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Santos AJ, Kislaya I, Matias-Dias C, Machado A. Health beliefs and attitudes toward Influenza and COVID-19 vaccination in Portugal: a study using a mixed-method approach. Front Public Health 2024; 11:1331136. [PMID: 38312138 PMCID: PMC10834706 DOI: 10.3389/fpubh.2023.1331136] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/21/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Vaccination is one of the most effective population strategies to prevent infectious diseases and mitigate pandemics, and it is important to understand vaccine uptake determinants since vaccine hesitancy has been increasing for the past few decades. The Health Belief Model (HBM) has been widely used for understanding vaccination behavior. The current study aimed to assess influenza vaccine (IV) non-uptake and attitudes toward COVID-19 vaccination, two important respiratory diseases with similar symptoms, and routes of transmission in the Portuguese population. Methods We conducted a cross-sectional study using a panel sample of randomly chosen Portuguese households. A total of 1,050 individuals aged 18 years and over responded to a telephone or online questionnaire. Through a mixed-method approach, we employed thematic content analysis to describe reasons for not taking the IV, considering the HBM dimensions, and quantitative statistical analysis to estimate IV and COVID-19 vaccine coverage. Results The IV uptake for the overall population was 30.7% (CI 95%: 26.5, 35.2). Susceptibility was found to be a main factor for IV non-uptake, followed by barriers, such as stock availability and fear of adverse effects. The uptake of the COVID-19 vaccine was very high in the study population (83.1%, CI 95%: 13.6%-20.9%). There was a high perception of COVID-19-associated severity and fear of the consequences. Individuals who reported IV uptake seemed to perceive a higher severity of COVID-19 and a higher benefit of taking the COVID-19 vaccine for severe complications. Discussion Thus, the population does not seem to consider influenza to be a health risk, as opposed to COVID-19, which is considered to be a possibly severe disease. The association between IV uptake and COVID-19 perceptions highlights that an overall attitude toward vaccination in general may be an important individual determinant.
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Affiliation(s)
- Ana João Santos
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Irina Kislaya
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, Lisbon, Portugal
| | - Carlos Matias-Dias
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Ausenda Machado
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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Santos AJ, Braz P, Folha T, Machado A, Matias-Dias C. Parents of Children Diagnosed with Congenital Anomalies or Cerebral Palsy: Identifying Needs in Interaction with Healthcare Services. Children (Basel) 2023; 10:1051. [PMID: 37371282 DOI: 10.3390/children10061051] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/25/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
The changes deriving from the birth of a child with a congenital anomaly (CA) or cerebral palsy (CP) imply, in many cases, an increased interaction with health services. A cross-sectional descriptive study was conducted with a convenience sample of parents of children diagnosed with four groups of CA (severe heart anomalies, spina bifida, orofacial clefts, and Down syndrome) and/or CP. A semistructured online questionnaire to be answered by parents was sent by web link to focal points of five parent associations and professional institutions. Data were analyzed through thematic content analysis (open-ended questions) and descriptive analysis (closed-ended questions). The results indicate consistency of responses of parents of children diagnosed with different conditions, namely with respect to the perception of health services and professionals. Closed and open-ended responses indicated three main topics in the interaction between health services and parenthood: information, coordinated and integrated responses, and support. The less positive outcomes suggest unmet information needs, while positive aspects include confidence in the care provided and the "training" received from health professionals.
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Affiliation(s)
- Ana João Santos
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
- Comprehensive Health Research Center, National School of Public Health (ENSP), University of Lisbon, 1600-560 Lisboa, Portugal
| | - Paula Braz
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
| | - Teresa Folha
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
| | - Ausenda Machado
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
- Comprehensive Health Research Center, National School of Public Health (ENSP), University of Lisbon, 1600-560 Lisboa, Portugal
| | - Carlos Matias-Dias
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal
- Comprehensive Health Research Center, National School of Public Health (ENSP), University of Lisbon, 1600-560 Lisboa, Portugal
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Gaio V, Santos AJ, Amaral P, Faro Viana J, Antunes I, Pacheco V, Paiva A, Pinto Leite P, Antunes Gonçalves L, Araújo L, Silva A, Dias C, Kislaya I, Nunes B, Machado A. COVID-19 vaccine effectiveness among healthcare workers: a hospital-based cohort study. BMJ Open 2023; 13:e068996. [PMID: 37130692 PMCID: PMC10163328 DOI: 10.1136/bmjopen-2022-068996] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES Healthcare workers (HCWs) were the first to be prioritised for COVID-19 vaccination. This study aims to estimate the COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 symptomatic infection among HCWs in Portuguese hospitals. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS We analysed data from HCWs (all professional categories) from three central hospitals: one in the Lisbon and Tagus Valley region and two in the central region of mainland Portugal, between December 2020 and March 2022. VE against symptomatic SARS-CoV-2 infection was estimated as one minus the confounder adjusted HRs by Cox models considering age group, sex, self-reported chronic disease and occupational exposure to patients diagnosed with COVID-19 as adjustment variables. RESULTS During the 15 months of follow-up, the 3034 HCWs contributed a total of 3054 person-years at risk, and 581 SARS-CoV-2 events occurred. Most participants were already vaccinated with a booster dose (n=2653, 87%), some are vaccinated with only the primary scheme (n=369, 12.6%) and a few remained unvaccinated (n=12, 0.4%) at the end of the study period. VE against symptomatic infection was 63.6% (95% CI 22.6% to 82.9%) for HCWs vaccinated with two doses and 55.9% (95% CI -1.3% to 80.8%) for HCWs vaccinated with one booster dose. Point estimate VE was higher for individuals with two doses taken between 14 days and 98 days (VE=71.9%; 95% CI 32.3% to 88.3%). CONCLUSION This cohort study found a high COVID-19 VE against symptomatic SARS-CoV-2 infection in Portuguese HCWs after vaccination with one booster dose, even after Omicron variant occurrence. The small sample size, the high vaccine coverage, the very low number of unvaccinated individuals and the few events observed during the study period contributed to the low precision of the estimates.
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Affiliation(s)
- Vânia Gaio
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Ana João Santos
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | | | | | - Isabel Antunes
- Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Vânia Pacheco
- Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Artur Paiva
- Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
- University of Coimbra Institute for Clinical and Biomedical Research, Coimbra, Portugal
| | - Pedro Pinto Leite
- Directorate of Information and Analysis, Direção-Geral da Saúde, Lisbon, Portugal
| | | | - Lucília Araújo
- Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Adriana Silva
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Carlos Dias
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Irina Kislaya
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Baltazar Nunes
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Ausenda Machado
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
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Marcus E, Latos-Bielenska A, Jamry-Dziurla A, Barišić I, Cavero-Carbonell C, Den Hond E, Garne E, Genard L, Santos AJ, Lutke LR, Matias Dias C, Neergaard Pedersen C, Neville AJ, Niemann A, Odak L, Pierini A, Rico J, Rissmann A, Rankin J, Morris JK. Information needs of parents of children with congenital anomalies across Europe: a EUROlinkCAT survey. BMC Pediatr 2022; 22:657. [PMID: 36368959 PMCID: PMC9652126 DOI: 10.1186/s12887-022-03734-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Parents of children who have a congenital anomaly can experience significant worry about their child's health. Access to clear, helpful, and trustworthy information can provide a valuable source of support. In this study the aim was to explore the information needs of parents/carers of children with congenital anomalies across Europe. METHOD A cross-sectional online survey was developed in nine languages to measure parents' information needs, including: (1) the 'helpfulness'/'trustworthiness' of information received from eight relevant sources, and (2) overall satisfaction with information received. Parents/carers of children (0-10 years) with cleft lip, spina bifida, congenital heart defect [CHD] requiring surgery, and/or Down syndrome were recruited online via relevant organisations in 10 European countries from March-July 2021. Quantitative analyses using multivariable logistic regressions were performed. RESULTS One thousand seventy parents/carers of children with a cleft lip (n = 247), spina bifida (n = 118), CHD (n = 366), Down syndrome (n = 281), and Down syndrome with CHD (n = 58) were recruited in Poland (n = 476), the UK (n = 120), Germany (n = 97), the Netherlands/Belgium (n = 74), Croatia (n = 68), Italy (n = 59), other European countries (n = 92), and not specified/non-European countries (n = 84). Most participants were mothers (92%) and aged 31-40 years (71%). Participants were most likely to rate support groups (63%), patient organisations (60%), specialist doctors/nurses (58%), and social media (57%) as 'very helpful' information sources. 'Very trustworthy' ratings remained high for specialist doctors/nurses (61%), however, they declined for support groups (47%), patient organisations (48%), and social media (35%). Germany had the highest proportion of participants who were 'very satisfied' (44%, 95% CI = 34%-54%) with information, whereas this percentage was lowest in Croatia (11%, 95% CI = 3%-19%) and Poland (15%, 95% CI = 11%-18%). Parents of children with Down syndrome had significantly lower satisfaction ratings than parents of children with CHD; 13% (95% CI = 8%-18%) reported being 'very satisfied' compared to 28% (95% CI = 23%-33%) in the CHD group. CONCLUSIONS Findings suggest that informal sources of information (e.g. support groups) are of value to parents, however, they are not deemed as trustworthy as specialist medical sources. Satisfaction ratings differed across countries and by anomaly, and were particularly low in Croatia and Poland, as well as for parents of children with Down syndrome, which warrants further investigation.
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Affiliation(s)
- Elena Marcus
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.
| | - Anna Latos-Bielenska
- Chair and Department of Medical Genetics, Poznan University of Medical Sciences, Collegium Maius, Fredry 10, 61-701, Poznań, Poland
| | - Anna Jamry-Dziurla
- Chair and Department of Medical Genetics, Poznan University of Medical Sciences, Collegium Maius, Fredry 10, 61-701, Poznań, Poland
| | - Ingeborg Barišić
- Centre of Excellence for Reproductive and Regenerative Medicine, Children's Hospital Zagreb, Medical School University of Zagreb, Ul. Vjekoslava Klaića 16, 10000, Zagreb, Croatia
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Fundacio per al Foment de la Investigacio Sanitaria i Biomedica, Av. de Catalunya, 21, 46020, València, Spain
| | - Elly Den Hond
- Provincial Institute for Hygiene (PIH), Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Ester Garne
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Lucas Genard
- Provincial Institute for Hygiene (PIH), Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Ana João Santos
- Department of Epidemiology, National Institute of Health Doctor Ricardo Jorge, Av. Padre Cruz, 1600-609, Lisbon, Portugal
| | - LRenée Lutke
- Department of Genetics, University Medical Center, University of Groningen, 9712 CP, Groningen, Netherlands
| | - Carlos Matias Dias
- Department of Epidemiology, National Institute of Health Doctor Ricardo Jorge, Av. Padre Cruz, 1600-609, Lisbon, Portugal
| | - Christina Neergaard Pedersen
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Amanda J Neville
- IMER Registry (Emilia Romagna Registry of Birth Defects), University of Ferrara and Azienda Ospedaliero Universitaria Di Ferrara, Via Aldo Moro, 8, 44124, Ferrara, Italy
| | - Annika Niemann
- Medical Faculty, Malformation Monitoring Centre Saxony-Anhalt, Otto-Von-Guericke-University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Ljubica Odak
- Centre of Excellence for Reproductive and Regenerative Medicine, Children's Hospital Zagreb, Medical School University of Zagreb, Ul. Vjekoslava Klaića 16, 10000, Zagreb, Croatia
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Via Giuseppe Moruzzi, 1, 56124, Pisa, Italy
| | - Juan Rico
- Rare Diseases Research Unit, Fundacio per al Foment de la Investigacio Sanitaria i Biomedica, Av. de Catalunya, 21, 46020, València, Spain
| | - Anke Rissmann
- Medical Faculty, Malformation Monitoring Centre Saxony-Anhalt, Otto-Von-Guericke-University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK
| | - Joan K Morris
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
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Kislaya I, Rodrigues AP, Silva S, Santos AJ, Matias Dias C, Nunes B, Machado A. Impact of booster vaccination on COVID-19 outcomes in Portuguese population aged 80 or more years old. Eur J Public Health 2022. [PMCID: PMC9594436 DOI: 10.1093/eurpub/ckac129.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Vaccination is essential to control SARS-CoV-2 transmission and complications. The study aimed to estimate the number of SARS-CoV-2 infections, COVID-19 hospitalizations and deaths averted by booster vaccination in Portuguese population aged 80 or more years old. Methods We developed an ecological study for the period of the Omicron variant of concern predominance (week 2 to week 16, 2022). Data on vaccine coverage and effectiveness, and number of events of different severity reported to the national COVID-19 surveillance system were used to estimate the number of averted events, prevented fraction and number needed to vaccinate. Uncertainty intervals (UI) were obtained using Monte Carlo simulations. Results By week 2 2022, vaccination coverage in the target population reached 91.2%. Booster vaccine effectiveness was 4.1% (CI95%: -0.1 to 9.0), 87.5% (CI95%: 84.9 to 89.7) and 83.2 (CI95%: 80.3 to 85.7) against infection, hospitalization and death, respectively. During the study period, 70862 SARS-CoV-2 infections, 2697 COVID-19 hospitalizations and 2106 deaths were reported. Booster vaccination averted 2731 (UI95%: -298 to 5838) infections, 10629 (UI95%: 9173 to 12127) hospitalizations and 6608 (UI95%: 5725 to 7546) COVID-19 related deaths among individuals aged 80 years or more resident in Portugal. Prevented fractions were 3.7% (UI95%: 0 to 7.6%), 79.7% (UI95%: 77.3 to 81.7%) and 75.8% (UI95%: 73.2 to 78.1%), respectively. It would require to vaccinate 59 individuals (UI95%: 52 to 69) to prevent one hospitalization and 94 individuals (UI95%: 82 to 109) to prevent one death in the target population. Conclusions The booster vaccination strategy had considerable impact on preventing severe outcomes in the Portuguese population aged 80 and more years old. Key messages • High vaccine coverage combined with high vaccine effectiveness resulted in considerable reduction of severe COVID-19 outcomes. • Information on number of outcomes of different severity levels averted by COVID-19 booster vaccination allows to strength public health communication.
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Affiliation(s)
- I Kislaya
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - AP Rodrigues
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
| | - S Silva
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
| | - AJ Santos
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - C Matias Dias
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - B Nunes
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - A Machado
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
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Lyshol H, Gil AP, Tolonen H, Namorado S, Kislaya I, Barreto M, Antunes L, Gaio V, Santos AJ, Rodrigues AP, Dias CM. Local problem solving in the Portuguese health examination survey: a mixed method study. Arch Public Health 2022; 80:198. [PMID: 36002860 PMCID: PMC9400230 DOI: 10.1186/s13690-022-00939-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Participation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other similar health examination surveys. The objective of this article is to describe how local teams of survey personnel conducted the survey, describing strategies used to solve practical survey problems and to try to increase the participation rate.
Methods
After a literature search, informal interviews were conducted with 14 public health officials from local health examination teams, regional and central authorities. Forty-one of the local staff members (survey personnel) also filled in a short questionnaire anonymously. The interviews and self-administered questionnaires were analysed using mixed methods, informed by thematic analysis.
Results
The local teams believed that the detailed manual, described as a “cookbook for making a health examination survey”, made it possible to maintain high scientific standards while allowing for improvising solutions to problems in the local context. The quality of the manual, supported by a series of training workshops with the central research and support team, gave the teams the confidence and knowledge to implement local solutions. Motivation and cohesion within the local teams were among the goals of the training process.
Local teams felt empowered by being given large responsibilities and worked hard to incite people to attend the examination through a close and persuasive approach.
Local teams praised their INSA contacts for being available for assistance throughout the survey, and said they were inspired to try harder to reach participants to please their contacts for interpersonal reasons.
Conclusions
The theory of organizational improvisation or bricolage, which means using limited resources to solve problems, was useful to discuss and understand what took place during INSEF.
A detailed manual covering standard procedures, continuous monitoring of the data collection and face-to-face workshops, including role-play, were vital to assure high scientific standards and high participation rates in this health examination survey. Close contacts between the central team and local focal points in all regions and all survey sites were key to accommodating unexpected challenges and innovative solutions.
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Sinclair M, McCullough JEM, Elliott D, Braz P, Cavero-Carbonell C, Dornan L, Jamry-Dziurla A, João Santos A, Latos-Bieleńska A, Machado A, Páramo-Rodríguez L. Using Social Media as a Research Tool for a Bespoke Web-Based Platform for Stakeholders of Children With Congenital Anomalies: Development Study. JMIR Pediatr Parent 2021; 4:e18483. [PMID: 34779778 PMCID: PMC8663440 DOI: 10.2196/18483] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/12/2021] [Accepted: 08/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Limited research evidence exists on the development of web-based platforms for reciprocal communication, coproduction research, and dissemination of information among parents, professionals, and researchers. This paper provides learning and the outcomes of setting up a bespoke web-based platform using social media. OBJECTIVE This study aims to explore the establishment of a web-based, multicontextual research communication platform for parents and stakeholders of children with congenital anomalies using social media and to identify associated research and ethical and technical challenges. METHODS The ConnectEpeople e-forum was developed using social media platforms with a stakeholder engagement process. A multilevel approach was implemented for reciprocal engagement between parents of children with congenital anomalies, researchers, health care professionals, and other stakeholders using private and invisible and public Facebook groups, closed Twitter groups, and YouTube. Ethical approval was obtained from Ulster University. RESULTS Nonprofit organizations (N=128) were invited to engage with an initial response rate of 16.4% (21/128). Of the 105 parents contacted, 32 entered the private and invisible Facebook groups to participate in the coproduction research. Public Facebook page followers rose to 215, a total of 22 posts had an engagement of >10%, and 34 posts had a reach of over 100. Webinars included requested information on childhood milestones and behavior. YouTube coverage included 106 ConnectEpeople videos with 28,708 impressions. Project information was obtained from 35 countries. The highest Facebook activity occurred during the early morning hours. Achievement of these results required dedicated time management, social media expertise, creativity, and sharing knowledge to curate valuable content. CONCLUSIONS Building and maintaining a multilayered online forum for coproduction and information sharing is challenging. Technical considerations include understanding the functionality and versatility of social media metrics. Social media offers valuable, easily accessible, quantitative, and qualitative data that can drive the reciprocal process of forum development. The identification and integration of the needs of the ConnectEpeople e-forum was a key driver in the dissemination of useful, meaningful, and accessible information. The necessary dedicated administration to respond to requests and posts and collate data required significant time and effort. Participant safety, the development of trust, and the maintenance of confidentiality were major ethical considerations. Discussions on social media platforms enabled parents to support each other and their children. Social media platforms are particularly useful in identifying common family needs related to early childhood development. This research approach was challenging but resulted in valuable outputs requiring further application and testing. This may be of particular importance in response to COVID-19 or future pandemics. Incorporating flexible, adaptable social media strategies into research projects is recommended to develop effective platforms for collaborative and impactful research and dissemination.
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Affiliation(s)
- Marlene Sinclair
- Institute of Nursing and Health Research, Ulster University, Northern Ireland, United Kingdom
| | - Julie E M McCullough
- Institute of Nursing and Health Research, Ulster University, Northern Ireland, United Kingdom
| | | | - Paula Braz
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Lesley Dornan
- Institute of Nursing and Health Research, Ulster University, Northern Ireland, United Kingdom
| | - Anna Jamry-Dziurla
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Ana João Santos
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal.,Public Health Research Centre, National School of Public Health, Nova University Lisbon, Lisbon, Portugal
| | - Anna Latos-Bieleńska
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Ausenda Machado
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal
| | - Lucía Páramo-Rodríguez
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
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Alves R, Santos AJ, Kislaya I, Nunes B, Freire AC. [Metabolic Syndrome in Portugal: Prevalence and Associated Factors]. ACTA MEDICA PORT 2021; 35:633-643. [PMID: 34615592 DOI: 10.20344/amp.15051] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/01/2021] [Accepted: 04/16/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The metabolic syndrome consists of a set of factors that, when associated, are associated with a higher risk of developing cardiovascular diseases and type 2 diabetes, and is thus an important public health problem. The objective of this study was to estimate the prevalence of this syndrome in the Portuguese population, and to evaluate possible associations with demographic and socioeconomic determinants. MATERIAL AND METHODS Based on the 1st National Health Survey with Physical Examination of 2015, a cross-sectional epidemiological study was conducted on a representative sample of the Portuguese population (n = 4797) aged between 25 and 74 years old. The prevalence was estimated for the total population and each gender, stratified by age group, health region, type of urban area, marital status, education, professional status, and risk of poverty. The magnitude of the associations was measured with adjusted prevalence ratios. RESULTS In the Portuguese population the estimated prevalence was 33.4% [95% CI, 31.7 - 35.1] [35.6% in men (95% CI, 31.9 - 39.2) and 31.3% in women (95% CI, 28.5 - 34.2)]. In both genders, the highest prevalence was significantly associated with increasing age, widowed/married/de facto partners and those with lower levels of education. There was no association with gender, health region, type of urban area, professional status or risk of poverty. DISCUSSION This syndrome was present in a third of the Portuguese population. The knowledge of its epidemiology enables the identification of population groups with higher cardiovascular and metabolic risk. CONCLUSION Metabolic syndrome was independently associated with specific groups. This knowledge reinforces the importance of a holistic assessment of the health determinants associated with the metabolic syndrome.
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Affiliation(s)
- Ricardo Alves
- Unidade de Saúde Pública. Agrupamento de Centros de Saúde Almada-Seixal. Almada. Portugal
| | - Ana João Santos
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Irina Kislaya
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Ana Cristina Freire
- Unidade de Saúde Pública. Agrupamento de Centros de Saúde Almada-Seixal. Almada. Portugal
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Santos AJ, Nunes B, Kislaya I, Gil AP, Ribeiro O. Exploring the Correlates to Depression in Elder Abuse Victims: Abusive Experience or Individual Characteristics? J Interpers Violence 2021; 36:NP115-NP134. [PMID: 29294926 DOI: 10.1177/0886260517732346] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Depression and depressive symptoms have been studied both as risk factors and consequences of elder abuse, even though the most common cross-sectional design of the studies does not allow inferring cause or consequence relationships. This study estimates the proportion of older adults who screened positive for depressive symptoms among those self-reporting elder abuse and examines whether individual characteristics and/or abusive experience aspects are associated with self-reported depressive symptoms. Participants were 510 older adults self-reporting experiences of abuse in family setting enrolled in the cross-sectional victims' survey of the Aging and Violence Study. Depressive symptoms were assessed through the abbreviated version of the Geriatric Depression Scale (GDS-5). Poisson regression was used to determine the prevalence ratio (PR) of screening depressive symptoms according to individual and abusive experience covariates: sex, age group, cohabitation, perceived social support, chronic diseases, functional status, violence type, perpetrator, and number of conducts. Women (PR = 1.18, 95% confidence interval [CI] = [1.04, 1.35]) individuals perceiving low social support level (PR = 1.36, 95% CI = [1.16, 1.60]) and with long-term illness (PR = 1.17, 95% CI = [1.02, 1.33]) were found to be associated with increased risk for screening depressive symptoms. In regard to abusive experience, only the number of abusive conducts increased the PR (PR = 1.07, 95% CI = [1.05, 1.09]). Routine screening for elder abuse should include psychological well-being assessment. Interventions toward risk alleviation for both mental health problems and elder abuse should target women perceiving low social support level and with long-term illness.
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Affiliation(s)
- Ana João Santos
- National Health Institute Doutor Ricardo Jorge, Lisboa, Portugal
- University of Porto, Portugal
| | - Baltazar Nunes
- National Health Institute Doutor Ricardo Jorge, Lisboa, Portugal
- NOVA University of Lisbon, Portugal
| | - Irina Kislaya
- National Health Institute Doutor Ricardo Jorge, Lisboa, Portugal
| | | | - Oscar Ribeiro
- University of Porto, Portugal
- University of Aveiro, Portugal
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Leite A, Santos AJ, Silva S, Nunes B, Mexia R, Rodrigues AP. Assessing the use and understanding of the Portuguese heat-health warning system (ÍCARO). J Public Health (Oxf) 2020; 42:395-402. [PMID: 32166309 DOI: 10.1093/pubmed/fdaa029] [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] [Received: 08/05/2019] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Heatwaves can lead to increased mortality. In the Portuguese heat-health warning system (HHWS), ÍCARO, a daily report with heat-related mortality prediction is sent to heat-health action plan (HHAP) practitioners. HHAP practitioners assess risk and implement measures to prevent heatwave-related impact, but ÍCARO's use and understanding are unknown. We assessed ÍCARO's use and understanding by key HHAP practitioners. METHODS We conducted semi-structured interviews with national/regional HHAP practitioners. Interviews were recorded, transcribed and analysed using thematic content analysis. To maximize credibility a validation process was implemented through researcher triangulation; a sample of 30 segments was recorded by independent researchers. RESULTS We conducted six interviews with nine professionals (mean time 52 min) from five regions. We identified four categories: report's content and presentation, report's reception and communication, ÍCARO and risk assessment and other issues. Practitioners use ÍCARO and perceived it as relevant; they raised issues on its interpretation and felt these were not fully addressed, given researchers' use of statistical/epidemiological terms. We identified the need for improved communication and report's clarity. CONCLUSIONS Our study stresses the need for collaboration between experts within HHWS/HHAP. Despite ÍCARO's understanding being challenging, practitioners consider it a relevant tool. Researchers should use less statistical language and clarify ÍCARO's interpretation. Practitioners' needs should be considered when developing/revising tools.
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Affiliation(s)
- A Leite
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A J Santos
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Silva
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal
| | - B Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - R Mexia
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal
| | - A P Rodrigues
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal
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Machado A, Santos AJ, Kislaya I, Larrauri A, Nunes B. Understanding influenza vaccination among Portuguese elderly: the social ecological framework. Health Promot Int 2020; 35:1427-1440. [DOI: 10.1093/heapro/daaa011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
This study intended to identify and quantify the social ecological model (SEM) levels associated to seasonal IV uptake in the Portuguese elderly population. Data from the 2014 National Health Survey was restricted to individuals aged 65+ years (n = 5669). Twenty-three independent variables were allocated to the SEM levels: individual, interpersonal, organizational, community and policy. Sex stratified and age adjusted analysis using Poisson regression were performed for each level and for a fitted full model. Relative reduction in pseudo R magnitude measured marginal contribution of each level. For men and women, older groups (85+ vs. 65–69; men, PR = 1.59 and women, PR = 1.56); having 3+ chronic conditions (men, PR = 1.39 and women, PR = 1.35); previous 4 weeks GP and outpatient visits were associated to higher IV uptake. For men, only 2 SEM levels were associated (individual and organizational) while for women the community level was also relevant. Main marginal contribution came from individual (17.9% and 16.3%) and organizational (30.7% and 22.7%) levels. This study highlights the importance of individual characteristics, access and use of health care services for the IV uptake and the sex differential behaviour.
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Affiliation(s)
- Ausenda Machado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ana João Santos
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Amparo Larrauri
- National Centre of Epidemiology, Institute of Health Carlos III, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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Sinclair M, McCullough JE, Elliott D, Latos-Bielenska A, Braz P, Cavero-Carbonell C, Jamry-Dziurla A, João Santos A, Páramo-Rodríguez L. Exploring Research Priorities of Parents Who Have Children With Down Syndrome, Cleft Lip With or Without Cleft Palate, Congenital Heart Defects, or Spina Bifida Using ConnectEpeople: A Social Media Coproduction Research Study. J Med Internet Res 2019; 21:e15847. [PMID: 31763986 PMCID: PMC6902131 DOI: 10.2196/15847] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/29/2019] [Accepted: 09/30/2019] [Indexed: 11/13/2022] Open
Abstract
Background Using social media for research purposes is novel and challenging in terms of recruitment, participant knowledge about the research process, and ethical issues. This paper provides insight into the recruitment of European parents of children with specific congenital anomalies to engage in coproduction research by using social media. Secret Facebook groups, providing optimal security, were set up for newly recruited research-aware parents (RAPs) to communicate privately and confidentially with each other and for the research team to generate questions and to interpret findings. Objective This study aimed to use social media for the recruitment and engagement of parents in research and to determine the research priorities of parents who have children with Down syndrome, cleft lip with or without cleft palate, congenital heart defects, and spina bifida. Methods The design was exploratory and descriptive with 3 phases. Phase 1 included the recruitment of RAPs and generation of research questions important to them; phase 2 was a Web-based survey, designed using Qualtrics software, and phase 3 included analysis and ranking of the top 10 research questions using an adapted James Lind Alliance approach. Simple descriptive statistics were used for analysis, and ethical approval was obtained from the Ethics Filter Committee of the Institute of Nursing and Health Research, Ulster University. Results The recruitment of 32 RAPs was a sensitive process, varying in the time taken to consent (mean 51 days). However, parents valued the screening approach using the State-Trait Anxiety Inventory as a measure to ensure their well-being (mean 32.5). In phase 1, RAPs generated 98 research questions. In phase 2, 251 respondents accessed the Web-based survey, 248 consented, and 80 completed the survey, giving a completeness rate of 32.3% (80/248). Most parents used social media (74/80, 92%). Social media, online forums, and meeting in person were ranked the most preferable methods for communication with support groups networks and charities. Most respondents stated that they had a good understanding of research reports (71/80, 89%) and statistics (68/80, 85%) and could differentiate among the different types of research methodologies (62/80, 78%). Phase 3 demonstrated consensus among RAPs and survey respondents, with a need to know the facts about their child’s condition, future health, and psychosocial and educational outcomes for children with similar issues. Conclusions Social media is a valuable facilitator in the coproduction of research between parents and researchers. From a theoretical perspective, ocularcentrism can be an applicable frame of reference for understanding how people favor visual contact.
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Affiliation(s)
- Marlene Sinclair
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland, United Kingdom
| | - Julie Em McCullough
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland, United Kingdom
| | | | - Anna Latos-Bielenska
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Paula Braz
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Anna Jamry-Dziurla
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Ana João Santos
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal.,Public Health Research Centre, National School of Public Health, Nova University Lisbon, Lisbon, Portugal
| | - Lucía Páramo-Rodríguez
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
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Leite A, Santos AJ, Silva S, Nunes B, Mexia R, Rodrigues AP. Assessing the use and understanding of the Portuguese Heat–Health Warning System (ÍCARO). Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Heatwaves can lead to increased mortality. Portugal has a Heat-Health Warning System (HHWS) in place (ÍCARO system). Researchers at the Instituto Ricardo Jorge send a daily report with heat-related mortality forecasts to key stakeholders (e.g. Heat-Health Action Plans (HHAP) staff). HHAP practitioners issue warnings and implement measures to prevent heatwaves-related mortality. ICARO is amongst the recommended data sources to assess risk and issue warnings but its use and understanding is unknown. Therefore, we aimed to assess ÍCARO’s use and understanding by key HHAP practitioners.
Methods
We conducted semi-structured interviews with national and regional HHAP practitioners. Interviews were recorded, transcribed, and analysed using thematic content analysis. Intercoder reliability was applied to a sample of segments from 5 of 6 interviews.
Results
We conducted 6 interviews with 9 professionals (mean time 52 minutes). We identified 4 categories: Report’s content and presentation, Report’s reception and communication, ÍCARO and risk assessment, Other issues. Practitioners use ÍCARO and perceived it as very relevant tool. However, they mentioned several questions on its interpretation. Practitioners also felt their questions were not fully answered, given researchers’ use of statistical terms. Finally, practitioners referred the need to assess risk at the local level, information not currently provided. We also identified the need for improved communication and report’s clarity.
Conclusions
Our study stresses the need for an integrated collaboration between experts within HHWS and HHAP. Despite ICARO’s understanding being challenging, practitioners consider it a relevant tool. Researchers should use less statistical language and clarify ÍCARO interpretation. Practitioners’ needs should be considered when developing or revising tools. We are currently implementing some of these recommendations in an attempt to close the gap between researchers and practitioners.
Key messages
Portuguese Heat–Health Action Plans practitioners use heat-related mortality forecasts (ICARO) and perceived it as very relevant instrument. However there find ICARO’s interpretation challenging. Portuguese Heat/Health Action Plans Practitioners’ needs should be considered when revising or developing tools, and notes should be added to clarify statistical/technical concepts.
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Affiliation(s)
- A Leite
- Department of Epidemiology, National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, Nova University Lisbon, Lisbon, Portugal
| | - A J Santos
- Department of Epidemiology, National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
| | - S Silva
- Department of Epidemiology, National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
| | - B Nunes
- Department of Epidemiology, National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, Nova University Lisbon, Lisbon, Portugal
| | - R Mexia
- Department of Epidemiology, National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
| | - A P Rodrigues
- Department of Epidemiology, National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
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Santos CD, Santos AJ, Santos M, Rodrigues F, Bárbara C. Pulmonary rehabilitation adapted index of self-efficacy (PRAISE) validated to Portuguese respiratory patients. Pulmonology 2019; 25:334-339. [PMID: 31540750 DOI: 10.1016/j.pulmoe.2019.06.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/17/2019] [Accepted: 06/05/2019] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Recent updates on Pulmonary Rehabilitation highlight the importance of patients' self-efficacy on long-term adherence to health-enhancing behaviors. The Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE) is an adaptation of the General Self-Efficacy Scale. This study aimed to translate, culturally adapt and evaluate reliability and validity of PRAISE in Portuguese respiratory patients. PATIENTS OR MATERIALS AND METHODS Forward-backward translation and pilot testing were performed. Content validity was assessed by a multidisciplinary panel of expert judges. To evaluate reliability and validity, 150 respiratory outpatients on Pulmonary Rehabilitation participated in a cross-sectional study. Descriptive and reliability analyses, and exploratory factorial analysis using principal axis factoring, followed by oblique oblimin factor rotation were conducted to identify construct validity. IBM® SPSS® version 22 was used to perform statistical analysis. RESULTS 150 patients with a mean age of 67 years, 54% male and 83% currently on Pulmonary Rehabilitation participated in the study. These included mainly Chronic Obstructive Pulmonary Disease patients (46.7%) but also Bronchiectasis (20%), Interstitial Lung Disease (20%) and other respiratory diseases. PRAISE mean score was 49. Exploratory factor analysis extraction provided a 4-factor solution that cumulatively explained 52.3% of total variance (F1: 26.6%; F2: 9.7%; F3: 8.7%; F4: 7.3%). Portuguese PRAISE showed a reliability of 0.78 (Chronbach alpha). CONCLUSIONS The Portuguese version of PRAISE showed adequate psychometric properties for it to be used as an instrument to measure self-efficacy as a patient-centered outcome on Pulmonary Rehabilitation.
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Affiliation(s)
- Catarina Duarte Santos
- Universidade de Lisboa, Faculdade de Medicina, Instituto de Saúde Ambiental, Lisbon, Portugal; Centro Hospitalar Universitário Lisboa Norte, Hospital Pulido Valente, Unidade de Reabilitação Respiratória, Lisbon, Portugal.
| | - Ana João Santos
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Departamento de Epidemiologia, Lisbon, Portugal
| | - Margarida Santos
- Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa, Unidade de Ensino e Investigação em Psicologia e Sociologia; Universidade de Lisboa, Faculdade de Psicologia, Lisbon, Portugal
| | - Fátima Rodrigues
- Universidade de Lisboa, Faculdade de Medicina, Instituto de Saúde Ambiental, Lisbon, Portugal; Centro Hospitalar Universitário Lisboa Norte, Hospital Pulido Valente, Unidade de Reabilitação Respiratória, Lisbon, Portugal
| | - Cristina Bárbara
- Universidade de Lisboa, Faculdade de Medicina, Instituto de Saúde Ambiental, Lisbon, Portugal; Centro Hospitalar Universitário Lisboa Norte, Hospital Pulido Valente, Unidade de Reabilitação Respiratória, Lisbon, Portugal
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15
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Kislaya I, Tolonen H, Rodrigues AP, Barreto M, Gil AP, Gaio V, Namorado S, Santos AJ, Dias CM, Nunes B. Differential self-report error by socioeconomic status in hypertension and hypercholesterolemia: INSEF 2015 study. Eur J Public Health 2019; 29:273-278. [PMID: 30380048 DOI: 10.1093/eurpub/cky228] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study aimed to compare self-reported and examination-based prevalence of hypertension and hypercholesterolemia in Portugal in 2015 and to identify factors associated with the measurement error in self-reports. METHODS We used data from the Portuguese National Health Examination Survey (n = 4911), that combines personal interview, blood collection and, physical examination. Sensitivity and specificity of self-reported hypertension and hypercholesterolemia were calculated. Poisson regression was used to estimate prevalence ratios (PRs) of underreport of hypertension and hypercholesterolemia according to sex, age, socioeconomic status (education and income) and general practitioner (GP) consultation in the past year. RESULTS Sensitivity of self-reports was 69.8% for hypertension and 38.2% for hypercholesterolemia. Underreport of hypertension was associated with male gender (PR = 1.54), lack of GP consultation (PR = 1.70) and being 25-44 years old (PR = 2.45) or 45-54 years old (PR = 2.37). Underreport of hypercholesterolemia was associated with lack of GP consultation (PR = 1.15), younger age (PR = 1.83 for 25-44 age group and PR = 1.52 for 45-54 age group), secondary (PR = 1.30) and higher (PR = 1.27) education. CONCLUSION Self-reported data underestimate prevalence of hypertension and hypercholesterolemia. Magnitude of measurement error in self-reports varies by health conditions and population characteristics. Adding objective measurements to self-reported questionnaires improve data accuracy allowing better understanding of socioeconomic inequalities in health.
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Affiliation(s)
- Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Hanna Tolonen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal
| | - Marta Barreto
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana Paula Gil
- Interdisciplinary Centre of Social Sciences (CICS.NOVA) NOVA School of Social Sciences and Humanities, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Vânia Gaio
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Sónia Namorado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana João Santos
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal
| | - Carlos Matias Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
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Magalhaes ILF, Neves DM, Santos FR, Vidigal THDA, Brescovit AD, Santos AJ. Phylogeny of Neotropical Sicarius sand spiders suggests frequent transitions from deserts to dry forests despite antique, broad-scale niche conservatism. Mol Phylogenet Evol 2019; 140:106569. [PMID: 31362083 DOI: 10.1016/j.ympev.2019.106569] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 07/03/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022]
Abstract
Phylogenetic niche conservatism (PNC) shapes the distribution of organisms by constraining lineages to particular climatic conditions. Conversely, if areas with similar climates are geographically isolated, diversification may also be limited by dispersal. Neotropical xeric habitats provide an ideal system to test the relative roles of climate and geography on diversification, as they occur in disjunct areas with similar biotas. Sicariinae sand spiders are intimately associated with these xeric environments, particularly seasonally dry tropical forests (SDTFs) and subtropical deserts/scrublands in Africa (Hexophthalma) and the Neotropics (Sicarius). We explore the role of PNC, geography and biome shifts in their evolution and timing of diversification. We estimated a time-calibrated, total-evidence phylogeny of Sicariinae, and used published distribution records to estimate climatic niche and biome occupancy. Topologies were used for estimating ancestral niches and biome shifts. We used variation partitioning methods to test the relative importance of climate and spatially autocorrelated factors in explaining the spatial variation in phylogenetic structure of Sicarius across the Neotropics. Neotropical Sicarius are ancient and split from their African sister-group around 90 (57-131) million years ago. Most speciation events took place in the Miocene. Sicariinae records can be separated in two groups corresponding to temperate/dry and tropical/seasonally dry climates. The ancestral climatic niche of Sicariinae are temperate/dry areas, with 2-3 shifts to tropical/seasonally dry areas in Sicarius. Similarly, ancestral biomes occupied by the group are temperate and dry (deserts, Mediterranean scrub, temperate grasslands), with 2-3 shifts to tropical, seasonally dry forests and grasslands. Most of the variation in phylogenetic structure is explained by long-distance dispersal limitation that is independent of the measured climatic conditions. Sicariinae have an ancient association to arid lands, suggesting that PNC prevented them from colonizing mesic habitats. However, niches are labile at a smaller scale, with several shifts from deserts to SDTFs. This suggests that PNC and long-distance dispersal limitation played major roles in confining lineages to isolated areas of SDTF/desert over evolutionary history, although shifts between xeric biomes occurred whenever geographical opportunities were presented.
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Affiliation(s)
- I L F Magalhaes
- División Aracnología, Museo Argentino de Ciencias Naturales "Bernardino Rivadavia", Buenos Aires, Argentina; Departamento de Zoologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
| | - D M Neves
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, USA; Departamento de Botânica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - F R Santos
- Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Brazil
| | - T H D A Vidigal
- Departamento de Zoologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - A D Brescovit
- Laboratório Especial de Coleções Zoológicas, Instituto Butantan, São Paulo, Brazil
| | - A J Santos
- Departamento de Zoologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
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Santos J, Antunes L, Namorado S, Kislaya I, João Santos A, Rodrigues AP, Braz P, Gaio V, Barreto M, Lyshol H, Nunes B, Matias Dias CM. Oral hygiene habits in Portugal: results from the first Health Examination Survey (INSEF 2015). Acta Odontol Scand 2019; 77:334-339. [PMID: 30712422 DOI: 10.1080/00016357.2018.1564839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 10/27/2022]
Abstract
Oral health is a determinant for quality of life and preventive behaviours such as regular tooth brushing can reduce the risk of a wide spectrum of oral diseases. Adopting preventive behaviours increases the likelihood of being healthy and can be conditioned by demographic and socio-economic factors. OBJECTIVE This study aims to describe preventive oral hygiene behaviours in the Portuguese population and assess their association with sociodemographic and socioeconomic factors. MATERIAL AND METHODS A cross-sectional epidemiologic study was developed using data from the first Portuguese National Health Examination Survey. The target population comprised Portuguese community-dwelling residents aged between 25 and 74 years old. The percentage of individuals who brushed their teeth at least twice a day, provided that once was before sleeping, was considered the indicator showing a preventive behaviour, as this is recommended by the General Directorate of Health in Portugal. Poisson regression was used to identify factors independently associated with this behaviour. RESULTS Sixty-five per cent of the participants reported tooth brushing as recommended. The prevalence of adoption of this preventive behaviour was higher among those living in urban areas and those who have higher educational level. Results show an association between being male and having low educational level with lesser adoption of preventive oral health behaviours. CONCLUSION These findings suggest a need for integrated approaches, from measures tackling social inequalities to actions focused on improving health literacy. It is also important to expand dental healthcare services and improve effective coverage to increase access for rural population.
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Affiliation(s)
- Joana Santos
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Liliana Antunes
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Sónia Namorado
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Irina Kislaya
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Ana João Santos
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Ana Paula Rodrigues
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Paula Braz
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Vânia Gaio
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Marta Barreto
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Heidi Lyshol
- Norwegian Institute of Public Health, Oslo, Norway
| | - Baltazar Nunes
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Carlos Manuel Matias Dias
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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Santos AJ, Gil AP, Ribeiro O. The ageing process in older adults’ narratives of family violence. QAOA 2019. [DOI: 10.1108/qaoa-10-2018-0046] [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: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to examine, through a qualitative lens, how community elder abuse and the ageing process are represented in the older adults’ narratives reporting abuse perpetrated by family members.
Design/methodology/approach
A qualitative study of a convenience sample of 22 interviews from 24 older adults (two couples) aged 60 years or older who had experienced one or more types of abuse and had sought help about the victimisation experience. A general inductive approach of thematic content analysis was employed.
Findings
The four main emergent themes related to the passage of time or the perception of becoming old within the process of abuse were: abuse grown old, abuse after entering later life, vulnerability to abuse and responses to abuse. Ageing was found to be associated with an increase vulnerability to abuse and an important element in shaping how older adults experience, report and cope with victimization. The social and contextual issues of being older also influenced the decision of ending (or not) the abuse and the victims’ repertoire of responses.
Originality/value
Despite the little suitability of chronological age to define and delimit elder abuse, understanding the phenomenon demands the recognition of ageing (both as a process and as a product) in order to more accurately identify aetiology processes and develop interventions.
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Santos AJ, Nunes B, Kislaya I, Gil AP, Ribeiro O. Older adults' emotional reactions to elder abuse: Individual and victimisation determinants. Health Soc Care Community 2019; 27:609-620. [PMID: 30334593 DOI: 10.1111/hsc.12673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/22/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 06/08/2023]
Abstract
Elder abuse has been gaining public, state, and scientific attention for the past 40 years, but research focusing on emotional reactions of older adults to victimisation is still scarce. The study describes the emotions and feelings of older adults who experienced abuse in a community setting, and the association between these emotions and individual or abuse characteristics. The cross-sectional study comprises 510 older adults who were identified and referred by four institutions. Participants answered a questionnaire on elder abuse experiences, including the emotion or feeling brought out by the act of abuse that was perceived to be the most serious. Fear and sadness comprised 67.1% of all provided responses. Emotional reactions were associated with functional status, the presence of depressive symptoms, relationship with the perpetrator and, to a limited degree, to the experience of multiple types of abuse. The most significant and meaningful variable was the relationship with the perpetrator. This study demonstrates that older adults present very similar patterns of emotional reactions, but individual characteristics and the established relationship with the perpetrator might mediate the emotional response. Implications for prevention and intervention of elder abuse are discussed.
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Affiliation(s)
- Ana João Santos
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Baltazar Nunes
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
- CISP - Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Lisboa, Portugal
| | - Irina Kislaya
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Ana Paula Gil
- CICS.NOVA - Centro Interdisciplinar de Ciências Sociais, Faculdade de Ciências Sociais e, Humanas da Universidade Nova de Lisboa, Lisboa, Portugal
| | - Oscar Ribeiro
- Departamento de Educação e Psicologia, Universidade de Aveiro, Porto, Portugal
- CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Universidade do Porto, Porto, Portugal
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Santos AJ, Nunes B, Kislaya I, Gil AP, Ribeiro O. Elder abuse victimization patterns: latent class analysis using perpetrators and abusive behaviours. BMC Geriatr 2019; 19:117. [PMID: 31014265 PMCID: PMC6480599 DOI: 10.1186/s12877-019-1111-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/21/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Research on elder abuse has defined it as a multidimensional construct that encompasses a set of different abusive behaviours, victims, perpetrators and settings. The array of possible elder abuse configurations is difficult to capture. This study sought to identify victimization patterns that represent distinct elder abuse configurations based on specific abusive behaviours and on the relationship with the perpetrator; it also sought to determine the association between these latent classes with victims' characteristics. METHOD Data comes from two elder abuse surveys: a representative sample of community-dwelling adults and a convenience sample of older adults reporting elder abuse to four state and NGOs institutions. Latent Class Analysis (LCA) was used to categorize victimization in the population-based (N = 245) and in the victims' sample (N = 510) using 7 items measuring physical, psychological and financial abuse, and appointed perpetrators. Association tests were conducted to determine differences and similarities of victims' characteristics between the different obtained classes. RESULTS The LCA procedure identified six different latent classes of victimization experiences in each of the samples, which were statistically and plausibly distinct. In the population-based survey: verbal abuse by others (29%); psychological abuse from children/grandchildren (18%); overlooked by others (18%); stolen by others (15%); verbal Intimate Partner Violence (IPV) (14%) and physical and psychological IPV (6%). In the victims' survey: physical abuse by children/grandchildren (29%); physical IPV (26%); psychological abuse by children/grandchildren (18%); polyvictimization by others (16%); physical abuse by others (6%) and physical and psychological IPV (4%). In the victims survey the 6 groups significantly differ in age, gender, civil status, living arrangements, perceived social support and functional status. CONCLUSIONS The results support the possibility of the multidimensionality of elder abuse not being accounted by the "classical" abuse typologies. Elder abuse victims seeking help may represent a distinct group from that included in population-based prevalence studies. The appointed perpetrators may be the most meaningful and relevant aspect in distinguishing victimization experiences. Further research is needed to develop tailored interventions to specific elder abuse cases and enhance successful outcomes.
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Affiliation(s)
- Ana João Santos
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
- CISP - Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Lisboa, Portugal
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - Ana Paula Gil
- CICS.NOVA - Centro Interdisciplinar de Ciências Sociais, Faculdade de Ciências Sociais e Humanas da Universidade Nova de Lisboa, Av. de Berna, 26-C, 1069-061 Lisboa, Portugal
| | - Oscar Ribeiro
- Departamento de Educação e Psicologia, Universidade de Aveiro, Aveiro, Portugal
- CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Universidade do Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
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Machado A, Kislaya I, Santos AJ, Gaio V, Gil AP, Barreto M, Namorado S, Antunes L, Matias Dias C, Nunes B. Factors associated to repeated influenza vaccination in the Portuguese adults with chronic conditions. Vaccine 2018; 36:5265-5272. [DOI: 10.1016/j.vaccine.2018.07.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022]
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Barreto M, Kislaya I, Gaio V, Rodrigues AP, Santos AJ, Namorado S, Antunes L, Gil AP, Boavida JM, Ribeiro RT, Silva AC, Vargas P, Prokopenko T, Nunes B, Matias Dias C. Prevalence, awareness, treatment and control of diabetes in Portugal: Results from the first National Health examination Survey (INSEF 2015). Diabetes Res Clin Pract 2018; 140:271-278. [PMID: 29626582 DOI: 10.1016/j.diabres.2018.03.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/20/2018] [Accepted: 03/29/2018] [Indexed: 12/14/2022]
Abstract
AIMS Diabetes Mellitus is a major public health threat worldwide and continues to increase in numbers and significance. Estimates of diabetes prevalence, awareness, treatment and control are essential to effectively monitor its trends, plan and evaluate interventions. METHODS We conducted a nationwide health examination survey in the population residing in Portugal aged between 25 and 74 years old in 2015. It consisted in a cross sectional prevalence study which included the measurement of HbA1c, a physical examination and a general health interview of a probabilistic sample of 4911 individuals (Authorization n°9348/2010 of the National Committee for Data Protection). RESULTS The overall prevalence of diabetes was 9.9% (95%CI: 8.4; 11.5). It was higher in males than in females (12.1% vs 7.8%). Diabetes was more prevalent among individuals of lower education and without any professional activity. The majority of persons with diabetes was aware of their condition (87.1%) and was taking antidiabetic medication (79.7%). Of these, 63.2% had glycated hemoglobin levels lower than 7.0% (53 mmol/mol), but the majority failed to comply with the LDL and blood pressure recommended clinical targets (71.9% and 59.0%). Similarly, the prevalence of prediabetes was 16%, higher among women than men (17.5% vs 14.4%). CONCLUSION The prevalence of diabetes and prediabetes remains higher than the global and European estimates, although there is increasing awareness of this disorder.
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Affiliation(s)
- Marta Barreto
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1649-560 Lisboa, Portugal.
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Vânia Gaio
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Ana João Santos
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Sónia Namorado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Liliana Antunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Ana Paula Gil
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - José Manuel Boavida
- Associação Protetora dos Diabéticos de Portugal, Rua Rodrigo da Fonseca n°1, 1250-189 Lisboa, Portugal
| | - Rogério Tavares Ribeiro
- Associação Protetora dos Diabéticos de Portugal, Rua Rodrigo da Fonseca n°1, 1250-189 Lisboa, Portugal
| | - Ana Clara Silva
- Instituto de Administração da Saúde e Assuntos Sociais, IP-RAM, Secretaria Regional da Saúde da Região Autónoma da Madeira, Rua das Pretas n°1, 9050-000 Funchal, Madeira, Portugal
| | - Patrícia Vargas
- Direção de Serviços de Cuidados de Saúde, Secretaria Regional da Saúde da Região Autónoma dos Açores, Solar dos Remédios, 9701-855 Angra do Heroísmo, Açores, Portugal
| | - Tamara Prokopenko
- Unidade de Saúde Pública Alentejo Litoral, Núcleo de Alcácer do Sal, Avenida José Saramago n°14, 7580-206 Alcácer do Sal, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1649-560 Lisboa, Portugal
| | - Carlos Matias Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1649-560 Lisboa, Portugal
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Santos J, Kislaya I, Antunes L, Santos AJ, Rodrigues APP, Neto M, Dias CM. [Diabetes: Socioeconomic Inequalities in the Portuguese Population in 2014]. ACTA MEDICA PORT 2017; 30:561-567. [PMID: 28926330 DOI: 10.20344/amp.8235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 04/11/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Diabetes is a major public health problem and it is related to socioeconomic factors. The aim of this study is to describe socioeconomic inequalities in the distribution of diabetes in the population with 25 years or more, resident in Portugal in 2014. MATERIAL AND METHODS Data from the Health National Survey 2014 was analysed, n = 16 786. We estimated the prevalence of diabetes in the population and stratified by socioeconomic variables namely educational level and income. The extent of socioeconomic inequalities was assessed using concentration index and the relative index of inequality. RESULTS Diabetes was found to be concentrated among the people with lower educational levels (concentration index = -0.26) and lower income quintiles (concentration index = -0.14). Relative index of inequality also showed a lower degree of inequality among the most educated (0,20; CI 95% = [0,12; 0,32]) and with higher income (0,59; CI 95% = [0,48; 0,74]). DISCUSSION Distribution of diabetes is associated with education and income. Previous studies have shown that although income might reflect lifestyle patterns, education reflects better social factors that are important for establishing healthier behaviours. Also, the National Health Service, of universal coverage and free of charge, might have contributed to reduce inequalities in the access to health by those with the lowest income. CONCLUSION Supporting 'Health in All Policies' might reduce inequalities, namely by improving population educational level and actions that promote health literacy.
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Affiliation(s)
- Joana Santos
- Departamento de Epidemiologia. Instituto Nacional de Saúde Dr. Ricardo Jorge. Lisboa. Portugal
| | - Irina Kislaya
- Departamento de Epidemiologia. Instituto Nacional de Saúde Dr. Ricardo Jorge. Lisboa. Portugal
| | - Liliana Antunes
- Departamento de Epidemiologia. Instituto Nacional de Saúde Dr. Ricardo Jorge. Lisboa. Portugal
| | - Ana João Santos
- Departamento de Epidemiologia. Instituto Nacional de Saúde Dr. Ricardo Jorge. Lisboa. Portugal
| | | | - Mariana Neto
- Departamento de Epidemiologia. Instituto Nacional de Saúde Dr. Ricardo Jorge. Lisboa. Portugal
| | - Carlos Matias Dias
- Departamento de Epidemiologia. Instituto Nacional de Saúde Dr. Ricardo Jorge. Lisboa. Portugal
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Nunes B, Barreto M, Gil AP, Kislaya I, Namorado S, Antunes L, Gaio V, Santos AJ, Rodrigues AP, Santos J, Alves-Alves C, Castilho E, Cordeiro E, Dinis A, Prokopenko T, Silva AC, Vargas P, Lyshol H, Dias CM. The first Portuguese National Health Examination Survey (2015): design, planning and implementation. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rodrigues AP, Kislaya I, Antunes L, Gaio V, Barreto M, Santos AJ, Gil AP, Namorado S, Lyshol H, Nunes B, Dias CM. Prevalence of Elevated Cholesterol in Portugal: National Health Examination Survey Results (2015). Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Namorado S, Kislaya I, Gaio V, Santos AJ, Gil AP, Barreto M, Santos J, Lyshol H, Nunes B, Matias Dias C. Participants’ recruitment: preliminary results of Portuguese National Health Examination Survey. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gil AP, Santos AJ, Santos J, Kislaya I, Rodrigues AP, NamoradoV S, Gaio, Barreto M, Lyshol H, Nunes B, Matias Dias C. Population's adherence to the Portuguese Health Examination Survey:the perspective of fieldwork teams. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kislaya I, Rodrigues AP, Santos J, Gaio V, Gil AP, Santos AJ, Namorado S, Barreto M, Lyshol H, Nunes B, Matias Dias C. Portuguese National Health Examination Survey: Lessons from data collection monitoring. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gil AP, Santos AJ, Kislaya I, Santos C, Mascoli L, Ferreira AI, Vieira DN. Estudo sobre pessoas idosas vítimas de violência em Portugal: sociografia da ocorrência. CAD SAUDE PUBLICA 2015. [DOI: 10.1590/0102-311x00084614] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O presente artigo apresenta dados sobre violência contra pessoas com 60 e mais anos residentes em Portugal há mais de 12 meses. O estudo transversal e descritivo recolheu dados por meio de um questionário aplicado presencialmente a vítimas que recorreram a três entidades governamentais e a uma instituição não-governamental de apoio a vítimas. A amostra não probabilística foi constituída por 510 vítimas de violência em contexto familiar. A violência física e a psicológica foram os tipos mais reportados, afetando 87,8% e 69,6% das pessoas estudadas, seguindo-se a violência financeira (47,5%), sexual (7,5%) e a negligência (6,5%). A maioria (74,1%) dos respondentes indicou mais de um tipo de violência. As vítimas, na maioria mulheres, tinham uma média de idade de 70,7 anos. A maioria dos agressores pertencia à família nuclear, nomeadamente, cônjuges ou companheiros, filhos/enteados e filhas/enteadas. Contudo, observaram-se diferenças no agressor consoante o gênero da vítima. Os resultados indicam que a violência não é um fenômeno uniforme, apresentando-se sob diferentes configurações.
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Affiliation(s)
- Ana Paula Gil
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal
| | | | - Irina Kislaya
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal
| | - César Santos
- Instituto Nacional de Medicina Legal e Ciências Forenses, Portugal
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Eisenlohr PV, Tavares JR, Oliveira SL, Santos AO, Valadão MBX, Bilce JM, Roberto RL, Castro HB, Zaratim ECP, Lima SL, Santos AJ, Silva APG, Lima LB, Melo-Santos KS, Figueiredo JDS, Santos LM, Pereira FC, Oliveira JCA, Miguel TB, Serpa AO, Kreutz C, Reis SMA. Thinking better about high-quality science: a look at some ethical flaws and productivity evaluation. BRAZ J BIOL 2015; 74:1009-10. [PMID: 25627616 DOI: 10.1590/1519-6984.17413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 03/11/2014] [Indexed: 11/21/2022] Open
Affiliation(s)
- P V Eisenlohr
- Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Alta Floresta, Alta Floresta, MT, Brasil
| | - J R Tavares
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - S L Oliveira
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - A O Santos
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - M B X Valadão
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - J M Bilce
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - R L Roberto
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - H B Castro
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - E C P Zaratim
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - S L Lima
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - A J Santos
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - A P G Silva
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - L B Lima
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - K S Melo-Santos
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - J D S Figueiredo
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - L M Santos
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - F C Pereira
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - J C A Oliveira
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - T B Miguel
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - A O Serpa
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - C Kreutz
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - S M A Reis
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
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Abstract
In this study, we present findings of the Portuguese national prevalence study, "Aging and Violence," the purpose of which was to estimate the prevalence of abuse and neglect of older people in family settings over a 12-month period and examine the relationship between abuse and sociodemographic and health characteristics. Through a telephone survey of a representative probability sample (N = 1,123), we evaluated 12 abusive behaviors and demographic data. Overall, 12.3% of older adults experienced elder abuse in family settings. The prevalence rates of specific types were as follows: psychological, 6.3%; financial, 6.3%; physical, 2.3%; neglect, 0.4%; and sexual, 0.2%. Logistic regression was employed to determine the relationship between abuse and covariates. The study suggests that education level, age, and functional status are significantly associated with abuse. Accurate estimates of the prevalence of elder abuse and understanding of victim and perpetrator characteristics are fundamental to designing effective strategies for prevention and intervention.
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32
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Santos AJ, Carvalho HM, Gonçalves CE. YOUTH SOCCER ATHLETES’ INVOLVEMENT IN DIFFERENT SPORT PRACTICE CONTEXTS. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-093073.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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33
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Santos AJ, Carvalho HM, Gonçalves CE. EFFECTS OF SPORT INVOLVEMENT IN ASSETS, ATTITUDES AND ENJOYMENT IN YOUTH SOCCER PLAYERS. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-093073.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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34
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Kislaya I, Santos AJ, Nicolau R, Gil AP. Violence against older adults in Portugal: findings from the first national prevalence study. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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João Santos A, Ferreira‐Alves J, Penhale B. Prevalence of older adults' abuse and neglect in Portugal: an overview. Quality in Ageing and Older Adults 2011. [DOI: 10.1108/14717791111163596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to identify, describe and compare the studies of the prevalence of abuse and neglect of older adults developed in Portugal.Design/methodology/approachA retrospective bibliographic search of seven descriptors in English and Portuguese, of academic and professional papers and university institutional repositories was performed.FindingsOf the nine studies selected, seven consisted of grey literature – research developed within the course of academic post‐graduate studies. The studies were conducted on a small scale, more often than not, through a non‐probabilistic convenience sampling method. From the nine studies, two instruments prevailed: the Questions to Elicit Elder Abuse aimed at older adults and the Caregiver Abuse Screen aimed at caregivers. Community‐dwelling older adults self‐reported a higher prevalence of abuse (between 66.7 and 86.7 per cent) than care professionals working with older adults suffering from dementia (between 26.7 and 47.4 per cent). Emotional abuse and neglect were the first and second most prevalent forms of abuse, followed by financial abuse, whereas physical abuse was the least prevalent type of abuse encountered. A poorer perception of health, not making/receiving visits and residing in an urban area were the more consistent variables associated with abuse of older adults.Originality/valueOverall, this paper provides a first consideration to the prevalence rates of older adult abuse and neglect from research studies in Portugal. The revised design studies and screening methods employed can help researchers improve future study design and move from the description to a more theoretically oriented research. Furthermore, it can help practitioners learn screening methods and discover the findings associated with abuse.
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36
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Gil MC, García-Herreros M, Barón FJ, Aparicio IM, Santos AJ, García-Marín LJ. Morphometry of porcine spermatozoa and its functional significance in relation with the motility parameters in fresh semen. Theriogenology 2008; 71:254-63. [PMID: 18760833 DOI: 10.1016/j.theriogenology.2008.07.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Revised: 07/11/2008] [Accepted: 07/12/2008] [Indexed: 10/21/2022]
Abstract
Both the study and the relationship between sperm design and sperm function have been a target of several researchers. In our study we have evaluated the relationship between the morphometry of sperm head and midpiece as well as the relationship between morphometry of these two spermatic components and sperm motion characteristics in the boar. Analysis of regression (lineal and multiple) and principal components analysis were used for the study of these relationships. Semen samples from five Iberian boars were taken for analysis. Analysis of morphometry was assessed by CASMA system and motility by CASA system. Sperm midpiece showed a significant relationship (positive or negative, depending on the morphometric parameter evaluated) with sperm head. VSL, LIN, STR, BCF and VAP showed a significant relationship with several head and midpiece morphometric parameters. Finally, through the analysis of multiple lineal regression we obtained several statistical models that predict STR, LIN, VCL, ALH, BCF, PC1 and PC2 (the last two variables have been obtained from a principal components analysis) as a function of one, two or three morphometric parameters. Our results suggest a co-evolution of sperm head and midpiece and in addition that sperm motion characteristics of porcine spermatozoa are influenced by morphometry of head and midpiece.
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Affiliation(s)
- M C Gil
- Department of Animal Medicine, Faculty of Veterinary Medicine, University of Extremadura, Cáceres, Spain.
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37
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Abstract
Computer-assisted sperm morphometry analysis was used to determine the effects of cryopreservation on boar sperm head and midpiece morphometry. Sperm-rich fractions were collected from five mature boars. Three microscope slides were prepared from single extended sperm samples prior freezing and post-thawing. All slides were stained with Hemacolor, and 250 sperm images were obtained from each slide. The sperm head dimensions for length, width, area, perimeter and four shape factors and sperm-midpiece dimensions for area, width, angle and distance were determined in each spermatozoa. The effects of sperm freezing on sperm dimensions within and among boars were determined. A previous discriminant analysis of the results was able to correctly classify a 78.3 and 82% of fresh and frozen-thawed spermatozoa respectively. Sperm heads were significantly smaller in cryopreserved spermatozoa than in the companion extended samples for length, width, area and perimeter. Sperm midpieces were also significantly smaller in cryopreserved spermatozoa for width and area. The highest changes in morphometric dimensions after the freeze-thawing process were found in the midpiece of spermatozoa. The variability of morphometric measurements only was significantly different between fresh and thawed samples for head rugosity and midpiece area. The effects of cryopreservation on morphometric parameters were similar in the boars, which allow us to conclude that cryopreservation process does not have a different effect in each individual boar. In summary, morphometric changes associated with the cryopreservation process on boar spermatozoa do not apparently depends on an effect at individual level.
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Affiliation(s)
- M García-Herreros
- Intracellular Signaling and Technology of Reproduction Research Group, Faculty of Veterinary, University of Extremadura, Spain
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38
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Malheiros SMF, Carrete H, Stávale JN, Santos AJ, Borges LRR, Guimarães IF, Pelaez MP, Franco CMR, Gabbai AA. MRI of medulloblastoma in adults. Neuroradiology 2003; 45:463-7. [PMID: 12819839 DOI: 10.1007/s00234-003-1011-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2003] [Accepted: 04/02/2003] [Indexed: 10/26/2022]
Abstract
Medulloblastoma has variable appearances on MRI in both children and adults. Adults are more likely to have heterogeneous cerebellar hemisphere tumours, and this is thought to be related to the greater prevalence of desmoplastic tumours in adulthood. Few studies have addressed the MRI features of adult medulloblastoma and the specific characteristics of desmoplastic and classic tumours have not been analysed. Our aim was to analyse the imaging characteristics of desmoplastic (DM) and classic (CM) medulloblastomas in adult. We retrospectively studied preoperative MRI of six men and three women, median age 33 years, range 23-53 years, with pathologically proved medulloblastomas. There were six (67%) with DM. The tumour was in the cerebellar hemisphere in eight patients (89%), including the three with CM, one of which was bilateral. All tumours were heterogeneous, giving predominantly low or isointense signal on T1- and isointense signal on T2-weighted images. Cystic or necrotic areas in all patients were particularly visible on T2-weighted images. Contrast enhancement was absent in one DM and varied from slight to intense in eight (three CM), homogeneous in one DM and patchy in seven. All tumours extended to the surface of the cerebellum and two had well-defined margins. MRI does not allow a clear distinction between DM and CM in adults.
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Affiliation(s)
- S M F Malheiros
- Department of Neurology, Universidade Federal de São Paulo Rua Botucatu 740, SP 04023-900, Sao Paulo, Brazil.
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39
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Marcondes CB, Pirmez C, Silva ES, Laurentino-Silva V, Steindel M, Santos AJ, Smaniotto H, Silva CFB, Schuck Neto VF, Donetto A. [A survey of visceral leishmaniasis in dogs from Santa Maria and neighbouring municipalities, State of Rio Grande do Sul]. Rev Soc Bras Med Trop 2003; 36:499-501. [PMID: 12937728 DOI: 10.1590/s0037-86822003000400011] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Five dogs from the municipalities of Santa Maria, Itaara and Júlio de Castilhos, in the centre of the Brazilian State of Rio Grande do Sul, were diagnosed as positive for visceral leishmaniasis. A survey was developed by indirect immunofluorescence in blood obtained in filter paper from 40 dogs from Santa Maria, 20 from Itaara and 11 from Júlio de Castilhos. Examined dogs were generally related to those reputedly positive. Besides the above dogs, blood from 44 stray dogs from Júlio de Castilhos, 68 from Cachoeira do Sul and 20 from Caçapava do Sul was also examined. Slightly positive sera ( 1:40) were examined with ELISA. PCR and histology was used to examine the liver, spleen, lungs and lymph nodes from a sixth dog considered at necropsy to be positive for visceral leishmaniasis. All results for the 204 dogs were negative. This indicates that visceral leishmaniasis, due to various factors discussed below, is extremely rare in this region. A more detailed exam of the material from the five dogs considered positive is necessary.
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Affiliation(s)
- Carlos Brisola Marcondes
- Departamento de Microbiologia e Parasitologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florian polis, SC, Brasil.
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40
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Franco CM, Malheiros SM, Nogueira RG, Batista MA, Santos AJ, Abdala N, Stávale JN, Ferraz FA, Gabbai AA. [Multiple gliomas. Illustrative cases of 4 different presentations]. Arq Neuropsiquiatr 2000; 58:150-6. [PMID: 10770881 DOI: 10.1590/s0004-282x2000000100023] [Citation(s) in RCA: 6] [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: 11/22/2022]
Abstract
Multiple gliomas are uncommon and may be classified according to: a) the time of presentation in early (at diagnosis) or late (during treatment); b) the characteristics of computed tomography or magnetic resonance imaging (CT/MRI) in multifocal (with evidence of spread) and multicentric (without evidence of spread). From 212 patients with histopathologic diagnosis of glioma evaluated from March/90 to September/99, 15 (7%) had multiple lesions. We describe 4 patients: early multicentric, late multicentric, early multifocal and late multifocal, with emphasis on characteristics of CT/MRI and possible differential diagnosis. The differential diagnosis of multiple lesions in the central nervous system includes mainly infectious/inflammatory diseases and metastasis, however multiple gliomas should always be considered, even in patients with known systemic cancer, as described by others. Considering that CT/MRI features are not definite, the diagnosis should always be confirmed by histopathologic examination.
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Affiliation(s)
- C M Franco
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP.
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41
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Gallo P, Dalacorte A, Raupp E, Santos AJ, Frank MR, Saraiva GA. Giant pseudoaneurysm of the extracranial vertebral artery: case report. Arq Neuropsiquiatr 1996; 54:297-303. [PMID: 8984990 DOI: 10.1590/s0004-282x1996000200019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Pseudoaneurysms of the extracranial vertebral artery are extremely rare due to their deep location and the anatomical protection of this artery. They can be caused by cervical traumas (firearm injuries, sports, hyperextension of the neck and iatrogeny). The authors report the case of a patient who developed a giant pseudoaneurysm of the extracranial vertebral artery after surgery for the removal of a tumor of the cerebellopontine angle in which surgical lesion of the artery occurred. Treatment was performed by endovascular approach. Literature is reviewed and comments are made on the physiopathogeny of the lesion and the different forms of treatment.
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Affiliation(s)
- P Gallo
- Department of Neurosurgery, Cristo Redentor Hospital, Porto Alegre, Brazil
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42
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Soares-Costa JT, Soares-Costa TJ, Santos AJ, Monteiro AJ. [Influence of age on systolic and diastolic time intervals in normal individuals]. Rev Port Cardiol 1991; 10:943-51. [PMID: 1807299] [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: 12/28/2022] Open
Abstract
OBJECTIVE To evaluate the influence of age (I) on the left ventricle (VE) systolic time intervals, the S2O interval, the pulse transmission time (TTP) and the relative amplitude of the a wave (Aa%) of the apexcardiogram (ACG) of normal individuals. METHODS 202 subjects considered as normal by clinical and electrocardiographic examinations were studied. Their age (I) was 38 +/- 13 years (average +/- 1 SD), being 125 male and 77 female. The electrocardiogram (ECG), phonocardiogram, ACG and carotid arterial pulse tracing (PC) were simultaneously recorded. The following intervals were determined: Electromechanical (IEM)--from the onset of QRS complex of the ECG to the ascending branch of the great wave of the ACG (A point); mechanical systole (SM)--from the A point of the ACG to the beginning of first high frequency vibration of the aortic component of the second heart sound (S2); ejection period (FE)--from the beginning of the anacrotic branch of the PC to the nadir of its dicrotic notch (ID); isovolumic contraction time (FIS)--subtracting FE duration to the SM duration; S2O interval--since S2 to the O point (nadir) of the ACG; Aa%--relation percentage expressed between a wave amplitude and total amplitude of the ACG; pulse transmission time--since S2 to ID. Statistically significant correlations (p less than 0.05) between I (years expressed) and the previously mentioned variables were investigated. RESULTS It was possible to verify: a) the IEM and FIS intervals were not significantly correlated with I; b) the FE had a linear, positive and significant correlation with I (r = 0.222); c) the correlations between FE and heart rate (FC) were not significantly different between the considered age groups (14-34, 35-49, 50-69 years); d) the S2O interval had a linear, negative and significant correlation with FC (r = -0.196), and a linear, positive and significant correlation with I (r = 0.392); e) multiple regression equation between S2O, I and FC was: S2O = 70 - 0.36 x FC + 0.55 x I; f) the Aa% had a linear, positive and significant correlation with I (r = 0.252); g) TTP has a linear, negative and significant correlation with I (r = -0.793). CONCLUSIONS a) The FE increases with I related probably to the afterload increasing that follows aging process; b) the S2O interval increases with I reflecting the elongation of the relaxing time that is associated to the senescence; c) the Aa% increases with I, expressing the reduction of the compliance of the VE associated to the aging; d) the TTP decreases with I related to the increasing of velocity of the pulse wave that follows senescence and is attributed to the increasing of the aortic stiffness.
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43
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Abstract
The profiles of testosterone (T) 11-ketotestosterone (11-KT), 17 alpha-hydroxy-4-pregnen-3-one (17-P), and 17 alpha,20 beta-dihydroxy-4-pregnen-3-one (17,20 beta-P) were determined in groups of spermiating male common carp (Cyprinus carpio) which were or were not mated with females and subjected to an increase in water temperature, a treatment which usually induces females to spawn. The steroid levels were correlated with changes in gonadotropin (GtH). All males mated with ovulatory females showed a GtH surge and spawned. Two distinct classes of these spawned males were differentiated based on their initial androgen levels and hormone profiles. Androgen levels were initially elevated in the "high" males. In these fish there was a very rapid shift in the steroidogenic pathway from androgen to progestogen production coincident with the GtH surge. In the "low" males, 17-P levels rose significantly in response to the GtH surge, but there was no steroidogenic shift. In the males mated with nonovulatory females, the levels of 17-P, 17,20 beta-P, T, and 11-KT all increased coincident with a small rise in GtH; there was no steroidogenic shift. In the unmated males, the steroid profiles were similar to those in the nonspawned fish, except that T and 11-KT levels were significantly lower in comparison. In all groups, 17-P rose higher than 17,20 beta-P, and 11-KT was generally the predominant androgen. A model is proposed which explains the steroidogenic shift in the "high" males. This involves the inhibition of androgen biosynthesis by 17,20 beta-P or by a related progestogen.
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Affiliation(s)
- T P Barry
- Department of Fisheries, Faculty of Agriculture, University of Tokyo, Japan
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44
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Dariano JA, Furlanetto TW, Costa SS, Prenna FJ, Santos AJ, Sharer LR. Suprasellar germinoma: an unusual clinical presentation. Surg Neurol 1981; 15:294-7. [PMID: 7245016 DOI: 10.1016/s0090-3019(81)80010-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A case is described of suprasellar tumor with diabetes insipidus, diminishing visual acuity, inferior bitemporal quadrantanopia, and hypopituitarism in a 19-year-old man. Computerized tomographic scan of the brain after contrast injection demonstrated periventricular enhancement. Diagnosis of germinoma was made on the basis of clinical and radiographic information and a biopsy that revealed malignant cells. The tumor responded well to radiation therapy. Diagnostic difficulties were created by systemic manifestations unrelated to endocrinopathy. Pertinent literature is reviewed.
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