High-Intensity Interval Training in Patients with Type 2 Diabetes Mellitus: a Systematic Review.

PURPOSE OF REVIEW: High-intensity exercise may beneficially impact on insulin sensitivity. However, there is still uncertainty on the actual impact of high-intensity interval training (HIIT) on chronic physiologic adaptations among patients with type 2 diabetes mellitus (T2DM). We aimed to systematically search and appraise the evidence base on the effects of HIIT in comparison to mild- or moderate-intensity interval training (MMIIT) on glycemic control inT2DM. RECENT FINDINGS: A total of 5 RCT met the inclusion criteria. Most studies presented significant differences for weight and BMI with HIIT, and with both interventions for total body fat. For the other health-related variables (systolic and diastolic BP, fasting cholesterol, LDL and HDL, triglycerides, fasting glucose, and HbAc1), only 1 study provided detailed results for HIIT, showing significant differences for systolic BP and HDL cholesterol in 2 studies, total cholesterol, LDL, and triglycerides, whereas for MIIT, only 1 study brought significant differences for LDL cholesterol. For glucose levels, significant differences were reported in 4 studies for both HIIT and MMIT, but only two studies used the percentage delta assessment tool, whereas 1 study only showed significant improvements for HIIT. The number of studies for the analysis is not precise as to the statements regarding the results of the intervention proposed for this public, since they do not allow identifying a consistency of the findings, not presenting diversity between the training methods and the different methods of volume control and intensity of training.

Burnout syndrome and job satisfaction in community health workers.

Introduction: Community health workers play a prominent role in the primary care context in Brazil. Burnout syndrome is an important work-related condition whose consequences affect job satisfaction. Objectives: To evaluate the extent of burnout syndrome and job satisfaction among community health workers in a city in southern Santa Catarina. Methods: This analytical, individual, cross-sectional study was conducted in Family Health Units. The participants were selected through random probability sampling, with a sampling error of 10%. After sociodemographic data collection, the Maslach Burnout Inventory and a job satisfaction scale were applied. Results: All 66 included workers were women. According to the analyses, there was a moderate positive correlation between satisfaction with colleagues and satisfaction with supervisors. There were weak positive correlations between emotional exhaustion and depersonalization and between professional fulfillment and satisfaction with promotions. However, there was a weak negative correlation between emotional exhaustion and both professional fulfillment and satisfaction with salary. Conclusions: The results indicate that the conditions of these workers are sufficiently satisfactory to deal with the demands of the job. Nevertheless, there was substantial dissatisfaction with salary, which can be a demotivator and trigger work-related depression.

Introdução: Os agentes comunitários de saúde possuem um lugar de evidência na atual proposta da atenção básica. Uma das doenças no meio trabalhista é a síndrome de burnout, e, ao adquirir essa doença, o trabalhador sofre com consequências que afetam a satisfação no trabalho. Objetivos: Avaliar a existência da síndrome de burnout e a satisfação no trabalho dos agentes comunitários de saúde de uma cidade do extremo Sul catarinense. Métodos: Tratou-se de um estudo analítico, individual, transversal realizado nas Estratégias de Saúde da Família. Os participantes foram selecionados por meio de amostragem aleatória probabilística, com erro amostrai de 10%. Foi realizada anamnese de identificação, e os participantes responderam ao Inventário de Burnout de Maslach e à Escala de Satisfação no Trabalho. Resultados: Participaram do estudo 66 agentes comunitárias, todas do sexo feminino. As análises demonstraram correlação positiva moderada entre satisfação com os colegas e com o chefe, e correlações positivas fracas entre exaustão emocional e despersonalização, assim como entre realização profissional e satisfação com promoções. Por outro lado, exaustão emocional, realização profissional e satisfação com a remuneração obtiveram correlação negativa fraca. Conclusões: Os resultados indicam boas condições dos agentes comunitários para lidar com as demandas do trabalho. Destaca-se a insatisfação com a remuneração, podendo ser desmotivante e podendo desencadear doenças relacionadas à saúde mental.

Physical Activity and Sleep in Adults and Older Adults in Southern Brazil.

Good sleep quality is a well-known indicator of physical and mental health, well-being, and overall vitality. This study aimed to verify the association between the practice of physical activity and sleep duration and quality in adults and older adults in southern Brazil. A cross-sectional population-based study was carried out with 820 individuals of both sexes aged 18 years or more, where sociodemographic variables were collected and also health-related variables. This study included 523 (63.8%) women and 297 (36.2%) men, and the prevalence of adequate sleep hours was 41.5% (95%CI: 39.1; 44.9). People who performed leisure walking were 34% more likely to present adequate sleep duration (PR: 1.34; 95%CI: 1.10; 1.64) compared to those who did not perform leisure walking. Individuals who met the recommendations for moderate or vigorous physical activity were more likely to have good sleep quality (PR: 1.16; 95%CI: 1.01; 1.34). Future health behavior modification strategies to improve sleep quality at the population level should consider encouraging lifestyle improvements, thus increasing the practice of physical activities.

Physical Exercise Training Improves Judgment and Problem-Solving and Modulates Serum Biomarkers in Patients with Alzheimer's Disease.

Alzheimer's disease (AD) is characterized by progressive impairment of memory, with an etiology involving oxidative stress and inflammation. Exercise training is a safe, efficacious, and economic approach to manage neurodegenerative diseases. In AD, the biomarkers of oxidative damage to lipids, proteins, and DNA are elevated. In the present study, we aimed to evaluate whether exercise is effective in patients with AD by assessing the serum biomarkers associated with the redox status, neurotrophin levels, and inflammatory system. This nonrandomized clinical study (n = 15) involved 22 training sessions performed twice a week (60 min/session) in patients diagnosed with AD. The cognitive and self-awareness tests were performed 48 h before and after the physical training session. In patients with AD, physical training significantly improved the judgment and problem-solving domains of the memory score; however, general mental health, memory, orientation, and home/hobby domains were improved slightly, and the neurotrophin levels remained unaltered. Significantly, the markers of protein integrity also increased following exercise. Furthermore, catalase activity and ROS levels decreased, nitrite levels increased, and interleukin-4 level increased following physical training in patients with AD. Although proinflammatory cytokines remained unaltered, the levels of neuron-specific enolase, a marker of neuronal damage, decreased following exercise training in these patients. In conclusion, physical exercise training could be a safe and effective method for blocking the AD progression and improving the antioxidant capacity and anti-inflammatory system, whereas certain assessed biomarkers could be utilized to monitor AD therapy.

Effective/cost effective interventions of child mental health problems in low- and middle-income countries (LAMIC): Systematic review.

BACKGROUND: This systematic review protocol aims to examine the evidence of effectiveness and cost-effectiveness of interventions for children and adolescents with, or at risk of developing mental disorders in low- and middle-income countries (LAMICs). METHODS: We will search Medline Ovid, EMBASE Ovid, PsycINFO Ovid, CINAHL, LILACS, BDENF and IBECS. We will include randomised and non-randomised controlled trials, economic modelling studies and economic evaluations. Participants are 6 to 18 year-old children and adolescents who live in a LAMIC and who present with, or are at high risk of developing, one or more of the conditions: depression, anxiety, behavioural disorders, eating disorders, psychosis, substance abuse, autism and intellectual disabilities as defined by the DSM-V. Interventions which address suicide, self-harm will also be included, if identified during the extraction process. We will include in person or e-health interventions which have some evidence of effectiveness (in relation to clinical and/or functional outcomes) and which have been delivered to young people in LAMICs. We will consider a wide range of delivery channels (e.g., in person, web-based or virtual, phone), different practitioners (healthcare practitioners, teachers, lay health care providers) and sectors (i.e., primary, secondary and tertiary health care, education, guardianship councils). In the pilot of screening procedures, 5% of all references will be screened by two reviewers. Divergences will be resolved by one expert in mental health research. Reviewers will be retrained afterwards to ensure reliability. The remaining 95% will be screened by one reviewer. Covidence web-based tool will be used to perform screening of references and full text paper, and data extraction. RESULTS: The protocol of this systematic review will be disseminated in a peer-reviewed journal and presented at relevant conferences. The results will be presented descriptively and, if possible, meta-analysis will be conducted. Ethical approval is not needed for anonymised secondary data. CONCLUSION: the systematic review could help health specialists and other professionals to identify evidence-based strategies to deal with child and adolescents with mental health conditions.