The Portuguese Sibling Study on Growth, Fitness, Lifestyle and Health.

Esta tese pretendeu descrever e interpretar a teia relacional entre fatores individuais, familiares e ambientais na forma do corpo, composição corporal, aptidão física, síndrome metabólica e estilos de vida em pares de irmãos. Amostraram-se 1583 pares de irmãos com idades compreendidas entre 9 e 20 anos; 202 pares foram seguidos durante três anos consecutivos. As variáveis utilizadas foram colhidas com protocolos estandardizados e a informação obtida foi hierarquicamente distribuída por três domínios: individual, familiar e ambiental. Os procedimentos estatísticos recorreram aos softwares SPSS, Somatotype calculation, Mplus, MIXREGLS, Supermix e STATA. Os resultados mostraram que: (1) a semelhança fraterna é maior nos irmãos do mesmo sexo comparativamente com os irmãos do sexo oposto; (2) um índice familiar de magnitude moderado foi observado no somatótipo e na agregação de marcadores de saúde (MS); (3) os fatores individuais e familiares influenciaram, em diferentes magnitudes, as características em análise. Porém, a idade cronológica, a maturação biológica e a aptidão física (AptF) associaram-se com todos os fenótipos; (4) as características ambientais relacionaram-se com a variação nos fenótipos; (5) emergiram dois perfis de MS sendo o mais prevalente (86.7%) caracterizado por menores valores de percentagem de gordura, maiores níveis de AptF e maiores scores de dieta não saudável; (6) apenas a profissão e habilitações literárias do pai associaram-se à pertença aos perfis; (7) os valores de tracking individual são mais elevados nos marcadores de obesidade comparativamente com as componentes de AptF; (8) todos os tipos de pares tendem a ser consistentes nas suas trajetórias dos marcadores de obesidade, mas nas componentes de AptF são as irmãs que se mostraram mais consistentes; (9) os estilos de vida e as características ambientais influenciam os marcadores de obesidade. Contudo, nas componentes de AptF são as características biológicas que mais afetam as suas trajetórias. Esta tese destacou um conjunto de questões e sugestões que devem ser consideradas aquando da elaboração de programas que visem a promoção de saúde em crianças e adolescentes. PALAVRAS-CHAVE: IRMÃOS, SOMATÓTIPO, ATIVIDADE FÍSICA, MARCADORES DE SAÚDE, SINDROME METABÓLICAThis thesis aimed to describe and interpret the network of relations between individual, familial and environmental factors in their body shape and composition, physical fitness, metabolic syndrome and lifestyle behaviours in sibling pairs. We sampled 1583 sibling pairs aged 9 to 20 years; 202 pairs were consecutively followed for three years. All data was collected using standardized protocols and the information was distributed over three nested domains: individual, family and environmental. Statistical procedures were done in SPSS, Somatotype calculation, Mplus, MIXREGLS, Supermix and STATA software. Results showed that: (1) fraternal similarity is greater in same-sex siblings compared to the opposite sex siblings; (2) A familial index of moderate magnitude was observed in the somatotype and in the clustering of health markers (HM); (3) individual and family factors differently associated with traits under scrutiny with different effect-sizes. However, chronological age, biological maturation and physical fitness (PF) associated with all phenotypes; (4) environmental characteristics were related with phenotype´s variation; (5) two HM profiles emerged: the most prevalent (86.7%) was characterized by lower values of percentage body fat, higher PF levels and higher unhealthy diet scores; (6) only father's occupation and educational qualifications were associated with membership in these two profiles; (7) individual tracking was higher in obesity markers compared to PF components; (8) all types of pairs tend to be consistent in their trajectories of obesity markers; however, in PF components sisters were more consistent; (9) lifestyle behaviours and environmental characteristics influenced obesity markers; however, in the PF components, were the biological characteristics that most affected sibling's trajectories. This thesis highlighted a set of issues and suggestions that need to be considered when designing health promotion programs in children and adolescents

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Physical activity, BMI and metabolic risk in Portuguese adolescents

It has been reported, in the last decades, a significant decrease in physical activity (PA) levels, with a consequent increase in obesity and metabolic risk factors among youth. The aims of this study were to describe PA levels, the prevalence of overweight/obesity and metabolic risk factors, and to examine the association between PA and body mass index (BMI) with metabolic risk among Portuguese youth. The sample comprises 212 Portuguese adolescents (12-16 years old). Height and weight were measured. PA was estimated with the Bouchard questionnaire (3 days recall), as well as with the use of a pedometer (used for 5 consecutive days). Metabolic risk factors comprised fasting glucose, triglycerides, HDL-cholesterol, systolic blood pressure and waist circumference. Subjects were classified as normal weight, overweight or obese according to BMI; the maturational status was indirectly estimated with the maturity offset procedure. A continuous metabolic risk score was computed (zMR) and PA values were divided into tertiles. Qui-square test, t-test and ANOVA were used in statistical analyses. SPSS 18.0 and WinPepi softwares were used and p<0.05. A moderate to high prevalence of overweight/obesity and HDL-cholesterol was found, as well as a high prevalence of high blood pressure and low to moderate PA levels among Portuguese youth. The relationship between BMI and zMR showed that obese adolescents have higher zMR when compared to normal weight or overweight adolescents. This finding suggests that increased levels of PA and reduction in the prevalence of overweight/obesity may have a positive role against the development of metabolic risk factors

The Oporto mixed-longitudinal growth, health and performance study. Design, methods and baseline results

Background: Studies concerning child and adolescent growth, development, performance and health aimed at the multiple interactions amongst this complex set of variables are not common in the Portuguese speaking countries. Aim: The aim of this paper is to address the key ideas, methodology and design of the Oporto Growth, Health and Performance Study (OGHPS). Subjects and methods: The OGHPS is a multidisciplinary mixed-longitudinal study whose main purpose is to examine the multiple interactions among biological, environmental and lifestyle indicators that affect growth, development, health and performance of Portuguese adolescents aged 10–18 years old. Results: This study briefly presents baseline results for growth, physical fitness and lifestyle behaviours for those participating in the cross-sectional sample (n ≈ 8000). Approximately 30% were over-fat or obese. On average, boys were more physically fit and active than girls. Few adolescents meet the guidelines for sleep duration (≈10%) and eating habits (16.2–24.8%), while 76–85% meet the recommended levels of moderate-to-vigorous physical activity. Conclusions: The OGHPS has an innovative approach due to its mixed-longitudinal design and the broad array of variables. Furthermore, subsequent analyses of the longitudinal data will enable a detailed exploration of important factors affecting the growth trajectories of health and performance variables and will also help to identify some of the most opportune times for interventions in terms of health behaviours

Association between breakfast frequency and physical activity and sedentary time : a cross-sectional study in children from 12 countries

BackgroundExisting research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites.MethodsThis multinational, cross-sectional study included 6228 children aged 9-11years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2days/week [rare], 3 to 5days/week [occasional] or 6 to 7days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200h) and afternoon (1200h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time.ResultsParticipants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated witha higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4min/day and 1.3%) than rare breakfast consumption (all p0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found.ConclusionsIn this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance.Trial registrationThe International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is registered at(Identifier NCT01722500).Peer reviewe

Management practices for postdural puncture headache in obstetrics: a prospective, international, cohort study

© 2020 British Journal of AnaesthesiaBackground: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19–1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score≤3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP

Management practices for postdural puncture headache in obstetrics : a prospective, international, cohort study

Background: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19-1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score <= 3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data