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- Quality of life in adults living in the community with previous self-reported myocardial infarctionPublication . Timóteo, Ana Teresa; Dias, Sara Simões; Rodrigues, Ana Maria; Gregório, Maria João; Sousa, Rute Dinis; Canhão, HelenaQuality of life (QoL) is one of the most important patient-reported outcomes in chronic diseases. Using a population-based cohort, our objective was to assess health-related QoL in individuals with a previous myocardial infarction (MI).
- Veggies4myHeart – educational project to promote vegetable knowledge and consumption in preschoolersPublication . Novo, R; Edra, J; Vieito, L; Dias, S. Simões; Lages, M; Guarino, M P; Braga-Pontes, CVegetable consumption among children is below recommended. Given the critical role of vegetable consumption in health promotion, it is essential to identify effective strategies to promote this intake. The Veggies4myHeart project aims to increase vegetable knowledge and consumption in preschool children through nutrition education strategies (NES). Veggies4myHeart is a prospective longitudinal study with children aged 2 to 6 years who attend preschools in the Leiria district. A questionnaire was applied to the parents to characterize the sample. NES were used: children’s story, digital game, vegetable-themed sticker booklet and the food wheel. The intervention consisted of 5 food education sessions, each focusing on one selected vegetable (lettuce, carrot, red cabbage, cucumber, and tomato). Sessions to assess knowledge and consumption of vegetables were held pre-and post-intervention. Knowledge was evaluated through a taxonomic categorization questionnaire. Consumption was assessed by recording the number of portions of each vegetable consumed. Wilcoxon test was used to compare pre-and post-intervention vegetable knowledge and consumption. ANOVA test was used to compare NES. Between 2018 and 2024, 649 children (52,5% female, mean age 4,36 ± 0,942) from 17 preschools participated. After the intervention, there was a statistically significant increase in vegetable knowledge (p < 0,001) and a statistically significant increase in the consumption of vegetables (p < 0,001). There are statistically significant differences between NES, with the digital game having greater vegetable knowledge (p < 0,001) and consumption (p < 0,001) than the others. The Veggies4myHeart project effectively increased vegetable knowledge and consumption in preschoolers. It is essential to continue the intervention to promote consumption and familiarity with vegetables, as well as the involvement of parents and preschool teachers, due to their prominent role as models for acquiring healthy eating habits.
- Upper airway assessment in obstructive sleep apnea patients: can computed tomography with lateral cephalometry replace drug-induced sleep endoscopy (DISE)?Publication . Campos, Ana; Cebola, Pedro; Dias, Sara Simões; Pais, José Pedro; Sousa, Susana; Cardoso, Sérgio; Paço, João; Caroça, CristinaObjective: To evaluate the association between results from drug-induced sleep endoscopy (DISE) and computed tomography with lateral cephalometry (CTLC) of the pharynx in obstructive sleep apnea (OSA) patients, regarding the same anatomic level, in order to understand if CTLC could replace DISE in selected patients. Study design: Cross-sectional. Setting: Tertiary hospital. Methods: A total of 71 patients who attended the Sleep Medicine Consultation in the Otorhinolaryngology Department of Hospital CUF Tejo between 1.6.2019 and 30.9.2021, performed a polysomnographic sleep study and were elected to undergo DISE and CTLC of the pharynx for diagnostic purposes were selected. Obstructions at the same anatomic levels – tongue base, epiglottis and velum - were compared in both exams. Results: Patients with reduction of epiglottis-pharynx space on CTLC had also a complete obstruction at epiglottis level on the VOTE classification of DISE (p = 0,027). Reduction of velum-pharynx space or tongue base-pharynx space were not related to complete obstruction of the velum (P = 0,623) or the tongue base (p = 0,594) found in DISE. Those with two or more space reductions had a tendency to multilevel obstruction observed in DISE (p = 0.089). Conclusion: When evaluating the obstruction level(s) of an OSA patient, efforts should be made to perform DISE, since CTLC measures, though regarding at the same structures, don´t correlate completely with obstructions observed in DISE. © 2023 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello
- Validação Exploratória e Confirmatória da Escala de Resiliência Connor-Davidson (CD-RISC-10) numa Amostra de Inscritos em Centros de EmpregoPublication . Almeida, Maria Helena; Dias, Sara; Xavier, Miguel; Torgal, JorgeIntrodução: Bonanno definiu resiliência como a capacidade do indivíduo em lidar com os eventos traumáticos, nomeadamente a capacidade de manter os níveis de funcionamento físico e psicológico relativamente estáveis. O objetivo do estudo foi avaliar as propriedades psicométricas da escala de resiliência Connor-Davidson de 10 itens. A escala resumida apresenta boas qualidades psicométricas (α Cronbach – 0,85) quando comparada com a escala longa (25 itens) (α Cronbach – 0,89). Material e Métodos: Obtivemos uma amostra de conveniência de inscritos em centros de emprego que foi aleatoriamente dividida em duas subamostras (amostra 1 = 5127 e amostra 2 = 5134). Aplicámos a análise de componentes principais na amostra 1. Com a amostra 2 procedeu-se à análise fatorial confirmatória usando o método da máxima verosimilhança. Usámos a análise multigrupo para a comparação do modelo fatorial entre os géneros e a situação profissional. Efetuámos a análise convergente e divergente através da análise de correlação de Pearson. Resultados: A análise de componentes principais extraiu um fator com uma variância explicada de 53,97%. A análise fatorial confirmatória comprovou a unidimensionalidade da escala. Confirmámos a invariância entre géneros e situação profissional. A escala de resiliência Connor-Davidson de 10 itens correlacionou-se positivamente com as medidas da escala SF-36 e negativamente com a escala GHQ-12. Discussão: A análise exploratória e confirmatória corroborou a unidimensionalidade e boas propriedades psicométricas, semelhantes à escala original de 10 itens. Conclusão: Trata-se do primeiro estudo de validação desta escala na população portuguesa (Portugal), de acordo com a pesquisa efetuada. Os seus resultados são muito satisfatórios, recomendando-se o seu uso na população portuguesa.
- 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.
- 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.
- 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).
- 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.
- The Longitudinal Association between Co-Residential Care Provision and Healthcare Use among the Portuguese Population Aged 50 and Over: A SHARE StudyPublication . Barbosa, Fátima; Dias, Sara Simões; Voss, Gina; Matos, Alice DelerueCo-residential care is associated with poor caregiver health and a high burden. Although Portugal relies heavily on co-residential care by individuals aged 50 and over, studies on the impact of co-residential care provision on Portuguese caregivers’ healthcare use are lacking. This study aims to analyze the impact of co-residential care (spousal and non-spousal care) on healthcare use of the Portuguese population aged 50 plus. Data from waves 4 (n = 1697) and 6 (n = 1460) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Negative Binomial Generalized Linear Mixed Models with random (individual level) and fixed (covariates) effects were performed. The results show that the number of visits to the doctor decrease significantly over time for the co-residential spousal caregivers as compared to the non-co-residential caregivers. This result highlights the fact that the Portuguese co-residential spousal caregiver group is at a higher risk of not using healthcare, thus jeopardizing their own health and continuity of care. Promoting more accessible healthcare services and implementing public policies adjusted to the needs of informal caregivers are important to improve the health and healthcare use of Portuguese spousal co-residential caregivers.
- Cohort Profile: The Epidemiology of Chronic Diseases Cohort (EpiDoC)Publication . Rodrigues, Ana Maria; Gregório, Maria João; Sousa, Rute Dinis de; Branco, Jaime Cunha; Canhão, Helena; Dias, Sara