Rafaela Rosário

The Impact of an Intervention Taught by Trained Teachers on Childhood Overweight

The purpose of this study was to assess the effects of a six-months’ nutrition program, delivered and taught by classroom teachers with in-service nutrition training, on the prevention of overweight and obesity among children in grades 1 to 4. In this randomized trial, four hundred and sixty four children from seven elementary schools were allocated to a nutrition educational program delivered by their own teachers. Intervened teachers had 12 sessions of three hours each with the researchers throughout six months, according to the topics nutrition and healthy eating, the importance of drinking water and healthy cooking activities. After each session, teachers were encouraged to develop activities in class focused on the learned topics. Sociodemographic, anthropometric, dietary, and physical activity assessments were performed at baseline and at the end of the intervention. In the intervention group the increase in Body Mass Index (BMI) z-score was significantly lower than in the control group (p = 0.009); fewer proportion of children became overweight in the intervened group compared with the control (5.6% vs. 18.4%; p = 0.037). Our study provides further support to decrease the overweight epidemic, involving classroom teachers in a training program and making them dedicated interventionists.

The impact of an intervention taught by trained teachers on childhood fruit and vegetable intake: A randomized trial

Our study aimed to assess the impact of a six-months nutrition program, taught by trained teachers, on fruit and vegetable consumption among children in grades 1 to 4. Four hundred and sixty-four children (239 female), 6 to 12 years old, from seven elementary schools were assigned to this randomized trial. Teachers were trained by researchers over six months, according to the following topics: nutrition, healthy eating, and strategies to increase physical activity. After each session, teachers were encouraged to develop activities in the classroom on the topics learned. Childrens sociodemographic, anthropometric, dietary, and physical activity data were assessed at baseline and at the end of the intervention. The effect sizes ranged between small (Cohens d = 0.12 on “other vegetables”) to medium (0.56 on “fruit and vegetable”), and intervened children reported a significantly higher consumption of vegetables and fruit. Interventions involving trained teachers offer promise to increase consumption of fruit and vegetable in children.

Impact of an intervention through teachers to prevent consumption of low nutrition, energy-dense foods and beverages: a randomized trial.

OBJECTIVE To examine the effects of an intervention program held by teachers previously trained in nutrition, on the consumption of low nutrient, energy-dense (LNED) foods, of children attending elementary schools. METHOD 464 children (239 female, 6 to 12 years) from seven elementary Portuguese schools participated in this randomized trial. Three schools were allocated to the intervention, and four to the control group. The intervention program was based on the Health Promotion Model and social cognitive theory. Teachers previously trained by researchers in nutrition and healthy eating implemented the intervention in the classroom from November 2008 to March 2009. Sociodemographic, anthropometric, physical activity, and dietary assessments were performed before (2007/2008) and at the end of the intervention (2009). Dietary intake was gathered by a 24-hour dietary recall and two groups of LNED foods were defined, namely SSBs and solid LNED foods. RESULTS Children from intervention group reported a reduction whereas the control group reported an increase in solid LNED foods consumption. The odds of increasing solid LNED foods consumption was 0.48, 95%CI (0.24, 0.95) in the intervention schools. CONCLUSION Our study provides further support for the success of intervention programs aimed at limiting the consumption of solid LNED foods in children.

Adherence to the Mediterranean diet in children: Is it associated with economic cost?

HighlightsThe average diet cost was 4.58&U20AC; (SD = 1.24) in 6–12 years‐old children.Diet cost calculations were based on food prices information from 2011.Most children reported medium (69.1%) or high (4.6%) adherence to Mediterranean diet.Higher adherence to Mediterranean diet was associated with higher diet cost. Objective: To assess how the diet cost is associated with socio‐demographic factors and adherence to Mediterranean diet in children. Methods: Data were obtained from a community‐based survey of children selected from public elementary schools in Portugal. Of a total of 586 children attending these schools, 464 (6–12 years), were studied. Dietary intake was assessed by a 24 hour recall and the adherence to Mediterranean diet was evaluated through the KIDMED index. The cost of the diet was calculated based on the collection of food prices of a national leader supermarket, and expressed as Total Daily Cost (TDC) and Total Daily Cost‐Adjusted for Energy (TDEC). Anthropometric measures were taken and socio‐demographic data were gathered from a questionnaire filled by parents. Logistic regression was used to quantify the association between diet cost, socio‐demographics and adherence to Mediterranean diet. Results: The average TDC was 4.58&U20AC; (SD = 1.24). Most children (69.1%) reported medium adherence to Mediterranean diet, and 4.6% rated the higher score. TDC was higher for children with highest adherence to Mediterranean diet, compared to those with lowest adherence [TDC: OR = 5.70 (95% CI 1.53, 21.33), p for trend = 0.001; TDEC: OR = 2.83 (95% CI 0.89, 8.96, p for trend 0.018)]. No meaningful variation in the diet cost with age and parental education was observed. Conclusion: Higher adherence to Mediterranean diet was associated with higher diet cost in children.

Optimal adherence to a mediterranean diet may not overcome the deleterious effects of low physical fitness on cardiovascular disease risk in adolescents: a cross-sectional pooled analysis

To examine the combined association of cardiorespiratory fitness (CRF), muscular fitness (MF), and adherence to a Mediterranean diet (MeDiet) on cardiovascular risk in adolescents, a pooled study, including cross-sectional data from two projects [2477 adolescents (1320 girls) aged 12–18 years], was completed. A shuttle run test was used to assess CRF. MF was assessed by the standing-long jump and handgrip tests. Adherence to a MeDiet was assessed by the Kidmed questionnaire. A cardiovascular risk score was computed from the following components: Age and sex, waist circumference, triglycerides, systolic blood pressure, high-density lipoprotein cholesterol (HDL), and glucose. Analysis of covariance showed that participants classified as having optimal (High) adherence to a MeDiet/HighMF/HighCRF, as well those classified as low adherence to a MeDiet/HighMF/HighCRF, had, on average, the lowest cardiovascular risk score (F = 15.6; p < 0.001). In addition, the high adherence to a MeDiet/LowMF/LowCRF group had the highest odds of having a high cardiovascular risk (OR = 7.1; 95% CI: 3.4–15.1; p < 0.001), followed by the low adherence to a MeDiet/LowMF/LowCRF group (OR = 3.7; 95% CI: 2.2–6.3; p < 0.001), high adherence to a MeDiet/HighMF/LowCRF group (OR = 3.1; 95% CI: 1.4–7.0; p = 0.006), and low adherence to a MeDiet/LowMF/HighCRF group (OR = 2.5; 95% CI: 1.5–4.4; p = 0.002) when compared to those with high adherence to a MeDiet/HighMF/HighCRF, after adjustments for potential confounders. In conclusion, our findings showed that, regardless of the MeDiet status, adolescents with low MF and low CRF cumulatively, presented the highest cardiovascular disease risk. Therefore, these findings suggest that the combination of these two fitness components may be beneficial to adolescents’ cardiometabolic profile, independent of MeDiet behaviour.

Health promotion intervention to improve diet quality in children: A randomized trial

Objective. This study aims to evaluate the impact of an intervention program, taught by trained teachers, on foods and nutrients components of the Diet Quality Index–International among children in Grades 1 to 4. Method. A total of 464 children (239 female, 6-12 years) from seven elementary Portuguese schools participated in this randomized trial. Three schools were allocated to the intervention, and four to the control group. The intervention program was based on the health promotion model and social cognitive theory. Teachers previously trained by researchers in nutrition, healthy eating, and healthy cooking implemented the intervention in the classroom from November 2008 to March 2009. Sociodemographic, anthropometric, physical activity, and dietary assessments were performed before (2007/2008) and at the end of the intervention (2009). Dietary intake was gathered by a 24-hour dietary recall and the components of Diet Quality Index–International were defined. Results. Children from the intervention schools reported a significantly higher adequacy in vegetable consumption (p = .018) and a significantly higher moderation in sodium consumption (p = .032) compared with the controllers. Conclusion. Our study provides further support for the success of intervention programs that aim to enhance children’s dietary intake. Implementing similar interventions can be promising to support vegetable consumption and moderate sodium intake.

Intervention in social skills and bullying

OBJECTIVE to verify if the improvement of social and emotional skills reduces bullying victimization in 6th grade students 12 months after the end of the intervention. METHOD Quasi-experimental study with 78 students who were bullying victims. A cognitive behavioral intervention based on social skills was conducted with the intervention group. The eight sessions addressed politeness, making friendships, self-control, emotional expressiveness, empathy, assertiveness and solution of interpersonal problems. Data were analyzed using Poisson regression with random effect. RESULTS Quasi-experimental study with 78 students who were bullying victims. A cognitive behavioral intervention based on social skills was conducted with the intervention group. The eight sessions addressed politeness, making friendships, self-control, emotional expressiveness, empathy, assertiveness and solution of interpersonal problems. Data were analyzed using Poisson regression with random effect. CONCLUSION Social skills are important in anti-bullying interventions and can be the basis for intersectoral interventions in the health area, aimed at favoring the empowerment of victims by improving their social interactions and quality of life in school.

Impact of a healthy lifestyle intervention program during pregnancy on women and newborn: STUDY PROTOCOL for a quasi-experimental study

Abstract Physical activity during pregnancy assumes an important role in the health of both the pregnant and newborn. Given that physical activity tends to decrease throughout this period, it is essential to inform and encourage pregnant women to acquire healthy lifestyles, enabling them to improve their physical and psychological well-being. This study aims to evaluate the impact of an intervention program on pregnant, newborn, and gestation outcomes, by increasing physical activity levels during this important period of womans life. This study will be conducted with 410 pregnant women in the first trimester. Participants will be recruited through the central hospital or community centers. Following consent and baseline data collection, pregnant women who do not have any medical or obstetric contraindication for physical exercise, will be assigned to the control or intervention groups. There will be 3 assessment periods: baseline (time 1—between the 7th and 10th week of gestation), after the intervention (time 2—between the 1st and 3rd day after delivery), and follow-up (time 3—1 month after delivery). The intervention group will have an intervention program, which comprises 2 terms: (1) teachers’ training delivered by researchers and (2) intervention delivered to pregnant women by trained teachers, which consists in 3 weekly classes of physical exercise (45/50 min each). The control group will have the standard care that is usually provided by health professionals. The research has been approved by the Subcommittee on Ethics for the Life Sciences and Health of the University of Minho (id: SECVS 086/2015) and by the Ethics Committee for Health from the Central Hospital (id: 056/2014). There is a registration in clinical trials.gov, with the reference NCT03045237 (02/2017). This study has the potential to increase pregnants physical activity levels and contribute to programs and policies developed to optimize lifestyles during pregnancy and with implications in newborn outcomes.

Body Mass Index Categories and Attained Height in Portuguese Adults

Objective: To analyze the associations between height and BMI categories in a Portuguese representative sample. Methods: This is a cross-sectional study with a representative sample of 32,644 Portuguese adults (52.4% females). Sociodemographic and lifestyle characteristics were obtained along with self-reported height and weight. We performed generalized linear models to assess the differences in attained height across BMI categories; analyses were adjusted for age, gender, education, family income per month, proxy reporting information, dietary patterns, and smoking. Results: BMI categories included underweight and normal weight (46.4%), overweight (37.6%), obese class I and II (15.2%), and obese class III (0.8%). Adults with normal weight had a significantly higher height (females +7 cm and males +5 cm) when compared to obese class III. As BMI categories increased, height decreased. In females and males, after adjusting for confounders, estimates of attained height decreased when compared to the unadjusted model (β = -0.049, 95% CI = -0.050; -0.049 and β = -0.030, 95% CI = -0.031; -0.029, respectively), although they remained still significant. Conclusion: Our results suggest a significant difference in attained height between BMI categories. Future intervention programs aiming at preventing overweight and obesity should monitor sociodemographic, health and environmental conditions that affect attained height potential.

Partnership between the school of nursing and the hospital: supervisors' perspectives

Table of contentsS1 Health literacy and health education in adolescenceCatarina Cardoso TomásS2 The effect of a walking program on the quality of life and well-being of people with schizophreniaEmanuel Oliveira, D. Sousa, M. Uba-Chupel, G. Furtado, C. Rocha, A. Teixeira, P. FerreiraS3 Diagnosis and innovative treatments - the way to a better medical practiceCeleste AlvesS4 Simulation-based learning and how it is a high contributionStefan GisinS5 Formative research about acceptability, utilization and promotion of a home fortification programme with micronutrient powders (MNP) in the Autonomous Region of Príncipe, São Tomé and PríncipeElisabete Catarino, Nelma Carvalho, Tiago Coucelo, Luís Bonfim, Carina SilvaS6 Safety culture of the patient: a reflexion about the therapeutic approach on the patient with vocal pathologyDébora FrancoS7 About wine, fortune cookies and patient experienceJesús Alcoba GonzálezO1 The psychological impact on the emergency crews after the disaster event on February 20, 2010Helena G. Jardim, Rita SilvaO2 Musculoskeletal disorders in midwivesCristina L. Baixinho, Mª Helena Presado, Mª Fátima Marques, Mário E. CardosoO3 Negative childhood experiences and fears of compassion: Implications for psychological difficulties in adolescenceMarina Cunha, Joana Mendes, Ana Xavier, Ana Galhardo, Margarida CoutoO4 Optimal age to give the first dose of measles vaccine in PortugalJoão G. Frade, Carla Nunes, João R. Mesquita, Maria S. Nascimento, Guilherme GonçalvesO5 Functional assessment of elderly in primary careConceição Castro, Alice Mártires, Mª João Monteiro, Conceição RainhoO6 Smoking and coronary events in a population of Spanish health-care centre: An observational studyFrancisco P. Caballero, Fatima M. Monago, Jose T. Guerrero, Rocio M. Monago, Africa P. Trigo, Milagros L. Gutierrez, Gemma M. Milanés, Mercedes G. Reina, Ana G. Villanueva, Ana S. Piñero, Isabel R. Aliseda, Francisco B. RamirezO7 Prevalence of musculoskeletal injuries in Portuguese musiciansAndrea Ribeiro, Ana Quelhas, Conceição MansoO8 Hip fractures, psychotropic drug consumption and comorbidity in patients of a primary care practice in SpainFrancisco P. Caballero, Jose T. Guerrero, Fatima M. Monago, Rafael B. Santos, Nuria R. Jimenez, Cristina G. Nuñez, Inmaculada R. Gomez, Mª Jose L. Fernandez, Laura A. Marquez, Ana L. Moreno, Mª Jesus Tena Huertas, Francisco B. RamirezO9 The role of self-criticism and shame in social anxiety in a clinical SAD sampleDaniel Seabra, Mª Céu SalvadorO10 Obstruction and infiltration: a proposal of a quality indicatorLuciene Braga, Pedro Parreira, Anabela Salgueiro-Oliveira, Cristina Arreguy-Sena, Bibiana F. Oliveira, Mª Adriana HenriquesO11 Balance and anxiety and depression symptoms in old age peopleJoana Santos, Sara Lebre, Alda MarquesO12 Prevalence of postural changes and risk factors in school children and adolescents in a northern region (Porto)Clarinda Festas, Sandra Rodrigues, Andrea Ribeiro, José LuminiO13 Ischemic stroke vs. haemorrhagic stroke survival rateAna G. FigueiredoO14 Chronobiological factors as responsible for the appearance of locomotor pathology in adolescentsFrancisco J. Hernandez-Martinez, Liliana Campi, Mª Pino Quintana-Montesdeoca, Juan F. Jimenez-Diaz, Bienvenida C. Rodriguez-De-VeraO15 Risk of malnutrition in the elderly of BragançaAlexandra Parente, Mª Augusta Mata, Ana Mª Pereira, Adília Fernandes, Manuel BrásO16 A Lifestyle Educational Programme for primary care diabetic patients: the design of a complex nursing interventionMª Rosário Pinto, Pedro Parreira, Marta L. Basto, Ana C. Rei, Lisete M. MónicoO17 Medication adherence in elderly peopleGilberta Sousa, Clementina Morna, Otília Freitas, Gregório Freitas, Ana Jardim, Rita VasconcelosO18 Hospitalization for cervical cancer of residents in the metropolitan region of Porto Alegre, Southern Brazil, 2012 to 2014Lina G. Horta, Roger S. Rosa, Luís F. Kranz, Rita C. Nugem, Mariana S. Siqueira, Ronaldo BordinO19 Oncologic assistance of high complexity: evaluation of regulating accessesRosiane Kniess, Josimari T. LacerdaO20 Perceived barriers for using health care services by the older population as seen by the social sector: findings from the Vila Nova de Gaia Gerontological PlanJoana Guedes, Idalina Machado, Sidalina Almeida, Adriano Zilhão, Helder Alves, Óscar RibeiroO21 Sleep difficulties and depressive symptoms in college studentsAna P. Amaral, Ana Santos, Joana Monteiro, Mª Clara Rocha, Rui CruzO22 Psychopathological symptoms and medication use in higher educationAna P. Amaral, Marina Lourenço, Mª Clara Rocha, Rui CruzO23 Sexually transmitted diseases in higher education institutionsSandra Antunes, Verónica Mendonça, Isabel Andrade, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando MendesO24 Alcohol consumption and suicide ideation in higher education studentsLídia Cabral, Manuela Ferreira, Amadeu GonçalvesO25 Quality of life in university studentsTatiana D. Luz, Leonardo Luz, Raul MartinsO26 Male and female adolescent antisocial behaviour: characterizing vulnerabilities in a Portuguese sampleAlice Morgado, Maria L. Vale-DiasO27 Risk factors for mental health in higher education students of health sciencesRui Porta-NovaO28 International classification of functioning disability and health as reflexive reasoning in primary attention in healthTânia C. Fleig, Éboni M. Reuter, Miriam B. Froemming, Sabrina L. Guerreiro, Lisiane L. CarvalhoO29 Risk factors and cardiovascular disease in PortalegreDaniel Guedelha, P. Coelho, A. PereiraO30 Health status of the elderly population living in Portalegre historic city centre: A longitudinal studyAntónio Calha, Raul CordeiroO31 Student’s sleep in higher education: sleep quality among students of the IPBAna Gonçalves, Ana Certo, Ana Galvão, Mª Augusta MataO32 Trend in mortality from cervical cancer in the metropolitan area of Florianópolis, state of Santa Catarina, Brazil, 2000 to 2013Aline Welter, Elayne Pereira, Sandra Ribeiro, Marcia KretzerO33 Adherence to treatment in the elderly in an urban environment in SpainJuan-Fernando Jiménez-Díaz, Carla Jiménez-Rodríguez, Francisco-José Hernández-Martínez, Bienvenida-Del-Carmen Rodríguez-De-Vera, Alexandre Marques-RodriguesO34 Beira Baixa Blood Pressure Study (Study PABB)Patrícia Coelho, Tiago Bernardes, Alexandre PereiraO35 Trends in cervical cancer mortality statistics in Santa Catarina State, Brazil, by age group and macro-region, from 2000 to 2013Patrícia Sousa, João G. Filho, Nazare Nazario, Marcia KretzerO36 Sleep problems among Portuguese adolescents: a public health issueOdete Amaral, António Garrido, Nélio Veiga, Carla Nunes, Ana R. Pedro, Carlos PereiraO37 Association between body fat and health-related quality of life in patients with type 2 diabetesAntónio Almeia, Helder M. Fernandes, Carlos Vasconcelos, Nelson Sousa, Victor M. Reis, M. João Monteiro, Romeu MendesO38 Therapy adherence and polypharmacy in non-institutionalized elderly from Amares county, PortugalIsabel C. Pinto, Tânia Pires, João GamaO39 Prevalence of surgical site infection in adults at a hospital unit in the North of PortugalVera Preto, Norberto Silva, Carlos Magalhães, Matilde MartinsO40 Frailty phenotype in old age: implications to interventionMafalda Duarte, Constança Paúl, Ignácio MartínO41 Portuguese women: sexual symptoms in perimenopauseArminda A. PinheiroO42 Predictive ability of the Perinatal Depression Screening and Prevention Tool – preliminary results of the categorical approachSandra Xavier, Julieta Azevedo, Elisabete Bento, Cristiana Marques, Mariana Marques, António Macedo, Ana T. PereiraO43 Aging and muscle strength in patients with type 2 diabetes: cross sectional analysisJosé P. Almeida, António Almeida, Josiane Alves, Nelson Sousa, Francisco Saavedra, Romeu MendesO44 Accessibility of the elderly in the prevention of hypertension in a family health unitAna S. Maia, Michelle T. Oliveira, Anderson R. Sousa, Paulo P. Ferreira, Luci S. Lopes, Eujcely C. SantiagoO45 Community Health screenings and self-reported chronic diseasesSílvia Monteiro, Ângelo Jesus, Armanda Colaço, António Carvalho, Rita P. Silva, Agostinho CruzO46 Evaluation of indoor air quality in KindergartensAna Ferreira, Catarina Marques, João P. Figueiredo, Susana PaixãoO47 Atmospheric exposure to chemical agents under the occupational activity of pathology techniciansAna Ferreira, Carla Lopes, Fernando Moreira, João P. FigueiredoO48 Occupational exposure to air pollutants in night entertainment venues workersAna Ferreira, Diana Ribeiro, Fernando Moreira, João P. Figueiredo, Susana PaixãoO49 Beliefs and attitudes of young people towards breastfeedingTelma Fernandes, Diogo Amado, Jéssica Leal, Marcelo Azevedo, Sónia RamalhoO50 Profiling informal caregivers: surveying needs in the care of the elderlyCatarina Mangas, Jaime Ribeiro, Rita GonçalvesO51 Visual health in teenagersAmélia F Nunes, Ana R. Tuna, Carlos R. Martins, Henriqueta D. ForteO52 Amenable mortality and the geographic accessibility to healthcare in PortugalCláudia Costa, José A. Tenedório, Paula SantanaO53 Bacterial contamination of door handles in a São Paulo See Metropolitan Cathedral public restrooms in BrazilJ. A. Andrade, J. L. Pinto, C. Campofiorito, S. Nunes, A. Carmo, A. Kaliniczenco, B. Alves, F. Mendes, C. Jesus, F. Fonseca, F. GehrkeO54 Adherence of patients to rehabilitation programmesCarlos Albuquerque, Rita Batista, Madalena Cunha, António Madureira, Olivério Ribeiro, Rosa MartinsO55 Prevalence of malnutrition among Portuguese elderly living in nursing homes: preliminary results of the PEN-3S projectTeresa Madeira, Catarina Peixoto-Plácido, Nuno Santos, Osvaldo Santos, Astrid Bergland, Asta Bye, Carla Lopes, Violeta Alarcão, Beatriz Goulão, Nuno Mendonça, Paulo Nicola, João G. ClaraO56 Relation between emotional intelligence and mental illness in health studentsJoão Gomes, Ana Querido, Catarina Tomás, Daniel Carvalho, Marina CordeiroP1 Fall risk factors in people olObjectives: Dietary restraint, the intentional restriction of caloric intake for the purpose of weight loss, is linked to maladaptive eating and lower mental and physical health. This study aimed to validate for the Portuguese population the Dietary Intent Scale (DIS), a measure of dietary restraint. Methods The sample comprised 1077 participants (415 males), aged between 14 and 34 years old. Males presented a mean age of 18.09 (SD=3.32) and a mean BMI of 22.03 (SD=3.28), and females showed a mean age of 17.73 (SD=3.38) and a mean BMI of 21.32 (SD=2.86). No differences were found between genders regarding age. Results A reliability analysis revealed that DIS presented a Cronbach’s alpha of .92 and that three items did not contribute for the scale’s internal consistency. Therefore, and since their content was similar to other items, these three items were excluded. A confirmatory factor analysis revealed the adequacy of the final 6-item DIS, showing good local (SRWs between .64 and .94) and global adjustments (X(8)=12.07, p=.148; CFI=1.00; TLI=1.00; RMSEA=.03, p=.876). Furthermore, the model showed invariance between genders. Finally, DIS revealed a good convergent validity (eating psychopathology, eating restraint, inflexible eating, body image-related experiential avoidance, body imagerelated cognitive fusion, depression, anxiety, and stress) and temporal validity (r = .82) Discussion DIS seems to be a short and valid measure of eating restraint, highly correlated with an important measure of eating psychopathology (EDE-Q). The DIS may represent an advantage in relation to other existing measures, particularly for research and community interventions regarding eating difficulties.Introduction: Continuous blood pressure (BP) monitoring provides important information about the cardiovascular system condition. Invasive methods are accurate but denote increased risk. Non-invasive methods are safe but less reliable and don ́t provide continuous information. An alternative approach for a continuous, non-invasive measurement of BP is based on changes in pulse transit time (PTT). PTT is defined as the time delay between the R-wave of the electrocardiogram (ECG) and the peak value of the photoplethysmogram (PPG) signal acquired in the patient finger on the same cardiac cycle.