Clinical trials

This study is part of a doctoral research project in Oral Health Sciences and Technologies, with a specialization in Dental Hygiene, at the Faculty of Dental Medicine, University of Lisbon. With the advancement of technology, smartphones and mobile applications (apps) have become an integral part of daily life, especially among adolescents and young adults, who are the main users of these devices. In 2023, global app downloads reached an estimated 257 billion, including a growing number of health-related apps, known as Mobile Health or mHealth, and, more specifically, apps targeting oral health. Oral diseases, such as dental caries and periodontal disease, remain a major public health issue due to their high prevalence and impact on quality of life. Although these conditions are preventable, the adoption and maintenance of healthy behaviors continues to be challenging. Mobile apps may serve as an effective complement to oral health consultations, promoting motivation, adherence to recommendations, and communication with healthcare professionals. Despite the increasing availability of oral health apps, evidence regarding their effectiveness is still limited. Many of these tools lack scientific rigor and fail to adequately meet users' needs. In this context, an original Portuguese-language mobile application for promoting oral health was developed, based on current scientific evidence and preliminary exploratory studies involving adolescents and oral health professionals. These studies aimed to identify the most relevant features for this type of tool. The app was designed using the Behaviour Change Wheel (BCW) model, widely recognized for structuring effective behavior change interventions in health. This mobile app was developed by a multidisciplinary team from the University of Lisbon, involving experts from various faculties, including Psychology, Sciences, Dental Medicine, and Fine Arts. As an original tool, it is not yet available on app stores. The main aim of this study is to test the effectiveness of this app as a complement to oral health consultations in a population of adolescents living in Portugal, contributing to the advancement of knowledge in this field and to the promotion of more innovative and user-centered clinical practices. These are the specific objectives of the study: 1. To assess the effectiveness of the app when used as a complement to dental hygiene consultations in relation to several oral health indicators, namely risk of dental caries, gingival inflammation, dental plaque presence, and oral self-care behaviors. 2. To analyze the level of satisfaction and usability of the app's features. The main hypotheses are: 1. The app will significantly improve oral health indicators, including plaque levels, gingival inflammation, and caries risk, compared to a control group. 2. The app will increase adherence to recommended oral hygiene behaviors (e.g., brushing frequency, interdental cleaning). 3. Adolescents using the app will report higher motivation and self-efficacy for oral self-care. 4. The app will demonstrate high usability and user satisfaction, supporting its potential for broader implementation.

With this study, the investigators intend to measure oxygen saturation before and after hip surgery in the context of proximal femur fracture, comparing two types of anesthesia (general or spinal). The investigators also intend to study the effects of the two anesthetic techniques on sleep apnea, delirium, respiratory complications, and length of hospital stay. This is an observational study, in which oxygen is measured at the fingertip with a sensor and a bracelet, without any intervention, inconvenience, or discomfort for the participant. Data will be collected on: respiratory complications, sleep apnea, delirium, length of hospital stay, and survival. Data will be collected in the operating room and wards of Santa Maria Hospital, Lisbon, Portugal over a period of approximately 24 hours after the participant's operation. Information about participant's health and co-morbidities will be recorded. There will be no implication for the participants' clinical care, since the study measurements will not be sent to the health professionals in charge. The operation, recovery, and treatments will not be influenced at any time by participation in the study.

Cardiovascular disease (CVD) remains leader of global causes of death worldwide and recent documented trends show a rise in acute myocardial infarction in younger women. Compared to men, women have a higher cardiovascular risk due to hypertension, dyslipidaemia, diabetes mellitus, obesity, physical inactivity, and a sedentary lifestyle. Plus, they have additional sex-specific cardiovascular risk factors such as gestational hypertension/diabetes, preterm delivery, premature menopause, and polycystic ovary syndrome. Cardiovascular rehabilitation (CR) is a Class I, level A, clinical practice guideline recommendation, multidisciplinary secondary prevention program that has been shown to reduce cardiovascular mortality, rehospitalization, and improve quality of life. Despite all established benefits, CR continues to be under referred to women compared to men, with lower enrolment rates and lower adherence to exercise sessions. The reasons for the underuse of CR by women and the main barriers have been widely studied. Thus, sex-specific implementation strategies have been developed to improve adherence, however, the efficacy claims of these interventions are equivocal, as some studies revealed no significative difference regarding adherence between different exercise delivery modes and mixed-sex programs, whereas others revealed greater preference towards women-only programs. Few randomized controlled trials (RCT) examined the efficacy of CR programs tailored to women in adherence, enrolment, functional capacity, physical activity, body composition, and quality of life. Importantly, to the investigators knowledge, no RCTs used counselling sessions, women-focused educational sessions, personalized follow-ups and supervised exercise sessions as adherence strategies in maintenance CR community programs. The goal of this RCT is to test whether a women-focused maintenance CR community program increases adherence compared to a standard care. Thus, the investigators hypothesized that: • The women-focused group will have greater adherence to the CR community program (main outcome) Participants will: * Be assessed at baseline, at 3-months and at 6-months * Enrol in a supervised community-based maintenance CR program * Receive individually prescribed exercise sessions (both groups), a tailored package consisting of individual counselling sessions and educational sessions (women-focused group)

The main objective of this project is to analyze the effect of a tailor-made, one-to-one, exercise program (aiming to treat and handle obesity-related comorbidities in adolescents with severe obesity at high risk of cardiovascular disease development) on BMI z-score, specific comorbidities, and other health-related indicators. This project will further allow to analyze the long-term impact of the exercise program not only on clinical parameters, but also on the interaction with drug-treatment, health-related behaviors, and quality of life, further contributing to the understanding of the individual characteristics associated with a positive exercise response and frequency. The secondary objective of the THOR-X project is to build an educational toolkit, based on project results and relevant literature, addressed to health and exercise professionals, in order to improve management of adolescents with obesity, in particular those with severe obesity.