Shift work (SW) encompasses 20% of the European workforce. Moreover, high blood pressure (BP) remains a leading cause of death globally. This review aimed to synthesize the magnitude of the potential impact of SW on systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension (HTN). MEDLINE, EMBASE and CENTRAL databases were searched for epidemiological studies evaluating BP and/or HTN diagnosis among shift workers, compared with day workers. Random-effects meta-analyses were performed and the results were expressed as pooled mean differences or odds ratios and 95% confidence intervals (95% CI). The Newcastle–Ottawa Scale was used to assess the risk of bias. Forty-five studies were included, involving 117,252 workers. We found a significant increase in both SBD and DBP among permanent night workers (2.52 mmHg, 95% CI 0.75–4.29 and 1.76 mmHg, 95% CI 0.41–3.12, respectively). For rotational shift workers, both with and without night work, we found a significant increase but only for SBP (0.65 mmHg, 95% CI 0.07–1.22 and 1.28 mmHg, 95% CI 0.18–2.39, respectively). No differences were found for HTN. Our findings suggest that SW is associated with an increase of BP, mainly for permanent night workers and for SBP. This is of special interest given the large number of susceptible workers exposed over time.

Background: This paper aims to discuss how physical activity (PA) brief assessment, brief counseling, and self-monitoring tools were designed and implemented in the Portuguese National Health Service (NHS), and to report on their current use by health professionals and citizens. Methods: Three digital tools to facilitate PA promotion in primary health care (PHC) were developed: 1) a PA brief assessment tool was incorporated in the electronic health record platform “SClínico Cuidados de Saúde Primários“; 2) a brief counseling tool was developed in the software “PEM—Prescrição Eletrónica Médica” (electronic medical prescription); and 3) a “Physical Activity Card” was incorporated in an official NHS smartphone app called “MySNS Carteira”. Results: From September 2017 to June 2019, 119,386 Portuguese patients had their PA assessed in PHC. Between December 2017 and June 2019, a total of 7957 patients received brief intervention for PA by a medical doctor. Regarding the app “MySNS Carteira”, 93,320 users activated the “Physical Activity Card”, between February 2018 and December 2018. Conclusions: These tools represent key actions to promote PA among Portuguese citizens using PHC as a priority setting. Further initiatives will follow, including proper assessment of their clinical impact and training programs for health care professionals on PA promotion.

Introduction: Differences in the manner circadian clocks entrain to the 24-h day are expressions of different chronotypes that can range from extreme early to extreme late, from proverbial larks to owls. The Morningness Eveningness Questionnaire (MEQ) was one of the first to assess daily preference based on subjective self-assessment-a psychological construct. The later developed Munich Chronotype Questionnaire (MCTQ) uses instead the actual sleep timing to assess chronotype. It calculates the midsleep point, halfway between onset and offset on work-free days (MSF), which is then corrected for potential oversleep on free days compensating for sleep debt accumulated over the workweek (MSF sc). MSF sc is expressed in local time and is thought to be a proxy for "phase of entrainment" of the circadian clock. The MCTQ-derived chronotype is therefore a biological construct. In the present report, we validate the Portuguese variant (MCTQ PT) of the MCTQ. Portugal is of particular interest, since it is thought to consist of especially late chronotypes. Methods: We have used three methods to assess the timing of daily behavior, namely, the chronotype (MCTQ), the daily preference (rMEQ), and a simple self-assessment (time-of-day type). A total of 80 healthy adults living in Portugal, with age and sex distributed according to the Portuguese population, were recruited. We analyzed 4 weeks of continuous records of actimetry data to validate the MCTQ PT and used the rMEQ to compare between a biological chronotype (sleep timing) and a psychological chronotype (daily preference). MCTQ variables were analyzed by descriptive statistics; correspondence between measurements was done by Spearman correlations or cross-tabulation; in a subset of 41 individuals, test-retest reliability was assessed. Results: MCTQ-derived variables (MSF, MSW, MSF sc) correlated highly with their counterparts calculated from actimetry (MSW: rho = 0.697; MSF: rho = 0.747; MSF sc : rho = 0.646; all p < 0.001). The MCTQ assessment of the chronotype showed good test-retest reliability (rho = 0.905; p < 0.001). The rMEQ score correlates with MSF sc (rho = −0.695; p < 0.001), and the agreement for the self-assessment with the MSF sc was fair (kw = 0.386; p < 0.001).