Browsing by Author "Marinho, Ricardo"
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- First touch course—the impact of a nation-wide boot camp on the transition to surgical residencyPublication . Reis, Sofia Gaspar; Gonçalves, Mário Rui; Azevedo, Constança; Ruivo, Ana; Guidi, Gonçalo; Marinho, Ricardo; Teles, Joana Pinto; Domingos, Ana Sofia; Borges, André Luís; Quintas, Filipe Rodrigues; Miranda, Liliana Grilo; Oliveira, António; Matos, José Novo deSurgical residents face numerous challenges and undergo significant changes at the beginning of their residency. Although there are several courses throughout residency, it is difficult to address all of them in a single activity. Boot camps (BC) have been a way for easing this transition period. Our team developed the “First Touch Course” boot camp in 2017 to join all residents of the same year, before they initiate Surgical residency. Since then, 8 editions have been organised (one per year) with the participation of a total of 481 residents. Eighty-four residents have enrolled in the last two editions, mainly from General Surgery, Gynecology and Urology. The present study analysed the 2023 and 2024 editions to evaluate the impact of this BC on residents’ preparedness and confidence to face residency. More than 71% of the participants rated the course as excellent and 100% considered it exceeded their expectations. Almost 100% considered it will have a significant impact and more than 75% felt better prepared to start residency after the course. More than 73% believe that having a laparoscopic simulator will be useful for continuous skills acquisition. This is the first nationwide, multi-speciality boot camp that promotes continuing education, providing each resident with a personal laparoscopy simulator and laparoscopic instruments, allowing for home-based training. This study highlights the importance and impact of this kind of boot camps in preparing residents for the early stages of surgical residency and the impact it may have on basic skills acquisition.
- High prevalence of malnutrition in Internal Medicine wards–a multicentre ANUMEDI studyPublication . Marinho, Ricardo; Pessoa, Ana; Lopes, Marta; Rosinhas, João; Pinho, João; Silveira, Joana; Amado, Ana; Silva, Sandra; Oliveira, Bruno M. P. M.; Marinho, Anibal; Jager-Wittenaar, HarrietBackground Disease-related malnutrition is a significant problem in hospitalized patients, with high prevalence rates depending on the studied population. Internal Medicine wards are the backbone of the hospital setting. However, prevalence and determinants of malnutrition in these patients remain unclear. We aimed to determine the prevalence of malnutrition in Internal Medicine wards and to identify and characterize malnourished patients. Methods A cross-sectional observational multicentre study was performed in Internal Medicine wards of 24 Portuguese hospitals during 2017. Demographics, hospital admissions during the previous year, type of admission, primary diagnosis, Charlson comorbidity index, and education level were registered. Malnutrition at admission was assessed using Patient-Generated Subjective Global Assessment (PG-SGA). Demographic characteristics were compared between well-nourished and malnourished patients. Logistic regression analysis was used to identify determinants of malnutrition. Results 729 participants were included (mean age 74 years, 51% male). Main reason for admission was respiratory disease (32%). Mean Charlson comorbidity index was 5.8 ± 2.8. Prevalence of malnutrition was 73% (56% moderate/suspected malnutrition and 17% severe malnutrition), and 54% had a critical need for multidisciplinary intervention (PG-SGA score ≥9). No education (odds ratio [OR] 1.88, 95% confidence interval [CI]: 1.16–3.04), hospital admissions during previous year (OR 1.53, 95%CI: 1.05–2.26), and multiple comorbidities (OR 1.22, 95%CI: 1.14–1.32) significantly increased the odds of being malnourished. Conclusions Prevalence of malnutrition in the Internal Medicine population is very high, with the majority of patients having critical need for multidisciplinary intervention. Low education level, admissions during previous year, and multiple comorbidities increase the odds of being malnourished.
- Prevalence of nutritional risk at admission in internal medicine wards in Portugal: the multicentre cross-sectional ANUMEDI studyPublication . Marinho, Ricardo; Pessoa, Ana; Lopes, Marta; Rosinhas, João; Pinho, João; Silveira, Joana; Amado, Ana; Silva, Sandra; Oliveira, Bruno; Marinho, Aníbal; Jager-Wittenaar, HarriëtIntroduction: Disease-related undernutrition is highly prevalent and requires timely intervention. However, identifying undernutrition often relies on physician judgment. As Internal Medicine wards are the backbone of the hospital setting, insight into the prevalence of nutritional risk in this population is essential. We aimed to determine the prevalence of nutritional risk in Internal Medicine wards, to identify its correlates, and to assess the agreement between the physicians’ impression of nutritional risk and evaluation by Nutritional Risk Screening 2002. Material and Methods: A cross-sectional multicentre study was performed in Internal Medicine wards of 24 Portuguese hospitals during 2017. Data on demographics, previous hospital admissions, primary diagnosis, and Charlson comorbidity index score were collected. Nutritional risk at admission was assessed using Nutritional Risk Screening 2002. Agreement between physicians’ impression of nutritional risk and Nutritional Risk Screening 2002 was tested by Cohen’s kappa. Results: The study included 729 participants (mean age 74 ± 14.6 years, 51% male). The main reason for admission was respiratory disease. Mean Charlson comorbidity index score was 5.8 ± 2.8. Prevalence of nutritional risk was 51%. Nutritional risk was associated with admission during the previous year (odds ratio = 1.65, 95% confidence interval: 1.22 - 2.24), solid tumour with metastasis (odds ratio = 4.73, 95% confidence interval: 2.06 - 10.87), any tumour without metastasis (odds ratio = 2.04, 95% confidence interval:1.24 - 3.34), kidney disease (odds ratio = 1.83, 95% confidence interval: 1.21 - 2.75), peptic ulcer (odds ratio = 2.17, 95% confidence interval: 1.10 - 4.25), heart failure (odds ratio = 1.51, 95% confidence interval: 1.11 - 2.04), dementia (odds ratio = 3.02, 95% confidence interval: 1.96 - 4.64), and cerebrovascular disease (odds ratio = 1.62, 95% confidence interval: 1.12 - 2.35). Agreement between physicians’ evaluation of nutritional status and Nutritional Risk Screening 2002 was weak (Cohen’s kappa = 0.415, p < 0.001). Discussion: Prevalence of nutritional risk in the Internal Medicine population is very high. Admission during the previous year and multiple comorbidities increase the odds of being at-risk. Subjective physician evaluation is not appropriate for nutritional screening. Conclusion: The high prevalence of at-risk patients and poor subjective physician evaluation suggest the need to implement mandatory nutritional screening.