Team sports as a protective factor against mental health problems and suicidal ideation in adolescents / El deporte colectivo como factor protector ante problemas de salud mental e ideación suicida en adolescentes

Abstract Introduction Adolescents who practice sports have better mental health indicators. Objective To analyze the association between different types of physical activity (systematized exercise, individual, and collective sports), mental health, and suicidal ideation in adolescents. Method We conducted a cross-sectional study with 666 Brazilian adolescents (14-19 y.o.) attending high schools and selected using random cluster sampling. The mental health indicators analyzed were evaluated through the Self Reporting Questionnaire and the Strengths and Difficulties Questionnaire, including suicidal ideation. We also obtained physical activity information through questionnaires. Results There was a higher prevalence related to mental disorders (54.2% vs. 32.5%), difficulties related to mental health (79.6% vs. 48.4%), and suicidal thoughts (22.9% vs. 11.4%) in girls than in boys (p < .001 for all). The boys engaged in more team sports (41.0 vs. 23.8), whereas girls performed more exercise (45.1 vs. 26.5; p < .001). Discussion and conclusion The practice of team sports helps develop the collective spirit, stimulates social interaction, and develops reasoning and emotional intelligence. Boys who play team sports have fewer symptoms of common mental disorders, lower mental health problems, and less suicidal ideation than physically inactive boys.

Resumen Introducción Los adolescentes que practican deportes tienen mejores indicadores de salud mental. Objetivo Analizar la asociación entre los diferentes tipos de actividad física (ejercicio sistematizado, deportes individuales y colectivos), la salud mental y la ideación suicida en adolescentes. Método Se realizó un estudio transversal realizado con 666 adolescentes brasileños (14-19 años) que asisten a escuelas secundarias y fueron seleccionados mediante muestreo aleatorio por conglomerados. Los indicadores de salud mental analizados fueron evaluados a través del Cuestionario de Autoinforme y el Cuestionario de Fortalezas y Dificultades, incluyendo la ideación suicida. También obtuvimos información de la actividad física a través de cuestionarios. Resultados Hubo una mayor prevalencia relacionada con trastornos mentales (54.2% contra 32.5%), dificultades relacionadas con la salud mental (79.6% contra 48.4%) y pensamientos suicidas (22.9% contra 11.4%) en niñas que en niños (p < .001 para todos). Los chicos practicaban más deportes de equipo (41.0 contra 23.8), mientras que las chicas hacían más ejercicio (45.1 contra 26.5; p < .001). Discusión y conclusión La práctica de deportes de equipo ayuda en el desarrollo del espíritu colectivo, estimula la interacción social, desarrolla el razonamiento y la inteligencia emocional. Los niños que practican deportes de equipo tienen menos síntomas de trastornos mentales comunes, menos problemas de salud mental y menos ideación suicida en comparación con los niños físicamente inactivos.

Brain changes in neuroimaging of adult patients with vitamin D deficiency: systematic review protocol.

INTRODUCTION: Brain abnormalities detected through neuroimaging are described in patients with vitamin D deficiency, however, it is still not clear which cerebral alterations are more frequent and characteristic in this population. Thus, this review aims to identify and classify which are the main and most frequent brain changes found by neuroimaging in patients with vitamin D deficiency. METHODS AND ANALYSIS: The study protocol was constructed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the leading research question was formulated through Population, Intervention, Comparator, Outcome, Setting. The evidence will be researched at the following electronic databases: PubMed, PsycINFO, Scopus, Web of Science and EMBASE. Two researchers will work in the selection, analysis and inclusion phases of the articles. In the case of divergence, a third-party reviewer will be contacted. The following studies will be included: (1) cohort studies, case-control studies and cross-sectional studies; (2) studies carried out on patients with serum 25-hydroxyvitamin D levels below 30 ng/mL; (3) studies conducted with an adult population; (4) studies using neuroimaging methods. Articles considered eligible will be analysed by the Newcastle-Ottawa Quality Assessment Scale/cross-section studies to evaluate study quality. The survey will be conducted from June to December 2022. ETHICS AND DISSEMINATION: The identification of the main and most frequent brain alterations found through neuroimaging in patients with vitamin D deficiency can guide professionals as to the identification which of the main cerebral pathologies detected through neuroimaging are related to vitamin D deficiency, in choosing more sensitive and specific neuroimaging tests to detect these brain changes, in addition to emphasising the importance of monitoring and maintaining adequate serum levels of vitamin D, in order to reduce possible cognitive sequelae. Results will be announced at national and international conferences. PROSPERO REGISTRATION NUMBER: CRD42018100074.

Voxel-Based Morphometry and Relaxometry Demonstrate Macro- and Microstructural Damages in Spinocerebellar Ataxia Type 3.

Spinocerebellar ataxia type 3/Machado-Joseph disease (SCA3/MJD) is the most common SCA worldwide and comprises about 70% of SCA patients in Brazil. Magnetic resonance imaging (MRI) sequences have been used to describe microstructural abnormalities in many neurodegenerative diseases and helped to reveal the excessive iron accumulation in many of these conditions. This study aimed to characterize brain changes in gray matter (GM) and white matter (WM), detected by voxel-based morphometry (VBM) and relaxometry in patients with SCA3/MJD. A group of consecutive individuals, older than 18 years of age, with symptomatic and genetically proven SCA3/MJD diagnosed, and a control group, were submitted to clinical evaluation and MRI. The images were analyzed using VBM technique and relaxometry. The global assessment of brain volume by region of interest showed a significant difference in GM between SCA3/MJD and normal controls. VBM was used to locate these volumetric changes and it revealed a noticeable difference in the GM of the cerebellum and the brainstem. The global assessment of the brain by relaxometry also showed a significant difference in the comparison of GM between SCA3/MJD and normal controls, detecting noticeable prolongation of T2 time in the medulla oblongata (p < 0.001) and in the pontine tegmentum (p = 0.009) in SCA3/MJD compared to control group. Our study suggests that SCA3/MJD affects the macrostructure of the cerebellum and brainstem and microstructure of pons and medulla oblongata GM, as already demonstrated in the pathological study.

Brain ventricles, CSF and cognition: a narrative review.

The brain ventricles are structures that have been related to cognition since antiquity. They are essential components in the development and maintenance of brain functions. The aging process runs with the enlargement of ventricles and is related to a less selective blood-cerebrospinal fluid barrier and then a more toxic cerebrospinal fluid environment. The study of brain ventricles as a biological marker of aging is promissing because they are structures easily identified in neuroimaging studies, present good inter-rater reliability, and measures of them can identify brain atrophy earlier than cortical structures. The ventricular system also plays roles in the development of dementia, since dysfunction in the clearance of beta-amyloid protein is a key mechanism in sporadic Alzheimer's disease. The morphometric and volumetric studies of the brain ventricles can help to distinguish between healthy elderly and persons with mild cognitive impairment (MCI) and dementia. Brain ventricle data may contribute to the appropriate allocation of individuals in groups at higher risk for MCI-dementia progression in clinical trials and to measuring therapeutic responses in these studies, as well as providing differential diagnosis, such as normal pressure hydrocephalus. Here, we reviewed the pathophysiology of healthy aging and cognitive decline, focusing on the role of the choroid plexus and brain ventricles in this process.

Análise da associação entre fumo passivo e consumo de álcool e drogas entre adolescentes / Analysis of the association between passive smoking and alcohol and drug consumption among adolescents

Analisar a associação entre o fumo passivo e o consumo de álcool e drogas ilícitas entre adolescentes. Estudo epidemiológico, descritivo, com abordagem quantitativa e abrangência estadual, em uma amostra de 6.264 adolescentes, captados por amostragem aleatória por conglomerados. Os dados foram recolhidos por meio do Global School-Based Student Health Survey. O teste do Qui-quadrado de Pearson (x²) e a regressão logística binária foram utilizados nas análises dos dados. Observou-se exposição significante ao fumo passivo (70,7%), e identificou-se que a exposição ao fumo passivo esteve associado com o consumo de álcool (OR = 2,04; IC 95%: 1,72 2,42) e drogas ilícitas (OR = 4,33; IC 95%: 2,72 6,90), mesmo entre aqueles adolescentes que não fumam e seus pais não fumam e independentemente do sexo, idade e escolaridade materna. O fumo passivo esteve associado ao consumo de álcool e drogas ilícitas pelos adolescentes, excluindo uso de cigarro por parte dos jovens e dos seus pais

To analyze an association between secondhand smoke and alcohol and illicit drug use among adolescents. Epidemiological, descriptive study, with a quantitative approach and state coverage, in a sample of 6,264 adolescents, captured by random sampling by clusters. Data were collected using the Global School-Based Student Health Survey. Pearson's chi-square test (x²) and binary logistic regression were used in the data analysis. There was a significant exposed to secondhand smoke (70.7%). In addition, it was found that exposure to secondhand smoke was associated with alcohol consumption (OR = 2.04; 95% CI: 1.72 2.42) and illicit drugs (OR = 4.33; 95% CI: 2.72 6.90), even among those adolescents who do not smoke and their parents do not smoke and regardless of gender, age and maternal education. Passive smoking was associated with alcohol and illicit drug use by adolescents, excluding the use of cigarettes by young people and their parents

Which Factors in Spinocerebellar Ataxia Type 3 Patients Are Associated with Restless Legs Syndrome/Willis-Ekbom Disease?

There is evidence of a higher prevalence of restless legs syndrome/Willis-Ekbom disease (RLS/WED) in individuals with spinocerebellar ataxia type 3 (SCA3), although the factors underlying this association remain unknown. The present study aimed to determine the prevalence of RLS/WED in SCA3 patients and to investigate which factors of SCA3 patients are associated with presence of RLS/WED. From February to August of 2006, we carried out clinical interviews in 40 controls and 40 SCA3 patients, diagnosed and followed up at Faculty of Medicine of Ribeirão Preto, University of São Paulo. Twenty-seven SCA3 patients were submitted to a detailed clinical protocol, electroneuromyography, blood work up, polysomnography (PSG), suggested immobilization test (SIT), and magnetic resonance image (MRI). RLS/WED was found in 27.5% of SCA3 patients and 2.5% of normal controls (p = 0.003). The factors related to RLS/WED in SCA3 patients were female gender, age at start of the symptoms of ataxia after 30 years, presence of peripheral neuropathy, and documented iron deficiency. Among SCA3 patients, those with RLS showed higher values of maximal discomfort level and discomfort level sum compared to non-RLS individuals on SIT. There is a relation between RLS/WED and SCA3, which seems to be resultant of different factors whose identification could improve the quality of assistance to those patients as well as to promote a better comprehension of the pathophysiology of both RLS/WED and SCA3.

Effects of Different Exercise Intensities on Headache: A Systematic Review.

The benefits of the regular exercise on quality of life of individuals living with a headache are well known. However, whether the benefits of the exercise training on headache parameters (i.e., intensity, frequency, and pain duration) occur in an intensity-dependent fashion remains unknown. OBJECTIVE: The aim of the study was to investigate the effects of different exercise intensities on headache parameters. DESIGN: A systematic review of clinical trials that analyzed the effect of physical exercise on headache, without time or language restriction. The TESTEX scale was used to evaluate the methodological quality of the articles. RESULTS: Sixteen (16) articles were included with interventions with aerobic training and resistance training. Primary results are positive effects of exercise on migraine symptoms, tension-type headache among others, and a decrease in the use of headache-related medications. On the other hand, the studies did not provide information on exercise intensity, especially studies with aerobic exercises. The intensities used for aerobic training was mostly controlled subjectively and the resistance training ranged from 10% to 80% of maximum repetition. CONCLUSIONS: Exercise had a positive influence on the frequency and severity of headache crises, although the studies presented inconclusive data regarding the exercise parameters.

Anatomic and neuropsychological findings in low-educated cognitively intact elderly from a Brazilian cohort.

In elderly individuals, low educational level may represent a risk factor for the development of dementia and a proxy of cognitive reserve. OBJECTIVE: This study examined the cognitive and neuroanatomic correlates of high versus low educational levels in cognitively healthy community-dwelling older adults in Brazil. METHODS: Fifty-three older adults (mean age: 68±5.3 years) were divided into a "low education" group [LE; 1-4 years of education (N=33)] and "high education" group [HE; >11 years of education (N=20)]. Both groups completed a comprehensive neuropsychological battery and underwent in vivo structural MRI close to the time of testing. RESULTS: Higher educational level increased the chance of having better scores on neuropsychological tests, including verbal and visual delayed recall of information, verbal learning, category fluency, global cognition, and vocabulary. Better scores on these tests were observed in the HE group relative to the LE group. Despite this, there were no group differences between MRI measures. CONCLUSION: Older adults with higher educational levels showed better scores on neuropsychological measures of cognition, highlighting the need for education-adjusted norms in developing countries. Given the absence of differences in structural anatomy between the groups, these findings appear to be best explained by theories of cognitive reserve.

Sabe-se que baixos níveis de educação são comuns em países em desenvolvimento. Em indivíduos idosos, em particular, baixos níveis de educação podem representar um fator de risco para o desenvolvimento de demência. Objetivo: Este estudo examina os correlatos cognitivos e neuroanatômicos de escolaridade alta versus baixa, em idosos cognitivamente saudáveis,vivendo em comunidade no Brasil. Métodos: Cinquenta e três idosos (média de idade: 68±5,3) foram divididos em um grupo de "baixa escolaridade" [LE; 1-4 anos de escolaridade (N=33)] e um grupo de "alta escolaridade" [HE; >11 anos de escolaridade (N=20)]. Ambos os grupos completaram uma bateria neuropsicológica abrangente e foram submetidos à RM estrutural in vivo próximo à testagem. Resultados: O nível educacional aumentou a chance de se obter melhores pontuações em testes neuropsicológicos, incluindo evocação verbal e visual da informação, aprendizagem verbal, fluência de categoria, cognição global e vocabulário. Escores mais altos foram encontrados no grupo HE, em detrimento do LE. Apesar disso, não houve diferenças entre os grupos nas medidas de ressonância magnética in vivo. Conclusão: Idosos com maiores níveis de escolaridade apresentaram melhores pontuações nas medidas neuropsicológicas da cognição, destacando a necessidade de normas ajustadas à educação nos países em desenvolvimento. Não havendo diferenças na anatomia estrutural entre os grupos, os achados parecem ser melhor explicados pelas teorias da "reserva cognitiva".

Anatomic and neuropsychological findings in low-educated cognitively intact elderly from a Brazilian cohort / Achados Anatômicos e Neuropsicológicos de Idosos Cognitivamente Saudáveis com Baixa Escolaridade em uma Coorte Brasileira

ABSTRACT In elderly individuals, low educational level may represent a risk factor for the development of dementia and a proxy of cognitive reserve. Objective: This study examined the cognitive and neuroanatomic correlates of high versus low educational levels in cognitively healthy community-dwelling older adults in Brazil. Methods: Fifty-three older adults (mean age: 68±5.3 years) were divided into a "low education" group [LE; 1-4 years of education (N=33)] and "high education" group [HE; >11 years of education (N=20)]. Both groups completed a comprehensive neuropsychological battery and underwent in vivo structural MRI close to the time of testing. Results: Higher educational level increased the chance of having better scores on neuropsychological tests, including verbal and visual delayed recall of information, verbal learning, category fluency, global cognition, and vocabulary. Better scores on these tests were observed in the HE group relative to the LE group. Despite this, there were no group differences between MRI measures. Conclusion: Older adults with higher educational levels showed better scores on neuropsychological measures of cognition, highlighting the need for education-adjusted norms in developing countries. Given the absence of differences in structural anatomy between the groups, these findings appear to be best explained by theories of cognitive reserve.

RESUMO Sabe-se que baixos níveis de educação são comuns em países em desenvolvimento. Em indivíduos idosos, em particular, baixos níveis de educação podem representar um fator de risco para o desenvolvimento de demência. Objetivo: Este estudo examina os correlatos cognitivos e neuroanatômicos de escolaridade alta versus baixa, em idosos cognitivamente saudáveis,vivendo em comunidade no Brasil. Métodos: Cinquenta e três idosos (média de idade: 68±5,3) foram divididos em um grupo de "baixa escolaridade" [LE; 1-4 anos de escolaridade (N=33)] e um grupo de "alta escolaridade" [HE; >11 anos de escolaridade (N=20)]. Ambos os grupos completaram uma bateria neuropsicológica abrangente e foram submetidos à RM estrutural in vivo próximo à testagem. Resultados: O nível educacional aumentou a chance de se obter melhores pontuações em testes neuropsicológicos, incluindo evocação verbal e visual da informação, aprendizagem verbal, fluência de categoria, cognição global e vocabulário. Escores mais altos foram encontrados no grupo HE, em detrimento do LE. Apesar disso, não houve diferenças entre os grupos nas medidas de ressonância magnética in vivo. Conclusão: Idosos com maiores níveis de escolaridade apresentaram melhores pontuações nas medidas neuropsicológicas da cognição, destacando a necessidade de normas ajustadas à educação nos países em desenvolvimento. Não havendo diferenças na anatomia estrutural entre os grupos, os achados parecem ser melhor explicados pelas teorias da "reserva cognitiva".

Improving Education of Medical Students Through Telehealth.

Telehealth can be used in medical education to promote teaching-service integration as a low-cost solution to broaden the field of medical practice, especially in rural areas of low and middle-income countries. This article presents our experience in the use of telehealth to broaden the practice field of medical students. In 2017, two itinerants' actions were carried out in municipalities in the state of Pernambuco. In both actions, 396 patients were assisted by a team of professionals, teachers and students in various specialties, with emphasis on mental health and dermatology. 9 students experimented with the use of an electronic patient record system, telehealth platform and a mobile application for tracking of disorders and diseases. The students reported high satisfaction with digital distance practices, and the enrichment of their learning. This digital approach to medical education has fostered greater collaboration among students, faculty and staff, teaching students the skills necessary for their future digital practices.

Influence of parental smoking on the use of alcohol and illicit drugs among adolescents.

OBJECTIVE: To evaluate the association between parental smoking and the use of alcohol and illicit drugs among adolescent children. METHODS: A cross-sectional study with 6,264 adolescents (59.7% female) aged between 14 and 19 years. To establish the sample, we used two-stage cluster random sampling. The data on parental smoking and use of cigarettes, alcohol and illicit drugs among adolescents were collected using a questionnaire. RESULTS: Smoking adolescents were more prone to use alcohol (odds ratio - OR: 10.35; 95%CI: 7.85-13.65) and illicit drugs (OR: 11.75; 95%CI: 9.04-15.26) than non-smokers (p<0.001). Adolescents with at least one parent (OR: 1.4; 95%CI: 1.13-1.89) or both parents smoking (OR: 1.6; 95%CI: 1.01-2.67) were more likely to smoke when compared to those having no parents smoking. The adjusted analysis limited to non-smoking adolescents showed a positive association (p<0.05) between parental tobacco use and the use of alcohol (OR: 1.4; 95%CI: 1.23-1.62) and illicit drugs (OR: 1.6; 95%CI: 1.24-2.13), irrespective of age, sex, maternal schooling and place of residence. CONCLUSION: Parental smoking was associated with the use of alcohol and other illicit drugs by adolescents, even among nonsmokers.

Influence of parental smoking on the use of alcohol and illicit drugs among adolescents / Influência do tabagismo parental no consumo de álcool e drogas ilícitas entre adolescentes

ABSTRACT Objective: To evaluate the association between parental smoking and the use of alcohol and illicit drugs among adolescent children. Methods: A cross-sectional study with 6,264 adolescents (59.7% female) aged between 14 and 19 years. To establish the sample, we used two-stage cluster random sampling. The data on parental smoking and use of cigarettes, alcohol and illicit drugs among adolescents were collected using a questionnaire. Results: Smoking adolescents were more prone to use alcohol (odds ratio − OR: 10.35; 95%CI: 7.85-13.65) and illicit drugs (OR: 11.75; 95%CI: 9.04-15.26) than non-smokers (p<0.001). Adolescents with at least one parent (OR: 1.4; 95%CI: 1.13-1.89) or both parents smoking (OR: 1.6; 95%CI: 1.01-2.67) were more likely to smoke when compared to those having no parents smoking. The adjusted analysis limited to non-smoking adolescents showed a positive association (p<0.05) between parental tobacco use and the use of alcohol (OR: 1.4; 95%CI: 1.23-1.62) and illicit drugs (OR: 1.6; 95%CI: 1.24-2.13), irrespective of age, sex, maternal schooling and place of residence. Conclusion: Parental smoking was associated with the use of alcohol and other illicit drugs by adolescents, even among nonsmokers.

RESUMO Objetivo: Analisar a associação entre tabagismo parental e uso de álcool e drogas ilícitas dos filhos adolescentes. Métodos: Estudo transversal conduzido com 6.264 adolescentes (59,7% meninas) com idade entre 14 e 19 anos. Para estabelecimento da amostra, recorreu-se à amostragem aleatória por conglomerados em dois estágios. Os dados sobre tabagismo dos pais e uso de cigarros, álcool e drogas ilícitas entre os adolescentes foram obtidos por questionário. Resultados: Os adolescentes fumantes eram mais propensos a usar álcool (odds ratio − OR: 10,35; IC95%: 7,85-13,65) e drogas ilícitas (OR: 11,75; IC95%: 9,04-15,26) do que os não fumantes (p<0,001). Os adolescentes que pelo menos um dos pais fumava (OR: 1,4; IC95%: 1,13-1,89) ou os dois fumavam (OR: 1,6; IC95%: 1,01-2,67) tiveram mais chances de fumar quando comparados aos que não tinham pais fumantes. Análise ajustada limitada a adolescentes não fumantes revelou associação positiva (p<0,05) entre o tabagismo dos pais e o consumo de álcool (OR: 1,4; IC95%: 1,23-1,62) e drogas ilícitas (OR: 1,6; IC95%: 1,24-2,13), independentemente de sexo, idade, escolaridade materna e região de moradia. Conclusão: O tabagismo dos pais esteve associado com o consumo de álcool e outras drogas ilícitas em adolescentes, até mesmo entre os não fumantes.

Manual Hippocampal Subfield Segmentation Using High-Field MRI: Impact of Different Subfields in Hippocampal Volume Loss of Temporal Lobe Epilepsy Patients.

In patients with temporal lobe epilepsy (TLE), presurgical magnetic resonance imaging (MRI) often reveals hippocampal atrophy, while neuropathological assessment indicates the different types of hippocampal sclerosis (HS). Different HS types are not discriminated in MRI so far. We aimed to define the volume of each hippocampal subfield on MRI manually and to compare automatic and manual segmentations for the discrimination of HS types. The T2-weighted images from 14 formalin-fixed age-matched control hippocampi were obtained with 4.7T MRI to evaluate the volume of each subfield at the anatomical level of the hippocampal head, body, and tail. Formalin-fixed coronal sections at the level of the body of 14 control cases, as well as tissue samples from 24 TLE patients, were imaged with a similar high-resolution sequence at 3T. Presurgical three-dimensional (3D) T1-weighted images from TLE went through a FreeSurfer 6.0 hippocampal subfield automatic assessment. The manual delineation with the 4.7T MRI was identified using Luxol Fast Blue stained 10-µm-thin microscopy slides, collected at every millimeter. An additional section at the level of the body from controls and TLE cases was submitted to NeuN immunohistochemistry for neuronal density estimation. All TLE cases were classified according to the International League Against Epilepsy's (ILAE's) HS classification. Manual volumetry in controls revealed that the dentate gyrus (DG)+CA4 region, CA1, and subiculum accounted for almost 90% of the hippocampal volume. The manual 3T volumetry showed that all TLE patients with type 1 HS (TLE-HS1) had lower volumes for DG+CA4, CA2, and CA1, whereas those TLE patients with HS type 2 (TLE-HS2) had lower volumes only in CA1 (p ≤ 0.038). Neuronal cell densities always decreased in CA4, CA3, CA2, and CA1 of TLE-HS1 but only in CA1 of TLE-HS2 (p ≤ 0.003). In addition, TLE-HS2 had a higher volume (p = 0.016) and higher neuronal density (p < 0.001) than the TLE-HS1 in DG + CA4. Automatic segmentation failed to match the manual or histological findings and was unable to differentiate TLE-HS1 from TLE-HS2. Total hippocampal volume correlated with DG+CA4 and CA1 volumes and neuronal density. For the first time, we also identified subfield-specific pathology patterns in the manual evaluation of volumetric MRI scans, showing the importance of manual segmentation to assess subfield-specific pathology patterns.

EXERCISE OR PHYSICAL ACTIVITY: WHICH IS MORE STRONGLY ASSOCIATED WITH THE PERCEPTION OF SLEEP QUALITY BY ADOLESCENTS? / EXERCÍCIO FÍSICO OU ATIVIDADE FÍSICA: QUAL APRESENTA MAIOR ASSOCIAÇÃO COM A PERCEPÇÃO DA QUALIDADE DO SONO DE ADOLESCENTES?

OBJECTIVE: To analyze the association of exercises and physical activity with the perception of sleep quality by adolescents. METHODS: This is a cross-sectional epidemiological survey with statewide coverage, whose sample was composed of 6,261 adolescents (14-19 years old) who were selected by random sampling of conglomerates. The Global School-Based Student Health Survey questionnaire was used for data collection. The chi-square test and the binary logistic regression were applied for data analyses. RESULTS: In the sample, 29% of adolescents did not exercise and were not classified as physically active. Adolescents who did not exercise were more likely to present a negative perception of sleep quality (OR 1.13, 95%CI 1.04-1.28, p=0.043). No association between the level of physical activity and the perception of sleep quality was found (OR 1.01, 95%CI 0.89-1.14, p=0.868). Those who practiced exercises only had less chance of perceiving sleep quality as poor (OR 0.82, 95%CI 0.71-0.95). However, those who practiced exercise and had a physically active life had less chances of having a negative perception of their sleep (OR 0.79, 95%CI 0.68-0.93). CONCLUSIONS: Practicing physical activity alone was not enough to increase the chances of positive sleep quality perception. Only physical exercise had a positive association with sleep quality perception.

OBJETIVO: Analisar a associação do exercício físico e da atividade física com a percepção da qualidade do sono em adolescentes. MÉTODOS: Trata-se de um estudo com abordagem quantitativa que integra o levantamento epidemiológico transversal de base escolar e abrangência estadual cuja amostra foi constituída por 6.261 adolescentes (14 a 19 anos), selecionados por meio de uma estratégia de amostragem aleatória de conglomerados. Os dados foram coletados a partir do questionário Global School-based Student Health Survey. O teste do qui-quadrado e a regressão logística binária foram utilizados nas análises dos dados. RESULTADOS: Na amostra, 29% dos adolescentes não faziam exercício e não foram classificados como fisicamente ativos. Os adolescentes que não praticavam exercício físico tinham mais chances de apresentar uma percepção negativa da qualidade do sono (OR 1,13, IC95% 1,04-1,28; p=0,043). Não foi encontrada associação entre o nível de atividade física e a percepção da qualidade do sono (OR 1,01, IC95% 0,89-1,14; p=0,868). Ao serem avaliadas as práticas de forma isolada ou simultânea, constatou-se que aqueles que praticavam exercício físico apresentavam menor chance de terem uma percepção negativa da qualidade do sono (OR 0,82, IC95% 0,71-0,95) e, ao praticarem exercício e, paralelamente, terem uma vida fisicamente ativa, essas chances diminuíam ainda mais (OR 0,79, IC95% 0,68-0,93). CONCLUSÕES: Ser classificado como fisicamente ativo, por si só, não foi suficiente para uma melhor percepção da qualidade do sono, pois apenas a prática de exercício físico apresentou tal associação.

Associação entre a percepção da qualidade do sono e a assimilação do conteúdo abordado em sala de aula / Association between perception of sleep quality and assimilation of content covered in class

RESUMO Objetivo: Analisar a associação, em adolescentes, entre a percepção da qualidade do sono e a assimilaçãodo conteúdo abordado em salas de aula. Métodos: Estudo epidemiológico, transversal, com abordagem quantitativa e abrangência municipal. A amostra foi selecionada por intermédio de uma estratégia de amostragem aleatória de cluster, sendo constituída por 481 estudantes (de 14 a 19 anos), de ambos os sexos, de escolas da rede pública estadual de ensino médio da cidade de Caruaru, Pernambuco. As análises foram realizadas por meio do teste do qui-quadrado e da regressão logística binária. Resultados: 44,1% relataram dificuldade de assimilação do conteúdo abordado em sala, 77,1% dormiam menos de 8 horas e 28,9% tinham uma percepção ruim da qualidade do sono. Constatou-se que os jovens que estudavam pelo menos 1 hora por dia extraclasse tinham menos chance de ter dificuldade de assimilação do conteúdo abordado em sala de aula (OR=0,34; IC95% 0,19-0,58). Verificou-se que aqueles jovens que relataram ter uma percepção ruim da qualidade de sono tinham mais chances de ter dificuldade de assimilação do assunto abordado em sala (OR=1,73; IC95% 1,13-2,65), independentemente de sexo, idade, turno, tempo de estudo fora da sala de aula e quantidade de horas dormidas. Conclusões: A percepção da qualidade do sono, independentemente da quantidade de horas dormidas e do tempo de estudo extraclasse, foi associada com a dificuldade de assimilação do conteúdo abordado em sala de aula.

ABSTRACT Objective: To analyze the association between self-perception of sleep quality and assimilation of content covered in classes by adolescents. Methods: Epidemiological cross-sectional study conducted with 481 high-school students (14 to 19 years), both genders, enrolled in public schools in the city of Caruaru, Pernambuco, and selected by random cluster sampling strategy. Analyses were conducted using the Chi-square test and binary logistic regression. Results: 44.1% of the adolescents reported learning difficulties during classes, 77.1% slept less than eight hours per day, and 28.9% had a bad perception of their sleep quality. Young people who studied at least one extra hour per day out of school had less difficulty in assimilating class content (OR=0.34; 95%CI 0.19-0.58). We also found that participants who reported a bad perception of sleep quality were more likely to have learning difficulties at school (OR=1.73; 95%CI 1.13-2.65) regardless of gender, age, school shift, study time out of school, and sleeping hours. Conclusions: Perception of sleep quality was associated with learning difficulties at school regardless of the number of sleeping and study hours.

Exercício físico ou atividade física: qual apresenta maior associação com a percepção da qualidade do sono de adolescentes? / Exercise or physical activity: which is more strongly associated with the perception of sleep quality by adolescents?

RESUMO Objetivo: Analisar a associação do exercício físico e da atividade física com a percepção da qualidade do sono em adolescentes. Métodos: Trata-se de um estudo com abordagem quantitativa que integra o levantamento epidemiológico transversal de base escolar e abrangência estadual cuja amostra foi constituída por 6.261 adolescentes (14 a 19 anos), selecionados por meio de uma estratégia de amostragem aleatória de conglomerados. Os dados foram coletados a partir do questionário Global School-based Student Health Survey. O teste do qui-quadrado e a regressão logística binária foram utilizados nas análises dos dados. Resultados: Na amostra, 29% dos adolescentes não faziam exercício e não foram classificados como fisicamente ativos. Os adolescentes que não praticavam exercício físico tinham mais chances de apresentar uma percepção negativa da qualidade do sono (OR 1,13, IC95% 1,04-1,28; p=0,043). Não foi encontrada associação entre o nível de atividade física e a percepção da qualidade do sono (OR 1,01, IC95% 0,89-1,14; p=0,868). Ao serem avaliadas as práticas de forma isolada ou simultânea, constatou-se que aqueles que praticavam exercício físico apresentavam menor chance de terem uma percepção negativa da qualidade do sono (OR 0,82, IC95% 0,71-0,95) e, ao praticarem exercício e, paralelamente, terem uma vida fisicamente ativa, essas chances diminuíam ainda mais (OR 0,79, IC95% 0,68-0,93). Conclusões: Ser classificado como fisicamente ativo, por si só, não foi suficiente para uma melhor percepção da qualidade do sono, pois apenas a prática de exercício físico apresentou tal associação.

ABSTRACT Objective: To analyze the association of exercises and physical activity with the perception of sleep quality by adolescents. Methods: This is a cross-sectional epidemiological survey with statewide coverage, whose sample was composed of 6,261 adolescents (14-19 years old) who were selected by random sampling of conglomerates. The Global School-Based Student Health Survey questionnaire was used for data collection. The chi-square test and the binary logistic regression were applied for data analyses. Results: In the sample, 29% of adolescents did not exercise and were not classified as physically active. Adolescents who did not exercise were more likely to present a negative perception of sleep quality (OR 1.13, 95%CI 1.04-1.28, p=0.043). No association between the level of physical activity and the perception of sleep quality was found (OR 1.01, 95%CI 0.89-1.14, p=0.868). Those who practiced exercises only had less chance of perceiving sleep quality as poor (OR 0.82, 95%CI 0.71-0.95). However, those who practiced exercise and had a physically active life had less chances of having a negative perception of their sleep (OR 0.79, 95%CI 0.68-0.93). Conclusions: Practicing physical activity alone was not enough to increase the chances of positive sleep quality perception. Only physical exercise had a positive association with sleep quality perception.

Does the type of sedentary behaviors influence blood pressurein adolescents boys and girls? A cross-sectional study.

The aim of this study was to analyze the association between different sedentary behaviors and high blood pressure in adolescent boys and girls. We conducted a cross-sectional study with 6,264 Brazilian adolescents (14 to 19 years old). Demographic data, obesity indicators and blood pressure, were evaluated. Time spent in the sedentary behaviors (television viewing, playing video games, using the computer, non-screen sitting and, total time sitting) were also assessed. The girls spent more time watching television than boys, whereas boys spent more time using computers and video games (12.7% vs. 7.4%, p < 0.001) than girls. Boys who watched more than four hours of television presented higher odds to give high blood pressure after adjustments for physical activity level, body mass index, age and educational level of mother (OR = 2.27, p < 0.001). In girls, we did not find a relation between sedentary behaviors and high blood pressure (p > 0.05). Television viewing time is associated with high blood pressure only boys. So, reduce this sedentary behavior, stimulating physical activities, might be essential to health, principally for male adolescents.

Does the type of sedentary behaviors influence blood pressurein adolescents boys and girls? A cross-sectional study / Será que o tipo de comportamento sedentário influencia a pressão arterial em meninos e meninas adolescentes? Um estudo transversal

Abstract The aim of this study was to analyze the association between different sedentary behaviors and high blood pressure in adolescent boys and girls. We conducted a cross-sectional study with 6,264 Brazilian adolescents (14 to 19 years old). Demographic data, obesity indicators and blood pressure, were evaluated. Time spent in the sedentary behaviors (television viewing, playing video games, using the computer, non-screen sitting and, total time sitting) were also assessed. The girls spent more time watching television than boys, whereas boys spent more time using computers and video games (12.7% vs. 7.4%, p < 0.001) than girls. Boys who watched more than four hours of television presented higher odds to give high blood pressure after adjustments for physical activity level, body mass index, age and educational level of mother (OR = 2.27, p < 0.001). In girls, we did not find a relation between sedentary behaviors and high blood pressure (p > 0.05). Television viewing time is associated with high blood pressure only boys. So, reduce this sedentary behavior, stimulating physical activities, might be essential to health, principally for male adolescents.

Resumo O objetivo desta pesquisa foi analisar a associação entre diferentes comportamentos sedentários e pressão arterial elevada em meninos e meninas adolescentes, em estudo transversal com 6.264 adolescentes brasileiros (14 a 19 anos de idade). Foram avaliados dados demográficos, indicadores de obesidade e pressão arterial, assim como o tempo gasto em comportamentos sedentários (assistir televisão, jogar videogame, usar o computador, e o tempo total sentado). As meninas passaram mais tempo vendo televisão do que os meninos, enquanto estes usaram mais computadores e jogos de vídeogame (12,7% vs. 7,4%, p < 0,001) do que elas. Meninos que assistiram mais de quatro horas de televisão apresentaram maior probabilidade de ter pressão arterial elevada após os ajustes pelo nível de atividade física, índice de massa corporal, idade e nível de instrução da mãe (OR = 2,27, p < 0,001). Com as meninas não foi observada uma relação entre comportamentos sedentários e pressão arterial elevada (p > 0,05). O tempo assistindo televisão esteve associado com a pressão arterial elevada apenas entre os meninos. Assim, reduzir o comportamento sedentário, estimulando atividades físicas, pode ser essencial para a saúde, principalmente para adolescentes do sexo masculino.

ASSOCIATION BETWEEN PERCEPTION OF SLEEP QUALITY AND ASSIMILATION OF CONTENT COVERED IN CLASS. / ASSOCIAÇÃO ENTRE A PERCEPÇÃO DA QUALIDADE DO SONO E A ASSIMILAÇÃO DO CONTEÚDO ABORDADO EM SALA DE AULA.

OBJECTIVE: To analyze the association between self-perception of sleep quality and assimilation of content covered in classes by adolescents. METHODS: Epidemiological cross-sectional study conducted with 481 high-school students (14 to 19 years), both genders, enrolled in public schools in the city of Caruaru, Pernambuco, and selected by random cluster sampling strategy. Analyses were conducted using the Chi-square test and binary logistic regression. RESULTS: 44.1% of the adolescents reported learning difficulties during classes, 77.1% slept less than eight hours per day, and 28.9% had a bad perception of their sleep quality. Young people who studied at least one extra hour per day out of school had less difficulty in assimilating class content (OR=0.34; 95%CI 0.19-0.58). We also found that participants who reported a bad perception of sleep quality were more likely to have learning difficulties at school (OR=1.73; 95%CI 1.13-2.65) regardless of gender, age, school shift, study time out of school, and sleeping hours. CONCLUSIONS: Perception of sleep quality was associated with learning difficulties at school regardless of the number of sleeping and study hours.

OBJETIVO: Analisar a associação, em adolescentes, entre a percepção da qualidade do sono e a assimilaçãodo conteúdo abordado em salas de aula. MÉTODOS: Estudo epidemiológico, transversal, com abordagem quantitativa e abrangência municipal. A amostra foi selecionada por intermédio de uma estratégia de amostragem aleatória de cluster, sendo constituída por 481 estudantes (de 14 a 19 anos), de ambos os sexos, de escolas da rede pública estadual de ensino médio da cidade de Caruaru, Pernambuco. As análises foram realizadas por meio do teste do qui-quadrado e da regressão logística binária. RESULTADOS: 44,1% relataram dificuldade de assimilação do conteúdo abordado em sala, 77,1% dormiam menos de 8 horas e 28,9% tinham uma percepção ruim da qualidade do sono. Constatou-se que os jovens que estudavam pelo menos 1 hora por dia extraclasse tinham menos chance de ter dificuldade de assimilação do conteúdo abordado em sala de aula (OR=0,34; IC95% 0,19-0,58). Verificou-se que aqueles jovens que relataram ter uma percepção ruim da qualidade de sono tinham mais chances de ter dificuldade de assimilação do assunto abordado em sala (OR=1,73; IC95% 1,13-2,65), independentemente de sexo, idade, turno, tempo de estudo fora da sala de aula e quantidade de horas dormidas. CONCLUSÕES: A percepção da qualidade do sono, independentemente da quantidade de horas dormidas e do tempo de estudo extraclasse, foi associada com a dificuldade de assimilação do conteúdo abordado em sala de aula.

Factors related to the association of social anxiety disorder and alcohol use among adolescents: a systematic review / Fatores relacionados à associação de transtorno de ansiedade social e uso de álcool entre adolescentes: uma revisão sistemática

Abstract Objective: To identify the risk factors related to the association between social anxiety disorder and alcohol use in adolescents. Source of data: The PICO research strategy was used to perform a systematic review in Medline, LILACS, Pubmed, IBECS and Cochrane Library databases. DeCS/MeSH: Phobic Disorders, Adolescent, Behavior, Ethanol, Risk Factors, and the Boolean operator "AND" were used. Inclusion criteria were: cross-sectional, prospective/retrospective cohort, and case-control studies, carried out in adolescents (10-19 years), original articles on social anxiety disorder and alcohol use published between 2010 and 2015. Studies that did not report the terms "anxiety disorder" and "alcohol use" in the title and abstract were excluded. Synthesis of data: 409 articles were retrieved; after the exclusion of 277 repeated articles, the following were eligible: 94 in MEDLINE, 68 in Pubmed, 12 in IBCS, and three in LILACS. Titles and abstracts were independently read by two examiners, which resulted in the selection of eight articles for the analysis. Risk factors associated to the two disorders were female gender, age, peer approval and affective problems for alcohol use, confrontation situations and/or compliance reasons, frequency of alcohol use, and secondary comorbidities, such as depression and generalized anxiety. Conclusions: It is necessary to assess the period of social anxiety disorders first symptom onset, as well as the risks for alcohol use in order to establish corrective intervention guidelines, especially for socially anxious students.

Abstract Objective: To identify the risk factors related to the association between social anxiety disorder and alcohol use in adolescents. Source of data: The PICO research strategy was used to perform a systematic review in Medline, LILACS, Pubmed, IBECS and Cochrane Library databases. DeCS/MeSH: Phobic Disorders, Adolescent, Behavior, Ethanol, Risk Factors, and the Boolean operator "AND" were used. Inclusion criteria were: cross-sectional, prospective/retrospective cohort, and case-control studies, carried out in adolescents (10 to 19 years), original articles on social anxiety disorder and alcohol use published between 2010 and 2015. Studies that did not report the terms "anxiety disorder" and "alcohol use" in the title and abstract were excluded. Synthesis of data: 409 articles were retrieved; after the exclusion of 277 repeated articles, the following were eligible: 94 in MEDLINE, 68 in Pubmed, 12 in IBCS, and three in LILACS. Titles and abstracts were independently read by two examiners, which resulted in the selection of eight articles for the analysis. Risk factors associated to the two disorders were female gender, age, peer approval and affective problems for alcohol use, confrontation situations and/or compliance reasons, frequency of alcohol use, and secondary comorbidities, such as depression and generalized anxiety. Conclusions: It is necessary to assess the period of social anxiety disorders first symptom onset, as well as the risks for alcohol use in order to establish corrective intervention guidelines, especially for socially anxious students.