Active and Healthy Aging After COVID-19 Pandemic in Portugal and Other European Countries: Time to Rethink Strategies and Foster Action.

The population aging in Europe imposes challenges to societies that require adaptations and responses at various levels to minimize impacts and figuring out opportunities. Portugal has been committed to the World Health Organization and European Union's values and policy frameworks concerning active and healthy aging. In 2017, an inter-ministerial working group developed the National Strategy for Active and Healthy Aging. In the face of the COVID-19 pandemic that exposed the vulnerabilities of older populations, the launch of the Decade of Healthy Aging 2021-2030 and its baseline report and the 2018 Active Aging Index Analytical Report may constitute an opportunity to strategically think about the aging of the population as a national purpose in Portugal and in the other European countries that face similar challenges.

Sociodemographic disparities in hypertension prevalence: Results from the first Portuguese National Health Examination Survey.

INTRODUCTION: Cardiovascular disease is an important cause of death and disability worldwide, and hypertension is responsible for at least 45% of all deaths due to heart disease and 51% of deaths due to stroke. This study aimed to estimate and describe the distribution of prevalence, awareness, treatment and control of hypertension in the Portuguese population in 2015. METHODS: A national survey using a representative sample of 4911 individuals residing in Portugal and aged between 25 and 74 years was implemented. Trained nurses performed a health interview and a physical examination, including blood pressure measurement (right arm, three measurements at 1-min intervals). The prevalence of hypertension was stratified by gender, age group, marital status, education, occupation and type of residential area. Associations between hypertension prevalence and sociodemographic factors were assessed using bivariate and multivariate Poisson regression. RESULTS: The overall hypertension prevalence was 36.0%. The highest rates were observed in males (39.6%), in individuals aged between 65 and 74 years (71.3%), and in those with low levels of education (62.6%) and with no formal occupation (64.5%). Among hypertensive individuals, 69.8% were aware of their condition and 69.4% were under treatment, of whom 71.3% were controlled. Rates of awareness and medical treatment were significantly higher among women and older individuals. CONCLUSIONS: A large majority of the adult Portuguese population are likely to reach blood pressure levels defined as hypertension in adulthood. Significant differences in hypertension prevalence were found according to gender, age and socioeconomic status, which highlights the importance of population strategies in public health policies.

PRIORITIES FOR HEALTH ECONOMIC METHODOLOGICAL RESEARCH: RESULTS OF AN EXPERT CONSULTATION.

BACKGROUND: The importance of economic evaluation in decision making is growing with increasing budgetary pressures on health systems. Diverse economic evidence is available for a range of interventions across national contexts within Europe, but little attention has been given to identifying evidence gaps that, if filled, could contribute to more efficient allocation of resources. One objective of the Research Agenda for Health Economic Evaluation project is to determine the most important methodological evidence gaps for the ten highest burden conditions in the European Union (EU), and to suggest ways of filling these gaps. METHODS: The highest burden conditions in the EU by Disability Adjusted Life Years were determined using the Global Burden of Disease study. Clinical interventions were identified for each condition based on published guidelines, and economic evaluations indexed in MEDLINE were mapped to each intervention. A panel of public health and health economics experts discussed the evidence during a workshop and identified evidence gaps. RESULTS: The literature analysis contributed to identifying cross-cutting methodological and technical issues, which were considered by the expert panel to derive methodological research priorities. CONCLUSIONS: The panel suggests a research agenda for health economics which incorporates the use of real-world evidence in the assessment of new and existing interventions; increased understanding of cost-effectiveness according to patient characteristics beyond the "-omics" approach to inform both investment and disinvestment decisions; methods for assessment of complex interventions; improved cross-talk between economic evaluations from health and other sectors; early health technology assessment; and standardized, transferable approaches to economic modeling.

Facing unemployment: study protocol for the implementation and evaluation of a community-based intervention for psychological well-being promotion.

BACKGROUND: Economic crises and unemployment have profound impact on mental health and well-being. Main goal of the Healthy Employment (HE) project is to enhance intersectoral actions promoting mental health among unemployed, namely through the implementation and effectiveness-evaluation of short-term and sustainable group interventions. METHODS: The project follows a RE-AIM-based (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework for assessing a cognitive-behavioural and psychoeducational intervention that has been developed for promoting mental health among unemployed people. It is a short-term group intervention (five sessions, four hours each, 20 unemployed persons per group) focused on mental health literacy, interpersonal communication and of emotional regulation. Implementation of the intervention will be carried out by clinical psychologists, following a standardized procedure manual. Effectiveness will be assessed through a randomized field study with two arms (intervention and control). Participants are unemployed people (18-65 years old, both genders, having at least nine years of formal education) registered at public employment centres from different geographical regions for less than 12 months (including first-job seekers). Allocation to arms of the study will follow a random match-to-case process, considering gender, age groups and educational level. Three moments of evaluation will occur: before intervention (baseline), immediately after its ending and three months later. Main outcomes are mental health literacy, mental health related personal and perceived stigma, psychological well-being, satisfaction with life and resilience. Intention-to-treat and per-protocol analyses will be conducted. Cohen's d coefficient and odds ratio will be used for assessing the size of the intervention effect, when significant. DISCUSSION: Scientific and clinical knowledge will be applied to promote/protect psychological well-being of unemployed people. While the first phases of the project are funded by the European Economic Area Grants, long-term assessments of the intervention require a larger timeframe. Further funding and institutional support will be sought for this purpose. Already established intersectoral collaborations are key-assets to reach long-term sustainability of this project. TRIAL REGISTRATION: The study was registered with the Australian New Zealand Clinical Trials Registry; Prospectively registered number: ACTRN12616001432404 ; date of registration: 13 October 2016.

O Museu da Saúde em Portugal: um espaço físico, um espaço virtual / The Museu da Saúde in Portugal: a physical space, a virtual space

Resumo O Museu da Saúde em Portugal, baseado no duplo conceito de espaço físico polinucleado e espaço virtual, desenvolve o inventário do seu acervo, tendo, até ao momento, estudado mais aprofundadamente cinco das suas coleções – Tuberculose, Urologia, Psicologia, Medicamento e Malária. Neste artigo, o museu apresenta essas coleções, bem como a problemática do desenvolvimento da atividade museológica no espaço de um laboratório nacional, o Instituto Nacional de Saúde Doutor Ricardo Jorge, salientando as questões dos espaços de reserva e de exposição, o processo de inventário e as atividades de divulgação, atendendo aos desafios inerentes a uma atividade desenvolvida num espaço não museológico.

Abstract Museu da Saúde (Museum of Health) in Portugal, based on the dual concept of a multifaceted physical space and a virtual space, is preparing an inventory of its archive. So far, it has studied five of its collections in greater depth: tuberculosis, urology, psychology, medicine, and malaria. In this article, these collections are presented, and the specificities of developing museological activities within a national laboratory, Instituto Nacional de Saúde Doutor Ricardo Jorge, are also discussed, highlighting the issues of the store rooms and exhibition spaces, the inventory process, and the communication activities, with a view to overcoming the challenges inherent to operating in a non-museological space.

[Health Communication: Preventing the Spread of Ebola Virus Disease in the Portuguese Spoken African Countries--Methodology KISS & KEYWORDS]. / Comunicação em Saúde: Evitar o Contágio da Doença por Vírus Ãbola nos PALOP - Metodologia KISS & KEYWORDS.

In this work, Health Communication is considered as an important discipline in medicine and health sciences for his role as true determinant of health. We highlight their contribution to health promotion and disease prevention. Thus, the Health Communication Plan (PCS): Preventing the spread of Ebola virus disease in the Portuguese Speaking African Countries - KISS & KEYWORDS methodology is a tool that aims to minimize the risk of infection by Ebola virus in the Portuguese Speaking African Countries and also train for a general improvement of health conditions of the local populations. In the PCS design are especially considered the social and cultural contexts of the target populations, especially the customs, traditions and religion. Health Communication is considered as an Essential Function of Public Health and its main is to provide a population-based approach. The target of communication actions are population groups in addition to the individual communication, target-audiences are people without access to the media, in Guinea Bissau, Cape Verde and Sao Tome and Principe. Under the communication plan uses the methodology, models and practices both by media professionals as health. A proximity approach and cultural mediation, previously identified key facts, are defined objectives; outlines to the Plan in concrete and its implementation methodology (target-audience and following intervention, materials to be used and key-messages and partners to mobilize) following the World Health Organisation standards.

Neste trabalho, a Comunicação em Saúde é considerada como uma disciplina importante para a Medicina e ciências da saúde pelo seu papel como verdadeiro determinante da saúde. Destaca-se o seu contributo para a promoção da saúde e prevenção da doença. Assim, o Plano de Comunicação em Saúde: Evitar o contágio da doença por vírus Ãbola nos Países de Língua Oficial Portuguesa â Metodologia KISS & KEYWORDS é um instrumento que tem por objetivos minimizar o risco de contágio por vírus Ãâbola nos Países de Língua Oficial Portuguesa e ainda, capacitar para uma melhoria geral das condições sanitárias das populações visadas. No delineamento do Plano de Comunicação em Saúde são, especialmente, considerados os contextos sociais e culturais das populações-alvo, com destaque para os costumes, tradições e religião. A Comunicação em Saúde é encarada como uma Função Essencial da Saúde Pública e nessa medida visa sobretudo a abordagem populacional. O alvo das ações de comunicação são os grupos populacionais em complemento da comunicação individual, os públicos-alvo são populações sem acesso a meios de comunicação, na Guiné Bissau, Cabo-Verde e São Tomé e Príncipe. No âmbito do Plano de comunicação recorre-se a metodologia, modelos e práticas seguidas tanto pelos profissionais da comunicação como da saúde. Numa abordagem de proximidade e de mediação cultural, identificam-se previamente factos-chave, definem-se objetivos, delineia-se o Plano em concreto e sua metodologia de implementação (público-alvo e intervenção a seguir, materiais a utilizar e mensagens-chave, e os parceiros a mobilizar) seguindo as normas da Organização Mundial de Saúde.

[The Museu da Saúde in Portugal: a physical space, a virtual space]. / O Museu da Saúde em Portugal: um espaço físico, um espaço virtual.

Museu da Saúde (Museum of Health) in Portugal, based on the dual concept of a multifaceted physical space and a virtual space, is preparing an inventory of its archive. So far, it has studied five of its collections in greater depth: tuberculosis, urology, psychology, medicine, and malaria. In this article, these collections are presented, and the specificities of developing museological activities within a national laboratory, Instituto Nacional de Saúde Doutor Ricardo Jorge, are also discussed, highlighting the issues of the store rooms and exhibition spaces, the inventory process, and the communication activities, with a view to overcoming the challenges inherent to operating in a non-museological space.

Patterns of adherence to and compliance with the Portuguese smoke-free law in the leisure-hospitality sector.

BACKGROUND: In 2008, the Portuguese smoke-free law came into effect including partial bans in the leisure-hospitality (LH) sector. The objective of the study is to assess the prevalence of smoking control policies (total ban, smoking permission and designated smoking areas) adopted by the LH sector in Portugal. The levels of noncompliance with each policy are investigated as well as the main factors associated with smoking permission and noncompliance with the law. METHODS: Cross-sectional study conducted between January 2010 and May 2011. A random sample of venues was selected from the Portuguese LH sector database, proportionally stratified according to type, size and geographical area. All venues were assessed in loco by an observer. The independent effects of venues' characteristics on smoking permission and the level of noncompliance with the law were explored using logistic regression. RESULTS: Overall, 1.412 venues were included. Total ban policy was adopted by 75.9% of venues, while 8.4% had designated smoking areas. Smoking ban was more prevalent in restaurants (85.9%). Only 29.7% of discos/bars/pubs opted for complete ban. Full or partial smoking permission was higher in discos/bar/pubs (OR = 7.37; 95%CI 4.87 to 11.17). Noncompliance with the law was higher in venues allowing smoking and lower in places with complete ban (33.6% and 7.6% respectively, p<0.001). Discos/bars/pubs with full smoking permission had the highest level of noncompliance (OR = 3.31; 95%CI 1.40 to 7.83). CONCLUSIONS: Our findings show a high adherence to smoking ban policy by the Portuguese LH sector. Nonetheless, one quarter of the venues is fully or partially permissive towards smoking, with the discos/bars/pubs considerably contributing to this situation. Venues with smoking permission policies were less compliant with the legislation. The implementation of a comprehensive smoke-free law, without any exceptions, is essential to effectively protect people from the second hand smoke.