A multiple criteria approach for building a pandemic impact assessment composite indicator: The case of COVID-19 in Portugal.

The COVID-19 pandemic has caused major damage and disruption to social, economic, and health systems (among others). In addition, it has posed unprecedented challenges to public health and policy/decision-makers who have been responsible for designing and implementing measures to mitigate its strong negative impact. The Portuguese health authorities have used decision analysis techniques to assess the impact of the pandemic and implemented measures for counties, regions, or across the entire country. These decision tools have been subject to some criticism and many stakeholders requested novel approaches. In particular, those which considered the dynamic changes in the pandemic's behaviour due to new virus variants and vaccines. A multidisciplinary team formed by researchers from the COVID-19 Committee of Instituto Superior Técnico at the University of Lisbon (CCIST analyst team) and physicians from the Crisis Office of the Portuguese Medical Association (GCOM expert team) collaborated to create a new tool to help politicians and decision-makers to fight the pandemic. This paper presents the main steps that led to the building of a pandemic impact assessment composite indicator applied to the specific case of COVID-19 in Portugal. A multiple criteria approach based on an additive multi-attribute value theory aggregation model was used to build the pandemic assessment composite indicator. The parameters of the additive model were devised based on an interactive socio-technical and co-constructive process between the CCIST and GCOM team members. The deck of cards method was the adopted technical tool to assist in the assessment the value functions as well as in the assessment of the criteria weights. The final tool was presented at a press conference and had a powerful impact on the Portuguese media and on the main health decision-making stakeholders in the country. In this paper, a completed mathematical and graphical description of this tool is presented.

Perceptions and risk behaviors regarding biological invasions in inland aquatic ecosystems.

Public engagement is vital to effectively manage Invasive Alien Species (IAS) and biosecurity campaigns directed to stakeholders are decisive to raise awareness regarding IAS regulations and problems. To design and implement adequate communication plans, stakeholders' perceptions and risk behaviors regarding IAS need to be monitored by surveys. IAS do not recognize borders and most countries are not biogeographically isolated. Therefore, international information and consensus are necessary when applying measures at a biogeographic scale. Our bilingual survey was performed at the Iberian Peninsula, targeting the general public, decision-makers and other stakeholders, covering all taxa associated to inland aquatic ecosystems. We found differences in IAS' awareness between countries, and between different stakeholder groups. Results showed that the awareness of socioeconomic and human health impacts is substantially lower when compared with impacts on biodiversity. We found that the perception regarding the predation impacts is consistent across groups and countries, while other perceptions differ. The negative socioeconomic impact on angling due to IAS introductions is widely recognized. However, angling is also the activity most referred as positively impacted by IAS due to fish introductions. Most responders knew what IAS are, providing correct species examples. For all three awareness types (Biodiversity, Socio-economic and Human health) the model regressions showed that the most important predictor was the country of provenance of the respondent, followed by Education level for the socio-economic and biodiversity regressions and the stakeholder group in the Human health regression. We can conclude that in Portugal and Spain the general public and other key target-groups have reduced understanding of some threats posed by IAS. We highlight that raising awareness about IAS impacts on humans, namely on socio-economic aspects and human health, may be more effective and it is certainly needed in education campaigns towards IAS.

Sociodemographic, Clinical, and Behavioral Factors Associated with Sexual Transmitted Infection among HIV-1 Positive Migrants in Portugal: Are There Differences between Sexes?

INTRODUCTION: Sexually transmitted infections (STIs) continue to occur at high levels. According to the WHO, each year there are an estimated 374 million new infections with syphilis, gonorrhea, chlamydia, and trichomoniasis. STIs are associated with an increased risk of acquiring HIV infection. Migrants are reportedly highly affected by STIs. OBJECTIVES: This study aims to characterize factors associated with STIs in a population of HIV-positive migrants living in Portugal. METHODOLOGY: This is a cross-sectional observational study of 265 newly diagnosed HIV-1 positive migrants, who were defined as individuals born outside Portugal. This group of people were part of the BESTHOPE study that was developed in 17 Portuguese hospitals between September 2014 and December 2019, and included information collected through sociodemographic and behavioral questionnaires filled in by the migrant patients, clinical questionnaires filled in by the clinicians and HIV-1 genomic sequences generated through resistance testing (Sanger sequencing). A multivariable statistical analysis was used to analyze the association between sociodemographic characteristics, sexual behaviors, HIV testing and sexual infections. RESULTS: Most HIV-1 positive individuals included in the study were men (66.8%) and aged between 25 and 44 years old (59.9%). Men had a higher proportion of STIs when compared to women (40.4% vs. 14.0%) and the majority of men reported homosexual contacts (52.0%). Most men reported having had two or more occasional sexual partners in the previous year (88.8%) and 50.9% reported always using condoms with occasional partners, while 13.2% never used it. For regular partners, only 29.5% of the women reported using condoms, compared to 47.3% of men. Other risk behaviors for acquiring HIV, such as tattooing and performing invasive medical procedures, were more prevalent in men (38.0% and 46.2%, respectively), when compared to women (30.4% and 45.1% respectively) and 4.7% of men reported having already shared injectable materials, with no data for comparison in the case for women. Additionally, 23.9% of women reported having had a blood transfusion while only 10.3% of men reported having had this medical procedure. Meanwhile, 30.9% of the individuals reported having been diagnosed with some type of STI in the last 12 months. In addition, 43.3% of individuals that answered a question about hepatitis reported to be infected with hepatitis B, while 13.0% reported having hepatitis C infection. According to the multivariable analysis, the only transmission route was significantly associated with reports of previous STI infection: men who have sex with men (MSM) were 70% more likely to have been diagnosed with an STI in the past 12 months compared to the heterosexual route. CONCLUSION: HIV-1 infected men were more likely to report previous STIs than women. On the other hand, most migrant women had a regular sexual partner and never or only sometimes used condoms. This somewhat discrepant findings suggest that gender inequalities may make women unable to negotiate safe sexual practices, resulting in increased susceptibility to infection. However, since migrant women report less STIs, we cannot exclude that these STIs may remain undiagnosed. The implementation of safer sex awareness campaigns for condom use and screening for STIs in women is crucial. On the other hand, health education campaigns for STI knowledge need to be implemented for both MSM and women and their partners.

Determinants of HIV late presentation among men who have sex with men in Portugal (2014-2019): who's being left behind?

Introduction: HIV late presentation (LP) remains excessive in Europe. We aimed to analyze the factors associated with late presentation in the MSM population newly diagnosed with HIV in Portugal between 2014 and 2019. Methods: We included 391 newly HIV-1 diagnosed Men who have Sex with Men (MSM), from the BESTHOPE project, in 17 countrywide Portuguese hospitals. The data included clinical and socio-behavioral questionnaires and the viral genomic sequence obtained in the drug resistance test before starting antiretrovirals (ARVs). HIV-1 subtypes and epidemiological surveillance mutations were determined using different bioinformatics tools. Logistic regression was used to estimate the association between predictor variables and late presentation (LP). Results: The median age was 31 years, 51% had a current income between 501-1,000 euros, 28% were migrants. 21% had never been tested for HIV before diagnosis, with 42.3% of MSM presenting LP. 60% were infected with subtype B strains. In the multivariate regression, increased age at diagnosis, higher income, lower frequency of screening, STI ever diagnosed and higher viral load were associated with LP. Conclusion: Our study suggests that specific subgroups of the MSM population, such older MSM, with higher income and lower HIV testing frequency, are not being targeted by community and clinical screening services. Overall, targeted public health measures should be strengthened toward these subgroups, through strengthened primary care testing, expanded access to PrEP, information and promotion of HIV self-testing and more inclusive and accessible health services.

Hospital admissions of adults with community-acquired pneumonia in Portugal between 2000 and 2009.

Recent studies in the USA and northern Europe have shown an increase in community-acquired pneumonia (CAP). In southern Europe, this increase has not yet been documented. We carried out a retrospective analysis from encoded information from the Portuguese database for hospital admissions that included all individuals aged ≥18 years, with a primary diagnosis of pneumonia, who were discharged between 2000 and 2009. We excluded patients infected with HIV, individuals immunocompromised as a result of anti-cancer or immunosuppressive treatment, and transplant recipients. Of the 294 027 admissions for CAP, 56% were male. The mean age was 73.1 years and the median age 77 years. Between 2000 and 2009, there was a 5% increase in the average age of patients admitted with CAP. Admissions for CAP represented 3.7% of total admissions of adult patients. The average annual rate of hospital admissions for adults with CAP was 3.61 per 1000 total population, rising to 13.4 for those aged ≥65 years. Between 2000-2004 and 2005-2009 the average annual rate of hospital admission for CAP per 1000 population increased by 28.2%. Hospital admissions for CAP in Portugal increased between 2000 and 2009. It has grown consistently over time, varying according to age with males over-represented.

Individual and Contextual Variables as Predictors of MRI-Related Perceived Anxiety.

BACKGROUND: Magnetic resonance imaging (MRI) generates patient anxiety (PA) and, therefore, it is important to understand individual and contextual variables that may cause it. In study one, we explored those anxiety predictors. In study two, we examined the effect of the experience of MRI on PA comparing anxiety pre- to post-MRI. METHODS: PA was measured with an anxiety and stress scale in an interview format. Data collection occurred at a public hospital with MRI outpatients aged 18 or older. In study one (n = 204), participants answered the questionnaire immediately after experiencing the MRI and the data were analyzed through structural equation modeling. In study two (n = 242), participants answered the questionnaire before and after the examination and the data were analyzed through Bayesian statistics. RESULTS: Being female, having a higher education level (EL), and not receiving information about the examination predicts higher PA after MRI. Patients with prior information have a decrease in PA from pre- to post-MRI. Those who do not have no change in PA. In low-educated patients, PA also decreases and no changes occur in highly educated patients. CONCLUSION: This study provides health professionals with valuable indicators about patients who are more likely to perceive and express anxiety during MRI.

What do Portuguese cardiologists think and feel about their work?

INTRODUCTION AND OBJECTIVES: This study reports the results of an online survey carried out by the Portuguese Society of Cardiology about its medical members' work characteristics before and during the COVID-19 pandemic, their job satisfaction, work motivation, and burnout. METHODS: A sample of 157 participants answered a questionnaire with demographic, professional, and health-related information, followed by questionnaires on job satisfaction and motivation designed and validated for this study and a Portuguese version of the Maslach Burnout Inventory. Data were analyzed through descriptive statistics, ANOVA, and MANOVA, considering gender, professional level, and sector of activity, respectively. Multiple regression was used to assess the impact of job satisfaction and motivation on burnout. RESULTS: The only variable that distinguished participants was sector of activity. Cardiologists working in the private sector worked fewer weekly hours during COVID-19, while those in the public sector worked more. The latter expressed more desire to reduce their working hours than those who worked in private medicine and in both sectors. There were no differences between sectors in work motivation, while job satisfaction was higher in the private sector. Moreover, job satisfaction negatively predicted burnout. CONCLUSIONS: Our findings point to a deterioration in working conditions during the COVID-19 pandemic, with its consequences being felt especially in the public sector, which may have contributed to the lower levels of satisfaction among cardiologists who worked exclusively in this sector, but also for those working in both public and private sectors.

Determinants of Major Choice and Academic Expectations: Testing a Prediction Model Across Gender.

With this study, we aim to test the predictive relationships between determinants of major choice (DMC) and academic expectations (AEs) and to analyze gender differences, using six items of the Determinants of Major Choice Scale and the Academic Perceptions Questionnaire to assess AEs. A convenience sample of Portuguese (n = 839) and Spanish (n = 1,001) first-year students (age-range = 17-23 years), mostly composed of women (56.9%, n = 1,047), was selected from two public universities. The invariance of the multivariate regression model with latent variables of the effect of DMC on AEs, with determinants linked to Personal Characteristics (PCs; e.g., capacities) and Mediating Agents (MAs; e.g., parents) as AE predictors, was tested across gender with LISREL. The invariance test of the multivariate regression model across gender fit the data well and revealed an equivalence of slopes between women and men, which allows a unique interpretation of the model's predictive relationships for both genders. We also found statistically significant predictive relationships of PCs for six AE factors and MAs for five AE factors. The results showed theoretical relationships with the self-determination theory. At a practical level, they indicated the importance of PCs and MAs to design AE intervention programs in Higher Education (HE) institutions.

HIV-1-Transmitted Drug Resistance and Transmission Clusters in Newly Diagnosed Patients in Portugal Between 2014 and 2019.

Objective: To describe and analyze transmitted drug resistance (TDR) between 2014 and 2019 in newly infected patients with HIV-1 in Portugal and to characterize its transmission networks. Methods: Clinical, socioepidemiological, and risk behavior data were collected from 820 newly diagnosed patients in Portugal between September 2014 and December 2019. The sequences obtained from drug resistance testing were used for subtyping, TDR determination, and transmission cluster (TC) analyses. Results: In Portugal, the overall prevalence of TDR between 2014 and 2019 was 11.0%. TDR presented a decreasing trend from 16.7% in 2014 to 9.2% in 2016 (p for-trend = 0.114). Multivariate analysis indicated that TDR was significantly associated with transmission route (MSM presented a lower probability of presenting TDR when compared to heterosexual contact) and with subtype (subtype C presented significantly more TDR when compared to subtype B). TC analysis corroborated that the heterosexual risk group presented a higher proportion of TDR in TCs when compared to MSMs. Among subtype A1, TDR reached 16.6% in heterosexuals, followed by 14.2% in patients infected with subtype B and 9.4% in patients infected with subtype G. Conclusion: Our molecular epidemiology approach indicates that the HIV-1 epidemic in Portugal is changing among risk group populations, with heterosexuals showing increasing levels of HIV-1 transmission and TDR. Prevention measures for this subpopulation should be reinforced.

Training health professionals in patient-centered communication during magnetic resonance imaging to reduce patients' perceived anxiety.

OBJECTIVE: We examined how a patient-centered communication training program for magnetic resonance imaging (MRI) affected health professional (HP) practice and patients' perceived anxiety (PA). METHODS: We implemented an intervention program. Six of the 17 eligible HPs completed the study. The proportion of observed desired behaviors (PODBs), including MRI procedure explanation (MRI-PE), communication, and MRI checking procedures was measured using an observation grid. We tested 182 patients (85 pre-, 58 post-, and 39 at follow-up) for PA pre- and post-MRI. RESULTS: The Bayesian ANOVA effect size suggested moderate evidence of improvement in HP PODBs, pre- to post-intervention. Use of MRI-PE declined between post-intervention and follow-up (6 months later). Observed changes in PA, pre- to post-MRI, could be related to time constraints and perceived pressure to explain the exam in detail once institutional routines are reestablished. CONCLUSION: In MRI units, time constraints condition the performance of HPs who address patients' PA. PRACTICE IMPLICATIONS: "Real workplace" interventions that promote better patient-centered communication and provide each patient with a comprehensive explanation of MRI procedures also appear to improve HP PODBs.

Gender, planning, and academic expectations in first-year higher education students: testing two alternative mediation models.

We examined the relationships among gender, planning, and academic expectations through the testing of two alternative models with latent variables tested with LISREL 8.80: one model considered planning as a mediator of the relationship between gender and academic expectations, and the other model considered academic expectations as mediators of the relationship between gender and planning. Participants were 662 first-year higher-education students from two academic years, predominantly female (60%) and mainly with majors in the juridical-social field (66.2%). The Inventario sobre Estrategias Metacognitivas (IEM; Inventory of Metacognitive Strategies) and the Academic Perceptions Questionnaire (APQ) were applied at the beginning of the first semester to assess planning and academic expectations, respectively. Multigroup confirmatory factor analysis was used to test the IEM's structure after examining its psychometric properties with the sample from the first academic year (N = 338). The test of the alternative mediation models with the full sample indicates that the best model was that with planning as a mediator. In this model, gender directly predicted only two APQ academic expectations, but with the mediation of planning, gender predicted all seven academic expectations. Women showed higher levels of academic expectations and planning than did men. The results are discussed at both the theoretical and practical levels.

Practices and challenges on coordinating the Brazilian Unified Health System.

OBJECTIVE: To analyze the obstacles and challenges faced by managers and coordination professionals in their practices in municipal coordinating centers. METHODS: An exploratory descriptive study with a qualitative focus, applied in 40 managers and coordination professionals, from September 2017 to November 2018, with semi-structured interviews, resulting in two categories of analysis: limiting factors and factors that facilitate the management and operationalization of the Brazilian Unified Health System (SUS) coordinating sector. RESULTS: Analyzing the statements, we found evidence of the following limiting factors: failure in the criteria of referral, unavailability of beds, high demand, systemic difficulties in relation to the coordinating system, procedures of difficult scheduling and execution, increased repressed demand for elective procedures and difficulties in the flow of information between primary care and coordination. In the category of facilitating factors, the most significant possibilities were: expansion of the capability to know the user's reality, improvement in primary care and increase in health financial resources, health training and education and restructuring, in addition to reorganizing internal coordinating procedures. CONCLUSION: The limiting factors of coordination show the need to promote actions that offer all SUS users full access to health services.

[Rhodococcus equi pneumonia in an HIV+ patient: An uncommon association]. / Pneumonia por Rhodococcus equi em doente VIH (+): A propósito de uma associção rara.

The human infection by Rhodococcus equi, even in the presence of HIV infection, remains a rare disease. The authors present a case report of pneumonia, occurring in a HIV+ man. After identifying Pneumocystis jiroveci in the BAL, despite proper medication, the patient didn't improve. Another BAL was performed and a Rhodococcus equi isolated. The therapeutic regimen was changed according to this finding and the patient improved. The authors make a review of the literature, focusing on the rarity of this association and the high survival observed.

[Construction and validation of a multidimensional model of students' adjustment to college context]. / Construcción y validación de un modelo multidimensional de ajuste de los jóvenes al contexto universitario.

This article presents a model of interaction of personal and contextual variables in the prediction of academic performance and psychosocial development of Portuguese college students. The sample consists of 560 first-year college students of the University of Minho. The path analysis results suggest that initial expectations of the students' involvement in academic life constituted an effective predictor of their involvement during their first year; as well as the social climate of the classroom influenced their involvement, well-being and levels of satisfaction obtained. However, these relationships were not strong enough to influence the criterion variables integrated in the model (academic performance and psychosocial development). Academic performance was predicted by the high school grades and college entrance examination scores, and the level of psychosocial development was determined by the level of development showed at the time they entered college. Though more research is needed, these results point to the importance of students' pre-college characteristics when we are considering the quality of their college adjustment process.

Gender, planning, and academic expectations in first-year higher education students: testing two alternative mediation models

Abstract We examined the relationships among gender, planning, and academic expectations through the testing of two alternative models with latent variables tested with LISREL 8.80: one model considered planning as a mediator of the relationship between gender and academic expectations, and the other model considered academic expectations as mediators of the relationship between gender and planning. Participants were 662 first-year higher-education students from two academic years, predominantly female (60%) and mainly with majors in the juridical-social field (66.2%). The Inventario sobre Estrategias Metacognitivas (IEM; Inventory of Metacognitive Strategies) and the Academic Perceptions Questionnaire (APQ) were applied at the beginning of the first semester to assess planning and academic expectations, respectively. Multigroup confirmatory factor analysis was used to test the IEM's structure after examining its psychometric properties with the sample from the first academic year (N = 338). The test of the alternative mediation models with the full sample indicates that the best model was that with planning as a mediator. In this model, gender directly predicted only two APQ academic expectations, but with the mediation of planning, gender predicted all seven academic expectations. Women showed higher levels of academic expectations and planning than did men. The results are discussed at both the theoretical and practical levels.

Practices and challenges on coordinating the Brazilian Unified Health System / Práticas e desafios da regulação do Sistema Único de Saúde

ABSTRACT OBJECTIVE To analyze the obstacles and challenges faced by managers and coordination professionals in their practices in municipal coordinating centers. METHODS An exploratory descriptive study with a qualitative focus, applied in 40 managers and coordination professionals, from September 2017 to November 2018, with semi-structured interviews, resulting in two categories of analysis: limiting factors and factors that facilitate the management and operationalization of the Brazilian Unified Health System (SUS) coordinating sector. RESULTS Analyzing the statements, we found evidence of the following limiting factors: failure in the criteria of referral, unavailability of beds, high demand, systemic difficulties in relation to the coordinating system, procedures of difficult scheduling and execution, increased repressed demand for elective procedures and difficulties in the flow of information between primary care and coordination. In the category of facilitating factors, the most significant possibilities were: expansion of the capability to know the user's reality, improvement in primary care and increase in health financial resources, health training and education and restructuring, in addition to reorganizing internal coordinating procedures. CONCLUSION The limiting factors of coordination show the need to promote actions that offer all SUS users full access to health services.

RESUMO OBJETIVO Analisar os entraves e desafios enfrentados pelos gestores e profissionais de regulação em suas práticas nas centrais reguladoras municipais. MÉTODOS Estudo descritivo exploratório com enfoque qualitativo, aplicado em quarenta gestores e profissionais de regulação, no período de setembro de 2017 e novembro de 2018, por meio de entrevista semiestruturada, resultando em duas categorias de análise: fatores limitantes e fatores facilitadores da gestão e operacionalização do setor de regulação do SUS. RESULTADOS Na análise dos enunciados, foram encontradas evidências dos seguintes fatores limitantes: falha nos critérios de encaminhamento, indisponibilidade de leitos, grande demanda, dificuldades sistêmicas em relação ao sistema de regulação, procedimentos de difícil agendamento e execução, aumento da demanda reprimida de procedimentos eletivos e dificuldades no fluxo de informações entre a atenção primária e a regulação. Na categoria de fatores facilitadores, as possibilidades mais significativas foram: ampliação da capacidade de conhecer a realidade do usuário, melhoria na atenção primária e incrementos de recursos financeiros para a saúde, capacitação e formação em saúde e reestruturação, além de reorganização dos procedimentos internos de regulação. CONCLUSÃO Os fatores limitantes da regulação demonstram a necessidade de fomentar ações que ofereçam a todos os usuários do SUS o acesso pleno aos serviços de saúde.

Characteristics of late presentation of HIV infection in MSM and heterosexual adults in Portugal 2011-2013.

INTRODUCTION: It is estimated that over half of newly diagnosed HIV infections in Europe present late. An HIV positive individual presenting late to care represents a missed opportunity to benefit from treatment, increasing the risk of morbidity and mortality at an individual level, and onward disease transmission at population level. Reducing late presentation is a strategic priority of the Portuguese HIV/AIDS program. We set out to describe the characteristics of late presentation in the two largest transmission risk groups currently in Portugal to inform HIV prevention and treatment. METHODS: We extracted details of all notified cases from individuals over 15 years with a laboratory confirmed HIV diagnosis made between January 2011 and December 2013 from the Portuguese HIV surveillance database and selected cases from heterosexuals and men who have sex with men (MSM). We defined late presentation as an initial CD4 count <350 cells/mm(3) or presence of AIDS-defining disease at time of HIV diagnosis. We calculated adjusted odds ratios (aOR) with 95% confidence intervals (CI) for characteristics associated with late presentation in separate logistic regression for heterosexuals and MSM. RESULTS: Of 4219 HIV positive cases notified, 2589 (61%) were heterosexuals and 1220 (29%) were MSM. A total of 1586 (38%) cases presented late of which 1037 (40%) were heterosexual and 328 (27%) were MSM. The median age at late presentation was 40 in heterosexual women, 46 in heterosexual men and 35 in MSM. A total of 1446 (55%) of heterosexual HIV positive adults were unaware of having had a high risk sexual contact. Late presentation among heterosexuals was associated with being male (aOR=1.58 95% CI 1.29-1.93), not knowing a partners' HIV status (OR=1.59 95% CI 1.35-1.87) and age, increasing the odds of late presentation by a factor of 1.02 per year (95% CI 1.01-1.03). Among MSM, only age was associated with late presentation, increasing by 1.04 (95% CI 1.03-1.05) per year. CONCLUSIONS: Portuguese HIV prevention programs need to increase the risk awareness of heterosexuals, particularly men, to reduce missed opportunities for early diagnosis. As half of all cases presenting late are aged 40 and over, we recommend that general HIV outreach services and specialist services for MSM review their accessibility and acceptability to both middle and older-aged clients.

HIV-2 integrase polymorphisms and longitudinal genotypic analysis of HIV-2 infected patients failing a raltegravir-containing regimen.

To characterize the HIV-2 integrase gene polymorphisms and the pathways to resistance of HIV-2 patients failing a raltegravir-containing regimen, we studied 63 integrase strand transfer inhibitors (INSTI)-naïve patients, and 10 heavily pretreated patients exhibiting virological failure while receiving a salvage raltegravir-containing regimen. All patients were infected by HIV-2 group A. 61.4% of the integrase residues were conserved, including the catalytic motif residues. No INSTI-major resistance mutations were detected in the virus population from naïve patients, but two amino acids that are secondary resistance mutations to INSTIs in HIV-1 were observed. The 10 raltegravir-experienced patients exhibited resistance mutations via three main genetic pathways: N155H, Q148R, and eventually E92Q - T97A. The 155 pathway was preferentially used (7/10 patients). Other mutations associated to raltegravir resistance in HIV-1 were also observed in our HIV-2 population (V151I and D232N), along with several novel mutations previously unreported. Data retrieved from this study should help build a more robust HIV-2-specific algorithm for the genotypic interpretation of raltegravir resistance, and contribute to improve the clinical monitoring of HIV-2-infected patients.

Equivalencia factorial de las versiones en español y portugués de un cuestionario de expectativas académicas / Factorial equivalence of the Spanish and Portuguese versions of a questionnaire of academic expectations

Resumen Este estudio presenta los resultados de una investigación sobre expectativas académicas de estudiantes universitarios de primer año de Enseñanza Superior (ES) pertenecientes al norte de Portugal y noroeste de España. Su objetivo es replicar las propiedades psicométricas del instrumento utilizado obtenidas con una versión anterior del mismo. La muestra está integrada por 1.268 estudiantes de primer año de ES con edades comprendidas entre los 17 y 52 años (Mdn = 18, siendo de más de 23 años el 7.4%). Proceden de la región noroeste de España 413 estudiantes (Galicia, Universidad de Vigo) y 855 de la región norte de Portugal (Minho, Universidade do Minho). El 58.1% del total de la muestra son mujeres. Por ámbito de estudio, el 58.4% cursa titulaciones del ámbito científico-tecnológico y los demás del ámbito jurídico-social. Se aplicó el Cuestionario de Percepciones Académicas-Expectativas (CPA-E), estructurado en siete dimensiones: Formación para el empleo/carrera, Desarrollo personal y social, Movilidad estudiantil, Implicación político/ciudadana, Presión social, Calidad de formación e Interacción social. La invarianza del modelo factorial oblicuo del CPA-E fue testada con el LISREL 8.80 mediante el método bivariado latente normal y la estimación de máxima verosimilitud, con la corrección de Satorra y Bentler (1994). Todos los ítems representaron bien a sus respectivos factores y los factores mostraron una buena validez y fiabilidad para los países y el género. Se obtuvo, por tanto, invarianza factorial del modelo para los países y el género. Se asume una versión final del cuestionario común para España y Portugal, así como para mujeres y hombres.

Abstract We present the results of a study conducted with first-year students from the Euro-region of Galicia-North Portugal, with the aim of replicating the psychometric properties of the instrument as obtained from a prior version. Participants included 1268 first-year students with ages ranging from 17 to 52 years (Mdn = 18; 7.4% with ages above 23 years). Four-hundred and thirteen students are from the North Spanish region (Galicia, University of Minho) and 855 are from the North Portuguese region (Minho, University of Minho), and 58.1% of the students are women. Students are enrolled in scientific-technological courses (58.4%) and juridical-social studies. We administered the Academic Perceptions Questionnaire- Expectations (APQ-E), which is structured in seven dimensions: Training for career development, Personal and social development, Student mobility, Political engagement and citizenship, Social pressure, Training quality, and Social interaction. The invariance of the factorial model of the APQ-E was tested with LISREL 8.80, based on a bivariate latent model and maximum likelihood estimation, with Satorra and Bentler correction (1994). All items contributed to the representation of the factors, and the factors showed good validity and reliability for country and gender. Therefore, we obtained factorial invariance of the measurement model for country and gender. We present the final version of the common questionnaire for Portugal and Spain, and for women and men.