Portuguese Version of the HLS-EU-Q6 and HLS-EU-Q16 Questionnaire: Psychometric Properties.

Health literacy refers to the competencies of individuals and the general population to navigate all the areas of health care, making health decisions. Health professionals need a set of skills and information to adapt to people's health literacy. To succeed, it is crucial to determine the health literacy level of a population, in this case, the Portuguese. This study aims to measure the psychometric properties of the Portuguese version of HLS-EU-Q16 and HLS-EU-Q6 from the long form of HLS-EU-Q47, already validated for Portugal. To analyse these results, a comparison was made with the HLS-EU-PT index. Spearman correlation analysis was performed between the single items and scale scores. Cronbach's alphas for all the indexes were calculated. For the statistical analysis, SPSS (version 28.0) was used. Cronbach's alpha coefficient for HLS-EU-PT-Q16 internal consistency was 0.89 overall, and for HLS-EU-PT-Q6 was 0.78 overall. Indexes were not normally distributed, and the Spearman correlation was computed. The correlation between G HL47 and G HL16 indexes was ρ = 0.95 (p < 0.001), and between G HL6 and HLS-EU-PT-Q6 was perfect. The HLS-EU-PT-Q16 and HLS-EU-PT-Q6 are concise and present adequate psychometric properties to measure the HL level of the Portuguese population. However, more similarities are found between the 47-item and the 16-item forms.

Validity and reliability of the Portuguese version of the rapid estimate of adult literacy in dentistry: REALD-29 PT.

BACKGROUND: Health literacy is a main factor in health for its improvement, allowing the individuals to have a greater capacity to engage and participate in collective health promotion actions. The evaluation of functional health literacy is essential to determine the ability that each individual has to understand basic health information. The present study aimed to perform the translation and cross-cultural adaptation of the Rapid Estimate of Adult Literacy in Dentistry-30 to the Portuguese language and test the reliability and validity of this version. METHODS: After translation and cultural adaptation, the instrument was applied to a group of individuals that participate in the program Atividade Senior, developed by the municipality of Viseu, Portugal. The final sample was composed by 206 participants that accepted responding to the translated version of the instrument. Statistical validation was accomplished to complete the process and obtain the final instrument. One question was removed for the creation of the final instrument with 29 questions, therefore being named Rapid Estimate of Adult Literacy in Dentistry-29 PT. RESULTS: The Rapid Estimate of Adult Literacy in Dentistry-29 PT presented good internal reliability. Cronbach's alpha ranged from 0.89 to 0.90 when words were deleted individually. The analysis of test-retest reliability revealed excellent reproducibility. We can verify that the Rapid Estimate of Adult Literacy in Dentistry-29 PT scale for assessment of oral health literacy among older adults presents an acceptable internal consistency, with a global Cronbach´s alpha of 0.894. CONCLUSIONS: The new scale can be applied to assess oral health literacy among older Portuguese adults, presenting an acceptable internal consistency and is validated to assess oral health literacy and is crucial in epidemiological studies.

Oral health behaviour perception scale applied among a sample of portuguese adolescents / Escala de percepción del comportamiento de salud bucal aplicada en una muestra de adolescentes portugueses

Introduction: The application of a scale can be particularly useful for the epidemiological studies comparing different populations and for analysis of the influence of distinct aspects of oral health on the development of certain health conditions. The aim of this study consists in the creation of a scale to classify the level of perception of the oral health behaviors applicable to a sample of Portuguese adolescents. Material and Methods: An observational cross-sectional study was designed with a total of 649 adolescents between the ages of 12 and 18 years old from five public schools in the Viseu and Guarda districts, in Portugal. Data was collected by the application of a self-administered questionnaire and, after analysis of data collection, the newly Universidade Católica Portuguesa (UCP) oral health perception scale was created. Statistical analysis was performed using SPSS-IBM software version 24.0 (IBM SPSS, Chicago, Il., USA). In the descriptive statistical analysis, absolute and descriptive frequencies were used for variables with nominal measurement level, mean as a measure of central tendency and standard deviation as a measure of dispersion for interval variables. Results: Oral health behaviors perception respecting the assumptions defined by the present scale has been elaborated. The result showed that 67% of the sample presented a poor perception of their oral health behaviors, 23.9% intermediate/sufficient, while 8.2% refer having good perception, respecting the assumptions defined for the elaboration of the present scale. Conclusion: For this purpose, through the scale to classify the level of oral health behaviors applicable to the sample of portuguese adolescents, it is possible to compare the data of several samples and understand what are the most frequent oral or eating habits among adolescents

Introducción: La aplicación de una escala puede ser particularmente útil para los estudios epidemiológicos que comparan diferentes poblaciones y para el análisis de la influencia de distintos aspectos de la salud bucal en el desarrollo de determinadas condiciones de salud. El objetivo de este estudio consiste en la creación de una escala para clasificar el nivel de percepción de las conductas de salud bucal aplicable a una muestra de adolescentes portugueses. Material y Métodos: Se diseñó un estudio observacional transversal con un total de 649 adolescentes de entre 12 y 18 años de cinco escuelas públicas de los distritos de Viseu y Guarda, en Portugal. La recolección de datos se realizó mediante la aplicación de un cuestionario autoadministrado y, tras el análisis de la recolección de datos, se creó la nueva escala de percepción de salud bucal de la Universidad Católica Portuguesa (UCP). El análisis estadístico se realizó utilizando el software SPSS-IBM versión 24.0 (IBM SPSS, Chicago, Il., EE. UU.). En el análisis estadístico descriptivo se utilizaron frecuencias absolutas y descriptivas para variables con nivel de medida nominal, media como medida de tendencia central y desviación estándar como medida de dispersión para variables de intervalo. Resultados: ha elaborado la percepción de conductas de salud bucal respetando los supuestos definidos por la presente escala. El resultado mostró que el 67% de la muestra presentó mala percepción de sus conductas de salud bucal, el 23,9% intermedia / suficiente, mientras que el 8,2% refiere tener buena percepción, respetando los supuestos definidos para la elaboración de la presente escala. Conclusión: Para ello, a través de la escala para clasificar el nivel de conductas de salud bucal aplicable a la muestra de adolescentes portugueses, es posible comparar los datos de varias muestras y comprender cuáles son los hábitos orales o alimentarios más frecuentes entre los adolescentes.

Health professionals perception and beliefs about drug- related problems on polymedicated older adults- a focus group study.

BACKGROUND: Polymedicated older patients are at greater risk of suffering from adverse events. For this reason, the detection of both inappropriate polypharmacy and polypharmacy-associated Drug-Related Problems (DRPs) are essential to improve the health and wellbeing of older adults and to reduce healthcare costs. This work aims to explore health professionals' perceptions and opinions about polypharmacy and the handling of medicines by polymedicated older adults. METHODS: Thirteen focus groups with 94 health professionals (20 community pharmacists, 40 general practitioners and, 34 nurses) were conducted in primary healthcare centers of the center region of Portugal. Participants were asked to discuss their perceptions and beliefs concerning DRPs in polymedicated older adults. The sessions were audiotaped. After the transcription and coding of focus group sessions, a thematic analysis was done. RESULTS: The following four main themes emerged from the 13 focus group sessions: poor compliance and polypharmacy- A perpetuated vicious cycle, organization of the healthcare system, interaction and communication between the health professionals, and strategies to prevent inappropriate polypharmacy. CONCLUSIONS: The lack of both an efficient network of information and Interaction and communication between Health professionals makes the detection and/ or prevention of polypharmacy in older adults difficult. The implementation of new models to manage and/or prevent polypharmacy based on health professional perception and beliefs is essential to prevent DRPs and improve compliance among older adults.

Voices of Polymedicated Older Patients: A Focus Group Approach.

Polypharmacy in older adults is frequently associated with incorrect management of medicines, which causes drug-related problems and, subsequently, poor health outcomes. Understanding why older adults incorrectly manage their medicines is fundamental to health outcomes, however, it is an issue that remains poorly explored. The aim of this study is to examine older people's perceptions, attitudes, beliefs, and concerns in the central region of Portugal. Thirteen focus groups with sixty-one older adults taking five or more prescription medicines were conducted to explore older patients' perceptions and beliefs about and management of their medication. Sampling was conducted until theme saturation had been achieved. Transcripts were coded and data were obtained using the NVivo qualitative data-analysis software programme. Older adults recognise the importance of medicines for ensuring healthy ageing. Owing to a lack of literacy, however, they frequently commit medication mistakes and compromise their health outcomes. Promoting the literacy and empowerment of older patients, as well as strengthening the relationship between health professionals and patients, is crucial when it comes to addressing drug-related problems and improving health outcomes.

Identificação de emoções e sentimentos: estudo exploratório com alunos do ensino básico / Identificación de emociones y sentimientos: estudio exploratorio con alumnos de educación primaria / Identifying emotions and feelings: exploratory study with elementary and high school students

Resumo Objetivo Avaliar a competência de alunos do 2º e 3º ciclo do Ensino Básico na identificação e diferenciação de emoções e sentimentos. Métodos Estudo exploratório de corte transversal, desenvolvido no âmbito do Projeto MaiSaúdeMental com referência CENTRO-01-0145-FEDER-023293, desenvolvido na Escola Superior de Saúde do Instituto Politécnico de Viseu, Portugal. Foi realizado com uma amostra de conveniência constituída por 101 crianças/adolescentes. Foi utilizado um questionário de caracterização sociodemográfica e o Inventário de Identificação de Emoções e Sentimentos. Este é um inventário de auto-relato que avalia a capacidade das crianças/adolescentes identificarem e diferenciarem emoções e sentimentos, partindo de situações quotidianas. É composto por 15 itens que correspondem a 15 situações. A aplicação do questionário decorreu em sala de aula, após uma breve explicação do seu funcionamento e esclarecimento de dúvidas. No tratamento dos dados foi utilizado o programa informático Statistical Package for the Social Sciences ® (SPSS versão 24.0) e efetuada análise descritiva e analítica, considerando-se para análise dos testes o Intervalo de Confiança (IC) a 95% (significância p<0,05). Resultados Os alunos tinham entre 9 e 15 anos de idade e a maioria (27,7%) frequentava o 8º ano de escolaridade. Globalmente identificam poucas emoções e sentimentos, numa média de 13,36 pontos para um score máximo de identificação emocional de 39, sendo que em média identificam mais emoções e sentimentos positivos (5,11 pontos) do que negativos (4,33 pontos) e neutros (3,91 pontos). Para todas as dimensões os valores médios são mais elevados no sexo feminino e nos alunos de 14 anos, mas apenas significativos em algumas das diferenciações emocionais (p<0,05). Conclusão Os resultados encontrados vão ao encontro de investigações nesta área, concluindo-se que as crianças e adolescentes apresentaram fraca capacidade de identificação e diferenciação de emoções, evidenciando contudo maior capacidade de diferenciação emocional positiva do que negativa e/ou neutra. Verificou-se ainda que existem maiores competências de diferenciação e identificação emocional no género feminino e que essas competências aumentam com a idade.

Resumen Objetivo Evaluar la competencia de alumnos de 5° a 9° año de primaria en la identificación y diferenciación de emociones y sentimientos. Métodos Estudio exploratorio de corte transversal, desarrollado en el ámbito del Proyecto "MaiSaúdeMental" (Más Salud Mental), referencia CENTRO-01-0145-FEDER-023293, llevado a cabo en la Escola Superior de Saúde del Instituto Politécnico de Viseu, Portugal. Se realizó con una muestra de conveniencia formada por 101 niños/adolescentes. Se utilizó un cuestionario de caracterización sociodemográfica y el Inventario de Identificación de Emociones y Sentimientos. Es un inventario de autorrelato que evalúa la capacidad de los niños/adolescentes de identificar y diferenciar emociones y sentimientos, a partir de situaciones cotidianas. Se compone de 15 ítems que corresponden a 15 situaciones. La aplicación del cuestionario se realizó en el aula, luego de una breve explicación de su funcionamiento y esclarecimiento de dudas. Para el tratamiento de datos, se utilizó el programa informático Statistical Package for the Social Sciences ® (SPSS versión 24.0) y se realizó un análisis descriptivo y analítico, en el que se consideraron para el análisis de las pruebas el intervalo de confianza (IC) a 95% (significación p<0,05). Resultados Los alumnos tenían entre 9 y 15 años de edad y la mayoría (27,7%) estaba en 8° año de escuela. De forma global, identifican pocas emociones y sentimientos, un promedio de 13,36 puntos en una puntuación máxima de identificación emocional de 39, de modo que, en promedio, identifican más emociones y sentimientos positivos (5,11 puntos) que negativos (4,33 puntos) y neutros (3,91 puntos). En todas las dimensiones, los valores promedio son mayores en el sexo femenino y en alumnos de 14 años, pero poco significativos en algunas diferenciaciones emocionales (p<0,05). Conclusión Los resultados encontrados están en línea con las investigaciones de esta área, con lo que se concluye que los niños y adolescentes presentan poca capacidad de identificación y diferenciación de emociones, sin embargo se observa mayor capacidad de diferenciación emocional positiva que negativa o neutra. Además, se verificó que existen mayores competencias de diferenciación e identificación emocional en el género femenino y que esas competencias aumentan con la edad.

Abstract Objective To assess the competence of students from Grade 5 to 10 of elementary and high school to identify and differentiate emotions and feelings. Methods This was cross-sectional, exploratory study, carried out during the Project "MaiSaúdeMental" (More Mental Health), at the referall CENTRO-01-0145-FEDER-023293, and developed in Escola Superior de Saúde of Instituto Politécnico de Viseu, Portugal. This was a convenience sample including 101 children/adolescents. A questionnaire for sociodemographic characterization and an Inventory to Identify Emotions and Feelings were used. This self-reporting inventory evaluated the capacity of children/adolescents to identify and differentiate their emotions and feelings, based on everyday situations. The questionnaire was composed of 15 items that correspond to 15 situations. The questionnaire was applied in the classroom, after a short explanation on how it worked and clarification to questions of participants. Statistical Package for the Social Sciences ® (SPSS version 24.0) was used for data process, and a descriptive and analytical assessment was performed. The 95% confidence interval for the tests analysis was considered significant (p<0.05). Results The students were aged between 9 and 15 years old, and the majority (27.7%) was attending grade 8. In general, students identified few emotions and feelings, a mean score of 13.36 points for a maximum score of 39 of emotion identification, whereas on average they identify more positive emotions and feelings (5.11 points) than negative (4.33 points) or neutral (3.91 points). In all dimensions, mean values were higher in female students and in 14-year-old students, but slightly significant for some emotion differentiations (p<0.05). Conclusion The results found corroborate with investigations in this area. Children and adolescents have poor capacity to identify and differentiate emotions, although they show greater capacity to differentiate positive emotions rather than negative or neutral emotions. We also observed that female students have more competence to differentiate and identify emotions, and these competences increase with age.

Nurses- puerperal mothers interaction: searching for cultural care.

OBJECTIVE: To identify the importance of the cultural care dimension in the nurse-puerperal mother interaction. METHOD: Qualitative study based on content analysis. To collect data, 36 semi structured interviews were applied (21 nurses and 15 women who had recently given birth). The participants' free and informed consent was ensured and all ethical requirements were respected. Data analysis was supported by NVivo 10 software. RESULTS: The following categories were considered the most relevant: (i) nurses' attitudes that puerperal mothers consider crucial in health care provision; (ii) nurses' cultural competence; (iii) language resources used by nurses in their interaction with people from other cultures; (iv) the limitations that were observed during nurses-new mothers interactions. CONCLUSION: Evidence shows that, generally speaking, nurses claim to provide personalized health care assistance. However data revealed that the kind of interaction observed between nurses and women who had just given birth has not always been the most effective and that the former often show they lacked the appropriate cultural competence to deal with the latter's expectations and needs.

Nurses- puerperal mothers interaction: searching for cultural care / Interacción enfermeras y madres: en la búsqueda de un cuidado cultural / Interação enfermeiros e puérperas: na procura de um cuidado cultural

ABSTRACT Objective: To identify the importance of the cultural care dimension in the nurse-puerperal mother interaction. Method: Qualitative study based on content analysis. To collect data, 36 semi structured interviews were applied (21 nurses and 15 women who had recently given birth). The participants' free and informed consent was ensured and all ethical requirements were respected. Data analysis was supported by NVivo 10 software. Results: The following categories were considered the most relevant: (i) nurses' attitudes that puerperal mothers consider crucial in health care provision; (ii) nurses' cultural competence; (iii) language resources used by nurses in their interaction with people from other cultures; (iv) the limitations that were observed during nurses-new mothers interactions. Conclusion: Evidence shows that, generally speaking, nurses claim to provide personalized health care assistance. However data revealed that the kind of interaction observed between nurses and women who had just given birth has not always been the most effective and that the former often show they lacked the appropriate cultural competence to deal with the latter's expectations and needs.

RESUMEN Objetivo: identificar la dimensión de la competencia cultural en la interacción entre enfermeras y mujeres que hayan dado a luz recientemente. Método: estudio cualitativo basado en el análisis de contenidos. En la recopilación de datos se utilizó la entrevista semiestructurada. Han participado 21 enfermeras y 15 madres en un total de 36 entrevistas. Se aseguró el consentimiento previo, libre e informado de todos los participantes y todos los requisitos éticos fueron respetados. El análisis de datos fue apoyado por el programa NVivo 10. Resultados: las siguientes categorías fueron destacadas: (i) actitudes de las enfermeras que las madres creen ser indispensables en el proceso de cuidar; ii) el ejercicio de la competencia cultural; iii) los recursos lingüísticos utilizados por las enfermeras en la interacción con personas de otras culturas; iv) restricciones y problemas observados en las interacciones entre enfermeras y madres. Conclusión: se concluye que, en general, las enfermeras afirman que cuidan de sus pacientes de manera personalizada. Todavía, los datos revelaron que las interacciones entre enfermeras y madres son a menudo poco eficaces y a las enfermeras les resulta difícil demostrar su competencia cultural.

RESUMO Objetivo: Identificar a dimensão do cuidado cultural na interação entre enfermeiras e puérperas. Método: Estudo qualitativo assente na análise de conteúdo. Na colheita de dados se utilizou a entrevista semiestruturada, a 21 enfermeiras e 15 puérperas num total de 36 entrevistadas. Se assegurou o consentimento livre e esclarecido bem como respeitaram-se todos os requisitos éticos. A análise de dados foi suportada pelo NVivo 10. Resultados: Destacaram-se as categorias: (i) Atitudes das enfermeiras que as puérperas reconhecem imprescindíveis no processo de cuidar; (ii) Exercitar a competência cultural; (iii) Recursos linguísticos utilizados pelas enfermeiras na interação com pessoas de outras culturas; (iv) Constrangimentos manifestados nas interações enfermeiras e puérperas. Conclusão: Conclui-se que apesar das enfermeiras, ao nível discursivo, afirmarem que cuidam de forma personalizada, os dados revelaram que nem sempre as enfermeiras foram eficazes nas interações com as puérperas, de forma a demonstrarem a competência cultural, num estadio considerado culturalmente consciente.

Daily Medication Management and Adherence in the Polymedicated Elderly: A Cross-Sectional Study in Portugal.

The presence of age-related comorbidities prone elderly patients to the phenomenon of polypharmacy and consequently to a higher risk of nonadherence. Thus, this paper aims to characterize the medication consumption profile and explore the relationship of beliefs and daily medication management on medication adherence by home-dwelling polymedicated elderly people. A questionnaire on adherence, managing, and beliefs of medicines was applied to polymedicated patients with ≥65 years old, in primary care centers of the central region of Portugal. Of the 1089 participants, 47.7% were considered nonadherent. Forgetfulness (38.8%), difficulties in managing medication (14.3%), concerns with side effects (10.7%), and the price of medication (9.2%) were pointed as relevant medication nonadherence-related factors. It was observed that patients who had difficulties managing medicines, common forgetfulness, concerns with side effects, doubting the need for the medication, considered prices expensive, and had a lack of trust for some medicines had a higher risk of being nonadherent. This study provides relevant information concerning the daily routine and management of medicines that can be useful to the development of educational strategies to promote health literacy and improve medication adherence in polymedicated home-dwelling elderly.

European questionnaire on health literacy - (HLS-EU-PT) in a sample of pregnant women

Introduction and objectives: The knowledge and skills that enable pregnant women to adopt healthy lifestyles is broad and complex. In addition to factual knowledge, the adoption of health behaviours also implies a set of emotional, cognitive and behavioural skills that allow the use of this knowledge in the context of pregnancy. Methodology: Cross-sectional, quantitative, descriptive-correlational study with non-probabilistic, intentional sample by convenience (n = 404 pregnant women) with a mean age of 32 years. They answered the sociodemographic, obstetrical and HLS-EU-PT questionnaire (National School of Public Health, 2014). Following the methodology used in the European Survey, four ways of dealing with relevant health information were recognized. Results and discussion: Overall, 36.9% of pregnant women presented a problematic level of health literacy, 40.1%, 39.9% and 38.4%, a sufficient level of health literacy in the area of Health Care, Disease Prevention and Health Promotion, respectively. The factorial analysis demonstrates the validity of its framework. The alpha values of the items are above 0.9. The correlations between the different domains and the overall value are all positive and above 0.8. All dimensions of the scale correlate with each other in a statistically significant way, with values for the different do-mains. The split-half coefficient was alfa = 0.939 in the first half and alfa = 0.930 in the second half. Conclusions: The results of the present study support the psychometric adequacy of the European Questionnaire on Health Literacy - (HLS-EU-PT) for the population of pregnant women, indicating that it could be used in future trials

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Living Conditions and Helicobacter pylori in Adults.

INTRODUCTION: Infection by the bacterium Helicobacter pylori (H. pylori) is transmissible and is considered a public health issue which affects people of all ages. The objective of this study was to identify factors (lifestyles, dietary factors, and hygiene conditions) related to the prevalence of H. pylori infection. METHODS: We carried out an observational cross-sectional study with a community sample of adults from the municipalities of Viseu and Sátão, Portugal. The final sample resulted in 166 adults. The data were collected through a self-administered questionnaire with questions regarding sociodemographic aspects and lifestyles. H. pylori infection was identified using the 13C-urea breath test. RESULTS: No association was found between the prevalence of H. pylori infection and the use of tobacco, alcohol, or coffee or dietary factors. The prevalence of H. pylori infection was higher in adults who reported higher consumption of fried food and lower consumption of vegetables and fruit. H. pylori infection was significant for the variables of lower frequency of handwashing before going to the bathroom (p = 0.02) and well water consumption (p = 0.05). CONCLUSION: A significant association was found for H. pylori infection with the lower frequency of handwashing before going to the bathroom and the consumption of well water.

Domestic violence in pregnancy: prevalence and characteristics of the pregnant woman.

AIMS AND OBJECTIVES: To determine the prevalence of domestic violence (physical, psychological or sexual) during pregnancy and to characterise these women. BACKGROUND: Pregnant women are not immune to domestic violence and therefore may be subject to any form of physical, psychological or sexual violence by partners. Health professionals' knowledge and awareness are important in the identification and intervention of pregnant women who experience domestic violence. METHODS: Quantitative, descriptive, correlational study, using a nonprobabilistic convenience sample consisting of a total of 852 postpartum women, of whom 370 were experiencing domestic violence according to the criteria adopted through the modified scale of prevalence, applied between February-June 2012 in two Portuguese public health institutions. Authorisation was given by the Ethics Committees/Administration Councils of both institutions involved and the National Committee of Data Protection. RESULTS: The prevalence of DV during pregnancy was 43·4% (physical violence - 21·9%; psychological violence - 43·2%; and sexual violence - 19·6%). These women had the following profile: immigrant (OR = 5·70; IC95% 3·32-9·78), non-Caucasian (OR = 6·27; IC95% 3·76-10·46), single/divorced/widowed (OR = 2·28; IC95% 1·70-3·05), academic qualifications up to year 9 (OR = 4·94; IC95% 3·31-7·37); between 10-12 years of schooling (OR = 2·36; IC95% 1·70-3·29); unemployed (OR = 2·01; IC95% 1·50-2·69); and with a monthly income <1000 euros (OR = 1·90; IC95% 1·44-2·50). Through logistic regression, the following protective factors have been identified: nationality (Portuguese), race (Caucasian) and place of residence (city). CONCLUSIONS: Almost half of the sample had experienced some form of domestic violence. This is associated with certain sociodemographic factors identified in the study. Psychological violence was the most prevalent during pregnancy. RELEVANCE TO CLINICAL PRACTICE: Knowledge of the prevalence and characteristics of pregnant women who experience domestic violence is of paramount importance in planning appropriate strategies for their needs during pregnancy. Results indicate the need for nurses to intervene when warning signs of domestic violence against pregnant women are detected.

Eating behaviour effects on health and school performance in adolescents

OBJECTIVES: To identify factors associated with academic performance of adolescents, including sociodemographic variables; analyse the influence of eating behaviour may have in predicting the quality of school performance of adolescents; and analyse the relationship these variables establish among themselves. DESIGN: Quantitative, cross-sectional, analytical, descriptive and correlational, explanatory and retrospective study. SETTING: 2nd and 3rd Cycle Basic School in the Viseu Municipality, Portugal, 2011-2012. PARTICIPANTS: Non-probability convenience sampling, consisting of 380 students attending 7th, 8th and 9th grades, aged between 11 and 17 years. Measurements: Data collected by direct questionnaire, with socio-demographic information, eating behaviour, and school performance scale (adapted from Fermin, 2005). RESULTS: The prevalence of adolescents who do not have breakfast was 4.5%. Within adolescents with unhealthy diets, boys commit a higher of percentage food errors (51.3%) and more on 8th and 9th years (35.6%). Academic achievement is higher in girls (P < .001), in the younger students (P < .001) in those with a parent with secondary or higher education (P = .019) and students who have a healthy diet (P = .000). CONCLUSIONS: An inadequate eating behaviour and an unhealthy diet are associated with decreased school performance in adolescents. The implications at the individual, family and social level proves to be important to identify risk groups to develop prevention policies in the field of nutrition education

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Gender and age differences in the sleep habits: a cross-sectional study in adolescents

OBJECTIVES: Analyze gender and age differences in sleep habits in a sample of adolescents. DESIGN: A cross-sectional study. SETTING: Public schools of Viseu, Portugal. PARTICIPANTS: Sample consisted of 7534 students, aged 11-20 years (mean age: 14.96 ± 1.81 years; 53.6% girls). Measurements: Data was collected using a self-administered questionnaire, answered in class and consists of questions to assess insomnia (DSM-IV criteria), sleep patterns, socio-demographic and daily habit variables. RESULTS: Mean sleep duration in this sample was 8.02 ± 1.13 h. Age interfered with sleep duration that decreased with the increasing of age, from 8.45 ± 1.14 h among 11/12 years old to 7.37 ± 1.04 h for ages ≥ 17 years old. Insomnia and symptoms of insomnia were associated with gender and with increasing of age. Nearly 80% of students reported daytime tiredness, 66.7% sleepiness during the day; 56.1% during classes and 47.6% reported waking up with headaches, all variables more prevalent among girls and older adolescents. CONCLUSIONS: The sleep problems and variables related to sleep have become more frequent among girls and with increasing age. We recommend that the promotion of sleep hygiene and prevention of the consequences should be encouraged in adolescents and their families, especially among the female gender and older adolescents

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Hostile behaviours in children and adolescents: sociodemographic and parental variables

BACKGROUND: Hostile behaviour in children and adolescents is a current and very relevant problem due to individual, social and economic harm it produces. OBJECTIVES: To verify if sociodemographic variables (gender, age, grade, place of residence and cohabitation) influence hostile behaviour in children and adolescents; to ascertain whether family variables (marital status, occupation, education level, monthly income) interfere with hostile behaviour in children and adolescents. MATERIAL AND METHODS: Quantitative, cross-sectional, descriptive and analytical study involving a sample of 999 students of the 2nd and 3rd cycles of basic education (5th-9th years of schooling), with an average age of 12.15 years (SD = ±1.46 years). Data collection includes the questionnaire of demographic data and family context, the Buss-Durkee Hostility Inventory. RESULTS: Sociodemographic variables, sex, age, area of residence and cohabitation interfered in hostile behaviour in children and adolescents: girls, older students, residents in urban areas, living with parents were shown to have higher levels of hostile behaviours as a whole. Parents' marital status, their secularity and family income also interfered in the hostile behaviour of the sample under study, finding that children and adolescents whose parents have no partner and have an average high / high household income reveal higher levels of hostile behaviours, particularly with regard to resentment, verbal hostility, fear, negativity and global hostility. CONCLUSION: We hope that this study contributes to preventing hostile behaviour in children and adolescents, reducing the potential risks of this problem

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Motivation for breastfeeding: a matter of educational level?

BACKGROUND: The incidence of breastfeeding at hospital discharge is high; however, its prevalence is low up to the age of 2 years. OBJECTIVES: The aim of this study is to verify the relationship between motivation towards breastfeeding and sociodemographic and obstetric variables, and to analyse the influence of those variables on motivation for breastfeeding when compared to educational level. MATERIALS AND METHODS: This is a quantitative, correlational, descriptive and analytic study. The sample is non-probabilistic with 479 puerperal women (on the day of hospital discharge). The data collection instrument is a questionnaire for sociodemographic and obstetric characterisation and includes the Breastfeeding Motivation Scale. RESULTS: In the sample, 59.5% have higher education, 73.9% are employed and 55.3% live in urban areas.48.0% are first-time mothers, 92.4% have a planned pregnancy. Most deliveries were at term (68.4%). Almost all (9 in 10) are found to be highly motivated to breastfeed. Age, marital status, residence and educational attainment did not influence the overall motivation for breastfeeding. The unemployed are the most motivated. Multiparous mothers are more motivated. The relationship between the other obstetric variables and motivation for breastfeeding has not been proven. The mediator variable (educational level) only had an impact on residence, where those residing in urban areas and with higher education are more motivated in the physiological dimension, followed by residents in urban with qualifications up to secondary education. CONCLUSION: We suggest that a working group is created with activities in the school community to elucidate young people about the importance of breastfeeding based on the guidelines laid out in the breastfeeding policy

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Tobacco consumption in adolescents and school performance

OBJECTIVES: To determine the percentage of adolescent smokers, identify the sociodemographic variables, predictors of school performance of adolescents and analyse the relationship between tobacco use and school performance. DESIGN: Quantitative, analytical, cross-sectional, descriptive, correlational, explanatory and retrospective study. SETTING: 2nd and 3rd Cycle Basic School in the Viseu Municipality, Portugal, 2011-2012. PARTICIPANTS: Non-probability convenience sampling, with 380 students from the 7th, 8th and 9th grades, aged between 11 and 17 years. Measurements: Data collected by questionnaire with socio-demographic information, smoking behaviour, and school performance scale (adapted from Fermin, 2005). RESULTS: The prevalence of adolescents who smoke was 12.4%. Daily smokers are more boys than girls (55%) and over the age of 15 years (47.81%). Academic achievement is higher in girls (p < 0.001), the younger students (p < 0.001), and in those with a parent with secondary or higher education (p = 0.019) and students who do not smoke (p = 0.001). CONCLUSIONS: Tobacco use is associated with decreased school performance. It is important to identify risk groups and develop prevention policies, starting in the school, in the field of addictive behaviour, due to impacts at the individual, family, school and social level

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Oral and gastric Helicobacter pylori: effects and associations.

INTRODUCTION: This study consisted in the comparison of the prevalence of Helicobacter pylori (H. pylori) present in the stomach and in saliva of a sample of Portuguese adolescents and the assessment of the association between H. pylori infection with socio-demographic variables and prevalence of dental caries. MATERIALS AND METHODS: A cross-sectional study was designed including a sample of 447 adolescents aged 12 to 19 years old, attending a public school in Sátão, Portugal. A questionnaire about socio-demographic variables and oral health behaviors was applied. Gastric H. pylori infection was determined using the urease breath test (UBT). Saliva collection was obtained and DNA was extracted by Polymerase Chain Reaction (PCR) in order to detect the presence of oral H. pylori. RESULTS: The prevalence of gastric H. pylori detected by UBT was 35.9%. Within the adolescents with a gastric UBT positive, only 1.9% were positive for oral H. pylori. The presence of gastric H. pylori was found to be associated with age (>15years, Odds ratio (OR)=1.64, 95%CI=1.08-2.52), residence area (urban, OR=1.48, 95%CI=1.03-2.29) and parents´ professional situation (unemployed, OR=1.22, 95%CI=1.02-1.23). Among those with detected dental caries during the intra-oral observation, 37.4% were positive for gastric H. pylori and 40.2% negative for the same bacterial strain (p=0.3). CONCLUSIONS: The oral cavity cannot be considered a reservoir for infection of H. pylori. Gastric H. pylori infection was found to be associated with socio-demographic variables such as age, residence area and socioeconomic status.

Prevalence and determinants of insomnia symptoms among schoolteachers.

INTRODUCTION: Insomnia is the most common sleep disorder. In Portugal, teachers have a specific socioeconomic situation, caused by the distance between home and workplace, unstable job situation and students' behavioral problems. The aim of this study was to determine the prevalence of insomnia in a sample of Portuguese schoolteachers. PARTICIPANTS AND METHODS: In a cross-sectional study 604 teachers were assessed of seventeen public schools, from the districts of Aveiro and Viseu, Portugal. Data was collected through a self-administered questionnaire. Insomnia had been defined according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as the presence of one or more of the following symptoms: a) difficulty initiating sleep; b) difficulty maintaining sleep; c) early morning awakening and difficulty getting back to sleep; d) non-restorative sleep, that lasts for a period of 1 month. RESULTS: Prevalence of insomnia symptoms in the sample was 40.6%. Prevalence of the variables difficulty initiating sleep, difficulty maintaining sleep, early morning awakening and difficulty getting back to sleep and non-restorative sleep were 14.3%, 28.7%, 19.7% and 20.7%, respectively. Insomnia symptoms had been associated with marital status (divorced; OR=1.65; 95%CI, 0.78-3.48), years of teaching experience (10 to 20 years; OR=0.46; 95%CI, 0.28-0.75) and job satisfaction (OR=0.74; 95%CI, 0.53-1.0). CONCLUSION: Portuguese schoolteachers show a high prevalence of insomnia. Insomnia was associated with sociodemographic and occupational variables.

Sleep patterns and insomnia among portuguese adolescents: a cross-sectional study.

INTRODUCTION: Inadequate sleep patterns and insomnia are frequently linked and represent common sleep disorders among adolescents. The present study provides data on sleep patterns and insomnia among Portuguese adolescents. MATERIAL E METHODS: In a cross-sectional study we evaluated 6,919 students from the 7th to the 12th grade from twenty-six secondary schools. Data was collected using a self-administered questionnaire. Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria and daytime sleepiness was assessed with the Epworth Sleepiness Scale. Sleep patterns evaluated both sleep duration ("insufficient" sleep was defined as < 8 hours per night) and bedtime schedules and regularity. RESULTS: The prevalence of insomnia was 8.3%, insomnia symptoms 21.4% and insufficient sleep 29.3%. All prevalence were higher among girls (P<.001). Average sleep time, on weeknights, was 8:04±1:13 hours. On average adolescents went to bed at 22:18±1:47 hours, took 21 minutes to fall asleep and woke up at 7:15±0:35 hours. Only 6.4% of adolescents stated having a regular bedtime. The majority of adolescents (90.6%) reported having difficulty waking up, 64.7% experienced daytime sleepiness and 53.3% experienced sleep during classes. CONCLUSIONS: There are high prevalence of inadequate sleep patterns, insufficient sleep and insomnia among Portuguese adolescents. Insufficient sleep is associated with sleep patterns and social and behavioural factors. These results add to our knowledge of adolescent sleep worldwide.