CIIS - Contribuições em Revistas Científicas / Contribution to Journals
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- Changing life expectancy in European countries 1990-2021: a subanalysis of causes and risk factors from the Global Burden of Disease Study 2021Publication . GBD 2021 Europe Life Expectancy Collaborators; Steel, Nicholas; Bauer-Staeb, Clarissa Maria Mercedes; Ford, John A.; Abbafati, Cristiana; Abdalla, Mohammed Altigani; Abdelkader, Atef; Abdi, Parsa; Zuñiga, Roberto Ariel Abeldaño; Abiodun, Olugbenga Olusola; Abolhassani, Hassan; Abu-Gharbieh, Eman; Abukhadijah, Hana J.; Abu-Zaid, Ahmed; Addo, Isaac Yeboah; Addolorato, Giovanni; Adekanmbi, Victor; Adetunji, Juliana Bunmi; Adeyeoluwa, Temitayo Esther; Agardh, Emilie E.; Agyemang-Duah, Williams; Ahmad, Danish; Ahmed, Anisuddin; Ahmed, Ayman; Ahmed, Syed Anees; Akinosoglou, Karolina; Akkaif, Mohammed Ahmed; Al Awaidy, Salah; Al Hasan, Syed Mahfuz; Al Zaabi, Omar Ali Mohammed; Aldridge, Robert W.; Algammal, Abdelazeem M.; Al-Gheethi, Adel Ali Saeed; Ali, Abid; Ali, Mohammed Usman; Ali, Syed Shujait; Ali, Waad; Alicandro, Gianfranco; Alif, Sheikh Mohammad; Al-Jumaily, Adel; Allebeck, Peter; Alrawashdeh, Ahmad; Al-Rifai, Rami H.; Alsabri, Mohammed A.; Alshahrani, Najim Z.; Aluh, Deborah Oyine; Al-Wardat, Mohammad; Al-Zyoud, Walid A.; Amiri, Sohrab; Anderlini, Deanna; Bettencourt, Paulo J.G.Background: Decades of steady improvements in life expectancy in Europe slowed down from around 2011, well before the COVID-19 pandemic, for reasons which remain disputed. We aimed to assess how changes in risk factors and cause-specific death rates in different European countries related to changes in life expectancy in those countries before and during the COVID-19 pandemic. Methods: We used data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to compare changes in life expectancy at birth, causes of death, and population exposure to risk factors in 16 European Economic Area countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden) and the four UK nations (England, Northern Ireland, Scotland, and Wales) for three time periods: 1990–2011, 2011–19, and 2019–21. Changes in life expectancy and causes of death were estimated with an established life expectancy cause-specific decomposition method, and compared with summary exposure values of risk factors for the major causes of death influencing life expectancy. Findings: All countries showed mean annual improvements in life expectancy in both 1990–2011 (overall mean 0·23 years [95% uncertainty interval [UI] 0·23 to 0·24]) and 2011–19 (overall mean 0·15 years [0·13 to 0·16]). The rate of improvement was lower in 2011–19 than in 1990–2011 in all countries except for Norway, where the mean annual increase in life expectancy rose from 0·21 years (95% UI 0·20 to 0·22) in 1990–2011 to 0·23 years (0·21 to 0·26) in 2011–19 (difference of 0·03 years). In other countries, the difference in mean annual improvement between these periods ranged from –0·01 years in Iceland (0·19 years [95% UI 0·16 to 0·21] vs 0·18 years [0·09 to 0·26]), to –0·18 years in England (0·25 years [0·24 to 0·25] vs 0·07 years [0·06 to 0·08]). In 2019–21, there was an overall decrease in mean annual life expectancy across all countries (overall mean –0·18 years [95% UI –0·22 to –0·13]), with all countries having an absolute fall in life expectancy except for Ireland, Iceland, Sweden, Norway, and Denmark, which showed marginal improvement in life expectancy, and Belgium, which showed no change in life expectancy. Across countries, the causes of death responsible for the largest improvements in life expectancy from 1990 to 2011 were cardiovascular diseases and neoplasms. Deaths from cardiovascular diseases were the primary driver of reductions in life expectancy improvements during 2011–19, and deaths from respiratory infections and other COVID-19 pandemic-related outcomes were responsible for the decreases in life expectancy during 2019–21. Deaths from cardiovascular diseases and neoplasms in 2019 were attributable to high systolic blood pressure, dietary risks, tobacco smoke, high LDL cholesterol, high BMI, occupational risks, high alcohol use, and other risks including low physical activity. Exposure to these major risk factors differed by country, with trends of increasing exposure to high BMI and decreasing exposure to tobacco smoke observed in all countries during 1990–2021. Interpretation: The countries that best maintained improvements in life expectancy after 2011 (Norway, Iceland, Belgium, Denmark, and Sweden) did so through better maintenance of reductions in mortality from cardiovascular diseases and neoplasms, underpinned by decreased exposures to major risks, possibly mitigated by government policies. The continued improvements in life expectancy in five countries during 2019–21 indicate that these countries were better prepared to withstand the COVID-19 pandemic. By contrast, countries with the greatest slowdown in life expectancy improvements after 2011 went on to have some of the largest decreases in life expectancy in 2019–21. These findings suggest that government policies that improve population health also build resilience to future shocks. Such policies include reducing population exposure to major upstream risks for cardiovascular diseases and neoplasms, such as harmful diets and low physical activity, tackling the commercial determinants of poor health, and ensuring access to affordable health services. Funding: Gates Foundation.
- Trait mindfulness is protective for development of psychological distress in women with early breast cancerPublication . Manica, Isabel; Almeida, Sílvia; Lemos, Raquel; Sousa, Berta; Oliveira-Maia, Albino J.Background: Breast cancer causes significant psychological and physical burden, with survivors often reporting persistent psychological symptoms, such as anxiety and depression, along with somatic symptoms like fatigue and pain. Psychological factors may protect from the development of long-term distress and help identify patients with greater needs for supervision and/or care. Here we aimed to study the predictive role of mindfulness as a trait in determining affective and somatic symptoms 12 months after cancer diagnosis. Methods: Women with a diagnosis of breast cancer were recruited at the onset of systemic treatments and compared with healthy women from the general population. Over a 12-month period, participants were periodically assessed using the Mindfulness Attention Awareness Scale (MAAS), the Hospital Anxiety and Depression Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 and the Positive and Negative Affect Scale. Regression models were employed to assess the predictive associations of baseline mindfulness trait with symptoms after 12 months. Results: The study included 282 participants, 243 of whom contributed complete data for analysis. The Portuguese version of MAAS demonstrated adequate psychometric properties for patients with breast cancer, supporting its use to address our main aim. Mindfulness trait scores remained stable across time, did not differ significantly between patients and healthy participants, and were similarly stable across time for patients undergoing different treatments. Also in the clinical group, MAAS scores at baseline significantly predicted affective, but not somatic symptoms, 12 months later, with higher levels of mindfulness predicting more clinically significant distress. Conclusions: In women with a recent diagnosis of breast cancer, mindfulness trait appears unaffected by diagnosis or its treatments, serving as a protective factor against affective, but not somatic, symptoms, in the first year following diagnosis.
- Prevalence of autism spectrum disorder in children in the Azores islands (Portugal): sociodemographic and clinical profilePublication . Conde, Ana Rita; Mota, Pilar; Botelho, Tânia; Caldeira, Suzana; Rego, Isabel; Silva, Osvaldo; Sousa, Áurea Sandra Toledo de; Freitas, CarinaPrevalence studies are essential to provide objective indicators about Autism Spectrum Disorder (ASD) and are a source of information for public policies. This study aimed to estimate the prevalence of ASD among children in the Azores Islands (Portugal). Administrative data on the number of children with a proven diagnosis of ASD were collected from all schools. Parents completed a questionnaire about the child’s sociodemographic characteristics, the diagnostic process, and clinical history. The overall prevalence of ASD in the Azores region was 9.92 per 1000 children, approximately equivalent to 1% (0.99). The prevalence of ASD in the Azores seems to be higher when compared with the global rate in Portugal, as well as with other regions of Europe. There appears to be a concentration of children with ASD in the region, and the results appear to support the hypothesis of a heritable predisposition to ASD.
- National integrated continuing care network: difficulties in referralPublication . Costa, Elisabete; Bacelo, Sérgio Manuel Oliveira Gonçalves; Picoito, Ricardo Jorge de Barros RomeiraBackground: Understanding health professionals’ literacy when referring to the National Integrated Continuing Care Network (RNCCI) is essential to ensure efficient and adequate access to integrated continuing care. Objective: Understand the difficulties faced by Doctors, Nurses and Social Workers at ULSLO hospital units who refer users to the RNCCI. Methodology: Quantitative, observational, descriptive and cross-sectional study using a questionnaire applied in the three hospitals of the Western Lisbon Local Health Unit. Results: When it comes to user signage, 69.8% of professionals find it difficult to choose the typology and 73.9% consider filling out the computerized system complex. In the referral process, 78.1% of professionals report experiencing difficulties in general. Suggestions for improvement: improve the interoperability of the RNCCI IT system with SClinico and greater coordination between the Discharge Management Team (EGA) and the referring Services. Conclusion: It is crucial to identify difficulties experienced in referral in order to avoid delays in accessing care. Improvement suggestions provide valuable input to develop strategies to optimize the reference process.
- Unlocking the soul: AI and neuroscience insights into spiritualityPublication . Martins, Helga; Romeiro, Joana; Caldeira, Sílvia
- Free will, neurosciences & roboticsPublication . Fernandes, Sara; Almeida, Leonor; Caldas, Alexandre Castro
- Predição de lesões por pressão através de inteligência artificial em unidades de cuidados intensivos: protocolo de scoping reviewPublication . Alves, José; Azevedo, Rita; Marques, Ana; Alves, PauloIntrodução: As lesões por pressão são eventos adversos frequentes em unidades de cuidados intensivos, com impacto na qualidade de vida das pessoas e nos custos em saúde. As escalas tradicionais de avaliação de risco apresentam limitações no contexto do doente crítico. A inteligência artificial tem vindo a afirmar-se como uma abordagem promissora na identificação precoce do risco, com maior sensibilidade e capacidade de integração de dados clínicos complexos. Objetivo: Identificar e mapear a evidência científica sobre a utilização de inteligência artificial na predição de lesões por pressão em adultos em situação crítica internados em unidades de cuidados intensivos. Métodos: Será realizada uma scoping review segundo a metodologia do Joanna Briggs Institute e a checklist PRISMA-ScR. A pesquisa incluirá bases de dados e literatura cinzenta, sem restrições de idioma ou data. Serão incluídos estudos que abordem a utilização de inteligência artificial na predição de lesões por pressão em unidades de cuidados intensivos. Resultados: Os dados serão apresentados de forma descritiva e narrativa, com quadros e tabelas que evidenciam os tipos de inteligência artificial, variáveis preditoras, desempenho dos modelos e implicações clínicas. Conclusões: Esta revisão permitirá sistematizar o conhecimento disponível, identificar lacunas na literatura e apoiar a integração de soluções baseadas em inteligência artificial na prática de enfermagem em cuidados intensivos.
- Necrotizing perineal fasciitis, a challenge in treatment!Publication . Miranda, Liliana Grilo; Neves-Amado, João; Alves, PauloObjectives: To present a case series of necrotizing perineal fasciitis; - To share expertise in the treatment of complex wounds with deep tissue infection, using Negative Pressure Wound Therapy. Methodology: Case reports. Results: We presente threee cases. First one of necrotizing perineal fasciitis in a female patient, and second and third of necrotizing fasciitis due to Founier gangrene in males (ICD – 10 N49.3). After cleaning and surgical debridement in the operating room, extensive and deep lesions resulted, with muscular involvement in a difficult anatomical region requiring bypass of the intestinal transit. Treatment was started with Negative Pressure Wound Therapy with dressing replacement 2 times a week, initially as an inpatient and then at the outpatient clinic until complete healing of the lesions. Conclusion: With the use of Negative Pressure Wound Therapy we were able to heal these extensive and deep lesions located in difficult anatomical areas, with a significant reduction in healing time, allowing an early discharge, also contributing to a better quality of life for the person.
- Consensus on quality indicators in ambulatory surgery: a Delphi survey conducted in PortugalPublication . Pinto, J.; Sá, L.; Amaral, A.Aim: To establish consensus on the most appropriate quality indicators for evaluating the quality of Ambulatory Surgery (AS) in Portugal. Methods: Data were collected using a modified e-Delphi technique in two rounds.A total of 58 potential quality indicators in AS were assessed by 27 experts. Results: In the first round consensus was found for accepting 44 indicators.The data analysis that took place in the second round revealed consensus for including 10 more quality indicators. Conclusion: The quality indicators in AS used in Portugal are in line with the literature recommendations, but they only reflect some aspects of the quality process.