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Dores H, Antunes M, Caldeira D, Pereira HV. Cardiovascular benefits of resistance exercise: It's time to prescribe. Rev Port Cardiol 2024:S0870-2551(24)00117-3. [PMID: 38703948 DOI: 10.1016/j.repc.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 05/06/2024] Open
Abstract
Despite the well-known health benefits of regular physical activity, sedentary behavior and physical inactivity remain a real global pandemic. Exercise is associated with increased life expectancy, improved quality of life and prevention of multiple diseases. Although less implemented in practice compared to aerobic exercise, recent evidence shows that resistance exercise (RE) is also responsible for various benefits, including improvements in body composition, control of several cardiovascular (CV) risk factors, and reduction of CV outcomes. RE increases strength and muscle mass, is effective in controlling type 2 diabetes, and improves the management of obesity, lipids, and blood pressure profiles. In this setting, clinical guidelines recommend the inclusion of RE for primary and secondary CV risk prevention, particularly in combination with aerobic exercise, in which the benefits are most pronounced. Prescription of RE should follow a methodology that includes key variables such as frequency, intensity, type, time, and progression. Despite challenges, professionals in the CV field should be familiar with RE prescription in order to maximize its referral in clinical practice. This review aims to analyze the CV effects of RE and current recommendations regarding the prescription of this type of exercise.
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Affiliation(s)
- Hélder Dores
- Hospital da Luz, Lisbon, Portugal; CHRC, NOVA Medical School, Lisbon, Portugal; NOVA Medical School, Lisbon, Portugal.
| | | | - Daniel Caldeira
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Centro Cardiovascular da Universidade de Lisboa - CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Serviço de Cardiologia, Hospital de Santa Maria - CHULN, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Hugo V Pereira
- Hospital da Luz, Lisbon, Portugal; CIDEFES, Universidade Lusófona, Lisbon, Portugal
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Neves B, Haghighi ED, Pereira HV, Costa F, Carlos JS, Ferreira D, Moreno P, Ferreira PM, Machado J, Goncalves B, Moreira JM, Leite F, da Silva NA. Impact of a wearable-based physical activity and sleep intervention in multimorbidity patients: protocol for a randomized controlled trial. BMC Geriatr 2023; 23:853. [PMID: 38097933 PMCID: PMC10720080 DOI: 10.1186/s12877-023-04511-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The benefits of physical activity (PA) and adequate sleep are well documented, and their importance strengthens with the increasing prevalence of chronic diseases and multimorbidity (MM). Interventions to promote physical activity and sleep that use commercial activity trackers may be useful non-pharmacological approaches to managing individual health; however, limited evidence exists on their use to improve physical activity in older adult patients with MM. METHODS This study aims to measure the effects of behavioral change techniques (BCTs) delivered by a wearable device on physical activity and quality of sleep (QS) in older adult patients with MM. We designed an open-label randomized controlled trial with participants recruited through primary care and a specialist outpatient clinic. Participants must be more than 65 years old, have MM, and have access to smartphones. All eligible participants will receive PA promotion content and will be randomly assigned to wear a smartwatch. The primary outcome will be the participants' PA measurement at baseline and at six months using the International Physical Activity Questionnaire - Short Form (IPAQ-SF). Secondary outcomes will include changes in the participants' frailty status, biometric measurements, quality of life, and biopsychosocial assessments. A sample size of 40 participants per arm was calculated to detect group differences, with 50 participants planned to recruit and randomize into each arm. DISCUSSION This study aims to contribute to a better understanding of PA patterns and the impact of wearable-based PA interventions in patients with MM. In addition, we aim to contribute to more knowledge about the relationship between PA patterns, Patient Reported Outcomes Measures (PROMs), and healthcare resource utilization in patients with MM. To achieve this, the study will leverage a locally developed PROMs registry and assess data from participants' medical records, in order to understand the added impact of wearable data and medical information data on predicting PROMs and unplanned hospital admissions. TRIAL REGISTRATION NCT05777291.
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Affiliation(s)
- Bernardo Neves
- Hospital da Luz Learning Health, Luz Saúde, Lisboa, Portugal.
- Internal Medicine Department, Hospital da Luz Lisboa, Luz Saúde, Lisboa, Portugal.
| | - Eduardo D Haghighi
- Internal Medicine Department, Hospital da Luz Lisboa, Luz Saúde, Lisboa, Portugal
| | - Hugo V Pereira
- Centro de Medicina Desportiva, Hospital da Luz Lisboa, Luz Saúde, Lisboa, Portugal
- CIDEFES - Centro de Investigação em Desporto, Educacao Fisica, Exercicio e Saude, Universidade Lusofona, Lisboa, Portugal
| | - Filipe Costa
- Value Based Healthcare, Luz Saúde, Lisboa, Portugal
| | - João S Carlos
- General Practice/Family Medicine Department, Hospital da Luz Lisboa, Luz Saúde, Lisboa, Portugal
| | - Daniel Ferreira
- Hospital da Luz Learning Health, Luz Saúde, Lisboa, Portugal
| | - Plinio Moreno
- Instituto de Sistemas e Robótica (ISR/IST), LARSyS, Instituto Superior Tecnico, Unviersidade de Lisboa, Av. Rovisco Pais 1, 1049-001, Lisboa, Portugal
| | - Pedro M Ferreira
- Heinz College and at the Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburg, USA
| | - Jaime Machado
- Hospital da Luz Learning Health, Luz Saúde, Lisboa, Portugal
| | - Breno Goncalves
- Hospital da Luz Learning Health, Luz Saúde, Lisboa, Portugal
| | | | - Francisca Leite
- Hospital da Luz Learning Health, Luz Saúde, Lisboa, Portugal
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Bunn C, Palmer V, Chng NR, Andersen E, Gray CM, Hunt K, Jelsma JGM, Morgan H, der Sanden MNV, Pereira HV, Philpott M, Roberts GC, Rooksby J, Røynesdal ØB, Silva MN, Sørensen M, Teixeira PJ, van Achterberg T, van de Glind I, van Mechelen W, van Nassau F, van der Ploeg HP, Wyke S. How European Fans in Training (EuroFIT), a lifestyle change program for men delivered in football clubs, achieved its effect: a mixed methods process evaluation embedded in a randomised controlled trial. BMC Public Health 2023; 23:526. [PMID: 36941552 PMCID: PMC10026416 DOI: 10.1186/s12889-023-15419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/10/2023] [Indexed: 03/22/2023] Open
Abstract
BACKGROUND A randomised trial of European Fans in Training (EuroFIT), a 12-week healthy lifestyle program delivered in 15 professional football clubs in the Netherlands, Norway, Portugal, and the United Kingdom, successfully increased physical activity and improved diet but did not reduce sedentary time. To guide future implementation, this paper investigates how those effects were achieved. We ask: 1) how was EuroFIT implemented? 2) what were the processes through which outcomes were achieved? METHODS We analysed qualitative data implementation notes, observations of 29 of 180 weekly EuroFIT deliveries, semi-structured interviews with 16 coaches and 15 club representatives, and 30 focus group discussions with participants (15 post-program and 15 after 12 months). We descriptively analysed quantitative data on recruitment, attendance at sessions and logs of use of the technologies and survey data on the views of participants at baseline, post program and after 12 months. We used a triangulation protocol to investigate agreement between data from difference sources, organised around meeting 15 objectives within the two research questions. RESULTS We successfully recruited clubs, coaches and men to EuroFIT though the draw of the football club seemed stronger in the UK and Portugal. Advertising that emphasized getting fitter, club-based deliveries, and not 'standing out' worked and attendance and fidelity were good, so that coaches in all countries were able to deliver EuroFIT flexibly as intended. Coaches in all 15 clubs facilitated the use of behaviour change techniques and interaction between men, which together enhanced motivation. Participants found it harder to change sedentary time than physical activity and diet. Fitting changes into daily routines, planning for setbacks and recognising the personal benefit of behaviour change were important to maintain changes. Bespoke technologies were valued, but technological hitches frustrated participants. CONCLUSION EuroFIT was delivered as planned by trained club coaches working flexibly in all countries. It worked as expected to attract men and support initiation and maintenance of changes in physical activity and diet but the use of bespoke, unstable, technologies was frustrating. Future deliveries should eliminate the focus on sedentary time and should use only proven technologies to support self-monitoring and social interaction. TRIAL REGISTRATION ISRCTN81935608, registered 16/06/2015.
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Affiliation(s)
- Christopher Bunn
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK.
| | - Victoria Palmer
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Nai Rui Chng
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Eivind Andersen
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
| | - Cindy M Gray
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
- Institute for Social Marketing and Health, Faculty of Health and Sports Sciences, University of Stirling, Scotland, UK
| | - Judith G M Jelsma
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Heather Morgan
- Institute of Applied Health Sciences, University of Aberdeen, Scotland, UK
| | - Maria Nijhuis-van der Sanden
- Radboud Institute for Health Sciences, Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
| | - Hugo V Pereira
- CIDEFES - Centro de Investigação em Desporto, Faculdade de Educação Física e Desporto da Universidade Lusófona, Educação Física, Exercício e Saúde, Lisbon, Portugal
| | | | - Glyn C Roberts
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
| | - John Rooksby
- Computer and Information Sciences, Northumbria University, Newcastle Upon Tyne, UK
| | - Øystein B Røynesdal
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
- Department of Teacher Education, NLA University College, Bergen, Norway
| | - Marlene N Silva
- CIDEFES - Centro de Investigação em Desporto, Faculdade de Educação Física e Desporto da Universidade Lusófona, Educação Física, Exercício e Saúde, Lisbon, Portugal
- Direcção-Geral da Saúde, Programa Nacional Para a Promoção da Atividade Física, Lisbon, Portugal
| | - Marit Sørensen
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
| | - Pedro J Teixeira
- CIDEFES - Centro de Investigação em Desporto, Faculdade de Educação Física e Desporto da Universidade Lusófona, Educação Física, Exercício e Saúde, Lisbon, Portugal
| | - Theo van Achterberg
- Department of Public Health and Primary Care, KU Louvain, Academic Centre for Nursing and Midwifery, Louvain, Belgium
| | - Irene van de Glind
- FWG, Department of Researchesearch and Development, Utrecht, The Netherlands
| | - Willem van Mechelen
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Femke van Nassau
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Hidde P van der Ploeg
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Sally Wyke
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
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van Nassau F, Huis A, van de Glind I, Andersen E, Bunn C, Gray CM, Hunt K, Jelsma JGM, van Mechelen W, Morgan H, Røynesdal Ø, Pereira HV, van der Ploeg HP, Roberts GC, Silva MN, Sørensen M, Wyke S, Nijhuis-van der Sanden MWG, van Achterberg T. Factors influencing the implementation of the EuroFIT lifestyle change program in professional football clubs in Europe: a qualitative study in four European countries. Transl Behav Med 2023; 13:212-225. [PMID: 36694360 PMCID: PMC10105865 DOI: 10.1093/tbm/ibac100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
This paper investigated facilitators and barriers to implementing the European Football Fans in Training program (EuroFIT) in professional sports clubs in England, the Netherlands, Norway, and Portugal. We analyzed qualitative data collected at clubs that delivered EuroFIT, based on semi-structured interviews with coordinating staff (n = 15), coaches (n = 16), and focus group interviews with participants (n = 108), as well as data from clubs that considered delivering EuroFIT in the future, based on interviews with staff (n = 7) and stakeholders (n = 8). Facilitators for implementation related to the content and structure of the program, its evidence-base, and the context for delivery in the football stadia. Financial and human resources were both facilitators and barriers. Further barriers were mostly practical, relating to human resources and infrastructure. Major differences between countries related to experience and commitment to running community projects, and differences in infrastructure, financing, and human resources. Professional football clubs' ability to support health promotion efforts depended on their ethos and the financial and human resources available to them. Overall, the EuroFIT program was well received by clubs, coaches, participants, and stakeholders, which was reflected by the many facilitators supporting sustained implementation. For sustainable implementation, it is crucial that clubs and their stakeholders engage fully with the EuroFIT program and understand that for an adequate program delivery their views (ethos) and ways of working influence the implementation and thereby the effectiveness of EuroFIT. An important prerequisite for future roll out of EuroFIT would be a strong EuroFIT delivery partner organization to ensure financial and human resources while overseeing and guiding the quality of delivery in clubs.
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Affiliation(s)
- Femke van Nassau
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anita Huis
- Radboud Institute for Health Sciences, Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
| | - Irene van de Glind
- Radboud Institute for Health Sciences, Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
| | - Eivind Andersen
- Department of Sport and Social Sciences, NSSS, Institute for Sport and Social Sciences, Oslo, Norway
| | - Christopher Bunn
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Judith G M Jelsma
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Heather Morgan
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Øystein Røynesdal
- Department of Sport and Social Sciences, NSSS, Institute for Sport and Social Sciences, Oslo, Norway.,Department of Teacher Education, NLA University College, Bergen, Norway.,Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Hugo V Pereira
- CIDEFES Faculdade de Educação Física e Desporto, Universidade Lusófona, Lisbon, Portugal.,Faculdade de Motricidade Humana, Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Universidade de Lisboa, Lisbon, Portugal
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Glyn C Roberts
- Department of Sport and Social Sciences, NSSS, Institute for Sport and Social Sciences, Oslo, Norway
| | - Marlene N Silva
- CIDEFES Faculdade de Educação Física e Desporto, Universidade Lusófona, Lisbon, Portugal.,Faculdade de Motricidade Humana, Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Universidade de Lisboa, Lisbon, Portugal
| | - Marit Sørensen
- Department of Sport and Social Sciences, NSSS, Institute for Sport and Social Sciences, Oslo, Norway
| | - Sally Wyke
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Theo van Achterberg
- Department of Public Health and Primary Care, KU Leuven, Academic Centre for Nursing and Midwifery, Leuven, Belgium
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5
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Andersen E, van der Ploeg HP, van Mechelen W, Gray CM, Mutrie N, van Nassau F, Jelsma JGM, Anderson AS, Silva MN, Pereira HV, McConnachie A, Sattar N, Sørensen M, Røynesdal ØB, Hunt K, Roberts GC, Wyke S, Gill JMR. Contributions of changes in physical activity, sedentary time, diet and body weight to changes in cardiometabolic risk. Int J Behav Nutr Phys Act 2021; 18:166. [PMID: 34930299 PMCID: PMC8686269 DOI: 10.1186/s12966-021-01237-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Increased physical activity (PA), reduced time spent sedentary (SED), healthier diet and reduced body weight may all have a positive impact on cardiometabolic risk. The relative importance of change in each of these variables on cardiometabolic risk, however, is unclear. We therefore sought to investigate the relative contributions of changes in PA, SED, diet and body weight on cardiometabolic risk. Methods This is a secondary analysis of data collected from the EuroFIT randomised controlled trial, which was a 12-week group-based lifestyle intervention for overweight middle-aged men delivered by coaches in football club stadia aiming to improve PA, SED, diet, and body weight. PA and SED were assessed by accelerometry, diet using the Dietary Instrument for Nutrition Education (DINE). An overall cardiometabolic risk score was derived from combining z-scores for glucose, HbA1c, insulin, lipids and blood pressure. In total, 707 men (from the overall cohort of 1113) with complete data for these variables at baseline and 12-month follow-up were included in the multivariable linear regression analyses. Results In multivariable analyses, change in number of steps (explaining 5.1% of R2) and dietary factors (less alcohol, fatty and sugary food, and more fruit and vegetables) (together explaining 4.5% of R2), but not changes in standing time or SED, were significantly associated with change in body weight. Changes in number of steps (R2 = 1.7%), fatty food score (R2 = 2.4%), and sugary food score (R2 = 0.4%) were significantly associated with change in cardiometabolic risk score in univariable models. However, in multivariable models which included changes in weight as well as changes in steps and dietary variables, change in weight explained a substantially larger proportion of the change in cardiometabolic risk score, explaining 14.1% of R2 (out of an overall model R2 of 19.0%). When baseline (as well as change) values were also included in the model, 38.8% of R2 for change in cardiometabolic risk score was explained overall, with 14.1% of R2 still explained by change in weight. Conclusion Change in body weight, together with baseline cardiometabolic risk explained most of the change in cardiometabolic risk. Thus, the benefits of increasing physical activity and improving diet on cardiometabolic risk appear to act largely via an effect on changes in body weight. Trial registration International Standard Randomised Controlled Trials, ISRCTN-81935608. Registered 06052015. https://www.isrctn.com/ISRCTN81935608?q=&filters=recruitmentCountry:Portugal&sort=&offset=7&totalResults=92&page=1&pageSize=10&searchType=basic-search Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01237-1.
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Affiliation(s)
- Eivind Andersen
- Institute for Sport and Social Science, Norwegian School of Sport Science, PO box 4014, Ullevål stadium, 0806, Oslo, Norway.
| | - Hidde P van der Ploeg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Willem van Mechelen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, the University of Edinburgh, Edinburgh, UK
| | - Femke van Nassau
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Judith G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Dundee, UK
| | - Marlene N Silva
- CIDEFES, Faculdade de Educação Física e Desporto, Universidade Lusófona, Lisboa, Portugal
| | - Hugo V Pereira
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Marit Sørensen
- Institute for Sport and Social Science, Norwegian School of Sport Science, PO box 4014, Ullevål stadium, 0806, Oslo, Norway
| | - Øystein B Røynesdal
- Institute for Sport and Social Science, Norwegian School of Sport Science, PO box 4014, Ullevål stadium, 0806, Oslo, Norway
| | - Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Glyn C Roberts
- Institute for Sport and Social Science, Norwegian School of Sport Science, PO box 4014, Ullevål stadium, 0806, Oslo, Norway
| | - Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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V. Pereira H, Teixeira PJ, Marques MM, Carraça EV, Silva MN, Encantado J, Santos I, Palmeira AL. Keep on running - a randomized controlled trial to test a digital evidence-based intervention for sustained adoption of recreational running: rationale, design and pilot feasibility study. Health Psychol Behav Med 2021; 9:149-164. [PMID: 34104554 PMCID: PMC8158207 DOI: 10.1080/21642850.2021.1885410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/13/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This paper describes the rationale, intervention development, study design and results from the pilot feasibility study of the Keep On Running (KOR) trial. KOR aims to test a web-based brief theory-based intervention, targeting maintenance of recreational running behavior over time (i.e. relapse preventing). METHODS Intervention development was based both on Self-Determination Theory and on Self-Regulation Theory. As part of it, a pilot study was implemented (n=18) to measure intervention adherence and participant satisfaction in order to establish the feasibility and acceptability of the intervention toolkit. Furthermore, this pilot study was also used to test the feasibility and acceptability of the questionnaires selected to be part of the later RCT. RESULTS Pilot intervention acceptability was good, but overall adherence was low. Features such as feedback and social sharing should be added to the toolkit. The main trial should lessen questionnaire length and include data from usual monitoring gadgets and apps (APIs). The protocol of the RCT was adjusted to test the efficacy of the refined final version of the intervention, and the RCT that will test it, contributing to the understanding of recreational running sustainability, allowing the optimization of future interventions aimed at physical activity promotion.
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Affiliation(s)
- Hugo V. Pereira
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada-Dafundo, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal
| | - Pedro J. Teixeira
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada-Dafundo, Portugal
| | - Marta M. Marques
- ADAPT SFI Research Centre and Trinity Centre for Practice & Health Care Innovation, Trinity College Dublin, Dublin, Ireland
| | - Eliana V. Carraça
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal
| | - Marlene N. Silva
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal
| | - Jorge Encantado
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada-Dafundo, Portugal
- ISPA Instituto Universitário, APPsyCI – Applied Psychology Research Center Capabilities & Inclusion, Lisboa, Portugal
| | - Inês Santos
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - António L. Palmeira
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal
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7
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Wyke S, Bunn C, Andersen E, Silva MN, van Nassau F, McSkimming P, Kolovos S, Gill JMR, Gray CM, Hunt K, Anderson AS, Bosmans J, Jelsma JGM, Kean S, Lemyre N, Loudon DW, Macaulay L, Maxwell DJ, McConnachie A, Mutrie N, Nijhuis-van der Sanden M, Pereira HV, Philpott M, Roberts GC, Rooksby J, Røynesdal ØB, Sattar N, Sørensen M, Teixeira PJ, Treweek S, van Achterberg T, van de Glind I, van Mechelen W, van der Ploeg HP. The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial. PLoS Med 2019; 16:e1002736. [PMID: 30721231 PMCID: PMC6363143 DOI: 10.1371/journal.pmed.1002736] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/24/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting. METHODS AND FINDINGS A total of 1,113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Recruitment was between September 19, 2015, and February 2, 2016. Participants consented to study procedures and provided usable activity monitor baseline data. They were randomised, stratified by club, to either the EuroFIT intervention or a 12-month waiting list comparison group. Follow-up measurement was post-programme and 12 months after baseline. EuroFIT is a 12-week, group-based programme delivered by coaches in football club stadia in 12 weekly 90-minute sessions. Weekly sessions aimed to improve physical activity, sedentary time, and diet and maintain changes long term. A pocket-worn device (SitFIT) allowed self-monitoring of sedentary time and daily steps, and a game-based app (MatchFIT) encouraged between-session social support. Primary outcome (objectively measured sedentary time and physical activity) measurements were obtained for 83% and 85% of intervention and comparison participants. Intention-to-treat analyses showed a baseline-adjusted mean difference in sedentary time at 12 months of -1.6 minutes/day (97.5% confidence interval [CI], -14.3-11.0; p = 0.77) and in step counts of 678 steps/day (97.5% CI, 309-1.048; p < 0.001) in favor of the intervention. There were significant improvements in diet, weight, well-being, self-esteem, vitality, and biomarkers of cardiometabolic health in favor of the intervention group, but not in quality of life. There was a 0.95 probability of EuroFIT being cost-effective compared with the comparison group if society is willing to pay £1.50 per extra step/day, a maximum probability of 0.61 if society is willing to pay £1,800 per minute less sedentary time/day, and 0.13 probability if society is willing to pay £30,000 per quality-adjusted life-year (QALY). It was not possible to blind participants to group allocation. Men attracted to the programme already had quite high levels of physical activity at baseline (8,372 steps/day), which may have limited room for improvement. Although participants came from across the socioeconomic spectrum, a majority were well educated and in paid work. There was an increase in recent injuries and in upper and lower joint pain scores post-programme. In addition, although the five-level EuroQoL questionnaire (EQ-5D-5L) is now the preferred measure for cost-effectiveness analyses across Europe, baseline scores were high (0.93), suggesting a ceiling effect for QALYs. CONCLUSION Participation in EuroFIT led to improvements in physical activity, diet, body weight, and biomarkers of cardiometabolic health, but not in sedentary time at 12 months. Within-trial analysis suggests it is not cost-effective in the short term for QALYs due to a ceiling effect in quality of life. Nevertheless, decision-makers may consider the incremental cost for increase in steps worth the investment. TRIAL REGISTRATION International Standard Randomised Controlled Trials, ISRCTN-81935608.
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Affiliation(s)
- Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Christopher Bunn
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Eivind Andersen
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - Marlene N Silva
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Paula McSkimming
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Spyros Kolovos
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Kate Hunt
- Institute for Social Marketing, University of Stirling, Stirling, United Kingdom
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Dundee, United Kingdom
| | - Judith Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sharon Kean
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Nicolas Lemyre
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | | | - Lisa Macaulay
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, the University of Edinburgh, Edinburgh, United Kingdom
| | - Maria Nijhuis-van der Sanden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, the Netherlands
| | - Hugo V Pereira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Matthew Philpott
- European Healthy Stadia Network CIC Ltd., Liverpool, United Kingdom
| | - Glyn C Roberts
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - John Rooksby
- Computer and Information Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Øystein B Røynesdal
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Marit Sørensen
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - Pedro J Teixeira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | | | - Irene van de Glind
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, the Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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van Nassau F, van der Ploeg HP, Abrahamsen F, Andersen E, Anderson AS, Bosmans JE, Bunn C, Chalmers M, Clissmann C, Gill JMR, Gray CM, Hunt K, Jelsma JGM, La Guardia JG, Lemyre PN, Loudon DW, Macaulay L, Maxwell DJ, McConnachie A, Martin A, Mourselas N, Mutrie N, Nijhuis-van der Sanden R, O'Brien K, Pereira HV, Philpott M, Roberts GC, Rooksby J, Rost M, Røynesdal Ø, Sattar N, Silva MN, Sorensen M, Teixeira PJ, Treweek S, van Achterberg T, van de Glind I, van Mechelen W, Wyke S. Study protocol of European Fans in Training (EuroFIT): a four-country randomised controlled trial of a lifestyle program for men delivered in elite football clubs. BMC Public Health 2016; 16:598. [PMID: 27430332 PMCID: PMC4950080 DOI: 10.1186/s12889-016-3255-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/01/2016] [Indexed: 12/24/2022] Open
Abstract
Background Lifestyle interventions targeting physical activity, sedentary time and dietary behaviours have the potential to initiate and support behavioural change and result in public health gain. Although men have often been reluctant to engage in such lifestyle programs, many are at high risk of several chronic conditions. We have developed an evidence and theory-based, gender sensitised, health and lifestyle program (European Fans in Training (EuroFIT)), which is designed to attract men through the loyalty they feel to the football club they support. This paper describes the study protocol to evaluate the effectiveness and cost-effectiveness of the EuroFIT program in supporting men to improve their level of physical activity and reduce sedentary behaviour over 12 months. Methods The EuroFIT study is a pragmatic, two-arm, randomised controlled trial conducted in 15 football clubs in the Netherlands, Norway, Portugal and the UK (England). One-thousand men, aged 30 to 65 years, with a self-reported Body Mass Index (BMI) ≥27 kg/m2 will be recruited and individually randomised. The primary outcomes are objectively-assessed changes in total physical activity (steps per day) and total sedentary time (minutes per day) at 12 months after baseline assessment. Secondary outcomes are weight, BMI, waist circumference, resting systolic and diastolic blood pressure, cardio-metabolic blood biomarkers, food intake, self-reported physical activity and sedentary time, wellbeing, self-esteem, vitality and quality of life. Cost-effectiveness will be assessed and a process evaluation conducted. The EuroFIT program will be delivered over 12 weekly, 90-minute sessions that combine classroom discussion with graded physical activity in the setting of the football club. Classroom sessions provide participants with a toolbox of behaviour change techniques to initiate and sustain long-term lifestyle changes. The coaches will receive two days of training to enable them to create a positive social environment that supports men in engaging in sustained behaviour change. Discussion The EuroFIT trial will provide evidence on the effectiveness and cost-effectiveness of the EuroFIT program delivered by football clubs to their male fans, and will offer insight into factors associated with success in making sustained changes to physical activity, sedentary behaviour, and secondary outcomes, such as diet. Trial registration ISRCTN: 81935608. Registered 16 June 2015.
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Affiliation(s)
- Femke van Nassau
- Department of Public and Occupational Health, and EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, and EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands.
| | - Frank Abrahamsen
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - Eivind Andersen
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, Level 7, Ninewells Medical School, University of Dundee, Dundee, UK
| | - Judith E Bosmans
- Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Christopher Bunn
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS, UK
| | - Matthew Chalmers
- School of Computing Science, University of Glasgow, Glasgow, G12 8RZ, UK
| | | | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS, UK
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Judith G M Jelsma
- Department of Public and Occupational Health, and EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | | | - Pierre N Lemyre
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - David W Loudon
- PAL Technologies Ltd, PAL Technologies Ltd 50 Richmond Street, Glasgow, G1 1XP, Scotland, UK
| | - Lisa Macaulay
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS, UK
| | - Douglas J Maxwell
- PAL Technologies Ltd, PAL Technologies Ltd 50 Richmond Street, Glasgow, G1 1XP, Scotland, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Scotland, UK
| | - Anne Martin
- Physical Activity for Health Research Centre, University of Edinburgh, Institute for Sport, Physical Education and Health Sciences, Edinburgh, EH8 8AQ, UK
| | - Nikos Mourselas
- PAL Technologies Ltd, PAL Technologies Ltd 50 Richmond Street, Glasgow, G1 1XP, Scotland, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Institute for Sport, Physical Education and Health Sciences, Edinburgh, EH8 8AQ, UK
| | - Ria Nijhuis-van der Sanden
- Radboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Kylie O'Brien
- Pintail Ltd, 77 Springhill Ave, Blackrock, Co. Dublin, Ireland
| | - Hugo V Pereira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Matthew Philpott
- European Healthy Stadia Network, 151 Dale Street, Liverpool, L2 2JH, UK
| | - Glyn C Roberts
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - John Rooksby
- School of Computing Science, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Mattias Rost
- School of Computing Science, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Øystein Røynesdal
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Marlene N Silva
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Marit Sorensen
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - Pedro J Teixeira
- European Healthy Stadia Network, 151 Dale Street, Liverpool, L2 2JH, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Irene van de Glind
- Radboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, and EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS, UK
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Amaral MCS, Pereira HV, Nani E, Lange LC. Treatment of landfill leachate by hybrid precipitation/microfiltration/nanofiltration process. Water Sci Technol 2015; 72:269-276. [PMID: 26177410 DOI: 10.2166/wst.2015.218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper describes a promising method to treat stabilized landfill leachate. Such method consists of a combination of chemical precipitation processes, a cost-effective technique with high potential to remove contaminants with foulant nature, microfiltration aimed at removing the produced precipitate and nanofiltration (NF) for final polishing. This study was carried out on a bench unit comprising a precipitation reactor associated with a submerged hollow-fiber microfiltration membrane module and a flat NF membrane cell operated in batch and continuous mode with a treating capacity of 0.1 L h(-1). Combining these processes yielded a clear and colorless permeate and proved to be very efficient at removing organic and inorganic matter. The results showed the importance of membrane processes to ensure treated landfill leachate quality. Also the precipitation associated with microfiltration as a pretreatment process is able to guarantee low membrane fouling due to the significant retention of humic substances which are known for their high potential to cause NF membrane fouling.
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Affiliation(s)
- M C S Amaral
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Presidente Antônio Carlos Avenue, 6627, Engineering School - 4th floor, Pampulha, Belo Horizonte/MG, CEP: 31.270-901, Brazil E-mail:
| | - H V Pereira
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Presidente Antônio Carlos Avenue, 6627, Engineering School - 4th floor, Pampulha, Belo Horizonte/MG, CEP: 31.270-901, Brazil E-mail:
| | - E Nani
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Presidente Antônio Carlos Avenue, 6627, Engineering School - 4th floor, Pampulha, Belo Horizonte/MG, CEP: 31.270-901, Brazil E-mail:
| | - L C Lange
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Presidente Antônio Carlos Avenue, 6627, Engineering School - 4th floor, Pampulha, Belo Horizonte/MG, CEP: 31.270-901, Brazil E-mail:
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