Unidade de Investigação - ciTechCare - Center for Innovative Care and Health Technology
URI permanente desta comunidade:
New solution driven research and development (R&D) unit dedicated to promote health in a multidisciplinary and inter-professional approach.
Navegar
Percorrer Unidade de Investigação - ciTechCare - Center for Innovative Care and Health Technology por Domínios Científicos e Tecnológicos (FOS) "Ciências Médicas::Ciências da Saúde"
A mostrar 1 - 10 de 160
Resultados por página
Opções de ordenação
- Anthropometric and Body Composition Changes After Bariatric Surgery—The Effect of Sex, Age, and Type of SurgeryPublication . Guerra, Rita Soares; Pinho-Reis, Cíntia; Sousa, Ana Sofia; Mendes, Joana; Silva, CláudiaThe rise in obesity and its associated health problems increases the need for therapeutic approaches such as bariatric surgery. Therefore, this study aims to explore the changes in the anthropometric and body composition characteristics of patients undergoing bariatric surgery. A retrospective longitudinal study was conducted in subjects ≥ 18 y who underwent bariatric surgery and attended one nutrition appointment before and after surgery. Information on their sex, age, weight, fat mass (kg and %), fat-free mass (kg and %), and skeletal muscle mass, obtained using bioelectrical impedance, and on their waist circumferences was collected. Their BMIs and skeletal muscle mass indexes were calculated. The differences in the anthropometric and body composition parameters between pre- and post-surgery were also calculated. The participants were grouped by sex, age groups (18–44 y and 45–69), and type of surgery (Roux-en-Y gastric bypass and gastric sleeve). The variables are presented as n (%) and as means (SDs) or medians (interquartile ranges). Student’s t-test and the Mann–Whitney test were employed (p < 0.05). The sample consisted of 57 subjects (aged 18–69 years; 75% women). Between the pre- and post-surgical periods (63 (42) days), their weight (mean: 103.0 (SD: 16.3) kg vs. 91.2 (14.2) kg, p < 0.001); BMIs (37.9 (4.2) kg/m2 vs. 33.6 (4.1) kg/m2, p < 0.001); waist circumferences (116.2 (12.4) cm vs. 105.7 (12.3) cm, p < 0.001); % fat mass (45.5 (6.0) vs. 41.0 (8.0), p < 0.001); skeletal muscle mass (32.8 (7.4) kg vs. 30.3 (6.5) kg, p < 0.001); and skeletal muscle mass indexes (12.0 (1.8) kg/m2 vs. 11.1 (1.7) kg/m2, p < 0.001) decreased; meanwhile, their % fat-free mass increased (54.7 (6.0) vs. 59.0 (8.0), p < 0.001). Most of these changes occurred regardless of sex, age, or type of surgery. Shortly after bariatric surgery, patients show a better nutritional status and body composition.
- Antithrombotic therapy after stent implantation. One size does not fit allPublication . Morais, João; Oliveira, MárioThe study published by Baptista et al.1 sought to assess the quality of antithrombotic therapy in a group of 996 patients with diabetes prior to coronary percutaneous intervention, searching for how guidelines are being applied in a realworld setting.
- Antithrombotic treatment following revascularization for chronic limb-threatening ischaemia: a scientific statement of the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases and the European Society of Cardiology Working Group on Cardiovascular PharmacotherapyPublication . Schlager, Oliver; De Carlo, Marco; Mazzolai, Lucia; Bura-Riviere, Alessandra; Heiss, Christian; Palomares, Jose Rodriguez; Morais, João C. A.; Steiner, Sabine; Brodmann, Marianne; Aboyans, Victor; Caterina, Raffaele DeChronic limb-threatening ischaemia (CLTI) is defined as ischaemic rest pain, or non-healing ulceration, requiring endovascular or surgical lower limb revascularization (LLR). Lower limb revascularization in CLTI entails a high risk of major adverse limb events (MALE) and major adverse cardiovascular events (MACE). This scientific statement addresses this risk based on a systematic review. A structured literature search was performed, and articles were independently evaluated by two investigators. In total, 1678 articles were identified, of which 34 were included in the final analysis. Only three randomized controlled trials (RCTs) addressed antithrombotic therapy in CLTI following LLR. None of these demonstrated superiority of any antithrombotic regimen over the other. Eight RCTs investigated antithrombotic therapy following LLR in populations with peripheral arterial disease including CLTI subgroups and suggest a benefit of dual antiplatelet therapy on limb events. One large RCT demonstrated that dual pathway inhibition with aspirin and vascular-dose rivaroxaban reduced the risk of MALE, MACE, and unplanned target limb revascularization. Data from 22 observational studies suggest a benefit of dual antiplatelet therapy on overall survival and amputation-free survival after LLR as compared with single antiplatelet therapy. Intensified antithrombotic treatment should be proposed in patients with CLTI following LLR to reduce the risk of MALE and MACE. Randomized controlled trials on antithrombotic therapy in patients with CLTI following LLR are scarce. Dual pathway inhibition is the only regimen for which an RCT demonstrated a reduction of MALE and MACE following LLR. Dual antiplatelet therapy appears to be associated with a reduced risk of MALE in CLTI following LLR.
- The Arabic Control Attitudes Scale-Revised: Method Effect (Negatively Worded Items) and Measurement Invariance as Threats to Its Construct Validity Are Remedied in a 5-Item Version With Improved PerformancePublication . Ali, Amira Mohammed; Al-Dossary, Saeed A.; Alharrasi, Maryam; Laranjeira, Carlos; Ayed, Ahmad; El-Gazar, Heba Emad; Zoromba, Mohamed Ali; Atalla, Amal Diab Ghanem; Alamer, Rasmieh; Al-Abri, Khalood; Subih, Maha; Pakai, AnnamariaBackground: The Control Attitudes Scale-Revised (CAS-R) is widely used to explore cardiac patients’ beliefs about their ability to manage illness. The CAS-R’s construct validity may be questionable in different cultural contexts. Conclusions/applications based on inaccurate construct validity can be misleading and incorrect. Objective: In this study, we aimed to evaluate the psychometric properties of the Arabic version of the CAS-R. Methods: Within a cross-sectional design involving 180 Omani patients with heart failure (mean age = 70.3 ± 9.8 years, 51.7% females), exploratory/confirmatory factor analysis (CFA) and multigroup CFA were used to evaluate the construct validity and measurement invariance of the CAS-R across gender and marital groups. Results: In exploratory factor analysis, 2 factors with eigenvalues >1 explained 37.9% of the variance. Despite the poor fit of the unidimensional CAS-R, CFA revealed an excellent fit of a 2-factor structure. Negative (5 and 8) and cross-loading items (1) contributed to scale variance at the configural level. Eliminating negative items and item 6 improved model fit, reliability (Cronbach’s α = 0.66 vs. 0.56), and invariance at all levels. In support of its convergent and criterion validity, the CAS-R 5 correlated with the CAS-R and depression (r = 0.953, −0.268; P values <.01). Conclusions: Negative items comprised a minor weak factor (helplessness) that was not stable across groups. Eliminating items 5, 6, and 8 resulted in a clean invariant short form (CAS-R 5) with superior properties that may implicate nursing decisions and interventions concerning perceived control.
- The Arabic Version of the Patient Health Questionnaire‐2 (PHQ‐2): Psychometric Evaluation Among Mothers of Children With Intellectual DisabilitiesPublication . Ali, Amira Mohammed; Al-Dossary, Saeed A; Aljaberi, Musheer A.; El-Gazar, Heba Emad; Laranjeira, Carlos; Khatatbeh, Haitham; Zoromba, Mohamed Ali; Alamer, Rasmieh; Amer, Faten; Pakai, Annamaria; Fekih-Romdhane, Feten; Lidoriki, EiriniAim: Mothers of children with intellectual disabilities are particularly vulnerable to mental distress due to demanding and exhausting caregiving. However, in the Arab world, they are seldom screened for depression because of limited diagnostic resources. Addressing the urgent need for brief and reliable screening tools, this study evaluated the psychometric properties of the Arabic version of the Patient Health Questionnaire-2 (PHQ-2) among 85 Saudi mothers. Design: A cross-sectional study. Methods: The construct, convergent, and divergent validity of the PHQ-2 was examined through a latent variable model (LVM), while its cutoff score was examined through receiver-operating characteristic (ROC) curve analysis. Results: The unidimensional PHQ-2 (item loadings > 0.7) was positively predicted by stress and negatively predicted by high mood and happiness, supporting its convergent and divergent validity. The PHQ-2 effectively predicted low mood, poor sleep quality, nightmares, high stress, low general physical health, and willingness to join a psychological support program (area under the curve [AUC] range = 0.72–0.84, p values < 0.001). The best balance between sensitivity and specificity was achieved at the PHQ-2 threshold ≥ 2.5, while the cutoff ≥ 3.5 demonstrated a higher positive predictive value (PPV) for all outcomes (range = 30.0–78.8 vs. 23.0–70.8). Conclusions: The PHQ-2 is a brief, valid tool, which at cutoffs ≥ 2.5 and ≥ 3.5 can reliably detect clinically significant depression and related psychological and physical adverse effects. Mothers scoring ≥ 3.5 may require a clinician-based examination for depression, and they may benefit from specific mental health literacy interventions. However, the results should be interpreted with caution given convenience sampling, a small sample size, and elevated distress levels in the current population. These limitations highlight the need to replicate the study with larger, randomly selected samples from more diverse populations. Implications for Practice: Nurses can efficiently screen for depression and its mental/physical sequelae, as well as monitor response to treatment using only two items. The study provided two well-interpreted cutoffs of the PHQ-2, with real-world implications for mental health screening in under-resourced settings. Reporting Method: The study adhered to STROBE guidelines. Patient or Public Contribution: No patient or public contribution. Copyright © 2025 Amira Mohammed Ali et al. Nursing Research and Practice published by John Wiley & Sons Ltd.
- Article Title: Impact of Dysphagia on Quality of Life in Machado-Joseph DiseasePublication . Mota, Joana Paz; Rodrigues, Inês Tello; Rodrigues, Inês Tello; Ferreira, Ana Filipa; Melo, Ana Rosa Vieira; Pires, Paula; Lopes, Pedro; Vasconcelos, João; Raposo, Mafalda; Lima, ManuelaDysphagia is a frequent symptom of spinocerebellar ataxia type 3 (SCA3)/Machado-Joseph disease (MJD), being associated with alterations in nutritional intake and hydration, as well as an increased risk of aspiration pneumonia. This study aims to evaluate the impact of self-perceived dysphagia and its relationship with quality of life in SCA3/MJD mutation carriers. 41 SCA3/MJD mutation carriers from the Azorean cohort were recruited. The Swallowing Quality-of-Life Questionnaire (SWAL-QOL), the Eating Assessment Tool (EAT-10), the Functional Oral Intake Scale (FOIS), the Volume-Viscosity Swallow Test (V-VST), the Scale for the Assessment and Rating of Ataxia (SARA), the Inventory of Non-Ataxia Signs (INAS), and the Activities of Daily Living (ADL) were applied. Dysphagia was confirmed in 40% SCA3/MJD patients, whose SWAL-QOL was significantly decreased when compared to participants without dysphagia (p = 0.001). As expected, SCA3/MJD carriers with worse SWAL-QOL showed a high risk of dysphagia (p < 0.01), a worse functional oral intake of food and liquids (p < 0.01) and more severe ataxia (p < 0.01). Additionally, high severity of dysphagia reported on the INAS scale, (p < 0.01) and high frequency of swallowing disorders, perceived by SCA3/MJD carriers (p < 0.01) were observed in SCA3/MJD carriers with worse SWAL-QOL. Our findings confirm that dysphagia negatively impacts the quality of life of SCA3/MJD carriers, highlighting the need for permanent support by specialized healthcare professionals during disease progression. Additionally, we recommend that SCA3/MJD carriers with a score of 1 or higher on both the INAS dysphagia item and the ADL swallowing item be referred for specialized healthcare support in swallowing disorders.
- Assessment of potentially motivating factors to follow time-restricted eating protocols in a population of adults living in PortugalPublication . Lages, Marlene; Carmo Silva, Sara; Barros, Renata; Guarino, MariaChrononutrition is a growing field that has been attracting significant attention for its potential benefits in metabolic health and body weight regulation. Among chrononutrition strategies, time-restricted eating (TRE) is the most extensively investigated approach in clinical studies. TRE intends to synchronise eating and fasting cycles with the human circadian rhythms. However, larger and longer randomised clinical trials are still needed to establish the effectiveness and long-term health outcomes of TRE interventions. Furthermore, it is crucial to explore whether individuals in free-living conditions, outside controlled clinical settings, can successfully adopt TRE principles into their daily routines to achieve potential health benefits. This study aimed to investigate the association between daily routines and potential adherence to TRE protocols, as well as to identify factors that can potentially predict adherence to these protocols in a sample of adults living in Portugal. A cross-sectional study was conducted using an online questionnaire to assess dietary and sleeping habits, daily routines and the likelihood of adherence to various restrictions in daily eating windows. Associations between variables were analysed using the Spearman correlation coefficient and the Chi-Square test, while an ordinal logistic regression was performed to identify predictive factors. Statistical analyses were conducted on IBM SPSS Statistics version 29.0. The questionnaire was filled out by 130 participants (80 % women) with a mean age of 37.9 ± 13.59 years. On workdays, 71.6 % of participants reported a daily eating window of 12 to 14 h, while on free days, the highest percentage (46.6 %) reported between 10 and 12 h. A significant inverse correlation was observed between willingness to adhere to a TRE protocol based on perceived health benefits and both age (ρ = -0.356, p < 0.001) and sex (ρ = -0.321, p < 0.001). Moderate correlations were also found between the willingness to follow a TRE protocol on workdays (ρ = 0.538) and free days (ρ = 0.598) and the potential health benefits of this type of intervention (p < 0.001). Additionally, sex was associated with potential adherence to the TRE protocol (χ²(2) = 10.644, p = 0.005), with a tendency for men to show lower willingness for adherence. Associations were also identified between body weight management and reducing the eating window by 1 to 2 h (χ²(12) = 24.883, df = 12, p = 0.015) and 2 to 3 h (χ²(12) = 22.367, p = 0.034). Moreover, the perceived importance of income, body weight management and cooking knowledge were significant predictors of the likelihood of adherence to a TRE protocol with a 3 to 4 h restriction in the eating window on workdays (p < 0.005). These results provide valuable insights that should be considered when translating research into clinical practice, specifically in an adult population, as individuals’ willingness and motivation to adopt TRE protocols in free-living conditions are influenced by multiple factors.
- Assistive technologies for children with cognitive and/or motor disabilities: interviews as a means to diagnose the training needs of informal caregiversPublication . Almeida, Ivone Carmo Rodrigues; Ribeiro, Jaime; Moreira, AntónioPurpose: The present study seeks to survey information and training needs of informal caregivers related to the use of assistive technologies at home, so as to, in the near future, try to meet them. Therefore, the full aim of this study is to contribute to reducing technology abandonment and to enhancing its use in the family setting by children with cognitive and/or motor limitations. Materials and methods: Content analysis of a set of ten interviews with informal caregivers of children and youngsters with cognitive and/or motor disabilities. Results: Assistive technologies open a wide range of opportunities, mostly to students whose learning skills diverge from standard development. They promote communication, independence as well as inclusion of children with cognitive and/or motor disabilities. Despite the human and material resources available, the implementation of assistive technologies in many family settings is still a struggling task. The results reveal a perspective on (i) the interaction between those caregivers and their children, (ii) children’s skills in using assistive technology, (iii) caregivers’ digital literacy and (iv) their training needs. Conclusions: The present paper highlights the fact that carrying out interviews with informal caregivers leads to obtaining significant data for a diagnosis of the use of assistive technologies in the family setting and to assess the needs of informal caregivers. From this study, the need to provide caregivers with further training on assistive technologies emerges as preponderant, and to improve caregivers’ skills in the search for and access to practical information.
- Association between dietary intake and the expression of clock genes in adults: a brief reportPublication . Lages, Marlene; Barros, Renata; Ferreira-Marques, Marisa; Correia, Joana; Caseiro, Armando; Guarino, Maria P.; Carmo Silva, Sara; Le Coutre, JohannesBackground: The circadian system regulates several physiological processes, including energy metabolism, through the expression of core clock genes. Animal studies suggest that dietary composition can influence circadian gene expression; however, evidence in humans remains limited. Objective: This study aimed to explore the association between dietary macronutrient intake and the expression of circadian clock genes in the whole blood of adults with distinct metabolic profiles. Methods: Nineteen adults (94.7% female; 43.4 ± 16.05 years) were categorized into healthy-weight and overweight/obesity groups based on BMI. Dietary intake was assessed using a 3-day food diary, and clock gene expression (CLOCK, BMAL1, PER2, CRY) was evaluated in whole blood samples collected between 08:00 a.m. and 04:00 p.m. Statistical analyses included group comparisons and correlation analyses between macronutrient intake and gene expression. Results: No statistically significant differences were observed in the clock gene expression between BMI groups, although group-level trends were noted, particularly in PER2 and CRY expression. The overweight/obesity group exhibited a significantly higher percentage of energy intake from protein. Correlation analyses revealed several time-dependent associations between macronutrient intake and clock gene expression. Notably, in the healthy BMI group, BMAL1 and CRY expression correlated with lipid and protein intake, while in the overweight/obesity group, CLOCK expression was strongly associated with both lipid and carbohydrate intake. Conclusion: These findings suggest that macronutrient composition may influence peripheral circadian gene expression in a time- and BMI-dependent manner. Further research is necessary to confirm these associations in larger and more diverse populations and to investigate the potential for chrononutrition strategies to support metabolic health.
- Avaliação da dor na pessoa não comunicante em contexto de cuidados pós-anestésicosPublication . Oliveira, João Pedro; Costeira, CristinaIntrodução: No processo de heteroavaliação de dor em contexto de cuidados pós-anestésicos, os enfermeiros deparam-se com diversas dificuldades. Acresce a este desafio a falta de uniformização e treino neste processo. Objetivos: Identificar as dificuldades dos enfermeiros na avaliação de dor em pessoas não comunicantes; implementar a utilização de instrumentos de heteroavaliação; comparar a satisfação dos enfermeiros na avaliação de dor após implementação de medidas. Métodos: Projeto de melhoria contínua da qualidade realizado num serviço de cuidados pós anestésicos de uma instituição de Saúde de Portugal. Desenvolvido em 3 fases: I: identificação do problema e avaliação; II: implementação de medidas; III: avaliação após implementação de medidas. Participaram 37 enfermeiros. Dados colhidos nas fases I e III através de aplicação de questionários eletrónicos, analisados por estatística descritiva e inferencial. Cumpridos pressupostos éticos. Resultados: Principais dificuldades identificadas na heteroavaliação: défice de conhecimento (32,87%), défice de treino (26,03%) e recursos materiais/logísticos desadequados (23,29%). Correlação positiva de 97% entre o tempo de experiência profissional e a satisfação na utilização de instrumentos de heteroavaliação. Após implementação de medidas verifica-se diferença estatisticamente significativa (p = 0,002) na satisfação dos enfermeiros na heteroavaliação de dor. Conclusões: A avaliação de dor é afetada por diversos fatores (profissionais, organizacionais e mistos). A heteroavaliação de dor exige formação contínua, melhorando o conhecimento, treino e satisfação dos profissionais, suportada por políticas institucionais que uniformizem práticas clínicas.