Taste sensitivity and lifestyle are associated with food preferences and BMI in children.

Oral food perception together with lifestyle may affect food preferences and choices, influencing weight gain and obesity development. The present study was designed to evaluate the association of biological (taste sensitivity) and lifestyle variables with children food preferences, assessing whether all these variables contribute to explain BMI percentile. After anthropometric evaluation, 387 children were classified for bitter and sweet taste sensitivities. Socioeconomic/lifestyle aspects and hedonics for 36 foods were collected. Watching TV during meals associate with lower preference for several vegetables, as well as being sweet taste low sensitive, in the case of girls. Moreover, regression analysis showed that bitter taste sensitivity is one of the variables contributing to explain high BMI percentiles. These results present evidences that both biological and socioeconomic and the attention that is given to food (eating in the presence or absence of distractors) are aspects that should be considered in children nutrition to prevent obesity.

Prevalence of acute and chronic wounds - with emphasis on pressure ulcers - in integrated continuing care units in Alentejo, Portugal.

The aim of the study was to describe the prevalence and general characteristics of acute and chronic wounds in 2018 in Alentejo (Portugal) continuing care units. In order to look at associations, wound characteristics studied were location, type, place of acquisition, number, and duration, and patient characteristics were sex, age, and presence of risk factors. During the first 2 weeks of February 2018, a total of 770 patients were assessed at continuing care units of Alentejo. Of these, 135 exhibited wounds, a prevalence of 17.5%. Almost two out of three patients (63%) had arterial hypertension, slightly more than one in three (37%) had a stroke and/or immobility and 30% had diabetes. Of the total wounds identified, 18% were acute wounds and 82% were chronic wounds. Of the 24 acute wounds, traumatic wounds (76%), and surgical wounds (22%) were the most prevalent. The four types of pressure ulcers represented 80% of the chronic wounds. The median duration of the pressure ulcers was 5.5 months and 25% had duration over 10 months.

Evaporative heat loss in Bos taurus: do different cattle breeds cope with heat stress in the same way?

The aim of this study was to compare two Portuguese (Alentejana and Mertolenga) and two exotic (Frisian and Limousine) cattle breeds in terms of the relationship between the increase in ambient temperature and the responses of the evaporative heat loss pathways and the effects on homeothermy. In the experiment, six heifers of the Alentejana, Frisian, and Mertolenga breeds and four heifers of the Limousine breed were used. The animals were placed in four temperature levels, the first one under thermoneutral conditions and the other ones with increase levels of thermal stress. When submitted to severe heat stress, the Frisian developed high thermal tachypnea (125 mov/min) and moderate sweating rates (117 gm(-2) h(-1)), which did not prevent an increase in the rectal temperature (from 38.4 °C to 40.0 °C). Moderate increases in rectal temperature were observed in the Alentejana (from 38.8 °C to 39.4 °C) and Limousine (from 38.6 °C to 39.4 °C), especially in the period of highest heat stress. The Limousine showed moderate levels of tachypnea (101 mov/min) while showing the lowest sweating rates. The Alentejana showed significant increases in sweating rate (156 gm(-2)h(-1)) that played a major role in homeothermy. The Mertolenga showed a superior stability of body temperature, even in the period of highest heat stress (from 38.5 °C to 39.1 °C). Uncommonly, the maintenance of homeothermy during moderate heat stress was achieved primarily by intense tachypnea (122 mov/min). The sweating rate remained abnormally low under conditions of moderate heat stress, rising significantly (110 gm(-2)h(-1)) without evidence of stabilization, only when tendency for heat storage occurred. This unusual response of the evaporative heat loss pathways infers a different thermoregulatory strategy, suggesting a different adaptation to semi-arid environment and strong association with water metabolism.

The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal's Long-Term Care Units.

BACKGROUND: The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people's quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serious public health problem. This study aims to describe the nursing work environment in Portuguese long-term care (LTC) units and to assess how this environment relates to the quality of PU care. METHODS: A longitudinal study among inpatients with PUs was conducted in LTC units. The Nursing Work Index-Revised Scale (NWI-R) was sent to all nurses in these units. Cox proportional hazard models were used to relate the satisfaction degree with the service (measured by the NWI-R-PT items) to the healing time of the PUs, adjusting for confounders. RESULTS: A total of 165 of 451 invited nurses completed the NWI-R-PT. Most were women (74.6%) and had 1 to 5 years of professional experience. Less than half (38.4%) had education in wound care. Of the 88 patients identified with PUs, only 63 had their PU documented, highlighting the difficulties in updating electronic records. The results showed that the level of concordance with Q28 "Floating so that staffing is equalised among units" is strongly associated with a shorter PU healing time. CONCLUSION: A good distribution of nursing staff over the units will likely improve the quality of wound care. We found no evidence for possible associations with the questions on participation in policy decisions, salary level, or staffing educational development and their relationship with PUs healing times.

Primary School Children's Sleep Habits: Association with Socioeconomic Factors and Physical Activity Habits.

Sleep disorders have significant health impacts and affect children's performance and wellbeing. This study aims to characterise the sleep habits of Portuguese primary school children considering socioeconomic factors, daily lifestyle, presence of electronic devices in the bedrooms, and the practice of physical and sports activity (PSA) and to identify clinical factors that may be related to a child's insufficient sleeping time. This study involved 1438 primary students. Sleep habits and problems were assessed using the short version of the Children's Sleep Habits Questionnaire (CSHQ). The mean sleep duration was 9 h 37 min/ per night (SD = 44 min). The prevalence of global sleep disturbances was 25.8%. The main factors we identified to be positively associated with a child's sleep deficit (i.e., <10 h) were: being older than 7 years, living further away from school, having electronic devices in the bedroom, going to bed and eating dinner later, less daily time of PSA, and having higher scores on the sleep duration subscales. Sleeping and eating habits, electronic devices in the bedroom, and a low level of engagement with PSA are associated with children's sleep disturbance and shorter sleep duration.

Content Validity and Reliability of the Pressure Ulcer Knowledge Test and the Knowledge Level of Portuguese Nurses at Long-Term Care Units: A Cross-Sectional Survey.

(1) Background: Improvement in pressure ulcer care depends both on the dissemination of knowledge and its implementation. This study aims to translate the Pressure Ulcer Knowledge Test into Portuguese from Portugal and evaluate the internal consistency of the questionnaire. The second aim is to assess nurses' pressure ulcer knowledge level. (2) Methods: The Pressure Ulcer Knowledge Test was translated into Portuguese, and the translated test's internal consistency and content validity were assessed. Further, the authors conducted a cross-sectional survey using the test among 221 nurses working in long-term care units. (3) Results: The Cronbach's alpha internal coefficient of reliability recorded for the 47 items was 0.738, which is higher than the minimum acceptable level of 0.7. The Cronbach's alpha for the subscales was 0.709 for prevention/risk and less than 0.5 for staging and wound description. Only two of the 221 nurses achieved a score of 90% correct answers or more. The nurses scored lower in questions related to prevention/risk (Me = 67.4%, IQR = 60.6-75.8% vs. staging: ME = 85.7%, IQR = 71.4-85.7%, description: ME = 85.7%, IQR = 71.4-85.7%, p < 0.001). (4) Conclusion: The internal consistency of the instrument was acceptable. The instrument can accurately measure Portuguese nurses' knowledge of pressure ulcers, and its information can help improve education and implementation of best practices.

A device to improve the Schleger and Turner method for sweating rate measurements.

The objective of this study was to test a device developed to improve the functionality, accuracy and precision of the original technique for sweating rate measurements proposed by Schleger and Turner [Schleger AV, Turner HG (1965) Aust J Agric Res 16:92-106]. A device was built for this purpose and tested against the original Schleger and Turner technique. Testing was performed by measuring sweating rates in an experiment involving six Mertolenga heifers subjected to four different thermal levels in a climatic chamber. The device exhibited no functional problems and the results obtained with its use were more consistent than with the Schleger and Turner technique. There was no difference in the reproducibility of the two techniques (same accuracy), but measurements performed with the new device had lower repeatability, corresponding to lower variability and, consequently, to higher precision. When utilizing this device, there is no need for physical contact between the operator and the animal to maintain the filter paper discs in position. This has important advantages: the animals stay quieter, and several animals can be evaluated simultaneously. This is a major advantage because it allows more measurements to be taken in a given period of time, increasing the precision of the observations and diminishing the error associated with temporal hiatus (e.g., the solar angle during field studies). The new device has higher functional versatility when taking measurements in large-scale studies (many animals) under field conditions. The results obtained in this study suggest that the technique using the device presented here could represent an advantageous alternative to the original technique described by Schleger and Turner.

Microtomographic characterization of calcifications in canine mammary tumours.

The present work describes the microtomographic characterization of macro- and microcalcifications present in excised canine mammary glands. In human breast cancer, microcalcifications are highly relevant for diagnosis and prognosis, often being the sole element determining biopsy. Canine mammary tumours are considered a model for human breast cancer, but the morphological features of calcifications had still to be studied in this species. The objective of this research is to contribute to the characterization of the mineralization features of the canine mammary gland. In the present study, the excised mammary glands of 33 bitches underwent fluoroscopic examination. In 30 of the samples, the presence of calcification was suspected, and multiple biopsies were taken of these areas. Biopsy fragments underwent microtomographic scanning. Microcalcifications were found in non-neoplastic glandular tissue, benign and malign lesions, as it is known to happen in humans. Qualitative evaluation regarding morphology of the imaged calcifications showed similarities to breast cancer findings, based on the BI-RADS 2013 classification, such as pleomorphism and shape. No differences in the quantitative morphological parameters of volume, surface, surface/volume, SMI and structure thickness were found when macrocalcifications were considered. However, although significant differences existed in these parameters between microcalcifications from malignant canine mammary tumours and the two other groups, none were found between non-neoplastic and benign tumours. Findings further support the use of this spontaneous animal model for the study of human breast cancer, considering how clinically relevant microcalcifications are in humans.

Depression and quality of life in patients with breast cancer undergoing chemotherapy and monoclonal antibodies.

BACKGROUND: Depression is one of the major psychiatric morbidities in cancer patients. The purpose of our study was to evaluate the impact of depressive symptoms in the quality of life (QoL) of patients with breast cancer undergoing chemotherapy and monoclonal antibodies treatments. METHODS: Observational, cross-sectional study conducted between April and November 2016. To evaluate the QoL, the EORTC QLQ-C30 and QLQ-BR23 questionnaire were used. The patients were screened for depressive symptoms using the Hospital Anxiety and Depression Scale (HADS-D) and those with a positive HADS-D positive questionnaire were referenced to the Psychiatry and Mental Health Department for further assessment and follow-up. RESULTS: We included 45 female patients. Sixteen (35.6%) patients had a positive HADS-D questionnaire and depressive symptoms confirmed by a psychiatric physician. Of those patients, 7 (15.6%) had a major depressive episode confirmed by psychiatric interview. There was a significant association of depressive symptoms with the future perspectives scale (p = 0.022), breast symptoms scale (p = 0.011) and arm symptom scale (p = 0.005). Significant differences were found in the fatigue (p = 0.024), pain (p = 0.037) and dyspnea (p = 0.009) subscales being worse in patients with depressive symptoms. The association between having depressive symptoms or not was shown to be significant or marginally significant for the variables stage of the tumour (p = 0.057), presence of distant metastasis (p = 0.072) and previous diagnosis of depression (p = 0.011). The patients treated with regimens containing monoclonal antibodies presented better outcomes in various subscales of the EORTC QLQ-C30 and QLQ-B23 questionnaires than those patients treated with chemotherapy regimens without monoclonal antibodies. CONCLUSIONS: Despite the small sample of our study, this study provided evidence that depressive symptoms in patients with breast cancer undergoing chemotherapy and monoclonal antibodies treatments detrimentally reduced various aspects of QoL.

Role of physical activity in the occurrence of falls and fall-related injuries in community-dwelling adults over 50 years old.

PURPOSE: This study examined the effect of the type, level and amount of physical activity in falls and fall-related injuries. METHOD: Participants were 506 community-dwelling adults aged >50 years (390 women: 67.7 ± 6.8 years and 116 men: 69.6 ± 6.6 years). Falls, fall-related injuries (slight and severe), and physical activity (type, level and energy expenditure) were evaluated by questionnaires. Confounders included co-morbidities, fear of falling, environmental hazards and physical fitness. RESULTS: After adjustment for confounders, logistic analysis revealed that the likelihood of falling decreased by 2% for each 100 metabolic expenditure (MET-min/week) of total physical activity and increased by 5% for each 100 MET-min/week of vigorous-intensity physical activity; total physical activity >1125 MET-min/week and vigorous physical activity <500 MET-min/week were identified as cut-off values discriminating non-fallers from fallers. Compared to the low physical activity level, increased physical activity levels diminished the likelihood of the occurrence of severe fall-related injuries by 76% (moderate) and 58% (high; p < 0.05) in fallers. CONCLUSIONS: Being active, especially sufficiently active, reduces fall-related injuries by decreasing falls and by safeguarding against severe injuries when falls occur. At least 1125 MET-min/week of total physical activity including >500 MET-min/week of vigorous intensity seems to prevent falls and, therefore, fall-related injuries.

Translation, adaptation and validation of a Portuguese version of the Moorehead-Ardelt Quality of Life Questionnaire II.

The prevalence of obesity has increased worldwide. An assessment of the impact of obesity on health-related quality of life (HRQoL) requires specific instruments. The Moorehead-Ardelt Quality of Life Questionnaire II (MA-II) is a widely used instrument to assess HRQoL in morbidly obese patients. The objective of this study was to translate and validate a Portuguese version of the MA-II.The study included forward and backward translations of the original MA-II. The reliability of the Portuguese MA-II was estimated using the internal consistency and test-retest methods. For validation purposes, the Spearman's rank correlation coefficient was used to evaluate the correlation between the Portuguese MA-II and the Portuguese versions of two other questionnaires, the 36-item Short Form Health Survey (SF-36) and the Impact of Weight on Quality of Life-Lite (IWQOL-Lite).One hundred and fifty morbidly obese patients were randomly assigned to test the reliability and validity of the Portuguese MA-II. Good internal consistency was demonstrated by a Cronbach's alpha coefficient of 0.80, and a very good agreement in terms of test-retest reliability was recorded, with an overall intraclass correlation coefficient (ICC) of 0.88. The total sums of MA-II scores and each item of MA-II were significantly correlated with all domains of SF-36 and IWQOL-Lite. A statistically significant negative correlation was found between the MA-II total score and BMI. Moreover, age, gender and surgical status were independent predictors of MA-II total score.A reliable and valid Portuguese version of the MA-II was produced, thus enabling the routine use of MA-II in the morbidly obese Portuguese population.

Men older than 50 yrs are more likely to fall than women under similar conditions of health, body composition, and balance.

OBJECTIVE: The aim of this study was to analyze the contribution of sex to the occurrence of falls, accounting for comorbidities and differences in physical fitness. DESIGN: This was a cross-sectional study of 587 community-dwelling adults who were older than 50 yrs. Falls, comorbidities (number of diseases and physical impairments), and physical fitness (body composition, lower and upper body strength and flexibility, agility, aerobic endurance, and balance) were evaluated via questionnaires, bioimpedance, and Fullerton batteries, respectively. RESULTS: Compared with the men, the women presented a 10% higher fall prevalence, 1.7 more diseases/impairments, 10% more body fat, 26% less lean body mass, and poorer physical capacity (P < 0.05). Multivariate logistic regression revealed that male sex (odds ratio [OR], 2.723; 95% confidence interval [CI], 1.190-6.230) increased the likelihood of falling, after adjustment for comorbidities (OR, 1.213; 95% CI, 1.109-1.328), lean mass (OR, 0.958; 95% CI, 0.927-0.989), fat mass (OR, 1.053; 95% CI, 1.021-1.086), and balance (OR, 0.942; 95% CI, 0.914-0.971), which were the main risk factors of falls. CONCLUSIONS: Women are more susceptible to falling, presumably because they have poorer health and physical fitness than do men. However, when the values for comorbidities, lean and fat body mass, and balance were similar, the men demonstrated a higher probability of falling. Age is not a significant risk factor of falls under favorable conditions of health, body composition, and balance.

Evaluation of reactivity of horses in the presence of unknown stimulus / Avaliação da reatividade de equinos na presença de estímulo sonoro desconhecido

The study aimed to evaluate reactivity of horses during usual brushing management against the repeated presence of an unknown sonorous stimulus. Twenty Mangalarga Marchador horses, distributed in different categories (mares and foals), were evaluated. The animals were allocated into the control treatment (N = 10) and the treatment with unknown sonorous stimulus (N = 10) from a rattle and a tambourine. Four consecutive evaluations were carried out first (day 0, 1, 2, 3). Two consecutive assessments were carried out after 30 days of the first collection (day 30 and 31), and two consecutive assessments were carried out 15 days after the second evaluation (day 45 and 46). The behavioral observations were made by assigning a score to behaviors of movement, position of ears and eyes, breathing, and vocalization during brushing management. A response variable called reactivity was attributed to each animal, ranging from score 1 (not reactive or calm animal) to reactivity score 4 (very reactive or aggressive animal). For statistical analysis, the results were adjusted to a logistic regression model using the categories, day, and treatment as covariates. The animals of the unknown stimuli showed greater reactivity. The days of the experimental period influenced the reactivity of animals between 6 and 7 months old, with a decrease in the possibilities of the animals to have a higher reactivity. The maturity of the foal with repeated exposure to the unknown sound stimulus may decrease the possibility of the animal being reactive.

O objetivo do presente estudo foi avaliar a reatividade de equinos durante o manejo habitual de escovação, frente à exposição repetida a um estímulo sonoro desconhecido. Para isto, foram utilizados 20 equinos da raça Mangalarga Marchador, de diferentes categorias (éguas e potros), os quais foram alocados aos tratamentos: controle (N = 10) e com estímulo sonoro desconhecido (N = 10), que consistia em confrontar os animais com o estímulo sonoro de um chocalho e um tamborim. Primeiramente, foram realizadas quatro avaliações consecutivas (dia 0, 1, 2, 3). Após 30 dias da primeira coleta, foram realizadas duas avaliações consecutivas (dia 30 e 31), e passados 15 dias desta, foram realizadas mais duas avaliações consecutivas (dia 45 e 46). As observações comportamentais foram feitas por meio da atribuição de escores aos comportamentos de movimentação, posição das orelhas e dos olhos, respiração e vocalização durante o manejo de escovação. Também foi conferida a variável resposta de reatividade com valores variando de 1 a 4 (animal não reativo ou calmo a animal muito reativo ou agressivo). Foi ajustado o modelo de regressão logística ordinal usando como covariáveis as categorias, dia e tratamento. A reatividade dos animais com estímulo sonoro desconhecido foi maior. Os dias do período experimental influenciaram a reatividade dos animais entre 6 e 7 meses de idade, com diminuição das chances dos animais desta idade apresentarem maior reatividade no decorrer dos dias. O amadurecimento do potro junto com a exposição repetida ao estímulo sonoro desconhecido podem diminuir a possibilidade de o animal ser reativo.