Audiologists’ preferences for patient-centredness: a cross-sectional questionnaire study of cross-cultural differences and similarities among professionals in Portugal, India and Iran

Objective Patient-centredness has become an important aspect of health service delivery; however, there are a limited number of studies that focus on this concept in the domain of hearing healthcare. The objective of this study was to examine and compare audiologists’ preferences for patient-centredness in Portugal, India and Iran. Design The study used a cross-sectional survey design with audiologists recruited from three different countries. Participants A total of 191 fully-completed responses were included in the analysis (55 from Portugal, 78 from India and 58 from Iran). Main outcome measure The Patient–Practitioner Orientation Scale (PPOS). Results PPOS mean scores suggest that audiologists have a preference for patient-centredness (ie, mean of 3.6 in a 5-point scale). However, marked differences were observed between specific PPOS items suggesting these preferences vary across clinical situations. A significant level of difference (p<0.001) was found between audiologists’ preferences for patient-centredness in three countries. Audiologists in Portugal had a greater preference for patient-centredness when compared to audiologists in India and Iran, although no significant differences were found in terms of age and duration of experience among these sample populations. Conclusions There are differences and similarities in audiologists’ preferences for patient-centredness among countries. These findings may have implications for the training of professionals and also for clinical practice in terms of optimising hearing healthcare across countries.

A influência da dor no joelho na incapacidade e proprioceção em adultos mais velhos

Introdução: A dor no joelho apresenta uma etiologia multifatorial, sendo a idade um fator de risco importante. A dor no joelho poderá estar relacionada com alterações na propriocetividade do joelho. Objetivo (s): Comparar a influência dor unilateral com bilateral do joelho na incapacidade e proprioceção em adultos mais velhos. Métodos: Estudo transversal com uma amostra de 11 indivíduos com dor no joelho, divididos em grupo com dor unilateral (GDU=6) e grupo com dor bilateral (GDB=5). Utilizou-se, a Knee injury and Osteoarthritis Outcome Score (KOOS) para analisar a dor, rigidez e outros sintomas, atividades de vida diária, desportivas e de lazer e qualidade de vida. Foi medida a sensação de posição articular passiva e ativa, bem como a sensação de discriminação de carga. Foram utilizados os testes de Mann-Whitney e de correlação de Spearman, com um nível de significância de 0,05. Resultados: Nas diferentes dimensões da KOOS apesar de não se ter verificado diferenças significativas entre os grupos, o GDU apresenta scores menores, que traduzem uma maior incapacidade. Na sensação de posição articular e na sensação de discriminação de carga não se verificaram diferenças significativas entre os grupos. Conclusão: A dor no joelho ser unilateral ou bilateral não influencia nem a incapacidade nem a proprioceção nos adultos mais velhos.

Influência do alinhamento do pé nos Ajustes Posturais Antecipatórios em crianças com Paralisia Cerebral

Introdução: A dificuldade na organização dos ajustes posturais antecipatórios (APAs) é frequentemente associada ao défice de controlo postural (CP) em crianças/jovens com um quadro motor de hemiplegia espástica, resultante de paralisia cerebral. As alterações biomecânicas da tibiotársica e do pé são características comummente observadas nestas crianças/jovens e influenciam o CP na sua globalidade. Objectivo(s): descrever o comportamento dos APAs associados ao início da marcha, face à modificação do alinhamento do pé em crianças/jovens com hemiplegia espástica, após 12 semanas de intervenção, segundo o Conceito Bobath-TND e aplicação de uma Ligadura Funcional (LF). Métodos: Foram avaliadas quatro crianças/jovens num momento inicial (M0) e após 12 semanas de intervenção e de aplicação de uma LF (M1). Recorrendo à eletromiografia de superfície, registaram-se os timings de activação dos músculos tibial anterior, solear, recto abdominal e erector da espinha (bilateralmente). O início do movimento foi calculado a partir da alteração do sinal obtido através da plataforma de pressões. Recorreu-se à aplicação da TMFM-88 para avaliar a função motora global e à aplicação da CIF-CJ para classificar a funcionalidade mediante as actividades e a participação. Procedeu-se ao registo de imagem para facilitar a observação/avaliação das componentes de movimento das crianças/jovens em estudo. Resultados: Após o período de intervenção, verificou-se uma modificação nos valores dos timings de ativação dos músculos em análise, que se aproximaram da janela temporal definida como APAs, bem como na distribuição de carga na base de suporte, nos scores da TMFM-88 e nos qualificadores das “Actividades e Participação”, sugestivos de uma melhor organização dos mecanismos de controlo postural. Conclusão: As crianças/jovens em estudo evidenciaram, após uma intervenção de fisioterapia baseada no Conceito Bobath- TND e aplicação de uma LF, uma evolução favorável tanto ao nível do CP da tibiotársica e do pé, apresentando timings de ativação muscular temporalmente mais ajustados à tarefa, com repercussões positivas nas actividades e participação.

Vitamin D Intake and Cardiometabolic: Risk Factors in Adolescents

Background: A growing body of research suggests that vitamin D might play an important role in overall health. No data exist on vitamin D intake for the Azorean adolescent population. The purpose of this study was to assess vitamin D intake and investigate a possible association between vitamin D intake and cardiometabolic risk factors in Azorean adolescents. Methods: A cross-sectional school-based study was conducted on 496 adolescents (288 girls) aged 15–18 years from the Azorean Islands, Portugal. Anthropometric measurements (waist circumference and height), blood pressure (systolic), and plasma biomarkers [fasting glucose, insulin, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs)] were measured to assess metabolic risk. Homeostasis model assessment (HOMA), TC-to-HDL-C ratio, and waist-to-height ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score was constructed by summing the Zscores of all individual risk factors. High risk was considered when the individual had ‡ 1 standard deviation(SD) of this score. Vitamin D intake was assessed with a semiquantitative food frequency questionnaire. Participants were classified into quartiles of vitamin D intake. Logistic regression was used to determine odds ratios for high cardiometabolic risk scores after adjusting for total energy intake, pubertal stage, fat mass percentage, and cardiorespiratory fitness. Results: Mean (SD) vitamin D intake was 5.8 (6.5) mg/day, and 9.1% of Azorean adolescents achieved the estimated average requirement of vitamin D (10 mg/day or 400 IU). Logistic regression showed that the odds ratio for a high cardiometabolic risk score was 3.35 [95% confidence interval (CI) 1.28–8.75] for adolescents in the lowest vitamin D intake quartile in comparison with those in the highest vitamin D intake quartile, even after adjustment for confounders. Conclusion: A lower level of vitamin D intake was associated with worse metabolic profile among Azorean adolescents.

Intake of milk, but not total dairy, yogurt, or cheese, is negatively associated with the clustering of cardiometabolic risk factors in adolescents

Epidemiologic studies have reported an inverse association between dairy product consumption and cardiometabolic risk factors in adults, but this relation is relatively unexplored in adolescents. We hypothesized that a higher dairy product intake is associated with lower cardiometabolic risk factor clustering in adolescents. To test this hypothesis, a cross-sectional study was conducted with 494 adolescents aged 15 to 18 years from the Azorean Archipelago, Portugal. We measured fasting glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, triglycerides, systolic blood pressure, body fat, and cardiorespiratory fitness. We also calculated homeostatic model assessment and total cholesterol/high-density lipoprotein cholesterol ratio. For each one of these variables, a z score was computed using age and sex. A cardiometabolic risk score (CMRS) was constructed by summing up the z scores of all individual risk factors. High risk was considered to exist when an individual had at least 1 SD from this score. Diet was evaluated using a food frequency questionnaire, and the intake of total dairy (included milk, yogurt, and cheese), milk, yogurt, and cheese was categorized as low (equal to or below the median of the total sample) or “appropriate” (above the median of the total sample).The association between dairy product intake and CMRS was evaluated using separate logistic regression, and the results were adjusted for confounders. Adolescents with high milk intake had lower CMRS, compared with those with low intake (10.6% vs 18.1%, P = .018). Adolescents with appropriate milk intake were less likely to have high CMRS than those with low milk intake (odds ratio, 0.531; 95% confidence interval, 0.302-0.931). No association was found between CMRS and total dairy, yogurt, and cheese intake. Only milk intake seems to be inversely related to CMRS in adolescents.

An Exercise Program Improves Health-Related Quality of Life of Workers

Low back problems are associated with decreased quality of life. Specific exercises can improve quality of life, resulting in better professional performance and functionality. The purpose of this study was to evaluate the effect of following a 21-month exercise program on the quality of life of warehouse workers. The population included 557 male warehouse workers from a food distribution company in Oporto, Portugal. Upon application of the selection criteria, 249 workers were deemed eligible, which were randomized into two groups (125 in the intervention group and 124 in the control group). Then, subjects were asked to volunteer for the study, the sample being formed by 229 workers (112 in the intervention group and 117 in the control group). All subjects completed the SF-36 questionnaire prior to beginning the program and on the 11th and 21st months following it. The exercises were executed in the company facilities once a day for 8 min. Data were analyzed using SPSS® 17.0 for Windows®. After 11 months of following the exercise program, there was an increase in all scores for the experimental group, with statistically significant differences in the dimensions physical functioning (0.019), bodily pain (0.010), general health (0.004), and rolephysical (0.037). The results obtained at the end of the study (21 months) showed significant improvements in the dimensions physical functioning (p = 0.002), rolephysical (p = 0.007), bodily pain (p = 0.001), social functioning (p = 0.015), role-emotional (p = 0.011), and mental health (p = 0.001). In the control group all dimensions showed a decrease in mean scores. It can be concluded that the implementation of a low back specific exercise program has changed positively the quality of life of warehouse workers.

Safety climate and its relationship with furniture companies’ safety performance and workers’ risk acceptance

This study aims to analyse the relationship between safety climate and the level of risk acceptance, as well as its relationship with workplace safety performance. The sample includes 14 companies and 403 workers. The safety climate assessment was performed by the application of a Safety Climate in Wood Industries questionnaire and safety performance was assessed with a checklist. Judgements about risk acceptance were measured through questionnaires together with four other variables: trust, risk perception, benefit perception and emotion. Safety climate was found to be correlated with workgroup safety performance, and it also plays an important role in workers’ risk acceptance levels. Risk acceptance tends to be lower when safety climate scores of workgroups are high, and subsequently, their safety performance is better. These findings seem to be relevant, as they provide Occupational, Safety and Health practitioners with a better understanding of workers’ risk acceptance levels and of the differences among workgroups.

Cultural adaptation of websites: a comparative study of portuguese and dutch corporate websites

Master Thesis Presented at Instituto de Contabilidade e Administração do Porto for obtaining the Master’s degree in Digital Marketing under the supervision of Professor José de Freitas Santos

Multilevel model of safety climate for furniture industries

BACKGROUND: Furniture companies can analyze their safety status using quantitative measures. However, the data needed are not always available and the number of accidents is under-reported. Safety climate scales may be an alternative. However, there are no validated Portuguese scales that account for the specific attributes of the furniture sector. OBJECTIVE: The current study aims to develop and validate an instrument that uses a multilevel structure to measure the safety climate of the Portuguese furniture industry. METHODS: The Safety Climate in Wood Industries (SCWI) model was developed and applied to the safety climate analysis using three different scales: organizational, group and individual. A multilevel exploratory factor analysis was performed to analyze the factorial structure. The studied companies’ safety conditions were also analyzed. RESULTS: Different factorial structures were found between and within levels. In general, the results show the presence of a group-level safety climate. The scores of safety climates are directly and positively related to companies’ safety conditions; the organizational scale is the one that best reflects the actual safety conditions. CONCLUSIONS: The SCWI instrument allows for the identification of different safety climates in groups that comprise the same furniture company and it seems to reflect those groups’ safety conditions. The study also demonstrates the need for a multilevel analysis of the studied instrument.

Exploring the long-term associations between adolescents’ music training and academic achievement

There is a positive relationship between learning music and academic achievement, although doubts remain regarding the mechanisms underlying this association. This research analyses the academic performance of music and non-music students from seventh to ninth grade. The study controls for socioeconomic status, intelligence, motivation and prior academic achievement. Data were collected from 110 adolescents at two time points, once when the students were between 11 and 14 years old in the seventh grade, and again 3 years later. Our results show that music students perform better academically than non-music students in the seventh grade (Cohen’s d = 0.88) and in the ninth grade (Cohen’s d = 1.05). This difference is particularly evident in their scores in Portuguese language and natural science; the difference is somewhat weaker in history and geography scores, and is least pronounced in mathematics and English scores (η2 p from .09 to .21). A longitudinal analysis also revealed better academic performance by music students after controlling for prior academic achievement (η2 p = .07). Furthermore, controlling for intelligence, socioeconomic status and motivation did not eliminate the positive association between music learning from the seventh to the ninth grade and students’ academic achievement (η2 p = .06). During the period, music students maintained better and more consistent academic standing. We conclude that, after controlling for intelligence, socioeconomic status and motivation, music training is positively associated with academic achievement.

Influence of cardiorespiratory fitness and parental lifestyle on adolescents' abdominal obesity

The aims of this study were (1) to analyse the influence of cardiorespiratory fitness (CRF) and parental overweight status (POS) and socioeconomic status (SES) on abdominal obesity. This study was comprised of 779 adolescents (12-18 years). Waist-height ratio (WHtR), 20 m shuttle-run test to ascertain CRF, POS according to World Health Organization recommendations and SES of parents using level of education were analysed. Using WHtR, the prevalence of abdominal obesity was 21.3% (23.5% girls and 17.9% boys; p = 0.062). Regardless of gender, participants who belonged to the WHtR risk group had significantly (p ≤ 0.05) lower CRF scores than the WHtR non-risk group; 84.4% of girls who belonged to the WHtR risk group had one or two overweight parents (p ≤ 0.05). Boys with low CRF (OR: 6.43; CI: 3.33-12.39) were more likely to belong to the WHtR risk group compared with their lean peers. Girls with low CRF (OR: 1.78; CI: 1.14-2.78) and with at least one overweight parent (OR: 2.50; CI: 1.07-5.85) or two overweight parents (OR: 4.90; CI: 2.08-11.54) were associated with the risk of abdominal obesity. This study highlights the influence of adolescents' family on abdominal obesity, especially in girls. Further, the data suggested that low CRF was a strong predictor of risk values of abdominal obesity in adolescence.

The relationship of cardiorespiratory fitness, birth weight and parental BMI on adolescents’ obesity status

The aims of this study were as follows: (1) to analyze differences in cardiorespiratory fitness (CRF), parents' body mass index (BMI) and birth weight (BW) between non-overweight (NOW) and overweight/obese (OV/OB) adolescents, and (2) to investigate the association of those variables with the risk of their biological offspring being OV/OB. This study comprised 788 adolescents (477 girls and 311 boys), aged between 12 and 18 years. CRF was predicted by maximal multistage 20-m shuttle-run test according to the procedures described in FITNESSGRAM. Children's BMI was classified according to the International Obesity Task Force. Adolescents' BW was assessed from each child's pediatric record at birth. Parents' OV/OB status was defined and classified according to the World Health Organization. Socioeconomic status was defined by parental education. The prevalence OV/OB was 21.4 and 5.3%, respectively, and there were no gender differences. The OV/OB adolescents (girls and boys) had significantly (Pscores and higher BW (P

Um estudo sobre geometria no 1.º ciclo: simetria em figuras planas

Este estudo insere-se no âmbito da Geometria e pretende compreender a influência dos recursos didáticos utilizados no reconhecimento de propriedades e relações geométricas em figuras planas. De acordo com o objetivo do estudo formulamos duas questões orientadoras que se articulam entre si. - Que fragilidades apresentam os alunos, no reconhecimento de propriedades geométricas em figuras planas? - Que contributos resultam da utilização de materiais manipuláveis, na visualização espacial e investigação de propriedades geométricas? Com este estudo pretendemos reunir informação que contribua para aprofundar o conhecimento sobre o raciocínio geométrico dos alunos. Em termos metodológicos segue um método de investigação misto, com recolha de informação qualitativa de natureza interpretativa e quantitativa, na modalidade de estudo de caso. A recolha de dados foi realizada numa turma de 4.º ano do ensino básico onde foi desenvolvida a experiência didática. A informação recolhida resultou da observação direta e as fontes dos dados foram as produções dos alunos, as notas de campo, registos fotográficos, vídeo e áudio. A docente assumiu o papel de investigadora e orientadora das tarefas propostas aos alunos tendo estes desempenhado um papel ativo na construção do seu próprio conhecimento. Os resultados obtidos permitem evidenciar as fragilidades dos alunos no reconhecimento de propriedades geométricas de figuras planas em diferentes posições. Destacam ainda os contributos da utilização da Mira e do Tangram, no estudo da simetria e no desenvolvimento da visualização espacial para a concretização de aprendizagens concretas, motivadoras e significativas.