Caracterização cognitiva e funcional de idosos com idades entre os 65 e os 75 anos inscritos numa unidade saúde familiar

Introdução: As sociedades actuais, nomeadamente as ocidentais, estão envelhecidas. Em Portugal, as unidades de saúde familiar reflectem esta realidade tendo nas suas listas de utentes um grande número de idosos. Através da investigação tem sido possível conhecer melhor o envelhecimento, na sua vertente normal mas também patológica, mais propriamente as demências e uma fase pré-demência denominada Défice Cognitivo Ligeiro (DCL). Os trabalhos de investigação consideram o DCL como um factor de risco significativo para desenvolvimento de demência e uma entidade cada vez mais comum entre a população idosa. O DCL, normalmente passa despercebido aos doentes, aos seus familiares e, mesmo, aos profissionais de saúde pois tem ainda uma percepção de impacto reduzido no quotidiano das pessoas. Posto isto, torna-se premente conhecer a população idosa em termos cognitivos e funcionais, como meio de diagnóstico, de modo a possibilitar uma intervenção precoce. Tratando-se, o DCL e a demência, de doenças progressivas e degenerativas com severo impacto na vida das pessoas, família e sociedade, o retardar da progressão e a manutenção da qualidade de vida por mais anos torna-se fundamental e até mesmo uma obrigação das sociedades perante os seus cidadãos. Objectivo: Caracterizar a cognição e funcionalidade dos idosos com idades entre os 65 e os 75 anos inscritos numa Unidade Saúde Familiar. Método: Optou-se por um estudo exploratório descritivo transversal. Foram seleccionados para amostra 126 utentes inscritos na Unidade Saúde Familiar Horizonte, a quem depois de obtido o consentimento informado foi aplicado um instrumento de avaliação cognitiva e funcional. O instrumento utilizado possibilitou a recolha de informações sociodemográficas e clínicas, e utiliza três instrumentos para avaliação cognitiva e dois instrumentos para avaliação funcional: Exame Breve do Estado Mental, Teste do Relógio, Escala de Avaliação de Demência, Índice de Lawton e Índice de Barthel. Resultados e discussão: Os principais resultados demonstraram, que 20 dos 126 utentes apresentam desempenho nos testes de avaliação da função cognitiva compatível com défice cognitivo o que corresponde a cerca de 15,9% de prevalência. Os principais defeitos cognitivos destes utentes são ao nível da evocação, atenção e cálculo e habilidade construtiva. O desempenho no TR e na EAD correlacionaram-se com o desempenho no MMSE. A escolaridade mais comum varia de 1 a 4 anos e como antecedentes patológicos os utentes apresentam principalmente doenças cardiovasculares, osteoarticulares e a multipatologia. A nível funcional estamos perante um conjunto de utentes sem alterações significativas ao nível das suas Actividades Básicas de Vida Diária e Actividades Instrumentais de Vida Diária. A percepção dos utentes sobre saúde, capacidade para fazer face ao dia-a-dia e qualidade de vida demonstra que estes se classificam entre o nível razoável e bom. Conclusão: A realização de avaliação da função cognitiva e funcional após os 65 anos revela-se útil na detecção precoce de alterações nestas dimensões dos idosos. Os valores obtidos para DCL neste estudo são compatíveis com outros dados de estudos semelhantes realizados a nível nacional e internacional

Biophysical chances in aqua-sky exercise with different musical cadences : instructors evaluation

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Efeitos da variabilidade de prática e da interferência contextual na aprendizagem de uma habilidade motora : o largar e pontapear sem ressalto : em precisão

O objectivo deste estudo foi verificar se a variabilidade das condições de práticas e a interferência contextual, na aprendizagem da habilidade motora - largar e pontapear sem ressalto - em precisão, se traduz numa melhor performance num teste de Transfer. Para tal, sujeitámos um grupo de crianças de 9 e 10 anos de idade, à prática da habilidade referida, em quatro situações distintas de organização de prática: contínua; por blocos, por séries e aleatória. A prática variada revelou-se a forma de organização com melhores resultados no teste de transfer. Apenas na prática por blocos se encontraram diferenças significativas, entre o teste diagnóstico e o teste de transfer

Local-scale factors matter for tree cover modelling in Mediterranean drylands

Forests contribute directly to ecosystem structure and functioning, maintaining biodiversity, acting as a climate regulator and reducing desertification. To better manage forests, it is essential to have high-resolution forest models and appropriate spatial-explicit variables able to explain tree cover at different scales, including the management scale. Most tree cover models rely only on broad-scale variables (>500 m), such as macroclimate, while only few studies include also local-scale variables (<500 m). This study aimed to identify the importance of local-scale factors relative to broad-scale factors and identify the environmental variables at different scales that explain tree cover in oak woodlands in Mediterranean drylands. Sixty sites previously identified as being covered with Holm oak or Cork oak were stratified by precipitation. Normalized Difference Vegetation Index, used here as a surrogate of tree cover, was modelled using simultaneously broad-scale factors (macroclimate) and local-scale factors (microclimatic and edaphic conditions). The percentage of variance explained by local- and broad-scale factors and the effect size of each environmental variable on tree cover was determined for the study site. It was found that local-scale factors and their interaction with broad-scale factors explained more variance than broad-scale factors alone. The most important local-scale factors explaining tree cover were elevation, potential solar radiation, used as a surrogate of microclimatic conditions, and wetness evaluated terrain used as an indicator of water flow accumulation. The main broad-scale factors were related to temperature and precipitation. The effect of some local-scale variables in tree cover seems to increase in areas where water as a limiting factor is more important. This study demonstrates the critical importance of including local-scale factors in multi-scale modelling of tree cover to obtain better predictions. These models will support well-suited forest management decisions, such as reforestation and afforestation plans to reverse evergreen oaks decline in Mediterranean drylands.info:eu-repo/semantics/publishedVersio

Adaptação de esqueletos metálicos de próteses parciais removíveis produzidos por CAD-CAM – estudo clínico

Objectives: To assess the effect of a CAD-CAM protocol fabrication on the clinical fit accuracy of removable partial denture metal frameworks to abutment teeth. Methods: Fifteen patients with partial edentulism were selected to participate in this clinical study, and twenty dental arch rehabilitations were planned. For each dental arch (n=20), two cobalt-chromium frameworks were produced through two protocols: CAD-CAM production (experimental group); and conventional lost-wax casting technique (control group). Clinical fit accuracy was assessed using an indirect quantitative method to evaluate the gap between the framework occlusal rest and the corresponding rest seat. A silicone mold of that gap was obtained, digitized, and analyzed by micro-computed tomography. The two silicone molds obtained for each occlusal rest were overlapped and evaluated for thickness and volume. Data were analyzed with the paired t test for silicone thickness results and the Wilcoxon test for silicone volume results (α= 0.05). Results: Considering the two dependent variables under study, no statistically significant (p=0.441 for silicone thickness and p=0.204 for silicone volume) differences were found between groups. Conclusions: The results of this study suggest that the CAD-CAM protocol applied is a viable method for the production of removable partial denture metal frameworks.info:eu-repo/semantics/publishedVersio

Assessment of environment, land management, and spatial variables on recent changes in Montado land cover in southern Portugal

Montado decline has been reported since the end of the nineteenth century in southern Portugal and increased markedly during the 1980s. Consensual reports in the literature suggest that this decline is due to a number of factors, such as environmental constraints, forest diseases, inappropriate management, and socioeconomic issues. An assessment on the pattern of montado distribution was conducted to reveal how the extent of land management, environmental variables, and spatial factors contributed to montado area loss in southern Portugal from 1990 to 2006. A total of 14 independent variables, presumably related to montado loss, were grouped into three sets: environmental variables, land management variables, and spatial variables. From 1990 to 2006, approximately 90,054 ha disappeared in the montado area with an estimated annual regression rate of 0.14 % year-1. Variation partitioning showed that the land management model accounted for the highest percentage of explained variance (51.8 %), followed by spatial factors (44.6 %) and environmental factors (35.5 %). These results indicate that most variance in the large-scale distribution of recent montado loss is due to land management, either alone or in combination with environmental and spatial factors. The full GAM model showed that different livestock grazing is one of the most important variables affecting montado loss. This suggests that optimum carrying capacity should decrease to 0.18–0.60 LU ha-1 for livestock grazing in montado under current ecological conditions in southern Portugal. This study also showed that land abandonment, wildfire, and agricultural practices (to promote pastures, crops or fallow lands) were three significant variables influencing montado loss

Information needs of family caregivers of dependent individuals

The increase in the number of dependent individuals means that more and more families find themselves in the situation of caregivers, with all the consequences that performing this role entails. Based on this reality, we considered it to be completely relevant to systematize knowledge in this area. This study aimed to identify the information needs of the family caregiver-dependent individuals in the available scientific literature, having performed an integrative review of the literature. The main results and conclusions indicate that the information needs of family caregivers can be grouped into three main themes: 1) caregiver knowledge and skills, 2) potential resources for the caregiver and 3) caregiver coping strategies and well-being. The comprehensive nature of the integrative review as the chosen method allowed us to get a good understanding of the information needs of family caregivers of dependent individuals. The relevance of this study to clinical practice is that, although it is still necessary to expand and enhance the scope of research in this area, we consider this information essential for all health professionals seeking to provide effective support to family caregivers, as well as to serve as support for the development of intervention projects and health servicesinfo:eu-repo/semantics/publishedVersio

Lithium in Public Drinking Water and Suicide Mortality in Portugal: Initial Approach

Introduction: Lithium can be found naturally in drinking water. There is some evidence that natural levels of lithium in drinking water may have a protective effect on suicide mortality. The aim of this study is to evaluate if higher natural concentrations of lithium in public drinking water are associated with lower local rates of suicide in Portugal. Material and Methods: Suicide standardized mortality ratios at 54 Portuguese municipalities within the 6-year period from 2011 to 2016 was correlated with lithium concentrations in public drinking water and socioeconomic factors using Pearson’s correlation coefficients (r) with one-tailed tests. Multivariate regression models were adjusted for well-known socioeconomic factors known to influence suicide mortality in Portugal (population density, average income per capita, unemployment rates and proportion of Roman Catholics). Results: The average lithium level, as evidenced by raw values for 54 municipalities, was 10.88 μg/L (standard deviation = 27.18). There was no statistically significant correlation between lithium levels and suicide standardized mortality ratio (r = 0.001, p-value = 0.996). There was a statistically significant higher suicide standardized mortality ratio for males (p-value = 0.000). When analyzed separately for both sexes, no statistically significant correlation between suicide standardized mortality ratio and lithium levels was found (male r = 0.024, p-value = 0.862; female r = 0.000, p-value = 0.999). No association between suicide standardized mortality ratio and socioeconomic factors was found: population density (r = -0.144, p-value = 0.300), average income per capita (r = -0.112, p-value = 0.418), unemployment rates (r = -0.001, p-value = 0.994), and proportion of Roman Catholics (r =- 0.150, p-value = 0.278). Discussion: Unlike most international studies regarding natural lithium levels and suicide risk, no inverse relation was found in Portugal. Factors such as the country’s low suicide rate, confunding suicide risk variables, and unaccounted lithium intake might have influenced these findings. Conclusions: No association between lithium in public drinking water and suicide rates was found in Portugal

Adult body height is a good predictor of different dimensions of cognitive function in aged individuals: a cross-sectional study

Background: Adult height, weight, and adiposity measures have been suggested by some studies to be predictors of depression, cognitive impairment, and dementia. However, the presence of confounding factors and the lack of a thorough neuropsychological evaluation in many of these studies have precluded a definitive conclusion about the influence of anthropometric measures in cognition and depression. In this study we aimed to assess the value of height, weight, and abdominal perimeter to predict cognitive impairment and depressive symptoms in aged individuals. Methods and Findings: Cross-sectional study performed between 2010 and 2012 in the Portuguese general community. A total of 1050 participants were included in the study and randomly selected from local area health authority registries. The cohort was representative of the general Portuguese population with respect to age (above 50 years of age) and gender. Cognitive function was assessed using a battery of tests grouped in two dimensions: general executive function and memory. Two-step hierarchical multiple linear regression models were conducted to determine the predictive value of anthropometric measures in cognitive performance and mood before and after correction for possible confounding factors (gender, age, school years, physical activity, alcohol consumption, and smoking habits). We found single associations of weight, height, body mass index, abdominal perimeter, and age with executive function, memory and depressive symptoms. However, when included in a predictive model adjusted for gender, age, school years, and lifestyle factors only height prevailed as a significant predictor of general executive function (beta, = 0.139; p < 0.001) and memory (beta = 0.099; p 0.05). No relation was found between mood and any of the anthropometric measures studied. Conclusions and Relevance: Height is an independent predictor of cognitive function in late-life and its effects on the general and executive function and memory are independent of age, weight, education level, gender, and lifestyle factors. Altogether, our data suggests that modulators of adult height during childhood may irreversibly contribute to cognitive function in adult life and that height should be used in models to predict cognitive performance.European Commission (FP7) “SwitchBox” (Contract HEALTH-F2-2010-259772) project and co-financed by the Portuguese North Regional Operational Program (ON.2—O Novo Norte) under the National Strategic Reference Framework (QREN), through the European Regional Development Fund (FEDER), and by Fundação Calouste Gulbenkian—Inovar em Saúde (“Envelhecimento cognitivo saudável—proporcionar saúde mental no processo biológico do envelhecimento,” Contract P-139977). NCS is supported by a SwitchBox post-doctoral fellowshi