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1.
J Bras Nefrol ; 47(2): e20240127, 2025.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39907321

RESUMO

INTRODUCTION: In the northwest of Portugal, AA amyloidosis was reported as the most frequent amyloid nephropathy, but it is unclear if the disease's incidence and outcomes have changed. The authors studied the changing epidemiology, aetiologies, and outcomes of patients with renal AA amyloidosis over the last 40 years. METHODS: This is a retrospective single-center cohort study involving patients with renal biopsy-proven AA amyloidosis diagnosed in the northwest of Portugal between 1978 and 2019. The patients were grouped into 14-year cohorts based on the year of diagnosis (CA 1978-1991; CB 1992-2005; CC 2006-2019), and clinical course and outcomes were analyzed. RESULTS: Sixty-nine AA amyloidosis patients were included. The incidence of the disease remained stable in CA (64%) and CB (62.7%) as opposed to the significant decrease in the most recent cohort (44%, p = 0.027). The mean age at presentation increased by ten years from CA to CC. Overall, infections were the leading cause of death, with a significant rise over time (9.1% in CA to 76.9% at CC, p = 0.002). There were no significant global and renal survival differences between the three cohorts. However, the CC patients died at an older age (61.4 years) than the CA (52.3 years). CONCLUSION: The incidence of AA amyloidosis has been declining over the last 40 years. In contrast, the age at presentation of amyloid nephropathy has been increasing. Global and renal outcomes did not improve, but the average life expectancy increased, suggesting progress in general management and supportive care of renal and underlying pathology.


Assuntos
Amiloidose , Nefropatias , Humanos , Masculino , Estudos Retrospectivos , Feminino , Pessoa de Meia-Idade , Amiloidose/epidemiologia , Portugal/epidemiologia , Idoso , Nefropatias/epidemiologia , Nefropatias/etiologia , Adulto , Incidência , Proteína Amiloide A Sérica
2.
Rev Bras Enferm ; 77Suppl 2(Suppl 2): e20240118, 2025.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39813440

RESUMO

OBJECTIVE: Describe the activities aimed at achieving the Sustainable Development Goals (SDGs), implemented by a polytechnic higher education institution, in the northern region of Portugal. METHODS: This is an experience report from a Higher Education Institution, which characterizes the contribution to the SDGs, within the scope of teaching, research, campus and leadership. RESULTS: In total, 1247 activities were mapped, with a preponderance in the "people" dimension (685 activities), with SDG 3 being the most prominent. Scientific articles contribute significantly to the SDGs, with a notable discrepancy between automatic (Scopus) and manual classifications, indicating a tendency to underestimate the impact of nursing studies. CONCLUSION: The results demonstrate the significant contribution of this institution to the SDGs, with a special focus on health and education. This contribution reflects the mission of the institution, which involves training competent and socially conscious health professionals, but simultaneously the need for greater awareness and training of the teaching staff.


Assuntos
Desenvolvimento Sustentável , Desenvolvimento Sustentável/tendências , Humanos , Portugal , Objetivos , Universidades/organização & administração
3.
Rev Bras Enferm ; 77Suppl 2(Suppl 2): e20240047, 2025.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39813436

RESUMO

OBJECTIVE: to comparatively analyze the health, education and social development systems of Brazil and Portugal, their relationship with the Sustainable Development Goals and the Organization for Economic Cooperation and Development averages. METHOD: exploratory and descriptive qualitative research, through documentary analysis. The indicators address health, education and social development, considering life expectancy, mortality, prevalence of chronic diseases, literacy, educational performance and poverty rates. RESULTS: indicate significant differences between countries. Portugal presents better indicators in life expectancy, educational quality and poverty rates, whereas Brazil faces greater challenges in chronic diseases and equity in access to healthcare services. FINAL CONSIDERATIONS: the importance of public policies adapted to local realities and the need for a strategic vision for healthcare systems aligned with the Sustainable Development Goals, in addition to the need for continuous investments and integration of digital health for efficient and equitable systems, stand out.


Assuntos
Desenvolvimento Sustentável , Brasil , Humanos , Desenvolvimento Sustentável/tendências , Portugal , Pesquisa Qualitativa , Educação/métodos , Educação/tendências , Educação/normas , Objetivos , Mudança Social , Expectativa de Vida/tendências
4.
J Bras Pneumol ; 50(6): e20240357, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39813510

RESUMO

OBJECTIVE: The demanding nature and psychosocial burdens of directly observed treatment (DOT) have opened a path to alternative strategies such as video-observed therapy (VOT), which offers comparable treatment outcomes and patient satisfaction while potentially saving time and reducing costs. The objective of this study was to evaluate the perceptions and experiences of patients and health care professionals regarding DOT and other treatment strategies implemented in Portugal. METHODS: Patients with a confirmed diagnosis of tuberculosis, treated at the Vila Nova de Gaia Outpatient Tuberculosis Centre in the last two years, were asked to complete a brief questionnaire, as were health care professionals working in the northern region of Portugal. Differences were analysed with chi-square tests, complemented by thematic analysis. RESULTS: A total of 62 individuals completed the questionnaire: 29 health care professionals and 33 patients. There were significant differences between the two groups in their views regarding the impact of DOT on treatment outcomes, with health care professionals perceiving a higher degree of negative effects and patients expressing greater satisfaction. Long travel distances, transportation issues and high costs were some of the challenges mentioned by the patients. Significant differences were also found regarding the role DOT plays in ensuring treatment adherence, with patients emphasising personal responsibility and its importance in preventing loss to follow-up and strengthening relationships with health care professionals. Dose dispensing was favoured for its convenience in specific situations, and VOT was generally preferred to reduce constant travelling. Both parties raised some concerns. CONCLUSIONS: Existing discrepancies suggest a misalignment between patient experiences and health care provider perceptions, underscoring the need for enhanced communication and a more nuanced understanding of patient perspectives when designing and implementing different tuberculosis treatment adherence strategies.


Assuntos
Terapia Diretamente Observada , Satisfação do Paciente , Tuberculose , Humanos , Estudos Transversais , Masculino , Feminino , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Portugal , Tuberculose/tratamento farmacológico , Tuberculose/psicologia , Percepção , Atitude do Pessoal de Saúde , Resultado do Tratamento , Adulto Jovem , Pessoal de Saúde/psicologia , Idoso
5.
Cad Saude Publica ; 40(12): e00096123, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39813568

RESUMO

Personality traits and coping strategies significantly predict predisposition to psychopathology. This study aimed to examine the predictive role of coping strategies in psychological distress during the COVID-19 pandemic in a sample of Portuguese individuals, considering personality and sociodemographic variables. Data were collected using Google Forms from 2402 individuals (86.8% women; mean age ± SD = 36.80 ± 11.80) between March and June 2020, found primarily through Facebook. The evaluation instruments included the Brief Symptom Inventory (BSI), NEO Five-Factor Inventory, and Brief-COPE. Younger adults, females, single individuals, and those with lower education experienced higher distress. Neuroticism was strongly associated with all dimensions of psychological distress and the overall BSI. Maladaptive coping strategies (self-distraction, denial, self-blame, behavioral disengagement) were positively correlated with distress, whereas agreeableness and positive reframing were negatively correlated. Regression analysis showed that gender, age, education, and psychiatric diagnosis predicted 12% of distress; adding neuroticism increased prediction to 34% and coping strategies to 37%, with self-blame among coping strategies being the strongest predictor. Personality traits and coping strategies were significant predictors of psychological distress during the COVID-19 pandemic. These findings emphasize the need for interventions that target neuroticism and maladaptive coping strategies to improve mental health outcomes during public crises.


Assuntos
Adaptação Psicológica , COVID-19 , Pandemias , Personalidade , Angústia Psicológica , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Portugal/epidemiologia , Adulto Jovem , SARS-CoV-2 , Estresse Psicológico/psicologia , Fatores Socioeconômicos , Fatores Sexuais , Neuroticismo , Idoso , Adolescente , Fatores Etários , Capacidades de Enfrentamento
6.
Rev Gaucha Enferm ; 45(spe1): e20240005, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39607115

RESUMO

OBJECTIVE: To explore how the development of research skills through postgraduate training is transferred to the use of research in clinical nursing practice. METHOD: This was a qualitative, exploratory, descriptive study developed based on a focus group in October 2021, using an intentional sample of eight postgraduate nurses from a healthcare institution in the region of Baixo Alentejo, Portugal. Bardin's content analysis was performed to analyze data. The participants and two reviewers legitimized the findings. In addition, the consolidated criteria for reporting qualitative research checklist were applied to this study to ensure the quality of the research report. RESULTS: From the data analysis, three categories emerged: 1) transfer of research skills to clinical practice, 2) constraints to the development of research, and 3) expectations concerning the development of nursing research. CONCLUSION: Appreciation of research skills in contexts of practice, team involvement, improvement of nursing care outcomes, greater understanding of the research process, communication of results, and transferring knowledge to the clinic are contributions of research skills acquired in postgraduation training. The findings from this study can contribute to the development of health and nursing education policies.


Assuntos
Educação de Pós-Graduação em Enfermagem , Pesquisa Qualitativa , Humanos , Portugal , Pesquisa em Enfermagem , Grupos Focais , Feminino , Adulto , Masculino , Pesquisa em Enfermagem Clínica
7.
Health Informatics J ; 30(4): 14604582241274282, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39607870

RESUMO

Objectives: This study characterized toothache-related Portuguese Facebook posts, identifying factors driving misinformation production and user engagement. Methods: Investigators qualitatively analyzed 500 posts published between August 2018 and August 2022, screening on language and theme. Posts were selected using CrowdTangle and assessed for motivation, author profile, content, sentiment, facticity, and format. The interaction metrics (total interactions/overperforming scores) were compared between groups of dichotomized characteristics, including time of publication. Data were evaluated by descriptive analysis, the Mann-Whitney U test, and the path analysis by generalized structural equation modeling. Results: 39.6% of posts (n = 198) contained misinformation, significantly linked to noncommercial posts with positive sentiment, links, and videos from regular users motivated by financial motivation. Additionally, user engagement was only positively associated with business/health authors' profiles and the time of publication. Conclusion: Toothache-related posts often contain misinformation, shared by regular users in links and video formats, tied to positive sentiments, and generally with financial motivation.


Assuntos
Comunicação , Mídias Sociais , Odontalgia , Humanos , Mídias Sociais/tendências , Mídias Sociais/estatística & dados numéricos , Mídias Sociais/instrumentação , Odontalgia/psicologia , Portugal , Motivação , Pesquisa Qualitativa
8.
Rev Esc Enferm USP ; 58: e20240222, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39607883

RESUMO

OBJECTIVE: To identify variables related to perceived stress and resilience of international migrants. METHOD: Multicenter, observational, cross-sectional study carried out with 403 migrants residing in Brazil, Spain, or Portugal. The following instruments were used to collect data: Perceived Stress Scale and Resilience Scale. Student's t-test and analysis of variance were applied in the analysis. RESULTS: Perceived stress was related to: living in Brazil or Portugal; shorter stay in the host country; being black or brown; and having no religion. Greater resilience was related to: not being divorced; having less education and lower family income; being from developing countries; living in Spain; and having a religion. CONCLUSION: Aspects such as host and origin country, skin color, income, marital status, education, length of stay in the host country, and religion are related to the level of stress and/or resilience of migrants. Knowing this profile is useful for developing public integration policies and interventions that seek to reduce stress and improve resilience.


Assuntos
Resiliência Psicológica , Estresse Psicológico , Migrantes , Humanos , Estudos Transversais , Feminino , Masculino , Brasil , Adulto , Espanha , Portugal , Migrantes/psicologia , Pessoa de Meia-Idade , Adulto Jovem
9.
Hist Cienc Saude Manguinhos ; 31: e2024058, 2024.
Artigo em Português | MEDLINE | ID: mdl-39504107

RESUMO

The issue of public health and epidemics is again in the spotlight today because of the recent epidemic we have experienced, which, although weaker, continues to be the object of our attention. In this article, we attempt to understand the relationship between the environment and public health, within this context exploring the main epidemics known to have occurred in Portugal in the Modern Age. Conditions in Portugal at that time were favorable for the spread of several epidemics; the environment encouraged the spread of disease and boosted virulence at a time when medicine was unable to cope, causing mortality rates to soar.


A questão da saúde pública e das epidemias conheceu nos nossos dias novamente a ribalta, devido à recente epidemia vivida e que, embora mais enfraquecida, continua a ser objeto da nossa atenção. Procuramos, neste artigo, compreender a relação existente entre meio ambiente e saúde pública e, nesse âmbito, estudar as principais epidemias conhecidas em Portugal ao longo da Idade Moderna. Foram várias as epidemias que encontraram no Portugal moderno condições favoráveis à sua propagação. O meio ambiente favoreceu o alastramento da doença e potenciou a sua virulência num período em que a medicina era incapaz de fazer face à doença, disparando as taxas de mortalidade.


Assuntos
Epidemias , Saúde Pública , Portugal/epidemiologia , Humanos , Epidemias/história , História do Século XX , Meio Ambiente
10.
Occup Environ Med ; 81(10): 532-534, 2024 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-39375034

RESUMO

OBJECTIVE: This descriptive study aimed to measure the excess all-cause mortality potential years of working life lost (PYWLL) in the working-age population of six Ibero-American countries in 2020 and 2021. METHODS: This study was based on all-cause deaths for the age group 15-69 years for men and women in six countries: Colombia, Costa Rica, México, Peru, Portugal and Spain. The expected PYWLL was the average value determined from the previous 5 years (2015-2019). To estimate the excess of PYWLL, the expected PYWLL was subtracted from the observed PYWLL values for 2020 and 2021, separately. RESULTS: In the four Latin American countries, the excess PYWLL per death was approximately double (between 12 and 16 years) that of the two European countries (between 3 and 9 years). CONCLUSIONS: The loss of working-age individuals will probably have a profound social and economic recovery impact, affecting families and communities. The informal employment and labour market structures may be contributing to the adverse effects of the pandemic in the region. Investing in universal, comprehensive and sustainable health and social protection systems in the Latin American countries is crucial to build resilience against current and future crises.


Assuntos
Emprego , Humanos , Pessoa de Meia-Idade , Masculino , Adulto , Feminino , Adolescente , Idoso , Adulto Jovem , América Latina/epidemiologia , Europa (Continente)/epidemiologia , Emprego/estatística & dados numéricos , Expectativa de Vida/tendências , COVID-19/epidemiologia , COVID-19/mortalidade , Portugal/epidemiologia , Mortalidade/tendências , Espanha/epidemiologia , Causas de Morte/tendências , Peru/epidemiologia
11.
Crit Care Sci ; 36: e20240236en, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39356899

RESUMO

OBJECTIVE: To elucidate the impact of lymphopenia on critical COVID-19 patient outcomes. METHODS: We conducted a multicenter prospective cohort study across five hospitals in Portugal and Brazil from 2020 to 2021. The study included adult patients admitted to the intensive care unit with SARS-CoV-2 pneumonia. Patients were categorized into two groups based on their lymphocyte counts within 48 hours of intensive care unit admission: the Lymphopenia Group (lymphocyte serum count < 1 × 109/L) and the Nonlymphopenia Group. Multivariate logistic regression, propensity score matching, Kaplan‒Meier survival curve analysis and Cox proportional hazards regression analysis were used. RESULTS: A total of 912 patients were enrolled, with 191 (20.9%) in the Nonlymphopenia Group and 721 (79.1%) in the Lymphopenia Group. Lymphopenia patients displayed significantly elevated disease severity indices, including Sequential Organ Failure Assessment and Simplified Acute Physiology Score 3 scores, at intensive care unit admission (p = 0.001 and p < 0.001, respectively). Additionally, they presented heightened requirements for vasopressor support (p = 0.045) and prolonged intensive care unit and in-hospital stays (both p < 0.001). Multivariate logistic regression analysis after propensity score matching revealed a significant contribution of lymphopenia to mortality, with an odds ratio of 1,621 (95%CI: 1,275 - 2,048; p < 0.001). Interaction models revealed an increase of 8% in mortality for each decade of longevity in patients with concomitant lymphopenia. In the subanalysis utilizing three-group stratification, the Severe Lymphopenia Group had the highest mortality rate, not only in direct comparisons but also in Kaplan‒Meier survival analysis (log-rank test p = 0.0048). CONCLUSION: Lymphopenia in COVID-19 patients is associated with increased disease severity and an increased risk of mortality, underscoring the need for prompt support for critically ill high-risk patients. These findings offer important insights into improving patient care strategies for COVID-19 patients.


Assuntos
COVID-19 , Unidades de Terapia Intensiva , Linfopenia , Pontuação de Propensão , Humanos , COVID-19/mortalidade , COVID-19/complicações , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Prospectivos , Idoso , Brasil/epidemiologia , Portugal/epidemiologia , Índice de Gravidade de Doença , Estado Terminal , Contagem de Linfócitos , SARS-CoV-2 , Estimativa de Kaplan-Meier
12.
Hist Cienc Saude Manguinhos ; 31Suppl 1(Suppl 1): e2024052, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39417456

RESUMO

This study analyzes the influence of hospitals on medical specialization and resulting implications for the history of public health from 1880 to 1933, with a focus on Lisbon as a case study. After the 1755 earthquake, a shift occurred from Renaissance-style hospitals to a network of hospitals that strategically occupied diverse urban spaces, significantly shaping the modernization of medicine and governmental healthcare policies. Employing the framework of the history of science, technology and medicine studies, this research enriches the historiography of hospitals, offering comprehensive insight into their societal significance during the study period.


Assuntos
Hospitais , História do Século XIX , Portugal , História do Século XX , Humanos , Hospitais/história , Especialização/história , Saúde Pública/história , Medicina
13.
Hist Cienc Saude Manguinhos ; 31Suppl 1(Suppl 1): e2024053, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39417457

RESUMO

The aim of this work is to ascertain the relevance of the miasmatic theory for the construction and spatial organization of the Hospital Geral de Santo António in Porto, Portugal, in the 19th century, from then recent graduate physicians' viewpoint. The methodology consists of analyzing the inaugural dissertations presented to the Escola Médico-Cirúrgica do Porto in order to assess the physicians' perceptions of the Santo António Hospital building, with emphasis on the relationship between health, medicine and environment. This work intends to contribute to better understand the relationship between the theoretical referential approach to disease and medical practice, at the interface of health, medicine, and environment by analyzing interspecies encounters.


Assuntos
Arquitetura Hospitalar , Portugal , História do Século XIX , Arquitetura Hospitalar/história , Humanos , Médicos/história , Hospitais/história
14.
Hist Cienc Saude Manguinhos ; 31Suppl 1(Suppl 1): e2024056, 2024 Sep.
Artigo em Português | MEDLINE | ID: mdl-39417460

RESUMO

This paper aims at illustrating the panorama of health and medicine in Portugal in the first quarter of the twentieth century using the photographic collection of Jorge Marçal da Silva, a doctor and amateur photographer, which has been preserved by his family. From his collection, we have chosen a selection of photographs that illustrate the modus vivendi of the Portuguese population, in the rural interior, on the fishing coast and in city life, as well as some that depict hospital environments and medical care in the capital, in order to reflect on their importance as a source for the historiographical reflection on the history of Portuguese medicine in the 1900s.


Este trabalho pretende ilustrar o panorama da saúde e da medicina em Portugal no primeiro quartel do século XX a partir do espólio fotográfico de Jorge Marçal da Silva, médico e fotógrafo amador, que tem sido preservado pela família. Da sua coleção, escolhemos uma seleção de fotografias que ilustram o modus vivendi da população portuguesa, no interior rural, no litoral piscatório e na vida citadina, bem como algumas das que retratam os ambientes hospitalares e a assistência médica na capital, no sentido de reflectir sobre a sua importância como fonte de reflexão historiográfica para a história da medicina portuguesa de Novecentos.


Assuntos
Fotografação , Portugal , História do Século XX , Fotografação/história , Humanos , História da Medicina
15.
Hist Cienc Saude Manguinhos ; 31Suppl 1(Suppl 1): e2024038, 2024 Sep.
Artigo em Português | MEDLINE | ID: mdl-39383428

RESUMO

Since the modern era, healthcare in Portugal has been provided primarily by hospitals, many of which were founded by the Sisters of Mercy and known as Misericordias. However, the creation of new hospitals in the nineteenth century and first half of the twentieth century did not necessarily yield improved patient care, since these institutions tended to be small, poorly equipped, and lacking in human and material resources. This study presents a reflection on developments in Portuguese hospitals from 1834 through to the first decades of the twentieth century, drawing on data on several institutions to identify changes and continuities in the healthcare offered.


Desde a época moderna, em Portugal, a assistência à doença foi prestada, sobretudo, pelos hospitais, muitos deles criados pelas Misericórdias. No entanto, a criação de novos hospitais no século XIX e nas primeiras décadas do século XX não trouxe, necessariamente, uma melhoria no tratamento dos doentes, visto que, salvo raras exceções, eram espaços pequenos, mal equipados e carentes de recursos humanos e materiais. O objetivo deste texto é apresentar uma reflexão sobre a resposta hospitalar em Portugal entre 1834 e as primeiras décadas do século XX. Pretendemos apontar as mudanças e continuidades que, nesse período, ocorreram no campo da assistência à doença, fazendo referência à criação de diversas instituições.


Assuntos
Hospitais , Portugal , História do Século XIX , História do Século XX , Hospitais/história , Humanos
16.
Cad Saude Publica ; 40(8): e00189823, 2024.
Artigo em Português | MEDLINE | ID: mdl-39292135

RESUMO

Food and nutrition surveillance is fundamental to the formulation, implementation, monitoring, and evaluation of public policies on food and nutrition. The comparative analysis of the evolution of food and nutrition surveillance actions between countries makes it possible to learn about advances, challenges and innovations for the planning of interventions. This study aimed to describe and compare food and nutrition surveillance actions in Brazil and Portugal, countries with different geographical dimensions and socio-economic profiles, but with the common characteristic of having a universal healthcare system. We manually searched for documents describing food and nutrition surveillance actions and for potential data sources on the institutional websites of the Brazilian and Portuguese governments. The recommendations of the READ approach were used (59 documents were identified for Brazil and 29 for Portugal). In Brazil, food and nutrition surveillance actions are included in health policies and in the constraints of conditional cash transfer programs. The Brazilian Households Budget Surveys and health surveys are used simultaneously with the Brazilian National Food and Nutrition Surveillance System (SISVAN). In Portugal, food and nutrition surveillance actions are part of health policies, via the National Program and the Integrated Strategy for the Promotion of Healthy Eating. Among the data sources identified are the Portuguese Food Balance Sheet and household budget, health and food surveys, as well as initiatives to monitor the nutritional status of children and adolescents. In both countries, strategies need to be improved in terms of the regularity of data recording, the harmonization of food consumption indicators and the dissemination of information.


A vigilância alimentar e nutricional é fundamental para a formulação, a implementação, o monitoramento e a avaliação de políticas públicas de alimentação e nutrição. A análise comparativa da evolução das ações de vigilância alimentar e nutricional entre países permite o conhecimento de avanços, desafios e inovações para o planejamento de intervenções. O objetivo foi descrever e comparar as ações de vigilância alimentar e nutricional no Brasil e em Portugal, países com dimensões geográficas e perfis socioeconômicos distintos, mas com sistema de saúde universal em comum. Nós buscamos por documentos que descrevessem as ações de vigilância alimentar e nutricional e por potenciais fontes de dados de maneira manual em websites institucionais dos governos brasileiro e português. O estudo utilizou as recomendações da abordagem READ (59 documentos foram identificados para o Brasil e 29 para Portugal). No Brasil, as ações de vigilância alimentar e nutricional estão inseridas em políticas de saúde e nas condicionalidades dos programas de transferência condicionada de renda. As Pesquisas de Orçamentos Familiares e os inquéritos de saúde são utilizados simultaneamente no Sistema de Vigilância Alimentar e Nutricional (SISVAN). Em Portugal, as ações de vigilância alimentar e nutricional estão inseridas nas políticas de saúde, por meio do Programa Nacional e da Estratégia Integrada para a Promoção da Alimentação Saudável. Entre as fontes de dados identificadas estão a Balança Alimentar Portuguesa, os inquéritos de orçamentos familiares, de saúde e alimentares, além de iniciativas para o monitoramento do estado nutricional de crianças e adolescentes. Em ambos os países, as estratégias precisam ser aprimoradas em relação à regularidade do registro de dados, à harmonização dos indicadores do consumo alimentar e à disseminação das informações.


La vigilancia alimentaria y nutricional es fundamental para la formulación, implementación, monitoreo y evaluación de las políticas públicas de alimentación y nutrición. El análisis comparativo de la evolución de las acciones de vigilancia alimentaria y nutricional entre países permite el conocimiento de los avances, desafíos e innovaciones para la planificación de intervenciones. El objetivo fue describir y comparar las acciones de vigilancia alimentaria y nutricional en Brasil y en Portugal, países con diferentes dimensiones geográficas y perfiles socioeconómicos, pero con un sistema de salud universal en común. Buscamos documentos que describieran las acciones de vigilancia alimentaria y nutricional y posibles fuentes de datos manualmente en sitios web institucionales de los gobiernos de Brasil y Portugal. El estudio utilizó las recomendaciones del enfoque READ (se identificaron 59 documentos para Brasil y 29 para Portugal). En Brasil, las acciones de vigilancia alimentaria y nutricional están incluidas en políticas de salud y en las condicionalidades de los programas de transferencia condicionada de ingresos. Las Encuestas de Presupuestos Familiares y los estudios de salud se utilizan simultáneamente con el Sistema de Vigilancia Alimentaria y Nutricional (SISVAN). En Portugal, las acciones de vigilancia alimentaria y nutricional están incluidas en las políticas de salud, por medio del Programa Nacional y de la Estrategia Integrada para la Promoción de una Alimentación Saludable. Entre las fuentes de datos identificadas, se encuentran la Balanza Alimentaria Portuguesa, las encuestas de presupuestos familiares, de salud y alimentarias. Además de iniciativas para el monitoreo del estado nutricional de niños y adolescentes. En ambos países, es necesario mejorar las estrategias con relación a la regularidad del registro de datos, a la armonización de los indicadores de consumo de alimentos y a la difusión de la información.


Assuntos
Política Nutricional , Estado Nutricional , Brasil , Portugal , Humanos , Política de Saúde , Inquéritos Nutricionais , Fatores Socioeconômicos
17.
Rev Bras Enferm ; 77(4): e20240059, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39319971

RESUMO

OBJECTIVES: to construct a Subcutaneous Hydration Device semi-functional prototype and gather initial information to improve this prototype design and realize its acceptance potential. METHODS: a qualitative, descriptive and exploratory study, which used focus group, following the Technology Acceptance Model. The group was held at the Escola Superior de Enfermagem de Coimbra, Portugal, in December 2022, composed of nine participants from six different disciplinary areas, and followed thematic analysis. RESULTS: four topics emerged associated with the device components: elastomeric infusion pump; needle/access device; clamp; administration set. From these topics, topics were triggered that highlighted: characteristics about the target population; ease of use and accessories; patient comfort and safety; and device application context. FINAL CONSIDERATIONS: the Subcutaneous Hydration Device semi-functional prototype is viable and interesting for the clinic. The results support its improvement and direct future investments for experimental studies.


Assuntos
Desenho de Equipamento , Grupos Focais , Pesquisa Qualitativa , Humanos , Desenho de Equipamento/normas , Desenho de Equipamento/métodos , Grupos Focais/métodos , Portugal , Masculino , Feminino , Adulto , Bombas de Infusão/normas , Bombas de Infusão/estatística & dados numéricos
18.
PLoS One ; 19(9): e0305790, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39264926

RESUMO

OBJECTIVES: To develop an allometric body mass index (ABMI) reference that adjusts the weight in relation to height, taking into account the changes during development (MULT ABMI reference), and to compare it with international BMI references. METHODS: The MULT ABMI reference was constructed through the LMS method, calculated with 65 644 ABMI observations of 17 447 subjects aged 5-22 years, from the United Kingdom, Ethiopia, India, Peru, Vietnam, Portugal, and Brazil. The M, S, and L curves of the MULT ABMI reference were compared with the curves of the MULT, World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF), and Dutch Growth Study (DUTCH). RESULTS: The greater differences in the M curve between MULT ABMI and WHO, CDC, IOTF, DUTCH, and MULT BMI references were around puberty (138 to 150 months for boys; 114 to 132 for girls). MULT ABMI presented S values similar to IOTF and DUTCH BMI references for boys 60 to 114 months and then became higher, approaching the MULT BMI S values from 198 to 240 months. For girls the MULT ABMI S values were close to the IOTF, CDC, and DUTCH from 60 to 110 months, and then became higher, approaching the MULT BMI S values until 240 months. CONCLUSION: MULT ABMI presented an advantage in comparison to the existing BMI references because it takes into account the growth changes during puberty and is a new option to assess the nutritional status of multiethnic populations.


Assuntos
Índice de Massa Corporal , Estado Nutricional , Humanos , Criança , Adolescente , Masculino , Feminino , Pré-Escolar , Brasil , Adulto Jovem , Valores de Referência , Estatura , Vietnã , Peso Corporal , Índia , Peru , Etiópia , Reino Unido , Portugal , Etnicidade
19.
BMC Palliat Care ; 23(1): 225, 2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39256708

RESUMO

BACKGROUND: Countries with formal policies for palliative care, and advanced and integrated practices in this field, such as Portugal, face challenges in achieving excellence in care, particularly in home-based assistance. Issues include care coordination among providers, confusion regarding the roles of each health care professional in the network, and a lack of monitoring and evaluation of actions. Our objective was to analyze the implementation of palliative care in primary health care in Portugal. METHODS: We conducted a qualitative, descriptive, and exploratory study in Portugal involving health care professionals with experience in palliative care. The data were collected through semistructured interviews and focus groups between March and October 2023. Eighteen health care professionals participated. We used the Alceste software for lexicographic analysis. The research was authorized by an Ethics Committee. RESULTS: Four classes were identified; classes 1 and 2, comprising 77% of the corpus, addressed the study objectives. Participants highlighted inequitable access, strategic development plans with unattainable short-term goals; and low literacy. They emphasized the importance of legislation, professional training initiatives for generalist palliative care at home, and early referral. Home-based challenges included professionals' lack of exclusive dedication, absence of 24/7 coverage, and unavailability of capable family caregivers. The networks' response to hospital admissions and patient transitions from hospital to home, with access to the specialized team, was also inadequate. CONCLUSIONS: Health care professionals aim to increase patients' time spent at home, reduce emergency department visits, and minimize hospitalizations by leveraging the resources of the national palliative care network. In addition to investments to sustain network implementation and legally guaranteed palliative care rights, the country must focus on measurable indicators for evaluating and monitoring actions, providing better guidance in the short, medium, and long term.


Assuntos
Grupos Focais , Cuidados Paliativos , Pesquisa Qualitativa , Humanos , Cuidados Paliativos/normas , Cuidados Paliativos/métodos , Portugal , Grupos Focais/métodos , Política de Saúde/tendências , Masculino , Feminino , Adulto , Pessoa de Meia-Idade
20.
Arq Neuropsiquiatr ; 82(8): 1-7, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39187258

RESUMO

BACKGROUND: The magnetic resonance imaging-guided focused ultrasound (MRgFUS) has emerged as an innovative treatment for patients with medically refractory essential tremor (ET). OBJECTIVE: This retrospective observational study aims to present the results of the first five patients with medically refractory ET who underwent MRgFUS treatment at this pioneering medical unit in Portugal. METHODS: We conducted a retrospective chart review for the first five patients who underwent unilateral MRgFUS thalamotomy of the ventral intermediate (Vim) nucleus to treat medically refractory ET at our medical unit. RESULTS: The mean patient age was 65.4 (26-84) years, and 60% were male. All patients had a family history of ET. The mean duration of disease was 17.4 years (range 10-24 years), and their dominant hand was the right. According to personal preference, the thalamotomy was performed on the left side in four patients, and on the right side in one. The MRgFUS thalamotomy led to significant improvements in both the clinical rating scale for tremor (CRST) score, by 62%, and the CRST composite score for the treated hand, by 73%. All patients experienced improvements in functionality and quality of life, by 52%. No severe adverse events were observed, and those that did occur during and following the procedure were mild and transient. CONCLUSION: The initial results from Portugal's first MRgFUS medical unit indicate promising outcomes, with improvement in quality of life, as well as mild and temporary adverse events These findings contribute to the growing body of literature supporting the efficacy and safety of MRgFUS as a viable treatment option for patients with medication-resistant ET.


ANTECEDENTES: A talomotomia por ultrassons focados - guiada por imagem de ressonância magnética (MRgFUS) surgiu recentemente como um tratamento inovador para pacientes com tremor essencial (TE) refratário ao tratamento médico. OBJETIVO: Este estudo observacional retrospectivo tem como objetivo apresentar os resultados dos primeiros cinco pacientes com TE refratário à medicação submetidos ao tratamento com MRgFUS numa unidade médica pioneira em Portugal. MéTODOS: Realizamos uma revisão retrospectiva dos dados clínicos dos cinco primeiros pacientes submetidos a talamotomia MRgFUS unilateral do núcleo ventral intermédio (Vim) para tratamento do TE medicamente refratário em nossa unidade médica. RESULTADOS: A idade média dos pacientes era de 65,4 (26­84) anos, e 60% eram do sexo masculino. Todos os pacientes tinham história familiar de TE. A duração média da doença foi de 17,4 anos, e todos eram destros. De acordo com a preferência individual, em 4 pacientes, a talamotomia foi realizada no lado esquerdo, e em um, no lado direito. A talamotomia por MRgFUS levou a melhorias significativas tanto na pontuação da escala de classificação clínica para tremor (CRST), de 62%, e na pontuação composta da CRST para a mão tratada, de 73%. Todos os pacientes apresentaram melhorias na funcionalidade e na qualidade de vida, de 52%. Não foram observados efeitos adversos graves e os que ocorreram durante e após o procedimento foram ligeiros e transitórios. CONCLUSãO: Os resultados iniciais da primeira unidade médica MRgFUS de Portugal indicam melhorias na qualidade de vida dos pacientes, com efeitos adversos ligeiros e transitórios. Estes dados reforçam a evidência crescente sobre a eficácia e segurança da talamotomia por MRgFUS como opção viável para pacientes com TE resistente à medicação.


Assuntos
Tremor Essencial , Humanos , Masculino , Tremor Essencial/cirurgia , Tremor Essencial/diagnóstico por imagem , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Feminino , Adulto , Idoso de 80 Anos ou mais , Resultado do Tratamento , Portugal , Tálamo/cirurgia , Tálamo/diagnóstico por imagem , Imagem por Ressonância Magnética Intervencionista , Imageamento por Ressonância Magnética , Reprodutibilidade dos Testes , Ultrassonografia de Intervenção/métodos
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