Association between sedentary behavior and Brain-Derived Neurotrophic Factor (BDNF) in children and adolescents: A protocol for systematic review and meta-analysis

BACKGROUND

There is evidence in the literature suggesting that high time spent in sedentary behavior (SB) can reduce the Brain-Derived Neurotrophic Factor (BDNF) levels, an important neurotrophin that plays a role in modulating cognition, learning and memory. Children and adolescents usually spend many hours a day on SB, either sitting for a long time and/or using screen equipment.

OBJECTIVE

The aim of this study is to describe a systematic review and meta-analysis protocol on the associations between SB and BDNF levels in children and adolescents.

METHODS

This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and was published in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42023392246). The databases that will be searched are EMBASE, Scopus, ScienceDirect, Web of Science, SPORTDiscus, CINAHL, and PubMed. Cross-sectional and cohort studies conducted with children and adolescents (5 to 19 yr) that analyzed the association between SB and BDNF will be included in the systematic review. The characteristics of the studies, methodological aspects, and main results will be described. Then, the risk of bias (assessed by STROBE and Newcastle-Ottawa scales) and the level of evidence (assessed by the GRADE tool) from included studies will be evaluated. Sub-group analysis will also be performed. Two experienced reviewers will perform the studies selection, data extraction, and methodological quality assessment.

CONCLUSION

This systematic review and meta-analysis will analyze the association between SB and BDNF in children and adolescents. The results will provide subsidies to better understand this relationship and will strengthen evidence-based practice for both health professionals and future researches.

Effect of School-Based Food and Nutrition Education Interventions on the Food Consumption of Adolescents: A Systematic Review and Meta-Analysis

The school is a favorable environment for the development of interventions to prevent obesity. The objective of this systematic review is to evaluate the effects of school-based food and nutrition education interventions on adolescent food consumption. The literature search was conducted on databases: MEDLINE/PubMed, Embase, Scopus, ERIC, Science Direct, Web of Science, Cochrane, LILACS, and ADOLEC. The following research strategies were focused on: population (adolescents), intervention (food and nutrition education), outcome (food consumption), and study design (clinical trial). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement guidelines were followed and all stages of this review were performed by two researchers and, when necessary, a third researcher resolved discrepancies. Included studies are randomized clinical trials (RCT). A total of 24 articles were included for review and 11 articles in meta-analysis. In the evaluation of the general effects, there was a significant effect (mean difference (MD) for fruit consumption (MD = 0.09, CI 0.05, 0.14) in serving/day; and for vegetables (MD = 0.59, IC 0.15, 1.03) at times/week. In the consumption of FV (fruits and vegetables), there was no significant effect (standardized mean difference (SMD) of interventions in their consumption (SMD = 0.00, 95% C1 -0.11, 0.11). The evidence available in this review and meta-analysis concludes that food and nutrition education interventions in schools presented favorable results in the food consumption of adolescents. Registered on the PROSPERO database (CRD42019116520).

Mechanisms of action of anti-inflammatory proteins and peptides with anti-TNF-alpha activity and their effects on the intestinal barrier: A systematic review

Several studies in animal models of intestinal inflammation have been performed with the aim of understanding the mechanisms of action of anti-inflammatory proteins and peptides that reduce TNF-α. In order to present the best targets, effects and strategies for the treatment of intestinal inflammation in experimental models, this systematic review (SR) aimed to answer the following question: what are the mechanisms of action of molecules with anti-TNF-α activity on the intestinal barrier? The SR protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, number CRD42019131862) and guided by the methodological procedures used for the elaboration of the SR. Articles that were part of the SR were selected considering the eligibility criteria according to the PICO (Population, Intervention, Comparison/Control and Outcomes) and were searched in the PubMed, Scopus, Web of Science, Excerpta Medica Database (EMBASE) and ScienceDirect databases. Twenty-five articles reporting studies in rats and mice were selected and the risk of bias was assessed using the tool from the SYstematic Review Center for Laboratory Animal Experimentation (SYRCLE). A descriptive synthesis of the results obtained was carried out. Based on the results, the anti-inflammatory molecules that reduced TNF-α acted mainly on the TNF-TNFR1/TNFR2 and TLR4/MD2 complex signaling pathways, and consequently on the NF-κB pathway. This improved the aspects of the inflammatory diseases studied. In addition, these mechanisms also improved the macroscopic, histological and permeability aspects in the intestine of the animals. These findings point to the potential of protein and peptide molecules that act on inflammatory pathways for medical applications with specific and promising strategic targets, aiming to improve inflammatory diseases that affect the intestine. This systematic review also highlights the need for more details during the methodological description of preclinical studies, since this was a limitation found.

Associations of the consumption of unprocessed red meat and processed meat with the incidence of cardiovascular disease and mortality, and the dose-response relationship: A systematic review and meta-analysis of cohort studies

OBJECTIVES

The aim of this study was to examine the associations of unprocessed red meat and processed meat consumption with cardiovascular disease (CVD) incidence and mortality, and the dose-response relationship.

METHODS

Published literature was retrieved through a structured search of 10 electronic databases: MEDLINE/PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, Cochrane (CENTRAL), WHOLIS, PAHO and Embase, without language or year of publication restrictions. In addition, we searched the references of published studies. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes: The PRISMA Statement.

RESULTS

Twenty-one prospective cohort studies were included in the systematic review. The CVDs evaluated in the inserted studies were stroke, heart failure (HF) and coronary heart disease (CHD). Considering the heterogeneity found in the studies, for the meta-analysis, 9 articles were included. The results presented in the meta-analysis of the association of consumption of unprocessed red meat and CVD indicated that there was a significant association with total stroke incidence (RR 1.10; 95%; CI 1.01 to 1.19; p = 0.02). There was no association with Ischemic stroke incidence, nor CHD Mortality with consumption of unprocessed red meat. However, for Hemorrhagic Stroke Mortality the assessment in the consumption of unprocessed red meat showed an association of protection for women (RR 0.64; 95%; CI 0.45 to 0.91; p = 0.01). As for the results of the meta-analysis of the association between consumption of processed meat and CVD, they indicated that there was a significant association with total stroke incidence (RR 1.17; 95%; CI 1.08 to 1.26; p < 0.0001). There was no association with Ischemic stroke, nor with CHD Mortality with consumption of processed meat. Some studies that showed no association of risk, presented a significant linear trend dose response for the association of the consumption of unprocessed red meat (Bernstein et al. 2010; Nagao et al. 2012) or processed meat (Bernstein et al. 2012) and CVD.

CONCLUSION

According to the results found in the meta-analysis, the consumption of unprocessed red meat and processed meat are associated with the incidence of stroke, however, no positive association was observed in relation to mortality from CVD. This systematic review and meta-analysis protocol was registered on the PROSPERO (number: CRD42019100914).

Training in communication skills for self-efficacy of health professionals: a systematic review

BACKGROUND

Communication skills are essential for health professionals to establish a positive relationship with their patients, improving their health and quality of life. In this perspective, communication skills training can be effective strategies to improve the care provided by professionals in patient care and the quality of health services.

OBJECTIVE

To identify the best available evidence on training programs in communication skills to promote changes in attitude and behavior or self-efficacy of health professionals.

METHODS

Systematic searches were performed in eight databases, evaluating Randomized Controlled Trials and quasi-experimental studies with a control group, focusing on training communication skills for health professionals, who assessed self-efficacy or behaviors related to these skills. The phases of study selection and data extraction were carried out by two independent researchers, and the conflicts were resolved by a third. The risk of bias was assessed using the Cochrane method.

RESULTS

Eight studies were included in the review. Most programs lasted between 4½ h and 2 days, involved information about communication skills and the content was applied to the health professionals' context. Several teaching strategies were used, such as lectures, videos and dramatizations and the evaluation was carried out using different instruments. Improvements in the performance and in the self-efficacy of communication skills were observed in the trained groups. The RCT had a low risk of bias and the quasi-experimental studies had a moderate risk.

CONCLUSION

Training in communication skills can improve the performance and self-efficacy of health professionals. Programs that approach the conceptual issues and promote the space for experiential learning could be effective in communication skills training for professionals.

PROSPERO

CRD42019129384.

Is rituximab effective for systemic sclerosis? A systematic review and meta-analysis

BACKGROUND

Systemic sclerosis (SSc) is a clinically complex and challenging disease, that leads to skin fibrosis. Its most frequent complication is interstitial lung disease (ILD), which leads to a worse prognosis. In this situation, cyclophosphamide is considered the gold standard for its treatment, despite the controversies regarding its efficacy and toxicity. However, studies using rituximab (RTX) have shown that this drug may be a promising therapeutic option.

OBJECTIVES

This paper objective was to analyze the scientific evidence on the RTX effects on SSc.

METHODS

A systematic review (SR) was performed including clinical trials (CTs) on the use of RTX in SSc, published up to May 2020. The studies were identified through systematic searches in bibliographic databases using a predefined search strategy. The following databases were used: PUBMED, SCOPUS, SCIELO, LILACS, SCIENCE DIRECT, WEB OF SCIENCE, COCHRANE, WHOLIS, PAHO and EMBASE. Also, a manual search was performed. The methodological quality of the studies was determined using Jadad scale, Risk of Bias Tool (RoB 2.0) and Risk of Bias in Non-Randomized Studies - of Interventions tool (ROBINS-I). A meta-analysis of the randomized CTs was performed, using Review Manager.

RESULTS

Ten CTs were included in this SR. Of these, three were randomized and seven were non-randomized. Five showed a statistically significant improvement in forced vital capacity (FVC) at some time during follow-up. Regarding the skin, eight studies showed statistically significant improvements according toa the modified Rodnan skin score. The meta-analysis found positive effects of RTX in SSc, with a statistical significance for lung disease.

CONCLUSION

Rituximab is a promising strategy for the SSc-associated ILD and cutaneous fibrosis treatment. PROSPERO registration number: CRD42019132018.

Media and scientific communication about the COVID-19 pandemic and the repercussions on the population's mental health: A protocol for a systematic review and meta-analysis

BACKGROUND

Good communication strategies are essential in times of crisis, such as the coronavirus pandemic. The dissemination of inaccurate information and the need for social isolation to control coronavirus disease 2019 (COVID-19) have shown a negative impact on the population, causing damage to mental health, with the appearance or worsening of symptoms of stress, fear, anxiety, and depression. Thus, the systematic review study is intended to gather evidence on the impact of information about COVID-19 on the mental health of the population.

METHODS

This systematic review protocol is conducted using the guidelines of the preferred reporting items for systematic reviews and meta-analyses protocols and the Cochrane Handbook for Systematic Reviews of Interventions. The review aims to include published studies that address the exposure of the general population to information about COVID-19, through observational and experimental studies, which consider the following outcomes: fear, stress, anxiety, and depression. Thus, a comprehensive research strategy will be conducted in the following databases: PubMed / Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO and Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will perform all procedures, such as study selection, data collection, and methodological evaluation. Disagreements will be forwarded to a third reviewer. RevMan 5.3 software will be used for data analysis.

RESULTS

This systematic review will provide evidence of the influence of access to and consumption of media and scientific information about COVID-19 on the mental health of the population. It will consider information about the characterization of the study and the population studied, clinical and epidemiological information on mental health, and data on access to and consumption of media and scientific information.

DISCUSSION

The results should inform about the consequences of communication about the new coronavirus on the emergence or worsening of psychological and psychiatric symptoms, allowing to develop strategies to achieve effective communication of information to promote the mental health of the population.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020182918.

Placebo use and outcome quality: A protocol for systematic review and meta-analysis

BACKGROUND

The Pharmaceutical industry sponsorship, research outcome and quality has been already evaluated for clinical trials in order to analyze if this kind of sponsorship affects the results of clinical trials. In this sense, this study has the aim to investigate whether placebo use allows positive outcomes regarding efficacy and safety compared to synthetic medicines.

METHODS

We designed and registered a study protocol for a systematic review for methodology data. We will only randomized clinical trials that use placebo as comparator. The main outcome will be the evaluation of placebo use regarding the tendency for positive results (efficacy and security) when comparing to synthetic medicines. PubMed, Cochrane, LILACS (BVS), Web of Science, Scopus, and Excerpta Medica dataBASE (EMBASE) databases will be searched. Gray literature will be identified through the databases Proquest (Dissertation and Theses), OpenGrey and Google Scholar. Two review authors will independently assess trial quality and will extract data in accordance with standard Cochrane methodology. If necessary, we will also contact authors for additional information. The Cochrane Collaboration's risk of bias tool will be used. If feasible, it means homogenous data, we will conduct random effects meta-analysis. Subgroup analyses will be conducted for different justifications for placebo use and for studies sponsored/not sponsored by the pharmaceutical industry.

RESULTS

Our present findings will indicate the effects of placebo use as comparator regarding efficacy and safety of the oral synthetic medicines.

DISCUSSION

This systematic review will identify, summarize, and analyze if there is a trend for positive efficacy and safety results for synthetic medicines in clinical trials when compared with placebo and if the justification for placebo use is considered ethically acceptable.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42018110829.

The Effects of Exercise on BDNF Levels in Adolescents: A Systematic Review with Meta-Analysis

The aim of this study was to analyze the evidence available in the literature about the effects of exercise on brain-derived neurotrophic factor levels in adolescents. The literature searches were conducted in PubMed, Embase, Scopus, ScienceDirect, Web of Science, SportDiscus, the Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL. Randomized controlled trials and non-randomized controlled trials performed with adolescents (10–19 years) who underwent different exercise programs and who evaluated BDNF levels before and after the intervention were included. We included six studies, four RCTs and two non-RCTs in the systematic review with a total of 407 adolescents. In two randomized trials and one non-RCT, the intervention groups showed significant improvements in BDNF levels compared with the control group. The results presented in the meta-analysis indicate that despite the positive effect in favor of the intervention, there were no significant differences (standardized mean difference 0.28 ng/mL, 95% confidence interval −0.28 to 0.85; p = 0.32, I² = 0%). The results presented in our review indicate that aerobic exercise programs practiced in moderate- or high-intensity are promising strategies to increase BDNF levels in adolescents. However, further studies are required to support this finding.

The Control and Prevention of COVID-19 Transmission in Children: A Protocol for Systematic Review and Meta-analysis

BACKGROUND

The pandemic following the rapid spread of the new SARS-CoV-2 virus has hit all continents and caused thousands of deaths worldwide. Evidence has been published on epidemiological and clinical characteristics of population groups considered at risk; however, information for the other population groups, especially for the child population, is needed. In this context, this protocol describes a systematic review that will aim to identify the evidence on control and prevention of COVID-19 transmission among children and adolescents, as well as to describe the epidemiological profile and clinical and immunological characteristics of COVID-19 in this population.

METHODS

This protocol will be developed in accordance with PRISMA-P. The searches will be conducted in PubMed, Web of Science, ScienceDirect, EMBASE, and Scopus, seeking clinical trials. Observational studies and case reports with Children and adolescents (≤19 years) infected with SARS-CoV-2 will be included whether they report information on the control of prevention and COVID-19 transmission. Two independent researchers will perform the selection of articles, removal of duplication, and screening by Rayyan QCRI application. Cochrane's RoB 2.0, ROBINS-I, and CASP tools will be used to assess the risk of bias. Meta-analysis, subgroup analyses, and/or descriptive analyses will be carried out based on the data conditions included.

RESULTS

A high-quality synthesis of the available evidences on the epidemiological profile, the clinical and immunological characteristics involved in children, and adolescents diagnosed with COVID-19, as well as the participation of this population in the transmission dynamics of SARS-CoV-2 will be provided.

CONCLUSION

This systematic review has an important relevance in the current context because it has a great potential to help the development of new control and prevention strategies in the pediatric population.

RECORD OF SYSTEMATIC REVIEW

CRD42020179263.

Can people self-select an exercise intensity sufficient to enhance muscular strength during weight training?: A systematic review protocol of intervention studies

BACKGROUND

Previous studies have reported that self-selection of the training intensity can be an interesting strategy to improve adherence in aerobic exercise programs. However, its effectiveness with weight training has not been systematically reviewed and remains unclear. In this study, we will describe a systematic review protocol that aims to investigate if people are able to self-select an intensity during weight training sufficient to enhance muscular strength.

METHODS

This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. In this study, we will search the following electronic databases: PubMed, Science Direct, Scopus, Web of Science and SPORTDiscus. Intervention studies with at least one weight training session performed at self-selected intensity, with people from both genders and all age ranges will be included. The Downs & Black checklist will be used for methodological quality assessment. Two experienced reviewers will independently perform the selection of studies, data extraction, and evaluation of the methodological quality.

CONCLUSION

This will be the first systematic review describing the results of weight training intervention studies with self-selected intensity. This study will provide high-quality and reliable evidence for health professionals and may direct methodological recommendations for further studies.

PROSPERO REGISTRATION NUMBER

CRD42019120323.

Mechanisms of action of molecules with anti-TNF-alpha activity on intestinal barrier inflammation: A systematic review protocol

BACKGROUND

Tumor necrosis factor-alpha (TNF-alpha), among cytokines that mediate the inflammatory process, plays an important role in diseases involving the loss of intestinal barrier integrity. Several molecules with anti-TNF-alpha activity have been studied aiming to develop new therapies. The purpose of this paper is to describe the systematic review protocol of experimental studies that determine mechanisms of action of molecules with anti-TNF-alpha activity on intestinal barrier inflammation.

METHODS

This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Protocols (PRISMA-P). The databases to be searched are PubMed, EMBASE, Scopus, ScienceDirect, and Web of Science. Experimental studies in rats or mice that assessed the activity of anti-TNF-alpha molecules in models of intestinal barrier inflammation will be included in the systematic review. Studies characteristics, experimental model, and main results will be described and the bias risk assessment will be performed. Two independent reviewers will perform study selection, data extraction, and methodological quality assessment. A narrative synthesis will be made for the included studies. Also, if sufficient data is available, a meta-analysis will be conducted. I statistics will be used to assess heterogeneity.

RESULTS

The present protocol will assist in producing a systematic review that identifies the mechanisms underlying the reduction of TNF-alpha in intestinal barrier inflammation models.

CONCLUSION

The systematic review may contribute to the theoretical basis of research on new molecules with anti-TNF-alpha potential and, consequently, in the development of new therapies employed in humans.

PROSPERO REGISTRATION NUMBER

CRD42019131862.

Red meat consumption, risk of incidence of cardiovascular disease and cardiovascular mortality, and the dose-response effect: Protocol for a systematic review and meta-analysis of longitudinal cohort studies

BACKGROUND

Red and (particularly) processed meats are high in cholesterol and saturated and solid fatty acids. Their consumption is considered one of the risk factors for metabolic disorders. Numerous studies demonstrated a possible association between red meat consumption and cardiovascular disease (CVD). In this protocol, we propose a systematic review of the literature to examine the associations of red meat consumption with CVD incidence and mortality, and explore the potential dose-response relationship.

METHODS

We will search MEDLINE/PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, Cochrane (CENTRAL), WHOLIS, PAHO, and Embase. We will include prospective epidemiological studies (longitudinal cohort). Risk of bias will be assessed using the Newcastle-Ottawa scale (NOS). Four independent researchers will conduct all evaluations. Disagreements will be referred to a fifth reviewer. We will summarize our findings using a narrative approach and tables to describe the characteristics of the included studies. The heterogeneity between trial results will be evaluated using a standard chi-squared test with P < .05. We will conduct the study in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-analyses Protocols (PRISMA-P).

RESULTS

This review will evaluate the association between red meat consumption and incidence of CVD and mortality (primary outcome measures). The secondary outcome measure will include the dose-response effect.

CONCLUSION

The findings of this systematic review will summarize the latest evidence of the association between red meat consumption and incidence of CVD and mortality and the dose-response effect through a systematic review and meta-analysis.

REGISTRATION

PROSPERO CRD42019100914.

Rituximab in systemic sclerosis: A protocol for systematic review

BACKGROUND

Systemic sclerosis (SSc) is a clinically complex and challenging disease, the most frequent complication of which is interstitial lung disease, which leads to a worse prognosis. In this situation, cyclophosphamide is considered the criterion standard for treatment, despite the controversies regarding its efficacy and toxicity. However, studies using rituximab (RTX) have shown that this drug may be a promising therapeutic option. The objective is to describe a protocol of a systematic review (SR) that analyzes the scientific evidence on the effects of RTX on SSc.

METHODS

This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases to be searched are PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, COCHRANE, WHOLIS, PAHO, and EMBASE. The studies that would be included in SR are clinical trials that evaluate the use of RTX in patients with SSc who meet the classification criteria for the disease according to American College of Rheumatology and European League Against Rheumatism (2013) and/or LeRoy criteria will be included in the SR. The data to be extracted are related to the characteristics of the studies: authors, year of publication, study location, type of study, sample size and age, patient characteristics, duration of intervention, therapeutic scheme, follow-up time, main variables, and main results.

RESULTS

In our study, we hope to find articles presenting new evidence supporting treatment of SSc with RTX.

CONCLUSIONS

The SR will present results of scientific evidence for the effects of RTX in SSc. We hope that the results could strengthen clinical decisions for the best treatment of SSc and guide future researches.

PROSPERO REGISTRATION NUMBER

CRD42019132018.

Training programs in communication skills to improve self-efficacy for health personnel: Protocol for a systematic review and meta-analysis

BACKGROUND

Patient-centered care should be the focus of health services, where improvements in the communication skills of health professionals promote excellent health and quality care. Thus, this study is a protocol for a systematic review and meta-analysis to evaluate the effectiveness of training programs in communication skills to promote self-efficacy in the communication of health personnel.

METHODS

This systematic review protocol is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) statement guidelines and the Cochrane Handbook of Systematic Reviews of Interventions. The review should include studies carried out with health professionals who have undergone training in communication skills aimed at promoting their self-efficacy. Clinical trials (randomized, non-randomized), community trials, and quasi-experimental studies should be included. Therefore, the comprehensive search strategy will be conducted in the following databases: PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will conduct all study selection procedures, data extraction, and methodological evaluation, and disagreements will be referred to a third reviewer. RevMan 5.3 software will be used to gather data and perform the meta-analysis if possible.

RESULTS

This systematic review will provide evidence on more effective programs for communication skills training and will consider information such as duration, educational strategies, assessment measures, and outcomes that promote health worker self-efficacy.

DISCUSSION

This systematic review should provide evidence for effective communication skills training for health professionals in order to guide new strategies for quality care.

DISSEMINATION AND ETHICS

The findings of this scoping review will be disseminated in print, at conferences, or via peer-reviewed journals. Ethical approval is not necessary as this paper does not involve patient data.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42019129384.

Protocol for systematic reviews of school-based food and nutrition education intervention for adolescent health promotion: Evidence mapping and syntheses

BACKGROUND

Nutrition is an important modifiable factor in combating overweight and obesity among adolescents. School has been indicated as an effective environment for influencing eating behavior; however, recent reviews assessing school-based interventions specifically for adolescents are scarce. Therefore, we propose the present systematic review with the aim to comprehensively review the quantitative and qualitative literature on the effects of school-based food and nutrition education interventions on adolescent health promotion through healthy eating habits.

METHODS

We will search MEDLINE/PubMed, Embase, Scopus, ERIC, ScienceDirect, Web of Science, Cochrane, LILACS, and ADOLEC. We will include randomized controlled trials (RCT), non-RCT, and controlled before-after studies. Risk of bias will be assessed using the EPOC Risk of Bias Tool for RCT, Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for non-RCT or controlled before-after, as well as the Critical Appraisal Skills Program (CASP) checklist for qualitative studies. We will analyze the overall strength of the evidence for each outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Two independent researchers will conduct all evaluations and any disagreements will be consulted with a third reviewer. Data analysis and synthesis will be analyzed by the RevMan 5.3 software. We will conduct the study in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-analyses Protocols.

RESULT

This review will evaluate the effects of school-based food and nutrition education interventions on adolescent health promotion through healthy eating habits. The primary outcome will be changes in adolescent food consumption. Secondary outcomes will be biological parameters (e.g., body mass index (BMI), waist circumference (WC), body composition, etc); biochemical parameters (e.g., glycemia, triglycerides, total cholesterol, etc); qualitative evidences that support or explain the effect of school-based food and nutrition education interventions on adolescent food consumption.

CONCLUSION

The findings of this systematic review will summarize the latest evidence of the effects of school-based food and nutrition education interventions on adolescent health promotion. The findings will be an available reference for school-based interventions and other further research.

REGISTRATION

PROSPERO CRD42019116520.

Effects of exercise on the levels of BDNF and executive function in adolescents: A protocol for systematic review and meta-analysis

BACKOGROUND

Evidence available in the literature suggests that physical exercise increases the release of brain-derived neurotrophic factor (BDNF) in humans and may possibly be related to improvements in executive function. However, studies of this phenomenon in adolescents are still scarce. The objective of this work is to describe the protocol for a systematic review (SR) and meta-analysis of interventional studies aiming to determine the effect of physical exercise on BDNF levels and executive function in adolescents.

METHODS

This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) and by the Cochrane Handbook of Systematic Reviews of Interventions. The databases to be searched are PubMed, EMBASE, Scopus, ScienceDirect, Web of Science, SPORTDiscus, the Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. Interventional studies conducted on adolescents with different exercise protocols and evaluations of BDNF levels and executive function in pre- and post-intervention periods will be included in the systematic review. The characteristics of the studies, participants, and main results will be described, then the evaluation of the risk of biases and the level of evidence obtained by the protocol will be assessed. The selection of studies, data extraction, and evaluation of the methodological quality will be performed by 2 experienced reviewers independently.

CONCLUSION

The systematic review will present the effects of the practice of physical exercises on the BDNF and executive function levels. The results will strengthen the interventions with the focus on the brain health of adolescents through general orientations and the evidences described shall direct future research.

PROSPERO REGISTRATION NUMBER

CRD42018110683.

Lifestyle and sleep patterns among people living with and without HIV/AIDS

INTRODUCTION

Negative lifestyles affect the health and quality of sleep of those living with and without HIV/AIDS.

METHODS

Individuals were divided into two groups based on whether or not they were living with HIV/AIDS.

RESULTS

Among the 20 participants, 95% displayed a poor lifestyle, and both groups demonstrated low-quality sleep with significant differences between groups in the early sleep variables, total sleep time, and sleep patterns.

CONCLUSIONS

Both groups demonstrated similar behavior with unsatisfactory lifestyles, poor sleep quality, and irregular sleep patterns.

Level of pain and quality of life of people living with HIV/AIDS pain and quality of life in HIV/AIDS

The aim of this descriptive study was to correlate the level of pain with the quality of life in 261 people living with HIV/AIDS. Mild pain/no pain was reported by 47.5% of subjects, 24.1% reported moderate pain, and 28.4% reported severe pain; pain levels were correlated with gender (p = 0.02), health status (p < 0.001), perception (p < 0.001), and stage of infection (p = 0.005). Being female represented a risk factor for moderate (p < 0.001) and intense pain (p = 0.004). Poor health represented a risk for moderate (p < 0.038) and intense pain (p = 0.005). Being young was a factor of protection for moderate pain (21-30 years, p = 0.046; 41-50 years, p = 0.023; and 51-60 years, p < 0.030). The low quality of life averages was identified and correlated with pain in all evaluated domains (p < 0.001). The risk factors for moderate and severe pain were a low level of independence (p = 0.004) and compromised social relations (p = 0.029), respectively. Psychological control behaved as a protection factor for moderate pain (p = 0.011), and bad physical domain proved to be a protection factor for severe pain (p = 0.007). The level of pain is a negative impact on the quality of life of people with HIV/AIDS.