Programa digital para la conciencia fonológica: un estudio aleatorizado

The purpose of this study is to analyze the efficacy of the Phonological Awareness Digital Program (PADP) in typically developing preschool children aged 4 to 6 years. A randomized controlled trial was conducted with a total of 49 children assigned to two groups: the experimental group, EG (n=25) and the delayed control group, CG (n=24). Both groups were assessed before and after the implementation of the PADP. A follow-up study for the experimental group was also performed after two months. Outcome measures of phonological awareness skills (task 1: Syllable segmentation task; task 2: Syllable identification task; task3: Syllable omission task; task 4: Onset-rime units segmentation task; task 5: Phoneme segmentation task; task 6: Phoneme blending task) were evaluated at three separate moments. The results showed significant improvement in phonological awareness skills for the EG between the first and the second assessments for all the tasks considered. Between the second and third assessment, the results showed a significant improvement for the CG. The follow-up study also demonstrated the PADP’s efficacy. The PADP has shown to be an effective program in promoting the development of phonological awareness in children. These findings provide evidence for different professionals to use PADP with preschool children.El propósito de este estudio es analizar la eficacia del Programa Digital de Conciencia Fonológica (PADP) en niños en edad preescolar con desarrollo típico de 4 a 6 años. Se realizó un ensayo controlado aleatorio con un total de 49 niños asignados a dos grupos: el grupo experimental, GE (n = 25) y el grupo de control retardado, GC (n = 24). Ambos grupos fueron evaluados antes y después de la implementación del PADP. También se realizó un estudio de seguimiento para el grupo experimental después de dos meses. Medidas de resultado de las habilidades de conciencia fonológica (tarea 1: tarea de segmentación de sílabas; tarea 2: tarea de identificación de sílabas; tarea 3: tarea de omisión de sílabas; tarea 4: tarea de segmentación de unidades de inicio-tiempo; tarea 5: tarea de segmentación de fonemas; tarea 6: tarea de combinación de fonemas) fueron evaluados en tres momentos separados. Los resultados mostraron una mejora significativa en las habilidades de conciencia fonológica para el GE entre la primera y la segunda evaluación para todas las tareas consideradas. Entre la segunda y la tercera evaluación, los resultados mostraron una mejora significativa para el GC. El estudio de seguimiento también demostró la eficacia del PADP. El PADP ha demostrado ser un programa eficaz para promover el desarrollo de la conciencia fonológica en los niños. Estos hallazgos proporcionan evidencia para que diferentes profesionales utilicen PADP con niños en edad preescolar.publishe

Physicians' perceptions of psychosocial factors and coping strategies in their ability to work: a multivariate analysis

Background/Objective: Physicians play a crucial role in healthcare systems but face negative impacts from a challenging work environment, leading to burnout. Burnout has negative effects on physician health and patient care. Understanding psychosocial aspects of work and coping strategies used by physicians is essential. Validated tools, including COPSOQ-II, BriefCOPE, and WAI scales, can provide insight into the psychosocial impact of the medical profession. The study aims to use these scales to explore the relationship between job demands (COPSOQ-II), coping strategies (BriefCOPE), and work ability (WAI) among Portuguese physicians. Methods: Participants were recruited through professional associations and organizations with access to physicians, and data was collected via a self-administered web-based questionnaire. Participants’ sociodemographic characteristics were associated with WAI scores through Chi-Square analysis and One-way ANOVA. Outliers were detected through sensitivity analysis, and exploratory and confirmatory factor analyses were performed for the COPSOQ-II and BriefCOPE scales. Associations between WAI scores and COPSOQ-II and BriefCOPE scales were also analyzed. Results: The study surveyed 55 physicians and found that except for sex, there were no significant differences in the work ability index (WAI) by sociodemographic characteristics. Significant differences were found between WAI and higher scores in job purpose, quality of management, and general health, while higher stress, sleep issues, and depressive symptoms were associated with lower WAI groups. Exploratory (EFA) and confirmatory factorial analyses (CFA) were conducted on the BriefCOPE and COPSOQ-II scales, revealing disconnection with the theoretical model. Under EFA, the BriefCOPE items related to theoretical dimension of "dysfunctional coping" are scattered into other coping dimensions, and the empirical model of the COPSOQ-II scale presented a different configuration from its theoretical model, either in the number of dimensions or in the distribution of items by their dimensions. Under CFA, these differences between the theoretical and empirical models are even clearer, as neither dataset fits to its theoretical counterpart without changes. In BriefCOPE, removing self-blaming is sufficient to correct this, while in COPSOQ, a minimum of 9 dimensions needed to be excluded. Even then this result presents unacceptable CFI(Comparative Fit Index), TLI(Tucker-Lewis Index) and RMSEA(Root Mean Square Error of Approximation) values. Conclusions: This study analyzed physician perceptions of workplace environment and job-related and psychosocial factors using a questionnaire. However, the results did not provide any significant findings, and only suggested some possible associations between certain workplace factors, coping abilities, and work ability. The study had a small sample size and further research with larger sample sizes is needed to confirm these findings.publishe

Neuromuscular electrostimulation vs traditional therapy in the stroke patient with oropharyngeal dysphagia: effects on quality of life - randomized study

Oropharyngeal dysphagia (OD) is common after stroke. Its presence submits the patient to clinical instability, which can cause complications such as aspiration pneumonia, dehydration, malnutrition and death. The objective was to compare effectiveness of traditional therapy (TT) with associated NMES versus traditional therapy in the rehabilitation of patients with OD after stroke and the effects on their quality of life (QOL). We have observed that in the EG, there is a trend towards a faster recovery of OD, reaching the level 7 of the FOIS scale about a week before the CG. Regarding QOL, it was possible to observe that the patients of both groups, when recovering from DO improved their QOL and that the EG tends to present better results.publishe

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

Characterization of the epidemiological curve of the 1st wave of the pandemic: study of the determinants for death and hospitalization due to COVID-19 in Portugal

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that emerged in China and has since spread rapidly to all countries in the world. The aim of this study is to characterize the peak of the first wave of the pandemic in Portugal using some demographic and clinical determinants. The database studied contains epidemiological surveillance data of COVID-19 from Portugal until June 30, 2020. The peak of the pandemic was determined considering the number of diagnoses, deaths, and hospitalizations over time, and the estimated period for the first wave was between March 19 and April 24. Multivariable logistic regression models were performed to estimate the Odds Ratio (OR) and the respective 95% confidence intervals (95% CI) for this period and for each of the variables considered in relation to both study outcomes: mortality (5.8%) and hospitalization (18.8%). The main risk factors considered for the mortality outcome were: Age Group (≥ 80 years: OR = 11.98; 65-79 years: OR = 4.06; reference group: <64 years), Hospitalization (OR = 6.48) and Comorbidities (OR = 5.74). For the outcome hospitalization, the main risk factors were: Age Group (≥ 80 years: OR = 8.54; 65-79 years: OR = 3.90; reference group: <64 years), male gender (OR= 1.58) and Comorbidities (OR = 5.19). The proposed models presented high area under the curve (AUC) results (mortality: AUC=91.1%; and hospitalization: AUC=84.5%), with small amplitudes in the 95% CI. The present study demonstrated that, overall, the major risk factors associated with worse prognostics of COVID-19 were advanced age (over 65 years), and the existence of comorbidities. For the risk of hospitalizations, the male gender was also a significant risk factor.in publicatio

Cross-sectional study to investigate the presence of sarcopenic dysphagia in a Portuguese geriatric population

Oropharyngeal Dysphagia (OD) and sarcopenia have been recognized as geriatric syndromes and have shown a higher prevalence in institutionalized elderly, being associated with increased socioeconomic burdens. The objectives were to investigate the presence of sarcopenia and risk of OD in a geriatric population and to analyse the relationship between the factors associated with Sarcopenic Dysphagia (SOD). We have observed that female gender, low educational level and score ≥4 on the SARC-F screening test are associated with higher odds of being at risk for OD, sarcopenia, and even probable SOD. Based on the results, we suggested including a Speech and Language Therapist in the multidisciplinary geriatric teams in order to improve the prevention of OD, sarcopenia and SOD, avoiding its consequences.publishe

Are coping and workplace psychosocial factors related to work ability in physicians? A PLS-SEM approach

Background/Objective: Over the last few years, new statistical techniques have been developed in the context of multivariate analysis, which are proving to be very useful in the social or health sciences, even marketing. The aim of this work was to study the interplay between 3 scales: BriefCOPE for evaluating coping strategies; COPSOQII for assessing psychosocial factors; and WAI for assessing work ability. Methods: Considering a subpopulation of physicians (n=35) we applied the Partial Least Squares Structure Equations Modelling (PLS-SEM) technique to study the relation between the 3 scales. Results: Regarding the analysis of BriefCOPE and WAI, the only BriefCOPE domain significantly related to WAI was ‘Strategies focused on emotions’ (β=0.329;p=0.038). In COPSOQII and WAI analysis, the COPSOQII domain ‘Health and wellness’ was significantly associated with WAI (β= 0.599; p<0.001) with a strong effect. In final model regarding the three scales, we could observe that the apparent relationship between WAI and ‘Strategies focused on emotions' (BriefCOPE) is mediated by the COPSOQII domain ‘Health and wellness’ (p = 0.047), which shows that there is small effect between the BriefCOPE and WAI. Conclusions: This study is the first to test relationships between these three scales simultaneously. Using a PLS-SEM approach to analyse the data, the results of the present study highlight the central role of ‘Health and wellness’ in work ability and in the mediation between coping ‘Strategies focused on emotions’ and work ability. These data suggest that employers should implement organizational policies that enhance health and well-being in order to achieve better performance from their employees.publishe

Os efeitos do Kinesio Taping em pacientes com osteoartrite no joelho: revisão bibliográfica

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em FisioterapiaA osteoartrite é a causa mais frequente de doença crónica musculosquelética, constituindo uma das principais causas para a limitação das atividades diárias. Objetivo: investigar, através de uma revisão bibliográfica, os efeitos do Kinesio Taping em pacientes com osteoartrite do joelho. Metodologia: Foi efetuada uma pesquisa nas bases de dados da PubMed, PEDro e Web of Science. A qualidade metodológica dos estudos foi analisada através da Escala Critical Appraisal Skills Programme (CASP). Resultados: Foram incluídos 7 artigos, com um total de 556 participantes, com idades compreendidas entre 55 e 70 anos com uma qualidade metodológica média de 9. Num dos artigos, o kinesio tape não demonstrou qualquer tipo de efeito, no entanto, nos outros 6 artigos os resultados foram significativos. Conclusão: O Kinesio Taping demonstrou produzir efeitos significativos no tratamento da osteoartrite, diminuindo a dor e melhorando os movimentos dos pacientes, o que resultou numa diminuição do consumo de analgésicos.Osteoarthritis is the most frequent cause of chronic musculoskeletal disease and is one of the biggest causes of limitation of daily activities. Purpose: To investigate, through a bibliographic review, the effects of Kinesio Taping in patients with knee osteoarthritis. Methodology: A search was conducted in the databases PubMed, PEDro and Web of Science. The methodological quality of the studies was analyzed by using the Critical Appraisal Skills Program (CASP). Results: Seven articles were included, with a total of 556 participants, aged between 55 and 70 years old with an average methodological quality of 9. In one of the articles the kinesio taping showed no effect, however, in the other 6 articles, the results were significant. Conclusion: Kinesio Taping has demonstrated to produce significant effects in the treatment of osteoarthritis, decreasing pain and improving patients’ movements, which resulted in a reduction of the use of painkillers.N/

Coping strategies and psychosocial factors at work of dietitians/nutritionists: a multivariate analysis approach

Background/Objective: Dietitians and nutritionists, like many healthcare professionals, frequently experience stress, which can be influenced by coping strategies (BriefCOPE) and the psychosocial work environment (COPSOQ-II) and their impact on work ability and stress levels (WAI). The main objective of this short paper is to examine how BriefCOPE and COPSOQ-II scales can be used to study coping with work-related stress among dietitians and nutritionists (n=301), with a focus on exploring the relationship among these scales and WAI. Methods: BriefCOPE is a self-report measure of coping strategies, and it evaluates various coping strategies, including problem-solving, positive reframing, and avoidance coping. COPSOQ-II is a questionnaire that assesses various psychosocial factors related to the work environment, including job demands, job control, social support, and rewards. WAI is a tool used to assess an individual's work ability, considering their health status, physical and mental demands, and work-related resources. BriefCOPE and COPSOQ-II multivariate outliers were removed based on Mahalanobis distance. The sociodemographic characteristics, the BriefCOPE (n=285) and COPSOQ-II (n=233) scales association with WAI scores were analysed through Chi-Square, Kruskal-Wallis and one-way Analysis of Variance (ANOVA) tests. Exploratory (EFA) and confirmatory (CFA) factor analyses were conducted for both scales. Data was analysed using the R software. Results: BriefCOPE and COPSOQ-II dimensions were obtained, and the WAI scores was reduced to three levels: “Poor/Moderate” (n=69; 22.9%), “Good” (n=158; 52.5%), and “Excellent” (n=74; 24.6%). About BriefCOPE and COPSOQ-II dimensions, association with WAI scores revealed 8 and 22 dimensions, respectively, with statistically different distribution among WAI categories. In exploratory factor analysis, for BriefCOPE scale the best model selected was constituted by 4 factors and explained 57% of variance, and for COPSOQ-II scale the best model was constituted by 7 factors and explained 64% of variance. In confirmatory factor analysis, the best models selected for each scale demonstrated better fit values in comparison with the theoretical models. Conclusions: Most of the BriefCOPE and COPSOQ-II dimensions revealed statistically different distribution among WAI categories for the dietitians and nutritionists group. The excellent work capacity is related to the situation of “I almost always do this” for the dimensions of “Active coping”, and “Positive reinterpretation” for BriefCOPE, and with the situations of “Never/almost never” or “Rarely” for the dimensions of “Role conflicts”, “Work/Family conflict”, “Stress”, “Sleeping troubles”, “Depressive symptoms”, and “Bullying” for COPSOQ-II. This indicates that individuals with excellent work capacity frequently experienced active coping and positive reinterpretation, and never or rarely experienced stress, sleeping issues, burnout, and depressive symptoms. For both scales, EFA presented different factor structures when compared to the theoretical ones. Our data do not fit the theoretical models of BriefCOPE and COPSOQ-II scales, but present good results for the models proposed by EFA.publishe

Goal setting for cerebral palsy children in context therapy: improve reliability when linking to ICF

The linking process of information to ICF is a common task in different strategies used in rehabilitation practise but is a time consuming process mainly due to reliability issues. This work aims to developed additional rules to those already published in order to improve reliability of the linking process to ICF. The results are encouraging and these work could help to develop in formation technologies tools for facilitate this process