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Background: After two years of psychological, physical, social, economic, environmental, and societal challenges, this paper examines the psychological health and well-being of Portuguese students based on their socioemotional skills (SSES), positive youth development (PYD), depression, anxiety, and stress (DASS), as well as the relationship between these variables and their influence on perceived quality of life and life satisfaction. Methods: This study examined 3235 students from lower to upper secondary, half of whom were female (M = 14.46 ± 1.883 years old). Using SPSS software, descriptive statistics were determined for all variables; mean differences between age and gender were found using ANOVA and the post hoc Scheffe test. Linear regressions with the Enter method were used to study how to predict perceived quality of life and satisfaction with life. Results: Males had scores indicating more SSES|optimism, emotional control, resilience, confidence, sociability, creativity, energy, a sense of belonging to school, and PYD. Girls had better skills for cooperating and relating to teachers but more test anxiety and DASS. Younger adolescents had better psychological health, greater skills, and a better perception of quality of life and life satisfaction when compared to older adolescents. Age, gender, SSES, PYD, and the DASS variables can explain 69% of the variance in life satisfaction, while these variables can explain 60.5% of the variance in perceived quality of life. Conclusions: These results point to the relevance of SSES for psychological health and well-being, suggesting that interventions should focus on promoting these variables, paying special attention to female gender and age-related challenges. [ABSTRACT FROM AUTHOR]

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]

A stroke is a time-sensitive emergency, so diagnosing and treating the victim promptly is extremely important. Therefore, the purpose of this study was to identify the influence of the Stroke Code Protocol's activation on the door-to-computed-tomography (door-to-CT) time and determine whether factors such as previous Modified Rankin Scale (mRS), age, and gender influence its activation. A retrospective study was conducted in a Medical-Surgical Emergency Department in the centre of Portugal from 1 January 2021 to 31 December 2022. The sample was selected according to the diagnosis assigned at the time of clinical discharge from the Emergency Department and the Stroke Code Protocol activation criteria. It was observed that 113 (50%) suspected stroke victims who met the activation criteria for the Stroke Code Protocol did not have the protocol activated, which had a highly significant influence (p < 0.001) on door-to-CT time. It was determined that activation at triage has an average door-to-CT time of 35 ± 18 min, post-triage activation has an average door-to-CT time of 38 ± 26 min, and non-activation has an average door-to-CT time of 1 h 04 ± 45 min. The need to implement an institutional protocol for activating the Stroke Code Protocol and provide specialised training for the multidisciplinary team is reiterated. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity presents a significant public health concern globally, with implications for cardiovascular health and metabolic syndrome. In Portugal, approximately 31.6% of children are affected, highlighting the urgency for intervention strategies. This study aimed to assess the prevalence of overweight and obesity in Portuguese school-aged children, with a focus on sex and age differences. Methods: Anthropometric measurements were conducted on 1564 children aged 6–10 years, including weight, height, and skinfold thickness. Body Mass Index (BMI) and the percentage of body fat were calculated using established methods. Results: The results revealed significant differences in BMI (≤0.001) and body fat percentage (≤0.001) among different BMI categories, with a notable prevalence of overweight and obesity, particularly among boys. A total of 37% of the studied population is overweight or obese, among which 40.1% and 33.9% are boys and girls, respectively. Conclusions: This study highlights statistically significant differences in BMI and body fat percentage for both sexes in different BMI categories. A large proportion of the population is overweight or obese, with a greater prevalence in boys. In short, childhood obesity has a negative impact on body composition and is associated with significant differences in anthropometric parameters, emphasizing the importance of preventative and intervention strategies to address this health problem. [ABSTRACT FROM AUTHOR]

Background/Objectives: The relevance of psychomotor skills in children's growth is being increasingly recognized. The transversal role of psychomotor skills in learning performance is described through a link between cognitive and motor functioning, promoting socio-affective–expressive competencies, but there is a scarcity of evidence from the field. A two-fold goal was defined: to investigate the relationship between psychomotor functions and academic performance and to examine the factors affecting children's academic performance. Methods: The Portuguese versions of the Neuropsychomotor Functions Assessment Battery for Children (NPmot.pt), Preschool Diagnostic Tasks (PRE), and School Learning Skills Battery (SLSB) were applied to 350 children (85.72 ± 24.23 months) with and without disabilities attending mainstream schools. Results: Pearson correlations and regression analyses were used. NPmot.pt domains showed moderate to strong correlations with PRE domains (0.30 < r < 0.82) and weak ones with SLSB domains (r < 0.30). Psychomotor development is a stronger predictor (p < 0.001) of pre-academic performance outcomes: (βTonus = 0.67, βGross Motor Skills = 1.04, βSpatial Orientation = −1.44, βRhythm = −1.59 and βAuditory Attention = 3.68) than of academic performance above 7 years old (p > 0.05). Conclusions: Results strengthen the importance of psychomotor skills development from an early age, also at school, with implications for an early psychomotor assessment and intervention for children with and without disabilities. Tailor-fit interventions, including strategies to improve psychomotor skills, should be promoted during the school process of all children for a successful learning process. [ABSTRACT FROM AUTHOR]

This cross-sectional study aims to describe and compare energy, nutrient intake and food consumption according to eating location and by age groups using data from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015/2016). Dietary intake was estimated by two non-consecutive days of food diaries (children)/24-h recalls (other age groups), and four eating location categories were defined according to the proportion of meals consumed at out-of-home locations: Home (at least 80 % of meals at home), Other Homes , School or Work and Restaurants and Other Places. The majority of meals (69·1 %) were consumed at home. Meals were also often taken at school by children and adolescents and in restaurants and similar outlets by adults and elderly. Children and adolescents in the School or Work category ate more fruit, vegetables and pulses and cereals and starchy tubers, whereas adults in this category ate more red and processed meats, sugar-sweetened beverages and sweets. Compared with Home category, Restaurants and Other Places was associated with worse diet adequacies among children (β = –1·0; 95 % CI = –2·0, −0·04), adolescents: (β = –2·4; 95 % CI = –3·2, −1·5) and adults (β = –1·3; 95 % CI = –1·6, −1·0) reflecting higher intakes of energy, fat, trans -fatty acids and SFA, and Na. The elderly consumed more free sugars and fat when eating out of home in general. Overall, findings reflect important variation in nutrient profiles by eating location, with meals taken at school or work contributing to higher consumption of nutrient-dense foods and those taken in restaurants and other similar settings implying higher consumption of energy-dense foods. [ABSTRACT FROM AUTHOR]

Background: The incidence and mortality of pleural mesothelioma (PM) reflect the production and consumption of asbestos over time. However, despite the current global concern, these data remain to be known. Objective: Our aim was to carry out a descriptive analysis of PM cases and mortality from some Portuguese databases between 2014 and 2020. Methods: A retrospective observational study was carried out between 2014 and 2020. Data on the number of PM cases were provided by the Portuguese Cancer Registry, and data on mortality were from the Portuguese Death Certificate Information System. Results: Between 2014 and 2020, 315 cases of PM were reported, with 222 (70.5%) men. The average age of patients was 72.1, with the highest number of cases in patients aged >70 years (n = 198; 62.9%). The highest number of cases was reported in 2018 (n = 62; 19.7%). Regarding mortality, 169 deaths were reported, with 126 (74.6%) men and mostly in individuals aged >70 years (n = 109; 64.5%). It is estimated that around 520 years of potential life were lost. The highest number of deaths occurred in 2015 (n = 33; 19.5%). Conclusion: It is mandatory to reinforce the need for surveillance programs that allow us to gather real and reliable data and eliminate asbestos-related diseases. [ABSTRACT FROM AUTHOR]

Copyright of Motricidade is the property of Silabas Didaticas LDA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. The Distress Tolerance Scale (DTS) was adapted for American and Chinese youth, but never for European youth. Moreover, the factor structures found in these previous studies were not consistent. Methods. The DTS was adapted for Portuguese children and then validated among 153 children aged 6–13 years with emotional disorders. A confirmatory factor analysis (CFA) was conducted; the DTS reliability and validity were analyzed, and sex and age differences were explored. A sub-sample of children who received a transdiagnostic CBT (Unified Protocol for Children) was used to analyze the DTS's sensitivity to therapeutic change. Results. The five tested models (based on previous studies) exhibited adequate fit in the CFA. However, the model previously reported for use in American children with emotional disorders was selected as the most appropriate. The DTS demonstrated adequate psychometric properties, and its validity was established through significant negative associations with measures of anxiety, depression and negative affect, as well as positive associations with positive affect. Age and sex differences were discussed. The DTS scores significantly increased from pre- to post-treatment, demonstrating sensitivity to therapeutic change. Conclusions. The DTS is a suitable and useful measure for assessing children's distress tolerance and to assess the efficacy of CBT. [ABSTRACT FROM AUTHOR]

Copyright of Motricidade is the property of Silabas Didaticas LDA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Background: Obesity is a serious and largely preventable global health problem. Obesity-related electronic health records can be a useful resource to identify and address obesity. The analysis of real-world data from T82-coded (International Classification of Primary Care coding, for obesity) primary care individuals can be an excellent national source of data on obesity's prevalence, characteristics, and impact on the National Health Service. Methods: Retrospective longitudinal study, based on a database of electronic medical records, from the Regional Health Administration of northern Portugal. The study objectives were to determine the prevalence of obesity and to characterize an adult obese population in northern Portugal from a bio-demographic point of view along with profiles of comorbidities and the use of health resources. This study used a database of 266,872 patients in December 2019 and screened for diagnostic code T82 from the International Classification of Primary Care. Results: The prevalence of obesity was 10.2% and the highest prevalence of obesity was in the 65–74 age group (16.1%). The most prevalent morbidities in patients with obesity as coded through ICPC-2 were K86 (uncomplicated hypertension), T90 (non-insulin-dependent diabetes), and K87 (complicated hypertension). Descriptive information showed that T82 subjects used more consultations, medications, and diagnostic tests than non-T82 subjects. Conclusions: Routine recording of weight and height deserves special attention to allow obesity recognition at an early stage and move on to the appropriate intervention. Future work is necessary to automate the codification of obesity for subjects under 18 years of age, to raise awareness and anticipate the prevention of problems associated with obesity. Practical strategies need to be implemented, such as the creation of a specific program consultation with truly targeted approaches to obesity. [ABSTRACT FROM AUTHOR]

Introduction: The goal of this study was to assess the impact of COVID-19 on Portuguese dental students on their depression, anxiety, temporomandibular dysfunction, academic degree, and oral behaviors. Methods: The target of this population study was to enroll third-, fourth-, and fifth-year students of the Integrated Master's degree in Dental Medicine at the Universidade Católica Portuguesa—Faculty of Dental Medicine (Viseu, Portugal) in the academic year 2021–2022. Temporomandibular disorders (TMD) symptoms, oral behaviors, anxiety, and depression were assessed using validated questionnaires. The variables under study were (a) age, gender, marital status, academic level, academic degree, medication, and any existing pathologies; (b) questions related to taste changes or thoughts that would indicate (or not) worsening psychological conditions (anxiety and depression). After data collection (Google Forms®), data were transferred to an Excel file and entered into SPSS® software. A chi-square test allowed the independence between ordinal or nominal variables. The Spearman correlation test was used to analyze the relationship between variables in the study (significant if p ≤ 0.05). Results: 98.2% of the students answered the questionnaire. TMD had a prevalence of 35%, and anxiety and depression a prevalence of 29% and 24%, respectively. The results showed that the female gender was the most affected by psychological and temporomandibular disorders. Statistically significant correlations were identified between variables, such as gender and anxiety, TDM, and depression (respectively, p = 0.0001, p = 0.014, and p = 0.026); between TDM and anxiety and depression (respectively, p = 0.001 and p < 0.001); and between performing oral behaviors and TMD, anxiety, and depression (respectively, p = 0.0001, p = 0.0001, and p = 0.006). The variables, such as age and academic degree, did not establish a statistically significant relationship with TMD, oral behaviors, and the two psychological conditions. Conclusions: It was possible to conclude that there was a moderate prevalence of TMD, anxiety, and depression in the period studied. Moreover, a statistically significant relationship was found between TMD, anxiety, and depression with gender and frequency of OBs; however, no significant association was found for TMD, anxiety, and depression with the age of students and with the academic degree. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of the study was to explore how child's characteristics (age, sex, and temperament) were associated with father's involvement in child-related activities. In a sample of 410 bi-parental families with pre-school age children. (2) Methods: Dividing the sample into two age groups, OLS regression models were conducted for each dimension of father involvement with child characteristics as predicting variables. (3) Results: for the younger children (3 and 4 years) fathers were more involved in teaching/discipline and played with their more extroverted daughters. With older children (5 and 6 years), fathers were more involved in teaching/discipline and played when children were higher on negative-affectivity. An interaction was found with boys' higher negative-affectivity, predicting fathers' higher involvement in teaching and discipline. (4) Conclusions: Our results suggest that children's characteristics have an impact on what fathers do, particularly in a dimension salient to pre-school years such as teaching/discipline. This can help build tailored empirical-sustained programs aiming to encourage and support fathers' positive involvement. [ABSTRACT FROM AUTHOR]

Objective: Users of publicly funded voluntary HIV Counseling and Testing Centers (VCT C) in the Portuguese National Service have been found to have higher rates of HIV risk behavior than the general population, but data concerning the relationship between socio-demographic, behavioral, and cognitive variables, and Sexually Transmitted Infections (ST Is) in this specific population are limited. This study tests the impact of socio-demographic, behavioral and cognitive variables on ST Is in a sample of 168 users of VCT C. Methods: A cross-sectional study using structured questionnaires was conducted. Results: Being older, being gay or bisexual, and having more barriers towards safer sex (e.g., negative attitudes toward safer sex behavior) were associated with increased odds of having had a ST I diagnosis. We found significant differences between heterosexual and gay men for number of sexual partners, frequency of anal sex, exchanging sex for money or drugs, history of ST Is, AIDS knowledge, and risk beliefs about the partner, with gay men showing higher rates. Conclusions: ST Is education should target older, gay or bisexual individuals, and focus on information as well as on changing barriers towards safer sex and associated health beliefs. [ABSTRACT FROM AUTHOR]

Background: Transcranial direct current stimulation (tDCS) has been employed to boost working memory training (WMT) effects. Nevertheless, there is limited evidence on the efficacy of this combination in older adults. The present study is aimed to assess the delayed transfer effects of tDCS coupled with WMT in older adults in a 15-day follow-up. We explored if general cognitive ability, age, and educational level predicted the effects. Methods: In this single-center, double-blind randomized sham-controlled experiment, 54 older adults were randomized into three groups: anodal-tDCS (atDCS)+WMT, sham-tDCS (stDCS)+WMT, and double-sham. Five sessions of tDCS (2 mA) were applied over the left dorsolateral prefrontal cortex (DLPFC). Far transfer was measured by Raven's Advanced Progressive Matrices (RAPM), while the near transfer effects were assessed through Digit Span. A frequentist linear mixed model (LMM) was complemented by a Bayesian approach in data analysis. Results: Working memory training improved dual n -back performance in both groups submitted to this intervention but only the group that received atDCS+WMT displayed a significant improvement from pretest to follow-up in transfer measures of reasoning (RAPM) and short-term memory (forward Digit Span). Near transfer improvements predicted gains in far transfer, demonstrating that the far transfer is due to an improvement in the trained construct of working memory. Age, formal education, and vocabulary score seem to predict the gains in reasoning. However, Bayesian results do not provide substantial evidence to support this claim. Conclusion: This study will help to consolidate the incipient but auspicious field of cognitive training coupled with tDCS in healthy older adults. Our findings demonstrated that atDCS may potentialize WMT by promoting transfer effects in short-term memory and reasoning in older adults, which are observed especially at follow-up. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem Referência is the property of Escola Superior de Enfermagem de Coimbra and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. COPD is a common worldwide condition associated with morbidity and mortality. Its symptoms can be easily overlooked, accounting for an elevated level of under-recognition and under-diagnosis. Knowledge of the prevalence of COPD and the significance of its associated factors in the population enables better management of medical resources. Objectives. To establish the prevalence of COPD in General Practice patients in the Central Region of Portugal and analyze the correlation with associated factors. Methods. Cross-sectional study of patients’ data with COPD (R95, International Classification for Primary Care 2), anonymously gathered from the official database of the Central Health Administration of Portugal. Results. Out of 937,817 individuals, 24,148 patients were identified with COPD, a prevalence of 2.57/100,000. 73.7% were above 65 years of age, and 60.2% were males. BMI was recorded in 60.2% patients, FEV1(%) in 8.0%, and smoking pack-years in 37.1%. Age and BMI were significantly negatively correlated (ρ = -0.032, p < 0.001), with the same occurring between age and FEV1(%) (ρ = -0.073, p < 0.05). A strong association of COPD with male gender and older age groups was found. Conclusions. The prevalence of COPD was significantly higher in males, and age was identified as a risk factor for this condition. Higher age was non-significantly associated with lower FEV1(%) and significantly associated with BMI. The lack of e-records calls for an improvement. [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]

Background: It is estimated that around 70% of Type 2 Diabetes Mellitus patients (T2DM) have Non-Alcoholic Fatty Liver Disease (NAFLD). Awareness and education are amongst the major shortcomings of the public health response to the increasing threat of NAFLD. Characterizing the specific NAFLD-related information needs of particular high-risk metabolic communities, for instance, T2DM patients, might aid in the development of evidence-based health promotion strategies, ultimately promoting NAFLD-awareness, treatment adherence and therapeutic success rates.Methods: Semi-structured interviews with T2DM patients were conducted to gain insight into their awareness of NAFLD, including its relationship with insulin resistance and T2DM.Results: Awareness of NAFLD as a disease entity, as well as its progression to end-stage liver disease or its relationship with other metabolic conditions, including insulin resistance and T2DM was low. Surveillance behaviours were also suboptimal and perceptions on the self-management knowledge and praxis regarding lifestyle intervention components of T2DM treatment seemed detached from those of NAFLD.Conclusions: Our findings could inform the integration of NAFLD-related content in T2DM health promotion strategies. Rising awareness on NAFLD progression and its relationship with T2DM using culturally and community-relevant constructs might facilitate the development of primary and secondary prevention programmes to promote the adherence to lifestyle interventions by influencing NAFLD threat perceptions. [ABSTRACT FROM AUTHOR]

Background: Community-acquired pneumonia (CAP) is one of the leading causes of morbidity and mortality worldwide, often leading to hospital admissions. In Portugal, the factors associated with in-hospital mortality due to CAP are not fully documented. The aim of this study was to characterize the trends of CAP hospitalization in all age groups and the factors associated with their mortality between 2000 and 2014.Methods: We conducted a cross-sectional study using CAP hospitalization data in all age groups, in Portugal Mainland. Logistic regression was used to identify the factors associated with in-hospital mortality.Results: Between 2001 and 2011, CAP hospitalization rate increased from 2.8 to 4.3 per 1000 population. Hospitalization rates were higher in the extreme ages ( ≤ 4 and  ≥ 75 years). However, a decrease in the hospitalization rate and its mortality was observed, in the younger ages. A total of 548,699 hospitalization CAP episodes, between 2000 and 2014, were analyzed, with male (56.2%) and elderly ≥65 years (91.7%) predominance, resulting in 101,740 deaths (18.5%). Men had a significantly lower mean age (64.3 ± 26.4 years versus 67.9 ± 27.5 years; p < 0.001). During the studied 15 years, there was an increase of 45.2% in the number of annual hospitalizations, concomitant with the admission increase of individuals aged over 75 years. Since 2012 a decrease in hospitalizations and associated deaths were detected. The increase in age represented a progressive and significant rise in the probability of death, except for the age group 1-4 years. The age group ≥85 years old (Adjusted OR = 124.256; 95%CI: 97.838-157.807) and males (Adjusted OR = 1.261; 95%CI: 1.243-1.280) were significantly associated with death risk for CAP hospitalization. After 2010, this risk decreased (Adjusted OR = 0.961; 95%CI: 0.940-0.982). The main factors affecting mortality were age, sex, unemployment rate, number of performed procedures and admission quinquennia.Conclusions: Despite a trend of decrease in CAP hospitalizations and associated death since 2012, the numbers of in-hospital mortality showed, in the 15 years under analysis, an overall increase over time, mainly associated with age, in particular very old people ( ≥ 75 years), males and a higher parish unemployment rate. Therefore, the implementation of CAP preventive measures should be reinforced in these vulnerable groups. [ABSTRACT FROM AUTHOR]

Background. Multimorbidity (MM) is associated with decreased quality of life, mainly due to decreased functional capacity and increased use of health care. Objectives. Evaluate the prevalence of MM in older people of Central Portugal and understand the impact of MM on daily life activities (DLA) and how socio-economic level influences the prevalence of MM. Material and methods. Observational study of data on age, sex, number of ICPC2 codes and Barthel (Bt) and Graffar (Gr) Indexes in clinical records of individuals aged between 65 to 99 years enrolled in the Health Centres of the Central Region of Portugal. The Bt was used to assess the dependence on DLA, and the Gr the socio-economic level. Results. Population of 190,025, mean age of 80.16 ± 8.03 years. MM prevalence of 80%, out of which 52.9% were female, and the majority was aged between 76-85 years (39.1%). Average number of health problems: 8.7 problems for males and 9.5 for females. Bt and Gr Indexes we filled in 7.4% and 4.9% of the population. Older people without MM have higher dependency rates than those with MM (total dependence 7.4% vs 6.2% and severe dependence 20.1% vs 9.6%). MM in older people is mainly in the middle (55.3% vs 27.5%) and low (31.8% vs 19.6%) Graffar class, while the older people without MM are mainly in middle to upper (35.3%) and upper (17.6%) Graffar classes. Conclusions. Multimorbidity is mainly associated with lower social classes. The dependence for DLA appears unrelated to MM. Individuals with multimorbidity need special attention based on socio-economic contexts. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem Referência is the property of Escola Superior de Enfermagem de Coimbra and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Enfermagem Referência is the property of Escola Superior de Enfermagem de Coimbra and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background In Health Examination Surveys interview information is complemented with objective information, providing more accurate indicators than self-reported data. We report the study design, planning and implementation of the first Portuguese Health Examination Survey (INSEF). Methods INSEF was a cross-sectional population-based study representative at regional and national level. Individuals aged between 25 and 74 years old, residing in Portugal were selected from the national health users' registry through multi-stage stratified probabilistic sampling. Sample size was set at 4200 individuals. Data was collected in primary care units and included blood pressure, height, weight, hip and waist measurements, blood collection for lipid profile, HbA1c and blood count and a general health questionnaire. European HES procedures were followed. Results A total of 4911 individuals agreed to participate (43.9% participation rate). Participation rate varied by region, sex and age group, being lower in Lisbon and Tagus Valley (32.8%), for men (41.8%) and for those aged 25–34 years old (36%). Conclusions INSEF has set up an experienced national and regional structure for HES implementation. Nationally representative quality epidemiological data is now available for public health monitoring, planning and research. [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]

Background. The "Ten Commandments for patient-centred treatment" suggest a different approach to therapy. Objectives. To ascertain the level of agreement with the "Ten Commandments for patient-centred treatment" by physicians in Central Portugal, exploring differences by age group, sex and medical speciality. Material and methods. An online questionnaire in September of 2016, sent to doctors registered in the Central Regional Section of the Portuguese Medical Association, with weekly reminders to non-respondents. The English wording was translated to Portuguese, a questionnaire with a four-grade answer was created and its reliability determined. Variables such as sex, age group and medical specialty were considered. Descriptive and inferential statistics were performed. Results. A representative yet convenient sample of 811 doctors participated. Their description is as follows: ≤ 35 years n = 203, ≥ 36 and ≤ 55 years n = 217 and ≥ 56 years n = 373, women n = 391 (49.2%), General Practice/Family Medicine (GP/FM) n = 301, medical specialty n = 303 and medico-surgical specialty n = 173. By medical specialty, for commandment 1, there is higher prevalence of "Disagree/Completely Disagree" in the GP/FM specialty (p < 0.001). By gender, for commandment 1, women vs men doctors "Disagree/Completely Disagree" proportion of 11.7% vs 6,4% (p = 0.003). For the younger age groups, there is a greater proportion of "Disagree/Completely Disagree" for Commandment 1 (p = 0.016), for Commandment 4 (p = 0.007), for Commandment 6 (p = 0.001), for Commandment 7 (p = 0.001) and for Commandment 8 (p = 0.020). Conclusions. There is vast agreement with the "Ten Commandments for patient-centred treatment" in central Portugal. For Commandments 1, 3 and 6, the proportion of "Disagree/Completely Disagree" is higher than for the remaining. There is a need for future investigations to explain the present results. [ABSTRACT FROM AUTHOR]

Background Inequalities in the distribution of self-reported health (SRH) have been widely reported. Its higher expressivity among women, elderly and least educated groups has been partly attributed to differences in their health perceptions. However, this subjectivity may be masking the burden of mental illness in these groups. Thus, we sought to understand if depression symptoms mediate inequalities in SRH. Methods SHARE waves 4 and 6, pertaining to Spain, Italy and Portugal, were used (n 2011 = 8517, n 2015 = 11 046). Inequalities in SRH were calculated, comparing the risk amongst education level, gender and age groups, adjusting for chronic diseases, functional limitations and country fixed effects. We then tested depression symptoms as mediators. Results Depression symptoms were associated with poor SRH (odds ratio (OR)2011 = 1.379, OR2015 = 1.384, P < 0.001). Their inclusion reduced the magnitude of the association between SRH and education, annulled the statistical significance for age, and reversed the gender effect. As expected, chronic diseases and functional limitations remained significant predictors of poor SRH. Conclusions Depression symptoms, together with chronic diseases and functional limitations, explain the poorer SRH of the least educated, female and older groups in the Southern European population. Therefore, tackling inequalities in SRH must require focusing on mental health issues, which disproportionately affect the most vulnerable groups. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem Referência is the property of Escola Superior de Enfermagem de Coimbra and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Enfermagem Referência is the property of Escola Superior de Enfermagem de Coimbra and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Enfermagem Referência is the property of Escola Superior de Enfermagem de Coimbra and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Enfermagem Referência is the property of Escola Superior de Enfermagem de Coimbra and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Problematic eating behaviours during early childhood could be mediators of poor dietary habits. This study aims to prospectively relate early eating behaviours with fruit and vegetable (F&V) intake and a healthy diet variety score of children aged between 4 and 5 years. Eating behaviours were assessed in three European birth cohorts (Generation XXI from Portugal, ALSPAC from the UK and EDEN from France) at 4–6, 12–15, 24 and 48–54 months of age, based on the child’s feeding difficulties, mother’s perception of child’s poor eating (eating small quantities at each meal, not eating enough or needing to be stimulated to eat), food refusal and difficulties in the establishment of daily food routines. Daily servings of F&V (>1 v. ≤1 serving/d, except in Generation XXI: >3 v. ≤3) and the Healthy Plate Variety Score (categorised by the median score of each sample) were calculated using FFQ. Associations were tested by logistic regressions adjusted for maternal age, education, smoking during pregnancy, any breast-feeding and the child’s z-score BMI at 4–5 years of age. Children with more feeding difficulties, poor eating, food refusal/neophobia and difficulties in establishing a daily routine at 12–15, 24 and 48–54 months of age had in general lower F&V intake at 4–5 years of age. The association with vegetables was slightly stronger than with fruits. These early feeding problems were also inversely associated with the variety score at 4–5 years of age, particularly when eating behaviours were reported after 12–15 months of age. A better understanding of these early feeding difficulties may help define strategies to increase the dietary quality in children. [ABSTRACT FROM PUBLISHER]

Copyright of Motricidade is the property of Silabas Didaticas LDA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)