Paulo J NicolaUniversity of Lisbon | UL · Instituto de Medicina Preventiva
Paulo J Nicola
Master of Science in Clinical Research; MD
About
77
Publications
15,444
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
5,902
Citations
Introduction
Additional affiliations
January 2005 - July 2017
January 2005 - present
July 2001 - December 2004
Publications
Publications (77)
Background
There is a need for a deeper understanding of the barriers to research in family medicine (FM) and to consider the perceptions and perspectives of professionals. Our study aims to provide a strategic view for research capacity building in FM. We included the perspective of family physician researchers (FPR) on the existing barriers to in...
Introduction
The qualities of primary healthcare (PHC) make it a very relevant environment for research; however, there is still work to be done to enhance the research capabilities of family physicians in healthcare units. Considering there is no ongoing review that specifically addresses this objective, the proposed goal of this scoping review is...
Introduction: There are several barriers discouraging clinicians from undertaking research, including insufficient funding, lack of time, organizational issues and lack of support. The strengthening of research capacity is perceived from three levels: characteristics of the researcher, the environment, and organizational issues. To date, Portugal i...
Background:
Remote patient monitoring (RPM) has been increasingly adopted over the last decade, with the COVID-19 pandemic fostering its rapid development. As RPM implementation is recognised as complex and highly demanding in terms of resources and processes, there are multiple challenges in providing RPM in an integrated logic.
Methods:
To exa...
Introduction:
Remote monitoring (RM) is a safe and effective alternative to in-office conventional follow-up.
Objective:
We aimed to evaluate patient satisfaction with RM and its impact on healthcare resources in a population with cardiac implantable electronic devices.
Methods:
Randomized, pragmatic, open-label controlled trial, with adult we...
Physical activity (PA) and sedentary behaviours (SB) influence health. Since most people engage in different combinations of both behaviours every day, understanding the socio-demographic characteristics of adults with distinct PA and sitting time (ST) patterns is important to contribute to evidence-based planning of public health strategies. Data...
Background
Recent evidence suggests that exposures in early life that are known to influence microbiome development may affect the risk of developing inflammatory bowel disease (IBD). Cesarean section has been associated with altered colonization of commensal gut flora and is thought to predispose to immune-mediated diseases later in life.AimsTo ev...
Introduction and objectives:
Asthma is a chronic and heterogeneous disease that affects people of all ages and has a high estimated increase in prevalence worldwide. Asthma control represents a main goal in the disease management. International studies revealed low levels of disease control resulting in a significant burden for healthcare systems,...
Background
Information about the users' experience is an essential element in patient-centered healthcare. We determined the score of the different elements of inpatient experiences of admission episodes in hospitals of the Portuguese health system and examined their contribution to the overall experience score.
Methods
A national cross-sectional...
Evidence on how gender intersects with relevant social constructs in later phases of life is scarce. This investigation examined gender inequalities in perceived health status (self-perceived general health; SPGH) by Portuguese elderly community-dwellers while considering psycho-social and socio-demographic determinants. This study used data from a...
Introduction:
As populations live longer, they also aim to live better. A crucial step for this is to improve the understanding about older adults' physical and psychological health. Therefore, the aim of the present study was to characterise the Portuguese population over-65 regarding nutritional status, cognitive function, functional status, sym...
Both malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The...
Artigo publicado com erros: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13928
Na página 376, no Abstract, parágrafo Results, onde se lê: “Despite the inherent uncertainty, it is safe to assume an observed excess mortality of 2400 to 4000 deaths. Excess mortality was associated with older age groups (over age 65).”
Deve...
Objectives:
Malnutrition is frequent among older adults, especially those living in nursing homes, but the association between residential setting and nutritional status is controversial. The aim of this study was to examine the association between living setting (nursing home versus community) and malnutrition while adjusting for demographic, soc...
Introduction:
Portugal is experiencing the effects of the COVID-19 pandemic since March 2020. All-causes mortality in Portugal increased during March and April 2020 compared to previous years, but this increase is not explained by COVID-19 reported deaths. The aim of this study was to analyze and consider other criteria for estimating excessive al...
Every population subgroup should know the physical activity (PA) recommendations to benefit their health. The present study sought to examine the knowledge and explore the perceptions of PA recommendations for adults among Portuguese college students, by gender and fields of study. A total of 255 bachelor students (55.3% women; Mage = 21.0±2.2 year...
Every population subgroup should know the physical activity (PA) recommendations to benefit their health. The present study sought to examine the knowledge and explore the perceptions of PA recommendations for adults among Portuguese college students, by gender and fields of study. A total of 255 bachelor students (55.3% women; Mage = 21.0±2.2 year...
Background
Recent evidence suggests that early life exposures known to influence microbiome development (eg, breastfeeding, exposure to antibiotics, etc.) may also affect the risk of developing IBD. Mode of delivery is one of the major factors impacting the newborn’s microbiome development, and specifically, Caesarean-section (C-section), which has...
![Table 1 EQ-5D-3L health states set assignments (groups from [56])](publication/329765205/figure/tbl1/AS:705356405682176@1545181480692/EQ-5D-3L-health-states-set-assignments-groups-from-56_Q320.jpg)
Background
Quality Adjusted Life Years (QALYs) are a key outcome measure widely used within health technology assessment and health service research studies. QALYs combine quantity and quality of life, with quality of life calculations relying on the value of distinct health states. Such health states’ values capture the preferences of a population...
Background:
Every population subgroup should know the physical activity (PA) recommendations to benefit their health. The present study sought to examine the knowledge and explore the perceptions of the World Health Organization PA recommendations for adults among Portuguese college students, by gender and fields of study.
Methods:
A total of 25...
Objective
To characterise the nutritional status and to identify malnutrition-associated variables of older adults living in Portuguese nursing homes.
Design
Cross-sectional study. Data on demographic and socio-economic characteristics, self-reported morbidity, eating-related problems, nutritional status, cognitive function, depression symptoms, l...
Introduction: Ethnic and cultural diversity in Portugal has reinforced the importance of adjusting healthcare services to the health needs of different populations. This study aims to analyse longitudinally the factors associated with health care use by native Portuguese and African hypersive patients. Methods: Longitudinal study including treated...
Introdução: A diversidade étnica e cultural em Portugal tem reforçado a importância de adequar os serviços de saúde às necessidades em saúde de diferentes populações. Este estudo pretende analisar longitudinalmente os fatores associados à utilização de cuidados de saúde em hipertensos tratados portugueses e imigrantes africanos. Métodos: Estudo lon...
Objectives: Self-perceived health declines with age, varies by gender and is a predictor of mortality, morbidity, physical and psychological functioning. However, gender differences in health and illness perception are complex and not yet fully understood. This study aimed to explore gender-related differences in psychosocial determinants of self-p...
Background:
The assessment of food consumption data using harmonized methodologies at the European level is fundamental to support the development of public policies. Portugal is one of the countries with the most outdated information on individual food consumption.
Objective:
The objective of this study was to describe the design and methodolog...
The National Food, Nutrition and Physical Activity Survey of the Portuguese general population aimed to collect nationwide and regional data on dietary intake and physical activity, and their relation with health determinants, namely socioeconomic factors. Results from this project were obtained from a representative sample of the Portuguese popula...
Teresa Madeira, Catarina Peixoto, Nuno Neto Santos, Osvaldo Santos, Violeta Alarcão, Paulo Nicola, Beatriz Goulao, Nuno Mendonca, Astrid Bergland, Asta Bye, Teresa Amaral, Carla Lopes, João Gorjão Clara
Background:
Worldwide we are facing a serious demographic challenge due to the dramatic growth of the population over 60 years. It is expected that the proportion of this population will nearly double from 12 to 22 %, between 2015 and 2050. This demographic shift comes with major health and socio-economic concerns. Nutrition is a fundamental deter...
Introduction: In Portugal, the frequency of patient with treated and controlled hypertension is low. It is unknown the relation of socioeconomic
determinants with hypertension control, particularly in African immigrants.
Aims: To compare frequency of control in treated hypertension and to identify characteristics associated with uncontrolled and tr...
Objectivos: Caracterizar as atitudes dos médicos de família quanto à decisão terapêutica na hipertensão, incluindo aspectos como controlo e tratamento e comparar estas atitudes com as recomendações clínicas à data do estudo. Tipo de estudo: Estudo observacional transversal. Local: Unidades de Cuidados de Saúde Personalizados (UCSP)/Unidades de Saúd...
According to the World Health Organization, breast cancer is the top cancer in women both in developed and developing countries.
In 2012, breast accounted for 522.000 deaths worldwide. Although these numbers, breast cancer mortality has been falling in many European countries due to the combined effects of breast screening and better treatments.
So...
p> Introduction: Blood pressure is significantly improved with weight loss. Behavioral interventions for weight loss seem to be less successful in African immigrants. Our main aims were to assess the effect of a dietary and lifestyle intervention on weight among hypertensive Portuguese natives and immigrants and to identify success factors for weig...
Introduction: Blood pressure is significantly improved with weight loss. Behavioral interventions for weight loss seem to be less successful in African immigrants. Our main aims were to assess the effect of a dietary and lifestyle intervention on weight among hypertensive Portuguese natives and immigrants and to identify success factors for weight...
BACKGROUND:
Patient non-adherence to antibiotic therapy may lead to therapeutic failure, re-infection, and bacterial resistance. Assessing the factors associated with this problem is important for promoting rational use of antibiotics.
OBJECTIVE:
This study aimed to measure prevalence and reasons for non-adherence to antibiotic treatment and to ide...
Bearing in mind the increasing health expenses and their weight in the Portuguese gross domestic product, it is of the utmost importance to evaluate the performance of Primary Health Care providers taking into account both efficiency, quality and equity. This paper aims to contribute to a better understanding of the performance of Primary Health Ca...
With expanding indications for cardiac implantable electronic devices (CIEDs) capable of treating bradycardias, complex cardiac tachyarrhythmias and heart failure, the number of patients requiring regular long-term specialized care is growing rapidly. Currently, routine face-to-face follow-up consultations for patients with CIEDs are a significant...
With expanding indications for cardiac implantable electronic devices (CIEDs) capable of treating bradycardias, complex cardiac tachyarrhythmias and heart failure, the number of patients requiring regular long-term specialized care is growing rapidly. Currently, routine face-to-face follow-up consultations for patients with CIEDs are a significant...
Background: One of the risk factors identified in the development of hypertension (HTA) is overweight. International studies have shown that Blacks are more vulnerable to the effects of HTA. Furthermore, behavioral interventions for weight loss seem to be less successful in Blacks than in Caucasians. In a Portuguese study DIMATCH-HTA with hypertens...
To examine the influence of rheumatoid arthritis (RA) characteristics and antirheumatic medications on the risk of heart failure (HF) in patients with RA.
A population-based incidence cohort of RA patients aged ≥ 18 years (1987 American College of Rheumatology criteria first met between January 1, 1980, and January 1, 2008) with no history of HF wa...
The introduction of biological therapies for the treatment of rheumatic diseases has drawn attention to the limitations of traditional means of assessing drug safety. Consequently, a series of European academic biologics registers dedicated to this task have been established. Increasing reliance upon safety data generated from observational drug re...
To develop evidence-based EULAR recommendations for cardiovascular (CV) risk management in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA).
A multidisciplinary expert committee was convened as a task force of the EULAR Standing Committee for Clinical Affairs (ESCCA), comprising 18 members including...
Considering the relevance of tumor necrosis factor-alpha (TNF-alpha) in the pathophysiology of juvenile idiopathic arthritis (JIA), it is likely that polymorphisms in its promoter area may be relevant in disease susceptibility and activity. We investigated if clinical measures of JIA activity and TNF-alpha serum concentrations were associated with...
Features of systemic lupus erythematosus (SLE) are commonly observed in patients with rheumatoid arthritis (RA). However, their frequency and clinical significance are uncertain. We examined the frequency of SLE features in RA and their effect on overall mortality.
We assembled a population-based incidence cohort of subjects aged >or=18 years first...
Overall mortality rates in the general US population have declined substantially over the last 4-5 decades, but it is unclear whether patients with rheumatoid arthritis (RA) have experienced the same improvements in survival. The purpose of this study was to determine the mortality trends among RA patients compared with those in the general populat...
To determine the relationship between glucocorticoid exposure and cardiovascular (CV) events in patients with rheumatoid arthritis (RA).
A total of 603 adult residents of Rochester, Minnesota with incident RA between 1955 and 1995 were followed up through their medical records for a median of 13 years (total of 9,066 person-years). Glucocorticoid e...
Inflammatory markers are associated with heart failure. Patients with rheumatoid arthritis have twice the risk of heart failure compared with people without rheumatoid arthritis.
To assess whether heart failure in patients with rheumatoid arthritis is preceded by an inflammatory activation as shown by erythrocyte sedimentation rate (ESR), a systemi...
Objective. Considering the relevance of tumor necrosis factor-α (TNF-α) in the pathophysiology of juvenile idiopathic arthritis (JIA), it is likely that polymorphisms in its promoter area may be relevant
in disease susceptibility and activity. We investigated if clinical measures of JIA activity and TNF-α serum concentrations were associated with T...
A major challenge in management of rheumatoid arthritis (RA) is prediction of longterm response to disease-modifying antirheumatic drug (DMARD) treatment. Our objective was to identify the predictors of DMARD discontinuation in an incidence cohort of patients with RA followed continuously from their incidence date.
Members of a population-based inc...
Objective:
Although mortality among patients with rheumatoid arthritis (RA) is higher than in the general population, the relative contribution of comorbid diseases to this mortality difference is not known. This study was undertaken to evaluate the contribution of congestive heart failure (CHF) and ischemic heart disease (IHD), including myocardi...
To compare the proportion of the risk for the development of heart failure (HF) that is attributable to traditional cardiovascular (CV) risk factors, ischemic heart disease (IHD), and alcohol abuse between subjects with and subjects without rheumatoid arthritis (RA).
A population-based inception cohort of RA patients was assembled along with a simi...
To determine whether systemic inflammation confers any additional risk for cardiovascular death among patients with rheumatoid arthritis (RA), after adjusting for traditional cardiovascular risk factors and comorbidities.
Using the population-based data resources of the Rochester Epidemiology Project, we assembled an incidence cohort of all Rochest...
It is hypothesized that the systemic inflammation associated with rheumatoid arthritis (RA) promotes an increased risk of cardiovascular (CV) morbidity and mortality. We examined the risk and determinants of congestive heart failure (CHF) in patients with RA.
We assembled a population-based, retrospective incidence cohort from among all individuals...
To examine the risk of clinical coronary heart disease (CHD) in patients with rheumatoid arthritis (RA) compared with age- and sex-matched non-RA subjects, and to determine whether RA is a risk factor for CHD after accounting for traditional CHD risk factors.
We assembled a population-based incidence cohort of 603 Rochester, Minnesota residents age...
To examine trends in therapeutic strategies and to identify the determinants of starting disease modifying antirheumatic drug (DMARD) therapy over a 40-year period in a population based inception cohort of patients with rheumatoid arthritis (RA).
A population based inception cohort was assembled from among all Rochester, Minnesota, residents aged >...
Various etiologic mechanisms have been implicated in the observed increase in cardiovascular mortality in rheumatoid arthritis (RA). Body mass index (BMI) is associated with cardiovascular mortality in the general population. This study compared the effect of BMI on cardiovascular mortality in a population-based cohort of subjects with RA with that...
Thesis (M.S.) -- Biomedical Sciences--Clinical Research -- Mayo Graduate School, 2006. Includes bibliographical references (leaves 65-75).
Questions
Question (1)
Consider a survey on two schools, where the same students are asked, in the begining of the school year and at the end, whether they like sports, or not. In one of the schools (intervention) there are sport promotion activities during the school year. The question of interest is whether the proportion of change (doesn't like --> like, or likes --> doesn't like: it should be symmetrical, right?) in the school subject to the intervention is statistically different from the change observed in the control school. That is, if the intervention is able to generate 'more change', with statistical significance, in the intervention school.
Within a school, I believe one can apply the McNemar test for a paired 2x2 table. But both schools can have (within school) a significant change. So, how can we test if the intervention is associated with a statistically significant change, when compared to the change observed in the control group?
I wonder if the answer can be extended to a situation where the answers are classifications of 3 or more classes (e.g., doesn't like, indiferente, likes, ...).
I thank you in advance!, and hope this questions maybe helpful to many others, besides me.
