ABSTRACT We report the discovery of a new Kepler transiting circumbinary planet (CBP). This latest addition to the still-small family of CBPs defies the current trend of known short-period planets ...orbiting near the stability limit of binary stars. Unlike the previous discoveries, the planet revolving around the eclipsing binary system Kepler-1647 has a very long orbital period (∼1100 days) and was at conjunction only twice during the Kepler mission lifetime. Due to the singular configuration of the system, Kepler-1647b is not only the longest-period transiting CBP at the time of writing, but also one of the longest-period transiting planets. With a radius of 1.06 0.01 RJup, it is also the largest CBP to date. The planet produced three transits in the light curve of Kepler-1647 (one of them during an eclipse, creating a syzygy) and measurably perturbed the times of the stellar eclipses, allowing us to measure its mass, 1.52 0.65 MJup. The planet revolves around an 11-day period eclipsing binary consisting of two solar-mass stars on a slightly inclined, mildly eccentric (ebin = 0.16), spin-synchronized orbit. Despite having an orbital period three times longer than Earth's, Kepler-1647b is in the conservative habitable zone of the binary star throughout its orbit.
IntroductionHealth information systems represent an opportunity to improve the care provided to people with multimorbidity. There is a pressing need to assess their impact on clinical outcomes to ...validate this intervention. Our study will determine whether using a digital platform (Multimorbidity Management Health Information System, METHIS) to manage multimorbidity improves health-related quality of life (HR-QoL).Methods and analysisA superiority, cluster randomised trial will be conducted at primary healthcare practices (1:1 allocation ratio). All public practices in the Lisbon and Tagus Valley (LVT) Region, Portugal, not involved in a previous pilot trial, will be eligible. At the participant level, eligible patients will be people with complex multimorbidity, aged 50 years or older, with access to an internet connection and a communication technology device. Participants who cannot sign/read/write and who do not have access to an email account will not be included in the study. The intervention combines a training programme and a customised information system (METHIS). Both are designed to help clinicians adopt a goal-oriented care model approach and to encourage patients and carers to play a more active role in autonomous healthcare. The primary outcome is HR-QoL, measured at 12 months with the physical component scale of the 12-item Short Form questionnaire (SF-12). Secondary outcomes will also be measured at 12 months and include mental health (mental component Scale SF-12, Hospital Anxiety and Depression Scale). We will also assess serious adverse events during the trial, including hospitalisation and emergency services. Finally, at 18 months, we will ask the general practitioners for any potentially missed diagnoses.Ethics and disseminationThe Research and Ethics Committee (LVT Region) approved the trial protocol. Clinicians and patients will sign an informed consent. A data management officer will handle all data, and the publication of several scientific papers and presentations at relevant conferences/workshops is envisaged.Trial registration numberNCT05593835.
The association between family environment and child's eating behaviors is well established but a multidimensional approach to study this relation is lacking. This study aimed to assess the ...proprieties of a questionnaire created to evaluate parental practices, preferences, skills and attitudes regarding fruit and vegetables (F&V), sugar and salt. Participants (n = 714) were families of pre-school children (aged 2-6 years old) of the Nutriscience Project-a web-based gamification program-who answered a questionnaire assessing socio-demographic characteristics, nutrition knowledge, and a scale evaluating parental practices, preferences, skills and attitudes, at the baseline of the project. Exploratory factorial analysis was applied to the scale: 21 items and 5 factors were extracted (52.4% of explained variance) with a Kaiser-Meyer-Olkin (KMO) value of 0.770: 1. Modelling/active promotion of F&V consumption (alpha = 0.73), 2. Skills for choosing/preparing healthy food (alpha = 0.75), 3. Food preferences and satiety perception (alpha = 0.70), 4. Awareness regarding sugar/salt intake (alpha = 0.61), 5. Allowance regarding F&V consumption (alpha = 0.55). Kruskal-Wallis and Mann-Whitney tests were conducted to compare factors according to socio-demographic characteristics. Higher scores for parental modelling and active promotion of F&V consumption were observed in older parents, those with higher nutrition knowledge and who reported to live without income difficulties. Regarding food preferences, higher scores were observed in mothers, with higher nutrition knowledge and from higher educated groups. Higher awareness regarding salt and sugar consumption were observed in older parents, with higher education, higher nutrition knowledge and with female children. Older parents and with female children also registered higher scores of skills for choosing/preparing healthy food. The scale showed satisfactory proprieties and may contribute to assess family food environment using a multidimensional approach. It also highlighted the importance of considering socio-demographic characteristics in interventions to promote healthy eating.
The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns as it has been consistently associated with several beneficial health outcomes. Adherence to the MD pattern has ...been decreasing in southern European countries for the last decades, especially among low socioeconomic groups. The aim of this study was to assess the adherence to the MD in Portugal, to evaluate regional differences, and explore associated factors (sociodemographic, economic, and lifestyles behaviors). This study used the third data collection wave of the Epidemiology of Chronic Diseases Cohort Study (EpiDoC 3). MD adherence was assessed using the Portuguese-validated MD adherence score (MEDAS) questionnaire. Non-adjusted and adjusted logistic regression models were used to assess the risk factors for low MD adherence and individual MEDAS items. In this cross-sectional evaluation of the EpiDoC 3 cohort study (
= 5647), 28.8% of the Portuguese population had low adherence to a MD. Azores and Madeira had lower adherence to the MD than the rest of the country. Younger individuals in lower income categories (e.g., OR
= 1.48; 95% CI 1.16-1.91) and with a lower educational level (e.g., OR
= 2.63; 95% CI 2.09-3.32) had higher odds of having a lower adherence to the MD. Portuguese adults have a high prevalence of low adherence to the MD, especially among those who are younger and have lower socioeconomic status. Public health policies to promote adherence to the MD should pay special attention to these groups.
Obesity leads to poor health outcomes and may adversely affect work productivity. This study, aimed to investigate the obesity- attributable costs of absenteeism among working adults in Portugal.
The ...study population included individuals actively working at baseline from the Epidemiology of Chronic Diseases Cohort (EpiDoC), a large Portuguese population-based prospective study. Body mass index was measured at baseline and in two follow-up interviews. Absenteeism in each wave of the EpiDoC was assessed by the question "Did you have a sick leave in the previous 12 months? yes/no", followed by "How many days did you miss work due to sickness in the previous twelve months?". Body mass index (BMI) was classified into underweight, normal weight, overweight, and obese, based on the standard World Health Organization definition. Association between obesity and absenteeism was estimated with the negative binomial regression model adjusted for BMI, chronic diseases, and lifestyle. Obesity- attributable costs were calculated using lost gross income during the time absent from work, through the human-capital approach.
The EpiDoC included 4338 working adults at baseline. Of these, 15.2% were obese at the beginning of the study and 22.7% of the population had been absent from work in the last 12 months. Participants with obesity missed 66% more days at work (IRR: 1.66; CI 95%:1.13-2.44; (p = 0.009.) than those with normal weight. The odds of having been absent from work were 1.4 times higher in obese compared to non-obese individuals (CI 95%: 1.18-1.67; p < 0.01) adjusted to sex and type of work. Obese individuals missed 3.8 more days per year than those with normal weight (95%CI: 3.1-4.5). Extrapolating to the entire Portuguese working population, absenteeism due to obesity incurred an additional cost of €238 million per year.
Obesity imposes a financial burden due to absenteeism in Portugal. Employers and national health regulators should seek effective ways to reduce these costs.
To solve problems related to Radio Frequency Identification, as well as to develop new technologies and applications with chipless RFID tags, this article describes the development of an innovative ...reader system based on Software-Defined Radios. Called SpuR, the system proposes a method of reading the spectral signature of RFID tags chipless, using general purpose hardware, reconfigurable by software, and operating in a wide frequency range without the need to change the reading equipment. This approach allows the accurate reading and identification of different types of chipless tags, using a classification procedure, by Euclidean distance, comparing them with a previously stored database.
Introduction:
Current literature lacks detailed understanding of the reimbursement framework of medication adherence enhancing interventions (MAEIs). As part of the ENABLE COST Action, the EUREcA ...(“EUropen REimbursement strategies for interventions targeting medication Adherence”) study aimed to provide an in-depth overview of reimbursed MAEIs currently available in European countries at national and regional levels and to pave the way for further MAEIs to be implemented in the future.
Methods:
A web-based, cross-sectional survey was performed across 38 European countries and Israel. The survey questionnaire was developed as a result of an iterative process of discussion informed by a desk review. The survey was performed among invited ENABLE collaborators from June to July 2021. Besides descriptive analysis, association between country income and health care expenditure, and the availability of reimbursed MAEIs were also assessed.
Results:
The survey identified 13 reimbursed MAEIs in nine countries: multi-dose drug dispensing (
n
= 5), medication review (
n
= 4), smart device (
n
= 2), mobile application (
n
= 1), and patient education (
n
= 1). The median GDP per capita of countries having ≥1 reimbursed MAEI was significantly higher compared to countries having no reimbursed adherence intervention (33,888 EUR vs 16,620 EUR, respectively;
p
= 0.05).
Conclusions:
Our findings highlight that to date only a small number of MAEIs have been reimbursed in European countries. Comprehensive health technology assessment recommendations and multi-stakeholder collaboration could help removing barriers related to the implementation and reimbursement of MAEIs.
We present two cases about projects in different maturity levels regarding infrastructure as code. The intent is to expose experiences and problems that may arise on new or already existing projects. ...Each case is exposed in a separate session.
Abstract
Background
Nutrition and particularly protein play a role in optimally stimulating muscle protein synthesis and maintaining function. Animal foods are excellent sources of high-quality ...protein. Therefore, we aimed to determine the association between the consumption of animal foods and mobility limitations in young-old adults.
Methods
The analytic sample was composed of 2860 community-dwelling adults aged 50 and over from a nationally representative longitudinal cohort of Portuguese adults who were followed up to 2.7 years. An animal food intake score was derived from the frequency of consumption of meat, fish, and dairy products. Mobility limitations were defined as the difficulty standing up from a chair, walking, and climbing stairs. To determine the association between animal food intake and mobility limitations mixed effects logistic models were fitted.
Results
Associations between quartiles of animal food intake and mobility limitations (for example, for walking outdoors Quartile 4 v Q1: OR: 0.29; 95%CI: 0.15, 0.56) in unadjusted models were present, but there was no difference in the rate of change of mobility limitations over time in unadjusted models. These associations were no longer present when models were adjusted for sociodemographic, lifestyle and health variables. For example, participants in Q4 of animal food intake were not more or less likely to have difficulty climbing stairs than those in Q1 (OR: 0.95; 95%CI: 0.65, 1.38) nor have a different rate of change over time (OR: 0.86; 95%CI: 0.54, 1.37).
Conclusions
No convincing evidence was found to support an effect of animal foods intake measured at baseline on self-reported mobility limitations over a short period of time.
Background
Food insecurity is a global public health challenge, affecting predominately the most vulnerable people in society, including older adults. For this population, eHealth interventions ...represent an opportunity for promoting healthy lifestyle habits, thus mitigating the consequences of food insecurity. However, before their widespread dissemination, it is essential to evaluate the feasibility and acceptability of these interventions among end users.
Objective
This study aims to explore the feasibility and acceptability of a home-based eHealth intervention focused on improving dietary and physical activity through an interactive television (TV) app among older adults with food insecurity.
Methods
A pilot noncontrolled quasi-experimental study was designed with baseline and 3-month follow-up assessments. Older adult participants with food insecurity were recruited from 17 primary health care centers in Portugal. A home-based intervention program using an interactive TV app aimed at promoting healthy lifestyle behaviors was implemented over 12 weeks. Primary outcomes were feasibility (self-reported use and interest in eHealth) and acceptability (affective attitude, burden, ethicality, perceived effectiveness, and self-efficacy), which were evaluated using a structured questionnaire with a 7-point Likert scale. Secondary outcomes were changes in food insecurity (Household Food Insecurity Scale), quality of life (European Quality of Life Questionnaire with five dimensions and three levels and Functional Assessment of Chronic Illness Therapy-Fatigue), physical function (Health Assessment Questionnaire, Elderly Mobility Scale, grip strength, and regularity of exercise), and nutritional status (adherence to the Mediterranean diet).
Results
A sample of 31 older adult individuals with food insecurity was enrolled in the 12-week intervention program with no dropouts. A total of 10 participants self-reported low use of the TV app. After the intervention, participants were significantly more interested in using eHealth to improve food insecurity (baseline median 1.0, IQR 3.0; 3-month median 5.0, IQR 5.0; P=.01) and for other purposes (baseline median 1.0, IQR 2.0; 3-month median 6.0, IQR 2.0; P=.03). High levels of acceptability were found both before and after (median range 7.0-7.0, IQR 2.0-0.0 and 5.0-7.0, IQR 2.0-2.0, respectively) the intervention, with no significant changes for most constructs. Clinically, there was a reduction of 40% in food insecurity (P=.001), decreased fatigue (mean −3.82, SD 8.27; P=.02), and improved physical function (Health Assessment Questionnaire: mean −0.22, SD 0.38; P=.01; Elderly Mobility Scale: mean −1.50, SD 1.08; P=.01; regularity of exercise: baseline 10/31, 32%; 3 months 18/31, 58%; P=.02). No differences were found for the European Quality of Life Questionnaire with five dimensions and three levels, grip strength, or adherence to the Mediterranean diet.
Conclusions
The home-based eHealth intervention was feasible and highly acceptable by participants, thus supporting a future full-scale trial. The intervention program not only reduced the proportion of older adults with food insecurity but also improved participants’ fatigue and physical function.
International Registered Report Identifier (IRRID)
RR2-10.2196/resprot.6626
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