Evaluation of long term persistence of Diabetes Mellitus Type II treatment newly diagnosed patients in Lisbon and Tagus health administration region : a three year follow up study

RESUMO: Raional: A persistência à terapêutica é o tempo em qualquer antidiabético oral, desde o seu início até à descontinuação de todas as medicações ou até ao fim do período do estudo. Os objetivos deste estudo foi a análise da persistência à terapêutica no segundo e terceiro anos após início do tratamento em doentes adultos diagnosticados na região de Lisboa e Vale do Tejo e determinar o efeito de determinadas variáveis na persistência a longo prazo. Métodos: Um estudo retrospetivo não interventivo foi desenhado com base nos dados a obter do SIARS (prescrições e aquisições na farmácia) e Pordata. A persistência foi quantificada como a percentagem de doentes que continuam a adquirir pelo menos um antidiabético oral ao segundo e terceiro anos após a compra da primeira receita. A associação entre a persistência e o segundo e terceiro anos com cada uma das co-variáveis foi aferido pelo teste qui-quadrado e os odd ratios foram calculados com recurso a um modelo de regressão logística. Resultados: A persistência à terapêutica obtida foi de 80% e 62% para o segundo e terceiro anos após início da terapêutica. Odd ratios para primeiro e segundo ano: número de grupos farmacoterapêuticos diferentes (OR = 2.167, 1.807 – 2.598, p = 0.000 / OR = 1.863, 1.621 – 2.142, p = 0.000); idade (OR = 0.914, 0.772 – 1.081, p = 0.294 / OR = 0.875, 0.764 – 1.002, p = 0.054); sexo (OR = 1.163, 0.983 – 1.377, p = 0.079); número de diferentes prescritores (OR = 3.594, 3.030 – 4.262, p = 0.000 / OR = 2.167, 1.886 – 2.491, p = 0.000); instituição de prescrição (OR = 0.725, 0.698 – 0.753, p = 0.000 / OR = 0.683, 0.650 – 0.717, p = 0.000); grupo farmacoterapêutico (OR = 1.056, 1.043 – 1.069, p = 0.000 / OR = 1.077, 1.060 – 1.095, p = 0.000); relação com o médico (OR = 0.834, 0.816 – 0.852, p = 0.000 / OR = 0.799, 0.777 – 0.821, p = 0.000) e custo médio mensal por grupo farmacoterapêutico (OR = 0.954, 0.942 – 0.968, p = 0.000 / OR = 0.930, 0.914 – 0.947, p = 0.000). Conclusões: O valor da persistência à terapêutica no segundo ano é ligeiramente acima do que é mencionado na literatura e não existem dados para comparar os resultados do terceiro ano. Relativamente ao efeito das co-variáveis no segundo e terceiro anos após o início do tratamento, os resultados são sobreponíveis, sendo que o sexo não está associado à persistência ao terceiro ano.----------------------------------ABSTRACT: Background: Therapy persistence is the time on any antidiabetic medication, from initiation of therapy to discontinuation of all medications or the end of the study period. The aim of the study was to analyse the therapy persistence in the second and third years after treatment initiation in newly diagnosed adult patients in the Lisbon and Tagus Valley region and to determine the effect of several co-variables in the long term persistence. Methods: A retrospective non-interventional study based on SIARS data (drug prescriptions and acquisitions) and Pordata was designed. Persistence was quantified as the percentage of patients that continued to purchase at least one type of antidiabetic at year 2 and 3 after the date of first prescription acquisition. Association between persistence at second and third years with each of the other co-variables were verified by using the Chi-Square test and odds ratio were calculated using a regression logistic model. Results: Therapy persistence obtained was 80% and 62% for the second and third years after treatment initiation. Odd ratios for second and third years: number of different pharmacotherapeutic groups (OR = 2.167, 1.807 – 2.598, p = 0.000 / OR = 1.863, 1.621 – 2.142, p = 0.000); age (OR = 0.914, 0.772 – 1.081, p = 0.294 / OR = 0.875, 0.764 – 1.002, p = 0.054); gender (OR = 1.163, 0.983 – 1.377, p = 0.079); number of different prescribers (OR = 3.594, 3.030 – 4.262, p = 0.000 / OR = 2.167, 1.886 – 2.491, p = 0.000); institution of prescription (OR = 0.725, 0.698 – 0.753, p = 0.000 / OR = 0.683, 0.650 – 0.717, p = 0.000); pharmacotherapeutic group (OR = 1.056, 1.043 – 1.069, p = 0.000 / OR = 1.077, 1.060 – 1.095, p = 0.000); relationship with the physician (OR = 0.834, 0.816 – 0.852, p = 0.000 / OR = 0.799, 0.777 – 0.821, p = 0.000) and average cost per month and per pharmacotherapeutic group (OR = 0.954, 0.942 – 0.968, p = 0.000 / OR = 0.930, 0.914 – 0.947, p = 0.000). Conclusions: Second year therapy persistence value is slightly above of what is referenced in literature and no data was found to compare the third year value. Regarding the effect of the co-variables analysed at second and third years after treatment initiation, the results were overlapping with gender being not associated with persistence at the third year.

Sport, immigration and multiculturality: a conceptual analysis

Paper given by Chris Kennett at the European Forum: Culture, Sport and Proximity held in Almería on the 5 May 2005 and promoted by the Diputación Provincial de Almería. The paper explores the key concepts that comprise the social policy discourse related to immigration and how these relate to sports provision. The potential role for sport in the integration of immigrants is considered, as well as the risks of sports as a potentially divisive force, particularly in terms of racism. This discussion leads to the consideration of the need for intercultural dialogue through sport in order to contribute to the achievement of the sustainable integration of immigrant groups. In order to achieve this goal, research is called for into the needs of immigrant groups as a key phase in the development of sports policy.

Weekly sport practice and adolescent well-being.

OBJECTIVE: Sport practice is widely encouraged, both in guidelines and in clinical practice, because of its broad range of positive effects on health. However, very limited evidence directly supports this statement among adolescents and the sport duration that we should recommend remains unknown. We aimed to determine sport durations that were associated with poor well-being. METHODS: We conducted a survey including 1245 adolescents (16-20 years) from the general Swiss population. Participants were recruited from various settings (sport centres, peers of sport practicing adolescents, websites) and asked to complete a web-based questionnaire. Weekly sport practice was categorised into four groups: low (0-3.5 h), average (≈ recommended 7 h (3.6-10.5)), high (≈14 h (10.6-17.5)) and very high (>17.5 h). We assessed well-being using the WHO-5 Well-Being Index. RESULTS: Compared with adolescents in the average group, those in the very high group had a higher risk of poor well-being (OR 2.29 (95% CI 1.11 to 4.72)), as did those in the low group (OR 2.33 (1.58 to 3.44)). In contrast, those in the high group had a lower risk of poor well-being than those in the average group (OR 0.46 (0.23 to 0.93)). CONCLUSIONS: We found an inverted, U-shaped relationship between weekly sport practice duration and well-being among adolescents. The peak scores of well-being were around 14 h per week of sport practice, corresponding to twice the recommended 7 h. Practicing higher sport durations was an independent risk factor of poor well-being.

Oui à la chasse au dopage pour la santé des athlètes et du sport [Sports and athletes deserve doping runting].

Cet article se veut une revue des effets ergogéniques et potentiellement délétères des principaux compléments alimentaires consommés par les sportifs populaires ou d'élite. De nombreux produits sont proposés sur le marché avec des allégations prometteuses, le plus souvent sans preuve scientifique sur leur validité ou leur innocuité. Les antioxydants n'augmentent ni la force ni l'endurance. La créatine améliore la capacité de récupération pour les exercices en intervalle anaérobie mais pas en course à pied ni en natation. L'hormone de croissance et les stéroïdes anabolisants augmentent la synthèse protéique et la masse maigre mais comportent des effets secondaires graves et souvent irréversibles. Les médecins, les diététiciens et les fédérations sportives ont un rôle important à jouer dans l'information et la prévention, afin d'éviter des attitudes néfastes pour la santé, pouvant même créer des addictions. This article reviews the evidence-based ergogenic potential adverse effects of the most common products in use by recreational and elite athletes today. This is an aggressively marketed and controversial area of sports medicine wordwide. It is therefore important for the scientific societies, clinicians, dieticians sports federations to be well versed in the more popular supplements and drugs in order to have an important role in information and prevention attitudes that can lead to health risks or addictions!

THE INFLUENCE OF THE REGULATORY ENVIRONMENT ON THE DEFINITION OF PERFORMANCE: THE EXAMPLE OF THE SPORT BETTING AND LOTTERY SECTORS

This thesis examines the interplay between state regulation and the way organisations define performance. Performance is generally understood to be a multidimensional concept, but the extent to which its different facets are shaped by regulation remains an understudied question. This thesis aims to address this question and provide at least a partial answer to it. To do so, it examines whether the level of regulation amplifies or abates the multidimensionality of regulated entities' performance definition, i.e. the way they define the concept of performance. The leading question is whether an organisation's performance definition can be associated with the regulatory intensity its environment confronts it with. Moreover, the study explores whether the type of ownership-public or private-plays a role in regard to how a regulated entity defines performance. In order to undertake this investigation, the thesis focuses on the performance definitions of organisations in six different sport betting and lottery regulations. Qualitative data is gathered from primary and secondary documents as well as through semi-structured interviews with chief executive officers (CEO), members of executive management and gambling experts in each of these countries. The thesis concludes that the performance definitions of the organisations under study are indeed multidimensional, as well as clearly influenced by their respective regulatory environments. However, not all performance dimensions identified in the literature are present, nor can they all be estimated to be part of the performance definition. In addition, the public-private difference in defining performance-as conceptualised in the literature- seems to be abated in a regulated environment. The central role played by regulation in regard to the multidimensionality of the performance definition partially outweighs the effect of the nature of ownership.

Assessing the sociology of sport: On sport organizations and critical knowledge

The purpose of this contribution is to analyse the trajectory, the challenges and the future of the sociology of sport on three levels: the internal dynamic within the specific sub-field of the sociology of sport, its interactions with sociology and sport sciences, and its relation with sport organizations. The paper notes that the changes of the trajectory of the sociology of sport, first leaning on the profession of physical education teacher and then to sport sciences, as important consequences. Because most of the sociologists specialized in sport are working in sport sciences departments, the most important consequence is the dependency on sport sciences rather than on sociology. Compared to other fields of sociology, it means challenging other sciences for recognition. The paper argues that to face the threat of a marginalization within the field of sport science, the future of sociology of sport could be to fight for an external recognition. Applying sociology could spread critical views that are necessary to sport organizations. It could also give sociologists access to very interesting data, which can help producing good research, and give it a greater legitimacy within sport sciences. However, it is a risky strategy because of the necessity for the sociologists to stay critical both on sporting organization and on their own work.

Troubles du comportement alimentaire (TCA), sports de remise en forme et motivations de pratique = Fitness sports, sport motives and eating disorders

Cet article a pour but d'identifier et de mieux comprendre les liens entre les motivations des pratiquantes de sports de remise en forme, les troubles du comportement alimentaire (TCA) et les troubles psychologiques associés (i.e., insatisfaction corporelle, dépendance à l'exercice physique). Au total, 1270 pratiquantes ont répondu à un questionnaire et 40 ont participé à un entretien semi-directif. Les motivations de perte de poids et/ou modification de l'apparence corporelle sont en lien avec les TCA et l'insatisfaction corporelle. La dépendance à l'exercice physique n'est pas systématique chez les femmes avec TCA. Les pratiquantes de sports de remise en forme motivées uniquement par la perte de poids et/ou la modification de l'apparence sont plus à risques dans levdéveloppement des TCA. The aim of this study was to identify and to better understand links between females' motives in fitness sports, eating disorders (ED) and associated psychological disorders (i.e. body dissatisfaction, exercise dependence). In all, 1270 women were asked by questionnaire and 40 by semi-structured interview. Weight loss/body appearance change motives are related to ED and body dissatisfaction. Exercise dependence are not systematic in women with ED. Fitness sports are at risk in the development of ED for women motivated only by weight loss/body appearance change motives

Examining sport commitment and intentions to participate in intramural sports : application of the Sport Commitment Model and the Theory of Planned Behaviour in a campus recreational sport setting

Fifty-six percent of Canadians, 20 years of age and older, are inactive (Canadian Community Health Survey, 200012001). Research has indicated that one of the most dramatic declines in population physical activity occurs between adolescence and young adulthood (Melina, 2001; Stephens, Jacobs, & White, 1985), a time when individuals this age are entering or attending college or university. Colleges and universities have generally been seen as environments where physical activity and sport can be promoted and accommodated as a result of the available resources and facilities (Archer, Probert, & Gagne, 1987; Suminski, Petosa, Utter, & Zhang, 2002). Intramural sports, one of the most common campus recreational sports options available for post-secondary students, enable students to participate in activities that are suited for different levels of ability and interest (Lewis, Jones, Lamke, & Dunn, 1998). While intramural sports can positively affect the physical activity levels and sport participation rates of post-secondary students, their true value lies in their ability to encourage sport participation after school ends and during the post-school lives of graduates (Forrester, Ross, Geary, & Hall, 2007). This study used the Sport Commitment Model (Scanlan et aI., 1993a) and the Theory of Planned Behaviour (Ajzen, 1991) with post secondary intramural volleyball participants in an effort to examine students' commitment to intramural sport and 1 intentions to participate in intramural sports. More specifically, the research objectives of this study were to: (1.) test the Sport Commitment Model with a sample of postsecondary intramural sport participants(2.) determine the utility of the sixth construct, social support, in explaining the sport commitment of post-secondary intramural sport participants; (3.) determine if there are any significant differences in the six constructs of IV the SCM and sport commitment between: gender, level of competition (competitive A vs. B), and number of different intramural sports played; (4.) determine if there are any significant differences between sport commitment levels and constructs from the Theory of Planned Behaviour (attitudes, subjective norms, perceived behavioural control, and intentions); (5.) determine the relationship between sport commitment and intention to continue participation in intramural volleyball, continue participating in intramurals and continuing participating in sport and physical activity after graduation; and (6.) determine if the level of sport commitment changes the relationship between the constructs from the Theory of Planned Behaviour. Of the 318 surveys distributed, there were 302 partiCipants who completed a usable survey from the sample of post-secondary intramural sport participants. There was a fairly even split of males and females; the average age of the students was twenty-one; 90% were undergraduate students; for approximately 25% of the students, volleyball was the only intramural sport they participated in at Brock and most were part of the volleyball competitive B division. Based on the post-secondary students responses, there are indications of intent to continue participation in sport and physical activity. The participation of the students is predominantly influenced by subjective norms, high sport commitment, and high sport enjoyment. This implies students expect, intend and want to 1 participate in intramurals in the future, they are very dedicated to playing on an intramural team and would be willing to do a lot to keep playing and students want to participate when they perceive their pursuits as enjoyable and fun, and it makes them happy. These are key areas that should be targeted and pursued by sport practitioners.

In search of academic identity : physical education, sport science and the field of human movement studies

This thesis addresses the problem of the academic identity of the area traditionally referred to as physical education. The study is a critical examination of the argu ments for the justi cation of this area as an autonomous branch of knowledge. The investigation concentrates on a selected number of arguments. The data collection comprised articles books and proceedings of conferences. The preliminary assessment of these materials resulted in a classi cation of the arguments into three groups. The rst group comprises the arguments in favour of physical education as an academic discipline. The second includes the arguments supporting a science of sport. The third consists of the arguments in favour of to a eld of human movement study. The examination of these arguments produced the following results. (a) The area of physical education does not satisfy the conditions presupposed by the de nition of academic discipline. This is so because the area does not form an integrated system of scienti c theories. (b) The same di culty emerges from the examination of the ar guments for sport science. There is no science of sport because there is no integrated system of scienti c theories related to sport. (c) The arguments in favour of a eld of study yielded more productive results. However di culties arise from the de nition of human movement. The analysis of this concept showed that its limits are not well demarcated. This makes it problematic to take human movement as the focus of a eld of studies. These aspects led to the conclusion that such things as an academic discipline of physical education sport science and eld of human movement studies do not exist. At least there are not such things in the sense of autonomous branches of knowledge. This does not imply that a more integrated inquiry based on several disciplines is not possible and desirable. This would enable someone entering phys ical education to nd a more organised structure of knowledge with some generally accepted problem situations procedures and theories on which to base professional practice.

Physical education in schools, sport activity and total physical activity in adolescents

Less than half of adolescents reach the recommended 300 minutes per week of physical activity (PA). Physical education classes and sports participation provide opportunities for adolescents to accumulate more time for PA practice; however, little is known about the influence of these variables on the level of total physical activity of adolescents. The aim of this study was to investigate the association between the practice of physical education (PE) in schools and sports activities (SA) with the practice of total PA of adolescents. The study was cross-sectional and involved 467 adolescents of high school (15.8 ± 0.9 years-old) from the city of Rio Claro, in the State of São Paulo. Participants completed the Physical Activity Questionnaire to Older Children (PAQ-C) and questions related to the practice of PE and SA in schools. We performed a logistic regression with p<0.05 using SPSS. Girls had lower prevalence of PA than boys, 9.4% and 26.8%, respectively. Boys who did not participate of PE classes (OR=0.25, 95% CI=0.09-0.66) and SA in schools (OR=0.34, 95% CI=0.12-0.95) were less likely to be active in PA than boys who practiced these activities. The participation in PE classes or engagement in some SA were positively associated with the practice of total PA in boys.

The association between extra-curricular sport participation and social anxiety symptoms in children

Social anxiety is a common psychological complaint that can have a significant and long-term negative impact on a child’s social and cognitive development. In the current study, the relationship between sport participation and social anxiety symptoms was investigated. Swiss primary school children (N = 201), parents, and teachers provided information about the children’s social anxiety symptoms, classroom behavior, and sport involvement. Gender differences were observed on social anxiety scores, where girls tended to report higher social anxiety symptoms, as well as on sport activity, where boys engaged in more sport involvement. MANCOVAs with gender as covariant showed no differences in social anxiety symptoms between children involved in an extracurricular sport and those not engaged in sport participation. Nevertheless, children engaged in team sports displayed fewer physical social anxiety symptoms than children involved in individual sports.