Conhecimento acerca dos benefícios e recomendações para a prática de atividade física: relação com o nível de atividade física autorreportada em indivíduos com diabetes tipo 2

Dissertação de Mestrado em Fisioterapia, ramo Saúde PúblicaAtualmente a prática de regular de atividade física é mencionada na literatura como uma estratégia fundamental no tratamento da diabetes tipo 2, com influencia positiva na redução das comorbilidades associadas a esta doença. (Sigal et al., 2006; Praet & van Loon, 2009). No entanto, e apesar deste reconhecimento, a maioria da população com diabetes tipo 2, apresenta baixos níveis de atividade física que na literatura têm sido relacionados com conhecimento deficitário ou inadequado acerca dos benefícios e das recomendações para a mesma (Madden, et. al., 2009). Este estudo foi realizado com o objetivo de determinar o nível de atividade física e de avaliar a sua associação com o conhecimento acerca dos benefícios da atividade física e recomendações específicas para a sua prática. Trata-se de um estudo observacional, de natureza descritiva e do tipo Survey (estudo de levantamento) realizado com uma amostra de 50 indivíduos recrutados a partir da consulta de diabetes de uma Unidade de Saúde Familiar da região de Setúbal. A recolha de dados foi feita através da aplicação conjunta, e de uma só vez, de três questionários (Questionário de caracterização sócio-demográfica; versão portuguesa do International Physical Activity Questionnaire - IPAQ; Questionário de Avaliação de Conhecimentos acerca dos benefícios e recomendações específicas da prática regular de atividade física), adaptados ao método de entrevista telefónica. Os resultados revelaram que a maioria dos participantes tinham baixos níveis de atividade física (60%), apesar de demonstrarem bons conhecimentos acerca dos benefícios da sua prática regular (67%). Nas analises exploratórias verificou-se uma associação estatisticamente significativa entre as variáveis, “género” (p= 0,045) e “existência de recomendação para a prática do exercício por parte de um profissional de saúde” (p=0,017), com os conhecimentos acerca dos benefícios da prática regular de atividade física. São os indivíduos do género feminino e com a existência de recomendação para o exercício por parte dos profissionais de saúde, que tendem a demonstrar um nível mais elevado de conhecimento acerca dos benefícios da atividade física.Abstract: The practice of physical activity has been referred in the research literature as a key strategy in the management of type 2 diabetes mellitus (T2DM), with positive influence in reducing its associated complications (Sigal et al., 2006; Praet & van Loon, 2009). However, the majority of people with T2DM, presents low levels of physical activity, which has been associated, with poor knowledge about its benefits and/or about the current guidelines’ recommendations for that practice (Madden, et. al., 2009). The purpose of this study was to determine the level of physical activity, in a sample of T2DM patients, and to assess its relationship with knowledge of physical activity benefits and knowledge about specific recommendations for the practice of physical activity. An observational descriptive study was carried out with a sample of 50 T2DM participants, recruited from the medical consultation of one of the Familiar Health Units in the Setúbal Region. Three aggregated questionnaires sociodemographic questionnaire, Portuguese version of the International Physical Questionnaire- IPAQ; Knowledge evaluation about physical activity benefits and specific recommendations for regular physical activity practice Questionnaire) were administrated by telephone interview, all at the same time. The study’s findings showed that the majority of the participants had low levels of physical activity (60%), regardless their appropriate knowledge concerning the benefits of regular physical activity (67%). The results of this study have also shown that participants have a poor and/ or inappropriate knowledge concerning the specific physical activity recommendations that have a positive impact in this specific condition. The exploratory analyses revealed a statistically significant association between an appropriate knowledge about the benefits of physical activity and both “gender” (p=0,045) and “recommendation for physical activity practice by an health professional” (p=0,017). Female participants, who received recommendations for regular physical activity, showed higher levels of knowledge concerning the benefits of being physically ative. The study’s findings suggest that T2DM patients need appropriate information and knowledge about how they should practice physical activity.Practising physical activity following current specific recommendations about the mode, frequency, intensity and duration has a positive effect on the management of T2DM

The tourism and lifestyle mobilities of the Madeiran community in the Channel Island of Jersey

This thesis critically examines the multiple mobilities and travel experiences of the Madeiran community that decided to migrate to the Channel Island of Jersey, most during the 1990’s. The thesis explores: reasons for their move to the island; the challenges of their settlement; the links they maintain with the homeland. It specifically analyses the Madeiran’s’ experiences in Jersey and whether they desire to return to the homeland in the future. The theoretical discussion explores the concept of diaspora, its historical development, and the connections between diasporas, mobilities and migration movements. Themes related to diaspora tourism, labour mobilities and family migration are also discussed, to develop a critical standing about contemporary mobilities and the importance of transnationalism. Connections between diaspora tourism and the loyalty to the homeland are also explored. The methodology explains why I have opted for a qualitative research study and my interest in the nature of the participants’ experiences and my focus on understanding their social world. I conducted 28 in-depth semi-structured interviews in Jersey and in Madeira. The findings show that these migrants came to Jersey when they were young and came through curiosity, a sense of adventure and the possibility of improving their living standards. The appeal of Jersey lay in the job opportunities and the higher salaries, while the push factors of Madeira were the less developed economy and the limited career prospects. Most Madeirans in Jersey work in the hospitality, tourism, and agriculture industries. The focus of this study on small island-to-island migration is a relatively neglected topic. Whereas mobilities studies have tended to focus on the highly skilled and more affluent groups of migrants, the discussion explores the mobilities and travel habits gained by a lower income group and contributes to the understanding of the mobility paradigm, by bringing attention to the less understood individual decisions made by citizens who wish to migrate. A framework is developed that explains how their lifestyle mobilities have changed and the travel trends that have emerged with their move to Jersey, influenced by their attachment to the homeland and their family relations. A research agenda on islandto-island migration mobilities is proposed

A satisfação dos colaboradores com a certificação da qualidade: o caso da Câmara Municipal de Águeda

Mestrado em Administração e Gestão PúblicaNos últimos anos, a certificação pela ISO 9001 na Administração Pública tem vindo a crescer em Portugal. A C.M. de Águeda é uma referência nacional no que diz respeito à qualidade e modernização dos serviços municipais – possui todas as suas divisões e unidades técnicas certificadas pela NP EN ISO 9001:2008, sendo a única autarquia do distrito de Aveiro a possuir este tipo de certificação. O trabalho desta investigação empírica tem como objetivo aferir a influência das variáveis sociodemográficas (sexo, faixa etária, habilitações académicas, grupo profissional e escalão do tempo de serviço) e das variáveis organizacionais (divisão e unidade técnica) na satisfação dos colaboradores da C.M. Águeda, e “medir” a sua satisfação em relação às Práticas de Gestão da Qualidade utilizadas por esta entidade local. Tendo em consideração as nossas hipóteses de investigação, é possível classificar o nosso estudo, de acordo com diversos autores, como intrínseco e único. O nosso objeto de análise foram todos os colaboradores da C.M. Águeda. Os níveis de satisfação dos colaboradores da autarquia com a Certificação da Qualidade foram avaliados através da perceção dos mesmos explicitada no preenchimento de um questionário construído para o efeito. Os dados recolhidos através destes questionários foram analisados estatisticamente com recurso ao auxílio do software SPSS. Das sete hipóteses enunciadas, apenas a hipótese relativa à faixa etária não foi confirmada no estudo, isto é, apenas a variável idade não influencia a satisfação dos colaboradores da C.M. Águeda. Os resultados revelaram que a nível global os colaboradores estão medianamente ou muito satisfeitos quer com a entidade local quer com o processo de certificação da qualidade.In recent years, the ISO 9001 certification in Public Administration has been growing in Portugal. The C.M. Águeda is a national reference with regard to the quality and modernization of municipal services – all its divisions and technical units are certified by the NP EN ISO 9001: 2008 standard, being the only municipality of the district of Aveiro to possess this type of certification . The work of this empirical research aims to assess the influence of sociodemographic variables (sex, age, academic qualifications, professional group and level of seniority) and organizational variables (division and technical unit) in satisfaction of the C.M. Águeda employees, and "measure" their satisfaction with the Quality Management Practices used by this local entity. Considering our research hypotheses, it is possible to classify our study, according to several authors, such as intrinsic and unique. Our object of analysis were the employees of the C.M. Águeda. The levels of satisfaction of this local entity workforce regarding the Quality Assurance were assessed by analysis of their perception explicit in a questionnaire constructed for this purpose. The data collected through these questionnaires were statistically analyzed using the SPSS software. Of the seven cases listed, only the hypothesis on the age group was not confirmed by this study, meaning that the age variable does not influence the satisfaction of the CM Águeda employees. The results revealed that the majority of the employees are moderately or very satisfied with both the local authority and with the quality certification process

Efectividade de programas de intervenção na prevenção de quedas em idosos com osteoporose: revisão sistemática

Background: Falls are the third cause of chronic incapacity among elders. Among others, elders with osteoporosis are more vulnerable to negative consequences such as fractures. Recent research evidence suggests that some interventions are effective in preventing elderly falls but there is limited information concerning the effectiveness of fall prevention programmes for elders with osteoporosis. Objectives: To identify the most effective programmes in falls prevention in elders with osteoporosis, living in the community and compare the results with prevention for a non-specific condition. Search Strategy: We searched RCT’s published in the last 5 years conducted on PubMed, PEdro, CENTRAL, Web of Knowledge and CINAHL (January, 2009). Selection criteria: RCT’s, published in English in the last 5 years that addressed interventions to prevent falls for community-dwelling elders with osteoporosis. Results: Eight RCT’s were included in this review. For falls reduction, different approaches were evaluated, but only the intervention with hip protectors and the intervention with an exercise program to promote balance had significant statistical results. However the confidant intervals are unknown. For fractures reduction, only two interventions had significant statistical results – annual intramuscular Vitamin D2 over 3 years (HR- 1,49; 95%CI – 1,02 – 2,18), and Hip protectors (OR- 0,75; 95%CI- 0,57-0,97). Finally for risk of falling reduction, despite the significant statistical results – exercise program and a exercise program plus protein supplement, the confidants intervals are unknown. Conclusion: Our results are similar to the most recent systematic review of literature data concerning preventing falls for elders with a non-specific condition. However more studies are needed in this health issue

Prognostic indicators for poor outcomes in low back pain patients consulted in primary care

SAICT-POL/23439/2016| LISBOA-01-0145-FEDER-023439). This Grant covers all the planned activities for this study including, the design of the study, data collection, data analysis and interpretation and the writing of this manuscript.The funder did not play any role in the study design, data collection and analysis, decision to publish, or preparation of this manuscriptBackground Non-specific low back pain (NSLBP) is the most prevalent musculoskeletal condition in western countries and is associated with persistent disability and high consumption of health care resources. NSLBP patients first seek primary health care services but the outcomes are often uncertain. This study aimed to examine the clinical course of the outcomes and to identify prognostic indicators for poor outcomes in NSLBP patients who consulted primary care. Methods A prospective cohort study of 115 patients seeking treatment for NSLBP in primary care was conducted. Participants were consecutively recruited by their General Practitioners (GPs) and then assessed at baseline and 2 and 6 months later. Baseline assessment included socio-demographic and clinical data, psychosocial factors, pain, disability, and health related quality of life (HRQoL). Pain, disability, HRQoL and global perception of change were also assessed at 2 and 6-months’ follow-up. In addition, information regarding the GP’ practice was collected. Poor outcomes were determined according to the cut-off point used to define a persistent disabling condition and the minimal important change established for disability, pain and for global perception of change. The relationship between variables on baseline and poor outcomes was modulated through binary logistic regression analysis. The significance of associations was evaluated at ≤ 0.05 p-value with 95% confidence intervals (CI) and adjusted odds ratios (AOR). Results 110 (94.8%) and 104 (89.7%) participants completed the follow-up assessment at 2 and 6 months, respectively. The mean age (±SD) was 48.06 ± 11.41, with 53.9%, (N = 62) reporting an acute presentation of NSLBP. Six months after GP consultation, 53.8% (N = 56) of the participants reported a persistent disabling condition. An “LBP episode of less than 12 weeks” [AOR: 0.26; 95% CI (0.10, 0.65); AOR: 0.34; 95% CI (0.14, 0.81); AOR: 0.21; 95% CI (0.09, 0.53)],”maladaptive psychosocial factors” [AOR: 2.06; 95% CI (1.40, 3.04); AOR: 1.82; 95% CI (1.27, 2.59); AOR: 1.72; 95% CI (1.20, 2.47)] were significantly associated with poor outcomes on disability, pain and global perception of change, respectively. Besides these factors, being employed reduces the chances of poor outcomes on disability [AOR 0.31; 95% CI (0.11, 0.92)]. Conclusions A large proportion of LBP patients seeking primary health care reported poor outcomes 6 months after GP consultation. Patients who report chronic LBP, maladaptive psychosocial factors and are unemployed have a significant increase in the risk of poor outcome. These findings suggest the need of implementing effective models of care able to provide early screening and appropriate treatment to those at greatest risk of a poor outcome.publishersversionpublishe

Evolução da Função do Idoso: Identificação dos Factores Predisponentes e Incidentes Críticos com Influência no Declínio Funcional: Resultados Preliminares

info:eu-repo/semantics/publishedVersio

The MOVE.TE Falls Prevention and Management Program: lessons learnt in the Portuguese context

MOVE.TE is a non-profit participatory physiotherapy platform that aims at translating knowledge in the field of physiotherapy and developing freely available evidence-based physiotherapy programmes targeting the primary care services of the Portuguese National Health service. A group of volunteer academics and clinicians collaborated at different stages and time points to create the first ever falls prevention and management programme and guidance for Physiotherapy in primary care, in Portugal. This report describes this seven-step process. In spite of many challenges, this project constitutes an example of advocacy in physiotherapy for the promotion of better healthcare for older adults.info:eu-repo/semantics/publishedVersio

Conhecimento acerca dos benefícios e recomendações para a prática de atividade física: relação com o nível de atividade física autorreportada em indivíduos com diabetes tipo 2

RESUMO: Atualmente a prática de regular de atividade física é mencionada na literatura como uma estratégia fundamental no tratamento da diabetes tipo 2, com influencia positiva na redução das comorbilidades associadas a esta doença. (Sigal et al., 2006; Praet & van Loon, 2009). No entanto, e apesar deste reconhecimento, a maioria da população com diabetes tipo 2, apresenta baixos níveis de atividade física que na literatura têm sido relacionados com conhecimento deficitário ou inadequado acerca dos benefícios e das recomendações para a mesma (Madden, et. al., 2009). Este estudo foi realizado com o objetivo de determinar o nível de atividade física e de avaliar a sua associação com o conhecimento acerca dos benefícios da atividade física e recomendações específicas para a sua prática. Trata-se de um estudo observacional, de natureza descritiva e do tipo Survey (estudo de levantamento) realizado com uma amostra de 50 indivíduos recrutados a partir da consulta de diabetes de uma Unidade de Saúde Familiar da região de Setúbal. A recolha de dados foi feita através da aplicação conjunta, e de uma só vez, de três questionários (Questionário de caracterização sócio-demográfica; versão portuguesa do International Physical Activity Questionnaire - IPAQ; Questionário de Avaliação de Conhecimentos acerca dos benefícios e recomendações específicas da prática regular de atividade física), adaptados ao método de entrevista telefónica. Os resultados revelaram que a maioria dos participantes tinham baixos níveis de atividade física (60%), apesar de demonstrarem bons conhecimentos acerca dos benefícios da sua prática regular (67%). Nas analises exploratórias verificou-se uma associação estatisticamente significativa entre as variáveis, “género” (p= 0,045) e “existência de recomendação para a prática do exercício por parte de um profissional de saúde” (p=0,017), com os conhecimentos acerca dos benefícios da prática regular de atividade física. São os indivíduos do género feminino e com a existência de recomendação para o exercício por parte dos profissionais de saúde, que tendem a demonstrar um nível mais elevado de conhecimento acerca dos benefícios da atividade física. Os resultados mostram igualmente que apesar de não existir uma associação estatisticamente significativa entre o conhecimento acerca das recomendações específicas para a prática da atividade física (recomendações para o modo, frequência duração e intensidade da atividade física), e o nível de atividade física autorreportada, a maioria dos participantes desconhece estas recomendações (70,3%). Estes resultados sugerem a necessidade de realizar programas educativos dirigidos a este aspeto ou de incluir este tipo de informação nas recomendações dos profissionais de saúde para a prática regular de atividade física em indivíduos com diabetes do tipo 2. -----------ABSTRACT:The practice of physical activity has been referred in the research literature as a key strategy in the management of type 2 diabetes mellitus (T2DM), with positive influence in reducing its associated complications (Sigal et al., 2006; Praet & van Loon, 2009). However, the majority of people with T2DM, presents low levels of physical activity, which has been associated, with poor knowledge about its benefits and/or about the current guidelines’ recommendations for that practice (Madden, et. al., 2009). The purpose of this study was to determine the level of physical activity, in a sample of T2DM patients, and to assess its relationship with knowledge of physical activity benefits and knowledge about specific recommendations for the practice of physical activity. An observational descriptive study was carried out with a sample of 50 T2DM participants, recruited from the medical consultation of one of the Familiar Health Units in the Setúbal Region. Three aggregated questionnaires (sociodemographic questionnaire, Portuguese version of the International Physical Questionnaire- IPAQ; Knowledge evaluation about physical activity benefits and specific recommendations for regular physical activity practice Questionnaire) were administrated by telephone interview, all at the same time. The study’s findings showed that the majority of the participants had low levels of physical activity (60%), regardless their appropriate knowledge concerning the benefits of regular physical activity (67%). The results of this study have also shown that participants have a poor and/ or inappropriate knowledge concerning the specific physical activity recommendations that have a positive impact in this specific condition. The exploratory analyses revealed a statistically significant association between an appropriate knowledge about the benefits of physical activity and both “gender” (p=0,045) and “recommendation for physical activity practice by an health professional” (p=0,017). Female participants, who received recommendations for regular physical activity, showed higher levels of knowledge concerning the benefits of being physically ative. The study’s findings suggest that T2DM patients need appropriate information and knowledge about how they should practice physical activity. Practising physical activity following current specific recommendations about the mode, frequency, intensity and duration has a positive effect on the management of T2DM

Fisioterapia na prevenção de quedas do adulto mais velho: Proposta de Modelo de Intervenção nos Cuidados de Saúde Primários

info:eu-repo/semantics/publishedVersio