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1.
J Adolesc Health ; 68(5): 922-929, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33067152

RESUMO

PURPOSE: To analyze the potential association between social support, experiences of violence, and sociodemographic characteristics of adolescents and the likelihood of acceptance of violence and machismo in different European countries. METHODS: Cross-sectional design. We recruited 1,555 participants ages 13-16 from secondary schools in Alicante (Spain), Rome (Italy), Iasi (Romania), Matosinhos (Portugal), Poznan (Poland), and Cardiff (UK). We used linear regression models to identify how social support from teachers and parents, experiences of violence-dating violence, bullying, cyberbullying, abuse in childhood-and sociodemographic characteristics were associated with violent thinking, specifically: machismo and acceptance of violence. The analysis was stratified by sex. RESULTS: Acceptance of violence was higher for those who had lower perceived social support from parents (ßgirls = -154, p < .001; ßboys = -.114, p = .019) for both sexes. Perpetration of bullying and/or cyberbullying was associated with higher scores for machismo and acceptance of violence for both sexes (ßgirls = .067, p = .035; ßboys = .225, p < .001; (ßgirls = .118, p < .001; ßboys = .210, p < .001). Being the victim of dating violence, having suffered physical and/or sexual abuse in childhood, and lower perceived social support from teachers were associated with higher scores for both machismo and acceptance of violence. These associations differed between girls and boys. CONCLUSIONS: Machismo and acceptance of violence are widely present amongst adolescents in different European countries. Our results suggest the importance of providing educational/psycho-educational interventions with boys and girls to prevent these attitudes and, in turn, prevent interpersonal violence, including bullying and dating violence.


Assuntos
Comportamento do Adolescente , Bullying , Vítimas de Crime , Violência por Parceiro Íntimo , Adolescente , Criança , Estudos Transversais , Europa (Continente) , Feminino , Humanos , Itália , Masculino , Portugal , Apoio Social , Violência
2.
Artigo em Inglês | MEDLINE | ID: mdl-33271817

RESUMO

The aim of the article is to show the role of school social support and school social climate in dating violence victimization prevention among adolescents in Europe. Study participants were students from secondary schools (age 13-16) in Spain, Italy, Romania, Portugal, Poland and UK. The analysis in this text concern student with dating experience (n = 993) (57.2% of girls and 66.5% of boys). School social support was measured by School Social Climate, Factor 1 Scale (CECSCE) and by Student Social Support Scale (CASSS), subscales teachers and classmates. The association between school social support and different types of dating victimization (physical and/or sexual dating violence, control dating violence and fear) was measured by calculating the prevalence ratios and their 95% confidence intervals, estimated by Poisson regression models with robust variance. All the models were adjusted by country and by sociodemographic variables. The results show that the average values of all types of social support are significantly lower in young people who have suffered any type of dating violence or were scared of their partner. The likelihood of suffering physical and/or sexual dating violence decreased when school social support increased [PR (CI 95%): 0.96 (0.92; 0.99)]. In the same way, the likelihood of fear decreased when school social climate increased [PR (CI 95%): 0.98 (0.96; 0.99)].There is an association between school social support and school social climate and experiences of being victim of dating violence among adolescents in Europe. Our results suggest that in the prevention of dating violence building a supportive climate at schools and building/using the support of peers and teachers is important.


Assuntos
Comportamento do Adolescente , Vítimas de Crime , Violência por Parceiro Íntimo , Apoio Social , Adolescente , Europa (Continente) , Feminino , Humanos , Itália , Masculino , Polônia , Portugal , Romênia , Instituições Acadêmicas , Espanha
3.
Aging Clin Exp Res ; 32(10): 2099-2110, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31782124

RESUMO

BACKGROUND: The Portuguese long-term care sector is classified into home and community-based services (HCBS) and three nursing home (NH) units: convalescence, medium term and rehabilitation, and long term and maintenance. AIMS: To identify the main factors of admission into each care setting and explore to what extent these populations are different. 14,140 patients from NH and 6844 from HCBS were included from all over the country. METHODS: A logistic regression was estimated to identify determinants of admission into NH care, using sociodemographic characteristics, medical conditions and dependence levels at admission as independent variables, and region of care, referral entity and placement process as control variables. Then, ordered logistic regression was used to identify the contribution of the above factors in each specific NH unit. RESULTS: Being female, not being married, not having family/neighbour support, being literate, having mental illness, being cognitively or physically impaired are the main predictors of being admitted into a NH. Within the NH units, placements of the large majority of patients were accurately predicted, based on the available variables. However, for around half of the patients referred to long-term care units, the model expected placements into medium-term units, while for those admitted into short-stay units, the model returned that 29% could have benefited from being admitted into a medium-term care unit. DISCUSSION AND CONCLUSIONS: Patients' accurate placement is a highly complex and challenging process, demanding more variables than the ones available for the model here presented. Our work confirms the need to collect other type of variables to improve the placement decision process.


Assuntos
Assistência de Longa Duração , Casas de Saúde , Feminino , Hospitalização , Humanos , Modelos Logísticos , Fatores de Risco
4.
J Health Serv Res Policy ; 23(2): 87-97, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29624086

RESUMO

Objectives To investigate a possible weekend effect in the in-hospital mortality rate for acute myocardial infarction in Portugal, and whether the delay in invasive intervention contributes to this effect. Methods Data from the National 2011-2015 Diagnostic-Related-Group databases were analysed. The focus was on adult patients admitted via the emergency department and with the primary diagnosis of acute myocardial infarction. Patients were grouped according to ST-elevation myocardial infarction and non-ST-elevation myocardial infarction episodes. We employed multivariable logistic regressions to determine the association between weekend admission and in-hospital mortality, controlling for episode complexity (through a severity index and acute comorbidities), demographic characteristics and hospital identifications. The association between the probability of a prompt surgery (within one day) and the day of admission was investigated to explore the possible delay of care delivery for patients admitted during weekends. Results Our results indicate that in-hospital mortality rates were not significantly higher for weekend admissions than for weekday admissions in both ST-elevation myocardial infarction (STEMI) and non-STEMI episodes. This result is robust to the inclusion of a number of potential confounding mechanisms. Patients admitted on weekends had lower probabilities of undergoing invasive cardiac surgery within the day after admission, but delay in care delivery during the weekend was not associated with worse outcomes in terms of in-hospital mortality. Conclusions There is no evidence for the existence of a weekend effect due to admission for acute myocardial infarction in Portugal, in both STEMI and non-STEMI episodes.


Assuntos
Mortalidade Hospitalar/tendências , Infarto do Miocárdio/mortalidade , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/cirurgia , Admissão do Paciente/estatística & dados numéricos , Portugal , Estudos Retrospectivos , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Índice de Gravidade de Doença , Fatores Socioeconômicos , Fatores de Tempo , Tempo para o Tratamento/estatística & dados numéricos
5.
Arch Gerontol Geriatr ; 76: 160-168, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29524916

RESUMO

OBJECTIVES: To identify the survival time, the mortality risk factors and the individuals' characteristics associated with cognitive and physical status at discharge, among the Portuguese long-term care (LTC) populations. SETTINGS: Home-and-Community-Based Services (HCBS) and three types of Nursing Homes (NH). PARTICIPANTS: 20,984 individuals admitted and discharged in 2015. MEASUREMENTS: The Kaplan-Meier survival analysis and the Cox Proportional Hazards Models were used to study the mortality risk; the Wilcoxon signed-rank test to identify the number of individuals with cognitive and physical changes between admission and discharge; two cumulative odds ordinal logistic regressions to predict the cognitive and physical dependence levels at discharge RESULTS: The mortality rate at HCBS was 30%, and 17% at the NH, with a median survival time of 173 and 200 days, respectively. The main factors associated with higher mortality were older age, male gender, family/neighbour support, neoplasms and cognitive/physical dependence at admission. In NH/HCBS, 26%/18% of individuals improve their cognitive status, while in physical status the proportion was 38%/27%, respectively. Finally, older age, being illiterate and being classified at the lowest cognitive and physical status at admission decrease the likelihood of achieving a higher level of cognitive and physical independence at discharge. CONCLUSIONS: The adoption of a robust and complete assessment tool, the definition of guidelines to enable a periodical assessment of individuals' autonomy and the adoption of benchmark metrics allowing the comparison of results between similar units are some of the main goals to be taken into account for future developments of this care in Portugal.


Assuntos
Assistência de Longa Duração , Mortalidade , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Logísticos , Masculino , Portugal
6.
Ultrasound Med Biol ; 42(9): 2043-9, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27181690

RESUMO

Boys usually have higher values of bone mineral density measured by dual-energy X-ray absorptiometry than girls, but contradictorily also have a greater incidence of fractures during growth. The purpose of this study was to investigate sex- and maturity-related differences in bone speed of sound (SoS) at the radius and tibia in a sample of 625 healthy children aged 10-14 y and to analyze the contributions of physical activity (PA) to possible dissimilarities. Radial and tibial SoS was evaluated by quantitative ultrasound, maturity was estimated as the years of distance from the peak height velocity age, and PA was assessed by accelerometry. Comparisons between sexes and maturity groups (low: below average [<-2.5 y], high: average or above [≥-2.5 y]) were made by two-sample t-tests with unequal variances. Girls in the high-maturity group had higher SoS at the radius and tibia compared with girls in the low-maturity group (p < 0.001). There were no SoS differences at the radius or tibia between the high- and low-maturity groups in boys. Within high-maturity children, girls had higher SoS than boys at the radius and tibia (p < 0.001). There were no differences at the radius and tibia between girls and boys with low maturity. The results were not modified after controlling for PA. Regardless of PA, the results provide insight into sex- and maturity-related differences in bone SoS at the distal radius and midshaft tibia from maturity less than 2.5 y from the peak height velocity age, with boys having lower SoS.


Assuntos
Osso Cortical/anatomia & histologia , Rádio (Anatomia)/anatomia & histologia , Tíbia/anatomia & histologia , Ultrassonografia/métodos , Adolescente , Fatores Etários , Criança , Feminino , Humanos , Masculino , Valores de Referência , Fatores Sexuais
7.
Expert Rev Pharmacoecon Outcomes Res ; 2(2): 179-87, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19807328

RESUMO

Project selection and portfolio management are particularly challenging in the pharmaceutical industry due to the high risk - high stake nature of the drug development process. In the recent years, scholars and industry experts have agreed that traditional Net-Present-Value evaluation of the projects fails to capture the value of managerial flexibility, and encouraged adopting a real options approach to recover the missed value. In this paper, we take a closer look at the drug development process and at the indices currently used to rank projects. We discuss the economic value of information and of real options arising in drug development and present decision analysis as an ideal framework for the implementation of real options valuation.

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