Blend of Baru (Dipteryx alata Vog.) By-Products as Nutritive and Healthy Food Ingredients: Chemical Composition, Functional Properties and Application in Plant-Based Burger

The chemical composition, antioxidant capacity and functional properties of mixtures of baru by-products, named baru food ingredients (BFI), were investigated and applied in a plant-based burger formulation. BFI were prepared from wasted baru by-products - partially defatted baru nut cake and baru pulp plus peel. A plant-based burger was developed and its chemical composition, antioxidant capacity, cooking and texture parameters were determined. BFI1 (50% partially defatted baru nut cake + 50% baru pulp plus peel) had the highest content of carbohydrate (31.9%), and dietary fibre (28.3%). BFI2 (75% partially defatted baru nut cake + 25% baru pulp plus peel) and BFI3 (90% partially defatted baru nut cake + 10% baru pulp plus peel) showed high concentration of protein and dietary fibre, and BFI3 had the highest protein content (29.5%). All BFI showed high concentration of total phenolics (402-443 mg GAE/100 g). Replacing textured pea protein of control burger (PPB) with 35% of BFI3 in the formulation of baru protein burger (BPB) resulted in a low-fat product (2.9%), with protein content (19.2%) comparable to the PPB (15.9%) and the commercial burger (mixed plant proteins - 16.3%). The BPB also showed a higher concentration of dietary fibre (4.9%) and phenolic compounds (128 mg GAE/100 g) than the control burger. BPB's cooking yield was the highest among the tested burgers. BPB had a softer texture when compared to other burgers. Baru food ingredients can be used as nutritive ingredients of health-promoting foods, especially in plant-based products, such as burger and meat analogues, or in hybrid meat products. BPB showed a healthy and nutritious profile.

A miniaturised semi-dynamic in-vitro model of human digestion

Reliable in-vitro digestion models that are able to successfully replicate the conditions found in the human gastrointestinal tract are key to assess the fate and efficiency of new formulations aimed for oral consumption. However, current in-vitro models either lack the capability to replicate crucial dynamics of digestion or require large volumes of sample/reagents, which can be scarce when working with nanomaterials under development. Here, we propose a miniaturised digestion system, a digestion-chip, based on incubation chambers integrated on a polymethylmethacrylate device. The digestion-chip incorporates key dynamic features of human digestion, such as gradual acidification and gradual addition of enzymes and simulated fluids in the gastric phase, and controlled gastric emptying, while maintaining low complexity and using small volumes of sample and reagents. In addition, the new approach integrates real-time automated closed-loop control of two key parameters, pH and temperature, during the two main phases of digestion (gastric and intestinal) with an accuracy down to ± 0.1 °C and ± 0.2 pH points. The experimental results demonstrate that the digestion-chip successfully replicates the gold standard static digestion INFOGEST protocol and that the semi-dynamic digestion kinetics can be reliably fitted to a first kinetic order model. These devices can be easily adapted to dynamic features in an automated, sensorised, and inexpensive platform and will enable reliable, low-cost and efficient assessment of the bioaccessibility of new and expensive drugs, bioactive ingredients or nanoengineered materials aimed for oral consumption, thereby avoiding unnecessary animal testing.

KeyRecs: A keystroke dynamics and typing pattern recognition dataset

Keystroke dynamics can valuably contribute to the development of intelligent authentication systems by enabling a single and continuous authentication process in a passive and non-intrusive manner by continuously verifying a user's identity. This work describes the KeyRecs dataset, which contains fixed-text and free-text samples of user typing behavior and demographic information of the participants age, gender, handedness, and nationality. The keystroke data was obtained from 99 participants of various nationalities who completed password retype and transcription exercises. The recorded samples consist of inter-key latencies computed in a digraph fashion measuring the time between each key press and release during an exercise. KeyRecs can be leveraged to improve the recognition of authorized users and prevent unauthorized access in biometric authentication software.

Holistic Security and Safety for Factories of the Future

The accelerating transition of traditional industrial processes towards fully automated and intelligent manufacturing is being witnessed in almost all segments. This major adoption of enhanced technology and digitization processes has been originally embraced by the Factories of the Future and Industry 4.0 initiatives. The overall aim is to create smarter, more sustainable, and more resilient future-oriented factories. Unsurprisingly, introducing new production paradigms based on technologies such as machine learning (ML), the Internet of Things (IoT), and robotics does not come at no cost as each newly incorporated technique poses various safety and security challenges. Similarly, the integration required between these techniques to establish a unified and fully interconnected environment contributes to additional threats and risks in the Factories of the Future. Accumulating and analyzing seemingly unrelated activities, occurring simultaneously in different parts of the factory, is essential to establish cyber situational awareness of the investigated environment. Our work contributes to these efforts, in essence by envisioning and implementing the SMS-DT, an integrated platform to simulate and monitor industrial conditions in a digital twin-based architecture. SMS-DT is represented in a three-tier architecture comprising the involved data and control flows: edge, platform, and enterprise tiers. The goal of our platform is to capture, analyze, and correlate a wide range of events being tracked by sensors and systems in various domains of the factory. For this aim, multiple components have been developed on the basis of artificial intelligence to simulate dominant aspects in industries, including network analysis, energy optimization, and worker behavior. A data lake was also used to store collected information, and a set of intelligent services was delivered on the basis of innovative analysis and learning approaches. Finally, the platform was tested in a textile industry environment and integrated with its ERP system. Two misuse cases were simulated to track the factory machines, systems, and people and to assess the role of SMS-DT correlation mechanisms in preventing intentional and unintentional actions. The results of these misuse case simulations showed how the SMS-DT platform can intervene in two domains in the first scenario and three in the second one, resulting in correlating the alerts and reporting them to security operators in the multi-domain intelligent correlation dashboard.

Linear and Non-Linear Soft Sensors for Predicting the Research Octane Number (RON) through Integrated Synchronization, Resolution Selection and Modelling

The Research Octane Number (RON) is a key quality parameter for gasoline, obtained offline through complex, time-consuming, and expensive standard methods. Measurements are usually only available a few times per week and after long delays, making process control very challenging. Therefore, alternative methods have been proposed to predict RON from readily available data. In this work, we report the development of inferential models for predicting RON from process data collected in a real catalytic reforming process. Data resolution and synchronization were explicitly considered during the modelling stage, where 20 predictive linear and non-linear machine learning models were assessed and compared using a robust Monte Carlo double cross-validation approach. The workflow also handles outliers, missing data, multirate and multiresolution observations, and processes dynamics, among other features. Low RMSE were obtained under testing conditions (close to 0.5), with the best methods belonging to the class of penalized regression methods and partial least squares. The developed models allow for improved management of the operational conditions necessary to achieve the target RON, including a more effective use of the heating utilities, which improves process efficiency while reducing costs and emissions.

Portuguese Football Federation consensus statement 2020: nutrition and performance in football

Nutrition is an undeniable part of promoting health and performance among football (soccer) players. Nevertheless, nutritional strategies adopted in elite football can vary significantly depending on culture, habit and practical constraints and might not always be supported by scientific evidence. Therefore, a group of 28 Portuguese experts on sports nutrition, sports science and sports medicine sought to discuss current practices in the elite football landscape and review the existing evidence on nutritional strategies to be applied when supporting football players. Starting from understanding football's physical and physiological demands, five different moments were identified: preparing to play, match-day, recovery after matches, between matches and during injury or rehabilitation periods. When applicable, specificities of nutritional support to young athletes and female players were also addressed. The result is a set of practical recommendations that gathered consensus among involved experts, highlighting carbohydrates periodisation, hydration and conscious use of dietary supplements.

Precipitation-optimised targeting of nitrogen fertilisers in a model maize cropping system

Typically, half of the nitrogen (N) fertiliser applied to agricultural fields is lost to the wider environment. This inefficiency is driven by soil processes such as denitrification, volatilisation, surface run-off and leaching. Rainfall plays an important role in regulating these processes, ultimately governing when and where N fertiliser moves in soil and its susceptibility to gaseous loss. The interaction between rainfall, plant N uptake and N losses, however, remains poorly understood. In this study we use numerical modelling to predict the optimal N fertilisation strategy with respect to rainfall patterns and offer mechanistic explanations to the resultant differences in optimal times of fertiliser application. We developed a modelling framework that describes water and N transport in soil over a growing season and assesses nitrogen use efficiency (NUE) of split fertilisations within the context of different rainfall patterns. We used ninety rainfall patterns to determine their impact on optimal N fertilisation times. We considered the effects of root growth, root N uptake, microbial transformation of N and the effect of soil water saturation and flow on N movement in the soil profile. On average, we show that weather-optimised fertilisation strategies could improve crop N uptake by 20% compared to the mean uptake. In drier years, weather-optimising N applications improved the efficiency of crop N recovery by 35%. Further analysis shows that maximum plant N uptake is greatest under drier conditions due to reduced leaching, but it is harder to find the maximum due to low N mobility. The model could capture contrasting trends in NUE seen in previous arable cropping field trials. Furthermore, the model predicted that the variability in NUE seen in the field could be associated with precipitation-driven differences in N leaching and mobility. In conclusion, our results show that NUE in cropping systems could be significantly enhanced by synchronising fertiliser timings with both crop N demand and local weather patterns.

Trajectories of cognitive performance over 5 years in a cohort of breast cancer patients (NEON-BC)

Purpose

Cancer-related cognitive impairment may affect 30-70% of cancer patients, either at baseline or during and after treatment. We aimed to identify trajectories of cognitive performance, from before any treatment to 5 years later, in a cohort of breast cancer (BCa) patients.

Methods

BCa women admitted to the Portuguese Institute of Oncology, Porto, were included in the NEON-BC study during 2012. They were evaluated with the Montreal Cognitive Assessment (MoCA) before any treatment, and after 1, 3 and 5 years (N = 506, 503, 475 and 466, respectively). Nlme R package was used to fit a mixed-effect model of the trends in MoCA scores over time, with age and education as fixed effect. Coefficients of this model were retrieved to calculate an age- and education-modified MoCA score (mMoCA). Mclust was used to obtain clusters of trajectories of mMoCA.

Results

Two trajectories were identified, one with higher scores and increasing over time, and the other showing a continuous decline (25.9% of the participants and 84% of the women with cognitive impairment confirmed by neuropsychological tests and clinical examination by neurologist at the 5 year follow-up). Each trajectory was split into 2, according to scoring above or below to the median value of mMoCA at baseline to account for the possibility of patients being in a declining pathway before treatment. In addition to trajectories characterized by the highest and lowest scores, respectively, relatively stable over time, two trajectories with middle-range scores were observed, one increasing over time and the other decreasing (12.7% of the participants); being older than 65 years, suffering from anxiety, depression or poor sleep after treatment were more frequent among the latter.

Conclusions

One quarter of the 5-year breast cancer survivors had a declining trajectory in cognitive performance. Anxiety, depression and sleep quality should be considered as targets for preventive or curative interventions of cognitive decline.

Key messages

Cognitive decline occurs during breast cancer care, affecting one quarter of the patients. Anxiety, depression and sleep quality should be considered as targets for preventive or curative interventions of cognitive decline.

Linking root structure to functionality: the impact of root system architecture on citrate-enhanced phosphate uptake

Root citrate exudation is thought to be important for phosphate solubilization. Previous research has concluded that cluster-like roots benefit most from this exudation in terms of increased phosphate uptake, suggesting that root structure plays an important role in citrate-enhanced uptake (additional phosphate uptake due to citrate exudation). Time-resolved computed tomography images of wheat root systems were used as the geometry for 3D citrate-phosphate solubilization models. Citrate-enhanced uptake was correlated with morphological measures of the root systems to determine which had the most benefit. A large variation of citrate-enhanced uptake over 11 root structures was observed. Root surface area dominated absolute phosphate uptake, but did not explain citrate-enhanced uptake. Number of exuding root tips correlated well with citrate-enhanced uptake. Root tips in close proximity could collectively exude high amounts of citrate, resulting in a delayed spike in citrate-enhanced uptake. Root system architecture plays an important role in citrate-enhanced uptake. Singular morphological measurements of the root systems cannot entirely explain variations in citrate-enhanced uptake. Root systems with many tips would benefit greatly from citrate exudation. Quantifying citrate-enhanced uptake experimentally is difficult as variations in root surface area would overwhelm citrate benefits.

P5739Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock: exploring prognostic variables and risk prediction tools

Introduction

The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) to support patients in cardiogenic shock has been increasing in Portugal over the past few years. Nonetheless, epidemiologic, prognostic and clinical outcome data are scarce.

Purpose

We aim to identify clinical variables with prognostic significance in this challenging population, as well as the performance of various risk scores in mortality prediction.

Methods

All patients that underwent VA-ECMO support at our Cardiac ICU between 2011 and 2018 were included in the analysis. Logistic regression analysis was used to assess the relationship between clinical variables and outcomes.

Results

Short-term mechanical support with VA-ECMO was given to 40 patients, with a mean age of 52±11 years. At the time of the implant, the mean SOFA score was 11.2±4.0, and mean SAVE score was −4.75±4.6. Mean ECMO support duration was 116±96 hours. In 70% (N=28) of patients, VA-ECMO was successfully weaned. In-hospital mortality was observed in 52.5% of patients, which was in accordance with the predicted mortality by SOFA score (22.5% to 82% in our population risk range) and by SAVE score (60 to 70%). Those who placed the VA-ECMO as a bridge to transplant or to long-term mechanical LV assist device had greater in-hospital mortality rates (91.6 vs 41.9%, p=0.013), as well as those under ≥2 inotropic/vasopressors (69.2 vs 21.4%, p=0.012) or when adrenaline use was needed (100% vs 44.1%, p=0.01). No other between-group differences were observed in what concerns short-term mortality. After logistic regression analysis, independent predictors of in-hospital mortality included AMI setting, number of vasoactive amines used, and necessity of a LV venting device. SAVE score had the greater predictive ability in these patients (AUC = 0.638) among the most utilized clinical risk scores (SOFA score AUC = 0.37; APACHE II score AUC = 0.59; SAPS II score AUC = 0.54).

Conclusion

In our analysis, patients in profound cardiogenic shock on VA-ECMO support had slightly better survival rates than predicted by classical Risk Scores. The SAVE score may be the most accurate tool to predict in-hospital mortality in this specific, and yet heterogeneous, clinical subset. Other well recognized clinical markers of severity may also help refine short-term prognosis, and potentially improve organ transplant or other destination therapy prioritization.

Metabolomic Fingerprinting of Salinispora From Atlantic Oceanic Islands

Salinispora (Micromonosporaceae) is an obligate marine bacterium genus consisting of three species that share over 99% 16S rRNA identity. The genome and biosynthetic pathways of the members of this genus have been widely investigated due to their production of species-specific metabolites. However, despite the species’ high genetic similarity, site-specific secondary metabolic gene clusters have been found in Salinispora strains collected at different locations. Therefore, exploring the metabolic expression of Salinispora recovered from different sites may furnish insights into their environmental adaptation or their chemical communication and, further, may lead to the discovery of new natural products. We describe the first occurrence of Salinispora strains in sediments from the Saint Peter and Saint Paul Archipelago (a collection of islets in Brazil) in the Atlantic Ocean, and we investigate the metabolic profiles of these strains by employing mass-spectrometry-based metabolomic approaches, including molecular networking from the Global Natural Products Social Molecular Networking platform. Furthermore, we analyze data from Salinispora strains recovered from sediments from the Madeira Archipelago (Portugal, Macaronesia) in order to provide a wider metabolomic investigation of Salinispora strains from the Atlantic Oceanic islands. Overall, our study evidences a broader geographic influence on the secondary metabolism of Salinispora than was previously proposed. Still, some biosynthetic gene clusters, such as those corresponding to typical chemical signatures of S. arenicola, like saliniketals and rifamycins, are highly conserved among the assessed strains.

Birth-weight differences at term are explained by placental dysfunction and not by maternal ethnicity

OBJECTIVE

To investigate the influence of ethnicity, fetal gender and placental dysfunction on birth weight (BW) in term fetuses of South Asian and Caucasian origin.

METHODS

This was a retrospective study of 627 term pregnancies assessed at two public tertiary hospitals in Spain and Sri Lanka. All fetuses underwent biometry and Doppler examinations within 2 weeks of delivery. The influences of fetal gender and ethnicity, gestational age (GA) at delivery, cerebroplacental ratio (CPR) and maternal age, height, weight and parity on BW were evaluated by multivariable regression analysis.

RESULTS

Fetuses born in Sri Lanka were smaller than those born in Spain (mean BW = 3026 ± 449 g vs 3295 ± 444 g; P < 0.001). Multivariable regression analysis demonstrated that GA at delivery, maternal weight, CPR, maternal height and fetal gender (estimates = 0.168, P < 0.001; 0.006, P < 0.001; 0.092, P = 0.003; 0.009, P = 0.002; 0.081, P = 0.01, respectively) were associated significantly with BW. Conversely, no significant association was noted for maternal ethnicity, age or parity (estimates = -0.010, P = 0.831; 0.005, P = 0.127; 0.035, P = 0.086, respectively). The findings were unchanged when the analysis was repeated using INTERGROWTH-21^st fetal weight centiles instead of BW (log odds, -0.175, P = 0.170 and 0.321, P < 0.001, respectively for ethnicity and CPR).

CONCLUSION

Fetal BW variation at term is less dependent on ethnic origin and better explained by placental dysfunction. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

Propriedade antimicrobiana e potencial citotóxico in vitro do gel de Aloe vera: uma discussão sobre o uso em queimaduras

Estudo experimental que teve por objetivo avaliar a propriedade antimicrobiana e o potencial citotóxico do gel da Aloe vera, a fim de discutir seu uso tópico em queimaduras. Para tanto, foram coletadas na cidade de Palmas-TO folhas da A. vera. O gel obtido após processamento das folhas foi dividido em dois grupos in natura (Amostra A) e liofilizado (Amostra B). A propriedade antimicrobiana foi realizada pelo método de macrodiluição em ágar e microdiluição em caldo para determinação da concentração inibitória mínima (CIM) e da concentração bactericida mínima (CBM), para microrganismos comumente identificados em lesões infectadas de indivíduos queimados. O ensaio de fragilidade osmótica eritrocitária (FOE) foi realizado para avaliação da citotoxicidade. Os resultados sugerem que a Aloe vera possui atividade antimicrobiana de caráter bacteriostática para S. aureus, E. cloacae, A. baumanii, P. aeuruginosa, E. coli e C. albicans, tanto na forma in natura como liofilizada. Quanto à citotoxicidade, não houve taxa de hemólise significativa (p < 0,05), bem como deformidade em membrana celular, que evidenciasse risco tóxico no uso do gel da planta para as concentrações máximas testadas 100% in natura e 20 mg/ml do extrato do gel liofilizado. No que tange ao uso popular no tratamento de queimaduras, as evidências deste estudo corroboram para a segurança do uso tópico. Entretanto, mais estudos de como ocorre a absorção e metabolização devem ser realizados. 

Influence of chorionicity and gestational age at single fetal loss on risk of preterm birth in twin pregnancy: analysis of STORK multiple pregnancy cohort

OBJECTIVE

Single intrauterine death (sIUD) in twin pregnancy is associated with a significant risk of cotwin demise and preterm birth (PTB), especially in monochorionic (MC) twins. However, it is yet to be established whether the gestational age at loss may influence the pregnancy outcome. The aim of this study was to explore the risk of PTB according to the gestational age at diagnosis of sIUD.

METHODS

This was a cohort study of all twin pregnancies booked for antenatal care in a large regional network of nine hospitals over a 10-year period. Ultrasound data were matched to hospital delivery records and to a mandatory national register for stillbirth and neonatal loss provided by the Centre for Maternal and Child Enquires. Cases with double fetal loss at the time of the scan and cases of sIUD occurring at or after 34 weeks of gestation were not included in the analysis. The relative risk (RR) of PTB at < 34, < 32 and < 28 weeks of gestation in twin pregnancies complicated by sIUD was assessed and compared with that in twin pregnancies without fetal loss. The risk of PTB at < 34 weeks was stratified according to the gestational age at diagnosis of sIUD. The risk of PTB in twin pregnancy after sIUD according to the gestational age at death was also explored.

RESULTS

The analysis included 3013 twin gestations (2469 dichorionic (DC) and 544 MC). Median gestational age at birth was lower in the pregnancies complicated by sIUD compared with those that were not (32.0 weeks: interquartile range (IQR), 29.0-34.3 weeks vs 36.7 weeks: IQR, 35.0-37.6; P < 0.001) and this difference persisted when stratifying the data according to chorionicity (P < 0.0001 for both MC and DC pregnancies). The risk of PTB at < 34 weeks (RR, 4.3 (95% CI, 3.5-5.2)), < 32 weeks (RR, 6.1 (95% CI, 4.6-8.1)) and < 28 weeks (RR, 12.4 (95% CI, 6.9-22.2)) of gestation was higher in pregnancies complicated by sIUD compared with those which did not experience fetal loss. This association was observed both in MC and DC twin gestations. When compared with DC pregnancies, MC twins affected by sIUD were not at significantly increased risk of PTB before either 34, 32 or 28 weeks of gestation. The risk of PTB at < 34 weeks of gestation was higher when the sIUD occurred at a later gestational age (chi-square test for trend, P < 0.001).

CONCLUSIONS

Twin pregnancies complicated by sIUD, regardless of the chorionicity, have a significantly higher risk of PTB at < 34, < 32 and < 28 weeks of gestation. The risk of PTB at < 34 weeks of gestation was higher when the sIUD occurred in the second half of the pregnancy. Large prospective multicenter studies with shared protocols for prenatal management are needed to ascertain the actual risk of spontaneous PTB in twin pregnancies affected by sIUD. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Comparison of self-expanding and balloon-expandable transcatheter aortic valves morphology and association with paravalvular regurgitation: Evaluation using multidetector computed tomography

OBJECTIVES

Compare final morphology of self-expanding and balloon-expandable prosthesis and association with paravalvular regurgitation (PVR).

BACKGROUND

PVR after transcatheter aortic valve replacement (TAVR) remains a frequent complication. A better understanding of the prosthesis geometry may be important to improve selection of the best device for each case and possibly reduce the rates of PVR.

METHODS

Retrospective study including patients consecutively submitted to transcatheter aortic valve replacement: August/2007-October/2016. Three months after the procedure a multidetector computed tomography (MDCT) was performed to assess prosthesis geometry: dimensions, eccentricity, and expansion.

RESULTS

A total of 147 individuals were included (mean age of 78.8 ± 6.7 and 50.3% males), 57% treated with a self-expanding prosthesis. On the postprocedure MDCT, the self-expanding group had higher eccentricity index (15.0 vs. 7.1%, p < .001) and lower expansion (68.3 vs. 82.8%, p < .001). In that group, the volume of calcium of landing zone had a significant correlation with eccentricity index and under-expansion. Patients with ≥mild PVR presented higher eccentricity (12.6 vs. 7.9%, p < .001) and lower expansion (68 vs. 75%, p = .012). Eccentricity index and landing zone calcium volume were independent predictors of PVR.

CONCLUSIONS

Self-expanding prosthesis have greater eccentricity and under-expansion. Calcium burden exerts more influence in the final morphology of that type of valve. Calcification and eccentricity are associated with the development of PVR. These factors should be considered in the selection of the most appropriate type of prosthesis for each scenario.

Association between implantation depth assessed by computed tomography and new-onset conduction disturbances after transcatheter aortic valve implantation

BACKGROUND

Transcatheter aortic valve replacement (TAVR) is often associated with intraventricular conduction disturbances. We aimed to determine the association between implantation depth assessed by multidetector computed tomography (MDCT) and new-onset conduction abnormalities after TAVR.

METHODS

Retrospective single-center study including patients consecutively submitted to TAVR, between August/2007 and October/2016, who underwent routine MDCT 3 months after the procedure. The endpoint of conduction disturbances included permanent pacemaker implantation and/or new-onset left bundle-branch block. Implantation depth was determined as the distance between the ventricular end of the prothesis and the native ring, at the level of the non-coronary cusp.

RESULTS

138 patients were included (female gender 52.2%, mean age 78.7 ± 6.9 years). The EuroSCORE II was 4.0 ± 3.9% and 57.2% were treated with self-expanding prosthesis. The endpoint of conduction abnormalities was found in 45.7% (n = 63). The implantation depth was greater in the group with conduction disturbances (7.7 vs 6.4 mm, p = 0.006). Chronic obstructive pulmonary disease, oversizing and implantation depth were independent predictors of conduction abnormalities. Implantation depth had an AUC of 0.64 (p = 0.004) for the prediction of conduction abnormalities and a cut-off value of 7.1 mm predicted the composed endpoint with a sensitivity and specificity of 65% and 70%, respectively.

CONCLUSIONS

Implantation depth assessed by MDCT is associated with new-onset conduction disturbances after TAVR. In patients with conduction abnormalities, which do not qualify for the immediate implantation of pacemaker, the assessment of implantation depth by MDCT may be an additional marker of risk to aid decision-making.

The Madeira Archipelago As a Significant Source of Marine-Derived Actinomycete Diversity with Anticancer and Antimicrobial Potential

Marine-derived actinomycetes have demonstrated an ability to produce novel compounds with medically relevant biological activity. Studying the diversity and biogeographical patterns of marine actinomycetes offers an opportunity to identify genera that are under environmental pressures, which may drive adaptations that yield specific biosynthetic capabilities. The present study describes research efforts to explore regions of the Atlantic Ocean, specifically around the Madeira Archipelago, where knowledge of the indigenous actinomycete diversity is scarce. A total of 400 actinomycetes were isolated, sequenced, and screened for antimicrobial and anticancer activities. The three most abundant genera identified were Streptomyces, Actinomadura, and Micromonospora. Phylogenetic analyses of the marine OTUs isolated indicated that the Madeira Archipelago is a new source of actinomycetes adapted to life in the ocean. Phylogenetic differences between offshore (>100 m from shore) and nearshore (< 100 m from shore) populations illustrates the importance of sampling offshore in order to isolate new and diverse bacterial strains. Novel phylotypes from chemically rich marine actinomycete groups like MAR4 and the genus Salinispora were isolated. Anticancer and antimicrobial assays identified Streptomyces, Micromonospora, and Salinispora as the most biologically active genera. This study illustrates the importance of bioprospecting efforts at unexplored regions of the ocean to recover bacterial strains with the potential to produce novel and interesting chemistry.

Proceedings of the 3rd IPLeiria's International Health Congress : Leiria, Portugal. 6-7 May 2016

S1 Health literacy and health education in adolescence

Catarina Cardoso Tomás

S2 The effect of a walking program on the quality of life and well-being of people with schizophrenia

Emanuel Oliveira, D. Sousa, M. Uba-Chupel, G. Furtado, C. Rocha, A. Teixeira, P. Ferreira

S3 Diagnosis and innovative treatments - the way to a better medical practice

Celeste Alves

S4 Simulation-based learning and how it is a high contribution

Stefan Gisin

S5 Formative research about acceptability, utilization and promotion of a home fortification programme with micronutrient powders (MNP) in the Autonomous Region of Príncipe, São Tomé and Príncipe

Elisabete Catarino, Nelma Carvalho, Tiago Coucelo, Luís Bonfim, Carina Silva

S6 Safety culture of the patient: a reflexion about the therapeutic approach on the patient with vocal pathology

Débora Franco

S7 About wine, fortune cookies and patient experience

Jesús Alcoba González

O1 The psychological impact on the emergency crews after the disaster event on February 20, 2010

Helena G. Jardim, Rita Silva

O2 Musculoskeletal disorders in midwives

Cristina L. Baixinho, Mª Helena Presado, Mª Fátima Marques, Mário E. Cardoso

O3 Negative childhood experiences and fears of compassion: Implications for psychological difficulties in adolescence

Marina Cunha, Joana Mendes, Ana Xavier, Ana Galhardo, Margarida Couto

O4 Optimal age to give the first dose of measles vaccine in Portugal

João G. Frade, Carla Nunes, João R. Mesquita, Maria S. Nascimento, Guilherme Gonçalves

O5 Functional assessment of elderly in primary care

Conceição Castro, Alice Mártires, Mª João Monteiro, Conceição Rainho

O6 Smoking and coronary events in a population of Spanish health-care centre: An observational study

Francisco P. Caballero, Fatima M. Monago, Jose T. Guerrero, Rocio M. Monago, Africa P. Trigo, Milagros L. Gutierrez, Gemma M. Milanés, Mercedes G. Reina, Ana G. Villanueva, Ana S. Piñero, Isabel R. Aliseda, Francisco B. Ramirez

O7 Prevalence of musculoskeletal injuries in Portuguese musicians

Andrea Ribeiro, Ana Quelhas, Conceição Manso

O8 Hip fractures, psychotropic drug consumption and comorbidity in patients of a primary care practice in Spain

Francisco P. Caballero, Jose T. Guerrero, Fatima M. Monago, Rafael B. Santos, Nuria R. Jimenez, Cristina G. Nuñez, Inmaculada R. Gomez, Mª Jose L. Fernandez, Laura A. Marquez, Ana L. Moreno, Mª Jesus Tena Huertas, Francisco B. Ramirez

O9 The role of self-criticism and shame in social anxiety in a clinical SAD sample

Daniel Seabra, Mª Céu Salvador

O10 Obstruction and infiltration: a proposal of a quality indicator

Luciene Braga, Pedro Parreira, Anabela Salgueiro-Oliveira, Cristina Arreguy-Sena, Bibiana F. Oliveira, Mª Adriana Henriques

O11 Balance and anxiety and depression symptoms in old age people

Joana Santos, Sara Lebre, Alda Marques

O12 Prevalence of postural changes and risk factors in school children and adolescents in a northern region (Porto)

Clarinda Festas, Sandra Rodrigues, Andrea Ribeiro, José Lumini

O13 Ischemic stroke vs. haemorrhagic stroke survival rate

Ana G. Figueiredo

O14 Chronobiological factors as responsible for the appearance of locomotor pathology in adolescents

Francisco J. Hernandez-Martinez, Liliana Campi, Mª Pino Quintana-Montesdeoca, Juan F. Jimenez-Diaz, Bienvenida C. Rodriguez-De-Vera

O15 Risk of malnutrition in the elderly of Bragança

Alexandra Parente, Mª Augusta Mata, Ana Mª Pereira, Adília Fernandes, Manuel Brás

O16 A Lifestyle Educational Programme for primary care diabetic patients: the design of a complex nursing intervention

Mª Rosário Pinto, Pedro Parreira, Marta L. Basto, Ana C. Rei, Lisete M. Mónico

O17 Medication adherence in elderly people

Gilberta Sousa, Clementina Morna, Otília Freitas, Gregório Freitas, Ana Jardim, Rita Vasconcelos

O18 Hospitalization for cervical cancer of residents in the metropolitan region of Porto Alegre, Southern Brazil, 2012 to 2014

Lina G. Horta, Roger S. Rosa, Luís F. Kranz, Rita C. Nugem, Mariana S. Siqueira, Ronaldo Bordin

O19 Oncologic assistance of high complexity: evaluation of regulating accesses

Rosiane Kniess, Josimari T. Lacerda

O20 Perceived barriers for using health care services by the older population as seen by the social sector: findings from the Vila Nova de Gaia Gerontological Plan

Joana Guedes, Idalina Machado, Sidalina Almeida, Adriano Zilhão, Helder Alves, Óscar Ribeiro

O21 Sleep difficulties and depressive symptoms in college students

Ana P. Amaral, Ana Santos, Joana Monteiro, Mª Clara Rocha, Rui Cruz

O22 Psychopathological symptoms and medication use in higher education

Ana P. Amaral, Marina Lourenço, Mª Clara Rocha, Rui Cruz

O23 Sexually transmitted diseases in higher education institutions

Sandra Antunes, Verónica Mendonça, Isabel Andrade, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes

O24 Alcohol consumption and suicide ideation in higher education students

Lídia Cabral, Manuela Ferreira, Amadeu Gonçalves

O25 Quality of life in university students

Tatiana D. Luz, Leonardo Luz, Raul Martins

O26 Male and female adolescent antisocial behaviour: characterizing vulnerabilities in a Portuguese sample

Alice Morgado, Maria L. Vale-Dias

O27 Risk factors for mental health in higher education students of health sciences

Rui Porta-Nova

O28 International classification of functioning disability and health as reflexive reasoning in primary attention in health

Tânia C. Fleig, Éboni M. Reuter, Miriam B. Froemming, Sabrina L. Guerreiro, Lisiane L. Carvalho

O29 Risk factors and cardiovascular disease in Portalegre

Daniel Guedelha, P. Coelho, A. Pereira

O30 Health status of the elderly population living in Portalegre historic city centre: A longitudinal study

António Calha, Raul Cordeiro

O31 Student’s sleep in higher education: sleep quality among students of the IPB

Ana Gonçalves, Ana Certo, Ana Galvão, Mª Augusta Mata

O32 Trend in mortality from cervical cancer in the metropolitan area of Florianópolis, state of Santa Catarina, Brazil, 2000 to 2013

Aline Welter, Elayne Pereira, Sandra Ribeiro, Marcia Kretzer

O33 Adherence to treatment in the elderly in an urban environment in Spain

Juan-Fernando Jiménez-Díaz, Carla Jiménez-Rodríguez, Francisco-José Hernández-Martínez, Bienvenida-Del-Carmen Rodríguez-De-Vera, Alexandre Marques-Rodrigues

O34 Beira Baixa Blood Pressure Study (Study PABB)

Patrícia Coelho, Tiago Bernardes, Alexandre Pereira

O35 Trends in cervical cancer mortality statistics in Santa Catarina State, Brazil, by age group and macro-region, from 2000 to 2013

Patrícia Sousa, João G. Filho, Nazare Nazario, Marcia Kretzer

O36 Sleep problems among Portuguese adolescents: a public health issue

Odete Amaral, António Garrido, Nélio Veiga, Carla Nunes, Ana R. Pedro, Carlos Pereira

O37 Association between body fat and health-related quality of life in patients with type 2 diabetes

António Almeia, Helder M. Fernandes, Carlos Vasconcelos, Nelson Sousa, Victor M. Reis, M. João Monteiro, Romeu Mendes

O38 Therapy adherence and polypharmacy in non-institutionalized elderly from Amares county, Portugal

Isabel C. Pinto, Tânia Pires, João Gama

O39 Prevalence of surgical site infection in adults at a hospital unit in the North of Portugal

Vera Preto, Norberto Silva, Carlos Magalhães, Matilde Martins

O40 Frailty phenotype in old age: implications to intervention

Mafalda Duarte, Constança Paúl, Ignácio Martín

O41 Portuguese women: sexual symptoms in perimenopause

Arminda A. Pinheiro

O42 Predictive ability of the Perinatal Depression Screening and Prevention Tool – preliminary results of the categorical approach

Sandra Xavier, Julieta Azevedo, Elisabete Bento, Cristiana Marques, Mariana Marques, António Macedo, Ana T. Pereira

O43 Aging and muscle strength in patients with type 2 diabetes: cross sectional analysis

José P. Almeida, António Almeida, Josiane Alves, Nelson Sousa, Francisco Saavedra, Romeu Mendes

O44 Accessibility of the elderly in the prevention of hypertension in a family health unit

Ana S. Maia, Michelle T. Oliveira, Anderson R. Sousa, Paulo P. Ferreira, Luci S. Lopes, Eujcely C. Santiago

O45 Community Health screenings and self-reported chronic diseases

Sílvia Monteiro, Ângelo Jesus, Armanda Colaço, António Carvalho, Rita P. Silva, Agostinho Cruz

O46 Evaluation of indoor air quality in Kindergartens

Ana Ferreira, Catarina Marques, João P. Figueiredo, Susana Paixão

O47 Atmospheric exposure to chemical agents under the occupational activity of pathology technicians

Ana Ferreira, Carla Lopes, Fernando Moreira, João P. Figueiredo

O48 Occupational exposure to air pollutants in night entertainment venues workers

Ana Ferreira, Diana Ribeiro, Fernando Moreira, João P. Figueiredo, Susana Paixão

O49 Beliefs and attitudes of young people towards breastfeeding

Telma Fernandes, Diogo Amado, Jéssica Leal, Marcelo Azevedo, Sónia Ramalho

O50 Profiling informal caregivers: surveying needs in the care of the elderly

Catarina Mangas, Jaime Ribeiro, Rita Gonçalves

O51 Visual health in teenagers

Amélia F Nunes, Ana R. Tuna, Carlos R. Martins, Henriqueta D. Forte

O52 Amenable mortality and the geographic accessibility to healthcare in Portugal

Cláudia Costa, José A. Tenedório, Paula Santana

O53 Bacterial contamination of door handles in a São Paulo See Metropolitan Cathedral public restrooms in Brazil

J. A. Andrade, J. L. Pinto, C. Campofiorito, S. Nunes, A. Carmo, A. Kaliniczenco, B. Alves, F. Mendes, C. Jesus, F. Fonseca, F. Gehrke

O54 Adherence of patients to rehabilitation programmes

Carlos Albuquerque, Rita Batista, Madalena Cunha, António Madureira, Olivério Ribeiro, Rosa Martins

O55 Prevalence of malnutrition among Portuguese elderly living in nursing homes: preliminary results of the PEN-3S project

Teresa Madeira, Catarina Peixoto-Plácido, Nuno Santos, Osvaldo Santos, Astrid Bergland, Asta Bye, Carla Lopes, Violeta Alarcão, Beatriz Goulão, Nuno Mendonça, Paulo Nicola, João G. Clara

O56 Relation between emotional intelligence and mental illness in health students

João Gomes, Ana Querido, Catarina Tomás, Daniel Carvalho, Marina Cordeiro

P1 Fall risk factors in people older than 50 years old – a pilot report

Marlene C. Rosa, Alda Marques

P2 What about the Portuguese oldest old? A global overview using census data

Daniela Brandão, Óscar Ribeiro, Lia Araújo, Constança Paúl

P3 Prevalence of injuries in senior amateur volleyball athletes in Alentejo and Algarve clubs, Portugal: factors associated

Beatriz Minghelli, Sylvina Richaud

P4 Shame feelings and quality of life: the role of acceptance and decentring

Ana L. Mendes, Joana Marta-Simões, Inês A. Trindade, Cláudia Ferreira

P5 Assessment of social support during deployment in portuguese colonial war veterans

Teresa Carvalho, Marina Cunha, José Pinto-Gouveia

P6 Hospitalization for acute viral bronchiolitis of residents in the metropolitan region of Porto Alegre, Southern Brazil, 2012 to 2014

Morgana C. Fernandes, Roger S. Rosa, Rita C. Nugem, Luís F. Kranz, Mariana S. Siqueira, Ronaldo Bordin

P7 Falls-risk screening – an opportunity for preventing falls in the elderly from Nordeste

Anabela C. Martins, Anabela Medeiros, Rafaela Pimentel, Andreia Fernandes, Carlos Mendonça, Isabel Andrade, Susana Andrade, Ruth L. Menezes

P8 Aging provokes chronodisruption in mature people in temperature circadian rhythm

Rafael Bravo, Marta Miranda, Lierni Ugartemendia, José Mª Tena, Francisco L. Pérez-Caballero, Lorena Fuentes-Broto, Ana B. Rodríguez, Barriga Carmen

P9 The influence of climate and pollution factors in dengue cases of great ABC region, São Paulo

M. A. Carneiro, J. N. Domingues, S. Paixão, J. Figueiredo, V. B. Nascimento, C. Jesus, F Mendes, F. Gehrke, B. Alves, L. Azzalis, F. Fonseca

P10 Visual function and impact of visual therapy in children with learning disabilities: a pilot study

Ana R. Martins, Amélia Nunes, Arminda Jorge

P11 Edentulism and the need of oral rehabilitation among institutionalized elderly

Nélio Veiga, Ana Amorim, André Silva, Liliana Martinho, Luís Monteiro, Rafael Silva, Carina Coelho, Odete Amaral, Inês Coelho, Carlos Pereira, André Correia

P12 Therapy adherence of outpatients in the pharmacy services of a hospital unit

Diana Rodrigues, Nídia Marante, Pedro Silva, Sara Carvalho, André Rts Araujo, Maximiano Ribeiro, Paula Coutinho, Sandra Ventura, Fátima Roque

P13 Universal access and comprehensive care of oral health: an availability study

Cristina Calvo, Manoela Reses

P14 Is the respiratory function of children a predictor of air quality? Coimbra as a case study

Jorge Conde, Ana Ferreira, João Figueiredo

P15 Meaning-in-life of college students

David Silva, Luís Seiça, Raquel Soares, Ricardo Mourão, Teresa Kraus

O57 Training needs for nurses in palliative care

Ana C. Abreu, José M. Padilha, Júlia M. Alves

O58 Impact of computerized information systems in the global nurses’ workload: nurses’ perceptions and real-time

Paulino Sousa, Manuel Oliveira, Joana Sousa

O59 The perspective of health care professionals on self-care in hereditary neurodegenerative disease: a qualitative study

Sónia Novais, Felismina Mendes

O60 Contribution for health-related physical fitness reference values in healthy adolescents

Joana Pinto, Joana Cruz, Alda Marques

School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal

O61 Perception of learning, satisfaction and self-efficacy of nursing students about High-Fidelity Simulation

Hugo Duarte, Maria Dos Anjos Dixe, Pedro Sousa

O62 Analysis of statements of diagnosis about health deviation in self-care requisites customized in a Nursing Practice Support System (SAPE®): Management of therapeutic regimen

Inês Cruz, Fernanda Bastos, Filipe Pereira

O63 Hybrid management and hospital governance: doctors and nurses as managers

Francisco L. Carvalho, Teresa T. Oliveira, Vítor R. Raposo

O64 Time management in health professionals

Conceição Rainho, José C. Ribeiro, Isabel Barroso, Vítor Rodrigues

O65 Financial rewards and wellbeing in primary health care

Carmo Neves, Teresa C. Oliveira

O66 Patient safety promotion in the operating room

Bárbara Oliveira, Mª Carminda Morais, Pilar Baylina

O67 Difficulties and needs of pre-graduate nursing students in the area of Geriatrics/Gerontology

Rogério Rodrigues, Zaida Azeredo, Corália Vicente

O68 Teaching and learning sexuality in nursing education

Hélia Dias, Margarida Sim-Sim

O69 Entrepreneurial Motivations Questionnaire: AFC and CFA in academy

Pedro Parreira, Anabela Salgueiro-Oliveira, Amélia Castilho, Rosa Melo, João Graveto, José Gomes, Marina Vaquinhas, Carla Carvalho, Lisete Mónico, Nuno Brito

O70 Nursing intervention to patient with Permanent Pacemakers and Implantable Cardioverter Defibrillators: a qualitative analysis

Cassilda Sarroeira, José Amendoeira, Fátima Cunha, Anabela Cândido, Patrícia Fernandes, Helena R. Silva, Elsa Silva

O71 Alcohol consumption among nursing students: where does education fail?

Isabel Barroso, Leila Lapa, Cristina Antunes

O72 Labour stress in nursing

Ana Gonçalves, Ana Galvão, Mª José Gomes, Susana R. Escanciano

O73 The influence of safe staff nursing in patient satisfaction with nursing care

Maria Freitas, Pedro Parreira, João Marôco

O74 Intention to use eHealth strategies with nursing students

Ana R. Fernandes, Cremilde Cabral, Samuel Alves, Pedro Sousa

O75 Community Based Mental Health: contributions of an interdisciplinary international program for students in higher health education

António Ferreira, Fernanda Príncipe, Ulla-Maija Seppänen, Margarida Ferreira, Maribel Carvalhais, Marilene Silva

O76 Study of satisfaction at work of graduates in nursing: 2002-2014

Manuela Ferreira, Joana Silva, Jéssica Neves, Diana Costa, Bruno Santos, Soraia Duarte

O77 Health professionals’ attitudes towards breastfeeding

Sílvia Marques, Sónia Ramalho, Isabel Mendes

O78 Continuity of nursing care to person with type 2 diabetes

Clarisse Louro, Eva Menino, Maria Dixe, Sara S. Dias

O79 Stigma toward mental illness among future health professionals

Marina Cordeiro, Catarina Tomás, Ana Querido, Daniel Carvalho, João Gomes

O80 Working with fears and anxieties of medical students in search of a humanized care

Frederico C. Valim, Joyce O. Costa, Lúcia G. Bernardes

P16 Surgical paediatrics patients’ psycho prophylaxis at a teaching hospital

Helena Prebianchi

P17 Patient-perceived outcomes in physiotherapy – a pilot study

Marlene Cristina Rosa

P18 Building competencies for managers in nursing

Narcisa Gonçalves, Maria M. Martins, Paulina Kurcgant

P19 Theoretical basis underlying physiotherapy practice in stroke rehabilitation

André Vieira

P20 When the life-cycle ends: the nurse’s confrontation with death

Sandrina Bento, Sérgio Deodato, Isabel Rabiais

P21 Nursing students’ opinion about the supervision relationship during their first clinical experience

Laura Reis

P22 Nursing Relational Laboratory: Pedagogical, dialogic and critical project

Ana Torres, Sérgio Soares, Margarida Ferreira, Pedro Graça

P23 Job satisfaction of bioscientists at a Lisbon hospital

Céu Leitão, Renato Abreu, Fernando Bellém, Ana Almeida, Edna Ribeiro-Varandas, Ana Tavares

P24 Sociodemographic and professional profile of nurses and its relation with the importance of family in nursing practices

João G. Frade, Carolina Henriques, Eva Menino, Clarisse Louro, Célia Jordão

P25 Professional satisfaction of rehabilitation nurses

Sofia Neco, Carminda Morais, Pedro Ferreira

P26 The person living with a stoma: the formalization of knowledge in nursing

Carla R. Silva, Alice Brito, Antónia Silva

P27 Validation of the Portuguese versions of the nursing students’ perceptions of learning and learner satisfaction with simulation tool

Hugo Duarte, Maria Dos Anjos Dixe, Pedro Sousa

P28 Physiotherapists’ perceived knowledge on technologies for electronic health records for physiotherapy

Gabriela Postolache, Raul Oliveira, Isabel Moreira, Luísa Pedro, Sónia Vicente, Samuel Domingos, Octavian Postolache

P29 Quality of life and physical activity of medicine undergraduate students in the University of Southern Santa Catarina, Brazil

Darlen Silva, João G. Filho, Nazare Nazario, Marcia Kretzer, Dulcineia Schneider

P30 The curricular skills for decision making education in a Nursing Degree

Fátima M. Marques

P31 Effect of nurses’ mobilization in satisfaction at work and turnover: An empirical study in the hospital setting

Pedro Parreira, Carla Carvalho, Lisete M. Mónico, Carlos Pinto, Sara Vicente, São João Breda

P32 Entrepreneurial skills of students of polytechnic higher education in Portugal: Business influences

José H. Gomes, Rosa Melo, Pedro Parreira, Anabela Salgueiro, João Graveto, Marina Vaquinhas, Amélia Castilho

P33 Design and assessment of e-learning modules for Pharmacology

Ângelo Jesus, Nuno Duarte, José C. Lopes, Hélder Nunes, Agostinho Cruz

P34 Perspective of nurses involved in an action-research study on the changes observed in care provision: results from a focus group

Anabela Salgueiro-Oliveira, Pedro Parreira, Marta L. Basto, Luciene M. Braga

P35 Use of peer feedback by nursing students during clinical training: teacher’s perception

António Ferreira, Beatriz Araújo, José M. Alves, Margarida Ferreira, Maribel Carvalhais, Marilene Silva, Sónia Novais

P36 What’s new on endotracheal suctioning recommendations

Ana S. Sousa, Cândida Ferrito

P37 Assessment of the nurses satisfaction on the Central Region of Portugal

Pedro L. Ferreira, Alexandre Rodrigues, Margarida Ferreira, Isabel Oliveira

P38 Study of graduate’s satisfaction with the school of nursing

Manuela Ferreira, Jéssica Neves, Diana Costa, Soraia Duarte, Joana Silva, Bruno Santos

P39 Partnership between the school of nursing and the hospital: Supervisors´ perspectives

Cristina Martins, Ana P. Macedo, Odete Araújo, Cláudia Augusto, Fátima Braga, Lisa Gomes, Maria A. Silva, Rafaela Rosário

P40 Coping strategies of college students

Luís Pimenta, Diana Carreira, Patrícia Teles, Teresa Barros

P41 Emotional intelligence and mental health stigma in health students

Catarina Tomás, Ana Querido, Daniel Carvalho, João Gomes, Marina Cordeiro

P42 Stigma of mental health assessment: Comparison between health courses

Daniel Carvalho, Ana Querido, Catarina Tomás, João Gomes, Marina Cordeiro

O81 Short- and long-term effects of pulmonary rehabilitation in mild COPD

Cristina Jácome, Alda Marques

O82 Phonological awareness programme for preschool children

Sylvie Capelas, Andreia Hall, Dina Alves, Marisa Lousada

O83 REforma ATIVA: An efficient health promotion program to be implemented during retirement

Mª Helena Loureiro, Ana Camarneiro, Margarida Silva, Aida Mendes, Ana Pedreiro

O84 Intervention for men who batter women, a case report

Anne G.Silva, Elza S. Coelho

O85 Immediate effects of Bowen Therapy on muscle tone and flexibility

Flávio Melo, Fernando Ribeiro, Rui Torres, Rui Costa

O86 Predictive equation for incremental shuttle walk test in adolescents

Tânia Pinho, Cristina Jácome, Alda Marques

O87 Life satisfaction and psychopathology in institutionalized elderly people: The results of an adapted Mindfulness-Based Stress Reduction program

Bárbara Cruz, Daniel Seabra, Diogo Carreira, Maria Ventura

O88 Outcome changes in COPD rehabilitation: exploring the relationship between physical activity and health-related outcomes

Joana Cruz, Dina Brooks, Alda Marques

O89 Assessing the effectiveness of a Complex Nursing Intervention

M Rosário Pinto, Pedro Parreira, Marta Lima-Basto, Miguel Neves, Lisete M. Mónico

O90 Psychotherapeutic intervention in addiction disorders: Change in psychopathological symptoms and emotional states

Carla Bizarro, Marina Cunha, Ana Galhardo, Couto Margarida, Ana P. Amorim, Eduardo Silva

O91 Economic impact of a nursing intervention program to promote self-management in COPD

Susana Cruz, José M. Padilha, Jorge Valente

O92 Multimodal acute pain management during uterine artery embolization in treatment of uterine myomas

José T. Guerrero, Francisco P. Caballero, Rafael B. Santos, Estefania P. Gonzalez, Fátima M. Monago, Lierni U. Ugalde, Marta M. Vélez, Maria J. Tena

O93 Fluid administration strategies in major surgery: Goal-directed therapy

José T. Guerrero, Rafael Bravo, Francisco L. Pérez-Caballero, Isabel A. Becerra, Mª Elizabeth Agudelo, Guadalupe Acedo, Roberto Bajo

O94 Development and implementation of a self-management educational programme using lay-led’s in adolescents Spina Bifida: A pilot study

Isabel Malheiro, Filomena Gaspar, Luísa Barros

O95 Influence of chair-based yoga exercises on salivary anti-microbial proteins in institutionalized frail-elderly women: a preliminary study

Guilherme Furtado, Mateus Uba-Chupel, Mariana Marques, Luís Rama, Margarida Braga, José P. Ferreira, Ana Mª Teixeira

O96 High intensity interval training vs moderate intensity continuous training impact on diabetes 2

João Cruz, Tiago Barbosa, Ângela Simões, Luís Coelho

O97 Family caregiver of people with pressure ulcer: Nursing intervention plan

Alexandre Rodrigues, Juan-Fernando Jiménez-Díaz, Francisco Martinez-Hernández, Bienvenida Rodriguez-De-Vera, Pedro Ferreira, Alexandrina Rodrigues

O98 Chronic effects of exercise on motor memory consolidation in elderly people

André Ramalho, João Petrica, Pedro Mendes, João Serrano, Inês Santo, António Rosado

O99 Impression cytology of the ocular surface: Collection technique and sample processing

Paula Mendonça, Kátia Freitas

O100 Does sport practice affect the reaction time in neuromuscular activity?

Dora Ferreira, António Brito, Renato Fernandes

O101 Efficiency of the enteral administration of fibbers in the treatment of chronic obstipation

Sofia Gomes, Fernando Moreira, Cláudia Pinho, Rita Oliveira, Ana I. Oliveira

O102 Fast decalcifier in compact bone and spongy bone

Paula Mendonça, Ana P. Casimiro, Patrícia Martins, Iryna Silva

O103 Health promotion in the elderly – Intervention project in dementia

Diana Evangelista

O104 Prevention of musculoskeletal disorders through an exercise protocol held in labour context

Catarina Leitão, Fábia Velosa, Nélio Carecho, Luís Coelho

O105 Knowledge of teachers and other education agents on diabetes type 1: Effectiveness of an intervention program

Eva Menino, Anjos Dixe, Helena Catarino, Fátima Soares, Ester Gama, Clementina Gordo

O106 Treatment of diabetic peripheral neuropathic pain: a systematic review of clinical trials of phase II and III

Eliana Moreira, Cristiana Midões, Marlene Santos

O107 New drugs for osteoporosis treatment: Systematic review of clinical trials of phase II and III

Sara Machado, Vânia P. Oliveira, Marlene Santos

O108 Promoting hope at the end of life: Effectiveness of an Intervention Programme

Ana Querido, Anjos Dixe, Rita Marques, Zaida Charepe

P43 Psychomotor therapy effects on adaptive behaviour and motor proficiency of adults with intellectual disability

Ana Antunes, Sofia Santos

P44 The effect of exercise therapy in multiple sclerosis – a single study case

Marlene C. Rosa

P45 Physical condition and self-efficacy in people with fall risk – a preliminary study

Marlene C. Rosa, Silvana F. Marques

P46 Shock waves: their effectiveness in improving the symptoms of calcifying tendinitis of the shoulder

Beatriz Minghelli, Eulália Caro

P47 Pacifier – construction and pilot application of a parenting intervention for parents of babies until six months in primary health care

Mª José Luís, Teresa Brandão

P48 The influence of Motor Imagery in fine motor skills of individuals with disabilities

Pedro Mendes, Daniel Marinho, João Petrica, Diogo Monteiro, Rui Paulo, João Serrano, Inês Santo

P49 Evaluation of the effects of a walking programme on the fall risk factors in older people – a longitudinal pilot study

Lina Monteiro, Fátima Ramalho, Rita Santos-Rocha, Sónia Morgado, Teresa Bento

P50 Nursing intervention programme in lifestyles of adolescents

Gilberta Sousa, Otília Freitas, Isabel Silva, Gregório Freitas, Clementina Morna, Rita Vasconcelos

P51 The person submitted to hip replacement rehabilitation, at home

Tatiana Azevedo, Salete Soares, Jacinta Pisco

P52 Effects of Melatonin use in the treatment of neurovegetative diseases

Paulo P. Ferreira, Efrain O. Olszewer, Michelle T. Oliveira, Anderson R. Sousa, Ana S. Maia, Sebastião T. Oliveira

P53 Review of Phytotherapy and other natural substances in alcohol abuse and alcoholism

Erica Santos, Ana I. Oliveira, Carla Maia, Fernando Moreira, Joana Santos, Maria F. Mendes, Rita F. Oliveira, Cláudia Pinho

P54 Dietary programme impact on biochemical markers in diabetics: systematic review

Eduarda Barreira, Ana Pereira, Josiana A. Vaz, André Novo

P55 Biological approaches to knee osteoarthritis: platelet-rich plasma and hyaluronic acid

Luís D. Silva, Bruno Maia, Eduardo Ferreira, Filipa Pires, Renato Andrade, Luís Camarinha

P56 Platelet-rich plasma and hyaluronic acid intra-articular injections for the treatment of ankle osteoarthritis

Luís D. Silva, Bruno Maia, Eduardo Ferreira, Filipa Pires, Renato Andrade, Luís Camarinha

P57 The impact of preventive measures in the incidence of diabetic foot ulcers: a systematic review

Ana F. César, Mariana Poço, David Ventura, Raquel Loura, Pedro Gomes, Catarina Gomes, Cláudia Silva, Elsa Melo, João Lindo

P58 Dating violence among young adolescents

Joana Domingos, Zaida Mendes, Susana Poeta, Tiago Carvalho, Catarina Tomás, Helena Catarino, Mª Anjos Dixe

P59 Physical activity and motor memory in pedal dexterity

André Ramalho, António Rosado, Pedro Mendes, Rui Paulo, Inês Garcia, João Petrica

P60 The effects of whole body vibration on the electromyographic activity of thigh muscles

Sandra Rodrigues, Rui Meneses, Carlos Afonso, Luís Faria, Adérito Seixas

P61 Mental health promotion in the workplace

Marina Cordeiro, Paulo Granjo, José C. Gomes

P62 Influence of physical exercise on the self-perception of body image in elderly women: A systematic review of qualitative studies

Nelba R. Souza, Guilherme E. Furtado, Saulo V. Rocha, Paula Silva, Joana Carvalho

O109 Psychometric properties of the Portuguese version of the Éxamen Geronto-Psychomoteur (P-EGP)

Marina Ana Morais, Sofia Santos, Paula Lebre, Ana Antunes

O110 Symptoms of depression in the elderly population of Portugal, Spain and Italy

António Calha

O111 Emotion regulation strategies and psychopathology symptoms: A comparison between adolescents with and without deliberate self-harm

Ana Xavier, Marina Cunha, José Pinto-Gouveia

O112 Prevalence of physical disability in people with leprosy

Liana Alencar, Madalena Cunha, António Madureira

O113 Quality of life and self-esteem in type 1 and type 2 diabetes mellitus patients

Ilda Cardoso, Ana Galhardo, Fernanda Daniel, Vítor Rodrigues

O114 Cross-cultural comparison of gross motor coordination in children from Brazil and Portugal

Leonardo Luz, Tatiana Luz, Maurício R. Ramos, Dayse C. Medeiros, Bruno M. Carmo, André Seabra, Cristina Padez, Manuel C. Silva

O115 Electrocardiographic differences between African and Caucasian people

António Rodrigues, Patrícia Coelho, Alexandre Coelho

O116 Factors associated with domestic, sexual and other types of violence in the city of Palhoça - Brazil

Madson Caminha, Filipe Matheus, Elenice Mendes, Jony Correia, Marcia Kretzer

O117 Tinnitus prevalence study of users of a hospital of public management - Spain

Francisco J. Hernandez-Martinez, Juan F. Jimenez-Diaz, Bienvendida C. Rodriguez-De-Vera, Carla Jimenez-Rodriguez, Yadira Armas-Gonzalez

O118 Difficulties experienced by parents of children with diabetes mellitus of preschool age in therapeutic and nutritional management

Cátia Rodrigues, Rosa Pedroso

O119 E-mental health - “nice to have” or “must have”? Exploring the attitudes towards e-mental health in the general population

Jennifer Apolinário-Hagen, Viktor Vehreschild

O120 Violence against children and adolescents and the role of health professionals: Knowing how to identify and care

Milene Veloso, Celina Magalhães, Isabel Cabral, Maira Ferraz

O121 Marital violence. A study in the Algarve population

Filipe Nave, Emília Costa, Filomena Matos, José Pacheco

O122 Clinical factors and adherence to treatment in ischemic heart disease

António Dias, Carlos Pereira, João Duarte, Madalena Cunha, Daniel Silva

O123 Can religiosity improve optimism in participants in states of illness, when controlling for life satisfaction?

Lisete M. Mónico, Valentim R. Alferes, Mª São João Brêda, Carla Carvalho, Pedro M. Parreira

O124 Empowerment, knowledge and quality of life of people with diabetes type 2 in the Alto Minho Health Local Unit

Mª Carminda Morais, Pedro Ferreira, Rui Pimenta, José Boavida

O125 Antihypertensive therapy adherence among hypertensive patients from Bragança county, Portugal

Isabel C. Pinto, Tânia Pires, Catarina Silva

O126 Subjective perception of sexual achievement - An exploratory study on people with overweight

Maria Ribeiro, Maria Viega-Branco, Filomena Pereira, Ana Mª Pereira

O127 Physical activity level and associated factors in hypertensive individuals registered in the family health strategy of a basic health unit from the city of Palhoça, Santa Catarina, Brazil

Fabrícia M. Almeida, Gustavo L. Estevez, Sandra Ribeiro, Marcia R. Kretzer

O128 Perception of functional fitness and health in non-institutionalised elderly from rural areas

Paulo V. João, Paulo Nogueira, Sandra Novais, Ana Pereira, Lara Carneiro, Maria Mota

O129 Medication adherence in patients with type 2 diabetes mellitus treated at primary health care in Coimbra

Rui Cruz, Luiz Santiago, Carlos Fontes-Ribeiro

O130 Multivariate association between body mass index and multi-comorbidities in elderly people living in low socio-economic status context

Guilherme Furtado, Saulo V. Rocha, André P. Coutinho, João S. Neto, Lélia R. Vasconcelos, Nelba R. Souza, Estélio Dantas

O131 Metacognition, rumination and experiential avoidance in Borderline Personality Disorder

Alexandra Dinis, Sérgio Carvalho, Paula Castilho, José Pinto-Gouveia

O132 Health issues in a vulnerable population: nursing consultation in a public bathhouse in Lisbon

Alexandra Sarreira-Santos, Amélia Figueiredo, Lurdes Medeiros-Garcia, Paulo Seabra

O133 The perception of quality of life in people with multiple sclerosis accompanied in External Consultation of the Local Health Unit of Alto Minho

Rosa Rodrigues, Mª Carminda Morais, Paula O. Fernandes

O134 Representation of interaction established between immigrant women and nurse during pregnancy to postpartum, from the perspective of immigrant women

Conceição Santiago, Mª Henriqueta Figueiredo, Marta L. Basto

O135 Illness perceptions and medication adherence in hypertension

Teresa Guimarães, André Coelho, Anabela Graça, Ana M. Silva, Ana R. Fonseca

O136 A Portuguese study on adults’ intimate partner violence, interpersonal trust and hope

Luz Vale-Dias, Bárbara Minas, Graciete Franco-Borges

P63 QOL’ predictors of people with intellectual disability and general population

Cristina Simões, Sofia Santos

P64 Content validation of the Communication Disability Profile (CDP) - Portuguese Version

Ana Serra, Maria Matos, Luís Jesus

P65 Study of biochemical and haematological changes in football players

Ana S. Tavares, Ana Almeida, Céu Leitão, Edna Varandas, Renato Abreu, Fernando Bellém

P66 Body image dissatisfaction in inflammatory bowel disease: exploring the role of chronic illness-related shame

Inês A. Trindade, Cláudia Ferreira, José Pinto-Gouveia, Joana Marta-Simões

P67 Obesity and sleep in the adult population - a systematic review

Odete Amaral, Cristiana Miranda, Pedro Guimarães, Rodrigo Gonçalves, Nélio Veiga, Carlos Pereira

P68 Frequency of daytime sleepiness and obstructive sleep apnea risk in COPD patients

Tânia C. Fleig, Elisabete A. San-Martin, Cássia L. Goulart, Paloma B. Schneiders, Natacha F. Miranda, Lisiane L. Carvalho, Andrea G. Silva

P69 Working with immigrant-origin clients: discourses and practices of health professionals

Joana Topa, Conceição Nogueira, Sofia Neves

P70 Systemic Lupus Erythematosus – what are audiovestibular changes?

Rita Ventura, Cristina Nazaré

P71 Mental disorders in the oldest old: findings from the Portuguese national hospitalization database

Daniela Brandão, Alberto Freitas, Óscar Ribeiro, Constança Paúl

P72 Recurrence analysis in postural control in children with cerebral palsy

Cristiana Mercê, Marco Branco, Pedro Almeida, Daniela Nascimento, Juliana Pereira, David Catela

P73 The experience of self-care in the elderly with COPD: contributions to reflect proximity care

Helga Rafael

P74 Culturally competent nurses: managing unpredictability in clinical practice with immigrants

Alcinda C. Reis

O137 Paediatric speech and language screening: An instrument for health professionals

Ana Mendes, Ana R. Valente, Marisa Lousada

O138 Anthropometric and nutritional assessment in bodybuilders

Diana Sousa, Ana L. Baltazar, Mª Helena Loureiro

O139 Computerized adventitious respiratory sounds in children with lower respiratory tract infections

Ana Oliveira, José Aparício, Alda Marques

O140 Role of computerized respiratory sounds as a marker in LRTI

Alda Marques, Ana Oliveira, Joana Neves, Rodrigo Ayoub

O141 Confirmatory factor analysis of the Personal Wellbeing Index in people with chronic kidney disease

Luís Sousa, Cristina Marques-Vieira, Sandy Severino, Helena José

O142 Phonological awareness skills in school aged children

Inês Cadorio, Marisa Lousada

O143 Assessment of early memories of warmth and safeness in interaction with peers: its relationship with psychopathology in adolescence

Marina Cunha, Diogo Andrade, Ana Galhardo, Margarida Couto

O144 The molecular effects induced by single shot irradiation on a diffuse large B cell lymphoma cell line

Fernando Mendes, Cátia Domingues, Susann Schukg, Ana M. Abrantes, Ana C. Gonçalves, Tiago Sales, Ricardo Teixo, Rita Silva, Jéssica Estrela, Mafalda Laranjo, João Casalta-Lopes, Clara Rocha, Paulo C. Simões, Ana B. Sarmento-Ribeiro, Mª Filomena Botelho, Manuel S. Rosa

O145 Morpho-functional characterization of cardiac chambers by Transthoracic Echocardiography, in young athletes of gymnastics competition

Virgínia Fonseca, Diogo Colaço, Vanessa Neves

O146 Prevalence of the antibodies of the new histo-blood system – FORS system

Carlos Jesus, Camilla Hesse, Clara Rocha, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Lola Svensson, Fernando Mendes, Wafa A. Siba, Cristina Pereira, Jorge Tomaz

O147 Assessment of the war-related perceived threat in Portuguese Colonial War Veterans

Teresa Carvalho, José Pinto-Gouveia, Marina Cunha

O148 Pulse transit time estimation for continuous blood pressure measurement: A comparative study

Diana Duarte, Nuno V. Lopes, Rui Fonseca-Pinto

O149 Blood pressure assessment during standard clinical manoeuvres: A non-invasive PPT based approach

Diana Duarte, Nuno V. Lopes, Rui Fonseca-Pinto

O150 Development and initial validation of the Activities and Participation Profile related to Mobility (APPM)

Anabela C. Martins

O151 MEASYCare-2010 Standard–A geriatric evaluation system in primary health care: Reliability and validity of the latest version in Portugal

Piedade Brandão, Laura Martins, Margarida Cardoso

O152 Interrater and intrarater reliability and agreement of the range of shoulder flexion in the standing upright position through photographic assessment

Nuno Morais, Joana Cruz

O153 Three-dimensional biofabrication techniques for tissue regeneration

Nuno Alves, Paula Faria, Artur Mateus, Pedro Morouço

O154 A new computer tool for biofabrication applied to tissue engineering

Nuno Alves, Nelson Ferreira, Artur Mateus, Paula Faria, Pedro Morouço

O155 Development and psychometric qualities of a scale to measure the functional independence of adolescents with motor impairment

Isabel Malheiro, Filomena Gaspar, Luísa Barros

O156 Organizational Trust in Health services: Exploratory and Confirmatory factor analysis of the Organizational Trust Inventory- Short Form (OTI-SF)

Pedro Parreira, Andreia Cardoso, Lisete Mónico, Carla Carvalho, Albino Lopes, Anabela Salgueiro-Oliveira

O157 Thermal symmetry: An indicator of occupational task asymmetries in physiotherapy

Adérito Seixas, Valter Soares, Tiago Dias, Ricardo Vardasca, Joaquim Gabriel, Sandra Rodrigues

O158 A study of ICT active monitoring adoption in stroke rehabilitation

Hugo Paredes, Arsénio Reis, Sara Marinho, Vítor Filipe, João Barroso

O159 Paranoia Checklist (Portuguese Version): Preliminary studies in a mixed sample of patients and healthy controls

Carolina Da Motta, Célia B. Carvalho, José Pinto-Gouveia, Ermelindo Peixoto

O160 Reliability and validity of the Composite Scale on Morningness: European Portuguese version, in adolescents and young adults

Ana A. Gomes, Vanessa Costa, Diana Couto, Daniel R. Marques, José A. Leitão, José Tavares, Maria H. Azevedo, Carlos F. Silva

O161 Evaluation scale of patient satisfaction with nursing care: Psychometric properties evaluation

João Freitas, Pedro Parreira, João Marôco

O162 Impact of fibromyalgia on quality of life: Comparing results from generic instruments and FIQR

Miguel A. Garcia-Gordillo, Daniel Collado-Mateo, Gang Chen, Angelo Iezzi, José A. Sala, José A. Parraça, Narcis Gusi

O163 Preliminary study of the adaptation and validation of the Rating Scale of Resilient Self: Resilience, self-harm and suicidal ideation in adolescents

Jani Sousa, Mariana Marques, Jacinto Jardim, Anabela Pereira, Sónia Simões, Marina Cunha

O164 Development of the first pressure ulcer in inpatient setting: Focus on length of stay

Pedro Sardo, Jenifer Guedes, João Lindo, Paulo Machado, Elsa Melo

O165 Forms of Self-Criticizing and Self-Reassuring Scale: Adaptation and early findings in a sample of Portuguese children

Célia B. Carvalho, Joana Benevides, Marina Sousa, Joana Cabral, Carolina Da Motta

O166 Predictive ability of the Perinatal Depression Screening and Prevention Tool – Preliminary results of the dimensional approach

Ana T. Pereira, Sandra Xavier, Julieta Azevedo, Elisabete Bento, Cristiana Marques, Rosa Carvalho, Mariana Marques, António Macedo

O167 Psychometric properties of the BaSIQS-Basic Scale on insomnia symptoms and quality of sleep, in adults and in the elderly

Ana M. Silva, Juliana Alves, Ana A. Gomes, Daniel R. Marques, Mª Helena Azevedo, Carlos Silva

O168 Enlightening the human decision in health: The skin melanocytic classification challenge

Ana Mendes, Huei D. Lee, Newton Spolaôr, Jefferson T. Oliva, Wu F. Chung, Rui Fonseca-Pinto

O169 Test-retest reliability household life study and health questionnaire Pomerode (SHIP-BRAZIL)

Keila Bairros, Cláudia D. Silva, Clóvis A. Souza, Silvana S. Schroeder

O170 Characterization of sun exposure behaviours among medical students from Nova Medical School

Elsa Araújo, Helena Monteiro, Ricardo Costa, Sara S. Dias, Jorge Torgal

O171 Spirituality in pregnant women

Carolina G. Henriques, Luísa Santos, Elisa F. Caceiro, Sónia A. Ramalho

O172 Polypharmacy in older patients with cancer

Rita Oliveira, Vera Afreixo, João Santos, Priscilla Mota, Agostinho Cruz, Francisco Pimentel

O173 Quality of life of caregivers of people with advanced chronic disease: Translation and validation of the quality of life in life threatening illness - family carer version (QOLLTI-C-PT)

Rita Marques, Mª Anjos Dixe, Ana Querido, Patrícia Sousa

O174 The psychometric properties of the brief Other as Shamer Scale for Children (OAS-C): preliminary validation studies in a sample of Portuguese children

Joana Benevides, Carolina Da Motta, Marina Sousa, Suzana N. Caldeira, Célia B. Carvalho

O175 Measuring emotional intelligence in health care students – Revalidation of WLEIS-P

Ana Querido, Catarina Tomás, Daniel Carvalho, João Gomes, Marina Cordeiro

O176 Health indicators in prenatal assistance: The impact of computerization and of under-production in basic health centres

Joyce O. Costa, Frederico C. Valim, Lígia C. Ribeiro

O177 Hope genogram: Assessment of resources and interaction patterns in the family of the child with cerebral palsy

Zaida Charepe, Ana Querido, Mª Henriqueta Figueiredo

O178 The influence of childbirth type in postpartum quality of life

Priscila S. Aquino, Samila G. Ribeiro, Ana B. Pinheiro, Paula A. Lessa, Mirna F. Oliveira, Luísa S. Brito, Ítalo N. Pinto, Alessandra S. Furtado, Régia B. Castro, Caroline Q. Aquino, Eveliny S. Martins

O179 Women’s beliefs about pap smear test and cervical cancer: influence of social determinants

Ana B Pinheiro, Priscila S. Aquino, Lara L. Oliveira, Patrícia C. Pinheiro, Caroline R. Sousa, Vívien A. Freitas, Tatiane M. Silva, Adman S. Lima, Caroline Q. Aquino, Karizia V. Andrade, Camila A. Oliveira, Eglidia F. Vidal

O180 Validity of the Portuguese version of the ASI-3: Is anxiety sensitivity a unidimensional or multidimensional construct?

Ana Ganho-Ávila, Mariana Moura-Ramos, Óscar Gonçalves, Jorge Almeida

O181 Lifestyles of higher education students: the influence of self-esteem and psychological well-being

Armando Silva, Irma Brito, João Amado

P75 Assessing the quality of life of persons with significant intellectual disability: Portuguese version of Escala de San Martín

António Rodrigo, Sofia Santos, Fernando Gomes

P76 Childhood obesity and breastfeeding - A systematic review

Marlene C. Rosa, Silvana F. Marques

P77 Cross-cultural adaptation of the Foot and Ankle Ability Measure (FAAM) for the Portuguese population

Sara Luís, Luís Cavalheiro, Pedro Ferreira, Rui Gonçalves

P78 Cross-cultural adaptation of the Patient-Rated Wrist Evaluation score (PRWE) for the Portuguese population

Rui S. Lopes, Luís Cavalheiro, Pedro Ferreira, Rui Gonçalves

P79 Cross-cultural adaptation of the Myocardial Infraction Dimensional Assessment Scale (MIDAS) for Brazilian Portuguese language

Bruno H. Fiorin, Marina S. Santos, Edmar S. Oliveira, Rita L. Moreira, Elizabete A. Oliveira, Braulio L. Filho

P80 The revised Portuguese version of the Three-Factor Eating Questionnaire: A confirmatory factor analysis

Lara Palmeira, Teresa Garcia, José Pinto-Gouveia, Marina Cunha

P81 Assessing weight-related psychological inflexibility: An exploratory factor analysis of the AAQW’s Portuguese version

Sara Cardoso, Lara Palmeira, Marina Cunha; José Pinto-Gouveia

P82 Validation of the Body Appreciation Scale-2 for Portuguese women

Joana Marta-Simões, Ana L. Mendes, Inês A. Trindade, Sara Oliveira, Cláudia Ferreira

P83 The Portuguese validation of the Dietary Intent Scale

Ana L. Mendes, Joana Marta-Simões, Inês A. Trindade, Cláudia Ferreira

P84 Construction and validation of the Inventory of Marital Violence (IVC)

Filipe Nave

P85 Portable continuous blood pressure monitor system

Mariana Campos, Iris Gaudêncio, Fernando Martins, Lino Ferreira, Nuno Lopes, Rui Fonseca-Pinto

P86 Construction and validation of the Scale of Perception of the Difficulties in Caring for the Elderly (SPDCE)

Rogério Rodrigues, Zaida Azeredo, Corália Vicente

P87 Development and validation of a comfort rating scale for the elderly hospitalized with chronic illness

Joana Silva, Patrícia Sousa, Rita Marques

P88 Construction and validation of the Postpartum Paternal Quality of Life Questionnaire (PP-QOL)

Isabel Mendes, Rogério Rodrigues, Zaida Azeredo, Corália Vicente

P89 Infrared thermal imaging: A tool for assessing diabetic foot ulcers

Ricardo Vardasca, Ana R. Marques, Adérito Seixas, Rui Carvalho, Joaquim Gabriel

P90 Pressure ulcers in an intensive care unit: An experience report

Paulo P. Ferreira, Michelle T. Oliveira, Anderson R. Sousa, Ana S. Maia, Sebastião T. Oliveira, Pablo O. Costa, Maiza M. Silva

P91 Validation of figures used in evocations: instrument to capture representations

Cristina Arreguy-Sena, Nathália Alvarenga-Martins, Paulo F. Pinto, Denize C. Oliveira, Pedro D. Parreira, Antônio T. Gomes, Luciene M. Braga

P92 Telephone assistance to decrease burden in informal caregivers of stroke older people: Monitoring and diagnostic evaluation

Odete Araújo, Isabel Lage, José Cabrita, Laetitia Teixeira

P93 Hope of informal caregivers of people with chronic and advanced disease

Rita Marques, Mª Anjos Dixe, Ana Querido, Patrícia Sousa

P94 Functionality and quality information from the Portuguese National Epidemiological Surveillance System

Sara Silva, Eugénio Cordeiro, João Pimentel

P95 Resting metabolic rate objectively measured vs. Harris and Benedict formula

Vera Ferro-Lebres, Juliana A. Souza, Mariline Tavares

O182 Characteristics of non-urgent patients: Cross-sectional study of an emergency department

Mª Anjos Dixe, Pedro Sousa, Rui Passadouro, Teresa Peralta, Carlos Ferreira, Georgina Lourenço

O183 Physical fitness and health in children of the 1st Cycle of Education

João Serrano, João Petrica, Rui Paulo, Samuel Honório, Pedro Mendes

O184 The impact of physical activity on sleep quality, in children

Alexandra Simões, Lucinda Carvalho, Alexandre Pereira

O185 What is the potential for using Information and Communication Technologies in Arterial Hypertension self-management?

Sara Silva, Paulino Sousa, José M. Padilha

O186 Exploring psychosocial factors associated with risk of falling in older patients undergoing haemodialysis

Daniela Figueiredo, Carolina Valente, Alda Marques

O187 Development of pressure ulcers on the face in patients undergoing non-invasive ventilation

Patrícia Ribas, Joana Sousa, Frederico Brandão, Cesar Sousa, Matilde Martins

O188 The elder hospitalized: Limiting factors of comfort

Patrícia Sousa, Rita Marques

O189 Physical activity and health state self-perception by Portuguese adults

Francisco Mendes, Rosina Fernandes, Emília Martins, Cátia Magalhães, Patrícia Araújo

O190 Satisfaction with social support in the elderly of the district of Bragança

Carla Grande, Mª Augusta Mata, Juan G. Vieitez

O191 Prevalence of death by traumatic brain injury and associated factors in intensive care unit of a general hospital, Brazil

Bruna Bianchini, Nazare Nazario, João G. Filho, Marcia Kretzer

O192 Relation between family caregivers burden and health status of elderly dependents

Tânia Costa, Armando Almeida, Gabriel Baffour

O193 Phenomena sensitive to nursing care in day centre

Armando Almeida, Tânia Costa, Gabriel Baffour

O194 Frailty: what do the elderly think?

Zaida Azeredo, Carlos Laranjeira, Magda Guerra, Ana P. Barbeiro

O195 The therapeutic self-care as a nursing-sensitive outcome: A correlational study

Regina Ferreira

O196 Phonetic-phonological acquisition for the European Portuguese from 18 months to 6 years and 12 months

Sara Lopes, Liliana Nunes, Ana Mendes

O197 Quality of life of patients undergoing liver transplant surgery

Julian Martins, Dulcineia Schneider, Marcia Kretzer, Flávio Magajewski

O198 Professional competences in health: views of older people from different European Countries

Célia Soares, António Marques

O199 Life satisfaction of working adults due to the number of hours of weekly exercise

Marco Batista, Ruth J. Castuera, Helena Mesquita, António Faustino, Jorge Santos, Samuel Honório

O200 Therapeutic itinerary of women with breast cancer in Santa Maria City/RS

Betina P. Vizzotto, Leticia Frigo, Hedioneia F. Pivetta

O201 The breastfeeding prevalence at 4 months: Maternal experience as a determining factor

Dolores Sardo

O202 The impact of the transition to parenthood in health and well-being

Cristina Martins, Wilson Abreu, Mª Céu Figueiredo

P96 Self-determined motivation and well-being in Portuguese active adults of both genders

Marco Batista, Ruth Jimenez-Castuera, João Petrica, João Serrano, Samuel Honório, Rui Paulo, Pedro Mendes

P97 The geriatric care: ways and means of comforting

Patrícia Sousa, Rita Marques

P98 The influence of relative age, subcutaneous adiposity and physical growth on Castelo Branco under-15 soccer players 2015

António Faustino, Paulo Silveira, João Serrano, Rui Paulo, Pedro Mendes, Samuel Honório

P99 Data for the diagnostic process focused on self-care – managing medication regime: An integrative literature review

Catarina Oliveira, Fernanda Bastos, Inês Cruz

P100 Art therapy as mental health promotion for children

Cláudia K. Rodriguez, Márcia R. Kretzer, Nazaré O. Nazário

P101 Chemical characterization of fungal chitosan for industrial applications

Pedro Cruz, Daniela C. Vaz, Rui B. Ruben, Francisco Avelelas, Susana Silva, Mª Jorge Campos

P102 The impact of caring older people at home

Maria Almeida, Liliana Gonçalves, Lígia Antunes

P103 Development of the first pressure ulcer in an inpatient setting: Focus on patients’ characteristics

Pedro Sardo, Jenifer Guedes, João Simões, Paulo Machado, Elsa Melo

P104 Association between General Self-efficacy and Physical Activity among Adolescents

Susana Cardoso, Osvaldo Santos, Carla Nunes, Isabel Loureiro

O203 Characterization of the habits of online acquisition of medicinal products in Portugal

Flávia Santos, Gilberto Alves

O204 Waiting room – A space for health education

Cláudia Soar, Teresa O. Marsi

O205 Safey culture evaluation in hospitalized children

Ernestina Silva, Dora Pedrosa, Andrea Leça, Daniel Silva

O206 Sexual Self-awareness and Body Image

Ana Galvão, Maria Gomes, Paula Fernandes, Ana Noné

O207 Perception of a Portuguese population regarding the acquisition and consumption of functional foods

Jaime Combadão, Cátia Ramalhete, Paulo Figueiredo, Patrícia Caeiro

O208 The work process in primary health care: evaluation in municipalities of southern Brazil

Karine C. Fontana, Josimari T. Lacerda, Patrícia O. Machado

O209 Exploration and evaluation of potential probiotic lactic acid bacteria isolated from Amazon buffalo milk

Raphaelle Borges, Flávio Barbosa, Dayse Sá

O210 Road safety for children: Using children’s observation, as a passenger

Germana Brunhoso, Graça Aparício, Amâncio Carvalho

O211 Perception and application of quality-by-design by the Pharmaceutical industry in Portugal

Ana P. Garcia, Paula O. Fernandes, Adriana Santos

O212 Oral health among Portuguese children and adolescents: a public health issue

Nélio Veiga, Carina Brás, Inês Carvalho, Joana Batalha, Margarida Glória, Filipa Bexiga, Inês Coelho, Odete Amaral, Carlos Pereira

O213 Plant species as a medicinal resource in Igatu-Chapada Diamantina (Bahia, Brazil)

Cláudia Pinho, Nilson Paraíso, Ana I. Oliveira, Cristóvão F. Lima, Alberto P. Dias

O214 Characterization of cognitive and functional performance in everyday tasks: Implications for health in institutionalised older adults

Pedro Silva, Mário Espada, Mário Marques, Ana Pereira

O215 BMI and the perception of the importance given to sexuality in obese and overweight people

Ana Mª Pereira, Mª Veiga-Branco, Filomena Pereira, Maria Ribeiro

O216 Analysis and comparison of microbiological contaminations of two different composition pacifiers

Vera Lima, Ana I. Oliveira, Cláudia Pinho, Graça Cruz, Rita F. Oliveira, Luísa Barreiros, Fernando Moreira

O217 Experiences of couple relationships in the transition to retirement

Ana Camarneiro, Mª Helena Loureiro, Margarida Silva

O218 Preventive and corrective treatment of drug-induced calcium deficiency: an analysis in a community pharmacy setting

Catarina Duarte, Ângelo Jesus, Agostinho Cruz

O219 Profile of mood states in physically active elderly subjects: Is there a relation with health perception?

Maria Mota, Sandra Novais, Paulo Nogueira, Ana Pereira, Lara Carneiro, Paulo V. João

O220 (Un)Safety behaviour at work: the role of education towards a health and safety culture

Teresa Maneca Lima

O221 Analysis of the entrepreneurial profile of students attending higher education in Portugal: the Carland Entrepreneurship Index application

Anabela Salgueiro-Oliveira, Marina Vaquinhas, Pedro Parreira, Rosa Melo, João Graveto, Amélia Castilho, José H. Gomes

O222 Evaluation of welfare and quality of life of pregnant working women regarding the age of the pregnant

María S. Medina, Valeriana G. Blanco

O223 Psychological wellbeing protection among unemployed and temporary workers: Uncovering effective community-based interventions with a Delphi panel

Osvaldo Santos, Elisa Lopes, Ana Virgolino, Alexandra Dinis, Sara Ambrósio, Inês Almeida, Tatiana Marques, Mª João Heitor

O224 Chilean population norms derived from the Health-related quality of life SF-6D

Miguel A. Garcia-Gordillo, Daniel Collado-Mateo, Pedro R. Olivares, José A. Parraça, José A. Sala

O225 Motivation of college students toward Entrepreneurship: The influence of social and economic instability

Amélia Castilho, João Graveto, Pedro Parreira, Anabela Oliveira, José H. Gomes, Rosa Melo, Marina Vaquinhas

O226 Use of aromatic and medicinal plants, drugs and herbal products in Bragança city

Mónia Cheio, Agostinho Cruz, Olívia R. Pereira

O227 Edible flowers as new novel foods concept for health promotion

Sara Pinto, Adriana Oliveira, M. Conceição Manso, Carla Sousa, Ana F. Vinha

O228 The influence of leisure activities on the health and welfare of older people living in nursing homes

Mª Manuela Machado, Margarida Vieira

O229 Risk of falling, fear of falling and functionality in community-dwelling older adults

Beatriz Fernandes, Teresa Tomás, Diogo Quirino

O230 Musculoskeletal pain and postural habits in children and teenage students

Gustavo Desouzart, Rui Matos, Magali Bordini, Pedro Mouroço

O231 What's different in Southern Europe? The question of citizens’ participation in health systems

Ana R. Matos, Mauro Serapioni

O232 Occupational stress in Portuguese police officers

Teresa Guimarães, Virgínia Fonseca, André Costa, João Ribeiro, João Lobato

O233 Is occupational therapy culturally relevant to promote mental health in Burkina Faso?

Inmaculada Z. Martin, Anita Björklund

P105 Pay-for-performance satisfaction and quality in primary care

Aida I. Tavares, Pedro Ferreira, Rui Passadouro

P106 Economic development through life expectancy lenses

Sónia Morgado

P107 What is the effectiveness of exercise on smoking cessation to prevent clinical complications of smoking?

Nuno Tavares, João Valente, Anabela C. Martins

P108 A systematic review of the effects of yoga on mental health

Patrícia Araújo, Rosina Fernandes, Francisco Mendes, Cátia Magalhães, Emília Martins

P109 Healthy lifestyle: comparison between higher education students that lived until adult age in rural and urban environment

Pedro Mendes, Rui Paulo, António Faustino, Helena Mesquita, Samuel Honório, Marco Batista

P110 Evaluation of the Mobile Emergency Care Service (SAMU) in Brazil

Josimari T. Lacerda, Angela B. Ortiga, Mª Cristina Calvo, Sônia Natal

P111 Bioactive compounds - antioxidant activity of tropical fruits

Marta Pereira

P112 Use of non-pharmacological methods to relieve pain in labour

Manuela Ferreira, Ana R. Prata, Paula Nelas, João Duarte

P113 Mechanical safety of pacifiers sold in Portuguese pharmacies and childcare stores

Juliana Carneiro, Ana I. Oliveira, Cláudia Pinho, Cristina Couto, Rita F. Oliveira, Fernando Moreira

P114 The importance of prenatal consultation: Information to pregnant women given on a unit of primary care

Ana S. Maia, Michelle T. Oliveira, Anderson R. Sousa, Paulo P. Ferreira, Géssica M. Souza, Lívia F. Almada, Milena A. Conceição, Eujcely C. Santiago

P115 Influence of different backpack loading conditions on neck and lumbar muscles activity of elementary school children

Sandra Rodrigues, Gabriela Domingues, Irina Ferreira, Luís Faria, Adérito Seixas

P116 Efficacy and safety of dry extract Hedera helix in the treatment of productive cough

Ana R. Costa, Ângelo Jesus, Américo Cardoso, Alexandra Meireles, Armanda Colaço, Agostinho Cruz

P117 A portrait of the evaluation processes of education groups in primary health care

Viviane L. Vieira, Kellem R. Vincha, Ana Mª Cervato-Mancuso

P118 Benefits of vitamins C and E in sensorineural hearing loss: a review

Melissa Faria, Cláudia Reis

P119 BODY SNAPSHOT – a web-integrated anthropometric evaluation system

Marco P. Cova, Rita T. Ascenso, Henrique A. Almeida, Eunice G. Oliveira

P120 Anthropometric evaluation and variation during pregnancy

Miguel Santana, Rafael Pereira, Eunice G. Oliveira, Henrique A. Almeida, Rita T. Ascenso

P121 Knowledge of college students on the amendments of their eating habits and physical activity index in the transition to higher education

Rita Jesus, Rodrigo Tapadas, Carolina Tim-Tim, Catarina Cezanne, Matilde Lagoa, Sara S. Dias, Jorge Torgal

P122 Muscular activity of a rally race car driver

João Lopes, Henrique Almeida, Sandra Amado, Luís Carrão

O234 Literacy and results in health

Madalena Cunha, Luís Saboga-Nunes, Carlos Albuquerque, Olivério Ribeiro

O235 Literacy promotion and empowerment of type 2 diabetics elderly in four family health units of the group of health centers of Dão Lafões

Suzete Oliveira, Mª Carminda Morais

O236 Mediterranean diet, health and life quality among Portuguese children

Emília Martins, Francisco Mendes, Rosina Fernandes, Cátia Magalhães, Patrícia Araújo

O237 Health literacy, from data to action - translation, validation and application of the European Health Literacy Survey in Portugal (HLS-EU-PT)

Ana R. Pedro, Odete Amaral, Ana Escoval

O238 Oral health literacy evaluation in a Portuguese military population

Victor Assunção, Henrique Luís, Luís Luís

O239 Preferences to Internet-based cognitive behavioural therapy – do attachment orientations matter?

Jennifer Apolinário-Hagen, Viktor Vehreschild

O240 A comparative transnational study in health literacy between Austria and Portugal

Ulrike Fotschl, Gerald Lirk, Anabela C. Martins, Isabel Andrade, Fernando Mendes

O241 Health literacy and social behaviours: relationship with sexually transmitted diseases?

Verónica Mendonça, Sandra Antunes, Isabel Andrade, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes

O242 Parenting styles and attachment to parents: what relationships?

Paula A. Silva, Lisete M. Mónico, Pedro M. Parreira, Carla Carvalho

O243 Work-life balance in health professionals and professors: comparative study of workers with shift work and fixed schedule

Carla Carvalho, Pedro M. Parreira, Lisete M. Mónico, Joana Ruivo

O244 Technology literacy in self-management of diabetes

Vânia Silva, Paulino Sousa, José M. Padilha

O245 Satisfaction with therapeutic education and its relationship with clinical variables in children with type 1 diabetes

Vera Ferraz, Graça Aparício, João Duarte

O246 Nutrition-related knowledge in middle-age and older patients with type 2 diabetes

Carlos Vasconcelos, António Almeida, Joel Neves, Telma Correia, Helena Amorim, Romeu Mendes

O247 Validating the HLS-EU-(PT) questionnaire to measure health literacy in adolescents (CrAdLiSa project: HLS-EU-PT)

Luís Saboga-Nunes, Madalena Cunha, Carlos Albuquerque

O248 Health education in people with coronary heart disease: Experience of the cardiology department of a hospital on the outskirts of Lisbon

Elsa S. Pereira, Leonino S. Santos, Ana S. Reis, Helena R. Silva, João Rombo, Jorge C. Fernandes, Patrícia Fernandes

O249 Information and training needs of informal caregivers of individuals with stroke sequelae: a qualitative survey

Jaime Ribeiro, Catarina Mangas, Ana Freire

O250 Prevention of psychoactive substances consumption in students from 6th grade of Albergaria-a-Velha´s School Group

Sara Silva, Irene Francisco, Ana Oliveira

O251 Promoting healthy sexuality: shared responsibility for family, youth and educators

Helena Catarino, Mª Anjos Dixe, Mª Clarisse Louro

O252 Sexual risk behaviour in adolescents and young people

Saudade Lopes, Anjos Dixe

O253 Knowledge of school staff on type 1 diabetes

Mª Anjos Dixe, Eva Menino, Helena Catarino, Fátima Soares, Ana P. Oliveira, Sara Gordo, Teresa Kraus

O254 Sexual health in adolescents: the impact of information search in literacy

Catarina Tomás, Paulo Queirós, Teresa Rodrigues

P123 Improving basic life support skills in adolescents through a training programme

Pedro Sousa, João G. Frade, Catarina Lobão

P124 Difficulties in sexual education reported by basic education teachers in the city of Foz do Iguaçu - Brazil

Cynthia B. Moura, Laysa C. Dreyer, Vanize Meneghetti, Priscila P. Cabral

P125 Breast cancer survivors: subjects and resources for information. A qualitative systematic review

Francisca Pinto, Paulino Sousa, Mª Raquel Esteves

P126 Relationship between health literacy and prevalence of STI in Biomedical Laboratory Science students

Sofia Galvão, Ite Tytgat, Isabel Andrade, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes

P127 Health literacy, risk behaviours and sexually transmitted diseases among blood donors

Mónica Casas-Novas, Helena Bernardo, Isabel Andrade, Gracinda Sousa, Ana P. Sousa, Clara Rocha, Pedro Belo, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes

P128 Promoting literacy in pregnancy health-care

Fátima Martins, Montserrat Pulido-Fuentes

P129 The lifestyles of the operating assistants of education

Isabel Barroso, Gil Cabral, M. João Monteiro, Conceição Rainho

P130 Experiences of service-learning health and the literary art: reflections about the health education

Alessandro Prado, Yara M. Carvalho

P131 Life long swimming – a European Erasmus + project

Maria Campos, Liliana Moreira, José Ferreira, Ana Teixeira, Luís Rama

Comparison of Coronary Artery Disease Consortium 1 and 2 Scores and Duke Clinical Score to Predict Obstructive Coronary Disease by Invasive Coronary Angiography

BACKGROUND

The first step in evaluating a patient with suspected stable coronary artery disease (CAD) is the determination of the pretest probability. The European Society of Cardiology guidelines recommend the use of the CAD Consortium 1 score (CAD1), which contrary to CAD Consortium 2 (CAD2) score and Duke Clinical Score (DCS), does not include modifiable cardiovascular risk factors.

HYPOTHESIS

Using scores that include modifiable risk factors (DCS and CAD2) enhances prediction of CAD.

METHODS

We retrospectively included all patients referred to invasive coronary angiography for suspected CAD from January/2008-December/2012 (N = 2234). Pretest probability was calculated using 3 models (CAD1, DCS, and CAD2), and they were compared using the net reclassification improvement.

RESULTS

Mean patient age was 63.7 years, 67.5% were male, and the majority (66.9%) had typical angina. Coronary artery disease was diagnosed in 58.5%, and the area under the curve was 0.685 for DCS, 0.664 for CAD1, and 0.683 for CAD2, with a statistically significant difference between CAD1 and the others (P < 0.001). The net reclassification improvement was 20% for DCS, related to adequate reclassification of 32% of patients with CAD to a higher risk category, and 5% for CAD2, at the cost of adequate reclassification of 34% of patients without CAD to a lower risk category.

CONCLUSIONS

Prediction of CAD using scores that include modifiable cardiovascular risk factors seems to improve accuracy. Our results suggest that, in high-prevalence populations, DCS may better identify patients at higher risk and CAD2 those at lower risk for CAD.

Use of ultrasound in predicting success of intrauterine contraceptive device insertion immediately after delivery

OBJECTIVES

To assess by ultrasound examination the success of insertion of an intrauterine contraceptive device (IUD) immediately after delivery and to determine the optimal distance between the lower end of the IUD and the internal os in predicting successful retention of an IUD.

METHODS

This was a prospective study carried out between December 2012 and April 2013. Two ultrasound examinations, transabdominal and transvaginal, were performed prior to hospital discharge following delivery and again at 6 weeks following delivery in women who received a postpartum IUD. Distance from the internal os to the lower end of the IUD was measured at each examination and compared in unsuccessful and successful cases of postvaginal delivery (PVD) and post-Cesarean section (PCS) IUD insertion. Logistic regression and receiver-operating characteristics (ROC) curve analysis were used to determine the difference in success between the two modes of delivery and to determine the optimal cut-off of the internal os-to-IUD distance for successful retention, respectively.

RESULTS

Ninety-one women were included in the study, comprising 60 PVD and 31 PCS IUD insertions. Thirteen PVD (22.4%) and eight PCS (25.8%) IUDs were either expelled spontaneously or removed at the 6-week scan because of improper placement. Mean distance from the internal os to the lower end of the IUD on ultrasound examination immediately after insertion was significantly greater in successful cases than in those in which IUDs were subsequently expelled/displaced (mean difference after PVD insertion, 20.1 mm (P = 0.006); mean difference after PCS insertion, 10.3 mm (P = 0.05)). Logistic regression analysis demonstrated that mode of delivery was not independently associated with successful retention of the IUD (P = 0.72; OR, 0.831 (95% CI, 0.301-2.189)). The distance from the lower end of the IUD to the internal os measured at ultrasound examination prior to hospital discharge provided reasonable predictive accuracy for determining retention of the IUD, with an area under the ROC curve of 0.74 (95% CI, 0.60-0.88) and an optimal cut-off of ≥ 30 mm (sensitivity, 64.71% (95% CI, 52.17-75.92%) and specificity, 80.95% (95% CI, 58.09-94.55%)).

CONCLUSIONS

IUD insertion immediately postpartum is feasible but carries a substantial risk of unsuccessful IUD retention. Ultrasound examination after insertion of an IUD could be considered for predicting the success of IUD retention.

Ultrasound estimation of birth weight in twin pregnancy: comparison of biometry algorithms in the STORK multiple pregnancy cohort

OBJECTIVES

The aims of this study were first, to ascertain the accuracy of formulae for ultrasonographic birth-weight estimation in twin compared with singleton pregnancies and second, to assess the accuracy of sonographic examination in the prediction of birth-weight discordance in twin pregnancies.

METHODS

This was a retrospective cohort study including both singleton and twin pregnancies. Routine biometry was recorded and estimated fetal weight (EFW) calculated using 33 different formulae. Only pregnancies that delivered within 48 h of the ultrasound scan were included (4280 singleton and 586 twin fetuses). Differences between the EFW and actual birth weight (ABW) were assessed by percentage error, accuracy in predictions within ± 10% and ± 15% of error and use of the Bland-Altman method. The accuracy of prediction of the different cut-offs of birth-weight discordance in twin pregnancies was also assessed using the area under the receiver-operating characteristics curve (AUC).

RESULTS

The overall mean absolute percentage error was ≤ 10% for 25 formulae in singleton pregnancies compared with three formulae in twin pregnancies. The overall predictions within ± 10% and ± 15% of the ABW were 62.2% and 81.5% in singleton and 49.7% and 68.5% in twin pregnancies, respectively. When t e formulae were categorized according to the biometric parameters included, those based on a combination of head, abdomen and femur measurements showed the lowest mean absolute percentage error, in both singleton and twin pregnancies. The predictive accuracy for 25% birth-weight discordance using the Hadlock 2 formula, as assessed by the AUC, was 0.87.

CONCLUSIONS

Ultrasound estimation of birth weight is less accurate in twin than in singleton pregnancies. Formulae that include a combination of head, abdomen and femur measurements perform best in both singleton and twin pregnancies.

Anaerobic co-digestion of dairy cattle manure and pear waste

Anaerobic co-digestion of pre-treated dairy cattle manure (LCM) with pear waste after a storage period (PLF) was tested at four inclusion levels: 0%, 25%, 75% and 100%. Inclusion levels consisted in the replacement of the volatile solids (VS) from the LCM with the VS from PLF keeping the organic loading rate around 1.1 ± 0.4 g SVL(-1)d(-1). The introduction of the co-substrate clearly enhanced methane production rate (MPR) in comparison to single substrate (phase I) as phases II and III, respectively, achieving values 1.3 and 2.8 times higher than phase I. The overall performance was optimized for the mixture 25:75 (LCM:PLF; v:v). Moreover, storage of pear waste did not compromise its use in AD. This fact is important once it can improve waste management from pear production through its valorisation as co-substrate in AD process.

Crown-rump length discordance and adverse perinatal outcome in twins: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort

OBJECTIVE

Evidence for the role of first-trimester ultrasound in predicting outcome in twin pregnancies is conflicting. The aim of this study was to determine the association between crown-rump length (CRL) discordance and adverse perinatal outcome in twin pregnancies.

METHODS

This was a retrospective study of all twin pregnancies of known chorionicity from a large regional cohort over a 10-year period. Terminations of pregnancy, cases with fetal or chromosomal abnormalities and monoamniotic pregnancies were excluded. Receiver-operating characteristics (ROC) curve and logistic regression analyses were performed to evaluate the association between CRL discordance and stillbirth, neonatal mortality, intrauterine growth restriction, preterm birth (PTB) at < 34 weeks' gestation and birth weight (BW) and ultrasound estimated fetal weight (EFW) discordance of ≥ 25%.

RESULTS

A total of 2155 twin pregnancies were analyzed, of which 420 were monochorionic (MC) and 1735 dichorionic (DC). There were 42 fetal losses before 24 weeks' gestation and 23 perinatal deaths. CRL discordance was poorly predictive for fetal loss at < 24 weeks (area under the ROC curve (AUC), 0.54 (95% CI, 0.46-0.62)), perinatal loss (AUC, 0.52 (95% CI, 0.41-0.64)), BW discordance (AUC, 0.61 (95% CI, 0.56-0.65)), BW < 5(th) centile (AUC, 0.56 (95% CI, 0.53-0.59)), EFW discordance (AUC, 0.55 (95% CI, 0.51-0.60)) and PTB at < 34 weeks (AUC, 0.50 (95% CI, 0.47-0.54)). Overall mortality was significantly higher in MC (5.0%) than in DC (2.6%) twins (P = 0.016). Logistic regression analysis demonstrated that chorionicity (odds ratio 2.09 (95% CI, 1.06-4.10); P = 0.033) independently contributed to determining mortality, while CRL discordance (P = 0.201) did not. Adjusting for chorionicity did not improve the detection of adverse outcomes using CRL discordance.

CONCLUSION

In the absence of aneuploidy or structural fetal abnormality, CRL discordance is of poor predictive value for adverse perinatal outcome in both MC and DC twin pregnancies. CRL discordance should not be used routinely to identify twin pregnancies at high risk of adverse perinatal outcome.

Weight discordance and perinatal mortality in twins: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort

OBJECTIVES

The degree of actual intertwin birth weight (BW) or ultrasound estimated fetal weight (EFW) discordance that justifies elective delivery is yet to be established. The main aim of this study was to ascertain the performance of BW and ultrasound EFW discordance in the prediction of perinatal loss in twin pregnancies.

METHODS

This was a retrospective study of all twin pregnancy births from a large regional cohort of nine hospitals over a 10-year period. Intertwin BW and ultrasound EFW discordance were analyzed in relation to the occurrence of stillbirth or neonatal death of one or both twins from 26 weeks' gestation as obtained from a mandatory national register. Receiver-operating characteristics (ROC), survival and logistic regression analyses were performed to evaluate the contribution of weight discordance in determining perinatal loss.

RESULTS

A total of 2161 twin pregnancies were included in the analysis. The area under the ROC curve for the prediction of perinatal loss was similar for BW and ultrasound EFW discordance (P = 0.62). Kaplan-Meier analysis showed that twins with BW or EFW of ≥ 25% discordance had a significantly lower survival trend than did those with lesser degrees of discordance (P < 0.001). The hazard ratios for the risk of total perinatal loss in twins with a BW or EFW discordance of ≥ 25% were 7.29 (95% CI, 4.37-12.00) and 7.28 (95% CI, 4.46-11.92), respectively. Logistic regression analysis demonstrated that BW discordance and gestational age, but not chorionicity or individual fetal size percentile, were independently associated with perinatal mortality.

CONCLUSIONS

An EFW discordance of ≥ 25% represents the optimal cut-off for the prediction of stillbirth and neonatal mortality irrespective of chorionicity or individual fetal size. A policy of increased fetal surveillance commencing from 26 weeks' gestation might be reasonable for pregnancies beyond this cut-off, but this would require confirmation in large-scale prospective trials.

Does antenatal ultrasound labeling predict birth order in twin pregnancies?

OBJECTIVE

It is often assumed by obstetricians, neonatologists and parents that the prenatal nomenclature used to identify twins on ultrasound is consistent with twin labeling after their birth. The aim of this study was to use a large regional database of twin ultrasound scans to validate the effectiveness of a scan before delivery in predicting twin birth-order.

METHODS

A large regional database of twin ultrasound scans with data from nine hospitals over a 10-year period was used to identify all ultrasound examinations carried out just before birth. The discordance in twin order between the last scan and birth was evaluated by observing discrepancies in fetal sex and weight.

RESULTS

In total, 2103 twin pregnancies with ultrasound estimated fetal weights (EFWs) and birth weights were assessed. Of these, fetal sex was recorded in 149 different-sex pregnancies. Discrepancy between antenatal labeling and the anticipated birth order was noted in 37.6% (56/149) of cases when judged by sex discordance and in 36% (757/2103) of cases when judged by weight discordance. Multiple logistic regression analyses demonstrated that weight discordance, but not chorionicity, scan-to-delivery interval, gestation at scan or gestation at delivery, significantly influenced the change in birth order (P < 0.001).

CONCLUSION

Antenatal ultrasound labeling does not predict twin birth-order in a significant proportion of twin deliveries. This finding should be borne in mind not only by parents, but also by physicians when delivering twins discordant for anomalies that are not evident on external examination.

First-trimester ultrasound determination of chorionicity in twin pregnancy

OBJECTIVE

To determine the accuracy of ultrasound at 11-14 weeks' gestation in the diagnosis of chorionicity in twin pregnancy.

METHODS

This was a retrospective observational study of data obtained between 1999 and 2010. At the first-trimester routine ultrasound scan, chorionicity was assigned according to the number of placental masses and T or λ-signs for a single placental mass. Chorionicity was confirmed by histology or discordant sex at birth.

RESULTS

A total of 648 pregnancies were assigned chorionicity by first-trimester ultrasound during the study period. Chorionicity was ascertained in 613 cases, either by histology (n = 340) or discordant sex (n = 273). Chorionicity was correctly assigned by ultrasound at 11-14 weeks in 612 of 613 pregnancies (accuracy 99.8%). Sensitivity and specificity for determining monochorionicity were 100% and 99.8%, respectively.

CONCLUSIONS

First-trimester ultrasound can be used to determine chorionicity reliably by noting the number of placental masses and T or λ-signs. Determination of twin chorionicity is important and should be completed in the first trimester.

Systematic labeling of twin pregnancies on ultrasound

OBJECTIVE

Correct labeling of twin fetuses is needed for consistency in assigning and interpreting longitudinal scan and prenatal screening/diagnostic results. The aim of this study was to describe a standard method of twin labeling in the first trimester of pregnancy and to assess the robustness of such a technique in predicting the presenting twin in subsequent scans and at delivery.

METHODS

This was a retrospective first-trimester study of all twin pregnancies assessed by ultrasonography at our center between 2000 and 2010. The fetus contained in the gestational sac closer to the maternal cervix was designated as Twin 1 and the relative orientation of the fetuses to each other was then defined as either lateral (left/right) or vertical (top/bottom). In discordant-sex twins, their sex and presenting order on the final scan prior to delivery were documented and compared with the sex and birth order at delivery.

RESULTS

A total of 416 twin pregnancies were seen during the study period. At the 11-14-week scan 90.9% of twins were in lateral orientation while the remainder were oriented vertically. None of the vertically oriented twin pairs but 32 (8.5%) of the laterally oriented twin pairs changed their presenting order between the first and the last ultrasound scan prior to delivery. There were 108 discordant-sex twins scanned in the third trimester, of which the birth order changed in 20.3% that were delivered by Cesarean section and in 5.9% of those delivered vaginally.

CONCLUSION

The study demonstrates that antenatal labeling of twins according to laterality or vertical orientation is reliable. The technique ensures continuity of biometric assessment from serial scans at each visit, and as such should be adopted as the preferred method of twin labeling. Furthermore, the use of orientation for antenatal labeling of twins rather than assignment of a number based on proximity to the cervix, precludes any misconception regarding which twin will be born first and ensures that parents and pediatricians are aware of the significant likelihood of a peripartum switch.

Second-trimester assessment of gestational age in twins: validation of singleton biometry charts

OBJECTIVE

To determine the accuracy of dating twin pregnancies, of between 16 and 26 weeks' gestation, using singleton head circumference (HC) formulae.

METHODS

This was a retrospective study of 269 singleton and 119 twin non-anomalous pregnancies conceived by in-vitro fertilization (IVF) with a known embryo transfer date. Fetal ultrasound biometry data for HC, obtained using different formulae, were compared with expected fetal HC size for gestation calculated from the date of conception. Similar comparisons were undertaken for femur length (FL) and for transverse cerebellar diameter.

RESULTS

The mean differences in HC between observed ultrasound measurements and those expected from the IVF history were small (1-4 mm) and within the measurement error for both singletons and twins for all formulae. All measurements from the larger and the smaller twins straddled those of singletons, regardless of biometry and formula used. Negative skewing of FL measurements in the smaller twin suggests that fetal growth restriction may occur at this gestation and supports the practice of dating using the HC of the larger twin.

CONCLUSIONS

Singleton pregnancy HC charts can be used to date reliably twin pregnancies. The data of the study also suggest that the HC of the larger twin is the most reliable measurement for use in dating.

Cord entanglement and perinatal outcome in monoamniotic twin pregnancies

OBJECTIVES

To assess the prevalence of cord entanglement and perinatal outcome in a large series of monoamniotic twin pregnancies and to review the recent literature on similar published large series.

METHODS

Prospective observational study of all prenatally detected cases of monoamniotic twin pregnancies during an 8-year period in a tertiary fetal medicine unit. A Medline database review for publications since 2000 containing five or more cases of monoamniotic pregnancies that showed data on cord entanglement and perinatal outcome was also undertaken.

RESULTS

A total of 32 monoamniotic pregnancies were diagnosed during the study period, including three conjoined twins, seven pregnancies with twin reversed arterial perfusion (TRAP) syndrome, three surgical pregnancy interruptions for discordant fetal abnormality and one miscarriage before 16 weeks' gestation. The remaining 18 monoamniotic pregnancies were included in the study analysis. All monoamniotic pregnancies were complicated with antenatal cord entanglement diagnosed by B-mode and color Doppler ultrasound. There were 34 live births and a double intrauterine death diagnosed at 19 + 2 weeks' gestation. There were two late neonatal deaths, one from congenital complete heart block and the other after surgery for transposition of the great arteries. The overall perinatal loss rate was 11.1% after 16 weeks and 5.9% after 20 weeks' gestation. The cumulative rates of cord entanglement and perinatal mortality in the reviewed literature were 74% and 21%, respectively.

CONCLUSIONS

Umbilical cord entanglement is present in all monoamniotic twins when it is systematically evaluated by ultrasound and color Doppler. Perinatal mortality in monoamniotic twins is mainly a consequence of conjoined twins, TRAP, discordant anomaly and spontaneous miscarriage before 20 weeks' gestation. Expectantly managed monoamniotic twins after 20 weeks have a very good prognosis despite the finding of cord entanglement. The practice of elective very preterm delivery or other interventions to prevent cord accidents in monoamniotic twins should be re-evaluated.