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- Determinants of psychological adjustment of institutionalized adolescents: a systematic reviewPublication . Simão, Ana; dos Santos, Rita Alexandra Mendes; Brás, Marta; Nunes, CristinaBackground Adolescents in residential care present a greater risk of developing various problems in several domains compared to adolescents residing with their biological families. Psychological adjustment is an emerging area of investigation with this particularly vulnerable population to understand the factors that underlie the difficulties youths present within this context. Objective The present study aimed to contribute to recognizing these factors through a systematic literature review following the PRISMA guidelines. Methods A search was conducted in seven databases (Academic Search Complete, MEDLINE, Psychology and Behavioral Sciences Collection, PsycINFO, Web of Science, PsycArticles, Scopus), and quantitative studies from the last thirty years were included. RESULTS: Of the initial 8,174 articles identified, 64 were included, and all the studies were qualitatively assessed with the Mixed Methods Appraisal Tool. Four categories of factors influencing psychological adjustment were identified: personal characteristics, social characteristics, caregiving, and adjustment problems. Most of the studies were cross-sectional and published in European countries. Conclusions The present review contributes to the research on the psychological adjustment of adolescents in residential care by providing an update and supplementing the previous systematic reviews. The proposed organization of the different factors and domains found in publications allowed us to analyze in detail what most impacted these youths' psychological adjustment. Practical and institutional implications for professionals working with this population are discussed, as well as the limitations to overcome in future studies.
- Exploring the relationship between daily sedentary time and occurrence of multimorbidity in middle-aged and older adults: results from ELSI-BrazilPublication . Cordeiro, Jéssica Fernanda Corrêa; Santos, André Pereira dos; Bohn, Lucimere; Sebastião, Emerson; Marchiori, Gianna Fiori; Gomide, Euripedes Barsanulfo Gonçalves; Castro-Piñero, Jose; Florindo, Alex Antonio; Mota, Jorge; Machado, Dalmo Roberto LopesAimTo explore the relationship between varying durations of sedentary time (ST) in hours per day and multimorbidity, while considering covariates such as non-compliance to moderate to vigorous physical activity (MVPA) recommendations, age, sex, and smoking in middle-aged and older adults.MethodsData from the first wave (2015-2016) of the nationally-representative Brazilian Longitudinal Study of Aging (ELSI-Brazil) were analyzed. Ordinary regression analysis was utilized to assess the odds ratio for individuals with varying daily ST durations concerning the escalation in the number of diseases while accounting for covariates such as failure to meet MVPA recommendations, age, sex, and smoking status.ResultsA cohort of 7,314 individuals aged 50-105 years (56,3% females) participated in the study. The most prevalent occurrence of multimorbidity was having 2 conditions (1521/19.3%). A clear trend emerges, showing a rise in the number of multimorbidities as ST increase. Notably, individuals engaging in less than 4 h of daily ST exhibited a significantly lower likelihood of experiencing an increase in the total number of multimorbidity cases, with an odds ratio of 0.842 and a confidence interval of 0.764 to 0.928, even after adjusting for potential covariables.ConclusionsOur findings indicate a progressive increase in multimorbidity with longer durations of ST. Moreover, limiting ST to less than 4 h daily was associated with a lower chance of multimorbidity.
- Biologic disease-modifying antirheumatic drugs survival in late-onset axial spondyloarthritis — data from a Portuguese registryPublication . Silva, Susana P.; Monteiro, Beatriz; Oliveira, Cláudia Pinto; Costa, Roberto Pereira da; Matos, Carolina Ochôa; Lopes, Mariana Diz; Gomes, Carlos Marques; Bernardes, Miguel; Santos, Mariana Emília; Gago, Laura; Abreu, Catarina; Fraga, Vanessa; Mendes, Beatriz; Rocha, Margarida Lucas; Soares, Catarina Dantas; Silva, Cândida; Santos, Helena; Valente, Paula; Silva, Lígia; Eugénio, Gisela; Barcelos, AnabelaObjectives Although axial spondyloarthritis (axSpA) typically begins before age 45, late-onset axSpA (lo-axSpA) has been widely recognized. While existing literature describes this subgroup, data on therapeutic approaches remain limited. Therefore, we aimed to evaluate the efficacy and safety of biologic DMARDs in patients with lo-axSpA.Methods We conducted a retrospective, multicentre, national cohort study using data from the Rheumatic Diseases Portuguese Register. A cut-off age of 45 years was applied to define lo-axSpA. Group differences between early- and late-onset disease activity scores were evaluated, and drug survival was assessed over 12 months. Predictors of drug discontinuation were identified using a Cox proportional hazards model.Results In total, 2256 patients were included, of whom 260 (11.5%) had lo-axSpA. Patients with late-onset disease exhibited significantly higher scores in the Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index at baseline, 3, 6 and 12 months. Despite these differences, both groups showed proportional reductions in disease activity scores, indicating a continuous decrease in disease activity over time. Although the late-onset group had a higher discontinuation rate during the first 12 months of treatment, lo-axSpA was not associated with an increased risk of therapy discontinuation. The primary reason for treatment discontinuation in both groups was inefficacy, with low rates of infections and other adverse events observed across the cohort.Conclusion Our study demonstrated that lo-axSpA is not associated with reduced treatment efficacy or compromised safety.
- Modelling of childbearing progression among women living with HIV in Ibadan, NigeriaPublication . Akinyemi, Joshua O.; Afolabi, Rotimi; Awolude, Olutosin A.; OLAGUNJU, AHMEDBackground Childbearing is a major concern for women living with HIV especially in low-middle income countries. There are fears about access to care, risk of vertical transmission, health challenges, maternal and child morbidity/ mortality. Investigation of childbearing progression and its associated factors among these women will be useful for design of reproductive healthcare services of these women and ultimately address their multifaceted concerns. This study examined childbearing progression and its correlates another among women living with HIV in Ibadan. Method The study used a dataset from a cross-sectional study on childbearing progression among 933 respondents aged (18–49) receiving HIV care at the University College Hospital, Ibadan. Synthetic Relational Gompertz method was used to estimate fertility rate in the study population while a multistate model was developed to identify the factors associated with progression from one birth to the next. Results The average age of participants was 38 years, with majority being Yoruba tribe (80.5%). Nearly all had at least basic education (93%), and about half had 1–2 children at the time of their HIV diagnosis (47.6%). The likelihood of progressing from the first to a second birth was 77%, though no specific factors were statistically significant. However, progression to a third birth was significantly less likely (86% lower), and associated with factors such as: Having 1–2 children at HIV diagnosis (59% less likely to progress). Having more than 2 children at HIV diagnosis (94% more likely to progress), marital status (widowed women were 36% more likely to progress), partner’s education (secondary education increased the likelihood by 23%), partner’s employment status (unemployed partners increased the likelihood by 40%), desire for more children, partner’s HIV-negative status. Progression to fourth and subsequent births showed a continued decline, with the likelihood of a fourth birth being 82% lower and a fifth or sixth birth 85% lower. Women with secondary education were significantly less likely to progress to fifth births. Conclusion Overall, the corrected total fertility rate is 3.54, it’s below the national estimates and Southwest region which implies fertility is declining among women living with HIV in Ibadan. The findings revealed the relevance of socio-economic and demographic factors in childbearing progression among women living with HIV. Focused interventions should aim to provide better family planning support and integrate reproductive health counseling into HIV care programs.