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- Predictors of physical activity promotion in clinical practice: a cross-sectional study among medical doctorsPublication . Silva, Catarina Santos; Mendes, Romeu; Godinho, Cristina; Monteiro-Pereira, Ana; Pimenta-Ribeiro, Jaime; Martins, Helena Silva; Brito, João; Themudo-Barata, José Luís; Fontes-Ribeiro, Carlos; Teixeira, Pedro J.; Freitas, Graça; Silva, Marlene NunesBackground: Physical activity is a major determinant of physical and mental health. International recommendations identify health professionals as pivotal agents to tackle physical inactivity. This study sought to characterize medical doctors’ clinical practices concerning the promotion of patients’ physical activity, while also exploring potential predictors of the frequency and content of these practices, including doctors’ physical activity level and sedentary behaviours. Methods: A cross-sectional study assessed physical activity promotion in clinical practice with a self-report questionnaire delivered through the national medical prescription software (naturalistic survey). Physical activity and sedentary behaviours were estimated using the International Physical Activity Questionnaire (short form). Indicators of medical doctors’ attitudes, knowledge, confdence, barriers, and previous training concerning physical activity promotion tar‑ geting their patients were also assessed. Multiple regression analysis was performed to identify predictors of physical activity promotion frequency by medical doctors, including sociodemographic, attitudes and knowledge-related variables, and physical activity behaviours as independent variables. Results: A total of 961 medical doctors working in the Portuguese National Health System participated (59% women, mean age 44±13 years) in the study. The majority of the participants (84.6%) reported to frequently promote patients’ physical activity. Five predictors of physical activity promotion frequency emerged from the multiple regression analysis, explaining 17.4% of the dependent variable (p<0.001): working in primary healthcare settings (p=0.037), having a medical specialty (p=0.030), attributing a high degree of relevance to patients’ physical activity promotion in healthcare settings (p<0.001), being approached by patients to address physical activity (p<0.001), and having higher levels of physical activity (p=0.001). Conclusions: The sample of medical doctors approached reported a high level of engagement with physical activity promotion. Physical activity promotion frequency seems to be infuenced by the clinical practice setting, medical career position and specialty, attitudes towards physical activity, and perception of patients´ interest on the topic, as well as medical doctors’ own physical activity levels.
- How to improve access to data from epidemic surveillance and electronic health records in order to advance research in PortugalPublication . Peixoto, Vasco Ricoca; Santos, Nina de Sousa; Souto, Tiago L.; Conde, Margarida Gil; Heleno, Bruno; Cordeiro, João V.; Aguiar, Pedro; Abrantes, Alexandre
- Complex interactions between p.His558Arg and linked variants in the sodium voltage-gated channel alpha subunit 5 (NaV1.5)Publication . Lopes-Marques, Mónica; Silva, Raquel; Serrano, Catarina; Gomes, Verónica; Cardoso, Ana; Prata, Maria João; Amorim, António; Azevedo, LuísaCommon genetic polymorphisms may modify the phenotypic outcome when co-occurring with a disease-causing variant, and therefore understanding their modulating role in health and disease is of great importance. The polymorphic p.His558Arg variant of the sodium voltage-gated channel alpha subunit 5 (NaV1.5) encoded by the SCN5A gene is a case in point, as several studies have shown it can modify the clinical phenotype in a number of cardiac diseases. To evaluate the genetic backgrounds associated with this modulating effect, we reanalysed previous electrophysiological findings regarding the p.His558Arg variant and further assessed its patterns of genetic diversity in human populations. The NaV1.5 p.His558Arg variant was found to be in linkage disequilibrium with six other polymorphic variants that previously were also associated with cardiac traits in GWAS analyses. On account of this, incongruent reports that Arg558 allele can compensate, aggravate or have no effect on NaV1.5, likely might have arose due to a role of p.His558Arg depending on the additional linked variants. Altogether, these results indicate a major influence of the epistatic interactions between SCN5A variants, revealing also that phenotypic severity may depend on the polymorphic background associated to each individual genome.