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Lemos M, Henriques AR, Lopes DG, Mendonça N, Victorino A, Costa A, Arriaga M, Gregório MJ, de Sousa R, Canhão H, Rodrigues AM. Usability and Utility of a Mobile App to Deliver Health-Related Content to an Older Adult Population: Pilot Noncontrolled Quasi-Experimental Study. JMIR Form Res 2024; 8:e46151. [PMID: 38758585 DOI: 10.2196/46151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/31/2023] [Accepted: 12/04/2023] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Digital patient-centered interventions may be important tools for improving and promoting social interaction, health, and well-being among older adults. In this regard, we developed a mobile app called DigiAdherence for an older adult population, which consisted of easy-to-access short videos and messages, to improve health-related knowledge among them and prevent common health conditions, such as falls, polypharmacy, treatment adherence, nutritional problems, and physical inactivity. OBJECTIVE This study aimed to assess the usability and utility of the DigiAdherence app among Portuguese older adults 65 years or older. METHODS In this pilot noncontrolled quasi-experimental study, older adults who were patients at the primary health care center in Portimão, Portugal, and owned a smartphone or tablet were recruited. Participants were assessed at baseline, given access to the DigiAdherence app for 1 month, and assessed again immediately after 30 days (first assessment) and 60 days after stopping the use of the app (second assessment). App usability and utility (primary outcomes) were analyzed in the first follow-up assessment using a structured questionnaire with 8 items. In the second follow-up assessment, our focus was on knowledge acquired through the app. Secondary outcomes such as treatment adherence and health-related quality of life were also assessed. RESULTS The study included 26 older adults. Most participants rated the different functionalities of the app positively and perceived the app as useful, attractive, and user-friendly (median score of 6 on a 7-point Likert scale). In addition, after follow-up, participants reported having a sense of security and greater knowledge in preventing falls (16/24, 67%) and managing therapies and polypharmacy (16/26, 62%). CONCLUSIONS The DigiAdherence mobile app was useful and highly accepted by older adults, who developed more confidence regarding health-related knowledge. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/29675.
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Affiliation(s)
- Marta Lemos
- Unidade de Saúde Pública do ACES Algarve II - Barlavento, Centro de Saúde de Portimão, Portimão, Portugal
| | - Ana Rita Henriques
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - David Gil Lopes
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Nuno Mendonça
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - André Victorino
- Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Costa da Caparica, Almada, Portugal
| | - Andreia Costa
- Direção-Geral de Saúde, Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), Lisboa, Portugal
- Catolica Research Centre for Psychological, Family and Social Wellbeing, Lisboa, Portugal
| | - Miguel Arriaga
- Direção-Geral de Saúde, Lisboa, Portugal
- Catolica Research Centre for Psychological, Family and Social Wellbeing, Lisboa, Portugal
| | - Maria João Gregório
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, Lisboa, Portugal
| | - Rute de Sousa
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Helena Canhão
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana M Rodrigues
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
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Costa A, Henriques J, Alarcão V, Madeira T, Virgolino A, Henriques A, Feteira-Santos R, Polley M, Arriaga M, Nogueira P. Social prescribing for older adults in mainland Portugal: Perceptions and future prospects. Prev Med Rep 2024; 39:102652. [PMID: 38384966 PMCID: PMC10879768 DOI: 10.1016/j.pmedr.2024.102652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
Background In order to address health inequalities, which have been exacerbated by the COVID-19 pandemic, and promote older adults' quality of life, it is necessary to explore non-medical approaches such as social prescribing. Social prescribing is a person-centered approach that allows health professionals to refer patients to services provided by the social and community sectors. This study aimed to explore older adults' perceptions of social prescribing in mainland Portugal and to identify factors associated with these perceptions, providing insights for future implementation strategies. Methods A cross-sectional study was conducted with 613 older adults aged 65 to 93. Participants' sociodemographic, economic, and health characteristics were assessed, along with their perceptions of social prescribing's benefits and activity interest. Results Over 75% of respondents agreed that social prescribing would benefit the health system and their community. Most participants (87.7% and 89.7%, respectively) thought that activities like personal protection and development activities and cultural enrichment would be particularly relevant to them. Factors such as marital status, education, health status, and pain/discomfort levels influenced the perceived relevance of these activities. Conclusion This study reveals that older adults in mainland Portugal are open to social prescribing and suggests that tailored interventions considering individual preferences and characteristics can lead to more effective implementation and equal access to social prescribing. Further research and policy efforts should focus on integrating social prescribing into the healthcare system to support healthy aging in Portugal.
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Affiliation(s)
- Andreia Costa
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon 1649-023, Portugal
| | - Joana Henriques
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa 1600-560, Portugal
| | - Violeta Alarcão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Centro de Investigação e Estudos de Sociologia (CIES-Iscte), Instituto Universitário de Lisboa (Iscte), Lisboa 1649-026, Portugal
| | - Teresa Madeira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Marie Polley
- University of Westminster, School of Social Sciences (Psychology), 115 New Cavendish Street, London W1W 6UW, United Kingdom
- Consultancy Ltd., Hitchin SG4 0AP, United Kingdom
| | - Miguel Arriaga
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon 1649-023, Portugal
| | - Paulo Nogueira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa 1600-560, Portugal
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Costa A, Feteira-Santos R, Alarcão V, Henriques A, Madeira T, Virgolino A, Arriaga M, Nogueira PJ. Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related Factors. Int J Environ Res Public Health 2023; 20:4172. [PMID: 36901182 PMCID: PMC10002045 DOI: 10.3390/ijerph20054172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Although the health literacy level of the general population was described recently, little is known about its specific levels among older adults in Portugal. Therefore, this cross-sectional study aimed to investigate the levels of health literacy demonstrated by older adults in Portugal and explore associated factors. Using a randomly generated list of telephone numbers, adults aged 65 years or more living in mainland Portugal were contacted in September and October 2022. Sociodemographic, health and healthcare-related variables were collected, and the 12-item version of the European Health Literacy Survey Project 2019-2021 was used to measure health literacy. Then, binary logistic regression models were used to investigate factors associated with limited general health literacy. In total, 613 participants were surveyed. The mean level of general health literacy was (59.15 ± 13.05; n = 563), whereas health promotion (65.82 ± 13.19; n = 568) and appraising health information (65.16 ± 13.26; n = 517) were the highest scores in the health literacy domain and the dimension of health information processing, respectively. Overall, 80.6% of respondents revealed limited general health literacy, which was positively associated with living in a difficult household financial situation (4.17; 95% Confidence Interval (CI): 1.64-10.57), perceiving one's own health status as poorer (7.12; 95% CI: 2.02-25.09), and having a fair opinion about a recent interaction with primary healthcare services (2.75; 95% CI: 1.46-5.19). The proportion of older adults with limited general health literacy in Portugal is significant. This result should be considered to inform health planning according to the health literacy gap of older adults in Portugal.
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Affiliation(s)
- Andreia Costa
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- CIDNUR—Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa, 1600-190 Lisboa, Portugal
- CRC-W—Católica Research Centre for Psychological, Family and Social Wellbeing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- EPI Task-Force FMUL, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- EPI Task-Force FMUL, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Violeta Alarcão
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Centro de Investigação e Estudos de Sociologia (CIES-Iscte), Instituto Universitário de Lisboa (Iscte), 1649-026 Lisboa, Portugal
| | - Adriana Henriques
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- CIDNUR—Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa, 1600-190 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Teresa Madeira
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Miguel Arriaga
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- CIDNUR—Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa, 1600-190 Lisboa, Portugal
- CRC-W—Católica Research Centre for Psychological, Family and Social Wellbeing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Paulo J. Nogueira
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- EPI Task-Force FMUL, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
- Comprehensive Health Research Center, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
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Costa A, Henriques J, Alarcão V, Henriques A, Madeira T, Virgolino A, Sousa J, Feteira-Santos R, Arriaga M, Rocha J, Nogueira P. Active aging awareness and well-being among older adults in Portugal. Front Public Health 2023; 11:1149731. [PMID: 37124788 PMCID: PMC10130580 DOI: 10.3389/fpubh.2023.1149731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
Objective This study aims to assess the active aging awareness of older adults in mainland Portugal and their levels of overall well-being and to identify social and health-related factors. Methods A cross-sectional study was conducted with a representative sample of 613 older adults, aged 65 or older, who participated in the PROKnos - Knowing Social Prescribing needs of the elderly study in Portugal. The questionnaire consisted of the Active Ageing Awareness Questionnaire and the World Health Organization - Five Well-Being Index, as well as sociodemographic, economic, and health status questions. Correlation coefficients, t-tests for independent samples, and one-way ANOVA were used to explore potential associations between variables. Results The active aging awareness levels were significantly higher for women (p = 0.031), and those who were younger (p = 0.011), more educated (p < 0.001), had a better financial situation (p < 0.001), and had better health (p < 0.001). The same pattern was found for well-being, except in relation to gender, as men had higher levels (p = 0.016). These variables were found to be correlated. Discussion Even though active aging is an important strategy to implement, it is indispensable to consider the perceptions and conditions that need to be in place before that. This study reveals that several social and health-related factors are associated with well-being and active aging awareness, as well as the differences between groups that exist in mainland Portugal in relation to that. This emphasizes how vital it is to address social inequalities in active aging efforts, which are not necessarily uncovered when only considering actual active aging measures.
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Affiliation(s)
- Andreia Costa
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisbon, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon, Portugal
- *Correspondence: Andreia Costa,
| | - Joana Henriques
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Violeta Alarcão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisbon, Portugal
- Centro de Investigação e Estudos de Sociologia (CIES-Iscte), Instituto Universitário de Lisboa (Iscte), Lisbon, Portugal
| | - Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisbon, Portugal
| | - Teresa Madeira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisbon, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisbon, Portugal
| | - Joana Sousa
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisbon, Portugal
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisbon, Portugal
| | - Miguel Arriaga
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisbon, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Jorge Rocha
- Instituto de Geografia e Ordenamento do Território da Universidade de Lisboa (IGOT-ULisboa), Lisbon, Portugal
| | - Paulo Nogueira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisbon, Portugal
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Lisbon, Portugal
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Leung T, Victorino A, Lemos M, Porojan L, Costa A, Arriaga M, Gregório MJ, de Sousa RD, Rodrigues AM, Canhão H. A Video-Based Mobile App as a Health Literacy Tool for Older Adults Living at Home: Protocol for a Utility Study. JMIR Res Protoc 2022; 11:e29675. [PMID: 36476754 PMCID: PMC9773022 DOI: 10.2196/29675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 11/25/2021] [Accepted: 05/26/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND People aged ≥65 years are more likely to have health problems related to aging, polypharmacy, and low treatment adherence. Moreover, health literacy levels decrease with increasing age. OBJECTIVE The aim of this study is to assess an app's utility in promoting health-related knowledge in people aged ≥65 years. METHODS We developed a simple, intuitive, and video-based app (DigiAdherence) that presents a recipe, nutritional counseling, and content on physical activity, cognitive exercise, motivation to adhere to treatment, fall prevention, and health literacy. A convenience sample of 25 older adults attending the Personalized Health Care Unit of Portimão or the Family Health Unit of Portas do Arade (ACeS Algarve II - Barlavento, ARS Algarve, Portugal) will be recruited. Subjects must be aged ≥65 years, own a smartphone or tablet, be willing to participate, and consent to participate. Those who do not know how to use or do not have a smartphone/tablet will be excluded. Likewise, people with major cognitive or physical impairment as well as those living in a long-term care center will not be included in this study. Participants will have access to the app for 4 weeks and will be evaluated at 3 different timepoints (V0, before they start using the app; V1, after using it for 30 days; and V2, 60 days after stopping using it). After using the app for 30 days, using a 7-point Likert scale, participants will be asked to score the mobile tool's utility in encouraging them to take their medications correctly, improving quality of life, increasing their health-related knowledge, and preventing falls. They will also be asked to assess the app's ease of use and visual esthetics, their motivation to use the app, and their satisfaction with the app. Subjects will be assessed in a clinical interview with a semistructured questionnaire, including questions regarding user experience, satisfaction, the utility of the app, quality of life (EQ-5D-3L instrument), and treatment adherence (Morisky scale). The proportion of participants who considered the app useful for their health at V1 and V2 will be analyzed. Regarding quality of life and treatment adherence perceptions, comparisons will be made between V0 and V1, using the t test for dependent samples. The same comparisons will be made between V0 and V2. RESULTS This study was funded in December 2019 and authorized by the Executive Board of ACeS Algarve II - Barlavento and by the Ethics Committee of NOVA Medical School (99/2019/CEFCM, June 2020). This protocol was also approved by the Ethics Committee for Health (16/2020, September 2020) and the Executive Board (December 2020) of the Regional Health Administration of the Algarve, IP (Instituto Público). Recruitment was completed in June 2021. CONCLUSIONS Since the next generation of older adults may have higher digital literacy, information and communication technologies could potentially be used to deliver health-related content to improve lifestyles among older adults. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/29675.
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Affiliation(s)
| | - André Victorino
- Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Costa da Caparica, Portugal
| | - Marta Lemos
- Unidade de Saúde Pública Algarve II - Barlavento, Centro de Saúde de Portimão, Portimão, Portugal
| | - Ludmila Porojan
- Unidade de Saúde Pública Algarve II - Barlavento, Centro de Saúde de Portimão, Portimão, Portugal
| | - Andreia Costa
- Direção-Geral da Saúde, Lisbon, Portugal.,Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Escola Superior de Enfermagem de Lisboa, Lisbon, Portugal.,Catolica Research Centre for Psychological, Family and Social Wellbeing, Lisbon, Portugal
| | - Miguel Arriaga
- Direção-Geral da Saúde, Lisbon, Portugal.,Catolica Research Centre for Psychological, Family and Social Wellbeing, Lisbon, Portugal
| | - Maria João Gregório
- Comprehensive Health Research Center, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiDoC Unit, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, Lisbon, Portugal
| | - Rute Dinis de Sousa
- Comprehensive Health Research Center, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiDoC Unit, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,Episaúde - Associação Científica, Évora, Portugal
| | - Ana Maria Rodrigues
- Comprehensive Health Research Center, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiDoC Unit, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,Episaúde - Associação Científica, Évora, Portugal
| | - Helena Canhão
- Comprehensive Health Research Center, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiDoC Unit, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,Episaúde - Associação Científica, Évora, Portugal
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6
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Águas D, Paço M, Henriques A, Arriaga M, Costa A. Digital Health Literacy in the Training of Informal Caregivers – Community Intervention. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Health Literacy allows optimizing healthy lifestyles and preventive and health protective behaviors (DGS, 2019). Low literacy can lead to a greater number of hospitalizations, a more frequent use of emergency services and a lower prevalence of preventive attitudes in the field of health. Internet-based interventions could have a positive impact on informal caregivers, reducing the geographical barrier, promoting self-efficacy in managing their own emotions, reducing burden.
Aim
Contribute to the training of informal caregivers of a primary health care unit in Lisbon, through the promotion of digital health literacy.
Methods
The Community Intervention project was carried out in the context of a home visit, focusing on 11 informal caregivers, through the presentation of an interactive digital manual. It was based on the methodology of health planning, through the elaboration of a diagnosis of the situation, definition of priorities, setting of objectives, selection of strategies, operational preparation and evaluation (Imperatori & Giraldes, 1993).
Results
It was found that not all informal caregivers have access to the internet or digital technologies, and it was necessary to deliver the printed manual. Caregivers who accessed the interactive digital manual rated its content as very important, having accessed the suggested links without difficulty. The possibility of forwarding the digital manual to other caregivers was valid for all.
Conclusions
Digital technologies promote communication in terms of health promotion, contributing to universal access and digital training in health, giving individuals the opportunity to increase care for their own health. The creation of digital health tools must be directed to the characteristics of the population. For individuals with low digital literacy, simple technologies must be created and for those who cannot or do not want to use digital tools, adequate alternatives must be created.
Key messages
• Primary care health professionals may use digital technologies to promote health literacy.
• Vulnerable groups with low digital health literacy need support to increase access to digital technology that can promote health literacy.
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Affiliation(s)
- D Águas
- USF, ACES Lisboa Norte , Lisbon, Portugal
- ESEL, Escola Superior de Enfermagem de Lisboa , Lisbon, Portugal
| | - M Paço
- USF, ACES Lisboa Norte , Lisbon, Portugal
| | - A Henriques
- Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa , Lisbon, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa , Lisbon, Portugal
| | - M Arriaga
- DGS, Direção-Geral da Saúde , Lisbon, Portugal
- Católica Research Centre for Psychological, Family and Social Wellbeing, Universidade Católica Portuguesa , Lisbon, Portugal
| | - A Costa
- Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa , Lisbon, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa , Lisbon, Portugal
- Católica Research Centre for Psychological, Family and Social Wellbeing, Universidade Católica Portuguesa , Lisbon, Portugal
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7
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Martins R, Capitão C, Fialho M, Feteira-Santos R, Virgolino A, Santos RR, Alarcão V, Silva M, Arriaga M, Graça P, Gregório MJ, Santos O. Are beliefs and attitudes about COVID-19 associated with self-perceived changes in food consumption? Results from a nationwide survey during lockdown. Appetite 2022; 168:105681. [PMID: 34500013 PMCID: PMC8421078 DOI: 10.1016/j.appet.2021.105681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/09/2021] [Accepted: 09/02/2021] [Indexed: 12/25/2022]
Abstract
This study aimed to understand how beliefs and attitudes regarding COVID-19 are associated with self-perceived changes in food consumption during lockdown between March 19 and May 2, 2020. We conducted a cross-sectional study with a non-probabilistic weighted sample of the Portuguese population. Data were collected using an online survey and telephone interviews. The association between agreement with sentences about food and COVID-19 and perceived changes in food consumption were assessed by multinomial logistic regression models. Overall, 5858 citizens were included, with a mean age of 38.2 (17.3) years. Exclusive agreement with the belief "SARS-CoV-2 can be transmitted by food" (27.5%) was associated with decreased odds of perceived positive changes (e.g., increased consumption of fruit and vegetables). Agreement only with the attitudinal sentence "I started to consume foods that may protect against COVID-19" (11.9%) was associated with positive perceived consumption changes (e.g., increasing fruit and vegetables, and decreasing soft drinks and snacks). Cumulative agreement (with both sentences; 10.6%) was also associated with mostly positive food consumption changes. Specific beliefs and attitudes regarding COVID-19 and food are associated with self-perceived changes in food consumption. Longitudinal research is needed to understand how beliefs and/or attitudes about the role of food in infectious diseases act as determinants of eating behavior modification.
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Affiliation(s)
- Raquel Martins
- EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Corresponding author. EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Carolina Capitão
- EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Mónica Fialho
- EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Rodrigo Feteira-Santos
- EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Ana Virgolino
- EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Ricardo R. Santos
- EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Violeta Alarcão
- EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Centro de Investigação e Estudos de Sociologia, ISCTE - Instituto Universitário de Lisboa, Avenida das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Marlene Silva
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, Alameda D. Afonso Henriques, 45, 1049-005, Lisbon, Portugal,CIDEFES - Faculdade de Educação Física e Desporto, Universidade Lusófona de Humanidades e Tecnologias, Campo Grande, 376, 1749-024, Lisbon, Portugal
| | - Miguel Arriaga
- Direção-Geral da Saúde, Alameda D. Afonso Henriques, 45, 1049-005, Lisbon, Portugal,CRW-C Universidade Católica Portuguesa, Palma de Cima, 1649-023, Lisbon, Portugal
| | - Pedro Graça
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Oporto, Portugal,Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, Alameda D. Afonso Henriques, 45, 1049-005, Lisbon, Portugal
| | - Maria João Gregório
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Oporto, Portugal,Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, Alameda D. Afonso Henriques, 45, 1049-005, Lisbon, Portugal
| | - Osvaldo Santos
- EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal,Unbreakable Idea Research, Estrada Nacional 115, Sítio da Caniceira, nº 1, Casarão, 2550-426, Painho, Portugal
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8
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Costa A, Lopes J, Sousa CJ, Santos O, Virgolino A, Nogueira P, Henriques A, Seabra P, Capitão C, Martins R, Arriaga M, Alarcão V. Developing a social prescribing local system in a European Mediterranean country: a feasibility study to promote active and healthy aging. BMC Health Serv Res 2021; 21:1164. [PMID: 34706718 PMCID: PMC8548849 DOI: 10.1186/s12913-021-07186-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Social Prescribing (SP) is an innovative strategy to respond to the non-clinical health needs of the population. A Social Prescribing Local System (SPLS) can be defined as a set of joined community, health, and social organizations to foster SP-oriented activities. This study aimed to develop and assess the feasibility of an SPLS implemented in a Mediterranean country, to promote health and wellbeing and contribute to active and healthy aging. METHODS A mixed-methods approach was followed, including three sequential components: 1) Cross-sectional online survey targeting health professionals (HP) working in a primary health care cluster, Portugal's southern region; 2) Pilot study implementing an on-the-job training program for HP, designed to meet identified training needs in the survey; 3) Focus group (FG) with the HP who participated in the pilot study, two individual interviews, with an elderly patient and a community provider for assessing the satisfaction with the pilot test. RESULTS Sixty-five HP completed the survey; of these, 13 completed the theoretical part of the on-the-job training program; and six (out of these 13) completed the full program. Five HP participated in the FG, one patient and one community provider were interviewed. The surveyed HP perceived as facilitators to implement SP: an automatic system of notifications to prompt the use of SP, contribute to patient satisfaction, human and community resources' stability. The survey also highlighted barriers to SP implementation: length of appointments, shortage of human resources, data records confidentiality, low patient adherence rates, bureaucratic issues, time constraints, and financial costs. Participants were satisfied with the training. Identified SPLS implementation benefits were grouped into four dimensions (from the qualitative approach): gains for patients' health and wellbeing, support for the health services, sustainability of the community resources, and HP' professional satisfaction. CONCLUSIONS Our study took the first steps towards the implementation of an SPLS. Findings reinforce that training HP in SP and on-the-job training seems feasible. This approach was well received and appears to represent a suitable and sustainable strategy. It can promote professional satisfaction, support health services, contribute to the stability of community resources, improve health and promote active and healthy aging.
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Affiliation(s)
- A Costa
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal.
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal.
- Católica Research Centre for Psychological, Family and Social Wellbeing, Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Palma de Cima, 1649-023, Lisbon, Portugal.
| | - J Lopes
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal
| | - C J Sousa
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - O Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Unbreakable Idea Research, Lda, 2550-426, Painho, Portugal
| | - A Virgolino
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - P Nogueira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Laboratório de Biomatemática, Instituto de Medicina Preventiva e Saúde pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Egas Moniz, 1649-028, Lisbon, Portugal
| | - A Henriques
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal
| | - P Seabra
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal
| | - C Capitão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - R Martins
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - M Arriaga
- Católica Research Centre for Psychological, Family and Social Wellbeing, Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Palma de Cima, 1649-023, Lisbon, Portugal
- Directorate-General for Health, Health Literacy and Wellbeing Division, Alameda Dom Afonso Henriques, 1000-123, Lisbon, Portugal
| | - V Alarcão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Centro de Investigação e Estudos de Sociologia, ISCTE-Instituto Universitário de Lisboa (ISCTE-IUL), Avenida das Forças Armadas, 1649-026, Lisbon, Portugal
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9
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Silva MN, Gregório MJ, Santos R, Marques A, Rodrigues B, Godinho C, Silva CS, Mendes R, Graça P, Arriaga M, Freitas G. Towards an In-Depth Understanding of Physical Activity and Eating Behaviours during COVID-19 Social Confinement: A Combined Approach from a Portuguese National Survey. Nutrients 2021; 13:2685. [PMID: 34444845 PMCID: PMC8399723 DOI: 10.3390/nu13082685] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/15/2021] [Accepted: 07/28/2021] [Indexed: 01/08/2023] Open
Abstract
Rapid worldwide decreases in physical activity (PA), an increase in sedentary behaviour (SB) and poorer dietary patterns have been reported during COVID-19 confinement periods. However, as national variability has been observed, this study sought to describe PA, SB and eating patterns, and to explore their gender as well as other socio-demographic correlates and how they interrelate in a representative sample of Portuguese adults during the COVID-19 first mandatory social confinement. The survey was applied online and by telephone to 5856 adults (mean age = 45.8 years; 42.6% women). The majority reported high (46.0%) or moderate (20.5%) PA levels. Men, younger participants, those with higher education levels and a favourable perception of their financial situation reported higher PA levels, with the opposite pattern for SB. Physical fitness activities and household chores were more reported by women, with more strength training and running activities reported by men. Regarding eating behaviours, 45.1% reported changes, positive (58%) and negative (42%), with 18.2% reporting increases in consumption of fruit, vegetables, and fish and other seafood consumption, while 10.8% (most with lower educational level and less comfortable with their income) reported an increase in consumption of ready-to-eat meals, soft drinks, savoury snacks, and take-away and delivered meals. Two clusters-a health-enhancing vs. risky pattern-emerged through multiple correspondence analysis characterized by co-occurrence of high vs. low PA levels, positive vs. negative eating changes, awareness or not of the COVID-19 PA and dietary recommendations, perceived financial situation, higher vs. lower educational level and time in social confinement. In conclusion, while in social confinement, both positive and negative PA and eating behaviours and trends were displayed, highlighting the role of key sociodemographic correlates contributing to healthy vs. risky patterns. Results may inform future health interventions and policies to be more targeted to those at risk, and also advocate the promotion of PA and healthy eating in an integrated fashion.
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Affiliation(s)
- Marlene Nunes Silva
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, 1049 Lisboa, Portugal; (R.S.); (A.M.); (B.R.); (C.G.); (C.S.S.); (R.M.)
- CIDEFES, Faculdade de Educação Física e Desporto, Universidade Lusófona de Humanidades e Tecnologias, 1749 Lisboa, Portugal
| | - Maria João Gregório
- Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, 1049 Lisboa, Portugal;
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4150 Porto, Portugal;
| | - Rute Santos
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, 1049 Lisboa, Portugal; (R.S.); (A.M.); (B.R.); (C.G.); (C.S.S.); (R.M.)
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, 4200 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050 Porto, Portugal
| | - Adilson Marques
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, 1049 Lisboa, Portugal; (R.S.); (A.M.); (B.R.); (C.G.); (C.S.S.); (R.M.)
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1495 Lisboa, Portugal
| | - Bruno Rodrigues
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, 1049 Lisboa, Portugal; (R.S.); (A.M.); (B.R.); (C.G.); (C.S.S.); (R.M.)
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, 4200 Porto, Portugal
| | - Cristina Godinho
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, 1049 Lisboa, Portugal; (R.S.); (A.M.); (B.R.); (C.G.); (C.S.S.); (R.M.)
- Católica Research Centre for Psychological, Family and Social Wellbeing, Universidade Católica Portuguesa, 1649 Lisbon, Portugal
| | - Catarina Santos Silva
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, 1049 Lisboa, Portugal; (R.S.); (A.M.); (B.R.); (C.G.); (C.S.S.); (R.M.)
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1495 Lisboa, Portugal
| | - Romeu Mendes
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, 1049 Lisboa, Portugal; (R.S.); (A.M.); (B.R.); (C.G.); (C.S.S.); (R.M.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050 Porto, Portugal
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050 Porto, Portugal
- Northern Region Health Administration, 4000 Porto, Portugal
| | - Pedro Graça
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4150 Porto, Portugal;
| | - Miguel Arriaga
- Divisão de Literacia, Saúde e Bem-Estar, Direção-Geral da Saúde, 1049 Lisboa, Portugal;
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10
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Abstract
Background During events that involve health risks, people may feel the need personal and social resources to cope with the demands posed by event. Depending on their individual characteristics, people may perceive their resources as sufficient or as insufficient to face the situation. Risk perception analysis was conducted in Portugal during the COVID-19 outbreak, to develop communication strategies, customized to the changing needs, helping people make informed decisions. Methods Citizens messages on social networks of 3 official information sources, and 8 media sources were analyzed between 26th January and 5th March 2020. A sample of comments to publications related to COVID-19 were analyzed in 4-days periods and categorized. A qualitative theory-driven thematic analysis was carried out based on two global categories: Demands and Resources. From this analysis, the threat level ratio (Demands/Resources) was calculated. Results A total of 8,251 comments were analysed in 10 periods of 4 days of data collection, from 26th January to 5th March. The threat level ratio increased during the first 15 days of analysis, having its maximum (6.80) in the period between the 7th and 14th of February, mostly associated with the perceived danger associated with the lack of airports arrivals control from China. After the announcement of the first confirmed case of COVID-19 in a Portuguese citizen outside Portugal, on 23rd February, the risk perception increased 1,4% compared to the previous period of analysis. On the contrary, after announcing the first confirmed case in Portugal, on the 1st March, the risk perception decreased 1,6%, which is inferred to be associated with a shift in the media discourse and to the use of humour. Conclusions Awareness of risks is a necessary condition for people to adhere to the necessary recommendations to mitigate the crisis. During an epidemic, an effective communication strategy can become an opportunity to promote health literacy. Key messages Risk perception is essential to define effective communication strategies to promote health literacy and best practices among targeted populations. effective communication strategies customized to people’s needs and priorities help people making informed decisions during a public health emergency.
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Affiliation(s)
- G Leiras
- Baixo Mondego Health Cluster, IHMT, Porto, Portugal
| | - M Arriaga
- Directorate-General for Health, Lisbon, Portugal
| | - R Gaspar
- Católica Research Centre for Psychological - Family and Social Wellbeing, Lisbon, Portugal
- Faculty of Human Science, Universidade Católica Portuguesa, Lisbon, Portugal
| | - B Raposo
- Católica Research Centre for Psychological - Family and Social Wellbeing, Lisbon, Portugal
| | - S Domingos
- William James Centre for Research, ISPA-Instituto Universitário, Lisbon, Portugal
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11
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Arriaga M, Freitas G, Costa A, Ribeiro da Silva C, Mata F, dos Santos B, Chaves da Silva N. Health Literacy Action Plan: the Portuguese Implementation. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Noncommunicable diseases represent a significant burden in terms of mortality and years lived with disability within the Portuguese population. This burden can be prevented though the adoption of healthy lifestyles, making health literacy (HL) an important factor in this scope. In order to minimise the impact of NCDs, it is important to implement extensive and effective interventions for disease management. In view of this situation, the Directorate-General of Health (DGS) developed a National HL Action Plan to promote HL and design new opportunities to engage the population.
Methods
Recognising the importance of HL, in 2017, the DGS created the Division of Literacy, Health and Well-being. With this in mind, and with an intersectoral group of experts, this division defined the national policy for HL. The action plan was developed based on international best practices for the definition and implementation of actions to promote HL, taking into account that these actions should explore different approaches such as life-cycle and stage of development, taking advantage of all the opportunities to promote HL and self-care. Thus, three main goals were defined: Promote the adoption of healthy lifestyles; promote the proper use of the health system; promote well-being in chronic illness; promote knowledge and research.
Results
The implementation of the activities has been carried out with the citizens and multiple stakeholders in order to achieve a sustainable growth of the HL in all levels. This, in turn, directly contributes to an informed self-management of health for the improvement of the health levels of the Portuguese population.
Conclusions
The HL Action Plan is still in effect and the products developed in articulation with other sectors has been shown to be central for achieving the goals defined. Hopefully the impact of this action plan will be reflected in upcoming literacy assessments and allow the benchmarking with other stakeholders.
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Affiliation(s)
- M Arriaga
- Directorate-General of Health, Lisbon, Portugal
| | - G Freitas
- Directorate-General of Health, Lisbon, Portugal
| | - A Costa
- Directorate-General of Health, Lisbon, Portugal
- Higher School of Nursing of Lisbon, Lisbon, Portugal
| | | | - F Mata
- Directorate-General of Health, Lisbon, Portugal
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12
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Silva Costa A, Arriaga M, Veloso Mendes R, Miranda D, Barbosa P, Sakellarides C, Peralta A, Ambrósio Lopes N, Roque C, Ribeiro S. A Strategy for the Promotion of Health Literacy in Portugal, Centered around the Life-Course Approach: The Importance of Digital Tools. Port J Public Health 2019. [DOI: 10.1159/000500247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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13
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Costa A, Arriaga M. O22 Health literacy measurement in high burden of disease context. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz093.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Costa
- Lisbon School of Nursing, Lisbon, PORTUGAL
- Instituto de Saúde Ambiental (ISAMB), Faculty of Medicine, Universidade de Lisboa, Lisbon, PORTUGAL
- Direção-Geral da Saúde, Lisbon, PORTUGAL
| | - M Arriaga
- Direção-Geral da Saúde, Lisbon, PORTUGAL
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14
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Costa A, Mata F, Silva C, Santos B, Arriaga M. O42 Seasonal digital literacy. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz093.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Costa
- Lisbon School of Nursing, Lisbon, PORTUGAL
- Instituto de Saúde Ambiental (ISAMB), Faculty of Medicine, Lisbon University, Lisbon, PORTUGAL
- Direção-Geral da Saúde, Lisbon, PORTUGAL
| | - F Mata
- Direção-Geral da Saúde, Lisbon, PORTUGAL
| | - C Silva
- Direção-Geral da Saúde, Lisbon, PORTUGAL
| | - B Santos
- Direção-Geral da Saúde, Lisbon, PORTUGAL
| | - M Arriaga
- Direção-Geral da Saúde, Lisbon, PORTUGAL
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15
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Vargas L, Amaral S, Arriaga M, Sarno M, Brites C. High prevalence of syphilis in parturient women and congenital syphilis cases in public maternities in Salvador-Bahia, Brazil. BJOG 2018; 125:1212-1214. [PMID: 29802689 DOI: 10.1111/1471-0528.15304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2018] [Indexed: 11/27/2022]
Affiliation(s)
- L Vargas
- LAPI, Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Prof. Edgard Santos, Federal University of Bahia, Salvador, BA, Brazil
| | - S Amaral
- LAPI, Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Prof. Edgard Santos, Federal University of Bahia, Salvador, BA, Brazil
| | - M Arriaga
- LAPI, Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Prof. Edgard Santos, Federal University of Bahia, Salvador, BA, Brazil
| | - M Sarno
- Department of Obstetrics and Gynecology, School of Medicine, Federal University of Bahia, Salvador, BA, Brazil
| | - C Brites
- LAPI, Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Prof. Edgard Santos, Federal University of Bahia, Salvador, BA, Brazil
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16
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Aksit A, Arteaga DN, Arriaga M, Wang X, Watanabe H, Kasza KE, Lalwani AK, Kysar JW. In-vitro perforation of the round window membrane via direct 3-D printed microneedles. Biomed Microdevices 2018; 20:47. [PMID: 29884927 PMCID: PMC6091873 DOI: 10.1007/s10544-018-0287-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The cochlea, or inner ear, is a space fully enclosed within the temporal bone of the skull, except for two membrane-covered portals connecting it to the middle ear space. One of these portals is the round window, which is covered by the Round Window Membrane (RWM). A longstanding clinical goal is to reliably and precisely deliver therapeutics into the cochlea to treat a plethora of auditory and vestibular disorders. Standard of care for several difficult-to-treat diseases calls for injection of a therapeutic substance through the tympanic membrane into the middle ear space, after which a portion of the substance diffuses across the RWM into the cochlea. The efficacy of this technique is limited by an inconsistent rate of molecular transport across the RWM. A solution to this problem involves the introduction of one or more microscopic perforations through the RWM to enhance the rate and reliability of diffusive transport. This paper reports the use of direct 3D printing via Two-Photon Polymerization (2PP) lithography to fabricate ultra-sharp polymer microneedles specifically designed to perforate the RWM. The microneedle has tip radius of 500 nm and shank radius of 50 μ m, and perforates the guinea pig RWM with a mean force of 1.19 mN. The resulting perforations performed in vitro are lens-shaped with major axis equal to the microneedle shank diameter and minor axis about 25% of the major axis, with mean area 1670 μ m2. The major axis is aligned with the direction of the connective fibers within the RWM. The fibers were separated along their axes without ripping or tearing of the RWM suggesting the main failure mechanism to be fiber-to-fiber decohesion. The small perforation area along with fiber-to-fiber decohesion are promising indicators that the perforations would heal readily following in vivo experiments. These results establish a foundation for the use of Two-Photon Polymerization lithography as a means to fabricate microneedles to perforate the RWM and other similar membranes.
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Affiliation(s)
- Aykut Aksit
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Daniel N Arteaga
- Department of Otolaryngology - Head, Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA
| | - Miguel Arriaga
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Xun Wang
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Hirobumi Watanabe
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Karen E Kasza
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
| | - Anil K Lalwani
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA
- Department of Otolaryngology - Head, Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA
| | - Jeffrey W Kysar
- Department of Mechanical Engineering, Columbia University, 220 Mudd Building 500 West 120th Street, New York, NY, 10027, USA.
- Department of Otolaryngology - Head, Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA.
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17
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Beerle BJ, Arriaga M. Myringotomy tube placement--another role for EMLA cream? Anesth Analg 1996; 83:435. [PMID: 8694340 DOI: 10.1097/00000539-199608000-00047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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18
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Abstract
A subset of patients with acoustic neuromas and useful hearing have tumors that are inadequately approached by both middle fossa and retrosigmoid techniques. The enhanced retrosigmoid technique combines the hearing preservation of posterior semicircular canal ablation to achieve lateral internal auditory canal exposure with the ample cerebel-lopontine angle exposure of the standard retrosigmoid technique.
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Affiliation(s)
- M Arriaga
- Department of Otology/Neurotology, Wilford Hall Medical Center, USA
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19
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Affiliation(s)
- M Arriaga
- Department of Otolaryngology, Wilford Hall Medical Center, Lackland AFB, TX 78236-5300
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20
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Arriaga M. The benefits of cochlear implants. Ear Nose Throat J 1994; 73:858-9. [PMID: 7828487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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21
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Abstract
This study developed a technique for magnetic resonance imaging (MRI)-based volume calculation and defined the specific volume-diameter relationship in acoustic neuromas (AN). Computer-assisted measurement calculated the area of tumor in each MRI slice. Volume was determined by multiplying area by slice interval. The technique was validated by imaging known volumes of gadolinium. The precision was greater than 95%. Our volume calculations revealed a specific volume-diameter relationship in ANs. The following conclusions can be drawn: 1. our technique can accurately determine AN tumor volume; 2. the AN volume-diameter relationship is a specific function and cannot be predicted by assumptions of tumor shape; 3. the volume-diameter relationship should be combined with clinical data to determine the "break point" at which small increments of diameter produce significant clinical sequelae.
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Affiliation(s)
- S A Long
- Department of Otolaryngology, Loma Linda University, Calif
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22
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Abstract
It is a common clinical impression that preservation of hearing is more often achieved when removing a meningioma than a similarly sized acoustic tumor. However, relatively few reports have focused on postoperative hearing results after meningioma removal, and detailed audiometric data are not commonly provided, particularly in the neurosurgical literature. During the past 16 years, 56 meningiomas affecting the temporal bone have been surgically removed at the House Ear Clinic. Hearing preservation was attempted in 16 (29%) of the 56 cases, and these were the focus of this study. The primary presenting symptom was otologic in 67% of these cases, including hearing loss as the primary symptom in 27%. Measurable postoperative hearing was present in 11 (92%) of 12 patients with postoperative audiograms available, and 8 (67%) of 12 patients had good hearing postoperatively. Hearing was preserved near the preoperative level (within 10 dB speech reception threshold and 15% speech discrimination) in 75% of cases.
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Affiliation(s)
- P S Nassif
- University of Southern California School of Medicine, Los Angeles
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23
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Abstract
The varied locations of meningiomas within the temporal bone require a wide array of neurotologic approaches to accomplish complete resection with minimal morbidity. We reviewed 56 consecutive patients with temporal bone meningiomas. The six surgical approaches are described with regard to site of lesion, morbidity of procedure, and long-term patient outcome. Recommendations are made for selection of surgical approach. Hearing preservation was attempted in 25%. Middle fossa tumor removal was performed in nine patients (16%), retrosigmoid (suboccipital) in five patients (9%), translabyrinthine in 24 patients (43%), transcochlear in 15 patients (27%), infratemporal fossa in two patients (4%), and retrolabyrinthine in one patient (2%). Overall, meningioma surgery has higher morbidity, poorer facial nerve outcome, and higher recurrence rates than acoustic neuroma surgery. Thirteen percent of patients were unable to resume full preoperative activities after their surgery. Facial nerve transection occurred in 9% of the cases, and 83% of cases with more than 1 year followup had satisfactory or intermediate facial function (grades I to IV). Meningiomas of the temporal bone are insidious and aggressive lesions. Particular care is required to select the surgical approach appropriate for location, level of hearing, and the anatomic structures involved. Patients must be realistically counseled about the surgical morbidity and long-term outcome associated with each approach.
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Affiliation(s)
- M Arriaga
- Department of Otolaryngology-Head and Neck Surgery, Wilford Hall USAF Medical Center, Lackland AFB, Los Angeles, CA
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24
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Arriaga M, Curtin HD, Takahashi H, Kamerer DB. The role of preoperative CT scans in staging external auditory meatus carcinoma: radiologic-pathologic correlation study. Otolaryngol Head Neck Surg 1991; 105:6-11. [PMID: 1909009 DOI: 10.1177/019459989110500102] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Survival is related to the pathologic extent of tumor in external auditory meatus (EAM) carcinoma. This study assesses the validity of preoperative CT scans in staging EAM carcinoma. The accuracy of staging EAM carcinoma with preoperative CT scans was evaluated by comparing radiography and histopathology. Patients who received preoperative CT scan were selected from a retrospective series of 35 temporal bone resections for EAM squamous cell carcinoma. The CT scans were systematically reviewed for tumor involvement in 12 anatomic areas. The histopathology slides for the corresponding patients were reviewed according to the same criteria. CT scan findings accurately diagnosed the extent of tumor involvement identified during histopathologic examination. These tumors demonstrated the capacity to spread along existing anatomic pathways as well as direct bone erosion. We conclude that preoperative CT scans accurately stage EAM squamous cell carcinoma.
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Affiliation(s)
- M Arriaga
- House Ear Institute, University of Pittsburgh School of Medicine, PA
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25
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Weissman JL, Arriaga M, Curtin HD, Hirsch B. Duplication anomaly of the internal auditory canal. AJNR Am J Neuroradiol 1991; 12:867-9. [PMID: 1950913 PMCID: PMC8333500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- J L Weissman
- Department of Radiology, University of Pittsburgh School of Medicine, PA 15213
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26
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Abstract
Nasopharynx, clivus, and cavernous sinus are difficult regions of the cranial base in which to perform oncologic surgery. We have developed an approach to this area by using facial soft tissue translocation and craniofacial osteotomies. Surgical field obtained at the skull base can extend from the contralateral eustachian tube to ipsilateral geniculate ganglion. It includes the nasopharynx, clivus, sphenoid, and cavernous sinus, as well as the entire infratemporal fossa and superior orbital fissure. Our experience with this technique in 12 patients is reported. All patients healed primarily.
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Affiliation(s)
- I P Janecka
- Department of Otolaryngology, Eye and Ear Institute, Pittsburgh, PA 15213
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27
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Arriaga M, Curtin H, Takahashi H, Hirsch BE, Kamerer DB. Staging proposal for external auditory meatus carcinoma based on preoperative clinical examination and computed tomography findings. Ann Otol Rhinol Laryngol 1990; 99:714-21. [PMID: 2396807 DOI: 10.1177/000348949009900909] [Citation(s) in RCA: 201] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
An accepted staging system for squamous cell carcinoma of the external auditory meatus is currently lacking and would permit accurate comparison of treatment strategies and results for patients with this unusual neoplasm. In order to develop such a staging system we reviewed the prognostic variables and the accuracy of radiographic diagnosis in 39 patients undergoing temporal bone resection for squamous carcinoma of the external auditory meatus. Predictors of poor survival were extensive tumor involvement, facial nerve paralysis, middle ear involvement, and cervical or periparotid lymphadenopathy. In a comparison of 12 specific anatomic sites, computed tomography was found to be an accurate indicator of histopathologically proven tumor invasion. On the basis of this clinical radiographic-histopathologic analysis, we propose a TNM staging system for external auditory meatus carcinoma utilizing preoperative computed tomography and physical examination. This system fulfills the requirements of the American Joint Committee on Cancer that a staging system should provide a sound basis for therapeutic planning for cancer patients by describing the survival and resultant treatment of different patient groups in comparable form.
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Affiliation(s)
- M Arriaga
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pennsylvania
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28
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Abstract
Twelve of 14 children (86%) given a pathologic diagnosis of posttransplantation lymphoproliferative disease (PTLD) at the Children's Hospital of Pittsburgh presented with head and neck symptoms, and are included in this retrospective analysis. Upper airway obstruction was the most common symptom, evident in nine children (75%). Ten children (83%) had febrile illnesses with dysphagia, odynophagia, and evidence of hypertrophy of components of Waldeyer's ring. Associated findings included cervical adenopathy, sinusitis, and otitis media. The two remaining children had an intratracheal and paratracheal mass, respectively. Excision of obstructing lymphoid tissue with proper handling of the specimen is advocated for diagnosis and relief of airway obstruction. Systemic therapy is necessary for treatment of PTLD and includes reduction of immunosuppression. Erythromycin causes elevation in cyclosporine levels and should be avoided in patients taking this drug.
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Affiliation(s)
- N Sculerati
- Department of Otolaryngology, New York University Medical Center, NY 10016
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29
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Abstract
A retrospective study of 35 patients with squamous cell carcinoma of the external auditory meatus treated at the Eye and Ear Hospital of the University of Pittsburgh was performed. The standard treatment was a temporal bone resection that corresponded to the extent of the lesion, followed by postoperative radiation therapy. The tumor extensions, symptoms, treatments, survival rates, and prognostic variables were reviewed. Overall, 12 of 35 patients survived. Lesions limited to the external auditory meatus with no erosion had excellent prognoses. Survival in intermediate lesions with bony erosion or middle ear involvement was related to the status of surgical margins after partial or subtotal temporal bone resections. Extensive lesions that involved the surrounding soft tissue or dura had poor prognoses. The survival value of total temporal bone resection remains unproved.
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Affiliation(s)
- M Arriaga
- Department of Otolaryngology, University of Pittsburgh School of Medicine, PA
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30
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Arriaga M, South K, Cohen JL, Mazur EM. Interrelationship between mitosis and endomitosis in cultures of human megakaryocyte progenitor cells. Blood 1987; 69:486-92. [PMID: 3492223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Sera from dogs rendered aplastic by total-body irradiation stimulate human bone marrow megakaryocyte progenitors to form megakaryocyte colonies in plasma clot cultures. In this investigation, we evaluated the effects of varying concentrations of such sera on both the mitotic and endomitotic phases of human megakaryocyte development in vitro. When low concentrations of aplastic canine sera (2.5% to 5.0% [vol/vol]) were added to cultures of human peripheral blood mononuclear cells in place of normal AB serum, megakaryocyte colony formation was augmented fivefold, cell numbers per colony increased approximately 2.5-fold, and the geometric mean megakaryocyte ploidy almost doubled. Further increasing the aplastic canine serum concentration from 10% to 30% (vol/vol) stimulated no additional colony formation. However, there was a further augmentation of cell numbers per colony associated with a progressive decrease in the mean megakaryocyte ploidy. Megakaryocyte cultures were harvested after 7, 12, 15, and 19 days of incubation, and these demonstrated that the lower mean ploidy values found at the higher concentrations of aplastic canine serum did not result from delayed endoreduplication. At all aplastic serum concentrations evaluated, there existed a strong correlation between nuclear ploidy and cell diameter. We conclude that both the mitotic and endomitotic events in human megakaryocytopoiesis may be influenced by a factor or factors present in aplastic canine serum. At lower in vitro concentrations, such sera stimulate both mitosis and endomitosis, which promotes the development of megakaryocyte colonies composed of larger cells with a higher mean ploidy. With increasing aplastic serum concentrations, colony formation plateaus and mitosis is favored over endomitosis. This results in colonies composed of more numerous but smaller megakaryocytes with a lower mean ploidy. Our data suggest that the size and extent of polyploidization that can be achieved by a developing megakaryocyte may be influenced by the mitotic prior history of its immediate precursor cell.
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31
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Velázquez J, Arriaga M. [Surgical treatment of temporomandibular joint pain syndrome and recurrent luxation]. Rev Asoc Odontol Argent 1981; 69:399-403. [PMID: 6950467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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32
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Velazquez J, Arriaga M. [Clinical case of cylindroma]. Rev Asoc Odontol Argent 1981; 69:27-30. [PMID: 6267662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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33
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Velázquez J, Arriaga M. [Protrusion of both jaws]. Rev Asoc Odontol Argent 1979; 67:371-5. [PMID: 296481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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