Isolamento social durante a pandemia de COVID-19 aumenta o indicativo de sarcopenia e o comportamento sedentário em idosos brasileiros / Social isolation during the Covid-19 pandemic increases the indicator of sarcopenia and sedentary behavior in brazilians older adults

Objetivo: comparar se o indicativo de sarcopenia e comportamento sedentário aumentou durante o isolamento social devido à pandemia de COVID-19 em idosos brasileiros. Métodos: Estudo transversal realizado com 98 idosos de ambos os sexos, sendo 64 homens e 34 mulheres das regiões Sul e Sudeste do Brasil, e que estavam em isolamento social total ou parcial devido à pandemia de COVID-19 (junho a julho de 2020). Foram utilizados o SARC-F e o Questionário Internacional de Atividade Física (IPAQ), versão curta. A coleta de dados quantitativos ocorreu através de um formulário on-line disponibilizado pela Survey Monkey. Os dados foram analisados por meio dos testes Kolmogorov-Smirnov, Levene, t independente e dependente, e coeficiente de Spearman. Adotou-se significância quando p < 0,05. Resultados: as mulheres (p = 0,047) e os idosos que não praticavam exercício físico (p = 0,001), apresentaram maior tempo sentado após o início da pandemia. Os idosos mais novos (p = 0,002) e que reportaram estar praticando exercício antes do isolamento social (p = 0,006) apresentam menores escores indicativos de sarcopenia durante a pandemia. Os idosos apresentaram aumento nos indicativos de sarcopenia (p = 0,050) e no comportamento sedentário (p = 0,001) durante o período de isolamento social. Conclusão: o período de isolamento social devido à pandemia da COVID-19 provocou aumento no indicativo de sarcopenia e no comportamento sedentário das pessoas idosas.

Objective: to compare whether the indicative of sarcopenia and sedentary behavior increased during social isolation due to the COVID-19 pandemic in elderly Brazilians. Methods: Cross-sectional study conducted with 98 elderly people of both sexes, 64 men and 34 women from southern and southeastern Brazil, and who were in total or partial social isolation due to the COVID-19 pandemic (June to July 2020). The SARC-F and the International Physical Activity Questionnaire (IPAQ), short version, were used. The collection of quantitative data took place through an online form provided by Survey Monkey. Data were analyzed using the Kolmogorov-Smirnov, Levene, independent and dependent t tests, and Spearman's coefficient. Significance was adopted when p < 0.05. Results: women (p = 0.047) and the elderly who did not exercise (p = 0.001) had more time sitting after the onset of the pandemic. Younger elderly (p = 0.002) and those who reported having been exercising before social isolation (p = 0.006) had lower scores indicative of sarcopenia during the pandemic. The elderly showed an increase in sarcopenia indicatives (p = 0.050) and in sedentary behavior (p = 0.001) during the period of social isolation. Conclusion: the period of social isolation due to the COVID-19 pandemic caused an increase in the indicative of sarcopenia and in the sedentary behavior of the elderly.

Physical Activity Influences Health-Related Quality of Life in Adults with Juvenile Idiopathic Arthritis.

This cross-sectional study aimed to evaluate the impact of physical activity and physical fitness on the health-related quality of life (HQoL) of adult patients with Juvenile Idiopathic Arthritis (JIA). Fifty-nine JIA patients and sixty healthy individuals participated in this study. All individuals had the following evaluations performed: body composition (electrical bioimpedance), physical fitness (6 min walk test (6MWT)), physical activity level (International Physical Activity Questionnaire (IPAQ)), and HQoL (Quality of Life Questionnaire in relation to Health-Short Form (SF36)). Thirty-nine (66%) JIA patients were considered sedentary compared with 15 (25%) in the control group (p < 0.01). JIA patients had a lower HQoL compared with the control group in all variables studied (p < 0.05). JIA patients who were very physically active had better HQoL conditions in the categories of functional capacity (p = 0.001), limitations by physical aspects (p = 0.003), and emotional aspects (p = 0.002) compared with sedentary patients. JIA patients had more cardiovascular abnormalities and walked shorter distances compared with healthy controls in the 6MWT. In conclusion, we observed that HQoL was reduced in adults with JIA. A high percentage of JIA patients were sedentary with lower physical fitness, but physically active patients had a better HQoL than sedentary patients. The duration of physical activity, rather than intensity, influenced the mental aspects of HQoL.

Microstructural Changes in the Corpus Callosum in Systemic Lupus Erythematous.

Central nervous system (CNS) involvement in childhood-onset systemic lupus erythematosus (cSLE) occurs in more than 50% of patients. Structural magnetic resonance imaging (MRI) has identified global cerebral atrophy, as well as the involvement of the corpus callosum and hippocampus, which is associated with cognitive impairment. In this cross-sectional study we included 71 cSLE (mean age 24.7 years (SD 4.6) patients and a disease duration of 11.8 years (SD 4.8) and two control groups: (1) 49 adult-onset SLE (aSLE) patients (mean age of 33.2 (SD 3.7) with a similar disease duration and (2) 58 healthy control patients (mean age of 29.9 years (DP 4.1)) of a similar age. All of the individuals were evaluated on the day of the MRI scan (Phillips 3T scanner). We reviewed medical charts to obtain the clinical and immunological features and treatment history of the SLE patients. Segmentation of the corpus callosum was performed through an automated segmentation method. Patients with cSLE had a similar mid-sagittal area of the corpus callosum in comparison to the aSLE patients. When compared to the control groups, cSLE and aSLE had a significant reduction in the mid-sagittal area in the posterior region of the corpus callosum. We observed significantly lower FA values and significantly higher MD, RD, and AD values in the total area of the corpus callosum and in the parcels B, C, D, and E in cSLE patients when compared to the aSLE patients. Low complement, the presence of anticardiolipin antibodies, and cognitive impairment were associated with microstructural changes. In conclusion, we observed greater microstructural changes in the corpus callosum in adults with cSLE when compared to those with aSLE. Longitudinal studies are necessary to follow these changes, however they may explain the worse cognitive function and disability observed in adults with cSLE when compared to aSLE.

Cognitive Performance in Patients with Systemic Lupus Erythematosus Using the Ped-ANAM.

Computerized batteries have been widely used to investigate cognitive impairment (CI) in patients with SLE. The aim of this study was to evaluate the cognitive performance of patients with SLE in relation to healthy controls using the Pediatric Automated Neuropsychological Assessment Metrics (Ped-ANAM) battery. In addition, we aimed to examine differences in Ped-ANAM scores according to age of disease onset, presence of disease activity, and disease damage. We included 201 consecutive adult-onset (aSLE) and childhood-onset SLE (cSLE) patients who were being followed at the hospital's rheumatology outpatient clinic and 177 healthy controls. We applied the percentage of correct answers on the Ped-ANAM subtests and the Performance Validity Index (PVI) metric and correlated them with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus Erythematosus Damage Index (SDI). Then, we established their relationships with neuropsychiatric systemic lupus erythematosus (NPSLE). We observed CI in a total of 38 (18.9%) SLE patients and 8 (4.5%) healthy controls (p < 0.001). CI was observed in eight (19.5%) cSLE patients and 32 (20%) aSLE patients (p = 0.8175). Individual analysis of the aSLE subtests showed a significant difference in all subtests compared to healthy controls; the greatest differences were in matching to sample (p < 0.001) and memory search ( p < 0.001). In the cSLE group, we observed a difference in the code substitution subtests (p = 0.0065) compared to the healthy controls. In the evaluation of clinical outcomes, disease activity was significantly correlated with CI in cSLE (r = 0.33; p = 0.042) and aSLE (r = 0.40; p = 0.001). We also observed an association between disease activity and neuropsychiatric manifestations (p = 0.0012) in aSLE. In conclusion, we determined that cognitive dysfunction, mainly in memory and attention, was more prevalent in patients with SLE. In both the cSLE and aSLE groups, disease activity was associated with worse cognitive function. This is the first study to use the Ped-ANAM in Brazil. Longitudinal studies are necessary to determine how the Ped-ANAM will perform over time.

Cross-cultural adaptation and initial validation of the Brazilian-Portuguese version of the pediatric automated neuropsychological assessment metrics.

Automated neuropsychiatric batteries have been used in research and clinical practice, including for chronic diseases, such as Systemic Lupus Erythematosus. The Pediatric Automated Neuropsychological Assessment Metrics battery (Ped-ANAM), originally developed for use in American-English speaking individuals, allows tracking of cognitive functions. It can be applied to people over 9 years old. The aim of this study was to translate and present initial validation data from the Ped-ANAM into Brazilian-Portuguese. We translated the battery according to Beaton's guidelines. Psychometric properties were tested, internal consistency was analyzed by Cronbach's alpha coefficient, test-retest reliability by the intraclass correlation coefficient (ICC). Further, we measured the test execution speed at both times as a temporal stability. Principal component analysis (PCA) was used for structural validity. Evidence of construct validity was assessed through assessment of the relationships with the Wechsler Intelligence Scales. All participants prior to the start of study related activities signed an informed consent form approved by the local ethics committee. A sample of 230 individuals [mean (range) of age: 23 (9 to 60) years; 65% females] was included; a subset of 51 individuals [mean (range) of age: 18 (9 to 57) years, 59% female] completed the Ped-ANAM twice to assess test-retest reliability, and another subset of 54 individuals [mean (range) of age: 20.4 (7 to 62) years; 67% female] completed the Wechsler Intelligence Scales for Children and Adult for assessment of the Ped-ANAM's construct validity. Our results suggest that the internal consistency of the Ped-ANAM (Cronbach's α = 0.890) and its subtest test-retest reliability were excellent (ICC: 0.59 to 0.94). There was no clustering in the Principal Components Analysis, suggestive of non-grouping of the evaluated variables. Construct validity assessment to the Wechsler Scales showed expected ranges of low to strong correlations (Spearman correlations: ρ = 0.40 to ρ = 0.69). We concluded that, based on the results of this study, a cross-culturally validated Brazilian-Portuguese version of the Ped-ANAM has been developed and it is a reliable tool for the screening cognitive function.

COVID-19 infection rate and time spent at home: analysis of the beginning of the pandemic / Taxa de infecção por COVID-19 e tempo gasto em casa: análise do começo da pandemia / Tasa de infección por COVID-19 y tiempo en casa: análisis del inicio de la pandemia

Background and Objectives: Evidence suggests that the failure of epidemiological control impedes the resumption of socioeconomic activities. Therefore, this study aimed to describe epidemiological aspects and the pattern of mobility on each continent and to verify the association between the COVID-19 infection rate and time spent at home. Methods: We analyzed reports from Global Positioning System of 97 countries and their epidemiological indicators until May 27, 2020. Results: Cases of COVID-19 ranged from 22 to 1,745,803, and deaths ranged from 0 to 102,107. The highest rates per 100,000 population were observed in Europe and America. Approximately 54% of COVID-19 cases occurred in America and 51% of deaths in Europe. Countries reduced mobility in retail and recreation (-43.45%±20.42%), grocery and pharmacy (-17.95%±20.82%), parks (-18.77%±37.34%), transit stations (-43.09%±20.31%), workplaces (-21.74%±19.92%), and increased time spent at home (13.00%±8.80%). Linear regression showed that European inhabitants stayed at home less when compared those on the American continent (ß=-4.933, SE=0.976, p<.001). In addition, every unit increase in the infection rate per 100,000 population increased 0.005 points in the mean time spent at home (ß=0.005, SE=0.001, p<.001). Conclusions: We provide evidence that increased infection rate of COVID-19 is associated with increased length of stay at home. As a main lesson, COVID-19 showed that in the absence of pharmacological resources, government authorities need to act quickly to contain the spread of infectious diseases.(AU)

Justificativa e objetivos: Evidências sugerem que as dificuldades no controle epidemiológico impedem a retomada das atividades socioeconômicas. Diante disso, tivemos os objetivos de descrever aspectos epidemiológicos e o padrão de mobilidade em cada continente e verificar a associação entre a taxa de infecção por COVID-19 e o tempo de permanência em casa. Métodos: Analisamos relatórios de Global Positioning System de 97 países e seus indicadores epidemiológicos até 27 de maio de 2020. Resultados: Casos de COVID-19 variaram de 22 a 1.745.803, e as mortes variaram de 0 a 102.107. Maiores taxas por 100.000 habitantes foram observadas na Europa e América. Aproximadamente 54% dos casos de COVID-19 ocorreram na América e 51% dos óbitos na Europa. Os países reduziram a mobilidade no varejo e recreação (-43,45% ± 20,42%), mercearia e farmácia (-17,95%±20,82%), parques (-18,77%±37,34%), estações de trânsito (-43,09%±20,31%), locais de trabalho (-21,74%±19,92%), e aumentaram o tempo em casa (13,00% ± 8,80%). A regressão linear mostrou que os habitantes europeus ficaram menos tempo em casa do que os habitantes do continente americano (ß=-4,933, EP=0,976, p<0,001). Além disso, cada unidade de aumento na taxa de infecção por 100.000 habitantes aumentou 0,005 pontos no tempo médio de permanência em casa (ß=0,005, EP=0,001, p<0,001). Conclusões: Fornecemos evidências de que o aumento da taxa de infecção por COVID-19 está associado ao aumento do tempo de permanência em casa. Como lição principal, a COVID-19 mostrou que, na ausência de recursos farmacológicos, as autoridades governamentais precisam agir rapidamente para conter a propagação de doenças infecciosas.(AU)

Justificación y Objetivos: Dificultades en el control epidemiológico dificultan la reactivación de actividades socioeconómicas. Nuestros objetivos fueron describir aspectos epidemiológicos y el patrón de movilidad en cada continente y verificar la asociación entre tasa de infección por COVID-19 y duración de estancia en casa. Métodos: Examinamos informes del Global Positioning System de 97 países y sus indicadores epidemiológicos hasta 27 de mayo de 2020. Resultados: Casos de COVID-19 oscilaron entre 22 y 1.745.803, y muertes entre 0 y 102.107. Tasas más altas por 100.000 habitantes ocurrieron en Europa y América. Aproximadamente 54% de los casos de COVID-19 ocurrieron en América y 51% de las muertes en Europa. Los países redujeron la movilidad en comercio y recreación (-43,45%±20,42%), tienda de comestibles y farmacia (-17,95%±20,82%), parques (-18,77%±37,34%), estaciones de tránsito (-43,09%±20,31%), lugares de trabajo (-21,74%±19,92%), y aumentaron la duración de la estancia en casa (13,00%±8,80%). La regresión lineal (R²=0,906) mostró que los europeos permanecían menos tiempo en casa en comparación con los del continente americano (ß=-4,933, EE=0,976, p<0,001). Además, cada unidad de aumento de la tasa de infección por 100.000 habitantes aumentó la duración media de la estancia en casa en 0,005 puntos (ß=0,005, EE=0,001, p<0,001). Conclusiones: Mostramos que el aumento de la tasa de infección de COVID-19 se asocia con una mayor duración de la estancia en casa. Como lección clave, COVID-19 demostró que, en ausencia de recursos farmacológicos, las autoridades gubernamentales deben actuar rápidamente para contener la propagación de enfermedades infecciosas.(AU)

A idade comopreditora de ansiedade e depressão de adultos brasileiros durante a pandemia da Covid-19 / Age as a predictor of anxiety and depression among brazilian adults during the Covid-19 pandemic

Objetivo: analisar o papel preditor da idade sobre os sintomas de ansiedade e depressão de adultos durante a pandemia da Covid-19. Métodos: estudo transversal realizado com 1118 adultos. Foi utilizado um questionário sociodemográfico e a Hospital Anxiety And Depression Scale. A análise de dados foi conduzida por meio da Análise Multivariada de Variância, correlação de Pearson e Regressão Múltipla (p <0,05). Resultados: a idade foi um preditor negativo dos sintomas de ansiedade (R2 = 0,03; p < 0,05; ß = -0,18) e depressão (R2 = 0,03, p < 0,05; ß = -0,19) entre os homens. Em relação às mulheres, a idade também se mostrou como uma preditora negativa dos sintomas de ansiedade (R2 = 0,05; p < 0,05; ß = -0,23) e dos sintomas depressivos (R2 = 0,03; p < 0,05; (ß = -0,17). Conclusão: existe associação inversamente proporcional da idade com os sintomas depressivos e de ansiedade dos brasileiros durante a Covid-19.

Objective: To analyze age's predictive role in anxiety and depression symptoms in adults during the COVID-19 pandemic. Methods: A cross-sectional study was carried out with 1,118 adults. A sociodemographic questionnaire and the Hospital Anxiety and Depression Scale were used. Data analysis was conducted using multivariate analysis of variance, Pearson's correlation, and multiple regression (p < .05). Results: Age was a negative predictor of symptoms of anxiety (R2 = 0.03; p < .05; ß = ­0.18) and depression (R2 = 0.03, p < .05; ß = ­0.19) among men and a negative predictor of anxiety symptoms (R2 = 0.05, p < .05; ß = ­0.23) and depressive symptoms (R2 = 0.03; p < .05; (ß = ­0.17) among women as well. Conclusion: Age has had an inversely proportional association with depressive and anxiety symptoms among Brazilians during the COVID-19 pandemic.

Trabalho pós-carreira esportiva: fatores pessoais e contextuais de ex-atletas femininas de elite / Post-career work: personal and contextual factors offormer female elite athletes / Trabajo de carrera postdeportiva: factores personales y contextuales de ex deportistas femeninas de élite

Dada a importância da adaptação do atleta à fase pós-aposentadoria, este estudo qualitativo objetivou analisar as variáveis pessoais e contextuais associadas com a atuação profissional pós-carreira esportiva de mulheres atletas de elite. Foram feitas entrevistas pessoais e análise de conteúdo das respostas. O nível escolar, a motivação, a abertura ao novo, a criatividade e a independência de julgamento foram verificadas como fatores pessoais relacionados com a atuação profissional pós-carreira esportiva das atletas entrevistadas. Quanto aos fatores contextuais, destacaram-se os desafios atuais e o apoio social. Conclui-se que há importância na convergência das variáveis pessoais e contextuais para compreender a prática profissional pós-carreira de ex-atletas femininas de elite (AU).

The athlete's adaptation to the post-retirement phase is important. Thus, this qualitative study aimed to analyze the personal and contextual variables associated with the post-career professional performance of elite female athletes. A personal interview and content analysis of the responses were made. School level, motivation, openness to the new, creativity and independence of judgment were verified as personal factors related to the athletes' post-career professional performance. As for contextual factors, the current challenges and social support were highlighted. It concludes about the importance of the convergence of personal and contextual variables to understand the post-career professional practice of excellent female ex-elite athletes (AU).

Dada la importancia de la adaptación del deportista a la fase post jubilación, fueron analizados en este estudio cualitativo las variables personales y contextuales asociadas al desempeño profesional post-carr-era deportiva de atletas femeninas de élite. Se realizó una entrevista personal y un análisis de contenido de las respuestas. Los fatores personales nivel escolar, motivación, apertura a lo nuevo, creatividad y independencia de juicio fueron relacionados con el desempeño profesional post-carrera de las deportistas. Los factores contextuales, se destacaron los desafíos actuales y el apoyo social. Concluye sobre la importancia de la convergencia de variables personales y contextuales para comprender la práctica profesional posterior a la carrera de ex deportistas de élite femeninas (AU).

Trabalho pós-carreira esportiva: fatores pessoais e contextuais de ex-atletas femininas de elite / Post-career work: personal and contextual factors offormer female elite athletes / Trabajo de carrera postdeportiva: factores personales y contextuales de ex deportistas femeninas de élite

Dada a importância da adaptação do atleta à fase pós-aposentadoria, este estudo qualitativo objetivou analisar as variáveis pessoais e contextuais associadas com a atuação profissional pós-carreira esportiva de mulheres atletas de elite. Foram feitas entrevistas pessoais e análise de conteúdo das respostas. O nível escolar, a motivação, a abertura ao novo, a criatividade e a independência de julgamento foram verificadas como fatores pessoais relacionados com a atuação profissional pós-carreira esportiva das atletas entrevistadas. Quanto aos fatores contextuais, destacaram-se os desafios atuais e o apoio social. Conclui-se que há importância na convergência das variáveis pessoais e contextuais para compreender a prática profissional pós-carreira de ex-atletas femininas de elite.

The athlete's adaptation to the post-retirement phase is important. Thus, this qualitative study aimed to analyze the personal and contextual variables associated with the post-career professional performance of elite female athletes. A personal interview and content analysis of the responses were made. School level, motivation, openness to the new, creativity and independence of judgment were verified as personal factors related to the athletes' post-career professional performance. As for contextual factors, the current challenges and social support were highlighted. It concludes about the importance of the convergence of personal and contextual variables to understand the post-career professional practice of excellent female ex-elite athletes.

Dada la importancia de la adaptación del deportista a la fase post jubilación, fueron analizados en este estudio cualitativo las variables personales y contextuales asociadas al desempeño profesional post-carrera deportiva de atletas femeninas de élite. Se realizó una entrevista personal y un análisis de contenido de las respuestas. Los fatores personales nivel escolar, motivación, apertura a lo nuevo, creatividad y independencia de juicio fueron relacionados con el desempeño profesional post-carrera de las deportistas. Los factores contextuales, se destacaron los desafíos actuales y el apoyo social. Concluye sobre la importancia de la convergencia de variables personales y contextuales para comprender la práctica profesional posterior a la carrera de ex deportistas de élite femeninas.

Longitudinal comparison of IL-6, IL-10, and IL-12 cytokine profiles in adult and childhood-onset systemic lupus erythematosus.

Objective: To compare the levels of Th1 (IL-12) and Th2 (IL-6 and IL10) cytokines over a two-year period among systemic lupus erythematosus patients with childhood-onset (cSLE), adult-onset (sSLE), and healthy controls, and correlate with their clinical, laboratory, and treatment manifestations. Methods: The study included 63 patients with cSLE [57 (90%) women; mean age 19.7 ± 4.3 years (range = 10-29); mean disease duration 7.3 ± 4.2 years (range 2-15)], 67 patients with aSLE [65 (97%) women; mean age of 39.9 ± 11.8 years (range 21-68); disease duration 7.7 ± 3.1 years (range 4-16)], and 40 healthy controls [36 (90%) women; mean age of 29.6 ± 10 years (range 12-49)]. cSLE and aSLE patients were paired by disease duration. Clinical and laboratory manifestations, disease activity (SLEDAI), cumulative damage (SDI), and current drug exposures were evaluated. Symptoms of anxiety and depression were evaluated by the Beck inventory (BAI and BDI, respectively). Th1 (IL-12) and Th2 (IL-6 and IL-10) cytokines were measured by the ELISA test. Data were collected at four different time points (TI, TII, TIII, and TIV) and compared by non-parametric tests. Results: IL-6 levels were significantly higher in aSLE patients compared to healthy controls at times I, II, and III (TI p = 0.013, TII p = 0.015, TIII p = 0.004, and TIV p = 0.634). However, no difference was observed between cSLE patients and healthy controls (TI p = 0.223, TII p = 0.613, TIII p = 0.341, and TIV p = 0.977). In addition, no difference was observed between aSLE and cSLE patients (TI p = 0.377, TII p = 0.123, TIII p = 0.105, and TIV p = 0.591). The levels of IL-12 were significantly higher in cSLE patients compared to healthy controls at all time points (TI p = 0.04, TII p < 0.001, TIII p = 0.015, and TIV p = 0.021). aSLE patients showed significantly elevated levels when compared to healthy controls at time III and IV (TI p = 0.752, TII p = 0.827, TIII p = 0.011*, and TIV p < 0.001*). cSLE patients showed significantly higher levels than aSLE patients at times I and II (TI p = 0.07*, TII p < 0.001*, TIII p = 0.998, and TIV p = 0.140). In aSLE patients, IL-6 was associated with headache (p = 0.006), arthritis (p = 0.044), and nephritis (p = 0.012); IL-10 was associated with nephritis (p = 0.043), hypocomplementemia (p = 0.001), and disease activity (p = 0.001); in these patients, IL-12 was associated with alopecia (p = 0.025) and leukopenia (p = 0.044). In cSLE patients, IL-6 was associated with arthritis (p = 0.022) and malar rash (p = 0.012). Conclusion: aSLE and cSLE patients with long disease duration present similar levels of cytokines, despite differences in clinical activity patterns over time.

Axonal dysfunction is associated with interferon-γ levels in childhood-onset systemic lupus erythematosus: a multivoxel magnetic resonance spectroscopy study.

OBJECTIVE: Axonal/neuronal damage has been shown to be a pathological finding that precedes neuropsychiatric manifestations in SLE. The objective of this study was to determine the presence of axonal dysfunction in childhood-onset SLE patients (cSLE) and to determine clinical, immunological and treatment features associated with its occurrence. METHODS: We included 86 consecutive cSLE patients [median age 17 (range 5-28) years] and 71 controls [median age 18 (5-28) years]. We performed proton magnetic resonance spectroscopic imaging using point resolved spectroscopy sequence over the superior-posterior region of the corpus callosum and signals from N-acetylaspartate (NAA), choline-based (CHO), creatine-containing (Cr), myo-inositol (mI), glutamate, glutamine and lactate were measured and metabolites/Cr ratios were determined. Complete clinical, laboratory and neurological evaluations were performed in all subjects. Serum IL-4, IL-5, IL-6, IL-10, IL-12, IL-17, TNF-α and INF-γ cytokine levels, antiribosomal P protein antibodies (anti-P) and S100ß were measured by ELISA using commercial kits. Data were compared by non-parametric tests. RESULTS: NAA/Cr ratios (P = 0.035) and lactate/Cr ratios (P = 0.019) were significantly decreased in cSLE patients when compared with controls. In multivariate analysis, IFN-γ levels [odds ratio (OR) = 4.1; 95% CI: 2.01, 7.9] and depressive symptoms (OR = 1.9; 95% CI: 1.1, 3.2) were associated with NAA/Cr ratio. Increased CHO/Cr was associated with the presence of cognitive impairment (OR = 3.4; 95% CI: 2.034, 5.078; P < 0.001). mI/Cr ratio correlated with cumulative glucocorticoids dosage (r = 0.361, P = 0.014). CONCLUSION: NAA and CHO ratios may be useful as biomarkers in neuropsychiatric cSLE. Longitudinal studies are necessary to determine whether they predict structural damage.

The paradox of mental health versus mental disease in elite athletes: a scoping review

Abstract Aim: To analyze the concepts of mental health and illness as well as the instruments used to measure them in the elite athlete. Methods: The scoping review was conducted using PubMed, SPORTDiscus, PsycINFO, and Scielo. The keywords "Mental Health" AND "Sport" AND "Athlete" were used to find studies in peer-reviewed scientific journals published in English, Spanish, and Portuguese. Studies went through four stages of analysis according to PRISMA guidelines. A total of 179 records were included in this review. Results: Recent studies suggest that health and illness should not be recognized as deviations from the norm, but as a changing construct, varying on a continuum, where, at one extreme, we have health; and, at the other, we have illness even coexisting in an orthogonal way. Between the two extremes, there are degrees of psychological well-being and distress, leading from reduced functioning to effective functioning. This indicates the need for psychological support for both the maintenance and enhancement of mental health. An alarming result was that, although most of the studies investigated mental health, they used primarily instruments focused on illness. This new perspective of health-illness brings the need for the development of new instruments that encompass protective factors and symptom screening. Conclusions: We reinforce the need for a paradigm shift in relation to the mental health of elite athletes understanding it as a changing construct that should be constantly improved and/or maintained. This change led to the need for broader assessment instruments that encompass protective factors and illness symptoms.

Internal consistency of the Sport Motivation Scale-II Questionnaire in the Brazilian context: potentialities and limitations

Abstract Aim: The purpose of this paper was to analyze the internal consistency of the Sport Motivation Scale-II (SMS-II) questionnaire based on three studies with sports practitioners in the Brazilian college context. Methods: All the three studies i) were carried out with students enrolled in higher education and engaged in sports training by their institution (n1 = 304; n2 = 441; n3 = 310); ii) used SMS-II as an instrument for data collection; iii) used the online procedure for data collection. The Confirmatory Factor Analysis was performed and Cronbach's Alpha (α), McDonald's Omega (Ω), and the correlation between items were used to assess internal consistency. Results: As potentialities, five dimensions of the SMS-II presented high values of internal reliability (α and Ω > 0.60). As a limitation, the dimension of introjected regulation showed low reliability (α and Ω < 0.40) in the three studies conducted by our group. The exclusion of item 16 enabled an increase in alpha, but without achieving satisfactory reliability in Study 1 (α = 0.46) and Study 2 (α = 0.31). In Study 3, the exclusion of item 7 improved the internal reliability of the dimension (α = 0.43) also without reaching satisfactory values of internal consistency. It was not possible to identify a problematic item, given that each item had a different influence in the three studies. Conclusion: We found good values of validity and internal consistency for the Brazilian version of the SMS-II. However, we suggest attention to the introjected regulation dimension when using the instrument in the Brazilian college context.

Comparison of exergames versus conventional exercises on the cognitive skills of older adults: a systematic review with meta-analysis.

PURPOSE: To compare the effects of exergames versus conventional physical training on the cognitive skills of older adults. MATERIALS AND METHODS: Scientific studies published in PubMed, Web of Science, and Cochrane Library databases were searched. Individual studies were assessed using the Cochrane Risk-of-bias tool for randomized trials (RoB 2). The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE Pro). The cognitive outcomes were Trail Making Test (TMT)-A, TMT-B, Stroop Word-Color test, Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA). RESULTS: We identified 256 studies, in which 13 studies were included in the systematic review and 11 in the meta-analysis. The majority of the exergame interventions were based on the Xbox 360's Kinect, followed by the Impact Dance Platform, Nintendo Wii, and the Bike Labyrinth. We observed heterogeneity in the conventional exercise group and in the duration of training, which ranged from 12 to 52 sessions. There was no statistically significant difference between groups in TMT-A (p=0.083), TMT-B (p=0.122), and Stroop (p=0.191). There were differences in favor of exergames in MMSE (raw mean difference=-1.58, 95% CI: -2.87 to -0.28, p<0.001) and MoCA (raw mean difference=-1.22, 95% CI: -2.24 to -0.20, p=0.019). CONCLUSIONS: Despite statistical differences in MMSE and MoCA, these results should be interpreted with caution due to methodological heterogeneity. Some studies reported possible neurophysiological benefits induced by exergames, which should be explored in future investigations.

Motivação profissional na Educação Física adaptada / Professional motivation in adapted school Physical Education / La motivación profesional en el área de Educación Física adaptada

A formação profissional em Educação Física Escolar Adaptada tem sido assunto debatido de maneira significativa. Assim, novas possibilidades de temas têm sido pensadas, como a motivação profissional. Este estudo tem como objetivo compreender aspectos motivacionais em Professores de Educação Física Escolar Adaptada, sob uma abordagem quali-quantitativa. Foram entrevistados, em 2019, oito professores da rede pública de ensino, com idade média de 44 anos (±11), que concluíram a graduação há 20 anos (±12) e que trabalhavam com crianças com deficiência nas aulas de Educação Física. Os resultados mostraram que, mesmo com a conclusão de cursos de graduação e especialização, a maioria está insatisfeita com sua formação, por conta da carência de oportunidades. Porém, a maioria, ainda está motivada para melhorar sua prática com cursos e capacitações. Assim, fica claro a importância de ampliar possibilidades acadêmicas e de formação para novas abordagens metodológicas na área das atividades físicas escolares adaptadas.

Professional qualification in Adapted Physical Education has been significantly discussed nowadays. Thus, it is important new possibilities for this discussion, such as professional motivation. Therefore, this study aimed to understand motivational aspects of teachers of Adapted Physical Education, under a qualitative and quantitative approach. For this research, we interviewed eight public school teachers, with an average age of 44 years (± 11), who completed their graduation 20 years ago (± 12) and who worked with children with disabilities in Physical Education classes. The results showed that, even with the completion of undergraduate and specialization courses, most are dissatisfied with their education, due to the lack of opportunities. However, most of them are motivated to improve their practice with capacitation courses. With these data, we highlighted the importance of expanding academic and training possibilities for new methodological approaches in the area of ​​adapted school physical activities.

La formación Profesional em Educación Física Especial, há sido um tema muy discutido. Por lo tanto, es que surgen nuevas temáticas para su estúdio, por ejemplo la motivación professional. Este proyecto tiene como objetivo entender aspectos motivacionales de los Profesores en Educación Física especial, en perspectiva cuali-cuantitativa. De acuerdo con los resultados encuentrados con ocho Profesores de escuela de enseñanza pública en 2019, en promedio de edad 44 años y 11 meses y atienden a alumnos especiales en las clases. Los resultados demuestran que al igual que tienes han realizados estúdios avanzados, existe coincidencia pues se sienten insatisfechos con su formación, debido a la falta de oportunidades. La gran mayoría, estan motivados por actualizarse por medio de cursos y capacitaciones. Queda claro que es necesario ampliar las posibilidades académicas de formación para el abordaje de las nuevas metodologías en el área de las actividades físicas con alumnos especiales.

Body and appearance-related self-conscious emotions and exercise addiction in Brazilian adolescents: A person-centred study.

The present study aimed to identify profiles of adolescents based upon body and appearance-related self-conscious emotions, and to examine whether these profiles differed from each other in terms of their exercise addiction (EA) symptoms. A sample of 703 Brazilian adolescents (41% girls) completed a self-report questionnaire. The results from a two-step cluster analysis identified four profiles: prideful (19.5%), low self-consciousness (31.7%), moderately high self-consciousness (29.2%), and shameful-guilty (19.6%). The prideful profile was characterized by a greater presence of boys, as well as by higher frequency/intensity levels of exercise than the remaining groups. The shameful-guilty profile was characterized by a greater presence of girls and by higher levels of BMI compared to the remaining groups. Regarding EA symptoms, the results from the ANCOVA/MANCOVA analyses revealed that the prideful profile showed (i) higher salience and tolerance levels than the low-level balanced self-consciousness profile, and (ii) higher salience and lower conflict compared to the shameful-guilty profile. Additionally, the moderately high self-consciousness profile showed (i) higher salience and tolerance levels than the low self-consciousness profile, and (ii) higher salience levels than the shameful-guilty profile. Identifying subgroups on the basis of body appearance-related self-conscious emotions contributes to explaining different EA symptoms in adolescents.

The importance of transition from pediatric to adult rheumatology care in juvenile idiopathic arthritis.

Introduction: Juvenile idiopathic arthritis (JIA) is the most common rheumatic inflammatory condition in childhood. The long-term morbidity, mortality, and quality of life have improved with the earlier use of disease-modifying drugs (DMARDs) and the availability of biology disease-modifying drugs (bDMARDs). Despite the improvement of treatment, around 50% of the patients reach adulthood with articular and/or extra articular disease activity. A careful planned transition from pediatric to adult care is necessary to reduce the loss of follow-up that is associated with stopping medications, flares, and disability due to untreated arthritis or uveitis.Areas covered: This narrative review provides an overview of the importance of transition in JIA Articles were selected from Pubmed searches.Expert opinion: JIA patients, family, and healthcare workers have to be trained to provide an effective transition plan, based on local and national policies. Important aspects such as expectations, maturation, disease characteristics, disease activity, adherence, disability, and psychological aspects among others have to be considered and addressed during the transition phase to improve self-esteem, self-assurance, and quality of life.

Psychometric properties of the body and appearance self-conscious emotions scale in Brazilian adolescents.

This study examined the psychometric properties of the Body and Appearance Self-Conscious Emotions Scale in Brazilian adolescents. A sample of 827 adolescents (55% boys) filled out a questionnaire comprising the Body and Appearance Self-Conscious Emotions Scale and instruments assessing social physique anxiety, positive/negative affect, and self-esteem. After removing one item originally proposed for the guilt factor (Item 7), the results supported a 4-factor structure that was invariant across gender and weight status. Evidence supporting the internal consistency, temporal stability, and convergent validity of the Body and Appearance Self-Conscious Emotions Scale cores were also obtained. These results support the Body and Appearance Self-Conscious Emotions Scale as a psychometrically robust instrument to assess body and appearance self-conscious emotions in Brazilian adolescents.

Intervenção por realidade virtual e exercício físico em idosos / Intervention for virtual reality and physical exercise in elderly / La intervención de la realidad virtual y el ejercicio físico en los ancianos

Objetivo: Comparar nos idosos a evolução do equilíbrio, cognição e marcha durante a prática de exercício físico com a realidade virtual. Métodos: 31 participantes de ambos os sexos, foram divididos nos grupos: 1. Realidade Virtual (RV); 2. Exercício Físico (EF) e 3. Realidade Virtual e Exercício Físico (RVEF), realizaram procedimentos com um quebra-cabeça virtual (grupos RV) e/ou exercício físico de caminhada (grupos EF), durante 5 meses. Resultados: Na atenção todos os grupos aumentaram o escore médio após o período de intervenção. Na memória as diferenças estatisticamente significativas ocorreram nos grupos RV e RVEF. No equilíbrio todos os grupos aumentaram o escore após o período de intervenção. Na marcha o grupo RVEF obteve melhor resultado. Conclusões: As intervenções por RV e EF mostraram-se eficazes para a melhora do equilíbrio, marcha, atenção e memória. Portanto, conclui-se que a intervenção por RV associada ao EF melhora o desempenho físico funcional em idosos.

Objective: To compare in the elderly, the evolution of balance, cognition and walking during physical exercise with virtual reality. Methods: 31 participants of both sexes divided into groups: 1. Virtual Reality (VR); 2. Physical Exercise (PE) and 3. Virtual Reality and Physical Exercise (VRPE), performed procedures with a virtual puzzle (VR groups) or walking physical exercise (PE groups), during five months. Results: In the attention test, all groups increased the mean score after the intervention period; In the memory test, statistically significant differences occurred in the VR and VRPE groups; In the balance test, all groups increased the score after the intervention period, and in the gait test, the VRPE group obtained better results. Conclusions: The interventions by VR and PE were effective in improving balance, gait, attention and memory. Therefore, we conclude that VR intervention associated with PE improves functional physical performance in the elderly.

Objetivo: Comparar la evolución del equilibrio, la cognición y la marcha durante el ejercicio físico con la realidad virtual del ancianos. Métodos: 31 participantes de ambos sexos fueron divididos en grupos: 1. Realidad Virtual (RV) con un rompecabezas virtual; 2. Ejercicio Físico (EF) caminando; y 3. Realidad Virtual y Ejercicio Físico (RVEF). La intervención ha durado cinco meses. Resultados: En la atención todos aumentaron la puntuación media después del período de intervención. En la memoria, las diferencias estadísticamente significativas ocurrieron en los grupos RV y RVEF. En equilibrio, todos aumentaron la puntuación después del período de intervención. En la marcha el grupo RVEF obtuvo mejores resultados. Conclusiones: Las intervenciones de RV y EF fueron efectivas para mejorar el equilibrio, la marcha, la atención y la memoria. Se concluye que la intervención de la RV asociada a la EF mejora el rendimiento físico y funcional en los ancianos.

Latent profile analysis of exercise addiction symptoms in Brazilian adolescents: Association with health-related variables.

BACKGROUND: The purpose of the present study is to identify profiles of adolescent exercisers based on exercise addiction symptoms (EA), and to examine differences in several health-related variables potentially related to EA across these profiles. METHODS: A sample consisting of 618 adolescents, aged from 13 to 17 years, completed a questionnaire assessing EA, exercise characteristics (i.e., frequency and intensity of exercise), depression, body image (i.e., body appreciation and social physique anxiety), and disordered eating (i.e., concerns about eating and body weight gain as well as restrictive and compensatory practices). RESULTS: The profile analysis identified three EA profiles, which were labelled: low-risk, high-risk with conflict and high-risk without conflict. Based on their scores for the health-related variables considered, the low-risk profile emerged as the least problematic; this increasing in the high-risk without conflict and even more so in the high-risk with conflict profiles. Nevertheless, individuals belonging to the high-risk without conflict profile showed similar body appreciation scores but lower social physique anxiety scores than those belonging to the low-risk profile. LIMITATIONS: The study is limited by both its cross-sectional design and the self-reported nature of the collected data. CONCLUSIONS: Conflict symptom may be relevant in explaining the differences in certain health-related variables between adolescents showing similarly high levels of EA.