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1.
J Elder Abuse Negl ; 34(2): 109-123, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35135412

RESUMO

This study aimed to assess the prevalence of abuse against Portuguese older people after an economic crisis and to assess how it has influenced health. A cross-sectional study was carried out including 677 older adults (≥60 years) during 2017. Results show that overall, 23.9% of older people reported being a victim of abuse in the last 12 months. The prevalence of psychological abuse was 19.9%, financial abuse 5.8%, physical abuse 2.5% and sexual abuse 1.9%. Older people who report abuse were more likely to have perceived insufficient income and low social support. The abuse was also significantly associated with poor health status and depressive symptoms. Even in an auspicious period, more than a fifth of older people experiences abuse which is associated with social and health vulnerabilities. These results support that an investment should be made in terms of policies toward an age-friendly environment.


Assuntos
Abuso de Idosos , Idoso , Estudos Transversais , Recessão Econômica , Humanos , Portugal/epidemiologia , Prevalência
2.
Sleep Med ; 90: 44-52, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35093683

RESUMO

OBJECTIVE/BACKGROUND: To describe and characterize insomnia symptoms and nightmare profiles in Portugal during the first six weeks of a national lockdown due to COVID-19. PATIENTS/METHODS: An open cohort study was conducted to collect information of the general population during the first wave of SARS-CoV-2/COVID-19 pandemic in Portugal. We analyzed data from 5011 participants (≥16 years) who answered a weekly questionnaire about their well-being. Two questions about the frequency of insomnia and nightmares about COVID-19 were consecutively applied during six weeks (March-May 2020). Latent class analysis was conducted and different insomnia and nightmare profiles were identified. Associations between individual characteristics and both profiles were estimated using odds ratios (ORs) and 95% confidence intervals (CI). RESULTS: Five insomnia (No insomnia, Stable-mild, Decreasing-moderate, Stable-severe, Increasing-severe) and three nightmares profiles (Stable-mild, Stable-moderate, Stable-severe) were identified. Being female, younger, perceiving their income as insufficient and feelings of fear towards COVID-19 were associated with higher odds of insomnia (Women: OR = 6.98 95%CI: 4.18-11.64; ≥60 years: OR = 0.30 95%CI: 0.18-0.53; Insufficient income: adjusted OR (aOR) = 8.413 95%CI: 3.93-16.84; Often presenting fear of being infected with SARS-CoV-2 infection: aOR = 9.13 95%CI: 6.36-13.11), and nightmares (Women: OR = 2.60 95%CI: 1.74-3.86; ≥60 years: OR = 0.45 95%CI: 0.28-0.74; Insufficient income: aOR = 2.60 95%CI: 1.20-5.20; Often/almost always presenting fear of being infected with SARS-CoV-2 infection: aOR = 6.62 95%CI: 5.01-8.74). Having a diagnosis of SARS-CoV-2 virus infection was associated with worse patterns of nightmares about the pandemic. CONCLUSIONS: Social and psychological individual factors are important characteristics to consider in the development of therapeutic strategies to support people with sleep problems during the COVID-19 pandemic.


Assuntos
COVID-19 , Distúrbios do Início e da Manutenção do Sono , COVID-19/epidemiologia , Estudos de Coortes , Controle de Doenças Transmissíveis , Sonhos , Feminino , Humanos , Pandemias , Portugal/epidemiologia , SARS-CoV-2 , Distúrbios do Início e da Manutenção do Sono/epidemiologia
3.
J Environ Radioact ; 242: 106790, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34890932

RESUMO

Understanding the behaviour of particulate matter and chemicals at the sediment-water interface (SWI) is of interest in environmental studies and risk assessments. These processes are still poorly understood, and this work aims to gain relevant insights by using a kinetic reactive transport model. It merges early diagenetic processes and box models for the uptake kinetics. Numerical solutions have been found for synthetic scenarios and for studying real cases from the literature (210Pb and Chernobyl fallout radionuclides in Lake Sniardwy, Poland, and 7Be in sediments from Tema Harbour, Ghana). The study identifies a series of factors that dynamically interact to govern the final fate of tracers in the SWI region, leading to a wide diversity of behaviours. When a term of eddy diffusivity is included in the upper regions of the pore fluid, which seems feasible for some energetic scenarios, it is possible to explain the observed large penetration depths for Cs and Be, while high particle-reactive elements are retained in thinner sediment layers. Desorption from the sediment occurs through the pore fluid as diffusive fluxes. Transient depth profiles of tracer concentrations can last from months up to a year, and they can show subsurface maxima at positions unrelated with the accretion rate. In the application cases, the model explained a wide set of observational data that was beyond the capabilities of other approaches involving physical mixing of solids and equilibrium kd. This modelling study could provide useful guidance for future research works.


Assuntos
Poluentes Ambientais , Monitoramento de Radiação , Cinética , Radioisótopos , Água
4.
Eur Child Adolesc Psychiatry ; 30(1): 65-74, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32065326

RESUMO

Depressive symptoms display heterogeneous trajectories across adolescence, which can lead to different consequences. This study aimed to identify trajectories of depressive symptoms from adolescence to young adulthood, assessing the association with social and health outcomes at young adulthood. Adolescents born in 1990, enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) completed the Beck Depression Inventory II (BDI-II) at 13, 17 and 21 years. Mixed models and model-based clustering were used to describe the trajectories in the BDI-II score (n = 2010). Outcomes were assessed at age 21 years with self-administered questionnaires and face-to-face interviews (n = 1594). Odds ratios or regression coefficients, with 95% confidence intervals, were estimated using logistic and linear regression. Three trajectory classes of depressive symptoms were identified, similar in shape in both sexes: High (8.4%), Moderate (31.3%) and Low (60.2%). Participants in High or Moderate classes were more likely to describe lower scores of community involvement, more medical appointments during the last year, higher levels of pain and had higher probability of self-rating health as "good" or "fair or poor". Females in the High and Moderate classes were more likely to be current smokers, to describe ever using drugs and to report more sexual partners, emergency room visits and the use of antidepressants. The risk of depressive symptoms in adulthood is likely to be early determined in adolescence. The trajectory classes with higher levels of symptoms were associated with worse social and health outcomes.


Assuntos
Depressão/diagnóstico , Avaliação de Resultados em Cuidados de Saúde/métodos , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
5.
Prev Med ; 135: 106073, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32243939

RESUMO

Social support can obscure social gradients in health, but its role as a mediator between socioeconomic position (SEP) and quality of life (QoL) in older populations remains unknown. We aimed to examine to what extent social support mediates the association between SEP and overall QoL among older adults (aged 60-84 years). We studied a population-based cohort of 585 noninstitutionalized adults in Porto, Portugal, who were evaluated in 2009. Education, occupation, and perceived income adequacy were used as SEP indicators. The WHOQOL-OLD was used to determine overall QoL. Social support was assessed using the Multidimensional Scale of Perceived Social Support. Path analysis was conducted to quantify direct, indirect, and total effects of SEP on QoL. There was a positive total effect of education on QoL (ß = 0.28; 95% CI: 0.05-0.48). In this model, we found an indirect effect through social support (ß = 0.15; 95% CI: 0.05-0.26), explaining 54% of the pathway between education and QoL. A similar pattern was identified for the association between occupation and QoL. Perceived income adequacy had a total effect of 2.74 (95% CI: 1.68-3.93) on QoL. Although an indirect effect through social support was found (ß = 0.98; 95% CI: 0.42-1.55), a direct effect from this variable remained (ß = 1.76; 95% CI: 0.65-2.90). Social support can be a mechanism through which SEP impacts the QoL of older people. Strengthening social support ties may attenuate the impact of social inequalities and improve the QoL of this population.


Assuntos
Envelhecimento , Qualidade de Vida/psicologia , Apoio Social , Fatores Socioeconômicos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Portugal
7.
Nutr Metab Cardiovasc Dis ; 29(6): 590-597, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31078361

RESUMO

BACKGROUND AND AIMS: Longitudinal studies relating adiposity with low-grade inflammation are scarce. We aimed to examine the longitudinal association between the cumulative exposure to adiposity and low-grade inflammation from adolescence into early adulthood. METHODS AND RESULTS: Data from a population-based cohort (EPITeen) (n = 1147) was analyzed. Body mass index (BMI), body fat percentage (BF%), waist circumference (WC), and waist-to-height ratio (WHtR) and high-sensitivity C-reactive protein (hsCRP) were ascertained at 13, 17 and 21 years of age and standardized for each wave. Generalized least squares models with a compound symmetry correlation structure were fitted to estimate the longitudinal effect of adiposity on hsCRP and results were presented as linear regression coefficients and 95% confidence intervals [ß (95%CI)].The final model estimated the association between the difference in adiposity between two consecutive evaluations (13-17 and 17 to 21-years-old), adjusted for previous adiposity and hsCRP levels, sex, parental education, leisure-time physical activity and fruits and vegetables intake. A positive association between the cumulative exposure to adiposity and final hsCRP was observed, in which the difference between adiposity indicators of two consecutive study waves was independently associated with hsCRP: 0.382 (0.299; 0.465) for BMI, 0.234 (0.164; 0.304) for WC, 0.395 (0.314; 0.477) for BF% and 0.195 (0.133; 0.258) for WHtR. CONCLUSION: A significant longitudinal effect of the accumulation of adiposity on low-grade inflammation was observed. The change in adiposity from consecutive study waves was shown to have a stronger effect on final hsCRP concentrations than both previous adiposity and hsCRP levels.


Assuntos
Adiposidade , Proteína C-Reativa/metabolismo , Mediadores da Inflamação/sangue , Inflamação/sangue , Obesidade Infantil/fisiopatologia , Adolescente , Fatores Etários , Biomarcadores/sangue , Feminino , Humanos , Inflamação/diagnóstico , Inflamação/epidemiologia , Estudos Longitudinais , Masculino , Obesidade Infantil/diagnóstico , Obesidade Infantil/epidemiologia , Portugal/epidemiologia , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Adulto Jovem
8.
BJOG ; 126(8): 984-995, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30786138

RESUMO

OBJECTIVE: To assess the separate and combined associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact. DESIGN: Individual participant data meta-analysis of 39 cohorts. SETTING: Europe, North America, and Oceania. POPULATION: 265 270 births. METHODS: Information on maternal pre-pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used. MAIN OUTCOME MEASURES: Gestational hypertension, pre-eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth. RESULTS: Higher maternal pre-pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31- 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain. CONCLUSIONS: Maternal pre-pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre-pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity. TWEETABLE ABSTRACT: Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.


Assuntos
Índice de Massa Corporal , Ganho de Peso na Gestação/fisiologia , Sobrepeso/complicações , Complicações na Gravidez/etiologia , Adulto , Austrália/epidemiologia , Peso ao Nascer , Estudos de Coortes , Europa (Continente)/epidemiologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , América do Norte/epidemiologia , Razão de Chances , Gravidez , Complicações na Gravidez/epidemiologia , Fatores de Risco
9.
Epidemiol Psychiatr Sci ; 28(1): 66-76, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28655362

RESUMO

AIMS: The higher prevalence of depressive symptoms among females is well recognised but the reasons for this gender difference are not fully understood. There is growing evidence that current diagnostic criteria and instruments used to assess depression are less sensitive to depression in men, but studies about this issue among adolescents are scarce, especially in Latin countries. Our aim was to assess sex differences in the intensity of depressive symptoms, measured using the Beck Depression Inventory second edition (BDI-II), among Portuguese adolescents, at 13 and 17 years of age. METHODS: Urban adolescents born in 1990 and enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) completed the BDI-II at 13 and 17 years of age. The final sample included 1988 (52.2% girls) and 2131 (53.0% girls) adolescents at 13 and 17 years, respectively. Sex differences in the frequency of endorsing the statements on the 21 items of the BDI-II were examined using the χ2 test and effect sizes were estimated (Cohen's w). To examine whether responses were linked systematically to sex, we used a differential item functioning (DIF), based on the logistic regression approach. Option characteristic curves were estimated for items with differential endorsement and a new BDI-II score was computed excluding those items. RESULTS: Girls and boys at the same level of depression expressed similar severity ratings for most of the depressive symptoms. We had four items with DIF at 13 and 17 years of age. At 13 years, two items provided lower scores (sadness and crying items) and two higher scores (punishment feelings and loss of interest in sex items) among boys, comparing with equally depressed girls. At 17 years, the four items with DIF provided lower scores among boys (sadness, crying, self-dislike and tiredness or fatigue items). After excluding these items the prevalence of depression remained higher among girls but at 17 years the difference between sexes was attenuated. CONCLUSIONS: Sex differences were found in the functioning of the BDI-II, more relevant at 17 years of age, which may lead to an overestimation of symptoms among girls as well as to lower reported rates of depression among boys. For a higher diagnostic accuracy it is important that the criteria and instruments used to assess depression adequately reflect female and male common symptoms and experiences of depression.


Assuntos
Comportamento do Adolescente/psicologia , Depressão/diagnóstico , Depressão/psicologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Fatores Sexuais , Adolescente , Comportamento do Adolescente/etnologia , Depressão/epidemiologia , Feminino , Humanos , Masculino , Vigilância da População , Portugal/epidemiologia , Prevalência , Índice de Gravidade de Doença , População Urbana
10.
Eur Child Adolesc Psychiatry ; 28(4): 595-599, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29974214

RESUMO

Depression is the most important source of disability in adolescents, partially due to its recurrence. There is a lack of studies on population-based samples investigating the continuity of depressive symptoms during adolescence. This study evaluates depressive symptoms at early adolescence as predictors of depressive symptoms later in adolescence. Urban adolescents born in 1990 and enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) were evaluated at 13 and 17 years (n = 1106, 55.9% females), and completed a questionnaire comprising health behaviors and Beck Depression Inventory II (BDI-II) to assess depressive symptoms. A questionnaire on socio-demographic and clinical characteristics was self-reported. Regression coefficients (ß) and 95% confidence intervals (CI) were estimated using simple linear regression. The prevalence of adolescents with depressive symptoms above the cut-off (BDI-II > 13) was 11.9% at 13 years (girls: 17.1%; boys: 5.3%) and 10.8% at 17 years (girls: 14.7%; boys: 5.7%). Almost 6% of girls and 2% of boys had BDI-II > 13 at both assessments, and 35% of girls and boys with BDI-II > 13 at baseline also had BDI-II > 13 at follow-up. For both genders, depressive symptoms at age 13 were independently associated with depressive symptoms at age 17 (girls: ß = 0.35, 95% CI 0.28-0.42; boys: ß = 0.37, 95% CI 0.30-0.44). Depressive symptoms at age 13 were an independent predictive factor for adolescents' depressive symptoms at age 17. The prevalence of adolescents with BDI-II > 13 was higher in females, but the strength of this association was similar in both genders, highlighting the heavy burden of depressive symptoms already at an early age, among girls and boys.


Assuntos
Comportamento do Adolescente , Depressão/diagnóstico , Depressão/epidemiologia , Vigilância da População , Adolescente , Comportamento do Adolescente/psicologia , Idoso , Depressão/psicologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Feminino , Seguimentos , Humanos , Masculino , Vigilância da População/métodos , Portugal/epidemiologia , Valor Preditivo dos Testes , Prevalência , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
11.
J Environ Radioact ; 192: 342-348, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30031316

RESUMO

Radioactive related pollution due to suspended particulate matter dispersion is an important workplace and health care issue. Recycling oil production ducts and contaminated production equipment, represent a health hazard to workers and public alike. Radioactive plate-out NORM scales with crystal deposit is analyzed by different techniques; results provide proper information on physico-chemical features and emitted alpha particles. Recommendations for handling and recycling procedures are included in relation to health risk and radiological hazard.


Assuntos
Poluentes Ocupacionais do Ar/análise , Partículas alfa , Exposição Ocupacional/estatística & dados numéricos , Indústria de Petróleo e Gás , Material Particulado/análise , Humanos , Reciclagem
12.
Pulmonology ; 24(1): 3-9, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29589582

RESUMO

In Portugal, the spectrum of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene variants is not known. The main objective of this work was to determine the type and frequency of CFTR variants in a sample from northern Portugal by the complete analysis of the CFTR coding sequencing performed in 512 Portuguese children. A total of 30 different CFTR sequence variants, already reported as cystic fibrosis (CF) or CFTR related disorders variants, were detected. Ninety-two children (18.0%; 95%CI: 14.7-21.6) were found to be carriers of one sequence variant and 8 (1.6%; 95%CI: 0.7-3.1) had two sequence variants. Taking into consideration only variants that may cause CF when combined with a pathogenic CF variant, the CF pathogenic variant carrier frequency was 3.3% (95%CI: 1.9-5.3). One (0.2%; 95%CI: 0.01-0.7) child presented two CF pathogenic variants. CONCLUSIONS: The majority of CFTR variants detected have been associated with a less severe CF phenotype. A wide spectrum of CFTR variants was identified, confirming the highest CFTR allelic heterogeneity previously reported in Mediterranean country. Additionally, better knowledge about the CFTR sequence variation spectrum may contribute to more efficient genetic testing in the Portuguese population.


Assuntos
Regulador de Condutância Transmembrana em Fibrose Cística/genética , Fibrose Cística/genética , Variação Genética , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Portugal , Análise de Sequência de DNA
13.
Int J Obes (Lond) ; 41(10): 1526-1530, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28584300

RESUMO

BACKGROUND/OBJECTIVES: The effect of adiposity dynamics throughout adolescence on adult cardiometabolic outcomes is not well known. We aimed to assess the effect of duration and degree of adiposity from adolescence to early adulthood on blood pressure and insulin resistance at 24 years. SUBJECTS/METHODS: We used data from 2253 participants evaluated at 13, 17, 21 and 24 years of age in the EPITeen cohort, Porto, Portugal. The area under the curve of body mass index (BMIAUC) was computed to summarize duration and degree of BMI for the 11-year period. Outcomes were systolic blood pressure (SBP) and insulin resistance at 24 years. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an indicator of insulin resistance and the variable was log-transformed. Associations between BMIAUC and each outcome were estimated by linear regression models. RESULTS: The median BMIAUC was 243.1 (223.9-268.6) kg m-2 in 11 years, corresponding to 22.1 kg m-2 on average per year. In crude analyses, both BMIAUC and BMI at 24 years were positively associated with SBP (ß=0.096 mm Hg, 95% confidence interval (CI) 0.077; 0.115 for BMIAUC; ß=4.616 mm Hg, 95% CI 3.082; 6.151 for BMI at 24 years) and ln HOMA-IR (ß=0.004, 95% CI 0.003; 0.005 for BMIAUC; ß=0.047, 95% CI 0.036; 0.057 for BMI at 24 years). After adjustment for confounders and for BMI at 24 years, the magnitude of the association of BMIAUC attenuated for both outcomes, mostly for SBP, but the association remained statistically significant. Results using standardized variables confirmed that both outcomes were more strongly associated with BMI at 24 years than with BMIAUC. CONCLUSIONS: In addition to the effect of adult attained BMI, cumulative exposure to higher BMI throughout adolescence, taking into account duration and degree, was also relevant for adult cardiovascular risk factors, mainly for insulin resistance.


Assuntos
Adiposidade/fisiologia , Doenças Cardiovasculares/epidemiologia , Adolescente , Área Sob a Curva , Pressão Sanguínea , Índice de Massa Corporal , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/prevenção & controle , Estudos de Coortes , Feminino , Humanos , Insulina/sangue , Resistência à Insulina , Masculino , Obesidade/epidemiologia , Obesidade/fisiopatologia , Portugal/epidemiologia , Fatores de Risco , Fatores de Tempo , Adulto Jovem
14.
BJOG ; 124(10): 1595-1604, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28294506

RESUMO

OBJECTIVE: To investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTIs) between 2003 and 2012, and concurrent trends in their mortality and morbidity in ten European regions. DESIGN: Population-based cohort studies in 2003 (MOSAIC study) and 2011/2012 (EPICE study) and questionnaires from hospitals. SETTING: 70 hospitals in ten European regions. POPULATION: Infants born at <27 weeks of gestational age (GA) in hospitals participating in both the MOSAIC and EPICE studies (1240 in 2003, 1293 in 2011/2012). METHODS: We used McNemar's Chi2 test, paired t-tests and conditional logistic regression for comparisons over time. MAIN OUTCOMES MEASURES: Reported policies, mortality and morbidity of EPTIs. RESULTS: The lowest GA at which maternity units reported performing a caesarean section for acute distress of a singleton non-malformed fetus decreased from an average of 24.7 to 24.1 weeks (P < 0.01) when parents were in favour of active management, and 26.1 to 25.2 weeks (P = 0.01) when parents were against. Units reported that neonatologists were called more often for spontaneous deliveries starting at 22 weeks GA in 2012 and more often made decisions about active resuscitation alone, rather than in multidisciplinary teams. In-hospital mortality after live birth for EPTIs decreased from 50% to 42% (P < 0.01). Units reporting more active management in 2012 than 2003 had higher mortality in 2003 (55% versus 43%; P < 0.01) and experienced larger declines (55 to 44%; P < 0.001) than units where policies stayed the same (43 to 37%; P = 0.1). CONCLUSIONS: European hospitals reporting changes in management policies experienced larger survival gains for EPTIs. TWEETABLE ABSTRACT: Changes in reported policies for management of extremely preterm births were related to mortality declines.


Assuntos
Unidades Hospitalares/organização & administração , Mortalidade Infantil/tendências , Lactente Extremamente Prematuro , Serviços de Saúde Materno-Infantil/organização & administração , Nascimento Prematuro/mortalidade , Distribuição de Qui-Quadrado , Parto Obstétrico/normas , Europa (Continente) , Feminino , Mortalidade Hospitalar/tendências , Unidades Hospitalares/normas , Humanos , Lactente , Recém-Nascido , Doenças do Prematuro/mortalidade , Modelos Logísticos , Masculino , Serviços de Saúde Materno-Infantil/normas , Política Organizacional , Gravidez
15.
Int J Obes (Lond) ; 41(4): 533-541, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28028320

RESUMO

BACKGROUND/OBJECTIVES: The role of Protein Intake (PI) at preschool age on later adiposity is understudied, and prospective studies also examining Dietary Glycemic Load (GL) are lacking. The current study evaluated the association of PI and GL at 4 years with adiposity and Fasting Serum Insulin (FSI) 3 years later, and examined the possible interaction between PI and GL on these associations, by sex. DESIGN: This prospective study included 1999 singleton children enrolled in the population-based birth cohort, Generation XXI (Porto, Portugal, 2005-2006). Diet at 4 years was assessed by 3-days food diaries. Energy-adjusted PI and GL (g per day) were converted into sex-specific tertiles (T). At 7 years, Body Mass Index (BMI) z-scores were defined according to the World Health Organization. Sample's sex-specific z-scores were computed for Fat Mass Index (FMI), Waist-to-Height ratio (W/Ht) and FSI. Associations were estimated by linear regression coefficients (ß) and 95% confidence intervals (95% CI). RESULTS: After adjustment for confounders, PI was positively associated with BMI in girls (T2 vs T1: ß=0.187; 95% CI: 0.015, 0.359) and boys (T3 vs T1: ß=0.205; 95% CI: 0.003, 0.406), being associated with FSI only in boys (T3 vs T1: ß=0.207; 95% CI: 0.011, 0.404; P-interaction=0.026). Also, GL was associated with BMI only in boys (T3 vs T1: ß=0.362; 95% CI: 0.031, 0.693; P-interaction=0.006), in whom significant interactions between PI and GL were found on the association with FMI (P=0.019) and W/Ht (P=0.039). Boys within the third T of both PI and GL at 4 years had higher FMI (ß=0.505; 95% CI: 0.085, 0.925) and W/Ht (ß=0.428; 95% CI: 0.022, 0.834) at 7 years. CONCLUSIONS: In both girls and boys, PI at preschool age is positively associated with later BMI, being positively associated with FSI only in boys. Dietary GL is associated with adiposity only in boys, in whom it seems to interact with PI enhancing increased adiposity.


Assuntos
Adiposidade/fisiologia , Glicemia/metabolismo , Fenômenos Fisiológicos da Nutrição Infantil/fisiologia , Ingestão de Energia/fisiologia , Carga Glicêmica/fisiologia , Insulinas/sangue , Índice de Massa Corporal , Criança , Pré-Escolar , Proteínas Alimentares , Feminino , Índice Glicêmico/fisiologia , Humanos , Masculino , Inquéritos Nutricionais , Portugal/epidemiologia , Estudos Prospectivos
16.
Int J Oral Maxillofac Surg ; 45(12): 1508-1512, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27688168

RESUMO

The objective of this study was to evaluate, through cone beam computed tomography, the immediate changes in pharyngeal airway space (PAS) after orthognathic surgery in class III patients, and to determine the influence of surgery on the development of obstructive sleep apnoea hypopnoea syndrome (OSAHS). A prospective study was conducted; 33 patients were divided into three groups: mandibular setback surgery (nine patients), bimaxillary surgery (18 patients), and maxillary advancement surgery (six patients). PAS measurements obtained pre- and postoperatively were compared using the t-test. All patients were assessed clinically for OSAHS before surgery and at 6 months postoperative using the Berlin questionnaire and a combined clinical assessment, which included the assessment of OSAHS symptoms, Epworth Sleepiness Scale score, and body mass index. Patients undergoing isolated mandibular setback surgery demonstrated a decrease in total PAS volume, in hypopharynx volume, and in minimum cross-sectional area of the pharynx immediately after surgery (P<0.05). The clinical analysis did not reveal signs or symptoms of OSAHS in any of the 33 patients. Although patients who underwent mandibular setback surgery alone demonstrated a volume reduction in the PAS and a decrease in minimum cross-sectional area, these reductions were not accompanied by signs or symptoms of OSAHS.


Assuntos
Má Oclusão Classe III de Angle/cirurgia , Procedimentos Cirúrgicos Ortognáticos/efeitos adversos , Faringe/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Apneia Obstrutiva do Sono/etiologia , Adolescente , Adulto , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteotomia de Le Fort , Estudos Prospectivos , Adulto Jovem
17.
Int J Obes (Lond) ; 40(12): 1899-1905, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27677621

RESUMO

BACKGROUND/OBJECTIVES: Our aim was to identify trajectories of total and central adiposity from 13 to 21 years, and to investigate how adiposity changes at different phases of adolescence relate to adulthood cardiovascular risk factors. SUBJECTS/METHODS: This study included participants from a population-based cohort (EPITeen), Portugal. Body mass index (BMI) and waist circumference (WC) were measured at 13, 17 and 21 years, and sex- and age-specific z-scores were calculated. Adiposity trajectories were identified using mixture growth models (BMI, n=2901; WC, n=2898). Cardiovascular risk factors were evaluated at 21 years (n=1763): systolic (SBP) and diastolic blood pressure (DBP), insulin resistance (HOMA-IR), triglycerides and cholesterol. Association of trajectory, and changes in adiposity z-scores with each cardiovascular risk factor was estimated by linear regression models. RESULTS: 'Normal', 'high, declining' and 'high, increasing' trajectories were identified in both sexes. 'High, increasing' BMI trajectory was associated with less favorable cardiovascular risk profile at 21 years in both sexes, whereas 'high, declining' presented a more favorable profile, similar to 'normal' trajectory in females. In addition, BMI increases between 13-17 years and 17-21 years were associated with increases in systolic and diastolic blood pressure, and insulin resistance, but more strongly for the later period. For every standard deviation (s.d.) increase in BMI between 17-21 years, mean SBP increased by 1.99 mmHg (95% confidence interval (CI): 1.01; 2.97) for females and 3.83 mmHg (2.67; 4.98) for males; the respective increase was 1.56 mmHg (0.72; 2.40) and 2.80 mmHg (1.97; 3.64) for DBP and 0.27 (0.21; 0.32) and 0.30 (0.24; 0.36) for HOMA-IR (log-transformed). Similar results were found for WC. CONCLUSIONS: Increases in adiposity, particularly from late adolescence-to-young adulthood, were associated with unfavorable cardiovascular profile in early adulthood. A benefit on the cardiovascular risk profile for participants in the declining adiposity trajectory was observed.


Assuntos
Adiposidade/fisiologia , Doenças Cardiovasculares/etiologia , Obesidade Abdominal/complicações , Triglicerídeos/sangue , Adolescente , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Feminino , Promoção da Saúde , Humanos , Resistência à Insulina/fisiologia , Masculino , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/prevenção & controle , Vigilância da População , Portugal/epidemiologia , Fatores de Risco , Circunferência da Cintura , Adulto Jovem
18.
Nutr Metab Cardiovasc Dis ; 26(11): 1004-1010, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27461861

RESUMO

BACKGROUND AND AIMS: It remains unknown whether the effects of prenatal exposures on child's adiposity reflect entirely intrauterine programming. We aimed to assess the effects of maternal gestational weight gain, diabetes and smoking on the child's body fat patterns, disentangling the direct (through intrauterine programming) and indirect (through birthweight) effects. METHODS AND RESULTS: We included 4747 singleton 7-year-old children from the Generation XXI birth cohort (Porto, Portugal). At birth, maternal and newborn's characteristics were obtained. Anthropometrics were measured at age 7 years and body fat patterns were identified by principal component analysis. Path analysis was used to quantify direct, indirect and total effects of gestational weight gain, diabetes and smoking on body fat patterns. Pattern 1 was characterized by strong factor loadings with body mass index, fat mass index and waist-to-height ratio (fat quantity) and pattern 2 with waist-to-hip ratio, waist-to-thigh ratio, and waist-to-weight ratio (fat distribution). The positive total effect of maternal gestational weight gain and diabetes on the child's fat quantity was mainly through a direct pathway, responsible for 91.7% and 83.7% of total effects, respectively (ß = 0.022; 95% Confidence Interval (CI): 0.017, 0.027; ß = 0.041; 95% CI: -0.011, 0.093). No effects on fat distribution were found. Maternal prenatal smoking had a positive direct effect on patterns 1 and 2, explaining 94.9% and 76.1% of total effects, respectively. CONCLUSION: The effects of maternal gestational weight gain, diabetes and smoking on a child's fat quantity seem to be mainly through intrauterine programming. Maternal smoking also showed a positive direct effect on child's fat distribution.


Assuntos
Adiposidade , Peso ao Nascer , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Diabetes Gestacional , Fenômenos Fisiológicos da Nutrição Materna , Obesidade Infantil/etiologia , Efeitos Tardios da Exposição Pré-Natal , Fumar/efeitos adversos , Aumento de Peso , Fatores Etários , Índice de Massa Corporal , Criança , Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Gestacional/fisiopatologia , Feminino , Desenvolvimento Fetal , Humanos , Recém-Nascido , Masculino , Obesidade Infantil/fisiopatologia , Portugal , Gravidez , Análise de Componente Principal , Análise de Regressão , Fatores de Risco , Relação Cintura-Quadril
19.
Public Health ; 139: 44-52, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27262180

RESUMO

OBJECTIVES: This work explores the association between socio-economic position (SEP) and intimate partner violence (IPV) considering the perspectives of men and women as victims, perpetrators and as both (bidirectional). STUDY DESIGN: Cross-sectional international multicentre study. METHODS: A sample of 3496 men and women, (aged 18-64 years), randomly selected from the general population of residents from six European cities was assessed: Athens; Budapest; London; Östersund; Porto; and Stuttgart. Their education (primary, secondary and university), occupation (upper white collar, lower white collar and blue collar) and unemployment duration (never, ≤12 months and >12 months) were considered as SEP indicators and physical IPV was measured with the Revised Conflict Tactics Scales. RESULTS: Past year physical IPV was declared by 17.7% of women (3.5% victims, 4.2% perpetrators and 10.0% bidirectional) and 19.8% of men (4.1% victims, 3.8% perpetrators and 11.9% bidirectional). Low educational level (primary vs university) was associated with female victimisation (adjusted odds ratio, 95% confidence interval: 3.2; 1.3-8.0) and with female bidirectional IPV (4.1, 2.4-7.1). Blue collar occupation (vs upper white) was associated with female victimisation (2.1, 1.1-4.0), female perpetration (3.0, 1.3-6.8) and female bidirectional IPV (4.0, 2.3-7.0). Unemployment duration was associated with male perpetration (>12 months of unemployment vs never unemployed: 3.8; 1.7-8.7) and with bidirectional IPV in both sex (women: 1.8, 1.2-2.7; men: 1.7, 1.0-2.8). CONCLUSIONS: In these European centres, physical IPV was associated with a disadvantaged SEP. A consistent socio-economic gradient was observed in female bidirectional involvement, but victims or perpetrators-only presented gender specificities according to levels of education, occupation differentiation and unemployment duration potentially useful for designing interventions.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Classe Social , Adolescente , Adulto , Estudos Transversais , Europa (Continente) , Feminino , Humanos , Internacionalidade , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
Opt Express ; 23(14): 18288-99, 2015 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-26191885

RESUMO

We present a high-speed asynchronous optical sampling system, based on two different Kerr-lens mode-locked lasers with a GHz repetition rate: An Yb:KYW oscillator and a Ti:sapphire oscillator are synchronized in a master-slave configuration at a repetition rate offset of a few kHz. This system enables two-colour pump-probe measurements with resulting noise floors below 10⁻6 at a data aquisition time of 5 seconds. The measured temporal resolution within the 1 ns time window is below 350 fs, including a timing jitter of less than 50 fs. The system is applied to investigate zone-folded coherent acoustic phonons in two different semiconductor superlattices in transmission geometry at a probe wavelength far below the bandgap of the superlattice constituents. The lifetime of the phonon modes with a zero wave vector and frequencies in the range from 100 GHz to 500 GHz are measured at room temperature and compared with previous work.

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