DSpace Collection:
https://hdl.handle.net/10216/111648
2024-03-28T19:45:34ZDo foods sold in Portugal meet the international sodium benchmarks? A case-study of a national food retail company
https://hdl.handle.net/10216/156877
Title: Do foods sold in Portugal meet the international sodium benchmarks? A case-study of a national food retail company2023-01-01T00:00:00ZProinflammatory and endothelial activation profiles in hospitalized COVID-19 patients: impact of arterial hypertension and previous treatment with renin-angiotensin-aldosterone inhibitors
https://hdl.handle.net/10216/154626
Title: Proinflammatory and endothelial activation profiles in hospitalized COVID-19 patients: impact of arterial hypertension and previous treatment with renin-angiotensin-aldosterone inhibitors
Abstract: n/a2023-01-01T00:00:00ZO3-2 Evaluation of implementation and impact of a national mass media campaign to promote active lifestyles in Portugal: ‘Follow the Whistle: Physical Activity is Calling You'
https://hdl.handle.net/10216/151716
Title: O3-2 Evaluation of implementation and impact of a national mass media campaign to promote active lifestyles in Portugal: ‘Follow the Whistle: Physical Activity is Calling You'
Abstract: Background
Portugal has one of the highest rates of physical inactivity in Europe. To raise the profile of physical activity (PA) among adults, the Portuguese National Physical Activity Promotion Program of the Directorate-General of Health developed and implemented a national mass media campaign in 2019 named ?Follow the Whistle?. The campaign was based on social marketing principles and behavior change theory, namely the COM-B model, and was developed through formative research. We aim to describe the implementation process and short-term impact evaluation data.
Methods
‘Follow the Whistle' was launched in June 2019 and continued for 4 weeks (TV, Radio, Online and Cinema, newspapers, outdoors). Pre (n = 878, 57%women) and post (n = 1319, 58%women) independent adult population samples were used to assess campaign impact. Participants were recruited through the mailing list of a Portuguese mutual insurance company, a network from across Portugal. The online questionnaire comprised socio-demographic factors, campaign awareness and recall, and psychosocial and behavioral measures linked to the four targets of the COM-B model, including items to assess perceived capability for physical activity(C), perceived opportunity for practice/ ease of integration of PA in daily living(O), motivation for PA practice(M) and behavior(B) assessed with IPAQ and the Activity Choice Index.
Results
Pre-and post-campaign samples were broadly demographically similar. Campaign recall increased significantly from 1% to 24% in prompted tagline recall (1/3 at post-campaign correctly recalled specific campaign images). All the targeted COM-B indicators changed in the expected direction, suggesting increases in perceived capability to engage in PA, perceived daily opportunities for being physically active, and in motivation (considering PA as fun, important, and compatible with other important things in life) (all p > 0.05). Results from PA behavior measures revealed increases only for vigorous activities (p > 0.001).
Conclusions
The GAPPA recommends the creation of active societies starting with best-practice community-wide communications campaigns. Although one focus of the ?Follow-the whistle? (i.e. promotion of active transport and incidental everyday forms of physical activity) was not entirely achieved (i.e. changes only in vigorous activities), the initial campaign objectives of increases in awareness, and influencing intermediate outcomes were achieved. Further campaign waves are planned for future years.2022-01-01T00:00:00ZPhysical activity surveillance across the life-course: from data to policy
https://hdl.handle.net/10216/151717
Title: Physical activity surveillance across the life-course: from data to policy
Abstract: As a major risk factor for non-communicable diseases (NCDs), physical inactivity is a prominent challenge for public health. The purpose of this symposium is to present an overview of physical inactivity prevalence in Europe using data collected through international surveillance initiatives, while highlighting successes and discussing future challenges for utilising data to promote physical activity across the life course.
The World Health Organization (WHO) is involved in several physical activity surveillance systems on which discussions during this symposium will be based:
1. The WHO European Childhood Obesity Surveillance Initiative (COSI) is the largest survey of its kind in the world. An overview of results from the most recent round of COSI will be presented focusing on prevalence estimates for physical activity, screen time and sleep. Variations between countries of the socioeconomic determinants of physical inactivity, as well as the impact of the COVID-19 pandemic, will demonstrate the ongoing need for quality data to guide targeted policy actions in support of vulnerable groups throughout the life course.
2. The WHO’s STEPwise approach to surveillance (STEPS) survey provides important national level prevalence data on the behavioural and metabolic risk factors for NCDs. For many countries, the STEPS survey has provided the first estimates of physical inactivity and sedentary behaviour in the population and has been essential in raising awareness of the need for national policy actions to increase population levels of physical activity.
3. The European Commission, with the support of the WHO Regional Office for Europe, has established the European Union Physical Activity Focal Points Network to monitor implementation of the 23 indicators of the Health-Enhancing Physical Activity (HEPA) monitoring framework on physical activity policy development and implementation.
4. Within the European Union Physical Activity Focal Points Network, and during the COVID-19 pandemic, some countries established a survey on physical activity and screen time in children and adolescents.2022-01-01T00:00:00ZO1-5 Digital tools for physical activity assessment and brief counselling in Primary Health Care: The Portuguese model
https://hdl.handle.net/10216/151715
Title: O1-5 Digital tools for physical activity assessment and brief counselling in Primary Health Care: The Portuguese model
Abstract: Issue/problem
Implementation of national systems for patients' physical activity (PA) assessment and counselling is a cost-effective strategy recommended in the WHO Global Action Plan for PA 2018-2030. Although Primary Health Care (PHC) professionals are recognized as key agents for PA promotion, challenges remain on how to develop feasible and scalable tools to support them in promoting patients' PA. The Portuguese model could help other countries improve PA assessment and brief counselling in PHC settings. This study aims to describe the tools' development and usage.
Description of the problem
The Portuguese Directorate-General of Health developed two evidence-based digital tools to support PA promotion by healthcare professionals: a) PA brief assessment tool; and b) brief counselling tool. The assessment tool was incorporated within the electronic medical health record software ?SClínico? in September 2017. It includes three questions: 1) how many days per week the patient performs any kind of PA (work, commuting or leisure-time); 2) how much time per day; and 3) how many hours per day the patient spends in sedentary behaviours. The PA brief counselling tool is available through the electronic medical prescription software ?PEM? since December 2017 and consists of five inter-related self-explanatory guides that can be delivered to patients (printed or by email), according to their motivation and PA levels. They facilitate person-centered and autonomy-supportive PA counselling, targeting specific behaviour change mediators, and using validated techniques.
Results
From September 2017 to December 2021, 159,179 patients had their PA assessed (2235 per 100,000 users of the National Health Service) and, from these, 16133 received PA brief counselling guides (177 per 100000 residents in Portugal, ≥ 15 years old), with a six-fold and three-fold increases, respectively, between 2018 and 2019 (previous to the COVID-19 pandemic). Future actions will address cost-effectiveness of this policy.
Lessons
The brief assessment and brief counselling tools were well-accepted and are increasingly being used, with potential for generalized adoption within the Portuguese Health Care System.
Main messages
Portugal has taken a decisive action to promote PA using PHC as a priority setting. PA tools usage is increasing considerably, highlighting the importance of making available easy-to-use PA promotion tools.2022-01-01T00:00:00ZS02-3 Physical activity policies and good practices in Europe
https://hdl.handle.net/10216/151714
Title: S02-3 Physical activity policies and good practices in Europe
Abstract: Background
The establishment of the EU physical activity (PA) guidelines and the HEPA monitoring framework has had an impact on policy development and implementation across the region from 2015. This works presents results from the third round of monitoring in 2021 and discusses trends since 2015.
Methods
A questionnaire was distributed in 2021 to all EU Member States of the WHO European Region through the network of PA Focal Points, who were requested to collect data from national colleagues and complete the questionnaire. All EU Member States (27 in 2021) responded to the survey on the implementation of the 23 indicators of the HEPA monitoring framework.
Results
The results of the 2021 round of data collection on HEPA indicators showed an overall stabilization of the implementation of PA promotion policies. Besides important increases in several indicators, such as indicators 15 (HEPA in the training of physical education teachers), 20 (Schemes to promote physical activity at the workplace) and 21 (Schemes for community interventions to promote physical activity in older adults), many others decreased and others showed no progress. Most national physical activity policies or action plans were multi-sectoral, with good coverage of the sectors recognized as important for HEPA promotion. While some methodological aspects may have affected the results, this round also reflected policy implementation during the COVID-19 pandemic (2019–2021). COVID-19 has had a significant impact on all sectors of society but especially on health, sports, education and mobility, which are major areas for PA promotion and policy implementation.
Conclusions
There seems to be an overall stabilization of the implementation of PA promotion policies since 2015. Public health experts and decision makers could utilise the increase in public awareness of the health benefits of physical activity kindled by the COVID-19 crisis to implement new health-promoting policies. Policy design, development and implementation of HEPA promotion must be strengthened for post-COVID-19 social and economic recovery.2022-01-01T00:00:00ZP02-12 The implementation cost of a walking football exercise program for patients with type 2 diabetes: a case study of SWEET-Football (Portugal)
https://hdl.handle.net/10216/151713
Title: P02-12 The implementation cost of a walking football exercise program for patients with type 2 diabetes: a case study of SWEET-Football (Portugal)
Abstract: Background
Economic analysis of health interventions is essential to the development and implementation of sustainable health policies, especially in noncommunicable diseases area. Type 2 diabetes (T2D) is one of the most relevant noncommunicable diseases globally. Regular physical activity is an established cornerstone of T2D control, with benefits in glycemic control, cardiovascular risk factors and quality of life. Thus, the current study aimed to assess the cost of a community-based physical activity intervention for patients with T2D.
Methods
We assessed the SWETT-Football program - a community-based walking football exercise program for middle-aged and older male patients with T2D. The program was tested in Portugal through a scientific project (NCT03810846) funded by FIFA (FIFA Research Scholarship 2018). One season of this program consists of three sessions per week (60 minutes per session) during nine months (October to June). For the calculations, we considered a total of 40 patients (two groups of 20). We calculated the direct costs of one season for the host institution: 216 hours of renting a sports hall and hiring human resources (a football coach and a nurse); cardiac stress tests and sports insurance for the participants; sports equipment (balls, cones, vests); vital signs monitoring equipment (blood pressure, heart rate and capillary blood glucose); logistical equipment (disposable and non-disposable); and technical training. In addition, we considered an economic depreciation of five years for sports and electronic materials. Cost analysis dated January 2022.
Results
One season of this program for 40 patients with T2D was estimated to have a total implementation cost of 11,026.51€: 1,225.17€/month; 275.66€/patient; 51.05€/session; 30.63€/patient/month; and 2.55€/patient/session.
Conclusions
A community-based walking football program for patients with T2D has an affordable cost and is feasible for large-scale implementation by local communities with the involvement of football clubs, municipalities and primary health care units, promoting physical activity and contributing to T2D control.2022-01-01T00:00:00ZDecline in duration, satisfaction and sleep quality among informal caregivers of stroke survivors, 18-months post-stroke
https://hdl.handle.net/10216/149774
Title: Decline in duration, satisfaction and sleep quality among informal caregivers of stroke survivors, 18-months post-stroke
Abstract: Background. Data on stroke caregivers’ sleep is scarce. We aimed to assess changes in duration, satisfaction and sleep quality among informal caregivers of stroke survivors.
Methods. Informal caregivers (n = 126) of stroke survivors hospitalized between September 2018 and August 2019 in the 12 Stroke Units of the North of Portugal were invited to participate in the study, 18 months’ post-stroke. Sociodemographic and sleep characteristics (duration, satisfaction and quality) were collected through structured questionnaires. Odds ratios and 95% confidence intervals (95%CI) were estimated through logistic regression, adjusted for age and sex. Answers to open-ended questions were synthetized using content analysis.
Results. Due to care provision, informal caregivers reported sleeping, on average (SD), significantly less hours (7.0 (1.7) vs. 6.4 (1.8); p < 0.001). Since its beginning, caregivers’ satisfaction with their sleep decreased approximately 30%. Changes in sleep quality, namely difficulties in falling asleep and constant interruptions during sleep, were reported by almost 70% of caregivers. Only 6.4% described the prescription of medication to sleep after beginning care provision. Participants who returned to work (adjusted OR = 0.34; 95%CI:0.16-0.76) and with a monthly income above 1000€ (adjusted OR = 0.29; 95%CI:0.13-0.66) were less likely to report changes in sleep quality.
Conclusions. A decline in duration, satisfaction and sleep quality of informal caregivers of stroke survivors, 18 months’ post-stroke, was observed. Changes in sleep quality revealed socioeconomic inequalities, highlighting the need to prevent adverse health outcomes related to sleep disturbance.2021-01-01T00:00:00ZP–042 Impact of semen parameters, sperm DNA fragmentation and sperm aneuploidy in male infertility
https://hdl.handle.net/10216/149773
Title: P–042 Impact of semen parameters, sperm DNA fragmentation and sperm aneuploidy in male infertility
Abstract: Study question. Should sperm aneuploidies and sperm DNA fragmentation (sDNAfrag) be included as valid tests in the routine investigation of male infertility?
Summary answer. Sperm DNA fragmentation was associated with male age, oligozoospermia (OZ), oligoteratozoospermia (OT), astenoteratozoospermia (AT) and oligoastenoteratozoospermia (OAT). Sperm aneuploidies were associated with OT and OAT.
What is known already. Semen parameters assist male infertility diagnosis and treatment, but sDNAfrag and aneuploidy analysis could add useful information, as abnormal values compromise fertility. To include these tests in the routine diagnosis it should be determined if behave as informative parameter and add information regarding the fertility status. For that, further studies comparing these tests to semen parameters are needed, since previous results are not consensual. Additionally, standardization of a sDNAfrag cut-off is needed, as different sample sizes and techniques originate distinct results. Also, until a standardization of the protocol is missing, a cut-off value should be defined for each laboratory.
Study design, size, duration. A retrospective and prospective investigation was performed, within a 12 years period (April 2007-December 2019). A total of 835 infertile males with a normal karyotype (46,XY) were included. Karyotyping and evaluation of sDNAfrag and sperm aneuploidies were made at a public Genetic unit. All normozoospermic (NZ) patients with a born child and patients whose infertility treatments were done due to female factors were selected from our database and used as controls (60 individuals).
Participants/materials, setting, methods. Semen analysis followed WHO–2010 guidelines. sDNAfrag was evaluated using the TUNEL assay. Sperm aneuploidies were detected using FISH (chromosomes 13, 18, 21, X, Y). Several tests were applied: correlations for linear associations between numerical variables, ANOVA for comparisons between means, Dunn-test for post-hoc comparisons. To determine the sDNAfrag cut-off value, the area under the ROC curve, sensitivity and specificity, were calculated, with the Youden-Index used to find a threshold that maximizes both sensitivity and specificity.
Main results and the role of chance. Regarding male age, it was observed a positive correlation with sperm concentration, a negative correlation with sperm vitality (VT) and hypoosmolality, and a positive correlation with sDNAfrag. Regarding sDNAfrag, it was observed negative correlation with sperm concentration, total progressive motility (TPM), morphology, VT and hypoosmolality. Regarding sperm aneuploidies, both total sperm aneuploidy and total sperm disomy exhibited a negative association with sperm concentration, TPM and morphology. It was also investigated whose groups of individuals could be indicated for sDNAfrag or sperm aneuploidy testing. The NZ group evidenced significant lower sDNAfrag, total sperm aneuploidy and total sperm disomy in relation to the non-NZ group. In the NZ group, sDNAfrag was significantly lower in relation to the OZ, OT, AT and OAT groups. The NZ group presented significant lower percentages of sperm aneuploidy in relation to the OT and OAT groups, and significant lower percentages of sperm disomy in relation to the OAT group. Additionally, sDNAfrag was positively correlated with total sperm aneuploidy and total sperm disomy. From the present large population, ROC curve analysis allowed estimating a cut-off value of 18.8% for the TUNEL-assay (sDNAfrag), with 0.658 of area under the curve, 53.9% sensitivity and 76.7% specificity.
Limitations, reasons for caution. Although presenting a high number of cases and strict controls, the present study was unable to include as controls healthy men with proven fertility. Additionally, the present study did not take into account life-style factors and male associated pathologies besides infertility.
Wider implications of the findings: Semen parameters were shown to be negatively correlated with sDNAfrag and sperm aneuploidies. As sDNAfrag testing and sperm aneuploidy testing were associated with semen abnormalities and male age, it is suggested their inclusion in the routine evaluation of infertile men, thus adding important complementary information about the fertility status.2021-01-01T00:00:00ZDepression and anxiety consequences of the COVID-19 pandemic: A longitudinal cohort study with university students
https://hdl.handle.net/10216/149770
Title: Depression and anxiety consequences of the COVID-19 pandemic: A longitudinal cohort study with university students
Abstract: Introduction. For young people, just as in the general population, COVID-19 caused many changes in their lives. The literature review has shown an increased risk for mental illness symptoms as a consequence of the pandemic.
Objectives. With this study, we aimed to evaluate the impact of COVID-19 pandemic in university students’ anxiety and depression symptoms.
Methods. This study is part of a larger longitudinal research on university students’ mental health with the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) data with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information.
Results. 341 university students (257 females and 84 males) were included in this study, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived well-being loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. In the PHQ-9, the proportion of students with scores equal or above 15 ranged between 22.6% and 25.5% in 2019, however, in June 2020, the proportion was significantly higher (37.0%). The proportion of GAD-7 scores above the cut-off 10 ranged between 46.0% and 47.8% in 2019, and, in 2020, 64.5% of the students scored 10 or above. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher.
Conclusions. COVID-19 had a negative impact on depressive and anxiety symptoms in university students, in line with the literature and confirming the vulnerability of young people in such uncertain times.2021-01-01T00:00:00ZThe Portuguese S3-Non-invasive Ventilation (S3-NIV) questionnaire for home mechanically ventilated patients
https://hdl.handle.net/10216/149772
Title: The Portuguese S3-Non-invasive Ventilation (S3-NIV) questionnaire for home mechanically ventilated patients
Abstract: Short, valid and easy to use tools are needed to monitor home mechanical ventilation (HMV) in clinical practice and for organization of HMV services. The S3NIV is a self-administered questionnaire containing 11 items that includes a Respiratory Symptoms and Sleep & Side Effects subscores, ranging from 0 (highest impact of disease and treatment) to 10 (lowest impact of disease and treatment).
The Portuguese version of the questionnaire was obtained using translation-back translation process with two professional translators and it was then validated on 234 stable patients (128 male patients, 53.8%) with a mean age of 69.3 (SD 11.0) years under long-term home non-invasive ventilation.
Data on total score and subscales according to disease category are reported on the table.
Internal consistency for the total score was good (Cronbach’s α coefficient of 0.76) as well as for the Respiratory Symptoms and the Sleep & Side effects domains (Cronbach’s α coefficient=0.68 and Cronbach’s α coefficient=0.72, respectively).
The Portuguese version of the S3-NIV questionnaire is a simple and valid tool for the routine clinical assessment of patients receiving HMV. Although they have advanced diseases, it appears patients recognize treatment benefits and have controlled side effects.2021-01-01T00:00:00ZPatients' perspective and lung function correlation:the importance of questionnaires in home mechanical ventilation
https://hdl.handle.net/10216/149771
Title: Patients' perspective and lung function correlation:the importance of questionnaires in home mechanical ventilation
Abstract: Classical physiological variables used to monitor respiratory function in patients under non-invasive ventilation (NIV), such as FEV1 or FVC, correlate poorly with reported impairment of physical function or overall health status and hence provide an incomplete picture of impaired health.
Aim: to investigate the association between the Portuguese S3-non-invasive ventilation (S3-NIV) questionnaire score and objective measures of lung function.
Consecutive adult patients with chronic respiratory failure, established on home NIV for at least 30 days were recruited in one outpatient clinic. Correlations between physiological variables and S3-NIV score were computed with Spearman rank coefficient. We studied 230 stable patients (126 male, 54.8%) with a mean age of 69.2 (± 11,0) years. Demographic and spirometry characteristics, and S3-NIV respiratory and total scores are presented on the table, according to disease groups. Spearman coefficient values are also presented. Neither the S3-NIV total score nor the respiratory symptoms subscore correlate with lung function impairment in any of the disease groups. This reinforces the notion that symptoms questionnaires and patient reported outcome measures must always be obtained directly from the patient and should be included in regular treatment monitoring.2021-01-01T00:00:00ZThe stomach cancer pooling (STOP) project: a global consortium of epidemiological studies of gastric cancer, updated to 2021
https://hdl.handle.net/10216/149767
Title: The stomach cancer pooling (STOP) project: a global consortium of epidemiological studies of gastric cancer, updated to 2021
Abstract: The assessment of risk factors in cancer etiology is necessary for defining optimal preventive strategies, as well as for identifying high risk individuals, and it is therefore relevant for medical practice and cancer prevention. The Stomach cancer Pooling (StoP) Project is a consortium of epidemiological studies of gastric cancer (GC), established in year 2012. The StoP Project aims to examine the role of lifestyle, environmental and genetic determinants of GC through pooled analyses of subject-level data. The consortium is the major GC dataset globally, including original data from 35 studies – with case–control study design, including 5 nested case–control within cohort studies – conducted in the Americas, Asia and Europe (Table 1), for a total of about 13,500 cases and 32,000 controls, and it is continuously expanding. To date, the StoP Project contributed a detailed quantification of the risk of GC associated to several factors, including cigarette smoking (relative risk, RR, of 1.32 for heavy vs. never smokers), alcohol drinking (RR=1.48 for heavy vs. never drinkers), socio-economic status (RR=0.60 for high vs. low education), selected dietary factors (RR=1.30 for high vs. low meat intake; RR=0.65 for high vs. low vegetables consumption; RR=0.80 for high vs. low citrus fruit; RR=0.67 for high vs. low polyphenols intake) and occupational exposures (RR=1.70 for miners; RR=1.30 for construction workers; RR=1.33 for agricultural and animal husbandry workers; RR=1.41 for blacksmiths and machine-tool operators). Planned future developments are to analyze the role of rare exposures on GC risk and to examine risk factors in understudied patient subgroups (e.g., young onset GC, gastric cardia cancer, etc.); to integrate additional studies from East Asia; to develop a genome-wide modeling of polygenic risk score in GC; to include survival analyses and to apply machine learning methods in GC risk prediction and prognostication.2021-01-01T00:00:00ZAdaptation and learning processes of stroke survivors and family carers: a scoping review
https://hdl.handle.net/10216/149768
Title: Adaptation and learning processes of stroke survivors and family carers: a scoping review
Abstract: Background. Knowledge on the processes of adaptation and learning after stroke are scarce, hindering the development of evidence-based public health strategies to promote survivors and family carers' health and wellbeing, across the post stroke trajectory. This study aims to assess the available evidence on the processes of adaptation and learning after stroke, by mapping the main barriers and enablers according to the perspectives of stroke survivors and family carers.
Methods. A scoping review was performed, following PRISMA-ScR guidelines. The electronic databases PubMed, ISI Web of Science, PsycINFO and SciELO were searched for empirical, peer-reviewed, original, and full-length studies on the processes of adaptation and learning of stroke survivors and family carers, in March 2021. Eligibility and data extraction were conducted by two independent researchers. The main qualitative data were explored by thematic content analysis and quantitative findings were synthesized.
Results. The included studies, 29 qualitative and 1 quantitative, were published between 1994 and 2019. Most of the studies were carried out with small samples and without a specific focus on the adaptation and learning processes after stroke. Barriers and enablers to stroke adaptation and learning processes were influenced by physical, psychological and social characteristics. The poor physical and functional status of survivors, the inability to maintaining the Activities of Daily Living, emotional disturbances, lack of support and information, and changes in roles, were identify as main barriers to stroke adaptation. Using coping strategies and having psychological, educational, and financial support were described as enablers.
Conclusions. Public health policies and practices should consider the physical, psychological and social barriers and enablers to the stroke adaptation and learning processes to ensure a high-quality long-term care centred on survivors and family carers.2021-01-01T00:00:00ZPortuguese validation of the Adult Carer Quality of Life Questionnaire (AC-QoL)
https://hdl.handle.net/10216/149769
Title: Portuguese validation of the Adult Carer Quality of Life Questionnaire (AC-QoL)
Abstract: Background. Assuring informal carers' quality of life (QoL) must be a priority for public health policies and practices. The Adult Carer Quality of Life Questionnaire (AC-QoL) is a recent and valid instrument, overpassing limitations of previous tools, and being already used among informal stroke carers. This study aimed to assess the feasibility, reliability and validity of the AC-QoL among Portuguese informal carers of stroke survivors.
Methods. The linguistic adaptation of the AC-QoL was performed. Informal carers (n = 212) of stroke survivors hospitalized between September 2018 and August 2019 in all Stroke Units of the North of Portugal (n = 12) were invited to participate, 18 to 24 months post-stroke. Data on sociodemographic characteristics, psychological profile, burden and QoL were collected using a structured questionnaire. The psychometric properties of the AC-QoL were investigated through exploratory and confirmatory factor analyses. Cronbach's alpha was used to measure internal consistency. Construct validity was assessed through the association of the overall score of AC-QoL with anxiety and depressive symptoms, burden and sociodemographic characteristics.
Results. Exploratory factor analysis supported the original eight-factor structure of the AC-QoL, revealing an adequate goodness of fit to the study sample (X2(674)=1145.926; CFI=0.916; TLI=0.908; RMSEA=0.058). The AC-QoL showed a high degree of reliability, with Cronbach's scores for the subscales ranging from 0.64 to 0.97 and a Cronbach's alpha of 0.91 for the overall score. Anxiety symptoms (p < 0.001), depression symptoms (p < 0.001) and burden (p < 0.001) were inversely associated with the overall score of AC-QoL. Younger (p = 0.032) and employed (p = 0.021) informal carers presented more frequently higher scores of overall QoL, than those older and unemployed.
Conclusions. The Portuguese version of the AC-QoL is a comprehensive, simple, reliable and valid instrument to assess informal stroke carers' QoL.2021-01-01T00:00:00ZIn vitro Acute Toxicity of Metal-Based Nanoparticles in Human Trophoblast BeWo b30 Cells
https://hdl.handle.net/10216/149766
Title: In vitro Acute Toxicity of Metal-Based Nanoparticles in Human Trophoblast BeWo b30 Cells
Abstract: Metal nanoparticles (M-NP) are among the most widely used nanomaterials in consumer products available in the market. Thus, human exposure to these nanosized materials is increasing, which raises serious concerns regarding their environmental and human safety. Biological barriers are important lines of defence to xenobiotics, thus expected targets for M-NP. In this regard, special consideration must be given to the placenta that acts as barrier between maternal and the developing fetus. The present study aimed at evaluating in vitro toxicity of different M-NP in a human cell model of placental barrier: trophoblastic (BeWo clone b30) epithelial cells. BeWo b30 cells were exposed for 24 h to varied concentrations (0.8 – 48 μg/cm 2) of M-NP of different chemical composition (Au, Ag and TiO2), primary size (10, 30 and 60 nm), capping (citrate and PEG) and crystal structure (rutile and anatase). In vitro toxicity was assessed by determining changes in cell morphology, metabolic activity, plasma membrane integrity, generation of intracellular reactive oxygen species (ROS) and ATP intracellular levels. The tested M-NP can be ranked for their in vitro
toxicity potential with AgNPs > AuNPs > TiO2 NPs, being the effects more visible at higher concentrations. No significant changes in cell morphology following exposure to all tested M-NP were detected. The influence of the size in the cytotoxic-induced effects was more evident for AgNP than for AuNP, with the smaller NP causing more toxicity. In addition, PEG-capping effectively attenuated AuNP-induced toxicity. Only cells exposed to AgNP exhibited a significant increase in ROS levels. All tested M-NP significantly increased intracellular ATP levels compared to control cells, with the exception of AuNP 10 nm. Thus, our data support that the physicochemical properties of M-NP are an important determinant of their cytotoxicity in BeWo b30 cells. Future studies will be useful to further explore the effects of M-NP in the placental barrier.2021-01-01T00:00:00ZSwimming pool training environment may drive skin and gut dysbiosis in elite swimmers
https://hdl.handle.net/10216/125704
Title: Swimming pool training environment may drive skin and gut dysbiosis in elite swimmers2019-01-01T00:00:00ZA multicentre study of street foods purchased in urban areas of Central Asia: the FEEDCities Project
https://hdl.handle.net/10216/125695
Title: A multicentre study of street foods purchased in urban areas of Central Asia: the FEEDCities Project
Abstract: <jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>Background</jats:title>
<jats:p>Street food (SF) is a strong tradition in Central Asia, where urbanization and westernization of food habits is occurring. Research on SF consumption is scarce, and crucial to understand its implications for public health. This study aims to describe the SF purchases in urban areas of Tajikistan, Kyrgyzstan, Turkmenistan and Kazakhstan.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>A cross-sectional study was conducted in Dushanbe, Bishkek, Ashgabat and Almaty in 2016/2017. SF markets (n = 34) and vending sites (n = 270) were selected by random and systematic sampling. Data on customers characteristics and food items purchased was collected by direct observation. Nutritional composition of the food items (n = 852) was obtained by laboratorial analysis (n = 582) or food composition tables and labels (n = 270).</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>A total of 714 customers were identified. The most commonly purchased foods and beverages were savoury pastries/snacks (23.2%), main dishes (19.0%), sweet pastries/confectionery (17.9%), tea/coffee (11.3%) and soft drinks/juices (9.8%). Fruit was the least frequently purchased food (1.1%). Nearly one-third of customers purchased industrial food items; this proportion was significantly higher in Kazakhstan (43.2%) and Turkmenistan (32.3%). The median energy content of a SF purchase ranged between 352kcal (Tajikistan) and 568kcal (Turkmenistan). The median saturated (SFA) and trans fat contents were 4.74g and 0.36g, respectively; the highest values were 9.01g for SFA (Turkmenistan) and 0.60g for trans fat (Kazakhstan), accounting for 40.6% and 27.3% of the maximum daily recommendations, respectively. Sodium-potassium ratio was far above recommended, reaching the highest values of 6.57 and 5.17 in Tajikistan and Kyrgyzstan.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>Frequent purchase of industrial food reflects a shift to a westernized dietary pattern. Public health policies in these settings should aim to increase fruit availability and to improve SF nutritional composition, namely its lipid profile and sodium content.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Key messages</jats:title>
<jats:p>A relevant proportion of customers bought industrial foods, while fruit was rarely purchased, reflecting the nutrition transition process that is occurring in developing countries. Street food meals showed concerning levels of saturated fat, trans-fat and sodium, which must be considered when designing strategies targeted to improve the urban food environment in these settings.</jats:p>
</jats:sec>2019-01-01T00:00:00Z