Browsing by Author "Passadouro, Rui"
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- Awareness and Attitudes towards Advance Care Directives (ACDs): An Online Survey of Portuguese AdultsPublication . Laranjeira, Carlos; Dixe, Maria dos Anjos; Gueifão, Luís; Caetano, Lina; Passadouro, Rui; Querido, AnaEvidence shows that facilitated advance decisions can increase the number of meaningful and valid Advance Care Directives (ACDs) and improve the quality of care when EndOf-Life (EOL) is near. Little is known about the awareness and attitudes of Portuguese adults towards ACDs. The present study aims to assess the knowledge, attitudes, and preferences of a sample of Portuguese adults regarding EOL care decisions and ACDs. (2) Methods: A total of 1024 adults were assessed with an online cross-sectional survey collecting information on sociodemographic factors, knowledge, attitudes and preferences regarding advance decisions and EOL care. (3) Results: Participants had a mean age of 40.28 ± 11.41 years. Most were female and had a professional background related to healthcare. While 76.37% of participants had heard of ACDs, only a small percentage (2.34%) had actually ever made an ACD. Knowledge levels were weakly correlated with attitudes regarding ACDs (r = −0.344; p < 0.01). (4) Conclusions: Participants lacked a comprehensive understanding about ACDs, but revealed positive attitudes towards their use and usefulness. Further research can inform efforts to improve ACD engagement in this population. The discussion about ACDs should be part of health promotion education with a focus on planning for a comfortable and peaceful death
- Complex network model for COVID-19: human behavior, pseudo-periodic solutions and multiple epidemic wavesPublication . Silva, Cristiana J.; Cantin, Guillaume; Cruz, Carla; Pinto, Rui Fonseca; Passadouro, Rui; Santos, Estevão Soares dos; Torres, DelfimWe propose a mathematical model for the transmission dynamics of SARS-CoV-2 in a homogeneously mixing non constant population, and generalize it to a model where the parameters are given by piecewise constant functions. This allows us to model the human behavior and the impact of public health policies on the dynamics of the curve of active infected individuals during a COVID-19 epidemic outbreak. After proving the existence and global asymptotic stability of the disease-free and endemic equilibrium points of the model with constant parameters, we consider a family of Cauchy problems, with piecewise constant parameters, and prove the existence of pseudo-oscillations between a neighborhood of the disease-free equilibrium and a neighborhood of the endemic equilibrium, in a biologically feasible region. In the context of the COVID-19 pandemic, this pseudo-periodic solutions are related to the emergence of epidemic waves. Then, to capture the impact of mobility in the dynamics of COVID-19 epidemics, we propose a complex network with six distinct regions based on COVID-19 real data from Portugal. We perform numerical simulations for the complex network model, where the objective is to determine a topology that minimizes the level of active infected individuals and the existence of topologies that are likely to worsen the level of infection. We claim that this methodology is a tool with enormous potential in the current pandemic context, and can be applied in the management of outbreaks (in regional terms) but also to manage the opening/closing of borders.
- Determinantes do acesso ao serviço de urgência por utentes não urgentesPublication . Dixe, Maria dos Anjos; Passadouro, Rui; Peralta, Teresa; Ferreira, Carlos; Lourenço, Georgina; Sousa, PedroEnquadramento: A utilização dos serviços de urgência (SU) por situações não urgentes constitui uma preocupação a nível nacional e mundial. Objetivos: Avaliar as características sociodemográficas e o acesso ao SU por utentes não urgentes e identificar os fatores que motivam a sua procura. Metodologia: Neste estudo transversal recorreu-se a uma entrevista e à consulta dos processos clínicos eletrónicos de 357 doentes triados como não urgentes num SU de um hospital português seguindo-se uma amostragem acidental. Resultados: Os utentes da amostra são maioritariamente do sexo feminino, de meia-idade, com reduzidas habilitações literárias, que recorrem ao SU, sobretudo no período diurno e por iniciativa própria. Os motivos mais referenciados foram: A minha doença justifica a ida à urgência (91,7%) e Posso realizar os exames todos no mesmo dia (65,6%). A maioria dos utentes (87,9%) teve alta clínica, sendo que 84,9% dos utentes tem acesso ao médico de família. Conclusão: Foram identificados múltiplos determinantes do acesso ao SU, permitindo apontar sugestões que visam uma utilização racional dos cuidados de saúde.
- Determinants of non-urgent emergency department usePublication . Dixe, Maria dos Anjos; Passadouro, Rui; Peralta, Teresa; Ferreira, Carlos; Lourenço, Georgina; Sousa, Pedro Miguel LopesBackground: The use of the emergency department (ED) for non-urgent situations is a source of concern, both at the national and international levels. Objectives: To assess the sociodemographic characteristics and ED use of non-urgent patients and to identify the reasons for non-urgent ED use. Methodology: This cross-sectional study used patient interviews and the electronic medical records of 357 patients triaged as non-urgent at a Portuguese hospital ED, using an accidental sampling technique. Results: The majority of patients were women, middle-aged, and had a low education level; most of them used the ED during the day and on their own initiative. The most common reasons were: My disease justifies ED use (91.7%) and I can undergo all medical examinations on the same day (65.6%). The majority of patients (87.9%) were discharged, and 84.9% had access to a family doctor. Conclusion: Multiple determinants of non-urgent ED use were identified. Some recommendations were put forward to improve the rational use of healthcare services.
- Development and psychometric properties of the general public's attitudes toward advance care directives scale in PortugalPublication . Laranjeira, Carlos; Dixe, Maria dos Anjos; Gueifão, Luís Miguel Aleixo Oliveira; Caetano, Lina; Passadouro, Rui; Gabriel, Tiago; Querido, AnaBackground: To date, no instrument in Portugal has evaluated the attitudes of the population about advance care directives. This paper describes the development and testing of the General Public's Attitudes Toward Advance Care Directives (GPATACD) Scale. Design and Methods: Methodological study. The development of the instrument was based on a literature review, updated in 2018. Face and content validity were verified by an expert panel and piloted among six participants. Data were collected in an online survey of 1024 Portuguese adults. The obtained data were analyzed using Varimax rotation, while the reliability was evaluated by calculating Cronbach’s alpha. Results: The scale achieves good Item-Content Validity Index (I-CVI) values, between 0.89 and 1.00, and scale-CVI values of 0.91. A principal component analysis generated four dimensions with 26 items as a final scale, with overall Cronbach’s alpha of 0.848. Conclusions: The findings demonstrate that the scale is valid and reliable as a vehicle for assessment of the general public's attitudes toward advance care directives.
- Health literacy – study protocol for LiSa cohort studyPublication . Batalha, Maria João; Gabriel, Tiago; Valentim, Ana; Soledade, Ana; Gomes, Cátia; Alves, Bartolomeu; Santos, Estêvão Soares dos; Passadouro, Rui; Dias, Sara SimõesBackground: 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).
- Imunidade para o vírus da hepatite A: vigilância de onze anos (2002-2012) numa consulta de medicina das viagens da região centro de PortugalPublication . Passadouro, Rui; Silva, Ana; Rodrigues, Ruben; Pascoal, Dina; Soares, FátimaEm diversos países é crescente a proporção de indivíduos suscetíveis à infeção pelo vírus da hepatite A. O conhecimento da seroprevalência VHA numa população é muito importante para a definição de estratégias de controlo da infeção.
- Optimal control of the COVID-19 pandemic: controlled sanitary deconfinement in PortugalPublication . Silva, Cristiana J.; Cruz, Carla; Torres, Delfim F. M.; Muñuzuri, Alberto P.; Carballosa, Alejandro; Area, Iván; Nieto, Juan J.; Fonseca-Pinto, Rui; Passadouro, Rui; Santos, Estevão Soares dos; Abreu, Wilson; Mira, JorgeThe 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 mode 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.
- Prevention of sexual abuse in preschoolers – Teachers’ Knowledge and AttitudesPublication . Cascais, Mafalda; Passadouro, Rui; Mendes, Odete; Zarcos, MariaChild sexual abuse (CSA) is a global public health problem across different culture and socioeconomic strata. Teachers have a privileged role in prevention programs and the approach is feasible and effective in preschoolers. The aim of this study was to characterize preschool teachers’ knowledge, attitudes, and training about CSA prevention
- Public health: The voice of professionalsPublication . Passadouro, Rui; Ferreira, Pedro LTo monitor, for the first time in Portugal, job satisfaction on public health units (PHUs).