Percorrer por autor "Nunes, Carla"
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- Autopercepção da saúde bucal em idosos de uma população urbana em Lisboa, PortugalPublication . Carvalho, Catarina; Manso, Ana Cristina; Escova, Ana; Salvado, Francisco; Nunes, CarlaOBJETIVO: Analisar se a autopercepção de saúde bucal em contexto urbano está associada aos factores sociodemográficos que interferem na qualidade de vida da saúde bucal.
- Beyond pain and disability: an explanatory mixed methods study exploring outcomes after physiotherapy intervention in patients with chronic low back painPublication . Pires, Diogo; Cruz, Eduardo; Costa, Daniela; Nunes, CarlaPurpose: The primary aim of this study was to explore relevant outcome domains for patients with chronic low back pain (CLBP) undergoing physiotherapy. A secondary aim was to examine potential discrepancies between meaningful changes in pain and disability and the global perception of improvement. Methods: An explanatory mixed methods design was employed. Twenty-two patients with CLBP completed self-reported measures before and after a physiotherapy programme. After the intervention, three focus groups were conducted with patients who perceived an overall improvement. Discussions were recorded, transcribed and analysed using thematic analysis. Results: Quantitative analysis showed an inconsistent relationship between changes in pain and disability measures and global improvements as perceived by patients. Two main themes emerged from the thematic analysis: “pain relief” (subthemes: reducing pain intensity and other symptoms; reducing medication intake; improving sleep quality) and “gaining control over the LBP condition” (subthemes: ability to selfmanage; return to function; and sense of well-being and normality). Conclusion: Patients with CLBP perceived multiple outcomes from physiotherapy treatment that cover the domains of global, physical, mental and social health. These study findings suggest that the targets of measurement for physiotherapy need to be expanded in order to reflect outcome domains valued by patients.
- Contributions of pain intensity and disability changes to global perceived effect after physiotherapy in chronic low back pain patientsPublication . Pires, Diogo; Cruz, Eduardo Brazete; Nunes, Carla
- Contributions of pain intensity and disability changes to global perceived effect after physiotherapy in chronic low back pain patientsPublication . Pires, Diogo; Cruz, Eduardo; Canhão, Helena; Nunes, Carla
- Cross-cultural adaptation and psychometric properties of the european portuguese version of the Global Perceived Effect Scale in patients with chronic low back painPublication . Freitas, Petra; Pires, Diogo; Nunes, Carla; Cruz, EduardoPurpose: To cross-culturally adapt the Global Perceived Effect Scale (GPES) into Portuguese and investigate its psychometric properties in patients with chronic low back pain. Methods: Cross-cultural adaptation was carried out according to published guidelines. Along with measures for pain and disability, GPES was administered at baseline, 48-h later and post-intervention. To estimate test-retest reliability, the intraclass correlation coefficient was used. The validity was examined through the correlation between the GPES and the Patient Global Improvement Change Scale and the contribution of baseline status to GPES scores. Responsiveness was assessed by analyzing hypotheses regarding areas under the curve and correlations with changes in other measures. Results: The test-retest reliability, the convergent validity and the contribution of the baseline status to GPES scores were demonstrated. The EPES correlated strongly with global perception of change (r=0.677), and moderately with pain and disability changes (r=0.457 and r=0.452, respectively). Areas under the curve values of 0.71(95% CI = 0.607–0.825) and 0.83 (95% CI = 0.749–922) were found. Conclusion: The GPES demonstrated adequate psychometric properties. This study’s findings supported its use in clinical and research studies with patients with chronic low back pain.
- Cross-cultural validation and psychometric evaluation of the Self-Medication Assessment Tool (SMAT) for assessing and optimizing medication therapy management of older peoplePublication . Advinha, Ana Margarida; Barros, Carla Teixeira de; Guerreiro, Mara Pereira; Nunes, Carla; Lopes, Manuel José; Oliveira-Martins, Sofia deBackground, rationale and objectives: The assessment of medication management ability in the elderly can be performed using specific tools, such as the Self-Medication Assessment Tool, which considers real and simulated regimens. The objective of this study was to perform the linguistic and cultural adaptation of the Self-Medication Assessment Tool to European Portuguese and determine its psychometric properties. Methods: The adaptation commenced with the translation/back translation cycle completed by 4 independent bilingual experts. The cultural component was accomplished through an external expert meeting and a longitudinal screening of concepts and construct. The pilot study was carried out in a sample of 150 Portuguese community-dwelling elders. Descriptive data, correlations, internal reliability, response consistency and exploratory factor analysis was conducted using SPSS Statistics (v22). Results: The pilot study was carried out in a sample of 150 community-dwelling elders: 112 (74.7%) participants were women; mean age was 74.73 ± 6.43 years. The Self-Medication Assessment Tool (Portuguese version) standard regimen (simulated medication regimen) mean scores were 20.92 ± 6.83 in functional ability and 38.75 ± 5.92 in cognitive ability; the real regimen (medication taken by the elderly) mean scores were 83.74 ± 15.86 in medication recall, 96.96 ± 11.39 in adherence self-report and 4.82 ± 10.1 in intentional non-adherence. Cronbach's α were 0.87 (functional ability), 0.84 (cognitive ability), 0.57 (medication recall), 0.94 (adherence self-report) and 0.79 (intentional non-adherence). The response consistency between test and re-test was verified. Conclusions: We have developed the European Portuguese version of the Self-Medication Assessment Tool with acceptable psychometric properties which can now be employed in the study of the elderly in clinical and research contexts.
- earlyMYCO : a pilot mother-child cohort study to assess early-life exposure to mycotoxins : challenges and lessons learnedPublication . Martins, Carla; Assunção, Ricardo; Costa, Ana; Serrano, Débora; Visintin, Lia; De Boevre, Marthe; Lachat, Carl; Vidal, Arnau; De Saeger, Sarah; Namorado, Sónia; Vidigal, Cristina; Almeida, Elisabete; Alvito, Paula; Nunes, CarlaEarly-life exposure occurs during gestation through transfer to the fetus and later, during lactation. Recent monitoring data revealed that the Portuguese population is exposed to mycotoxins, including young children. This study aimed to develop a pilot study to assess the early-life exposure to mycotoxins through a mother–child cohort, and to identify the associated challenges. Participants were recruited during pregnancy (1st trimester) and followed-up in three moments of observation: 2nd trimester of pregnancy (mother), and 1st and 6th month of the child’s life (mother and child), with the collection of biological samples and sociodemographic and food consumption data. The earlyMYCO pilot study enrolled 19 mother–child pairs. The analysis of biological samples from participants revealed the presence of 4 out of 15 and 5 out of 18 mycotoxins’ biomarkers of exposure in urine and breast milk samples, respectively. The main aspects identified as contributors for the successful development of the cohort were the multidisciplinary and dedicated team members in healthcare units, reduced burden of participation, and the availability of healthcare units for the implementation of the fieldwork. Challenges faced, lessons learned, and suggestions were discussed as a contribution for the development of further studies in this area.
- Epidemiology of Non-Specific Back Pain in Children and Adolescents: a Systematic Review of Observational StudiesPublication . Robalo, Lina; Cruz, Eduardo Brazete; Nunes, Carla
- HBM4EU-MOM : prenatal methylmercury-exposure control in five countries through suitable dietary advice for pregnancy : study design and characteristics of participantsPublication . Katsonouri, Andromachi; Gabriel, Catherine; López, Marta Esteban; Namorado, Sonia; Halldorsson, Thorhallur I.; Tratnik, Janja Snoj; Martin, Laura Rodriguez; Karakoltzidis, Achilleas; Chatzimpaloglou, Anthoula; Giannadaki, Despina; Anastasi, Elena; Thoma, Anthi; Domínguez-Morueco, Noelia; Portilla, Ana I. Cañas; Jacobsen, Eva; Assunção, Ricardo; Peres, Maria; Santiago, Susana; Nunes, Carla; Pedraza-Diaz, Susana; Iavicoli, Ivo; Leso, Veruscka; Lacasaña, Marina; González-Alzaga, Beatriz; Horvat, Milena; Sepai, Ovnair; Castano, Argelia; Kolossa-Gehring, Marike; Karakitsios, Spyros; Sarigiannis, DimosthenisBackground: Seafood is a major source of vital nutrients for optimal fetal growth, but at the same time is the main source of exposure to methylmercury (MeHg), an established neurodevelopmental toxicant. Pregnant women must be provided with dietary advice so as to include safely fish in their diet for nutrition and mercury control. The aim of this work is to present the design of a multicentre randomized control trial (RCT), which combines human biomonitoring (HBM) with dietary interventions using seafood consumption advice to pregnant women for MeHg control, and to collect information about other possible sources of exposure to mercury. It also presents the materials developed for the implementation of the study and the characteristics of the study participants, which were self-reported in the first trimester of pregnancy. Methods: The “HBM4EU-MOM” RCT was performed in the frame of the European Human Biomonitoring Initiative (HBM4EU) in five coastal, high fish-consuming European countries (Cyprus, Greece, Spain, Portugal and Iceland). According to the study design, pregnant women (≥120/country, ≤20 weeks gestational age) provided a hair sample for total mercury assessment (THg) and personal information relevant to the study (e.g., lifestyle, pregnancy status, diet before and during the pregnancy, information on seafood and factors related to possible non-dietary exposures to mercury) during the first trimester of pregnancy. After sampling, participants were randomly assigned to “control” (habitual practices) or “intervention” (received the harmonized HBM4EU-MOM dietary advice for fish consumption during the pregnancy and were encouraged to follow it). Around child delivery, participants provided a second hair sample and completed another tailored questionnaire. Results: A total of 654 women aged 18–45 years were recruited in 2021 in the five countries, primarily through their health-care providers. The pre-pregnancy BMI of the participants ranged from underweight to obese, but was on average within the healthy range. For 73% of the women, the pregnancy was planned. 26% of the women were active smokers before the pregnancy and 8% continued to smoke during the pregnancy, while 33% were passive smokers before pregnancy and 23% remained passively exposed during the pregnancy. 53% of the women self-reported making dietary changes for their pregnancy, with 74% of these women reporting making the changes upon learning of their pregnancy. Of the 43% who did not change their diet for the pregnancy, 74% reported that their diet was already balanced, 6% found it difficult to make changes and 2% were unsure of what changes to make. Seafood consumption did not change significantly before and during the first trimester of pregnancy (overall average ∼8 times per month), with the highest frequency reported in Portugal (≥15 times per month), followed by Spain (≥7 times per month). During the first-trimester of pregnancy, 89% of the Portuguese women, 85% of the Spanish women and <50% of Greek, Cypriot and Icelandic women reported that they had consumed big oily fish. Relevant to non-dietary exposure sources, most participants (>90%) were unaware of safe procedures for handling spillage from broken thermometers and energy-saving lamps, though >22% experienced such an incident (>1 year ago). 26% of the women had dental amalgams. ∼1% had amalgams placed and ∼2% had amalgams removed during peri-pregnancy. 28% had their hair dyed in the past 3 months and 40% had body tattoos. 8% engaged with gardening involving fertilizers/pesticides and 19% with hobbies involving paints/pigments/dyes. Conclusions: The study design materials were fit for the purposes of harmonization and quality-assurance. The harmonized information collected from pregnant women suggests that it is important to raise the awareness of women of reproductive age and pregnant women about how to safely include fish in their diet and to empower them to make proper decisions for nutrition and control of MeHg, as well as other chemical exposures.
- How do physical therapists measure treatment outcomes in adults with chronic low back pain? a systematic reviewPublication . Pires, Diogo; Cruz, Eduardo; Gomes, Luís A; Nunes, CarlaBackground. There is an increasing recognition of the importance of using a conceptual framework covering the full range of relevant health domains and outcome measures addressed by physical therapy modalities in patients with chronic low back pain (CLBP). However, little is known about what outcome domains have been measured and through what measures in physical therapy research. Objective. The purpose of this review was to synthesize outcome domains, instruments, and cutoff values reported in published randomized controlled trials and their compliance with the original Patient-Reported Outcomes Measurement Information System (PROMIS) framework. Data sources. Embase, MEDLINE, Cochrane Library, and Physiotherapy Evidence Database electronic databases were systematically searched from January 2008 to April 2019. Study selection. Randomized controlled trials that compared physical therapy with any other intervention for adults with CLBP were included. Data extraction. Study characteristics, outcome domains, instruments, and cutoff values were extracted by 2 reviewers. The PROMIS framework was used for domain categorization. Data synthesis. One hundred ninety-five studies were included, with 52 outcome domains and 45 cutoff values identified from 182 instruments reported. Only 14 of 195 studies assessed all PROMIS health core areas, whereas the PROMIS physical health core area was assessed in all included studies. Pain intensity and disability were the most frequently used domains. Limitations. Only studies for which full texts were available in English were included. Conclusions. This review identified a poor overlap between the PROMIS framework and outcome domains used to define the effectiveness of physical therapy in adults with CLBP. This finding suggests that other potential benefits resulting from physical therapy modalities are not being measured. Furthermore, a large diversity in the outcome domains and instruments was found.