As plataformas tecnológicas aplicadas ao ensino e aprendizagem da bioestatística e epidemiologia: o exemplo do e.cuidHaMUs®

Lição apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do título de agregado em Ciências da Informação, especialidade em Sistemas, Tecnologias e Gestão da InformaçãoN/

Epidemiological study about health of university students

Doutoramento em Ciências da SaúdeOs factores de risco nos adultos jovens são fortes preditores da incidência de doença cardiovascular e mortalidade na idade mais avançada. Em Portugal, desconhecem-se estudos que avaliem os factores de risco para as doenças crónicas, em jovens adultos, na transição do ensino secundário para o universitário. Este estudo pretendeu contribuir para a promoção do conhecimento dos determinantes sócioculturais e ambientais no diagnóstico e detecção de factores de risco para as doenças crónicas, nomeadamente as doenças cardiovasculares, em estudantes universitários. Teve como objectivo principal a investigação do efeito da vida académica nos factores de risco modificáveis, estilos de vida e determinantes da saúde. Teve como objectivos específicos identificar a(s) prevalência(s) dos factores de risco cardiovascular numa população universitária, a identificação dos intervalos de referência para a homocisteína total no soro de adultos jovens portugueses, a determinação do perfil lípidico, comportamentos de saúde e dieta alimentar de tipo mediterrânico entre os estudantes universitários de acordo com o género e a área científica de frequência e a avaliação longitudinal do impacto da exposição à vida académica no estado de saúde dos estudantes universitários Participaram no estudo 781 estudantes sendo a média de idades de 20,6. Os factores de risco estudados para as doenças crónicas, foram o hábito tabágico, a pressão arterial, o índice de massa corporal, a composição do sangue (lípidos, homocisteina e glicose), a alimentação e a actividade física. O estudo mostra que a prevalência de: sedentarismo é significativamente mais elevada nos rapazes (p<0,001); dislipidemia e a hipertrigliceridemia é significativamente mais elevada nas raparigas. Mais de um quarto dos estudantes tem colesterol elevado sendo a hipercolesterolemia significativamente mais elevada nas raparigas (p<0,001); a hipertensão verificou-se em ambos os sexos (6,0%) mas foi significativamente mais elevada nos rapazes (p=0,001). O estudo identificou o intervalo de referência para a homocisteína em adultos jovens portugueses independentemente do sexo (6,2 a 11,6 μmol/) sendo que, acima de 11,6 μmol/l é condição para vigilância médica em populações jovens adultas. Quando se estudou a exposição à vida académica comparada com aqueles que acabaram de entrar na universidade, verificou-se uma associação significativa no que respeita às concentrações de lípidos no sangue, à pressão arterial sistólica e à actividade física, tendo sido as raparigas aquelas que mais se afastavam dos padrões saudáveis (p<0,001). No que respeita à adesão à dieta mediterranica, não foram encontradas associações entre este tipo de alimentação e os vários factores de risco independentemente do género. Os resultados forneceram, evidências empíricas acerca da importância da detecção dos principais factores de risco na idade adulta (jovem) na prevenção das doenças cardiovasculares e vieram corroborar as orientações do Plano de Desenvolvimento Estratégico do Instituto Nacional de Saúde Português para as doenças crónicas, nomeadamente o estabelecimento de valores de referência nacionais para análises biológicas e as orientações do Plano de Acção Estratégica Global para a Prevenção e Controle das Doenças Não-Transmissíveis-2008/2013 da Organização Mundial de Saúde.Risk factors in young adults are strong predictors of the incidence of cardiovascular disease and mortality in older age. This study aims to increase the knowledge of sociocultural and environmental determinants in the diagnosis and detection of risk factors for chronic diseases, including cardiovascular diseases, in university students. Its main aim was to investigate the effect of academic life in risk factors, lifestyles and health determinants. The objectives were: 1) to identify the prevalence of cardiovascular risk factors in a university population, 2) to identify the reference intervals for total homocysteine in the serum of young Portuguese adults, 3) to determine the lipid profile, the health related behaviour and the Mediterranean-diet of students according to gender and to scientific area of study and 4) to perform a longitudinal evaluation of the impact of academic exposure on students health. A total of 781 students with a mean age of 20.6 participated in this study. The risk factors for chronic diseases studied were smoking habits, blood pressure, body mass index, blood composition (lipids, homocysteine and glucose), food intake and physical activity. The study shows that the prevalence of inactivity is significantly higher in males (p <0.001), while the prevalence of dyslipidemia and hypertriglyceridemia was significantly higher in girls (p <0.001). More than a quarter of students had high cholesterol levels and hypercholesterolemia was significantly higher in girls when compared to boys (p <0.001), hypertension occurred in both sexes (6.0%) but was significantly higher in males (p = 0.001). The study identified the reference range for homocysteine in young Portuguese adults (6.2 to 11.6 μmol/), regardless of gender and that, above 11.6 mmol / l is a prerequisite for surveillance in young adults. When evaluating the impact of academic life, there was a significant association between time of exposure to academic life and the concentrations of blood lipids, systolic blood pressure and physical activity. This association was gender-dependent with girls showing a statistically significant change when compared to boys. (p <0.001). There was no association between the type of Mediterranean diet and any of the risk factors studied. These results provide empirical evidence about the importance of detecting major risk factors in adulthood (young) and the need to target this age group with preventive campaigns, which is in accordance with the guidelines of the Strategic Development Plan of the National Institutes of Health Portuguese for chronic conditions namely biological references values to Portuguese population, and the guidelines of the Strategic Action Plan for Global Strategy for the Prevention and Control of Noncommunicable Diseases-2008/2013 of the World Health Organization

Relatório pedagógico da unidade curricular de “Bioestatística e epidemiologia”

Relatório apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do título de agregado em Ciências da Informação, especialidade em Sistemas, Tecnologias e Gestão da InformaçãoRelatório pedagógico da unidade curricular de “Bioestatística e epidemiologia” e as tecnologias de informação e comunicação, o ensino e aprendizagem da bioestatística e epidemiologia nas licenciaturas em Fisioterapia, Terapia da Fala e Imagem Médica e Radioterapia.N/

Atitudes, conhecimentos e hábitos tabágicos dos professores do 2º e 3º ciclos do ensino básico do Porto

Dissertação de Mestrado em Saúde Pública, área de especialização em Saúde Ambiental e Ocupacional, apresentada à Faculdade de Medicina e ao Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Port

A systematic review of quality of life instruments in the elderly after Cochlear Implantation

RESUMO - Introdução: A deficiência auditiva é um problema particular de saúde que afeta mais de 275 milhões de pessoas em todo o mundo e é o défice sensorial mais comum nas pessoas idosas. O objetivo deste estudo foi identificar os instrumentos para avaliar a qualidade de vida em pessoas idosas com deficiência auditiva submetidas ao implante coclear e rever os estudos que incluem a avaliação da qualidade de vida na sua relação com a especificidade da deficiência auditiva pós-lingual sensorioneural severa a profunda bilateral nessa população. Métodos: Foi conduzida uma revisão sistemática da literatura entre Janeiro de 1900 e Junho de 2012. Instrumentos validados e usados em pessoas com 65 anos de idade ou mais, com deficiência auditiva pós-lingual, sensorioneural severa a profunda, que tivessem sido sujeitas a implante coclear, foram revistos. A pesquisa bibliográfica foi limitada a estudos escritos em língua inglesa. Resultados: A revisão identificou um total de sete instrumentos validados. Destes, um foi especialmente desenhado para avaliar o impacto do implante coclear e seis para as condições gerais das pessoas com deficiência auditiva. A qualidade metodológica de todos os artigos foi avaliada segundo as recomendações de STROBE e todos os artigos foram classificados na categoria B. Conclusões: Os resultados desta revisão sistemática podem ajudar os profissionais de saúde e os investigadores a selecionarem os instrumentos mais apropriados para avaliar as mudanças na qualidade de vida dos idosos com implantes cocleares.ABSTRACT - Introduction: Hearing loss is a health problem that affects over 275 million people worldwide and it is the most common sensory deficit in the elderly. The aim of this study was to identify quality of life instruments that have been validated in older people with hearing loss submitted to cochlear implant and to review the studies that have used the quality of life instruments in their relationship with the specificity of postlingual bilateral profound sensorineural hearing loss in this population. Methods: A systematic literature search was conducted from January 1900 to June 2012. Validated instruments that were used in persons aged ≥65 years with postlingual bilateral profound sensorineural hearing loss who underwent cochlear implantation were reviewed. The search was limited to studies in English language. Results: The review identified a total of 7 validated instruments. Of these, 1 was specially designed for the specific disease and 6 for the general conditions of persons with hearing loss. The methodological quality of all articles was assessed according to the STROBE recommendations, and all items were classified in category B. Conclusions: The results of this systematic review can help health professionals and researchers select the most appropriate instruments to assess the changes in quality of life in elderly with cochlear implantation.info:eu-repo/semantics/publishedVersio

Fiabilidad y validez del EASYCare-2010 Standard para evaluar a las personas mayores en Atención Primaria de Salud en Portugal

Introduction The EASYCare is a multidimensional assessment tool for older people, which corresponds to the concerns and priorities of older people in relation to their needs, health, and quality of life. The EASYCare instrument has been used in many countries worldwide. Lack of reliability evidence has recently been raised by researchers. This study aimed to test the validity and reliability of the EASYCare-2010 instrument in community-dwelling Portuguese older people attended in Primary Health Care centres. Methods The sample for this transversal study (N = 244) was collected from Portuguese Primary Health Care Centers. Categorical Principal Component Analysis was used to assess the underlying dimensions of EASYCare-2010. Construct validity was evaluated through correlation with the World Health Organization Quality of Life Assessment Instrument-Short Form. Results A two-factor model (labelled “mobility and activities of daily life”, and “general well-being and safety”) was found. The EASYCare-2010 instrument showed acceptable levels for internal consistency (≥0.70). The EASYCare-2010 factors were correlated with measures of quality of life. Results showed that in most polytomous items, some of the more extreme categories were not considered at all or only by a residual number of participants. Conclusion EASY Care -2010 version is a valid and reliable instrument for holistic assessment of the older people attended in Primary Health Care centres in Portugal

Description of an integrated e-health monitoring system in a Portuguese higher education institution: the e.cuidHaMUstm program

Background: The World Health Organization and the International Labour Organization recognize that workplace health is not only affected by occupational hazards, but is mainly affected by social determinants and individual factors. An accelerated rise in noncommunicable diseases has fostered the importance of creating supportive environments and encouraging healthy behaviours. Therefore, an operational approach to making workplaces healthy and sustainable is needed. This paper describes the development of an e-Health monitoring program entitled ‘Integrated eHealth Monitoring System for Health Management in Universities’ (e.cuidHaMUsTM) as a possible solution to that operational approach. Methods: We developed the program e.cuidHaMUsTM that proposes to detect risk behaviours related to noncommunicable diseases and to implement problem-solving measures by establishing a healthpromoting workspace in a Portuguese higher education institution. Based on the ‘I-Change’ conceptual model, our program provides personalized feedback; improves health-related knowledge, attitude and good practices; and encourages actions to promote healthy lifestyles through individual health capacitation. Focusing on evaluation as an activity that generates knowledge, the e.cuidHaMUsTM program aggregates all the relevant health information, shares the results with decision-makers and evaluates health-related policy changes in the workplace. Discussion: This paper presents the design of the e.cuidHaMUsTM program, the development of an eHealth web platform to share information between the different stakeholders, and a questionnaire to evaluate the health status of higher education institution workers (e.cuidHaMUs.QueST®). Also, the procedures for data collection and analysis are outlined. The e.cuidHaMUsTM program can enhance health surveillance through cross-sectional and longitudinal studies and provide scientific evidence to support the envisioned interventions and promotions of healthy lifestyles. This program is an effort to incorporate a holistic culture of health-promoting workspace in higher education institution policies.publishe

Factors associated with cardiovascular disease risk among employees at a portuguese higher education institution

This study aimed to estimate the prevalence of risk factors for cardiovascular disease (CVD) and to assess the CVD risk (CVDRisk) in a sample of workers at a specific workplace: a higher education institution in Portugal. Data were collected using a questionnaire (e.cuidHaMUs.QueST®) with 345 HEI workers from June 2017-June 2018 with a high response rate (93.3%). Two constructs of risks for CVD were considered: (i) metabolic risk and hypertension (CVDRisk1); and (ii) modifiable behavioural risk (CVDRisk2). Logistic regression analyses were used to establish a relationship between risk indexes/constructs (CVDRisk1 and CVDRisk2) and groups of selected variables. The most prevalent CVD risk factor was hypercholesterolaemia (43.2%). Sixty-eight percent of participants were in the construct CVDRisk1 while almost half of the respondents were in CVDRisk2 (45.2%). The consumption of soft drinks twice a week or more contributed to a significantly increased risk of CVD in CVDRisk1. Lack of regular exercise and lack of daily fruit consumption significantly increased the risk of CVD in CVDRisk2. The challenge to decision makers and the occupational medical community is to incorporate this information into the daily practices of health surveillance with an urgent need for health promotional education campaigns in the workplace.publishe

Threats to Health and Well-being Perceived by Older people in Poland and Portugal

Introduction: According to the OECD, Portugal and Poland rank below average in several well-being measures such as income and wealth, and health status. Investigating how people perceive the threats to health in these two countries, is an important issue to address priority needs. To meet this need, the objective of this paper was to compare the perceptions of the threats to the health and well-being among the Polish and Portuguese older persons and explore differences between the countries in respect of patterns of self-rated health. Material and Methods: A Cross-sectional study with two convenience samples from primary health care services of Poland and Portugal was conducted; 480 adults aged 65 and over (247 Portuguese) were included. The EASYCare standard assessment of 2010 was applied under a joint project of both countries. The association between ‘self-rated unhealthy’ and socio-demographic and threats to health variables was examined using logistic regression. Results: In both countries about two thirds of the older persons self-rated their health as unhealthy. Having more than enough finances was associated with a significant lower odds of being unhealthy compared with those without enough finances at the end of the month (Portugal: OR = 0.25, 95% CI 0.10 to 0.63; Poland: OR = 0.33, 95% CI 0.12 to 0.88). Visual problems, bodily pain, memory loss, feeling bored or lonely and reporting shortness of breath during normal activities was consistently associated with fair or poor self-rated health. Discussion: These findings provide important information regarding the health profile of older people which can help in the development of people-centred health systems where their lives and well-being can be improved. Conclusion: The unhealthy perception of older people was consistently associated with indicators of major health threats

O enfermeiro como educador na estratégia saúde da família

Introdução: a educação em saúde é uma das competências da enfermagem na estratégia saúde da família. Objetivo: compreender a atuação do enfermeiro como educador na Estratégia Saúde da Família. Método: Revisão Integrativa da literatura na Literatura Latino-Americana e do Caribe Ciências da Saúde, Banco de Dados em Enfermagem e Medical Literature Analysis and Retrievel System Online, por meio da Biblioteca Virtual de Saúde. Para seleção dos artigos, utilizou-se a combinação dos descritores “Enfermeiro”, “Educação em Saúde” e “Saúde da Família”. Foi empregado o operador booleano AND. Resultados: inicial foram encontrados 353 artigos, sendo selecionados 10. Discussão: a educação em saúde é uma prática fundamental do enfermeiro, promovendo mudanças na vida dos usuários. Na realização dessas atividades o profissional encontra dificuldades e potencialidades. Conclusão: o trabalho do enfermeiro como educador não pode ser limitado apenas a unidade básica de saúde e o processo educativo não é uma tarefa fácil, por isso, o enfermeiro precisa estar preparado para o enfrentamento os desafios. Percebe-se a importância de um trabalho coletivo e de o Enfermeiro ser um Profissional crítico em sua prática