Raw milk cheeses from Beira Baixa, Portugal-A contributive study for the microbiological hygiene and safety assessment.

Due to specific bacterial microbiota, raw milk cheeses have appreciated sensory properties. However, they may pose a threat to consumer safety due to potential pathogens presence. This study evaluated the microbiological contamination of 98 raw milk cheeses from Beira Baixa, Portugal. Presence and enumeration of Coagulase Positive Staphylococci (CPS), Listeria monocytogenes, Salmonella spp., pathogenic Escherichia coli, and indicator microorganisms (non-pathogenic E. coli and Listeria spp.) was attained. E. coli antimicrobial resistance (AMR) was also evaluated. PCR and/or Whole genome sequencing (WGS) was used to characterize E. coli, Salmonella spp. and L. monocytogenes isolates. Sixteen cheeses (16.3%) were classified as Satisfactory, 59 (60.2%) as Borderline and 23 (23.5%) as Unsatisfactory/Potential Injurious to Health. L. monocytogenes, CPS > 104 cfu g-1, Extraintestinal pathogenic E. coli (ExPEC) and Salmonella spp. were detected in 4.1%, 6.1%, 3.1% and 1.0% of the samples, respectively. Listeria innocua (4.1%) and E. coli > 104 cfu g-1 (16.3%) were also detected. AMR E. coli was detected in 23/98 (23.5%) of the cheese samples, of which two were multidrug resistant. WGS identified genotypes already associated to human disease and Listeria spp. cluster analysis indicated that cheese contamination might be related with noncompliance with Good Hygiene Practices during cheese production.

Patient-Reported Outcomes and Experiences Assessment in Women with Breast Cancer: Portuguese Case Study.

In 2020, female breast cancer was the most commonly diagnosed cancer worldwide, representing the type of cancer with the highest incidence among women and the second most common cause of cancer death among women in all OECD countries. The conventional measures addressing the burden of breast cancer by measuring mortality, incidence, and survival do not entirely reflect the quality of life and patients experience when receiving breast cancer care. The main objective of this study is to capture patient-reported outcomes and experiences in women with breast cancer in Portugal using methods developed for international benchmarking purposes, such as the OECD Patient-reported Indicators Surveys. The study included 378 women with breast cancer, with the age distribution being 19.8% aged 15 to 49 years and 80.2% aged 50 years and over. The data collection procedure and analysis followed the "OECD Breast Cancer Patient Reported Outcomes Working Group" protocol, allowing subsequent comparability with data from other OECD member countries. Most women were satisfied with the treatment outcome regarding the shape of their lumpectomy breast when wearing a bra (96.1%) and with the equal size of both breasts (78.3%). Findings on the WHO QOL-BREF showed that women manifest a lower score in well-being when compared with the general population or populations living with chronic diseases. This study shows the feasibility of implementing and using patient-reported metrics (PROM and PREM) in breast cancer services in Portugal. Measuring PROMs and PREMs from Portuguese women receiving breast cancer care provides insightful evidence into the quality and value of cancer care.

Healthcare Equity and Commissioning: A Four-Year National Analysis of Portuguese Primary Healthcare Units.

Equal and adequate access to healthcare is one of the pillars of Portuguese health policy. Despite the controversy over commissioning processes' contribution to equity in health, this article aims to clarify the relationship between socio-economic factors and the results of primary healthcare (PHC) commissioning indicators through an analysis of four years of data from all PHC units in Portugal. The factor that presents a statistically significant relationship with a greater number of indicators is the organizational model. Since the reform of PHC services in 2005, a new type of unit was introduced: the family health unit (USF). At the time of the study, these units covered 58.1% of the population and achieved better indicator results. In most cases, the evolution of the results achieved by commissioning seems to be similar in different analyzed contexts. Nevertheless, the percentage of patients of a non-Portuguese nationality and the population density were analyzed, and a widening of discrepancies was observed in 23.3% of the cases. The commissioning indicators were statistically related to the studied context factors, and some of these, such as the nurse home visits indicator, are more sensitive to context than others. There is no evidence that the best results were achieved at the expense of worse healthcare being offered to vulnerable populations, and there was no association with a reduction in inequalities in healthcare. It would be valuable if the Portuguese Government could stimulate the increase in the number of working USFs, especially in low-density areas, considering that they can achieve better results with lower costs for medicines and diagnostic tests.

Mental Health Patient-Reported Outcomes and Experiences Assessment in Portugal.

Mental ill-health is increasingly recognized by policymakers for its significant human and economic toll. The main objective of this study is to capture patient-reported outcomes and experiences on mental health care in Portugal using methods developed for international benchmarking purposes, such as the OECD Patient-reported Indicators Surveys. The study included 397 participants, 247 (62.2%) women, divided into four age groups: ages 16-24 years, ages 25-44 years, ages 45-65 years, and ages 66 years or older. The data collection procedure and analysis followed the OECD PaRIS Mental Health Working Group 2021 protocol allowing subsequent comparability with data from other OECD member countries. Findings on the WHO-5 Well-Being Index showed that women manifest a lower score in well-being following mental health care services use. This finding may be, at least in part, explained by the study population (mental health services users), including individuals with clinical depression which is more frequently observed in women. In terms of the level of satisfaction with treatment (provided by nurses, doctors, phycologists, etc.) the response "Yes, definitely" varied from 67% of answers regarding "time spent by care providers", 76.3% "involvement in decisions" to 79.7% regarding "clarity of explanations" and 84.4% regarding the item courtesy and respect. This study shows the feasibility of implementing and using patient-reported metrics (PROM and PREM) in mental health services in Portugal. The study results generate useful clinical information to help meet the expectations and needs of patients, contributing to a continuous improvement of mental health community services.

[Asthma Management and Control in Portuguese Speaking Countries]. / Gestão e Controlo da Asma em Países de Expressão Portuguesa.

INTRODUCTION: Asthma affects more than 339 million people worldwide. In the Community of Portuguese Speaking Countries, in 2016, its prevalence ranged from 9.5% (Portugal) to 3.91% (Brazil). Chronic disease management programs aim to improve the health status of patients with chronic disease and reduce associated costs. The objective of this study is to identify models of asthma asthma 'management and control' that are that are implemented in the Community of Portuguese Speaking Countries (CPLP), and analyse them through the integrated disease management model. MATERIAL AND METHODS: A rapid review of the PubMed indexed scientific literature and grey literature on 'management and control of asthma' in the countries of the Community of Portuguese-Speaking Countries was carried out. RESULTS: Portugal, Brazil and Mozambique presented publications on 'management and control of asthma', at different stages of implementation. Clinical management and organization and service delivery are the dimensions of integrated disease management most addressed in publications. DISCUSSION: The implementation of asthma management and control programs is influenced by health systems, care delivery structures, and the surrounding political and social environment. The dimensions of funding and information systems are the most difficult to implement given the degree of economic, social and technological development of most countries under study. CONCLUSION: Only Portugal, Brazil and Mozambique adopted asthma integrated disease management as the main form of asthma management and control. The programs developed by these countries can constitute a model for asthma integrated disease management in the other countries under study.

Introdução: A asma atinge mais de 339 milhões de pessoas mundialmente. Na Comunidade dos Países de Língua Portuguesa, em 2016, a sua prevalência variou entre 9,15% (Portugal) e 3,91% (Brasil). Os programas de gestão da doença crónica pretendem melhorar o estado de saúde de doentes com doença crónica e reduzir os custos associados. O objetivo deste estudo é identificar modelos de 'gestão e controlo da asma' implementados na Comunidade dos Países de Língua Portuguesa, analisando-os através do modelo de gestão integrada de doença.Material e Métodos: Realizou-se uma revisão rápida da literatura científica indexada na PubMed, e de literatura cinzenta sobre 'gestão e controlo da asma' nos países da Comunidade dos Países de Língua Portuguesa.Resultados: Portugal, Brasil e Moçambique apresentaram publicações sobre 'gestão e controlo da asma', em diferentes fases de implementação dos programas. A gestão clínica e organização e prestação de cuidados são as dimensões mais abordados nas publicações.Discussão: A implementação de programas de gestão e controlo da asma é influenciada pelos sistemas de saúde, estruturas de prestação de cuidados em que se inserem, meio político e social envolventes. As dimensões do financiamento e dos sistemas de informação são as mais difíceis de implementar, dado o desenvolvimento económico, social e tecnológico da maioria dos países em estudo.Conclusão: Apenas Portugal, Brasil e Moçambique adotaram a gestão integrada de doença da asma como principal forma de gestão e controlo da asma. Os programas desenvolvidos por estes países podem servir de modelo nos restantes países em estudo.