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- Analyzing adjustment to aging and subjective age from angolan and portuguese community-dwelling older adults' perspectivesPublication . von Humboldt, Sofia; Leal, I.; Pimenta, FilipaBackground: The aging experience influences the ways an aging individual self-adjusts to challenges in late adulthood in various cultural settings. This study aims at examining the indicators of adjustment to aging (AtA) and subjective age (SA), and at investigating the latent constructs that can work as major determinants in AtA and SA in an older Portuguese and Angolan community-dwelling population. Methods: Questionnaires were completed, specifically assessing participants’ sociodemographic and health-related information. Semi-interviews with 102 older adults aged between 75 and 99 years (mean ¼ 80.5, standard deviation ¼ 5.76) were conducted, focusing on AtA and SA. Data were subjected to content analysis. The correlational structure and latent constructs of indicators of AtA and SA were analyzed by a multiple correspondence analysis. Results: Outcomes from content analysis designated seven categories for AtA, which are “accomplishment and future projects,” “occupation and leisure,” “health and well-being,” “valorization of time and age,” “social support,” “stability and safety,” and “existential meaning and sense of limit”; and five emergent categories for SA, which are “in harmony,” “fearless,” “with concern,” “youthful,” and “satisfactory.” Social support was the most reported indicator of AtA (25.4%) and in harmony (22.3%) was indicated as the most frequent SA response. Adjustment and age was explained by a three-factor overall modeldintegrated, congruent, and concerned for Angolan participants; fulfilled, reconciliated, and driven were indicated as a best-fit model for the Portuguese elderly population. Conclusion: The findings presented in this paper emphasize the deepening of the concept of AtA in this population and its association with SA in an overall model.
- In the eyes of older adults: Self-reported age and adjustment in african and european older adultsPublication . von Humboldt, Sofia; Leal, I.; Pimenta, Filipa; Niculescu, GeorgetaTo explore older adults’ perceptions of subjective age and adjustment to ageing and to analyse the correlational structure of the pre-categories in our study: subjective age, indicators of adjustment to ageing and of personal age perception. An exploratory, descriptive mixedmethods design was utilised. A purposive sampling method was used to select 154 older adults aged between 75 and 99 years from three different nationalities. Semi-structured interviews were performed, addressing two core areas: subjective age and adjustment to ageing. Data was subjected to content analysis. Representation of the correlational structure of the precategories in our study (subjective age and indicators of adjustment to ageing) were analysed by a Multiple Correspondence Analysis. Standardised instruments measured regular cognitive abilities. Five categories derived from interviews for subjective age: ‘adapted’, ‘disconnected’, ‘old’, ‘youthful’ and ‘tolerant’. A total of seven categories emerged as indicators of adjustment to ageing: ‘social networking’, ‘health’, ‘time perspective’, ‘spirituality’, ‘financial autonomy’, ‘professional activities’ and ‘fulfilment and leisure’. These results supported a model for each pre-category. Subjective age was explained by a two-factor model: ‘age-conscientious’ and ‘youthful’. A three-dimensional model formed by ‘reconciled’, ‘satisficers’ and ‘maximisers’ was indicated as a best-fit solution for adjustment to ageing. A three-dimensional overall model for PAP was formed by ‘age-cognisant’, ‘fulfilled’ and ‘satisficers’. The findings highlighted the underdeveloped potential of subjective age, adjustment to ageing and a personal age perception overall model for this population. Enhancing subjective age and adjustment to ageing might be an important target to improve older adults’ interventions’ outcomes.
- ¿Qué influye en el bienestar subjetivo de los adultos mayores?: Una revision sistematica de la literaturaPublication . von Humboldt, Sofia; Leal, Isabel PereiraObjetivos: Esta revisión sistemática de la literatura tiene como objetivo proporcionar una visión fiable de las variables que influyen en el bienestar subjetivo (SWB – por sus siglas en ingles de Social Well Being) de los adultos mayores y ofrece sugerencias para futuras investigaciones. Métodos: se llevó a cabo una búsqueda bibliográfica informatizada, y se realizaron búsquedas de bases de datos a partir de 2001 a 2012 en PubMed / Medline, Psicología y Ciencias del Comportamiento de cobros y Scielo. Los estudios debían mencionar variables que hubieran influido en el SWB, incluyendo sus facetas cognitivas y afectivas. Resultados: Catorce artículos de 616 registros cumplieron los criterios de inclusión, con un total de 17.097 participantes con 60 años o más. Los hallazgos más robustos muestran que el apoyo social, la salud, el estilo de vida, las variables sociodemográficas y psicológicas y estrategias de afrontamiento influyen en el SWB de los adultos mayores. Conclusiones: Los resultados proporcionan apoyo a las correlaciones específicas del SWB en la vida posterior.
- CURB-65 and other markers of illness severity in community-acquired pneumonia among HIV-positive patientsPublication . Almeida, André; Almeida, Ana Rita; Branco, Sara Castelo; Vesza, Zsófia; Pereira, RuiIntroduction: As the relative burden of community-acquired bacterial pneumonia among HIV-positive patients increases, adequate prediction of case severity on presentation is crucial. We sought to determine what characteristics measurable on presentation are predictive of worse outcomes. Methods: We studied all admissions for community-acquired bacterial pneumonia over 1 year at a tertiary centre. Patient demographics, comorbidities, HIV-specific markers and CURB-65 scores on Emergency Department presentation were reviewed. Outcomes of interest included mortality, bacteraemia, intensive care unit admission and orotracheal intubation. Results: A total of 396 patients were included, 49 HIV positive and 347 HIV negative. Mean CURB-65 score was 1.3 for HIV-positive and 2.2 for HIV-negative patients (p<0.0001), its predictive value for mortality being maintained in both groups (p¼0.03 and p<0.001, respectively). Adjusting for CURB-65 scores, HIV infection by itself was only associated with bacteraemia (adjusted odds ratio 7.1 CI 95% [2.6–19.5]). Patients with<200 CD4 cells/mL presented similar CURB- 65 adjusted mortality (adjusted odds ratio 1.7 CI 95% [0.2–15.2]), but higher risk of intensive care unit admission (adjusted odds ratio 5.7 CI 95% [1.5–22.0]) and orotracheal intubation (adjusted odds ratio 9.1 CI 95% [2.2–37.1]), compared to HIV-negative patients. These two associations were not observed in the>200 CD4 cells/mL subgroup (adjusted odds ratio 2.2 CI 95% [0.7–7.6] and adjusted odds ratio 0.8 CI 95% [0.1–6.5] respectively). Antiretroviral therapy and viral load suppression were not associated with different outcomes (p>0.05). Conclusions: High CURB-65 scores and CD4 counts<200 cells/mL were both associated with worse outcomes. Severity assessment scales and CD4 counts may both be helpful in predicting severity in HIV-positive patients presenting with community-acquired bacterial pneumonia.
- Psychometric properties of the oral health impact profile and new methodological approachPublication . Zucoloto, Miriane Lucindo; Maroco, João; Campos, Juliana Alvares Duarte BoniniObjective: Evaluate the validity, reliability, and factorial invariance of the complete Portuguese version of the Oral Health Impact Profile (OHIP) and its short version (OHIP-14). Methods: A total of 1,162 adults enrolled in the Faculty of Dentistry of Araraquara/UNESP participated in the study; 73.1% were women; and the mean age was 40.7 ± 16.3 yr. We conducted a confirmatory factor analysis, where χ2/df, comparative fit index, goodness of fit index, and root mean square error of approximation were used as indices of goodness of fit. The convergent validity was judged from the average variance extracted and the composite reliability, and the internal consistency was estimated by Cronbach standardized alpha. The stability of the models was evaluated by multigroup analysis in independent samples (test and validation) and between users and nonusers of dental prosthesis. Results: We found best-fitting models for the OHIP-14 and among dental prosthesis users. The convergent validity was below adequate values for the factors “functional limitation” and “physical pain” for the complete version and for the factors “functional limitation” and “psychological discomfort” for the OHIP-14. Values of composite reliability and internal consistency were below adequate in the OHIP-14 for the factors “functional limitation” and “psychological discomfort.” We detected strong invariance between test and validation samples of the full version and weak invariance for OHIP-14. The models for users and nonusers of dental prosthesis were not invariant for both versions. Conclusion: The reduced version of the OHIP was parsimonious, reliable, and valid to capture the construct “impact of oral health on quality of life,” which was more pronounced in prosthesis users.
- Differential effects of behavioral interventions with a graded physical activity component in patients suffering from chronic fatigue (syndrome) : An updated systematic review and meta-analysisPublication . Marques, Marta Moreira; De Gucht, Véronique; Gouveia, Maria João Pinheiro Morais; Leal, Isabel Pereira; Maes, StanAn updated systematic review and meta-analysis was conducted to (1) evaluate the effects of behavioral and psychological interventions containing a graded physical activity component upon fatigue severity, physical functioning, physical activity and psychological distress, and to (2) examine potential moderator effects of trial characteristics (type of control, setting, provider, length of treatment, psychological component, flexibility in physical activity, and minimal face to face patient–provider contact). Pertinent content of selected studies was extracted and rated on a scale of methodological quality. Sixteen randomized controlled trials (N = 2004) were included in the meta-analyses. Significant small to medium effect sizes (Hedge's g = 0.25 to g = 0.66) were found for all outcomes at post-treatment (M = 5.2 months) and follow-up (M = 11.7 months), with the exception of physical activity at post-treatment (g = 0.11). The largest effects were found for fatigue severity (g = 0.61 to g = 0.66). Subgroup analyses revealed that minimal contact interventions had additional beneficial effects upon fatigue (g = 0.96) and depression (g = 0.85). Interventions provided by psychologistspsychotherapists and interventions conducted in secondary–tertiary settings also resulted in more beneficial effects on fatigue. We found some indication of publication bias. The small number of studies and variability between them are limitations of this study. Future research should explore additional moderating effects in order to improve the effectiveness of interventions.
- Validation of the psychometric properties of the self‐compassion scale. Testing the factorial validity and factorial invariance of the measure among borderline personality disorder, anxiety disorder, eating disorder and general populationsPublication . Costa, Joana; Maroco, João; Gouveia, José Augusto Pinto; Ferreira, Cláudia; Castilho, PaulaBackground: During the last years, there has been a growing interest in self-compassion. Empirical evidences show that self-compassion is associated with psychological benefits among young adults and it might be considered a buffer factor in several mental disorders. Aims: The aim of this study was to validate the psychometric properties of the Self-compassion Scale (SCS: Neff, 2003a) after the initial lack of replicating the original six-factor structure. Method: Data were collected from the overall database of a research centre (56 men and 305 women; mean age = 25.19) and comprised four groups: borderline personality disorder, anxiety disorder, eating disorder and general population. Results: Confirmatory factor analysis supported a two-factor model (self-compassionate attitude versus self-critical attitude) with good internal consistencies, construct-related validity and external validity. Configural, weak measurement and structural invariance of the two-factor model of SCS were also shown. Conclusions: Findings support the generalizability of the two-factor model and show that both properties and interpretations of scores on self-compassion are equivalent across these population groups.
- Free and Cued Selective Reminding Test is superior to the Wechsler Memory Scale in discriminating mild cognitive impairment from alzheimer's diseasePublication . Lemos, Raquel; Cunha, Catarina; Marôco, João Paulo; Afonso, Ana; Simões, Mário R.; Santana, IsabelAim: The Logical Memory (LM) and the Verbal Paired Associative Learning (VPAL) are subtests from the Wechsler Memory Scale commonly used to characterize the memory deficit of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD). The Free and Cued Selective Reminding Test (FCSRT) was suggested to assess the memory impairment of AD spectrum patients by the International Working Group on AD. In the present study, we compared the properties of the tests and their accuracy in classifying aMCI and AD. Methods: A group of aMCI patients (n=85) and AD patients (n=43) were included. The reliability and the validity of the three tests were analyzed. Results: AD patients showed a significant pattern of worse impairment on all tests than aMCI. The FCSRT was able to classify more patients as having memory impairment in the aMCI group rather than the WMS subtests. The FCSRT proved to be good in discriminating the two groups in both lower and higher educational levels, whereas the LM was more useful in higher educated patients. Conclusions: Although the instruments had good results, the FCSRT was more accurate in discriminating MCI from AD, and less influenced by the educational level.
- Validation of the Weight Concerns Scale applied to brazilian university studentsPublication . Dias, Juliana Chioda Ribeiro; Silva, Wanderson Roberto da; Maroco, João; Campos, Juliana Alvares Duarte BoniniThe aim of this study was to evaluate the validity and reliability of the Portuguese version of the Weight Concerns Scale (WCS) when applied to Brazilian university students. The scale was completed by 1084 university students from Brazilian public education institutions. A confirmatory factor analysis was conducted. The stability of the model in independent samples was assessed through multigroup analysis, and the invariance was estimated. Convergent, concurrent, divergent, and criterion validities as well as internal consistency were estimated. Results indicated that the one-factor model presented an adequate fit to the sample and values of convergent validity. The concurrent validity with the Body Shape Questionnaire and divergent validity with the Maslach Burnout Inventory for Students were adequate. Internal consistency was adequate, and the factorial structure was invariant in independent subsamples. The results present a simple and short instrument capable of precisely and accurately assessing concerns with weight among Brazilian university students.
- Validation of the Geriatric Oral Health Assessment Index in complete denture wearersPublication . Campos, Juliana Alvares Duarte Bonini; Zucoloto, Miriane Lucindo; Geremias, R. F.; Nogueira, S. S.; Maroco, JoãoTo perform a validation of the Geriatric Oral Health Assessment Index (GOHAI) for complete denture wearers and present a proposal for estimation of perceived oral health. This is a cross-sectional study with non-probabilistic sampling. A total of 211 subjects with a mean age of 62 5 (s.d. = 11 4) years participated, being 169 female. The GOHAI was applied in a personal interview. The construct/convergent/discriminant validity was tested using structural equation modelling. Confirmatory factor analysis was used to verify the fit of three proposals of the GOHAI: three-factor, one-factor and second-order hierarchical models. The stability of the models was evaluated in independent samples. The threefactor model presented an inadequate fit, and items 3, 4 and 9 were removed. The new structure presented an acceptable fit and strong invariance in independent samples. The convergent, discriminant validity and internal consistency were below adequate. The one-factor model presented an adequate fit to the sample. Convergent validity was compromised. A strong invariance of the one-factor model was observed. To calculate the overall scores of the GOHAI factors (three-factor model) or of the oral health perception (one-factor model), a matrix of regression weights for each item in the model was presented as a suggestion. We found an adequate fit of the both structures of the GOHAI for denture wearers, but the three-factor structure was more parsimonious. We suggested considering the weights of the regression model to calculate the overall score of perceived oral health or of its factors in different samples.