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Rocha R, Conceição C, Gonçalves L, Maia C. Knowledge and practices regarding leishmaniasis in Portugal - Comparison between blood donors and health students/professionals. One Health 2024; 18:100697. [PMID: 38463613 PMCID: PMC10924195 DOI: 10.1016/j.onehlt.2024.100697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/27/2024] [Indexed: 03/12/2024] Open
Abstract
Objective To compare the current knowledge and practices regarding leishmaniasis among blood donors and health students and professionals, in Portugal. Material and methods Data were collected through the application of two questionnaires (one online and one in paper) with similar questions in two distinct cross-sectional independent studies, each targeting one of the groups. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. Results In total, 3763 blood donors, 254 students and 232 professionals were included in the comparative analysis. Over 95% of students and professionals, but only around 70% of blood donors had previously heard of leishmaniasis. Over 90% of participants in each group admitted leishmaniasis affected animals, but only in the professional group over 90% were aware of human leishmaniasis. Conclusions Even though canine leishmaniasis is recognized by many blood donors and by most students and professionals, awareness of the disease in humans is less common, highlighting the importance of promoting an approach to this infection through a One Health lens.
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Affiliation(s)
- Rafael Rocha
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Rua da Junqueira N°100, Lisboa 1349-008, Portugal
| | - Cláudia Conceição
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Rua da Junqueira N°100, Lisboa 1349-008, Portugal
| | - Luzia Gonçalves
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Rua da Junqueira N°100, Lisboa 1349-008, Portugal
- Centro de Estatística e Aplicações da Universidade de Lisboa, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, Lisboa 1749-016, Portugal
- Z-Stat4life, Espaço Cowork Baldaya, Palácio Baldaya, Estrada de Benfica N° 701ª, Lisboa 1549-011, Portugal
| | - Carla Maia
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Rua da Junqueira N°100, Lisboa 1349-008, Portugal
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Cunha J, Cabecinha E, Villasante S, Gonçalves JA, Balbi S, Elliott M, Ramos S. Quantifying the role of saltmarsh as a vulnerable carbon sink: A case study from Northern Portugal. Sci Total Environ 2024; 923:171443. [PMID: 38447727 DOI: 10.1016/j.scitotenv.2024.171443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/08/2024]
Abstract
Saltmarshes play a crucial role in carbon sequestration and storage, although they are increasingly threatened by climate change-induced sea level rise (SLR). This study assessed the potential variation in Blue Carbon stocks across regional and local scales, and estimated their economic value and potential habitat loss due to SLR based on the IPCC AR6 scenarios for 2050 and 2100 in three estuarine saltmarshes in northern Portugal, the saltmarshes of the Minho, Lima and Cávado estuaries. The combined carbon stock of these saltmarshes was 38,798 ± 2880 t of organic carbon, valued at 3.96 ± 0.38 M€. Local and regional differences in carbon stocks were observed between common species, with the cordgrass Spartina patens and the reed Phragmites australis consistently showing higher values in the Lima saltmarsh in some of the parameters. Overall, the Lima saltmarsh had the highest total carbon per species cover, with S. patens showing the highest values among common species. Bolboschoenus maritimus had the highest values in the Minho saltmarsh, while the other species presented a similar carbon storage capacity. Potential habitat loss due to SLR was most evident in the Cávado saltmarsh over shorter timescales, with a significant risk of inundation even for median values of SLR, while the Lima saltmarsh was shown to be more resistant and resilient. If habitat loss directly equates to carbon loss within these saltmarshes, projected CO2 emissions may range from 22,000 to 43,449 t by 2050 and 33,000 to 130,000 t by 2100 (under the IPCC SSP5-8.5 scenario). The study shows the importance of Blue Carbon site-specific estimates, acknowledging the potential future repercussions from habitat loss due to SLR. It emphasizes the need to consider local and regional variability in Blue Carbon stocks assessments and highlights the critical importance of preserving and rehabilitating these ecosystems to ensure their continued efficacy as vital carbon sinks, thereby contributing to climate change mitigation efforts.
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Affiliation(s)
- Jacinto Cunha
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Matosinhos, Portugal; CITAB/Inov4Agro - Centre for Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
| | - Edna Cabecinha
- CITAB/Inov4Agro - Centre for Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Sebastian Villasante
- EqualSea Lab - CRETUS, Department of Applied Economics, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José A Gonçalves
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Matosinhos, Portugal; Department of Geosciences Environment and Spatial Planning, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Stefano Balbi
- Basque Centre for Climate Change (BC3), Sede Building, Campus EHU/UPV, Leioa, Bizkaia, Spain; IKERBASQUE, Basque Foundation for Science, Bilbao, Bizkaia, Spain
| | - Michael Elliott
- School of Environmental Sciences, University of Hull, HU6 7RX, UK; International Estuarine & Coastal Specialists (IECS) Ltd, Leven HU17 5LQ, UK
| | - Sandra Ramos
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Matosinhos, Portugal
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Costa CM, Santos AT. Building multiscalar sustainable ocean governance: How do global perspectives interact with the Portuguese national approach? Heliyon 2024; 10:e28233. [PMID: 38596052 PMCID: PMC11002049 DOI: 10.1016/j.heliyon.2024.e28233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 02/29/2024] [Accepted: 03/13/2024] [Indexed: 04/11/2024] Open
Abstract
UNESCO's Intergovernmental Oceanographic Commission launched the United Nations Decade of Ocean Science for Sustainable Development in 2021 to boost global and sustainable Ocean governance. The initiative resulted from historical and political dynamics at the global and lower political scales, with maritime environmental and economic concerns becoming more prominent in 2010. The Ocean Decade's pillars include science and research, sustainability, conservation, and bridging gaps for a global Ocean-Climate-Biodiversity nexus. The Sustainable Development Goals recognized the importance of oceans and marine resources, and the Ocean was officially perceived as a determining factor of Climate Change at CoP 21 in 2015. Portugal has built integrated and far-reaching policies for ocean governance, including significant involvement with an international perspective since the Lisbon World Exhibition in 1998. In addition, the national government established a Ministry of the Sea in 2015 to re-develop relations with its maritime space. This article analyzes and compares the discourse of the United Nations' Sustainable Development Goals reports and the Portuguese government programs (2005-2022) to explore the prominent trends in Portuguese Ocean governance discourse and how global and national perspectives interact. Through this case study, the research aims to develop insights into the multiscalar impacts of promoting global and sustainable Ocean governance and its interaction with national perspectives.
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Affiliation(s)
- Cátia Miriam Costa
- Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Estudos Internacionais, Lisbon, Portugal
| | - Ana Teresa Santos
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
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Mendonça R, Furtado R, Coelho A, Correia CB, Suyarko E, Borges V, Gomes JP, Pista A, Batista R. Raw milk cheeses from Beira Baixa, Portugal-A contributive study for the microbiological hygiene and safety assessment. Braz J Microbiol 2024:10.1007/s42770-024-01332-y. [PMID: 38622468 DOI: 10.1007/s42770-024-01332-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
Due to specific bacterial microbiota, raw milk cheeses have appreciated sensory properties. However, they may pose a threat to consumer safety due to potential pathogens presence. This study evaluated the microbiological contamination of 98 raw milk cheeses from Beira Baixa, Portugal. Presence and enumeration of Coagulase Positive Staphylococci (CPS), Listeria monocytogenes, Salmonella spp., pathogenic Escherichia coli, and indicator microorganisms (non-pathogenic E. coli and Listeria spp.) was attained. E. coli antimicrobial resistance (AMR) was also evaluated. PCR and/or Whole genome sequencing (WGS) was used to characterize E. coli, Salmonella spp. and L. monocytogenes isolates. Sixteen cheeses (16.3%) were classified as Satisfactory, 59 (60.2%) as Borderline and 23 (23.5%) as Unsatisfactory/Potential Injurious to Health. L. monocytogenes, CPS > 104 cfu g-1, Extraintestinal pathogenic E. coli (ExPEC) and Salmonella spp. were detected in 4.1%, 6.1%, 3.1% and 1.0% of the samples, respectively. Listeria innocua (4.1%) and E. coli > 104 cfu g-1 (16.3%) were also detected. AMR E. coli was detected in 23/98 (23.5%) of the cheese samples, of which two were multidrug resistant. WGS identified genotypes already associated to human disease and Listeria spp. cluster analysis indicated that cheese contamination might be related with noncompliance with Good Hygiene Practices during cheese production.
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Affiliation(s)
- Rita Mendonça
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal.
- Faculty of Sciences, University of Lisbon, Lisbon, Portugal.
| | - Rosália Furtado
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Anabela Coelho
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Cristina Belo Correia
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Elena Suyarko
- Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- NOVA School of Science and Technology, 2829-516, Caparica, Portugal
| | - Vítor Borges
- Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - João Paulo Gomes
- Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Animal and Veterinary Research Center (CECAV), Faculty of Veterinary Medicine, Lusófona University-Lisbon University Centre, Lisbon, Portugal
| | - Angela Pista
- Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Rita Batista
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal.
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Moreira DN, Pinto da Costa M. Barriers and facilitators of the reporting by family doctors of cases of domestic violence - a qualitative study across Portugal. BMC Prim Care 2024; 25:107. [PMID: 38580901 PMCID: PMC10996166 DOI: 10.1186/s12875-024-02329-0] [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: 01/08/2023] [Accepted: 03/06/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Domestic violence (DV) is a serious and prevalent public health problem with devastating consequences for the victims and their families. Whilst the number of cases reported to the authorities has risen in recent years, many victims still chose not to present a complaint. In Portugal, to address this, DV became a public crime. As victims of DV present multiple health problems and frequently seek professional help, family doctors are in a privileged position to detect and report cases of DV to the authorities. However, little is known about what motivates these professionals to report or not the DV cases they encounter in their practice to the authorities. METHODS We conducted semi-structured interviews with family doctors from all regional health administrations of continental Portugal. Interviews occurred between July 2020 and September 2022, were conducted in person or remotely, audio recorded, transcribed, and analysed using thematic analysis. Content analysis was conducted to assess the agreement or disagreement regarding mandatory reporting in each of the themes and subthemes. RESULTS Fifty-four family doctors took part in this study (n = 39 women, n = 15 men). The main themes that arose from the analysis were: "Barriers related to the physician's activity," "Barriers related to the victim or aggressor," "Facilitators related to the physician's activity," "Facilitators related to the victim or aggressor." Although different barriers were described, most doctors agreed with the mandatory reporting of DV cases. CONCLUSIONS Family doctors encounter multiple barriers and facilitators when considering reporting a DV case to the authorities. The results of this study can help develop new interventions to address the barriers described by the doctors, increasing their compliance with mandatory reporting, the protection of victims and the just persecution of the aggressor.
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Affiliation(s)
- Diana Nadine Moreira
- Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua Jorge de Viterbo Ferreira, nº 228, Porto, 4050-313, Portugal
| | - Mariana Pinto da Costa
- Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua Jorge de Viterbo Ferreira, nº 228, Porto, 4050-313, Portugal.
- Institute of Public Health of the University of Porto, Porto, Portugal.
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK.
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Alvarez-Peregrina C, Garcia de la Noceda A, Martinez-Perez C, Sánchez-Tena MÁ. Job satisfaction of Spanish and Portuguese optometrists. J Optom 2024; 17:100492. [PMID: 38171112 PMCID: PMC10796967 DOI: 10.1016/j.optom.2023.100492] [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: 04/19/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Given the increase in demand for optometry services by society and the importance of the Optometry profession in Portugal and Spain, the objective of this study was to determine job satisfaction and important factors related to this satisfaction in a sample of Portuguese and Spanish optometrists. METHODS A prospective, cross-sectional, and observational study was carried out from June to December 2021. An adaptation of the 15-item job satisfaction in eye-care personnel (JSEP) questionnaire validated by Paudel et al. was administered to Portuguese and Spanish optometrists. The questionnaire was shared through different social media (Facebook, LinkedIn, WhatsApp, etc.) in a Google form during the months of June to December 2021 in Portugal and Spain. RESULTS A total of 530 surveys were collected in Portugal (42.3%; n = 224) and Spain (57.7%; n = 306). The factors that most influence overall job satisfaction are salary, career development opportunities, recognition/prestige in society, good work-life balance (all p<0.001), workplace equipment and facilities, and encouragement reward positive feedback (both p = 0.002). When comparing the determinants of job satisfaction of optometrists, it was found that Portuguese professionals were generally more satisfied than Spanish ones (p<0.001). However, Spanish optometrists reported feeling more supported by their colleagues (p<0.001). CONCLUSION This study has shown that the level of job satisfaction was higher in Portugal than in Spain. The most important factors influencing job satisfaction were salary, job stability, and support from colleagues.
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Affiliation(s)
- Cristina Alvarez-Peregrina
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, 28037 Madrid, Spain
| | - Alejandro Garcia de la Noceda
- Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain; Dive Medical SL, Zaragoza, Spain
| | - Clara Martinez-Perez
- ISEC LISBOA-Instituto Superior de Educação e Ciências, 1750-179 Lisbon, Portugal
| | - Miguel Ángel Sánchez-Tena
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, 28037 Madrid, Spain; ISEC LISBOA-Instituto Superior de Educação e Ciências, 1750-179 Lisbon, Portugal.
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Prazeres F. [Family Physicians and Nutritionists in Health Centers, Commentary on "Eating Habits of People with Type 2 Diabetes Mellitus in Portugal: A Cross-Sectional Study"]. ACTA MEDICA PORT 2024. [PMID: 38527333 DOI: 10.20344/amp.21218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/09/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Filipe Prazeres
- Unidade de Saúde Familiar Beira Ria. Gafanha da Nazaré; Faculdade de Ciências da Saúde. Universidade da Beira Interior. Covilhã. Portugal
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Sosa-Cordobés E, Soares Morais MC, Lopes-Ferreira P, Sánchez-Alcón M, Garrido-Fernández A, García-Padilla FM. [Emotional eating in university students: a cross-sectional and comparative study in the Iberian Peninsula]. Rev Esp Salud Publica 2024; 98:e202403024. [PMID: 38516895] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 02/01/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE Although the lack of progress in reducing obesity is a global problem, different places have different contributing factors. One of the factors currently contributing to the increasing prevalence of obesity is emotional eating. The aim of this paper was to describe and compare the level of emotional eating and to analyse which variables and to what extent they affected the other variables. METHODS A descriptive cross-sectional study was conducted in students from 3 universities of the Iberian Peninsula (n=1,654) between October 2019 and June 2020. Data were collected through an online self-report questionnaire which included sociodemographic and anthropometric data and validated questionnaires such as: the Emotional Eaters Questionnaire, the ShortForm-36 and the Hospital Anxiety and Depression Questionnaire. Stratified random sampling was performed by faculty, degree, and class groups. For descriptive results, means, standard deviation and relative frequencies of variables were calculated. Student's t-test, chi-square and ANOVA were used to compare means. Simple and multiple linear regressions were performed for both samples. RESULTS The mean emotional eating score was 8.77±5.66 for spanish students and 10.02±6.19 for portuguese students, with a difference of 3.62 (<0.001). In Spain, the dependent variable that most affected emotional eating was quality of life (13.8% variance [<0.001]), while in Portugal it was anxiety (10.1% variance [<0.001]). CONCLUSIONS Statistically significant differences are found in the level of emotional eating between populations. In addition, there is dissimilarity in the variables influencing the principal in both countries. These findings imply that they should be considered in the design of future research or health interventions.
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Affiliation(s)
| | - Maria-Carminda Soares Morais
- Departamento de Enfermería; Instituto Politécnico de Viana do Castelo. Viana do Castelo. Portugal
- Centro de Estudios e Investigación Sanitarios; Universidad de Coimbra. Coimbra. Portugal
| | - Pedro Lopes-Ferreira
- Centro de Estudios e Investigación Sanitarios; Universidad de Coimbra. Coimbra. Portugal
- Departamento de Economía; Universidad de Coimbra. Coimbra. Portugal
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Nogueira PJ, Camarinha C, Feteira-Santos R, Silva Costa A, De-Araújo-Nobre M, Bacelar-Nicolau L, Furtado C, Elias C. Monthly Analysis of Infant Mortality Rate in Portugal during the COVID-19 Pandemic: Insights from Continuous Monitoring. ACTA MEDICA PORT 2024. [PMID: 38507776 DOI: 10.20344/amp.19642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/13/2023] [Indexed: 03/22/2024]
Abstract
INTRODUCTION The COVID-19 pandemic significantly impacted global public health. Infant mortality rate (IMR), a vital statistic and key indicator of a population's overall health, is essential for developing effective health prevention programs. Existing evidence primarily indicates a decrease in IMR during the COVID-19 pandemic. We conducted a national-level analysis to calculate IMR and describe its course over the years (from 2016 until 2022), using a month-by-month analysis. METHODS Data on the number of deaths under one year of age was collected from the Portuguese E-Death Certification System (SICO), and data on the number of monthly live births was obtained from Statistics Portugal. The IMR was calculated per month, considering the previous 12 months' cumulative number of deaths under one year of age and the number of live births. RESULTS In Portugal, the IMR decreased before and during the COVID-19 pandemic. The lowest values were observed in September and October 2021 (2.15 and 2.14 per 1000 live births, respectively). The IMR remained below the threshold of three deaths per 1000 live births during the pandemic's critical period. CONCLUSION Portugal has achieved remarkable progress in reducing its IMR over the last 60 years. The country recorded its lowest-ever IMR values during the COVID-19 pandemic. Further studies are needed to fully understand the observed trends.
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Affiliation(s)
- Paulo Jorge Nogueira
- Escola Nacional de Saúde Pública (ENSP). Centro de Investigação em Saúde Pública (CISP). Comprehensive Health Research Center (CHRC). Universidade NOVA de Lisboa. Lisboa; Laboratório Associado TERRA. Instituto de Saúde Ambiental. Faculdade de Medicina. Universidade de Lisboa. Lisboa; EPI Task-Force. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Catarina Camarinha
- EPI Task-Force. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática). Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Rodrigo Feteira-Santos
- Laboratório Associado TERRA. Instituto de Saúde Ambiental. Faculdade de Medicina. Universidade de Lisboa. Lisboa; EPI Task-Force. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática). Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Andreia Silva Costa
- Laboratório Associado TERRA. Instituto de Saúde Ambiental. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa (CIDNUR). Escola Superior de Enfermagem de Lisboa. Lisboa; Católica Research Centre for Psychological, Family and Social Wellbeing (CRC-W). Universidade Católica Portuguesa. Lisboa. Portugal
| | - Miguel De-Araújo-Nobre
- EPI Task-Force. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Clínica Universitária de Estomatologia. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Leonor Bacelar-Nicolau
- Laboratório Associado TERRA. Instituto de Saúde Ambiental. Faculdade de Medicina. Universidade de Lisboa. Lisboa; EPI Task-Force. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática). Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Cristina Furtado
- Laboratório Associado TERRA. Instituto de Saúde Ambiental. Faculdade de Medicina. Universidade de Lisboa. Lisboa; EPI Task-Force. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Cecília Elias
- EPI Task-Force. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Unidade de Saúde Pública Francisco George. Agrupamento de Centros de Saúde Lisboa Norte. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa. Portugal
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Fronteira I, Pacheco M, Schaltz-Buchholzer F, Ferrinho P. Nonspecific Effects of the Bacillus Calmette-Guérin Vaccine in Portuguese Children Under 5 Years of Age: Protocol for a Population-Based Historical Birth Cohort Study. JMIR Res Protoc 2024; 13:e55332. [PMID: 38328938 PMCID: PMC10979328 DOI: 10.2196/55332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The Bacillus Calmette-Guérin vaccine (BCG) against tuberculosis (TB) shows beneficial nonspecific effects, which are likely related to innate immune training. Until 2016, a single BCG dose was administered to all newborns in Portugal. In July 2016, a clinical guideline established that only children under 6 years belonging to high-risk groups should receive BCG. This might have prevented nonvaccinated children from developing trained immunological responses as effectively as BCG-vaccinated children. OBJECTIVE This study aims to investigate if there is variation in TB-related and all-cause mortality, and severe, moderate, or mild morbidity in children under 5 years of age, and whether such variation might be explained by the BCG vaccination policy change in 2016. METHODS This population-based historical birth cohort study includes children under 5 years of age born in Portugal between July 1, 2010, and June 30, 2021. Newborns with low birth weight, premature status, or known or suspected HIV infection are excluded. The follow-up period is until the completion of 5 years of age or the end of follow-up (June 30, 2021). The study will use secondary data from the National Health Service user registry, death certificate database, vaccination registry, communicable diseases surveillance system, TB surveillance system, diagnosis-related group information system for hospital admissions and emergency department visits, and primary health care information system. The data will be linked. Primary outcomes include person-time incidence rates of death (all causes and TB), TB diagnosis, and all causes and some specific causes of severe, moderate, or mild morbidity, and the incidence rate ratio of nonvaccinated to BCG-vaccinated children. We will compare the probability of surviving the first and fifth years of life or of not having severe, moderate, or mild morbidity during the follow-up period according to exposure (BCG vaccinated or nonvaccinated, number of doses, and time from birth until the first dose), using the log-rank test for assessing differences in survival rates between exposed and nonexposed children and hazard ratios for quantifying the differences. Moreover, we will perform a proportional hazards regression analysis. RESULTS Ethics approval has been obtained. In March 2022, database owners were contacted to present the project and discuss the request for data. A unique identifier will be used. In July 2023, a process of redefinition of the variables per database was initiated. Data were received in October and November 2023. In November 2023, further work was conducted. By April 2024, we expect to start analyzing the full data set. CONCLUSIONS The results will contribute to the accumulating body of knowledge and might have relevance to guide global BCG vaccination policy. Data linkage can contribute to a swifter mechanism to use available health data to conduct population-based studies and inform policy decision-making. TRIAL REGISTRATION ClinicalTrials.gov NCT05471167; https://clinicaltrials.gov/study/NCT05471167. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55332.
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Affiliation(s)
- Ines Fronteira
- NOVA National School of Public Health, Public Health Research Center, Comprehensive Health Research Center, NOVA University, Lisbon, Portugal
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisbon, Portugal
| | - Matilde Pacheco
- NOVA National School of Public Health, Public Health Research Center, Comprehensive Health Research Center, NOVA University, Lisbon, Portugal
- Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Frederik Schaltz-Buchholzer
- Bandim Health Project, OPEN, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odensen, Denmark
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisbon, Portugal
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Martins Leitão P, Oliveira S, Miranda A, Vivas C, Nascimento J, Leal S, Tavares Ferreira J, Magalhães A. Ophthalmology Census 2021: A Demographic Characterisation of Ophthalmologists in Portugal. ACTA MEDICA PORT 2024. [PMID: 38477300 DOI: 10.20344/amp.20321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/28/2023] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Human resources in ophthalmology have recently received particular attention, and it has been questioned whether there is a sufficient number of workers. The aim of this study was to analyze and characterize Portugal's ophthalmologist population. METHODS In this descriptive, cross-sectional study, an online questionnaire was sent to all ophthalmologists registered with the Portuguese College of Ophthalmology in December 2021. Information on the following variables was collected and analyzed: demographic factors, professional qualifications, professional activity, weekly professional activity and medium-term plans. RESULTS Among the 910 registered ophthalmologists, a response rate of 64.7% was achieved. There were 0.9 ophthalmologists for every 10 000 inhabitants, 0.45:10 000 working in the public sector (0.35:10 000 full-time equivalent). Among the respondents, 57.6% were over 50 years old (59.6% male), 97.3% were Portuguese, 46.7% completed their residency in the Lisbon region, 27.3% complemented their programme with additional training, 9.5% had a PhD and approximately 58% lived and worked in large urban centres. Regarding professional activity, 58.5% of the respondents worked in the public sector (4.2% exclusively), while 67.9% worked in different economic sectors. The median number of weekly working hours reported was 45 hours, with those in the public sector reporting 35 hours. Private/social sector work and public sector work accounted for 12 926 hours/week and 10 808 hours/week, respectively. It was found that 31.4% of the respondents provided emergency medical services and that 52.8% performed surgical procedures more than once a week. Looking ahead, 38.7% of the ophthalmologists intended to reduce their workload within the next five years due to family reasons, fatigue and demotivation. The projected rate of retirement or cessation of activity in the next five years was estimated to be 1.7%, while an average of 20 new ophthalmologists are expected to enter the profession annually, resulting in a generational balance of 0.8%. CONCLUSION While the number of ophthalmologists in Portugal meets the international recommendations, there is a shortage in the public sector and most ophthalmologists work in large urban centres. The number of ophthalmologists in Portugal is expected to be stable for the next five years.
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Affiliation(s)
- Paula Martins Leitão
- College of Ophthalmology. Portuguese Medical Association. Lisbon; Department of Ophthalmology. Associação Protectora dos Diabéticos de Portugal. Lisbon. Portugal
| | - Sandra Oliveira
- Santarém Higher School of Management and Technology. Instituto Politécnico de Santarém. Santarém; Life Quality Research Centre. Instituto Politécnico de Santarém. Santarém; Center for Innovation in Biomedicine and Biotechnology. Universidade de Coimbra. Coimbra. Portugal
| | - Ana Miranda
- College of Ophthalmology. Portuguese Medical Association. Lisbon; Department of Ophthalmology. Hospital Garcia de Orta. Almada. Portugal
| | - Carla Vivas
- Research Center. Instituto Universitário Militar. Lisbon. Portugal
| | - João Nascimento
- Santarém Higher School of Management and Technology. Instituto Politécnico de Santarém. Santarém. Portugal
| | - Susana Leal
- Santarém Higher School of Management and Technology. Instituto Politécnico de Santarém. Santarém; Center for Innovation in Biomedicine and Biotechnology. Universidade de Coimbra. Coimbra. Portugal
| | - Joana Tavares Ferreira
- College of Ophthalmology. Portuguese Medical Association. Lisbon; Department of Ophthalmology. Centro Hospitalar Universitário de Lisboa Norte. Lisbon. Portugal
| | - Augusto Magalhães
- College of Ophthalmology. Portuguese Medical Association. Lisbon; Department of Ophthalmology. Centro Hospitalar Universitário de São João. Oporto. Portugal
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12
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Cruz AVS, López-López P, Santos-Silva S, Rivero-Juárez A, Rebelo H, Mesquita JR. Molecular detection of Enterocytozoon bieneusi in bats from Portugal. Med Mycol 2024; 62:myae019. [PMID: 38414255 DOI: 10.1093/mmy/myae019] [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: 01/25/2024] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 02/29/2024] Open
Abstract
Enterocytozoon bieneusi is a microsporidia commonly found in the gastrointestinal tract of humans and a wide range of other animals, constituting a major cause of microsporidiosis in humans. Although E. bieneusi has been detected in humans, domestic, and wild animals in Portugal, and its presence in bats has been linked to zoonotic characteristics, its occurrence in bats within the country has not been reported. In this study, we investigated the presence of E. bieneusi in 380 bat fecal samples collected in mainland Portugal through a nested PCR assay targeting the internal transcribed spacer region and the flanking small and large subunits of the ribosomal RNA. Enterocytozoon bieneusi was detected in one bat sample (i.e., 0.26%; Pipistrellus pipistrellus). Additionally, another sample tested positive for Enterocytozoon sp. Phylogenetic analysis of the obtained ITS sequence of E. bieneusi revealed clustering within the potentially zoonotic Group 1. This study represents the first report of E. bieneusi in a bat from Europe. Findings presented here contribute to an enhanced understanding of E. bieneusi epidemiology.
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Affiliation(s)
- Andreia V S Cruz
- Departamento de Clínicas Veterinárias, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Pedro López-López
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Sérgio Santos-Silva
- Departamento de Clínicas Veterinárias, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Antonio Rivero-Juárez
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Hugo Rebelo
- Departamento de Biologia Animal, cE3c - Centre for Ecology, Evolution and Environmental Changes & CHANGE - Global Change and Sustainability Institute, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
| | - João R Mesquita
- Departamento de Clínicas Veterinárias, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit), ISPUP - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), ISPUP - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
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Chaves C, Zandonadi RP, Raposo A, Nakano EY, Ramos F, Farage P, Teixeira-Lemos E. Health-related quality of life among celiacs in Portugal: a comparison between general and specific questionnaires. Front Immunol 2024; 15:1372369. [PMID: 38500888 PMCID: PMC10944991 DOI: 10.3389/fimmu.2024.1372369] [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: 01/17/2024] [Accepted: 02/20/2024] [Indexed: 03/20/2024] Open
Abstract
Objective This study aimed to compare the 36-Item Short Form Survey Instrument version 2 (SF-36-v2) (generic) and Celiac Disease Questionnaire (CDQ) (specific) questionnaires used to evaluate the quality of life (QoL) in celiac Portuguese adult individuals. Methods This cross-sectional study used non-probabilistic sampling based on Portuguese celiac patients who accessed the online survey in 2022. The online data collection used a self-reported instrument composed of three parts: (i) socioeconomic, health, and gluten-free diet (GFD) adherence questions; (ii) SF-36 v2 - Portuguese version (generic questionnaire) and (iii) Celiac Disease Questionnaire (CDQ) (specific questionnaire). Results A total of 234 individuals who accessed the survey completed the questionnaire. Seven of the eight SF-36 domains positively correlated to the specific questionnaire CDQ. The "General Health" domain (domain 4) showed a negative correlation with the CDQ. Differences in content between the two instruments might be able to explain this finding since the CDQ explores issues regarding the specificities of celiac disease (CD) and the lifelong GFD burden. About half of the sample from this study displayed poor diet adherence, it is possible that the SF-36 could not reflect the impact of CD treatment - the complete elimination of gluten from the diet - on patients' health. Therefore, this issue should be carefully evaluated in future research. Conclusion Specific validated questionnaires for CD individuals, such as the CDQ, contemplate social, economic, and clinical variables that permeate the patient's life context. Therefore, these instruments may be more suitable for evaluating QoL in this public. However, using a general questionnaire such as the SF-36 would be indicated for comparing QOL between celiac patients and the general population or even between CD and other disease individuals. In this case, we recommend assessing GFD compliance for control parallelly.
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Affiliation(s)
- Cláudia Chaves
- ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic University of Viseu, Viseu, Portugal
| | | | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| | | | - Fernando Ramos
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
- Associated Laboratory for Green Chemistry (LAQV) of the Network of Chemistry and Technology (REQUIMTE), Porto, Portugal
| | - Priscila Farage
- Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
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14
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Rainho M, Melo Ferreira E. [Identifying Haemoglobinopathy Carriers in Portugal: Challenges and Considerations from a Primary Health Care Perspective]. ACTA MEDICA PORT 2024; 37:235-236. [PMID: 38373228 DOI: 10.20344/amp.20812] [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: 10/14/2023] [Accepted: 12/22/2023] [Indexed: 02/21/2024]
Affiliation(s)
- Marta Rainho
- Medicina Geral e Familiar. Unidade de Saúde Familiar Luísa Todi. Unidade Local de Saúde da Arrábida. Setúbal. Portugal
| | - Elisa Melo Ferreira
- Medicina Geral e Familiar. Unidade de Saúde Familiar Luísa Todi. Unidade Local de Saúde da Arrábida. Setúbal. Portugal
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15
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Seabra B, Duarte R. Tuberculosis national registries and data on diagnosis delay - Is there room for improvement? Pulmonology 2024; 30:130-136. [PMID: 34167933 DOI: 10.1016/j.pulmoe.2021.05.004] [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: 01/18/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Excessive delay in the diagnosis of Tuberculosis may have a negative impact on the epidemiological control and elimination of this disease. An accurate determination and analysis of delay times may help identify where and how to improve Tuberculosis diagnosis according to local needs. The Portuguese Tuberculosis Surveillance System - SVIG-TB - is the main source of data regarding diagnosis delay. However, to our knowledge, there has been no recent evaluation of its data. This study's primary aim was to conduct a thorough quantitative and qualitative evaluation of data obtained from the SVIG-TB registry concerning the delay in Tuberculosis diagnosis in Matosinhos, a Portuguese municipality. METHODS All patients living in the Matosinhos municipality diagnosed with Tuberculosis between January 1st 2012 and December 31st 2019 were identified and individual SVIG-TB records retrieved. Patient-related, Healthcare-related and Total delay in Tuberculosis diagnosis were determined based on data obtained from this source and compared to data recovered from patient record review. Missing data, registering errors and differences in diagnosis delay between these two sources were analysed and compared. Subsequently, diagnosis delay data from a recent Portuguese nationwide SVIG-TB paper, covering years 2010 to 2014, was compared to local SVIG-TB and patient record review data. RESULTS This study identified a significantly greater percentage of cases with missing data on delay in SVIG-TB records when compared to Patient Record Review (57.2% versus 1.11%). The median patient-related, healthcare-related and Total delay in Tuberculosis diagnosis were of 17, 30 and 68 days, respectively, in the SVIG-TB based data. A significant underestimation of healthcare-related and total Tuberculosis diagnosis delay was identified in SVIG-TB data when compared to Patient Record Review. There was no significant difference between Patient-related delays determined from these two sources. Compared to the national study results, missing values were more common in this data set (57.2 vs 44.6%), mainly due to the absence of patient-related delay data. Median Total and Healthcare-related delays were significantly greater in Matosinhos Municipality, regardless of the data source (SVIG-TB or Patient Record Review). The patient-related delay was, conversely, shorter. CONCLUSIONS SVIG-TB has been crucial in guiding National Public Health policies on the path towards Tuberculosis elimination in Portugal. However, there is still room for improvement. These results provide a basis for further reflection on the shortcomings and potential of SVIG-TB in guiding the national Tuberculosis program.
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Affiliation(s)
- Bárbara Seabra
- Pulmonology Department, Hospital Pedro Hispano - Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal; TB Outpatient Clinic (CDP) Matosinhos - Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.
| | - Raquel Duarte
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho; TB Outpatient Clinic (CDP) Vila Nova de Gaia, Vila Nova de Gaia Portugal; Faculty of Medicine of the University of Porto (FMUP), Porto Portugal; Institute of Public Health (ISPUP), University of Porto, Porto Portugal
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16
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Gouveia A, Martins F, Trindade P, Jesus G, M Bessa J, Heitor MJ, Câmara Pestana L, Fernandes LA, Morgado P, Oliveira-Maia AJ. [Neuroscience-Based Nomenclature for Psychotropic Drugs: Four Reasons to Use and Keep it in Portugal]. ACTA MEDICA PORT 2024; 37:155-159. [PMID: 38430470 DOI: 10.20344/amp.20267] [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: 06/08/2023] [Accepted: 10/30/2023] [Indexed: 03/03/2024]
Affiliation(s)
- Afonso Gouveia
- Serviço de Psiquiatria. Unidade Local de Saúde do Baixo Alentejo. Beja; Comprehensive Health Research Centre (CHRC). NOVA Medical School. Universidade NOVA de Lisboa. Lisboa. Portugal
| | - Filipa Martins
- Serviço de Psiquiatria. Centro Hospitalar Universitário de São João. Porto; Centro de Investigação em Tecnologias e Serviços de Saúde - CINTESIS. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Pedro Trindade
- Serviço de Psiquiatria. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal
| | - Gustavo Jesus
- Faculdade de Medicina. Universidade de Lisboa. Lisboa; Partners in Neuroscience - PIN. Lisboa; Serviço de Psiquiatria. Hospital de Vila Franca de Xira (ULS Estuário do Tejo). Lisboa. Portugal
| | - João M Bessa
- Faculdade de Medicina. Universidade de Lisboa. Lisboa; Partners in Neuroscience - PIN. Lisboa; Serviço de Psiquiatria. Hospital de Vila Franca de Xira (ULS Estuário do Tejo). Lisboa. Portugal
| | - Maria João Heitor
- Environmental Health Behaviour Lab. Instituto de Saúde Ambiental & Laboratório Associado TERRA. Faculdade de Medicina. Universidade de Lisboa; Departamento de Psiquiatria e Saúde Mental. Hospital Beatriz Ângelo. Loures; Centro de Investigação Interdisciplinar em Saúde - CIIS. Faculdade de Medicina. Universidade Católica Portuguesa. Lisboa. Portugal
| | - Luís Câmara Pestana
- Faculdade de Medicina. Universidade de Lisboa. Lisboa; Centro Hospitalar Universitário Lisboa Norte - CHULN. Lisboa. . Portugal
| | - Luís Afonso Fernandes
- Departamento de Saúde Mental. Hospital Professor Doutor Fernando Fonseca EPE. Lisboa. Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute - ICVS. Faculdade de Medicina. Universidade do Minho. Campus de Gualtar. Braga; Laboratório Associado ICVS/3B's. Braga/Guimarães. Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre. Fundação Champalimaud. Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Portugal
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Vieira Dias M, Gaspar P. Letter to the Editor Regarding "A Prospective Study of Patients with Persistent Symptoms after SARS-CoV-2 Infection Referred to Physical Medicine and Rehabilitation". ACTA MEDICA PORT 2024; 37:226-228. [PMID: 38354422 DOI: 10.20344/amp.20573] [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: 08/20/2023] [Accepted: 12/13/2023] [Indexed: 02/16/2024]
Affiliation(s)
- Mariana Vieira Dias
- Internal Medicine Department. Hospital Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisbon. Portugal
| | - Pedro Gaspar
- Internal Medicine Department. Hospital Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisbon; Instituto de Medicina Molecular João Lobo Antunes. Faculdade de Medicina. Universidade de Lisboa. Lisbon. Portugal
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Costa A, Henriques J, Alarcão V, Madeira T, Virgolino A, Henriques A, Feteira-Santos R, Polley M, Arriaga M, Nogueira P. Social prescribing for older adults in mainland Portugal: Perceptions and future prospects. Prev Med Rep 2024; 39:102652. [PMID: 38384966 PMCID: PMC10879768 DOI: 10.1016/j.pmedr.2024.102652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
Background In order to address health inequalities, which have been exacerbated by the COVID-19 pandemic, and promote older adults' quality of life, it is necessary to explore non-medical approaches such as social prescribing. Social prescribing is a person-centered approach that allows health professionals to refer patients to services provided by the social and community sectors. This study aimed to explore older adults' perceptions of social prescribing in mainland Portugal and to identify factors associated with these perceptions, providing insights for future implementation strategies. Methods A cross-sectional study was conducted with 613 older adults aged 65 to 93. Participants' sociodemographic, economic, and health characteristics were assessed, along with their perceptions of social prescribing's benefits and activity interest. Results Over 75% of respondents agreed that social prescribing would benefit the health system and their community. Most participants (87.7% and 89.7%, respectively) thought that activities like personal protection and development activities and cultural enrichment would be particularly relevant to them. Factors such as marital status, education, health status, and pain/discomfort levels influenced the perceived relevance of these activities. Conclusion This study reveals that older adults in mainland Portugal are open to social prescribing and suggests that tailored interventions considering individual preferences and characteristics can lead to more effective implementation and equal access to social prescribing. Further research and policy efforts should focus on integrating social prescribing into the healthcare system to support healthy aging in Portugal.
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Affiliation(s)
- Andreia Costa
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon 1649-023, Portugal
| | - Joana Henriques
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa 1600-560, Portugal
| | - Violeta Alarcão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Centro de Investigação e Estudos de Sociologia (CIES-Iscte), Instituto Universitário de Lisboa (Iscte), Lisboa 1649-026, Portugal
| | - Teresa Madeira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Marie Polley
- University of Westminster, School of Social Sciences (Psychology), 115 New Cavendish Street, London W1W 6UW, United Kingdom
- Consultancy Ltd., Hitchin SG4 0AP, United Kingdom
| | - Miguel Arriaga
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon 1649-023, Portugal
| | - Paulo Nogueira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa 1600-560, Portugal
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Cunha AS, Pedro AR, V Cordeiro J. Challenges of Using Telemedicine in Hospital Specialty Consultations during the COVID-19 Pandemic in Portugal According to a Panel of Experts. ACTA MEDICA PORT 2024; 37:198-206. [PMID: 38430471 DOI: 10.20344/amp.19931] [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: 03/22/2023] [Accepted: 07/12/2023] [Indexed: 03/03/2024]
Abstract
INTRODUCTION The COVID-19 pandemic has accelerated the adoption of telemedicine as a means of reducing face-to-face contact and protecting professionals and patients. In Portugal, the number of hospital telemedicine consultations has significantly increased. However, the rapid implementation of telemedicine has also led to disparities in access to these services, resulting in inequalities in healthcare delivery. The aim of this study was to identify the main challenges to accessing hospital medical specialty consultations through telemedicine in Portugal during the COVID-19 pandemic. Additionally, this study aimed to establish a consensus on possible solutions for the challenges which were identified. METHODS This study used the nominal group technique, which involved a panel of 10 experts. The panel generated a total of 71 ideas, which were then categorized into three groups: A) challenges relating to patients, which impact access to hospital-based medical specialty consultations through telemedicine; B) challenges relating to professionals, institutions and health systems, which impact access to hospital medical specialty consultations through telemedicine; C) recommendations to overcome the challenges faced in adopting telemedicine solutions. Each of the ideas was assessed, scored and ranked based on its relevance considering the study objectives. RESULTS This study identified several significant challenges that impacted the adoption of telemedicine in Portugal during the COVID-19 pandemic. The challenges that related to patients (A) that were deemed the most relevant were low digital literacy, lack of information about telemedicine processes, low familiarity with technologies and distrust about the quality of services; the challenges that impacted healthcare professionals, institutions, and health systems (B) and were deemed the most relevant were the lack of integration of telemedicine in the patient's journey, low motivation to adopt telemedicine solutions, poor interoperability between systems, and the absence of the necessary technological equipment. The most relevant recommendations (C) included investing in healthcare institutions, developing clear guidelines for the safety and quality of telemedicine practices, and incorporating telemedicine into the curricula of health professions. CONCLUSION This study identified several challenges that impacted the adoption and implementation of telemedicine services for hospital care in Portugal during the pandemic period. These challenges were related to digital health literacy, technological and operational conditions, and reluctance in technological adoption. To overcome these challenges, training programs for healthcare professionals and patients may be necessary, along with investment in technological infrastructures, interoperability between systems, effective communication strategies and the strengthening of specific regulations.
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Affiliation(s)
- Ana Soraia Cunha
- Public Health Research Centre. NOVA National School of Public Health. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Ana Rita Pedro
- Public Health Research Centre. NOVA National School of Public Health. Universidade NOVA de Lisboa. Lisbon; Public Health Research Centre. Comprehensive Health Research Center (CHRC). NOVA National School of Public Health. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - João V Cordeiro
- Public Health Research Centre. NOVA National School of Public Health. Universidade NOVA de Lisboa. Lisbon; Public Health Research Centre. Comprehensive Health Research Center (CHRC). NOVA National School of Public Health. Universidade NOVA de Lisboa. Lisbon; Interdisciplinary Center of Social Sciences. Universidade NOVA de Lisboa. Lisbon. Portugal
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Quina M, Ramos D, Silva C, Pádua E. Diversity of Human T-Lymphotropic Virus Type 1 Cosmopolitan Subtype (HTLV-1a) Circulating in Infected Residents in Portugal. AIDS Res Hum Retroviruses 2024; 40:171-180. [PMID: 37462999 DOI: 10.1089/aid.2023.0026] [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: 08/12/2023] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) prevalence in Portugal is low and mainly affects immigrants from endemic areas where human immunodeficiency virus (HIV) infection represents a public health problem. Despite the majority of HTLV-1-infected individuals remains asymptomatic, severe pathologies may develop after prolonged viral persistence, namely an aggressive form of leukemia. An increased mortality rate and faster progression to death is often related to HTLV-1/HIV coinfection. Nevertheless, studies showed that some antiretrovirals used in HIV treatment lead to a positive immune response against HTLV-1. This study aimed to analyze epidemiological and clinical data, and to assess the diversity of HTLV-1 strains circulating in infected residents diagnosed in the Portuguese national reference laboratory between 2010 and 2021. Long terminal repeat and env proviral sequences derived from 20 individuals were used to generate phylogenetic trees along with multiples reference sequences from different geographic origins retrieved from the database. Three samples belong to Portuguese natives and 17 belong to immigrants: 15 from several countries of Africa, 1 from South America, and 1 from Europe; 6 patients (30%, mean age 40.3 years) showed HTLV-1-related diseases, and 6 (30%, mean age 45.2 years) were coinfected with HIV/AIDS. The results show that the Cosmopolitan subtype is circulating in Portugal, with 10 sequences being classified as subgroup A, that include Portuguese and natives from S. Tomé and Príncipe with a mean age of 39.4 years, and 10 sequences that segregated into the Senegal cluster derived from natives born in Guinea-Bissau with a mean age of 43.5 years. A high proportion of HTLV-1-related diseases and HIV/AIDS coinfection was observed. Risk behavior practices and the absence of specific control measures, including diagnostic and treatment, may contribute to a silent dissemination of a broad diversity of HTLV-1 strains and, therefore, the increased rate of progression to debilitating diseases. In this manner, an early diagnostic and a molecular surveillance of HTLV-1 transmission remains necessary in Portugal.
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Affiliation(s)
- Miriam Quina
- Reference Laboratory of HIV and Hepatitis B and C, Infectious Diseases Department, National Institute of Health, Lisbon, Portugal
| | - Diogo Ramos
- Reference Laboratory of HIV and Hepatitis B and C, Infectious Diseases Department, National Institute of Health, Lisbon, Portugal
| | - Carolina Silva
- Reference Laboratory of HIV and Hepatitis B and C, Infectious Diseases Department, National Institute of Health, Lisbon, Portugal
| | - Elizabeth Pádua
- Reference Laboratory of HIV and Hepatitis B and C, Infectious Diseases Department, National Institute of Health, Lisbon, Portugal
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21
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Rocha S, Alves Â, Antunes C, Rodrigues P, Casal G. Characterization of novel aurantiactinomyxon types (Cnidaria, Myxosporea) from the oligochaete Ilyodrilus templetoni (Southern, 1909), with a comprehensive phylogeny of the collective group. J Invertebr Pathol 2024; 203:108043. [PMID: 38104963 DOI: 10.1016/j.jip.2023.108043] [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] [Revised: 09/26/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Three new aurantiactinomyxon types are described from the oligochaete Ilyodrilus templetoni (Southern, 1909) (Naididae) collected from a northern Portuguese estuary, based on light microscopy and sequencing of the 18S rDNA. The addition of I. templetoni to the group of freshwater annelids known to be permissive for aurantiactinomyxon development reinforces the crucial role of naidids in the evolution and settlement of myxozoans in estuarine environments. Maximum likelihood and Bayesian inference analyses of a comprehensive 18S rDNA dataset placed the novel types within the Paramyxidium clade. This positioning suggests them as probable life cycle counterparts to Paramyxidium spp. that most likely infect the European eel Anguilla anguilla, as the sole representative of Elopomorpha in Portuguese rivers. Although distance estimation revealed a genetic difference of only 0.4 % between Aurantiactinomyxon types 1 and 3, this value was determined to be representative of interspecific variability based on the consistent matching of both genotypes with distinct actinospore morphologies, and potential richness of closely related species of Paramyxidium infecting the European eel in Portuguese waters. The clustering of aurantiactinomyxon types within distinct myxosporean lineages, representative of the suborders Variisporina and Platysporina, demonstrates that the aurantiactinomyxon morphotype is highly functional in promoting myxozoan infections in estuarine environments.
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Affiliation(s)
- Sónia Rocha
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen no. 208, 4200-135 Porto, Portugal; ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Ângela Alves
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Carlos Antunes
- Aquamuseu do Rio Minho, Parque do Castelinho, 4920-290 Vila Nova de Cerveira, Portugal; Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Terminal de Cruzeiros de Leixões, Av. General Norton de Matos s/n, 4450-208 Matosinhos, Portugal
| | - Pedro Rodrigues
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen no. 208, 4200-135 Porto, Portugal; ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Graça Casal
- 1H-OXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences, CESPU, Rua Central da Gandra no. 1317, 4585-116, Gandra, Portugal
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22
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Manageiro V, Cano M, Furtado C, Iglesias C, Reis L, Vieira P, Teixeira A, Martins C, Veloso I, Machado J, Paiva JA, Caniça M. Genomic and epidemiological insight of an outbreak of carbapenemase-producing Enterobacterales in a Portuguese hospital with the emergence of the new KPC-124. J Infect Public Health 2024; 17:386-395. [PMID: 38246112 DOI: 10.1016/j.jiph.2023.12.014] [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: 11/06/2023] [Revised: 12/11/2023] [Accepted: 12/17/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Carbapenemase-producing Enterobacterales (CPE) is an increasing problem in healthcare settings. This study aimed to identify the source of a CPE outbreak that occurred in 2022, in a tertiary hospital in the North of Portugal, to identify exposed patients, and to assess the risk of becoming CPE-positive following hospital admission. METHODS A multi-disciplinary investigation was conducted including descriptive, analytical, and molecular epidemiology, environmental screening, and assessment of infection control measures. Clinical and environmental isolates were analyzed using whole-genome sequencing and phylogenetic analysis. Additionally, a prospective observational cohort study was conducted to further investigate the risk factors associated with the emergence of new cases in cohorts of CPE-negative admitted patients. RESULTS We observed the presence of multispecies KPC-, IMP-, and/or NDM-producing isolates. Genetically indistinguishable clinical and environmental isolates were found on the same room/ward. The ST45 KPC-3-producing Klebsiella pneumoniae clone was the responsible for the outbreak. During patients' treatment, we detected the emergence of resistance to ceftazidime-avibactam, associated with mutations in the blaKPC-3 gene (blaKPC-46, blaKPC-66 and blaKPC-124, the last variant never previously reported), suggesting a vertical evolutionary trajectory. Patients aged ≥ 75 years, hygiene/feeding-care dependent, and/or subjected to secretion aspiration were risk factors for CPE colonization after hospital admission. Additionally, cases with previous admission to the emergency department suggest that CPE dissemination may occur not only during hospitalization but also in the emergency department. CONCLUSION Overall, the study highlights that selection pressure with antibiotics, like ceftazidime-avibactam, is a contributing factor to the emergence of new β-lactamase variants and antibiotic resistance. It also shows that the hospital environment can be a significant source of CPE transmission, and that routine use of infection control measures and real-time molecular epidemiology investigations are essential to ensure the long-term termination of CPE outbreaks and prevent future resurgences.
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Affiliation(s)
- Vera Manageiro
- National Reference Laboratory of Antibiotic Resistance and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal; ECDC fellowship Programme, Public Health Microbiology path (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Manuela Cano
- Department of Environmental Health, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Cristina Furtado
- Reference and Surveillance Unit, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Carmen Iglesias
- Clinical Pathology Service, Hospital de Braga, Braga, Portugal
| | - Lígia Reis
- National Reference Laboratory of Antibiotic Resistance and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Patrícia Vieira
- National Reference Laboratory of Antibiotic Resistance and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Aida Teixeira
- Local Unit of the Program for Prevention and Control of Infection and Antimicrobial Resistance (UL-PPCIRA), Hospital de Braga, Braga, Portugal
| | - Cláudia Martins
- Local Unit of the Program for Prevention and Control of Infection and Antimicrobial Resistance (UL-PPCIRA), Hospital de Braga, Braga, Portugal
| | - Isabel Veloso
- Local Unit of the Program for Prevention and Control of Infection and Antimicrobial Resistance (UL-PPCIRA), Hospital de Braga, Braga, Portugal
| | - Jorge Machado
- Coordination of the Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal
| | - José Artur Paiva
- Intensive Care Medicine Service, Centro Hospitalar Universitário São João (CHUSJ), Porto, Portugal; Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal; Infections and Antimicrobial Resistance Prevention Programme, Directorate General of Health, Portugal
| | - Manuela Caniça
- National Reference Laboratory of Antibiotic Resistance and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal; Centre for the Studies of Animal Science, Institute of Agrarian and Agri-Food Sciences and Technologies, University of Porto, Porto, Portugal; AL4AnimalS, Associate Laboratory for Animal and Veterinary Sciences, Portugal.
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23
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Abrantes R, Pimentel V, Miranda MNS, Silva AR, Diniz A, Ascenção B, Piñeiro C, Koch C, Rodrigues C, Caldas C, Morais C, Faria D, Gomes da Silva E, Teófilo E, Monteiro F, Roxo F, Maltez F, Rodrigues F, Gaião G, Ramos H, Costa I, Germano I, Simões J, Oliveira J, Ferreira J, Poças J, Saraiva da Cunha J, Soares J, Fernandes S, Mansinho K, Pedro L, Aleixo MJ, Gonçalves MJ, Manata MJ, Mouro M, Serrado M, Caixeiro M, Marques N, Costa O, Pacheco P, Proença P, Rodrigues P, Pinho R, Tavares R, Correia de Abreu R, Côrte-Real R, Serrão R, Sarmento e Castro R, Nunes S, Faria T, Baptista T, Simões D, Mendão L, Martins MRO, Gomes P, Pingarilho M, Abecasis AB. Determinants of HIV late presentation among men who have sex with men in Portugal (2014-2019): who's being left behind? Front Public Health 2024; 12:1336845. [PMID: 38500732 PMCID: PMC10947991 DOI: 10.3389/fpubh.2024.1336845] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/26/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction HIV late presentation (LP) remains excessive in Europe. We aimed to analyze the factors associated with late presentation in the MSM population newly diagnosed with HIV in Portugal between 2014 and 2019. Methods We included 391 newly HIV-1 diagnosed Men who have Sex with Men (MSM), from the BESTHOPE project, in 17 countrywide Portuguese hospitals. The data included clinical and socio-behavioral questionnaires and the viral genomic sequence obtained in the drug resistance test before starting antiretrovirals (ARVs). HIV-1 subtypes and epidemiological surveillance mutations were determined using different bioinformatics tools. Logistic regression was used to estimate the association between predictor variables and late presentation (LP). Results The median age was 31 years, 51% had a current income between 501-1,000 euros, 28% were migrants. 21% had never been tested for HIV before diagnosis, with 42.3% of MSM presenting LP. 60% were infected with subtype B strains. In the multivariate regression, increased age at diagnosis, higher income, lower frequency of screening, STI ever diagnosed and higher viral load were associated with LP. Conclusion Our study suggests that specific subgroups of the MSM population, such older MSM, with higher income and lower HIV testing frequency, are not being targeted by community and clinical screening services. Overall, targeted public health measures should be strengthened toward these subgroups, through strengthened primary care testing, expanded access to PrEP, information and promotion of HIV self-testing and more inclusive and accessible health services.
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Affiliation(s)
- Ricardo Abrantes
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon (IHMT/UNL), Lisbon, Portugal
| | - Victor Pimentel
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon (IHMT/UNL), Lisbon, Portugal
| | - Mafalda N. S. Miranda
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon (IHMT/UNL), Lisbon, Portugal
| | - Ana Rita Silva
- Serviço de Infeciologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - António Diniz
- U. Imunodeficiência, Hospital Pulido Valente, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Bianca Ascenção
- Serviço de Infeciologia, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Carmela Piñeiro
- Serviço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Carmo Koch
- Centro de Biologia Molecular, Serviço de Imunohemoterapia do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Catarina Rodrigues
- Serviço de Medicina 1.4, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Cátia Caldas
- Serviço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Célia Morais
- Serviço de Patologia Clínica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Domitília Faria
- Serviço de Medicina 3, Hospital de Portimão, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | | | - Eugénio Teófilo
- Serviço de Medicina 2.3, Hospital de Santo António dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Fátima Monteiro
- Centro de Biologia Molecular, Serviço de Imunohemoterapia do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Fausto Roxo
- Hospital de Dia de Doenças Infeciosas, Hospital Distrital de Santarém, Santarém, Portugal
| | - Fernando Maltez
- Serviço de Doenças Infeciosas, Hospital Curry Cabral, Centro Hospitalar de Lisboa, Lisbon, Portugal
| | - Fernando Rodrigues
- Serviço de Patologia Clínica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Guilhermina Gaião
- Serviço de Patologia Clínica, Hospital de Sta Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Helena Ramos
- Serviço de Patologia Clínica, Centro Hospitalar do Porto, Porto, Portugal
| | - Inês Costa
- Laboratório de Biologia Molecular (LMCBM, SPC, CHLO-HEM), Lisbon, Portugal
| | - Isabel Germano
- Serviço de Medicina 1.4, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Joana Simões
- Serviço de Medicina 1.4, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Joaquim Oliveira
- Serviço de Infeciologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - José Ferreira
- Serviço de Medicina 2, Hospital de Faro, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - José Poças
- Serviço de Infeciologia, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - José Saraiva da Cunha
- Serviço de Infeciologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Jorge Soares
- Serviço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sandra Fernandes
- Laboratório de Biologia Molecular (LMCBM, SPC, CHLO-HEM), Lisbon, Portugal
| | - Kamal Mansinho
- Serviço de Doenças Infeciosas, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Liliana Pedro
- Serviço de Medicina 3, Hospital de Portimão, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | | | | | - Maria José Manata
- Serviço de Doenças Infeciosas, Hospital Curry Cabral, Centro Hospitalar de Lisboa, Lisbon, Portugal
| | - Margarida Mouro
- Serviço de Infeciologia, Hospital de Aveiro, Centro Hospitalar Baixo Vouga, Aveiro, Portugal
| | - Margarida Serrado
- U. Imunodeficiência, Hospital Pulido Valente, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Micaela Caixeiro
- Serviço de Infeciologia, Hospital Dr. Fernando da Fonseca, Amadora, Portugal
| | - Nuno Marques
- Serviço de Infeciologia, Hospital Garcia da Orta, Almada, Portugal
| | - Olga Costa
- Serviço de Patologia Clínica, Biologia Molecular, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Patrícia Pacheco
- Serviço de Infeciologia, Hospital Dr. Fernando da Fonseca, Amadora, Portugal
| | - Paula Proença
- Serviço de Infeciologia, Hospital de Faro, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - Paulo Rodrigues
- Serviço de Infeciologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - Raquel Pinho
- Serviço de Medicina 3, Hospital de Portimão, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | - Raquel Tavares
- Serviço de Infeciologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - Ricardo Correia de Abreu
- Serviço de Infeciologia, Unidade de Local de Saúde de Matosinhos, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Rita Côrte-Real
- Serviço de Patologia Clínica, Biologia Molecular, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Rosário Serrão
- Serviço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal
| | | | - Sofia Nunes
- Serviço de Infeciologia, Hospital de Aveiro, Centro Hospitalar Baixo Vouga, Aveiro, Portugal
| | - Telo Faria
- Unidade Local de Saúde do Baixo Alentejo, Hospital José Joaquim Fernandes, Beja, Portugal
| | - Teresa Baptista
- Serviço de Doenças Infeciosas, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Daniel Simões
- Grupo de Ativistas em Tratamentos (GAT), Lisbon, Portugal
| | - Luis Mendão
- Grupo de Ativistas em Tratamentos (GAT), Lisbon, Portugal
| | - M. Rosário O. Martins
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon (IHMT/UNL), Lisbon, Portugal
| | - Perpétua Gomes
- Laboratório de Biologia Molecular (LMCBM, SPC, CHLO-HEM), Lisbon, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
| | - Marta Pingarilho
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon (IHMT/UNL), Lisbon, Portugal
| | - Ana B. Abecasis
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon (IHMT/UNL), Lisbon, Portugal
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24
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Gałczyk M, Zalewska A, Sobolewski M, Fernandes H. Assessment of physical activity levels and back pain among poles and Portuguese in the further year of the COVID-19 pandemic - a pilot study. BMC Public Health 2024; 24:582. [PMID: 38395826 PMCID: PMC10885362 DOI: 10.1186/s12889-024-18088-7] [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: 04/10/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The vast majority of people have experienced the problem of back pain at least once in their lives for a variety of reasons. It is well known that regular physical activity at a moderate level has a number of health benefits regardless of age or gender with positive effects on the musculoskeletal, cardiovascular, respiratory or nervous systems improving fitness levels. During the pandemic, Poland experienced one of the longest periods of school lockdown in Europe. In Portugal, this period was considerably shorter. The aim of this study was to determine the level of physical activity and back pain as well as relationship between physical activity and back pain in a group of Polish and Portuguese students in the following year the COVID-19 pandemic. METHODS The study was conducted via the Internet among students from Poland and Portugal (398 respondents - 229 from Poland and 169 from Portugal) in October 2022. In the pilot study, the International Physical Activity Questionnaire and The Oswestry Disability Index and Neck Disability Index questionnaires were used to assess the level of back pain. RESULTS There are no statistically significant differences in the level of physical activity and pain complaints of respondents from the two countries. At least half of the students do not report any pain complaints (median in some groups being 0). In the Portuguese men, there is a correlation between the level of physical activity and the Neck Disability Index score (p = 0.0304). CONCLUSIONS The following year, after the pandemic COVID-19 was declared, the prevalence of back pain among students in Poland and Portugal is still significant.
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Affiliation(s)
- Monika Gałczyk
- Faculty of Health Sciences, University of Lomza, 14 Akademicka St., 18-400, Lomza, Poland
| | - Anna Zalewska
- Faculty of Health Sciences, University of Lomza, 14 Akademicka St., 18-400, Lomza, Poland
| | - Marek Sobolewski
- Plant of Quantitative Methods, Rzeszow University of Technology, al. Powstancow Warszawy 12, 35-959, Rzeszow, Poland
| | - Hélder Fernandes
- Health Sciences Research Unit: Nursing (UICISA: E), Instituto Politécnico de Bragança, 5300-253, Bragança, Portugal
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Duque E, Durán Vázquez JF. Working conditions and attitudes towards work: the case of Portuguese youth from Braga. Front Sociol 2024; 9:1356527. [PMID: 38419916 PMCID: PMC10899689 DOI: 10.3389/fsoc.2024.1356527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/24/2024] [Indexed: 03/02/2024]
Abstract
The purpose of this study is to explore the working conditions and attitudes towards work among the youth of Braga, Portugal. Focusing on residents of the Municipality of Braga born between 1990 and 2000, we employed a quantitative approach using a non-probabilistic convenience sampling method, with a sample size of 406 people. The survey, conducted through questionnaires, reveals a complex interplay between the youth's work attitudes and their conditions. Despite the predominance of precarious employment, their work experiences and expectations do not entirely reflect this instability. Our findings suggest a shift in the role of work in the youths' identity compared to previous generations. This shift, common in post-industrial societies, shows that their identity is increasingly tied to the sociability their work enables and other life spheres where they seek fulfilment, as evidenced by how they utilize their earnings from these occupations.
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Affiliation(s)
- Eduardo Duque
- Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa & Communication and Society Research Centre (CECS) of the University of Minho, Braga, Portugal
| | - José F Durán Vázquez
- Department of Sociology, Political Science and Management and Philosophy, Universidade of Vigo, Vigo, Spain
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Matos J, Querido A, Laranjeira C. Spiritual Care through the Lens of Portuguese Palliative Care Professionals: A Qualitative Thematic Analysis. Behav Sci (Basel) 2024; 14:134. [PMID: 38392487 PMCID: PMC10886057 DOI: 10.3390/bs14020134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
Providing spiritual care is paramount to patient-centered care. Despite the growing body of data and its recognized importance in palliative care, spiritual care continues to be the least advanced and most overlooked aspect. This study aims to explore the perceptions and experiences of spiritual care from the perspective of PC professionals and identify their strategies to address spiritual care issues. Data were collected through semi-structured personal interviews and managed using WebQDA software (Universidade de Aveiro, Aveiro, Portugal). All data were analyzed using thematic content analysis, as recommended by Clark and Braun. The study included 15 palliative care professionals with a mean age of 38.51 [SD = 5.71] years. Most participants identified as lacking specific training in spiritual care. Thematic analysis spawned three main themes: (1) spiritual care as key to palliative care, (2) floating between "shadows" and "light" in providing spiritual care, and (3) strategies for competent and spiritual-centered care. Spiritual care was considered challenging by its very nature and given the individual, relational, and organizational constraints lived by professionals working in palliative care. With support from healthcare institutions, spiritual care can and should become a defining feature of the type, nature, and quality of palliative care provision. Care providers should be sensitive to spiritual needs and highly skilled and capable of an in-the-moment approach to respond to these needs. Further research on educating and training in spiritual care competence is a priority.
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Affiliation(s)
- Juliana Matos
- Hospital Palliative Care Team, Local Health Unit of the Leiria Region, Hospital of Santo André, Rua das Olhalvas, 2410-197 Leiria, Portugal
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Ana Querido
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua de Santo André-66-68, 2410-541 Leiria, Portugal
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua de Santo André-66-68, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Fernandes A, Ferreira S, Moreira P, Machado-Sousa M, Couto B, Raposo-Lima C, Costa P, Morgado P, Picó-Pérez M. Stress, anxiety, and depression trajectories during the "first wave" of the COVID-19 pandemic: what drives resilient, adaptive and maladaptive responses in the Portuguese population? Front Public Health 2024; 12:1333997. [PMID: 38414900 PMCID: PMC10897044 DOI: 10.3389/fpubh.2024.1333997] [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: 11/06/2023] [Accepted: 01/25/2024] [Indexed: 02/29/2024] Open
Abstract
Introduction The COVID-19 outbreak and the community mitigation strategies implemented to reduce new SARS-CoV-2 infections can be regarded as powerful stressors with negative consequences on people's mental health. Although it has been shown that negative emotional symptoms subside during lockdown, it is likely the existence of inter-individual differences in stress, anxiety and depression trajectories throughout lockdown. Objectives We aimed to cluster participants' according to their trajectories of stress, anxiety and depression scores throughout lockdown, and identify the sociodemographic, clinical, and lifestyle factors that may distinguish the subjects included in the different clusters. Methods From March 23, 2020, to May 31, 2020, participants completed weekly online questionnaires on sociodemographic information (age, sex, education level, and employment status), psychological functioning (DASS-21, NEO-FFI-20), and clinical data (psychiatric disorders, psychiatric medication, physical disorders). Data regarding smoking status, alcohol consumption, physical activity, and time spent daily looking for COVID-19-related information were also collected. Stress, anxiety and depression trajectories were determined using latent class mixed models. Results A total of 2040 participants answered the survey at baseline and 603 participants answered all surveys. Three groups ("Resilient," "Recovered," and "Maladaptive") with distinct mental health trajectories were identified. Younger participants, women, participants with lower education level, not working, studying, diagnosed with a mental disorder, taking psychiatric medication, smokers, those who spent more time consuming COVID-19-related information and those with higher neuroticism tended to cluster in the "Maladaptive" group, placing them at higher risk of persistent negative emotional symptoms during compulsory confinement. Conclusion Accordingly, a tailored approach to emotional suffering for vulnerable subjects during the COVID-19 and future pandemics must be devised.
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Affiliation(s)
- Afonso Fernandes
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Pedro Moreira
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Mafalda Machado-Sousa
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
| | - Beatriz Couto
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
| | - Catarina Raposo-Lima
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
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Fialon M, Nabec L, Julia C. Understanding the influence of stakeholders on the implementation of front-of-pack nutrition labelling in the absence of public debate: the case of Portugal. Health Res Policy Syst 2024; 22:20. [PMID: 38326884 PMCID: PMC10848542 DOI: 10.1186/s12961-023-01065-8] [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: 01/08/2023] [Accepted: 10/27/2023] [Indexed: 02/09/2024] Open
Abstract
In the context of the European Commission's proposal for the harmonization of front-of-pack nutrition labels (FoPLs) across the European Union scheduled for 2023, Portugal's position on the preferred format to be adopted remains unclear. Our study aims to (1) describe the context of the political decision regarding FoPL's implementation in Portugal, (2) identify and characterize the actors involved in the debate and (3) evaluate their influence in the decision-making process and their position on the various formats of FoPLs considered. A document review complemented by a qualitative study with eight experts revealed the actors involved in the implementation of FoPLs in Portugal. The stakeholder theory was used to qualify their level of influence on the decision. To complement the experts' analysis, the views of 1014 Portuguese consumers on stakeholders' influence were collected via an online questionnaire. The results show a strong mobilization of the Portuguese Ministry of Health on the issue through the production of several technical and scientific reports. The background of the political decision related to FoPLs in Portugal highlights the commitment of some influential stakeholders in favour of the traffic light format, including one of the major Portuguese retailers, Continente. Nevertheless, in the face of public support for the Nutri-Score from a growing number of actors, Portugal has not yet adopted a specific format, partly due to some resistance from the agricultural sector. Portugal, by lack of consensus and agenda setting, is now awaiting formal harmonization of FoPLs by the European Commission. This study provides useful insights for public policy actors when promoting interventional measures.
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Affiliation(s)
- Morgane Fialon
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University/INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center, University of Paris (CRESS), 93017, Bobigny, France.
| | - Lydiane Nabec
- Centre de Recherche Réseaux, Innovation, Territoire et Mondialisation (RITM), Université Paris-Saclay, 91190, Gif-Sur-Yvette, France
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University/INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center, University of Paris (CRESS), 93017, Bobigny, France.
- Public Health Department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), 93017, Bobigny, France.
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Garrido-Hermosilla AM, Soto-Sierra M, Díaz-Ruiz MC, Gutiérrez-Sánchez E, Rodríguez-de-la-Rúa-Franch E. Burnout syndrome in Spanish, Portuguese and Latin American ophthalmologists: a cross-sectional analysis. Int Ophthalmol 2024; 44:27. [PMID: 38326583 DOI: 10.1007/s10792-024-02977-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 10/29/2023] [Indexed: 02/09/2024]
Abstract
PURPOSE Despite the well-known consequences of burnout syndrome, there has been little research into this syndrome in the field of ophthalmology. Our objective is to determine the frequency of burnout syndrome between Spanish, Portugal and Latin-American ophthalmologists, as well as to analyse its relationship with different sociodemographic variables. METHODS This is an observational cross-sectional descriptive study including ophthalmologists from Spain, Portugal and 15 Latin American countries. Burnout syndrome was evaluated by the Maslach Burnout Inventory-Human Services Survey. Burnout syndrome was defined as high emotional exhaustion, high depersonalization or low personal accomplishment. In addition, we recorded sociodemographic variables and aspects related to the type of work. A conditional backwards stepwise multivariate binomial logistic regression analysis was run to assess the variables associated with burnout syndrome, expressed as an odds ratio (OR). RESULTS A total of 527 surveys were analysed, the majority from Spain (401; 76.1%), followed by Argentina (45; 8.5%), and Mexico (31; 5.9%). The number of ophthalmologists with burnout syndrome was 351 (66.6%). The results show the profile of a young ophthalmologist (age OR 0.985), carrying out a public activity (OR 2.118) and dedicated to general ophthalmology (OR 1.860). CONCLUSIONS The frequency detected in this study confirms a steady increase in rates of burnout among ophthalmologists. As the consequences of this are well known, it is vital for health centre managers to develop a strategic plan to allow the causes to be understood better and to implement steps to improve the situation in each medical centre.
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Affiliation(s)
- Antonio Manuel Garrido-Hermosilla
- Department of Ophthalmology, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Spain.
- RETICS OftaRed, Institute of Health Carlos III, Madrid, Spain.
- University of Seville, Seville, Spain.
| | - Marina Soto-Sierra
- Department of Ophthalmology, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Spain
| | - María Concepción Díaz-Ruiz
- Department of Ophthalmology, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Spain
| | - Estanislao Gutiérrez-Sánchez
- Department of Ophthalmology, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Spain
- RETICS OftaRed, Institute of Health Carlos III, Madrid, Spain
- University of Seville, Seville, Spain
| | - Enrique Rodríguez-de-la-Rúa-Franch
- Department of Ophthalmology, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Spain
- RETICS OftaRed, Institute of Health Carlos III, Madrid, Spain
- University of Seville, Seville, Spain
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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. [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] [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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Lopes D, Ferrão A, Matança AF, Almeida C, Rosário F, Santos J, Santos MI. [A Cognitive Behavioural-Based Intervention in Reducing Test Anxiety in High School Students: A Pilot Cluster Randomized Controlled Trial]. ACTA MEDICA PORT 2024; 37:163-171. [PMID: 36939679 DOI: 10.20344/amp.18876] [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: 07/22/2022] [Accepted: 01/25/2023] [Indexed: 03/21/2023]
Abstract
INTRODUCTION School-age test anxiety is an important risk factor for school performance. Notwithstanding, few studies seek to identify which strategies are effective in improving test anxiety. The aim of this study was to assess whether a cognitive-behavioural intervention for high school students could significantly reduce test anxiety. MATERIAL AND METHODS Two-arm, cluster-randomized controlled, unblinded, parallel, trial. Participants were 10th grade students from Alves Martins High School in Viseu, Portugal. Students were randomized at class level to receive a cognitive-behavioural-based intervention combined with mindfulness, psychoeducation, and relaxation techniques, or to a control group with no intervention. Participants' anxiety levels were measured using the Test Anxiety Questionnaire. The analysis of the effect of the intervention was carried out on an intention-to-treat basis at the class level, using multilevel mixed effects models and Bayesian modelling. RESULTS The intervention had a significant effect in reducing test anxiety (d = 0.81, 95% CI 0.45;1.17, Bayes factor = 31.3). Male gender was an independent risk factor for smaller reductions in anxiety levels. The intervention was more effective in reducing the worry component of test anxiety (d = 0.76, 95% CI 0.41;1.11, Bayes factor = 19.9) than the emotionality component (d = 0.63, 95% CI 0.31;0.95, Bayes factor = 6.6). CONCLUSION A cognitive-behavioural intervention specifically designed to reduce test anxiety, using a combination of mindfulness, psychoeducation and relaxation techniques, was effective in reducing test anxiety levels. TRIAL REGISTRATION Retrospectively registered on clinicaltrials.gov (NCT05481099) in 08/01/2022.
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Affiliation(s)
| | | | | | | | | | - Joana Santos
- Hospital Casa de Saúde São Mateus. Viseu. Portugal
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32
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Matos Pereira I, Vidó I, Nogueira V, Teixeira J. [Intervention in Alcohol Consumption during Pregnancy in Portugal]. ACTA MEDICA PORT 2024; 37:237-238. [PMID: 38422221 DOI: 10.20344/amp.21059] [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] [Accepted: 01/05/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Inês Matos Pereira
- Unidade de Alcoologia e Novas Dependências. Centro Hospitalar Psiquiátrico de Lisboa. Lisboa. Portugal
| | - Inês Vidó
- Unidade de Alcoologia e Novas Dependências. Centro Hospitalar Psiquiátrico de Lisboa. Lisboa. Portugal
| | - Violeta Nogueira
- Unidade de Alcoologia e Novas Dependências. Centro Hospitalar Psiquiátrico de Lisboa. Lisboa. Portugal
| | - Joana Teixeira
- Unidade de Alcoologia e Novas Dependências. Centro Hospitalar Psiquiátrico de Lisboa. Lisboa. Portugal
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Manco L, Albuquerque D, Rodrigues D, Machado-Rodrigues AM, Padez C. Protective Association of APOC1/rs4420638 with Risk of Obesity: A case-control Study in Portuguese Children. Biochem Genet 2024; 62:254-263. [PMID: 37328602 PMCID: PMC10902077 DOI: 10.1007/s10528-023-10427-4] [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: 02/10/2023] [Accepted: 06/07/2023] [Indexed: 06/18/2023]
Abstract
The association of the rs4420638 polymorphism, near the APOC1 gene, was examined with the risk of obesity among Portuguese children. A sample of 446 Portuguese individuals (231 boys and 215 girls) of European descent, aged 3.2 to 13.7 years old (mean age: 7.98 years), were selected to conduct a case-control study. Body mass index (BMI), BMI Z-scores, and waist circumference were calculated. Genotyping was performed by real time PCR using a pre-designed TaqMan probe. Logistic regression and the nonparametric Mann-Whitney test were used to test the associations. The association results revealed a significant protective effect from the minor G-allele of SNP rs4420638 against obesity, with an odds ratio (OR) of 0.619 (95% CI 0.421-0.913; p = 0.0155) in the additive model, and OR of 0.587 (95% CI 0.383-0.9; p = 0.0145) in the dominant model. Moreover, comparing genotype groups (AA vs. AG + GG), significantly lower values (p < 0.05) for the anthropometric traits weight, height, BMI, BMI Z-score and waist circumference, were observed in the carriers of allele G. The present study provides further evidence for the APOE/APOC1 candidate-region association with the risk of obesity. This was the first study to describe the protective association of the rs4420638 minor G-allele against obesity in childhood exclusively.
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Affiliation(s)
- Licínio Manco
- Research Centre for Anthropology and Health (CIAS), University of Coimbra, Coimbra, 3000, Portugal.
- Department of Life Sciences, University of Coimbra, Coimbra, Portugal.
| | - David Albuquerque
- Research Centre for Anthropology and Health (CIAS), University of Coimbra, Coimbra, 3000, Portugal
| | - Daniela Rodrigues
- Research Centre for Anthropology and Health (CIAS), University of Coimbra, Coimbra, 3000, Portugal
| | - Aristides M Machado-Rodrigues
- Research Centre for Anthropology and Health (CIAS), University of Coimbra, Coimbra, 3000, Portugal
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Cristina Padez
- Research Centre for Anthropology and Health (CIAS), University of Coimbra, Coimbra, 3000, Portugal
- Department of Life Sciences, University of Coimbra, Coimbra, Portugal
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Rodrigues DA, Herdeiro MT, Mateos-Campos R, Figueiras A, Roque F. Magnitude and Determinants of Long-term Use of Proton Pump Inhibitors Among Portuguese Older Adults in Primary Health Care. Clin Ther 2024; 46:e54-e58. [PMID: 38061931 DOI: 10.1016/j.clinthera.2023.11.011] [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: 08/03/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 02/27/2024]
Abstract
PURPOSE Proton Pump Inhibitors (PPIs) have been associated with several adverse effects of particular concern in older populations. Their use for a period longer than 8 weeks is not recommended for older adults. Strategies to discontinue PPIs have been offered; however, their use remains high. This study aims to characterize PPI use in Portuguese older people and to identify the factors associated with potentially inappropriate use. METHODS A cross-sectional study was conducted on 1200 randomly selected older adults (≥65 years of age), users of primary health care facilities in the Regional Health Administration (Administração Regional de Saúde of Centro [ARSC]) of Portugal between April 2021 and August 2022. Data concerning their characteristics and PPI use were provided by the Shared Services of the Health Ministry (Serviços Partilhados do Ministério da Saúde) and collected retrospectively. Associations between independent variables and PPI use were investigated by logistic regression analysis. FINDINGS Of the older adults, 37.92% were receiving PPIs and 78.68% of them were taking them for a longer period than recommended; 49.79% were taking PPIs without having any digestive system-related disease. Multivariate analysis showed that the prolonged use of PPIs was not associated with any specific pattern, although inappropriate PPI use is high among Portuguese older adults. IMPLICATIONS Long-term PPI use in older adults is widespread and does not fit any particular patient profile; therefore, cross-cutting educational interventions should be designed independently of the patient's pathologic condition or treatment.
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Affiliation(s)
- Daniela A Rodrigues
- Research Laboratory on Epidemiology and Population Health, Polytechnic of Guarda (IPG), 6300-559, Guarda, Portugal; Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506, Covilhã, Portugal; PhD Student, University of Salamanca, 37007, Salamanca, Spain
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193, Aveiro, Portugal
| | - Ramona Mateos-Campos
- Area of Preventive Medicine and Public Health, Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007, Salamanca, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15702, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), 15706, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), 28001, Madrid, Spain
| | - Fátima Roque
- Research Laboratory on Epidemiology and Population Health, Polytechnic of Guarda (IPG), 6300-559, Guarda, Portugal; Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506, Covilhã, Portugal.
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35
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Prazeres F. [Present and Future of Scientific Publications in the Field of Family Medicine in Portugal]. ACTA MEDICA PORT 2024; 37:78-79. [PMID: 38309294 DOI: 10.20344/amp.21179] [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: 01/08/2024] [Indexed: 02/05/2024]
Affiliation(s)
- Filipe Prazeres
- Unidade de Saúde Familiar Beira Ria. Gafanha da Nazaré; Faculdade de Ciências da Saúde. Universidade da Beira Interior. Covilhã; CINTESIS@RISE. Departamento Medicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS). Faculdade de Medicina. Universidade do Porto. Porto. Portugal
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Morgado MB, Rodrigues V, Carmona Ramos R, Rente A, Nicola P, Gil Conde M. Strategies for the Promotion of Primary Health Care Research in Portugal: A Qualitative Study. ACTA MEDICA PORT 2024; 37:110-118. [PMID: 37314201 DOI: 10.20344/amp.19514] [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: 12/20/2022] [Accepted: 03/13/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION There are several barriers discouraging clinicians from undertaking research, including insufficient funding, lack of time, organizational issues and lack of support. The strengthening of research capacity is perceived from three levels: characteristics of the researcher, the environment, and organizational issues. To date, Portugal is lacking studies on this subject. The aim of this study was to identify the best practices to promote research in Portuguese Primary Health Care. METHODS We conducted a qualitative study using semi-structured interviews with family doctors with broadly recognized research work and other stakeholders. We selected a sample by convenience and snowball sampling. From a total of 14 doctors invited by email, 12 responded positively, and we subsequently included two other stakeholders. We conducted the interviews in digital or face-to-face formats. Two team members handled the coding of interviews independently. We kept all recordings and transcripts confidential, only accessible to researchers. RESULTS We identified 16 strategies: 1) increasing institutional support; 2) creating support structures; 3) redefining the residency program; 4) investing in research training; 5) redefining curriculum evaluation; 6) establishing dedicated time for research; 7) increasing funding; 8) improving access to research data; 9) being a research driver; 10) establishing a research culture; 11) working in collaboration; 12) creating formally organized research groups; 13) creating autonomous research centers; 14) improving the definition of the research subjects and study designs; 15) reviewing procedures for ethics' committees; and 16) reviewing the current selection of articles for publication. CONCLUSION Overall, a greater proportion of interviewees identified the following as the most relevant strategies for research promotion: institutional support, including technical and scientific support from public institutions, private entities and academic centers; the reorganization of working hours with protected time for research; increased funding directed towards research and breaking isolation in research, promoting teamwork with clinicians within the same area or from different professional backgrounds.
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Affiliation(s)
- Maria Beatriz Morgado
- Unidade de Saúde Familiar Cova da Piedade. Agrupamento de Centros de Saúde Almada-Seixal. Amora. Portugal
| | - Vera Rodrigues
- Centre for Research and Studies in Sociology. Universidade de Lisboa. Lisbon. Portugal
| | - Raquel Carmona Ramos
- Department of Family Medicine. Faculdade de Medicina. Universidade de Lisboa. Lisbon; Unidade de Cuidados de Saúde Personalizados Atlântica. Marinha Grande; Agrupamento de Centros de Saúde Pinhal Litoral. Leiria. Portugal
| | - Ana Rente
- Unidade de Saúde Familiar Jardins da Encarnação. Agrupamento de Centros de Lisboa Central. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisbon. Portugal
| | - Paulo Nicola
- Instituto de Medicina Preventiva e Saúde Pública. Faculdade de Medicina. Universidade de Lisboa. Lisbon. Portugal
| | - Margarida Gil Conde
- Unidade de Saúde Familiar Jardins da Encarnação. Agrupamento de Centros de Lisboa Central. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisbon; Instituto de Medicina Preventiva e Saúde Pública. Faculdade de Medicina. Universidade de Lisboa. Lisbon; Comissão de Ética para a Saúde da Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa. Portugal
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Da Fonseca Marques JP, Santiago LM, Donato H. [Evaluation of the Scientific Production in the Field of General Practice and Family Medicine in Portugal]. ACTA MEDICA PORT 2024; 37:100-109. [PMID: 38219237 DOI: 10.20344/amp.19750] [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: 02/08/2023] [Accepted: 08/28/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION The Portuguese publications in the field of General Practice and Family Medicine have not yet been assessed in bibliometric studies. The aim of this study was to analyze that production between 2012 and 2022. METHODS The Web of Science Core Collection was used to gather the number of articles, journals and citations obtained; the Journal Citation Reports to obtain the Impact Factor and quartile of journals; and Scimago Journal & Country Rank, for the comparison of data with other European countries. The search was based on the following query: "usf OR unidade de Saude Familiar OR centro de Saude OR ACeS OR medicina geral familiar OR Gen Practice Family SAME Portugal", and a time window between 2012 and 2022 was defined. The study considered the following quantitative indicators: total number of publications, typology, language, affiliation, co-authors, geographical distribution, thematic areas, and the number of publications/inhabitant and publications/physician from European countries; the qualitative indicators selected were the Impact Factor (IF), the quartile and the number of citations. RESULTS Between 2012 and 2022, the national scientific production had an average annual growth rate of 36.6%. Of 389 publications, 73.8% were 'Articles' and 11.8% were 'Review Articles', predominantly in English (88.4%). The fields of 'General Internal Medicine' (24.7%) and 'Public Environmental Health' (14.9%) had the highest publication rates among the journals. The 389 publications received 5354 citations, for an average of 13.76 citations per article, and the average yearly citation growth was 115%. According to IF, 22.5% of the 222 journals belonged to Q4, 27.5% to Q3, 29.7% to Q2 and 20.3% to Q1, and therefore no significant bias regarding the journals where Portuguese doctors publish was observed. CONCLUSION The bibliometric analysis allowed us to examine the evolution of the scientific production in the field of Portuguese General Practice and Family Medicine by observing an increasing publication trend and with a high potential for publication growth.
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Affiliation(s)
| | - Luiz Miguel Santiago
- Faculdade de Medicina. Universidade de Coimbra. Portugal; Centro de Estudos e Investigação em Saúde. Universidade de Coimbra. Coimbra. Portugal
| | - Helena Donato
- Faculdade de Medicina. Universidade de Coimbra. Portugal; Serviço de Documentação e Informação Científica. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
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Peixoto A. [Letter to the Editor Regarding "Prevalence and Predictive Factors of Exclusive Breastfeeding in the First Six Months of Life"]. ACTA MEDICA PORT 2024; 37:153-154. [PMID: 38309301 DOI: 10.20344/amp.20336] [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: 06/26/2023] [Accepted: 11/28/2023] [Indexed: 02/05/2024]
Affiliation(s)
- Ana Peixoto
- Unidade de Saúde Familiar Jardim dos Plátanos. Agrupamento de Centros de Saúde de Lisboa Ocidental e Oeiras. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa. Portugal
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Lourenço AC, Nogueira HG, Rodrigues D, Gama A, Machado-Rodrigues AM, Silva MRG, Padez C. Observing the neighborhood multidimensionality and overweight in children of different developmental stages-the emergence of an unusual association. Eur J Pediatr 2024; 183:611-618. [PMID: 37940707 DOI: 10.1007/s00431-023-05326-0] [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] [Received: 07/12/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
The present study examines whether the association of the neighborhood environment and overweight in children is moderated by age. This was a cross-sectional study of 832 children aged 3 to 10 years living in the city of Oporto (Portugal). Children were recruited under the scope of the project "Inequalities in Childhood Obesity: The impact of the socioeconomic crisis in Portugal from 2009 to 2015." Overweight was defined according to the International Obesity Task Force criteria. Parents completed a self-administered questionnaire capturing sociodemographic characteristics and their perceptions of their neighborhood environment. Logistic regressions were used to examine the influence of parental perceived neighborhood characteristics (latent variables: attractiveness, traffic safety, crime safety, and walkability) on overweight in children. A stratified analysis by age category was conducted. Overall, 27.8% of the children were overweight, 17.4% were aged 3 to 5 years, and 31.8% were aged 6 to 10 years. Children aged 3 to 5 years were more sensitive to the neighborhood environment than children aged 6 to 10 years. For children aged 3 to 5 years, the risk of overweight was inversely associated with neighborhood crime safety (OR = 1.84; 95% CI 1.07-3.15; p = 0.030). Conclusion: Our study suggests the existence of a sensitive age period in childhood at which exposure to a hostile neighborhood environment is most determining for weight gain. Until today, it was thought that the impact of the neighborhood environment on younger children would be less important as they are less autonomous. But it may not be true. What is Known: • The neighborhood environment may adversely affect children's weight status. However, the moderating role of child age in the association between neighborhood environment and overweight is uncertain. What is New: • The study highlights that the association between the neighborhood environment and child overweight is attenuated by age. It is stronger for preschoolers than for early school-age children.
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Affiliation(s)
- Ana C Lourenço
- CIAS - Research Centre for Anthropology and Health, University of Coimbra, Calçada Martim de Freitas, 3000-456, Coimbra, Portugal.
| | - Helena G Nogueira
- CIAS - Research Centre for Anthropology and Health, University of Coimbra, Calçada Martim de Freitas, 3000-456, Coimbra, Portugal
- Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Daniela Rodrigues
- CIAS - Research Centre for Anthropology and Health, University of Coimbra, Calçada Martim de Freitas, 3000-456, Coimbra, Portugal
- Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - Augusta Gama
- CIAS - Research Centre for Anthropology and Health, University of Coimbra, Calçada Martim de Freitas, 3000-456, Coimbra, Portugal
- Department of Animal Biology, University of Lisbon, Lisbon, Portugal
| | - Aristides M Machado-Rodrigues
- CIAS - Research Centre for Anthropology and Health, University of Coimbra, Calçada Martim de Freitas, 3000-456, Coimbra, Portugal
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Maria Raquel G Silva
- Faculty of Health Sciences and FP - I3ID, University Fernando Pessoa, Oporto, Portugal
- CHRC - Comprehensive Health Research Centre Group of Sleep, Chronobiology and Sleep Disorders, Nova University of Lisbon, Lisbon, Portugal
| | - Cristina Padez
- CIAS - Research Centre for Anthropology and Health, University of Coimbra, Calçada Martim de Freitas, 3000-456, Coimbra, Portugal
- Department of Life Sciences, University of Coimbra, Coimbra, Portugal
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Afonso P, Lopes AP, Quintas H, Cardoso L, Coelho AC. Ehrlichia canis and Rickettsia conorii Infections in Shelter Dogs: Seropositivity and Implications for Public Health. Pathogens 2024; 13:129. [PMID: 38392867 PMCID: PMC10893242 DOI: 10.3390/pathogens13020129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/19/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
A cross-sectional study was conducted to gain insight into the epidemiology of canine ehrlichiosis and rickettsiosis in northern Portugal. Specific IgG antibodies to Ehrlichia canis were analysed using a commercial enzyme-linked immunosorbent assay (ELISA), and antibodies to Rickettsia conorii were analysed using a commercial indirect immunofluorescence antibody test (IFAT). A total of 113 dogs from two different shelters were sampled, and seroprevalence values of 0.9% (95% confidence (CI): 0.2-4.8%) for E. canis and 9.7 (95% CI: 5.5-16.6%) for R. conorii were found. Multiple logistic regression investigated risk factors for seropositivity. The odds ratios (ORs) of R. conorii seropositivity were higher for female dogs (OR = 6.429; 95% CI: 1.201-34.407). Dogs seropositive for co-infection (E. canis + R. conorii) were more frequently observed among females (OR = 7.606; CI 95%: 1.478-39.132) and in Shelter 2 (OR = 18.229; 95% CI: 2.190-151.756). These findings show that shelter dogs in northern Portugal are exposed to E. canis and R. conorii, which can affect both canines and humans. It is imperative to adopt a One Health approach to educate the public about the hazards of canine zoonoses and develop legislation and procedures to control their spread and preserve public health.
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Affiliation(s)
- Paulo Afonso
- CECAV—Animal and Veterinary Research Centre, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (P.A.); (A.P.L.); (A.C.C.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 5000-801 Vila Real, Portugal
- Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal;
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Ana Patrícia Lopes
- CECAV—Animal and Veterinary Research Centre, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (P.A.); (A.P.L.); (A.C.C.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 5000-801 Vila Real, Portugal
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - Hélder Quintas
- Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal;
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Luís Cardoso
- CECAV—Animal and Veterinary Research Centre, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (P.A.); (A.P.L.); (A.C.C.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 5000-801 Vila Real, Portugal
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - Ana Cláudia Coelho
- CECAV—Animal and Veterinary Research Centre, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (P.A.); (A.P.L.); (A.C.C.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 5000-801 Vila Real, Portugal
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
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Portela V, Hamwi S, Oliveira Martins MR. Exploring refugees' health care access in times of COVID-19: a quantitative study in the Lisbon region, Portugal. Front Public Health 2024; 12:1337299. [PMID: 38347925 PMCID: PMC10859453 DOI: 10.3389/fpubh.2024.1337299] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/04/2024] [Indexed: 02/15/2024] Open
Abstract
Background To address the health needs of refugees, health services must be culturally competent and facilitate this population's access to health care, especially in a context prone to the amplification of social inequities, such as the COVID-19 pandemic. However, few quantitative studies exist in the European Union, and to the extent of our knowledge, there are no published quantitative studies exploring refugees' access to health care during the pandemic in Portugal. The objective of this study is to describe the demographic and socioeconomic characteristics of refugees living in Lisbon and to explore their healthcare access patterns during the COVID-19 pandemic. Methods We conducted a cross-sectional, descriptive, and quantitative study from May to November 2022. Using Levesque' s theory on health care access, we designed and applied a 38-item questionnaire through face-to-face interviews with refugees living in Lisbon for at least 12 months, and used descriptive statistics to characterize sociodemographic and healthcare access profiles during the pandemic. Results The mean age of the 36 recruited refugees was 35 years (SD = 10.24), the majority were male (56%), married (72%), had at least a secondary education (69%), were unemployed (77.8%), and had a median length of stay in Portugal of 17 months (IQR = 45). All were registered in a primary care center, and 94% used healthcare services during the pandemic. The majority never tested positive for the coronavirus (58%) and one out of the positive was admitted to hospital due to severe COVID-19. A total of 97% received COVID-19 vaccination, of which 69% had an incomplete schedule. A quarter of the participants did not have access to information about COVID-19 in a language they understood, and although 97% needed health care during the pandemic, more than half (63%) did not seek it because of structural and cultural barriers. Half of the respondents had difficulty getting medical advice by phone or email, and 39.4% could not afford a medical examination or treatment. Only 18.2% sought counseling services. A total of 58.8% of the participants felt like healthcare professionals did not always show respect towards their culture, and 64.7% reported that healthcare professionals did not always discuss treatment options with them. Conclusion This study's findings highlight the need to endow inclusive communication, cultural competency, and patient involvement in health care, alongside improving the socioeconomic condition of refugees. Identified population characteristics and barriers to health care access by refugees in this study may inform future research on the health care needs of refugees in Portugal and ultimately assist in the devising of strategies to reduce inequalities in health care access.
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Affiliation(s)
- Vanessa Portela
- Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Lisbon, Portugal
| | - Sousan Hamwi
- NOVA National School of Public Health, Public Health Research Centre, NOVA University of Lisbon, Lisbon, Portugal
| | - Maria R. Oliveira Martins
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Lisbon, Portugal
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Fernandes R, Sabino R, Cunha C, Cornely OA, Carvalho A, Salmanton-García J. Multicentric Study on the Clinical Mycology Capacity and Access to Antifungal Treatment in Portugal. Mycopathologia 2024; 189:15. [PMID: 38265528 PMCID: PMC10808446 DOI: 10.1007/s11046-024-00830-9] [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: 10/19/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024]
Abstract
The success of the clinical management of invasive fungal diseases (IFD) is highly dependent on suitable tools for timely and accurate diagnosis for effective treatment. An in-depth analysis of the ability of European institutions to promptly and accurately diagnose IFD was previously conducted to identify limitations and aspects to improve. Here, we evaluated and discussed the specific case of Portugal, for which, to our knowledge, there are no reports describing the national mycological diagnostic capacity and access to antifungal treatment. Data from 16 Portuguese medical institutions were collected via an online electronic case report form covering different parameters, including institution profile, self-perceived IFD incidence, target patients, diagnostic methods and reagents, and available antifungals. The majority of participating institutions (69%) reported a low-very low incidence of IFD, with Candida spp. indicated as the most relevant fungal pathogen, followed by Aspergillus spp. and Cryptococcus spp. All institutions had access to culture and microscopy, whereas 94 and 88% were able to run antigen-detection assays and molecular tests, respectively. All of the institutions capable of providing antifungal therapy declared to have access to at least one antifungal. However, echinocandins were only available at 85% of the sites. Therapeutic drug monitoring (TDM) was reported to remain a very restricted practice in Portugal, being available in 19% of the institutions, with the TDM of itraconazole and posaconazole performed in only 6% of them. Importantly, several of these resources are outsourced to external entities. Except for TDM, Portugal appears to be well-prepared concerning the overall capacity to diagnose and treat IFD. Future efforts should focus on promoting the widespread availability of TDM and improved access to multiple classes of antifungals, to further improve patient outcomes.
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Affiliation(s)
- Raquel Fernandes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Raquel Sabino
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal
- Laboratório Associado TERRA-Laboratório para o Uso Sustentável da Terra e dos Serviços dos Ecossistemas, Instituto Superior de Agronomia, Lisbon, Portugal
| | - Cristina Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Oliver A Cornely
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.
- ICVS/3B's - PT Government Associate Laboratory, Braga, Guimarães, Portugal.
| | - Jon Salmanton-García
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany.
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
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Gomes-Gonçalves S, Santos-Silva S, Cruz AVS, Rodrigues C, Soeiro V, Barradas P, Mesquita JR. A Thorny Tale of Parasites: Screening for Enteric Protozoan Parasites in Hedgehogs from Portugal. Animals (Basel) 2024; 14:326. [PMID: 38275786 PMCID: PMC10812701 DOI: 10.3390/ani14020326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Enteric protozoan parasites, such as Blastocystis sp., Balantioides coli, Cryptosporidium spp., and Giardia duodenalis, may have implications for both animal and human health.Transmitted through the fecal-oral route, these parasites cause symptoms such as diarrhea, abdominal pain, and weight loss. This study investigated the presence of these enteric protozoan parasites and genetically characterized them in hedgehogs from Portugal. A total of 110 hedgehog stool samples were collected. Molecular detection methods showed an overall occurrence of protozoa in 1.82% (2/110 95% CI: 0.22-6.41) of hedgehogs, with Blastocystis being found in one hedgehog and Cryptosporidium being found in another. No evidence for the presence of B. coli or G. duodenalis was found. This study suggests that there is a need to stay aware of hedgehogs as potential hosts of enteric protozoa. Ongoing research and surveillance efforts are recommended to explore practical prevention and control strategies. The results contribute to the limited knowledge of these parasites in Portuguese hedgehog populations and underscore their potential relevance to both veterinary and public health.
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Affiliation(s)
- Sara Gomes-Gonçalves
- Department of Biology, Campus de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Sérgio Santos-Silva
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal; (S.S.-S.); (A.V.S.C.)
| | - Andreia V. S. Cruz
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal; (S.S.-S.); (A.V.S.C.)
| | - Clarisse Rodrigues
- Centro de Recuperação e Interpretação do Ouriço—CRIDO, 4470-372 Maia, Portugal;
| | - Vanessa Soeiro
- Parque Biológico de Gaia, 4430-812 Vila Nova de Gaia, Portugal;
| | - Patrícia Barradas
- 1H-TOXRUN—One Health Toxicology Research Unit, University Institute of Health Sciences, Cooperativa de Ensino Superior Politécnico e Universitário, CRL(CESPU, CRL), 4585-116 Gandra, Portugal;
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - João R. Mesquita
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal; (S.S.-S.); (A.V.S.C.)
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
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Caldas Afonso A, Gouveia C, Januário G, Carmo M, Lopes H, Bricout H, Gomes C, Froes F. Uncovering the burden of Influenza in children in Portugal, 2008-2018. BMC Infect Dis 2024; 24:100. [PMID: 38238649 PMCID: PMC10797867 DOI: 10.1186/s12879-023-08685-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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/09/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Despite their higher risk of developing severe disease, little is known about the burden of influenza in Portugal in children aged < 5 years old. This study aims to cover this gap by estimating the clinical and economic burden of severe influenza in children, in Portugal, during ten consecutive influenza seasons (2008/09-2017/18). METHODS We reviewed hospitalizations in children aged < 5 years old using anonymized administrative data covering all public hospitals discharges in mainland Portugal. The burden of hospitalization and in-hospital mortality directly coded as due to influenza was supplemented by the indirect burden calculated from excess hospitalization and mortality (influenza-associated), estimated for four groups of diagnoses (pneumonia or influenza, respiratory, respiratory or cardiovascular, and all-cause), through cyclic regression models integrating the incidence of influenza. Means were reported excluding the H1N1pdm09 pandemic (2009/10). RESULTS The mean annual number of hospitalizations coded as due to influenza was 189 (41.3 cases per 100,000 children aged < 5 years old). Hospitalization rates decreased with increasing age. Nine-in-ten children were previously healthy, but the presence of comorbidities increased with age. Children stayed, on average, 6.1 days at the hospital. Invasive mechanical ventilation was used in 2.4% of hospitalizations and non-invasive in 3.1%. Influenza-associated excess hospitalizations between 2008 and 2018 were estimated at 1,850 in pneumonia or influenza, 1,760 in respiratory, 1,787 in respiratory or cardiovascular, and 1,879 in all-cause models. A total of 95 influenza-associated excess deaths were estimated in all-cause, 14 in respiratory or cardiovascular, and 9 in respiratory models. Over ten years, influenza hospitalizations were estimated to have cost the National Health Service at least €2.9 million, of which 66.5% from healthy children. CONCLUSIONS Influenza viruses led to a high number of hospitalizations in children. Most were previously healthy. Results should lead to a reflection on the adequate preventive measures to protect this age group.
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Affiliation(s)
- Alberto Caldas Afonso
- Unidade de Nefrologia Pediátrica, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal.
- Centro Hospitalar Universitário Santo António, Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal.
- EPIUnit - Instituto de Saúde Pública, Porto, Portugal.
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal.
| | - Catarina Gouveia
- Hospital D. Estefânia, Centro Hospitalar Lisboa Central, Lisboa, Portugal
- Faculdade de Ciências Médicas, Nova Medical School, Lisbon, Portugal
| | - Gustavo Januário
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | | | - Hugo Lopes
- IQVIA, Lisbon, Portugal
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center - Universidade NOVA de Lisboa, Lisbon, Portugal
| | | | | | - Filipe Froes
- Hospital Pulido Valente, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Alcântara B, Rainho M. [Mental Health in Primary Health Care: A Reality Far from Ideal]. ACTA MEDICA PORT 2024; 37:66-67. [PMID: 38063151 DOI: 10.20344/amp.20596] [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: 08/24/2023] [Accepted: 11/14/2023] [Indexed: 01/07/2024]
Affiliation(s)
| | - Marta Rainho
- Unidade de Saúde Familiar Luísa Todi. Setúbal. Portugal
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Pereira CS, Santiago LM, Rosendo Silva I, Ferreira P. Validation and Cultural Adaptation of the Problem Areas in Diabetes-5 (PAID-5) Scale to European Portuguese. ACTA MEDICA PORT 2024; 37:36-41. [PMID: 37498193 DOI: 10.20344/amp.18995] [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: 01/20/2023] [Accepted: 05/26/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION Diabetes distress syndrome (DDS) can lead to poor outcomes and should be assessed with adapted and validated tools. One of these tools is the Problem Areas in Diabetes (PAID) scale, which assesses diabetes distress in people suffering from diabetes (PsD). A short five-item form, PAID-5, is an easier and quicker alternative to be used in clinical and research practices, than the previous one with 20-items and has been validated by the original authors. This study intended to perform the cultural adaptation and validation of the PAID-5 scale in European Portuguese. METHODS To create the Portuguese version of PAID-5, translation-back translation, a clinical review, and a cognitive debriefing panel were performed. A convenience sample of 90 PsD was studied in three primary healthcare units for reliability and validity tests. Reliability was studied by the internal consistency (Cronbach's alpha) and the interval coefficient correlation (ICC) under a test-retest design. Structural validity was studied by principal component analysis. The construct validity was tested by the sensitivity of the PAID-5 total score with age, most recent HbA1c test, and socioeconomic class by the Socio-Economic Deprivation Index (SEDI). Criterion validity was tested by correlating the PAID-5 total score with the psychological distress questions of the Diabetes Health Profile 18 Questions (DHP-PDQ). RESULTS A Cronbach's alpha coefficient value of 0.905 and an ICC of 0.905 were computed. In a sample of n = 90 PsD, 55.6% were males, 63.3% aged 65 years or more, SEDI was 5.2 ± 0.8 [3 to 6], 44.4% studied for less than 4 years, and 18.9% were living alone. The Spearman correlation between PAID-5 and DHP-PDQ total scores was ρ = 0.382, p < 0.001, between PAID-5 total score and age was ρ = -0.207, p = 0.050 and between PAID-5 total score and most recent HbA1c knowledge was ρ = 0.275, p = 0.040. There was no significant relationship between PAID-5 total score and SEDI ρ = 0.080, p = 0.452. CONCLUSION DDS can now be assessed in the Portuguese context, accounting for better intervention by primary care teams. PAID-5 has good psychometric properties and is a reliable scale to identify diabetes-specific distress in the Portuguese diabetic population.
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Affiliation(s)
| | - Luiz Miguel Santiago
- Faculdade de Medicina. Universidade de Coimbra. Coimbra. & Centro de Estudos e Investigação em Saúde - CEISUC. Universidade de Coimbra. Coimbra. Portugal
| | - Inês Rosendo Silva
- Faculdade de Medicina. Universidade de Coimbra. Coimbra. & Unidade de Saúde Familiar Coimbra Centro. Agrupamento de Centros de Saúde Baixo Mondego. Coimbra. Portugal
| | - Pedro Ferreira
- Centro de Estudos e Investigação em Saúde - CEISUC. Universidade de Coimbra. Coimbra. Portugal
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Sousa S, Pereira AM, Santiago LM. Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study. ACTA MEDICA PORT 2024; 37:3-9. [PMID: 37000414 DOI: 10.20344/amp.18584] [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: 05/18/2022] [Accepted: 12/12/2022] [Indexed: 04/01/2023]
Abstract
INTRODUCTION Even though the prevalence rate of diabetes in Portugal is one of the highest in Europe, no studies on the association between patient centered medicine, diabetes self-care, and glycemic control have been published. Assuming that patient centered medicine increases adherence to treatment through the improvement of the doctor-patient relationship, the aim of this study was to assess the influence of patient-centered medicine on the self-care of patients with type 2 diabetes patients' (T2DM) in two Family Health Units in Central Portugal, according to gender and age. MATERIAL AND METHODS A cross-sectional study was conducted in two Family Health Units in Central Portugal between the 25th November 2021 and the 15th January 2022. Patients with type 2 diabetes were invited to fill in the Patient-Centered Medicine questionnaire, for patients (PCM-p) (where higher values represent worse results) and the Summary of Diabetes Self-Care Activities Measure (SDSCAM), (where higher values represent better results), while healthcare professionals filled in the epidemiologic variables on pre-defined days. RESULTS A sample of 298 patients with type 2 diabetes was studied. Linear regressions for the association between SDSCAM scale factors and PCM-p showed significant associations for general diet (β = -0.07, p < 0.001), specific diet (β = -0.10, p < 0.001), exercise (β = -0.03, p = 0.008), foot care (β = -0.11, p < 0.001) and medication adherence in general (β = -0.06, p = 0.001). Multiple linear regression including the association between glycated hemoglobin (HbA1c) and the SDSCAM scale dimensions showed that specific diet was associated with lower HbA1c levels (β = -0.01, p = 0.007) and blood sugar testing (β = 0.01, p < 0.001) and that a higher score in PCMp was associated with higher HbA1c levels (β = 0.06, p < 0.001). Male patients (β = -6.93, p = 0.007) and older patients (β = -0.42, p = 0.001) were associated with lower scores in the specific diet. The male gender was associated with higher scores in exercise (β = 7.62, p = 0.029), lower scores in foot care (β = -6.06, p = 0.029) and lower scores in medication adherence to injectable medicines/6.2 (β = -0.73, p = 0.018). Age was associated with a lower score in medication (β = -0.03, p = 0.045) and a higher PCMp total score (β = 0.07, p = 0.030). CONCLUSION Patient-centered medicine in type 2 diabetics is associated with better self-care behaviors in patients with type 2 diabetes. Gender and age differences were observed in self-care behaviors and age differences were observed in Patient Centered Medicine.
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Affiliation(s)
- Solange Sousa
- Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
| | - Albino Miguel Pereira
- Mondego Family Health Unit; General Practice Clinic. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
| | - Luiz Miguel Santiago
- General Practice Clinic. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
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Prazeres F. Letter to the Editor concerning "Prevalence and Predictive Factors of Exclusive Breastfeeding in the First Six Months of Life". ACTA MEDICA PORT 2024; 37:64-65. [PMID: 37967145 DOI: 10.20344/amp.20305] [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: 06/16/2023] [Accepted: 10/18/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Filipe Prazeres
- Unidade de Saúde Familiar Beira Ria. Gafanha da Nazaré; Faculdade de Ciências da Saúde. Universidade da Beira Interior. Covilhã. Portugal
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Louro M, Bexiga R, da Fonseca IP, Gomes J. Detection and molecular characterization of Cryptosporidium spp. in dairy calves in Lisbon and Tagus Valley, Portugal. Vet Parasitol Reg Stud Reports 2024; 47:100964. [PMID: 38199683 DOI: 10.1016/j.vprsr.2023.100964] [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: 06/23/2023] [Revised: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 01/12/2024]
Abstract
Cryptosporidium is a protozoan parasite with worldwide distribution, infecting a wide range of hosts with some zoonotic species. Calves have been identified as one of the most common reservoirs of this parasite. However, little is known about the genetics of Cryptosporidium in calves in Portugal. This study aimed to molecularly characterize infections of Cryptosporidium in pre-weaned calves from the Lisbon and Tagus Valley (LTV) in Portugal. Fifty-two samples were collected from calves from eight dairy and two beef farms in LTV, Portugal. Cryptosporidium oocysts were detected by Modified Ziehl-Neelsen staining (MZN) and direct immunofluorescent assay (DFA). MZN and DFA revealed the presence of Cryptosporidium oocysts in 40.4% (21/52) and 67.3% (35/52) samples, respectively. Positive samples were analyzed by PCR-RFLP of the 18 s rRNA gene for species identification. DNA amplification of the 18S rRNA gene was successful for 88.6% (31/35) of samples. Cryptosporidium parvum was identified in 96.8% (30/31) of the samples, and from one sample Cryptosporidium bovis was identified. Cryptosporidium parvum positive samples were subtyped by sequencing the PCR product of a partial fragment of the 60 kDa glycoprotein (gp60) gene. Subtype analysis of the C. parvum isolates revealed that all isolates belonged to subtype family IIa. Four subtypes were recognized within this subtype family, including the hyper-transmissible IIaA15G2R1 subtype that is the most frequently reported worldwide (27/30), IIaA14G2R1 (1/30), IIaA16G2R1 (1/30) and IIaA19G2R1 (1/30). To our knowledge, this is the first report of C. bovis, and C. parvum subtypes IIaA14G2R1 and IIaA19G2R1 in cattle in LTV, Portugal. The presence of the zoonotic C. parvum subtype in this study suggests that pre-weaned calves are likely to be a significant reservoir of zoonotic C. parvum, highlighting the importance of animal-to-human infection transmission risk. Further molecular studies are required to better understand the epidemiology of cryptosporidiosis in Portugal.
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Affiliation(s)
- Mariana Louro
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal
| | - Ricardo Bexiga
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal
| | - Isabel Pereira da Fonseca
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.
| | - Jacinto Gomes
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal; Agrarian School of Elvas, Polytechnic Institute of Portalegre, Portugal
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Manso MT, Matos VMJ. Spina bifida, the normal, the pathological and the in-between: first evidence from a forensic osteological collection. Int J Legal Med 2024; 138:249-258. [PMID: 37522954 PMCID: PMC10771999 DOI: 10.1007/s00414-023-03066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023]
Abstract
Spina bifida (SB), a rare congenital disorder, is often mentioned as an individualizing factor in Forensic Anthropology. A lack of empirical data regarding SB is noticed in the scientific literature. Moreover, within the scope of anthropological research on SB disparities in terminology, classification systems, and methodological approaches result in incomparable results. The wide range (1,2%-50%) of "spina bifida occulta" reported prevalences is a good example. This research aims to analyze and debate the standard diagnostic criteria of SB on human skeletal remains, and attempts to elaborate on an universal system, premised on the distinction between SB as a pathology, and cleft neural arch (CNA) as an anatomical variant, according to Barnes (1994, p. 360 [1). A study-base of 209 individuals (88 males; 121 females; 44-99 years old) from the 21st Century Identified Skeletal Collection from the University of Coimbra (CEI/XXI) was macroscopically analyzed, focusing on the sacrum and remaining vertebrae. Four individuals presented complete posterior opening of the sacral canal (2,6%[4/156]). The observed bone changes, combined with the analysis of the entire skeleton, indicate that CNA, rather than SB linked to a neural tube defect, is the most reliable explanation for these cases. Overall, CNA was observed on 11 skeletons (7.05% of 156). The viability and applicability of the developed methodology for the identification of SB/CNA in forensic and/or osteological contexts are discussed, as well as the possibility of a lower prevalence of SB occulta, in the general population, than speculated before. HIGHLIGHTS: • Spina bifida has been studied so far under different methodologies, classification systems and nomenclature, leading to unstandardized and incomparable data. • Spina bifida as a pathological manifestation of a neural tube defect, as opposed to cleft neural arch as a simple form of skeletal variation. • Both spina bifida and complete sacral cleft fit the criteria of an individualizing trait in Forensic Anthropology.
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Affiliation(s)
- Maria Torres Manso
- Department of Life Sciences, University of Coimbra, Calçada Martim de Freitas, 3000-456, Coimbra, Portugal.
| | - Vitor M J Matos
- Department of Life Sciences, University of Coimbra, Calçada Martim de Freitas, 3000-456, Coimbra, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Calçada Martim de Freitas, 3000-456, Coimbra, Portugal
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