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- Análise dos custos associados a programas de prevenção da obesidade infantil nas escolasPublication . Magalhães, Tomás de Moura Vieira da Rocha; Almeida, Anabela Antunes de; Ferreira, SofiaA obesidade é um dos principais fatores de risco para várias doenças não transmissíveis. Em particular, a obesidade infantil quintuplicou desde 1975, sendo estimado que 254 milhões de crianças serão obesas até 2030 segundo a World Obesity Federation. Consequentemente, a avaliação económica de programas de intervenção de obesidade em meio escolar é fundamental no apoio à toma de decisão de saúde pública no que toca à prevenção da obesidade. Este estudo tem por objetivo fazer uma Revisão da Literatura da Análise de Custobenefício de programas de prevenção da obesidade infantil nas escolas , comparar os programas entre si e identificar a sua importância. Foi realizada uma Revisão Sistemática da literatura nas bases de dados PubMed, Cochrane Library, Wiley online Library e Semantic Scholar, visando identificar os artigos mais recentes referentes a programas de prevenção da obesidade nas escolas. Foram posteriormente selecionados os artigos e retirados os dados para análise. Obtiveram-se 7 estudos que cumpriam os critérios de inclusão e exclusão, 3 dos quais demonstraram ser bastante dispendiosos e não muito eficazes, enquanto 4 dos artigos tiveram custos bastante reduzidos comparados com os resultados que obtiveram. Concluindo, apesar de existirem estudos que não conseguiram obter uma intervenção custo-desejável, podemos constatar que os programas de prevenção da obesidade infantil poderão ser, de facto, custo-eficazes. Com custos tão baixos quanto 5.21 € por criança por ano foram alcançados num dos estudos, mostrando que, apesar de poder haver variabilidade devido a valores de mão de obra, materiais e valor da moeda, é possível ter um impacto significativo na prevenção da obesidade em idades jovens por valores muito inferiores aos custos de tratamento da obesidade numa idade adulta, sendo a prevenção da obesidade em escolas um investimento fulcral para o futuro, tanto da saúde da população, como para gastos futuros no combate à obesidade. Mais investigação necessita de ser feita nesta área mas, à luz de resultados bastantes positivos em alguns estudos é possível afirmar que, após estes serem melhorados e estandardizados, serão uma mais-valia, quer em orçamento de saúde, quer na saúde das crianças e futuros adultos.
- Neuromodulation of the prefrontal cortex by iTBS: effects on the entrepreneurial attitude as evaluated by TAI testPublication . Gomes, Pedro Miguel Vasconcelos; Patto, Maria da Assunção Morais e Cunha Vaz; Leitão, João Carlos Correia; Pinto, Nuno Filipe CardosoIntroduction: Neuroentrepreneurship research suggests the importance in potential entrepreneurs of traits such as impulsiveness and novelty-seeking behaviour, along with an ambidextrous and flexible decision-making capacity that allows successful entrepreneurs to efficiently switch between exploitation behaviour (associated with regions involved in value-representation such as the ventromedial prefrontal cortex) and exploration behaviour (associated with attention- and cognitive-control frontoparietal regions). Simultaneously, the importance of creativity and ability for divergent thinking has also been underscored. The neurobiological basis for such functions is still being elucidated, but has pointed to the importance of several network-integrated prefrontal cortex regions involved in higher cognitive and attention-control mechanisms (such as the dorsolateral prefrontal cortex and frontopolar cortex) allowing the switching between exploitative and explorative behaviour, decision-making and relaxing of previous rules and constraints for innovative problem solving. Neuromodulation studies have shown changes in determinants of entrepreneurial attitude such as strategic decision-making, risk and novelty-seeking behaviour. In this exploratory study, we analysed the effects of stimulation of the right dorsolateral prefrontal cortex (DLPFC) on a test for entrepreneurial aptitude (TAI) in a group of 13 healthy volunteers randomly selected for either sham or active stimulation with intermittent theta burst stimulation (iTBS). Materials and methods: A total of 13 healthy volunteers were randomly allocated for either active (n=7) or sham (n=6) one-session iTBS stimulation of the right DLPFC. They were subsequently asked to answer the Entrepreneurial Attitude Test (TAI), which evaluates the determinants of entrepreneurial attitude in 8 factors and gives a global score, classified in three groups. Results: Mean TAI factor 3 scores (“adaptability”) were significantly higher in the active than in the sham group (6,64% ± 2,84%, p=0,039). Otherwise, there were no statistically significant differences in most TAI scores. Mean global TAI scores put the active group in the high-entrepreneurial attitude range (75,71%), and the sham group on the mid-entrepreneurial attitude range (71,66%), although such difference was not statistically significant (4,05% ± 2,67%, p=0,157). Discussion: Higher attention-control mechanisms (mediated by DLPFC via connections with the frontopolar and parietal cortices) which allow an efficient switching between exploration and exploitation behaviour may be a possible physiological basis for an ambidextrous entrepreneurial mindset, and thus the probable cause for the stimulated group having TAI factor 3 (“adaptability”) scores significantly higher than non-stimulated group. Despite stimulation of a major top-down cognitive control region of the prefrontal cortex, creativity’s neurobiology is increasingly understood in terms of the insertion of the relevant regions into major brain networks (such as default mode network or cognitive control network), such that modulation of other regions (such as the anterior temporal cortex) may be important for achieving improvements in creativity, innovativeness and insight problem solving, determinants for entrepreneurial behaviour. This, along our reduced sample size, possibly prevented us from finding other significant results in other entrepreneurship factors. Nevertheless, the fact that the active group had mean higher (although not significant) global TAI score, possibly suggests stimulation of the right DLPFC, if increasing activity of the higher-attention control mechanisms and stimulating some components of creativity (possibly divergent thinking and insight problem-solving), probably had indeed some overall effect in the determinants of entrepreneurial attitude, possibly worthy of future research. Conclusion: Stimulation of the higher cognitive and attention-control mechanisms (possibly the physiological basis for an ambidextrous entrepreneurial mindset) by stimulation of the right DLPFC is reflected in increased TAI factor 3 (“adaptability”) scores. The integration in future entrepreneurship neuromodulation protocols of open answer questionnaires or gambling tasks eventually allowing pre- and post-analysis is a suggestion to more directly evaluate creativity/innovativeness in future neuroentrepreneurship research.