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Mocho H, Martins C, dos Santos R, Nunes C. Parental Involvement and Stress in Children's Quality of Life: A Longitudinal Study with Portuguese Parents during the COVID-19 Pandemic Period. Children (Basel) 2024; 11:440. [PMID: 38671657 PMCID: PMC11049130 DOI: 10.3390/children11040440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024]
Abstract
Parental involvement (PI) has particular relevance on children's academic adjustment and on children's general quality of life (QoL). QoL can be influenced by parental stress, specifically the stress suffered during the COVID-19 pandemic. Thus, this study aimed to analyze the differences during the pandemic period (before, after and with no lockdown), comparing these constructs with parental educational level to provide predictors of their children's quality of life. Data collection was performed with a non-probability convenience sampling procedure. It was composed of 129 parents, mainly women (71.8%), with children aged between 6 and 12 years. The family's sociodemographic characteristics were assessed, as well as the PI, parental stress, and children's QoL. The comparison between the three times revealed an increase in the children's QoL, but no differences were found in PI. Based on the parental educational level, as defined by academic qualifications and split into superior and non-superior levels, it is possible conclude that engagement in school activities and parents' meetings increased in the parents with superior education levels and decreased in the parents with lower education levels. This study concluded that despite this difficult and uncertain pandemic period, these parents were able to maintain important aspects of their children's lives.
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Affiliation(s)
| | | | | | - Cristina Nunes
- Psychology Research Centre (CIP), University of Algarve, Campus of Gambelas, 8005-139 Faro, Portugal; (H.M.); (C.M.); (R.d.S.)
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Martins C, da Silva JT, de Jesus SN, Ribeiro C, Estêvão MD, Baptista R, Carmo C, Brás M, Santos R, Nunes C. The Volunteer Functions Inventory (VFI): Adaptation and Psychometric Properties among a Portuguese Sample of Volunteers. Eur J Investig Health Psychol Educ 2024; 14:823-837. [PMID: 38667808 PMCID: PMC11048745 DOI: 10.3390/ejihpe14040053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
The Volunteer Functions Inventory (VFI) is an instrument widely used to assess volunteers' motivation based on the Functionalist Model of Omoto and Snyder. It assesses six factors that reflect several motivational functions. The VFI has been translated into various languages and validated in different cultural contexts, but some studies have reported different factor structures (e.g., five or four factors). In the Portuguese context, previous studies have also shown inconsistent results. The aim of this study was to adapt and validate the VFI for Portuguese volunteers, testing several alternative models (nine models) using confirmatory factor analysis. The sample comprised 468 volunteers (76.3% women), aged from 13 to 81 years (M = 36.66, SD = 14.93). The results support the original interrelated six-factor model as the best-fitting one. The VFI showed good internal consistency and convergent validity. Significant correlations were found between the VFI factors, organizational commitment, and volunteers' satisfaction. Overall, the six-factor VFI is a valid and reliable tool for measuring the motivational functions of Portuguese volunteers, with implications for practice and research in the volunteering field.
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Affiliation(s)
- Cátia Martins
- Psychology Research Centre (CIP), Rua de Santa Marta, 47-3º, 1169-023 Lisboa, Portugal; (C.C.); (M.B.); (R.S.); (C.N.)
- Faculty of Human and Social Sciences, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (S.N.d.J.); (R.B.)
| | - José Tomás da Silva
- Centre for Social Studies, Faculty of Psychology and Educational Sciences, University of Coimbra, Colégio de S. Jerónimo, Largo D. Dinis, 3000-995 Coimbra, Portugal;
| | - Saúl Neves de Jesus
- Faculty of Human and Social Sciences, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (S.N.d.J.); (R.B.)
- Research Centre for Tourism, Sustainability and Well-Being (CinTurs), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Conceição Ribeiro
- Centre of Statistics and Its Applications (CEAUL), Faculty of Sciences, University of Lisboa, 1749-016 Lisboa, Portugal;
- Institute of Engineering, Universidade do Algarve, Campus da Penha, 8005-139 Faro, Portugal
| | - Maria Dulce Estêvão
- School of Health, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
| | - Ricardo Baptista
- Faculty of Human and Social Sciences, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (S.N.d.J.); (R.B.)
| | - Cláudia Carmo
- Psychology Research Centre (CIP), Rua de Santa Marta, 47-3º, 1169-023 Lisboa, Portugal; (C.C.); (M.B.); (R.S.); (C.N.)
- Faculty of Human and Social Sciences, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (S.N.d.J.); (R.B.)
| | - Marta Brás
- Psychology Research Centre (CIP), Rua de Santa Marta, 47-3º, 1169-023 Lisboa, Portugal; (C.C.); (M.B.); (R.S.); (C.N.)
- Faculty of Human and Social Sciences, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (S.N.d.J.); (R.B.)
| | - Rita Santos
- Psychology Research Centre (CIP), Rua de Santa Marta, 47-3º, 1169-023 Lisboa, Portugal; (C.C.); (M.B.); (R.S.); (C.N.)
| | - Cristina Nunes
- Psychology Research Centre (CIP), Rua de Santa Marta, 47-3º, 1169-023 Lisboa, Portugal; (C.C.); (M.B.); (R.S.); (C.N.)
- Faculty of Human and Social Sciences, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (S.N.d.J.); (R.B.)
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Pechorro P, Baptista MN, Bonfá-Araujo B, Nunes C, DeLisi M. Screening for Light Personalities in Portugal: A Cross-Cultural Validation of the Light Triad Scale With an At-risk-of-delinquency Sample. Int J Offender Ther Comp Criminol 2024:306624X241228234. [PMID: 38339801 DOI: 10.1177/0306624x241228234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
The Light Triad of personality refers to three prosocial personality traits-Faith in Humanity, Humanism, and Kantianism-that promote the worth and dignity of other people, focus on ethical behavior and empathy, and confidence that other people are naturally good. The aim of the present study is to examine the psychometric properties of the Light Triad Scale (LTS)-Portuguese version. Our convenience sample consisted of 242 male and female participants (M = 30.19 years, SD = 12.78, range = 16-77) from Portugal. The proposed latent structure models of the LTS obtained adequate fits. Internal consistency/reliability, as measured by the alpha and omega coefficients, was adequate to good. Construct validity with other psychometric measures (i.e., empathy, dark traits of personality, propensity to morally disengage, and antisociality/criminality measures) and criterion-related validity (with justice involvement variables such as problems with the law, arrested by the police, sentenced to prison and alcohol/drug abuse variables) were demonstrated. Cross-gender measurement invariance was established, with females scoring higher than males. The findings support the use of the LTS as a valid and reliable measure.
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Affiliation(s)
| | | | | | - Cristina Nunes
- Psychology Research Centre (CIP), Universidade do Algarve, Faro, Portugal
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Guerreiro T, Forjaz G, Antunes L, Bastos J, Mayer A, Aguiar P, Araújo A, Nunes C. Lung cancer survival and sex-specific patterns in Portugal: A population-based analysis. Pulmonology 2023; 29 Suppl 4:S70-S79. [PMID: 34642125 DOI: 10.1016/j.pulmoe.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/10/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION In Portugal, lung cancer (LC) is the first cause of cancer-related death and of death and disability combined. This study aims to analyze the overall survival (OS) and relative survival (RS) of patients diagnosed with LC in 2009-2011 by socio-demographic and tumor characteristics, and analyze sex-specific patterns. METHODS We estimated 5-year OS using the Kaplan-Meier method and 5-year net survival through the RS framework. Cox regression modeling was used to determine the hazard ratio (HR) of death associated with each independent variable. FINDINGS For the 11,523 cases analyzed, median 5-year OS was 264 days (95% confidence interval [CI]: 254.8-273.2), the cumulative OS was 13.6% and RS was 15.1%. Males had a lower median survival (237 days; 95% CI: 228.2-245.7) compared to females (416 days; 95% CI: 384.4-447.6) (p < 0.0001) and lower 5-year RS proportions (12.1% vs. 24.9%). RS progressively decreased with age (41.7% for age-group <40 to 7.2% for ≥80) and stage (66.6% for stage I to 2.4% for stage IV). As predictors of decreased survival, we identified male gender, increasing age >50, histologic types (squamous cell carcinoma, non-small cell lung cancer not otherwise specified, other unspecified and small cell lung cancer), and increasing stage. Compared to women, the risk of death in men was 37.7% higher (HR = 1.386; 95% CI: 1.295-1.484). CONCLUSIONS The differences between OS and RS were small, reflecting the high lethality of LC. Male gender and older age are factors related to poor prognosis. Histology also plays a role in survival prognosis and varies with gender, but the factor related to the worst survival is stage. Although the study reflects data from a decade ago, and major changes occurred in diagnosis, staging and treatment, particularly for advanced disease, as LC mortality is strongly correlated with late stage diagnosis, all efforts should be made to secure early diagnosis and improve survival prospects.
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Affiliation(s)
- T Guerreiro
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal.
| | - G Forjaz
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA; Azores Oncological Centre, Azores, Portugal
| | - L Antunes
- Cancer Epidemiology Group, IPO Porto Research (CI-IPOP), Portuguese Institute of Oncology Francisco Gentil, Porto, Portugal
| | - J Bastos
- Portuguese Institute of Oncology Francisco Gentil, Coimbra, Portugal
| | - A Mayer
- Portuguese Institute of Oncology Francisco Gentil, Lisbon, Portugal
| | - P Aguiar
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Research Center, NOVA University of Lisbon, Portugal
| | - A Araújo
- University Hospital Center of Porto, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - C Nunes
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Research Center, NOVA University of Lisbon, Portugal
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Rocha B, Ferreira LI, Martins C, Santos R, Nunes C. The Dark Side of Multimedia Devices: Negative Consequences for Socioemotional Development in Early Childhood. Children (Basel) 2023; 10:1807. [PMID: 38002898 PMCID: PMC10670731 DOI: 10.3390/children10111807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/11/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023]
Abstract
There is growing concern about the relationship between screen use by young children and negative effects on their development, as children with developmental and socioemotional impairments tend to have difficulties in their relationships and increased academic problems. The aim of our study was to analyse the relationship between the use of multimedia devices and paediatric symptoms in children below 5 years old. Data from 534 Portuguese parents of children aged from 18 to 57 months were collected via a self-report questionnaire. Children's daily exposure to multimedia devices was nearly 2 h per day. Paediatric symptoms were positively associated with watching television and screen time and negatively associated with parents' working hours. Touchscreen use was more frequent among girls and older children. Parents' working hours comprised the most significant predictor of paediatric symptoms. Our findings reinforce past findings on the adverse links between the use of multimedia devices and paediatric symptoms and also highlight the influence of other variables like the child's age and gender, as well as parental factors. The need to both create a more comprehensive framework regarding the long-term effects of multimedia device use and delineate effective strategies for prevention and intervention with parents and children is discussed.
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Affiliation(s)
- Bruno Rocha
- Department of Psychology and Educational Sciences, Campus de Gambelas, Universidade do Algarve, 8005-135 Faro, Portugal;
| | - Laura I. Ferreira
- Psychology Research Centre (CIP), Universidade do Algarve, 8005-135 Faro, Portugal; (L.I.F.); (C.M.); (R.S.)
| | - Cátia Martins
- Psychology Research Centre (CIP), Universidade do Algarve, 8005-135 Faro, Portugal; (L.I.F.); (C.M.); (R.S.)
| | - Rita Santos
- Psychology Research Centre (CIP), Universidade do Algarve, 8005-135 Faro, Portugal; (L.I.F.); (C.M.); (R.S.)
| | - Cristina Nunes
- Psychology Research Centre (CIP), Universidade do Algarve, 8005-135 Faro, Portugal; (L.I.F.); (C.M.); (R.S.)
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Brás M, Elias P, Cunha FF, Martins C, Nunes C, Carmo C. Vulnerability to Suicide Ideation: Comparative Study between Adolescents with and without Psychosocial Risk. Healthcare (Basel) 2023; 11:2663. [PMID: 37830700 PMCID: PMC10572437 DOI: 10.3390/healthcare11192663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/16/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
Adolescents are characterized as a risk group for suicide, being the fourth leading cause of death in young people. The main aim was to compare vulnerability to suicidal ideation in a sample of young people with and without psychosocial risk. The total sample consisted of 137 adolescents, aged between 10 and 19 years (M = 14.76; SD = 1.40), and it was composed of two groups-the psychosocial risk group (n = 60) and general population group (n = 77). In both groups, suicidal ideation correlated positively with negative events and negatively with self-esteem and social support satisfaction. When comparing the two groups, the psychosocial risk group presented significantly higher mean values of negative life events (mainly separations/losses and physical and sexual abuse) and significantly lower mean values of satisfaction with social support (particularly with family and social activities). It was also found that, in the psychosocial risk group, negative life events were the only significant predictors of suicidal ideation. This study allowed identifying the role of risk and protective factors in suicidal ideation, according to the psychosocial risk of adolescents. The practical implications of the findings on adolescents' mental health and the promotion of their well-being are discussed.
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Affiliation(s)
- Marta Brás
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
| | - Patrícia Elias
- Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
| | - Francisca Ferreira Cunha
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
| | - Cátia Martins
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
| | - Cristina Nunes
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
| | - Cláudia Carmo
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
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Marques J, Rocha JV, Soares P, Leite A, Duarte R, Nunes C. The effect of TB patient delay on loss to follow-up in Portugal. Int J Tuberc Lung Dis 2023; 27:537-542. [PMID: 37353867 DOI: 10.5588/ijtld.22.0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND: Early identification of TB cases, followed by treatment to completion, are essential for controlling and preventing the disease. Previous studies have found some factors associated with both loss to follow-up (LTFU) and patient delay. We aim to build a causal model to investigate the association between TB patient delay and LTFU.METHODS: Pulmonary TB cases were identified using the national surveillance system in Portugal between 2008 and 2017. A directed acyclic graph was used to identify the minimal set of variables to adjust for when studying the association between delay (exposure) and LTFU (outcome). Crude and adjusted hazard were estimated using Cox regression.RESULTS: Nearly 4% of the patients did not follow up treatment. There was no association between patient delay and LTFU, even after adjustment with the minimal set of covariates. Factors associated with a higher risk of LTFU were being younger, being unemployed, living in urban areas, having HIV and the abuse of alcohol and drugs.CONCLUSION: Patient delay was not associated with LTFU, while social conditions were. Future research should investigate the underlying reasons why patients discontinue TB treatment and use these findings to develop targeted interventions that can support patients in completing their treatment regimen.
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Affiliation(s)
- J Marques
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - J V Rocha
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Comprehensive Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Comprehensive Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Leite
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Comprehensive Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal, Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - R Duarte
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal, Unidade de Investigação Clínica da ARS Norte, Porto, Portugal, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal, Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Nunes
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Comprehensive Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
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Grounds GS, Dent H, Nunes C, Dhar V. Tubeless field anaesthesia for surgical removal of an aspirated endoscopy capsule. Anaesth Rep 2023; 11:e12242. [PMID: 37588044 PMCID: PMC10425334 DOI: 10.1002/anr3.12242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/18/2023] Open
Abstract
Capsule endoscopy is a safe, minimally invasive procedure used to investigate gastrointestinal bleeding of unknown origin that persists or recurs after a negative initial endoscopy. The most common adverse effects of capsule endoscopy include abdominal pain, nausea and vomiting. Capsule pulmonary aspiration, although a rare complication, has been reported in the literature. Most reported cases resolve without further medical intervention. In these cases, the capsule is either expelled by coughing, or it re-enters the oropharynx and is then swallowed. In a small number of cases, the capsule remains in the lung, unable to be expectorated. This requires prompt diagnosis and emergency bronchoscopic removal under general anaesthesia. Due to the smooth, rounded surfaces of the capsule, it may be difficult to grasp, and consequently extraction may be technically challenging. The existing literature contains limited documentation on anaesthetic and surgical approaches for managing an aspirated endoscopy capsule. In this case report, we present the management of an aspirated endoscopy capsule in a district general hospital, in which thoracic surgery was not available. Local resources were used to manage this potentially life-threatening complication without patient transfer. In our case, we provided a tubeless field to optimise surgical access. This facilitated the successful surgical extraction of the endoscopy capsule from the left main bronchus.
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Affiliation(s)
- G. S. Grounds
- Department of AnaesthesiaKent and Canterbury HospitalCanterburyKentUK
| | - H. Dent
- Department of AnaesthesiaKent and Canterbury HospitalCanterburyKentUK
| | - C. Nunes
- Department of GastroenterologyKent and Canterbury HospitalCanterburyKentUK
| | - V. Dhar
- Department of Ear, Nose and Throat SurgeryWilliam Harvey HospitalAshfordKentUK
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Pechorro P, DeLisi M, Freitas A, Gonçalves RA, Nunes C. Examination of the Weinberger Adjustment Inventory-Short Form Among Portuguese Young Adults: Psychometrics and Measurement Invariance. Int J Offender Ther Comp Criminol 2023; 67:803-821. [PMID: 34994214 DOI: 10.1177/0306624x211066838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The Weinberger Adjustment Inventory-Short Form (WAI-SF) is a multidimensional measure of behavioral adjustment frequently used with forensic, clinical, and community populations. However, no previous studies have examined the WAI-SF from a more modern psychometric perspective including second-order models, measurement invariance and a better estimation of reliability. The current sample is composed of female and male young adults (N = 610, M = 21.33 years, SD = 3.09, range = 18-37) from a university context in Portugal. Results indicated that both the four-factor intercorrelated and the four-factor second order models of the WAI-SF Distress and Restraint scales showed good fits. The WAI-SF Distress and Restraint scales were negatively and significantly correlated, and the intercorrelations between the subscales of each scale ranged from moderate to high. The WAI-SF scales and subscales mostly showed adequate to good reliability in terms of McDonald's Omega and the more traditional Cronbach's Alpha. Strong cross-gender measurement invariance was demonstrated, with females scoring significantly higher than males on the Anxiety subscale of the Distress scale, and on the Suppression of Aggression, Impulse Control, Consideration of Others, Responsibility subscales, and Restraint scale. The WAI-SF scales and subscales showed distinctive correlates with other measures (e.g., low self-control, psychopathy) and variables (e.g., delinquency seriousness, substance use). Considering our findings, the use of the WAI-SF is recommended among the Portuguese young adult population and its use in criminological research is encouraged.
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Affiliation(s)
| | | | | | | | - Cristina Nunes
- University of Algarve & Psychology Research Centre, Faro, Portugal
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Tabah A, Buetti N, Staiquly Q, Ruckly S, Akova M, Aslan AT, Leone M, Conway Morris A, Bassetti M, Arvaniti K, Lipman J, Ferrer R, Qiu H, Paiva JA, Povoa P, De Bus L, De Waele J, Zand F, Gurjar M, Alsisi A, Abidi K, Bracht H, Hayashi Y, Jeon K, Elhadi M, Barbier F, Timsit JF, Pollock H, Margetts B, Young M, Bhadange N, Tyler S, Ledtischke A, Finnis M, Ledtischke A, Finnis M, Dwivedi J, Saxena M, Biradar V, Soar N, Sarode V, Brewster D, Regli A, Weeda E, Ahmed S, Fourie C, Laupland K, Ramanan M, Walsham J, Meyer J, Litton E, Palermo AM, Yap T, Eroglu E, Attokaran AG, Jaramillo C, Nafees KMK, Rashid NAHA, Walid HAMI, Mon T, Moorthi PD, Sudhirchandra S, Sridharan DD, Haibo Q, Jianfeng X, Wei-Hua L, Zhen W, Qian C, Luo J, Chen X, Wang H, Zhao P, Zhao J, Wusi Q, Mingmin C, Xu L, Yin C, Wang R, Wang J, Yin Y, Zhang M, Ye J, Hu C, Zhou S, Huang M, Yan J, Wang Y, Qin B, Ye L, Weifeng X, Peije L, Geng N, Hayashi Y, Karumai T, Yamasaki M, Hashimoto S, Hosokawa K, Makino J, Matsuyoshi T, Kuriyama A, Shigemitsu H, Mishima Y, Nagashima M, Yoshida H, Fujitani S, Omori K, Rinka H, Saito H, Atobe K, Kato H, Takaki S, Hasan MS, Jamaluddin MFH, Pheng LS, Visvalingam S, Liew MT, Wong SLD, Fong KK, Rahman HBA, Noor ZM, Tong LK, Azman AH, Mazlan MZ, Ali S, Jeon K, Lee SM, Park S, Park SY, Lim SY, Goh QY, Ng SY, Lie SA, Kwa ALH, Goh KJ, Li AY, Ong CYM, Lim JY, Quah JL, Ng K, Ng LXL, Yeh YC, Chou NK, Cia CT, Hu TY, Kuo LK, Ku SC, Wongsurakiat P, Apichatbutr Y, Chiewroongroj S, Nadeem R, Houfi AE, Alsisi A, Elhadidy A, Barsoum M, Osman N, Mostafa T, Elbahnasawy M, Saber A, Aldhalia A, Elmandouh O, Elsayed A, Elbadawy MA, Awad AK, Hemead HM, Zand F, Ouhadian M, Borsi SH, Mehraban Z, Kashipazha D, Ahmadi F, Savaie M, Soltani F, Rashidi M, Baghbanian R, Javaherforoosh F, Amiri F, Kiani A, Zargar MA, Mahmoodpoor A, Aalinezhad F, Dabiri G, Sabetian G, Sarshad H, Masjedi M, Tajvidi R, Tabatabaei SMN, Ahmed AK, Singer P, Kagan I, Rigler M, Belman D, Levin P, Harara B, Diab A, Abilama F, Ibrahim R, Fares A, Buimsaedah A, Gamra M, Aqeelah A, AliAli AM, Homaidan AGS, Almiqlash B, Bilkhayr H, Bouhuwaish A, Taher AS, Abdulwahed E, Abousnina FA, Hdada AK, Jobran R, Hasan HB, Hasan RSB, Serghini I, Seddiki R, Boukatta B, Kanjaa N, Mouhssine D, Wajdi MA, Dendane T, Zeggwagh AA, Housni B, Younes O, Hachimi A, Ghannam A, Belkhadir Z, Amro S, Jayyab MA, Hssain AA, Elbuzidi A, Karic E, Lance M, Nissar S, Sallam H, Elrabi O, Almekhlafi GA, Awad M, Aljabbary A, Chaaban MK, Abu-Sayf N, Al-Jadaan M, Bakr L, Bouaziz M, Turki O, Sellami W, Centeno P, Morvillo LN, Acevedo JO, Lopez PM, Fernández R, Segura M, Aparicio DM, Alonzo MI, Nuccetelli Y, Montefiore P, Reyes LF, Reyes LF, Ñamendys-Silva SA, Romero-Gonzalez JP, Hermosillo M, Castillo RA, Leal JNP, Aguilar CG, Herrera MOG, Villafuerte MVE, Lomeli-Teran M, Dominguez-Cherit JG, Davalos-Alvarez A, Ñamendys-Silva SA, Sánchez-Hurtado L, Tejeda-Huezo B, Perez-Nieto OR, Tomas ED, De Bus L, De Waele J, Hollevoet I, Denys W, Bourgeois M, Vanderhaeghen SFM, Mesland JB, Henin P, Haentjens L, Biston P, Noel C, Layos N, Misset B, De Schryver N, Serck N, Wittebole X, De Waele E, Opdenacker G, Kovacevic P, Zlojutro B, Custovic A, Filipovic-Grcic I, Radonic R, Brajkovic AV, Persec J, Sakan S, Nikolic M, Lasic H, Leone M, Arbelot C, Timsit JF, Patrier J, Zappela N, Montravers P, Dulac T, Castanera J, Auchabie J, Le Meur A, Marchalot A, Beuzelin M, Massri A, Guesdon C, Escudier E, Mateu P, Rosman J, Leroy O, Alfandari S, Nica A, Souweine B, Coupez E, Duburcq T, Kipnis E, Bortolotti P, Le Souhaitier M, Mira JP, Garcon P, Duprey M, Thyrault M, Paulet R, Philippart F, Tran M, Bruel C, Weiss E, Janny S, Foucrier A, Perrigault PF, Djanikian F, Barbier F, Gainnier M, Bourenne J, Louis G, Smonig R, Argaud L, Baudry T, Dessap AM, Razazi K, Kalfon P, Badre G, Larcher R, Lefrant JY, Roger C, Sarton B, Silva S, Demeret S, Le Guennec L, Siami S, Aparicio C, Voiriot G, Fartoukh M, Dahyot-Fizelier C, Imzi N, Klouche K, Bracht H, Hoheisen S, Bloos F, Thomas-Rueddel D, Petros S, Pasieka B, Dubler S, Schmidt K, Gottschalk A, Wempe C, Lepper P, Metz C, Viderman D, Ymbetzhanov Y, Mugazov M, Bazhykayeva Y, Kaligozhin Z, Babashev B, Merenkov Y, Temirov T, Arvaniti K, Smyrniotis D, Psallida V, Fildisis G, Soulountsi V, Kaimakamis E, Iasonidou C, Papoti S, Renta F, Vasileiou M, Romanou V, Koutsoukou V, Matei MK, Moldovan L, Karaiskos I, Paskalis H, Marmanidou K, Papanikolaou M, Kampolis C, Oikonomou M, Kogkopoulos E, Nikolaou C, Sakkalis A, Chatzis M, Georgopoulou M, Efthymiou A, Chantziara V, Sakagianni A, Athanasa Z, Papageorgiou E, Ali F, Dimopoulos G, Almiroudi MP, Malliotakis P, Marouli D, Theodorou V, Retselas I, Kouroulas V, Papathanakos G, Montrucchio G, Sales G, De Pascale G, Montini LM, Carelli S, Vargas J, Di Gravio V, Giacobbe DR, Gratarola A, Porcile E, Mirabella M, Daroui I, Lodi G, Zuccaro F, Schlevenin MG, Pelosi P, Battaglini D, Cortegiani A, Ippolito M, Bellina D, Di Guardo A, Pelagalli L, Covotta M, Rocco M, Fiorelli S, Cotoia A, Rizzo AC, Mikstacki A, Tamowicz B, Komorowska IK, Szczesniak A, Bojko J, Kotkowska A, Walczak-Wieteska P, Wasowska D, Nowakowski T, Broda H, Peichota M, Pietraszek-Grzywaczewska I, Martin-Loeches I, Bisanti A, Cartoze N, Pereira T, Guimarães N, Alves M, Marques AJP, Pinto AR, Krystopchuk A, Teresa A, de Figueiredo AMP, Botelho I, Duarte T, Costa V, Cunha RP, Molinos E, da Costa T, Ledo S, Queiró J, Pascoalinho D, Nunes C, Moura JP, Pereira É, Mendes AC, Valeanu L, Bubenek-Turconi S, Grintescu IM, Cobilinschi C, Filipescu DC, Predoi CE, Tomescu D, Popescu M, Marcu A, Grigoras I, Lungu O, Gritsan A, Anderzhanova A, Meleshkina Y, Magomedov M, Zubareva N, Tribulev M, Gaigolnik D, Eremenko A, Vistovskaya N, Chukina M, Belskiy V, Furman M, Rocca RF, Martinez M, Casares V, Vera P, Flores M, Amerigo JA, Arnillas MPG, Bermudez RM, Armestar F, Catalan B, Roig R, Raguer L, Quesada MD, Santos ED, Gomà G, Ubeda A, Salgado DM, Espina LF, Prieto EG, Asensio DM, Rodriguez DM, Maseda E, De La Rica AS, Ayestaran JI, Novo M, Blasco-Navalpotro MA, Gallego AO, Sjövall F, Spahic D, Svensson CJ, Haney M, Edin A, Åkerlund J, De Geer L, Prazak J, Jakob S, Pagani J, Abed-Maillard S, Akova M, Aslan AT, Timuroglu A, Kocagoz S, Kusoglu H, Mehtap S, Ceyhun S, Altintas ND, Talan L, Kayaaslan B, Kalem AK, Kurt I, Telli M, Ozturk B, Erol Ç, Demiray EKD, Çolak S, Akbas T, Gundogan K, Sari A, Agalar C, Çolak O, Baykam NN, Akdogan OO, Yilmaz M, Tunay B, Cakmak R, Saltoglu N, Karaali R, Koksal I, Aksoy F, Eroglu A, Saracoglu KT, Bilir Y, Guzeldag S, Ersoz G, Evik G, Sungurtekin H, Ozgen C, Erdoğan C, Gürbüz Y, Altin N, Bayindir Y, Ersoy Y, Goksu S, Akyol A, Batirel A, Aktas SC, Morris AC, Routledge M, Morris AC, Ercole A, Antcliffe D, Rojo R, Tizard K, Faulkner M, Cowton A, Kent M, Raj A, Zormpa A, Tinaslanidis G, Khade R, Torlinski T, Mulhi R, Goyal S, Bajaj M, Soltan M, Yonan A, Dolan R, Johnson A, Macfie C, Lennard J, Templeton M, Arias SS, Franke U, Hugill K, Angell H, Parcell BJ, Cobb K, Cole S, Smith T, Graham C, Cerman J, Keegan A, Ritzema J, Sanderson A, Roshdy A, Szakmany T, Baumer T, Longbottom R, Hall D, Tatham K, Loftus S, Husain A, Black E, Jhanji S, Baikady RR, Mcguigan P, Mckee R, Kannan S, Antrolikar S, Marsden N, Torre VD, Banach D, Zaki A, Jackson M, Chikungwa M, Attwood B, Patel J, Tilley RE, Humphreys MSK, Renaud PJ, Sokhan A, Burma Y, Sligl W, Baig N, McCoshen L, Kutsogiannis DJ, Sligl W, Thompson P, Hewer T, Rabbani R, Huq SMR, Hasan R, Islam MM, Gurjar M, Baronia A, Kothari N, Sharma A, Karmakar S, Sharma P, Nimbolkar J, Samdani P, Vaidyanathan R, Rubina NA, Jain N, Pahuja M, Singh R, Shekhar S, Muzaffar SN, Ozair A, Siddiqui SS, Bose P, Datta A, Rathod D, Patel M, Renuka MK, Baby SK, Dsilva C, Chandran J, Ghosh P, Mukherjee S, Sheshala K, Misra KC, Yakubu SY, Ugwu EM, Olatosi JO, Desalu I, Asiyanbi G, Oladimeji M, Idowu O, Adeola F, Mc Cree M, Karar AAA, Saidahmed E, Hamid HKS. Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study. Intensive Care Med 2023; 49:178-190. [PMID: 36764959 PMCID: PMC9916499 DOI: 10.1007/s00134-022-06944-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/23/2022] [Indexed: 02/12/2023]
Abstract
PURPOSE In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. METHODS We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. RESULTS 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. CONCLUSIONS HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.
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Affiliation(s)
- Alexis Tabah
- Intensive Care Unit, Redcliffe Hospital, Brisbane, Australia. .,Queensland Critical Care Research Network (QCCRN), Brisbane, QLD, Australia. .,Queensland University of Technology, Brisbane, QLD, Australia. .,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Niccolò Buetti
- Infection Control Program and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Université de Paris, INSERM, IAME UMR 1137, 75018, Paris, France
| | | | - Stéphane Ruckly
- Université de Paris, INSERM, IAME UMR 1137, 75018, Paris, France.,ICUREsearch, Biometry, 38600, Fontaine, France
| | - Murat Akova
- Department of Infectious Diseases, Hacettepe University School of Medicine, Ankara, Turkey
| | - Abdullah Tarik Aslan
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Marc Leone
- Department of Anesthesiology and Intensive Care Unit, Hospital Nord, Aix Marseille University, Assistance Publique Hôpitaux Universitaires de Marseille, Marseille, France
| | - Andrew Conway Morris
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.,Division of Immunology, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, Cb2 1QP, UK.,JVF Intensive Care Unit, Addenbrooke's Hospital, Cambridge, Hills Road, Cambridge, CB2 0QQ, UK
| | - Matteo Bassetti
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy
| | - Kostoula Arvaniti
- Intensive Care Unit, Papageorgiou University Affiliated Hospital, Thessaloníki, Greece
| | - Jeffrey Lipman
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Nimes University Hospital, University of Montpellier, Nimes, France.,Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Ricard Ferrer
- Intensive Care Department, SODIR-VHIR Research Group, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Haibo Qiu
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Nanjing Zhongda Hospital, Southeast University, Nanjing, 210009, China
| | - José-Artur Paiva
- Intensive Care Medicine Department, Centro Hospitalar Universitário Sao Joao, Porto, Portugal.,Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal.,Infection and Sepsis ID Group, Porto, Portugal
| | - Pedro Povoa
- NOVA Medical School, New University of Lisbon, Lisbon, Portugal.,Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark.,Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, CHLO, Lisbon, Portugal
| | - Liesbet De Bus
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Jan De Waele
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Farid Zand
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohan Gurjar
- Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
| | - Adel Alsisi
- ICU Department, Prime Hospital, Dubai, United Arab Emirates.,Critical Care Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Khalid Abidi
- Medical ICU, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Hendrik Bracht
- Central Interdisciplinary Emergency Medicine, University Hospital Ulm, Ulm, Germany
| | - Yoshiro Hayashi
- Department of Intensive Care Medicine, Kameda General Hospital, Kamogawa, Japan
| | - Kyeongman Jeon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - François Barbier
- Service de Médecine Intensive-Réanimation, Centre Hospitalier Régional d'Orléans, 14, avenue de L'Hôpital, 45100, Orléans, France
| | - Jean-François Timsit
- Université Paris-Cité, INSERM, IAME UMR 1137, 75018, Paris, France.,Medical and Infectious Diseases Intensive Care Unit, AP-HP, Bichat-Claude Bernard University Hospital, 46 Omdurman maternity hospitalrue Henri Huchard, 75877, Paris Cedex, France
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Martins C, de Jesus SN, da Silva JT, Ribeiro C, Nunes C, Cunha FF, Marcelo B. The Volunteer Satisfaction Survey (VSS): Adaptation and Psychometric Properties among Portuguese Volunteers. Eur J Investig Health Psychol Educ 2022; 13:23-32. [PMID: 36661752 PMCID: PMC9858027 DOI: 10.3390/ejihpe13010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/24/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
(1) Background: Volunteering satisfaction is one significant construct that nourishes the sustaining of volunteer work, and it is present in reference models such as the three-stage volunteer process model (VPM). The volunteer satisfaction survey (VSS), created by Vecina, Chacón and Sueiro, evaluates three different domains of volunteer satisfaction: specific motivations, organization management and volunteering tasks. The aim of this study was to adapt the instrument and explore the psychometric properties of the 17 items of the VSS in a sample of Portuguese volunteers. (2) Methods: The sample was composed of 335 Portuguese volunteers (aged between 14 and 81 years), mainly women (76.4%). Measures included volunteer satisfaction, work engagement and organizational commitment. (3) Results: The original three-factor model was tested with a confirmatory factor analysis (CFA) and the model fitted the data. Satisfactory levels of internal consistency, discriminant and convergent validity were found. (4) Conclusions: The VSS reveals good psychometric properties and can be considered a useful tool for professionals and future research for volunteers' satisfaction assessment.
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Affiliation(s)
- Cátia Martins
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Saúl Neves de Jesus
- Research Centre for Tourism, Sustainability and Well-Being (CinTurs), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - José Tomás da Silva
- Centre for Social Studies, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Conceição Ribeiro
- Centre of Statistics and its Applications (CEAUL), Instituto Superior de Engenharia, Universidade do Algarve, Campus da Penha, 8005-139 Faro, Portugal
| | - Cristina Nunes
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Francisca Ferreira Cunha
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Beatriz Marcelo
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
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Alves J, Nunes C. Absence among National Health Service workers during the COVID-19 pandemic in Portugal. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
By March 2020, the first Covid-19 cases were detected in Portugal. While the National Health Service (NHS) faced an increased demand for health care, anecdotal evidence showed that the NHS absenteeism rose. This might be explained by outbreaks in healthcare units, COVID-19 infection due to close contact with patients, self-isolation and quarantines, and family challenges originated by lockdowns. The present work aimed to quantify the absenteeism among NHS workers during the COVID-19 pandemic in Portugal.
Methods
This study used data for the number of NHS workers and absence days (2015-2021), from the Portuguese NHS Transparency Portal and the Strategy and Planning Office. Absenteeism was compared, before and after the pandemic onset, in absolute terms, and as absence rates (number of absent days as a percentage of potential workforce days). Additionally, we performed an interrupted time series analysis, by fitting a Poisson regression model with level change. We controlled for data seasonality using Fourier terms (pairs of sine and cosine functions).
Results
From 2015 until March 2020, the average monthly absence rate was of 12.2, rising to 14.4 in the remaining period. This represented an increase of 18% in the absence rate. The interrupted time series showed an increase of 10.8% in the NHS absenteeism after the pandemic onset [Relative risk =1.10; 95% confidence interval (CI) 1.10-1.11; p < 0.01]. When accounting for seasonality in the data, the model showed an increase of 11.0% in the NHS absenteeism [Relative risk =1.11; 95% CI 1.01-1.22; p < 0.05].
Conclusions
These results highlight the excess of absence days among the NHS workers during the COVID-19 pandemic. In future healthcare crises, health professionals should be protected, by assuring a safe workplace and making protective equipment available. Only then will be possible to reduce constraints in healthcare assistance, guarantee the adequate response, and contain the absence costs.
Key messages
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Affiliation(s)
- J Alves
- Public Health Research Centre, NOVA National School of Public Health , Lisbon, Portugal
- Comprehensive Health Research Centre, NOVA National School of Public Health , Lisbon, Portugal
| | - C Nunes
- Public Health Research Centre, NOVA National School of Public Health , Lisbon, Portugal
- Directorate-General of Health , Lisbon, Portugal
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13
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Soares P, Aguiar A, Leite A, Duarte R, Nunes C. Ecological factors associated with areas of high tuberculosis diagnosis delay. Public Health 2022; 208:32-39. [DOI: 10.1016/j.puhe.2022.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/04/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
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de Noronha N, Moniz M, Gama A, Laires PA, Goes AR, Pedro AR, Dias S, Soares P, Nunes C. Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal. Public Health 2022; 211:5-13. [PMID: 35988506 PMCID: PMC9271418 DOI: 10.1016/j.puhe.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 11/15/2022]
Abstract
Objectives The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal. Study design Cross-sectional study. Methods This study used data from a Portuguese community-based survey entitled ‘COVID-19 Barometer: Social Opinion’. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown. Results Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate. Conclusions Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.
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Affiliation(s)
- N de Noronha
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal.
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P A Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
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Pechorro P, Curtis S, DeLisi M, Maroco J, Nunes C. Dark Triad Psychopathy Outperforms Self-Control in Predicting Antisocial Outcomes: A Structural Equation Modeling Approach. Eur J Investig Health Psychol Educ 2022; 12:549-562. [PMID: 35735462 PMCID: PMC9222205 DOI: 10.3390/ejihpe12060041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/16/2022] Open
Abstract
Dark Triad traits and self-control are considered viable causal precursors to antisocial and criminal outcomes in youth. The purpose of the present study is to concurrently compare how Dark Triad traits and self-control differ in terms of predicting self-reported juvenile delinquency, CD symptoms, proactive overt aggression, and crime seriousness. The sample consisted of 567 (M = 15.91 years, SD = 0.99 years, age range = 14–18 years) Southern European youth from Portugal. Structural-equation-modelling procedures revealed that the psychopathy factor of Dark Triad traits presented the strongest significant hypothetical causal associations with the antisocial/criminal outcomes, followed by self-control. Machiavellianism and narcissism presented the lowest causal associations. Our findings indicate that psychopathy, as operationalized in the Dark Triad, concurrently surpasses self-control and the remaining factors of the Dark Triad in terms of predicting antisocial/criminal outcomes in youth. This suggests that behavioral disinhibition, or a core incapacity to regulate one’s conduct, is central for understanding delinquency and externalizing psychopathology. Comparatively, the interpersonal component of dark personality features, such as Machiavellianism and narcissism, are secondary for understanding crime.
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Affiliation(s)
- Pedro Pechorro
- Faculdade de Psicologia (The Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Psychological Assessment and Psychometrics Laboratory), University of Coimbra, 3000-115 Coimbra, Portugal;
- Psychology Research Centre (CIP), Universidade do Algarve, 8005-139 Faro, Portugal
| | - Shelby Curtis
- Social Psychology Ph.D. Program, University of Nevada, Reno, NV 89557, USA;
| | - Matt DeLisi
- Department of Sociology, Iowa State University, Ames, IA 50011, USA;
| | - João Maroco
- William James Centre for Research, ISPA-Instituto Universitário, 1149-041 Lisbon, Portugal;
| | - Cristina Nunes
- Psychology Research Centre (CIP), Universidade do Algarve, 8005-139 Faro, Portugal
- Correspondence:
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Magalhães R, Proenca MP, Araújo JP, Nunes C, Pereira AM, Sousa CT. Fabrication of FePt nanowires through pulsed electrodeposition into nanoporous alumina templates. Appl Nanosci 2022. [DOI: 10.1007/s13204-022-02454-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Rocha B, Nunes C. Tradução e validação da versão portuguesa europeia da Baby Pediatric Symptom Checklist. Rev Enf Ref 2022. [DOI: 10.12707/rv21058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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18
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Almeida AS, Giger JC, Mendonça S, Fuertes M, Nunes C. Emotional Availability in Mother-Child and Father-Child Interactions as Predictors of Child's Attachment Representations in Adoptive Families. Int J Environ Res Public Health 2022; 19:ijerph19084720. [PMID: 35457588 PMCID: PMC9028699 DOI: 10.3390/ijerph19084720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/20/2022] [Accepted: 03/26/2022] [Indexed: 11/16/2022]
Abstract
Emotional availability (EA) in parent-child interactions is associated with positive child outcomes, including attachment security. However, little is known about EA in adoptive families. This study investigated the associations between secure representations of attachment in adopted children and the adoptive parents' EA. The participants (n = 75) included 26 mothers, 23 fathers, and 26 children who were aged 3 to 9 years. Children completed the Attachment Story Completion Task. Adult-child dyadic relationships were assessed using the EA® System. The results showed that the children's and parents' EA, age when adopted, and time elapsed since adoption were associated with more secure children's attachment representations. Implications for family support and public policy are discussed.
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Affiliation(s)
- Ana Susana Almeida
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (J.-C.G.); (C.N.)
- Correspondence:
| | - Jean-Christophe Giger
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (J.-C.G.); (C.N.)
| | - Sandra Mendonça
- CDI.UP—Cooperativa de Desenvolvimento Infantil e União Parental, CRL, 8125-196 Quarteira, Portugal;
| | - Marina Fuertes
- Centro de Psicologia da Universidade do Porto (CPUP) & Escola Superior de Educação (ESELX-IPL), Campus de Benfica do IPL, 1549-003 Lisboa, Portugal;
| | - Cristina Nunes
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (J.-C.G.); (C.N.)
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Nunes C, Martins C, Brás M, Carmo C, Gonçalves A, Pina A. Impact of an Online Parenting Support Programme on Children’s Quality of Life. Children 2022; 9:children9020173. [PMID: 35204894 PMCID: PMC8870604 DOI: 10.3390/children9020173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/17/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022]
Abstract
The study aims to describe the parental use of an online parenting support programme, the ‘Open Window to Family’ (JAF) and to evaluate its impact on perceived children’s quality of life (QoL). This programme makes online resources available to support positive parenting. The study included 363 parents (nintervention group = 142) who completed measures to evaluate their children’s QoL. The results suggest that using the programme for a longer time and accessing more information/services are positively related to the perception of utility but not to the frequency of use. The programme proved to be more useful for specific difficulties and to search for specific information. We found high levels of parental perception of children’s well-being, both physical and psychological, and lower values in social support and relationships with peers. No differences were observed between the total QoL of children in the intervention group and control group. The differences in the dimensions of QoL are due to interaction with the level of education of the mother: mothers with higher education reported higher physical well-being, social support, relationships with peers, and school context. Guidelines are suggested to enhance the accessibility of this type of programme as well as enhance its impact on parents and children.
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Affiliation(s)
- Cristina Nunes
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (C.M.); (M.B.); (C.C.)
- Correspondence: ; Tel.: +351-289-800-900
| | - Cátia Martins
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (C.M.); (M.B.); (C.C.)
| | - Marta Brás
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (C.M.); (M.B.); (C.C.)
| | - Cláudia Carmo
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (C.M.); (M.B.); (C.C.)
| | - Andrea Gonçalves
- Departamento de Ciências Sociais e da Educação, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
| | - António Pina
- Administração Regional de Saúde do Algarve, 8005-145 Faro, Portugal;
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20
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Cardoso T, Rodrigues PP, Nunes C, Almeida M, Cancela J, Rosa F, Rocha-Pereira N, Ferreira I, Seabra-Pereira F, Vaz P, Carneiro L, Andrade C, Davis J, Marçal A, Friedman ND. Prospective international validation of the predisposition, infection, response and organ dysfunction (PIRO) clinical staging system among intensive care and general ward patients. Ann Intensive Care 2021; 11:180. [PMID: 34950977 PMCID: PMC8702585 DOI: 10.1186/s13613-021-00966-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/04/2021] [Indexed: 11/17/2022] Open
Abstract
Background Stratifying patients with sepsis was the basis of the predisposition, infection, response and organ dysfunction (PIRO) concept, an attempt to resolve the heterogeneity in treatment response. The purpose of this study is to perform an independent validation of the PIRO staging system in an international cohort and explore its utility in the identification of patients in whom time to antibiotic treatment is particularly important. Methods Prospective international cohort study, conducted over a 6-month period in five Portuguese hospitals and one Australian institution. All consecutive adult patients admitted to selected wards or the intensive care, with infections that met the CDC criteria for lower respiratory tract, urinary, intra-abdominal and bloodstream infections were included. Results There were 1638 patients included in the study. Patients who died in hospital presented with a higher PIRO score (10 ± 3 vs 8 ± 4, p < 0.001). The observed mortality was 3%, 15%, 24% and 34% in stage I, II, III and IV, respectively, which was within the predicted intervals of the original model, except for stage IV patients that presented a lower mortality. The hospital survival rate was 84%. The application of the PIRO staging system to the validation cohort resulted in a positive predictive value of 97% for stage I, 91% for stage II, 85% for stage III and 66% for stage IV. The area under the receiver operating characteristics curve (AUROC) was 0.75 for the all cohort and 0.70 if only patients with bacteremia were considered. Patients in stage III and IV who did not have antibiotic therapy administered within the desired time frame had higher mortality rate than those who have timely administration of antibiotic. Conclusions To our knowledge, this is the first external validation of this PIRO staging system and it performed well on different patient wards within the hospital and in different types of hospitals. Future studies could apply the PIRO system to decision-making about specific therapeutic interventions and enrollment in clinical trials based on disease stage. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-021-00966-7.
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Affiliation(s)
- T Cardoso
- Intensive Care Unit (UCIP) and Hospital Infection Control Committee, Hospital de Santo António, Oporto University Hospital Center, University of Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal.
| | - P P Rodrigues
- Department of Community Medicine, Information and Health Decision Sciences & CINTESIS, Faculty of Medicine, University of Porto, Rua Dr. Plácido Costa, s/n, 4200-450, Porto, Portugal
| | - C Nunes
- Intensive Care Unit and Hospital Infection Control Committee, Hospital de Bragança, Northeastern Local Health Unit, Av. Abade Baçal, 5301-852, Bragança, Portugal
| | - M Almeida
- Neurocritical Care Unit and Hospital Infection Control Committee, Hospital de São Marcos, Sete Fontes - São Vitor, 4710-243, Braga, Portugal.,Intensive Care Unit (UCIP), Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - J Cancela
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - F Rosa
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - N Rocha-Pereira
- Infectious Diseases Department, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - I Ferreira
- Internal Medicine Department, Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - F Seabra-Pereira
- Intensive Care Unit (UCIP), Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal.,Intensive Care Unit and Internal Medicine Department, Hospital da Prelada, Rua de Sarmento de Beires, 4250-449, Porto, Portugal
| | - P Vaz
- Internal Medicine Department and Hospital Infection Control Committee, Hospital de Bragança, Northeastern Local Health Unit, Av. Abade Baçal, 5301-852, Bragança, Portugal
| | - L Carneiro
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - C Andrade
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal.,Internal Medicine Department, Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - J Davis
- Department of Renal Medicine, Barwon Health, Geelong, VIC, 3220, Australia
| | - A Marçal
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal.,Internal Medicine Department, Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - N D Friedman
- Department of Infectious Diseases, Barwon Health, Geelong, VIC, 3220, Australia
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21
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Almeida Santos J, Soares P, Leite A, Duarte R, Nunes C. Patient and healthcare delays in critical and non-critical pulmonary tuberculosis incidence areas in Portugal: are there differences? Public Health 2021; 201:41-47. [PMID: 34742116 DOI: 10.1016/j.puhe.2021.09.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/08/2021] [Accepted: 09/26/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To characterize patient, healthcare, and total delay in diagnosing pulmonary tuberculosis (PTB) in critical (higher PTB incidence) and non-critical (lower PTB incidence) areas and their determinants considering clinical and sociodemographic factors. STUDY DESIGN Retrospective cohort study. METHODS Data was retrieved from the Portuguese National Tuberculosis Surveillance System (SVIG-TB). Were included in the study all active PTB patients (n = 11,762) notified between 2008 and 2017. Spatial analysis was used to define critical and non-critical areas. Kaplan-Meier estimator, logrank test, and Cox regression were conducted, stratified by area. RESULTS PTB cases in critical areas (n = 6594, 56.1%) presented longer patient median delay (41 vs 31days), shorter healthcare median delay (7 vs 10 days), and longer total median delay (63 vs 61days) t.han non-critical areas. Patient and total delay increased in both areas over time, while healthcare delay only increased in non-critical areas. Icn both areas, being from a high TB incidence country and alcohol abuse were associated with longer patient delays. Being female, older age, and oncologic diseases were associated with longer healthcare delays. Respiratory diseases were only associated with a longer healthcare delay in non-critical areas. Being female, older, and from a high TB incidence country were associated with a longer total delay in both areas. CONCLUSIONS Patient delay was significantly longer in critical areas, and healthcare delay was significantly longer in non-critical areas. Several factors associated with longer delays have been identified, most of which are shared by critical and non-critical areas. Differences in patient and healthcare delay, for example, by sex, age, or country of birth, highlight the need for targeted public health interventions to help reduce these differences.
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Affiliation(s)
- J Almeida Santos
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; National Health Institute Dr. Ricardo Jorge, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
| | - P Soares
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
| | - A Leite
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
| | - R Duarte
- Centro Hospitalar de Vila Nova de Gaia, Rua Conselheiro Veloso da Cruz, 4400-092 Vila Nova de Gaia, Portugal; Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
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22
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Nunes C. Collective bargaining and gender equality (The Gendered Economy) by Jane Pillinger and Nora Wintour, newcastle upon tyne: Agenda publishing, 2019, 175 pp. Gender Work & Organization 2021. [DOI: 10.1111/gwao.12721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Cristina Nunes
- Institute of Social Sciences of University of Lisbon Lisbon Portugal
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Goes AR, Soares P, Moniz M, Gama A, Pedro AR, Laires P, Dias S, Nunes C. Factors associated with motivation to avoid meeting family and friends during the COVID-19 pandemic. Eur J Public Health 2021. [PMCID: PMC8574604 DOI: 10.1093/eurpub/ckab164.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The widespread adherence to behaviours that prevent the transmission of the SARS-CoV-2 virus depends on human will. There is a paucity of research on the factors that influence adherence to social distancing. Available research suggests that it varies with the specific behaviour and that reducing contact with family and friends is the hardest one. This study aims to identify factors associated with motivation to avoid meeting with family and friends during the second lockdown of the COVID-19 pandemic in Portugal. Methods We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes sociodemographics, psychosocial variables, and subjective health and wellbeing indicators from 20th February to 19th March 2021. We included 1336 participants who answered the question “To what extent is it easy for you to avoid visiting family and friends?”. Logistic regression analysis was used to identify factors associated with difficulty to avoid visiting family and friends. Results Preliminary data shows that 38.4% (513) had difficulties avoiding meeting with family and friends. Those with greater difficulty were the ones who have less education, higher negative emotionality, do not work remotely, have more difficulties to stay home and practice physical distancing and consider the Government's measures inadequate. Contrarily, those who have less difficulty avoiding visiting friends and family are older and have low risk perception of COVID-19 infection. Conclusions This study suggests higher difficulty in avoiding visiting friends and family for those whose routines demand not staying at home, with low agreement with Government measures, and struggle with higher negative emotionality, confirming the personal costs of these behaviours and the importance of habits. Older people had less difficulty, suggesting that these measures may be closer to their usual routines. Interventions should consider the specificities of social interaction. Key messages Social distancing comes at an enormous cost to people's livelihoods and it also depends on people living circumstances. Interventions to improve adherence to social distancing should consider the specificity of social interaction and the potential dissonance created by the overall routines.
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Affiliation(s)
- AR Goes
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Moniz
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Pedro
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Laires
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Vales L, Soares P, Nunes C, Lopes S. Healthcare system delay and utilization in tuberculosis patients in Portuguese high-incidence region. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In Portugal, the Tâmega e Sousa region (TeS) has a high incidence of tuberculosis (TB) [27.4 and 43.8 per 100.000 inhabitants in sub-regions Baixo Tâmega (BxT) and Vale do Sousa Sul (VSS), 2017]. Delay in TB diagnosis leads to increased transmission, which may lead to more people infected. This study aimed to describe healthcare system delay among TB patients and healthcare utilization from symptoms onset to diagnosis in TeS.
Methods
We analysed pulmonary TB cases notified in BxT and VSS in 2014-7 in the national surveillance system (SVIG-TB). Concomitantly, we analysed healthcare utilisation from patients in a retrospective study (URBAN-TB) about TB delays in 2019-20. We characterised demographics of patients from each data source and comorbidities from SVIG-TB. We calculated median overall delay until diagnosis (days); and healthcare delay overall and by patient characteristics, for each sub-region. Delay was calculated only when relevant dates were recorded. Healthcare utilisation from symptoms onset to diagnosis was described using the frequency of each first contact provider and the average number of visits until diagnosis.
Results
Included 139 patients from BxT and 206 from VSS (83% male, 53% aged 40-59y, and 17% with silicosis). Global delays were 48 and 75 days (n = 57/132; BxT and VSS). Healthcare delays were 7 and 8 days (n = 76/180; BxT and VSS). In both ACES, healthcare delays were longer for patients aged 60-79y, with COPD and aged 0-19y. Healthcare utilisation analysis included 38 patients (89% male; 55% aged 40-59y; n = 17/21). Primary care (n = 15; 39%) and emergency department (ED) (n = 9; 24%) were frequent points of first contact. The average number of visits until diagnosis was higher for patients from ED (3.9) and lower for patients from TB specialised units (1.3).
Conclusions
Our results suggest that in TeS it is important to avoid ED as a point of first contact of TB patients and to facilitate the diagnosis in young, older and COPD patients.
Key messages
Emergency department is a relevant point of first contact and may be included in efforts to reduce tuberculosis delay. Policies to reduce tuberculosis delay may target younger, older and COPD patients.
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Affiliation(s)
- L Vales
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Lopes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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25
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Lopes S, Soares P, Gama A, Pedro AR, Moniz M, Laires P, Goes AR, Nunes C, Dias S. Factors associated with avoidance of emergency department visits in Portugal during the pandemic. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Avoiding an emergency department (ED) visit risks irreversible negative consequences for patients' health. EDs are a frequent access point to the Portuguese health system. Previous studies have shown that patients may avoid visiting ED during the pandemic. This study aims to identify factors associated with avoidance of ED visits in Portugal during the COVID-19 pandemic.
Methods
We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes healthcare utilisation, health status, and risk perception in Portugal from 11th April 2020 to 16th April 2021. We included respondents that reported having needed ED care. Data were collected on sociodemographics, health status (comorbidities, mental health), risk perception (COVID-19 and complications), level of trust in health services and self-assessment of the severity of the reason for ED visit. The outcome of interest was the decision to avoid ED care. We used logistic regression to identify factors associated with the decision to avoid ED.
Results
Preliminary data showed that 914 respondents reported needing ED care (74.8% female; mean age 43 years). From those, 224 (25%) decided to avoid ED care. ED visits avoidance was higher during lockdowns (28%). People reporting specific comorbidities (cardiac, autoimmune, respiratory) avoided ED more than those without them. Perception of no severe reason for ED visit, poor mental health, perception of higher risk of COVID-19 and complications, and low trust in health services response to the pandemic were associated with higher odds of ED visit avoidance.
Conclusions
People avoiding ED visits represented a considerable share. The decision to avoid ED visit was associated with clinical characteristics, but the perception of risk and assessment of the context and health system response also played a role in decision making.
Key messages
The effect of avoided ED visits on health should be a research and policy concern. People with certain comorbidities or perception of high risk of COVID-19 and complications may be closely monitored.
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Affiliation(s)
- S Lopes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Almeida Santos J, Duarte R, Nunes C. The impact of age when screening for latent tuberculosis infection - is it a problem? Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Older population in developed countries represents a large reservoir of tuberculosis (TB) infection. Knowledge if age can contribute to false negative results in the immunological tests available for screening latent TB infections (LTBI) is critical to improve their usefulness in Public Health strategies for TB control. The aim of this study was to ascertain whether age was a risk factor for false negative (FN) results in the tuberculin skin test (TST) and in an interferon gamma release assay (IGRA).
Methods
Retrospective cohort study carried out using data from the Portuguese National Tuberculosis Surveillance system (2008-2015). Were included all active pulmonary TB cases with an IGRA (n = 597) and/or TST (n = 6185) result. TST outcomes were interpreted using a 5mm (TST-5mm) and 10mm (TST-10mm) cutoff. Logistic regression analysis crude and sex-adjusted was used to evaluate the association of age to the risk of FN results.
Results
Patients with a TST result presented a mean age of 42.7 years and patients with an IGRA result presented a median age of 45.5 years. TST-5mm, TST-10mm and IGRA had 36.5%, 43.9% and 24.5% FN results, respectively. Older patients presented a statistically significant association with the risk of FN TST results, regardless of using a 5mm [71-80years: OR 2.209; >80years: OR 2.491; p < 0.001] or 10mm [71-80years: OR 1.986; >80years: OR 2.308; p < 0.001] cut-off. Age was not a predictive factor for FN IGRA results. However, older patients presented a significant association with indeterminate IGRA results [71-80years: OR 3.808; >80years: OR 5.214; p < 0.001].
Conclusions
When using TST as part of the Public Health strategies for screening elderly patients, healthcare professionals should bear in mind that there is an increased risk of obtaining a FN result. On the other hand, age did not show an association with the occurrence of FN IGRA results, which suggests that this test could perform better when screening for LTBI in older patients.
Key messages
TST in elderly people is associated with false negative results thus, when using this test for screening for LTBI, a negative result should be interpreted with caution. IGRA was not associated with false negative results in elderly people, however indeterminate results can occur more frequently, thus performing better in this population group.
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Affiliation(s)
- J Almeida Santos
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - R Duarte
- Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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27
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Almeida Santos J, Nunes C. Space-time analysis of pulmonary tuberculosis hospitalizations in mainland Portugal (2002-2016). Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Tuberculosis (TB) imposes a great pressure on healthcare resources, particularly in terms of hospital-based treatment and extended hospitalization. Understanding the space-time clustering of pulmonary TB (PTB) hospitalizations leads to a richer knowledge to assist decision makers in Public Health to develop strategic interventions to reduce these hospitalizations. Our objective was to identify space-time clusters of PTB hospitalizations at municipality level in mainland Portugal.
Methods
Ecologic study using data from nationwide hospitalization database of Portugal. All patients with a diagnosis of PTB (primary or secondary) and reference to place of residence were included in the study (n = 22760). Space-time analysis was used to define clusters with high rates of hospitalizations at the municipality level between 2002 and 2016.
Results
Overall hospitalization rate was 17.7/105population/year, with hospitalization rates decreasing by 64.9% during this period (2002:29.4/105; 2016:9.6/105). Space-time analysis of the overall period identified five different clusters, with the clusters in Lisboa and Porto metropolitan areas presenting the highest hospitalization rates (51.5/105 and 43.6/105population, respectively). In a more recent period (2011-2016), were identified four clusters with Lisboa metropolitan area and a northeast rural region presenting the highest hospitalization rates (27.6/105 and 46.2/105population, respectively).
Conclusions
PTB hospitalization rates in continental Portugal presented a constant decrease between 2002 and 2016. We identified a cluster of PTB hospitalizations in a rural region of northeast mainland Portugal, an area where the incidence of TB is below 20/105population. A closer look is needed to understand the reasons behind this high number of hospitalizations. Our results show that space-time analysis can be a resource to monitor the dynamic of the disease and identify possible areas needing Public Health intervention.
Key messages
Pulmonary tuberculosis hospitalizations are decreasing in mainland Portugal, with the two major urban areas (Lisboa and Porto) presenting the clusters with highest hospitalization rates. A cluster of hospitalizations for pulmonary tuberculosis was identified in a rural region in the northeast of mainland Portugal, an area with a low incidence of tuberculosis.
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Affiliation(s)
- J Almeida Santos
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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28
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Cardoso T, Rodrigues PP, Nunes C, Almeida M, Cancela J, Rosa F, Rocha-Pereira N, Ferreira I, Seabra-Pereira F, Vaz P, Carneiro L, Andrade C, Davis J, Marçal A, Friedman ND. Identification of hospitalized patients with community-acquired infection in whom treatment guidelines do not apply: a validated model. J Antimicrob Chemother 2021; 75:1047-1053. [PMID: 31873750 DOI: 10.1093/jac/dkz521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To develop and validate a clinical model to identify patients admitted to hospital with community-acquired infection (CAI) caused by pathogens resistant to antimicrobials recommended in current CAI treatment guidelines. METHODS International prospective cohort study of consecutive patients admitted with bacterial infection. Logistic regression was used to associate risk factors with infection by a resistant organism. The final model was validated in an independent cohort. RESULTS There were 527 patients in the derivation and 89 in the validation cohort. Independent risk factors identified were: atherosclerosis with functional impairment (Karnofsky index <70) [adjusted OR (aOR) (95% CI) = 2.19 (1.41-3.40)]; previous invasive procedures [adjusted OR (95% CI) = 1.98 (1.28-3.05)]; previous colonization with an MDR organism (MDRO) [aOR (95% CI) = 2.67 (1.48-4.81)]; and previous antimicrobial therapy [aOR (95% CI) = 2.81 (1.81-4.38)]. The area under the receiver operating characteristics (AU-ROC) curve (95% CI) for the final model was 0.75 (0.70-0.79). For a predicted probability ≥22% the sensitivity of the model was 82%, with a negative predictive value of 85%. In the validation cohort the sensitivity of the model was 96%. Using this model, unnecessary broad-spectrum therapy would be recommended in 30% of cases whereas undertreatment would occur in only 6% of cases. CONCLUSIONS For patients hospitalized with CAI and none of the following risk factors: atherosclerosis with functional impairment; previous invasive procedures; antimicrobial therapy; or MDRO colonization, CAI guidelines can safely be applied. Whereas, for those with some of these risk factors, particularly if more than one, alternative antimicrobial regimens should be considered.
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Affiliation(s)
- Teresa Cardoso
- Intensive Care Unit (UCIP) and Hospital Infection Control Committee; Hospital de Santo António, Oporto Hospital Center, University of Porto, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal
| | - Pedro Pereira Rodrigues
- Department of Community Medicine, Information and Health Decision Sciences & CINTESIS, Faculty of Medicine, University of Porto, Rua Dr. Plácido Costa, s/n, 4200-450 Porto, Portugal
| | - Cristina Nunes
- Intensive Care Unit and Hospital Infection Control Committee, Hospital de Bragança, Northeastern Local Health Unit, Av. Abade Baçal, 5301-852 Bragança, Portugal
| | - Mónica Almeida
- Neurocritical Care Unit and Hospital Infection Control Committee, Hospital de Braga, Sete Fontes - São Victor, 4710-243 Braga, Portugal
| | - Joana Cancela
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - Fernando Rosa
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - Nuno Rocha-Pereira
- Infectious Diseases Department, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Inês Ferreira
- Internal Medicine Department, Hospital de Santo António, Oporto Hospital Center, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal
| | - Filipa Seabra-Pereira
- Intensive Care Unit (UCIP) and Hospital Infection Control Committee; Hospital de Santo António, Oporto Hospital Center, University of Porto, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal
| | - Prudência Vaz
- Internal Medicine Department and Hospital Infection Control Committee, Hospital de Bragança, Northeastern Local Health Unit, Av. Abade Baçal, 5301-852 Bragança, Portugal
| | - Liliana Carneiro
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - Carina Andrade
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - Justin Davis
- Department of Renal Medicine, Barwon Health, Geelong, Victoria 3220, Australia
| | - Ana Marçal
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - N Deborah Friedman
- Department of Infectious Diseases, Barwon Health, Geelong, Victoria 3220, Australia
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29
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Cruz L, Silva A, Lopes J, Damas D, Lourenço J, Costa A, Silva F, Sousa J, Galego O, Nunes C, Veiga R, Machado C, Rodrigues B, Cecilia C, Almendra L, Bras A, Santo G, Machado E, Sargento-Freitas J. Early Cerebrovascular Ultrasonography as a Predictor of Hemorrhagic Transformation After Thrombectomy. J Stroke Cerebrovasc Dis 2021; 30:105922. [PMID: 34157670 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/25/2021] [Accepted: 05/26/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To determine the predictive value of early transcranial color-coded sonography (TCCS) for intracranial hemorrhage (ICH) in patients with large artery occlusion (LAO) stroke of carotid circulation, who were submitted to endovascular therapy (EVT) with successful reperfusion. MATERIALS AND METHODS Retrospective study evaluating a cohort of consecutive stroke patients with LAO of the carotid circulation that were recanalyzed with EVT. We measured angle-corrected peak systolic velocities, end-diastolic velocities and mean flow velocities (PSV, EDV and MFV) of the symptomatic and asymptomatic middle cerebral artery (MCA). The ratio between MFV of the symptomatic MCA and MFV of the asymptomatic MCA (MCA-Ra) was calculated. Parenchymal hematoma in the 24 hours control CT was considered as ICH. Univariate associations and multivariate analyses were used to identify early independent predictors for ICH among TCCS findings. RESULTS We included 234 patients, mean age 72.5 (SD 12.6) years, 52.1% male. The mean time between recanalization and TCCS was 12.3 hours (range 3-22). Patients who developed postinterventional ICH showed a higher MCA-Ra (1.02 ± 0.26 vs 1.16 ± 0,21, p = 0.036). In multivariate analysis, only higher MCA-Ra remained independently associated with postinterventional ICH (OR: 6.778, 95%CI: 1.152-39.892, p = 0.034). A value of MCA-Ra ≥ 1,05 was associated with ICH, showing a sensitivity of 81.3% and a specificity of 65.9%; the AUC based of the ROC analysis was 0.688 (95% CI 0.570-0.806). CONCLUSION TCCS performed within the first 24 hours after stroke onset can help to predict hemorrhagic transformation in patients with LAO.
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Affiliation(s)
- L Cruz
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Lopes
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - D Damas
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Lourenço
- Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - A Costa
- Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - F Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Sousa
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - O Galego
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Nunes
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - R Veiga
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Machado
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - B Rodrigues
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Cecilia
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Almendra
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Bras
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - G Santo
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - E Machado
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Sargento-Freitas
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
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30
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Nunes C, Pérez-Padilla J, Martins C, Pechorro P, Ayala-Nunes L, Ferreira LI. The Brief COPE: Measurement Invariance and Psychometric Properties among Community and At-Risk Portuguese Parents. Int J Environ Res Public Health 2021; 18:ijerph18062806. [PMID: 33801958 PMCID: PMC7998814 DOI: 10.3390/ijerph18062806] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/01/2021] [Accepted: 03/07/2021] [Indexed: 12/11/2022]
Abstract
Parenting generally brings about high internal and external demands, which can be perceived as stressful when they exceed families’ resources. When faced with such stressors, parents need to deploy several adaptive strategies to successfully overcome these challenges. One of such strategies is coping, an important cognitive and behavioural skill. In this study, we intended to examine the psychometric properties of Carver’s (1997) Brief COPE (Coping Orientation to Problems Experienced), extending its cross-cultural validity among a Portuguese sample of community and at-risk parents. The sample comprised community (n = 153) and at-risk (n = 116) parents who completed the brief COPE, the Family Adaptability and Cohesion Scales and the Parenting Stress Index—Short Form. Confirmatory factor analysis, internal consistency, cross sample invariance, convergent and discriminant validity were analysed. Data from the confirmatory factor analysis revealed that the 14-factor model obtained the best fit. The results provided evidence that the Brief COPE is a psychometrically sound instrument that shows measurement invariance across samples and good reliability. Our findings demonstrated that the Portuguese version of brief COPE is a useful, time-efficient tool for both practitioners and researchers who need to assess coping strategies, a relevant construct in family context.
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Affiliation(s)
- Cristina Nunes
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
- Correspondence: ; Tel.: +351-289-800-100
| | - Javier Pérez-Padilla
- Faculty of Humanities and Education Sciences, University of Jaen & Research Group (HUM604) Development of Lifestyles in the Life Cycle and Health Promotion of University of Huelva, Campus de las Lagunillas, 23071 Jaén, Spain;
| | - Cátia Martins
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
| | - Pedro Pechorro
- School of Psychology, Universidade do Minho, 4710-057 Braga, Portugal;
| | - Lara Ayala-Nunes
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK;
| | - Laura I. Ferreira
- Department of Psychology and Educational Sciences, Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal;
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Jácome C, Almeida R, Pereira AM, Araújo L, Correia MA, Pereira M, Couto M, Lopes C, Chaves Loureiro C, Catarata MJ, Santos LM, Ramos B, Mendes A, Pedro E, Cidrais Rodrigues JC, Oliveira G, Aguiar AP, Arrobas AM, Costa J, Dias J, Todo Bom A, Azevedo J, Ribeiro C, Alves M, Pinto PL, Neuparth N, Palhinha A, Marques JG, Martins P, Trincão D, Neves A, Todo Bom F, Santos MA, Branco J, Loyoza C, Costa A, Silva Neto A, Silva D, Vasconcelos MJ, Teixeira MF, Ferreira-Magalhães M, Taborda Barata L, Carvalhal C, Santos N, Sofia Pinto C, Rodrigues Alves R, Moreira AS, Morais Silva P, Fernandes R, Ferreira R, Alves C, Câmara R, Ferraz de Oliveira J, Bordalo D, Calix MJ, Marques A, Nunes C, Menezes F, Gomes R, Almeida Fonseca J. Asthma App Use and Interest Among Patients With Asthma: A Multicenter Study. J Investig Allergol Clin Immunol 2021; 30:137-140. [PMID: 32327403 DOI: 10.18176/jiaci.0456] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - R Almeida
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - A M Pereira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - L Araújo
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - M A Correia
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - M Pereira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
| | - M Couto
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - C Lopes
- Unidade de Imunoalergologia, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.,Imunologia Básica e Clínica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - C Chaves Loureiro
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M J Catarata
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L M Santos
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - B Ramos
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Mendes
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - E Pedro
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - J C Cidrais Rodrigues
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - G Oliveira
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - A P Aguiar
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - A M Arrobas
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Costa
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Dias
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Todo Bom
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Azevedo
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Ribeiro
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Alves
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - P L Pinto
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - N Neuparth
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.,Pathophysiology, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisboa, Portugal
| | - A Palhinha
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - J G Marques
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - P Martins
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.,Pathophysiology, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisboa, Portugal
| | - D Trincão
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - A Neves
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - F Todo Bom
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - M A Santos
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - J Branco
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - C Loyoza
- Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal
| | - A Costa
- Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - A Silva Neto
- Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - D Silva
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M J Vasconcelos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M F Teixeira
- Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - M Ferreira-Magalhães
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - L Taborda Barata
- Serviço de Imunoalergologia, Hospital Pêro da Covilhã, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - C Carvalhal
- Serviço de Imunoalergologia, Hospital Pêro da Covilhã, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - N Santos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | - C Sofia Pinto
- Serviço de Pneumologia, Hospital São Pedro de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - R Rodrigues Alves
- Unidade de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | - A S Moreira
- Unidade de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | | | - R Fernandes
- Serviço de Pediatria, Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - R Ferreira
- Serviço de Pediatria, Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal
| | - C Alves
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - R Câmara
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | | | - D Bordalo
- Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, Portugal
| | - M J Calix
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - A Marques
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - C Nunes
- Imunoalergologia, Centro de Imunoalergologia do Algarve, Portimão, Portugal
| | - F Menezes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - R Gomes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - J Almeida Fonseca
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal.,MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
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Eley C, Lundgren PT, Kasza G, Truninger M, Brown C, Hugues VL, Izso T, Teixeira P, Syeda R, Ferré N, Kunszabo A, Nunes C, Hayes C, Merakou K, McNulty C. Teaching young consumers in Europe: a multicentre qualitative needs assessment with educators on food hygiene and food safety. Perspect Public Health 2021; 142:175-183. [PMID: 33461394 PMCID: PMC9047106 DOI: 10.1177/1757913920972739] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM Foodborne illnesses have a significant global burden and can be life-threatening, with higher risk in vulnerable groups such as children. SafeConsume is an EU-funded, transdisciplinary project aiming to improve consumers' food safety behaviour. Developing educational resources on food safety for use in schools has potential to improve teaching of our young consumers. The aim of this study was to explore school educators' attitudes, behaviours and knowledge towards food hygiene, safety and education. METHODS Focus groups and interviews in England, France, Portugal and Hungary explored educator knowledge, skills, intentions and beliefs around educating young people (11-18 years) about food safety. Data were analysed using NVivo and emerging themes were applied to the Theoretical Domains Framework. RESULTS A total of 48 educators participated. Knowledge, confidence and skills to teach food safety to young people varied depending on background and training. Educators reported they had a role to teach food safety to young people, were positive about delivering education and optimistic they could improve students' food safety behaviour. Barriers to teaching included lack of national curriculum coverage, limited time and money, and lack of facilities. Educators reported that social influences (family, celebrity chefs, public health campaigns and social media) were important opportunities to improve young peoples' awareness of food safety and consequences of foodborne illness. CONCLUSION Educator food safety expertise varied; training could help to optimise educator knowledge, confidence and skills. Ministries of Health and Education need encouragement to get food safety incorporated further into school curricula across Europe, so schools will be motivated to prioritise these topics.
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Affiliation(s)
- C Eley
- Primary Care and Interventions Unit, Public Health England, 4th Floor, Twyver House, Gloucester GL1 1DQ, UK
| | | | - G Kasza
- National Food Chain Safety Office, Budapest, Hungary
| | | | - C Brown
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | | | - T Izso
- National Food Chain Safety Office, Budapest, Hungary
| | - P Teixeira
- Universidade Católica Portuguesa, Lisboa, Portugal
| | - R Syeda
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | - N Ferré
- Nice University Hospital, Nice, France
| | - A Kunszabo
- National Food Chain Safety Office, Budapest, Hungary
| | - C Nunes
- University of Lisbon, Lisboa, Portugal
| | - C Hayes
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | - K Merakou
- National School of Public Health, University of West Attica, Egaleo, Attica, Greece
| | - Cam McNulty
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
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Moraes S, Marinho A, Lima S, Granja A, Araújo JP, Reis S, Sousa CT, Nunes C. Targeted nanostructured lipid carriers for doxorubicin oral delivery. Int J Pharm 2021; 592:120029. [PMID: 33130218 DOI: 10.1016/j.ijpharm.2020.120029] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 01/12/2023]
Abstract
The treatment with anticancer drugs remains a challenge, as available drugs still entail the risk of deleterious off-target effects. The present study describes folic acid conjugated nanostructured lipid carriers (NLCs) as an effective doxorubicin delivery approach targeted to breast cancer cells. Two distinct NLCs formulations were designed and optimized leading to an encapsulation efficiency over than 65%. Cytotoxic and targeting potential of NLCs were studied in vitro, using MDA-MB-231 cell line. Results showed an enhanced cellular uptake of conjugated NLCs. In vitro release studies, mimicking the path in the body after oral administration, show that all formulations would reach the tumor microenvironment bearing 50% of the encapsulated doxorubicin. Moreover, NLCs demonstrated storage stability at 25 °C for at least 42 days. Overall, results revealed that the developed NLCs enable the possibility of oral administration and are a promising approach for the targeted delivery of doxorubicin to breast cancer cells.
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Affiliation(s)
- S Moraes
- IFIMUP, Faculty of Sciences of Porto University, Portugal; LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - A Marinho
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - S Lima
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - A Granja
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - J P Araújo
- IFIMUP, Faculty of Sciences of Porto University, Portugal
| | - S Reis
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - C T Sousa
- IFIMUP, Faculty of Sciences of Porto University, Portugal
| | - C Nunes
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal.
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Corrêa Teixeira C, de Oliveira Neves D, Fraiha-Neto H, Martins da Silva AN, Lins Jennings Y, Martins da Silva A, Nunes C, Sodré R. Correlated prevalence of hydrocele and microfilaremia in Amazon (Belém, 1951-2005). J Vector Borne Dis 2021; 58:240-245. [DOI: 10.4103/0972-9062.321756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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35
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Sousa FTG, Nunes C, Romano CM, Sabino EC, González-Cardenete MA. Anti-Zika virus activity of several abietane-type ferruginol analogues. Rev Inst Med Trop Sao Paulo 2020; 62:e97. [PMID: 33295481 PMCID: PMC7723353 DOI: 10.1590/s1678-9946202062097] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022] Open
Abstract
Abietane diterpenoids are naturally occurring plant metabolites with a broad
spectrum of biological effects including antibacterial, antileishmanial,
antitumor, antioxidant, as well as antiinflammatory activities. Recently, we
found that some analogues of natural ferruginol ( 2 ) actively
inhibited dengue virus 2 (DENV-2) replication. Due to the similarity with DENV,
we envisaged that abietane diterpenoids would also be active against Zika virus
(ZIKV). Six selected semi-synthetic abietane derivatives of
(+)-dehydroabietylamine ( 3 ) were tested. Cytotoxicity was
determined by MTT assay in Vero cells. In vitro anti-ZIKV
(clinical isolate, IMT17) activity was evaluated by plaque assay. Interestingly,
these molecules showed potential as anti-ZIKV agents, with EC50
values ranging from 0.67 to 18.57 µM, and cytotoxicity (CC50 values)
from 2.56 to 35.09 µM. The 18-Oxoferruginol (8) (EC50 = 2.60 µM, SI =
13.51) and 12-nitro-N-benzoyldehydroabietylamine (9) (EC50= 0.67 µM,
SI = 3.82) were the most active compounds, followed by
12-hydroxy-N-tosyldehydroabietylamine ( 7 ) (EC50 = 3.58
µM, SI = 3.20) and 12-hydroxy-N,N-phthaloyldehydroabietylamine ( 5
) (EC50 = 7.76 µM, SI = 1.23). To the best of our knowledge, this is
the first report on anti-Zika virus properties of abietanes.
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Affiliation(s)
- Francielle T G Sousa
- University of California-Berkeley, School of Public Health, Division of Infectious Diseases and Immunity, Berkeley, California, USA.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Doenças Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
| | - Cristina Nunes
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Doenças Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
| | - Camila Malta Romano
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Doenças Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Virologia (LIM 52), São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Ester Cerdeira Sabino
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Doenças Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Miguel Angel González-Cardenete
- Universitat Politècnica de València, Instituto de Tecnología Química, Consejo Superior de Investigaciones Científicas, Valencia, Spain
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Santos J, Duarte R, Nunes C. Host factors associated to false negative and indeterminate results in an interferon‐γ release assay in patients with active tuberculosis. Pulmonology 2020; 26:353-362. [DOI: 10.1016/j.pulmoe.2019.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 02/05/2023] Open
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37
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Rocha B, Nunes C. Benefits and damages of the use of touchscreen devices for the development and behavior of children under 5 years old-a systematic review. Psicol Reflex Crit 2020; 33:24. [PMID: 33128692 PMCID: PMC7603436 DOI: 10.1186/s41155-020-00163-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/02/2020] [Indexed: 11/26/2022] Open
Abstract
AIM Several health organizations have been expressing concern about the amount of time children spend using electronic devices and about the benefits and damages of the use of touchscreen devices, such as smartphones or tablets, for the development and behavior of children under the age of 5. A systematic review was carried out in order to understand the impact of touchscreen device usage toward children's development and behavior under the age of 5. METHODS Using the PRISMA method, from a total of 6314 studies found in online databases, searched in English, between 01/01/2000 and 01/10/2018, 11 studies were selected for analysis. RESULTS The results revealed that, in children under the age of 5, the damages of the use of touchscreen devices are superior to the benefits that may result, especially when there are more hours of screen time. More importance is given to the quality of the child-adult relationship and not to the use of touchscreen devices. Nevertheless, some studies emphasize some aspects that may reduce the negative effects, such as moderate use, less screen time, parental monitoring, and viewing educational programs in an academic environment. CONCLUSIONS Guidelines that should be given to parents about the use of touchscreen devices by children are discussed. The limitation of this study was the difficulty in finding studies directed to the desired age and type of electronic device. This may be taken as a potential cause of bias.
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Affiliation(s)
| | - Cristina Nunes
- University of Algarve, Faro, Portugal
- Psychology Research Centre (CIP), University Autónoma de Lisboa, Lisboa, Portugal
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Carvalho V, Esteves P, Nunes C, Araújo D, Helsen W, Travassos B. Observe and make a call: football referee’s assessment is context sensitive. INT J PERF ANAL SPOR 2020. [DOI: 10.1080/24748668.2020.1820194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- V. Carvalho
- Department of Sport Sciences, Universidade Da Beira Interior, Covilhã, Portugal
| | - P.T. Esteves
- Polytechnic Institute of Guarda, Portugal
- CreativeLab, Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Portugal
| | - C. Nunes
- Department of Mathematics and Center of Mathematics and Applications, Universidade Da Beira Interior, Covilhã, Portugal
| | - D. Araújo
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - W.F. Helsen
- KU Leuven, Department of Movement Sciences, Research Group for Movement Control and Neuroplasticity, Leuven, Belgium
| | - B. Travassos
- Department of Sport Sciences, Universidade Da Beira Interior, Covilhã, Portugal
- CreativeLab, Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Portugal
- Portugal Football School, Portuguese Football Federation, FPF, Oeiras, Portugal
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39
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Moniz M, Soares P, Nunes C. Tuberculosis among immigrants: risk factors associated with a delayed diagnosis in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A timely diagnosis is a key factor to TB control, since delayed diagnosis increases transmission, severity and mortality rates. However, immigrants have a higher risk of delay due to difficulties in the access to the healthcare services. Hence, the aim of this study is to identify risk factors associated with delays in immigrants and compare the results with the national population.
Methods
We carried out a retrospective study to analyse all pulmonary TB cases notified in Portugal having a passive case finding, between 2008 and 2017. Global delay was defined as the number of days between symptoms onset and diagnosis date and divided into patient delay (time between symptoms onset and first appointment date) and healthcare services delay (time between first appointment date and diagnosis date). A descriptive analysis was performed, and factors associated with each delay were identified using a Cox regression. Analyses were stratified by country of origin: immigrants (born outside of Portugal) and nationals (Portuguese population).
Results
Our results were consistent with previous studies and showed that the immigrant population was younger, had a higher proportion of HIV infection and had a smaller proportion of alcoholics, drug addicts, inmates, homeless and individuals living in community residencies compared to nationals. Immigrants had higher patient delay (44 vs. 36 days) compared to nationals. Different risk factors were associated with the delay in immigrants and nationals. Alcohol addiction was the only significant variable in both populations and was associated with lower delay in health services.
Conclusions
Immigrants have higher global delay, attributable to a higher patient delay. The risk factors related to TB diagnosis delay have an heterogeneous association in immigrant and nationals. Hence, tailored interventions should be implemented to decrease the delay among immigrants.
Key messages
Different risk factors were identified for the patient and healthcare services delay among immigrants and nationals, which highlight the importance to analyse each component of TB diagnosis delay. Immigrants have higher patient delay compared to nationals, hence tailored interventions should be implemented to facilitate access to healthcare services in this population.
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Affiliation(s)
- M Moniz
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
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40
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Lutfor Rahman M, Nunes C, Aguiar P. Factors related to tuberculosis delays: Evidence from nationwide retrospective study in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Globally, tuberculosis (TB) remains one of the top 10 causes of deaths and the leading cause from a single infectious agent. Delayed TB diagnosis and/or treatment may result in the transmission of bacilli, increasing infectivity, the risk of severe disease states, morbidity and mortality. It is essential to identify the factors that prolong delays in TB services so that health planners can initiate necessary measures to control TB infections.
Methods
A nationwide retrospective study was conducted from 2010 until 2013 to analyze tuberculosis delays under the setting of the Portuguese National Tuberculosis Control Programme. There were 16824 participants who were from 25 administrative districts under 7 regions and were originated from 70 countries in the world. The log-rank test, Cox's regression, and the Kaplan-Meier method have employed to analyze TB delay data.
Results
The median of patients` delay was 34 days with interquartile ranges (IQR) 50 days. Alcohol addicted people with TB infection were delayed by 40 days with 95% CI 37.73-42.28 whereas the non-addicted people took 33 days with 95% CI 32.35-33.65. The median diagnostic delay was 12 days with an IQR of 38 days. The female participants were delayed more than that of male (median delay for female 17 days with 95% CI 15.80-18.19) in TB diagnosis. Further, comorbidities e.g. lung cancer affected TB candidates were delayed more than their counterparts (median delay 37 days with 95% CI 23.29-50.70). The median of public health delays was 63 days with IQR 72 days. The females were delayed more than that of males (median delay 68 days with 95% CI 66.06-69.94). The adjusted Cox's regression identifies the features - older age, female, drug addiction, and community residence as potential factors that might affect TB delays.
Conclusions
It is essential to emphasize on the influencing dynamics - older age, female patients, HIV patients, alcohol addiction, and comorbidities to minimize TB delays.
Key messages
To minimize spreading risk of TB infections the dynamics of TB delays e.g. older age, female patients, drug, and alcohol addiction, comorbidities should be prioritized in the TB control programs. Special attention should be given to other lung diseases while diagnosing TB infections.
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Affiliation(s)
- M Lutfor Rahman
- Institute of Statistical Research & Training, University of Dhaka, Dhaka, Bangladesh
| | - C Nunes
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - P Aguiar
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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41
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dos P, Luís S, Nunes C. Heat waves and mortality: developing a local prediction model based on two kinds of heat waves. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heat waves (HW) will tend to have a higher impact on mortality due to climate change. The aim of this study was to develop a tailored model to predict local mortality associated to HW.
Methods
In this ecological study, daily temperature and daily mortality were collected from May to October of 1980 to 2017 in Coimbra, Portugal. Two definitions of HW were used: more than two consecutive days of maximum temperature (MaxT) or minimum temperature (MinT) above percentile 95 for the periods in question. Attributable general mortalities with 13 and 30 lag days were calculated and then converted to attributable general mortality rates adjusted to the resident population. Bivariate and multivariate analyses with SPSS statistics were performed with the following independent variables for each HW: MaxT, diurnal temperature variation (DTV), mean of the mean daily temperatures, month, ageing index (AI), ordinal number of the HW for that year (ONHW), duration, overlapping of another HW and existence of a public health contingency plan.
Results
The multivariate analyses returned a R2=0,19 for the MaxT model (MaxTM) for both 13 and 30 lag days and a R2=0,51 for the MinT model (MinTM) with 13 lag days and R2=0,45 for 30 lag days. DTV was the only variable with statistical significance in the MaxTM (p < 0,023; β = 0,44 for 13 lag days and p < 0,024; β = 0,43 for 30 lag days). In the MinTM model two variables had statistical significance: AI (p < 0,008; β = 1,72 for 13 lag days and p < 0,037; β = 0,44 for 30 lag days) and ONHW (p < 0,038; β= -0,44 for 30 lag days).
Conclusions
MaxTM and MinTM had different predictability potentials with different statistical significant independent variables. This may mean HW defined by MaxT have impact in a distinct way from HW defined by MinT. Further development of these models that include acclimatization indexes and causes of mortality may help local public health services to create more efficient, selective contingency plans.
Key messages
Minimum and maximum temperature defined heat waves may impact mortality differently. Local heat wave/mortality models may contribute to more efficient, selective contingency plans than regional models.
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Affiliation(s)
| | - Santos Luís
- Public Health Unit, Pinhal Interior Norte Primary Healthcare Cluster/ARS Centro, Oliveira do Hospital, Portugal
| | - C Nunes
- Public Health Research Centre, NOVA National School of Public Health/Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
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42
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Leite A, Soares P, Santos J, Nunes C. Delays in the diagnosis of pulmonary tuberculosis in critical and non-critical areas in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Delays in diagnosing tuberculosis lead to longer infectious periods, posing a challenge in tuberculosis control. This is particularly relevant in high incidence areas (critical). Thus, the objectives of this work were to characterize tuberculosis diagnosis delay and its components (patient delay and health delay) in incidence critical and non-critical areas in Portugal, as well as associated factors.
Methods
Notified cases of pulmonary tuberculosis diagnosed due to symptoms (passive screening) in the Portuguese Tuberculosis Surveillance System were analysed (2008-2017). Patient, health and overall delays were calculated. Factors associated with each delays' components were identified utilising Cox regression, while adjusting for sex, age and education level. Analyses were stratified by area type (critical and non-critical).
Results
Median (1st-3rd quartile - Q1-Q3) delays in patient, health and overall delay in critical areas were: 40 (Q1-Q3: 21-76), 8 (Q1-Q3:1-31), and 65 (Q1-Q3: 40-105) days, respectively; similar delays in non-critical areas were 32 (Q1-Q3:16-63); 9 (Q1-Q3: 1-34) and 58 (Q1-Q3: 35-98), respectively. More recent cases, adults younger than 65 years and alcoholic presented longer patient delays (both areas); healthcare professionals and patients with HIV infection presented shorter patient delays (only critical areas). Tuberculosis high-risk groups (males, alcohol dependency, homelessness, community residency) presented shorter health delays in both areas; drug use also presented shorter health delays but only in critical areas. Existing comorbidities was associated with longer health delays in both areas.
Conclusions
Patient delays increased between 2008 and 2017. Groups with longer/shorter delays differed between delay type and area type. Intervening in tuberculosis diagnosis delays requires different action for critical and non-critical areas, targeting health literacy from the general population and training of healthcare professionals.
Key messages
Delays in diagnosing in Portugal are mainly driven by delays in patient seeking care and are longer in areas of higher tuberculosis incidence. Intervening in tuberculosis diagnosis delays in Portugal requires different action in different areas, targeting health literacy in the general population and training of professionals.
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Affiliation(s)
- A Leite
- Public Health Research Centre, NOVA National School of Public Health, Lisbon, Portugal
- Public Health Unit, Primary Healthcare Cluster, Amadora, Portugal
| | - P Soares
- Public Health Research Centre, NOVA National School of Public Health, Lisbon, Portugal
| | - J Santos
- Public Health Research Centre, NOVA National School of Public Health, Lisbon, Portugal
| | - C Nunes
- Public Health Research Centre, NOVA National School of Public Health, Lisbon, Portugal
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Palma VH, Pechorro P, Nunes C, Correia B, Jesus S. DARK TRIAD IN ADOLESCENCE: RELATIONSHIP WITH IMPULSIVITY AND CONDUCT DISORDER. Psic , Saúde & Doenças 2020. [DOI: 10.15309/20psd210210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Affiliation(s)
- C. Santos
- Department of Mathematics and Physical Sciences, Polytechnic Institute of Beja, Beja, Portugal
- CMA- Center of Mathematics and its Applications, Faculty of Science and Technology, New University of Lisbon, Portugal
| | - C. Nunes
- Department of Mathematics and Center of Mathematics and Applications, University of Beira Interior, Covilhã, Portugal
| | - C. Dias
- Polytechnic Institute of Portalegre, Portalegre, Portugal
- CMA- Center of Mathematics and its Applications, Faculty of Science and Technology, New University of Lisbon, Portugal
| | - J.T. Mexia
- Department of Mathematics, Faculty of Science and Technology, New University of Lisbon, Portugal
- CMA- Center of Mathematics and its Applications, Faculty of Science and Technology, New University of Lisbon, Portugal
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Assunção R. Burden of disease associated with dietary exposure to carcinogenic aflatoxins in Portugal using human biomonitoring approach. Food Res Int 2020; 134:109210. [PMID: 32517894 DOI: 10.1016/j.foodres.2020.109210] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 12/11/2022]
Abstract
Human biomonitoring is an important tool to assess human exposure to chemicals, contributing to describe trends of exposure over time and to identify population groups that could be under risk. Aflatoxins are genotoxic and carcinogenic food contaminants causing hepatocellular carcinoma, the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to aflatoxins and no previous study used human biomonitoring data to comprehensively characterize the associated burden of disease. 24 h urine and first-morning urine paired samples were collected by 94 participants and were analyzed by liquid chromatography-tandem mass spectrometry for the quantitative determination of aflatoxins (B1, B2, G1, G2 and M1). Deterministic and probabilistic models were developed to assess the Portuguese exposure to aflatoxins and to estimate the health impact of this exposure, estimating the attributed Disability-Adjusted Life Years (DALYs). Aflatoxins were detected in a maximum of 13% (AFB1), 16% (AFB2), 1% (AFG1), 2% (AFG2) and 19% (AFM1) of the urine samples. Data obtained through the probabilistic approach revealed an estimated mean probable daily intake of 13.43 ng/kg body weight per day resulting in 0.13 extra cases of hepatocellular carcinoma, corresponding to mean annual DALYs of 172.8 for the Portuguese population (10291027 inhabitants). The present study generated for the first time and within a human biomonitoring study, reliable and crucial data to characterize the burden associated to the exposure to aflatoxins of the Portuguese population. The obtained results constitute an imperative support to risk managers in the establishment of preventive policy measures that contribute to ensure public health protection.
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Affiliation(s)
- C Martins
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal.
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - C Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - P Alvito
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - R Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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Martins C, Assunção R, Nunes C, Torres D, Alvito P. Are Data from Mycotoxins’ Urinary Biomarkers and Food Surveys Linked? A Review Underneath Risk Assessment. Food Reviews International 2020. [DOI: 10.1080/87559129.2019.1709200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- C. Martins
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
- CISP, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - R. Assunção
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - C. Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
- CISP, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - D. Torres
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - P. Alvito
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Assunção R. Burden of disease attributable to exposure to aflatoxins in Portugal using Human biomonitoring data. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Human biomonitoring (HBM) is recognized as an important tool to assess the Human exposure to chemicals, contributing to describe trends and patterns of exposure over time and to identify population groups that could be under risk. Natural chemicals as mycotoxins, fungi metabolites that produce toxic effects in humans, are important compounds that could be found in foods usually consumed worldwide in a daily basis. Mycotoxins as aflatoxins (AFTs) are genotoxic, carcinogenic and immunosuppressive compounds. Hepatocellular carcinoma (HCC) is one of their main health toxic effects and is the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to AFTs and none previous study used HBM data to characterize comprehensively the burden associated to this exposure.
In the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016), 24h-urine samples from 94 participants were analyzed by liquid chromatography-mass spectrometry (LC-MS/MS) for the simultaneous determination of AFTs (B1, B2, G1, G2, M1). A model was developed to estimate the health impact of the exposure of Portuguese population to aflatoxins, estimating the number of cases of HCC and DALYs attributed to AFTs exposure.
AFTs were detected in 12.8% (AFB1), 16.0% (AFB2) and 19.1% (AFM1) of the 24h-urine samples. The estimated number of extra cases of HCC attributed to this exposure ranged from 17 to 65 cases/year; the associated DALYs for the Portuguese population ranged from 284 to 1802 years.
The present study generated, for the first time and within a HBM study, reliable data regarding the exposure of the Portuguese population to AFTs. These data were crucial to characterize the health impact associated to AFTs exposure and to support risk managers to establish preventive policy measures that contribute to ensure the public health protection.
Key messages
Portuguese population is exposed to aflatoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) to humans. Human biomonitoring studies provide realistic data on internal exposure at individual level, contributing to a more accurate estimation of the burden derived from this exposure.
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Affiliation(s)
- C Martins
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - C Nunes
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - P Alvito
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - R Assunção
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
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Martins C, Vidal A, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Assunção R, Alvito P, De Boevre M. Risk assessment of Portuguese population to multiple mycotoxins: the human biomonitoring approach. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Mycotoxins constitute a relevant group of food contaminants with several associated health outcomes such as estrogenic, immunotoxic, nephrotoxic and teratogenic effects. Although scarce data are available in Portugal, human biomonitoring studies have been globally developed to assess the exposure to mycotoxins at individual level.
The present study concerned the analysis of mycotoxins in 24h urine and first-morning urine paired samples from 94 participants enrolled within the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016). Following a salt-assisted matrix extraction, urine samples were analyzed by liquid chromatography-mass spectrometry for the simultaneous determination of 37 urinary mycotoxins’ biomarkers and data obtained used to estimate the probable daily intake as well as the risk characterization applying the Hazard Quotient approach.
Results revealed the exposure of Portuguese population to zearalenone, deoxynivalenol, ochratoxin A, alternariol, citrinin and fumonisin B1 through the quantification in 24h urine and first-morning urine paired samples. Risk characterization data revealed a potential concern to some reported mycotoxins since the reference intake values were exceeded by some of the considered participants. Alternariol was identified for the first time in urine samples from a European country; however, risk characterization was not performed due to lack of reference intake value.
The present study contributed with reliable and evidence-based results, and confirmed that mycotoxins represent a burden and are part of the human exposome of the Portuguese population. Further studies are needed to shed a light on the determinants of exposure in order to contribute for the promotion of public health measures to reduce the mycotoxins’ exposure in Portugal.
Key messages
Portuguese population is exposed to mycotoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) for human health. Human biomonitoring studies provide realistic data on internal exposure at individual level, allowing a more accurate knowledge of the determinants of exposure to these contaminants.
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Affiliation(s)
- C Martins
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - C Nunes
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - R Assunção
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - P Alvito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Bhering M, Kritski A, Nunes C, Duarte R. Multidrug-resistant tuberculosis in Lisbon: unfavourable treatment and associated factors, 2000-2014. Int J Tuberc Lung Dis 2019; 23:1075-1081. [PMID: 31627772 DOI: 10.5588/ijtld.18.0596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: The incidence of tuberculosis (TB) has been decreasing in Portugal. Lisbon concentrates the largest number of cases of multidrug-resistant (MDR) TB in the country. This study aims at identifying clinical and demographic factors associated with unfavourable treatment results of patients with MDR-TB in the city.METHOD: The data on 265 MDR-TB cases, notified from 2000 to 2014 in the District of Lisbon, were collected from the Tuberculosis Surveillance System. Unfavourable cases were classified as failure, loss to follow-up (LTFU) and death. Bivariate and multivariate logistic regressions were undertaken to estimate the factors associated with unfavourable outcomes, LTFU and death.RESULTS: The proportion of unfavourable outcomes was 30.5%. These were associated mostly with being male, foreign-born and resistant to kanamycin. Death was associated with being human immunodeficiency virus-positive and resistant to kanamycin. Being foreign-born had a 4.46-fold higher odds of a LTFU outcome than did being Portuguese-born. The foreign-born patients were mostly African immigrants.CONCLUSION: The main finding in this study is that foreign-born patients are associated with a higher probability of unfavourable outcomes than Portuguese-born patients. Therefore, foreign-born patients need more careful monitoring in the control of MDR-TB.
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Affiliation(s)
- M Bhering
- School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazilian Tuberculosis Network, Rio de Janeiro, Rio de Janeiro, Brazil
| | - A Kritski
- School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazilian Tuberculosis Network, Rio de Janeiro, Rio de Janeiro, Brazil
| | - C Nunes
- National School of Public Health at the Nova University Lisbon, Lisbon
| | - R Duarte
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Lisbon, Public Health Science and Medical Education Department, School of Medicine, University of Porto, Porto, Portugal
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Assunção R, Alvito P. Exposure assessment of Portuguese population to multiple mycotoxins: The human biomonitoring approach. Int J Hyg Environ Health 2019; 222:913-925. [DOI: 10.1016/j.ijheh.2019.06.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/18/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
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