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2.
ARP Rheumatol ; 3(2): 119-127, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38956995

RESUMEN

AIMS: to test the measurement properties of the Portuguese version of the Commissioning for Quality in Rheumatoid Arthritis Patient-Reported Experience Measure (CQRA-PREM) for patients with rheumatoid arthritis (RA). METHODS: This cross-sectional clinical field study recruited adult patients with RA during rheumatology appointments of a Portuguese rheumatology center. Patients completed the Portuguese version of CQRA-PREM, composed of 7 domains and 24 questions. Sociodemographic characteristics, symptoms/disease duration, current treatment, Pain-Visual Analog Scale (VAS), Patient Global Assessment (PGA)-VAS and Health Assessment Questionnaire (HAQ) were also collected from the patient. Disease Activity Score for 28 joints with C-reactive Protein (DAS28-CRP) was recorded by the rheumatologist. The assessment of CQRA-PREM measurement properties followed the Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) recommendations. RESULTS: A total of 61 patients with RA were included. The domains in which patients showed better experience were the "Needs and preferences", followed by "Coordination and Communication". The domain "Information, education and self-care" was an identified area of improvement for providing patient-centered care. Ceiling effects were found in four domains of the CQRA-PREM. Internal consistency of all domains was considered good (α>0.7). Homogeneity was considered good for each question in all domains analyzed (0.30≤rp≤0.70). The divergent validity of the PREM was good, revealing that the domains were not correlated (Pain-VAS, HAQ, DAS28-CRP) or only weakly (PGA-VAS) correlated with clinical outcomes. CONCLUSIONS: The CQRA-PREM showed acceptable measurement properties and is a useful tool for evaluating quality of healthcare provided in daily practice, as perceived by RA patients in Portugal.


Asunto(s)
Artritis Reumatoide , Medición de Resultados Informados por el Paciente , Humanos , Artritis Reumatoide/diagnóstico , Estudios Transversales , Masculino , Femenino , Persona de Mediana Edad , Portugal , Anciano , Adulto , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Índice de Severidad de la Enfermedad , Dimensión del Dolor/métodos
3.
ARP Rheumatol ; 3(2): 111-1118, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38956994

RESUMEN

OBJECTIVES: To compare spinal and lower limb pain in adolescents regarding prevalence, characteristics, causes, and impact. METHODS: A descriptive cross-sectional study was conducted in 13-year-old adolescents (female n=2210; male n=2353) from the Portuguese Generation XXI birth cohort. Data were collected between 2018 and 2020 through personal interviews by applying the Luebeck Pain Questionnaire. The pain features examined in each anatomical location (back and lower limb) were recurrence, duration, frequency, intensity, perceived causes, and impact on school and leisure activities. Frequencies and the Chi-square test were used. RESULTS: Questionnaires from 4563 adolescents were analysed, 57.9% had pain in the last three months (main pain in the spine: 11.6%; main pain in the lower limb: 29.0%). Of those, 69.4% and 62.4% reported recurrent pain in the spine and lower limb, respectively. Recurrent pain was more frequent in girls than in boys (spine: 80.0%; 57.0%; lower limb: 70.4%; 58.1% respectively). Pain lasted more than three months in most adolescents (spine: about 60%; lower limb: above 50%); frequency was similarly high in both regions and both sexes (girls: 47.0%; boys: 45.7% in the spine; girls: 45.7%; boys: 40.3% in the lower limb); intensity was rated as high by girls (spine: 45.5%; lower limb: 47.3%) and moderate by boys (spine: 42.0%; lower limb: 41.0%). The leading causes of pain were daily living activities, both for the spine (girls: 65.9%; boys: 76.5%) and the lower limb (girls: 62.2%; boys: 72.1%). Psychosocial causes were the second most common cause of spinal pain (girls: 25.0%; boys: 21.0%). Other causes of lower limb pain were traumatic (girls: 25.5%; boys: 16.6%) and physical factors (girls: 20.7%; boys: 23.8%). Absences from school (girls: 11.7%; boys: 4.8%) and restrictions of leisure activities (girls: 20.7%; boys: 25.2%) were more related to pain in the lower limb. CONCLUSION: More than half of the adolescents reported spinal or lower limb recurrent pain, which presents a higher frequency, higher intensity, and longer duration in the spine. However, lower limb pain led to more concurrent limitations.


Asunto(s)
Extremidad Inferior , Recurrencia , Humanos , Masculino , Femenino , Adolescente , Estudios Transversales , Prevalencia , Extremidad Inferior/fisiopatología , Portugal/epidemiología , Encuestas y Cuestionarios , Dimensión del Dolor , Dolor de Espalda/epidemiología
5.
AMA J Ethics ; 26(7): E546-550, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38958423

RESUMEN

Between 1999 and 2020, more than 564 000 people in the United States died from opioid overdose. Domestically, the opioid epidemic tends to be approached not as a public health problem but as a law enforcement or judicial problem. Some US localities, however, are trying interventions modeled after international approaches that decriminalize opioid dependence. This article describes Portuguese approaches to persons with opioid use disorder.


Asunto(s)
Epidemia de Opioides , Trastornos Relacionados con Opioides , Humanos , Portugal , Trastornos Relacionados con Opioides/epidemiología , Estados Unidos , New York , Sobredosis de Opiáceos , Analgésicos Opioides/efectos adversos , Aplicación de la Ley , Sobredosis de Droga/mortalidad
6.
J Assoc Nurses AIDS Care ; 35(3): 189-200, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38949901

RESUMEN

ABSTRACT: The purpose of this phenomenological study is to explore the acceptance of HIV diagnosis of women in stable relationships. Based on eight semistructured interviews with cisgender Portuguese women, thematic analysis identified four interrelated themes that illustrated the emotional and psychosocial dynamics involved in this journey. Following an HIV diagnosis, participants grappled with complex emotions, societal perceptions, and the internalization of stigma. Marital relationships underwent profound changes, with trust breakdown and emotional distancing. Coping mechanisms ranged from seeking support to living in secrecy, which impacted psychological well-being. Acceptance of HIV diagnosis is influenced by self-stigmatization, societal perceptions of HIV, and gender dynamics. The findings contribute to the development of tailored interventions, emphasizing the interconnected nature of physical and psychological well-being in the diagnosis acceptance process.


Asunto(s)
Adaptación Psicológica , Infecciones por VIH , Entrevistas como Asunto , Investigación Cualitativa , Estigma Social , Humanos , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/diagnóstico , Portugal , Adulto , Persona de Mediana Edad , Apoyo Social , Matrimonio/psicología , Emociones , Relaciones Interpersonales
7.
Acta Med Port ; 37(7-8): 526-534, 2024 Jul 01.
Artículo en Portugués | MEDLINE | ID: mdl-38950615

RESUMEN

INTRODUCTION: The quality and promptness of prehospital care for major trauma patients are vital in order to lower their high mortality rate. However, the effectiveness of this response in Portugal is unknown. The objective of this study was to analyze response times and interventions for major trauma patients in the central region of Portugal. METHODS: This was a retrospective, descriptive study, using the 2022 clinical records of the National Institute of Medical Emergency's differentiated resources. Cases of death prior to arrival at the hospital and other non-transport situations were excluded. Five-time intervals were determined, among which are the response time (T1, between activation and arrival at the scene), on-scene time (T2), and transportation time (T5; between the decision to transport and arrival at the emergency service). For each ambulance type, averages and dispersion times were calculated, as well as the proportion of cases in which the nationally and internationally recommended times were met. The frequency of recording six key interventions was also assessed. RESULTS: Of the 3366 records, 602 were eliminated (384 due to death), resulting in 2764 cases: nurse-technician ambulance (SIV) = 36.0%, physician- nurse ambulance (VMER) = 62.2% and physician-nurse helicopter = 1.8%. In a very large number of records, it was not possible to determine prehospital care times: for example, transport time (T5) could be determined in only 29%, 13% and 8% of cases, respectively for SIV, VMER and helicopter. The recommended time for stabilization (T2 ≤ 20 min) was met in 19.8% (SIV), 36.5% (VMER) and 18.2% (helicopter). Time to hospital (T5 ≤ 45 min) was achieved in 80.0% (SIV), 93.1% (VMER) and 75.0% (helicopter) of the records. The administration of analgesia (42% in SIV) and measures to prevent hypothermia (23.5% in SIV) were the most recorded interventions. CONCLUSION: There was substantial missing data on statuses and a lack of information in the records, especially in the VMER and helicopter. According to the records, the time taken to stabilize the victim on-scene often exceeded the recommendations, while the time taken to transport them to the hospital tended to be within the recommendations.


Introdução: A qualidade e rapidez do socorro pré-hospitalar à pessoa vítima de trauma major é vital para diminuir a sua elevada mortalidade. Contudo, desconhece-se a efetividade desta resposta em Portugal. O objetivo deste estudo foi analisar os tempos de resposta e as intervenções realizadas às vítimas de trauma major na região centro de Portugal. Métodos: Estudo retrospetivo, descritivo, utilizando os registos clínicos de 2022 dos meios diferenciados do Instituto Nacional de Emergência Médica. Casos de óbito pré-chegada ao hospital e outras situações de não transporte foram excluídos. Determinaram-se cinco tempos, entre os quais o tempo de resposta (T1, decorrente entre acionamento e chegada ao local), o tempo no local (T2) e o tempo de transporte (T5, intervalo entre a decisão de transporte e a chegada ao serviço de urgência). Foram calculadas médias e medidas de dispersão para cada meio, bem como a proporção de casos em que foram cumpridos os tempos recomendados nacional e internacionalmente. Avaliou-se também a frequência de registo de seis intervenções chave. Resultados: Dos 3366 registos, eliminaram-se 602 (384 por óbito), resultando em 2764 casos [suporte imediato de vida (SIV) = 36,0%, viaturas médicas de emergência e reanimação (VMER) = 62,2%, helicóptero de emergência médica (HEM) = 1,8%]. Num elevado número de registos não foi possível determinar tempos de socorro: por exemplo, o tempo de transporte (T5) foi determinável em apenas 29%, 13%, e 8% dos casos, respetivamente para SIV, VMER e HEM. O tempo recomendado para a estabilização (T2 ≤ 20 min), foi cumprido em 19,8% (SIV), 36,5% (VMER), e 18,2% (HEM) dos regis- tos. Já o tempo de transporte (T5 ≤ 45 min) foi cumprido em 80,0% (SIV), 93,1% (VMER) e 75,0% (HEM) dos registos (avaliáveis). A administração de analgesia (42% na SIV) e as medidas de prevenção de hipotermia (23,5% na SIV) foram as intervenções mais registadas. Conclusão: Observaram-se muitos status omissos e falta de informação nos registos, sobretudo na VMER e HEM. De acordo com os registos, o tempo no local superou frequentemente as recomendações, enquanto o tempo de transporte tende a estar dentro das normas.


Asunto(s)
Servicios Médicos de Urgencia , Estudios Retrospectivos , Humanos , Portugal , Servicios Médicos de Urgencia/organización & administración , Factores de Tiempo , Masculino , Femenino , Heridas y Lesiones/terapia , Adulto , Ambulancias/estadística & datos numéricos , Persona de Mediana Edad , Tiempo de Tratamiento/estadística & datos numéricos
8.
Acta Med Port ; 37(7-8): 507-517, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38950617

RESUMEN

INTRODUCTION: Evidence about the advantage of Lichtenstein's repair, the guidelines' recommended technique, is scarce regarding postoperative chronic inguinal pain (CPIP). The primary aim of this study was to compare CPIP in patients undergoing Lichtenstein versus other techniques. METHODS: Prospective multicentric cohort study including consecutive adults undergoing elective inguinal hernia repair in Portuguese hospitals (October - December 2019). Laparoscopic and mesh-free hernia repairs were excluded. The primary outcome was postoperative pain at three months, defined as a score of ≥ 3/10 in the European Hernia Society Quality of Life score pain domain. The secondary outcome was 30-day postoperative complications. RESULTS: Eight hundred and sixty-nine patients from 33 hospitals were included. Most were men (90.4%) and had unilateral hernias (88.6%). Overall, 53.6% (466/869) underwent Lichtenstein's repair, and 46.4% (403/869) were treated with other techniques, of which 83.9% (338/403) were plug and patch. The overall rate of CPIP was 16.6% and 12.2% of patients had surgical complications. The unadjusted risk was similar for CPIP (OR 0.76, p = 0.166, CI 0.51 - 1.12) and postoperative complications (OR 1.06, p = 0.801, CI 0.69 - 1.60) between Lichtenstein and other techniques. After adjustment, the risk was also similar for CPIP (OR 0.83, p = 0.455, CI 0.51 - 1.34) and postoperative complications (OR 1.14, p = 0.584, CI 0.71 - 1.84). CONCLUSION: The Lichtenstein technique was not associated with lower CPIP and showed comparable surgical complications. Further investigation as- sessing long term outcomes is necessary to fully assess the benefits of the Lichtenstein technique regarding CPIP.


Asunto(s)
Dolor Crónico , Hernia Inguinal , Herniorrafia , Dolor Postoperatorio , Humanos , Masculino , Hernia Inguinal/cirugía , Dolor Postoperatorio/etiología , Herniorrafia/efectos adversos , Herniorrafia/métodos , Estudios Prospectivos , Portugal , Femenino , Persona de Mediana Edad , Dolor Crónico/etiología , Dolor Crónico/epidemiología , Anciano , Adulto , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología
9.
Acta Med Port ; 37(7-8): 564, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38950620
10.
Acta Med Port ; 37(7-8): 535-540, 2024 Jul 01.
Artículo en Portugués | MEDLINE | ID: mdl-38950618

RESUMEN

INTRODUCTION: Minimally invasive surgery has been increasingly accepted and used in colorectal surgery. Several studies report that robotic surgery may provide advantages over 'conventional' laparoscopy, namely in rectal surgery. This paper provides an account of the first three years of experience with robotic surgery in the Unidade de Patologia Colorretal of the Unidade Local de Saúde S. José. METHODS: Variables were defined to develop a prospective database containing the data of consecutive patients operated by three internationally certified colorectal surgeons using the Da Vinci Xi® system between November 2019 and October 2022. The database was converted into an anonymized version that was used for this study. The analysis was performed on the data of all the patients operated during this period. RESULTS: Eighty patients were included, 47 male, median age 70 years, and median BMI 26 kg/m2 . ASA score was II in 53.7% and III in 41.3% of pa- tients. Of the total, 97.6% had malignant or potentially malignant disease. Operative procedures consisted of 34 colectomies proximal to the splenic flexure, 20 distal colectomies and 26 anterior resections. There were two synchronous resections of liver metastases. Early perioperative outcomes and histopathological results were analyzed: median operative time: 300 minutes; median estimated blood loss: 50 mL; conversion rate: 2.5%; median days until first bowel movement: three days; median length of hospital stay: six days; complication rate: 20%, of which 5% were Clavien III and 0% Clavien IV/V; anastomotic leak rate: 2.5%; 30-day readmission rate: 1.3%; median lymph nodes resected: 20; R0 resection rate: 100%; mesorectal integrity rate: 95,8% complete/near complete. CONCLUSION: Our results show that the adoption of robotic colorectal surgery in our center was safe and resulted in similar or improved short-term clinical outcomes and histopathological results when compared to those described in the literature.


Introdução: A utilização da cirurgia minimamente invasiva no tratamento da patologia colorretal é hoje cientificamente aceite e o seu uso na prática clí- nica diária tem vindo a aumentar de forma sustentada. Diversos estudos indicam que a abordagem robótica pode trazer vantagens sobre a laparoscopia 'convencional', especialmente na cirurgia do reto. Este trabalho descreve e analisa os resultados dos primeiros três anos de cirurgia robótica na Unidade de Patologia Colorretal da Unidade Local de Saúde S. José. Métodos: Foram definidas as variáveis a analisar e construída uma base de dados prospetiva com os dados referentes aos doentes operados conse- cutivamente por três cirurgiões colorretais, acreditados internacionalmente na utilização do sistema Da Vinci Xi®, entre novembro de 2019 e outubro de 2022. A base de dados foi convertida numa versão anonimizada e foi sobre essa mesma que se procedeu à análise de dados. Foram analisados os dados de todos doentes operados nesse período. Resultados: Foram incluídos 80 doentes, 47 homens, mediana de idade de 70 anos e de IMC de 26 kg/m2 . O score ASA era II em 53,7% e III em 41,3% dos doentes. Do total, 97,6% apresentavam doença maligna ou potencialmente maligna. Realizaram-se 34 colectomias proximais ao ângulo esplénico, 20 distais e 26 ressecções anteriores do reto. Houve ressecção síncrona de metástases hepáticas em dois casos. Foram analisados os resultados peri-operatórios a curto prazo e histopatológicos: duração (mediana): 300 minutos; perda hemática estimada (mediana): 50 mL; taxa de conversão: 2,5%; dias até retomar trânsito intestinal (mediana): três dias; dias de internamento (mediana): seis dias; taxa de complicações pós-operatórias: 20%, das quais 5% Clavien III e 0% Clavien IV/V; taxa de deiscência anastomótica: 2,5%; taxa de reintervenção: 2,5%; taxa de readmissão pós-alta: 1,3%; gânglios linfáticos ressecados (mediana): 20; taxa de ressecção R0: 100%; taxa de integridade mesorretal: 95,8% completo/quase completo. Conclusão: Os nossos resultados mostram que a introdução da cirurgia colorretal robótica no nosso centro foi segura e garantiu resultados clínicos a curto prazo e histopatológicos semelhantes ou favoráveis face aos descritos na literatura.


Asunto(s)
Procedimientos Quirúrgicos Robotizados , Humanos , Masculino , Anciano , Femenino , Portugal , Persona de Mediana Edad , Anciano de 80 o más Años , Colectomía/métodos , Factores de Tiempo , Tempo Operativo , Estudios Prospectivos , Adulto , Tiempo de Internación/estadística & datos numéricos , Laparoscopía
14.
BMC Public Health ; 24(1): 1737, 2024 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-38951815

RESUMEN

BACKGROUND: Health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others, whether at home, at the workplace, in the community, marketplace, healthcare sector, or the political arena. The main aim of this project is to measure health literacy in the adult population living in the municipality of Leiria over the next 10 years. As secondary objectives it is intended to characterize anxiety and depression, metabolic risk and health behaviors in the same population and over the same period. METHODS: This is a prospective cohort study that collects data on HL, anxiety and depression, health characteristics, health behavior and sociodemographic data. The study population will be composed by adults (≥ 18 years old) who are non-institutionalized and living in private households in Leiria. The random sample is stratified by gender and age groups. A face-to-face interview will be conducted with the Computer Assisted Personal Interview at baseline. Follow-up will be carried out every 2 years via telephone call. The association between independent variables and health literacy is examined by means of variance analysis with measurement repetition, and taking into consideration follow-up. DISCUSSION: The LiSa project is a population-based study, derived from a random sampling technique that will allow the analysis of health outcomes in a representative sample of the population of the municipality of Leiria. The LiSa study will be a valuable resource for epidemiological research, as it will provide fundamental information to improve public health policies regarding health literacy in Portugal. TRIAL REGISTRATION: Clinical trials: NCT05558631 (registered on 26/09/2022).


Asunto(s)
Alfabetización en Salud , Humanos , Alfabetización en Salud/estadística & datos numéricos , Adulto , Estudios Prospectivos , Masculino , Femenino , Persona de Mediana Edad , Portugal , Conductas Relacionadas con la Salud , Depresión/epidemiología , Anciano , Adulto Joven , Ansiedad/epidemiología , Estudios de Cohortes , Adolescente , Proyectos de Investigación
15.
ARP Rheumatol ; 3(2): 84-94, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38956991

RESUMEN

OBJECTIVE: To develop evidence-based recommendations for the non-pharmacological and pharmacological management of Raynaud's phenomenon (RP) and digital ulcers (DUs) in patients with systemic sclerosis and other immune-mediated connective tissue diseases (CTDs). METHODS: A task force comprising 21 rheumatologists, two surgeons (vascular and plastic), two nurses, and one patient representative was established. Following a systematic literature review performed to inform the recommendations, statements were formulated and discussed during two meetings (one online and one in-person). Levels of evidence, grades of recommendation (GoR), and level of agreement (LoA) were determined. RESULTS: Five overarching principles and 13 recommendations were developed. GoR ranged from A to D. The mean ± standard difference (SD) LoA with the overarching principles and recommendations ranged from 7.8±2.1 to 9.8±0.4. Briefly, the management of RP and DUs in patients with CTDs should be coordinated by a multidisciplinary team and based on shared decisions with patients. Nifedipine should be used as first-line therapy for RP and/or DUs. Sildenafil, tadalafil, and/or iloprost IV are second-line options for severe and/or refractory patients with RP and/or DUs. Sildenafil, tadalafil and/or Iloprost IV, should be prescribed for healing and prevention (also including bosentan) of DUs. In patients with RP and/or DUs, non-pharmacological interventions might be considered as add-ons, but there is limited quality and quantity of scientific evidence supporting their use. CONCLUSIONS: These recommendations will inform rheumatologists, specialist nurses, other healthcare professionals, and patients about a comprehensive and personalized management of RP and DUs. A research agenda was developed to address unmet needs, particularly for non-pharmacologic interventions.


Asunto(s)
Enfermedades del Tejido Conjuntivo , Dedos , Enfermedad de Raynaud , Esclerodermia Sistémica , Úlcera Cutánea , Humanos , Enfermedades del Tejido Conjuntivo/complicaciones , Enfermedades del Tejido Conjuntivo/terapia , Dedos/irrigación sanguínea , Dedos/patología , Portugal , Enfermedad de Raynaud/terapia , Enfermedad de Raynaud/etiología , Esclerodermia Sistémica/complicaciones , Esclerodermia Sistémica/terapia , Úlcera Cutánea/terapia , Úlcera Cutánea/etiología
16.
Sci Rep ; 14(1): 15631, 2024 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-38972872

RESUMEN

The use of lactose and cow milk protein (CMP) as potential allergens in pharmaceuticals and their ability to cause allergic reactions remains a significant concern in medicine. Lactose, a common pharmaceutical excipient due to its inert, inexpensive, and stable properties, is found in many prescription-only and over-the-counter medications. However, despite their widespread use, individuals with lactose intolerance (LI) or cow milk protein allergy (CMPA) may experience adverse reactions to these excipients. This study investigated the prevalence of lactose and other dairy-derived ingredients in pharmaceuticals marketed in Portugal. Using the Summary of Product Characteristics (SmPC) from the INFOMED database, various medications, including analgesics, antipyretics, non-steroidal anti-inflammatory drugs (NSAIDs), and antiasthmatics, were analyzed. Results showed a high prevalence of dairy-derived excipients, particularly in antiasthmatic drugs (62.6%) and NSAIDs (39%). Although CMP are not explicitly mentioned in SmPCs, the presence of lactose as an ingredient poses a risk of cross-contamination. The findings emphasize the need for healthcare professionals to be aware of potential allergens in medications and the importance of developing lactose-free alternatives to ensure the safety of patients with LI and CMPA. Further research is required to assess the safety and implications of lactose in medicines for these populations.


Asunto(s)
Excipientes , Intolerancia a la Lactosa , Lactosa , Hipersensibilidad a la Leche , Humanos , Excipientes/efectos adversos , Excipientes/química , Hipersensibilidad a la Leche/epidemiología , Animales , Lactosa/efectos adversos , Lactosa/análisis , Lactosa/química , Bovinos , Proteínas de la Leche/efectos adversos , Antiinflamatorios no Esteroideos/efectos adversos , Antiinflamatorios no Esteroideos/análisis , Alérgenos/análisis , Portugal , Productos Lácteos/análisis , Productos Lácteos/efectos adversos
17.
PLoS One ; 19(7): e0302563, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38985774

RESUMEN

Research on personal adornments depends on the reliable characterisation of materials to trace provenance and model complex social networks. However, many analytical techniques require the transfer of materials from the museum to the laboratory, involving high insurance costs and limiting the number of items that can be analysed, making the process of empirical data collection a complicated, expensive and time-consuming routine. In this study, we compiled the largest geochemical dataset of Iberian personal adornments (n = 1243 samples) by coupling X-ray fluorescence compositional data with their respective X-ray diffraction mineral labels. This allowed us to develop a machine learning-based framework for the prediction of bead-forming minerals by training and benchmarking 13 of the most widely used supervised algorithms. As a proof of concept, we developed a multiclass model and evaluated its performance on two assemblages from different Portuguese sites with current mineralogical characterisation: Cova das Lapas (n = 15 samples) and Gruta da Marmota (n = 10 samples). Our results showed that decisión-tres based classifiers outperformed other classification logics given the discriminative importance of some chemical elements in determining the mineral phase, which fits particularly well with the decision-making process of this type of model. The comparison of results between the different validation sets and the proof-of-concept has highlighted the risk of using synthetic data to handle imbalance and the main limitation of the framework: its restrictive class system. We conclude that the presented approach can successfully assist in the mineral classification workflow when specific analyses are not available, saving time and allowing a transparent and straightforward assessment of model predictions. Furthermore, we propose a workflow for the interpretation of predictions using the model outputs as compound responses enabling an uncertainty reduction approach currently used by our team. The Python-based framework is packaged in a public repository and includes all the necessary resources for its reusability without the need for any installation.


Asunto(s)
Minerales , Minerales/análisis , Minerales/química , Algoritmos , Portugal , Difracción de Rayos X , Espectrometría por Rayos X/métodos , Humanos , Aprendizaje Automático , Aprendizaje Automático Supervisado
18.
BMC Psychol ; 12(1): 405, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39044279

RESUMEN

BACKGROUND: Reflecting people with diabetes' self-management activities is often required in both research and clinical practice. This study evaluated the measurement properties of the Portuguese version of the Diabetes Self-Management Questionnaire-Revised (DSMQ-R) on a sample of people with type 2 diabetes mellitus (T2DM). METHODS: Translation and cultural adaptation were conducted according to guidelines for cross-cultural adaptation and validation of healthcare measurement instruments. A cross-sectional study was performed including 365 people with T2DM in primary care. Reliability, construct validity, and criterion validity were analyzed. RESULTS: The total scale of the translated DSMQ-R revealed sufficient internal consistency (alpha = 0.82), and most of the subscales performed adequately. The exploratory factor structure was robust, and confirmatory analysis showed a good model fit with the scale structure of the original scale. The scale scores correlated with the participants' last HbA1c estimates, supporting convergent validity, and convergence was confirmed by the adequate average variance extracted. CONCLUSIONS: The Portuguese version of the DSMQ-R is a reliable and valid tool for gauging self-management behaviors in people with T2DM and their relationship with glycemic values.


Asunto(s)
Diabetes Mellitus Tipo 2 , Psicometría , Automanejo , Humanos , Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/terapia , Masculino , Femenino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Encuestas y Cuestionarios/normas , Estudios Transversales , Anciano , Psicometría/instrumentación , Adulto , Portugal
19.
BMC Public Health ; 24(1): 1946, 2024 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-39033126

RESUMEN

BACKGROUND: Teleworking (TW) has recently shifted from a marginal into a common practice. Yet, concerns have been raised regarding potential work-health negative effects, related to the reduced socialization, and extended working hours with computers at home, possibly offset by reduced commuting time or better individual work-life balance. This paper aims at describing the influence of TW on health, well-being, and productivity perceptions, and how this is shaped by TW conditions. METHODS: We collected data from workers of 25 companies that exert their activity in Portugal. Data were completed with a representative sample of workers who regularly participate in surveys (total N = 1,069). We applied an on-line questionnaire from September the 1st 2022 to December the 1st 2022. We performed a simple descriptive analysis of each variable. Then, we analyzed the relationship between TW conditions and self-reported health, and between TW conditions at home and productivity, using logistic regression models. RESULTS: We observed a high prevalence of self-perceived health worsening (15.9%), mostly among those with poor TW conditions. Most teleworkers enjoyed favorable TW conditions, despite limited company support. Relevant changes were observed in lifestyle factors, towards more smoking (5.5%), alcohol drinking (4.5%), and worse diet (10.1%). Two thirds reported enhanced productivity. A statistically significant relationship was observed between inadequate TW conditions, health deterioration, and lower productivity. A 6.0% point (pp) increased risk of productivity worsening was observed when employees faced at least one inadequate condition at home (no private working place at home, inadequate heating, artificial light, or absence of well-being at home). The risk of health deterioration increased by 12.9 pp when facing at least one of these inadequate conditions, and by 6.3 under hybrid TW, compared to one or two days of TW. CONCLUSIONS: Most teleworkers highlighted a positive perspective about teleworking. Yet, TW conditions are not favorable for all workers, with consequences on health, well-being, and productivity, suggesting that further support is needed for teleworkers to protect their health at home, and reach its maximum benefit.


Asunto(s)
Teletrabajo , Humanos , Masculino , Femenino , Estudios Transversales , Adulto , Persona de Mediana Edad , Portugal , Eficiencia , Encuestas y Cuestionarios , Estado de Salud , Salud Laboral , Adulto Joven
20.
Sci Rep ; 14(1): 15977, 2024 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-38987631

RESUMEN

Consumers' mental pictures of wine are multifaceted and are shaped by their sensory (taste, smell, visual, sensation) perceptions, in addition to emotional, cultural and extrinsic (brand, price, and awards) influences. This study explores whether consumers from three different wine cultures share mental representations of three wine concepts. Through an online survey, French, Portuguese, and South African wine consumers described their conceptualizations of Wine, Red wine and White wine aroma. Given these nations' rich winemaking traditions and diverse wine styles, differences in consumer perspectives were likely to emerge. The findings demonstrate that, regardless of cultural background, the broad concept of Wine aligns with the more specific Red and White wine conceptualizations, although the latter concepts diverge from each other. Notably, cultural contexts significantly influence participants' representations of Red Wine, with particularly marked contrasts between the South African and French respondents. This suggests that like experts, wine consumers have also built representations of wine through semantic memory. This cross-cultural analysis of consumer interpretations of wine concepts holds the potential for refining marketing strategies to overcome cultural barriers in wine purchasing behaviour.


Asunto(s)
Comportamiento del Consumidor , Comparación Transcultural , Vino , Humanos , Femenino , Masculino , Sudáfrica , Adulto , Francia , Portugal , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven , Gusto
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