Physical activity during pregnancy and its effects on neonatal outcomes.

INTRODUCTION: Despite the acknowledgement that physical activity is beneficial during pregnancy and may result in positive health outcomes for the newborn child few studies have examined this issue. This research was deemed necessary with the primary objective of identifying possible associations between adherence to American College of Sports Medicine recommendations on neonatal outcome variables at birth. METHODS: An observational, longitudinal and prospective study focused on a sample of 70 pregnant women (the power score achieved was estimated to be 0.3). Data was collected in three stages (1st and 2nd trimester of pregnancy and 48 h after delivery). The variables analyzed included the physical activity measurement (with accelerometry), neonatal outcomes at birth and the mother's anxiety, dietary intake, anthropometric measures and socio-demographic and lifestyle. RESULTS: 21.4% women were active according to physical activity recommendations. There were no significant differences in neonatal outcomes at birth when comparing adherence to physical activity recommendations and the overall activity levels of the mothers. There were also no statistically significant differences in the birth weights of babies born to active and inactive mothers. Mother's anxiety level, weight gained and dietary intake were not statistically different according to compliance with physical activity behaviour or recommendations. DISCUSSION: There is no relationship between adherence to physical activity recommendations on neonatal outcome variables at birth. There were also no significant associations with sociodemographic and lifestyle variables. There is a need to identify attitudes associated with negative physical activity behavior to reduce the incidence of comorbidities associated with sedentary lifestyles during pregnancy.

Community Empowerment and Community Partnerships in Nursing Decision-Making.

Community empowerment has been studied as a process and result phenomenon throughout the last 40 years. Community partnership, which has been studied during the last 20 years, has been identified as a key process to promote intervention and research within communities. In this paper, we introduce the relation between these two concepts, from the research that is being developed at the Centre for Interdisciplinary Health Research (CIIS) in Universidade Católica Portuguesa. We comment on the available evidence regarding community partnership and community empowerment within the Nursing Decision-Making process. There is a particular focus on Community Health Nursing Specialists (CHNS) and the aim to promote the identification of CHNS as potential community partnership developers within society. It is also important to analyze how community partnership processes are intentionally integrated as a nursing intervention within the nursing process. This analysis should occur from the nursing diagnosis to the evaluation of health gains in communities sensitive to CHNS care in a Nursing Theoretical Model developed from a Nursing PhD process-the Community Assessment, Intervention, and Empowerment Model.

Physical Activity Patterns During Pregnancy in a Sample of Portuguese Women: A Longitudinal Prospective Study.

BACKGROUND: Physical activity (PA) patterns during pregnancy have not been explored in depth and most previous studies lack assessment of variables such as type, frequency, duration and intensity of activity. OBJECTIVES: This study had two goals: 1) to analyze PA patterns during pregnancy according to weekly time spent on different types of activity; and 2) to determine women's perception about health care providers regarding PA advisement during pregnancy. PATIENTS AND METHODS: A longitudinal prospective study was carried out with a 118-pregnant women cohort. Participants were evaluated during all trimesters. Self-reported questionnaires were used to collect personal and obstetric data. Type, duration and frequency of PA were evaluated using the pregnancy physical activity questionnaire (PPAQ) and intensity levels were calculated. Repeated measure analysis of variance was performed to determine differences between trimesters, and Wilcoxon signed-rank test was performed when appropriate. RESULTS: A decrease in values of self-reported PA (MET.h.wk(-1)) was found from the first to the second and the first to the third trimester of pregnancy, respectively; total (270.91 vs 220.54 vs 210.35; P < 0.01), light (109.45 vs 95.11vs 92.40; P < 0.01) and moderate intensity (81.99 vs 50.69 vs 62.94; P = 0.002). Time spent on most activities remained fairly stable throughout pregnancy. Women spent most of their weekly time during the entire pregnancy on household and caregiving activities, occupational activities and leisure, except sport activities. Swimming was the most reported organized PA, reaching its highest proportion (12.7%) in the second trimester. Prenatal exercise classes were reported by 39.8% of women during the 3rd trimester. Pregnant women reported that PA was recommended by health professionals: 53.9% in the 1st trimester, 70.4% in the 2nd trimester and 56.8% in the 3rd trimester. CONCLUSIONS: Self-reported PA decreased, especially from the first to the second trimester, in total, light and moderate intensity. Women spent most of their weekly time on domestic, occupational and leisure activities, except sport activities. There are some health care providers that do not recommend physical activity during pregnancy.

Presence and significance of Helicobacter spp. in the gastric mucosa of Portuguese dogs.

BACKGROUND: Non-Helicobacter pylori Helicobacters (NHPH) are also able to cause disease in humans. Dogs are a natural reservoir for many of these species. Close and intense human contact with animals has been identified as a risk factor and therefore, an important zoonotic significance has been attributed to NHPH. METHODS: To determine the prevalence of Helicobacter species and the gastric histopathological changes associated, gastric mucosa samples of 69 dogs were evaluated. RESULTS: Only one dog presented a normal histopathological mucosa with absence of spiral-shaped organisms. A normal gastric mucosa and the presence of spiral-shaped bacteria was observed in two dogs. All remaining animals presented histopathological changes representative of gastritis. Helicobacter species were detected in 60 dogs (87.0%) by at least one detection method. Histological, histochemical and immunohistochemical evaluations revealed that Helicobacter spp. were present in 45 (65.2%), 52 (75.4%) and 57 (82.6%) dogs, respectively. Spiral-shaped bacteria were detected by qPCR analysis in 33 (47.8%) dogs. H. heilmannii-like organisms were identified in 22 animals (66.7%) and predominantly in the antral gastric region. H. salomonis was the second most prevalent species (51.5%) although it was mainly found in association with other Helicobacter spp. and in the body gastric region. H. bizzozeronii and H. felis were less frequently detected. CONCLUSIONS: It was concluded that, despite the high incidence and worldwide distribution of gastric NHPH in dogs, the presence of specific Helicobacter species may vary between geographic regions. NHPH infections were significantly accompanied by mild to moderate intraepithelial lymphocyte infiltration and mild to moderate gastric epithelial injury, but a clear relationship between gastritis and Helicobacter infection could not be established.

Impact of compliance with different guidelines on physical activity during pregnancy and perceived barriers to leisure physical activity.

The aims of the this prospective study were to analyse physical activity (PA) engagement during the first and second trimesters, considering the different guidelines published on PA, to document the individual characteristics associated with the accomplishment of these guidelines and to examine pregnant women's perceived barriers to leisure PA, using a socioecological framework. A sample of 133 pregnant women in two stages--at 10-12 weeks' gestation (T1) and 20-22 weeks' gestation (T2)--were evaluated. PA was assessed by accelerometry during the T1 and T2 evaluation stages. Socio-demographic characteristics, lifestyle factors and barriers to leisure PA were assessed via questionnaire. A large proportion of women (ranging from 32% to 96%) did not reach the levels of PA recommended by the guidelines. There were no significant differences between T1 and T2 with regard to compliance with PA recommendations. A decrease in PA levels from T1 to T2 was noted for all recommendations. No associations were found between participants' characteristics and adherence to the recommendations in T1 and T2. No significant differences were found in barriers to leisure PA between T1 and T2. The most commonly reported barriers to leisure PA were intrapersonal, not health related. Our results indicate that there were no differences between trimesters regarding compliance of PA recommendations, and perceived barriers were similar in both trimesters.

Qualidade de vida de três categorias profissionais da saúde em um hospital de Minas Gerais, Brasil / Quality of life of three health care workers categories in a hospital in Minas Gerais, Brazil / Calidad de vida de tres categorias profesionales de la salud de un hospital en Minas Gerais, Brasil

Objetivo: investigar a qualidade de vida de três categorias profissionais da saúde de um hospital filantrópico de Minas Gerais, Belo Horizonte, Brasil. Método: trata-se de estudo transversal descritivo (n=27) com enfermeiros, médicos e fisioterapeutas de um Hospital Filantrópico no interior de Minas Gerais. O instrumento utilizado para mensurar a qualidade de vida foi o World Health Organization Quality Of Life na sua versão abreviada traduzida e validada para o português, mediante a aprovação do Comitê de Ética em Pesquisa da Pontifícia Universidade Católica de Minas Gerais sob o Certificado de Apresentação para Apreciação Ética (CAAE) – 1662.0.000.213-0. Resultados: a dicotomização dos escores do WHOQoL feitas pelas respectivas medianas mostrou que a maioria dos profissionais apresentou escore parcial abaixo da mediana, Físico (55,6%), Psicológico (63,0%), Social (74,1%) e Ambiental (70,4%). Conclusão: a mensuração da qualidade de vida dos profissionais de saúde entrevistados sugere uma baixa qualidade de vida dos mesmos, no entanto devido ao caráter descritivo do estudo nao foi possivel realizar nenhum tipo de comparação entre as três categorias profissionais.(AU)

Objective: investigate the quality of life of three health care workers in a philanthropic Hospital in Minas Gerais. Method: this is about a descriptive study, from transversal design (n=27) with nurses, doctors and physiotherapists whom work in a philanthropic Hospital in Minas Gerais. The valid and reliable Portuguese WHOQOL-bref version was used as a tool to measure quality of life. The study was approved by the Research Ethics Committee of the Pontifícia Universidade Católica de Minas Gerais, Brazil with protocol number 1662.0.000.213-0. Results: dichotomization of all WHOQoL scores based on respective medians showed that most of professionals had partial scores under it: Physic (55.6%), Psychology (63.0%), Social (74.1%) and Environmental (70.4%). Conclusions: measurement of health care workers' quality of life suggests low quality of life among them, however due descriptive study design it was not possible to consider none comparison among the three health care worker's categories.(AU)

Objetivo: investigar la calidad de vida de las tres categorías de profesionales de la salud de un hospital filantrópico de Minas Gerais. Método: estudio descriptivo transversal (n=27) con las enfermeras, médicos y terapeutas en un hospital de beneficencia en el estado de Minas Gerais. El instrumento utilizado para medir la calidad de vida era la de la Organización Mundial de la Salud la calidad de vida en su versión abreviada traducido y validado por los portugueses. El estudio fue aprobado por el Comité de Ética de la Pontifícia Universidade Católica de Minas Gerais con el numero de protocolo 1662.0.000.213-0. Resultados: La dicotomía de la WHOQOL realizados por sus medianas mostraron que la mayoría de los profesionales tenían una puntuación parcial por debajo de la mediana, físico (55,6%), psicológico (63,0%), sociales (74,1%) y Medio Ambiente (70,4%). Conclusión: La medición de la calidad de vida de los profesionales de la salud sugiere una menor calidad de vida para nosotros mismos, sin embargo debido a la naturaleza descriptiva de este estudio no fue posible hacer una comparación entre las tres categorías profesionales.(AU)

[Prevalence and impact of stress urinary incontinence before and during pregnancy]. / Prevalência e impacte da incontinência urinária de stresse antes e durante a gravidez.

INTRODUCTION: Female Urinary Incontinence (UI) is a major public health issue given its high prevalence and its physical, psychological and social impact on women's lives. The aim of this study was to determine the prevalence and impact of Stress Urinary Incontinence (SUI) before and during pregnancy in parturients from the Viana do Castelo district. METHODS: A cross-sectional study was carried out considering a representative sample of the district comprising 336 women who gave birth in the Santa Luzia Hospital between 15th January and 29th March 2002. A questionnaire was submitted to all the women during the postpartum period at hospital. RESULTS: The prevalence of SUI, defined as Have you ever experienced urine loss while performing an effort? was of 5.4% (IC 95%:3.0-7.8) before pregnancy and 51.5% (IC 95%:46.1-56.9) during the current pregnancy. The factors associated with the occurrence of SUI before pregnancy were multiparity (OR=9.96), diabetes (OR=4.61) and obesity (OR=4.76), and with SUI during pregnancy were multiparity (OR=1.66), diabetes (OR=2.62) and constipation (OR=1.73). The vast majority (88.9%) of women suffering from SUI feel uncomfortable as they feel wet, 48.5% feel nervous or troubled and 57.3% fear that others may notice the smell. During pregnancy, only less than half of the women who experienced urine loss sought help from a healthcare professional, although the majority was interested in having this problem treated. CONCLUSIONS: SUI affects a great number of women from the district before and during pregnancy. SUI is reflected in many aspects of health and mostly affects physical and emotional well-being, but only a small percentage of women reveal the burden of SUI to a healthcare professional. In the face of such evidence, it turns out very important for healthcare professionals to be aware of this reality and concerned to give response to this healthcare problem.