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- Trends in delivery hospitalizations and the impact of ICD-9-CM to ICD-10-CM-PCS transition in Portugal between 2010 and 2018Publication . Camarinha, Catarina de Paraíso; Oliveira, Maria Miguel Gomes; Elias, Cecília; Nobre, Miguel de Araújo; Nicolau, Leonor Bacelar Costa; Furtado, Cristina; Costa, Andreia Silva da; Nogueira, Paulo Jorge da SilvaBackground: Hospital discharge data are essential for maternal health surveillance, clinical research, and healthcare resource allocation. In 2017, Portuguese hospitals transitioned from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to the International Classification of Diseases, 10th edition, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS), impacting the recording of delivery hospitalizations. This study examines trends in delivery hospitalizations from 2010 to 2018 and assesses the impact of the ICD-10-CM/PCS transition. Methods: We conducted a register-based observational cross-sectional analysis using data from the National Hospital Discharge Database, covering delivery hospitalizations in public hospitals from January 1, 2010, to December 31, 2018. Delivery episodes were identified using diagnosis codes, normal delivery codes, diagnosis-related group (DRG) codes, and procedure codes. Statistical analyses included descriptive statistics, interrupted time series with segmented regression, and Prophet forecasting models to evaluate trends and the impact of the coding transition. Results: A total of 673,978 delivery hospitalizations were recorded. The transition from ICD-9-CM to ICD-10-CM/PCS in 2017 had minimal overall impact on delivery trends. DRG codes consistently identified the majority of delivery episodes, with outcome of delivery codes and selected procedure codes showing varying trends. An increase in episodes identified by normal delivery codes and a significant decrease in episodes identified by procedure codes was observed immediately after the ICD-10 transition (p < 0.001). The Prophet model indicated improved forecast accuracy for procedure codes when including the ICD-10 transition variable. Conclusion: The transition to ICD-10-CM/PCS had a limited impact on overall delivery hospitalization trends but significantly affected procedure coding. These findings underscore the importance of considering coding system changes in healthcare data analyses. Further research should incorporate private hospital data and continuously monitor coding practices to ensure reliable health data for research and policy-making.
- Monthly tracking of infant mortality in Portugal: post-COVID trendsPublication . Nogueira, P.; Elias, C.; Camarinha, C.; de-Araujo-Nobre, M.; Bacelar-Nicolau, L.; Furtado, C.; Oliveira, M. M.; Costa, A. S.Background: The Infant Mortality Rate (IMR) is a fundamental health indicator that reflects the overall well-being of populations. Recognizing the need for more timely data to inform public health strategies, the authors have presented a novel method for monitoring IMR monthly instead of traditional annual reporting. Our work aims to increase further the robustness of a novel method for monitoring IMR monthly. Methods: This new approach leverages the Portuguese E-Death Certification System (SICO) and Statistics Portugal (2016-2024) data. It provides the most recent insights into IMR trends in Portugal, highlighting the post-pandemic period. This method allows for the analysis of cumulative deaths under one year of age against live births over the previous 12 months, offering a more responsive metric to guide interventions. Results: The updated analysis reveals a continued pattern influenced by the dynamic public health landscape of the COVID-19 pandemic, including the phasing out of restrictions and the end of mandatory mask usage. The pandemic has significantly impacted IMR trends, with Portugal experiencing a decline in IMR during the stringent phases, reaching historically low levels. This trend slightly reversed following the lifting of restrictions, underscoring the urgent need for understanding the complex interplay between public health policies and infant mortality. In the post-pandemic period, the IMR increased until October 2023, showing a later (up to February 2024) global decreasing trend within the range of 2.5 and 2.9 deaths per 1000 live births. Conclusions: Recent updates confirm the effectiveness of real-time IMR monitoring as a vital tool for policymakers and health professionals. Portugal’s experience underscores the importance of realtime health indicators in managing public health crises. It stresses the need for further research to understand factors affecting IMR and to continue reducing infant mortality.
- Chrono-nutrition and post-bariatric weight loss: insights from the Portuguese ChronoWise cohortPublication . Rodrigues, J.; Magalhães, V.; Santos, M. P.; Reis, C.; Pichel, F.; Soares, P.; Santos, J.; Vilela, S.Background: Post-bariatric weight loss varies substantially, and a large proportion of patients respond poorly. The literature highlights the importance of chrono-nutrition for weight regulation. This study aims to explore the chrono-related factors associated with poorer weight loss. Methods: This study was conducted within the ChronoWise project, an ongoing prospective cohort study following patients undergoing bariatric surgery at the Santo Antonio Local Health Unit, Porto. The sample included patients evaluated at both pre-surgery and 3 months post-surgery. Baseline information on meal timing was gathered through the Chrononutrition Profile-Questionnaire. The eating midpoint (midpoint between first and last meal) was calculated for work and free days. Chronotype was determined using the Munich Chronotype Questionnaire. Weight loss was expressed as the percent of total weight loss (%TWL ¼ [(initial weight − current weight)/(initial weight)]100). Chrono-related variables were compared according to %TWL (dichotomized by the median) using the Mann-Whitney test. Results: Sixty patients were included (72% female; mean age 45± 11.8). The mean baseline BMI was 44±5.6 kg/m2, which decreased to 35±5.3 kg/m2 at 3 months post-surgery, resulting in an average 20± 3.9 %TWL. On free days, participants with lower %TWL tend to do the first meal later in the day (9h45 vs. 9h10, h¼0.367), and later lunch on workdays (12h45 vs 12h30, h¼0.531) compared with individuals with higher %TWL. Lower %TWL is typically observed in individuals having later eating midpoints (15h00 vs. 14h15 for workdays, h¼0.011; 15h07 vs. 14h44 for free days, h¼0.205). A later chronotype (3h37 vs 3h30, h¼0.347) was also linked with poorer weight loss. Conclusions: Eating later during the day and later chronotype may contribute to poorer post-bariatric weight loss. Funding: This work was supported by FCT - Fundac¸~ao para a Ci^encia e Tecnologia [2021.01096.CEECIND, UIDB/04750/2020,LA/P/0064/2020&SGITR 2023/EPIUnit]. Key messages: • Recognizing meal timing as a modifiable lifestyle factor may optimize current approaches by aligning food intake with circadian clock. • A later chronotype, i.e. a behavioural expression of an individual’s internal circadian clock system as a preference for eveningness or later sleep timing, may negatively influence weight loss.
- Burnout as a multidimensional phenomenon: how can workplaces be healthy environments?Publication . Gaspar, T.; Carvalho, M.; Matos, M.Purpose: Burnout was already a significant problem before the pandemics, but in the aftermath became a serious concern and a public health and occupational health priority. This study had two aims. First, it investigated how different healthy workplace dimensions and other health individual-level variables are related to burnout. Second, it examined differences in terms of presentism, absenteeism, quality of life between employees who report burnout symptoms and those who do not. Methods: Participants were 1702 Portuguese employees from various organizations. 69.68% were female, age ranged from 18 to 72 years (M ¼ 43.25 years, SD ¼ 10.40). Almost half of the participants (49.9%; 851 participants) reported having at least one burnout symptom. Results: Participants reported that they have felt exhausted (43.7%), irritated (34.5%) and sad (30.5%) always or very often in the last 4 weeks. Regression analysis revealed that the global score on burnout symptoms was negatively related to leadership engagement, psychosocial work environment, personal health resources, health behaviours, and satisfaction with salary. In addition, the global score on burnout symptoms was positively related to worker involvement, enterprise community involvement, perceived stress, and screen time at work. Furthermore, females tend to report a higher level of burnout symptoms compared to males. In addition, burnout has an impact on sickness absenteeism, presentism, and quality of life. Conclusions: Our findings have an important contribution to understanding and promoting a healthier work environment and reinforce the need for measures and policies to promote mental health, manage stress, and prevent burnout in the workplace. Key messages: • What best explains the burnout symptoms is the workers’ perceived stress, followed by psychosocial risk factors at work. • There is a positive relationship between perceived stress and burnout: effective work stress management is one of the protective factors that prevents burnout.
- Family involvement in early childhood education and care: insights from portuguese and norwegian curriculum frameworksPublication . Dardanou, Maria; Brito, RitaThe significance of family involvement in Early Childhood Education and Care has gained considerable attention within national reforms and regulations across various countries. This study aims to examine the early childhood education curriculum frameworks pertaining to family participation in Portugal and Norway. By analysing the national curriculum frameworks of these two countries, this study explores the distinct approaches they adopt towards family involvement in Early Childhood Education and Care, considering their unique cultural and policy contexts. Through content analysis of the curriculum frameworks from both nations, two primary themes emerge through coding: active involvement in the educational process and collaborative partnerships. The findings highlight the importance of fostering relationships between families and educational institutions to enhance children’s learning experiences and emphasize the necessity of ongoing communication and shared decision-making. Through an ecological perspective, this paper provides insights into how varying levels of family participation can influence educational practices and experiences in early childhood settings, suggesting potential improvements to strengthen partnerships between families and educators.
- Career services at HEI’s: what are they offering?Publication . Khurumova, Veronika; Pinto, Joana CarneiroHigher education career centers should tailor their services toward empowering students to make them employable after graduation to meet the demands of the 21st century world of work. This paper aims to reflect on career counseling services provided by Higher Education Institutions. We start by presenting a brief history of their development around the world, with particular emphasis on Portugal. Next, a study about the current situation of these services in the country is presented, starting with an analysis of their organization, the type of actions/activities/services provided, as well as their accessibility. Results indicate that the Career Services in some Portuguese Higher Education Institutions appear not to be fully developed, and where they exist, they often focus mostly (and sometimes solely) upon job placement or internship provision. More investment is needed to meet the new employability needs and demands of both students (and their families) and the labor market.
- Aphasia Screening Test (TeRAp): construction and validation for european portuguesePublication . Fonseca, José; Miranda, Filipa; Stein, Beatriz; Maruta, CarolinaIntroduction: Aphasia is a common acquired language disorder following stroke or other brain injuries. However, it is not always easy to make a differential diagnosis with another communication disorder. Communication assessment in acute phases of the stroke, when the patient is bedridden or when there is no time for a more in-depth assessment, needs to be done with a formal screening test that has normative data. The aim of this study was to develop the Aphasia Screening Test (TeRAp) in digital format (appWeb) and present its clinimetric values. Methods: A screening test (TeRAp) was built in appWeb format that assesses the main areas of language processing and automatically provides a diagnostic hypothesis. A group of people with aphasia was evaluated and their performance was compared with three control groups, one of healthy people and two groups of people with neurological conditions, one with dysarthria and the other with mild cognitive impairment. Results: Ceiling values were obtained in all the tests. Sensitivity values of 1 and specificity values of 0.99 were obtained for the presence of aphasia. Conclusion: An online aphasia screening test was developed, with excellent sensitivity and specificity results, which can be used by any health professional.
- Weight loss in patients with severe obesity after bariatric surgery - the potential role of the chrono-nutrition, chronotype and the circadian misalignment: a study protocol of the ChronoWise prospective cohortPublication . Rodrigues, Joana; Magalhães, Vânia; Santos, Maria Paula; Reis, Cátia; Pichel, Fernando; Soares, Paulo; Santos, Jorge; Vilela, SofiaBackground Despite the potential effectiveness of bariatric surgery in promoting weight loss, a considerable proportion of patients still face the challenge of achieving optimal post-surgery outcomes. The timing of eating, in addition to the content of what is eaten, as well as chronotype and social jetlag (a marker of circadian misalignment), have been implicated in weight regulation. However, the current understanding of these chrono-related behaviours in individuals undergoing bariatric surgery is still scarce. Thus, this study aims to evaluate the role of chrono-nutrition, chronotype, and circadian misalignment in the weight-loss trajectory among individuals living with severe obesity who underwent bariatric surgery. Methods The ChronoWise project is a prospective single-centre cohort study designed to follow patients experiencing bariatric surgery at the Santo António Local Health Unit (ULSSA), Porto, Portugal. Participants will be recruited and evaluated at pre-surgery and followed-up over 3 and 6 months after surgery. The baseline evaluation will be conducted face-to-face during the hospital stay and by telephone or video call on the subsequent evaluations, following standard procedures. Data collection includes sociodemographics, food intake, chrono-nutrition behaviours, sleep time behaviour, sleep quality, screen time, physical activity and exercise behaviours, anthropometric measurements, and biochemical parameters. The ‘Munich Chronotype Questionnaire’ will be used to assess chronotype and social jet lag. Chrono-nutrition dimensions will be measured by the ‘Chrononutrition Profile—Questionnaire’ in all evaluations. Weight and height will be self-reported and retrieved from medical registries. trajectories of weight-loss will be obtained. Discussion This study will add important evidence on the role of chrono-nutrition, chronotype and social jetlag profile in weight-loss outcomes after bariatric surgery. Identifying novel approaches to change the paradigm of post-surgical weight management towards a tailored treatment aligned with circadian rhythm may be useful to strengthen the existing treatments and improve patients’ response to bariatric surgery.
- Psychosocial factors and quality of life of portuguese adolescents with chronic conditions - increased risk for victims of bullyingPublication . Cerqueira, Ana; Guedes, Fábio Botelho; Gaspar, Tania; Godeau, Emmanuelle; Simões, Celeste; Matos, Margarida Gaspar deThe experience of living with a chronic condition (CC) impacts adolescents’ psychological and social adjustment and overall functioning. Considering the increased risk of psychosocial challenges among adolescents with CC, this study aimed to enhance our understanding of the psychological and social factors that impact their quality of life. It also compared the psychological and social variables among (a) adolescents with and without CC and (b) adolescents with CC who are and who are not victims of bullying. The results demonstrated that adolescents with CC showed more psychosocial difficulties than their peers, as they more frequently reported involvement in situations of violence, and demonstrated more difficulties at a psychological and emotional level. Further, being victims of bullying increased the psychosocial vulnerabilities of these adolescents. A better quality of life was associated with the following psychosocial factors: not being a victim of bullying or cyberbullying, having less anxiety and fewer depressive symptoms, liking school, receiving more support from family and friends, having better relationships with peers, and having fewer physical and psychological symptoms. These findings are significant for helping schools develop tools and strategies to address violence and support students with CC, who are at a higher risk of being involved in such situations and require a targeted response.