objectives: To compare the effects of self-selected and predetermined intensity on sleep quality and duration, daytime sleepiness, and sleep efficiency of adolescents with obesity after 12 weeks of aerobic training. Material and Methods: Thirty-seven adolescents (12 girls), 13-18 years old, with obesity (BMI = 95th) were randomized into a predetermined intensity group (PIG), exercise intensity around 60-70% of heart rate reserve; or self-selected intensity group (SIG), the adolescents chose the speed/intensity at the beginning of each session and were able to change it every 5 minutes. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to assess sleep outcomes. Results: No differences were observed for PSQI [0.00 ± 2.00 vs 1.38 ± 2.7; p=0.195; d=0.60 (moderate effect)], sleep duration [-0.95 ± 1.2 vs -0.35 ± 1.6; p=0.358; d=0.41 (small effect)], ESS [(2.10 ± 3.9 vs 1.15 ± 4.5; p=0.195; d=0.23 (small effect)], and sleep efficiency [(81.5 ± 24.0 vs 79.4 ± 17.0; p=0.8.14; d=0.10 (trivial effect)] for the PIG and SIG groups, respectively. Conclusion: Aerobic training at a self- selected or predetermined intensity does not modulate sleep quality, sleep duration and efficiency, and daytime sleepiness, independent of intensity

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Arquitetura da violência: a arquitetura antimendigo como eureca da regeneração urbana

As reflexões aqui apresentadas são parte da produção do grupo de pesquisa Arquitetura da Violência e estão particularizadas na análise dos efeitos reais e simbólicos da relação entre as formas atuais de reprodução do capital imobiliário e a multiplicação da arquitetura antimendigo como estratégia de expulsão dos mendigos/sem teto de áreas nobres das cidades globais, durante estratégicos processos de gentrificação e de regeneração urbana. Palavras-chave: Globalização, Gentrificação, Exclusão Las reflexiones que aquí se presenta hacen parte de la producción del Grupo de Investigación Arquitectura de la Violencia y son particularizadas en el análisis de los efectos reales y simbólicos de la relación entre las formas actuales de reproducción del capital inmobiliario y la multiplicación de arquitectura antimendigo como estrategia de expulsión de los mendigos/sin techo de áreas nobles de las ciudades globales por estratégicos procesos de gentrificación y regeneración urbana. Palabras clave: Globalización, Gentrificación, Exclusió

Clinical, imaging, morphologic, and molecular features of X-linked VMA21-related myopathy in two unrelated Brazilian families

International audienc

Individual and average responses of sleep quality and daytime sleepiness after four weeks of strength training in adolescents

<div><p>Abstract Aims: To analyze the average and individual responses of sleep quality and daytime sleepiness in adolescents after four weeks of strength training. Methods: 19 adolescents with sleep problems recruited in the Federal Institute of Pernambuco, were subject to anthropometric evaluations as well as those for body composition assessment, a 1 repetition maximum test, the sleep parameters (Pittsburgh Sleep Quality Index-PSQI and Epworth Sleepiness Scale-ESS) and were submitted to four weeks of strength-training, performed alternately by segment, two sessions per week, according to recommendations for this population. Results: A decrease in the average PSQI score was observed (10.3±3.3 vs 8.8±4.0; p=0.006), but not in ESS (p>0.05), after intervention. The individual analyses demonstrated that ~63% of adolescents experienced reductions ≥ 3 points in the PSQI and ~58% of them experienced reductions ≥ 3 points in the measure of daytime sleepiness. The prevalence of poor sleep quality and daytime sleepiness reduced from 84.2% to 68.4% and from 52.6% to 31.6%, respectively. The comparisons of high and low responders to exercise training show that adolescents who reduced ≥3 points in the score of a least one sleep parameter presented lower weight, fat mass, and fat percentage (p<0.05). Conclusion: A short-term strength-training program is able to improve global sleep quality, but not daytime sleepiness in adolescents. Furthermore, the changes after training are highly heterogeneous. Further studies are required to better understand the effects of strength training on sleep parameters of adolescents.</p></div