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Polónia J, Marques Pereira R. Guidelines-based therapeutic strategies for controlling hypertension in non-controlled hypertensive patients followed by family physicians in primary health care in Portugal: the GPHT-PT study. Blood Press 2024; 33:2345887. [PMID: 38680045 DOI: 10.1080/08037051.2024.2345887] [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: 02/08/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE In a prospective open study, with intervention, conducted in Primary Health Care Units by General Practitioners (GPs) in Portugal, the effectiveness of a single pill of candesartan/amlodipine (ARB/amlodipine), as the only anti-hypertension (anti-HTN) medication, in adult patients with uncontrolled HTN (BP > 140/or > 90 mm Hg), either previously being treated with anti-HTN monotherapies (Group I), or combinations with hydrochlorothiazide (HCTZ) (Group II), or not receiving medication at all (Group III), was evaluated across 12-weeks after implementation of the new therapeutic measure. MATERIALS AND METHODS A total of 118 GPs recruited patients with uncontrolled HTN who met inclusion/exclusion criteria. Participants were assigned, according to severity, one of 3 (morning) fixed combination candesartan/amlodipine dosage (8/5 or 16/5 or 16/10 mg/day) and longitudinally evaluated in 3 visits (v0, v6 and v12 weeks). Office blood pressure was measured in each visit, and control of HTN was defined per guidelines (BP< 140/90 mmHg). RESULTS Of the 1234 patients approached, 752 (age 61 ± 10 years, 52% women) participated in the study and were assigned to groups according to previous treatment conditions. The 3 groups exhibited a statistically significant increased control of blood pressure after receiving the fixed combination candesartan/amlodipine dosage. The overall proportion of controlled HTN participants increased from 0,8% at v0 to 82% at v12. The mean arterial blood pressure values decreased from SBP= 159.0 (± 13.0) and DBP= 91.1 (± 9.6) at baseline to SBP= 132,1 (± 11.3) and DBP= 77,5 (± 8.8) at 12 weeks (p < 0.01). Results remained consistent when controlling for age and sex. CONCLUSION In patients with uncontrolled HTN, therapeutic measures in accordance with guidelines, with a fixed combination candesartan/amlodipine, allowed to overall achieve HTN control at 12 weeks in 82% of previously uncontrolled HTN patients, reinforcing the advantages of these strategies in primary clinical practice.
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Affiliation(s)
- Jorge Polónia
- RISE & Department of Medicine, Faculty of Medicine of Porto, Porto, Portugal
- Blood Pressure Unit & CV Risk, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Raul Marques Pereira
- School of Medicine, University of Minho, Braga, Portugal
- Association P5 Digital Medical Center (ACMP5), School of Medicine, University of Minho, Braga, Portugal
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Ribeiro H, de Pinho R, Bronze L, Damião P, Martos Gonçalves F. Mission 70/26 Project: improving blood pressure control in Portugal. Blood Press 2024; 33:2296903. [PMID: 38130081 DOI: 10.1080/08037051.2023.2296903] [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: 11/21/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE As reported in most European countries, the percentage of treated hypertensive patients achieving a well-controlled blood pressure (e.g. < 140/90 mmHg) is insufficient. This represents a major health concern particularly in countries with a high prevalence of cardiovascular events such as stroke. Therefore, there is a need to develop national programs to increase not only the awareness regarding elevated blood pressure but also the percentage of treated patients achieving recommended blood pressure targets. The present paper describes the new initiative of the Portuguese Society of Hypertension (PSH) to achieveat least 70% of controlled hypertensive patients, followed in primary care, in 2026. MATERIALS AND METHODS The strategies used to improve blood pressure control are aimed at healthcare professionals and general population and include governmental and organizational interventions. To be able to analyze the control rate of HTN patients, and using BI-CSP reports (the Primary Care health unit platform), every six months, we will be addressing the proportion of HTN patients (age: 18-65 years) with BP < 140/90 mmHg and the proportion of HTN patients with at least one blood pressure recorded in the last semester. CONCLUSION With Mission 70/26, the PHS aims to improve awareness among all health professionals and community alike about the problem of uncontrolled HTN and its role in the consequent disability and high mortality rate from cardiovascular causes.
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Affiliation(s)
- Heloisa Ribeiro
- Internal Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | | | - Luís Bronze
- Portuguese Navy Cardiovascular Department, University of Beira Interior, Medical School, Covilhã, Portugal
| | | | - Fernando Martos Gonçalves
- Internal Medicine, Hospital Beatriz Ângelo, Faculty of Medicine of University of Lisbon, Faculty of Health Sciences and Nursing - Lisbon, Universidade Católica Portuguesa, Loures, Portugal
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Sousa S, Albuquerque G, Severo M, Costa AR, Moreira P, Lunet N, Padrão P. Development and validation of a photograph-based instrument to assess nutrition literacy: The NUTLY project. Appetite 2024; 198:107377. [PMID: 38679064 DOI: 10.1016/j.appet.2024.107377] [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: 10/05/2023] [Revised: 04/07/2024] [Accepted: 04/24/2024] [Indexed: 05/01/2024]
Abstract
Most instruments measuring nutrition literacy evaluate theoretical knowledge, not necessarily reflecting skills relevant to food choices. We aimed to develop and validate a photograph-based instrument to assess nutrition literacy (NUTLY) among adults in Portugal. NUTLY assesses the ability to distinguish foods with different nutritional profiles; from each of several combinations of three photographs (two foods with similar contents and one with higher content) participants are asked to identify the food with the highest energy/sodium content. The NUTLY version with 79 combinations, obtained after experts/lay people evaluations, was applied to a sample representing different age, gender and education groups (n = 329). Dimensionality was evaluated through latent trait models. Combinations with negative or with positive small factor loadings were excluded after critical assessment. Internal consistency was measured using Cronbach's alpha and construct validity by comparing NUTLY scores with those obtained in the Medical Term Recognition Test and the Newest Vital Sign (NVS), and across education and training in nutrition/health groups. The cut-off to distinguish adequate/inadequate nutrition literacy was defined through ROC analysis using the Youden index criterion, after performing a Latent class analysis which identified a two-class model to have the best goodness of fit. Test-retest reliability was assessed after one month (n = 158). The final NUTLY scale was unidimensional and included 48 combinations (energy: 33; sodium: 15; α = 0.74). Mean scores (±standard deviation) were highest among nutritionists (39.9 ± 4.4), followed by health professionals (38.5 ± 4.1) and declined with decreasing education (p < 0.001). Those with adequate nutrition literacy according to NVS showed higher NUTLY scores (37.9 ± 4.3 vs. 33.9 ± 6.9, p < 0.001). Adequate nutrition literacy was defined as a NUTLY score≥35 (sensitivity: 89.3%; specificity: 93.7%). Test-retest reliability was high (ICC = 0.77). NUTLY is a valid and reliable nutrition literacy measurement tool.
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Affiliation(s)
- Sofia Sousa
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal
| | - Gabriela Albuquerque
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Portugal
| | - Ana Rute Costa
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina da Universidade do Porto, Portugal
| | - Pedro Moreira
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Portugal; Centro de Investigação em Atividade Física, Saúde e Lazer da Universidade do Porto, Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina da Universidade do Porto, Portugal
| | - Patrícia Padrão
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Portugal.
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Grilo F, McPhearson T, Nunes A, Aleixo C, Santos-Reis M, Branquinho C. Where the not-so-wild things are in cities? The influence of social-ecological factors in urban trees at multiple scales. Sci Total Environ 2024; 929:172552. [PMID: 38643878 DOI: 10.1016/j.scitotenv.2024.172552] [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] [Received: 12/15/2023] [Revised: 03/30/2024] [Accepted: 04/16/2024] [Indexed: 04/23/2024]
Abstract
Green infrastructure plays an essential role in cities due to the ecosystem services it provides. However, these elements are shaped by social and ecological factors that influence their distribution and diversity, affecting ecological functions and human well-being. Here, we analyzed neighborhood tree distribution - trees in pocket parks, squares and along streets - in Lisbon (Portugal) and modelled tree abundance and taxonomic and functional diversity, at the parish and local scales, considering a comprehensive list of social and ecological factors. For the functional analyses, we included functional traits linked to dispersal, resilience to important perturbations in coastal Mediterranean cities, and ecosystem services delivery. Our results show not only that trees are unevenly distributed across the city, but that there is a strong influence of social factors on all biological indices considered. At the parish and local scales, abundance and diversity responded to different factors, with abundance being linked to both social and ecological variables. Although the influence of social factors on urban trees can be expected, by modelling their influence we can quantify how much humans modify urban landscapes at a structural and functional level. These associations can underlie potential biodiversity filters and should be analyzed over time to inform decisions that support long-term ecological resilience, maximize trait functional expression, and increase equity in ecosystem services delivery.
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Affiliation(s)
- Filipa Grilo
- cE3c - Center for Ecology, Evolution and Environmental Changes & CHANGE - Global Change and Sustainability Institute, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - Timon McPhearson
- Urban Systems Lab, The New School, New York, NY, USA; Cary Institute of Ecosystem Studies, Millbrook, NY, USA; Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden; Beijer Institute of Ecological Economics, Royal Swedish Academy of Sciences, Stockholm, Sweden
| | - Alice Nunes
- cE3c - Center for Ecology, Evolution and Environmental Changes & CHANGE - Global Change and Sustainability Institute, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - Cristiana Aleixo
- cE3c - Center for Ecology, Evolution and Environmental Changes & CHANGE - Global Change and Sustainability Institute, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - Margarida Santos-Reis
- cE3c - Center for Ecology, Evolution and Environmental Changes & CHANGE - Global Change and Sustainability Institute, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - Cristina Branquinho
- cE3c - Center for Ecology, Evolution and Environmental Changes & CHANGE - Global Change and Sustainability Institute, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal.
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Willman JC, Coutinho Nogueira D, Silva AM. Reassessing trauma in a Late Neolithic cranium from Megalitho da Capella (Figueira da Foz, Portugal). Anthropol Anz 2024; 81:341-349. [PMID: 38317614 DOI: 10.1127/anthranz/2024/1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 02/07/2024]
Abstract
The Megalitho da Capella (Figueira da Foz, Coimbra, Portugal) is one of at least 21 dolmens in a megalithic complex explored by António dos Santos Rocha between 1880 and 1909. Among the human remains from Megalitho da Capella is an incomplete and fragmented cranium. Santos Rocha interpreted a groove on the parietal bone as an incision of traumatic origin with signs of remodeling that was suggestive of prolonged survival after an intentional intervention. This study provides a new examination of the groove using microcomputed tomographic (microCT) imaging, microscopy, and macroscopic observations of the groove in addition to the direct dating the skeletal remains. Results indicate that the human remains are dated to the Late Neolithic and that the "incision" is a normal anatomical variant corresponding to impressions from vascular tissue and temporal projections of the squamosal. We conclude that studies of bone surface modifications should consider normal anatomical variants (e.g., sulci, grooves, and furrows) when reporting results. Paleoimaging, microscopy, and comparative observations can assist in the identification bone modifications versus anatomical variants.
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Affiliation(s)
- John Charles Willman
- CIAS - Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Dany Coutinho Nogueira
- CIAS - Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Ana Maria Silva
- CIAS - Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
- UNIARQ, Centro de Arqueologia da Universidade de Lisboa, Faculdade de Letras da Universidade de Lisboa,1600-214 Lisboa Portugal
- Centre for Functional Ecology (CEF), Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
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Pinto T, Sillero N, Mira A, Santos SM. Using the dead to infer about the living: Amphibian roadkill spatiotemporal dynamics suggest local populations' reduction. Sci Total Environ 2024; 927:172356. [PMID: 38614338 DOI: 10.1016/j.scitotenv.2024.172356] [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] [Received: 09/29/2023] [Revised: 03/08/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
Roads represent one of the main sources of wildlife mortality, population decline, and isolation, especially for low-vagility animal groups. It is still not clearly understood how wildlife populations respond to these negative effects over space and time. Most studies on wildlife road mortality do not consider the spatial and temporal components simultaneously, or the imperfect roadkill detection, both of which could lead to inaccurate assumptions and unreliable mitigation actions. In this study, we applied a multi-season occupancy model to a 14-year amphibian mortality dataset collected along 120 km of roads, combined with freely available landscape and remote sensing metrics, to identify the spatiotemporal patterns of amphibian roadkill in a Mediterranean landscape in Southern Portugal. Our models showed an explicit general decrease in amphibian roadkill. The Iberian painted frog (Discoglossus galganoi) experienced roadkill declines over time of ∼70 %, while the spiny common toad (Bufo spinosus) and the fire salamander (Salamandra salamandra) had a loss of nearly 50 %, and the Southern marbled newt (Triturus pygmaeus) had 40 %. Despite the decreasing trend in roadkill, spatial patterns seem to be rather stable from year to year. Multi-season occupancy models, when combined with relevant landscape and remote sensing predictors, as well as long-term monitoring data, can describe dynamic changes in roadkill over space and time. These patterns are valuable tools for understanding roadkill patterns and drivers in Mediterranean landscapes, enabling the differentiation of road sections with varying roadkill over time. Ultimately, this information may contribute to the development of effective conservation measures.
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Affiliation(s)
- Tiago Pinto
- MED - Mediterranean Institute for Agriculture, Environment and Development, CHANGE - Global Change and Sustainability Institute, Institute for Advanced Studies and Research, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal; Conservation Biology Lab (UBC), University of Évora, Mitra, 7002-554, Évora, Portugal.
| | - Neftalí Sillero
- Centre for Research in Geo-Spatial Sciences (CICGE), University of Porto, Alameda do Monte da Virgem, 4430-146 Vila Nova de Gaia, Portugal
| | - António Mira
- MED - Mediterranean Institute for Agriculture, Environment and Development, CHANGE - Global Change and Sustainability Institute, Institute for Advanced Studies and Research, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal; Conservation Biology Lab (UBC), University of Évora, Mitra, 7002-554, Évora, Portugal
| | - Sara M Santos
- MED - Mediterranean Institute for Agriculture, Environment and Development, CHANGE - Global Change and Sustainability Institute, Institute for Advanced Studies and Research, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal; Conservation Biology Lab (UBC), University of Évora, Mitra, 7002-554, Évora, Portugal
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Ferreira G, Carvalho A, Pereira MG. Educational Interventions on Diabetic Foot Self-Care: A Study Protocol for a Pragmatic Randomized Controlled Trial. Health Commun 2024; 39:1383-1392. [PMID: 37204003 DOI: 10.1080/10410236.2023.2213875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Diabetic foot is one of the most serious complications of diabetes and foot ulcer recurrence has been associated with poor foot care. Educational programs may work as a vehicle for promoting knowledge and adequate foot self-care behaviors, reducing potential ulcerative complications in the diabetic foot, and promoting a better quality of life. This study protocol will analyze the impact of two different educational strategies - an instructive video (Experimental Group 1) compared to a foot care leaflet with real-time guided reading (Experimental Group 2) and standard care (Control Group) - on adherence and knowledge about diabetic foot care and patients' perception of their foot health. This study is a Pragmatic Randomized Controlled Trial of a non-pharmacological treatment. Participants need to have a diabetic foot diagnosis and attend a Diabetic Foot Multidisciplinary Consultation at two hospitals from the North of Portugal. Participants will be assessed at the first appointment of the diabetic foot consultation (T0), two weeks after (T1), and three months later, at follow-up (T2). Primary outcomes will be adherence and knowledge about diabetic foot care and general foot health. Secondary outcomes will be illness representations regarding diabetic foot. The results of this study will inform educational interventions to decrease diabetic foot ulcers, amputation rates, and the costs associated with both, contributing to foot care adherence and improve patient's quality of life.
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Affiliation(s)
- Gabriela Ferreira
- Psychology Research Centre, School of Psychology, University of Minho
| | - André Carvalho
- Service of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário do Porto
| | - M Graça Pereira
- Psychology Research Centre, School of Psychology, University of Minho
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Fernandes AC, Morais C, Franchini B, Pereira B, Pinho O, Cunha LM. Clean-label products: Factors affecting liking and acceptability by Portuguese older adults. Appetite 2024; 197:107307. [PMID: 38518867 DOI: 10.1016/j.appet.2024.107307] [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: 12/04/2023] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/24/2024]
Abstract
Consumers are preferring more "natural" foods, made of "healthier" and "familiar" components - the "clean-label" trend. As the population ages, understanding the older adult consumer segment becomes increasingly important. This study aims to identify the factors influencing the acceptability and liking of clean-label products in older adults living in the community. A convenience sample of 100 older adults was used for this cross-sectional study. Socio-demographic data, health status, independence level, lifestyle characteristics, nutritional status, and food and nutrient intake data were collected. The acceptability and liking for clean-label products comprised two parts: Sensory analysis with overall liking evaluation of three pairs of products, using a 9-point hedonic scale and free comments; Willingness to eat and preference assessment of nine pairs of products using the Food Action scale and a simple preference test. The participants were 80% female with a mean age of 75 years old. The overall liking for clean-label versions of cookies and mayonnaise was lower than for traditional versions. However, participants were more willing to eat the clean-label versions of products, particularly ham and yogurt. Most of the participants would prefer buying the clean-label version of all nine pairs of products, especially for ham, loaf bread, sausages, and yogurt. In sum, older adults living in the community exhibit a lower liking but, a greater willingness to eat and a higher preference for buying clean-label products. Older adults who favor clean-label products have higher levels of education and are reported to have a more adequate diet.
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Affiliation(s)
- Ana Campos Fernandes
- Faculdade de Ciências da Nutrição e da Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; DGAOT, Faculdade de Ciências da Universidade do Porto, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal
| | - Cecília Morais
- GreenUPorto-Sustainable Agrifood Production Research Centre/Inov4Agro, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal; Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal; RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Bela Franchini
- Faculdade de Ciências da Nutrição e da Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; GreenUPorto-Sustainable Agrifood Production Research Centre/Inov4Agro, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal
| | - Bárbara Pereira
- Faculdade de Ciências da Nutrição e da Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; GreenUPorto-Sustainable Agrifood Production Research Centre/Inov4Agro, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal
| | - Olívia Pinho
- Faculdade de Ciências da Nutrição e da Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; LAQV/REQUIMTE - Laboratório de Bromatologia e Hidrologia, Departamento de Ciências Químicas, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Luís Miguel Cunha
- DGAOT, Faculdade de Ciências da Universidade do Porto, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal; GreenUPorto-Sustainable Agrifood Production Research Centre/Inov4Agro, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal.
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Nunes MA, Melnyk BM, Almeida S, Cardoso A, Vieira M. Psychometric Properties of the Healthy Lifestyle Behaviors Scale in Portuguese Pregnant Women. West J Nurs Res 2024; 46:428-435. [PMID: 38616562 PMCID: PMC11088217 DOI: 10.1177/01939459241245217] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
BACKGROUND Pregnancy provides a privileged and opportune moment to implement interventions promoting healthy lifestyle behaviors and significantly improving perinatal outcomes. The Healthy Lifestyle Behaviors Scale (HLBES) can be used to assess health promoting behaviors, such as diet, physical activity, and mental health. PURPOSE This study aimed to examine the psychometric properties of the HLBES in Portuguese pregnant women. METHODS A methodological study was conducted on a convenience sample of 192 pregnant women receiving prenatal care. After cross-cultural adaptation, an exploratory factor analysis and internal consistency assessment were carried out to evaluate the psychometric properties of the scale. Data collected included the Healthy Lifestyle Beliefs Scale to assess the HLBES' criterion validity. RESULTS Exploratory factor analysis with Varimax rotation yielded 2 subscales that explained 45.23% of the total variance. The scale revealed an overall internal consistency of 0.78 and a good criterion validity with the Healthy Lifestyle Beliefs Scale (r = 0.65, P < .01). CONCLUSION Our results suggest that the HLBES is an instrument for reporting healthy lifestyle behaviors in Portuguese pregnant women; however, further studies are recommended. This scale can be used to not only describe healthy lifestyle behaviors in pregnant women but also to determine the effects of health promoting interventions.
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Affiliation(s)
- Maria Arminda Nunes
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal
| | - Bernadette Mazurek Melnyk
- College of Nursing, The Ohio State University, Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, Columbus, OH, USA
| | - Sofia Almeida
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal
| | | | - Margarida Vieira
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal
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Giorgini R, Maestu F, Sara FM, Pastore M, Abellan M, Quattrone A, Caparello S, Quattrone A, Vaccaro MG. Measurement invariance across countries of the Test of Memory Strategies (TMS): A contribution to the cross-national validity study. Acta Psychol (Amst) 2024; 246:104291. [PMID: 38703656 DOI: 10.1016/j.actpsy.2024.104291] [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: 02/13/2024] [Revised: 03/28/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024] Open
Abstract
Previous literature showed a complex interpretation of recall tasks due to the complex relationship between Executive Functions (EF) and Long Term Memory (M). The Test of Memory Strategies (TMS) could be useful for assessing this issue, because it evaluates EF and M simultaneously. This study aims to explore the validity of the TMS structure, comparing the models proposed by Vaccaro et al. (2022) and evaluating the measurement invariance according to three countries (Italy, Spain, and Portugal) through Confirmatory Factor Analysis (CFA). Four hundred thirty-one healthy subjects (Age mean = 54.84, sd = 20.43; Education mean = 8.85, sd =4.05; M = 177, F = 259) were recruited in three countries (Italy, Spain, and Portugal). Measurement invariance across three country groups was evaluated through Structural Equation modeling. Also, convergent and divergent validity were examined through the correlation between TMS and classical neuropsychological tests. CFA outcomes suggested that the best model was the three-dimensional model, in which list 1 and list2 reflect EF, list 3 reflects a mixed factor of EF and M (EFM) and list4 and list5 reflect M. This result is in line with the theory that TMS decreases EF components progressively. TMS was metric invariant to the country, but scalar invariance was not tenable. Finally, the factor scores of TMS showed convergent validity with the classical neuropsychological tests. The overall results support cross-validation of TMS in the three countries considered.
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Affiliation(s)
- Roberto Giorgini
- Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Italy
| | - Fernando Maestu
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Complutense University of Madrid, Spain; Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Spain
| | - Fernandes Margarida Sara
- Department of Psychology and Education, CINTESIS - Research Center For Technology and Health Services- Portucalense University, Portugal
| | | | - Maria Abellan
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Spain
| | - Andrea Quattrone
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Sara Caparello
- Department of Business and Legal Sciences, University of Calabria, Italy
| | - Aldo Quattrone
- Neuroscience Research Center (CR), Department of Medical and Surgical Scienze, Magna Graecia University of Catanzaro, Italy
| | - Maria Grazia Vaccaro
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy; Neuroscience Research Center (CR), Department of Medical and Surgical Scienze, Magna Graecia University of Catanzaro, Italy.
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Pf B, Ac A, N VEB, Jr M. Cervids as Sentinels for Rickettsia spp. in Portugal. Acta Trop 2024; 254:107202. [PMID: 38565332 DOI: 10.1016/j.actatropica.2024.107202] [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: 01/18/2024] [Revised: 03/11/2024] [Accepted: 03/30/2024] [Indexed: 04/04/2024]
Abstract
Cervids are highly exposed to ticks, however, their role in the life cycle of these rickettsiae has not been fully elucidated. Given the expanding distribution and growing population of deer species in Portugal, coupled with their direct and indirect interactions with humans during hunting, it becomes crucial to explore their role as sentinels and potential reservoirs of Rickettsia. The present investigation aimed to detect and evaluate exposure to Rickettsia in free-living deer from Portugal. Blood samples (n = 77) were collected from hunted game animals (red deer and fallow deer) from different areas throughout Portugal (Idanha-a-Nova, Monte Fidalgo, Montalvão and Arraiolos) and sera were tested by immunofluorescence assay, to detect antibodies. Additionally, blood DNA samples were screened for SFGR by nested-polymerase chain reaction targeting a fragment of the outer membrane protein B (ompB) gene, as well as for Anaplasma and Ehrlichia spp. targeting the 16S rRNA gene. Thirty-five per cent (25 deer and two fallow deer) tested positive (sera with a titer ≥1:64) for IgG antibodies against Rickettsia conorii. No rickettsial DNA was detected by PCR for the ompB gene, and all DNA samples tested negative for Anaplasma and Ehrlichia. As far as we know, this study is the first screening of cervid species in Portugal for Rickettsia antibodies. The findings suggest that these animals serve as useful sentinel indicators for the circulation of rickettsiae, offering a complementary perspective to studies focused on ticks. The increasing numbers of hunted deer in Portugal and the potential zoonotic features of Rickettsia spp. highlight the importance of continued surveillance directed at tick-borne diseases, especially those involving wild animals.
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Affiliation(s)
- Barradas Pf
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; 1H -TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, 4585-116 Gandra, Paredes, Portugal (PB, NVB).
| | - Abrantes Ac
- CECAV-Animal and Veterinary Research Centre, Trás-os-Montes e Alto Douro University, Quinta de Prados, Vila Real, Portugal (ACA)
| | - Vieira E Brito N
- 1H -TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, 4585-116 Gandra, Paredes, Portugal (PB, NVB)
| | - Mesquita Jr
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal (JRM)
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14th National Congress of the Portuguese Society of Clinical Chemistry, Genetics and Laboratory Medicine. Clin Chem Lab Med 2024; 62:eA43-eA129. [PMID: 38582971 DOI: 10.1515/cclm-2024-0338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
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15th National Congress of the Portuguese Society of Clinical Chemistry, Genetics and Laboratory Medicine. Clin Chem Lab Med 2024; 62:eA130-87. [PMID: 38579344 DOI: 10.1515/cclm-2024-0339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
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Behzadi Koochnai N, Muñoz Romo R, Riera López N, Caballero Cubedo R, Gómez de la Oliva S, Martin de Rosales Cabrera T, Castaño Reguillo A. Digitalisation of information and management optimisation in Multiple Victim Incidents. Analytical study. PLoS One 2024; 19:e0303247. [PMID: 38743753 PMCID: PMC11093311 DOI: 10.1371/journal.pone.0303247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Triage is a crucial tool for managing a Multiple Victim Incident (MVI). One particularly problematic issue is the communication of results to the chain of command and control. Favourable data exists to suggest that digital triage can improve some features of analogue triage. Within this context we have witnessed the emergence of the Valkyries Project, which is working to develop strategies to respond to MVIs, and especially cross-border incidents. To that end, an IT platform called "SIGRUN" has been created which distributes, in real time, all the information to optimise MVI management. A full-scale simulation, held on the Spain-Portugal border and featuring contributions from different institutions on both sides of the border, put to the test the role of information digitalisation in this type of incidents. OBJECTIVE To evaluate the impact of the synchronous digitalisation of information on the optimal management of Multiple Victim Incidents. METHOD Clinical evaluation study carried out on a cross-border simulation between Spain and Portugal. A Minimum Data Set (MDS) was established by means of a modified Delphi by a group of experts. The digital platform "SIGRUN" integrated all the information, relaying it in real time to the chain of command and control. Each country assigned two teams that would carry out digital and analogue triage synchronously. Analogue triage variables were gathered by observers accompanying the first responders. Digital triage times were recorded automatically. Each case was evaluated and classified simultaneously by the two participating teams, to carry out a reliability study in a real time scenario. RESULTS The total duration of the managing of the incident in the A group of countries involved compared to the B group was 72.5 minutes as opposed to 73 minutes. The total digital assistance triage (AT) time was 37.5 seconds in the digital group, as opposed to 32 minutes in the analogue group. Total evacuation (ET) time was 28 minutes in the digital group compared with 65 minutes in the analogue group. The average differences in total times between the analogue and the digital system, both for primary and secondary evaluation, were statistically significant: p = 0.048 and p = 0.000 respectively. For the "red" category, AT obtained a sensitivity of 100%, also for ET, while with regard to AT safety it obtained a PPV of 61.54% and an NPV of 100%, and for ET it obtained a PPV of 83.33% and an NPV of 100%. For the analogue group, for AT it obtained a sensitivity of 62.50%, for ET, 70%, for AT safety it obtained a PPV of 45.45% and an NPV of 92.31%, while for ET it obtained a PPV of 70% and an NPV of 92.50%. The gap analysis obtained a Kappa index of 0.7674. CONCLUSION The triage system using the developed digital tool demonstrated its validity compared to the analogue tool, as a result of which its use is recommended.
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Affiliation(s)
- Navid Behzadi Koochnai
- Servicio de Urgencias Médicas de la Comunidad de Madrid (SUMMA112), Madrid, Spain
- Fundación para la Investigación e Innovación Biosanitarias en Atención Primaria (FIIBAP), Madrid, Spain
- Facultad de Ciencias de la Salud, Universidad Camilo José Cela de Madrid, Madrid, Spain
| | - Raúl Muñoz Romo
- Servicio de Urgencias Médicas de la Comunidad de Madrid (SUMMA112), Madrid, Spain
| | - Nicolás Riera López
- Servicio de Urgencias Médicas de la Comunidad de Madrid (SUMMA112), Madrid, Spain
| | | | | | | | - Almudena Castaño Reguillo
- Fundación para la Investigación e Innovación Biosanitarias en Atención Primaria (FIIBAP), Madrid, Spain
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Dantas T, Abreu CMC, De-Castro MJG, Grosso AR, de Sousa Valente J, da Silva Xavier G. 25 de Abril Sempre! Portuguese Science and the 50th anniversary of the Carnation Revolution. Commun Biol 2024; 7:537. [PMID: 38714771 PMCID: PMC11076588 DOI: 10.1038/s42003-024-06229-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2024] Open
Affiliation(s)
- Tiago Dantas
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; IBMC-Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Carla M C Abreu
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; IBMC-Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Maria J G De-Castro
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; IBMC-Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Ana Rita Grosso
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal
- UCIBIO-Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal
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Pena R, Lopes P, Gaspar G, Miranda A, Faustino P. Ancestry of the major long-range regulatory site of the α-globin genes in the Portuguese population with the common 3.7 kb α-thalassemia deletion. Mol Biol Rep 2024; 51:612. [PMID: 38704770 PMCID: PMC11070386 DOI: 10.1007/s11033-024-09530-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/05/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND The α-Major Regulatory Element (α-MRE), also known as HS-40, is located upstream of the α-globin gene cluster and has a crucial role in the long-range regulation of the α-globin gene expression. This enhancer is polymorphic and several haplotypes were identified in different populations, with haplotype D almost exclusively found in African populations. The purpose of this research was to identify the HS-40 haplotype associated with the 3.7 kb α-thalassemia deletion (-α3.7del) in the Portuguese population, and determine its ancestry and influence on patients' hematological phenotype. METHODS AND RESULTS We selected 111 Portuguese individuals previously analyzed by Gap-PCR to detect the presence of the -α3.7del: 50 without the -α3.7del, 34 heterozygous and 27 homozygous for the -α3.7del. The HS-40 region was amplified by PCR followed by Sanger sequencing. Four HS-40 haplotypes were found (A to D). The distribution of HS-40 haplotypes and genotypes are significantly different between individuals with and without the -α3.7del, being haplotype D and genotype AD the most prevalent in patients with this deletion in homozygosity. Furthermore, multiple correspondence analysis revealed that individuals without the -α3.7del are grouped with other European populations, while samples with the -α3.7del are separated from these and found more closely related to the African population. CONCLUSION This study revealed for the first time an association of the HS-40 haplotype D with the -α3.7del in the Portuguese population, and its likely African ancestry. These results may have clinical importance as in vitro analysis of haplotype D showed a decrease in its enhancer activity on α-globin gene.
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Affiliation(s)
- Rita Pena
- Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida Padre Cruz, Lisboa, 1649-016, Portugal
| | - Pedro Lopes
- Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida Padre Cruz, Lisboa, 1649-016, Portugal
| | - Gisela Gaspar
- Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Armandina Miranda
- Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Paula Faustino
- Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida Padre Cruz, Lisboa, 1649-016, Portugal.
- Grupo Ecogenética e Saúde Humana, Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisboa, Portugal.
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
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Milinovic J, Santos P, Sant'Ovaia H, Futuro A, Pereira CM, Murton BJ, Flores D, Azenha M. Multivariate analysis applied to X-ray fluorescence to assess soil contamination pathways: case studies of mass magnetic susceptibility in soils near abandoned coal and W/Sn mines. Environ Geochem Health 2024; 46:202. [PMID: 38696051 PMCID: PMC11065930 DOI: 10.1007/s10653-024-01988-3] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/06/2024] [Indexed: 05/05/2024]
Abstract
Determining the origin and pathways of contaminants in the natural environment is key to informing any mitigation process. The mass magnetic susceptibility of soils allows a rapid method to measure the concentration of magnetic minerals, derived from anthropogenic activities such as mining or industrial processes, i.e., smelting metals (technogenic origin), or from the local bedrock (of geogenic origin). This is especially effective when combined with rapid geochemical analyses of soils. The use of multivariate analysis (MVA) elucidates complex multiple-component relationships between soil geochemistry and magnetic susceptibility. In the case of soil mining sites, X-ray fluorescence (XRF) spectroscopic data of soils contaminated by mine waste shows statistically significant relationships between magnetic susceptibility and some base metal species (e.g., Fe, Pb, Zn, etc.). Here, we show how qualitative and quantitative MVA methodologies can be used to assess soil contamination pathways using mass magnetic susceptibility and XRF spectra of soils near abandoned coal and W/Sn mines (NW Portugal). Principal component analysis (PCA) showed how the first two primary components (PC-1 + PC-2) explained 94% of the sample variability, grouped them according to their geochemistry and magnetic susceptibility in to geogenic and technogenic groups. Regression analyses showed a strong positive correlation (R2 > 0.95) between soil geochemistry and magnetic properties at the local scale. These parameters provided an insight into the multi-element variables that control magnetic susceptibility and indicated the possibility of efficient assessment of potentially contaminated sites through mass-specific soil magnetism.
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Affiliation(s)
- Jelena Milinovic
- Chemistry and Biochemistry Department, Faculty of Sciences, CIQ‑UP, Institute of Molecular Sciences (IMS), University of Porto, Rua do Campo Alegre s/n, 4169‑007, Porto, Portugal.
| | - Patrícia Santos
- Institute of Earth Sciences, Pole of University of Porto, 4169-007, Porto, Portugal
- Department of Geosciences, Environment and Spatial Planning FCUP, University of Porto, 4169-007, Porto, Portugal
| | - Helena Sant'Ovaia
- Institute of Earth Sciences, Pole of University of Porto, 4169-007, Porto, Portugal
- Department of Geosciences, Environment and Spatial Planning FCUP, University of Porto, 4169-007, Porto, Portugal
| | - Aurora Futuro
- CERENA, Faculdade de Engenharia da Universidade do Porto, Rua Dr Roberto Frias s/n, 4200-465, Porto, Portugal
| | - Carlos M Pereira
- Chemistry and Biochemistry Department, Faculty of Sciences, CIQ‑UP, Institute of Molecular Sciences (IMS), University of Porto, Rua do Campo Alegre s/n, 4169‑007, Porto, Portugal
| | - Bramley J Murton
- NOC, National Oceanography Centre, European Way, Southampton, SO14 3ZH, UK
| | - Deolinda Flores
- Institute of Earth Sciences, Pole of University of Porto, 4169-007, Porto, Portugal
- Department of Geosciences, Environment and Spatial Planning FCUP, University of Porto, 4169-007, Porto, Portugal
| | - Manuel Azenha
- Chemistry and Biochemistry Department, Faculty of Sciences, CIQ‑UP, Institute of Molecular Sciences (IMS), University of Porto, Rua do Campo Alegre s/n, 4169‑007, Porto, Portugal
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Gonçalves-Pereira M, Marques MJ, F Alves R, Verdelho A, Balsinha C, Alves L, Alves Reis T, Woods B, De Vugt M, Verhey F. Needs for Care, Service Use and Quality of Life in Dementia: 12-Month Follow-Up of the Actifcare Study in Portugal. ACTA MEDICA PORT 2024; 37:355-367. [PMID: 38457746 DOI: 10.20344/amp.20427] [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: 07/21/2023] [Accepted: 11/02/2023] [Indexed: 03/10/2024]
Abstract
INTRODUCTION The intermediate stages of dementia are relatively under-researched, including in Portugal. The Actifcare (ACcess to TImely Formal Care) EU-JPND project studied people with mild-moderate dementia, namely their needs, access to and use of community services (e.g., day centers, home support). In our baseline assessment of the Portuguese Actifcare cohort, the unmet needs of some participants would call for formal support, which was not always accessible or used. We now report the main results of the 12-month follow-up, analyzing changes in needs, service (non)use, quality of life and related variables. METHODS This was a longitudinal, observational study using a convenience sample of 54 dyads of people with dementia and their family carers. Our main outcomes were the Camberwell Assessment of Need for the Elderly (CANE) and the Resources Utilization in Dementia. Clinical-functional, quality of life, psychological distress and caregiving-related assessments were also used. RESULTS At follow-up, the cognitive and functional status of people with dementia declined (p < 0.001), and their neuropsychiatric symptoms increased (p = 0.033). Considering CANE interviewers' ratings, the total needs of people with dementia increased at follow-up (p < 0.001) but not the unmet needs. Quality of life was overall stable. The use of formal care did not increase significantly, but informal care did in some domains. Carers' depressive symptoms increased (p = 0.030) and perseverance time decreased (p = 0.045). However, carers' psychological distress unmet needs were lower (p = 0.007), and their stress and quality of life remained stable. CONCLUSION People with dementia displayed complex biopsychosocial unmet needs. Their cognitive-functional decline over one year was not accompanied by a corresponding increase in any pattern of unmet need, nor of service use. Reliance on informal care (namely supervision) may have contributed to this. Caregiving-related outcomes evolved according to different trends, although stability was almost the rule. Primary carers were even more present at follow-up, without an apparently heavier toll on their own needs, burden, and quality of life. Overall, this longitudinal study comprehensively assessed Portuguese community-dwelling people with dementia. Despite the lack of generalizability, participants' needs remained overall stable and partly unmet over one year. Longer follow-up periods are needed to understand such complex processes.
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Affiliation(s)
- Manuel Gonçalves-Pereira
- Faculdade de Ciências Médicas | NOVA Medical School. Universidade NOVA de Lisboa. Lisbon; Comprehensive Health Research Center (CHRC). Laboratório Associado REAL. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Maria J Marques
- Comprehensive Health Research Center (CHRC). Laboratório Associado REAL. Universidade NOVA de Lisboa. Lisbon; NOVA School of Public Health. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Regina F Alves
- NOVA School of Public Health. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Ana Verdelho
- Faculdade de Medicina da Universidade de Lisboa. Centro Hospitalar Universitário Lisboa Norte. Instituto de Saúde Ambiental. Lisbon. Portugal
| | - Conceição Balsinha
- Faculdade de Ciências Médicas | NOVA Medical School. Universidade NOVA de Lisboa. Lisbon; Comprehensive Health Research Center (CHRC). Laboratório Associado REAL. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Luísa Alves
- Faculdade de Ciências Médicas | NOVA Medical School. Universidade NOVA de Lisboa. Lisbon; Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisbon. Portugal
| | - Teresa Alves Reis
- Comprehensive Health Research Center (CHRC). Laboratório Associado REAL. Universidade NOVA de Lisboa. Lisbon; Hospital do Espírito Santo. Portugal
| | - Bob Woods
- Dementia Services Development Centre Wales. Bangor University. Bangor
| | | | - Frans Verhey
- Alzheimer Centrum Limburg. Maastricht University. Maastricht
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Azevedo J, Carreiras D, Guiomar R, Martins MJ, Macedo A, Castilho P. Validation of the Bipolar Recovery Questionnaire for the Portuguese Population: Recovery and Predictors in People with Bipolar Disorder. ACTA MEDICA PORT 2024; 37:368-378. [PMID: 38621253 DOI: 10.20344/amp.20790] [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: 10/09/2023] [Accepted: 03/11/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION The paradigm in mental health care is progressively moving towards a recovery-focused perspective. Thus, there is a need for validated instruments to measure recovery in bipolar disorder (BD). The Bipolar Recovery Questionnaire (BRQ) is the most used instrument to assess it. The aim of this study was to translate and perform a cross-cultural adaptation of the BRQ to European Portuguese (PT-PT) and to explore further associations of recovery with sociodemographic and emotional regulation, as well as recovery predictors to inform future research and clinical practice. METHODS The BRQ was forward-translated and back-translated until a consensus version was found, and a test-retest design was used to assess temporal stability. Participants were recruited in public hospitals and organizations supporting people with BD, either referred by their psychiatrists or psychologists or through self-referral. Eighty-eight individuals diagnosed with BD were recruited to complete a battery of Portuguese-validated self-report questionnaires to assess recovery (BRQ), clinical mood symptoms (Hospital Anxiety and Depression Scale), affect (Positive and Negative Affect Scale), well-being (brief Quality of Life for Bipolar Disorder; Satisfaction with Life Scale) and emotion regulation (Difficulties in Emotion Regulation Scale). RESULTS The BRQ showed excellent internal consistency with a Cronbach alpha of 0.92, and test-retest exhibited good reliability (r = 0.88). Construct validity was confirmed through/by positive and moderate correlations with quality of life (QoL; r = 0.58) and positive affect (r = 0.52), and negative moderate correlations with depression (r = -0.64), and negative affect (r = -0.55). Both satisfaction with life (β = 0.38, p = 0.010) and recovery (β = 0.34, p = 0.022) impacted quality of life, supporting the BRQ's incremental validity. Depressive symptoms and emotion dysregulation accounted for 51% of its variance. CONCLUSION The BRQ is a valid and reliable instrument to measure recovery in people with BD in the Portuguese population and is suitable for both clinical and research contexts.
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Affiliation(s)
- Julieta Azevedo
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra; Institute of Psychological Medicine (IPM). Faculdade de Medicina. Universidade de Coimbra. Coimbra; School of Psychology and Sport Science. Bangor University. Bangor. United Kingdom
| | - Diogo Carreiras
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra; Instituto Superior Miguel Torga. Coimbra. Portugal
| | - Raquel Guiomar
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra. Portugal
| | - Maria João Martins
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra; Institute of Psychological Medicine (IPM). Faculdade de Medicina. Universidade de Coimbra. Coimbra; Serviços Médicos Universitários. Universidade de Coimbra. Coimbra. Portugal
| | - António Macedo
- Institute of Psychological Medicine (IPM). Faculdade de Medicina. Universidade de Coimbra. Coimbra; Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT). Coimbra; Centro Hospitalar e Universitário de Coimbra (CHUC). Coimbra. Portugal
| | - Paula Castilho
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra. Portugal
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Alves N, Rocha G, Flor-de-Lima F, Rosário M, Pissarra S, Mateus M, Azevedo I, Soares H. Neonatal Resuscitation Practices in Portuguese Delivery Rooms: A Cross-Sectional Study. ACTA MEDICA PORT 2024; 37:342-354. [PMID: 38744237 DOI: 10.20344/amp.20009] [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: 04/06/2023] [Accepted: 09/11/2023] [Indexed: 05/16/2024]
Abstract
INTRODUCTION Data from previous studies have demonstrated inconsistency between current evidence and delivery room resuscitation practices in developed countries. The primary aim of this study was to assess the quality of newborn healthcare and resuscitation practices in Portuguese delivery rooms, comparing current practices with the 2021 European Resuscitation Council guidelines. The secondary aim was to compare the consistency of practices between tertiary and non-tertiary centers across Portugal. METHODS An 87-question survey concerning neonatal care was sent to all physicians registered with the Portuguese Neonatal Society via email. In order to compare practices between centers, participants were divided into two groups: Group A (level III and level IIb centers) and Group B (level IIa and I centers). A descriptive analysis of variables was performed in order to compare the two groups. RESULTS In total, 130 physicians responded to the survey. Group A included 91 (70%) and Group B 39 (30%) respondents. More than 80% of participants reported the presence of a healthcare professional with basic newborn resuscitation training in all deliveries, essential equipment in the delivery room, such as a resuscitator with a light and heat source, a pulse oximeter, and an O2 blender, and performing delayed cord clamping for all neonates born without complications. Less than 60% reported performing team briefing before deliveries, the presence of electrocardiogram sensors, end-tidal CO2 detector, and continuous positive airway pressure in the delivery room, and monitoring the neonate's temperature. Major differences between groups were found regarding staff attending deliveries, education, equipment, thermal control, umbilical cord management, vital signs monitoring, prophylactic surfactant administration, and the neonate's transportation out of the delivery room. CONCLUSION Overall, adherence to neonatal resuscitation international guidelines was high among Portuguese physicians. However, differences between guidelines and current practices, as well as between centers with different levels of care, were identified. Areas for improvement include team briefing, ethics, education, available equipment in delivery rooms, temperature control, and airway management. The authors emphasize the importance of continuous education to ensure compliance with the most recent guidelines and ultimately improve neonatal health outcomes.
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Affiliation(s)
- Natacha Alves
- Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Gustavo Rocha
- Serviço de Neonatologia. Centro Hospitalar e Universitário de São João. Porto. Portugal
| | - Filipa Flor-de-Lima
- Serviço de Neonatologia. Centro Hospitalar e Universitário de São João. Porto; Departamento de Ginecologia-Obstetrícia e Pediatria. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Marta Rosário
- Serviço de Neonatologia. Centro Hospitalar e Universitário de São João. Porto; Departamento de Ginecologia-Obstetrícia e Pediatria. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Susana Pissarra
- Serviço de Neonatologia. Centro Hospitalar e Universitário de São João. Porto. Portugal
| | - Mário Mateus
- Serviço de Neonatologia. Centro Hospitalar e Universitário de São João. Porto. Portugal
| | - Inês Azevedo
- Departamento de Ginecologia-Obstetrícia e Pediatria. Faculdade de Medicina. Universidade do Porto. Porto; Serviço de Pediatria. Centro Hospitalar e Universitário de São João. Porto. Portugal
| | - Henrique Soares
- Serviço de Neonatologia. Centro Hospitalar e Universitário de São João. Porto; Departamento de Ginecologia-Obstetrícia e Pediatria. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
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21
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Woo K, Coca P, Moura A, Woodmansey E, Styche T, Polignano R. Improving wound infection management: education and evaluation of an infection management pathway. J Wound Care 2024; 33:290-296. [PMID: 38683781 DOI: 10.12968/jowc.2024.33.5.290] [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] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To assess the clinical impact and acceptance of an infection management (IM) pathway, designed to improve the consistency of care of wound infection when introduced, and supported by an educational programme. METHOD An education and evaluation programme (T3 programme) was-conducted in Portugal, Spain and Italy. This consisted of a two-hour educational, virtual seminar, followed by a four-week evaluation of an IM pathway during which survey data were collected on the impact of this pathway on clinician-selected patients. Finally, all participants reconvened for a virtual meeting during which the combined results were disseminated. The pathway provided guidance to clinicians regarding the targeted use of antimicrobial wound dressings according to the presence and absence of signs and symptoms of wound infection. RESULTS Responses relating to 259 patients treated according to the IM pathway, 139 (53.7%) of whom had received previous antimicrobial treatment, were captured. Signs and symptoms of infection resolved within four weeks of treatment in >90% of patients. All 25 patients who had received prior antimicrobial treatment for ≥3 months experienced a resolution in the signs and symptoms of infection within four weeks. The majority of participating clinicians agreed that the IM pathway improved decision-making (94.9%) and confidence (97.3%), and helped to determine the correct antimicrobial treatment (91.4%) in the context of wound infection. CONCLUSION The T3 programme was an efficient way to deliver a structured educational programme. The use of the IM pathway resulted in >90% of patients achieving resolution of their signs and symptoms of wound infection.
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Affiliation(s)
- Kevin Woo
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Pere Coca
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Anabela Moura
- Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
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22
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Pulido Valente F, Cunha H. [To Do More and Better Regarding Portugal's Alcohol Consumption, a Social Change Is Needed]. ACTA MEDICA PORT 2024; 37:395. [PMID: 38537647 DOI: 10.20344/amp.21100] [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: 12/14/2023] [Accepted: 02/22/2024] [Indexed: 05/16/2024]
Affiliation(s)
| | - Hilson Cunha
- Departamento de Medicina. Faculdade de Ciências da Saúde. Universidade da Beira Interior. Covilhã. Portugal
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23
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Roque Reis LS, Gani K, André, Peres C, Nunes G, Santos R, O'Neill A, Escada P. [Adaptation and Validation for European Portuguese of the Auditory Performance Categories-II and Infant-Toddler Meaningful Auditory Integration Scale for Children with Cochlear Implant]. ACTA MEDICA PORT 2024; 37:334-341. [PMID: 38498908 DOI: 10.20344/amp.20169] [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: 05/15/2023] [Accepted: 09/07/2023] [Indexed: 03/20/2024]
Abstract
INTRODUCTION The Categories of Auditory Performance II (CAP-II) scale and the Infant-Toddler Meaningful Audit Integration Scale (IT-MAIS) are simple and quick questionnaires that allow assessment of the auditory performance of children with cochlear implant (CI). The aim of this study was to translate, adapt and validate the European Portuguese version of the CAP-II and IT-MAIS scales. METHODS A total of 85 participants completed the European Portuguese version of the CAP-II and IT-MAIS questionnaires, of which 45 were parents of children with pediatric cochlear implants (9.84 ± 4.22 years) and another 40 were parents of children with normal hearing (8.35 ± 3.56 years). Inter-rater reproducibility, test-retest reproducibility, comparison of study group versus control group results, internal consistency and correlation of the new scales were evaluated. RESULTS The CAP-II and IT-MAIS scales showed high reliability and reproducibility, respectively, with an intraclass correlation coefficient (ICC) of 0.979 (p < 0.001) and a Spearman's correlation of 0.924 for the CAP-II scale, and an ICC of 0.932 (p < 0.001) and Spearman's correlation coefficient of 0.732 for the IT-MAIS scale. The IT-MAIS and CAP-II versions showed strong internal consistency (Cronbach's α coefficient value of 0.887 for the CAP-II scale and Spearman's positive correlation of 0.677 for the IT-MAIS scale, respectively) and allowed for the differentiation between children with normal hearing and post-implantation children (p = 0.001 and p < 0.001 respectively for each of the scales). There was no association between parental education and the results on the scales (p > 0.05). CONCLUSION The findings demonstrated that the European Portuguese version of these scales is a valid and reliable tool for assessing auditory performance in European Portuguese-speaking children with hearing loss.
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Affiliation(s)
- Luí S Roque Reis
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Kaamil Gani
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - André
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Carlota Peres
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa. Portugal
| | - Gonçalo Nunes
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa. Portugal
| | - Ricardo Santos
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Assunção O'Neill
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Pedro Escada
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
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Fronteira I, Schaltz-Buchholzer F, Stabell Benn C, Ferrinho P, Barros H. Using Large Cohort Data to Strengthen Information-Based Public Health Policies: An Appeal to Portuguese Authorities. ACTA MEDICA PORT 2024; 37:409-410. [PMID: 38744234 DOI: 10.20344/amp.21329] [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: 02/10/2024] [Accepted: 03/21/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Inês Fronteira
- Comprehensive Health Research Centre (CHRC). NOVA Medical School. Universidade NOVA de Lisboa. Lisbon; Associação Portuguesa de Epidemiologia. Porto. Portugal
| | - Frederik Schaltz-Buchholzer
- Odense Patient data Explorative Network (OPEN). Bandim Health Project. Institute of Clinical Research. Odense University Hospital/University of Southern Denmark. Odense. Denmark
| | - Christine Stabell Benn
- Odense Patient data Explorative Network (OPEN). Bandim Health Project. Institute of Clinical Research. Odense University Hospital/University of Southern Denmark. Odense; Danish Institute for Advanced Study. University of Southern Denmark. Odense. Denmark
| | - Paulo Ferrinho
- Associação Portuguesa de Epidemiologia. Porto; Global Health and Tropical Medicine. Instituto de Higiene e Medicina. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Henrique Barros
- Epidemiology Research Unit (EPIUnit). Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
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25
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Vicente F. [The Respect for the Decision-making Capacity of Patients Treated Involuntarily Under the New Mental Health Law]. ACTA MEDICA PORT 2024; 37:402. [PMID: 38744238 DOI: 10.20344/amp.21352] [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: 02/07/2024] [Accepted: 03/04/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Filipe Vicente
- Serviço de Psiquiatria e Saúde Mental. Hospital Garcia de Orta. Unidade Local de Saúde de Almada-Seixal, EPE. Almada. Portugal
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26
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Vera J, Gomes A, Póvoas D, Seixas D, Maltez F, Pedroto I, Maia L, Mota M, Vieira MJ, Manata MJ, Ferreira P, Lino S, Pereira Guedes T, Barradas V, Marques N. Real-World Effectiveness and Safety of Glecaprevir/Pibrentasvir for the Treatment of Chronic Hepatitis C: A Prospective Cohort Study in Portugal. ACTA MEDICA PORT 2024; 37:323-333. [PMID: 38325411 DOI: 10.20344/amp.19178] [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: 12/22/2022] [Accepted: 06/02/2023] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Information about pan-genotypic treatments for hepatitis in Portugal is scarce. We aimed to evaluate the effectiveness and safety of glecaprevir plus pibrentasvir (GLE/PIB) treatment for hepatitis C virus (HCV) infection in real-world clinical practice. METHODS An observational prospective study was implemented in six hospitals with 121 adult HCV patients who initiated treatment with GLE/PIB between October 2018 and April 2019, according to clinical practice. Eligible patients had confirmed HCV infection genotype (GT) 1 to 6 and were either treatment-naïve or had experience with interferon-, ribavirin- or sofosbuvir-based regimens, with or without compensated cirrhosis. Baseline sociodemographic and safety data are described for the total population (N = 115). Effectiveness [sustained virologic response 12 weeks after treatment (SVR12)] and patient-reported outcomes are presented for the core population with sufficient follow-up data (n = 97). RESULTS Most patients were male (83.5%), aged < 65 years (94.8%), with current or former alcohol consumption (77.3%), illicit drug use (72.6%), and HCV acquisition through intravenous drug use (62.0%). HIV co-infection occurred in 22.6% of patients. The prevalence of each GT was: GT1 51.3%, GT2 1.7%, GT3 30.4%, GT4 16.5%, and GT5.6 0%. Most patients were non-cirrhotic (80.9%) and treatment-naïve (93.8%). The SVR12 rates were 97.9% (95% CI: 92.8 - 99.4), and > 95% across cirrhosis status, GT, illicit drug use, alcohol consumption, and HCV treatment experience. The adverse event rate was 2.6%, and no patient discontinued treatment due to adverse events related to GLE/PIB. CONCLUSION Consistent with other real-world studies and clinical trials, treatment with GLE/PIB showed high effectiveness and tolerability overall and in difficult-to-treat subgroups (ClinicalTrials.gov: NCT03303599).
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Affiliation(s)
- José Vera
- Centro Hospitalar Barreiro-Montijo. Barreiro. Portugal
| | | | - Diana Póvoas
- Centro Hospitalar Lisboa Central. Lisboa. Portugal
| | - Diana Seixas
- Centro Hospitalar Lisboa Central. Lisboa. Portugal
| | | | | | - Luís Maia
- Centro Hospitalar Universitário Porto. Porto. Portugal
| | - Margarida Mota
- Centro Hospitalar Vila Nova de Gaia/Espinho. Vila Nova de Gaia. Portugal
| | | | | | | | - Sara Lino
- Centro Hospitalar Lisboa Central. Lisboa. Portugal
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27
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Margato R. Catheter ablation of atrial fibrillation in Portugal: Where do we stand? Rev Port Cardiol 2024; 43:255-257. [PMID: 38145649 DOI: 10.1016/j.repc.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 12/27/2023] Open
Affiliation(s)
- Renato Margato
- Serviço de Cardiologia do Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal.
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Guisantes R, Santos J, Ferreira AJ. Characterisation of Portuguese radiotherapy departments: Organisation, occupational exposure values and diagnostic reference levels for breast and prostate computed tomography planning. Radiography (Lond) 2024; 30:932-937. [PMID: 38657386 DOI: 10.1016/j.radi.2024.04.007] [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: 11/15/2023] [Revised: 03/25/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Portugal currently hosts 24 active radiotherapy departments, 8 public and 16 privates, presenting potential radiation exposure risks to multidisciplinary teams. Patients in these treatments also face ionising radiation during treatment planning and verification. METHODS Authorisation and ethical approval were secured for a national online survey, disseminated to radiotherapy departments across Portugal. The survey encompassed three sections: equipment, staff, and radiographer role characterisation; occupational exposure values for one month; and exposure parameters, including computed tomography (CT) dose values [CT dose index (CTDIvol) and dose length product (DLP)] for breast and prostate cancer CT planning. Local Diagnostic Reference Levels (DRLs) derived were based on the 75th percentile of median dose values. RESULTS The study garnered a 50% response rate from public institutions, 12,5% from private and 25% from all active radiotherapy institutions in Portugal. All departments employ Three-Dimensional Conformal Radiation Therapy (3D-CRT) and incorporate Intensity Modulated Radiation Therapy (IMRT) and/or Volumetric Modulated Arc Therapy (VMAT) irradiation techniques. Additionally, half of the departments also perform Brachytherapy (BT). Radiographers demonstrated an occupational dose of zero mSv. CT planning dose values were 13 mGy and 512 mGy cm for breast CT and 16 mGy and 689 mGy cm for prostate CT, pertaining to CTDIvol and DLP, respectively. CONCLUSION Most aspects of national radiotherapy characterisation align with the established literature. Occupational exposure values exhibited consistency across radiotherapy modalities. An approach to national DRLs was formulated for breast and prostate CT planning, yielding values congruent with recent European studies. IMPLICATIONS FOR PRACTICE This study offers vital insights for analysing occupational contexts and risk prevention, serving as the initial characterisation of the national radiotherapy landscape. It also pioneers the calculation of DRLs for CT planning in radiotherapy to optimise procedures.
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Affiliation(s)
- R Guisantes
- Unidade Local de Saúde de Coimbra, Radiotherapy Department, Praceta Mota Pinto, 3000-075, Coimbra, Portugal.
| | - J Santos
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854, Coimbra, Portugal.
| | - A J Ferreira
- Faculty of Medicine, University of Coimbra, Portugal.
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Svavarsdottir EK, Lemos S, Andrade L, Barbieri-Figueiredo MDC, Tryggvadottir GB, Lima L. Psychometric Testing of the Experience of Integrating Chronic Illness into Family Life Questionnaire. J Fam Nurs 2024; 30:174-184. [PMID: 38528681 DOI: 10.1177/10748407241236010] [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: 03/27/2024]
Abstract
Family members' experience of integrating chronic illnesses or chronic conditions into family life is valuable information for health care professionals, such as nurses, to understand, improve, and adjust the care provided to families of chronically ill patients. Furthermore, the assessment of the experience of integrating chronic illness into family life can support family nursing interventions and reduce suffering. This study aimed to adapt and psychometrically test a new Likert-type questionnaire on the experience of integrating pediatric chronic illness into family life (EICI-FLQ) in two European samples. A sample of 164 primary caregivers of children/adolescents with chronic illnesses/conditions in Iceland and another sample of 237 primary caregivers with children/adolescents with chronic illnesses/conditions in Portugal completed the online questionnaire. Exploratory factor analysis of the Icelandic sample yielded support for a one-factor solution with acceptable internal reliability (Cronbach's α = .866). Confirmatory factor analysis of the one-factor structure in the Portuguese sample indicated good model fit and similar internal reliability (Cronbach's α = .838). This instrument has good psychometric characteristics and is a promising tool for measuring the experience of integrating pediatric chronic illness into family life in clinical and research settings.
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Affiliation(s)
| | - Sara Lemos
- University of Porto Institute of Biomedical Sciences Abel Salazar, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Luísa Andrade
- Nursing School of Porto, Portugal
- Center for Health Technology and Services Research at the Health, Research Network (CINTESIS@RISE), Porto, Portugal
| | - Maria Do Céu Barbieri-Figueiredo
- University of Porto Institute of Biomedical Sciences Abel Salazar, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Nursing School of Porto, Portugal
- University of Huelva, Spain
| | | | - Lígia Lima
- Center for Health Technology and Services Research at the Health, Research Network (CINTESIS@RISE), Porto, Portugal
- Nursing School of Porto, Portugal
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Machado H, de Freitas C, Fiske A, Radhuber I, Silva S, Grimaldo-Rodríguez CO, Botrugno C, Kinner R, Marelli L. Performing publics of science in the COVID-19 pandemic: A qualitative study in Austria, Bolivia, Germany, Italy, Mexico, and Portugal. Public Underst Sci 2024; 33:466-482. [PMID: 38305243 PMCID: PMC11056084 DOI: 10.1177/09636625231220219] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Research about science and publics in the COVID-19 pandemic often focuses on public trust and on identifying and correcting public attitudes. Drawing on qualitative interviews with 209 residents in six countries-Austria, Bolivia, Germany, Italy, Mexico, and Portugal-this article uses the concept of performativity to explore how participants understand, and relate to science, in the COVID-19 context. By performativity, we mean the ways by which participants understand themselves as particular sorts of publics through identification with, and differentiation from, various other actors in matters that are perceived as controversies surrounding science: COVID-19 vaccination, media communication of science, and the interactions between governments and scientists. The criteria used to construct the similarities and differences among publics were heterogeneous and fluid, showing how epistemic beliefs about the nature of, and trust in, scientific knowledge are intermingled with social and cultural memberships embedded in specific contexts and across disparate places.
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Affiliation(s)
- Helena Machado
- Department of Sociology, Institute for Social Sciences, University of Minho, Portugal
| | - Cláudia de Freitas
- Laboratory for Integrative and Translational Research in Population Health, (ITR); EPIUnit - Institute of Public Health, University of Porto, Portugal
| | - Amelia Fiske
- Institute of History and Ethics in Medicine, TUM School of Medicine, Technical University of Munich, Germany
| | | | - Susana Silva
- Department of Sociology, Institute for Social Sciences, University of Minho, Portugal; Centre for Research in Anthropology (CRIA-UMinho), Portugal
| | | | - Carlo Botrugno
- Research Unit on Everyday Bioethics and Ethics of Science, Department of Legal Sciences, University of Florence, Italy; European Institute of Oncology (IEO), Italy
| | - Ralph Kinner
- Department of Development Studies, University of Vienna, Austria
| | - Luca Marelli
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Italy; Life Sciences & Society Lab, Centre for Sociological Research, KU Leuven, Belgium
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Carvalho T, Sousa-Mendes A, Benedito L, Gomes C, da Motta C. A Self-Reported Study on Explanatory Variables of Stress in Multiple Sclerosis Patients: Exploring the Effect of Physical Conditions and Emotion Regulation Processes. Clin Psychol Psychother 2024; 31:e2992. [PMID: 38706169 DOI: 10.1002/cpp.2992] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Multiple sclerosis (MS)-linked stress is frequent, multidetermined and facilitates the onset/exacerbation of MS. However, few explanatory models of stress analysed the joint explanatory effect of emotion regulation and clinical outcomes of MS in those patients. OBJECTIVE This study explored whether self-reported MS-related conditions (number of relapses, fatigue and global disability) and specific emotion regulation processes (experiential avoidance and self-compassion) explain stress symptoms in MS patients. METHODS The MS sample comprised 101 patients with MS diagnosis receiving treatment in hospitals and recruited through the Portuguese MS Society. The no-MS sample included 134 age-, sex- and years of education-matched adults without MS recruited from the general Portuguese population. Both samples did not report other neurological disorders. Data were collected using self-response measures. RESULTS All potential explanatory variables differed significantly between samples, with higher scores found in MS patients. In MS clinical sample, those variables and years of education correlated with stress symptoms and predicted stress symptoms in simple linear regression models. These results allowed their selection as covariates in a multiple linear regression model. Years of education, the number of relapses, fatigue and experiential avoidance significantly predicted 51% of stress symptoms' total variance. CONCLUSIONS This study provides preliminary evidence on the importance of clinicians and researchers considering the simultaneous contribution of years of education, the number of perceived relapses, fatigue and experiential avoidance as factors that can increase vulnerability to stress in MS patients. Psychological intervention programmes that tackle these factors and associated stress symptomatology should be implemented.
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Affiliation(s)
- Teresa Carvalho
- Instituto Superior Miguel Torga, Coimbra, Portugal
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | | | | | | | - Carolina da Motta
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
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Ribeiro-Almeida M, Mourão J, Magalhães M, Freitas AR, Novais C, Peixe L, Antunes P. Raw meat-based diet for pets: a neglected source of human exposure to Salmonella and pathogenic Escherichia coli clones carrying mcr, Portugal, September 2019 to January 2020. Euro Surveill 2024; 29:2300561. [PMID: 38699902 PMCID: PMC11067432 DOI: 10.2807/1560-7917.es.2024.29.18.2300561] [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: 10/16/2023] [Accepted: 03/04/2024] [Indexed: 05/05/2024] Open
Abstract
BackgroundThe pet industry is expanding worldwide, particularly raw meat-based diets (RMBDs). There are concerns regarding the safety of RMBDs, especially their potential to spread clinically relevant antibiotic-resistant bacteria or zoonotic pathogens.AimWe aimed to investigate whether dog food, including RMBD, commercially available in Portugal can be a source of Salmonella and/or other Enterobacteriaceae strains resistant to last-line antibiotics such as colistin.MethodsFifty-five samples from 25 brands (21 international ones) of various dog food types from 12 suppliers were screened by standard cultural methods between September 2019 and January 2020. Isolates were characterised by phenotypic and genotypic methods, including whole genome sequencing and comparative genomics.ResultsOnly RMBD batches were contaminated, with 10 of 14 containing polyclonal multidrug-resistant (MDR) Escherichia coli and one MDR Salmonella. One turkey-based sample contained MDR Salmonella serotype 1,4,[5],12:i:- ST34/cgST142761 with similarity to human clinical isolates occurring worldwide. This Salmonella exhibited typical antibiotic resistance (bla TEM + strA-strB + sul2 + tet(B)) and metal tolerance profiles (pco + sil + ars) associated with the European epidemic clone. Two samples (turkey/veal) carried globally dispersed MDR E. coli (ST3997-complexST10/cgST95899 and ST297/cgST138377) with colistin resistance (minimum inhibitory concentration: 4 mg/L) and mcr-1 gene on IncX4 plasmids, which were identical to other IncX4 circulating worldwide.ConclusionSome RMBDs from European brands available in Portugal can be a vehicle for clinically relevant MDR Salmonella and pathogenic E. coli clones carrying genes encoding resistance to the last-line antibiotic colistin. Proactive actions within the One Health context, spanning regulatory, pet-food industry and consumer levels, are needed to mitigate these public health risks.
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Affiliation(s)
- Marisa Ribeiro-Almeida
- UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal
| | - Joana Mourão
- UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Mafalda Magalhães
- UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Ana R Freitas
- UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- 1H-TOXRUN, One Health Toxicology Research Unit, University Institute of Health Sciences (CESPU-CRL), Gandra, Portugal
| | - Carla Novais
- UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luísa Peixe
- UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Patrícia Antunes
- UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
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Silva T, Lopes A, Vasconcelos J, Chokhachian A, Wagenfeld M, Santucci D. Thermal stress and comfort assessment in urban areas using Copernicus Climate Change Service Era 5 reanalysis and collected microclimatic data. Int J Biometeorol 2024; 68:949-963. [PMID: 38374295 PMCID: PMC11058791 DOI: 10.1007/s00484-024-02639-z] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/12/2024] [Accepted: 02/12/2024] [Indexed: 02/21/2024]
Abstract
In this initial study of a research project, this paper seeks to understand the thermal conditions in the cities of Lisbon and Munich, specifically focusing on Urban Heat Island intensity and on thermal comfort using the Universal Thermal Climate Index modeling data at the Local Climate Zone scale. Based on these datasets, Munich has exhibited more unfavourable thermal conditions than Lisbon. In terms of UHII, both cities have shown that low, medium, and high rise compact urban areas and bare rock or paved areas have the highest values, while sparsely built areas have the lowest. These results differ from the UTCI, which indicates that in Lisbon and Munich, these sparsely built areas as well as areas with low plants and vegetation are the most uncomfortable. In Munich, the population was exposed to very strong heat stress, while Lisbon experienced strong heat stress conditions. Conversely, low, medium, and high rise compact urban areas and densely wooded areas in Munich, and scattered trees areas and large low-rise urban areas in Lisbon, have demonstrated the lowest monthly mean and average maximum values. These results will be further explored in future studies in the city of Lisbon and cross-checked with data obtained from roving missions. This will enable a more detailed temporal and local analysis.
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Affiliation(s)
- Tiago Silva
- Centre of Geographical Studies (CEG), Institute of Geography and Spatial Planning, University of Lisbon, Rua Branca Edmée Marques, Lisbon, Portugal.
| | - António Lopes
- Centre of Geographical Studies (CEG), Institute of Geography and Spatial Planning, University of Lisbon, Rua Branca Edmée Marques, Lisbon, Portugal
- Associate Laboratory Terra, Coimbra, Portugal
| | - João Vasconcelos
- Centre of Geographical Studies (CEG), Institute of Geography and Spatial Planning, University of Lisbon, Rua Branca Edmée Marques, Lisbon, Portugal
- Associate Laboratory Terra, Coimbra, Portugal
- Instituto Politécnico de Leiria, Leiria, Portugal
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Carmo P, Mesquita D, Cabanelas N, Marinheiro AR, Nunes S, Chambel D, Moscoso Costa F, Sanfins V, Parreira L. Quality indicators in atrial fibrillation ablation (RIQAFA). A national registry from the Portuguese Association of Arrhythmology, Pacing and Electrophysiology (APAPE). Rev Port Cardiol 2024; 43:241-254. [PMID: 38122898 DOI: 10.1016/j.repc.2023.08.007] [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: 03/12/2023] [Revised: 05/30/2023] [Accepted: 08/01/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Atrial fibrillation (AF) is the most common sustained arrhythmia, with significant burden for patients. Catheter ablation is safe and superior for symptom improvement. The purpose of this work was to assess how clinical practice compares with current scientific evidence and quality indicators for AF ablation. METHODS The Portuguese Association of Arrhythmology, Pacing and Electrophysiology conducted a prospective registry among Portuguese centers to assess clinical practice regarding management of patients referred for ablation and the methodology used in the procedures and related outcomes. RESULTS A total of 337 patients were referred for ablation, 102 (37.91%) female, age 65 (56-70.8) years. The median CHADS2-VaSC2 thromboembolic risk score was 2 (1-3), and 308 (92.49%) were on anticoagulants. AF was mainly paroxysmal (224, 66.97%) and symptomatic (mEHRA score 3; 2-3). Before ablation most patients (273, 81.49%) underwent cardiac computed tomography and only 24 (7.36%) procedures were performed with uninterrupted anticoagulation. For ablation, Carto® (194; 59.15%) and Ensite® (55; 16.77%) were mainly used, and the preferential strategy was pulmonary vein isolation (316; 94.61%). Acute complications occurred in five (1.49%) patients, while most had symptom improvement at one month (200; 86.21%), sustained at one year. There were 40 (12.6%) relapses within 30 days and 19 (26.39%) at one year. CONCLUSIONS In a population of patients with AF referred for ablation in Portuguese centers, patient management is provided according to the best scientific evidence and there is a high standard of practice with respect to the quality of AF ablation practice.
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Affiliation(s)
- Pedro Carmo
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental E.P.E., Carnaxide, Portugal; Hospital da Luz, Lisboa, Portugal
| | - Dinis Mesquita
- Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., Setúbal, Portugal.
| | - Nuno Cabanelas
- Hospital Prof. Doutor Fernando Fonseca E.P.E., Amadora, Portugal
| | - Ana Rita Marinheiro
- Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., Setúbal, Portugal
| | | | - Duarte Chambel
- Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., Setúbal, Portugal
| | - Francisco Moscoso Costa
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental E.P.E., Carnaxide, Portugal; National Centre for Data Collection in Cardiology (CNDC), Portugal
| | | | - Leonor Parreira
- Hospital da Luz, Lisboa, Portugal; Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., Setúbal, Portugal
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Coelho C, Fagundes da Silva J, Stilwell G. Suspected intoxication by Kikuyu grass ( Cenchrus clandestinus) of dairy cattle in the Azores, Portugal. N Z Vet J 2024; 72:155-161. [PMID: 38438184 DOI: 10.1080/00480169.2024.2319101] [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: 06/29/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024]
Abstract
CASE HISTORY An outbreak of suspected Kikuyu grass (Cenchrus clandestinus) intoxication among dairy cattle occurred on the island of Terceira in the Azores (Portugal), in October 2022. The animals affected were non-lactating dairy cows and heifers from five small farms grazing (free or tethered) a Kikuyu-dominant pasture. Of the 29 animals exposed, 17 were affected, and eight (five heifers and three adult cows) died, resulting in a morbidity rate of 58%, a mortality rate of 28% and a case mortality rate of 47%. CLINICAL FINDINGS AND TREATMENT The clinical signs were non-specific and inconsistent, and included dry faeces, some with dark red blood; apathy and prostration; abdominal dilatation; tachycardia; tachypnoea; pale or jaundiced mucous membranes; sham drinking; sialorrhoea; and moderate to severe dehydration. Symptomatic treatment was provided but was ineffective. Haematology and serum biochemistry revealed an acute inflammatory leukogram, increased alkaline phosphatase (ALP) activity, decreased gamma-glutamyl transferase (GGT) activity, and azotaemia.The most consistent necropsy findings were haemorrhages in the epicardium and endocardium, an enlarged liver with rounded edges, non-perforated abomasal ulcers, and haemorrhagic lesions in the small and large intestines. Histopathology indicated myocarditis, hepatitis, interstitial nephritis, enteritis and colitis.Several fungal species were isolated from grass samples taken from affected pastures including several Fusarium spp., the genus implicated in Kikuyu toxicosis. Immediate removal of the animals from the pasture with Kikuyu was the only measure that prevented new cases and resulted in the recovery of some of the less affected animals. DIAGNOSIS The epidemiological features of this outbreak and the clinical signs and micro- and macroscopic lesions observed were highly suggestive of Kikuyu grass poisoning. CLINICAL RELEVANCE Although the weather conditions varied from other published cases, the grazing conditions (almost exclusive Kikuyu grass) and the post-mortem findings were very similar to those described in the literature, particularly the haemorrhages in the epicardium and endocardium. Kikuyu grass is very invasive and presents many desirable characteristics as cattle feed. Thus, an increase in cases of intoxication may be expected. Practitioners and farmers in areas where Kikuyu grass is abundant should be aware of the potential risks of grazing cattle exclusively on these pastures. They should also be aware of the early and subtle signs of Kikuyu intoxication to allow for timely removal of the animals from pasture.
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Affiliation(s)
- C Coelho
- Animal Behaviour and Welfare Laboratory, Centre of Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- Secção de Assistência Veterinária, Unicol - Cooperativa Agrícola, CRL, Angra do Heroísmo, Portugal
| | - J Fagundes da Silva
- Secção de Assistência Veterinária, Unicol - Cooperativa Agrícola, CRL, Angra do Heroísmo, Portugal
| | - G Stilwell
- Animal Behaviour and Welfare Laboratory, Centre of Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Faculty of Veterinary Medicine Faculty, University of Lisbon, Lisbon, Portugal
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Seixas S, Parrinha J, Gomes P, Bessa F. Incorporation of abandoned and lost fishing gear into the structure of Dendrophyllia ramea in the Atlantic coast of Portugal. Mar Pollut Bull 2024; 202:116302. [PMID: 38593712 DOI: 10.1016/j.marpolbul.2024.116302] [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] [Received: 10/01/2023] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024]
Abstract
Plastic pollution poses global and societal concerns, especially from discarded fishing gear, threatening seabed environments like coral reefs. This study examines the incorporation of lost and/or abandoned fishing gear - specifically synthetic lines, and filaments - into the structure of orange tree coral, Dendrophyllia ramea along the coast of Portugal, in the North-East Atlantic Ocean. The specimens were inadvertently captured by local fishers (Sines and Cascais), with 6 % showing filaments inside their structure, raising questions about their potential impact on coral health. We discuss the implications of understanding the interactions between plastics, fishing gear, and corals, which is important for developing conservation strategies. We address the need for improved of measures aimed at reducing the impact of fishing gear on corals, emphasizing the importance of endorsing biodegradable fishing materials and supporting lost gear retrieval initiatives. Furthermore, we emphasize the urgent need to communicate these issues to both fishers and stakeholders.
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Affiliation(s)
- Sónia Seixas
- MARE - Marine and Environmental Sciences Centre, ARNET - Aquatic Research Network, Universidade de Coimbra, Portugal; Universidade Aberta, Rua Escola Politécnica, 147, 1269-001 Lisbon, Portugal.
| | - Joaquim Parrinha
- MARE - Marine and Environmental Sciences Centre, ARNET - Aquatic Research Network, Universidade de Coimbra, Portugal; ECOALGA - Agricultura Subaquática Sociedade Unipessoal Lda., Porto Covo, Portugal
| | - Pedro Gomes
- Centre of Molecular and Environmental Biology, ARNET - Aquatic Research Network, Department of Biology, University of Minho, Portugal
| | - Filipa Bessa
- MARE - Marine and Environmental Sciences Centre, ARNET - Aquatic Research Network, Universidade de Coimbra, Portugal
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Ribeiro B. Will Boys Always Be Boys? The Criminalization of Street Harassment in Portugal. Violence Against Women 2024; 30:1431-1452. [PMID: 36659855 PMCID: PMC10998432 DOI: 10.1177/10778012221150276] [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] [Indexed: 01/21/2023]
Abstract
Albeit one of the most pervasive forms of gender violence, street harassment tends to be either not considered a crime or to be faulty criminalized. This investigation contributes to better understand the overall inefficiency of existing laws through an analysis of the criminalization of street harassment in Portugal. Particularly, it searches for obstacles to implementation among those responsible for the process-the street-level bureaucrats of the Portuguese Public Security Police. Through 14 semi-structured interviews, three groups of obstacles to implementation were identified: perceptions of the legislation's content, a masculinist institutional culture, and personal characteristics. These are new findings that contribute to an understanding of the perpetuation of gender violence through state's institutions and workers.
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Affiliation(s)
- Beatriz Ribeiro
- Faculty of Social Sciences and Humanities, Nova University of Lisbon, Lisbon, Portugal
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Santos S, Melo F, Fernandes O, Parraca JA. The effect of Ashtanga-Vinyasa Yoga method on air force pilots' operational performance. Front Public Health 2024; 12:1334880. [PMID: 38751579 PMCID: PMC11094342 DOI: 10.3389/fpubh.2024.1334880] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction In today's military landscape, optimizing performance and bolstering physical health and mental resilience are critical objectives. Introducing a 12-week Ashtanga Vinyasa Yoga Supta Method (AVYSM) to the training protocol of military trained Airforce pilots, we aim to assesses the feasibility and impact of the method. Materials and equipment Borg Scale assesses the intensity level of physical activity during the intervention. Flight simulator data gauges operational performance responses. Postural control responses are measured using a force platform, stress responses are monitored via heart monitor, and handgrip dynamometry will measure strength. Respiratory capacity is assessed using a spirometer, body composition is evaluated using impedance balance, and aviation-related questionnaires are administered before and after the intervention period. Methods In a randomized controlled trial, the totality of pilots from the "Masters in Military Aeronautics: aviator pilot specialist" course at the Portuguese Air Force Academy (PAA) were randomly assigned to the yoga intervention or the waiting list control groups, with participants providing written informed consent. The control group followed protocolized course classes for 12 weeks, while the intervention group integrated two weekly one-hour yoga sessions into their course. Results The PAA has approved the implementation of this intervention protocol at Airbase 11 in Beja, highlighting its significance for the organization's policy makers. We hypothesize that this method will enhance operational performance and, subsequently, elevate flight safety. Discussion This research's potential extends beyond the PAA, as it can be adapted for use in Airforce departments of other nations and various military contexts. Clinical trial registration Évora University research ethics committee-approval number 21050. Study registered on ClinicalTrials.gov under identifier NCT05821270, registered on April 19, 2023.
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Affiliation(s)
- Sara Santos
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | - Filipe Melo
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
- Universidade de Lisboa Faculdade de Motricidade Humana: Cruz Quebrada, Lisboa, Portugal
| | - Orlando Fernandes
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | - José Alberto Parraca
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
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Pinto AI, Caldas C, Santarém N, Luelmo S, Costa I, Martins C, Monteiro R, Conde S, Tavares R, da Silva AC. Leishmania and HIV co-infection: first naturally Leishmania strain presenting decreased susceptibility to miltefosine, recovered from a patient in Portugal. J Infect Public Health 2024; 17:810-818. [PMID: 38522155 DOI: 10.1016/j.jiph.2024.03.008] [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: 11/18/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND In Europe, up to 70% of visceral leishmaniasis (VL) cases occurring in adults living with HIV. People living with HIV with VL co-infection often display persistent parasitemia, requiring chronic intermittent anti-Leishmania therapies. Consequently, frequent VL relapses and higher mortality rates are common in these individuals. As such, it is of paramount importance to understand the reasons for parasite persistence to improve infection management. METHODS To outline possible causes for treatment failure in the context of HIV-VL, we followed a person living with HIV-VL co-infection for nine years in a 12-month period. We characterized: HIV-related clinicopathological alterations (CD4+ T counts and viremia) and Leishmania-specific seroreactivity, parasitemia, quantification of pro-inflammatory cytokines upon stimulation and studied a Leishmania clinical isolate recovered during this period. RESULTS The subject presented controlled viremia and low CD4+ counts. The subject remained PCR positive for Leishmania and also seropositive. The cellular response to parasite antigens was erratic. The isolate was identified as the first Leishmania infantum case with evidence of decreased miltefosine susceptibility in Portugal. CONCLUSION Treatment failure is a multifactorial process driven by host and parasite determinants. Still, the real-time determination of drug susceptibility profiles in clinical isolates is an unexplored resource in the monitoring of VL.
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Affiliation(s)
- Ana Isabel Pinto
- Host-Parasite Interaction Group, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, i3S, 4200-135 Oporto, Portugal.
| | - Cátia Caldas
- Infectious Disease Department, Centro Hospitalar e Universitário de São João, Faculdade de Medicina da Universidade do Porto, 4200-319 Oporto, Portugal
| | - Nuno Santarém
- Host-Parasite Interaction Group, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, i3S, 4200-135 Oporto, Portugal
| | - Sara Luelmo
- Host-Parasite Interaction Group, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, i3S, 4200-135 Oporto, Portugal
| | - Inês Costa
- Host-Parasite Interaction Group, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, i3S, 4200-135 Oporto, Portugal; Microbiology Department, Faculdade de Farmácia, Universidade do Porto, 4050-313 Oporto, Portugal
| | - Carlos Martins
- Host-Parasite Interaction Group, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, i3S, 4200-135 Oporto, Portugal
| | - Ricardo Monteiro
- Host-Parasite Interaction Group, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, i3S, 4200-135 Oporto, Portugal; Microbiology Department, Faculdade de Farmácia, Universidade do Porto, 4050-313 Oporto, Portugal
| | - Sílvia Conde
- Clinical Pathology Department, Centro Hospitalar e Universitário de São João, Faculdade de Medicina da Universidade do Porto, 4200-319 Oporto, Portugal
| | - Raquel Tavares
- Infectious Disease Department, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal
| | - Anabela Cordeiro da Silva
- Host-Parasite Interaction Group, Instituto de Investigação e Inovação em Saúde da Universidade do Porto, i3S, 4200-135 Oporto, Portugal; Microbiology Department, Faculdade de Farmácia, Universidade do Porto, 4050-313 Oporto, Portugal
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Silva-Cardoso J, Santos J, Araújo I, Andrade A, Morais Sarmento P, Santos P, Moura B, Marques I, Peres M, Ferreira JP, Agostinho J, Pimenta J. conTemporary reflectiOns regarding heart failure manaGEmenT - How to ovERcome the PorTuguese barriers (TOGETHER-PT). Rev Port Cardiol 2024; 43:225-235. [PMID: 37689388 DOI: 10.1016/j.repc.2023.05.012] [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: 01/10/2023] [Revised: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 09/11/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Heart failure (HF) is a complex clinical syndrome that is a significant burden in hospitalisations, morbidity, and mortality. Although a significant effort has been made to better understand its consequences and current barriers in its management, there are still several gaps to address. The present work aimed to identify the views of a multidisciplinary group of health care professionals on HF awareness and literacy, diagnosis, treatment and organization of care, identifying current challenges and providing insights into the future. METHODS A steering committee was established, including members of the Heart Failure Study Group of the Portuguese Society of Cardiology (GEIC-SPC), the Heart Failure Study Group of the Portuguese Society of Internal Medicine (NEIC-SPMI) and the Cardiovascular Study Group (GEsDCard) of the Portuguese Association of General and Family Medicine (APMGF). This steering committee produced a 16-statement questionnaire regarding different HF domains that was answered to by a diversified group of 152 cardiologists, internists, general practitioners, and nurses with an interest or dedicated to HF using a five-level Likert scale. Full agreement was defined as ≥80% of level 5 (fully agree) responses. RESULTS Globally, consensus was achieved in all but one of the 16 statements. Full agreement was registered in seven statements, namely 3 of 4 statements for patient education and HF awareness and 2 in 4 statements of both HF diagnosis and healthcare organization, with proportions of fully agree responses ranging from 82.9% to 96.7%. None of the HF treatment statements registered full agreement but 3 of 4 achieved ≥80% of level 4 (agree) responses. CONCLUSION This document aims to be a call-to-action to improve HF patients' quality of life and prognosis, by promoting a change in HF care in Portugal.
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Affiliation(s)
- José Silva-Cardoso
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; RISE - Health Research Network, Portugal.
| | - Jonathan Santos
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; ARS Norte, ACES Vale Sousa Norte, USF Torrão, Portugal
| | - Inês Araújo
- Clínica de Insuficiência Cardíaca, Serviço de Medicina III, Hospital S. Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Aurora Andrade
- Serviço de Cardiologia, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
| | - Pedro Morais Sarmento
- Departamento de Medicina Interna e Hospital de Dia de Insuficiência Cardíaca do Hospital da Luz de Lisboa, Lisboa, Portugal
| | - Paulo Santos
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; RISE - Health Research Network, Portugal; MEDCIDS, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Brenda Moura
- Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Irene Marques
- Serviço de Medicina Interna, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; Unidade Multidisciplinar de Investigação Biomédica - Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Marisa Peres
- Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal
| | - João Pedro Ferreira
- Unic@RISE, Serviço de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Université de Lorraine, Inserm, Centre d'Investigations Cliniques-Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Joao Agostinho
- Serviço de Cardiologia, Departamento de Coração e Vasos, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal; CCUL, Centro Académico de Medicina de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Joana Pimenta
- Serviço de Medicina Interna, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; UnIC@RISE, Departamento de Medicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Baptista A, Gavinha S, Conceição Manso M. Oral health knowledge and attitude among healthcare professionals of long-term care units: A cross-sectional survey. Spec Care Dentist 2024; 44:937-945. [PMID: 38057886 DOI: 10.1111/scd.12948] [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: 02/09/2023] [Revised: 10/25/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND This study aims to evaluate the knowledge and the attitude in oral health (OH) of nurses (NUR) and auxiliary health technicians (AHT) belonging to the Long-term Care Units (LTC). METHODS Observational cross-sectional study. A survey was applied in five MLTC in Porto (Portugal) to 145 healthcare works (HCW). Data were collected using structured questionnaires with questions about knowledge and attitude regarding oral care. Data analysis comparison was performed using non-parametric tests (α = 0.05). RESULTS Out of a total of 259 HCW, 145 responses were obtained (55.98% response rate). The median number of correct answers was significantly different for NUR and AHT without oral health training (OHT) (p = .035).AHT with OHT had a significantly lower number of correct answers compared to NUR with OHT (7 vs. 9, p < .001). There was no significant difference in the number of correct answers in NUR with or without OHT (p = .391) and that the AHT without OHT have a median of correct answers significantly higher than those who they have OHT (8 vs. 7, p = .020) CONCLUSIONS: Despite the positive attitude of the HCW, the knowledge is scarce. HCW recognized the urgence to update the protocols. PRACTICAL IMPLICATIONS Integrating dentists in the LTC team, implementation of OH protocols and providing OH training should be considered to bridge existing gaps.
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Affiliation(s)
- Ana Baptista
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal
| | - Sandra Gavinha
- FP-I3ID (Instituto de Investigação, Inovação e Desenvolvimento), FP-BHS, Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal
- CINTESIS.UFP, Porto, Portugal
| | - Maria Conceição Manso
- FP-I3ID (Instituto de Investigação, Inovação e Desenvolvimento), FP-BHS, Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal
- CINTESIS.UFP, Porto, Portugal
- LAQV-REQUIMTE, University of Porto, Porto, Portugal
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Silva Pinto S, Henriques TS, Teixeira ASC, Monteiro H, Martins C. Appropriateness of prescribing profiles and intake adherence to non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: analysis of a retrospective longitudinal study using real-world data from Northern Portugal (AF-React Study). BMJ Open 2024; 14:e076108. [PMID: 38688672 PMCID: PMC11086444 DOI: 10.1136/bmjopen-2023-076108] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 03/04/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVES This study aimed to assess the appropriateness of prescribing profiles and intake adherence to non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF). DESIGN Retrospective longitudinal study. SETTING The study was conducted in the Regional Health Administration of Northern Portugal. PARTICIPANTS The authors selected a database of 21 854 patients with prescriptions for NOACs between January 2016 and December 2018 and were classified with AF until December 2018. OUTCOME MEASURES The appropriate dosage of NOAC for patients with AF divided into three categories: contraindicated, inconsistent and consistent, based on the 2020 European Society of Cardiology guidelines for AF. RESULTS Dabigatran had a lower percentage of guideline-consistent doses (n=1657, 50.1%) than other drugs such as rivaroxaban (n=4737, 81.6%), apixaban (n=3830, 78.7%) and edoxaban (n=436, 82.1%). Most patients with an inconsistent dose were prescribed a lower dose than recommended based on their glomerular filtration rate (GFR). Among patients younger than 75 years with GFR >60 mL/min, 59.8% (n=10 028) had an adequate GFR range, while 27.8% (n=7166) of GFR measurements from patients older than 75 years old and 29.4% (n=913) of GFR measurements from patients younger than 75 years with GFR <60 mL/min were within an adequate time range. Adherence to NOACs varied across different drugs, with 59.1% (n=540) adhering to edoxaban, 56.3% (n=5443) to rivaroxaban, 55.3% (n=3143) to dabigatran and 53.3% (n=4211) to apixaban. CONCLUSIONS Dabigatran had the lowest percentage of guideline-consistent doses. Patients younger than 75 years with GFR >60 mL/min had the highest percentage with an adequate GFR range, while other groups who require closer GFR monitoring had lower percentages within an adequate GFR range. Adherence to NOACs differed among different drugs, with greater adherence to treatment with edoxaban and less adherence to apixaban.
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Affiliation(s)
- Susana Silva Pinto
- São Tomé Family Health Unit, Santo Tirso, Portugal
- CINTESIS@RISE, University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal
| | - Teresa S Henriques
- CINTESIS@RISE, University of Porto, Porto, Portugal
- CI-IPOP (Health Research Network), Portuguese Oncoloy Institute of Porto, Porto, Portugal
| | - Andreia Sofia Costa Teixeira
- CINTESIS@RISE, University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal
- ADiT-LAB, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
| | - Hugo Monteiro
- Regional Health Administration of Northern Portugal, Ministry of Health, Porto, Portugal
| | - Carlos Martins
- CINTESIS@RISE, University of Porto, Porto, Portugal
- H4A Primary Health Care Research Network, Porto, Portugal
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Andaluz S, Zhao B, Sinha S, Lagniton PNP, Costa DA, Ding X, Brito M, Wang SM. Using Portuguese BRCA pathogenic variation as a model to study the impact of human admixture on human health. BMC Genomics 2024; 25:416. [PMID: 38671360 PMCID: PMC11055274 DOI: 10.1186/s12864-024-10311-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Admixture occurs between different ethnic human populations. The global colonization in recent centuries by Europeans led to the most significant admixture in human history. While admixture may enhance genetic diversity for better fitness, it may also impact on human health by transmitting genetic variants for disease susceptibility in the admixture population. The admixture by Portuguese global exploration initiated in the 15th century has reached over 20 million of Portuguese-heritage population worldwide. It provides a valuable model to study the impact of admixture on human health. BRCA1 and BRCA2 (BRCA) are two of the important tumor suppressor genes. The pathogenic variation (PV) in BRCA is well determined to cause high risk of hereditary breast and ovarian cancer. Tracing the distribution of Portuguese BRCA PV in Portuguese-heritage population will help to understand the impact of admixture on cancer susceptibility in modern humans. In this study, we analyzed the distribution of the Portuguese-originated BRCA variation in Brazilian population, which has high degree Portuguese-heritage. METHODS By comprehensive data mining, standardization and annotation, we generated a Portuguese-derived BRCA variation dataset and a Brazilian-derived BRCA variation dataset. We compared the two BRCA variation datasets to identify the BRCA variants shared between the two populations. RESULTS The Portuguese-derived BRCA variation dataset consists of 220 BRCA variants including 78 PVs from 11,482 Portuguese cancer patients, 93 (42.2%) in BRCA1 and 127 (57.7%) in BRCA2. Of the 556 Portuguese BRCA PV carriers carrying the 78 PVs, 331 (59.5%) carried the three Portuguese-BRCA founder PVs of BRCA1 c.2037delinsCC, BRCA1 c.3331_3334del and BRCA2 c.156_157insAlu. The Brazilian-derived BRCA variation dataset consists of 255 BRCA PVs from 7,711 cancer patients, 136 (53.3%) in BRCA1 and 119 (46.6%) in BRCA2. We developed an open database named dbBRCA-Portuguese ( https://genemutation.fhs.um.edu.mo/dbbrca-portuguese/ ) and an open database named dbBRCA-Brazilian ( https://genemutation.fhs.um.edu.mo/dbbrca-brazilian ) to host the BRCA variation data from Portuguese and Brazilian populations. We compared the BRCA PV datasets between Portuguese and Brazilian populations, and identified 29 Portuguese-specific BRCA PVs shared between Portuguese and Brazilian populations, 14 in BRCA1 including the Portuguese founder BRCA1 c.3331_3334del and BRCA1 c.2037delinsCC, and 15 in BRCA2 including the Portuguese founder BRCA2 c.156_157insAlu. Searching the 78 Portuguese BRCA PVs in over 5,000 ancient human genomes identified evolution origin for only 8 PVs in Europeans dated between 37,470 and 3,818 years before present, confirming the Portuguese-specificity of Portuguese BRCA PVs; comparing the 78 Portuguese BRCA PVs Portuguese, 255 Brazilian BRCA PVs, and 134 African BRCA PVs showed little overlapping, ruling out the possibility that the BRCA PVs shared between Portuguese and Brazilian may also be contributed by African. CONCLUSION Our study provides evidence that the admixture in recent human history contributed to cancer susceptibility in modern humans.
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Affiliation(s)
- Stephanie Andaluz
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Center and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SRA, China
| | - Bojin Zhao
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Center and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SRA, China
| | - Siddharth Sinha
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Center and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SRA, China
| | - Philip Naderev Panuringan Lagniton
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Center and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SRA, China
| | - Diogo Alpuim Costa
- Medical Oncology Department, Hospital de Cascais, Cascais; Haematology and Oncology Department, CUF Oncologia, Lisbon; NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Xiaofan Ding
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Center and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SRA, China
| | - Miguel Brito
- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal.
| | - San Ming Wang
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Center and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SRA, China.
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Lopes GSG, Landeiro MJL, Sousa MRMGCD. Needs and preferences regarding a mobile application to support diabetic foot self-care. Rev Gaucha Enferm 2024; 45:e20230165. [PMID: 38655932 DOI: 10.1590/1983-1447.2024.20230165.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/06/2023] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE To identify the needs and preferences of individuals with type 2 diabetes regarding the functionalities and characteristics for a mobile application to support foot self-care. METHOD Qualitative research with 16 individuals diagnosed with type 2 diabetes recruited during clinical care at a university hospital in Porto, Portugal. Data were collected through semi-structured interviews between March and June 2022 and analyzed using inductive content analysis. RESULTS Three categories and nine subcategories were identified. Categories included informational needs, essential functionalities for foot health self-care, and user-relevant experience. The preference for objective, limited data input, flexible, and customizable applications was an important factor influencing technology engagement. CONCLUSION The research highlighted a preference for customizable and flexible applications, aiding nurses in creating solutions that transform care delivery and enhance the quality of life for individuals living with diabetes.
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Affiliation(s)
- Geysa Santos Góis Lopes
- Universidade do Porto (UP), Instituto de Ciências Biomédicas Abel Salazar. Programa Doutoral em Ciências de Enfermagem. Porto, Portugal
| | - Maria José Lumini Landeiro
- Escola Superior de Enfermagem do Porto (ESEP). Porto, Portugal
- Rede de Investigação em Saúde (RISE). Centro de Investigação em Tecnologias e Serviços de Saúde. Porto, Portugal
| | - Maria Rui Miranda Grilo Correia de Sousa
- Escola Superior de Enfermagem do Porto (ESEP). Porto, Portugal
- Rede de Investigação em Saúde (RISE). Centro de Investigação em Tecnologias e Serviços de Saúde. Porto, Portugal
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Mota M, Pires R, Cunha M, Santos MR. Nurses' perception of the impact of professional development sessions on their pre-hospital clinical practice with trauma victims. Front Public Health 2024; 12:1365509. [PMID: 38711765 PMCID: PMC11071442 DOI: 10.3389/fpubh.2024.1365509] [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: 01/04/2024] [Accepted: 04/10/2024] [Indexed: 05/08/2024] Open
Abstract
Background Continuing education is important for the quality of clinical practice because it complements it and focuses primarily on producing qualified pre-hospital nurses with operationally defined competence in nursing standards. The objective of this study was to assess pre-hospital nurses' opinion of the impact of professional development sessions on their clinical practice. Method A descriptive and quantitative study was carried out involving Portuguese pre-hospital nurses. Six professional development sessions were presented in 2020 to pre-hospital registered nurses in four of Portugal's main cities. To collect the data, at the end of each session, we apply a questionnaire designed specifically for this study. This data collection instrument consists of 11 questions, six designed to evaluate the session and five designed to evaluate the trainer responsible for the session. A five-point Likert scale was used for each question, where 1 corresponds to very dissatisfied and 5 to extremely satisfied. Results Two hundred and two nurses, which represents 55% of all Portuguese pre-hospital nurses, took part in the assessment of the professional development sessions. The nurses were from the Northern region of Portugal (51%; n = 102), the Centre region (29%; n = 59) and the Southern region of Portugal (20%; n = 41). Nurses found the session extremely satisfactory. All the assessment scores ranged between 4.4 and 4.7 points, on a scale of 1 to 5. 76.2% of the participants considered that the knowledge acquired could have a major impact [score = 5] on their future clinical practice. The majority of pre-hospital nurses (96.5%) felt that the session could have a major impact [score = 5; 76.2%, n = 154] or a very important impact [score = 4; 20.3%, n = 41] on their clinical practice. Conclusion The professional development sessions provide pre-hospital nurses with the latest research findings and the majority of nurses considered that the training had a huge impact on their clinical practice. However, it is important that future research aims to explore the cause-effect relationship between training and improved clinical practice.
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Affiliation(s)
- Mauro Mota
- Health School of the Polytechnic University of Viseu, Viseu, Portugal
- UICISA: E/ESEnfC—Cluster at the Health School of Polytechnic University of Viseu, Viseu, Portugal
- CINTESIS—Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Regina Pires
- CINTESIS—Center for Health Technology and Services Research, University of Porto, Porto, Portugal
- Nursing School of Porto, Porto, Portugal
| | - Madalena Cunha
- Health School of the Polytechnic University of Viseu, Viseu, Portugal
- UICISA: E/ESEnfC—Cluster at the Health School of Polytechnic University of Viseu, Viseu, Portugal
| | - Margarida Reis Santos
- CINTESIS—Center for Health Technology and Services Research, University of Porto, Porto, Portugal
- Nursing School of Porto, Porto, Portugal
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Nogueira-Leite D, Marques-Cruz M, Cruz-Correia R. Individuals' attitudes toward digital mental health apps and implications for adoption in Portugal: web-based survey. BMC Med Inform Decis Mak 2024; 24:99. [PMID: 38637866 PMCID: PMC11025147 DOI: 10.1186/s12911-024-02488-1] [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: 06/12/2023] [Accepted: 03/22/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The literature is consensual regarding the academic community exhibiting higher levels of mental disorder prevalence than the general population. The potential of digital mental health apps for improving access to resources to cope with these issues is ample. However, studies have yet to be performed in Portugal on individuals' attitudes and perceptions toward digital mental health applications or their preferences and decision drivers on obtaining mental health care, self-assessment, or treatment. OBJECTIVE This study aims to understand the determinants of digital mental health applications use in the Portuguese academic community of Porto, along with potential adoption barriers and enablers. METHODS A cross-sectional, web-based survey was delivered via dynamic email to the University of Porto's academic community. Data collection occurred between September 20 and October 20, 2022. We used structural equation modeling to build three models, replicating a peer-reviewed and published study and producing a newly full mediation model shaped by the collected data. We tested the relationships between use of digital mental health apps and perceived stress, perceived need to seek help for mental health, perceived stigma, past use of mental health services, privacy concerns, and social influence. RESULTS Of the 539 participants, 169 (31.4%) reported having used digital mental health apps. Perceived stress and a latent variable, comprising perceptions of mental health problems and coping strategies, were positively associated with mental health app use, while privacy concerns regarding one's information being accessible to others were negatively associated. Perceived stigma, need to seek help, and close relationships did not have a statistically significant direct effect. CONCLUSIONS These findings can inform product and policy development of new, better-targeted digital mental health app interventions, with implications for researchers and academia, industry, and policymakers. Our study concludes that, to maximize adherence to these apps, they should have low to no financial charges, demonstrate evidence of their helpfulness and focus on the timely delivery of care. We also conclude that to foster digital mental health app use, there is a need to improve mental health literacy, namely regarding self-awareness of one's conditions, acceptable stress levels, and overall behavior towards mental health. TRIAL REGISTRATION RR2-10.2196/41040.
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Affiliation(s)
- Diogo Nogueira-Leite
- Health Data Science Ph.D. Program, Faculty of Medicine of the University of Porto, Porto, Portugal.
- Department of Community Medicine, Health Information and Decision-Making, Faculty of Medicine of the University of Porto, Rua Dr. Plácido da Costa, Porto, 4200-450, Portugal.
- Nova School of Business and Economics Health Economics & Management Knowledge Center, New University of Lisbon, Lisbon, Portugal.
| | - Manuel Marques-Cruz
- Health Data Science Ph.D. Program, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Community Medicine, Health Information and Decision-Making, Faculty of Medicine of the University of Porto, Rua Dr. Plácido da Costa, Porto, 4200-450, Portugal
- Nova School of Business and Economics Health Economics & Management Knowledge Center, New University of Lisbon, Lisbon, Portugal
| | - Ricardo Cruz-Correia
- Department of Community Medicine, Health Information and Decision-Making, Faculty of Medicine of the University of Porto, Rua Dr. Plácido da Costa, Porto, 4200-450, Portugal
- Center for Health Technology and Services Research, Porto, Portugal
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Tavares JCD, Almeida AMD. The Portuguese mertolenga cattle breed: a review. Trop Anim Health Prod 2024; 56:129. [PMID: 38635153 DOI: 10.1007/s11250-024-03976-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024]
Abstract
This review summarizes the state of the art regarding the phylogenetic origins, recent history and present-day main traits and uses of the Mertolenga cattle breed from Southern Portugal, particularly those related to production performances and product quality. Named after the historical city of Mértola, in southern Portugal, the Mertolenga is one of the fifteen autochthonous bovine breeds of Portugal. It is a cattle breed thoroughly adapted to the poor Mediterranean pastures of the southern regions of the Iberian Peninsula. It is used predominantly in an extensive to semi-intensive sylvopastoral production system called montado, where pastures are combined with helm and cork trees. Its productive traits allow for a good adaptation to the intense dry heat and pasture shortage during the summer, and compensatory growth in autumn and spring, when pastures regenerate. They are small to medium sized animals, with well-balanced bodies, roan, red, or, less often, red-spotted coats, and known for their nervous temperament. Although this breed experienced a severe decline in numbers in the 1970s and classified as endangered in the 1990s, the work of a few breeders led to the establishment of larger Mertolenga breed inventories, starting from a limited base. For this reason, the entire breed has today a strong influence from a very few herds and sires. Reproduction is still mostly achieved using natural mating, and the males are often kept with the breeding females all year long. It is a heterogeneous breed both phenotypically and genetically. Recent phylogenetic studies have revealed the Mertolenga as a one of the most genetically diverse breeds in the country and in the Iberian Peninsula and helped classify this breed, once believed to be a variety of the Alentejana breed. These studies also showed genetic relations with other breeds in the Iberian Peninsula. Mertolenga beef currently benefits from several certifications, the most important one being the PDO - Protected Denomination of Origin.
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Affiliation(s)
- João Carlos de Tavares
- LEAF-Linking Landscape, Environment, Agriculture and Food Research Center, Associate Laboratory TERRA, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, Lisboa, 1349-017, Portugal
| | - André M de Almeida
- LEAF-Linking Landscape, Environment, Agriculture and Food Research Center, Associate Laboratory TERRA, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, Lisboa, 1349-017, Portugal.
- Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, Lisboa, 1349-017, Portugal.
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Soares AP, Rodrigues M, Padrão P, Gonçalves C, Moreira A, Moreira P. Association between Urinary Sodium Excretion and Body Fat in School-Aged Children: Insights from the ARIA Study. Nutrients 2024; 16:1197. [PMID: 38674887 PMCID: PMC11054948 DOI: 10.3390/nu16081197] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Childhood obesity has been associated with increased sodium intake. Nonetheless, evidence linking sodium intake to Body Mass Index (BMI) and Body Fat Mass Percentage (%BF) remains limited, especially in the pediatric age group. Therefore, this study aims to investigate whether there is an association between 24 h urinary sodium excretion with BMI and %BF in a sample group of children from the ARIA study. This cross-sectional analysis included 303 children aged 7 to 12 from across 20 public schools in Porto, Portugal. Weight and %BF were assessed using the Tanita™ BC-418 Segmental Body Analyzer. Children's Total Energy Intake (TEI) was estimated through a single 24 h Recall Questionnaire, and urinary sodium and potassium excretion was estimated by a 24 h urine collection. The association of %BF and BMI with 24 h sodium excretion was estimated by a binary logistic regression adjusted for sex, age, physical activity, total energy intake, parental education, and 24 h urinary excreted potassium. There was a significant positive association between higher levels of urinary sodium excretion and higher %BF values, even after adjusting for confounders. However, the same was not observed for BMI. Our findings suggest that higher sodium intake is associated with higher values of %BF among children, regardless of TEI and potassium intake.
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Affiliation(s)
- Ana Patrícia Soares
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
| | - Mónica Rodrigues
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| | - Carla Gonçalves
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - André Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Immuno-Allergology Department, São João Hospital Center, 4200-319 Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
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Gil Conde M, Rodrigues VL, Ramos RC, Rente A, Broeiro-Gonçalves P, Ribeiro C, Nicola PJ. Barriers to research in family medicine-interviews with Portuguese family physician researchers. Fam Pract 2024; 41:168-174. [PMID: 38300765 DOI: 10.1093/fampra/cmad126] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND There is a need for a deeper understanding of the barriers to research in family medicine (FM) and to consider the perceptions and perspectives of professionals. Our study aims to provide a strategic view for research capacity building in FM. We included the perspective of family physician researchers (FPR) on the existing barriers to investigation in this context. OBJECTIVES To understand and characterize the barriers to research in FM (personal and structural), from the perspective of Portuguese family physicians who are researchers. METHODS A qualitative study, of phenomenological nature, was performed, through the conduction of semi-structured interviews with FPR, from 2019 to 2022. Data analysis and thematic coding were done on MAxQDA®, with inductive and deductive approaches, until data saturation was reached. RESULTS A total of 12 family physicians/researchers were interviewed. Seven main themes were identified as barriers to research: time, professional valorization, funding, ethics committees, infrastructure, management/institutions, and participants. Each theme is divided into subthemes that make it possible to assess how a barrier can affect researchers in performing research activities. CONCLUSION Our study highlights the identification of 7 main barriers. Structuring them into sub-themes not only improved the organization of our results but also provided robust support for the next phase, namely the application of a survey with the aim of gaining a deeper insight into the repercussions that these barriers to FPR have at a national level. This research is crucial to laying the foundations for a policy document that offers well-defined and tailored recommendations to address the barriers we have uncovered.
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Affiliation(s)
- Margarida Gil Conde
- University Clinic of General and Family Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Family Unit Jardins da Encarnação, Group of Healthcare Centers of Central Lisbon, Lisbon, Portugal
| | | | - Raquel C Ramos
- University Clinic of General and Family Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Personalized Healthcare Unit Atlantica, Group of Healthcare Centers of Pinhal Litoral, Group of Healthcare Centers of the Central Region of Portugal, Leiria, Portugal
| | - Ana Rente
- Family Unit Jardins da Encarnação, Group of Healthcare Centers of Central Lisbon, Lisbon, Portugal
| | - Paula Broeiro-Gonçalves
- UCSP Olivais, Group of Healthcare Centers of Central Lisbon, Lisbon, Portugal
- Nova Medical School of the Nova University of Lisbon, Lisbon, Portugal
- School of Health and Human Development, Évora University, Évora, Portugal
| | - Cristina Ribeiro
- University Clinic of General and Family Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Department of Quality in Health at Directorate-General of Health, Lisbon, Portugal
| | - Paulo J Nicola
- Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Institute for Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
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Pinto C, Chaves C, Duarte J, Raposo A, Zandonadi RP, Monteiro S, Teixeira-Lemos E. Exploring Lifestyle Factors and Treatment Adherence among Older Adults with Hypertension Attending a Mobile Health Unit (MHU) in a Rural Area of Central Portugal. Nutrients 2024; 16:1112. [PMID: 38674805 PMCID: PMC11055154 DOI: 10.3390/nu16081112] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
This cross-sectional and analytical study aimed to characterize a sample of hypertensive older adults attending a Mobile Health Unit (MHU) in a rural area of central Portugal according to their lifestyle and to analyze the impact of lifestyles on treatment adherence. The sample comprised 235 Portuguese hypertense patients, mainly females (63.8%) with a mean age of 75 years (±8.14 years) and low level of education. The data collection was carried out through a questionnaire consisting of sociodemographic questions, dietary variables, an Alcohol Dependence Questionnaire, an International Physical Activity Questionnaire (Short Version), a Nutrition Health Determination Questionnaire, a Self-Care with Hypertension Scale, and an Adherence to Treatments Measurement Scale. Only 34.5% of the hypertensive patients have controlled blood pressure values (28.2% men and 38% women). However, more than half (56.2%) of the hypertensive patients are classified as adherent to therapeutic measures. The hypertensive individuals, who present higher levels of adherence to the treatment, do not present alcohol dependence, are frequent consumers of aromatic herbs, sporadically consume salt, present good nutritional health, and practice moderate physical activity. The predictor variables for treatment adherence are the self-care dimensions general dietary (p = 0.001), specific dietary (p = 0.034), physical activity (p = 0.031), and antihypertensive medication intake (p < 0.001). Hypertensive patients with healthier lifestyles present better levels of treatment adherence. Therefore, promoting physical activity and healthy dietary practices is necessary to improve treatment adherence and increase antihypertensive treatment's effectiveness.
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Affiliation(s)
- Cátia Pinto
- Câmara Municipal de Castro Daire, Rua Dr. Pio Figueiredo, No. 42, 3600-126 Castro Daire, Portugal;
| | - Cláudia Chaves
- ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic University of Viseu, 3504-510 Viseu, Portugal; (C.C.); (J.D.)
| | - João Duarte
- ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic University of Viseu, 3504-510 Viseu, Portugal; (C.C.); (J.D.)
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Renata Puppin Zandonadi
- Nutrition Department, Faculty of Health Sciences, University of Brasília, Campus Universitário Darcy Ribeiro, Brasilia 70910-900, Brazil;
| | - Sara Monteiro
- Center for Health Technology and Services Research of the Health Research Network (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Edite Teixeira-Lemos
- CERNAS Research Centre, Polytechnic University of Viseu, 3504-510 Viseu, Portugal
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