Os adolescentes portugueses dormem pouco e bem, ou pouco e mal? : e então?

Revista de Psicologia da Criança e do Adolescente. - ISSN 1647-4120. - V. 10, n. 1 (Janeiro-Dezembro 2019). - p. 159-171.O objetivo deste estudo é analisar as carateristicas do sono dos jovens e seu papel na perceção de saúde, satisfação com a vida, pressão com os trabalhos da escola e capacidade escolar. Foram incluido 5695 adolescentes portugueses no âmbito do estudo do Health Behaviour in School aged Children (HBSC) (46,1% rapazes), do 8º, 10º e 12º anos de escolaridade de Portugal Continental. Foram identificadas associações entre todas as variáveis relacionadas com a qualidade do sono e bem--estar físico e psicológicos, assim como o contacto online com os amigos chegados e satisfação com a vida dos jovens. As variáveis relacionadas com um sono perturbado indicam que a maioria dos adolescentes mostra um padrão de sono tardio e redução da duração do sono numa fase da vida em que este é fundamental para o bom desempenho das atividades diárias dos jovens, relacionadas com as suas atividades escolares e sociais. A qualidade e quantidade do sono, assim como as suas consequências, têm vindo a agravar-se com o uso muitas vezes problemático de ecrãs, um problema cada vez mais saliente e focado, e com as preocupações que os adolescentes apresentam e não conseguem gerir.The objective of this study is to analyse the characteristics of the sleep of young people and their role in the perception of health, satisfaction with life, pressure with school work and school competence. A total of 5695 Portuguese adolescents were included in the study of Health Behaviour in School aged Children (HBSC) (46.1% boys), 8th, 10th and 12th grades in Portugal. We identified associations between all variables related to sleep quality and physical and psychological well-being, as well as the online contact with the close friends and satisfaction with the life of the young people. Variables related to disturbed sleep indicate that the majority of adolescents show a pattern of late sleep and reduced sleep duration at a stage of life where it is fundamental to the good performance of the daily activities of young people related to their school activities and social. The quality and quantity of sleep, as well as its consequences, have been aggravated by the often problematic use of screens, an increasingly salient and focused problem, and with worries that adolescents refer and can not manage

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)