Catarina Samorinha

Portuguese children's exposure to second-hand tobacco smoke in the family car

OBJECTIVES To assess the prevalence of childrens exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. METHODS In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N=3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. RESULTS Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Childrens exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. CONCLUSIONS Childrens exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.

Factors associated with willingness to donate embryos for research among couples undergoing IVF

Between 2011 and 2012, 213 heterosexual couples undergoing fertility treatments in a Portuguese public fertility centre were systematically recruited to assess factors associated with willingness to donate embryos for research. Data were collected by questionnaire. Most couples (87.3%; 95% CI 82.1 to 91.5) were willing to donate embryos for research, citing benefits for science, health and infertile patients. Almost all couples (94.3%; 95% CI 89.8 to 96.7) reached consensus about the decision. Willingness to donate was more frequent in women younger than 36 years (adjusted OR 3.06; 95% CI 1.23 to 7.61) and who considered embryo research to be very important (adjusted OR: 6.32; 95% CI 1.85 to 21.64), and in Catholic men (adjusted OR 4.16; 95% CI 1.53 to 11.30). Those unwilling to donate reported conceptualizing embryos as children or living beings and a lack of information or fears about embryo research. Men with higher levels of trait anxiety (adjusted OR 0.90; 95% CI 0.84 to 0.96) were less frequently willing to donate. Future research on embryo disposition decision-making should include the assessment of gender differences and psychosocial factors. Ethically robust policies and accurate information about the results of human embryo research are required.

Couples' willingness to donate embryos for research: a longitudinal study

Decision‐making on embryo disposition is a source of distress and is subject to change over time. This paper analyzes the willingness of couples undergoing in vitro fertilization to donate cryopreserved embryos for research from 15 days after embryo transfer to 12 months later, taking into account the influence of psychosocial, demographic, and reproductive factors.

Paternal Adjustment and Paternal Attitudes Questionnaire: Antenatal and Postnatal Portuguese Versions.

The Paternal Adjustment and Paternal Attitudes Questionnaire (PAPA) was designed to assess paternal adjustment and paternal attitudes during the transition to parenthood. This study aimed to examine the psychometric characteristics of the Portuguese versions of the PAPA-Antenatal (PAPA-AN) and -Postnatal (PAPA-PN) versions. A nonclinical sample of 128 fathers was recruited in the obstetrics outpatient unit, and they completed both versions of the PAPA and self-report measures of depressive and anxiety symptoms during pregnancy and the postpartum period, respectively. Good internal consistency for both PAPA-AN and PAPA-PN was found. A three-factor model was found for both versions of the instrument. Longitudinal confirmatory factor analysis revealed a good model fit. The PAPA-AN and PAPA-PN subscales revealed good internal consistency. Significant associations were found between PAPA (PAPA-AN and PAPA-PN) and depressive and anxiety symptoms, suggesting good criterion validity. Both versions also showed good clinical validity, with optimal cutoffs found. The present study suggested that the Portuguese versions of the PAPA are reliable multidimensional self-report measures of paternal adjustment and paternal attitudes that could be used to identify fathers with adjustment problems and negative attitudes during the transition to parenthood.

Prevalência do consumo de tabaco em adolescentes escolarizados portugueses por sexo: podemos estar otimistas?

INTRODUCTION According to the MPOWER approach adopted in 2008 by the WHO, monitoring smoking epidemics is necessary in order to assess the effectiveness of the preventive measures used in smoking control in adolescents and adults. OBJECTIVES To determine the prevalence of smoking in Portuguese school-aged adolescents by region. MATERIAL AND METHODS The sample is made up of 8764 students, 4060 boys and 4704 girls, and is representative of the Portuguese students in regular public education. The data was collected in the 2008/2009 academic year, through a quantitative self-report questionnaire. RESULTS In the total sample, 10.2% of boys and 9.1% of girls are regular smokers. Smoking increases with age. At 15 years old 12.3% of the boys and 8.6% of the girls are regular smokers and 6.1% of the boys and 4.0% of the girls are occasional smokers. Looking at prevalence by region, the highest prevalence of regular smoking is found in Alentejo (14.7%), followed by Azores (11.8%) and the lowest is found in Algarve (4.1%). CONCLUSIONS The prevalence of smokers among Portuguese school-aged adolescents varies within the several regions of the country, similar to what happens in the adult Portuguese population.

Prevalence of secondhand smoke exposure in asthmatic children at home and in the car: A cross-sectional study.

OBJECTIVE To compare secondhand smoke exposure (SHSe) prevalence at home and inside the car between asthmatic and non-asthmatic Portuguese children. MATERIALS AND METHODS This is a cross-sectional study that assessed childrens SHSe in a representative sample of nine Portuguese cities. A validated self-reported questionnaire was administered to a random sample of 4th grade students during the school year of 2010/2011. The asthma prevalence was defined by the answers to three questions regarding asthma symptoms, medication and inhaler use. We performed chi-square tests and analysed frequencies, contingency tables, confidence intervals, and odd-ratios. RESULTS The self-reported questionnaire was administered to 3187 students. Asthma prevalence was 14.8% (472 students). Results showed that 32.3% of non-asthmatic children and 32.4% of asthmatic children were exposed to secondhand smoke as at least one of their household members smoked at home. The prevalence of parental smoking, smoking among fathers and smoking among mothers at home was also similar in both groups (asthmatic and non-asthmatic children). SHSe inside the car was 18.6% among non-asthmatic children and 17.9% among asthmatic children. CONCLUSIONS Asthmatic and non-asthmatic children were equally exposed to secondhand smoke, because no significant differences were found between the two groups concerning the prevalence of SHSe at home and inside the car. These findings highlight the need to include SHSe brief advice in paediatric asthma management.

Opinions on a car smoking ban: a needed guide for public health decision-makers

This study was supported through FEDER from the Operational Programme Factors of Competitiveness COMPETE and through national funding from the Foundation for Science and Technology FCT (Portuguese Ministry of Education and Science) (FCOMP-01-0124-FEDER-009117).

Consentir na criopreservação de embriões: perceção de casais usuários de medicina da reprodução

Este estudo qualitativo analisou as percecoes de casais quanto aos fatores que contextualizam o consentimento livre e esclarecido na criopreservacao de embrioes, a partir de 34 entrevistas semiestruturadas, em Portugal. Analisaram-se os dados segundo os principios da grounded theory. Dos resultados emergiram as seguintes necessidades: provisao de informacoes detalhadas, rigorosas, coerentes e no tempo adequado sobre os custos e duracao da criopreservacao e o destino dos embrioes; reforco da privacidade fisica; tempo para refletir sobre o destino dos embrioes e a divulgacao da identidade dos beneficiarios. As condicoes de aplicacao do consentimento parecem ameacar tres dos seus elementos fundamentais: informacao, voluntarismo e ponderacao. Importa desenvolver orientacoes etico-profissionais que assegurem um consentimento assente em praticas de aconselhamento e prestacao de informacao adequadas as necessidades e expectativas dos pacientes.

Traffic risk behaviour: an observational study of drivers’ behaviour in Braga (Portugal)

Traffic accidents are a serious public health problem which causes a high number of deaths and injuries. In Portugal, 32,299 traffic accidents involving victims (accidents involving at least one injured person), 554 accidents involving deaths and 2148 accidents involving severe injuries occurred in 2016.1 The use of cell phones and tobacco consumption cause traffic accidents, whose consequences are aggravated if passengers fail to use seat belts.2 Using a cell phone while driving (whether it is used with or without a hands-free system) causes visual, auditive, physical and cognitive distraction. Tobacco consumption negatively affects the health of the driver and the other passengers in the vehicle (particularly children) by the high concentrations of tobacco smoke inside the car, and it is also a distracting factor that compromises driving.3 Several studies have shown that using a seat belt is associated to a drastic reduction on the number of accidents and injuries. Many traffic accidents could be avoided by modifying these behaviors. The present study aimed to describe drivers’ risk behaviors in the city of Braga (Portugal), namely the use of cell phone, tobacco consumption and failure to use seat belts while driving. This is an observational study conducted between December 2016 and January 2017 which followed the validated methodology of Martínez-Sánchez et al.4 The observers registered the behavior of the first five drivers who stopped at a red light traffic in Avenida João XXI, Avenida 31 de Janeiro, Rua da Estrada Nova, and EN 103 (Braga, Portugal). Motorcycles, mopeds and non-motor vehicles were excluded from the study. The observation focused on the use of cell phones, tobacco consumption (lit cigarettes), and failure to use seat belts by the driver of the vehicle. Descriptive analysis was performed. Among the 705 conductors observed, 70 (9.8%) used a cell phone, 50 (7.1%) did not use a seat belt, and 39 (5.5%) smoked while driving. There is still a significant percentage of drivers who adopt risk behaviors while driving. Greater police attention is needed to prevent non-compliance with the law regarding the use of cell phones and driving without seat belts. However, it still does not exist a ban on smoking inside the cars in Portugal. Car smoking bans should be similar to other restrictions on drivers’ behavior that are critical for public health and safety, such as the driving ban under the influence of alcohol or other drugs. Studies show that over 90% of respondents agree with a car smoking ban, especially with children on board.5 Creating campaigns to highlight the importance of banning tobacco consumption inside the car would be useful, not only to increase awareness about the negative effects of smoking on the driver’s health and on the road traffic safety, but also as a way to collect signatures to present this ban at the Portuguese Parliament.

Self-reported psychosocial factors among in vitro fertilization patients interviewed alone or with the partner

Abstract The purpose of this study was to compare the sociodemographic and psychosocial characteristics reported by female in vitro fertilization (IVF) patients interviewed alone or with the partner in heterosexual couples. During 12 months (2011–2012), all patients undergoing IVF or intracytoplasmic sperm injection at one public reproductive medicine unit, in Portugal, were interviewed on the day of the diagnosis of pregnancy, being recruited 221 women interviewed with the partner and 92 interviewed alone. Interviewers collected data on sociodemographic and obstetric characteristics; and anxiety, depression, social support and partner relationship were collected by self-administered questionnaires. χ2 test was used to assess the independent association between the categorical variables and being interviewed alone or with the partner. For continuous variables, mean or median differences were compared by the t-test or the Mann–Whitney test, according to data distribution. No statistically significant differences were found in the self-reporting of depression, anxiety, social support and partner relationship or in sociodemographic and obstetric characteristics between women interviewed alone or with the partner. Although women interviewed alone were older and more frequently had children than women interviewed with the partner, no significant associations were observed. Thus, having a male partner present in the research setting during a self-administered questionnaire seems not to influence women’s responses to psychosocial measures. Other outcomes and settings need to be evaluated to support evidence-based guidelines for research on infertility.