2021
Authors
Soares, C; Figueiredo, A; Figueiredo, F;
Publication
JOURNAL OF EAST-WEST BUSINESS
Abstract
The subprime crisis was a global financial crisis that affected a large number of countries and, in particular, the European economies. In this paper we considered fourteen variables associated to the public, private and financial sectors, in order to analyze the main vulnerabilities, differences and similarities observed in twenty-seven European countries. The statistical analysis was performed with the STATIS methodology, with data collected in the period 2002-2011, including some years before and some after the historical crisis of 2007-2008. The study led us to conclude that European countries are different in which concerns to investment, savings, sustainability of public accounts and public investment.
2021
Authors
Daniele, P; Fulga, C; Martn Herran, G; Mazalov, V; Petrosyan, L; Oliveira, BMPM; Ramos, C; Weber, GW; Zenkevich, N;
Publication
JOURNAL OF DYNAMICS AND GAMES
Abstract
2021
Authors
Marinho, R; Pessoa, A; Lopes, M; Rosinhas, J; Pinho, J; Silveira, J; Amado, A; Silva, S; Oliveira, B; Marinho, A; Jager Wittenaar, H;
Publication
ACTA MEDICA PORTUGUESA
Abstract
Introduction: Disease-related undernutrition is highly prevalent and requires timely intervention. However, identifying undernutrition often relies on physician judgment. As Internal Medicine wards are the backbone of the hospital setting, insight into the prevalence of nutritional risk in this population is essential. We aimed to determine the prevalence of nutritional risk in Internal Medicine wards, to identify its correlates, and to assess the agreement between the physicians' impression of nutritional risk and evaluation by Nutritional Risk Screening 2002. Material and Methods: A cross-sectional multicentre study was performed in Internal Medicine wards of 24 Portuguese hospitals during 2017. Data on demographics, previous hospital admissions, primary diagnosis, and Charlson comorbidity index score were collected. Nutritional risk at admission was assessed using Nutritional Risk Screening 2002. Agreement between physicians' impression of nutritional risk and Nutritional Risk Screening 2002 was tested by Cohen's kappa. Results: The study included 729 participants (mean age 74 +/- 14.6 years, 51% male). The main reason for admission was respiratory disease. Mean Charlson comorbidity index score was 5.8 +/- 2.8. Prevalence of nutritional risk was 51%. Nutritional risk was associated with admission during the previous year (odds ratio = 1.65, 95% confidence interval: 1.22 - 2.24), solid tumour with metastasis (odds ratio = 4.73, 95% confidence interval: 2.06 - 10.87), any tumour without metastasis (odds ratio = 2.04, 95% confidence interval:1.24 - 3.34), kidney disease (odds ratio = 1.83, 95% confidence interval: 1.21 - 2.75), peptic ulcer (odds ratio = 2.17, 95% confidence interval: 1.10 - 4.25), heart failure (odds ratio = 1.51, 95% confidence interval: 1.11 - 2.04), dementia (odds ratio = 3.02, 95% confidence interval: 1.96 - 4.64), and cerebrovascular disease (odds ratio = 1.62, 95% confidence interval: 1.12 - 2.35). Agreement between physicians' evaluation of nutritional status and Nutritional Risk Screening 2002 was weak (Cohen's kappa = 0.415, p < 0.001). Discussion: Prevalence of nutritional risk in the Internal Medicine population is very high. Admission during the previous year and multiple comorbidities increase the odds of being at-risk. Subjective physician evaluation is not appropriate for nutritional screening. Conclusion: The high prevalence of at-risk patients and poor subjective physician evaluation suggest the need to implement mandatory nutritional screening.
2021
Authors
de Moraes, MM; Oliveira, B; Afonso, C; Santos, C; Torres, D; Lopes, C; de Miranda, RC; Rauber, F; Antoniazzi, L; Levy, RB; Rodrigues, S;
Publication
NUTRIENTS
Abstract
Considering the nature, extent, and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with sociodemographic factors and diet quality in Portuguese children and adolescents. Cross-sectional data were obtained from the National Food, Nutrition and Physical Activity Survey (2015-2016) of the Portuguese population. Dietary intake was obtained from two non-consecutive days and food items were classified according to the NOVA system. The proportion (in grams) of foods in the total daily diet was considered to identify DPs by latent class analysis, with age and sex as concomitant variables. Associations of DPs with sociodemographic characteristics were assessed using multinomial logistic regression. Linear regressions adjusted by sociodemographic characteristics tested associations of DPs with diet quality. DPs identified were: "Unhealthy " (higher sugar-sweetened beverages, industrial breads, and sausages intake), "Traditional " (higher vegetables, fish, olive oil, breads, ultra-processed yogurts, and sausages intake), and "Dairy " (higher intake of milk, yogurt, and milk-based beverages). "Unhealthy " was associated with older ages and lower intake of dietary fibre and vitamins and the highest free sugars and ultra-processed foods (UPF), although all DPs presented significant consumption of UPF. These findings should be considered for the design of food-based interventions and school-feeding policies in Portugal.
2021
Authors
Poinhos, R; Oliveira, BMPM; Sorokina, A; Franchini, B; Afonso, C; de Almeida, MDV;
Publication
CLINICAL NUTRITION ESPEN
Abstract
Background & aims: The Mini Nutritional Assessment (MNA) is the most used tool to assess malnutrition and/or its risk among older adults. Its Screening section was proposed as a short form (MNA-SF) but studies comparing the two forms present controversial results. Our main aims were to study the agreement between MNA-SF and its full form (MNA-FF) among Portuguese older adults living in the community and to develop a more sensible version of the MNA-SF. Material and methods: This cross-sectional study used a convenience sample of 456 older adults (54.2% females) aged 65-92 years (mean = 73; SD = 6). Data analyzed included: nutritional status (MNA), social support (Fillenbaum's Social Network Index), level of independency in daily activities (Lawton e Brody's scale) and eating-related quality of life. Both MNA-FF and MNA-SF classify participants as malnourished, at risk of malnutrition or with normal nutrition status. Anthropometric assessments (weight, height, arm and calf perimeters) were carried out and BMI was computed. Results: The agreement between the two classifications is 82.7%, but Cohen's k shows a weak agreement (weighted Cohen's k = 0.497; p < 0,001), and the sensitivity of the MNA-SF to detect malnutrition or its risk (as assessed by the MNA-FF) was 42.6% (despite a specificity of 98.8%). Participants classified as normal using the MNA-SF despite at risk using the MNA-FF present lower scores in two items from the Assessment section (number of full meals eaten daily and amount of fluid consumed per day). These were included in MNA-SF to obtain an extended short-version (MNA-5F8). The difference between the ROC curves for MNA-SF and MNA-5F8 justifies the preferential use of the MNA-5F8 with an estimated cut-off of 14 points, which showed high sensitivity (91.8%) and specificity (79.9%). Conclusions: The addition of two items to the MNA-SF provides a more sensible tool to detect the risk of malnutrition among older adults. General eating-related questions seem relevant to assess malnutrition in this age group.
2021
Authors
OTTONI, IC; OLIVEIRA, BMPMd; BANDONI, DH; GRAÇA, APSR;
Publication
Revista de Nutrição
Abstract
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