Background: The sequential multiple assignment randomized trial (SMART) design allows for changes in the intervention during the trial period. Despite its potential and feasibility for defining the best sequence of interventions, so far, it has not been utilized in a smartphone/gamified intervention for physical activity. Objective: We aimed to investigate the feasibility of the SMART design for assessing the effects of a smartphone app intervention to improve physical activity in adults. We also aimed to describe the participants’ perception regarding the protocol and the use of the app for physical activity qualitatively. Methods: We conducted a feasibility 24-week/two-stage SMART in which 18 insufficiently active participants (<10,000 steps/day) were first randomized to group 1 (smartphone app only), group 2 (smartphone app + tailored messages), and a control group (usual routine during the protocol). Participants were motivated to increase their step count by at least 2000 steps/day each week. Based on the 12-week intermediate outcome, responders continued the intervention and nonresponders were rerandomized to subsequent treatment, including a new group 3 (smartphone app + tailored messages + gamification) in which they were instructed to form groups to use several game elements available in the chosen app (Pacer). We considered responders as those with any positive slope in the linear relationship between weeks and steps per day at the end of the first stage of the intervention. We compared the accelerometer-based steps per day before and after the intervention, as well as the slopes of the app-based steps per day between the first and second stages of the intervention. Results: Twelve participants, including five controls, finished the intervention. We identified two responders in group 1. We did not observe relevant changes in the steps per day either throughout the intervention or compared with the control group. However, the rerandomization of five nonresponders led to a change in the slope of the steps per day (median −198 steps/day [IQR −279 to −103] to 20 steps/day [IQR −204 to 145]; P=.08). Finally, in three participants from group 2, we observed an increase in the number of steps per day up to the sixth week, followed by an inflection to baseline values or even lower (ie, a quadratic relationship). The qualitative analysis showed that participants’ reports could be classified into the following: (1) difficulty in managing the app and technology or problems with the device, (2) suitable response to the app, and (3) difficulties to achieve the goals. Conclusions: The SMART design was feasible and changed the behavior of steps per day after rerandomization. Rerandomization should be implemented earlier to take advantage of tailored messages. Additionally, difficulties with technology and realistic and individualized goals should be considered in interventions for physical activity using smartphones. Trial Registration: Brazilian Registry of Clinical Trials RBR-8xtc9c; http://www.ensaiosclinicos.gov.br/rg/RBR-8xtc9c/.

This study investigated the effect of the intake of high (HGI) or low glycemic index (LGI) high-carbohydrate meals on athletes’ sleep. Nine basketball adult male athletes were assessed during a championship and received high-carbohydrate meals (dinner and evening snack) with HGI or LGI. Quantitative and qualitative sleep variables were assessed: sleep latency (LAT), sleep efficiency (EFIC), Wake After Sleep Onset (WASO), sleep time through actigraphy and sleep diary. Dietary intake, satiety, sleepiness, glycemic response, salivary cortisol and melatonin were also assessed. On both days most athletes had LAT and WASO higher than recommendation, and nocturnal sleep time below the recommendations. There was no difference between sleep and hormonal parameters according to GI dietary manipulations; however, correlations were observed between sleep and diet. Daily energy intake had negative correlation with efficiency and nocturnal total sleep time, and a positive correlation with WASO, regardless of the GI nocturnal meals. No differences were observed in salivary cortisol and melatonin according to GI. The results suggest that food intake throughout the day seems to exert more influence on sleep parameters of basketball players than GI manipulation of evening meals on the pre-night game, but further studies are necessary to better understand this complex relationship.

Muitas características foram apontadas em relação a agressores conjugais, tais como: ciúme, baixa auto-estima, insegurança, minimização e negação da violência. A teoria da aprendizagem social de Bandura focaliza o papel do ambiente na aquisição, manutenção e modificação de respostas agressivas. Uma revisão da literatura brasileira realizada pelos autores indicou poucos trabalhos direcionados a agressores. Este estudo objetivou avaliar a eficácia de um grupo psicoterapêutico cognitivo-comportamental para agressores conjugais, buscando eliminar ou reduzir sua violência. Sete homens denunciados por agredirem suas parceiras participaram deste estudo. Os temas e as técnicas utilizados foram: assumir responsabilidade pela agressão, controle da raiva, role-playing e time-out. Realizaram-se oito sessões, sendo uma por semana (com duas horas de duração cada uma), durante dois meses. Os resultados foram avaliados por meio de entrevistas, questionários, Escala de Táticas de Conflito e relatos recolhidos no pré- e pós-teste e em três períodos de "follow-up" de três, seis e doze meses. Os resultados apontam para a redução das agressões, tendo sido registrados dois casos de reincidência.

The improvement or acquisition of socioemotional skills contributes to the academic and personal adaptation of university students. The way students think about themselves and others influence their social skills and well-being. Considering the importance of social competence for professional practice in the face of new social realities, the university must invest in programs that promote the socio-emotional development of students. This study compared the effects of interventions based on Rational Emotive Behavior Therapy and Psychoeducation on assertive skills and subjective well-being. This study involved 25 undergraduate students of a public university. The students were randomly allocated to three groups, including the Control group, and they were evaluated by means of questionnaires, inventories, scales, and written evaluation of the group process. The program consisted of 10 meetings and a 6-week follow-up. Irrational beliefs were reduced and their assertive skills’ scores increased in the post-intervention and follow-up evaluations, regardless of the group. Only verbal reports from participants indicated an increase in well-being. The students’ written reports after the end of the meetings indicate that the two forms of intervention were evaluated as promoting change by the students. One of the limitations of the study is the size of the groups. Despite the very small sample size, the study highlights that developing a set of flexible beliefs is fundamental to the exercise of assertiveness.

O treinamento em biofeedback tem sido utilizado para o tratamento de diferentes quadros clínicos e para a prevenção/alívio de sintomas relacionados ao estresse/ansiedade. Este trabalho analisou a literatura de 2008 a 2012 sobre o tema "biofeedback, estresse e ansiedade" publicada nas bases MEDLINE, LILACS e Web of Sciences, utilizando como palavras-chave "biofeedback", "anxiety", "stress", "psychology" e "biofeedback training". Os resultados demonstram que técnicas de biofeedback são eficazes no manejo do estresse/ansiedade nas diferentes populações estudadas. Entretanto, todos os estudos encontrados foram realizados fora do Brasil, o que sugere que técnicas de biofeedback como ferramenta terapêutica não tem sido utilizadas no país, por algum motivo que merece ser melhor investigado.