Mediterranean Diet Favors Vitamin K Intake: A Descriptive Study in a Mediterranean Population.

The Mediterranean diet (MD) is associated with improved longevity and the prevention and management of chronic inflammatory diseases (CIDs). Vitamin K, which is present in MD core components such as leafy green vegetables, is also known as a protective factor for CIDs. Estimates of vitamin K intake in Mediterranean settings are still scarce, and the association between MD and vitamin K intake is yet to be established. This study analyzed vitamin K intake and MD adherence in the Algarve region, in Portugal. We conducted a cross-sectional study in a nonrandom sample of adults using an online questionnaire which included a validated food-frequency questionnaire and a screener for MD adherence. A total of 238 participants were recruited (68% women and 32% men). Adherence to the MD was low (11%). Only 10% of the participants had vitamin K intake below the adequate intake. Adherence to the MD was positively correlated with vitamin K intake (r = 0.463; p < 0.001) and age (r = 0.223; p < 0.001). Our findings underscore the importance of promoting adherence to the MD for optimal vitamin K intake, and future research should focus on developing effective interventions to promote this dietary pattern, particularly among younger individuals and men.

New Food Frequency Questionnaire to Estimate Vitamin K Intake in a Mediterranean Population.

Vitamin K is a multifunctional micronutrient essential for human health, and deficiency has been linked to multiple pathological conditions. In this study, we aimed to develop and validate a new food frequency questionnaire (FFQ) to estimate total vitamin K intake, over the course of a 30-day interval, in a Portuguese, Mediterranean-based, population. We conducted a prospective study in a non-random sample of 38 healthy adult volunteers. The FFQ was designed based on a validated Portuguese FFQ used in nationally representative studies and on literature reviews, to include foods containing ≥5 µg of vitamin K/100 g and foods with a lower vitamin K content, yet commonly included in a Mediterranean diet. Vitamin K intake was estimated from 24 h recalls and six days of food records. The final FFQ included 54 food items which, according to regression analyses, explains 90% of vitamin K intake. Mean differences in vitamin K intake based on food records (80 ± 47.7 µg/day) and on FFQ (96.5 ± 64.3 µg/day) were statistically non-significant. Further, we found a strong correlation between both methods (r = 0.7; p = 0.003). Our results suggest that our new FFQ is a valid instrument to assess the last 30 days of vitamin K intake in the Portuguese Mediterranean population.

Knowledge Assessment During the Medication Process Use by Older Patients on Clinical Routine: A Pilot Study.

Objectives: The consumption of medicines has been increasing over the last decades. The lack of medication knowledge (MK) may affect the process of medication use and, consequently, may lead to negative health outcomes. This study carried out a pilot study using a new tool to assess MK in older patients in a daily clinical practice. Materials and Methods: An exploratory cross-sectional study was conducted, including older patients (≥65 years), taking two or more medicines, followed in a regional clinic. Data were collected during a structured interview, which included an algorithm for assessing MK regarding the identification of the medicines and its use and storage conditions. Health literacy and treatment adherence were also assessed. Results: The study enrolled 49 patients, mainly between 65 and 75 years (n: 33; 67.3%) and polymedicated (n: 40; 81.6%), taking a mean of 6.9 ± 2.8 medicines per day. A lack of MK (score <50%) was observed in 15 (30.6%) participant patients. "Drug strength" and "storage conditions" were the items which presented the lowest score. MK was positively correlated with higher scores for health literacy and treatment adherence. Younger patients (age <65 years old) also had a higher MK score. Conclusion: This study showed that the applied tool could evaluate the MK of the participants and identified specific gaps regarding MK within the process of medicine use. Further studies, with more participants, will allow the confirmation of these findings and will stimulate the development of specific strategies to improve MK, thus contributing to better health outcomes.

Impacto da capacitação do cuidador informal no equilíbrio corporal da pessoa dependente em contexto domiciliário / Impact of informal caregiver empowerment on body balance of the dependent person in a home setting

O presente relatório reporta-se ao Estágio de Natureza Profissional na Unidade de Cuidados na Comunidade de Ermesinde, Agrupamento de Centros de Saúde Grande Porto III Maia-Valongo, cujo objetivo geral foi desenvolver competências comuns e específicas na prática da Enfermagem de Reabilitação através da integração da formação académica adquirida com o exercício profissional em contexto real, incluindo também uma componente de investigação. Contexto e objetivo: A população portuguesa está cada vez mais envelhecida e a franja mais idosa, para além do declínio de algumas capacidades físicas e cognitivas, sofre ainda o aumento crescente do peso das doenças crónicas e degenerativas. Exemplos deste declínio é a perda de força muscular, alterações do padrão da marcha, diminuição da flexibilidade, da agilidade, da coordenação sensória-motora, da mobilidade articular e, consequentemente comprometimento do equilíbrio estático e dinâmico. Por outro lado, observa-se uma vontade da sociedade de cuidar destas pessoas em ambiente domiciliário, o mais tempo possível, o que dá uma enorme relevância à figura do cuidador informal e às suas necessidades educativas. Assim, o EEER assume também um papel de suporte ao cuidador familiar concebendo intervenções individualizadas (à pessoa dependente, familiar cuidadora e família ou suporte social equivalente) dirigidas à componente cognitiva, comportamental e emocional de todos os elementos envolvidos no processo de cuidar. Desta forma, decidimos abordar a seguinte questão de investigação - Quais os efeitos de um programa de capacitação de cuidadores informais na abordagem do equilíbrio corporal à pessoa dependente em contexto domiciliário? Através desta questão definimos como objetivo geral avaliar o impacto do programa de capacitação de cuidadores informais na abordagem do equilíbrio corporal na pessoa dependente em contexto domiciliário. Como objetivos específicos definimos: caracterizar os conhecimentos de um grupo de cuidadores informais à pessoa dependente em contexto domiciliário sobre equilíbrio corporal, antes e após a aplicação do programa de capacitação para o equilíbrio estático sentado; avaliar o impacto da capacitação do cuidador informal no equilíbrio corporal e autonomia na respetiva pessoa dependente em contexto domiciliário; avaliar a correlação entre as alterações decorrentes no equilíbrio corporal com autonomia e também com as variáveis sociodemográficas na pessoa dependente em contexto domiciliário após capacitação do respetivo cuidador informal.Método: O desenho metodológico escolhido foi o quase experimental de grupo único com observação antes e depois da intervenção. A amostra foi de cariz não probabilística e por conveniência. Abrangeu 10 cuidadores informais e respetiva pessoa dependente alvo de cuidados. Os cuidadores eram na sua maioria do género feminino (90,0%), próximos do final da idade ativa (idade média de 61,90 anos), com necessidade de apoio domiciliário (60%). Quanto aos utentes dependentes alvo de cuidados, são na sua maioria do género feminino (70,0%), com várias comorbilidades que incluíam na sua grande maioria afeções que afetavam a função corporal ligadas à pressão arterial e sistema metabólico e endócrino como a HTA e Diabetes respetivamente (90%), e na sua maioria idosos (média de idade de 80,8 anos). Para a recolha de dados foi utilizado um formulário sociodemográfico, pesquisa no processo clínico informatizado do utente, grelha de observação, Teste de Tinetti e o Índice de Barthel. Resultados: Na avaliação inicial à pessoa alvo de cuidados apresentaram equilíbrio estático e dinâmico comprometido (pontuação média no Teste de Tinetti de 2,10) e com grave dependência ou dependência total (pontuação média no Índice de Barthel de 20,05). Após a aplicação do programa de capacitação ao cuidador informal verificamos ganhos médios significativos nos utentes alvo de cuidados em equilíbrio e autonomia (8,90 pontos no Teste de Tinetti e 21,00 pontos no Índice de Barthel). Conclusão: As pessoas no domícilio com um grau elevado de dependência podem usufruir de cuidados básicos ligados ao equilíbrio estático sentado através da capacitação do respetivo cuidador informal, o que se reflete em ganhos no seu equilíbrio e autonomia.

This report on the Professional Internship at the Community Care Unit of Ermesinde, Group of Health Centers Grande Porto III Maia-Valongo, have as general objective to develop common and specific skills in the practice of Rehabilitation Nursing through the integration of the academic training acquired through professional practice in a real context, also including a research component. Context and Objective: The Portuguese population is increasingly aging and the elderly fringe, in addition to the decline of some physical and cognitive abilities, also suffers an increasing burden of chronic and degenerative diseases. An example of this deterioration is the loss of muscle strength, change in gait pattern, diminished flexibility, reduced agility, loss of sensory-motor coordination, diminished joint mobility and consequently impairment of static and dynamic balance. On the other hand, there is a desire on the part of society to take care of these people in a home environment for as long as possible, which gives enormous relevance to the figure of the informal caregiver and their educational needs. Thus, the Rehabilitation Nurse also assumes a role of support for the family caregiver designing individualized interventions (to the dependent person, family caregiver and family or equivalent social support) aimed at the cognitive, behavioral and emotional component of all the elements involved in the caregiving process. In this way, we decided to address the following research question - What are the effects of a training program for informal caregivers in approaching the body balance of the long-term care users at home? Through this question, we defined as a general objective to evaluate the impact of the training program for informal caregivers in the approach to body balance in the dependent person at home. As specific objectives we defined the following items: to characterize the knowledge of a group of informal caregivers to the dependent person at home about body balance before and after the application of the training program for static sitting balance; assess the impact of informal caregiver training on body balance and autonomy on the respective dependent person at home; to evaluate the correlation between the changes resulting from the body balance with autonomy and also with the sociodemographic variables in the dependent person at home after training the respective informal caregiver. Method: The methodological design chosen was the quasi-experimental single group with observation before and after the intervention. The sample was non-probabilistic and by convenience. It included 10 informal caregivers and their dependent person being cared for. Caregivers were mostly female (90.0%), near the end of working age (average age of 61.90 years), in need of home support (60%). As for the long-term care users they were mostly female (70.0%), with several comorbidities that included, for the most part, conditions that affected body function linked to blood pressure and metabolic and endocrine systems such as hypertension and Diabetes respectively (90%), and mostly elderly (mean age 80.8 years). For data collection was used a sociodemographic form, a research in the computerized clinical file of the user, an observation grid, the Tinetti Test and the Barthel Index. Results: In the initial assessment, the long-term care user showed impairment of static and dynamic balance (average score on the Tinetti Test of 2.10) and severe or total dependence (average score on the Barthel Index of 20.05). After applying the training program to the informal caregiver, we found significant average gains in balance and autonomy care on the dependent persons (8.90 points in the Tinetti Test and 21.00 points in the Barthel Index). Conclusion: People in the household with a high degree of dependence can benefit from basic care related to static sitting balance through the training of the respective informal caregiver, which is reflected in gains in their balance and autonomy.

Perception of Portuguese Consumers Regarding Food Labeling.

Food labels are the first information tool used by consumers in the purchase and consumption of food products. Food labeling is a tool that can influence the consumers' perception of quality and, in turn, their food choice. This study characterizes and demonstrates the importance of labeling and the degree of consumers' perception and literacy about food labels through the application of an online questionnaire. The results obtained, in a sample of n = 467, showed that Portuguese consumers have the habit of reading the label and recognizing its importance but do not understand all the information contained in the label. They have an easier time understanding the front-of-pack labeling systems, especially those presented through symbols/colors. Thus, it demonstrates the need for greater education and literacy in the areas of food and nutrition so that through the reading and interpretation of labels, consumers can make informed food choices.

Health behaviours as predictors of the Mediterranean diet adherence: a decision tree approach.

OBJECTIVE: This study aimed to identify health behaviours that determine adolescent's adherence to the Mediterranean diet (MD) through a decision tree statistical approach. DESIGN: Cross-sectional study, with data collected through a self-fulfilment questionnaire with five sections: (1) eating habits; (2) adherence to the MD (KIDMED index); (3) physical activity; (4) health habits and (5) socio-demographic characteristics. Anthropometric and blood pressure data were collected by a trained research team. The Automatic Chi-square Interaction Detection (CHAID) method was used to identify health behaviours that contribute to a better adherence to the MD. SETTING: Eight public secondary schools, in Algarve, Portugal. PARTICIPANTS: Adolescents with ages between 15 and 19 years (n 325). RESULTS: According to the KIDMED index, we found a low adherence to MD in 9·0 % of the participants, an intermediate adherence in 45·5 % and a high adherence in 45·5 %. Participants that regularly have breakfast, eat vegetable soup, have a second piece of fruit/d, eat fresh or cooked vegetables 1 or more times a day, eat oleaginous fruits at least 2 to 3 times a week, and practice sports and leisure physical activities outside school show higher adherence to the MD (P < 0·001). CONCLUSIONS: The daily intake of two pieces of fruit and vegetables proved to be a determinant health behaviour for high adherence to MD. Strategies to promote the intake of these foods among adolescents must be developed and implemented.

Health literacy assessment: Translation and cultural adaptation to the Portuguese population.

RATIONALE, AIMS, AND OBJECTIVES: Health literacy (HL) has been widely referenced as a determinant of health outcomes, making the assessment of low HL a fundamental step to plan educational interventions. This study aimed to translate and adapt the Short Assessment of Health Literacy-Spanish and English (SAHL-S&E) questionnaire into European Portuguese. METHODS: The SAHL-S&E questionnaire was translated using the recommendations of the International Society for Pharmacoeconomics and Outcomes Research. One hundred fifty-three Portuguese native speakers aged over 18 years old were included in this study, enrolled among users of community pharmacies in the Algarve region (Portugal). RESULTS: The translation of the questionnaire used showed a good internal consistency (Cronbach α: .812), and a statistically significant (F = 5.05 P < .001) interrater reliability. Over a third of subjects (37.9%) achieved a score less than or equal to 14, which is indicative of low HL. CONCLUSION: This tool, intended to be used in the European Portuguese population, can be used for low HL screening.

Ageing and Nutritional Therapy Adherence in Type 2 Diabetes.

The prevalence of diabetes increases with age, which is also a determinant of nutrition therapy adherence. This descriptive study was conducted in a non-random sample of 66 patients aged between 47 and 75 years (M=61.5; SD=8.0) receiving health care in a Diabetes Clinic in the municipality of Faro, in the Portuguese region of the Algarve. We aimed to assess the association between age and the clinical characteristics of type 2 diabetes and to analyze the perceptions regarding the barriers to an adequate diet. Glycated hemoglobin (HbA1c) (r=-0.372, P<0.001) showed a negative correlation with age, suggesting that older patients have a better glucose control. Older age is also correlated with a higher number of daily meals (r=0.263) and lower intake of energy (r=-0.334), protein (r=-0.249), sugars (r=-0.301), and water (r=-0.223). Forty-six patients (69.7%) had a mean excess energy intake of 384 kcal (SD=630.2), when compared with individual nutritional energy estimated requirements. Excess energy intake was uncorrelated with age (r=-0.138, P=0.269). Older patients also seem more confused with the nutrition information they received (r=0.248) and feel that they need more advice on what is a proper diet (r=0.242). Nutrition education interventions in this population must be tailored in order to address these factors.