Prevalence of dyslipidemia, atherogenic and cardiovascular risk in overweight and obese adolescents.

OBJECTIVE: To analyze the lipid profile and cardiovascular risk of overweight and obese adolescents and correlate the findings with anthropometric measurements. METHODS: This is a cross-sectional study on overweight and obese adolescents of both sexes (aged 14 to 18 years old). The collected variables were sex, weight, height, age, total cholesterol, triglycerides, High-density lipoprotein (HDL) and low-density lipoprotein (LDL). The Atherogenic Index of Plasma and Castelli Risk Indices I and II were calculated. These indices were classified into cutoff points to stratify cardiovascular risk. The anthropometric profile was evaluated by Z score according to Body Mass Index for age. Significance level was considered as p≤0.05. RESULTS: A total of 146 adolescents participated in the study; the mean age was 16.4±1.1 years and most of them were girls (74.7%) and obese (52.7%). The prevalent dyslipidemias were high triglycerides (47.9%), LDL (26.7%), total cholesterol (37.7%), and low HDL (46.6%). Most adolescents presented increased atherogenic risk according to the Atherogenic Index of Plasma (55.5%); 15.1% presented high cardiovascular risk according to Castelli Risk Index I; and 13.7%, according to Castelli Risk Index II. Boys presented higher values of anthropometric measurements and Castelli Risk Indices I and II in relation to girls - who, conversely, presented higher values of HDL. There was a positive correlation of the Z score with Atherogenic Index of Plasma and a negative correlation with HDL. CONCLUSIONS: The adolescents of the study presented high prevalence of cardiovascular and atherogenic risk according to the evaluated indices. In addition, the increased cardiovascular risk was correlated with higher Body Mass Index.

Prevalence of dyslipidemia, atherogenic and cardiovascular risk in overweight and obese adolescents / Prevalência de dislipidemia, risco aterogênico e cardiovascular em adolescentes com sobrepeso e obesidade

Abstract Objective: To analyze the lipid profile and cardiovascular risk of overweight and obese adolescents and correlate the findings with anthropometric measurements. Methods: This is a cross-sectional study on overweight and obese adolescents of both sexes (aged 14 to 18 years old). The collected variables were sex, weight, height, age, total cholesterol, triglycerides, High-density lipoprotein (HDL) and low-density lipoprotein (LDL). The Atherogenic Index of Plasma and Castelli Risk Indices I and II were calculated. These indices were classified into cutoff points to stratify cardiovascular risk. The anthropometric profile was evaluated by Z score according to Body Mass Index for age. Significance level was considered as p≤0.05. Results: A total of 146 adolescents participated in the study; the mean age was 16.4±1.1 years and most of them were girls (74.7%) and obese (52.7%). The prevalent dyslipidemias were high triglycerides (47.9%), LDL (26.7%), total cholesterol (37.7%), and low HDL (46.6%). Most adolescents presented increased atherogenic risk according to the Atherogenic Index of Plasma (55.5%); 15.1% presented high cardiovascular risk according to Castelli Risk Index I; and 13.7%, according to Castelli Risk Index II. Boys presented higher values of anthropometric measurements and Castelli Risk Indices I and II in relation to girls — who, conversely, presented higher values of HDL. There was a positive correlation of the Z score with Atherogenic Index of Plasma and a negative correlation with HDL. Conclusions: The adolescents of the study presented high prevalence of cardiovascular and atherogenic risk according to the evaluated indices. In addition, the increased cardiovascular risk was correlated with higher Body Mass Index.

RESUMO Objetivo: Analisar o perfil lipídico e os índices de risco cardiovascular de adolescentes com sobrepeso e obesidade e correlacionar os achados com medidas antropométricas. Métodos: Estudo transversal com adolescentes com sobrepeso ou obesidade de ambos os sexos (14 a 18 anos). Foram coletadas as variáveis: sexo, peso, altura, idade, colesterol total, triglicerídeos, lipoproteína de alta densidade (HDL-c) e lipoproteína de baixa densidade (LDL-c). Calcularam-se o índice aterogênico plasmático e os índices de Castelli I e II. Eles foram classificados em pontos de corte para estratificar o risco cardiovascular. O perfil antropométrico foi avaliado por meio do escore Z com base no índice de massa corporal para a idade. Considerou-se o nível de significância p≤0,05. Resultados: Foram incluídos 146 adolescentes, com média de idade de 16,4±1,1 anos, a maioria do sexo feminino (74,7%) e obesa (52,7%). As dislipidemias prevalentes foram: triglicerídeos (47,9%), LDL-c (26,7%), colesterol total (37,7%) elevado e HDL-c baixo (46,6%). A maioria apresentou risco aterogênico aumentado pelo índice aterôgenico plasmático (55,5%); 15,1% apresentaram alto risco cardiovascular segundo o índice de Castelli I e 13,7%, segundo o índice de Castelli II. Os meninos apresentaram valores superiores de medidas antropométricas e índices de Castelli I e II em relação às meninas, que, por outro lado, apresentaram valores superiores de HDL-c. Houve correlação positiva do escore Z com o índice aterôgenico plasmático e negativa com HDL-c. Conclusões: Os adolescentes do estudo apresentaram alta prevalência de risco cardiovascular e aterogênico conforme os índices avaliados. Além disso, o risco cardiovascular aumentado foi correlacionado com maior índice de massa corporal.

Terapia de aceitação e compromisso para redução do estresse em universitários: um estudo qualitativo / Acceptance and commitment therapy for university students: a qualitative study / Terapia de aceptación y compromiso para estudiantes universitarios: un estudio cualitativo

Este estudo teve como objetivo explorar a percepção de alunos de graduação em relação à sua participação em uma intervenção baseada na terapia de aceitação e compromisso (acceptance and commitment therapy[ACT]), para redução da inflexibilidade psicológica (IP) e do estresse em estudantes universitários. Parti­ciparam da pesquisa 21 alunos, de diferentes cursos de graduação, com idade média de 23,4 ± 5,61, sendo 71,4% do sexo feminino e 28,6% do sexo masculino. Os dados coletados nas entrevistas foram submetidos à análise de conteúdo e organizados em quatro categorias: experiência no programa, utilidade, viabilidade e sugestões e processos da ACT. Os resultados possibilitaram identificar que o programa foi uma experiên-cia positiva para os participantes. Além disso, constatou-se que a intervenção foi útil e viável, e possibili-tou que os estudantes desenvolvessem as habilidades necessárias para lidar melhor com as adversidades do dia a dia, sem que precisassem se afastar dos seus valores pessoais.

This study aims to explore undergraduate students' perception of their participation in an intervention, based on acceptance and commitment therapy (ACT), to reduce psychological inflexibility (PI) and stress in undergraduate students. Twenty­one students from different undergraduate programs participated in the research, with an average age of 23.4 ± 5.61, of whom 71.4% were female and 28.6% were male. The data collected in the interviews were submitted to content analysis and organized into four categories: experience in the program, utility, feasibility, and ACT suggestions and processes. The results made it possible to identify that the program was a positive experience for the participants, the intervention was useful and feasible and enabled students to develop the requirements to better deal with the adversities of daily life without departing from their personal values.

Este estudio tiene como objetivo explorar la percepción de los estudiantes de pregrado sobre su participa-ción en una intervención, basada en la terapia de aceptación y compromiso (acceptance and commitment therapy [ACT]), para reducir la inflexibilidad psicológica (IP) y el estrés en los estudiantes de pregrado. En la investigación participaron 21 estudiantes de diferentes carreras, con una edad promedio de 23,4 ± 5,61, de los cuales el 71,4% eran mujeres y el 28,6% hombres. Los datos recolectados en las entrevistas fueron sometidos a análisis de contenido y organizados en cuatro categorías: experiencia en el programa, utilidad, factibilidad y sugerencias y procesos de ACT. Los resultados permitieron identificar que el programa fue una experiencia positiva para los participantes, la intervención fue útil y factible y permitió a los estudian-tes desarrollar los requisitos necesarios para enfrentar mejor las adversidades de la vida diaria, sin apar-tarse de sus valores personales.

Efeitos do Trabalho de Regulação Infantil nas Competências Socioemocionais de Crianças no Ambiente Escolar / Effects of Child Regulation Work on Socioemotional Competencies of Children in the School Environment / Efectos del Trabajo de Regulación Infantil sobre las Competências Socioemocionales de los Niños en Escuela

Esse estudo objetivou avaliar os efeitos do Trabalho de Regulação Infantil nas competências socioemocionais e problemas de comportamento, assim como nos escores da sintomatologia ansiosa e depressiva em crianças com idade entre 7 e 9 anos. Trata-se de um estudo quasi-experimental, em que comparou-se o grupo experimental com o grupo do tipo lista de espera antes e após a intervenção no ambiente escolar. Os responsáveis preencheram o Social Skills Rating System e a Emotional Regulation Checklist. As crianças preencheram a Social Skills Rating System, Screen for Child Anxiety Related Emotional Disorders e Children Depression Inventory. Foram identificados resultados significativos no aumento das habilidades sociais e regulação emocional, assim como diminuição nos escores de problemas de comportamento e nos sintomas de ansiedade e depressão, no grupo experimental. A diferença entre grupos ocorreu apenas nos níveis de habilidades sociais e regulação emocional. Diante dos resultados, conclui-se que o Trabalho de Regulação Infantil pode ser uma proposta de prevenção de problemas emocionais e de comportamento na escola.

This study aimed to evaluate the effects of the Child Regulation Work on socioemotional skills, behavior problems and on scores of symptoms of anxiety and depression in children aged 7 to 9 years. This is a quasi-experimental study, in which the experimental group was compared with the waiting list group, before and after the intervention in the school environment. Those responsible answered the Social Skills Rating System and the Emotional Regulation Checklist. Children answered the Social Skills Rating System, Screen for Child Anxiety Related Emotional Disorders and Children Depression Inventory. Significant results were identified in increase of social skills and levels of emotional regulation, and a significant decrease in behavior problems and symptoms of anxiety and depression, in the experimental group. The significant difference between the groups occurred only in levels of social skills and emotional regulation scores. Given the results, it is concluded that the Child Regulation Work can be a proposal for the prevention of emotional and behavioral problems at school.

Este estudio evaluó los efectos del Trabajo de Regulación Infantil sobre las habilidades socioemocionales y los síntomas de ansiedad y depresión en niños de 7 a 9 años. Este es un estudio cuasi-experimental, en que se comparó el grupo experimental con el grupo lista de espera, antes y después de la intervención en el entorno escolar. Los responsables completaron el Social Skills Rating Systemy la Emotional Regulation Checklist. Los niños completaron el Social Skills Rating System, la Screenfor Child Anxiety Related Emotional Disorders y el Children Depression Inventory. Se identificaron resultados significativos en el aumento de las habilidades sociales, los niveles de regulación emocional y una disminución de los problemas de conducta, síntomas de ansiedad y depresión, en el grupo experimental. La diferencia entre los grupos ocurrió solamente en los niveles de habilidades sociales y regulación emocional. Dados los resultados, se concluye que el Trabajo de Regulación Infantil puede ser una propuesta para la prevención de problemas emocionales y de comportamiento en la escuela.

Evidências de validade do Inventário de Compensação de Young (YCI) para a população do Rio Grande do Sul / Validity evidence of the Young Compensation Inventory (YCI) for the population of Rio Grande do Sul / Evidencias de validez del Inventario de Compensación Young (YCI) para la población de Rio Grande do Sul

O objetivo deste estudo foi examinar a estrutura fatorial e as evidências de validade do Inventário de Compensação de Young (YCI) para a população do Rio Grande do Sul. Contou-se com a participação de 504 adultos da população geral, com média de idade de 34,2 anos (DP = 12,9). Os instrumentos utilizados foram o Questionário de Esquemas de Young - Versão Breve (YSQ-S3), a Escala de Avaliação dos Sintomas (SCL-90-R) e o YCI. Os dados foram coletados através de plataforma online. Realizou-se a análise fatorial exploratória, para verificar a distribuição dos itens em fatores comuns, e a validade convergente, com correlação não paramétrica de Spearman com a SCL-90-R e o YSQ-S3. Foram interpretados quatro fatores: Dominação e Manipulação (α =0,85 ω=0,71); Obsessão e Organização (α =0,75 ω=0,75); Rebeldia e Independência (α =0,73 ω=0,69); e Busca de Reconhecimento (α =0,81 ω=0,91). A validade de construto mostrou-se adequada conforme a teoria. Concluiu-se que a versão adaptada apresenta boas propriedades psicométricas. (AU)

This study aimed to examine the factorial structure and evidence of validity of the Young Compensation Inventory (YCI) for the population of the state of Rio Grande do Sul. For this purpose, 504 adults from the general population participated, with a mean age of 34.2 years (SD = 12.9). The instruments used were the Young Schema Questionnaire - Brief Version (YSQ-S3), the Symptom Checklist-90 (SCL-90-R), and the YCI. Data were collected using an online platform. Exploratory factor analysis was performed to verify the distribution of items in common factors, and convergent validity, with a non-parametric Spearman correlation with SCL-90-R and YSQ-S3. Four factors were interpreted: Domination and Manipulation (α = 0.85 ω = 0.71); Obsession and Organization (α = 0.75 ω = 0.75); Rebellion and Independence (α = 0.73 ω = 0.69); and Search for Recognition (α = 0.81 ω = 0.91). The result of construct validity proved to be adequate according to the theory. It was concluded that the adapted version has good psychometric properties. (AU)

El objetivo de este estudio fue examinar la estructura factorial y las evidencias de validez del Young Compensation Inventory (YCI) para la población de Rio Grande do Sul. Participaron 504 adultos de la población general, con una edad media de 34,2 años (DS = 12,9). Los instrumentos utilizados fueron el Young Scheme Questionnaire - Versión breve (YSQ-S3), la Escala de Evaluación de Síntomas (SCL-90-R) y el YCI. Los datos se recogieron a través de una plataforma online. Se realizó un análisis factorial exploratorio para verificar la distribución de los ítems en factores comunes, y la validez convergente, con la correlación no paramétrica de Spearman con SCL-90-R y YSQ-S3. Se interpretaron cuatro factores: Dominación y Manipulación (α =0,85 ω=0,71); Obsesión y Organización (α =0,75 ω=0,75); Rebeldía e Independencia (α =0,73 ω=0,69); y Búsqueda de Reconocimiento (α =0,81 ω=0,91). La validez de constructo demostró ser adecuada según la teoría. Se concluyó que la versión adaptada presenta buenas propiedades psicométricas. (AU)

Impacts of mindfulness-based interventions in people undergoing hemodialysis: a systematic review / Impactos de intervenções baseadas em mindfulness em pessoas submetidas a hemodiálise: uma revisão sistemática

Abstract Introduction: Chronic kidney disease (CKD) is a serious public health problem worldwide, leading to a series of physical and psychological comorbidities, in addition to costly treatments, lifestyle and dietary restrictions. There is evidence that mindfulness-based interventions (MBIs) offer complementary treatment for people with chronic illnesses, including CKD, with the aim of improving overall health, reducing side effects and treatment costs. This review aims to investigate the MBIs impact on people with CKD undergoing hemodialysis, and to identify the methodological quality of the current literature in order to support future studies. Methods: We ran searches in five databases (MEDLINE via PubMed, PsycINFO, Embase, Web of Science and Scopus) in July 2020. The papers were selected and evaluated by two reviewers independently, using predefined criteria, including the Cochrane Group's risk of bias tool and its recommendations (CRD42020192936). Results: Of the 175 studies found, 6 randomized controlled trials met the inclusion criteria, and ranged from 2014 to 2019. There were significant improvements in symptoms of anxiety, depression, self-efficacy, sleep quality, and quality of life (n=3) in the groups submitted to the intervention, in addition to physical measures such as blood pressure, heart rate and respiratory rate (n=1). Conclusions: MBIs can offer a promising and safe complementary therapy for people with CKD undergoing hemodialysis, acting on quality of life and physical aspects of the disease.

Resumo Introdução: A doença renal crônica (DRC) é reconhecida como um sério problema de saúde pública a nível mundial, levando a uma série de comorbidades físicas e psicológicas, além de tratamentos custosos e restrições no estilo de vida e alimentares. Há evidências de que as intervenções baseadas em mindfulness (IBMs) oferecem opções complementares ao tratamento de pessoas com doenças crônicas, incluindo DRC, com o objetivo de melhorar a saúde geral, reduzir os efeitos colaterais e custos do tratamento. Esta revisão objetiva investigar o impacto de IBMs em pessoas com DRC em hemodiálise, e identificar a qualidade metodológica da literatura atual a fim de auxiliar pesquisas futuras. Métodos: As pesquisas foram realizadas em cinco bases de dados (MEDLINE via PubMed, PsycINFO, Embase, Web of Science e Scopus), em julho de 2020. Os artigos foram selecionados e avaliados por dois revisores de forma independente, utilizando critérios predefinidos, incluindo a ferramenta de risco de viés do grupo Cochrane e suas recomendações (CRD42020192936). Resultados: Dos 175 estudos encontrados, 6 ensaios clínicos randomizados estavam de acordo com os critérios de inclusão, e variaram entre os anos de 2014 a 2019. Foram encontradas melhoras significativas para os sintomas de ansiedade, depressão, autoeficácia, qualidade de sono, e qualidade de vida (n=3) nos grupos que realizaram a intervenção, além de medidas físicas como pressão arterial, frequência cardíaca e taxa respiratória (n=1). Conclusões: As IBMs podem oferecer uma terapêutica complementar promissora e segura para pessoas com DRC em hemodiálise, atuando na qualidade de vida e em aspectos físicos da doença.

Intervenção interdisciplinar reduz o consumo de alimentos ultraprocessados em adolescentes com sobrepeso ou obesidade / Interdisciplinary intervention reduces the consumption of ultra-processed foods in adolescents with overweight or obesity

Este estudo objetivou avaliar o efeito da intervenção interdisciplinar com abordagem motivacional sobre o consumo de alimentos ultraprocessados em adolescentes com sobrepeso ou obesidade. O método utilizado foi um ensaio clínico randomizado no qual os participantes distribuíram-se em grupo controle (GC) e grupo intervenção (GI). A coleta de dados do consumo alimentar ocorreu mediante o recordatório de 24 horas, obtido no início e ao final das intervenções. Os alimentos consumidos foram categorizados nos quatro grupos da classificação alimentar NOVA conforme o grau de processamento a qual são submetidos. Participaram 42 adolescentes com média de idade de 16,5±1,3 anos, a maioria do gênero feminino (69%). No GI, a média de quilocalorias de alimentos ultraprocessados diminuiu 37,5% após a intervenção; em contrapartida, aumentou o consumo de alimentos processados em ambos os grupos. Concluiu-se que a intervenção interdisciplinar com abordagem motivacional foi eficaz na redução do consumo de alimentos ultraprocessados na população estudada.

The aim of this study was to evaluate the effect of interdisciplinary intervention with motivational approach on the consumption of ultra-processed foods in overweight or obese adolescents. The method used was a randomized clinical trial in which participants were allocated to control group (CG) and intervention group (IC). The data collection of food consumption occurred through the 24-hour food record, obtained at the beginning and end of interventions. The foods consumed were classified into the four NOVA groups according to the degree of processing which they are submitted. Forty-two adolescents with a mean age of 16.5±1.3 years, mostly female (69%), participated in the study. In IG, the average kcal of ultra-processed foods decreased by 37.5% after intervention. In contrast, there was an increase in the consumption of processed foods in both groups. It was concluded that the interdisciplinary intervention with a motivational approach was effective in reducing the consumption of ultra-processed foods in the studied population.

Impacts of mindfulness-based interventions in people undergoing hemodialysis: a systematic review.

INTRODUCTION: Chronic kidney disease (CKD) is a serious public health problem worldwide, leading to a series of physical and psychological comorbidities, in addition to costly treatments, lifestyle and dietary restrictions. There is evidence that mindfulness-based interventions (MBIs) offer complementary treatment for people with chronic illnesses, including CKD, with the aim of improving overall health, reducing side effects and treatment costs. This review aims to investigate the MBIs impact on people with CKD undergoing hemodialysis, and to identify the methodological quality of the current literature in order to support future studies. METHODS: We ran searches in five databases (MEDLINE via PubMed, PsycINFO, Embase, Web of Science and Scopus) in July 2020. The papers were selected and evaluated by two reviewers independently, using predefined criteria, including the Cochrane Group's risk of bias tool and its recommendations (CRD42020192936). RESULTS: Of the 175 studies found, 6 randomized controlled trials met the inclusion criteria, and ranged from 2014 to 2019. There were significant improvements in symptoms of anxiety, depression, self-efficacy, sleep quality, and quality of life (n=3) in the groups submitted to the intervention, in addition to physical measures such as blood pressure, heart rate and respiratory rate (n=1). CONCLUSIONS: MBIs can offer a promising and safe complementary therapy for people with CKD undergoing hemodialysis, acting on quality of life and physical aspects of the disease.

The role of social connection on the experience of COVID-19 related post-traumatic growth and stress.

BACKGROUND: Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense of social disconnection and loneliness. This study explores how people's experience of compassion and feeling socially safe and connected, in contrast to feeling socially disconnected, lonely and fearful of compassion, effects the impact of perceived threat of COVID-19 on post-traumatic growth and post-traumatic stress. METHODS: Adult participants from the general population (N = 4057) across 21 countries worldwide, completed self-report measures of social connection (compassion for self, from others, for others; social safeness), social disconnection (fears of compassion for self, from others, for others; loneliness), perceived threat of COVID-19, post-traumatic growth and traumatic stress. RESULTS: Perceived threat of COVID-19 predicted increased post-traumatic growth and traumatic stress. Social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. These effects were consistent across all countries. CONCLUSIONS: Social connection is key to how people adapt and cope with the worldwide COVID-19 crisis and may facilitate post-traumatic growth in the context of the threat experienced during the pandemic. In contrast, social disconnection increases vulnerability to develop post-traumatic stress in this threatening context. Public health and Government organizations could implement interventions to foster compassion and feelings of social safeness and reduce experiences of social disconnection, thus promoting growth, resilience and mental wellbeing during and following the pandemic.

Estresse, Ansiedade, Depressão e Inflexibilidade Psicológica em Estudantes Universitários de Graduação e Pós-Graduação / Prevalence of Stress, Anxiety, Depression and the Relationship with Psychological Inflexibility in University Students / Estrés, Ansiedad, Depresión e Inflexibilidad Psicológica en Estudiantes Universitarios de Pregrado y Posgrado

Este estudo tem como objetivo examinar a prevalência de estresse, ansiedade, depressão, inflexibilidade psicológica, dados sociodemográficos, clínicos e acadêmicos e a relação entre essas variáveis, em uma amostra de estudantes de graduação e pós-graduação do Rio Grande do Sul, além de comparar esses dois grupos quanto aos resultados. Participaram da pesquisa 574 estudantes, com idade a partir de 18 anos, de diferentes cursos e universidades, sendo 357 da graduação e 217 da pós-graduação. Trata-se de um estudo transversal, de levantamento, com questionários de autorrelato e coleta online. Os Instrumentos utilizados foram: Ficha de dados sociodemográficos e acadêmicos; Escala de Ansiedade, Depressão e Estresse; Escala de Estresse Percebido; Questionário de Aceitação e Ação para Estudantes Universitários. Os níveis de estresse, ansiedade e depressão foram considerados altos nesta amostra. A inflexibilidade psicológica mostrou uma correlação significativa com essas variáveis e mostrou-se preditiva de estresse percebido. Os estudantes de graduação apresentaram índices de estresse mais elevados que os de pós-graduação. Sugere-se investir em estudos que incluam a inflexibilidade psicológica e o estresse como variáveis investigadas e também como foco de intervenções com esta população. (AU)

This study aims to scan the prevalence of stress, anxiety, depression, psychological inflexibility, sociodemographic, clinical and academic data and the relationship between these variables, in a sample of undergraduate and graduate students in Rio Grande do Sul, in addition to comparing these two groups as to the results. 574 students, aged 18 and over, from different courses and universities took part in the research, 357 from undergraduate and 217 from graduate courses. This is a cross-sectional survey study, with self-report questionnaires and online collection. The instruments used were: Sociodemographic and academic data sheet; Depression Anxiety Stress Scale Perceived Stress Scale; Accept and Action Questionnaire for University Students. The levels of stress, anxiety and depression were considered high in this sample. Psychological inflexibility showed a significant correlation with these variables and was predictive of perceived stress. Undergraduate students had higher stress levels than graduate students. It is suggested to invest in studies that include psychological inflexibility and stress as variables investigated and also as the focus of interventions within this population. (AU)

Este estudio tiene como objetivo examinar la prevalencia de estrés, ansiedad, depresión, inflexibilidad psicológica, datos sociodemográficos, clínicos y académicos y la relación entre estas variables, en una muestra de estudiantes de pregrado y posgrado del Rio Grande del Sul, además de comparar estos dos grupos en cuanto a los resultados. En la investigación, participaron 574 estudiantes de 18 y más años de diferentes cursos y universidades, 357 de pregrado y 217 de posgrado. Se trata de un estudio transversal, con cuestionarios de autoinforme y recopilación de datos online. Los instrumentos utilizados fueron: Ficha sociodemográfica y académica; Escala de estrés, ansiedad y depresión; Escala de estrés percibido; Cuestionario de aceptación y acción para estudiantes universitarios. Los niveles de estrés, ansiedad y depresión se consideraron altos en esta muestra. La inflexibilidad psicológica mostró una correlación significativa con estas variables y fue predictiva del estrés percibido. Los estudiantes de pregrado tenían niveles de estrés más altos que los estudiantes de posgrado. Se sugiere invertir en estudios que incluyan la inflexibilidad psicológica y el estrés como variables investigadas y también como foco de intervenciones con esta población. (AU)

The Effect of Different Interventions for Lifestyle Modifications on the Number of Diagnostic Criteria and Clinical Aspects of Metabolic Syndrome.

Background: Lifestyle intervention programs comprise the first-choice therapy to reduce the cardiovascular risk factors in metabolic syndrome (MetS). Our aim was to compare the effects of three lifestyle modification programs on the number of diagnostic criteria and clinical parameters of MetS. Methods: Twelve-week clinical trial, including 125 adults who presented at least three of the criteria defined by the revised NCEP ATP III (National Cholesterol Education Program Adult Panel III) for MetS. Individuals were randomized into three multidisciplinary intervention groups: Standard Intervention (SI), Group Intervention (GI) and Individual Intervention (II). Results: Seventy-one individuals, aged 34-59 years, concluded the study: SI: 20, GI: 25, and II: 26. The GI and II groups presented a significant decrease of body mass index, abdominal circumference, diastolic and systolic arterial pressure after intervention. The number of diagnostic criteria for MetS decreased significantly. Within the GI and II groups, 16.0% and 15.4% of the individuals, respectively, did not meet the criteria for the clinical condition studied at the end of the interventions. In the II group, the percentage of individuals with five criteria reduced 83.5%. In the GI group, the percentage of individuals with five criteria remained the same, but the number of individuals with four criteria presented a 50.0% reduction. Conclusions: Results reinforce that nonpharmacological strategies for changing lifestyle affect the reduction of cardiovascular risk factors existing in MetS. They are also able to remove the population from this clinical condition by decreasing the diagnostic criteria. II or GI lead to a successful treatment of MetS, especially when conducted by multidisciplinary team. Brazilian Registry of Clinical Trials-ReBEC number: RBR-9wz5fc.

Protocolo preventivo da terapia de regulação infantil: estudo piloto no ambiente escolar / Preventive protocol of terapia de regulação infantil: pilot study in the school environment / Protocolo preventivo de terapia de regulação infantil: estudio piloto en el entorno escolar

A qualidade da educação relaciona-se com o investimento na aprendizagem acadêmica e com o desenvolvimento socioemocional dos alunos. Esse artigo objetiva avaliar os efeitos do protocolo preventivo da Terapia de Regulação Infantil (TRI-P) nas habilidades socioemocionais de crianças. A TRI-P tem como propósito desenvolver competências emocionais e sociais nas escolas. Utilizou-se delineamento quasi-experimental com avaliação pré e pós teste. Participaram 28 crianças de sete a nove anos, estudantes de uma escola particular no interior do Rio Grande do Sul. Aplicou-se as escalas Social Skills Rating System para a avaliação de habilidades sociais e comportamentos problemáticos e Emotional Regulation Checklist para avaliar regulação e labilidade emocional. Os resultados, após intervenção, apontam diminuição nos níveis de problema de comportamento e aumento nos escores de regulação emocional e habilidades sociais. Percebe-se que a implementação de programas de habilidades socioemocionais pode ser promissora frente à importância do cuidado com saúde mental no ambiente escolar.

The quality of education is related to the investment in students' academic learning and socio-emotional development. This article aims to evaluate the effects of the preventive protocol of Terapia de Regulação Infantil: (TRI-P) on children's socioemotional skills. TRI-P aims to develop socioemocional skills in schools. A quasi-experimental design with pre and posttest evaluation was used. Twenty-eight children from 7 to 9 years old, students from a private school in a country town of Rio Grande do Sul, participated in the study. The Social Skills Rating System scales were used to assess social skills and problem behaviors, and the Emotional Regulation Checklist to evaluate regulation and emotional lability. The results, after the intervention, indicated a decrease in behavior problem levels and an increase in emotional regulation and social skills scores. The implementation of socioemotional skills programs can be promising considering the importance of mental health care in the school environment.

La calidad de la educación está relacionada con la inversión en el aprendizaje y el desarrollo socioemocional de los estudiantes. Este artículo tiene como objetivo evaluar los efectos del protocolo de la terapia de regulación infantil (TRI-P) en habilidades socioemocionales de los niños. TRI-P tiene como objetivo desarrollar habilidades emocionales y sociales en las escuelas. Se utilizó un diseño cuasiexperimental con evaluación previa y posterior a la prueba. Veintiocho niños de 7 a 9 años de una escuela privada participaron en el estudio. Las escalas Social Skills Rating System se utilizaron para evaluar habilidades sociales y comportamientos problemáticos, la Emotional Regulation Checklist para evaluar regulación y labilidad emocional. Los resultados indican una disminución en los niveles de problemas de conducta y aumento en la regulación emocional y los puntajes de habilidades sociales. La implementación de programas de habilidades socioemocionales puede ser prometedora.

Intervention Protocol Based on Transtheoretical Model of Behavior Change for Metabolic Syndrome / Protocolo de Intervenção Baseada no Modelo Transteórico de Mudança de Comportamento para Síndrome Metabólica

Abstract The present study is the translation and adaptation of an intervention based on the Transtheoretical Model of Change directed to patients at cardiovascular risk. The original 29-session manual was translated into Portuguese, extended to 36 sessions, and applied in a pilot study. The protocol was reduced to 12 sessions through the grouping based on the processes of change. The products of the present study were the processes in each behavior, the versatility of the protocol, the interdisciplinary work, the great cost-benefit, and the potential of effectiveness. Finally, the importance of consistent training in Motivational Interview, Transtheoretical Model and group management for proper use are highlighted, and the costs and benefits of protocols versus more flexible treatments are discussed.

Resumo Trata-se da tradução e adaptação de uma intervenção baseada no Modelo Transteórico de Mudança e direcionada para pacientes com risco cardiovascular. Inicialmente, o manual original com 29 sessões foi traduzido para a língua portuguesa, sendo ampliado para 36 sessões, e posteriormente aplicado em um estudo piloto. A partir de agrupamentos pelos processos de mudança, foi reduzido para 12 sessões. Evidencia-se como produtos deste trabalho o aprofundamento dos processos em cada comportamento, a versatilidade do protocolo, o trabalho interdisciplinar, o ótimo custo-benefício e o potencial de efetividade. Por fim, salienta-se a importância de um treinamento consistente em Entrevista Motivacional, Modelo Transteórico e manejo de grupos para sua utilização adequada, e discute-se os custos e os benefícios dos protocolos versus tratamentos mais flexíveis.

Fatores preditivos de desistência em um programa para adolescentes com sobrepeso ou obesidade: estudo MERC / Predictive factors of dropout from a program for overweight or obese adolescents: MERC study / Factores predictivos de desistimiento en un programa para adolescentes con sobrepeso u obesidad: estudio MERC

O objetivo deste estudo foi identificar fatores potenciais de impacto sobre a desistência em um ensaio clínico randomizado. Para participar das 12 semanas de intervenção, foram selecionados adolescentes com sobrepeso ou obesidade (IMC percentil ≥ 85), dos sexos masculino e feminino, com média de idade 16,44±1,09. Utilizou-se regressão logística binária para responder pelo desfecho de não conclusão. As regressões foram realizadas por blocos e as variáveis estudadas foram características demográficas e antropométricas, marcadores metabólicos, aspectos motivacionais, funcionamento psicológico e percepção das práticas alimentares parentais. Foi constatada uma taxa de desistência de 48,8%. A maior chance de desistência foi explicada no modelo final de regressão pela autoeficácia para mudança de estilo de vida (OR: 0,732; IC95%: 0,581-0,921; p=0,008), pelo suporte familiar (OR: 0,807; IC95%: 0,685-0,950; p=0,010), pela HbA1c (OR: 11,366; IC95%: 3,123-37,702; p=0,010) e por fatores relacionados às práticas alimentares parentais. Concluiu-se que a família e os aspectos relacionados à motivação para mudança podem ser determinantes de desistência em programas para perda de peso para adolescentes.

The number of overweight or obese adolescents has increased, but the rate of dropping out in programs for this population is high. The objective of this study was to identify potential factors of impact on dropping out in a randomized clinical trial. To take part in a 12-week intervention, overweight or obese adolescents (BMI percentile ≥ 85), males and females, with mean age 17.99±1.09 were selected. Binary logistic regression was used to account for the non-completion outcome. Regressions were performed by blocks and the variables studied were demographic and anthropometric traits, metabolic markers, motivational aspects, psychological functioning, and perception of parental food practices. The drop-out rate was 48.8%. The highest chance of withdrawal was explained in the final regression model by self-efficacy to change lifestyle (OR: 0.732; IC95%: 0.581-0.921; p=0.008), by family support (OR: 0.807; IC95%: 0.685-0.950; p=0.010), by HbA1c (OR: 11.366; IC95%: 3.123-37.702; p=0.010), and by factors associated with parental food practices. It was concluded that the family and aspects related to motivation for change can be determinants of dropping-out in weight-loss programs for teenagers.

El objetivo de este estudio fue identificar factores potenciales del impacto sobre la desistencia en un ensayo clínico aleatorizado. Se seleccionaron para participar en 12 semanas de intervención, adolescentes con sobrepeso u obesidad (IMC percentil ≥ 85), del sexo masculino y femenino con media de edad 16,44±1,09. Se utilizó regresión logística binaria para responder por el resultado de conclusión incompleta. Las regresiones fueron realizadas por bloques y las variables estudiadas fueron características demográficas y antropométricas, marcadores metabólicos, aspectos motivacionales, funcionamiento psicológico y percepción de las prácticas alimentarias parentales. La tasa de desistimiento fue de 48,8%. La mayor probabilidad de desistimiento fue explicada en el modelo final de regresión por auto-eficacia para el cambio de estilo de vida (OR: 0,732, IC95%: 0,581-0,921, p=0,008), por el soporte familiar (OR: 0,807, IC95%: 0,685-0,950; p=0,010), por la HbA1c (OR: 11,366, IC95%: 3,123-37,702; p=0,010) y por factores relacionados con las prácticas alimentarias parentales. Se concluyó que la familia y los aspectos relacionados con la motivación para el cambio pueden ser determinantes de la desistencia de programas para la pérdida de peso para los adolescentes.

Effect of an interdisciplinary intervention with motivational approach on exercise capacity in obese adolescents: a randomized controlled clinical trial.

Objective To evaluate the effect of an interdisciplinary intervention with a motivational approach on exercise capacity and usual physical activity levels in overweight and obese adolescents. Methods This is a randomized, controlled clinical trial with single blinding of subjects. Adolescents aged 15 to 18 years with overweight and obesity (body mass index ≥ 85 percentile) were included. The adolescents were randomized into two groups: interdisciplinary intervention or control - traditional approach aiming at lifestyle modifications. The initial evaluations were carried out, including the cardiopulmonary exercise test and the physical activity level measurement by using the International Physical Activity Questionnaire and a pedometer. The evaluations were performed in two moments: time zero (time of inclusion in the study) and after 3 months (end of intervention). There were 12 sessions with weekly meetings. Results A total of 37 participants were included, 19 in the Intervention Group. There were no significant differences in the baseline demographic, anthropometric and physical activity characteristics between groups, with mean age of 17.3±1.0 years in the Control Group, and 16.8±0.9 years in the Intervention Group (p=0.14). The motivational intervention did not cause significant differences (p>0.05) in the comparison of the variables of exercise capacity and usual physical activity (questionnaire and pedometer) between groups. Conclusion The intervention with a motivational approach did not alter exercise capacity and levels of usual physical activity in overweight and obese adolescents. Clinical Trial Registry: NCT02455973 and REBEC: RBR-234nb5.

Reflexões sobre um treinamento em Entrevista Motivacional em estudantes da área da saúde / Reflections on Motivational Interview training for students in the health field

O uso da Entrevista Motivacional (EM) pode auxiliar o paciente na ativação das suas metas, configurando-se como um modo de comunicação eficaz para mudanças no estilo de vida. Entretanto, é necessário que o profissional esteja capacitado para a aplicação dos princípios da EM, a fim de ser uma prática efetiva. O objetivo deste estudo foi refletir sobre a importância do uso da EM no campo da saúde. Para isso, avaliou-se o nível de conhecimento em EM e a aplicação das habilidades fundamentais da EM em uma amostra de 120 estudantes da área da saúde, após um treinamento. Verificou-se o grau de Confiança e de Importância em utilizar essas habilidades na prática profissional dos participantes. Encontrou-se que quanto maior o grau de confiança em EM, maior é o percentual de perguntas consistentes com os fundamentos da EM e maior chance de acertos naEM. Os achados mostram a relevância do treinamento de Entrevista Motivacional nos cursos da área da saúde, pois potencializam a confiança dos alunos ao trabalharem com os pacientes sobre mudanças de comportamento e qualificam a formação do profissional daárea da saúde.(AU)

The use of Motivational Interviewing (MI) can help the patient to activate his goals, configuring himself as an effective way to communicate for changes in lifestyle. However, it is necessary that the professional is trained to apply the principles of MI in order to be an effective practice. The aim of this study was to reflect on the importance of using MI in the health field. To do this, use the level of knowledge in MI and an application of basic MI skills in a sample of 120 students in the health field, after training in MI. The degree of confidence and importance in the use of these skills in the participants' professional practice was verified. It was found that the greater the degree of confidence in MI, the greater the percentage of questions consistent with the fundamentals of MI and the greater the probability of success in MI. The results show the relevance of motivational interview training in health care courses, as they improve students' confidence when working with patients in behavioral changes and qualify the training of health professionals.(AU)

Psychological inflexibility in overweight and obese people from the perspective of acceptance and commitment therapy (ACT).

PURPOSE: To identify the psychological inflexibility (PI) processes (experiential avoidance, cognitive fusion, poor contact with the present moment, unclear personal values and lack of commitment to action) associated with body mass index (BMI), depression, anxiety and stress symptoms and binge eating in overweight and obese people by drawing on the acceptance and commitment therapy (ACT) framework. METHODS: A cross-sectional study of 243 people with a BMI of at least 25 and aged from 18 to 60 years old. The following instruments were used: Acceptance and Action Questionnaire II (AAQ-II), Acceptance and Action Questionnaire-Weight (AAQ-W), Valued Living Questionnaire (VLQ), Cognitive Fusion Questionnaire (CFQ-7), Cognitive Fusion Questionnaire-Body Image (CFQ-BI), Mindful Eating Questionnaire (MEQ), Binge Eating Scale (BES) and Depression, Anxiety and Stress Scale (DASS-21). Data were analyzed using one-way ANOVA and t tests. RESULTS: There were no differences between BMI categories with respect to PI variables, but PI was positively related to the severity of binge eating and to symptoms of depression, anxiety and stress. CONCLUSION: The development of interventions focused on psychological inflexibility can be useful for the treatment of symptoms associated with overweight and obesity. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Transtheoretical model for change in obese adolescents: MERC randomized clinical trial.

The randomized controlled trial evaluated the effectiveness of an intervention based on the Transtheoretical Model of Change on anthropometric, metabolic and motivational outcomes in obese adolescents. A total of 135 male and female adolescents were randomized to two groups: intervention group (n = 65) and control group (n = 70). The adolescents were evaluated 1 week before the interventions began and at the end of 12 weeks. There was no statistically significant difference between groups in the outcome variables. Intervention group reported magnitude of effect more expressive on body mass index percentile, waist circumference, waist-to-hip ratio, readiness to change diet and readiness to start exercise.

Effect of an interdisciplinary intervention with motivational approach on exercise capacity in obese adolescents: a randomized controlled clinical trial / Efeito de intervenção interdisciplinar com abordagem motivacional na capacidade de exercício em adolescentes obesos: ensaio clínico controlado randomizado

ABSTRACT Objective To evaluate the effect of an interdisciplinary intervention with a motivational approach on exercise capacity and usual physical activity levels in overweight and obese adolescents. Methods This is a randomized, controlled clinical trial with single blinding of subjects. Adolescents aged 15 to 18 years with overweight and obesity (body mass index ≥ 85 percentile) were included. The adolescents were randomized into two groups: interdisciplinary intervention or control − traditional approach aiming at lifestyle modifications. The initial evaluations were carried out, including the cardiopulmonary exercise test and the physical activity level measurement by using the International Physical Activity Questionnaire and a pedometer. The evaluations were performed in two moments: time zero (time of inclusion in the study) and after 3 months (end of intervention). There were 12 sessions with weekly meetings. Results A total of 37 participants were included, 19 in the Intervention Group. There were no significant differences in the baseline demographic, anthropometric and physical activity characteristics between groups, with mean age of 17.3±1.0 years in the Control Group, and 16.8±0.9 years in the Intervention Group (p=0.14). The motivational intervention did not cause significant differences (p>0.05) in the comparison of the variables of exercise capacity and usual physical activity (questionnaire and pedometer) between groups. Conclusion The intervention with a motivational approach did not alter exercise capacity and levels of usual physical activity in overweight and obese adolescents. Clinical Trial Registry: NCT02455973 and REBEC: RBR-234nb5.

RESUMO Objetivo Avaliar o efeito de uma intervenção interdisciplinar com abordagem motivacional na capacidade de exercício e no nível de atividade física habitual em adolescentes com sobrepeso e obesidade. Métodos Trata-se de ensaio clínico controlado, randomizado, com cegamento único dos indivíduos. Foram incluídos adolescentes com idade entre 15 e 18 anos, com sobrepeso e obesidade (índice de massa corporal ≥ percentil 85). Os adolescentes foram randomizados em dois grupos: intervenção interdisciplinar motivacional ou controle − abordagem tradicional, visando à modificação do estilo de vida. Foram realizadas as avaliações iniciais incluindo o teste de exercício cardiopulmonar e a aferição do nível de atividade física por meio do International Physical Activity Questionnaire e do pedômetro. As avaliações foram realizadas em dois momentos, no tempo zero (inclusão no estudo) e após 3 meses (término da intervenção). Foram realizadas 12 sessões com encontros semanais. Resultados Foram incluídos 37 participantes, sendo 19 no Grupo Intervenção. Não houve diferenças significativas nos dados basais de características demográficas, antropométricas e de atividade física entre os grupos, e a média de idade foi de 17,3±1,0 anos no Grupo Controle e 16,8±0,9 anos no Intervenção (p=0,14). A intervenção motivacional não provocou diferenças significativas (p>0,05) na comparação das variáveis de capacidade de exercício e atividade física habitual (questionário e pedômetro) entre os grupos. Conclusão A intervenção com abordagem motivacional não alterou a capacidade de exercício e os níveis de atividade física habitual em adolescentes com sobrepeso e obesidade. Clinical Trial Registry: NCT02455973 and REBEC: RBR-234nb5.

Adaptação brasileira do Questionário de Esquemas de Young - Versão Breve (YSQ-S3) / Brazilian adaptation of the Young Schema Questionnaire - Short Form (YSQ-S3) / Adaptación brasileña del Young Scheme Questionnaire - Versión Breve (YSQ-S3)

Este estudo tem como objetivo descrever o processo de adaptação semântica do Questionário de Esquemas de Young - versão breve (YSQ-S3) para o português brasileiro e apresentar dados preliminares da consistência interna do instrumento. Trata-se de um estudo instrumental que seguiu os passos de tradução, síntese, avaliação por experts, avaliação pelo público-alvo, retrotradução e estudo piloto. Inclui uma etapa de estudo de evidências preliminares, na qual foram aplicados o YSQ-S3 e uma ficha de dados sociodemográficos com 200 participantes para análise da consistência interna utilizando alfa de Cronbach. Os resultados indicam que o instrumento apresenta boa adequação semântica para uso no Brasil. A consistência interna total foi classificada como excelente. Destaca-se a importância do seguimento de estudos de evidências de validade. (AU)

This study aimed for the semantic adaptation of the Young Schema Questionnaire - short form (YSQ-S3) to Brazilian Portuguese and presents preliminary data on the internal consistency of the instrument. It was an instrumental study that followed the steps of translation, synthesis, expert and focus group evaluation, back-translation and pilot study. It included a preliminary evidence study stage, in which the YSQ-S3 and a sociodemographic data sheet with 200 participants were analyzed for internal consistency with Cronbach's alpha. The results indicate that the Brazilian version of the YSQ-S3 presents good semantic adequacy. Overall internal consistency was rated as excellent. A validation study of this version is currently being carried out. (AU)

Este estudio tiene como objetivo describir el proceso de adaptación semántica del Young Scheme Questionnaire - versión breve (YSQ-S3) para el idioma brasileño y presentar datos preliminares de la consistencia interna del instrumento. Se trata de un estudio instrumental que siguió los pasos de la traducción, síntesis, evaluación por los expertos, evaluación del público objetivo, retrotraducción y estudio piloto. Incluye una etapa de estudio de evidencias preliminares en las que se aplicaron el YSQ-S3 y una ficha de datos sociodemográficos con 200 participantes para el análisis de la consistencia interna a partir del alfa de Cronbach. Los resultados indicaron que el instrumento presenta buena adecuación semántica para uso en Brasil. La consistencia interna total fue clasificada como excelente. Se destaca la importancia del seguimiento de estudios de evidencias de validez. (AU)