Determinantes dos hábitos alimentares nos estudantes do ensino profissional

Introdução - A alimentação considera-se um elemento chave na definição de planos estratégicos para a prevenção de doenças crónicas. Na adolescência consolidam-se hábitos e aumentam as necessidades nutricionais. Os adolescentes expõem-se a novas experiências alimentares e a família é fundamental na criação e explicação dos hábitos alimentares. Objetivos - Caracterizar os hábitos alimentares dos estudantes do ensino profissional. Analisar a relação das variáveis sociodemográficas, académicas, de atividade física e de contexto familiar com os hábitos Alimentares. Método: Estudo de natureza quantitativa descritivo-correlacional. Amostra não probabilística de 249 estudantes (15 -19 anos M= 17,28 ± 0,98) de duas escolas do ensino profissional. O instrumento de recolha inclui a avaliação antropométrica, um questionário e sociodemográfico, académico, familiar, Escala FACES II (coesão e adaptabilidade familiar) e Escala de Hábitos Alimentares (EHA). Resultados: A maioria dos estudantes (99,6%) apresenta hábitos alimentares adequados. Existe relação entre as dimensões (quantidade, qualidade, variedade e adequação) dos hábitos alimentares e o género, rendimento escolar, coabitação, estado civil dos pais, ambiente familiar, frequência de refeições familiares, e atividade física. As variáveis género masculino, adaptabilidade familiar e IMC revelaram-se preditoras das dimensões da EHA. Conclusão: Os Hábitos alimentares mostraram-se multideterminados e adequados, mas devem continuar-se os esforços na sua manutenção. A adaptabilidade familiar revelou-se preditiva dos hábitos alimentares podendo sustentar a implementação de estratégias e intervenções centradas no adolescente e família no contexto da Enfermagem de saúde familiar. Palavras-chave: Hábitos Alimentares; adolescente; relações familiares; atividade motora.Abstract Introduction: A healthy diet is considered a key element in defining strategic plans for preventing chronic diseases. During adolescence eating habits should be consolidated and there is an increase in the nutritional needs. Adolescents exposed to new food experiences and the family's help are fundamental in the creation and explanation of Eating Habits. Objectives: To characterize the Eating Habits of students in vocational education. To analyze the relationship of sociodemographic and academic variables, physical activity and the family context with their Eating Habits. Method: A descriptive-correlational and quantitative study. A judgment sample of 249 students (15 -19 years M = 17.28 ± 0.98) from two vocational education schools. The instruments for gathering data include anthropometric measurements and a sociodemographic, academic and family questionnaire, FACES Scale II (cohesion and family adaptability) and the Eating Habits Scale (EHS). Results: The majority of students (99.6%) have proper eating habits. There is a relationship between the dimensions (quantity, quality, variety and appropriateness) of the eating habits and gender, school performance, cohabitation, parental marital status, family environment, frequency of family meals and physical activity. The variables, which are male gender, family adaptability and BMI proved to be predictive of the dimensions of EHS. Conclusion: Eating Habits proved to bemulti-determined and adequate but there efforts should be continued for their maintenance. Family adaptability proved to be predictive of Eating Habits and it can support the implementation of strategies and interventions focused on adolescents and family in the context of Nursing for family health. Keywords: Food Habits; adolescent; family relations; motor activity

Estudo epidemiológico das doenças neurodegenerativas na Região da Guarda - Portugal

The aim was to characterize the population with neurodegenerative diseases in the region of Guarda. An epidemiological, descriptive, cross-sectional study was carried out of the user population of the Local Health Unit of Guarda, EPE, located in the Central Region of Portugal, with an active diagnosis of neurodegenerative disease, according to the International Classification of Primary Health Care - ICPC-2 : P70 - Dementia, N86 - Multiple Sclerosis - and N87 - Parkinsonism. The data source was the Regional Health Administrations Information System (SIARS), and the sample consisted of 2500 people with neurodegenerative disease. Dementia is the most prevalent of these diseases (62%), followed by Parkinsonism (32%). The proportion of active diagnoses was 1.66%. Most are women (66%), the average age is 79 (± 11.99) years, with a range of 92 years, minimum 19 and maximum 111 years. The characterization of the population with an active diagnosis of neurodegenerative diseases proves to be an important contribution to delineating specific and targeted intervention strategies for the target population and, thus, proceeding with the study of the quality of life of people with neurodegenerative diseases and their families.Objetivou-se caracterizar a população portadora de doenças neurodegenerativas da Região da Guarda. Realizou-se um estudo epidemiológico, descritivo, transversal da população utilizadora da Unidade Local de Saúde da Guarda, EPE, localizada na Região Centro de Portugal, com diagnóstico ativo de doença neurodegenerativa, segundo a Classificação Internacional de Cuidados de Saúde Primários – ICPC-2: P70 - Demência, N86 - Esclerose Múltipla - e N87 - Parkinsonismo. A fonte de dados foi o Sistema de Informação das Administrações Regionais de Saúde (SIARS), sendo a amostra constituída por 2500 pessoas portadoras de doença neurodegenerativa. A Demência é a mais predominante dessas doenças (62%), seguida do Parkinsonismo (32%). A proporção de diagnósticos ativos foi 1,66%.  A maioria são mulheres (66%), a média de idades situa-se nos 79 (± 11,99) anos, com uma amplitude de 92 anos, mínimo 19 e máximo 111 anos. A caracterização da população com diagnóstico ativo de doenças neurodegenerativas, revela-se um importante contributo para delinear estratégias de intervenção especificas e direcionadas para a população-alvo e, assim, prosseguir para o estudo da qualidade de vida da pessoa portadora de doença neurodegenerativa e família

Estudo epidemiológico das doenças neurodegenerativas na Região da Guarda - Portugal

The aim was to characterize the population with neurodegenerative diseases in the region of Guarda. An epidemiological, descriptive, cross-sectional study was carried out of the user population of the Local Health Unit of Guarda, EPE, located in the Central Region of Portugal, with an active diagnosis of neurodegenerative disease, according to the International Classification of Primary Health Care - ICPC-2 : P70 - Dementia, N86 - Multiple Sclerosis - and N87 - Parkinsonism. The data source was the Regional Health Administrations Information System (SIARS), and the sample consisted of 2500 people with neurodegenerative disease. Dementia is the most prevalent of these diseases (62%), followed by Parkinsonism (32%). The proportion of active diagnoses was 1.66%. Most are women (66%), the average age is 79 (± 11.99) years, with a range of 92 years, minimum 19 and maximum 111 years. The characterization of the population with an active diagnosis of neurodegenerative diseases proves to be an important contribution to delineating specific and targeted intervention strategies for the target population and, thus, proceeding with the study of the quality of life of people with neurodegenerative diseases and their families.Objetivou-se caracterizar a população portadora de doenças neurodegenerativas da Região da Guarda. Realizou-se um estudo epidemiológico, descritivo, transversal da população utilizadora da Unidade Local de Saúde da Guarda, EPE, localizada na Região Centro de Portugal, com diagnóstico ativo de doença neurodegenerativa, segundo a Classificação Internacional de Cuidados de Saúde Primários – ICPC-2: P70 - Demência, N86 - Esclerose Múltipla - e N87 - Parkinsonismo. A fonte de dados foi o Sistema de Informação das Administrações Regionais de Saúde (SIARS), sendo a amostra constituída por 2500 pessoas portadoras de doença neurodegenerativa. A Demência é a mais predominante dessas doenças (62%), seguida do Parkinsonismo (32%). A proporção de diagnósticos ativos foi 1,66%.  A maioria são mulheres (66%), a média de idades situa-se nos 79 (± 11,99) anos, com uma amplitude de 92 anos, mínimo 19 e máximo 111 anos. A caracterização da população com diagnóstico ativo de doenças neurodegenerativas, revela-se um importante contributo para delinear estratégias de intervenção especificas e direcionadas para a população-alvo e, assim, prosseguir para o estudo da qualidade de vida da pessoa portadora de doença neurodegenerativa e família

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research