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Santos JMLG, Ribeiro O, Jesus LMT, Sa-Couto P, Matos MAC. Recommendations of good practice to prevent aspiration pneumonia in older adults at risk of oropharyngeal dysphagia living in nursing homes: A modified e-Delphi study protocol. Int J Lang Commun Disord 2024; 59:1223-1231. [PMID: 37966125 DOI: 10.1111/1460-6984.12985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Aspiration pneumonia (AP) is a subset of pneumonia caused by the aspiration of food and fluids to the lungs and is highly prevalent in the older population. Oropharyngeal dysphagia (OD) is one of the risk factors for AP and it is also associated with malnutrition, dehydration and poor functional outcomes. As pneumonia is the second most common infection in nursing homes (NHs) and OD represents a major concern to NH staff, good practices for the prevention of AP in older adults at risk of OD are needed. PURPOSE The aim of this modified e-Delphi study is to build consensus among a panel of experts regarding a set of recommendations for NH staff on good practices to prevent AP in older adults at risk of OD living in NHs. The objective of this paper is to establish the methodology inherent to the Delphi study. METHODS An online modified Delphi study will be developed in three rounds. Criteria for the Delphi panel participants include holding a master's or doctoral degree in OD or speech and language therapy; or having 10 or more years of experience in OD; or having at least one scientific publication related to OD. A previously described modified Delphi methodology will be used to achieve consensus (75% agreement). An additional round will be performed to collect the experts' perspectives regarding the priority for application of each recommendation previously validated. DISCUSSION This protocol aimed to describe the methodology of a future Delphi study on the prevention of AP, seeking to fulfil the gap in the literature regarding this topic. The modified Delphi technique is a widely used method for collecting experts' opinion in health sciences, but the absence of standardised guidelines allows some heterogeneity between studies with the same aim. WHAT THIS PAPER ADDS What is already known on the subject Aspiration pneumonia (AP) is related to three main risk factors: impaired safety of swallow, impaired nutritional status and poor oral health. It is known that being dependent for feeding is one of the main risk factors for AP and around 50% of nursing home (NH) residents need feeding assistance. Thus, it is important to promote specialised intervention and care by the NH staff for preventing AP. What this paper adds to existing knowledge It is hypothesised that increasing the knowledge of NH staff regarding the best practices for preventing AP in older adults at risk of oropharyngeal dysphagia (OD) will improve outcomes such as quality of life, incidence of AP and mortality. What are the potential or actual clinical implications of this work? The recommendations resulting from this study will address a current gap in healthcare practice of NH staff regarding older adults at increased risk for OD and, consequently, for AP.
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Affiliation(s)
- Joana M L G Santos
- Center for Health Technology and Services Research at the Associate Laboratory RISE - Health Research Network (CINTESIS@RISE), Institute of Electronics and Informatics Engineering of Aveiro (IEETA), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research at the Associate Laboratory RISE - Health Research Network (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Luis M T Jesus
- School of Health Sciences (ESSUA), Institute of Electronics and Informatics Engineering of Aveiro (IEETA), Intelligent Systems Associate Laboratory (LASI), University of Aveiro, Aveiro, Portugal
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications, Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Maria Assunção C Matos
- School of Health Sciences (ESSUA), Center for Health Technology and Services Research at the Associate Laboratory RISE - Health Research Network (CINTESIS@RISE), University of Aveiro, Aveiro, Portugal
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Matos AC, Lorigo J, Marques IA, Abrantes AM, Jóia-Gomes M, Sa-Couto P, Gonçalves AC, Valentim A, Tavares-Silva E, Figueiredo A, Pires AS, Botelho MF. Anti-Algics in the Therapeutic Response of Breast and Urological Cancers. Int J Mol Sci 2023; 25:468. [PMID: 38203640 PMCID: PMC10778606 DOI: 10.3390/ijms25010468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
The effect of anti-algics on tumor progression and the overall survival of patients is controversial and remains unclear. Herein, we disclose the in vitro effects of the local anesthetics lidocaine, ropivacaine, and levobupivacaine on breast (MCF7), prostate (PC3, LNCaP), and bladder (TCCSUP, HT1376) cancer cell lines, both as monotherapy and in combination with standard-of-care therapeutics. Assays for cell proliferation, viability, death profile, and migration were performed. Additionally, we explored the clinical outcomes of opioid use through a cross-sectional study involving 200 metastatic prostate cancer patients. The main clinical data collected included the type of opioid therapy administered, dosage, treatment duration, disease progression, and overall survival. Results obtained demonstrate that treatment with local anesthetics has a promising selective anti-tumor effect on these types of cancer, with higher effects when associated with docetaxel. This points out the use of local anesthetics as an added value in the treatment of prostate carcinoma patients. Alternatively, chronic opioid use was correlated with reduced overall survival (p < 0.05) and progression-free survival (p < 0.05) at each treatment line in the observational study. While these results provide valuable insights, larger prospective studies are imperative to comprehensively evaluate the clinical impact of opioid analgesics in prostate cancer patients.
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Affiliation(s)
- Ana Catarina Matos
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal (I.A.M.); (A.M.A.); (E.T.-S.); (A.F.); (M.F.B.)
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal;
| | - João Lorigo
- Department of Urology and Renal Transplantation, Centro Hospitalar e Universitário de Coimbra (CHUC), 3004-561 Coimbra, Portugal;
| | - Inês Alexandra Marques
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal (I.A.M.); (A.M.A.); (E.T.-S.); (A.F.); (M.F.B.)
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal;
| | - Ana Margarida Abrantes
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal (I.A.M.); (A.M.A.); (E.T.-S.); (A.F.); (M.F.B.)
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal;
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal;
| | - Matilde Jóia-Gomes
- Department of Mathematics, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Pedro Sa-Couto
- Center for Research & Development in Mathematics and Applications (CIDMA), Department of Mathematics, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Ana Cristina Gonçalves
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal;
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal;
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Laboratory of Oncobiology and Hematology and University Clinics of Hematology and Oncology, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Valentim
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal;
- Anaesthesiology Service, Centro Hospitalar e Universitário de Coimbra (CHUC), 3004-561 Coimbra, Portugal
| | - Edgar Tavares-Silva
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal (I.A.M.); (A.M.A.); (E.T.-S.); (A.F.); (M.F.B.)
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal;
- Department of Urology and Renal Transplantation, Centro Hospitalar e Universitário de Coimbra (CHUC), 3004-561 Coimbra, Portugal;
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal;
| | - Arnaldo Figueiredo
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal (I.A.M.); (A.M.A.); (E.T.-S.); (A.F.); (M.F.B.)
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal;
- Department of Urology and Renal Transplantation, Centro Hospitalar e Universitário de Coimbra (CHUC), 3004-561 Coimbra, Portugal;
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal;
| | - Ana Salomé Pires
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal (I.A.M.); (A.M.A.); (E.T.-S.); (A.F.); (M.F.B.)
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal;
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal;
| | - Maria Filomena Botelho
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal (I.A.M.); (A.M.A.); (E.T.-S.); (A.F.); (M.F.B.)
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal;
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal;
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dos Reis JD, Sa-Couto P, Mateus J, Simões CJ, Rodrigues A, Sardo P, Simões JL. Impact of Wound Dressing Changes on Nursing Workload in an Intensive Care Unit. Int J Environ Res Public Health 2023; 20:5284. [PMID: 37047900 PMCID: PMC10094196 DOI: 10.3390/ijerph20075284] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
The objective of this study is to understand how the type of wound dressing changes (routine or frequent) in patients admitted to intensive care units influences nurses' workload. This study used a database of retrospective and analytical observational study from one Portuguese intensive care unit. The sample included 728 adult patients admitted between 2015 and 2019. The nursing workload was assessed by the TISS-28 scale, both at admission and at discharge. The linear regression results show that patients with frequent dressing changes are associated with a higher nursing workload, both at admission (Coef. 1.65; 95% CI [0.53; 2.77]) and discharge (Coef. 1.27; 95% CI [0.32; 2.22]). In addition, age influences the nursing workload; older people are associated with a higher nursing workload (at admission Coef. 0.07; 95% CI [0.04; 0.10]; at discharge Coef. 0.08; 95% CI [0.05; 0.10]). Additionally, an increase in nursing workload at admission would significantly increase the nursing workload at discharge (Coef. 0.27; 95% CI [0.21; 0.33]). The relative stability of the nursing workload over the studied years is also another important finding (the influence of studied years is non-significant). In conclusion, patients with frequent dressing changes presented higher TISS-28 scores when compared with patients with an exchange of routine dressings, which leads to a higher nursing workload.
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Affiliation(s)
- Juliana Dias dos Reis
- Centre for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, 3810-193 Aveiro, Portugal; (J.D.d.R.); (P.S.-C.)
| | - Pedro Sa-Couto
- Centre for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, 3810-193 Aveiro, Portugal; (J.D.d.R.); (P.S.-C.)
| | - José Mateus
- Intensive Care Unit, Centro Hospitalar do Baixo Vouga E.P.E., 3810-164 Aveiro, Portugal; (J.M.); (C.J.S.)
| | - Carlos Jorge Simões
- Intensive Care Unit, Centro Hospitalar do Baixo Vouga E.P.E., 3810-164 Aveiro, Portugal; (J.M.); (C.J.S.)
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal; (A.R.); (P.S.)
| | - Alexandre Rodrigues
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal; (A.R.); (P.S.)
- Centre for Innovative Biomedicine and Biotechnology (CIBB)—Center for Health Studies and Research, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Pedro Sardo
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal; (A.R.); (P.S.)
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal
| | - João Lindo Simões
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal; (A.R.); (P.S.)
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal
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Albuquerque L, Oliveira C, Teixeira A, Sa-Couto P, Figueiredo D. A Comprehensive Analysis of Age and Gender Effects in European Portuguese Oral Vowels. J Voice 2023; 37:143.e13-143.e29. [PMID: 33293174 DOI: 10.1016/j.jvoice.2020.10.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 01/11/2023]
Abstract
The knowledge about the age effects in speech acoustics is still disperse and incomplete. This study extends the analyses of the effects of age and gender on acoustics of European Portuguese (EP) oral vowels, in order to complement initial studies with limited sets of acoustic parameters, and to further investigate unclear or inconsistent results. A database of EP vowels produced by a group of 113 adults, aged between 35 and 97, was used. Duration, fundamental frequency (f0), formant frequencies (F1 to F3), and a selection of vowel space metrics (F1 and F2 range ratios, vowel articulation index [VAI] and formant centralization ratio [FCR]) were analyzed. To avoid the arguable division into age groups, the analyses considered age as a continuous variable. The most relevant age-related results included: vowel duration increase in both genders; a general tendency to formant frequencies decrease for females; changes that were consistent with vowel centralization for males, confirmed by the vowel space acoustic indexes; and no evidence of F3 decrease with age, in both genders. This study has contributed to knowledge on aging speech, providing new information for an additional language. The results corroborated that acoustic characteristics of speech change with age and present different patterns between genders.
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Affiliation(s)
- Luciana Albuquerque
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal; Center for Health Technology and Services Research, University of Aveiro, Aveiro, Portugal; Department of Electronics Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal; Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.
| | - Catarina Oliveira
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal; School of Health Science, University of Aveiro, Aveiro, Portugal
| | - António Teixeira
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal; Department of Electronics Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications, University of Aveiro, Aveiro, Portugal; Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research, University of Aveiro, Aveiro, Portugal; School of Health Science, University of Aveiro, Aveiro, Portugal
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Andias R, Sa-Couto P, Silva AG. Blended-Learning Pain Neuroscience Education and Exercise in High School Students With Chronic Neck Pain: A Randomized Controlled Trial. Phys Ther 2022; 102:6575293. [PMID: 35485186 DOI: 10.1093/ptj/pzac048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/07/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Pain neuroscience education (PNE) and exercise have emerged as potential interventions in adolescents with chronic pain; however, very few studies have explored their effectiveness. Blended-learning approaches combining face-to-face and online educational sessions have also emerged as facilitating methods of health education. This study aimed to compare the effectiveness of exercises and PNE versus exercise alone in adolescents with chronic neck pain (NP). METHODS A randomized controlled trial with 6-month follow-up was conducted in 2 high schools. Over 8 weeks, a total of 127 adolescents with chronic NP were randomly allocated to either (1) perform functional and region-specific exercises, including generalized neuromuscular control, endurance, and strength exercises, as well as exercises targeting the deep neck flexor and extensor muscles and scapular stabilizer muscles; or (2) perform the same exercise-based intervention plus PNE. Pain intensity (primary outcome), disability, sleep, catastrophizing, fear of movement, self-efficacy, and knowledge of pain neuroscience were assessed at baseline, postintervention, and 6-month follow-up. Neck and scapular muscle endurance and pressure pain thresholds were assessed at baseline and postintervention. Patient's Global Impression of Change was assessed postintervention and at 6-month follow-up. RESULTS There was a significant decrease in pain intensity from baseline to postintervention and from baseline to follow-up in both groups, but there were no between-group differences or interactions between time and groups. These results were similar for the secondary outcomes, except for knowledge of pain neuroscience, for which a significant group and time interaction was found. CONCLUSION Exercise and exercise plus PNE were similarly effective in treating adolescents with chronic NP, and the results were maintained for up to 6 months. Further studies are needed to explore the effect of these interventions for longer follow-ups.
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Affiliation(s)
- Rosa Andias
- School of Health Sciences (ESSUA), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.,Center for Health Technology and Services Research (CINTESIS), Piso 2, Edifício nascente, Porto, Portugal
| | - Pedro Sa-Couto
- CINTESIS@RISE, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Anabela G Silva
- School of Health Sciences (ESSUA), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.,Center for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, Aveiro, Portugal
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Cerveira FR, Matos Coelho MA, Sa-Couto P. Development of the European Portuguese version of the oral health assessment tool: Content validity and reliability study in an elderly population. Spec Care Dentist 2022; 42:623-629. [PMID: 35397193 DOI: 10.1111/scd.12724] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/11/2022] [Accepted: 03/23/2022] [Indexed: 11/28/2022]
Abstract
AIMS Poor oral health is a risk factor for aspiration pneumonia (AP), especially in elderly patients at risk of oropharyngeal dysphagia (OD). In Portugal, available tools to screen oral problems in nursing homes are scarce. The oral health assessment tool (OHAT) is a screening tool that assesses elderly residents' oral health. This study aims to translate and validate the tool for the European Portuguese (EP) context. METHODS The original version was translated into EP throughout a forward-backward translation process. An instruction manual was created. Content of both documents were assessed by a panel of eight experts. The content validity Index was calculated. A reliability study was conducted in three nursing homes by two speech and language therapists in two different moments, separated by 48 h. RESULTS A sample of 30 institutionalized elderly with a mean age of 77 years was analyzed. The EP version and its instruction manual presented a content validity Index greater than 0.88 in all its items. Total scores showed excellent inter-rater and good intra-rater results. CONCLUSION The EP version showed to be a reliable and valid tool for the screening of oral health conditions of institutionalized older adults at risk of OD.
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Affiliation(s)
| | - Maria Assunção Matos Coelho
- School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal.,Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Portugal
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, Aveiro, Portugal
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Brandão MP, Sa-Couto P, Gomes G, Beça P, Reis J. Factors Associated with Cardiovascular Disease Risk among Employees at a Portuguese Higher Education Institution. Int J Environ Res Public Health 2022; 19:848. [PMID: 35055670 PMCID: PMC8775385 DOI: 10.3390/ijerph19020848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 01/15/2023]
Abstract
This study aimed to estimate the prevalence of risk factors for cardiovascular disease (CVD) and to assess the CVD risk (CVDRisk) in a sample of workers at a specific workplace: a higher education institution in Portugal. Data were collected using a questionnaire (e.cuidHaMUs.QueST®) with 345 HEI workers from June 2017-June 2018 with a high response rate (93.3%). Two constructs of risks for CVD were considered: (i) metabolic risk and hypertension (CVDRisk1); and (ii) modifiable behavioural risk (CVDRisk2). Logistic regression analyses were used to establish a relationship between risk indexes/constructs (CVDRisk1 and CVDRisk2) and groups of selected variables. The most prevalent CVD risk factor was hypercholesterolaemia (43.2%). Sixty-eight percent of participants were in the construct CVDRisk1 while almost half of the respondents were in CVDRisk2 (45.2%). The consumption of soft drinks twice a week or more contributed to a significantly increased risk of CVD in CVDRisk1. Lack of regular exercise and lack of daily fruit consumption significantly increased the risk of CVD in CVDRisk2. The challenge to decision makers and the occupational medical community is to incorporate this information into the daily practices of health surveillance with an urgent need for health promotional education campaigns in the workplace.
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Affiliation(s)
- Maria Piedade Brandão
- School of Health [ESSUA], Agras do Crasto-Campus Universitário de Santiago, University of Aveiro, Edifício 30, 3810-193 Aveiro, Portugal
- Center for Health Technology and Services Research [CINTESIS], Campus Universitário de Santiago, University of Aveiro, 3800-193 Aveiro, Portugal
| | - Pedro Sa-Couto
- Department of Mathematics [DMAT], University of Aveiro, 3810-193 Aveiro, Portugal; (P.S.-C.); (J.R.)
- Center for Research and Development in Mathematics and Applications [CIDMA], University of Aveiro, 3810-193 Aveiro, Portugal
| | - Gonçalo Gomes
- Department of Communication and Art [DECA], University of Aveiro, 3810-193 Aveiro, Portugal; (G.G.); (P.B.)
- Research Institute for Design, Media and Culture [ID+], University of Aveiro, 3810-193 Aveiro, Portugal
| | - Pedro Beça
- Department of Communication and Art [DECA], University of Aveiro, 3810-193 Aveiro, Portugal; (G.G.); (P.B.)
- Digital Media and Interaction [DigiMedia], University of Aveiro, 3810-193 Aveiro, Portugal
| | - Juliana Reis
- Department of Mathematics [DMAT], University of Aveiro, 3810-193 Aveiro, Portugal; (P.S.-C.); (J.R.)
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Sá M, Sa-Couto P, Lousada M. Phonological awareness digital program: a randomized controlled study. Rev investig logop 2022. [DOI: 10.5209/rlog.77402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study is to analyze the efficacy of the Phonological Awareness Digital Program (PADP) in typically developing preschool children aged 4 to 6 years. A randomized controlled trial was conducted with a total of 49 children assigned to two groups: the experimental group, EG (n=25) and the delayed control group, CG (n=24). Both groups were assessed before and after the implementation of the PADP. A follow-up study for the experimental group was also performed after two months. Outcome measures of phonological awareness skills (task 1: Syllable segmentation task; task 2: Syllable identification task; task3: Syllable omission task; task 4: Onset-rime units segmentation task; task 5: Phoneme segmentation task; task 6: Phoneme blending task) were evaluated at three separate moments.
The results showed significant improvement in phonological awareness skills for the EG between the first and the second assessments for all the tasks considered. Between the second and third assessment, the results showed a significant improvement for the CG.
The follow-up study also demonstrated the PADP’s efficacy. The PADP has shown to be an effective program in promoting the development of phonological awareness in children. These findings provide evidence for different professionals to use PADP with preschool children.
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Alves AM, Rodrigues A, Sa-Couto P, Simões JL. Effect of an Educational Nursing Intervention on the Mental Adjustment of Patients with Chronic Arterial Hypertension: An Interventional Study. Int J Environ Res Public Health 2021; 19:170. [PMID: 35010430 PMCID: PMC8750213 DOI: 10.3390/ijerph19010170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
The objective of this analytical and interventional prospective quantitative study was to assess the effect of an educational intervention performed by nurses for mental adjustment to chronic disease in patients with hypertension. A convenience sample was studied, composed of 329 participants with chronic hypertension, followed in a primary healthcare unit in the Central Region of Portugal. Data collection was carried out by applying the Mental Adjustment to Disease Scale (MADS) before and 1 month after the educational nursing intervention between September 2017 and February 2018. Prior to the application of the educational intervention, 43.5% of the participants were classified as "unadjusted" in at least one of the subscales of MADS. After the educational intervention, 21.3% of the participants classified as "unadjusted" became "adjusted" in all MADS subscales. The success rate of the intervention varied from 26.9% (in the fatalism subscale) to 44.6% (for the anxious concern subscale). Participants were more likely to be mentally "unadjusted" to hypertension if they lived with other family members, had an active professional situation before the diagnosis of hypertension, still had an active professional situation now, were under 65 years old, had a shorter time to diagnosis (1-2 years), and measured blood pressure less regularly. The educational intervention performed by nurses is relevant for the mental adjustment of hypertensive patients, contributing to increased knowledge, as well as improvement in preventive and self-care practices, facilitating the experience of the health/disease transition process.
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Affiliation(s)
- Ana Margarida Alves
- Inpatient Service of Surgical Specialties, Centro Hospitalar do Baixo Vouga E.P.E., 3810-164 Aveiro, Portugal;
| | - Alexandre Rodrigues
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Center for Health Studies and Research, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Pedro Sa-Couto
- Centre for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, 3810-193 Aveiro, Portugal;
| | - João Lindo Simões
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal
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10
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Tavares J, Sa-Couto P, Reis JD, Boltz M, Capezuti E. The Role of Frailty in Predicting 3 and 6 Months Functional Decline in Hospitalized Older Adults: Findings from a Secondary Analysis. Int J Environ Res Public Health 2021; 18:ijerph18137126. [PMID: 34281063 PMCID: PMC8297187 DOI: 10.3390/ijerph18137126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 01/13/2023]
Abstract
Frailty represents one of the most relevant geriatric syndromes in the 21st century and is a predictor of adverse outcomes in hospitalized older adult, such as, functional decline (FD). This study aimed to examine if frailty, evaluated with the Frailty Index (FI), can predict FD during and after hospitalization (3 and 6 months). Secondary data analysis of a prospective cohort study of 101 hospitalized older adults was performed. The primary outcome was FD at discharge, 3 and 6 months. The FI was created from an original database using 40 health deficits. Functional decline models for each time-point were examined using a binary logistic regression. The prevalence of frailty was 57.4% with an average score of 0.25 (±0.11). Frail patients had significant and higher values for functional decline and social support for all time periods and more hospital readmission in the 3 month period. Multivariable regression analysis showed that FI was a predictor of functional decline at discharge (OR = 1.07, 95% CI = 1.02–1.14) and 3-month (OR = 1.05, 95% CI = 1.01–1.09) but not 6-month (OR = 1.03, 95% CI = 0.99–1.09) follow-up. Findings suggest that frailty at admission of hospitalized older adults can predict functional decline at discharge and 3 months post-discharge.
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Affiliation(s)
- João Tavares
- School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Health Technology and Services Research, 3810-193 Aveiro, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), 3000-232 Coimbra, Portugal
- Correspondence: ; Tel.: +351-234372466
| | - Pedro Sa-Couto
- Department of Mathematics (DMAT), University of Aveiro, 3810-193 Aveiro, Portugal; (P.S.-C.); (J.D.R.)
| | - João Duarte Reis
- Department of Mathematics (DMAT), University of Aveiro, 3810-193 Aveiro, Portugal; (P.S.-C.); (J.D.R.)
| | - Marie Boltz
- College of Nursing, Pennsylvania State University, University Park, PA 10927, USA;
| | - Elizabeth Capezuti
- School of Nursing, Hunter College of the City University of New York, New York, NY 10010, USA;
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11
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Albuquerque L, Valente ARS, Teixeira A, Figueiredo D, Sa-Couto P, Oliveira C. Association between acoustic speech features and non-severe levels of anxiety and depression symptoms across lifespan. PLoS One 2021; 16:e0248842. [PMID: 33831018 PMCID: PMC8031302 DOI: 10.1371/journal.pone.0248842] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 03/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several studies have investigated the acoustic effects of diagnosed anxiety and depression. Anxiety and depression are not characteristics of the typical aging process, but minimal or mild symptoms can appear and evolve with age. However, the knowledge about the association between speech and anxiety or depression is scarce for minimal/mild symptoms, typical of healthy aging. As longevity and aging are still a new phenomenon worldwide, posing also several clinical challenges, it is important to improve our understanding of non-severe mood symptoms' impact on acoustic features across lifetime. The purpose of this study was to determine if variations in acoustic measures of voice are associated with non-severe anxiety or depression symptoms in adult population across lifetime. METHODS Two different speech tasks (reading vowels in disyllabic words and describing a picture) were produced by 112 individuals aged 35-97. To assess anxiety and depression symptoms, the Hospital Anxiety Depression Scale (HADS) was used. The association between the segmental and suprasegmental acoustic parameters and HADS scores were analyzed using the linear multiple regression technique. RESULTS The number of participants with presence of anxiety or depression symptoms is low (>7: 26.8% and 10.7%, respectively) and non-severe (HADS-A: 5.4 ± 2.9 and HADS-D: 4.2 ± 2.7, respectively). Adults with higher anxiety symptoms did not present significant relationships associated with the acoustic parameters studied. Adults with increased depressive symptoms presented higher vowel duration, longer total pause duration and short total speech duration. Finally, age presented a positive and significant effect only for depressive symptoms, showing that older participants tend to have more depressive symptoms. CONCLUSIONS Non-severe depression symptoms can be related to some acoustic parameters and age. Depression symptoms can be explained by acoustic parameters even among individuals without severe symptom levels.
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Affiliation(s)
- Luciana Albuquerque
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
- Center of Health Technology and Services Research, University of Aveiro, Aveiro, Portugal
- Department of Electronics Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- * E-mail:
| | - Ana Rita S. Valente
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
- Department of Electronics Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
| | - António Teixeira
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
- Department of Electronics Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
| | - Daniela Figueiredo
- Center of Health Technology and Services Research, University of Aveiro, Aveiro, Portugal
- School of Health Science, University of Aveiro, Aveiro, Portugal
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications, University of Aveiro, Aveiro, Portugal
- Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Catarina Oliveira
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
- School of Health Science, University of Aveiro, Aveiro, Portugal
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12
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Diniz-Sousa F, Veras L, Boppre G, Sa-Couto P, Devezas V, Santos-Sousa H, Preto J, Vilas-Boas JP, Machado L, Oliveira J, Fonseca H. The Effect of an Exercise Intervention Program on Bone Health After Bariatric Surgery: A Randomized Controlled Trial. J Bone Miner Res 2021; 36:489-499. [PMID: 33295063 DOI: 10.1002/jbmr.4213] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 10/12/2020] [Accepted: 11/04/2020] [Indexed: 12/12/2022]
Abstract
Exercise has been suggested as a therapeutic approach to attenuate bone loss induced by bariatric surgery (BS), but its effectiveness remains unclear. Our aim was to determine if an exercise-training program could induce benefits on bone mass after BS. Eighty-four patients, submitted to gastric bypass or sleeve gastrectomy, were randomized to either exercise (EG) or control group (CG). One month post-BS, EG underwent a 11-month supervised multicomponent exercise program, while CG received only standard medical care. Patients were assessed before BS and at 1, 6, and 12 months post-BS for body composition, areal bone mineral density (BMD), bone turnover markers, calciotropic hormones, sclerostin, bone material strength index, muscle strength, and daily physical activity. A primary analysis was conducted according to intention-to-treat principles and the primary outcome was the between-group difference on lumbar spine BMD at 12 months post-BS. A secondary analysis was also performed to analyze if the exercise effect depended on training attendance. Twelve months post-BS, primary analysis results revealed that EG had a higher BMD at lumbar spine (+0.024 g∙cm-2 [95% confidence interval (CI) 0.004, 0.044]; p = .015) compared with CG. Among total hip, femoral neck, and 1/3 radius secondary outcomes, only 1/3 radius BMD improved in EG compared with CG (+0.013 g∙cm-2 [95% CI 0.003, 0.023]; p = .020). No significant exercise effects were observed on bone biochemical markers or bone material strength index. EG also had a higher lean mass (+1.5 kg [95% CI 0.1, 2.9]; p = .037) and higher number of high impacts (+51.4 [95% CI 6.6, 96.1]; p = .026) compared with CG. In addition, secondary analysis results suggest that exercise-induced benefits may be obtained on femoral neck BMD but only on those participants with ≥50% exercise attendance compared with CG (+5.3% [95% CI 2.0, 8.6]; p = .006). Our findings suggest that an exercise program is an effective strategy to ameliorate bone health in post-BS patients. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Florêncio Diniz-Sousa
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Lucas Veras
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Giorjines Boppre
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics, Aveiro University, Aveiro, Portugal
| | - Vítor Devezas
- General Surgery Department, São João Medical Center, Porto, Portugal
| | - Hugo Santos-Sousa
- General Surgery Department, São João Medical Center, Porto, Portugal
| | - John Preto
- General Surgery Department, São João Medical Center, Porto, Portugal
| | - João Paulo Vilas-Boas
- Center of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.,Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Porto, Portugal
| | - Leandro Machado
- Center of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.,Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Porto, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Hélder Fonseca
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
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13
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Brandão MP, Sa-Couto P, Gomes G, Beça P. Description of an integrated e-health monitoring system in a Portuguese higher education institution: the e.cuidHaMUstm program. Glob Health Promot 2021; 29:65-73. [PMID: 33530849 DOI: 10.1177/1757975920984222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The World Health Organization and the International Labour Organization recognize that workplace health is not only affected by occupational hazards, but is mainly affected by social determinants and individual factors. An accelerated rise in noncommunicable diseases has fostered the importance of creating supportive environments and encouraging healthy behaviours. Therefore, an operational approach to making workplaces healthy and sustainable is needed. This paper describes the development of an e-Health monitoring program entitled 'Integrated eHealth Monitoring System for Health Management in Universities' (e.cuidHaMUsTM) as a possible solution to that operational approach. METHODS We developed the program e.cuidHaMUsTM that proposes to detect risk behaviours related to noncommunicable diseases and to implement problem-solving measures by establishing a health-promoting workspace in a Portuguese higher education institution. Based on the 'I-Change' conceptual model, our program provides personalized feedback; improves health-related knowledge, attitude and good practices; and encourages actions to promote healthy lifestyles through individual health capacitation. Focusing on evaluation as an activity that generates knowledge, the e.cuidHaMUsTM program aggregates all the relevant health information, shares the results with decision-makers and evaluates health-related policy changes in the workplace. DISCUSSION This paper presents the design of the e.cuidHaMUsTM program, the development of an eHealth web platform to share information between the different stakeholders, and a questionnaire to evaluate the health status of higher education institution workers (e.cuidHaMUs.QueST®). Also, the procedures for data collection and analysis are outlined. The e.cuidHaMUsTM program can enhance health surveillance through cross-sectional and longitudinal studies and provide scientific evidence to support the envisioned interventions and promotions of healthy lifestyles. This program is an effort to incorporate a holistic culture of health-promoting workspace in higher education institution policies.
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Affiliation(s)
- Maria Piedade Brandão
- ESSUA - Health School, University of Aveiro, Aveiro, Portugal.,CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto; University of Aveiro, Aveiro, Potugal
| | - Pedro Sa-Couto
- CIDMA - Center for Research and Development in Mathematics and Applications.,DMA - Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Gonçalo Gomes
- DECA - Department of Communication and Art, University of Aveiro, Aveiro, Portugal.,ID+ - Research Institute for Design, Media and Culture, University of Aveiro, Aveiro, Portugal
| | - Pedro Beça
- DECA - Department of Communication and Art, University of Aveiro, Aveiro, Portugal.,DIGIMEDIA - Digital Media and Interaction, University of Aveiro, Aveiro, Portugal
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14
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Simões JL, Sa-Couto P, Simões CJ, Oliveira C, Dos Santos NM, Mateus J, Magalhães CP, Martins M. Nursing workload assessment in an intensive care unit: A 5-year retrospective analysis. J Clin Nurs 2021; 30:528-540. [PMID: 33238046 DOI: 10.1111/jocn.15570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 11/27/2022]
Abstract
AIMS To study the correlation between the workload of intensive care nursing teams and the sociodemographic, anthropometric and clinical characteristics of patients in critical condition in a Portuguese Intensive Care Unit (ICU) during a 5-year period. BACKGROUND Currently, indices of nursing workload quantification are one of the resources used for planning and evaluating ICUs. Evidence shows that there are several factors related to critical patients and their hospitalisation which potentially influence the nursing workload. DESIGN Retrospective cohort analysis of a health record database from adult patients admitted to a Portuguese ICU between 1 January 2015-31 December 2019. METHODS Simplified Therapeutic Intervention Scoring System (TISS-28) scores of 730 adult patients. Three TISS-28 assessments were considered: first assessment, last assessment and average. The STROBE guidelines were used in reporting this study. RESULTS The TISS-28 has an average of 34.2 ± 6.9 points at admission, which is considered a high nursing workload. A somewhat lower result was found for the discharge and average assessments. It shows that basic activities accounted for the highest percentage of time spent (38.0%), followed by the cardiovascular support category (26.5%). The TISS-28 shows consistent results throughout the study period, despite a small trend reduction in the last 2 years. CONCLUSIONS Lower workloads were found for age ≤44 years and with a shorter length of stay. Higher workload was more probable in patients classified in Cullen Class IV (OR = 2.5) and with a normal to higher weight percentile (OR = 1.9 and 1.5, respectively). RELEVANCE TO CLINICAL PRACTICE Knowledge of the factors influencing the nursing workload facilitates the implementation of rules to improve performance in nursing interventions, based on the redefinition of care priorities, increased productivity, human resources management and reduction of additional costs to the organisation, related to possible adverse events, among others.
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Affiliation(s)
- João Lindo Simões
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Pedro Sa-Couto
- Department of Mathematics (DMAT), Centre for Research and Development in Mathematics and Applications (CIDMA), University of Aveiro, Aveiro, Portugal
| | - Carlos Jorge Simões
- Intensive Care Unit, Centro Hospitalar do Baixo Vouga, E.P.E., Aveiro, Portugal
| | - Cátia Oliveira
- Intensive Care Unit, Centro Hospitalar do Baixo Vouga, E.P.E., Aveiro, Portugal
| | | | - José Mateus
- Intensive Care Unit, Centro Hospitalar do Baixo Vouga, E.P.E., Aveiro, Portugal
| | - Carlos Pires Magalhães
- School of Health Sciences, Polytechnic Institute of Bragança and Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal
| | - Matilde Martins
- School of Health Sciences, Polytechnic Institute of Bragança and Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal
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15
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Bohn L, Sa-Couto P, Ramoa Castro A, Ribeiro F, Oliveira J. Effects of a short health education intervention on physical activity, arterial stiffness and cardiac autonomic function in individuals with moderate-to-high cardiovascular risk. Patient Educ Couns 2020; 103:1856-1863. [PMID: 32173214 DOI: 10.1016/j.pec.2020.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 03/02/2020] [Accepted: 03/06/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study evaluated the effects of a short health education and counseling intervention program, in a primary healthcare setting, on daily physical activity (PA), arterial stiffness, and cardiac autonomic function in individuals with moderate-to-high risk of cardiovascular disease. METHODS This was a parallel-group study with a 4-month-long intervention, plus 8 months of follow-up. 164 individuals with moderate-to-high cardiovascular risk were allocated to either an intervention (n = 87) or a control group (n = 77). The intervention consisted of 3 walking and face-to-face group sessions plus text messages. Primary outcome was daily PA (sedentary time, light and moderate-to-vigorous PA, all in min/day); secondary outcomes were arterial stiffness i.e., carotid-femoral pulse wave velocity (cfPWV, m/s)] and cardiac autonomic function [(i.e., standard deviation of all N-N intervals (SDNN, ms) and absolute high frequency (HF, ms2)]. RESULTS There were not significant group*time interactions for sedentary time [-7.4 (7.6); p = 0.331)], light PA [4.4 (6.4); p = 0.491] or moderate-to-vigorous PA [0.1 (2.6); p = 0.938]. Considering secondary outcomes, there were not significant group*time interactions for cfPWV [0.09 (0.18); p = 0.592], Ln_SDNN [0.09 (0.06); p = 0.148], or Ln_HF [0.16 (0.14); p = 0.263]. CONCLUSION The program did not improve daily PA, arterial stiffness, or the autonomic cardiac function. PRACTICE IMPLICATIONS Primary care staff should consider longer or other types of intervention to improve daily PA.
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Affiliation(s)
- Lucimére Bohn
- Research Centre in Physical Activity, Health and Leisure. Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450, Porto, Portugal.
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, Aveiro, Portugal.
| | | | - Fernando Ribeiro
- School of Health Sciences and Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal.
| | - José Oliveira
- Faculty of Sport, University of Porto, Research Centre in Physical Activity, Health and Leisure, Porto, Portugal.
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16
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Reis A, Santos M, Furtado I, Cruz C, Sa-Couto P, Queirós A, Almeida L, Rocha N. Disability and its clinical correlates in pulmonary hypertension measured through the World Health Organization Disability Assessment Schedule 2.0: a prospective, observational study. ACTA ACUST UNITED AC 2019; 45:e20170355. [PMID: 31166372 PMCID: PMC6733722 DOI: 10.1590/1806-3713/e20170355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 08/12/2018] [Indexed: 11/22/2022]
Abstract
Objective: To characterise the degree of disability in pulmonary hypertension (PH) patients based on the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0). Method: A prospective and observational study of patients with documented PH (N = 46). Patients completed the WHODAS 2.0 questionnaire during a scheduled routine clinical visit, and their demographic and clinical characteristics were retrieved from electronic medical records (EMR). In subsequent visits, selected clinical variables were registered to assess disease progression. Results: WHODAS 2.0 scores were indicative of mild to moderate disability for the domains of mobility (22.0 ± 23.2), life activities (23.7 ± 25.5), and participation in society (17.2 ± 15.9), as well as total WHODAS 2.0 score (15.3 ± 15.2). For the domains of cognition (9.1 ± 14.1), self-care (8.3 ± 14.4), and interpersonal relationships (11.7 ± 15.7), scores were lower. Disability scores were, generally, proportional to the PH severity. The main baseline correlates of disability were World Health Organisation (WHO) functional class, fatigue, dyspnoea, 6-minute walking distance (6MWD), and N-terminal pro b-type natriuretic peptide (NTproBNP). Baseline WHODAS 2.0 scores showed significant associations with disease progression. However, this effect was not transversal to all domains, with only a few domains significantly associated with disease progression variables. Conclusions: This PH population shows mild disability, with higher degree of disability in the domains of mobility and life activities. This study is the first one to assess disability in PH using WHODAS 2.0. Further studies should apply this scale to larger PH populations with suitable representations of more severe PH forms.
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Affiliation(s)
- Abílio Reis
- . Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
| | - Mário Santos
- . Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal.,. Cardiology Service, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal.,. Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of Porto, Porto, Portugal
| | - Inês Furtado
- . Internal Medicine Service, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
| | - Célia Cruz
- . Internal Medicine Service, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
| | - Pedro Sa-Couto
- . Center for Research and Development in Mathematics and Applications, Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Alexandra Queirós
- . School of Health, University of Aveiro, Aveiro, Portugal.,. Institute of Electronics and Telematics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
| | - Luís Almeida
- . MedInUP, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Nelson Rocha
- . Institute of Electronics and Telematics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal.,. Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
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17
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Lousada M, Sa-Couto P, Sutre D, Figueiredo C, Fazenda M, Lousada MJ, Valente AR. Validity and reliability of the Intelligibility in Context Scale: European Portuguese version. Clin Linguist Phon 2019; 33:1125-1138. [PMID: 30966829 DOI: 10.1080/02699206.2019.1589579] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 05/19/2023]
Abstract
The purpose of the study was to evaluate the validity, reliability, sensitivity and specificity of the European-Portuguese version of the Intelligibility in Context Scale (ICS-EP). Seventy-six children (age: M = 60.6, SD = 8.1 months), 25 having a parent or teacher concern about how they talked and 51 with no concern, were assessed with the phonetic-phonological test (TFF-ALPE) to calculate the following severity measures: percentage of phonemes correct (PPC), percentage of consonants correct (PCC), and percentage of vowels correct (PVC). Parents also filled out a questionnaire about their child's development (e.g. concern about how the child talks). The ICS was then completed by parents to estimate their children's intelligibility with different communicative partners. The results showed that item-level scores were different according to communicative partners. The mean ICS score for the whole sample was 4.5 (SD = 0.6), showing that children were "usually" to "always" intelligible. The ICS had excellent internal consistency (α = 0.96). Children with parental concern about their speech presented significantly lower mean scores (M = 3.91, SD = 0.59) than children without parental concerns (M = 4.78, SD = 0.36). There was a positive correlation between the ICS scores and PPC (r = .655), PCC (r = .654), and PVC (r = .588). A simple linear model was also obtained between the ICS mean score and the severity measures analyzed. High values were obtained for sensitivity (0.80) and specificity (0.84), using a cut-off point of 4.36. We conclude that the ICS-EP has good psychometric properties, suggesting it to be a valid tool for estimating children's intelligibility when talking with different communicative partners. Therefore, this version of the ICS can be used as a screening measure for children's speech intelligibility.
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Affiliation(s)
- Marisa Lousada
- School of Health Sciences (ESSUA), Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro , Aveiro , Portugal
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro , Aveiro , Portugal
| | - Diogo Sutre
- School of Health Sciences (ESSUA), University of Aveiro , Aveiro , Portugal
| | | | - Marisa Fazenda
- Associação de Beneficência Popular de Gouveia , Gouveia , Portugal
| | | | - Ana Rita Valente
- School of Health Sciences (ESSUA), University of Aveiro , Aveiro , Portugal
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18
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Reis A, Santos M, Vicente M, Furtado I, Cruz C, Melo A, Carvalho L, Gonçalves F, Sa-Couto P, Almeida L. Health-Related Quality of Life in Pulmonary Hypertension and Its Clinical Correlates: A Cross-Sectional Study. Biomed Res Int 2018; 2018:3924517. [PMID: 29750153 PMCID: PMC5884279 DOI: 10.1155/2018/3924517] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/18/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Health-related quality of life (HRQoL) impairment is common in pulmonary hypertension (PH), but its clinical predictors are not well established. This study aims to characterize the HRQoL of patients with pulmonary arterial hypertension (PAH) and other precapillary forms of PH (pcPH) and to explore its clinical correlates. MATERIALS AND METHODS A cross-sectional, observational study of patients with documented PAH and other forms of pcPH. Patients completed two patient-reported outcome measures (PROM): Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) and Nottingham Health Profile (NHP). Clinical characteristics were retrieved from electronic medical records. RESULTS Mean CAMPHOR and NHP scores for the study population were indicative of a moderate HRQoL impairment. Patients in World Health Organisation Functional Classes (WHO FC) III/IV showed significantly worse HRQoL. The main clinical correlates of HRQoL were WHO FC, 6-minute walking distance (6MWD), and Borg dyspnoea index. Overall quality of life (QoL), assessed through CAMPHOR's QoL domain, showed patterns comparable to HRQoL measured by both instruments. CONCLUSIONS HRQoL, measured by two different PROMs, is impaired in Portuguese patients with PAH and other forms of pcPH, particularly in patients with increased disease severity. WHO FC, 6MWD, and Borg dyspnoea index are highly correlated with HRQoL and QoL.
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Affiliation(s)
- Abílio Reis
- Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
| | - Mário Santos
- Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
- Cardiology Service, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of Porto, Porto, Portugal
| | - Margarida Vicente
- Department of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Inês Furtado
- Internal Medicine Service, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
| | - Célia Cruz
- Internal Medicine Service, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
| | - Alzira Melo
- Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
| | - Luísa Carvalho
- Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
- Internal Medicine Service, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
| | - Fabienne Gonçalves
- Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
- Internal Medicine Service, Medicine Department, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications, Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Luís Almeida
- MedInUP, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal
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Silva AG, Sa-Couto P, Queirós A, Neto M, Rocha NP. Pain, pain intensity and pain disability in high school students are differently associated with physical activity, screening hours and sleep. BMC Musculoskelet Disord 2017; 18:194. [PMID: 28511650 PMCID: PMC5434614 DOI: 10.1186/s12891-017-1557-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 05/06/2017] [Indexed: 12/31/2022] Open
Abstract
Background Studies exploring the association between physical activity, screen time and sleep and pain usually focus on a limited number of painful body sites. Nevertheless, pain at different body sites is likely to be of different nature. Therefore, this study aims to explore and compare the association between time spent in self-reported physical activity, in screen based activities and sleeping and i) pain presence in the last 7-days for 9 different body sites; ii) pain intensity at 9 different body sites and iii) global disability. Methods Nine hundred sixty nine students completed a questionnaire on pain, time spent in moderate and vigorous physical activity, screen based time watching TV/DVD, playing, using mobile phones and computers and sleeping hours. Univariate and multivariate associations between pain presence, pain intensity and disability and physical activity, screen based time and sleeping hours were investigated. Results Pain presence: sleeping remained in the multivariable model for the neck, mid back, wrists, knees and ankles/feet (OR 1.17 to 2.11); moderate physical activity remained in the multivariate model for the neck, shoulders, wrists, hips and ankles/feet (OR 1.06 to 1.08); vigorous physical activity remained in the multivariate model for mid back, knees and ankles/feet (OR 1.05 to 1.09) and screen time remained in the multivariate model for the low back (OR = 2.34. Pain intensity: screen time and moderate physical activity remained in the multivariable model for pain intensity at the neck, mid back, low back, shoulder, knees and ankles/feet (Rp2 0.02 to 0.04) and at the wrists (Rp2 = 0.04), respectively. Disability showed no association with sleeping, screen time or physical activity. Conclusions This study suggests both similarities and differences in the patterns of association between time spent in physical activity, sleeping and in screen based activities and pain presence at 8 different body sites. In addition, they also suggest that the factors associated with the presence of pain, pain intensity and pain associated disability are different.
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Affiliation(s)
- Anabela G Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal. .,Center for Health Technology and Services Research (CINTESIS), Piso 2, edifício nascente, Rua Dr. Plácido da Costa, s/n, 4200-450, Porto, Portugal.
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, Aveiro, Portugal
| | - Alexandra Queirós
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.,Institute of Electronics and Telematics Engineering of Aveiro (IEETA), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - Maritza Neto
- Primary Healthcare Center, Av. Dr. Rocha Madail,S/N, Ílhavo, Portugal
| | - Nelson P Rocha
- Institute of Electronics and Telematics Engineering of Aveiro (IEETA), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.,Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
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de Almeida Tavares JP, Sa-Couto P, Boltz M, Capezuti E. Portuguese Older Adults Presenting at the Emergency Department: Predictive Validity of the Identification of Seniors at Risk (ISAR) Tool. J Gerontol Nurs 2017; 43:1-7. [PMID: 28399314 DOI: 10.3928/00989134-20170405-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/02/2017] [Indexed: 11/20/2022]
Abstract
Following an emergency department (ED) visit, older adults are more likely to experience poorer outcomes than younger adults. It is crucial to identify older patients using a validated tool. One of the most studied tools is the Identification of Seniors at Risk (ISAR), which is used to identify older adults at risk of adverse outcomes after ED admission. The purpose of the current study was to examine the sensitivity, specificity, and interrater reliability of the Portuguese version of the ISAR when considering early (30 days) and late (180 days) outcomes. Four hundred two older adults presenting in EDs from January 2013 to August 2014 were prospectively enrolled and surveyed. The ISAR threshold (cutoff =2) presented a better compromise between sensitivity (81.8% to 88.7%) and specificity (14.7% to 28.1%) when compared to cutoffs =1 or =3, respectively. Interrater reliability results were very good (0.81 to 0.94). Overall, the Portuguese ISAR appears worthwhile for screening older adults at risk in EDs. [Journal of Gerontological Nursing, xx(x), xx-xx.].
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Loureiro CC, Sa-Couto P, Todo-Bom A, Bousquet J. Cluster analysis in phenotyping a Portuguese population. Rev Port Pneumol (2006) 2015; 21:S2173-5115(15)00138-4. [PMID: 26344641 DOI: 10.1016/j.rppnen.2015.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/08/2015] [Accepted: 07/17/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Unbiased cluster analysis using clinical parameters has identified asthma phenotypes. Adding inflammatory biomarkers to this analysis provided a better insight into the disease mechanisms. This approach has not yet been applied to asthmatic Portuguese patients. AIM To identify phenotypes of asthma using cluster analysis in a Portuguese asthmatic population treated in secondary medical care. METHODS Consecutive patients with asthma were recruited from the outpatient clinic. Patients were optimally treated according to GINA guidelines and enrolled in the study. Procedures were performed according to a standard evaluation of asthma. Phenotypes were identified by cluster analysis using Ward's clustering method. RESULTS Of the 72 patients enrolled, 57 had full data and were included for cluster analysis. Distribution was set in 5 clusters described as follows: cluster (C) 1, early onset mild allergic asthma; C2, moderate allergic asthma, with long evolution, female prevalence and mixed inflammation; C3, allergic brittle asthma in young females with early disease onset and no evidence of inflammation; C4, severe asthma in obese females with late disease onset, highly symptomatic despite low Th2 inflammation; C5, severe asthma with chronic airflow obstruction, late disease onset and eosinophilic inflammation. CONCLUSIONS In our study population, the identified clusters were mainly coincident with other larger-scale cluster analysis. Variables such as age at disease onset, obesity, lung function, FeNO (Th2 biomarker) and disease severity were important for cluster distinction.
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Affiliation(s)
- C C Loureiro
- Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Centre of Pneumology, Faculty of Medicine, University of Coimbra, Portugal.
| | - P Sa-Couto
- Center for Research and Development in Mathematics and Applications, Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - A Todo-Bom
- Immunoallergology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Centre of Pneumology, Faculty of Medicine, University of Coimbra, Portugal
| | - J Bousquet
- University Hospital Arnaud de Villeneuve, Montpellier, France; Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology Team, Villejuif, France
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Alvarelhão J, Queirós A, Sa-Couto P, Rocha NP. Goal setting for cerebral palsy children in context therapy: improve reliability when linking to ICF. Stud Health Technol Inform 2015; 217:886-891. [PMID: 26294579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The linking process of information to ICF is a common task in different strategies used in rehabilitation practise but is a time consuming process mainly due to reliability issues. This work aims to developed additional rules to those already published in order to improve reliability of the linking process to ICF. The results are encouraging and this work could help to develop information technologies tools for facilitate this process.
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Affiliation(s)
| | | | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications, University of Aveiro
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Lã FMB, Sundberg J, Howard DM, Sa-Couto P, Freitas A. Effects of the menstrual cycle and oral contraception on singers' pitch control. J Speech Lang Hear Res 2012; 55:247-261. [PMID: 22199189 DOI: 10.1044/1092-4388(2011/10-0348)] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE Difficulties with intonation and vibrato control during the menstrual cycle have been reported by singers; however, this phenomenon has not yet been systematically investigated. METHOD A double-blind randomized placebo-controlled trial assessing effects of the menstrual cycle and use of a combined oral contraceptive pill (OCP) on pitch control in singing is presented. Audio-electrolaryngograph recordings were made and blood samples were taken from 9 singers in each of the 3 phases of the menstrual cycle both under the placebo and the OCP conditions for a total of 6 months. Participants sang an exercise consisting of an ascending octave followed by a descending major triad, starting on pitches F4 and B4. Pitch control was assessed in terms of the octave's deviations from pure intonation and of the vibrato rate and extent. RESULTS Significant differences were found between the 3 phases of the cycle regarding octave size only for pitch F5 during OCP use. Significant vibrato rate differences between placebo and OCP conditions were found only for pitch F5. CONCLUSION OCP use may have an effect on pitch control in singers. Possible explanations point to a complex interaction between hormonal milieu and pitch control, enhancing the need for longitudinal studies.
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