Roberta Frontini

Measurement-based care (MBC) is a procedure in which systematic and routine assessments are performed. Through this practice, clinicians can verify the progress of the symptomatology of the patient and adapt the appointments and the intervention to the current symptoms. Studies have reflected on the importance and the benefits of this type of procedure in the adult population, and have shown positive results. However, there is a lack of evidence concerning the remaining populations. Regarding youth, for instance, few articles have evaluated the benefits of using this procedure in clinical practice. However, research focused on this topic has revealed positive results, especially when clinicians were loyal to the MBC procedures. Still, further research is needed. This letter aims to share the methodology used by our multidisciplinary team, composed of psychologists and psychiatrists, in a clinical context at the Hospital Cruz Vermelha, Lisboa, applied to the adult population; the objective is to share and discuss some alterations that could be made to our evaluation protocol to enable the same to be used with the youth population. We believe that implementing MBC for youth is crucial for several reasons, including enhanced treatment efficacy, more personalized treatment, a reduced reliance on subjectivity, and empowerment not only of patients but also families.

Introduction: Gamed-based interventions (GBI) in old people is an interesting topic for aging-well purposes, however, few studies exist focused on the assessment of multimodal interactive experience (emotions, skills, engagement, etc), and most of them used digital games. Therefore, validation of analog GBIs, when implemented in the geriatric field, should be completed with a playability analysis. Aim: To characterise a multicomponent playability analysis, considering (i) emotional state changes, and (ii) the perceived experience during the implementation of an analog gamed-based short-term intervention in the institutionalized elderly person. Method: A pre and post-test study was conducted during four weeks of intervention through an analogue game. Participants were elderly people institutionalised in a Residential Home for the Elderly in the central region of Portugal. Playability is assessed before and after the sessions with analogue games, using the Visual Analogue Scale (VAS) (0-10) of emotions and a questionnaire about participants’ perceptions of game-based experience. Results: Thirteen elderly people (9 women/4 men) with a mean age of 80±9.32 years participated in the study. A total of 48 states of tiredness/excitement, calmness/anxiety, and sadness/joy were recorded: 44,4% of participants increased their level of excitement; 66,7% decreased their level of excitement. The serious aims of the game were well perceived while maintaining the perception of the playful and fun character. Conclusion: The positive emotional changes in the elderly might be a sign of self-perceived novelty and challenge in the game. A good perception of the serious purpose of the game is associated with a positive emotional state, which encourages the adoption of proficiency feedback mode in the game. This pilot study was a relevant contribution to the continuing progression of playability analysis in elderly therapeutic contexts.

Studies show that physical activity, exercise, or sport reduces depressive symptoms in the general population. However, little is known about its effects on individuals with disabilities. Thus, this systematic review with meta-analysis aims to verify the effects of this practice on depressive symptoms in individuals with disabilities. The Pubmed, Web of Science, Scopus, and SportDiscus databases were used, with several descriptors and Boolean operators. A total of 1509 studies were identified through searching the databases. Studies that met the eligibility criteria were subsequently assessed for their methodological quality (Downs and Black scale), and a meta-analysis was performed. The Z-values that were obtained to test the null hypothesis, which states that there is no difference in means, showed Z = −2.294 and a corresponding p-value = 0.022. We can, therefore, reject the null hypothesis in the sense that exercise seems to reduce depressive symptoms in individuals with disabilities. In sum, participants from the intervention group presented more probability of reducing depressive symptoms when compared to the control group (approximately −1.4 standard differences in means; 95% CI −2.602 to −0.204).

The following case study aims to analyze the experience of a Portuguese trans individual regarding their practice of physical exercise (PE) and sports in Portuguese gyms and sports clubs. A 30-min interview was conducted through the Zoom platform. Before the interview, four questionnaires—Satisfaction with Life Scale (SWLS), Positive and Negative Affect Schedule (PANAS), Hospital Anxiety and Depression Scale (HADS), and EUROHIS-QOL 8-item index—were also applied, all in their Portuguese version. The interview was digitally video recorded after consent was obtained, transcribed verbatim, and subject to thematic analysis. Findings suggest positive values for satisfaction with life and quality of life. The values of positive affect were higher than those of negative affect, and there was an absence of depressive and anxious symptomatology. In the qualitative analysis, mental health was the main motive for the practice, while locker rooms separated by gender and university life were the main barriers mentioned. Mixed changing rooms were identified as facilitators of PE practice. This study highlights the importance of developing strategies for the creation of mixed changing rooms and sports teams in order to promote a comfortable and safe practice for all individuals.

O projeto RespirArFundo, através de uma metodologia mista quantitativa e qualitativa teve como objetivo avaliar o efeito de um programa de intervenção (22 “sessões teórico-práticas”), com realização de diferentes tipos de atividades, para melhorar os níveis de aptidão física, bem-estar e qualidade de vida (QdV) em professores e funcionários de uma escola secundária da região centro de Portugal. Pretendeu-se ainda avaliar os níveis de satisfação dos participantes com o projeto e identificar as principais barreiras e facilitadores à sua participação. A fase de intervenção deste projeto decorreu entre janeiro e junho de 2021. A amostra foi constituída por 26 profissionais da escola (19 professores e 7 funcionários não docentes), sendo na sua maioria (92,3%) do sexo feminino (53,7 ± 5,0 anos). Para a avaliação da aptidão física foram utilizados os testes “levantar e sentar da cadeira”, “levantar, percorrer 2,44m e sentar” e o “teste de preensão manual”. Para a avaliação do bem-estar recorreu-se às escalas PANAS, SWLS e SVS enquanto o WHOQOL-Bref foi utilizado para a avaliação da QdV. Foi ainda realizado um grupo focal. Após o programa, verificou-se que os participantes melhoraram no teste “levantar e sentar na cadeira”, em relação ao momento inicial. Para além disso, os participantes revelaram níveis elevados de satisfação com o programa e percecionaram a existência de benefícios físicos e de bem-estar associados ao projeto, adotando hábitos saudáveis. A importância do projeto foi reconhecida pela Direção da escola, sendo atribuídas horas específicas para que o projeto continue a funcionar nos seguintes anos letivos.

The present study aimed to analyze the association between motivation (self-determined and non-self-determined motivation), positive and negative affect, life satisfaction and state-anxiety in a sample of gym exercisers, during the 2nd COVID-19 lockdown in Portugal. Also, we aimed to analyze the possible mediating role of positive and negative affect and life satisfaction in the relationship between motivation and levels of state-anxiety. A total of 201 gym participants (30.42 ± 11.22) were enrolled in the present study, of which 116 (57.7%) were women and 85 (42.3%) were men. The survey included sociodemographic data as well as the subsequently validated instruments: the State-Trait Anxiety Inventory, the Positive and Negative Affect Schedule, and the Satisfaction with Life Scale. The results revealed a positive association between state-anxiety and negative affect (r = .69), controlled motivation (r = .33), and autonomous motivation (r = .25). Still, state-anxiety was negatively associated with positive affect (r = -.40) and with satisfaction with life (r = -.43),. In addition, the results of mediation analysis, revealed inconsistent mediation of positive affect and life satisfaction in the relationship between autonomous motivation and state-anxiety. However, a total mediation was observed through negative affect and life satisfaction in the relationship between controlled motivation and anxiety since the indirect effect (β = .27) is higher than the direct effect (β = .06). Overall, the results reinforce that positive affect and satisfaction with life could act as a possible buffer against state-anxiety in gym exercisers and, thus, should be considered in future interventions and studies.

Obesity is a chronic condition that influences the quality of life of patients and families while increasing the economic burden for the world population. Multidisciplinary prevention programs are crucial to address it, allowing an early introduction of healthy behaviors into daily habits. Mobile health interventions provide adequate support for these programs, especially considering the gamification techniques used to promote users’ engagement. TeenPower is a multidisciplinary mHealth intervention program conducted in Portugal during 2018 to empower adolescents, promoting healthy behaviors while preventing obesity. An agile software development process was applied to the development of the digital platform that holds a web-based application and a mobile application. We also propose a model for future developments based on the user-centered design approach adopted for this development and the assessment conducted in each phase. The user-centered design approach model proposed has three distinct phases: (1) design study; (2) pre-production usability tests; and (3) post-production data. Phase 1 allowed us to obtain the high-fidelity version of the graphical user interfaces (n = 5). Phase 2 showed a task completion success rate of 100% (n = 5). Phase 3 was derived from statistical analysis of the usage of the platform by real end users (n = 90). We achieved an average retention rate of 35% (31 out of 90 participants). Each technique has provided input for the continuous design and improvement of the platform. This allowed the creation of a tailored platform that could meet users’ expectations. Nevertheless, the retention rate decreased significantly over a short period of time, revealing the need for further work in the improvement of the gamification experience.

This study aimed to analyze the research conducted between 2016 and 2021, regarding barriers and motives for the practice of physical activity (PA), physical exercise (PE), and sports among trans individuals. The searches were carried out in the PubMed, Scopus, and Web of Science databases between January 2022 and April 2022, and included papers published between October 2016 and December 2021. After reading the full text of the studies, and according to the eligibility criteria previously defined, only six studies met the inclusion criteria. Internal barriers were related to body dissatisfaction and discomfort, discrimination, and fear of other people’s reactions. Regarding external barriers, sports environment, PE environment, and sports participation policies and regulations are the main factors expressed by trans individuals that hinder the practice of sports and PE. The desire to achieve a specific physical form and the role that PE plays in the preparation and/or replacement of gender-confirming surgery are the most important motives for the practice. This study highlights the importance of continuing to fight the barriers encountered in the practice of PE and sports, suggesting the main motives that could help create better interventions, plans, and inclusive policies that may help promote its practice.

This study aimed to (i) analyze the levels of state-anxiety of rafting customers, before and after the activity; and (ii) characterize the levels of trait-anxiety and the amount of physical activity performed weekly by clients of a rafting activity. The sample had 100 subjects of a nature sports company, in the rafting activity, with a mean age of 33.27 ± 10.10 years, with 44% female and 56% male participants. They were evaluated in two moments M1 (pre-activity) and M2 (post-activity). In M1, the STAI—State-Anxiety questionnaire and the IPAQ—International Physical Activity Questionnaire (short version) were applied. In M2, the STAI Form 1 State-Anxiety questionnaire was applied again, followed by the STAI trait-anxiety. The results showed no correlation between the amount of weekly physical activity and levels of trait-anxiety (rho(100) = −0.144; p-value = 0.152), thus not corroborating with the existing literature. Regarding state-anxiety, we found that in 55% of cases, it decreased with the practice of rafting, which suggests that the practice may have an anxiolytic effect and promote the well-being and relaxation of participants promoting, in this way, the sustainability of the rafting activity.