Browsing by Author "Dias, Sara Simões"
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- Association between food choices motivators and physical activity in body image (dis)satisfaction in Portuguese adolescentsPublication . Dias, Sara Simões; Lages, Marlene; Frontini, Roberta; Luís, Luís; Dixe, Maria dos Anjos; Sousa, PedroConcerns about weight and body image are common among adolescents since they are particularly vulnerable to body-image dissatisfaction due to the normal physiological, social, and psychological changes they are going through. This study aims to analyse the relationship between food choice motivations and physical activity in body-image perception among adolescents. Twelve to sixteen years old adolescents were recruited from three school districts. The Portuguese version of the Food Choices Questionnaire (FCQ) was used to assess food choice motivators, and the Quantification de l’Activité Physique en Altitude Chez les Enfants was used to assess physical activity and to calculate daily energy expenditure (DEE). Body image perception was measured using Collins’ sequence of seven silhouettes. Body image (dis)satisfaction was estimated by the present body shape minus the desired body shape. ANOVA and Kruskal-Wallis tests were performed to compare groups, and the post-hoc Bonferroni test was used to compare target groups. A multinominal logistic regression was performed to analyse the association between gender, age, hours of sport’s competition, FCQ, and body dissatisfaction. All analyses were performed in IBM SPSS Statistics 26.0. The sample comprised 286 adolescents (51.4% females). Means of FCQ categories varied between 0.33 and 0.97 (range: −2 to 2). Regarding the categories of FCQ, statistically significant differences were found in the category of body satisfaction and weight control among the three groups (p = 0.004). A preventive effect was found of choosing food regarding body satisfaction and weight control, on body-image dissatisfaction.
- Challenges of ageing in Portugal: data from the EpiDoC CohortPublication . Rodrigues, Ana Maria; Gregório, Maria João; Sousa, Rute Dinis; Dias, Sara Simões; Santos, Maria José; Mendes, Jorge M.; Coelho, Pedro Simões; Branco, Jaime C.; Canhão, HelenaPortuguese adults have a long lifespan, but it is unclear whether they live a healthy life in their final years. We aimed to determine the prevalence of multimorbidity and characterize lifestyle and other health outcomes among older Portuguese adults.
- A Clinical Decision Support System for Remote Monitoring of Cardiovascular Disease Patients: A Clinical Study ProtocolPublication . Ventura, Filipa; Sousa, Pedro; Dixe, Maria dos Anjos; Ferreira, Paulo; Martinho, Ricardo; Dias, Sara Simões; Morais, João; Gonçalves, Lino M.Introduction: Cardiovascular diseases (CVD) are the leading cause of death globally, taking an estimated 17. 9 million lives each year. Cardiac rehabilitation is shown to reduce mortality and hospital readmissions, while improving physical fitness and quality of life. Despite the recommendations and proven benefits, acceptance and adherence remain low. Mobile health (mHealth) solutions may contribute to more personalized and tailored patient recommendations according to their specific needs. This study protocol aims to assess the effectiveness of a user-friendly, comprehensive Clinical Decision Support System (CDSS) for remote patient monitoring of CVD patients, primarily on the reduction of recurrent cardiovascular events. Methods and Analysis: The study will follow a multicenter randomized controlled design involving two cardiology units in the Center Region of Portugal. Prospective CVD patients will be approached by the healthcare staff at each unit and checked for eligibility according to the predefined inclusion/exclusion criteria. The CDSS will suggest a monitoring plan for the patient, will advise the mHealth tools (apps and wearables) adapted to patient needs, and will collect data. The clinical study will start in January 2023. Discussion: The success of the mHeart.4U intervention will be a step toward the use of technological interfaces as an integrating part of CR programs. Ethics and Dissemination: The study will undergo ethical revision by the Ethics Board of the two hospital units where the study will unfold. The study was registered in ClinicalTrials.gov on 18th January 2022 with the number NCT05196802. The study findings will be published in international peer-reviewed scientific journals and encounters and in a user-friendly manner to the society.
- Common evaluations of disease activity in rheumatoid arthritis reach discordant classifications across different populationsPublication . Canhão, Helena; Rodrigues, Ana Maria; Gregório, Maria João; Dias, Sara Simões; Melo Gomes, José António; Santos, Maria José; Faustino, Augusto; Costa, José António; Allaart, Cornelia; Gvozdenović, Emilia; van der Heijde, Desirée; Machado, Pedro; Branco, Jaime C.; Fonseca, João Eurico; Silva, José AntónioThe classification of disease activity states in rheumatoid arthritis (RA) can be achieved through disease activity indices, such as the Disease Activity Score in 28 joints erythrocyte sedimentation rate (DAS28-ESR), the Simplified Disease Activity Index (SDAI), and the Clinical Disease Activity Index (CDAI). Subjective measurements, such as patient reported outcomes have been incorporated into several of these indices alongside more objective assessments, such as increases in the ESR and C-reactive protein. Moreover, while they use similar criteria, different indices weight these criteria to different extents. Therefore, the classifications based on each evaluation may not always be the same. We aim to compare the performance of the three indices and their individual components in two different populations.
- Controlled trial of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower): Effectiveness analysisPublication . Miguel Lopes de Sousa, Pedro; Martinho, Ricardo; Reis, Catarina I.; Dias, Sara Simões; Gaspar, Pedro; Dixe, Maria dos Anjos; Luís, Luís; Ferreira, ReginaAim To evaluate the effectiveness on lifestyle change of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower) and to analyse the predictors of the mHealth intervention effectiveness. Design This study is designed as a non‐randomized controlled trial with a two‐arm structure. Methods Adolescents of 12–16‐year old were recruited from three school districts, with access to the Internet and smartphone/tablet devices. The intervention group was invited to engage in the mHealth intervention (TeenPower) for 6 months in addition to a school‐based intervention. The control group only followed the school‐based intervention. A repeated measures factorial ANOVA was used and the main effectiveness outcome was the lifestyle change measured by the adolescent lifestyle profile. Results The outcomes of the mHealth intervention (TeenPower) show a significant effect on nutrition (ƞ2p = 0.03, p = .03), positive life perspective (ƞ2p = 0.04, p = .01), and global lifestyle (ƞ2p = 0.02, p = .05), with a dropout rate of 62.1%. The analysis of the effectiveness predictors of the mHealth intervention suggested that older adolescents tended to show a significant increase in the rates of stress management (r = .40; p < .05). Conclusions Although the considerable dropout rate, the mHealth intervention presented significant impact on multiple lifestyle domains, providing support for the effectiveness of mHealth interventions for health promotion as an add‐on to standard interdisciplinary interventions. Impact Adolescents must have the necessary and appropriate knowledge for the correct and responsible decision‐making regarding their health and lifestyle. Innovative strategies (mHealth intervention) were used to promote healthy behaviours. This study evaluates the effectiveness of an mHealth intervention (TeenPower) specifically designed for adolescents. We found a significant impact in several lifestyle domains such as health responsibility, nutrition, positive life perspective, and global lifestyle.
- Disease mapping models for data with weak spatial dependence or spatial discontinuitiesPublication . Baptista, Helena; Congdon, Peter; Mendes, Jorge M.; Rodrigues, Ana M.; Canhão, Helena; Dias, Sara SimõesRecent advances in the spatial epidemiology literature have extended traditional approaches by including determinant disease factors that allow for non-local smoothing and/or non-spatial smoothing. In this article, two of those approaches are compared and are further extended to areas of high interest from the public health perspective. These are a conditionally specified Gaussian random field model, using a similaritybased non-spatial weight matrix to facilitate non-spatial smoothing in Bayesian disease mapping; and a spatially adaptive conditional autoregressive prior model.
- Do GnRH Agonists Really Increase Body Weight Gain? Evaluation of a Multicentric Portuguese Cohort of Patients With Central Precocious PubertyPublication . Leite, Ana Luísa; Galo, Elisa; Antunes, Ana; Robalo, Brígida; Amaral, Daniela; Espada, Filipa; Castro, Sofia; Dias, Sara Simões; Limbert, CatarinaIntroduction: There are several concerns associated with gonadotropin-releasing hormone agonist (GnRHa) treatment for central precocious puberty (CPP), such as obesity and changes in body mass index (BMI). We aimed to investigate whether any anthropometric differences exist and if they persist over time. Methods: We conducted an observational study of Portuguese children (both sexes) diagnosed with CPP between January 2000 and December 2017, using a digital platform, in order to analyze the influence of GnRHa treatment on BMI-SD score (BMI-SDS). Results: Of the 241 patients diagnosed with CPP, we assessed 92 patients (8% boys) in this study. At baseline, 39% of the patients were overweight. BMI-SDS increased with treatment for girls but then diminished 1 year after stopping GnRHa therapy (p = 0.018). BMI-SDS variation at the end of treatment was negatively correlated with BMI-SDS at baseline (p < 0.001). Boys grew taller and faster during treatment than did girls (p < 0.001), and therefore, their BMI-SDS trajectory might be different. Conclusions: This study showed an increase of body weight gain during GnRHa treatment only in girls, which reversed just 1 year after stopping treatment. The overall gain in BMI-SDS with treatment is associated with baseline BMI-SDS.
- Health literacy – study protocol for LiSa cohort studyPublication . Batalha, Maria João; Gabriel, Tiago; Valentim, Ana; Soledade, Ana; Gomes, Cátia; Alves, Bartolomeu; Santos, Estêvão Soares dos; Passadouro, Rui; Dias, Sara SimõesBackground: Health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others, whether at home, at the workplace, in the community, marketplace, healthcare sector, or the political arena. The main aim of this project is to measure health literacy in the adult population living in the municipality of Leiria over the next 10 years. As secondary objectives it is intended to characterize anxiety and depression, metabolic risk and health behaviors in the same population and over the same period. Methods: This is a prospective cohort study that collects data on HL, anxiety and depression, health characteristics, health behavior and sociodemographic data. The study population will be composed by adults (≥ 18 years old) who are non-institutionalized and living in private households in Leiria. The random sample is stratified by gender and age groups. A face-to-face interview will be conducted with the Computer Assisted Personal Interview at baseline. Follow-up will be carried out every 2 years via telephone call. The association between independent variables and health literacy is examined by means of variance analysis with measurement repetition, and taking into consideration follow-up. Discussion: The LiSa project is a population-based study, derived from a random sampling technique that will allow the analysis of health outcomes in a representative sample of the population of the municipality of Leiria. The LiSa study will be a valuable resource for epidemiological research, as it will provide fundamental information to improve public health policies regarding health literacy in Portugal. Trial registration: Clinical trials: NCT05558631 (registered on 26/09/2022).
- Increased short-term risk of cardiovascular events in inflammatory rheumatic diseases: Results from a population-based cohortPublication . Da Silva Domingues, Vital; Rodrigues, Ana M.; Dias, Sara Simões; Delgado, Luís; Barkoudah, Ebrahim; Branco, J; Canhao, HCardiovascular diseases represent the frst cause of death globally. Infammatory rheumatic disease (IRMD) patients, due to their lifelong infammatory status, are at increased risk of developing premature cardiovascular disease. We aimed to assess the risk for cardiovascular events (CVE) in a population-based study. We followed 10,153 adults from the EpiDoC Cohort, a large Portuguese population-based prospective study (2011–2016). IRMD patients were identifed at baseline and followed during 5 years. CVE were defned as a composite of self-reported myocardial infarction or angina pectoris, arrhythmias, valvular disease, stroke or transient ischemic attack and peripheral artery disease. Statistical analysis was performed by utilizing multivariate logistic regression and goodness-of-ft and area under ROC curve. At baseline, IRMD patients had similar age as the non-IRMD participants (mean age 55 vs 53 years-old; 72.1% female); dyslipidaemia and sedentary lifestyle were more common (40.7% vs 31.4%, p=0.033; 87.3% vs 67%, p=0.016, respectively). During an average follow-up of 2.6 years, 26 CVE were reported among IRMD patients. IRMD patients had higher odd of CVE (OR 1.64, 95% CI 1.04–2.58; p=0.03), despite comparable mortality rates (1.7% vs 0.7%, p=0.806). A stepwise approach attained that gender, age, history of hypertension, body mass index, IRMD and follow-up time are the most important predictive variables of CVE (AUC 0.80). IRMD patients, at community level, have an increased short-term risk of major CVE when compared to non-IRMD, and that highlights the potential beneft of a systematic screening and more aggressive cardiovascular risk assessment and management of these patients.
- Nutrition education strategies to promote vegetable consumption in preschool children: The Veggies4myHeart projectPublication . Pontes, Cátia; Dias, Sara Simões; Lages, Marlene; Guarino, Maria Pedro; Graça, PedroObjective: To test the efficacy of three nutrition education strategies on the intake of different vegetables in preschool children. Design: This is an experimental study conducted in four Portuguese preschools. The intervention consisted of 20-min educational sessions, once a week, for 5 weeks, with one of the following randomised educational strategies: Portuguese Food Wheel Guide (control), digital game, storybook, storybook and reward (stickers). All groups had repeated exposure to vegetables in all sessions. A preand post-test were conducted to determine vegetable intake, and a 6-month follow-up was realised. Setting: Preschools of Leiria district, Portugal. Participants: A sample of 162 children aged 3 to 6 years. All eligible children attending the preschools were invited to participate. Results: All interventions tested were effective in increasing vegetable consumption both in the short and medium term, without statistically significant differences, compared to the control group. Stickers were more effective in the short term than in the medium term. Conclusions: The nutritional education strategies associated with repeated exposure tested in this study were effective in promoting vegetable consumption in preschool children. The use of stickers may be a valid strategy to promote the consumption of vegetables less recognised by children.