Search

IntroductionCarrying out studies using data from Food and Nutritional Monitoring is crucial given the current epidemiological scenario. This scenario reveals a coexistence of malnutrition and nutritional deficiencies alongside overweight and obesity, particularly among adult women in Brazil. Analyzing the microdata generated by the system is essential for accurately representing food and nutrition indicators in the country.ObjectiveTo analyze the association of food consumption markers and sociodemographic factors with changes in the Body Mass Index (BMI) among adult women.MethodologyA cohort study with a final sample of 30,354 women evaluated through individual records between the years 2015 and 2019. Nutritional status was assessed using body mass index (BMI). Food consumption markers used were the ones available in the system, which referred to foods consumed the previous day. Linear regression was used to evaluate factors associated with BMI and multiple Poisson regression was used to estimate the relative risk of obesity incidence.ResultsThere was an increase in BMI between 2015 and 2019. The average increase in BMI was lower in women who consumed, in the previous day, beans (β = −0,25; CI95%: −0.36; −0.13) and vegetables and/or legumes (β = −0.12; CI95%: −0.21; −0.04) and the increase was greater when they consumed hamburgers and/or sausages (β = 0.1; CI95%: 0.02; 0.19) adjusted by age, region and skin color. There was a 14% lower incidence of obesity in the group that consumed beans (RR = 0.86; 95% CI: 0.79; 0.93), and a 9% lower incidence when they consumed filled cookies, candies or treats (RR = 0.91; 95% CI 0.86; 0.96). The incidence of obesity was 11% higher in the group that consumed sweetened drinks (RR = 1.11; 95% CI: 1.05; 1.18) and 9% higher in the group that consumed instant noodles, packaged snacks or savory biscuits on the day before the 2015 registration (RR = 1.09; 95% CI: 1.03; 1.15).ConclusionThere was an increase in BMI in the population of adult women, rising nationally between 2015 and 2019, with the notable influence of diet on this change.

Abstract Conventional snap fasteners used in clothing are often used as electrical connectors in e-textile and wearable applications for signal transmission due to their wide availability and ease of use. Nonetheless, limited research exists on the validation of these fasteners, regarding the impact of contact-induced high-amplitude artefacts, especially under motion conditions. In this work, three types of fasteners were used as electromechanical connectors, establishing the interface between a regular sock and an acquisition device. The tested fasteners have different shapes and sizes, as well as have different mechanisms of attachment between the plug and receptacle counterparts. Experimental evaluation was performed under static conditions, slow walking, and rope jumping at a high cadence. The tests were also performed with a test mass of 140 g. Magnetic fasteners presented excellent electromechanical robustness under highly dynamic human movement with and without the additional mass. On the other hand, it was demonstrated that the Spring snap buttons (with a spring-based engaging mechanism) presented a sub-optimal performance under high motion and load conditions, followed by the Prong snap fasteners (without spring), which revealed a high susceptibility to artefacts. Overall, this work provides further evidence on the importance and reliability of clothing fasteners as electrical connectors in wearable systems.

Abstract In this paper, the authors, for the first time, have shown the use of 2D conformal microwave absorbing material (MAM) in the design and fabrication of a portable Anechoic chamber (AC). The MAM is fabricated on the transparent and conductive metal oxide layer named indium-tin-oxide (ITO) with Polyethylene terephthalate as the substrate and the ground plane for zero transmission having overall thickness of 0.012 $$\lambda$$ λ where $$\lambda$$ λ is calculated at 0.7 GHz. The MAM is characterized for 0.7 to 18 GHz for both TE- and TM-polarisation and oblique incidence. High sheet resistance, dipole-like resonance structure patterned on the ITO, and the air-spacing between the layers is optimized to achieve broadband absorption. The MAM is used to line the six sides of the rectangular anechoic chamber having inner dimensions of: (L × W × H: 850 × 650 × 720 mm3). The return loss (RL), gain, and radiation pattern of three antenna working at 1.56, 2.43, and 4.93 GHz are analyzed inside the AC. The measurement results for all frequencies very well match with the simulation studies, thus validating and opening the door for the future use of ultra-thin and planar MAM in the AC.

ABSTRACT Objectives: to analyze the validity evidence of the internal structure of the Risk Self-Medication Questionnaire Focused on Health Literacy. Methods: a psychometric study with 499 adults. The internal structure was assessed with exploratory and confirmatory factor analysis to prove the adjustment. Internal consistency was measured by composite reliability and McDonald’s omega coefficient (ω). Results: the parameters revealed a model of 35 items distributed across four factors, explaining 56% of the total variance, with factor loadings ranging from 0.31 to 0.85 and adequate communalities. Accuracy (0.79

Introdução: As doenças crônicas não transmissíveis têm alta prevalência e importância em saúde pública. A terapêutica dietética é um componente importante da abordagem terapêutica global destas doenças. No entanto, há baixa adesão no médio e longo prazo, e se faz necessário desenvolver e validar instrumentos voltados para verificar a adesão às orientações dietoterápicas. Objetivo: Desenvolver e validar uma escala para verificar precocemente comportamento de pessoas com doenças crônicas não transmissíveis para adesão à terapia dietética recomendada, a Escala Preditora de Adesão à Dietoterapia em Doenças Crônicas Não Transmissíveis (EPAD-DCNT). Métodos: Trata-se de um artigo original, de desenvolvimento e validação de uma escala, composta por oito questões, cada uma com cinco possibilidades de respostas, baseadas em escala do tipo Likert, com os extremos significando a melhor e a pior adesão. A validação da etapa teórica compreendeu a análise de conteúdo por oito juízes especialistas na área do constructo e uma aplicação piloto em sujeitos da população-alvo para análise semântica. Resultados: A escala apresentou alta confiabilidade e validade (coeficiente α de Cronbach de 0,731; ômega de McDonalds = 0,73; determinante da matriz de correlação de 0,235, KMO de 0,744 e o teste de esfericidade de Bartlett significante, com p < 0,001) para prever comportamentos de baixa adesão. Conclusões: A escala demonstrou ser viável para utilização como uma ferramenta de triagem rápida e simplificada para identificar comportamentos que tendem à baixa adesão à terapia dietética recomendada para portadores de DCNT, particularmente HAS e DM2, permitindo aprimorar as ações de orientação dietética para esse grupo.

Objective: To describe the characteristics of self-medication assessment instruments with evidence of validity in Brazil. Methods: An integrative review, without temporal delimitation, with collection in the LILACS, Scopus, PubMed, MEDLINE and Web of Science databases. Ten studies related to five instruments were included. Results: The most convergent domains were sociodemographic aspects, self-medication practice, reasons, medications used and recommendation/sources. Self-medication was assessed by only one instrument with evidence of validity, but it was multidimensional, making its application difficult. The instruments showed good reliability indices, however, of the five, one did not measure reliability. The good psychometric properties of the self-medication and temporomandibular pain instrument stand out (Kappa: 0.810, Cronbach’s alpha: 0.844). Conclusion: The different instruments analyzed present limitations in evidence of validity, showing the need to develop an instrument focused on self-medication that is reliable and valid.

Abstract Graphene is emerging in numerous wearable and biomedical applications. Understanding the impact of graphene‐based nanocomposites over bacterial activity is critical for design appropriate technical solutions. In this work, antibacterial activity of monolayer and few‐layer graphene is tested against Gram‐negative and Gram‐positive model bacteria. Such graphene‐based nanomaterials present different effects on bacteria viability, depending on concentration and shape. The presence of dopant agents can either increase or revert graphene antibacterial effect. Among other bactericidal mechanisms, we also demonstrate that graphene surface polarity is connected to antibacterial properties and can be easily modified by surface charge transfer doping. This electrophilicity tuning offers a novel mechanism for the molecular basis of graphene's antibacterial activity.

MotivationSevere to profound sensorineural hearing loss interferes with a child's development at the cognitive, linguistic, academic, and social levels. Since the beginning of the pediatric auditory rehabilitation program through cochlear implantation in the Ear, Nose, and Throat (ENT) Service of the Coimbra Hospital and University Center (CHUC), Portugal, its mentors defended the early diagnosis of hearing loss followed by timely intervention, and this was considered the starting point to optimize (re)habilitation through this method. Three decades or so later, recently we conducted this study to evaluate the performance of patients implanted in the initial phase of the cochlear implantation program.ObjectivesThe study aimed to evaluate the performance of individuals with severe to profound congenital hearing loss who underwent pediatric cochlear implantation and have used the cochlear implant for at least 25 years, to analyze the beneficial effect of early intervention in improving performance results.MethodsThe study sample is composed of 31 individuals with severe to profound congenital hearing loss and no other comorbidities, divided into two groups (Group 1: age at implantation was under 3 years; Group 2: age at implantation was over 3 years). All 31 subjects were evaluated at 15, 20, and 25 years of cochlear implant (CI) use with a comprehensive set of tests. In addition, data were collected regarding the academic level of each participant. The results of both groups were compared to find out if there is an effect of age at implantation on auditory performance, and if there is an improvement in the performance with CI over time (15, 20, and 25 years of use).ResultsThe results show that there is a positive effect, with statistical significance, of early implantation on auditory performance, and telephone use. In both groups, there is an increase in performance over time, but it tends to stabilize after 20 years of CI use.Discussion and conclusionThe results obtained in this work support the importance of early intervention in patients with severe to profound hearing loss who are cochlear implant users and show that CI is an effective and reliable method in the treatment of these patients, contributing to their improved socio-educational integration, and that the benefits last over time.

ABSTRACT Objectives: to build storyboards based on health literacy about breast cancer for women deprived of liberty for later production of videos and e-books. Methods: a methodological study, construction and validity of storyboards with 10 expert judges. The Educational Content Validation Instrument in Health and the Suitability Assessment of Materials were used. For validity, an agreement criterion greater than 80% was considered, verified from the Content Validation Index, with 40-100% for suitability. Results: the storyboards’ overall Content Validity Index was 0.99, combined with the measurement of suitability of 81% and readability percentage of 73.2, categorizing the material as superior and easy to read. Conclusions: the educational technology built proved to be valid and reliable, and can be transformed into an e-book and video to promote self-care for women deprived of liberty.

The COVID-19 pandemic is expected to have a significant impact on most sharing economy activities, and at present, it is particularly challenging to achieve a consensual model to predict sharing economy behaviour. Based on empirical and theoretical premises established before the pandemic, we intend to explore the association between a set of psychosocial variables (i.e., cooperation, environmental awareness, past behaviour) and sharing economy behaviour, particularly the use of shared assets (i.e., cars and accommodation) during the COVID-19 pandemic. Furthermore, the present study analyses the mediating role of transformation expectations, as the decision to engage or not in sharing behaviour may be influenced by beliefs about the consequences of those actions from the user’s perspective. This study comprised a total of 596 participants. Data was collected through a self-administered questionnaire and was statistically analysed and interpreted using PLS 3.0. Structural Equation Modelling statistical software. Contrary to our predictions, the results show that cooperation negatively influenced the willingness to participate in sharing activities during the COVID-19 pandemic, that environmental awareness was not a significant predictor, and that past sharing behaviour has the strongest influence on the willingness to share during pandemic times. Finally, the mediating effect of transformation expectations was significant in both associations, i.e., pro-environmental consciousness and past sharing experiences, and the willingness to adopt sharing behaviour during COVID-19.

Introdução: Estudantes universitários da área de saúde apresentam uma rotina que exacerba inadequações no estilo de vida e sono, as quais contribuem para um estado de inflamação crônica de baixo grau. Objetivo: investigar se há associação entre o consumo de uma dieta pró-inflamatória e a qualidade do sono de estudantes universitários. Materiais e métodos: Estudo transversal, com amostra de conveniência que incluiu 102 universitários, com 18 ou mais anos de idade, recrutados entre março de 2019 e março de 2020, matriculados em cursos de Nutrição de universidades públicas e privadas da cidade de Fortaleza. A qualidade do sono foi avaliada por meio da escala Pittsburgh Sleep Quality Index (PSQI) ou Índice de Qualidade do Sono de Pittsburgh, validado no Brasil (PSQI-BR). O consumo alimentar foi investigado a partir de um questionário de frequência alimentar. Foi determinado o Padrão Empírico de Inflamação da Dieta (EDIP-SP), validado para o Brasil, o qual quantifica ingestão de carnes processadas, verduras, legumes, frutas, arroz e feijão. Também foi determinada a presença de inflamação crônica por meio dos marcadores proteína C-reativa e Relação Neutrófilo/Linfócito. Resultados: A alimentação consumida é, em média, anti-inflamatória (-1,57 ± 0,69). Apenas 1,96% dos avaliados tinha boa qualidade do sono; 75,49% apresentavam distúrbio do sono. Não houve associação entre o EDIP-SP e os marcadores inflamatórios investigados, nem com a qualidade do sono. Discussão: A maioria dos estudantes apresentou má qualidade do sono e dieta anti-inflamatória. Esta homogeneidade pode ter determinado a ausência de associação e correlações. Conclusões: Os estudantes universitários avaliados têm má qualidade do sono, mas ingerem dieta anti-inflamatória, sem associação entre estas duas variáveis.

Objective: To analyze the problems experienced by caregivers of patients with Alzheimer's Disease (AD) in dietary care. Methods: An integrative review was carried out, whose guiding question was "What are the experiences and difficulties reported by caregivers of people with Alzheimer's disease concerning dietary care?". The search occurred in April/2021 in the following databases: MEDLINE, Science Direct, SCOPUS, Web of Science, SciELO, and Lilacs. Publications fromthe last 10 years in English, Portuguese or Spanish were included. Results: Of the 2,418 articles initially found, the titles of 39 seemed to fit the research objectives. Of these, 11 articles were selected for full reading, and 8 were evaluated to answer the research question. A gap in the approach to the problems experienced by caregivers of patients with AD concerning dietary care was observed. Difficulties dealing with reduced appetite, dysphagia, inability to remember eating, mealtime refusal, and food repulsion were reported. Allied to this, caregiver stress was reported. Conclusion: The main problems experienced by caregivers of patients with AD involve reduced appetite, dysphagia, difficulty remembering what they have already eaten, refusal at mealtimes, and food repulsion. Thus, the theme deserves the attention and involvement of health professionals to focus on the most frequent difficulties and teach caregivers to overcome them.

Abstract Objectives: to construct and validate educational videos as part of the LISA Down Program – Literacy and Innovation in Health for Adolescents with Down Syndrome. Methods: this is a methodological study of construction and validation of educational videos based on health literacy designed for adolescents with Down syndrome, assisted by an Associação de Pais e Amigos dos Excepcionais (APAE) (Association of Parents and Friends of the Exceptional) located in the Northeast of Brazil. The stages of construction and validation of the vídeos were: pre-production, production and post-production. The storyboards were prepared according to the fundamentals of health literacy and validated by seven expert judges. Subsequently, the storyboards were transformed into videos (production) and these were evaluated by 13 adolescents with Down Syndrome (postproduction). Results: the storyboards totaled 248 scenes, ranging from 39 to 67 scenes each, were approved by the judges with percentages of agreement ranging from 94% to 100%. The vídeos recorded were approved by adolescentes with Down syndrome, in agreement of percentages ranging from 79.17% to 83.33%. Conclusion: the educational vídeos were validated and well evaluated and, therefore, can be used among adolescents in social spaces in which the focus of attention is adolescentes with Down syndrome.

Introdução: A mudança dos hábitos de vida, decorrentes do desenvolvimento de tecnologias no transporte, nos meios de comunicação e na produção de alimentos, contribui para o sedentarismo e alimentação inadequada. Objetivo: Avaliar o consumo alimentar e verificar sua relação com o estado nutricional de crianças. Materiais e métodos: Participaram 80 escolares de ambos os sexos, idade entre 8 e 11 anos. Foram aferidas medidas antropométricas (peso, altura e circunferência da cintura) e aplicado um questionário de frequência alimentar. Para análise estatística utilizou-se o programa SPSS versão 20.0. Significância de 5% (p

Resumo Introdução A prevenção da infecção pelo coronavírus (SARS-CoV-2) é propagada pela mídia e recomendada pelos órgãos oficiais de saúde pública. Entretanto, há desafios para adoção de medidas comportamentais de prevenção, sendo o letramento em saúde (LS) uma preocupação que deve permear essas ações de comunicação na saúde. Objetivo Discutir o impacto que um baixo LS da população tem na compreensão e adesão às orientações relativas à prevenção da SARS-CoV-2. Método Trata-se de uma reflexão que resgata, na literatura especializada, o conceito e os fundamentos do LS, as principais orientações de prevenção da SARS-CoV-2 e como operacionalizar orientações letradas em saúde. Resultados A literatura aponta que o baixo LS dos indivíduos repercute negativamente no empoderamento e na operacionalização de informações de saúde recebidas. Não adianta a elaboração de ações educativas se a população não entende e/ou não percebe a importância de se adequar a essas propostas. Os fundamentos do LS são apresentados em guias de comunicação oral, escrita e midiática. Há ferramentas e estratégias para melhor compor uma mensagem educativa segundo o LS. Conclusão É recomendável generalizar que a população tem um letramento inadequado, para deixarmos muito claras as mensagens que transmitimos. Isto é possível seguindo os fundamentos do LS.

A crescente importância das tendências do ambientalismo levou a um aumento significativo de atitudes e comportamentos ecologicamente corretos, que demonstram uma força coletiva por meio de decisões individuais. A co-criação representa uma componente fundamental desta lógica, já que a colaboração permite que a sociedade em geral crie oportunidades e gere benefícios. No entanto continuam a existir práticas insustentáveis, e com isso uma grande necessidade de maior conscientização do público e participação em iniciativas de economia circular. Considerando o crescente interesse em envolver os cidadãos em causas socioambientais, e tendo em conta que ainda existe um longo caminho a se percorrer, o propósito dessa investigação é compreender as motivações dos cidadãos para a adoção de comportamentos pro-circulares e a forma como percebem o valor criado para si e para a comunidade em que estão inseridos. Para a recolha de dados adotou-se uma metodologia exploratória qualitativa, com base em diários digitais escritos por 25 participantes, durante um período de 7 dias. As descobertas encontradas foram diversas, entre elas, um perfil maioritariamente feminino e com elevado grau académico. As pessoas com maior preocupação social são as mais comprometidas ambientalmente, embora nem sempre traduzam o seu compromisso nos comportamentos diários. O presente trabalho apresenta sua originalidade e contribuição ao utilizar a técnica de diário para analisar o comportamento pro-circular dos participantes, com o intuito de co-criar valor para a sociedade em que estão inseridos.

Purpose – This paper aims to reinforce the arguments for applying the social support concept in social marketing. Design/methodology/approach – This paper aims to conceptually outline the potential positive contribution of social support for social marketing practice as a tool to induce behavior change. Findings – This paper focuses on the philosophical principle of social exchange, highlights the consumer-centered perspective of social marketing, which implies the natural evaluation of the social networks of influence and support and presents social support as a mechanism to induce long-term behavior change. Research limitations/implications – No empirical (qualitative or quantitative) investigations were used to test the application of the concept in practical interventions. Practical implications – This paper provides significant insights for intervention developers that can be used to program and theoretically justify future social marketing interventions applying the social support concept. Social implications – Empirical research concluded for a positive relation between social support and human health and well-being. Thus, increasing the use of the concept in social marketing can serve to attain these social goals. Originality/value – The concept of social support has gained considerable interest in the areas of behavioral medicine and health psychology. Despite such interest, it is still not clear how it can be approached in social marketing as there is a lack of conceptual literature discussing social support from a social marketing perspective, the number of social marketing interventions operationalizing the concept is limited and, till date, no research has focused in comprehensively establishing a theoretical rationale to operationalize the concept in social marketing.

Abstract Aim Antiretroviral therapy (ART) development has reduced the severity of neurological complications of the human immunodeficiency virus (HIV), but they remain prevalent and need prompt recognition. Acute inflammatory demyelinating polyneuropathy (AIDP) is a rare complication of human immunodeficiency virus (HIV) infection that may appear at any stage of the disease. In this case, AIDP represents a late presentation of HIV infection. Methods Descriptive study. Patient data were collected from their medical records and by health assessment interviews. Results We report a case of a 52-year-old male with acute lower limb weakness. Given the suggestive clinical presentation of AIDP and a positive HIV test, intravenous immunoglobulin (IVIG) was administered along with antiretroviral therapy. Progressive weakness to the upper limbs, autonomic dysfunction, and pain was observed. The second regimen of IVIG plus corticosteroids was administered. Muscle strength improved after three weeks. Conclusions Screening for HIV in a patient with AIDP may provide a better outcome because of the early start of ART with good central nervous system penetration in HIV-infected patients.

ABSTRACT Objective: To investigate the evidence of content validity and reliability of the Brazilian version of the Nutritional Literacy Scale (NLS) after the cultural adaptation process. Methods: Psychometric study of 1,197 users of the National Health Service (Brazilian SUS). The NLS was culturally adapted to Brazilian Portuguese and six items of the original scale were modified to improve its understanding, giving rise to the Brazilian version of the scale named NLS-BR. The analysis of evidence of content validity of the NLS-BR was performed using the Item Response Theory (IRT). Results: The final version of the NLS-BR had 23 items and proved to be adequate to assess nutritional literacy in adults assisted by the Brazilian SUS. Final considerations: The NLS-BR proved to be of adequate understanding and demonstrated evidence of content validity and reliability for users of the Brazilian SUS.

Objetivo: Verificar se e quais padrões alimentares podem estar associados ao apetite emocional em mulheres acompanhadas pelo Sistema Único de Saúde (SUS). Métodos: Estudo quantitativo, transversal e analítico realizado em 20 Centros de Saúde da Família do SUS, entre 2016 e 2017, com mulheres de 19 a 59 anos, em idade reprodutiva e alfabetizadas. Coletaram-se dados de peso, altura e circunferência da cintura, e aplicou-se o Questionário de Apetite Emocional (QUEAPEM), para avaliar o apetite emocional, e o Questionário de Frequência Alimentar, para avaliar o consumo alimentar, analisado na forma de padrões alimentares derivados por análise fatorial por meio de testes de esfericidade de Barllet e Kayse-Meyer-Olkin. Verificou-se relação entre os padrões alimentares e a dimensão do apetite emocional pelo teste de Spearman, considerando significativos os valores de p

Resumo Objetivo Analisar a tendência temporal da cobertura do Sistema de Vigilância Alimentar e Nutricional (Sisvan) e do estado nutricional, entre adultos acompanhados na Atenção Primária à Saúde do Brasil, 2008-2019. Métodos Estudo ecológico de séries temporais, sobre dados das macrorregiões brasileiras. A variação percentual anual da classificação do estado nutricional e da cobertura total foi estimada pela regressão de Prais-Winsten. Resultados Foram identificados 115.034.534 registros no período. A cobertura passou de 5,0% em 2008 para 10,6% em 2019, com variação anual de 8,4%, intervalo de confiança de 95% (IC95% 6,7;10,0) A obesidade apresentou tendência crescente entre 2008 e 2019, com variação anual de 6,4% (IC95% 5,3;7,3), assim como o sobrepeso (1,8%; IC95% 1,2;2,5). Já o baixo peso (-7,0%; IC95% -8,0;-6,1) e a eutrofia (-3,8%; IC95% -4,1;-3,4) decresceram no período. Conclusão Identificou-se melhora na cobertura do Sisvan, tendo-se observado aumento de excesso de peso e obesidade na população estudada.

Summary: Internet of Things (IoT) and recently Internet of Nano Things (IoNT) bear the promise of new devices able to communicate and assist our daily lives toward wearable technologies which demand a versatile integration such as in wireless body networks (WBN), sensing, and health monitorization. These must comply with stringent constraints on energy usage. Dimensions and complexity intensify the need for small and maintenance-free power sources. Environment energy harvesting and storage is an important approach to sustain operation for a long time. Triboelectric nanogenerators (TENGs) arise as a strong and promising solution to power the new field of outcoming self-sustainable devices, implantable, and wearable devices. They can transform mechanical energy in different modes, have simple structures, and use vulgar and sustainable materials. This paper makes a review about TENGs technology, construction, materials, operation, and focus on strategies for harvesting circuits. Main challenges like efficiency, reliability, energy storage, and sustainability are discussed.

RESUMO Objetivou-se desenvolver um protótipo de design de baixa e alta fidelidade à luz do Letramento em Saúde e contribuir com o profissional de saúde para a escolha do escore de risco cardiovascular mais adequado para cada indivíduo. Estudo metodológico em que se utilizou a metodologia do processo de design de interação participativo centrado no usuário, com contribuições de uma equipe interdisciplinar composta por nutricionista, enfermeira e designer. Contribui-se para a concepção do design de dez telas de baixa fidelidade e de dez telas de alta fidelidade, apoiando-se no checklist, com recomendações para a construção de tecnologias em saúde, considerando-se aspectos fundamentais do Letramento em Saúde. Buscou-se, nos protótipos de baixa e alta fidelidade, desenvolver um layout interativo e agradável para facilitar a utilização pelos profissionais de saúde.

Wearable devices have been shown to play an important role in disease prevention and health management, through the multimodal acquisition of peripheral biosignals. However, many of these wearables are exposed, limiting their long-term acceptability by some user groups. To overcome this, a wearable smart sock integrating a PPG sensor and an EDA sensor with textile electrodes was developed. Using the smart sock, EDA and PPG measurements at the foot/ankle were performed in test populations of 19 and 15 subjects, respectively. Both measurements were validated by simultaneously recording the same signals with a standard device at the hand. For the EDA measurements, Pearson correlations of up to 0.95 were obtained for the SCL component, and a mean consensus of 69% for peaks detected in the two locations was obtained. As for the PPG measurements, after fine-tuning the automatic detection of systolic peaks, the index finger and ankle, accuracies of 99.46% and 87.85% were obtained, respectively. Moreover, an HR estimation error of 17.40±14.80 Beats-Per-Minute (BPM) was obtained. Overall, the results support the feasibility of this wearable form factor for unobtrusive EDA and PPG monitoring.

A rapid development in personal electronics has raised challenging requirements for portable and sustainable power sources. For example, in wearable technologies, the concept of wearable body area network brings body motion and vital signs monitoring together in synergy. For this, a key aspect is sustainable portable energy, available anywhere, at any time, as generated by triboelectric nanogenerators (TENG). This technology usually demands high-cost processes and materials and still suffer from low power output, as well as unstable output values due to charge generating stimulus with variable intensities. In this work, we present TENGs using shear exfoliated graphene as electrodes as well as active triboelectric layer deposited by a simple solution process. Graphene in combination with polymers such as polydimethylsiloxane (PDMS) were used to produce TENG devices using low-cost solution processing methods. Device electrical power generation was tested with a cyclic physical stimulus for better control and understanding of device output. The triboelectric response of these materials showed open circuit voltages (Voc) and short-circuit currents (Isc)of approximately 233 V and 731 nA respectively when stimulated at 1.5 Hz. A power density of 13.14 μW/cm2 under a load of 200 MΩ was achieved, which can be 40 times higher when compared to devices made with aluminum and PDMS. These results demonstrate the potential of solution process for low-cost triboelectric devices for self-sustainable wearable portable nanogenerators on health and security applications using contact and positional sensors.

Purpose – The literature on the factors generating loyalty towards tourism destinations has seldom focussed its attention on relationship marketing, which has left a gap in the understanding of destination loyalty. This paper aims to examine the influence of relationship quality on rural destination loyalty, approaching this through the variables of trust, attachment and satisfaction. Design/methodology/approach – This study used a quantitative methodology based on an on line survey conducted in Spain. The sample consisted of 464 tourists who participate in rural tourism. The analysis of the proposed model was carried out based on the partial least squares method. Findings – The results confirm that the model has a substantial to moderate explanatory capacity for overall satisfaction and loyalty, in which overall satisfaction acts as a mediator between the variables that make up relationship quality in reference to loyalty. Research limitations/implications – The main limitations of this research arise from the scarcity of works which aim to understand relationship quality in tourism destinations. To broaden results, it should be applied in other tourism destinations, products, services and experiences. Practical implications – Destination managers should give relationships a special role in their tourism development programmes in rural tourism contexts. Social implications – Rural tourism destinations and companies are generally small-sized organisations that need managerial tools. These can benefit from developing sustainable relationships. Originality/value – The significant role played by relationship quality regarding destination loyalty is studied in detail in this model.

Abstract Background The Paleolithic diet has been studied in the scope of prevention and control of chronic noncommunicable diseases (CNCD). The objective of this study was to analyze the influence of the Paleolithic diet on the prevention and control of CNCD in humans, specifically on anthropometric markers, through a systematic review with meta-analysis. Methods What is the effect of the Paleolithic diet on anthropometric parameters (weight, body mass index and waist circumference) compared to other control diets based on recommendations in adults? We included only randomized studies with humans that used the Paleolithic Diet in the prevention and control of CNCD published in Portuguese, English or Spanish. The search period was until March 2019, in the LILACS, PubMed, Scielo, Science Direct, Medline, Web of Science and Scopus databases. The abstracts were evaluated by two researchers. We found 1224 articles, of which 24 were selected and 11 were included in the meta-analysis. The effect of dietary use on body weight, body mass index and waist circumference was evaluated. Results The summary of the effect showed a loss of − 3.52 kg in the mean weight (CI 95%: − 5.26; − 1.79; p

Abstract Objective To assess the association between dietary glycemic index (GI) and excess weight in pregnant women in the first trimester of pregnancy. Methods A cross-sectional study in a sample of 217 pregnant women was conducted at the maternal-fetal outpatient clinic of the Hospital Geral de Fortaleza, Fortaleza, state of Ceará, Brazil, for routine ultrasound examinations in the period between 11 and 13 weeks + 6 days of gestation.Weight and height were measured and the gestational body mass index (BMI) was calculated. The women were questioned about their usual body weight prior to the gestation, considering the prepregnancy weight. The dietary GI and the glycemic load (GL) of their diets were calculated and split into tertiles. Analysis of variance (ANOVA) or Kruskal-Walls and chi-squared (χ2) statistical tests were employed. A crude logistic regression model and a model adjusted for confounding variables known to influence biological outcomes were constructed. A p-value < 0.05 was considered significant for all tests employed. Results The sample group presented a high percentage of prepregnancy and gestational overweight (39.7% and 40.1%, respectively). InthetertilewiththehigherGIvalue, therewasa lower dietary intake of total fibers (p = 0.005) and of soluble fibers (p = 0.008). In the third tertile, the dietary GI was associated with overweight in pregnant women in the first trimester of gestation, both in the crude model and in the model adjusted for age, total energy intake, and saturated fatty acids. However, this association was not observed in relation to the GL. Conclusion A high dietary GI was associated with excess weight in women in the first trimester of pregnancy.

Introduction: Body shape is an important component of personal identity, since it is the way the body depicts itself. When this image brings a bad shape to the individual, it becomes a factor triggering eating disorders. Some groups suffer with significant social pressure due to their physical image, since they work in fields related to weight control or to body shape. These groups are prone to present body dissatisfaction and, then, to develop eating disorders. Students enrolled in courses related to the health fields are among these risk groups. Objective: Assessing the body shape and its correlation to the family environment of this group in two countries, Brazil and Spain. Methodology: Analytical study based on the quantitative approach. Data collection was performed based on an instrument, which was divided into two parts: data identification, and aspects linked to body shape (Body shape Questionnaire) and family environment (Family Environment Scale). Results: Dissatisfaction with the body shape reached 43.2% of the Brazilian students and 47.07% of the Spanish ones (p = 0.801), and there was association with different factors in the family environment scale. Conclusion: The study evidenced the need of including an evaluation about the reflex of body shape on actions taken to promote health in groups vulnerable to body shape distortions. DOI: 10.12957/demetra.2018.33189

Comparação do efeito da Dieta Paleolítica (DP) e da Dieta baseada em Diretrizes (DBD) em indicadores antropométricos de indivíduos obesos. Ensaio clínico randomizado. Pacientes obesos foram divididos em 2 grupos baseados na prescrição dietética: DP e DBD. Estas dietas abrangeram 82 e 73 pacientes, respectivamente que foram acompanhados durante 60 dias. Medidas antropométricas foram aferidas anteriormente ao início da intervenção, no 30º dia e no fim da intervenção. No 60º dia de acompanhamento, houve 26,8% de desistência no grupo DP e 19,2% no grupo DBD , não havendo diferença entre os grupos (p= 0.684). Peso e estatura foram aferidos para determinar o Índice de Massa Corporal (IMC), circunferência da cintura (CC), circunferência do quadril (CQ), com os quais foi determinada a relação cintura-quadril (RCQ). Não houve diferença estatística inicial entre os grupos nas variáveis demográficas, socioeconômicas, atividade física e antropométricas (p > 0.05). O grupo DP registrou maior redução de peso (p = 0.003), IMC (p = 0.002) e CC (p = 0.033) no 30º dia de experimento. Grupo DP manteve maior redução de peso no 60º dia (p < 0,001), bem como maior redução de IMC (p < 0.001), CC (p = 0.002) e RCQ (p = 0.002). DP é uma possível opção de tratamento para a obesidade, a qual resultou na redução de marcadores antropométricos. Outros estudos são necessários para verificar seu uso por maiores períodos de tempo.

Wearable electronics: graphene textiles get really smart Complex functionalities have been brought on to the graphene coated textile fibres in a roll-to-roll-compatible fashion for the first time. A collaborative team led by Monica F. Craciun from University of Exeter, UK employs a ‘roll-to-roll’ like method to fabricate graphene-based transparent and flexible functional devices on textile fibres. The scientists develop a universal approach to pattern the graphene in various forms on the tape-shaped polypropylene fibres via a sacrificial photoresist layer. This creates a versatile platform for efficient device prototyping: functional devices such as capacitive touch-sensors and light-emitting device arrays can then be easily integrated. Their methods show high compatibility with industrial scale roll-to-roll and printing techniques, opening the gateway to smart multi-functional textile electronics in the future.

Objetivo: Evaluar la correlación entre la imagen corporal y las mediciones antropométricas reales y las indicadas como deseadas en alumnos de Nutrición como un factor de riesgo potencial para el desarrollo de trastornos de la alimentación. Metodología: Los estudiantes de Nutrición de una universidad pública fueron evaluados por antropometría y se les aplicó el cuestionario Body Shape Questionnaire. Resultados: Se encontró una alta prevalencia de peso normal y sin insatisfacción en la imagen corporal (89,5%), pero sólo 14 (12,3%) estaban satisfechos con su peso. Discussión: Preocuparse demasiado por la imagen y la insatisfacción puede conducir a una baja autoestima, interferencia en sus estudios y en su futura práctica profesional. Conclusión: Aún con la baja prevalencia de insatisfacción en la imagen de sí mismo, esa alta tasa de insatisfacción con el peso actual es preocupante ya que ambos pueden aumentar el riesgo de perturbaciones futuras, una excesiva apreciación de la beleza a costa de la salud y que se refleje en su futura práctica profesional. DOI: 10.12957/demetra.2018.32918

Introduction: Implemented in 2007 by Ordinance No. 6357, allocation rules of cadaveric donor kidneys seek to distribute equitably a scarce community resource to patients who can improve their survival and quality of life. As stated in the aforementioned ordinance these rules must be updated whenever the state of the art recommends it. The objective of this work is to evaluate and compare three cadaveric donor allocation models: scoring criteria of ordinance nº 6537/2007 (model 1); similar to the previous model but with a lower score for the dialysis time (model 2); and a model adapted from the previously proposed color allocation system (model 3). Material and Methods: For the purpose of this analysis we generated data about 70 cadaveric donors taking into account information published regarding blood group distribution and human leucocyte antigens allelic and haplotype frequencies of Portuguese voluntary donors. We generated also data for a simulated waiting list of 500 first-time kidney transplant candidates. Results: We observed fewer candidates selected by model 3 with more than 3 human leucocyte antigens mismatches (39.3%) when compared to those selected by model 1 with more than 3 human leucocyte antigens mismatches (57.1%, p < 0.01). Discussion: In our analysis, model 3 selects transplant candidates with a lower number of human leucocyte antigens mismatches when compared to the adapted rules for kidney allocation of Ordinance No. 6537/2007 (model 1) without penalizing candidates with a longer time on dialysis. Conclusion: The analysis and discussion of the best rules for allocation of such a scarce resource as organs from deceased donors should be a continuous and adaptive process inherent to transplant candidate’s waiting list evolution and mutation.

Technological skills development is a central issue for a country’s educational and social policies. Throughout their school career, from primary to secondary education and later in higher education, students have the opportunity to build and develop various skills, including technological. Considering the different needs and different uses that these skills encompass, these will certainly be necessary and useful in students’ academic and professional life. This study reports on an investigation of technological skills development in higher education. It aims to analyze the relevance of technologies integration, which technological skills are built and developed by higher education students, and what their perception about the importance of technological skills is. Based on a literature review, an online questionnaire was designed and applied to 217 students from three public higher education institutions located in the North, Center, and South of Portugal. This intended to verify which areas of technological skills (from the European Digital Competence Framework for Citizens) are most developed and to understand respective repercussions. It is concluded that the balanced development of students’ technological skills in higher education is crucial for their personal, social, and professional future and consequently, for their quality of life, with the integration of digital technologies being relevant in the change of the academic work organization, in the relations between learners, teachers, and institutions, and in the new ways of teaching and learning.

The “film-induced tourism” concept serves for the study of tourism visits made to a destination or attraction resulting from its featuring in cinema films, television series or promotional videos. This phenomenon falls within the field of “film-induced versus destination branding image” research, a fairly recently established field, and with this article correspondingly seeking to carry out analysis of the contents and systematisation of this area based on the contents of the Web of Science database. Thus, this article consists of the application of a systematic survey involving the summary and evaluation based upon the interpretation of the results returned. The sample contains only those articles published in English language journals and explicitly excluding conference proceedings or commentaries. We thus sought to grasp the perspectives adopted by both empirical and theoretical studies, the themes studied and the main conclusions of those studies analysed here. The results convey the diversity of both the quantitative and qualitative studies and the various future lines of research defined in accordance with the gaps detected in the results returned.

Abstract Conducting fibres are essential to the development of e-textiles. We demonstrate a method to make common insulating textile fibres conductive, by coating them with graphene. The resulting fibres display sheet resistance values as low as 600 Ωsq−1, demonstrating that the high conductivity of graphene is not lost when transferred to textile fibres. An extensive microscopic study of the surface of graphene-coated fibres is presented. We show that this method can be employed to textile fibres of different materials, sizes and shapes, and to different types of graphene. These graphene-based conductive fibres can be used as a platform to build integrated electronic devices directly in textiles.

Objetivo: Avaliar o efeito da infecção por Helicobacter pylori (Hp) sobre a sensação subjetiva de apetite e consumo alimentar de pacientes usuários do Sistema Único de Saúde. Métodos: Trata-se de um estudo do tipo transversal, realizado em duas unidades de saúde durante o período de julho de 2012 a maio de 2013, em que foram avaliados 38 pacientes, 14 Hp positivos e 24 negativos, que relataram fazer apenas três refeições principais por dia. A presença da infecção foi investigada a partir de endoscopia digestiva alta. O consumo alimentar foi investigado por meio de dois recordatórios de 24 horas. A sensação subjetiva de apetite foi investigada utilizando-se a escala analógica visual (EAV) de apetite. Os pacientes foram estratificados em Hp positivos e Hp negativos. Para todas as análises considerou-se significante p

Objective: Investigating the association between Health students’ family environment and behaviors suggesting the risk of developing eating disorders. Methods: Descriptive cross-sectional study with quantitative approach. Data were collected with an instrument that was divided into three parts: anthropometric and identification data, aspects linked to eating disorders (Eating Attitudes test - Test-EAT-26) and environmental aspects (Family Environment scale). Results: the desire to lose weight was reported by students enrolled in all courses, although these students were healthy, according to their body mass index (22.75 kg/m²). Based on the EAT-26 distribution, 16% of the sample showed positive risk of developing eating disorders. The highest positive EAT-26 rates were recorded for Nursing students (27%), whereas the lowest rates were observed in medical students (10%). however, there was not significant difference between courses (p = 0.204). The comparative analysis between EAT-26 and family environment was a pioneer strategy adopted in this type of study and it showed that only domain “Conflict” was significantly associated with EAT-26 (p = 0.008). This outcome indicates that eating disorders are associated with conflicting families. Conclusion: The study highlighted the need of including the evaluation of eating disorder behaviors and the family environment scale in health promotion actions focused on vulnerable groups at risk to develop eating disorders. DOI: 10.12957/demetra.2019.33308

The objective of this research project is to evaluate the performance of Portuguese state universities in accordance with the expectations and satisfactions of their students and through recourse to the DEA methodology and thus representing one of the very few studies analysing university performance based upon student perceptions. According to an output oriented Variable Returns to Scale model, handling the responses returned by 1,669 students, the results demonstrate that faculties generally attain a good relationship between student expectations and their levels of satisfaction. We furthermore conclude that university scale does not guarantee efficiency. Hence, irrespective of size, universities are able to ensure the satisfaction of their students. Finally, the results show that satisfying only certain expectations related to specific aspects does not prove sufficient to guaranteeing overall student satisfaction. The analysis also correspondingly finds that while some decision making units prove efficient in satisfying expectations on specific aspects, they fail to attain such efficiency in the overall perspective of students.

This study analyses the influence of client operant resources, in the form of self-efficacy, bridging social capital and customer expertise, on co-creation activities with companies and the customer resulting perceived benefits. A quantitative study, based on a sample of 362 consumers was carried out to test a model that sets out the relationships among the variables in analysis. The results demonstrate not only how operant resources do effectively contribute towards explaining a certain percentage of the variation in customer co-creation activities, but also how this resources influence gets boosted by the efforts companies make to educate their customers. The results also show that co-creation with the firm enhances customer perceived benefits.

Purpose: This systematic literature review aims to identify the main areas of study related to co-creation and innovation in Higher Education Institutions (HEIs), as well as the main external and internal stakeholders with whom co-creation is made. Design/methodology/approach: The empirical approach is based on 258 articles selected from the Web of Science (WoS), Clarivate Analytics and Scopus, Elsevier databases, with analysis of titles, abstracts and keywords following a research protocol. VOS viewer and CitNetExplorer software were used, with the twin aim of identifying publications with a higher number of citations and designing maps of reference word co-occurrence. Findings: The analysis led to three clusters being identified--Cluster 1. Management and transfer of knowledge from HEIs to companies; Cluster 2. Co-creation and innovation in HEIs through cooperation between universities and companies; and Cluster 3. Universities' third mission and their role in developing entrepreneurship education. The results of the literature clusters analysis led to proposing a conceptual model of analysis. Research limitations/implications: Despite only employing two databases and the content analysis criteria, the three found clusters are linked, recognising the interplay between co-creation and innovation in HEIs, knowledge transfer to enterprises and the influence on HEIs' third goal. Practical implications: This systematic literature review highlights and gives a picture of the state-of-the-art in co-creation and innovation in HEIs, as well as presenting a model of co-creation and innovation in HEIs that can contribute to reinforcing the University-Industry-Community ties. Social implications: This study can lead to a better knowledge of the issue of co-creation and innovation at HEIs, as well as a deeper analysis of the sorts of relationships between HEIs and their stakeholders, as well as its impact on surrounding areas and influence. Originality/value: The research highlights the interaction between HEIs and their stakeholders on a basis of value co-creation and innovation, providing mutual benefits for all involved, as well as greater development and recognition of HEIs and their surrounding regions' image andreputation. A future research agenda is also presented on the topic of co-creation and innovation in HEIs.

The provision of institutional care, particularly for the elderly, assumes dedication and commitment of the employees. Hence, identifying the prevailing level of organizational commitment (OC) and precisely which internal marketing (IM) techniques may be deployed to shape this performance is of inherent importance. The objective of this research project is, correspondingly, to ascertain the extent to which IM influences the OC of employees at three elderly care support institutions. To study this influence, we selected a sample of 188 individuals, all employees at the three institutions who agreed to participate in the study by answering a questionnaire. As regards IM, quality of work, ascending communication, and valuing and sharing information are the most commonly adopted practices at institutions. In terms of OC related dimensions, we found the affective and the instrumental to be the predominant types of commitment. Our findings support a moderately positive correlation between the IM and OC variables. This study enables an evaluation of respective institutions, informing them of the changes that are both feasible and necessary to the provision of quality care services and, consequently, a higher level of employee commitment and performance.

Recruitment and management of volunteers in non-profit organizations is a fundamental activity in increasing these organizations’ capacity and one that can benefit considerably from applying marketing principles. However, these organizations are found to have difficulty in applying marketing principles due to the lack of capacity in this professional area. This article aims to draw a parallel between theory and practice based on the literature in this field and the case study of CooLabora in its activity of university volunteerism - UBICool. The case study shows that many of the principles suggested by theory are applied in this specific case, although often informally and unplanned, and so recognizing the positive and less positive factors can contribute to future improvement with benefits for the organization, volunteers and society.

From the perspective of the Stakeholder Theory, the objective of this paper was to, initially, identify and classify by importance the expectations of editors from scientific journal that are indexed in ISI about its relationship with the universities. After that, the objective was to measure the satisfaction levels of the same editors as to its relationship with universities in general. 276 answers were obtained and the results showed that the satisfaction of the editors with the universities comes from the offer, by the universities, of the adequate facilities for research, including scientific research in the degree programs, encouragement for having and funding scientific events at the university, and of the encourage by the university for their students to participate in research projects.

La infección con Helicobacter pylori afecta a más de la mitadde la humanidad, siendo un problema de salud pública. Suprevalencia es significativamente mayor en los países en de-sarrollo como Brasil. Se ha sugerido que la infección por Hpylori puede influir en la ingesta y la homeostasis calórica.Objetivo.Analizar la influencia de la infección por H pyloriy su erradicación en el estado nutricional y en la ingesta dealimentos.Material y métodos.En el estudio participaronun total de 124 pacientes (48 con H pylori positivo, 45 porH pylori negativo y 31 erradicados). Para calcular el índi-ce de masa corporal (IMC), se midieron el peso y la altura.La ingesta dietética se investigó mediante recordatorio de 24horas en la dieta (RA24h), que se evaluó en dos ocasiones.Resultados.Entre los pacientes erradicados, percibimos unamayor proporción de pre-obesidad (p = 0,011). El consumode los nutrientes estudiados fue homogéneo, con excepción dela sacarosa, que fue ingerida en menor cantidad por el grupo erradicado (p< 0,001).Conclusiones.Los pacientes con Hpylori erradicados indicaron mayor proporción de pre-obesi-dad. La ingesta de alimentos hecha por los grupos fue similarpara casi todos los nutrientes evaluados, excepto la sacarosaque se consumió en cantidades más pequeñas por el grupoerradicado. Este estudio permite la posibilidad de incluir lainvestigación del estado nutricional y de la dieta en las per-sonas que buscan el diagnóstico de la infección por H pylori.

OBJETIVO: Identificar fatores de risco para retenção de peso em mulheres após o parto.MÉTODOS: Foi um estudo prospectivo observacional que acompanhou durante seis meses mulheres adultas que realizaram o parto em uma maternidade terciária. Aplicou-se um questionário estruturado antes da alta hospitalar e no período de seis semanas e seis meses após o parto, por meio de visitas domiciliares. O desfecho considerado foi retenção de peso após o parto (se risco >7,5 kg). As variáveis analisadas foram: idade, cor da pele, trabalho na gravidez e atual, renda, escolaridade, estado civil, idade da menarca, idade da mãe no primeiro parto, paridade, tipo de parto, intervalo interpartal, peso pré-gravídico, ganho de peso gestacional, percentual de gordura corpórea e estado nutricional. A verificação dos dados se iniciou com análises bivariadas entre prevalência de retenção de peso aos 6 meses e as diversas covariáveis (p7,5 kg após 6 meses após o parto foi de 15%. Na análise bivariada, a retenção de peso se associou às seguintes variáveis: idade da menarca 30% (OR=5,0; IC95% 1,1−23,6) e estado nutricional 6 semanas após o parto >25 kg/m2 (OR=7,7; IC95% 1,6−36,1). A partir da análise multivariada, somente o ganho de peso gestacional excessivo (OR=74,1; IC95% 9,0−609,6) permaneceu como fator de risco. CONCLUSÃO: O ganho de peso excessivo durante a gestação deve ter atenção especial na assistência pré-natal, tendo em vista a sua associação com a retenção de peso e possível excesso ponderal em mulheres após o parto nessas mulheres.