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Purpose: To verify the reciprocal longitudinal relationships between cardiorespiratory fitness (CRF), percentage body fat (%body fat), and metabolic syndrome in Brazilian primary school students. Method: This longitudinal study involved 420 children and adolescents followed for 3 years (2011–2014). The continuous Metabolic Syndrome (cMetSyn) score was calculated by summing adjusted z scores of glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference. The CRF was assessed using running/walking tests, and %body fat was assessed through sex-specific 2-site skinfold thickness. Cross-lagged panel models were used to analyze longitudinal reciprocal relationships between CRF and %body fat with cMetSyn. Results: Results indicated that 2011 %body fat significantly predicted both 2014 CRF scores and 2014 cMetSyn scores (P <.001); however, 2011 CRF only predicted 2014 %body fat (P <.001) but not 2014 cMetSyn (P =.103). Furthermore, 2011 cMetSyn predicted 2014 %body fat (P =.002). The model explained 36%, 48%, and 37% of the variance in 2014 CRF, %body fat, and cMetSyn, respectively. Conclusion: The results suggest a reciprocal inverse relationship between %body fat and metabolic syndrome risk and that %body fat may play a more important role in the risk of developing metabolic syndrome compared with CRF. [ABSTRACT FROM AUTHOR]

Background: Patient navigation helps with better adherence to treatment, as well as better knowledge about diabetes and greater interest in performing, monitoring, and seeking health care. Therefore, this study aims to evaluate the effect of patient navigation on glycemic control, disease knowledge, adherence to self-care in people with type 1 diabetes mellitus. Methods: This is an intervention study using a single group pre-test post-test design, carried out in a tertiary public teaching hospital in Southern Brazil. Participants over 18 years of age and diagnosed with type 1 diabetes were included. In total, three teleconsultations and one face-to-face consultation were carried out, with three-month intervals, until completing one year of follow-up. The nurse navigator conducted diabetes education based on the guidelines of the Brazilian Diabetes Society and the Nursing Interventions Classification. The differences between glycated hemoglobin, adherence to self-care, and knowledge about initial and final diabetes were estimated to verify the effect of patient navigation by nurses, according to the tool applied in the first and last consultations. Interaction analyses between variables were also performed. Student's t-test, Generalized Estimating Equations, Wilcoxon test, and McNemar test were used. Results: The final sample consisted of 152 participants, of which 85 (55.9%) were women, with a mean age of 45 ± 12 years, and diabetes duration of 23.6 ± 11.1 years. Nurse navigators conducted 812 teleconsultations and 158 face-to-face consultations. After the intervention, glycemic control improved in 37 (24.3%) participants (p < 0.001), and knowledge about diabetes also improved in 37 (24.3%) participants (p < 0.001). Adherence to self-care increased in 82 (53.9%) patients (p < 0.001). The analysis of the interaction between glycemic control and the results from the questionnaire of knowledge about diabetes showed an interaction effect (p = 0.005). However, we observed no interaction effect between glycemic control and the results from the questionnaire on adherence to self-care (p = 0.706). Conclusions: Our results showed improvement in glycemic control, adherence to self-care, and knowledge of diabetes in the study participants. In addition, they suggest that patient navigation performed by nurses is promising and feasible in improving care for patients with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Simple Summary: Heat stress is a physiological condition where an animal fails to adequately dissipate body heat; this results in increased blood flow in the animal's core and negatively affects its physiological system. Considering this problem, this study aimed to analyze the reproductive and physiological changes in ewes subjected to heat stress during pregnancy. Twenty-four pregnant crossbred ewes were kept at UTFPR-DV's (Brazil) silvopastoral (SP) or open pasture (OP) systems throughout their pregnancy. During the experiment, microclimatic variables, sheep's blood samples, and physiological variables were collected every two weeks. After the birth of the lambs, the placentas were also collected. Our results showed that both systems were stressful for the sheep, but the SP system had lower air and grass temperatures than the OP system. The respiratory and heart rates of animals from the OP system were higher than those from the SP system. As regards the animals' immune cells, their mobilization was not affected by the systems, while the neutrophil count was only affected by time. Regarding placental biometry, it was observed that placentas in twin pregnancies had a greater membrane area. We concluded that the type of production system used affects the thermal comfort of pregnant ewes; an SP system can offer more amenable microclimatic conditions, which result in greater comfort for the ewes. This study aimed to analyze the reproductive and physiological changes in ewes subjected to heat stress during pregnancy at UTFPR-Brazil. Twenty-four pregnant crossbred ewes were kept in a silvopastoral system (SP) or an open pasture system (OP) throughout the final trimester of pregnancy. Both systems were stressful, but the SP system had lower air temperature than the OP system (26.0 ± 0.38 and 26.9 ± 0.41 °C, respectively; p = 0.0288). Moreover, the radiant thermal load of the two groups presented a difference of 34 Wm−2 (p = 0.0288), and the grass temperature was also lower in the SP system compared to that in the OP system (23.4 ± 0.37 and 25.6 ± 0.44 °C, respectively; p = 0.0043). The respiratory and heart rates of animals from the OP group were higher than those from the SP group (p < 0.001), but no difference was observed in the mobilization of white blood cells (p = 0.4777), and the neutrophil count was only affected by time (p < 0.0001). As regards placental biometry, placentas in twin pregnancies had a greater membrane area (p = 0.0223), but no differences between the systems were observed in placental weight (p = 0.1522) and the number of cotyledons (p = 0.5457). We concluded that the type of rearing system used affects the thermal comfort of pregnant ewes, and that an SP system can offer more amenable microclimatic conditions, which result in greater comfort for the ewes. [ABSTRACT FROM AUTHOR]

Background: A higher cardiometabolic risk has been associated with low cardiorespiratory fitness (CRF) levels and sedentary behaviours. However, most studies have focused predominantly on isolated behavioural, or CRF exposures. Aim: The present study aimed to evaluate the joint association of self-reported, sedentary TV viewing and CRF with cardio-metabolic risk in schoolchildren. Methods: Cross-sectional study with 2152 students (6–17 years old) from southern Brazil. Self-reported TV viewing and CRF were combined into a lifestyle-related exposure variable. Waist circumference, systolic blood pressure, glucose, and blood lipoprotein–lipids were determined and a clustered cardio-metabolic risk score (cCRS) was derived using internationally age and sex standardized Z-scores. Results: In boys and girls, the median values of cCRS were significantly (p < 0.05) higher among those with unfit levels of CRF, independent of TV viewing. The higher cardio-metabolic risk status was 18.0% more prevalent in participants classified as unfit, regardless of TV viewing. However, the higher cCRS associated with poor fitness was attenuated following adjustments for the confounding effect of adiposity, pubertal status, and sociodemographic factors. Conclusion: A higher cCRS prevalence was associated with low CRF levels, regardless of TV viewing. The association between higher CRF and the cardio-metabolic risk appeared to be attenuated by confounders, particularly adiposity. [ABSTRACT FROM AUTHOR]

Cardiorespiratory fitness (CRF) is considered a beneficial effect of physical activity (PA). PA and excessive screen time have implications for cardiometabolic risk. To verify the association between screen time and CRF grouped by cardiometabolic risk factors. Cross-sectional study evaluated 1,253 schoolchildren (54.2% girls) aged seven to 17 years from southern Brazil. The outcomes were body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), and diastolic (DBP), glucose, and lipid profile. Exposure was a combined variable of self-reported screen time (television, video game, computer) and CRF. The main result is that CRF had a more consistent association with anthropometric factors than with metabolic variables. Low CRF students, regardless of screen time, showed a 15% increase in the risk of elevated WC (p < 0.001) and a 24% (<2 h screen time) and 19% (≥2 h) higher risk of overweight (p < 0.001). Second, the increase in SBP was associated with a combination of the two risk factors, ≥2 h screen time/low CRF was associated with a 7% increase in elevated SBP (p = 0.025). Low CRF was a risk factor for elevated BMI and WC, regardless of screen time. High screen time and low CRF were associated with higher SBP values. [ABSTRACT FROM AUTHOR]

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