Acute Cardiopulmonary Response of High-Intensity Interval Training with Elastic Resistance vs. High-Intensity Interval Training on a Treadmill in Healthy Adults.

This study aims to describe and compare cardiopulmonary and subjective responses during high-intensity interval training with elastic resistance (EL-HIIT) and traditional high-intensity interval training (HIIT) sessions. Twenty-two healthy adults (27.6 ± 4.4 years) performed an EL-HIIT and a HIIT protocol consisting of 10 × 1 min at ~85% V·O2max prescribed by cardiopulmonary-specific tests. Pulmonary parameters, heart rate (HR), blood lactate, and rate of perceived exertion (RPE) were measured during exercise. Paired t-test and Cohen's d effect size were used to compare peak and average values. Two-way repeated measures ANOVA and mixed model with Bonferroni's post hoc test were used to compare each bout during the session. The EL-HIIT session showed higher peak and average values of HR, ventilation (V·E), relative and absolute oxygen uptake (V·O2), carbon dioxide production (V·CO2), and RPE than HIIT (p < 0.05). The effect size (ES) comparing HIIT and EL-HIIT was large for HR, V·E, and lactate (≥0.8) in peak values. Comparing each bout between HIIT and EL-HIIT, no difference was found in peak values (p > 0.05) during the session (excluding baseline, warm-up, and recovery). EL-HIIT presented a more pronounced cardiopulmonary and subjective response than HIIT.

Efficacy of a single-session online ACT-based mindfulness intervention among undergraduates in lockdown during the COVID-19 pandemic.

INTRODUCTION: COVID-19 has trickle-down psychological effects on multiple strata of society, particularly university students. Apart from the worry of contracting or spreading COVID-19, Malaysian university students were also locked down on their campuses, suffering significant psychological distress. Hence, an online mindfulness intervention was proposed to alleviate psychological distress and improve psychological flexibility and mindfulness. METHODS: This was a quasi-experimental study with university students as participants. Intervention group participants were instructed to complete online questionnaires which covered basic demographics and instruments assessing depression, anxiety, stress, mindfulness, psychological flexibility, and fear of COVID-19 before and after the one-hour intervention. The control group also completed before and after questionnaires and were subsequently crossed over to the intervention group. Repeated measures ANOVA was conducted to assess time*group effects. RESULTS: 118 participants were involved in this study. There were significant differences in anxiety (F(1,116) = 34.361, p < 0.001, partial eta-squared = 0.229) and psychological flexibility between the two groups (F(1,116) = 11.010, p = 0.001, partial eta-squared = 0.087), while there were no differences in depression, stress, mindfulness, or fear of COVID-19. CONCLUSION: The results of this study corroborate the efficacy of online single-session mindfulness therapy as a viable short-term psychological intervention under financial and time constraints. Since university students are in the age group with the highest incidence of depressive and anxiety disorders, it is crucial to utilize resources to address as many students as possible to ensure maximum benefit.

Factor structure and psychometric properties of a multicultural Spanish-language version of the Eating Disorder-15 in a nonclinical sample of Chilean women.

OBJECTIVE: The Eating Disorder-15 (ED-15) is a brief measure developed for the routine assessment of eating disorder (EDs), despite its use in research settings having increased over the last few years. To assess the psychometric properties of the ED-15 in a nonclinical sample of Chilean women. METHOD: A multicultural Spanish-language version was developed through combined translation techniques. University female students (N = 380) (Mage 22.32, SD = 2.48) were recruited through social media. After providing their informed consent, participants completed a battery of questionnaires online. RESULTS: A bi-factor model replicating the bi-factor structure and providing support for the general factor showed the best fit to the data. Moderate-to-strong correlations with measures of EDs, physical comparison, body appreciation, social physique anxiety, and depressive symptoms are presented as evidence of concurrent and convergent validity. Items analyses revealed strong correlations between manifest variables, their correspondent latent variable and the general factor (rs  = .60 to .89, ps < .001). Additionally, current findings provide support for the internal consistency of the scale (Cronbach's alpha and Omega values were ≥ .80) and test-retest reliability (ICCs = .84 to .89, ps < .001). DISCUSSION: Like previous findings, the current study provides validity to the original bi-factor structure of the ED-15 and additional validity to a general factor. The availability of this multicultural Spanish-language version would provide session-by-session assessment, providing crucial information throughout treatment. Also, the availability of the current measure would contribute to further research efforts in a yet understudied population such as Hispanic women. PUBLIC SIGNIFICANCE: The Eating Disorder-15 (ED-15) is a promising measure meant to assess session-by-session change for clinical and research purposes. The availability of a Multicultural Spanish language version of the ED-15 allows for routine clinical assessment and represents a contribution for research efforts in a yet understudied populations such as Hispanic women.

OBJETIVO: El Eating Disorder-15 (ED-15) es una breve medida de trastornos alimentarios (TCA) diseñada para realizar una evaluación rutinaria, a pesar de que su uso en la investigación ha crecido en los últimos años. Evaluar las propiedades psicométricas del ED-15 en una muestra no clínica de mujeres chilenas. MÉTODO: Se desarrolló una versión multicultural al español mediante técnicas de traducción combinadas. Las estudiantes universitarias (N = 380) (Medad 22.32, DT = 2.48) fueron reclutadas en redes sociales. Después de dar su consentimiento, las participantes completaron cuestionarios en línea. RESULTADOS: un modelo bifactorial que replica la estructura de dos factores y proporciona soporte para un factor general mostró el mejor ajuste. Correlaciones moderadas a fuertes con medidas de TCA, comparación física, apreciación corporal, ansiedad social física y síntomas depresivos se presentan como evidencia de validez concurrente y convergente. Análisis de ítems revelaron fuertes correlaciones entre las variables manifiestas, su correspondiente variable latente y el factor general (rs  = .60 a .89, ps < .001). Los hallazgos actuales respaldan la consistencia interna (alfa Cronbach y Omega > .80) y la confiabilidad test-retest (ICC = .84 a .89, ps < .001). DISCUSIÓN: El estudio actual proporciona validez a la estructura original de 2 factores del ED-15 y validez adicional a un factor general. La disponibilidad de esta versión multicultural en español permitirá una evaluación sesión por sesión, brindando información clínica crucial al tratamiento. Su disponibilidad permitirá el desarrollo de investigaciones en una población aún poco estudiada como la de mujeres latinas.

Monitoring of the Training Load and Well-Being of Elite Rhythmic Gymnastics Athletes in 25 Weeks: A Comparison between Starters and Reserves.

The objective of this study was to monitor the training loads (TL) and well-being of elite rhythmic gymnastics (RG) athletes, as well as compare these variables between starters and reserve gymnasts during 25 weeks of training. Ten athletes from the Brazilian national RG team (17.4 ± 1.1 y of age) were monitored during the general preparatory period (GPP), specific preparatory period (SPP), and pre-competitive period (PCP). The internal TL was quantified with the use of sessional ratings of perceived exertion (sRPE). We assessed well-being daily with a well-being scale. The TL, duration, monotony, and strain were calculated weekly. We found that the internal TL and session durations were 9242 ± 2511 AU and 2014 ± 450 min, respectively. The internal TL, strain, and monotony were greater in the PCP than in the GPP and SPP for starters. In the SPP, there were statistical differences in internal TL (p = 0.036) and strain (p = 0.027) between starters and reserves. In the PCP, there were also statistical differences between starters vs. reserves athletes regarding internal TL (p = 0.027) and strain (p = 0.05). There was no statistically significant difference in well-being between the periods assessed. In conclusion, RG athletes display a higher TL magnitude during the PCP, whereas only reporting non-significant minor variations in well-being. In addition, there is a discrepancy in the TL between starters and reserves.

Implementing joint training sessions of general practitioners and specialists aimed at improving clinical coordination in Colombia: Contributions from participatory action research.

OBJECTIVE: To analyse the contribution of participatory action research (PAR) in designing and implementing joint training sessions as a means to improve clinical coordination in a public health care network in Bogotá, Colombia. METHODS: A qualitative, descriptive-interpretative study using semi-structured individual interviews and focus groups with 40 professionals (GPs, specialists, members of the local steering committee (LSC) and network middle managers) involved in designing and implementing joint training sessions to improve cross-level clinical coordination. The intervention consisted of two forms of joint training sessions for GPs and specialists, implemented through two PAR cycles. RESULTS: The PAR approach in designing and implementing joint training sessions led to greater awareness of clinical coordination problems and helped adapting sessions to the local health care context. Study participants highlighted the role of LSC leadership during the PAR process and the importance of ensuring the necessary resources for adopting the intervention. Limited institutional support and differences between joint training sessions affected doctors' participation and reduced the time available to conduct the sessions. The use of a reflexive method was essential in enhancing doctors' participation, along with session duration, the facilitator's role and session content. CONCLUSIONS: The study provides evidence regarding the contribution of a PAR process to designing and implementing joint training sessions for improving clinical coordination. The findings can inform similar approaches in other health systems.

Internal Training Load Perceived by Athletes and Planned by Coaches: A Systematic Review and Meta-Analysis.

BACKGROUND: Rating of perceived exertion (RPE) and session RPE (sRPE) has been widely used to verify the internal load in athletes. Understanding the agreement between the training load prescribed by coaches and that perceived by athletes is a topic of great interest in sport science. OBJECTIVE: This systematic review and meta-analysis aimed to investigate differences between the training/competition load perceived by athletes and prescribed/intended/observed by coaches. METHODS: A literature search (September 2020 and updated in November 2021) was conducted using PubMed, Web of Science, Embase, and SPORTDiscus databases. The protocol was registered in the Open Science Framework (osf.io/wna4x). Studies should include athletes and coaches of any sex, age, or level of experience. The studies should present outcomes related to the RPE or sRPE for any scale considering overall training/competition sessions (physical, strength, tactical, technical, games) and/or classified into three effort categories: easy, moderate, and hard. RESULTS: Twenty-seven studies were included in the meta-analysis. No difference was found between coaches and athletes for overall RPE (SMD = 0.19, P = 0.10) and overall sRPE (SMD = 0.05, P = 0.75). There was a difference for easy RPE (SMD = - 0.44, small effect size, P = 0.04) and easy sRPE (SMD = - 0.54, moderate effect size, P = 0.04). No differences were found for moderate RPE (SMD = 0.05, P = 0.74) and hard RPE (SMD = 0.41, P = 0.18). No difference was found for moderate (SMD = -0.15, P = 0.56) and hard (SMD = 0.20, P = 0.43) sRPE. CONCLUSION: There is an agreement between coaches and athletes about overall RPE and sRPE, and RPE and sRPE into two effort categories (moderate and hard). However, there were disagreements in RPE and sRPE for easy effort category. Thus, despite a small disagreement, the use of these tools seems to be adequate for training monitoring.

Efficacy of a single-session online ACT-based mindfulness intervention among undergraduates in lockdown during the COVID-19 pandemic

Abstract Introduction COVID-19 has trickle-down psychological effects on multiple strata of society, particularly university students. Apart from the worry of contracting or spreading COVID-19, Malaysian university students were also locked down on their campuses, suffering significant psychological distress. Hence, an online mindfulness intervention was proposed to alleviate psychological distress and improve psychological flexibility and mindfulness. Methods This was a quasi-experimental study with university students as participants. Intervention group participants were instructed to complete online questionnaires which covered basic demographics and instruments assessing depression, anxiety, stress, mindfulness, psychological flexibility, and fear of COVID-19 before and after the one-hour intervention. The control group also completed before and after questionnaires and were subsequently crossed over to the intervention group. Repeated measures ANOVA was conducted to assess time*group effects. Results 118 participants were involved in this study. There were significant differences in anxiety (F(1,116) = 34.361, p < 0.001, partial eta-squared = 0.229) and psychological flexibility between the two groups (F(1,116) = 11.010, p = 0.001, partial eta-squared = 0.087), while there were no differences in depression, stress, mindfulness, or fear of COVID-19. Conclusion The results of this study corroborate the efficacy of online single-session mindfulness therapy as a viable short-term psychological intervention under financial and time constraints. Since university students are in the age group with the highest incidence of depressive and anxiety disorders, it is crucial to utilize resources to address as many students as possible to ensure maximum benefit.

Manejo da sessão na terapia psicanalítica de casal / Session's handling on couple's psychoanalytic psychotherapy / Manejo de sessiones en psicoterapia psicoanalítica de pareja

Um exemplo de terapia de casal ilustra as incontáveis possibilidades de manejos clínicos, fundamentadas em opções teórico-clínicas do analista. A partir da distinção entre método, técnica e enquadre, justificam-se manejos diferentes dentro da sessão, sempre respeitando-se o vértice psicanalítico. A utilização do WhatsApp, sugerir um tema, perguntar, explicar uma situação ao casal, são aspectos discutidos, levando-se em conta a psicanálise e seus limites. A história do casal, a biografia de cada um, os tipos de personalidade baseados nas angústias de castração, de fragmentação e de separação, são os elementos norteadores da terapia breve psicanalítica preconizada pelo Napc - Núcleo de atendimento epesquisa da conjugalidade e da família, da Clínica do Instituto Sedes Sapientiae.

An example of couple therapy illustrates unchallenging possibilities of clinical handling, based on the analyst's clinical-theoretical options. Departing from the distinction between method, technique and frame, different handlings are justified in a session, always regarding the psychoanalytic vertex. The use of WhatsApp, suggesting a topic, asking, explaining the couple a situation, are discussed aspects, considering psychoanalysis and its boundaries. The couple's story, the biography of each one, the personality types based on anxieties of castration, fragmentation and separation are guiding elements for brief psychoanalytic therapy as advocated by NAPC- Núcleo de atendimento e pesquisa de conjugalidade e da família - from Instituto Sedes Sapieantiae's clinic.

Un ejemplo de terapia de pareja ilustra las incontestables posibilidades de manejos clínicos, fundamentadas en opciones teórico-clínicas del analista. A partir de la distinción entre método, técnica y encuadre, se justifican manejos diferentes dentro de la sesión, siempre se respetando el vértice psicoanalítico. La utilización del WhatsApp, sugerir un tema, preguntar, explicar una situación a la pareja, son aspectos discutidos, teniéndose en cuenta el psicoanálisis y sus límites. La historia de la pareja, la biografía de cada uno, los tipos de personalidades basados en las angustias de castración, de fragmentación y de separación, son elementos que rigen la terapia breve psicoanalítica preconizada por el NAPC - Núcleo de atendimiento e pesquisa da conjugalidade e da familia, de la clínica del Instituto Sedes Sapientiae.

Predictors of gaming disorder in children and adolescents: a school-based study

Objective: To determine whether psychiatric and gaming pattern variables are associated with gaming disorder in a school-based sample. Methods: We analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders, a community sample aged 10 to 18, using questionnaires on gaming use patterns. We applied the Gaming Addiction Scale to diagnose gaming disorder and the Development and Well-Being Behavior Assessment for other diagnoses. Results: Out of 407 subjects, 83 (20.4%) fulfilled the criteria for gaming disorder. More role-playing game players were diagnosed with gaming disorder that any other genre. Gaming disorder rates increased proportionally to the number of genres played. Playing online, being diagnosed with a mental disorder, and more hours of non-stop gaming were associated with higher rates of gaming disorder. When all variables (including age and gender) were considered in a logistic regression model, the number of genres played, the number of non-stop hours, the proportion of online games, and having a diagnosed mental disorder emerged as significant predictors of gaming disorder. Conclusion: Each variable seems to add further risk of gaming disorder among children and adolescents. Monitoring the length of gaming sessions, the number and type of genres played, time spent gaming online, and behavior changes may help parents or guardians identify unhealthy patterns of gaming behavior.

Exercise Duration Affects Session Ratings of Perceived Exertion as a Function of Exercise Intensity.

Session ratings of perceived exertion (sRPE) are considered a practical marker of whole session exercise intensity, but its relationship to exercise volume has remained unclear. We analyzed the effects of exercise duration at different intensities on overall and differentiated sRPE. Sixteen males (Mage = 22.6, SD = 2.2 years; Mheight = 176.4, SD = 5.8 cm; Mweight = 74.0, SD = 5.9 kg; and Mbody fat = 9.4, SD = 2.2%) performed 15 and 30 minute runs at speeds associated with RPE levels of two (weak), three (moderate) and five (strong) on Borg's CR-10 scale during a previous graded exercise test. We used Foster's scale to access sRPE 30 minutes after each trial. Significant increases in sRPE were found with increases in running speed (p < 0.01, ηG2 = 0.48) and duration (p < 0.01, ηG2 = 0.16), with a significant speed X duration interaction (p < 0.01, ηG2 = 0.10). In addition, there was a significant effect for sRPE type (p = 0.01, ηG2 = 0.05) in that overall sRPE was slightly lower than sRPE differentiated to legs and higher than sRPE differentiated to breathing through the trials. Changes in sRPE from 15 to 30-minute trials were minimal for the slow speed and weak sRPE (Cohen´s dz = 0.04 - 0.25) but got higher at the moderate (Cohen´s dz = 0.88 - 1.06) and strong (Cohen´s dz = 1.94 - 2.50) speeds and sRPEs. Thus, exercise duration affects sRPE in an intensity dependent manner. This finding has practical relevance for prescribing exercise, suggesting a need to target specific training loads or aims to optimize trainees' retrospective perceptions of the exercise experience.

Determinant Factors of the Match-Based Internal Load in Elite Soccer Players.

Purpose: To analyze the contribution of physical measures and external load in the match-based internal load of elite soccer players. Methods: Twenty-three elite soccer players (n = 23, age 26.69 ± 3.93 years, body mass 78.04 ± 5.03 kg, height 178.04 ± 5.19 cm, body fat 10.98 ± 1.25%) from a first division soccer team of the Brazilian Championship were evaluated first with anthropometric and physical measures (flexibility and muscle power of lower limbs), and after 24 hrs they were asked to perform an incremental treadmill test (VO2max and ventilatory thresholds). Subsequently, athletes were monitored for 6 weeks during nine official matches of a regional championship. On match days, the external load data (e.g., player load) were collected by triaxial accelerometers with GPS systems and post 30 min after the end of the match the internal load was assessed with the Session Rating of Perceived Exertion method (Session-RPE). Results: Our main findings showed significant contributions of the Player Load (r = .62, p < .001; 42.3%) and Anaerobic Threshold (r = - .199, p = .05, 17%) for the predictive model of Session-RPE. Conclusions: Physical measures and external load have a significant influence on the internal load in elite soccer players. Our findings suggest that sport scientists can use the Session-RPE as a low-cost method for prescribing and monitoring training loads, by the influence of physical measures and external load on the match-based internal load, in order to optimize athletes' performance.

Movie watching during dialysis sessions reduces depression and anxiety and improves quality of life: A randomized clinical trial.

OBJECTIVE: Evaluate the effect of watching comedy movies as a complementary practice during dialysis on levels of anxiety, depression, quality of life, stress, laboratory findings and intra-dialysis complications. METHODS: A randomized clinical trial was conducted involving the practice of presenting comedy movies during dialysis. The primary outcome was depression. The secondary outcomes were anxiety, quality of life, stress, laboratory findings and intra-dialysis complications.ResultsTwenty-six patients were in the control group and 35 were in the experimental group. Significant intra-group differences [6.0 to 3.0 (p <0.001) and 8.0 to 4.0 (p <0.001), respectively] and inter-group differences [5.0 vs. 3.0 (p = 0.016) and 7.0 vs. 4.0 (p = 0.017), respectively] were found regarding anxiety and depression scores, with improvements in the experimental group. The experimental group was also less likely to have intra-dialysis complications, such as hypertension (p = 0.003) and headache (p = 0.020), and reported significant improvements in different domains of quality of life [symptoms/problems (p = 0.003); effects of the disease (p = 0.008); pain (p = 0.027); general health state (p = 0.004); and social function (p = 0.036)]. No significant differences were found in salivary cortisol or the results of the biochemical exams, with the exception of a reduction in hematocrit in the control group.ConclusionsThe proposed complementary practice was associated with reductions in anxiety and depression scores and intra-dialysis complications (hypertension and headache) as well as improvements in quality of life in patients with chronic kidney disease.

Training Load and Recovery During a Pre-Olympic Season in Professional Rhythmic Gymnasts.

CONTEXT: Rhythmic gymnastics requires a high level of complexity and perfection of technical gestures, associated with well-developed physical and artistic capacities. The training-load and recovery profiles of rhythmic gymnasts across a season are unknown. OBJECTIVE: To analyze the training load and recovery of professional rhythmic gymnasts during 1 season. DESIGN: Cohort study. SETTING: Brazilian National Training Center of Rhythmic Gymnastics and competition facilities. PATIENTS OR OTHER PARTICIPANTS: Eight gymnasts from the Brazilian national senior rhythmic gymnastics group. MAIN OUTCOME MEASURE(S): Session rating of perceived exertion (session-RPE) and total quality recovery (TQR) scores were collected daily for 43 weeks. We obtained the session-RPE after each session and TQR score before the first session of the day. Performances during 5 competitions were also recorded. The season was divided into 8 periods. Total weekly internal training load (wITL), training intensity, frequency, duration, recovery, and acute : chronic workload ratio were calculated for analysis. RESULTS: The season mean wITL was 10 381 ± 4894 arbitrary units, mean session-RPE score was 5.0 ± 1.6, and mean TQR score was 12.8 ± 1.3. The gymnasts trained an average of 8.7 ± 2.9 sessions per week, with a mean duration of 219 ± 36 minutes. Each competitive period showed increased wITL compared with the previous period. Training-load variables (wITL and session-RPE) and recovery were inversely correlated. Gymnasts were poorly recovered (TQR < 13) during 50.9% of the season (n = 167 times), especially during competitive weeks. Spikes in load (acute : chronic workload ratio ≥ 1.5) occurred across 18.1% of the season (n = 55 times). CONCLUSIONS: The training-load variables and recovery changed throughout a professional rhythmic gymnastics group season, mainly during competitive periods. The correct distribution of training load is critical to ensure that gymnasts are entering competitions in a recovered state.

Comparação da carga de treinamento de atletas profissionais entre modos de treinos especificos do voleibol e de força / Comparison of the training load of professional athletes between modes of volleyball specific drills and strength conditioning

RESUMO O objetivo deste estudo foi comparar a carga de treinamento em três tipos de treinamentos de uma equipe de voleibol profissional.. Participaram do estudo 28 jogadores (26,6 ± 4,7 anos; 91,5 ± 8,5 Kg; 194,1 ± 6,0 cm). Foi realizada uma análise descritiva de 29 sessões de treino técnico, 84 tecnico-tático e 75 de musculação e isoladamente das variáveis que compõem a carga de treinamento, PSE e o tempo de duração da sessão, posteriormente sendo reunidos em média e desvio padrão de acordo com tipo de treino. Para análise dos dados foi adotado o teste de Shapiro-Wilk e em seguida aplicou-se o teste Anova Two-Way com o Post Hoc de Tamhane e também foi utilizado o tamanho do efeito para análise das comparações. Os resultados demonstraram respostas significativas e grande tamanho de efeitos quando comparados técnico e técnico-tático com a musculação na carga interna de treinamento TxM (TE=1,2: grande; p= 0,002); TTxM (TE=1,3: grande; p= 0,001) e no tempo de duração da sessão TxM (TE=1,7: grande; p= 0,001); TTxM (TE=2,0: grande; p= 0,001), já a PSE da sessão apresentou apenas uma diferença sigifcativa TTxM (TE= 0,8: moderado; p= 0,001). Os estímulos de treinamentos específicos de quadra como técnico e técnico-tático promoveram maior carga interna nos atletas do que o treino de força, através principalmente pela influencia da variável tempo de duração da sessão que refletiu a carga externa.

ABSTRACT The aim of this study was to compare the training load in three types of training of a professional volleyball team. Participants were 28 players (26.6 ± 4.7 years, 91.5 ± 8.5 kg; 194.1 ± 6.0 cm). A descriptive analysis of 29 technical training sessions, 84 technical-tactical training sessions and 75 training sessions, and of the variables that compose the training load, PSE and the duration of the session were performed, and were then collected on average and standard deviation according to with type of training. To analyze the data, the Shapiro-Wilk test was adopted, and then the Anova Two-Way test was applied with Tamhane's Post Hoc and the effect size was also used for analysis of the comparisons. The results demonstrated significant responses and a large effect size when compared to technical and tactical-to- strength training (T = 1.2: large; p = 0.002); TTxM (TE = 1.3: large, p = 0.001) and the duration of the session / external load in the TxM training (TE = 1.7: large; p = 0.001); TTxM (TE = 2.0: large, p = 0.001), whereas the PSE of the session showed only a sigifcant difference TTxM (TE = 0.8: moderate; p = 0.001). The stimuli of specific training of court as technician and technician-tactician promoted greater internal load in the athletes than the strength training, mainly through the influence of the variable time of the session that reflected to external load.

Single- versus multiple-stage catheter-directed thrombolysis for acute iliofemoral deep venous thrombosis does not have an impact on iliac vein stent length or patency rates.

BACKGROUND: Incomplete venous thrombolysis and residual nonstented iliac vein disease are known predictors of recurrent deep venous thrombosis (DVT). Controversy exists as to whether the number of thrombolysis sessions affects total stent treatment length or stent patency. The goal of this study was to evaluate the outcomes of patients who underwent single vs multiple catheter-directed lysis sessions with regard to stent extent and patency. METHODS: Consecutive patients who underwent thrombolysis and stenting for acute iliofemoral DVT between 2007 and 2018 were identified and divided into two groups on the basis of the number of treatments performed (one vs multiple sessions). Operative notes and venograms were reviewed to determine the number of lytic sessions performed and stent information, including size, location, total number, and length treated. End points included total stent length, 30-day and long-term patency, and post-thrombotic syndrome (Villalta score ≥5). The χ2 comparisons, logistic regression, and survival analysis were used to determine outcomes. RESULTS: There were 79 patients who underwent lysis and stenting (6 bilateral interventions; mean age, 45.9 ± 17 years; 48 female). Ten patients (12 limbs) underwent single-stage treatment with pharmacomechanical thrombolysis, and the remaining 69 (73 limbs) had two to four operating room sessions combining pharmacomechanical and catheter-directed thrombolysis. Patients who underwent a single-stage procedure were older and more likely to have a malignant disease. These patients received less tissue plasminogen activator compared with the multiple-stage group (17.2 ± 2.2 mg vs 27.6 ± 11.6 mg; P = .008). Average stent length was 8.8 ± 5.2 cm for the single-stage group vs 9.2 ± 4.6 cm for the multiple-stage group (P = .764). Patients who underwent a single-stage procedure had no difference in average length of stay from that of patients who underwent multiple sessions (8.5 days vs 5.9 days; P = .269). The overall 30-day rethrombosis rate was 7.3%. Two-year patency was 72.2% and 74.7% for the single and multiple stages, respectively (P = .909). The major predictors for loss of primary patency were previous DVT (hazard ratio [HR], 5.99; P = .020) and incomplete lysis (HR, 5.39; P = .014) but not number of procedures (HR, 0.957; P = .966). The overall post-thrombotic syndrome rate was 28.4% at 5 years and was also not associated with the number of treatment sessions. CONCLUSIONS: Single- vs multiple-stage thrombolysis for DVT is not associated with a difference in extent of stent coverage. Patency rates remain high for iliac stenting irrespective of the number of lytic sessions, provided lysis is complete and the diseased segments are appropriately stented.

An Enhanced Lightweight IoT-based Authentication Scheme in Cloud Computing Circumstances.

With the rapid deployment of the Internet of Things and cloud computing, it is necessary to enhance authentication protocols to reduce attacks and security vulnerabilities which affect the correct performance of applications. In 2019 a new lightweight IoT-based authentication scheme in cloud computing circumstances was proposed. According to the authors, their protocol is secure and resists very well-known attacks. However, when we evaluated the protocol we found some security vulnerabilities and drawbacks, making the scheme insecure. Therefore, we propose a new version considering login, mutual authentication and key agreement phases to enhance the security. Moreover, we include a sub-phase called evidence of connection attempt which provides proof about the participation of the user and the server. The new scheme achieves the security requirements and resists very well-known attacks, improving previous works. In addition, the performance evaluation demonstrates that the new scheme requires less communication-cost than previous authentication protocols during the registration and login phases.

A verdade psíquica e o trabalho do analista em sessão / Psychic truth and the in-session analyst's work / La verdad psíquica y el trabajo del analista en sesión

O trabalho aborda um dos tópicos mais atingidos pela cultura pós-moderna, a crise da racionalidade e da verdade, tentando reformular o seu lugar no seio da clínica psicanalítica e, mais especificamente, no trabalho do analista durante a sessão. Neste sentido, o autor entende como necessária a expressão verdade psíquica, diferenciando-a dos conceitos de verdade histórica de Freud e de verdade narrativa de Spence, pois o conceito de verdade psíquica especifica o âmbito próprio da psicanálise, qual seja, o reconhecimento da realidade psíquica do indivíduo. É justamente a delimitação deste âmbito que permite à psicamálise conceitualizar os aspectos da vida psicoafetiva da mente inconsciente do ser humano com critérios de significação e esquemas referenciais próprios. O autor examina o pensamento de Freud sobre o tema, especialmente em Construções em análise, intercalando-o com as contribuições feitas por Ferenczi em A elasticidade da técnica psicanalítica e O problema do fim da análise, obras que abordam a questão da humildade e da paciência no saber do analista, abrindo as portas para os estudos de autores posteriores como Balint, Winnicott e o próprio Bion

This paper addresses one of the issues most affected by postmodern culture, i.e. the crisis of rationality and truth, and seeks to reformulate its place within psychoanalytic clinic and, more specifically, in the analyst's work during the session. In this regard, the author maintains that the expression psychic truth is necessary, and distinguishes it from the concepts of historical truth, as Freud conceived it, and of narrative truth put forward by Spence. Indeed, the concept of psychic truth refers to the specific field of psychoanalysis, that is the recognition of the individual's psychic reality. Delimiting that field allows psychoanalysis to conceptualize aspects of the psychoaffective life of human beings' unconscious mind with its own specific significance criteria and reference schemes. The author examines Freud's views on such a topic, by mainly referring to Constructions in analysis, and also resorts to the contributions made by Ferenczi in The elasticity of psychoanalytic technique and The problem of the end of analysis. Such works address the issue of humility and patience in the analyst's knowledge, and pave the way for later studies such as those conducted by Balint, Winnicott and Bion himself

El trabajo afronta uno de los temas más afectados por la cultura postmoderna, la crisis de la racionalidad y de la verdad, e intenta reformular su lugar en el seno de la clínica psicoanalítica y específicamente en el trabajo del analista durante la sesión. En este sentido, el autor entiende como necesaria la expresión verdad psíquica, diferenciándola de los conceptos de verdad histórica de Freud y de verdad narrativa de Spence ya que este concepto de verdad psíquica especifica el ámbito propio del psicoanálisis, es decir, el reconocimiento de la realidad psíquica del individuo. Y es precisamente la delimitación de este ámbito que permite al psicoanálisis conceptualizar los aspectos de la vida psicoafectiva de la mente inconsciente del ser humano con criterios de significación y esquemas referenciales propios. El autor recorre el pensamiento de Freud sobre el tema, especialmente en Construcciones en análisis y lo intercala con las aportaciones sobre el mismo de Ferenczi, en La elasticidad de la técnica psicoanalítica y El problema del fin del análisis donde aborda la cuestión de la humildad y la paciencia en el saber del analista que abren las puertas a las contribuciones de autores posteriores como Balint, Winnicott y el propio Bion

Monitoring Training Load, Recovery, and Performance of Brazilian Professional Volleyball Players During a Season.

PURPOSE: To describe and analyze the distribution of internal training load (ITL), recovery, and physical performance of professional volleyball players throughout 1 season. METHODS: Fifteen male professional Brazilian volleyball players participated in this study. The session rating of perceived exertion (s-RPE) and Total Quality Recovery (TQR) score were collected daily for 36 wk. s-RPE was collected after each training session, and TQR, before the first session of the day. The sum of the ITL of each session during the week, training monotony, strain, acute∶chronic workload ratio, match difficulty score, and average of the TQR scores were recorded for the analysis. In addition, the athletes performed countermovement-jump (CMJ) tests with and without the use of the arms 4 times over the season. RESULTS: The season mean weekly ITL was 3733 (1228) AU and the TQR was 15.02 (0.71). The ITL and recovery demonstrated undulating dynamics over the 36 wk, with higher weekly ITL in the preparatory periods (F = 50.32; P < .001) and worse recovery during the main competition (F = 6.47; P = .004). Negative correlations were found between TQR and ITL variables (P < .05). There was improvement and maintenance in CMJ tests without (F = 11.88; P < .001) and with (F = 16.02; P < .001) the use of the arms after the preparatory periods. CONCLUSIONS: The ITL variables, recovery, and physical performance changed significantly throughout a professional volleyball season. Despite the decrease in ITL during the main competitive period, the correct distribution of weekly ITL seems to be very important to guarantee the best recovery of athletes.

Monitoring internal training load and salivary immune-endocrine responses during an annual judo training periodization.

The objective of this study was to examine the internal training load (TL), IgA, and salivary steroid hormone responses in elite youth judo athletes during an entire annual training periodization. Ten male judo athletes (18±2 years, 72.3±12.3 kg, and 175±6 cm) competing at a state/national level were examined for the TL and salivary imune-endocrine responses variations over an annual judo season, divided in three macrocyles composed by distinct periods denominated preparatory period (PP), competitive period (CP) and transition period (TP). At the end of PP and CP, saliva samples were collected to determine cortisol, testosterone and IgA concentrations. Throughout PP and CP the session-rating of perceived exertion and the total duration of each session were monitored, allowing the internal TL and weekly training strain (TS) calculation. During all macrocycles, significant decreases in TL and TS were observed during CP compared with PP (P<0.05), although no significant differences were observed for immune-endocrine concentrations between PP and CP (P>0.05). Specific variations were observed comparing periods with similar characteristics throughout the macrocycles as higher TL and TS (PP1 to PP2 and PP3, P<0.05), increased testosterone (CP1 to CP3, P=0.024) and decreased testosterone-cortisol ratio (PP1 to PP2, P=0.005). The present findings suggest that the internal TL variations over an annual multipeak traditional periodization did not influence the resting mucosal immune-endocrinal responses in young judo athletes.

Multi-year school-based implementation and student outcomes of an evidence-based risk reduction intervention.

BACKGROUND: Intervention effects observed in efficacy trials are rarely replicated when the interventions are broadly disseminated, underscoring the need for more information about factors influencing real-life implementation and program impact. Using data from the ongoing national implementation of an evidence-based HIV prevention program [Focus on Youth in The Caribbean (FOYC)] in The Bahamas, this study examines factors influencing teachers' patterns of implementation, the impact of teachers' initial implementation of FOYC, and subsequent delivery of the booster sessions on students' outcomes. METHODS: Data were collected from the 80 government elementary and 34 middle schools between 2011 and 2014, involving 208 grade 6, 75 grade 7, and 58 grade 8 teachers and 4411 students initially in grade 6 and followed for 3 years. Student outcomes include HIV/AIDS knowledge, reproductive health skills, self-efficacy, and intention to use protection. Data from teachers includes implementation and modification of the curriculum, attitudes towards the prevention program, comfort level with the curriculum, and attendance at training workshops. Structural equation modeling and mixed-effect modeling analyses were applied to examine the impact of teachers' implementation. RESULTS: Teachers' attitudes towards and comfort with the intervention curriculum, and attendance at the curriculum training workshop had a direct effect on teachers' patterns of implementation, which had a direct effect on student outcomes. Teachers' attitudes had a direct positive effect on student outcomes. Teachers' training in interactive teaching methods and longer duration as teachers were positively associated with teachers' comfort with the curriculum. High-quality implementation in grade 6 was significantly related to student outcomes in grades 6 and 7 post-implementation. Level of implementation of the booster sessions in grades 7 and 8 were likewise significantly related to subsequent student outcomes in both grades. CONCLUSIONS: High-quality initial implementation of a prevention program is significantly related to better program outcomes. Poor subsequent delivery of booster sessions can undermine the positive effects from the initial implementation while strong subsequent delivery of booster sessions can partially overcome poor initial implementation.