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Portugal is commonly recognized as one of the best drug policy examples in the world. Nonetheless, contrasts between drug use risks in rural vs urban settings in the country is an understudied topic, even if its specific challenges are commonly affirmed, both by professionals and people who use drugs (PWUD). The aim of this study was to compare rural and urban environments concerning socio-sanitary services availability; illegal drugs availability; risk behaviors related to drug use; stigma associated with illicit drug use; and social support. Additionally, specific harm reduction challenges and recommendations for improvement were explored. A qualitative study with two focus groups involving people who use drugs, outreach workers and local decision-makers was conducted. Distinct scenarios and challenges in both settings were found: In large cities, a significantly higher specialized service coverage than in rural areas was described. In rural settings, a higher number of drug-related risks, higher levels of stigma and lower availability of human and material resources were mentioned, although being associated with higher levels of informal social support and more proximal relationships with harm reduction teams. This study emphasizes the need for a harm reduction paradigm strongly focused on environmental risk determinants, as much as in individual ones.

Background: Drug checking services are being implemented in recreational settings across the world, however these projects are frequently accused of a lack of evidence concerning their impact on people who use drugs. This paper describes the implementation of a drug checking service at the Boom Festival 2016 and explores the impact of this service on its users' behavioural intentions., Methods: 753 drug samples were submitted to the drug checking service for chemical analysis. All drug checking users were invited to fill a pre-analysis and a post-analysis questionnaire. 310 pre- and post-analysis questionnaires answered by users of the service were successfully matched., Results: When the test results were "unexpected" (N = 86), 94.3% of the service users reported that they would not to take the drug. When the test result indicated the sample contained "the expected substance plus adulterants" (N = 41) 32% of users stated they would not take it. When the test result was "only the expected substance" (N = 370), as anticipated, 98% of the participants reported they would take it. There was a statistically significant association between users' behavioural intentions and drug-checking result (χ 2 (2) = 350,042, p < .001)., Conclusions: These results support the hypothesis that providing drug checking services in large-scale festivals helps users to better manage their drug use and deal with drug adulteration. The data corroborates the supposition that when provided with objective information about the content of their drugs, some users consider health protecting behaviours. Additionally, these results can contribute to the design of tailored harm reduction interventions that take into consideration clients' characteristics, profiles and motivations., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: This paper describes the misrepresentation of LSD at Portugal's Boom Festival 2014 and the prevention of unintentional consumption of DOx and 25x-NBOMe among LSD consumers attending a drug-checking service., Methods: Two hundred forty-five drug samples expected to contain LSD were submitted to the drug-checking service for chemical analysis. One hundred ten post-test questionnaires were successfully matched with test results., Results: About 67.3% of the alleged LSD samples tested contained only LSD; 0.8% contained LSD combined with adulterants; 24.1% did not contain LSD but did contain another psychoactive substance, including 11.4% that were 2,5-dimethoxyamphetamine derivatives and 9.8% that were N-benzyl-2,5-dimethoxyphenethylamine derivatives; and no psychoactive substance was detected in 7.8%. The majority of service users who received unexpected test results regarding their alleged LSD (74.2%) reported that they did not intend to consume the drug. Following dissemination of alerts on day 2, a larger than expected proportion of all tests conducted were for LSD, when comparing the 2014 festival to 2012, where no such alert was disseminated., Conclusions: Although these results support the provision of integrated drug-checking services in party settings, evidence of their utility and effectiveness would be improved through future research incorporating more robust measures of outcomes following provision of drug-checking results., (Copyright © 2017 John Wiley & Sons, Ltd.)

Aim: This study aimed to investigate the response of blood antioxidants and biomarkers of lipid peroxidation, muscle damage and inflammation to a 1000m kayak trial in elite male kayakers., Methods: Enzymatic (superoxide dismutase [SOD], glutathione reductase [Gr] and glutathione peroxidase [GPx] activities) and non-enzymatic (total antioxidant status [TAS], uric acid, α-tocopherol, α-carotene, β-carotene, lycopene and lutein and zeaxanthin) antioxidants, thiobarbituric acid reactive substances (TBARS), creatine kinase (CK), interleukin-6 (IL-6) and cortisol were determined in 15 elite male kayakers before and 15 min after a 1000-m kayak simulated race., Results: Both enzymatic and non-enzymatic antioxidants were unaffected by exercise, with the exception of α-carotene which decreased (P=0.013). Uric acid levels were incremented following exercise (P=0.016). The acute exercise resulted in a significant decrease in TAS (P=0.001) and in an increase in CK (P=0.023), TBARS (P<0.001) and IL-6 (P=0.028)., Conclusion: Our study suggests that a 1000-m kayak simulated race induces oxidative stress and damage in highly-trained kayakers.

Objective: To assess the association between sugar-sweetened beverage (SSB) consumption and overweight in children from a Mediterranean country., Design: The children's dietary intake was measured using a semi-quantitative FFQ completed by the parents. Overall, 2512 questionnaires were returned and 837 children were removed, leaving a final sample of 1675 children, aged between 5 and 10 years. Height and weight were measured according to international standards, and BMI was calculated. The definition of overweight and obesity was based on average centiles according to the International Obesity Task Force cut-offs. To determine the magnitude of the association between SSB consumption and overweight, OR estimates, including CI, were computed using unconditional logistic regression, adjusting for confounders., Setting: Elementary schools throughout the city of Porto, Portugal., Subjects: We invited 5867 children, randomly selected, and their parents to participate in the study. Of those schools that agreed to take part, 3391 parents signed and returned the fully filled out consent form., Results: The prevalence of overweight (including obesity) was 36.6 % for girls and 38.8 % for boys. With regard to SSB consumption (serving/d), no differences between with overweight and non-overweight children were found even after adjustment for confounders (1-2 servings/d: OR = 1.67, 95 % CI 0.76, 3.66, in girls; OR = 1.63, 95 % CI 0.76, 3.47, in boys; and >2 servings/d: OR = 0.63, 95 % CI 0.33, 1.22, in girls; OR = 0.64, 95 % CI 0.33, 1.52, in boys)., Conclusions: The intake of SSB was not associated with increased risk of overweight in Portuguese schoolchildren.

Obesity is one of the most serious health problems in children, and it's frequently related to low activity levels and inadequate nutrition. To evaluate the prevalence of nutritional inadequacy a total of 4845 children (2445 girls and 2400 boys) aged 7-9 years old, were observed. Height and weight were measured according to international standards, and body mass index (BMI) was calculated. Overweight and obesity, using age- and sex-specific BMI cut-off points as defined by the International Obesity Taskforce, were used. Children's dietary intake was measured using a 24-h dietary recall by trained researchers. To evaluate nutritional inadequacy, Food and Nutrition Board Dietary Reference Intakes and World Health Organization (WHO) recommended intake goals were used. The prevalence of overweight/obesity in this sample was 30.8% and the proportion of children with an intake below the Estimated Average Intake/Adequate Intake was very low (= 10%) for the following nutrients: vitamins A, B1, B2, B6, B12, and PP; and for magnesium, zinc, iodine, phosphorous, selenium, and iron. High prevalences of inadequacy were found for folate (60.5% in girls and 54.6% in boys), vitamin E (63.9% in girls and 59.5% in boys), calcium (45% in girls and 40.7% in boys), molybdenum (89.7% in girls and 87.4% in boys, and fibre (87.8% in girls and 86.7% in boys). Regarding the macronutrients, 65.9% and 78.8% of the individuals were above WHO recommended intake values for protein and total fats, respectively; 22% didn't ingest lower than WHO carbohydrates intake recommendation. We've also found that 81.4% and 97.3% of the individuals were above WHO recommendations for saturated fatty acids and total sugars, respectively. Regarding cholesterol intake, 53% of the individuals ingested more than the recommended by WHO. In conclusion, the prevalence of inadequate intakes of calcium, vitamin E, folate, molybdenum and fibre was unacceptably high, while and the contribution of total fat, saturated fat and sugars were far above the recommended by WHO. This could be associated to major chronic diseases, such as coronary heart diseases, in later life.

Our study aimed to describe the association between food patterns and gender, parental education, physical activity, sleeping and obesity in 1976 children aged 5-10 years old. Dietary intake was measured by a semi quantitative food frequency questionnaire; body mass index was calculated and categorized according to the IOTF classification. Factor analysis and generalized linear models were applied to identify food patterns and their associations. TV viewing and male gender were significant positive predictors for fast-food, sugar sweetened beverages and pastry pattern, while a higher level of maternal education and longer sleeping duration were positively associated with a dietary patterns that included fruit and vegetables.

Background: Aerobic exercise leads to reduced sympathetic and increased cardiac vagal modulation, providing an antiarrhythmic effect. The optimal exercise intensity to promote this adaptation remains undefined. The aims of the present investigation were twofold. First, to examine differences in heart rate variability (HRV) measures in participants with different levels of objectively measured physical activity (PA). Second, to identify the characteristic of PA which most influences the cardiac autonomic nervous system (cANS) function in young adults., Methods: Cross-sectional evaluation of 84 adults examining relationships between PA amount and intensities, measured by accelerometry, cANS function derived from HRV. Groups were created based on tertiles of PA and analysis of covariance was used to assess between-group differences in HRV. Stepwise regression analysis was used to determine the characteristic of PA, which best predicted vagal HRV indices., Results: There were significantly higher levels of vagal HRV indices in the most active group compared with the least active group. Regression analysis revealed that the number of bouts of vigorous PA undertaken was the best predictor of the vagal HRV indices assessed., Conclusion: This study suggests that vagal modulation is enhanced with high levels of PA and that it is the number of bouts of vigorous PA that is most closely associated with cANS function.

Strenuous physical activity is known to generate reactive oxygen species to a point that can exceed the antioxidant defense system and lead to oxidative stress. Dietary intake of antioxidants, plasma enzymatic (superoxide dismutase, glutathione reductase [Gr], and glutathione peroxidase [GPx]) activities, nonenzymatic (total antioxidant status [TAS], uric acid, alpha-tocopherol, retinol, alpha-carotene, beta-carotene, lycopene, and lutein + zeaxanthin) antioxidants, and markers of lipid peroxidation (thiobarbituric-acid-reactive substances [TBARS]) and muscle damage (creatine kinase [CK]) were measured in 17 elite male kayakers and canoeists under resting conditions and in an equal number of age- and sex-matched sedentary individuals. Athletes showed increased plasma values of alpha-tocopherol (p = .037), alpha-carotene (p = .003), beta-carotene (p = .007), and superoxide dismutase activity (p = .002) and a lower TAS level (p = .030). Antioxidant intake (alpha-tocopherol, vitamin C, and beta-carotene) and plasmatic GPx, Gr, lycopene, lutein + zeaxanthin, retinol, and uric acid levels were similar in both groups. Nevertheless, TBARS (p < .001) and CK (p = .011) levels were found to be significantly higher in the kayakers and canoeists. This work suggests that despite the enhanced levels of antioxidants, athletes undergoing regular strenuous exercise exhibited more oxidative stress than sedentary controls.

The large volume of training performed by elite athletes throughout the season can translate into a chronic oxidative insult. To study the effects that chronically high training loads have on athletes' redox status, superoxide dismutase (SOD), glutathione reductase, glutathione peroxidase (GPx), and creatine kinase activities; total antioxidant status (TAS); and uric acid, retinol, alpha-tocopherol, alpha-carotene, beta-carotene, lycopene, lutein + zeaxanthin, vitamin C, thiobarbituric acid reactive substances (TBARS), interleukin-6, and cortisol levels were determined in 9 kayakers (6 men) in a competitive period during the first season (June, T1), and in precompetitive (March, T2) and competitive (June, T3) periods during the following season. TAS decreased from the first to the second season (T1 vs. T2, p < 0.001; T1 vs. T3, p < 0.001). TBARS (p = 0.024) decreased from T1 to T2. The alpha-tocopherol increase (p = 0.001) from T1 to T2 lost statistical significance after adjustment for total lipids (p = 0.243). GPx (p = 0.003) increased, while SOD (p < 0.001) and uric acid (p = 0.032) decreased from T2 to T3. Cortisol levels decreased significantly throughout the study (T1 vs. T2, p = 0.042; T2 vs. T3, p = 0.018; T1 vs. T3, p = 0.002). No significant differences were observed for any of the other parameters studied. Antioxidant status changed more within the same season than from one season to another. Redox markers should be monitored throughout the season to detect athletes at an increased oxidative risk.

Unlabelled: The global prevalence of overweight and obesity in children is growing. A number of eating patterns have been associated with different risks of overweight. Sugar sweetened beverages have received considerable attention as potential sources of energy in liquid form that could be responsible for body weight gain., Objective: Evaluate the association between fluid intake and overweight in schoolchildren., Material and Methods: The final sample of the study includes 1675 children schools between 5 and 10 years old, after excluding dietary misreporting and questionnaires with incomplete information. After parental written consent, children's height and weight were measured according to international standards, and body mass index was calculated. The definition of overweight was based on average centiles according to the International Obesity Task Force cutoffs. We administered a questionnaire to parents that included information about physical activity, dietary intake (food frequency questionnaire that included information on milk, vegetable soup, cola, ice-tea and other sugar-sweetened beverages) and socio-demographic information. Adjusted odds ratios were computed using logistic regression., Results: We found a high prevalence of overweight (including obesity) being 36,6% for girls, and 38,8% for boys. In girls the probability of being overweight increased significantly for those having low consumption of vegetable soup (equal or lower tan the median) compared to those with high consumption (higher than the median), even after adjusting for confounders (OR = 0,68, CI 95% 0,48-0,96, p = 0,030). We didn't find any significant association between sugar sweetened beverages and milk intake with overweight in both genders., Conclusion: In girls, high vegetable soup consumption significantly decreased the probability of being overweight, independently of other characteristics.