Percorrer por autor "Alves, Sara Elisa Brás"
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- Adherence to the mediterranean diet and metabolic health in older adults: insights from a feasibility studyPublication . Alves, Sara Elisa Brás; Fernandes, Hélder; Mendes, Eugénia; Monteiro, António M.; Fernandes, Adília; Vaz, Josiana A.; Pereira, Ana Maria Geraldes Rodrigues; Sá, Leandro Moreira de; Agradém, CarlaThe Mediterranean Diet is known for its protective effects against cardiovascular and metabolic diseases. Metabolic syndrome, characterized by multiple health risk factors, is increasingly concerning in older populations. Understanding dietary impacts on metabolic health is key for promoting healthy ageing. Objectives: This feasibility study aimed to explore the relationship between adherence to the Mediterranean Diet and metabolic risk factors in older adults participating in a community exercise program and to evaluate the feasibility of applying validated tools in this setting. Methods: A cross-sectional design was used. Adherence to the Mediterranean Diet was evaluated using the PREDIMED questionnaire, while Metabolic Syndrome was evaluated according to National Cholesterol Education Program criteria. Blood samples were taken following WHO guidelines. Results: Ten participants (mean age 73.1 years; 90% women) were included. 50% showed high adherence to the Mediterranean Diet, while 40% had moderate or low adherence. No participants met the full criteria for Metabolic Syndrome. Significant associations were found between Mediterranean Diet adherence and chronic disease (r = 0.869, p < 0.01), and an inverse correlation with the number of Metabolic Syndrome criteria (r = –0.707, p < 0.05). The Mediterranean Diet score was also inversely related to cholesterol (r = –0.740, p < 0.05). Conclusions: Higher adherence to the Mediterranean Diet was associated with better metabolic profiles, highlighting its potential protective role. The study demonstrates the feasibility of incorporating nutritional screening in community exercise programs for older adults. Future research should include larger and longitudinal samples and integrate inflammatory biomarkers.
- Adherence to the mediterranean diet and the risk of metabolic syndrome: a preliminary studyPublication . Alves, Sara Elisa Brás; Mendes, Eugénia; Monteiro, António M.; Fernandes, Adília; Fernandes, Hélder; Vaz, Josiana A.; Pereira, Ana Maria Geraldes RodriguesThe aging population is facing an increase in chronic diseases, particularly Metabolic Syndrome (MetS), which raises the risk of cardiovascular disease and diabetes1,2. Effective prevention strategies are essential. The Mediterranean diet, rich in vegetables, fruits, whole grains, and healthy fats, has been shown to improve metabolic health and reduce these risks, especially among older adults3,4
- Adherence to the mediterranean diet and the risk of metabolic syndrome: a preliminary studyPublication . Alves, Sara Elisa Brás; Monteiro, António M.; Fernandes, Adília; Fernandes, Hélder; Vaz, Josiana A.; Pereira, Ana Maria Geraldes Rodrigues; Mendes, EugéniaThe Mediterranean Diet has been widely recognized for its protective effects against cardiovascular and metabolic diseases (Zazpe et al., 2008). Metabolic syndrome, often defined as the simultaneous occurrence of health-related risk factors, is a growing concern in ageing populations (Swarup et al., 2024). Understanding how dietary patterns influence metabolic health in older adults is essential for promoting healthy ageing and preventing disease. Objectives: To explore the association between adherence to the Mediterranean Diet and health-related risk factors among older adults. Methods: A crosssectional study was employed. Self-administered questionnaires were used to collect participant data and assessed for sociodemographic characteristics, self-reported health status, presence of chronic diseases. Diet adherence was evaluated through the PREDIMED instrument (Zazpe et al., 2008). Metabolic Syndrome was inferred following cut-off values defined by The Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Cleeman, 2001). Blood collection for laboratory tests was performed following WHO guidelines. Informed consent obtained from all participants. Study approved by Ethical Council of Unidade Local de Saúde do Nordeste, Nº41/2024. Results: Ten participants, aged 69 to 81, adhere to the study. Most were female (90%), with 70% reporting at least one chronic disease. Abdominal obesity was noted in 40%, and 10% had elevated triglycerides, while 20% had high blood pressure. Approximately 50% of individuals exhibited a high level of Diet adherence, while 40% demonstrated moderate and low adherence. No participants met the criteria for Metabolic Syndrome. Statistically significant associations were found between adherence to the Mediterranean Diet and the presence of chronic disease (r=0.869, p<0.01), and an inverse correlation with Mediterranean Diet score and the number of Metabolic Syndrome criteria (r=–0.707, p<0.05). Moreover, the Mediterranean diet score was inversely associated with cholesterol (r=–0.740, p<0.05). Conclusions: While no participants fulfilled the criteria for metabolic syndrome, individual risk factors were present in the sample. Higher adherence to the Mediterranean Diet was associated with fewer metabolic risk factors and better overall health indicators. These preliminary findings suggest that dietary patterns may play a key role in the metabolic health of older adults and warrant further investigation with a larger sample.
- Baseline data and associations between urinary biomarkers of polycyclic aromatic hydrocarbons, blood pressure, hemogram, and lifestyle among wildland firefightersPublication . Barros, Bela; Paiva, Ana Margarida; Oliveira, Marta; Alves, Sara Elisa Brás; Esteves, Filipa; Fernandes, Adília; Vaz, Josiana A.; Slezakova, Klara; Costa, Solange; Teixeira, João Paulo Fernandes; Morais, SimoneAvailable literature has found an association between firefighting and pathologic pathways leading to cardiorespiratory diseases, which have been linked with exposure to polycyclic aromatic hydrocarbons (PAHs). PAHs are highlighted as priority pollutants by the European Human Biomonitoring Initiative in occupational and non-occupational contexts. Methods This cross-sectional study is the first to simultaneously characterize six creatinine-adjusted PAHs metabolites (OHPAHs) in urine, blood pressure, cardiac frequency, and hemogram parameters among wildland firefighters without occupational exposure to fire emissions (> 7 days), while exploring several variables retrieved via questionnaires. Results Overall, baseline levels for total OHPAHs levels were 2 to 23-times superior to the general population, whereas individual metabolites remained below the general population median range (except for 1-hydroxynaphthalene+1-hydroxyacenaphtene). Exposure to gaseous pollutants and/or particulate matter during work-shift was associated with a 3.5-fold increase in total OHPAHs levels. Firefighters who smoke presented 3-times higher total concentration of OHPAHs than non-smokers (p < 0.001); non-smoker females presented 2-fold lower total OHPAHs (p = 0.049) than males. 1-hydroxypyrene was below the recommended occupational biological exposure value (2.5 mu g/L), and the metabolite of carcinogenic PAH (benzo(a)pyrene) was not detected. Blood pressure was above 120/80 mmHg in 71% of subjects. Firefighters from the permanent intervention team presented significantly increased systolic pressure than those who performed other functions (p = 0.034). Tobacco consumption was significantly associated with higher basophils (p = 0.01-0.02) and hematocrit (p = 0.03). No association between OHPAHs and blood pressure was found. OHPAHs concentrations were positively correlated with monocyte, basophils, large immune cells, atypical lymphocytes, and mean corpuscular volume, which were stronger among smokers. Nevertheless, inverse associations were observed between fluorene and pyrene metabolites with neutrophils and eosinophils, respectively, in non-smokers. Hemogram was negatively affected by overworking and lower physical activity. Conclusion This study suggests possible associations between urinary PAHs metabolites and health parameters in firefighters, that should be further assessed in larger groups.
- Biomonitoring of firefighters' exposure to priority pollutant metal(loid)s during wildland fire combat missions: Impact on urinary levels and health risksPublication . Paiva, Ana Margarida; Barros, Bela; Azevedo, Rui; Oliveira, Marta; Alves, Sara Elisa Brás; Esteves, Filipa; Fernandes, Adília; Vaz, Josiana A.; Alves, Maria José; Slezakova, Klara; Pereira, Maria do Carmo; Teixeira, João Paulo Fernandes; Costa, Solange; Almeida, Agostinho; Morais, SimoneWildland firefighters are exposed to metal(loid)s released during wildfires through vegetation combustion, which also promotes remobilization of accumulated anthropogenic metal(loid)s. Studies biomonitoring metal(loid)s exposure promoted exclusively by wildfire suppression activities are lacking. This work aimed to characterize, for the first time, the impact of real-life wildland firefighting operations on urinary levels of priority pollutant metal(loid)s [14 included in ATSDR, 11 in USEPA, and 4 in Human Biomonitoring for Europe Initiative priority lists] in firefighters. Spot urines were sampled pre-exposure (105 non-smokers, 76 smokers) and post-exposure to firefighting activities (20 non-smokers, 25 smokers); among those, paired samples were collected from 14 nonsmoking and 24 smoking firefighters. Smokers displayed significantly higher baseline levels of zinc (28 %), lithium (29 %), cadmium (55 %), rubidium (13 %), and copper (20 %) than non-smokers. Following wildfire suppression, the concentration of the WHO potentially toxic metal(loid)s rose from 2 % to 3 % in smokers and 2 % to 5 % in non-smokers (up to 4 % for all firefighters and up to 5 % in paired samples). Levels of nickel (33–53 %), antimony (45–56 %), and cesium (40–47 %) increased significantly post-exposure in non-smokers (in all firefighters and in paired samples), whose urinary concentrations were generally more impacted by wildfire emissions than those of smokers. Arsenic (80 %) displayed the only significant increase post-exposure in smokers, being the best discriminant of exposure to wildfire emissions in these subjects. Significant positive correlations were found for age and/or career length with cadmium, lead, barium, strontium, and mercury, and for body mass index with arsenic. The reference/guidance values were exceeded for arsenic, zinc, cesium, nickel, antimony, cadmium, lead, thallium, mercury, copper, and cobalt in 1–90 % of firefighters suggesting augmented health risks due to wildfire combating and emphasizing the need of mitigation strategies. This study also provides biomonitoring data to help setting reference values for the occupationally exposed part of population.
- Biomonitoring of polycyclic aromatic hydrocarbons exposure and short-time health effects in wildland firefighters during real-life fire eventsPublication . Paiva, Ana Margarida; Barros, Bela; Oliveira, Marta; Alves, Sara Elisa Brás; Esteves, Filipa; Fernandes, Adília; Vaz, Josiana A.; Slezakova, Klara; Teixeira, João Paulo Fernandes; Costa, Solange; Morais, SimoneHuman biomonitoring data retrieved from real -life wildland firefighting in Europe and, also, worldwide are scarce. Thus, in this study, 176 Portuguese firefighters were biomonitored pre- and post- unsimulated wildfire combating (average:12-13 h; maximum: 55 h) to evaluate the impact on the levels of urinary polycyclic aromatic hydrocarbons hydroxylated metabolites (OHPAH; quantified by high-performance liquid chromatography with fluorescence detection) and the associated short-term health effects (symptoms, and total and differentiated white blood cells). Correlations between these variables and data retrieved from the self -reported questionnaires were also investigated. Firefighters were organized into four groups according to their exposure to wildfire emissions and their smoking habits: non-smoking non -exposed (NSNExp), non-smoking exposed (NSExp), smoking non -exposed (SNExp), and smoking and exposed (SExp). The most abundant metabolites were 1-hydroxynaphthalene and 1-hydroxyacenaphthene (1OHNaph + 1OHAce) (98-99 %), followed by 2-hydroxyfluorene (2OHFlu) (0.2-1.1 %), 1-hydroxyphenanthrene (1OHPhen) (0.2-0.4 %), and 1-hydroxypyrene (1OHPy) (0.1-0.2 %); urinary 3-hydroxybenzo(a)pyrene was not detected. The exposure to wildfire emissions significantly elevated the median concentrations of each individual and total OHPAH compounds in all groups, but this effect was more pronounced in non-smoking (1.7-4.2 times; p < 0.006) than in smoking firefighters (1.3-1.6 times; p < 0.03). The greatest discriminant of exposure to wildfire emissions was 1OHNaph + 1OHAce (increase of 4.2 times), while for tobacco smoke it was 2OHFlu (increase of 10 times). Post -exposure, white blood cells count significantly increased ranging from 1.4 (smokers, p = 0.025) to 3.7 -fold (non-smokers, p < 0.001), which was accompanied by stronger significant correlations (0.480 < r < 0.882; p < 0.04) between individual and total OHPAH and total white blood cells (and lymphocytes > monocytes > neutrophils in non-smokers), evidencing the impact of PAH released from wildfire on immune cells. This study identifies Portuguese firefighters with high levels of biomarkers of exposure to PAH and points out the importance of adopting biomonitoring schemes, that include multiple biomarkers of exposure and biomarkers of effect, and implementing mitigations strategies.
- Conhecimentos das mães face à criança com febrePublication . Alves, Sara Elisa Brás; Sousa, Marta; Mata, Maria Augusta; Sousa, FilomenaA febre é o motivo mais frequente de procura de cuidados de saúde em idade pediátrica. Para a DGS(2018) esta representa pelo menos 20% das causas de recurso aos serviços às urgências hospitalares e cerca de 50% das urgências realizadas em consultórios pediátricos. A febre é tradicionalmente, encarada pelos pais com uma situação grave, considerada não como um sintoma/sinal, mas sim como doença. A importância da febre na criança transcende do facto de sr tão comum e um dos principais motivos de consulta em pediatria.
- Current nursing education considering southern europe’s reality and legal framework: a two-phased research approachPublication . Antão, Celeste; Antolí-Forner, Aloma; Fernandes, Hélder; Alves, Sara Elisa Brás; Pimentel, Maria HelenaNursing education and formation is still heterogenous in spite of The Bologna Declaration in 1999. Apart from the existence of basic curriculum standards, universities have flexibility regarding its design. The objective of this study is to provide an overview of contemporary nursing education and contrast it with the legal frameworks in place in four Southern European countries: Portugal, Spain, Italy, and Greece. A scoping review was conducted in order to revise and obtain an up-to-date review of current nursing education and quality. Then, a content evaluation of the legal public framework was conducted. A total of nine articles were included in the review. Data analysis evoked three main themes from the results: nursing education heterogeneity owing to ECTS increased from 180 to 240 for the diversity of clinical practice hours; the nursing framework lacked a definition; and the evolution of nursing education, alongside quality improvement and more accurate guidelines were required. Regarding their legal framework, the main directives and legislation standards were assessed and compared with the current curriculum. To conclude, nursing heterogeneity education evokes competence inequality among students and future professionals as larger curricular programs (240 ECTS) offer more clinical practice. Nursing education uniformity could enhance international mobility and promote knowledge exchange and nursing competence framework definitions. These are facts that certainly bring nursing empowerment. This study was not registered.
- Exploring cardiovascular risk and plasma ghrelin levels in older adults: a preliminary studyPublication . Alves, Sara Elisa Brás; Capristano, Jeovana; Sá, Leandro Moreira de; Mendes, Eugénia; Fernandes, Hélder; Vaz, Josiana A.Cardiovascular diseases are a leading cause of illness and mortality worldwide, with ageing as a key risk factor. As people age, heightened inflammation, oxidative stress, and endothelial dysfunction increase their cardiovascular disease risk. Ghrelin, known as "the hunger hormone," is essential for energy regulation and metabolism. It offers cardiovascular benefits by promoting vasodilation and enhancing endothelial function. With anti-inflammatory and antioxidative properties, ghrelin aids vascular health, making it particularly significant for ageing populations where these processes are often disrupted. Imbalanced ghrelin levels may increase the risk of atherosclerosis and other cardiovascular complications. Understanding these variations in plasma ghrelin levels can offer insights into individual susceptibility to cardiovascular disease and highlight the hormone's role in metabolic and cardiovascular health. This preliminary study aimed to evaluate cardiovascular risk and plasma ghrelin levels in a community of 16 older adults aged 60 or above
- Exploring clinical trials to manage firefighters’ sleep quality: a PRISMA compliant systematic reviewPublication . Alves, Sara Elisa Brás; Vaz, Josiana A.; Fernandes, AdíliaSleep research has grown over the past decades and investigators are deeply involved in studying sleep and its impact on human health and body regulation. Despite the understanding that insufficient sleep is strongly linked to the development of several disorders, unsatisfactory sleep exposes health and safety to innumerous risks. The present study aims to review and analyze the main results of clinical trials, registered at ClinicalTrials.gov and ICTRT databases, and developed construct strategies to improve sleep quality on firefighters and enhance professionals’ sleep and health conditions. The protocol was registered in PROSPERO under number CRD42022334719. Trials registered between first registry and 2022 were included. We retrieved 11 registered clinical trials; seven met eligibility criteria and were included in the review. A relation between sleep disorders, shift work, and occupational health problems was found, and retrieved trials showed that sleep education programs can improve sleep quality and sleep hygiene. Science has already recognized sleep’s importance for metabolic functioning and survivorship. Nevertheless, it continues to play a major role in discovering methods to diminish the problems faced. Strategies contemplating sleep education, or intervention, should be presented to fire services to tackle this problem and promote healthier and safer environments.