Background: In response to rapid global spread of the newly emerged coronavirus disease 2019 (COVID-19), universities transitioned to online learning and telework to decrease risks of inter-person contact. To help administrators respond to the COVID-19 pandemic and better understand its impacts, we surveyed SARS-CoV-2 seroprevalence among NOVA University employees and assessed community mental health.Methods: Data were collected from voluntary participants at six NOVA University locations, in the Lisbon metropolitan area, from June 15–30, 2020. All subjects provided written informed consent. Of 1,627 recruited participants (mean age 42.0 ± 12.3 years), 1,624 were tested. Prior to blood collection, participants completed a questionnaire that assessed: COVID-19 symptoms during the previous 14 days, chronic non-communicable diseases, chronic medication, anxiety, and depression symptoms. SARS-CoV-2 serology tests were then performed, and results communicated approximately 4 days after blood draw. Participants with positive serology tests were contacted to assess COVID-19 symptoms since February.Results: Estimated prevalence of SARS-CoV-2 IgG antibodies was 3.1% (n = 50), of which 43.5% reported symptoms in the previous 4 months. The Medical School had the highest seroprevalence (6.2%). Participants reported having at least one chronic disease (63.7%), depression-like symptoms (2.1%), and anxiety symptoms (8.1%). Rates of depression and anxiety symptoms were significantly higher in women, with sleep hours and occasional alcohol consumption negatively associated with depression. Male gender, older age, and sleep hours negatively associated with anxiety symptoms. School of employment and presence of comorbidities positively associated with anxiety.Conclusion: By measuring seroprevalence of SARS-CoV-2 antibodies among NOVA employees and assessing subjects' mental health, we aim to help administrators at European public universities in urban areas, such as Lisbon, Portugal, better understand the needs of their communities. This study resulted in implementation of a stricter contingency plan in the Medical School, while other schools continued to follow Government mitigation guidelines. These findings may also guide the development of tailored strategies to ensure physical and mental health of the academic community during this pandemic crisis. We conclude that, together with COVID-19 contingency plans, psychological support services and facilities to help people effectively face pandemic-associated challenges and minimise anxiety and depression should be implemented.

Background People aged ≥65 years are more likely to have health problems related to aging, polypharmacy, and low treatment adherence. Moreover, health literacy levels decrease with increasing age. Objective The aim of this study is to assess an app’s utility in promoting health-related knowledge in people aged ≥65 years. Methods We developed a simple, intuitive, and video-based app (DigiAdherence) that presents a recipe, nutritional counseling, and content on physical activity, cognitive exercise, motivation to adhere to treatment, fall prevention, and health literacy. A convenience sample of 25 older adults attending the Personalized Health Care Unit of Portimão or the Family Health Unit of Portas do Arade (ACeS Algarve II – Barlavento, ARS Algarve, Portugal) will be recruited. Subjects must be aged ≥65 years, own a smartphone or tablet, be willing to participate, and consent to participate. Those who do not know how to use or do not have a smartphone/tablet will be excluded. Likewise, people with major cognitive or physical impairment as well as those living in a long-term care center will not be included in this study. Participants will have access to the app for 4 weeks and will be evaluated at 3 different timepoints (V0, before they start using the app; V1, after using it for 30 days; and V2, 60 days after stopping using it). After using the app for 30 days, using a 7-point Likert scale, participants will be asked to score the mobile tool’s utility in encouraging them to take their medications correctly, improving quality of life, increasing their health-related knowledge, and preventing falls. They will also be asked to assess the app’s ease of use and visual esthetics, their motivation to use the app, and their satisfaction with the app. Subjects will be assessed in a clinical interview with a semistructured questionnaire, including questions regarding user experience, satisfaction, the utility of the app, quality of life (EQ-5D-3L instrument), and treatment adherence (Morisky scale). The proportion of participants who considered the app useful for their health at V1 and V2 will be analyzed. Regarding quality of life and treatment adherence perceptions, comparisons will be made between V0 and V1, using the t test for dependent samples. The same comparisons will be made between V0 and V2. Results This study was funded in December 2019 and authorized by the Executive Board of ACeS Algarve II – Barlavento and by the Ethics Committee of NOVA Medical School (99/2019/CEFCM, June 2020). This protocol was also approved by the Ethics Committee for Health (16/2020, September 2020) and the Executive Board (December 2020) of the Regional Health Administration of the Algarve, IP (Instituto Público). Recruitment was completed in June 2021. Conclusions Since the next generation of older adults may have higher digital literacy, information and communication technologies could potentially be used to deliver health-related content to improve lifestyles among older adults. International Registered Report Identifier (IRRID) PRR1-10.2196/29675

The physiological signals are a challenge in terms of identification and processing due to its lack of stationarity and linearity. The autonomic output to the cardiovascular system is classically quantified by analysis of heart rate variability. The Fast Fourier Transform (FFT) and Discrete Wavelet Transform applied to the cardiac signals showed limitations in terms of time and frequency resolutions. With this work we propose the application of a Modified Hilbert-Huang Transform for tachogram and systogram evaluation with the introduction of a new method to smooth fluctuations endpoint. This work presents a comparative study using FFT and Hilbert-Huang methodologies. It is known that patients and animal models with diseases involving sympathoexcitation, eg.: Metabolic Syndrome (MetS), show increases in low frequencies band. Therefore, these mathematical tools are evaluated by analyzing experimental data from two animal species: MetS-rabbits (n=6) and MetS-rats (n=6) and their respective lean age and sex-matched controls (n=6 for each group). Modified Hilbert-Huang Transform analysis showed a sympathoexcitatory condition in MetS comparing to controls both in a rabbit and in a rat model of MetS. These significant differences on sympathetic tone were also confirmed by FFT but, the parasympathetic activity, was similar between normal and MetS animals. Results and its physiological interpretation clearly show the suitability of the modified Hilbert-Huang Transform as an alternative methodology for the dynamic assessment of the autonomic nervous system in MetS.

BACKGROUND People aged 65 and over are more likely to have health problems related to aging, polypharmacy, and low treatment adherence. Moreover, health literacy levels decrease with increasing age. OBJECTIVE To assess an app’s utility in promoting health literacy in people aged 65 and over. METHODS A multidisciplinary team of professionals has developed a simple, intuitive, and video-based app (DigiAdherence) with recipes, nutritional counseling, physical activity, cognitive exercise, motivation to adhere to treatment, falls' prevention, and health literacy content. A total of 25 seniors attending the Personalized Health Care Unit of Portimão or the Family Health Unit of Portas do Arade (ACeS Algarve II - Barlavento, ARS Algarve, Portugal), will be recruited. Subjects must have 65 years of age or more, own a smartphone or tablet, and be willing and consent to participate. Those who do not know how to use or do not have a smartphone/tablet will be excluded. Likewise, people with major cognitive or physical impairment as well as living in a long-term care center will also not be included in this study. Participants will have access to the application for 4 weeks and will be evaluated at 3 different timepoints. Participants will be asked about the app’s utility, expectations (before access to the app), satisfaction (after access to the app), and benefits for their health. Subjects will be assessed in a clinical interview with a semi-structured questionnaire, including questions of users’ experience, satisfaction, app’s utility, quality of life, treatment adherence and lifestyles. RESULTS This study is expected to start recruiting before mid-2021. CONCLUSIONS Since the next generation of elderly is quite digitized, information and communication technologies could potentially be used as a health literacy tool to improve lifestyles among seniors.

Introduction: Treatment-Resistant Depression (TRD) and Major Depression with Suicide Risk (MDSR) are types of depression with relevant effects on the health of the population and a potentially significant economic impact. This study estimates the burden of disease and the costs of illness attributed to Treatment-Resistant Depression and Major Depression with Suicide Risk in Portugal.Methods: The disease burden for adults was quantified in 2017 using the Disability-Adjusted Life Years (DALYs) lost. Direct costs related to the health care system and indirect costs were estimated for 2017, with indirect costs resulting from the reduction in productivity. Estimates were based on multiple sources of information, including the National Epidemiological Study on Mental Health, the Hospital Morbidity Database, data from the Portuguese National Statistics Institute on population and causes of death, official data on wages, statistics on the pharmaceutical market, and qualified opinions of experts.Results: The estimated prevalence of TRD, MDSR, and both types of depression combined was 79.4 thousand, 52.5 thousand, and 11.3 thousand patients, respectively. The disease burden (DALY) due to the disability generated by TRD alone, MDSR alone, and the joint prevalence was 25.2 thousand, 21 thousand, and 4.5 thousand respectively, totaling 50.7 thousand DALYs. The disease burden due to premature death by suicide was 15.6 thousand DALYs. The estimated total disease burden was 66.3 thousand DALYs.In 2017, the annual direct costs with TRD and MDSR were estimated at € 30.8 million, with the most important components being medical appointments and medication. The estimated indirect costs were much higher than the direct costs. Adding work productivity losses due to reduced employment, absenteeism, presenteeism, and premature death, a total cost of € 1,1 billion was obtained.Conclusions: Although TRD and MDSR represent relatively small direct costs for the health system, they have a relevant disease burden and extremely substantial productivity costs for the Portuguese economy and society, making TRD and MDSR priority areas for achieving health gains.