FM-ISAMB-Conferências
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- RESCUR em ação : resultados preliminares do estudo de impacto do projeto RESCUR em contexto nacionalPublication . Simões, Celeste; Santos, Anabela Caetano; Lebre, Paula; Branquinho, Cátia Sofia dos Santos; Gaspar, Tania; Matos, MGRESCUR into Action (2017‐2018) is national project that aims to implement RESCUR, European Resilience Curriculum, in schools with migrant and/or refugee students. RESCUR into Action, promoted by the Social Adventure association, with the support of the Ciência Viva Program, has promoted free and accredited training actions to 123 teachers and specialized technicians, of whom 64 are currently implementing RESCUR with 1665 children aged three to 17 years. This trial comprehends one full‐year implementation group (IG) with 675 children and a waiting group (WG) with 417 children, between 3 and 17 years old (53.2% males, 7% migrants/refugees, 5.3% with migrants/refugees parents). No statistical significant differences between the two groups were found at the baseline according to Strengths and Difficulties Questionnaire teachers’ version (SDQ, Goodman, 2001). The results of the intermediate evaluation show statistically significant differencesin all SDQ dimensions for the IG (decreases in emotional problems, conduct problems, peer problems and hyperactivity and increases in prosocial behaviour), with WG maintaining scores, except for emotional problems and peers problems, which got worse. The qualitative assessment, after nearly 12 sessions, showed a decrease in disruptive behaviour and the increase of prosocial behaviours, like giving help or protection, sharing, availability to listen to one another, and a greater autonomy and competence to solve problem.
- Prevalence of malnutrition among Portuguese elderly living in nursing homes : preliminary results of the PEN-3S projectPublication . Madeira, Teresa; Plácido, Catarina Peixoto; Santos, Nuno; Santos, Osvaldo; Bergland, Astrid; Bye, Asta; Lopes, Carla; Alarcão, Violeta; Goulão, Beatriz; Mendonça, Nuno; Nicola, Paulo Jorge Morais Zamith; Gorjão Clara, João Pedro PereiraBackground: Malnutrition is a modifiable risk factor for several diseases among elderly. To develop appropriate nutrition policies to decrease malnutrition, up-to-date information on the dimension of the problem is warranted. Objective: To estimate the prevalence of malnutrition among Portuguese elderly (65+ years old) resident in nursing homes.
- The patients’ perspective : what causes hospitalizations for ambulatory care sensitive conditions?Publication . Siopa, Margarida; Sarmento, João; Santos, Rodrigo; Lopes, Sílvia; Dias, Sónia; Guerreiro, António Sousa; Panarra, António; Nascimento, Paula; Rodrigues, Ana; Santana, RuiIntroduction: In Portugal, the hospitalizations for ambulatory care sensitive conditions (ACSH) account for 12% of all hospitalizations with an estimated financial impact of up to 450 million€. Therefore, understanding the determinants of avoidable hospitalizations is important to develop policies and interventions that reduce the ACSH. Analyzing the patient’s perspective brings an angle relevant to explain the ACSH. Despite patients are the most qualified to express the social and individual context of their experience, few studies have investigated the patients’ perspective about what causes ACSH. The aim of this study is to compare the perspective of patients on the determinants of the ACSH.
- Genetic and environment interactions contribute to longevity : a case-control study with centenariansPublication . da Silva, Alda Pereira; Aguiar, L.; Matos, A.; Covas-Lima, J.; Gil, Â.; Gorjão Clara, João; Polónia, J.; Bicho, Manuel PiresObjective: Environmental or genetic factors, together with the interaction between them, may explain the increasing population of centenarians. This research aimed to understand these interactions that underlie centenarian’s phenotypes, namely gene-gene and gene-environment, particularly in relation to cardiovascular risk (CVR).
- Sarcopenia, more than dehydratation, can be associate to Portuguese underweight centenariansPublication . Silva, Alda Pereira da; Matos, Andreia; Valente, Ana; Gil, Ângela; Alonso, Isanete; Ribeiro, Ricardo; Clara, João Gorjão; Bicho, ManuelIntroduction: Fat-free mass has a functional significance in aging. The objective of this study was to evaluate the prevalence of underweight in a Portuguese population of centenarians and their relationship with dehydration or sarcopenia. Methods/design: Anthropometric data were obtained using standard procedures from 252 centenarians (100.26±1.99 years), 77.8% women (W). Body composition was assessed by tetrapolar bioimpedance. It was considered dehydration: total body water (TBW) (%) <45 (W) and <50 male (M), and excess of fat mass (FM) (%): >35 (W) and >25 (M). The fat mass index (FMIndex): FM (kg)/height (m2) and muscle mass index (MMIndex): MM (kg)/height (m2) were calculated. Statistical methods: T-student, ANOVA, χ2, linear correlation. Results: In the sample, 61.4% had normal weight (BMI=21.42±1.86), but 25.3% were underweight (BMI=16.84±1.51), and of these, 28.8% were women. Instead, overweight (BMI=27.52±2.40) checked in 13.3% subjects, was predominant in men (10.6 vs 22.6%). Dehydration was observed in 12.9% of subjects and was tendentiously higher in women (15.4 vs 5.0%, P=0.087). Excess of FM was found in 6.0% of subjects with no gender differences (P=0.225). In the overweight subgroup there were differences in TBW (P=0.003) and FM (P=0.022) between genders, which was not observed in the underweight subgroup. The FMIndex in underweight or overweight subgroups did not vary significantly with gender. Muscle mass and MMIndex were different between genders, with the lowest values observed in underweight W compared to M (31.7±3.96 vs 36.3±2.84; P=0.01) or to the other subgroups. There was a direct linear correlation between BMI and MM (β(M)=0.749; β(W)=0.683) and inverse with TBW (β(M)=−0.428; β(W) =−0.397), men and women, P<0.001. Conclusion: The underweight was more represented in the Portuguese centenarians. More than body water and FM, sarcopenia may be responsible for this low weight particularly in the women.
- Helping decision-makers visualize inequities in health impact assessment : linked electronic records, mortality and regional disparities in PortugalPublication . Nicolau, Leonor Bacelar; Rodrigues, T.; Fernandes, E.; Lobo, M. F.; Nisa, C.; Azzone, V.; Pinto, A. Teixeira; Gonçalves, F. N. Rocha; Azevedo, L. F.; Freitas, A.; Normand, S. T.; Pereira, A. Costa; Miguel, J. PereiraObjectives: Show how multivariate methods outputs visualization may help decision-makers identify inequities through health impact assessment (HIA). Show how a policy promoting quality of linked Electronic Health Records (EHR) regarding Acute Myocardial Infarction (AMI) patients may be associated to mortality and regional inequities. Methods: Data: Adults (>=20 years) admitted in Portuguese NHS Hospitals with AMI diagnosis during the 2nd semester 2012, followed regularly in NHS Primary Care (PC) during 2013. Variables: Mortality outcome at December 31 2013, 4 PC registered indicators- Blood Pressure, Cholesterol, Triglycerides, Waist Circumference, Body Mass Index (BMI); 5 regions Norte, Centro, LVT, Alentejo, Algarve; adjustment variables sex, age, AMI hospital readmissions during the 2nd semester 2012, surgery during hospital admission, mean admission duration>6 days, hospital diagnosis>=6. Statistical Procedures: X2 and Fisher exact tests; logistic regressions, simple and stratified by region, estimating crude and adjusted ORs (and 95%CI); multivariate correspondence analysis (MCA). Results: Regions Algarve and LVT present the highest no-registration percentages for every indicator. Norte, usually followed by Algarve and then Centro, has the lowest percentage of no-registration. Patients without registered information for all health indicators are more than twice as likely to be deceased, than patients with information registered (OR>2.0). Norte presents higher OR for Cholesterol and Triglycerides (OR>13.0) and Blood pressure (OR>3) and Alentejo for BMI (OR near7). Centro presents high values especially regarding Cholesterol and Triglycerides (3.173 and 4.409). MCA summarizes previous findings with a very clear, visual graphical aid. Conclusions: HIA assesses health impacts (here, mortality) of policies (EHR policy to promote PC uniform information registration), identifying groups where effects are worse (regional equity concerns). Disparities between regions are found regarding registering information, but also concerning association patterns of mortality and registration of these health indicators. Complex multivariate methodologies may generate visual outputs easily interpreted by decision-makers.
- Eating habits : determinants of Portuguese adolescents’ choicesPublication . Cardoso, Susana; Nunes, Carla; Santos, Osvaldo; Loureiro, IsabelBackground: Proper eating habits are crucial to a healthy life. It is important to understand the determinants of eating choices made at adolescence because this stage of life is paramount for the formation of lifelong enduring habits. Goals: To identify determinants of eating choices based on adolescents' perception and characterizing them, in particular, to the level of relevance attributed by adolescents. Methods: A cross-sectional study was carried out, based on a sample of 358 adolescents (14-18 years old) from two schools of Coimbra. First, a quantitative study was carried out using the scales: EHA (eating habits scale), TAA-25 (eating attitudes test) and GSQ (general self-efficacy scale). In a second step, a qualitative study was carried out with subgroups that were selected from the results of the first phase of the study. These subgroups presented opposite patterns of habits (group A: better eating habits - EHA≥160 and group B: worst habits - EHA≤125) and we moved into a grounded theory approach with semi-structured individual interviews. Results: Sex emerges as a determinant of eating choices pattern, with girls assuming more adequate eating habits (t=3,84; p<,0001; r2 adjusted=,037, p<,0001). The perception of general self-efficacy assumes greater relevance for boys, functioning as a protective factor that reduces unhealthy options. Through multinomial regression models, we could see that gender and general self-efficacy have a big influence on eating habits. The ideals of beauty have influence on this effect. Resisting adversity has an important influence in the choices, being associated to self-regulation. The situations of risk to develop an eating behavior disturbance appear mainly in the cases of adolescents presenting better habits (rSP=,203; p<,001) and are more frequent in girls (t=3,54; p<,0001; OR=4,04). Through content analysis it was possible to identify determinant factors that were perceived by adolescents in both groups. The ones that were more often mentioned (in a decreasing order) were family influence, taste preferences, knowledge of healthy eating rules and availability. This was followed by determinants such as self-control capacity, feeling well or bad, peer influence, feeling hungry or full, developing a task or not, impulsiveness, time available and humor/stress. Conclusions: The differences found between sexes can justify differentiated interventions. Our results also suggest the relevance to work on self-image. Family must be considered as an integrating part of the interventions in health education. Political measures taken by schools and government agents can also have a very important role in making healthy choices easier and, therefore, in establishing healthy eating patterns.
- Escolhas alimentares e de atividade física dos adolescentes : sexo, atitudes alimentares e perceção de autoeficácia geralPublication . Cardoso, Susana; Nunes, Carla; Santos, Osvaldo; Loureiro, IsabelFood choices and physical activity have a relevant influence on health status. It is important to understand the network of factors that contribute to the choices. The aim is to identify potential determinants of the adoption of eating behaviors and physical activity and to characterize the association of perceived self‐efficacy on eating habits and physical activity of Portuguese adolescents. A cross‐sectional study was carried out on a sample of 358 adolescents (14‐18 years old). EHA (eating habits scale), IPAQ (international physical activity questionnaire), TAA‐25 (eating attitudes test) and GSQ (general self‐efficacy scale) were applied and data analysed using the software IBM SPSS v.22.0. Girls tend to assume healthier eating behaviors (t = 3.84, p <, 0001) and present a higher risk of eating disorders (t = 3.54, p <, 0001), mainly associated to the motivation to be thin (t = 5.98, p <, 0001). The boys practiced more physical activity (ᵡ2 (2) = 28.2; p <.001) and presented a higher perception of general self‐efficacy (t = 2.45; p <0.015). The model that follows the multinomial regression that best fits integrates sex and general self‐efficacy. Resistance to adversity is the sub‐dimension that presents the smallest difference between the sexes but greater association with either eating habits (rP =, 32; p <, 0001) or with physical activity (rP=, 235; p < 001). Some physiological factors and the ideals of beauty may explain the greater risk of eating behavior pathology in girls. The perception of good general self‐efficacy will protect the inadequate food choices that boys tends to make. Differences found in gender can justify differentiated interventions in health education. Dimensions such as self‐image and self‐esteem should be worked on.
- Promoção do bem‐estar e saúde mental através do surf em jovens em contexto de acolhimentoPublication . Matos, Margarida Gaspar de; Santos, Anabela; Fauvelet, Cristiana; Marta, Francisco; Evangelista, Ema Shaw; Ferreira, José; Moita, Miguel; Conibear, Tim; Mattila, MattThe Surf‐Salva Camp 2016 project aimed at promoting social inclusion, wellbeing, and mental health, as well as developing beach security values and social citizenship in children and youth in foster care institutions, through surfing (Surf‐Therapy). Participants were 48 adolescents aged 10 to 16,selected from 4 foster institutions in the Lisbon district. Results suggest that intervention through Surf Therapy had a number of positive effects: exploration, effort and perseverance, problem‐solving, time management, social competencies, interpersonal relationships and emotional regulation all developed among the participants throughout the project. Results support the claim that within a suitable theoretical framework, with a solid and well‐trained team and with adequate psychotherapeutic supervision and evaluation, Surf Therapy can be a very promising alternative in the care of at‐risk young people.
- Do we know what really works? A systematic review about using video games for cognitive trainingPublication . Brito, F.; Virgolino, Ana; Fialho, Mónica; Miranda, A. C.; Peixoto, J.; Neves, I.; Camolas, J.; Reis, M. F.; Carriço, L.; Santos, Osvaldo