Health Education to Strengthen Breastfeeding Actions

Introduction: Breast milk is, without a doubt, the food that provides all the nutrients essential for the healthy growth and development of children. Through effective breastfeeding practices, it is possible to prevent several chronic noncommunicable diseases in childhood, adolescence, and adulthood. Objective: To investigate the relevance of using an educational strategy in breastfeeding promotion. Methods: It was a descriptive study with uncontrolled analytical approach conducted with 36 mothers of children under 2 years of age about breastfeeding, through an educational intervention using the booklet “Breastfeeding: an act of love”. Data collection took place in two moments (pre-test and post-test). Ethics Committee approved the project under protocol No. 058657. Results: Data analysis revealed that 41.6% of the interviewees stated that they did not receive guidance about breast problems from any professional during prenatal care, and 22% reported having presented nipple fissures. Regarding the initiation of breastfeeding, 11.1% of the women interviewed did not knowthe importance of colostrum, and 30.6% did not know its benefits. Assessment of the mothers’ knowledge before and after the intervention obtained a percentage of correctness of 50.7% and 70%, respectively. Conclusion: The educational activity to encourage breastfeeding was able to increase the mothers’ knowledge about breastfeeding and its health benefits for women and children. It is imperative to carry out activities such as the one proposed in this study, which enables the prevention of several problems that directly affect the health of families, acting effectively to promote a solid knowledge for the population. Keywords: Breast Feeding. Child Health. Health Education. Infant Nutrition. Food and Nutrition Education

EpiDoC Unit - a clinical research unit open to the rheumatology community

EpiDoC is an epidemiology and outcomes research unit, with a main focus in Rheumatology clinical research but also in other non-communicable chronic diseases. Established in 2016, it is located at NOVA Medical School1 – CEDOC, and integrates the Comprehensive Health Research Center (CHRC)2, a clinical and public health research unit, scored Excellent by Fundação Ciencia e Tecnologia (FCT) 2019’s evaluation.publishersversionpublishe

Unraveling Depressive Symptomatology and Risk Factors in a Changing World

Funding Information: The present publication was funded by the Fundação Ciência e Tecnologia, IP national support, through CHRC (UIDP/04923/2020). Publisher Copyright: © 2023 by the authors.Background: This study aimed to examine the prevalence and factors associated with symptoms of depression during the third wave of the COVID-19 pandemic. Methods: A representative sample of Portuguese adults was included in this populational survey, conducted between 25 March and 31 July 2021, with participants completing a structured questionnaire via phone interview. The symptoms of depression were measured using the Portuguese version of the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression analyses were used to examine the association between sociodemographic, health, and lifestyle factors and depression levels (normal, mild, or moderate/severe). Results: The estimated prevalence of depression symptoms among participants was 24%. Participants who were women, were in older age groups, had multimorbidity, lived in isolated Portuguese regions such as islands and Alentejo, and were retired or unemployed more frequently reported depression symptoms. Economic hardship was also found to be associated with an increased frequency of mild or moderate-to-severe depression. In contrast, higher levels of education, regular alcohol intake, and regular exercise were associated with a lower frequency of depression symptoms. Conclusions: These findings highlight that during the third wave of the COVID-19 pandemic, a high proportion of Portuguese adults reported depression symptoms, particularly the COVID-19-vulnerable strata such seniors, patients with multimorbidity, and people in economic hardship. On the other hand, citizens who performed regular physical exercise reported lower depressive symptomology. Our work contributes to improving the planning of mental health promotion after the COVID-19 pandemic and future emergencies.publishersversionpublishe

Optimal Control and Adaptive Learning for Stabilization of a Quadrotor-type Unmanned Aerial Vehicle via Approximate Dynamic Programming

The development of an optimal controller for stabilization of a quadrotor system using an adaptive critic structure based on policy iteration schemes is proposed in this paper. This approach is inserted in the context of Approximate Dynamic Programming and it is used to solve optimal decision problems on-line, without requiring complete knowledge of the system dynamics model to be controlled. The main feature of the adaptive critic design method that allows for on-line implementation is that it solves the Bellman optimality equation in a forward-in-time fashion, whereas traditional dynamic programming requires a backward-in-time procedure. This feedback control design technique is able to tune the controller parameters on-line in the presence of variations in plant dynamics and external disturbances using data measured along the system trajectories. Computational simulation results based on a quadrotor model demonstrate the effectiveness of the proposed control scheme

Functional Status and Quality of Life Determinants of a Group of Elderly People With Food Insecurity

Background: A good functionality is appointed by the elderly as one of the most important factors for a good quality of life, since it is associated with independency and autonomy. Studies show that elderly with food insecurity have greater limitations in daily living activities (DLA) when compared to food security elderly. Moreover, food insecure elderly are 60% more likely to be diagnosed with depression. We aimed to investigate the potential determinants of functional status (HAQ) and quality of life (EQ-5D-3L) in a sample of elderly with food insecurity.Methods: Forty-one participants with food insecurity were evaluated by a multidisciplinary team, in April and May of 2016 (a baseline cross-sectional study prior to the intervention program).Results: This study demonstrates correlations of functional status and quality of life to such aspects of elderly assessment as age, BMI, manual strength, among others. It was found that manual strength, gender, family income, anxiety, and depression were correlated to quality of life; and that mobility, manual strength, anxiety and gender were correlated to the functional status. After multivariable adjustment, only mobility (β = −0.220; p ≤ 0.01) and quality of life (β = −1.457; p ≤ 0.01) remained significantly associated with higher levels of functional disability. With regard to quality of life, only the functional status (β = −0.242; p ≤ 0.01), the presence of depression (β = −0.169; p ≤ 0.05), and family income (β = 0.185; p ≤ 0.05) remained significantly associated with health-related quality of life.Conclusions: The study aims to verify the potential determinants of functional status (HAQ) and quality of life (EQ-5D-3L) in a sample of elderly with food insecurity. Even in a small cohort, the study demonstrated that in an elderly population with food insecurity, functional status is associated with mobility and quality of life, and that health-related quality of life is also associated with symptoms of depression and family income. Larger studies in other populations may be useful to confirm these observations

A longitudinal analysis

Funding Information: This research was funded by Fundação Álvaro Carvalho (funding manager), Câmara Municipal de Cascais, Fundação Vox Populi, Fundação Manuel Viegas Guerreiro, and Claude and Sofia Foundation. Publisher Copyright: Copyright © 2023 Carvalho, Henriques, Queirós, Rodrigues, Mendonça, Rodrigues, Canhão, de Sousa, Antunes and Guimarães.Background and aim: The kinetics of antibody production in response to coronavirus disease 2019 (COVID-19) infection is not well-defined yet. This study aimed to evaluate the antibody responses to SARS-CoV-2 and its dynamics during 9-months in a cohort of patients infected during the first phase of the pandemic. As a secondary aim, it was intended to evaluate the factors associated with different concentrations of IgG antibodies. Methods: A prospective cohort study was conducted from June 2020 to January 2021. This study recruited a convenience sample of adult individuals who where recently diagnosed with COVID-19 and were living in mainland Portugal. A total of 1,695 blood samples were collected from 585 recovered COVID-19 patients up to 9 months after SARS-CoV-2 acute infection. A blood sample was collected at baseline and three, 6 and 9 months after SARS-CoV-2 acute infection to assess the concentration of IgG antibody against SARS-CoV-2. Results: The positivity rate of IgG reached 77.7% in the first 3 months after symptom onset. The IgG persists at all subsequent follow-up time-points, which was 87.7 and 89.2% in the 6th and 9th months after symptom onset, respectively. Three distinct kinetics of antibody response were found within the 9 months after infection. Kinetic 1 (K1) was characterized by a constant low IgG antibody concentration kinetic (group size: 65.2%); kinetic 2 (K2), composed by constant moderate IgG kinetic (group size: 27.5%) and kinetic 3 (K3) characterized by higher IgG kinetic (group size: 7.3%). People with ≥56 years old (OR: 3.33; CI 95%: [1.64; 6.67]; p-value: 0.001) and symptomatic COVID-19 (OR: 2.08; CI 95%: [1.08; 4.00]; p-value: 0.031) had higher odds of a “Moderate IgG kinetic.” No significant association were found regarding the “Higher IgG kinetic.” Conclusion: Our results demonstrate a lasting anti-spike (anti-S) IgG antibody response at least 9 months after infection in the majority of patients with COVID-19. Younger participants with asymptomatic disease have lower IgG antibody positivity and possibly more susceptible to reinfection. This information contributes to expanding knowledge of SARS-CoV-2 immune response and has direct implications in the adoption of preventive strategies and public health policies.publishersversionpublishe

Uso de extrato de plantas medicinais (Psidium guajava Linn. e Carica papaya Linn.) frente a bactérias isoladas de pescado, causadoras de diarréias infantis

Out of the twenty-four samples of shrimp and fish muscle used for this study, twelve were collected near a large marine sewer for waste disposal, 3 km off the coast of Fortaleza (Brazil) and used for the isolation of E. coli. Other twelve were collected at the Mucuripe fresh fish market (Fortaleza, Brazil) and used for the isolation of Staphylococcus aureus. Ethanol, water and acetone-diluted extracts of guava and papaya leaf sprouts were tested on the bacteria in order to verify their microbicidal potential. The E. coli strains used in the trials were rated LT positive. The papaya leaf extracts (Carica papaya Linn) showed no microbicidal activity while the guava sprout extracts (Psidium guajava Linn) displayed halos exceeding 13 mm for both species, an effect considered to be inhibitory by the method employed. Guava sprout extracts by 50% diluted ethanol most effectively inhibited E. coli (EPEC), while those in 50% acetone were less effective. It may be concluded that guava sprout extracts constitute a feasible treatment option for diarrhea caused by E. coli or by S. aureus-produced toxins, due to their quick curative action, easy availability in tropical countries and low cost to the consumer.Foram coletadas doze amostras de camarão e peixes nas imediações do interceptor oceânico, em Fortaleza e igual número na Feira de pescado do Mucuripe, Fortaleza, para isolamento de E. coli e Staphylococcus aureus, respectivamente. Extratos aquosos, alcoólicos e cetônicos de broto de goiabeira e de folha de mamão foram testados frente às bactérias para se verificar suas ações antibióticas. As cepas de E. coli utilizadas nos ensaios foram as classificadas como LT positivas. Os extratos de folhas de mamão (Carica papaya Linn) não revelaram quaisquer atividades antibióticas enquanto que os preparados com broto de goiabeira (Psidium guajava Linn) apresentaram halos sempre >;13 mm para as duas espécies, considerados como de inibição pelo método empregado. Os extratos de broto de goiabeira que apresentaram melhores resultados frente às cepas de E. coli ETEC foram os alcoólicos a 50% seguido do cetônico também a 50%. Concluímos que nos tratamentos de diarréias causadas por E. coli ou por toxinas elaboradas por S. aureus o extrato de brotos de goiabeira é uma opção devido a sua pronta ação curativa, seu fácil cultivo nos países tropicais e ao seu baixo valor aquisitivo

Linguistic and cultural adaptation of the EARP Questionnaire to European Portuguese

OBJECTIVE: This study aims at the linguistic and cultural adaptation of the Early ARthritis for Psoriatic Patients (EARP) questionnaire into European Portuguese, for psoriatic patients attending dermatology medical examination. METHODS: Firstly, we performed a process of translation and back-translation of the English version of the EARP Questionnaire to European Portuguese, with interim and final harmonization. The resulting Portuguese version was approved by the EARP original author. Secondly, individual interviews were conducted to complete the linguistic and cultural adaptation of the initial translated Portuguese version, with the think-aloud and probe methods. At this stage, we conducted eight interviews, four with rheumatology and dermatology doctors (experts), and four with patients with psoriasis and psoriatic arthritis. Finally, the version resulting from the adaptation process was back-translated from Portuguese to English. RESULTS: Our results showed that EARP Questionnaire's items are easy to understand and do not raise comprehension concerns in experts or patients. Our findings suggested that items demanding health literacy from patients and that do not include a precise cue to signal the inflammatory nature of the joint pain may lead to confusion while answering, potentially leading to the patient's need for assistance. CONCLUSION: The Portuguese version of the EARP Questionnaire demonstrated adequate comprehension properties. Our findings support the use of this measure in clinical practice and future research, however, a validation study with Portuguese patients is needed.publishersversionpublishe

Isolamento de Vibrio parahaemolyticus e Vibrio cholerae em ostras, Crassostrea rhizophorae, coletadas em um criadouro natural no estuário do rio Cocó, Fortaleza, Ceará, Brasil

Oysters are edible organisms that are often ingested partially cooked or even raw, presenting therefore a very high risk to the consumers' health, especially in tropical regions. The presence of Vibrio cholerae and Vibrio parahaemolyticus in oysters sampled at an estuary in the Brazilian northeastern region was studied, with 300 oysters tested through an 8-months period. The salinity of the water at the sampling point varied between 3% and 27. V. cholerae was the most frequently detected species (33.3% of the samples), and of the 22 V. cholerae isolates, 20 were identified as non-O1/non-O139, with two of the colonies presenting a rough surface and most of remaining ones belonging to the Heiberg II fermentation group. V. parahaemolyticus was isolated from just one of the samples. Other bacteria such as Providencia spp., Klebsiella spp. and Morganella morganii were also isolated.As ostras são alimentos marinhos freqüentemente ingeridos crus ou parcialmente cozidos. Por esta razão, o risco para a saúde dos consumidores desses produtos é muito elevado, principalmente, quando são de regiões tropicais. Foi estudada a presença de Vibrio cholerae e Vibrio parahaemolyticus em ostras de um estuário na região Nordeste do Brasil. Trezentas ostras foram analisadas, em um período de 8 meses. A salinidade da água, no local de coleta, variou de 3 a 27. V. cholerae foi o vibrio mais freqüentemente detectado (33,3% das amostras). Dos 22 isolados, 20 foram identificados como V. cholerae não-O1/não-O139, duas delas apresentando forma rugosa sendo a maioria das demais pertencente ao tipo fermentativo Heiberg II. V. parahaemolyticus foi isolado em apenas umas das coletas. Foram, também, identificadas nas amostras isolados de Providencia spp., Klebsiella spp., Proteus spp. e Morganella morganii