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1.
Sci Rep ; 11(1): 3451, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-33568716

RESUMEN

The COVID-19 pandemic has forced policy makers to decree urgent confinements to stop a rapid and massive contagion. However, after that stage, societies are being forced to find an equilibrium between the need to reduce contagion rates and the need to reopen their economies. The experience hitherto lived has provided data on the evolution of the pandemic, in particular the population dynamics as a result of the public health measures enacted. This allows the formulation of forecasting mathematical models to anticipate the consequences of political decisions. Here we propose a model to do so and apply it to the case of Portugal. With a mathematical deterministic model, described by a system of ordinary differential equations, we fit the real evolution of COVID-19 in this country. After identification of the population readiness to follow social restrictions, by analyzing the social media, we incorporate this effect in a version of the model that allow us to check different scenarios. This is realized by considering a Monte Carlo discrete version of the previous model coupled via a complex network. Then, we apply optimal control theory to maximize the number of people returning to "normal life" and minimizing the number of active infected individuals with minimal economical costs while warranting a low level of hospitalizations. This work allows testing various scenarios of pandemic management (closure of sectors of the economy, partial/total compliance with protection measures by citizens, number of beds in intensive care units, etc.), ensuring the responsiveness of the health system, thus being a public health decision support tool.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles , Modelos Teóricos , Predicción , Humanos , Método de Montecarlo , Pandemias/prevención & control , Portugal
2.
J Environ Manage ; 284: 112043, 2021 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-33607548

RESUMEN

Environmental empowering to control resource consumption and environmental impacts is critical to engage citizens to adopt more sustainable habits. This study demonstrates the potential benefits of innovative approaches based on sustainability indicators towards a low-carbon economy. A methodology to measure and promote sustainability in schools has been proposed and evaluated, aiming at showing the environmental performance and informing of potential environmental savings. The methodology, titled ClimACT, has two main purposes: measuring the environmental performance of schools through a school sustainability index based on measurable indicators in the areas of transport, procurement, green spaces, indoor air quality, energy, water and waste; and encouraging students, teachers and families towards an energy-efficient and low-carbon pathway through a structural procedure based on roles, activities and progress evaluation. The approach, applied to 39 pilot schools from Portugal, Spain, France and Gibraltar, achieved promising and encouraging results. All schools deployed the methodology successfully, achieving measurable environmental benefits in 95% of cases, with an average improvement of 10% in the global performance of schools after one year. Moreover, the 5112 surveys applied to school communities, before and after the methodology implementation, highlighted how the sustainable indicators had a significant influence on the daily lives of families, leading to improvements of their behaviour, with an average increase of 20% in indicators regarding good practices in transport, energy, water, waste and citizenship. The environmental empowering through measurable indicators is a step forward a low-carbon economy. This methodology is open and adaptable to all sectors and requirements.


Asunto(s)
Carbono , Instituciones Académicas , Francia , Humanos , Portugal , España
3.
Medicine (Baltimore) ; 100(3): e23987, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545989

RESUMEN

ABSTRACT: The use of beta-blockers (BB) in the context of ST-segment elevation myocardial infarction (STEMI) was a universal practice in the pre-reperfusion era. Since then, evidence of their use for secondary prevention after STEMI is scarce. Our aim is to determine treatment results associated with BB therapy after a STEMI at 1-year follow-up in a contemporary nationwide cohort.A prospective analysis involving 49 national centers, including patients admitted with STEMI, enrolled between October 2010 and September 2019 was conducted. The primary outcome was defined as the composite of all-cause mortality or hospital re-admission for a cardiovascular (CV) cause in the first year after STEMI. The patients were distributed into 2 groups, depending on whether they received therapy with BB at hospital discharge or not (BB and NB group, respectively).A total of 3145 patients were included in the analysis, of which 2526 (80.3%) in the BB group. A total of 12.2% of patients reached the primary outcome. Regarding the univariate Cox regression analysis, the BB group presented lower mortality or re-admission for CV cause at 1-year follow-up [hazard ratio (HR) 0.69, confidence interval (CI) 95% 0.55-0.87, P = .001]. However, after adjustment for significant covariates, this association was lost (HR 0.73, CI 95% 0.51-1.04, P = .081). In patients with preserved (HR 0.73, CI 95% 0.51-1.04, P = .081) and mid-range (HR 1.01, CI 95% 0.64-1.61, P = .959) left ventricular ejection fraction (LVEF), the primary outcome was similar between the 2 groups, while in patients with reduced LVEF, the BB group presented a better prognosis, with fewer patients reaching the primary outcome (HR 0.431, CI 95% 0.262-0.703, P = .001).BB universal therapy after STEMI has not proved useful, but it seems to be beneficial in patients with reduced LVEF.


Asunto(s)
Antagonistas Adrenérgicos beta/uso terapéutico , Alta del Paciente/estadística & datos numéricos , Readmisión del Paciente/estadística & datos numéricos , Infarto del Miocardio con Elevación del ST/tratamiento farmacológico , Prevención Secundaria/estadística & datos numéricos , Anciano , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Portugal , Estudios Prospectivos , Sistema de Registros , Infarto del Miocardio con Elevación del ST/mortalidad , Infarto del Miocardio con Elevación del ST/prevención & control , Resultado del Tratamiento
4.
Artículo en Inglés | MEDLINE | ID: mdl-33451083

RESUMEN

During the COVID-19 pandemic, healthcare workers (HCW) have been exposed to multiple psychosocial stressors. Resilience might protect employees from the negative consequences of chronic stress. The aim of this study was to explore the mediating role of resilience in the relationship between depression and burnout (personal, work-related, and client-related). A cross-sectional study was performed using an online questionnaire distributed via social networks. A survey was conducted comprising standardized measures of resilience (Resilience Scale-25 items), depression (subscale of Depression Anxiety Stress Scales-21 items), and burnout (Copenhagen Burnout Inventory Scale-19 items). A total of 2008 subjects completed the survey, and a hierarchical regression model was estimated for each burnout dimension. The results revealed that depression had not only a directed effect on personal, work- and client-related burnout, but also an indirect small effect on it through resilience. Psychological resilience played a partial mediating role between depression and all burnout dimensions. This partial mediation suggests that there may be other possible variables (e.g., social connection, self-compassion, gratitude, sense of purpose) that further explain the associations.


Asunto(s)
Agotamiento Profesional/epidemiología , Depresión/epidemiología , Personal de Salud/psicología , Resiliencia Psicológica , /epidemiología , Estudios Transversales , Humanos , Pandemias , Portugal/epidemiología , Encuestas y Cuestionarios
5.
JMIR Public Health Surveill ; 7(1): e22794, 2021 01 12.
Artículo en Inglés | MEDLINE | ID: mdl-33433397

RESUMEN

BACKGROUND: COVID-19, a viral respiratory disease first reported in December 2019, quickly became a threat to global public health. Further understanding of the epidemiology of the SARS-CoV-2 virus and the risk perception of the community may better inform targeted interventions to reduce the impact and spread of COVID-19. OBJECTIVE: In this study, we aimed to examine the association between chronic diseases and serious outcomes following COVID-19 infection, and to explore its influence on people's self-perception of risk for worse COVID-19 outcomes. METHODS: This study draws data from two databases: (1) the nationwide database of all confirmed COVID-19 cases in Portugal, extracted on April 28, 2020 (n=20,293); and (2) the community-based COVID-19 Barometer survey, which contains data on health status, perceptions, and behaviors during the first wave of COVID-19 (n=171,087). We assessed the association between relevant chronic diseases (ie, respiratory, cardiovascular, and renal diseases; diabetes; and cancer) and death and intensive care unit (ICU) admission following COVID-19 infection. We identified determinants of self-perception of risk for severe COVID-19 outcomes using logistic regression models. RESULTS: Respiratory, cardiovascular, and renal diseases were associated with mortality and ICU admission among patients hospitalized due to COVID-19 infection (odds ratio [OR] 1.48, 95% CI 1.11-1.98; OR 3.39, 95% CI 1.80-6.40; and OR 2.25, 95% CI 1.66-3.06, respectively). Diabetes and cancer were associated with serious outcomes only when considering the full sample of COVID-19-infected cases in the country (OR 1.30, 95% CI 1.03-1.64; and OR 1.40, 95% CI 1.03-1.89, respectively). Older age and male sex were both associated with mortality and ICU admission. The perception of risk for severe COVID-19 disease in the study population was 23.9% (n=40,890). This was markedly higher for older adults (n=5235, 46.4%), those with at least one chronic disease (n=17,647, 51.6%), or those in both of these categories (n=3212, 67.7%). All included diseases were associated with self-perceptions of high risk in this population. CONCLUSIONS: Our results demonstrate the association between some prevalent chronic diseases and increased risk of worse COVID-19 outcomes. It also brings forth a greater understanding of the community's risk perceptions of serious COVID-19 disease. Hence, this study may aid health authorities to better adapt measures to the real needs of the population and to identify vulnerable individuals requiring further education and awareness of preventive measures.


Asunto(s)
/terapia , Enfermedad Crónica/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Anciano , Anciano de 80 o más Años , /mortalidad , Comorbilidad , Bases de Datos Factuales , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Portugal/epidemiología , Medición de Riesgo , Encuestas y Cuestionarios , Resultado del Tratamiento
6.
Psicothema ; 33(1): 125-130, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33453745

RESUMEN

BACKGROUND: Despite being necessary to delay the spread of COVID-19, home confinement could have affected the emotional well-being of children and adolescents. Knowing which variables are involved in anxiety and depressive symptoms could help to prevent young people's psychological problems related to lockdown as early as possible. This cross-sectional study aims to examine anxiety and depressive symptomatology in Italian, Spanish, and Portuguese children and adolescents in order to determine which variables are related to poorer well-being during the pandemic. METHOD: The parents of 515 children, aged 3-18 years old, completed an online survey. Children's anxiety symptoms were assessed using the Spence Children's Anxiety Scale-Parent Version, and depressive symptoms were measured with the Short Mood and Feelings Questionnaire-Parent Version. RESULTS: We found differences in anxiety and depression between countries, with higher anxiety scores in Spanish children, and higher depression scores in Spanish and Italian children compared to the Portuguese. Anxiety and depressive symptoms were more likely in children whose parents reported higher levels of stress. CONCLUSIONS: These findings are discussed in the light of detecting and supporting affected children as early as possible.


Asunto(s)
Ansiedad/epidemiología , Depresión/epidemiología , Adolescente , Niño , Preescolar , Estudios Transversales , Características Culturales , Femenino , Humanos , Italia/epidemiología , Masculino , Portugal/epidemiología , Cuarentena , España/epidemiología
7.
Harm Reduct J ; 18(1): 13, 2021 01 25.
Artículo en Inglés | MEDLINE | ID: mdl-33494726

RESUMEN

Four emergency shelters were instituted in Lisbon during COVID-19, and are still in operation. Between March and August 2020, they served over 600 people. The shelters host a diverse population, including people experiencing homelessness, foreigners, LGBTI + people, those with reduced mobility, couples, those with pets, and People Who Use Drugs, including alcohol (henceforth PWUD). Individuals are provided care regardless of their immigration or residence status. In order to ensure continuity of care in the shelters and to bring in clients who usually refuse to be sheltered, a range of social and health interventions are integrated into the shelters. Harm reduction services ensure that the most vulnerable populations, PWUD and people experiencing homelessness, have access to the services they need. Innovations in service provision maximize the services impacts and pave the way for the future inclusion and development of these services.


Asunto(s)
/prevención & control , Consumidores de Drogas/estadística & datos numéricos , Refugio de Emergencia/métodos , Reducción del Daño , Personas sin Hogar , Humanos , Portugal
8.
Artículo en Inglés | MEDLINE | ID: mdl-33430397

RESUMEN

The aim of this study is to determine the anxiety and fear related to coronavirus disease 2019 (COVID-19) and their associations with travel, tourism and hospitality, in the Portuguese population. The Coronavirus Anxiety Scale (CAS) and Fear of COVID-19 Scale (FCV-19S) were validated for the Portuguese population and correlations with issues related to travel, tourism and hospitality were established. CAS and FCV-19S presented a good adjustment model and solid reliability and validity. Correlations between CAS and FCV-19S and the perception of the impact of COVID-19 in travel, tourism and hospitality were found. Participants considered that COVID-19 mainly affected their holidays and leisure time. However, the strongest correlation established was between total FCV-19S and emotional fear FCV-19S and the fear of attending hotel facilities. The Portuguese versions of CAS and FCV-19S are reliable psychological tools to assess anxiety and fear in relation to COVID-19 for the general population. The use of hotel facilities is the most threatening issue related to travel, tourism and hospitality. The results suggest that hotels should invest in hygiene and safety measures that allow users to regain confidence in hotel equipment.


Asunto(s)
Ansiedad/epidemiología , Psicometría , Turismo , Miedo , Humanos , Portugal/epidemiología , Reproducibilidad de los Resultados
9.
J Environ Manage ; 277: 111412, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33038670

RESUMEN

Wildlife roadkill hotspots are frequently used to identify priority locations for implementing mitigation measures. However, understanding the landscape-context and the spatial and temporal dynamics of these hotspots is challenging. Here, we investigate the factors that drive the spatiotemporal variation of bat mortality hotspots on roads along three years. We hypothesize that hotspot locations occur where bat activity is higher and that this activity is related to vegetation density and productivity, probably because this is associated with food availability. Statistically significant clusters of bat-vehicle collisions for each year were identified using the Kernel Density Estimation (KDE) approach. Additionally, we used a spatiotemporal analysis and generalized linear mixed models to evaluate the effect of local spatiotemporal variation of environmental indices and bat activity to predict the variation on roadkill hotspot locations and to asses hotspot strength over time. Between 2009 and 2011 we conducted daily surveys of bat casualties along a 51-km-long transect that incorporates different types of roads in southern Portugal. We found 509 casualties and we identified 86 statistically significant roadkill hotspots, which comprised 12% of the road network length and contained 61% of the casualties. Hotspots tended to be located in areas with higher accumulation of vegetation productivity along the three-year period, high bat activity and low temperature. Furthermore, we found that only 17% of the road network length was consistently classified as hotspots across all years; while 43% of hotspots vanished in consecutive years and 40% of new road segments were classified as hotspots. Thus, non-persistent hotspots were the most frequent category. Spatiotemporal changes in hotspot location are associated with decreasing vegetation production and increasing water stress on road surroundings. This supports our hypothesis that a decline on overall vegetation productivity and increase of roadside water deficit, and the presumed lower abundance of prey, have a significant effect on the decrease of bat roadkills. To our knowledge, this is the first study demonstrating that freely available remote sensing data can be a powerful tool to quantify bat roadkill risk and assess its spatiotemporal dynamics.


Asunto(s)
Quirópteros , Animales , Animales Salvajes , Ecosistema , Portugal , Análisis Espacio-Temporal
10.
Chemosphere ; 266: 129211, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33316473

RESUMEN

In this study, the six indicator non-dioxin-like polychlorinated biphenyls NDL-PCBs (PCB28, PCB52, PCB101, PCB138, PCB153, PCB180), as well as four organochlorine pesticides (OCPs), hexachlorobenzene (HCB), ß-hexachlorocyclohexane (ß-HCH), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichlorethylene (DDE) were measured in 98 maternal and 49 cord sera samples of a group of Lebanese women who gave birth in three hospitals in Greater Beirut, between March and July 2018. Results showed that the levels of these persistent organic pollutants (POPs) in maternal serum were below critical limits as well as those in other countries (Tunisia, France, Portugal, Spain, Poland, Greenland, Canada, Brazil, and China). The ratios of cord serum concentrations to maternal serum concentrations of analyzed POPs were higher than 1. PCB maternal serum concentrations were found to be linked to illegal incineration (OR = 5.78; p = 0.004) as well as eggs (OR = 4.68; p = 0.027) and fruits and vegetables consumption (OR = 3.92; p = 0.016). OCP concentrations were linked to red meat and cold cuts intake (OR = 3.67-4.59; p = 0.001-0.004). While PCB levels were not correlated to newborns anthropometric measurements, OCP levels in cord serum were found to be positively linked to the birth length of newborns (p = 0.014-0.027).


Asunto(s)
Contaminantes Ambientales , Hidrocarburos Clorados , Plaguicidas , Bifenilos Policlorados , Brasil , Canadá , China , Monitoreo del Ambiente , Contaminantes Ambientales/análisis , Femenino , Francia , Groenlandia , Humanos , Hidrocarburos Clorados/análisis , Recién Nacido , Plaguicidas/análisis , Polonia , Bifenilos Policlorados/análisis , Portugal , Embarazo , Mujeres Embarazadas , España , Túnez
11.
Sci Total Environ ; 759: 144314, 2021 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-33338692

RESUMEN

Sediments colonised by three halophyte species, Spartina maritima (Curtis) Fernald, Halimione portulacoides (L.) Aellen and Sarcocornia fruticosa (L.) Scott) and bulk sediment from a SW European salt marsh (Tagus estuary, Portugal) were subjected to sequential extractions and analysed to assess the rare earth elements (REE) geochemical fractionation and to evaluate the plants' role in the mobility and bioavailability of these elements. The results showed that REE were mainly bound to the residual (yttrium and heavy-REE) and carbonate (middle-REE and heavy-REE) fractions, followed by the reducible and oxidisable (light-REE and middle-REE) fractions, while the easily soluble fraction was negligible. This fractionation evidenced a sediment REE mobility mainly dependent not only on carbonates but also on FeMn oxyhydroxides and on organic matter content. On the other hand, REE associated with the reducible and oxidisable fractions, and particularly the redox-sensitive Ce, may become more available, due to the redox condition seasonal changes that occur in salt marshes' sediments promoted by the plants' activity. Moreover, this study demonstrated that the REE bioavailability depends not only on the sediments' characteristics and the plants' seasonal activity but also on the specificity of each element, as demonstrated by the different fractionation patterns observed in the various sedimentary fractions.


Asunto(s)
Sedimentos Geológicos , Humedales , Disponibilidad Biológica , Raíces de Plantas , Portugal
12.
J Environ Sci (China) ; 100: 51-61, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33279053

RESUMEN

Traffic is a main source of air pollutants in urban areas and consequently daily peak exposures tend to occur during commuting. Personal exposure to particulate matter (PM) was monitored while cycling and travelling by bus, car and metro along an assigned route in Lisbon (Portugal), focusing on PM2.5 and PM10 (PM with aerodynamic diameter <2.5 and 10 µm, respectively) mass concentrations and their chemical composition. In vehicles, the indoor-outdoor interplay was also evaluated. The PM2.5 mean concentrations were 28 ± 5, 31 ± 9, 34 ± 9 and 38 ± 21 µg/m3 for bus, bicycle, car and metro modes, respectively. Black carbon concentrations when travelling by car were 1.4 to 2.0 times higher than in the other transport modes due to the closer proximity to exhaust emissions. There are marked differences in PM chemical composition depending on transport mode. In particular, Fe was the most abundant component of metro PM, derived from abrasion of rail-wheel-brake interfaces. Enhanced concentrations of Zn and Cu in cars and buses were related with brake and tyre wear particles, which can penetrate into the vehicles. In the motorised transport modes, Fe, Zn, Cu, Ni and K were correlated, evidencing their common traffic-related source. On average, the highest inhaled dose of PM2.5 was observed while cycling (55 µg), and the lowest in car travels (17 µg). Cyclists inhaled higher doses of PM2.5 due to both higher inhalation rates and longer journey times, with a clear enrichment in mineral elements. The presented results evidence the importance of considering the transport mode in exposure assessment studies.


Asunto(s)
Contaminantes Atmosféricos , Material Particulado , Contaminantes Atmosféricos/análisis , Exposición a Riesgos Ambientales/análisis , Monitoreo del Ambiente , Tamaño de la Partícula , Material Particulado/análisis , Portugal , Emisiones de Vehículos/análisis
13.
Sci Total Environ ; 751: 142332, 2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-33182008

RESUMEN

Portugal (Southwestern Europe) experiences a high incidence of dry hazards such as drought, a phenomenon that entails a notable burden of morbidity and mortality worldwide. For the first time in the Lisbon district, a time-series study was conducted to evaluate the impact of drought measured by the Standardised Precipitation Index (SPI) and Standardised Precipitation-Evapotranspiration Index (SPEI) on the daily natural, circulatory, and respiratory mortality from 1983 to 2016. An assessment by gender and adult age population groups (45-64, 65-74, ≥75 years old) was included. To estimate the relative risks and attributable risks, generalised linear models with a Poisson link were used. Additionally, the influence of heatwaves and atmospheric pollution for the period from 2007 to 2016 (available period for pollution data) was considered. The main findings indicate statistically significant associations between drought conditions and all analysed causes of mortality. Moreover, SPEI shows an improved capability to reflect the different risks. People in the 45-64 year-old group did not indicate any significant influence in any of the cases, whereas the oldest groups had the highest risk. The drought effects on mortality among the population varied across the different study periods, and in general, the men population was affected more than the women population (except for the SPEI and circulatory mortality during the long study period). The short-term influence of droughts on mortality could be explained primarily by the effect of heatwaves and pollution; however, when both gender and age were considered in the Poisson models, the effect of drought also remained statistically significant when all climatic phenomena were included for specific groups of the total population and men. This type of study facilitates a better understanding of the population at risk and allows the development of more effective measures to mitigate the drought effects on the population.


Asunto(s)
Sequías , Adulto , Europa (Continente) , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Portugal/epidemiología , Factores de Riesgo
15.
Zootaxa ; 4894(2): zootaxa.4894.2.9, 2020 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-33311088

RESUMEN

Oxybelus lusitanicus spec. nov., a new European Crabronid wasp species is described and diagnosed. It is currently known only from two regions of Portugal. An amendment to the relevant section of Guichard's (1993) most recent English language key to European Oxybelus Latreille, 1796 is included.


Asunto(s)
Himenópteros , Avispas , Animales , Portugal
16.
Front Public Health ; 8: 553345, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33313033

RESUMEN

COVID-19 mitigation measures present unprecedented challenges in mental healthcare delivery, posing high risk to the mental health of at-risk populations, namely patients diagnosed with COVID-19, frontline healthcare providers, and those submitted to quarantine or isolation measures, as well as the general population. Ensuring safe and equitable access to mental healthcare by these groups entails resorting to innovative psychosocial intervention strategies, such as digital mental health. In this perspective piece, we describe the impact of COVID-19 on the Portuguese population's mental health, present an overview on initiatives developed to address the challenges currently faced by the Portuguese mental healthcare system, and discuss how the timely implementation of a comprehensive digital mental health strategy, coupling research, education, implementation, and quality assessment initiatives, might buffer COVID-19's impact on the Portuguese society.


Asunto(s)
/complicaciones , Personal de Salud , Trastornos Mentales , Servicios de Salud Mental , Telemedicina , Cuidadores/psicología , Personal de Salud/psicología , Humanos , Trastornos Mentales/diagnóstico , Trastornos Mentales/terapia , Portugal , Cuarentena
17.
Artículo en Inglés | MEDLINE | ID: mdl-33348556

RESUMEN

The teaching personal and social responsibility (TPSR) model has been extensively used in a vast array of settings. However, few TPSR studies have focused on preschool settings. The purpose of this action research study was to analyze the experiences of a program leader, her preschool children, and their parents throughout a TPSR program focused on transference of responsibility model goals. The participants were 25 preschool children, six parents, and a program leader involved in a preschool setting located in the north of Portugal. Data were collected through reflexive journaling, participant observations, semi-structured interviews, and focus group interviews. Findings suggest the TPSR model could be a useful instructional model for preschool teachers focused on providing social and emotional learning opportunities to their students. In order to foster transference, parents played a pivotal role in this process and were included in the intervention, which appeared to enhance life skill transfer.


Asunto(s)
Objetivos , Evaluación de Programas y Proyectos de Salud/métodos , Maestros/psicología , Responsabilidad Social , Estudiantes/psicología , Enseñanza , Preescolar , Femenino , Investigación sobre Servicios de Salud , Humanos , Educación y Entrenamiento Físico , Portugal
18.
J. optom. (Internet) ; 13(4): 257-261, oct.-dic. 2020.
Artículo en Inglés | IBECS | ID: ibc-193462

RESUMEN

The pandemic of the severe acute respiratory syndrome disease caused by the new coronavirus SARS-CoV-2 (COVID-19), had profound impact in many countries and their health care systems. Regarding Portugal, a suppression strategy with social distancing was adopted, attempting to break the transmission chains, bending the epidemy curve and reducing mortality. These measures seek to prevent an eventual National Health Service over-running, enforcing the suspension of all elective and non-urgent health care. Despite the success in so far, there is a consensus on the need to recover the previous level of health care provision and further enhance it. The Portuguese National Health Service, as a public, universal access, health care system funded by the State proved, in this context, its importance and relevance to the Portuguese population. However, long standing issues, such as the pre pandemic over long waiting lists for hospital ophthalmology attendance, whose determinants are fully identified but still unmet, emerge amplified from this pandemic. The lack of primary eye care in the National Health Service is a significant bottleneck, placing a huge stress on hospital-based care. An exclusive ophthalmologist's center care was over-runned before pandemic and will be even more so. The optometrist's exclusion from differentiated, multisectoral and multidisciplinary eye care teams remains the main hurdle to overcome and insure universal eye care in Portugal. National Health Service highlights the consequences of an overcome model. Universal eye care more than ever demands an evidence-based, integrated approach with primary eye care, in the community, on time and of proximity


La pandemia del síndrome respiratorio agudo grave causado por el nuevo coronavirus SARS-CoV-2 (COVID-19) ha tenido amplias repercusiones en muchos países y en sus sistemas sanitarios. En Portugal, se ha adoptado una estrategia de contención basada en el distanciamiento social, con la cual se ha intentado cortar las cadenas de transmisión, frenar la curva de la epidemia y reducir la mortalidad. Con estas medidas se trataba de evitar un eventual desbordamiento del Servicio Nacional de Salud y se imponía la suspensión de toda la atención médica programada, que no fuera urgente. A pesar del éxito logrado hasta este momento, existe consenso sobre la necesidad de recuperar el nivel anterior de atención médica y fomentar su mejora. El Servicio Nacional de Salud de Portugal, como sistema sanitario público y de acceso universal, a cargo del Estado, ha demostrado, en este contexto, su importancia y pertinencia para la población portuguesa. Sin embargo, los problemas que acarrea desde hace mucho tiempo, como las largas listas de espera, anteriores a la pandemia, en la asistencia oftalmológica hospitalaria, cuyos factores determinantes están completamente identificados, pero que continúan sin solución, se han visto agravados a resultas de esta pandemia. La falta de atención primaria oftalmológica en el Servicio Nacional de Salud es un importante cuello de botella, que ejerce una enorme presión en la atención hospitalaria. La atención de un centro exclusivamente oftalmológico estaba desbordada antes de la pandemia y lo estará aún más después de esta. La exclusión de los optómetras de los equipos de atención oftalmológica diferenciados, multisectoriales y multidisciplinarios continúa siendo el principal obstáculo que debe superar y asegurar la atención oftalmológica universal en Portugal. El Servicio Nacional de Salud hace hincapié en las consecuencias de un modelo superado. La atención oftalmológica universal exige, más que nunca, un enfoque integral basado en la evidencia para abordar la atención primaria oftalmológica en la comunidad, puntual y de proximidad


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Sistemas de Salud , Servicios de Salud Ocular , Atención al Paciente/normas , Portugal/epidemiología
20.
Acta Med Port ; 33(11): 733-741, 2020 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-33160423

RESUMEN

INTRODUCTION: Portugal took early action to control the COVID-19 epidemic, initiating lockdown measures on March 16th when it recorded only 62 cases of COVID-19 per million inhabitants and reported no deaths. The Portuguese public complied quickly, reducing their overall mobility by 80%. The aim of this study was to estimate the initial impact of the lockdown in Portugal in terms of the reduction of the burden on the healthcare system. MATERIAL AND METHODS: We forecasted epidemic curves for: Cases, hospital inpatients (overall and in intensive care), and deaths without lockdown, assuming that the impact of containment measures would start 14 days after initial lockdown was implemented. We used exponential smoothing models for deaths, intensive care and hospitalizations and an ARIMA model for number of cases. Models were selected considering fitness to the observed data up to the 31st March 2020. We then compared observed (with intervention) and forecasted curves (without intervention). RESULTS: Between April 1st and April 15th, there were 146 fewer deaths (-25%), 5568 fewer cases (-23%) and, as of April 15th, there were 519 fewer intensive care inpatients (-69%) than forecasted without the lockdown. On April 15th, the number of intensive care inpatients could have reached 748, three times higher than the observed value (229) if the intervention had been delayed. DISCUSSION: If the lockdown had not been implemented in mid-March, Portugal intensive care capacity (528 beds) would have likely been breached during the first half of April. The lockdown seems to have been effective in reducing transmission of SARS-CoV-2, serious COVID-19 disease, and associated mortality, thus decreasing demand on health services. CONCLUSION: An early lockdown allowed time for the National Health Service to mobilize resources and acquire personal protective equipment, increase testing, contact tracing and hospital and intensive care capacity and to promote broad prevention and control measures. When lifting more stringent measures, strong surveillance and communication strategies that mobilize individual prevention efforts are necessary.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Urgencias Médicas/epidemiología , Epidemias/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Política Pública/legislación & jurisprudencia , Cuarentena/métodos , Ocupación de Camas , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/transmisión , Cuidados Críticos/estadística & datos numéricos , Epidemias/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Humanos , Neumonía Viral/epidemiología , Neumonía Viral/mortalidad , Neumonía Viral/transmisión , Portugal/epidemiología , Cuarentena/estadística & datos numéricos
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