ESS2-Artigos (em revistas ou actas indexadas)
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Percorrer ESS2-Artigos (em revistas ou actas indexadas) por Objetivos de Desenvolvimento Sustentável (ODS) "10:Reduzir as Desigualdades"
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- Bone mineral density and body composition among individuals who practice sports with mechanical impact and sedentary activitiesPublication . Pinheiro, João; Ribeiro, Luís Pedro; Coelho-e-Silva, ManuelThe purpose of this study was to evaluate indicators of bone health associated with sports practice in male adolescents using dual-energy X-ray absorptiometry (DXA) to measure bone mineral content (BMC), density (BMD), and body composition (BC) for the whole body (WB) and specific regions. This cross-sectional study involved 65 individuals (18–35 years). Athletes had higher BMD for WB (1.064 ± 0.121 g/m−2) than sedentary individuals (0.753 ± 0.129 g/cm−2). Differences were also observed within specific regions such as the trunk, upper and lower limbs. Individuals who practice regular sports present improved bone health indicators compared to their sedentary peers.
- Editorial: Innovative teaching and learning in health education and promotionPublication . da Costa, Emilia; Ruiz Fernández, María Dolores; Fernández Medina, Isabel María; Jimenez Lasserrotte, Maria del Mar; Ventura-Miranda, Maria IsabelHealth education and health promotion are undergoing profound transformation. Demographic transitions, aging populations, increasing multimorbidity, persistent inequities, and rapid technological change are reshaping how learners understand and navigate health. In this evolving context, traditional knowledge-transmission models are no longer sufficient to prepare future professionals for complex, multicultural and digitally mediated environments. Innovation in teaching and learning has therefore become essential, not only to improve learning outcomes, but to strengthen ethical reasoning, equity, and learner autonomy. This global shift echoes recent OECD (1) analyses highlighting how digitalisation, demographic aging and widening social disparities are redefining the competencies required of tomorrow’s health workforce and calling for educational approaches attuned to complexity and uncertainty. It is also consistent with the World Health Organization’s call for transformative health workforce education, which stresses that conventional training models can no longer meet the demands posed by demographic change, chronic disease burdens, technological acceleration and growing inequities.
- The effect of nutritional intervention in nutritional risk screening on hospitalised lung cancer patientsPublication . de Oliveira, Raquel; Cabrita, Bruno; Cunha, Ângela; Silva, Sónia; Lima, João P. M.; Martins, Diana; Mendes, FernandoBackground: Lung cancer (LC) patients are prone to suffer from malnutrition. Malnutrition negatively affects patients’ response to therapy, increases the incidence of treatment-related side effects, and decreases survival. Early identification of LC patients who are malnourished or at risk of malnutrition can promote recovery and improve prognosis. Objective: This study aimed to assess the risk and nutritional status of lung cancer patients who are hospitalised, as well as to evaluate the impact of nutritional intervention on the risk of malnutrition. Methods: From January 2022 to December 2023, 53 LC patients hospitalised in a pulmonology department had their nutritional risk (initial and final) and nutritional status (initial) assessed. All were selected for nutritional intervention. Nutrition counselling was the first intervention option, along with dietary changes with/without oral nutritional supplements. Results: At the time of hospitalisation, 90.6% of the patients were at nutritional risk, 45.3% were classified as moderately malnourished, and 35.8% were classified as severely underweight. After the hospitalisation, 73.6% were at nutritional risk at the time of discharge, suggesting a statistically significant decrease in the number of patients with nutritional risk. Conclusions: Most LC patients hospitalised presented an altered nutritional status. Our study suggests that a nutritional intervention must be implemented to reduce malnutrition risk, which may impact prognosis. The comprehensive nutritional problems experienced by LC patients require nutritional assessment and improved individually tailored nutritional support.
- Food insecurity in higher education studentsPublication . Paula, Aline de; Carneiro, Beatriz; Mendes, Inês; Pacheco, Mariana; Gonçalves, Marta; Pinto, Ezequiel; Palma Mateus, MariaFood insecurity (FI) indicates a situation in which there is no regular access to food in satisfactory quantity and quality. To characterize FI in students from Portuguese higher education institutions, a study was conducted in a non-random sample of students, with an online questionnaire consisting of sociodemographic questions and the Portuguese version of the IF scale. There were 200 valid questionnaires and 27.5% of the participants were classified as having some degree of FI. Participants with FI reported fewer visits to the family’s home (p = 0.024) and less financial resources (p < 0.001). The results indicate that interventions are needed in this area.
- Frailty and outcomes in elderly ICU patients: insights from a portuguese cohortPublication . Lourenço, Eva; Rodrigues, Isabel; Sampaio, Mário; da Costa, EmiliaBackground: Frailty is a key determinant of outcomes in critically ill elderly patients, but data from Portugal remain limited. To our knowledge, this is the first study to examine the prevalence and prognostic impact of frailty among elderly ICU patients in a Portuguese hospital setting. Objective: To determine the prevalence of frailty among elderly patients admitted to an intensive care unit (ICU) in southern Portugal and to examine its crude associations with illness severity, organ support, and mortality outcomes. Methods: We conducted a retrospective cohort study including 125 patients aged ≥ 65 years admitted to the polyvalent ICU of Hospital de Faro over the last six months of 2024. Data included demographics, comorbidities, Charlson Comorbidity Index (CCI), severity scores (SOFA, SAPS II, APACHE II), and frailty status assessed by the Clinical Frailty Scale (CFS). Outcomes were the need for organ support, ICU and hospital mortality, and length of stay. Results: Frailty (CFS ≥ 5) was identified in 30.4% of patients. Frail patients were older, had higher comorbidity burden (CCI), and presented with significantly higher severity scores at admission. They also required more invasive support, including vasopressors and invasive mechanical ventilation, while acute kidney injury (AKI) requiring renal replacement therapy (RRT) was similar between groups. ICU mortality was significantly higher among frail patients (50.0% vs. 31.0%), as was hospital mortality (76.3% vs. 33.3%). Length of ICU stay did not differ, although frail patients tended to have longer hospitalizations overall. Conclusions: Frailty was highly prevalent and strongly associated with increased severity, greater need for organ support, and higher mortality. Routine frailty assessment at ICU admission may enhance prognostic accuracy and support patient-centered decision-making.
- Gamification on mathematics engagement and motivation in secondary school and higher education: a systematic review and meta-analysisPublication . Ratinho, Elias; Figueiredo, Mauro; Estêvão, Maria Dulce da Mota Antunes de Oliveira ; Faísca, Luís; Martins, CátiaThis systematic review and meta-analysis examined the effects of gamification on students’ motivation and engagement in mathematics at the secondary and higher education levels. A literature search (April 2025) followed by an updated search (November 2025) across ten databases identified 45 studies for qualitative synthesis and 11 for meta-analysis. The review followed PRISMA 2020 guidelines with a pre-registered protocol, and study quality was appraised with the Mixed Methods Appraisal Tool. Meta-analytic results using a three-level Correlated and Hierarchical Effects model with robust variance estimation showed a significant small-to-moderate positive effect on motivation (g = .383, 95% CI [.11, .66], p = .0218). Motivation was assessed more consistently than engagement that could not be included in the meta-analysis due to the lack of validated measures. The systematic review indicates that gamification supports motivation and engagement, with only four studies reporting negative effects. Most interventions used digital platforms (e.g., Kahoot!; Classcraft) and common game elements such as points, leaderboards and instant feedback. Overall, gamification appears promising for enhancing motivation and engagement in mathematics when designs are aligned with students’ needs, balancing competition with mastery and cooperation. Therefore, educators should limit excessive competition and prioritize personal progress and cooperative tasks that foster social interaction. Future studies should employ validated measures, larger samples, and examine both motivation and engagement to strengthen the evidence base and guide effective implementation in education.
- Impacto dos grupos de apoio na sobrecarga de cuidadores familiares em PortugalPublication . Bernabéu-Álvarez, Claudia; Costa, Emília IsabelObjetivo: Analisar a relação entre a sobrecarga do cuidador familiar e o apoio social com a participação em grupos de apoio presenciais e virtuais. Métodos: Estudo pré-experimental. Critérios de inclusão: cuidadores informais, maiores de idade, residentes na região centro-sul de Portugal. Variável independente: participação num grupo de apoio presencial (GA), num fórum virtual (FV) ou nenhum grupo (GC). Variáveis dependentes: sobrecarga de cuidado (Índice de Esforço do Cuidador) e apoio social percebido (escala MOS). Análise descritiva, binária e multivariada com o programa estatístico SPSS 22. Resultados: Participaram 109 cuidadores, principalmente mulheres, cuidando dos seus filhos. 47,7% sofreram sobrecarga pelo cuidado, sendo mais alta no GC. O apoio social foi bom em 64,2% dos participantes, sendo maior no GA. Houve uma associação significativa com o género e a rede social (ser mulher está associado a uma maior sobrecarga, enquanto uma ampla rede social diminui a sobrecarga do cuidador). A participação num GA ou FV melhorou significativamente a rede e o apoio social. Conclusão: A participação em grupos de apoio, tanto presenciais quanto virtuais, tem uma relação positiva significativa com a redução da sobrecarga do cuidador e o aumento do apoio social percebido. Estes grupos de apoio são recursos essenciais para os cuidadores informais, ajudando a mitigar os efeitos negativos do cuidado e fortalecendo as suas redes sociais e o apoio. Portanto, promover a participação em tais grupos pode ser uma estratégia eficaz para melhorar o bem-estar dos cuidadores familiares.
- Prescribed hospital diet influence on dietary intake of hospitalised patients: a cross-sectional studyPublication . Gameiro, Joana; de Oliveira, Raquel; Baltazar, Ana Lúcia; Rocha, Clara; Pereira, Marta; Martins, Diana; Lima, João P. M.; Mendes, FernandoThe dietary intake of hospitalised patients is often compromised during hospitalisation, which can be a causal factor for hospital malnutrition. This is considered a public health problem worldwide and is associated with an increased risk of other complications. Objectives: Our objective was to determine the dietary intake of hospitalised individuals and if the prescribed diet influences it. Methods: Food intake data were collected from 299 lunches of patients admitted to a hospital, using the visual estimation method with a five-point scale. Three existing diets were considered, and the energy and macronutrient values of the meal were calculated. The minimum energy and protein requirements were also calculated. Results: The components of the tray with the highest intake were soup and dessert; no significant differences were found between the percentage intake of each element and the prescribed diet. More than 50% of the individuals did not meet their minimum energy requirements, and only 36.5% had a protein intake that was within the recommendations. Conclusions: Dietary intake is much lower than prescribed, and nutritionists need to act to reduce the prevalence of hospital malnutrition.
- Reporting of participant race and ethnicity from COVID-19 randomized controlled drug and biologicals trials: a scoping reviewPublication . Pranić, Shelly Melissa; Estêvão, Maria Dulce da Mota Antunes de Oliveira ; Vasanthan, Lenny T; Pérez-Neri, Iván; Pulumati, Anika; Junior, Fábio Antonio Serra de Lima; Malih, Narges; Mishra, Vinayak; Thompson, Jacqueline; Nnate, DanielRacial and ethnic minorities have been disproportionally burdened by hospitalization and death due to COVID-19. Participation of individuals of diverse races and ethnicities in clinical trials, according to study-level characteristics of randomized controlled trials (RCTs) that test effectiveness of COVID-19 drugs, could be insightful for future researchers. Our objective for this scoping review was to describe the frequency of race and ethnicity reported as demographic variables and specific reporting of race and ethnicity according to COVID-19 RCT characteristics. We conducted comprehensive searches in PubMed, ProQuest, World Health Organization Database, and Cochrane Central Register of Controlled Trials, and gray literature via preprint servers from January 1, 2020, to May 4, 2022. We included RCTs on emergency- or conditionally approved COVID-19 drug interventions (remdesivir, baricitinib, and molnupiravir) with or without comparators. Self-reported race as American Indian/Pacific Islander, Asian, Black/African American, or White, ethnicity as Hispanic/Latinx, study design characteristics, and participant-relevant data were collected. In total, 17 RCTs with 17 935 participants were included. Most (n = 13; 76%) reported at least 1 race and ethnicity and were US-based, industry-funded RCTs. Asian, Black, Latinx, and White participants were mostly enrolled in RCTs that studied remdesivir. Native American and Hawaiian participants were mostly assessed for progression to high-f low oxygen/noninvasive ventilation. Time to recovery was assessed predominantly in Black and White participants, whereas hospitalization or death was mostly assessed in Asian, Latinx, and multirace participants. Trialists should be aware of RCT-level factors and characteristics that may be associated with low participation of racial and ethnic minorities, which could inform evidence-based interventions to increase minority participation.
- Telehealth for integrated cardiovascular and diabetes management: a scoping reviewPublication . Estêvão, Maria Dulce da Mota Antunes de Oliveira ; Teotónio Fernandes, Mónica Alexandra; De Sousa-Coelho, Ana Luísa; Neto Espírito-Santo, Margarida de Fátima; Nascimento, Tânia; Alfredo CaturanoCardiovascular disease (CVD) and diabetes mellitus represent major global health challenges, frequently co-occurring and mutually exacerbating. Telehealth interventions offer a promising approach for their management, with potential to improve patient outcomes, enhance access to care, and increase cost-effectiveness. This review synthesized existing evidence from randomized controlled trials (RCTs) and observational studies to evaluate the effectiveness of telehealth interventions for the management of diabetes, focusing on CVD risk, and to identify critical research gaps. A systematic literature search was conducted across major databases (PubMed, Web of Science, and Scopus) to identify studies meeting predefined eligibility criteria, considering digital tools for remote monitoring, consultation, education, and medication management. After the screening of 3041 articles, six studies met the inclusion criteria. Telehealth interventions utilized a range of digital health tools, including mobile applications, artificial intelligence–powered clinical decision aids, electronic consultations, and integrated remote monitoring platforms. Although direct assessment of composite cardiovascular risk was largely absent, the included studies reported several clinical parameters associated with cardiovascular health, namely, blood pressure, lipid profile, and glycated hemoglobin. Telehealth interventions implemented for individuals with Type 2 diabetes mellitus demonstrated promising potential in improving glycemic control and supporting self-management. However, their effectiveness in managing broader cardiovascular risk factors remains less clear due to inconsistent reporting and heterogeneous intervention designs.