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Body image issues can affect all domains of sexual functioning. The aim of this study was to examine how, in a sociocultural context where physical and sexual attractiveness is equated with young and slim body ideals, appearance dissatisfaction and importance are related to sexual satisfaction in older adults in four European countries. A cross-sectional survey with probability samples of the population aged 60–75 years was used. Only respondents with a partner were included in this paper, and the countries included Norway (n = 957), Denmark (n = 846), Belgium (n = 612), and Portugal (n = 367). Sexual satisfaction, appearance dissatisfaction, and importance were assessed, and frequency of intercourse/kissing and cuddling, relationship satisfaction, age, and body mass index were all used as control variables. Belgian men scored significantly lower on sexual satisfaction, while there was no difference in sexual satisfaction in women. Appearance dissatisfaction was lower in Scandinavian women and men, and in Belgian men, and appearance salience was lower in Norwegian men and women, and in Portuguese women. Linear regression analysis revealed that, adjusting for confounders, appearance dissatisfaction was significantly related to sexual satisfaction in Scandinavian women and men, as well as in Belgian men. Compared to research on younger adults, appearance evaluation appeared to play an equally important role in sexual satisfaction in older adults in our study. The variation in appearance dissatisfaction in older adults across European countries is a novel finding that needs to be examined further. [ABSTRACT FROM AUTHOR]

The length of hospital stay (LOS) is an important measure of efficiency in the use of hospital resources. Acute Myocardial Infarction (AMI), as one of the diseases with higher mortality and LOS variability in the OECD countries, has been studied with predominant use of administrative data, particularly on mortality risk adjustment, failing investigation in the resource planning and specifically in LOS. This paper presents results of a predictive model for extended LOS (LOSE - above 75th percentile of LOS) using both administrative and clinical data, namely laboratory data, in order to develop a decision support system. Laboratory and administrative data of a Portuguese hospital were included, using logistic regression to develop this predictive model. A model with three laboratory data and seven administrative data variables (six comorbidities and age ≥ 69 years), with excellent discriminative ability and a good calibration, was obtained. The model validation shows also good results. Comorbidities were relevant predictors, mainly diabetes with complications, showing the highest odds of LOSE (OR = 37,83; p = 0,001). AMI patients with comorbidities (diabetes with complications, cerebrovascular disease, shock, respiratory infections, pulmonary oedema), with pO2 above level, aged 69 years or older, with cardiac dysrhythmia, neutrophils above level, pO2 below level, and prothrombin time above level, showed increased risk of extended LOS. Our findings are consistent with studies that refer these variables as predictors of increased risk. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic placed unprecedented pressure on societies and healthcare systems around the world. Over the last years, measures imposed in almost all countries dealing with the pandemic sent the entire world into an extensive crisis and thus into a deep global recession. Since the outbreak began, many European countries have faced three/four waves of pandemic. Portugal has mainly dealt with three waves (March/April'2020; October/November'2020; January/February'2021), the third being the deadliest one. The purpose of this article is to provide evidence on the impact of the COVID-19 on health-related quality of life (HRQol) and well-being (W-B) of Portuguese citizens. It aims to (i) characterize these outcomes during the COVID-19 pandemic; (ii) compare them to pre-COVID-19 Portuguese population; and (iii) identify the social determinants that may affect these outcomes during the COVID-19 pandemic. Methods: This study used data from a survey that collected data on HRQoL, W-B, satisfaction with life, economic and labour impacts, access to healthcare, mental and physical health, amongst others. The survey was implemented by telephone to a representative random sample of 1,255 respondents from the general adult Portuguese population, stratified by sex, age group and region. Data was collected during the end of the second national lockdown. For comparison purposes, we have also used two other representative databases from the general Portuguese population: (i) data from before the pandemic (n = 1,006); and (ii) data from a survey conducted during the first lockdown, (n = 904). Results: Looking at health and access to healthcare, 4% of citizens had their surgeries postponed or cancelled because of COVID-19, more than a quarter had medical appointments or complementary exams postponed or cancelled, with 7% over 65 years old with surgeries cancelled or postponed and 32% medical appointments. COVID-19 pandemic also impacted negatively on the HRQoL of citizens, especially in the first lockdown. Half of the respondents reported feeling nervous, anxious, or on edge, about 45% of citizens felt sad or depressed. Sleeping problems were reported for almost 39% of citizens, and loneliness is reported by 29% of citizens. For about 70–85% of citizens, these feelings were more so than before the pandemic. Citizens with fair/strong economic stability were the most economically affected by the pandemic. Conclusions: We provided evidence on the impact of COVID-19 on health and W-B of Portuguese citizens. Their health was worse than before the pandemic and the access to healthcare was highly affected. [ABSTRACT FROM AUTHOR]

Older adults are particularly susceptible to sedentary behaviours. Sitting time has been increasingly referred to as a potentially modifiable risk factor in the prevention of chronic diseases. Identifying factors associated with sitting time, particularly those that are modifiable, will allow for more effective public health strategies. This study aimed to describe sitting time among Portuguese older adults and to evaluate associated factors. A cross-sectional study including 1423 older adults ≥ 65 years old was conducted. Sitting time was assessed with the International Physical Activity Questionnaire. Socio-demographic, health, anthropometric and functional variables were collected. Bivariate and multivariate linear regression models were conducted to study the association between these variables and sitting time. The median of sitting time was 300 min/day (interquartile range = 240 min/day), which is equal to 5 h/day. The following factors were directly associated with longer sitting time: being male, age ≥ 80 years, living in Central or Southern Portugal, being retired from work, as well as presenting low physical activity, obesity or longer time to walk 4.6 metres. On the other hand, being married, having higher education and higher household income were inversely associated with longer sitting time. It can be concluded that Portuguese older adults spend a considerable amount of time sitting per day. Potentially modifiable risk factors associated with longer sitting time in this population were related to nutritional status and functional ability. [ABSTRACT FROM AUTHOR]

In a context of increasing ageing of the population, it is crucial to better understand multimorbidity and its consequences. This study measured the prevalence of multimorbidity in a Southern Europe population and projected its evolution based on expected demographic changes. It also analysed its associated consequences on self-reported health status, functional capacity, and healthcare use. Our sample included all people aged 25–79 years (6679 men and 8517 women) who participated in the fifth Portuguese National Health Interview Survey, conducted in 2014. Multimorbidity was measured by the presence of at least two self-reported chronic conditions. Multivariable regressions were used to assess the association of multimorbidity with health status, functional capacity, and healthcare use. The projected evolution of multimorbidity was based on official demographic projections. 43.9% of the Portuguese population self-reported the multimorbidity, which was more frequent among older people, women, and low-educated people. We found an association of multimorbidity with poorer health status (OR 3.32, 95%CI 2.60–4.24) and with limited functional capacity (OR 4.44, 95%CI 3.85–5.11). Multimorbidity was also associated with higher healthcare resource use, namely a 26% increased likelihood of hospitalization in the previous 12 months per additional comorbidity. We projected a 13.1% growth in the prevalence of multimorbidity until the year 2050. Multimorbidity affects a substantial share of the population and is expected to grow in the near future related to population ageing. The co-occurrence of chronic health conditions increases sharply with age and is associated with worse health status, reduced functional capacity, and increased healthcare use. [ABSTRACT FROM AUTHOR]

Psychological dysregulation is a complex and multidimensional construct encompassing cognitive, emotional, and behavioral dimensions. Research on psychological dysregulation emphasizes its importance in relation to several psychological disorders. However, assessing psychological dysregulation is often problematic because many of the existing instruments address a specific dysregulation dimension at a time, predominantly emotional dysregulation. The Abbreviated Dysregulation Inventory (ADI) was developed to assess three dimensions of psychological dysregulation: emotional, cognitive and behavioral. This study’s goal was to analyze the factor structure, internal consistency, and validity in relation to external variables of the Portuguese version of the ADI in a sample of 511 adolescents aged between 12 and 19 years old. The 3-factor solution was confirmed, and high internal consistency was found for the three subscales. Peculiar findings on the cognitive dysregulation subscale raised issues addressed in the discussion section. Results indicated that dysregulation associates positively with aggressive behavior and negatively with quality of life. Age and gender presented small influence on the cognitive and behavioral subscales scores, respectively. Findings suggested that ADI can be a valuable self-report measure to assess cognitive, behavioral or emotional dysregulation in youths, within research and psychological intervention settings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze the relationship between biological maturation and health-related quality of life (HRQoL) in Portuguese children and adolescents of both sexes when the effect of chronological age (CA) and volume of physical activity (VPA) were removed.Methods: HRQoL, biological maturation, CA, and VPA were assessed in 750 children and adolescents, 11-17 years old, from 3 schools in Lisbon, Portugal. The KIDSCREEN-52 was used to assess HRQoL. Maturity indicator was bone age (BA), using Tanner-Whitehouse III method (TW3). The participants were classified into three different maturity categories: late, on time, and early maturers. VPA was assessed by questionnaire (RAPIL II). An analysis of covariance (ANCOVA), using the CA and the VPA as covariates was completed. The level of significance was set at p ≤ 0.05.Results: Analysis of covariance suggested an influence of biological maturation in physical well-being dimension in both sexes, with early-maturing girls and boys having worst perception. Maturity groups were also influent in moods and emotions for girls. CA seems to be particularly important in self-perception and parent relation and home life for girls and in school environment for boys.Conclusion: Biological maturation and CA have relevant impact on some HRQoL dimensions. These variables, due to their nature and effect should be considered particularly when working with specific domains of HRQoL as physical well-being in both sexes, moods and emotions and self-perception and parent relation and home life for girls and in school environment for boys. [ABSTRACT FROM AUTHOR]

The article discusses a study on the knowledge of adults with cerebral palsy (CP) about sexually transmitted diseases (STDs). Topics covered include the study involving adults with CP in Portugal, the development of a Guttman scale to assess knowledge about STDs, and the role of health literacy in influencing safe behaviors in terms of sexual living. Also mentioned is the usefulness of the Guttman scale in a comprehensive evaluation of specific incidents related to people with CP.

Research on the role of parental rearing behaviors in the development of children's anxiety problems has predominantly adopted a dimensional approach studying the effects of isolated parenting behaviors such as overprotection and rejection, while mainly focusing on the mother. Our study was set up to identify parenting typologies of both mothers and fathers, and to explore their relationship with children's anxiety symptoms. Three-hundred-and-ninety non-clinical Portuguese children aged 8-12 years completed a self-report questionnaire on anxiety disorder symptoms, while their fathers (27-64 years of age) and mothers (24-65 years of age) filled in two scales on parental rearing behaviors as well as an index of parental anxiety. Cluster analysis revealed three parenting typologies that were similar for mothers and fathers, and were labeled as overinvolved, disengaged, and supportive parenting. Only the disengaged typology of mothers was associated with higher levels of anxiety symptoms on children. Disengaged parents and Overinvolved fathers were associated with higher levels of parental anxiety whereas overinvolved parents evidenced more anxiety/worry about the child. These results suggest that the study of parenting typologies, contextualized within a cultural background, are an invaluable approach because it can be used to explore the effects that different combinations of various parenting behaviors may have on childhood anxiety. [ABSTRACT FROM AUTHOR]

Summary: Age modifies the effect of area-level socioeconomic status (SES) in the risk of fragility hip fractures (HF). For older individuals, the risk of HF increases as SES increases. For younger individuals, risk of HF increases as SES decreases. Our study may help decision-makers to better direct the implementation of political decisions. Introduction: The effect of socioeconomic status (SES) on hip fracture (HF) incidence remains unclear. The objective of this study is to evaluate the association between HF incidence and municipality-level SES as well as interactions between age and SES. Methods: From the Portuguese Hospital Discharge Database, we selected hospitalizations (2000-2010) of patients aged 50+, with HF diagnosis (codes 820.x, ICD9-CM), caused by traumas of low/moderate energy, excluding bone cancer cases and readmissions for aftercare. Municipalities were classified according to SES (deprived to affluent) using 2001 Census data. A spatial Bayesian hierarchical regression model (controlling for data heterogeneity and spatial autocorrelation), using the Poisson distribution, was used to quantify the relative risk (RR) of HF, 95 % credible interval (95%CrI), and analyze the interaction between age and SES after adjusting for rural conditions. Results: There were 96,905 HF, 77.3 % of which were on women who, on average, were older than men (mean age 81.2 ± 8.5 vs 78.2 ± 10.1 years) at admission ( p < 0.001). In women, there was a lower risk associated with better SES: RR = 0.83 (95%CrI 0.65-1.00) for affluent versus deprived. There was an inverse association between SES and HF incidence rate in the youngest and a direct association in the oldest, for both sexes, but significant only between deprived and affluent in older ages (≥75 years). Conclusions: Interaction between SES and age may be due to inequalities in lifestyles, access to health systems, and preventive actions. These results may help decision-makers to better understand the epidemiology of hip fractures and to better direct the available funding. [ABSTRACT FROM AUTHOR]

The youth self-report (YSR), which is theoretically based in the field of developmental psychopathology and follows a dimensional approach, is an important instrument to assess the behavioral and emotional problems and the psychosocial competencies of adolescents between the ages of 11 and 18 years in both clinical and research contexts. Our main aims were to propose a short form of the YSR, conduct a first validation study, and compare the short-form YSR with the full version of the Portuguese YSR. We conducted the first study (Study 1) in a sample of 1,266 Portuguese community adolescents between the ages of 11 and 21 years to analyze the factor structure of the YSR. We conducted the second study (Study 2) in a sample of 302 community adolescents between the ages of 11 and 21 years to validate the factor structure of the short form of the YSR, which consisted of 33 items that focused on the dimensions of internalization-depression, internalization-anxiety, externalization-destructiveness and externalization-exhibitionism. Our findings confirmed that the YSR-SF provides a good fit to the data, explains similarly the variance on several criteria compared with the longer version, and is sensitive to sex and age differences. [ABSTRACT FROM AUTHOR]

This study aimed to describe the proportion of HIV testing among an African immigrant population in Portugal and identify the socio-demographic factors that may be associated. A questionnaire was applied to 522 African immigrants (53% men) who attend the National Immigrant Support Centre, in Lisbon. Odds ratios (OR) with corresponding 95% confidence intervals (95% CI) were calculated through logistic regression to analyse the relationships between HIV testing and other variables. Around 52% of participants reported having been HIV tested, mostly women. After adjusting for potential confounders, age and educational level were significantly associated with HIV testing for both women and men. Searching for HIV information at NHS was also significantly associated with HIV testing, but only among men. This study points out interesting challenges for HIV prevention programs among African immigrants and may help in the development of tailored projects focused on the promotion of HIV testing among these populations. [ABSTRACT FROM AUTHOR]