FM-ISAMB-Artigos em Revistas Nacionais
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- Sports events: crowd dynamics and relevance in the context of the COVID-19 pandemic: fact-sheets collection from the Portuguese COVID-19 pandemic Task Force on Behavioral SciencesPublication . Santos, Osvaldo; Matos, Margarida Gaspar deCultural and sporting events hold significant social value, promoting cognitive, emotional, and interpersonal skills. The COVID-19 pandemic has disrupted these events, necessitating a careful examination of safety conditions for their resumption. This policy brief summarizes evidence on safety predictors in organizing large-scale sporting events, focusing on crowd dynamics and relevance in the context of the pandemic. Emphasis is given to the importance of understanding crowd behavior, noting that violent behavior is an exception rather than the rule. Various factors need to be considered for promoting public health safety in the pandemic context, including the nature of the sport, spatial organization, and socio-demographic characteristics of the audience. Key recommendations include maintaining physical distance, organizing outdoor events, and perceiving crowds as compositions of smaller groups with shared social identities. Clear communication, consistent messaging, and involvement of informed individuals to guide crowd behavior are also crucial. Mega events can be used to promote COVID-19 health behaviors and to enhance collaborative actions among various stakeholders, including government bodies, sports organizations, and the media, to ensure safe sporting events.
- Respiratory syncytial virus vaccination in older adults and patients with chronic disorders: a position paper from the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal MedicinePublication . Alfaro, Tiago; Froes, Filipe; Vicente, Cláudia; Costa, Rui; Gavina, Cristina; Baptista, Rui; Maio, António; da Cunha, Saraiva; Neves, João Sérgio; Leuschner, Pedro; Duque, Sofia; Pinto, PaulaBackground: Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infection, hospitalisation and death in adults. Methods: Based on evidence regarding the impact of RSV on adult populations at risk for severe infection and the efficacy and safety of RSV vaccines, the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal Medicine endorses this position paper with recommendations to prevent RSV-associated disease and its complications in adults through vaccination. Conclusion: The RSV vaccine is recommended for people aged ≥50 years with risk factors (chronic obstructive pulmonary disease, asthma, heart failure, coronary artery disease, diabetes, chronic kidney disease, chronic liver disease, immunocompromise, frailty, dementia, and residence in a nursing home) and all persons aged ≥60 years. If it cannot be made available to this population, then the vaccine should be prioritised for individuals aged ≥75 years and those aged ≥50 years with risk factors. The vaccine should preferably be given between September and November and can be co-administered with the influenza vaccine. Ongoing studies on RSV vaccines may justify extending these recommendations in the future.
- Aerobic fitness questionnaires: still not enough to estimate VO2 peak in cardiac patients!Publication . Abreu, AnaThe present study by Lima et al. “Validation of an Aerobic Fitness Questionnaire to estimate VO2 peak in a cohort of adult cardiac patients – Is it enough?”, intends to validate the CLINIMEX Aerobic Fitness Questionnaire (C-AFQ),3 comprising a list of activities, in a Portuguese population sample of 124 CV patients (93% male, mean age 61 years old, 61% with heart failure), who were referred for CPET and cardiac rehabilitation. In this prospective study, which enrolled exclusively CV patients (mainly male), C-AFQ was not sufficiently accurate to predict functional capacity measured by VO2 peak. Despite a numerically strong and positive correlation between measured and estimated, by C-AFQ, VO2 peak (r=0.723, p<0.001), high levels of disagreement in the Bland–Altman plot analysis were observed.
- Strategies and factors to promote research in primary care in Portugal: a cross-sectional studyPublication . Morgado, Maria Beatriz; Penedo, Carolina; Correia, Rubina; Amaral, Sandra Diniz; Nicola, Paulo; Gil Conde, MargaridaIntroduction: Research is crucial for building an efficient health system care. This reality is particularly evident in primary care, the cornerstone of healthcare services. However, research in primary care is not consistently implemented across Europe. With this study we aimed to: 1) identify the factors and strategies that healthcare professionals consider relevant for promoting research in primary care in Portugal; 2) analyze whether the prioritized strategies vary according to the geographical area, professional group, workplace, interest, and experience in research of the participants. Methods: We conducted an analytical cross-sectional study using an online survey applied in the first semester of 2023. We designed the survey based on strategies identified in a previous qualitative study. We included health professionals working in Primary Care in Portugal (continental and autonomous regions). We intended to obtain at least 200 answers for each professional category and geographical area. The survey was initially sent to a convenience sample to assess the acceptability and interpretation of the questions. We then disseminated the survey through all national Health Center Clusters and through professional associations. We conducted an analysis using a 5% significance level. Results: The sample consisted of 1027 participants: 507 doctors, 377 nurses, 106 diagnostic and therapeutic technicians, and 30 secretaries. The majority worked in the Lisbon and Tagus Valley region (51.9%), followed by the North (22.1%) and Centre (17.1%). Around half of the participants worked in a Family Health Unit, 16.5% worked in a Personalized Healthcare Unit, 11% in a Community Care Unit, and 8.7% in a Public Health Unit. The factors promoting research mentioned by a greater proportion of participants were research training (76%), access to mentors (71%) and grants (56%). As for strategies to promote research, most participants supported the existence of dedicated time for research (82%), public grants (65%), institutional support (51%), access to support services (58%) and research data (57%). Conclusion: There seems to be a consensus on which factors are currently promoting research and what future strategies might be useful for promoting research in primary care in Portugal. Nevertheless, there are some differences between certain sub-groups. This information might be useful to tailor initiatives directed at specific sub-groups. Our intention is to help form policies and strategies to promote research in primary care in Portugal, contributing to the national development on the subject.
- Cardiopulmonary exercise testing in clinical practice: principles, applications, and basic interpretationPublication . Dores, Hélder; Mendes, Miguel; Abreu, Ana; Durazzo, Anaí; Rodrigues, Cidália; Vilela, Eduardo; Cunha, Gonçalo; Gomes Pereira, José; Bento, Luísa; Moreno, Luís; Dinis, Paulo; Amorim, Sandra; Clemente, Susana; Santos, MárioCardiopulmonary exercise testing (CPET) provides a noninvasive and integrated assessment of the response of the respiratory, cardiovascular, and musculoskeletal systems to exercise. This information improves the diagnosis, risk stratification, and therapeutic management of several clinical conditions. Additionally, CPET is the gold standard test for cardiorespiratory fitness quantification and exercise prescription, both in patients with cardiopulmonary disease undergoing cardiac or pulmonary rehabilitation programs and in healthy individuals, such as high-level athletes. In this setting, the relevance of practical knowledge about this exam is useful and of interest to several medical specialties other than cardiology. However, despite its multiple established advantages, CPET remains underused. This article aims to increase awareness of the value of CPET in clinical practice and to inform clinicians about its main indications, applications, and basic interpretation.
- Geographical variation in lung function: results from the multicentric cross-sectional BOLD studyPublication . Burney, Peter G. J.; Potts, James; Knox-Brown, Ben; Erhabor, Gregory; Hacene Cherkaski, Hamid; Mortimer, Kevin; Anand, Mahesh Padukudru; Mannino, David M.; Cardoso, Joao; Ahmed, Rana; Elsony, Asma; Bárbara, Cristina; Nielsen, Rune; Bateman, Eric; Paraguas, Stefanni Nonna M.; Cher Loh, Li; Rashid, Abdul; Wouters, Emiel F. M.; Franssen, Frits M. E.; Dias, Hermínia Brites; Gislason, Thorarinn; Ghobain, Mohammed A. l.; Biaze, Mohammed E. l.; Agarwal, Dhiraj; Juvekar, Sanjay; Rodrigues, Fatima; Obaseki, Daniel O.; Koul, Parvaiz A.; Harrabi, Imed; Nafees, Asaad A.; Seemungal, Terence; Janson, Christer; Vollmer, William M.; Amaral, Andre F. S.; Buist, A. SoniaSpirometry is used to determine what is "unusual" lung function compared with what is "usual" for healthy non-smokers. This study aimed to investigate regional variation in the forced vital capacity (FVC) and in the forced expiratory volume in one second to FVC ratio (FEV1/FVC) using cross-sectional data from all 41 sites of the multinational Burden of Obstructive Lung Disease study. Participants (5,368 men; 9,649 women), aged ≥40 years, had performed spirometry, had never smoked and reported no respiratory symptoms or diagnoses. To identify regions with similar FVC, we conducted a principal component analysis (PCA) on FVC with age, age2 and height2, separately for men and women. We regressed FVC against age, age2 and height2, and FEV1/FVC against age and height2, for each sex and site, stratified by region. Mean age was 54 years (both sexes), and mean height was 1.69 m (men) and 1.61 m (women). The PCA suggested four regions: 1) Europe and richer countries; 2) the Near East; 3) Africa; and 4) the Far East. For the FVC, there was little variation in the coefficients for age, or age2, but considerable variation in the constant (men: 2.97 L in the Far East to 4.08 L in Europe; women: 2.44 L in the Far East to 3.24 L in Europe) and the coefficient for height2. Regional differences in the constant and coefficients for FEV1/FVC were minimal (<1%). The relation of FVC with age, sex and height varies across and within regions. The same is not true for the FEV1/FVC ratio.
- Respiratory syncytial virus vaccination in older adults and patients with chronic disorders: a position paper from the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal MedicinePublication . Alfaro, Tiago; Froes, Filipe; Vicente, Cláudia; Costa, Rui; Gavina, Cristina; Baptista, Rui; Maio, António; da Cunha, Saraiva; Neves, João Sérgio; Leuschner, Pedro; Duque, Sofia; Pinto, PaulaBackground: Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infection, hospitalisation and death in adults. Methods: Based on evidence regarding the impact of RSV on adult populations at risk for severe infection and the efficacy and safety of RSV vaccines, the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal Medicine endorses this position paper with recommendations to prevent RSV-associated disease and its complications in adults through vaccination. Conclusion: The RSV vaccine is recommended for people aged ≥50 years with risk factors (chronic obstructive pulmonary disease, asthma, heart failure, coronary artery disease, diabetes, chronic kidney disease, chronic liver disease, immunocompromise, frailty, dementia, and residence in a nursing home) and all persons aged ≥60 years. If it cannot be made available to this population, then the vaccine should be prioritised for individuals aged ≥75 years and those aged ≥50 years with risk factors. The vaccine should preferably be given between September and November and can be co-administered with the influenza vaccine. Ongoing studies on RSV vaccines may justify extending these recommendations in the future.
- Is the cardiovascular risk SCORE2 globally valid and useful?Publication . Abreu, AnaAtherosclerotic cardiovascular (CV) disease (ASCVD) is known to be a major cause of mortality and morbidity worldwide. There have been many advances in treatment over the years, including invasive percutaneous coronary intervention, and in secondary prevention with widespread use of statins, other lipid-lowering agents and new antiplatelet agents, impacting on prognosis. However, in the population not diagnosed with CV disease (CVD), a major issue remains in practice: how to assess CV risk, which could enable primary prevention of ASCVD, acting upstream. Most CV events can be prevented by control of behavioral risk factors, such as unhealthy diet, smoking, obesity, physical inactivity, and excessive alcohol consumption.
- Monthly analysis of infant mortality rate in Portugal during the COVID-19 pandemic: insights from continuous monitoringPublication . Nogueira, Paulo Jorge; Camarinha, Catarina; Feteira-Santos, Rodrigo; Costa, Andreia; Nobre, Miguel de Araújo; Bacelar-Nicolau, Leonor; Furtado, Cristina; Elias, CecíliaIntroduction: 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.
- Mental health and well-being of migrant populations in Portugal two years after the COVID-19 pandemicPublication . Alarcão, Violeta; Candeias, Pedro; Stefanovska-Petkovska, Miodraga; Pintassilgo, Sónia; Machado, Fernando Luís; Virgolino, Ana; Santos, OsvaldoIn Portugal, like in other European countries, the COVID-19 pandemic aggravated the risk of poverty and social exclusion faced by migrants. This study aimed to assess mental health and well-being, and their social determinants, among Brazilian and Cape Verdean immigrant populations two years after the COVID-19 pandemic while exploring the role of positive psychological factors such as resilience and perceived social support. We conducted a cross-sectional survey combining online and face-to-face questionnaires for data collection between February and November 2022 on dimensions of mental health considered potentially relevant to the post-pandemic context: psychological distress, anxiety, and depression. Overall, 604 immigrants were included (322 Brazilian and 282 Cape Verdean); 58.5% of those surveyed were women and 41.5% were men. The results revealed that gender (being a woman) was associated with both psychological distress and depression, higher education was associated with anxiety, and that, for the three mental health dimensions under analysis, the perception of discrimination and resilience were negative and positive predictors, respectively. Findings can inform the design and implementation of relevant public mental health promotion programs with a focus on equity targeted to the general population. Such programs would help to address the psychological and social impacts of this long-term, insidious global pandemic that has challenged governments, health care systems, health care professionals, individuals, families, and communities worldwide.