Unidade de Investigação - ciTechCare - Center for Innovative Care and Health Technology
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- 2ARTs: A Platform for Exercise Prescriptions in Cardiac Recovery PatientsPublication . Pereira, Andreia; Martinho, Ricardo; Pinto, Rui; Rijo, Rui; Grilo, CarlosDue to limited access, increasing costs and an ageing population, the global healthcare system faces significant coverage problems that call for innovative approaches. Health professionals are actively seeking alternative methods to provide care to an increasingly needy population, without increasing human effort and associated costs. eHealth platforms, which use technology to provide patient care, are emerging as transformative solutions for addressing these problems. This study is centered on the demand for a Decision Support System (DSS) in cardiology to enable doctors to prescribe individualized care inside Cardiac Rehabilitation Programmes (CRPs). The 2ARTs project’s main objective is to include a cardiac rehabilitation platform with a DSS within the hospital infrastructure. This DSS uses models to classify patients into different groups, delivering crucial information to assist with decisions regarding treatment. Regarding the DSS, Principal Component Analysis (PCA) emerged as a standout technique for dimensionality reduction, due to its interoperability with clustering algorithms and superior evaluation metrics. The most appropriate clustering technique was determined to be the K-means algorithm, which was supported by the experts analysis. In accordance with the goals of the 2ARTs project, this integration of PCA and K-means provides meaningful insights that improve reasoned decision-making.
- Abandono das Tecnologias de Apoio para a comunicação em meio familiar: capacitação de cuidadores — uma solução possívelPublication . Almeida, Ivone; Moreira, António; Ribeiro, Jaime; Décio Nascimento Guimarães; Douglas Christian Ferrari de Melo; Ribeiro, Jaime MoreiraIntrodução É indubitável que as Tecnologias de Apoio4 (TA) promovem a comunicação, a independência pessoal e social e a inclusão de crianças com limitações cognitivo-motoras. As TA para as crianças com diversidade funcional são uma ferramenta de ação fundamental, permitindo-lhes participar numa base de equidade nos ambientes em que se inserem. Podem contribuir para aumentar a motivação, o sentido de pertença ao grupo e aumentar a produtividade na sala de aula e em casa.
- Ação antimicrobiana e antioxidante da epicatequina em óleos de pinhãoPublication . Marques-da-Silva, Dorinda; Ribeiro, Vânia; Lagoa, Ricardo
- Aceitação de um programa mHealth para prevenção da obesidade em adolescentes: estudo misto sequencialPublication . Sousa, Pedro Miguel Lopes; Ferreira, Inês; Filipe, Maria; Guerra, Patrick; Ferreira, Raquel; Lages, Marlene; Dixe, Maria dos AnjosA área da saúde tem-se adaptado ao uso de tecnologia, recorrendo a esta como um aliado relevante em programas de monitorização e prevenção da obesidade e problemas associados. Objetivo: Avaliar a aceitação do programa e-terapêutico TeenPower em adolescentes
- Acesso a cuidados de saúde sexual e planeamento familiar em adolescentesPublication . Teixeira, Catarina Sofia Serrasqueiro; Pedrosa, Inês Veríssimo; Frade, João Manuel Graça; Ramalho, Sónia; Dixe, Maria dos Anjos Coelho Rodrigues; Barros, Teresa Madalena Kraus Brincheiro Hüttel; Moleiro, PascoalIntrodução: Os adolescentes valorizam o aconselhamento os profissionais de saúde sobre métodos contracetivos e sexualidade como fonte de informação. Objetivos: Caracterizar o conhecimento dos adolescentes sobre sexualidade e a adesão às consultas de medicina do adolescente/planeamento familiar; avaliar diferenças no conhecimento sobre métodos contracetivos e comportamentos sexuais de risco no grupo que frequenta as consultas; analisar limitações na comunicação sobre sexualidade com profissionais de saúde. Material e métodos: Estudo transversal e observacional, com amostra não probabilística e intencional, constituída por adolescentes de duas escolas do centro do país, dividida em dois grupos etários: G1 (13-15A); G2 (16-19A). Após consentimento informado dos pais e participantes aplicou-se um instrumento de colheita de dados, assumindo-se nível de significância estatística quando p<0,05. Resultados: Incluídos 394 adolescentes, 276 (70%) do G1, 53% do sexo feminino avaliam os serviços de saúde como fonte de informação fidedigna. Frequentavam as consultas de medicina do adolescente/planeamento familiar 119 (30,8%), destes 61,3% do G1 (p=0,02) e 66,3% do sexo feminino (p=0,01). Consideram-se esclarecidos sobre métodos contracetivos 64,2%, sendo o grau de esclarecimento semelhante em G1 e G2, mas superior nas raparigas frequentadoras das consultas (p=0,03). Iniciaram relações sexuais 21,1%, com mediana da idade de início de 15A, superior à dos adolescentes do G1 não frequentadores das consultas de medicina do adolescente/planeamento familiar (p=0,007). Em 32,8% dos adolescentes sexualmente ativos existiram relações sexuais desprotegidas, sobretudo no G2, e 8 não usavam habitualmente métodos contracetivos, sem diferença quanto à frequência das consultas. “A falta de abertura por parte dos profissionais, medo de serem mal interpretados e medo de que o profissional de saúde quebre a confidencialidade” foram os fatores mais frequentemente apontados como limitantes na comunicação com os profissionais de saúde. Discussão/Conclusão: Frequentavam as consultas de medicina do adolescente/planeamento familiar 30,8%, com predomínio do G1 e sexo feminino, com idade mais tardia da primeira relação sexual e a registar melhor esclarecimento sobre métodos contracetivos, respetivamente. Os fatores apontados como limitantes da comunicação com profissionais de saúde salientam a necessidade destes, a par dos cuidados de saúde preventivos, rastreio de comportamentos de risco e aconselhamento sobre saúde sexual, adotarem estratégias eficazes de comunicação com os adolescentes.
- Acute, periprocedural and longterm antithrombotic therapy in older adultsPublication . Andreotti, Felicita; Geisler, Tobias; Collet, Jean-Philippe; Gigante, Bruna; Gorog, Diana A; Halvorsen, Sigrun; Lip, Gregory Y H; Morais, João; Navarese, Eliano Pio; Patrono, Carlo; Rocca, Bianca; Rubboli, Andrea; Sibbing, Dirk; Storey, Robert F; Verheugt, Freek W A; Vilahur, GemmaThe first international guidance on antithrombotic therapy in the elderly came from the European Society of Cardiology Working Group on Thrombosis in 2015. This same group has updated its previous report on antiplatelet and anticoagulant drugs for older patients with acute or chronic coronary syndromes, atrial fibrillation, or undergoing surgery or procedures typical of the elderly (transcatheter aortic valve implantation and left atrial appendage closure). The aim is to provide a succinct but comprehensive tool for readers to understand the bases of antithrombotic therapy in older patients, despite the complexities of comorbidities, comedications and uncertain ischaemic- vs. bleeding-risk balance. Fourteen updated consensus statements integrate recent trial data and other evidence, with a focus on high bleeding risk. Guideline recommendations, when present, are highlighted, as well as gaps in evidence. Key consensus points include efforts to improve medical adherence through deprescribing and polypill use; adoption of universal risk definitions for bleeding, myocardial infarction, stroke and cause-specific death; multiple bleeding-avoidance strategies, ranging from gastroprotection with aspirin use to selection of antithrombotic-drug composition, dosing and duration tailored to multiple variables (setting, history, overall risk, age, weight, renal function, comedications, procedures) that need special consideration when managing older adults. © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved.
- Addressing spiritual needs, facilities and barriers in portuguese palliative care: a cross-sectional surveyPublication . Laranjeira, Carlos A.; Querido, Ana IsabelBackground: Spiritual care is an essential component of Palliative Care (PC) and a dimension of holistic care that preserves dignity and helps sick people to find meaning in suffering and in life. The knowledge about its implementation is still scarce in the Portuguese context. This study aimed to evaluate the facilities, barriers and needs for spiritual care in PC. Method: We conducted a descriptive cross-sectional survey of 180 health professionals in the period November 2018 to September 2019 at PC units. The data were collected through an online questionnaire published on social networks, after approval by an Ethics Committee. Sociodemographic and professional data, spiritual beliefs and knowledge about the objectives and purposes of PCs were collected. These were evaluated using an instrument consisting of 26 statements of dichotomous response (true/false). Results: The average age of participants was 42.42 years (SD=11.35), most are female (82.2%), nurses (43.9%), and 70% work in the health field. The total sample has worked on average for 15.67 ± 10.28 years and more than half (58.9%) perform functions in palliative care. Most identify with a religious belief (87.8%), attaching great importance to spiritual/religious conviction (45% of participants). The results suggest that empathy and the therapeutic use of silence (82.2%) are facilitators of spiritual care. The key barriers refer to the lack of expert professionals and the organization of care (36.1%). The results also highlight the need for specific training in the area of spirituality, hope and intervention strategies (53.9%). Conclusion: This study has provided insight into spiritual care in PC in Portugal. Future studies are necessary to investigate the effects of spiritual care more fully, and to develop outcome measurements that appropriately capture the effects of the variety of spiritual care practices.
- Adolescent gender identity and sexual orientation: a school-based correlational studyPublication . Cordeiro, Ana Catarina Lobo Maurício; Da Mota, Ana João Dinis; Barros, Teresa Madalena Kraus Brincheiro Hüttel; Ramalho, Sónia; Gordo, Clementina Maria Gomes de Oliveira; Dixe, Maria dos Anjos Coelho Rodrigues; Moleiro, PascoalAdolescents are increasingly encouraged to freely express their sexuality. The purpose of this study was to compare non-cisgender adolescents with cisgender/heterosexual adolescents and those who have an undefined gender identity and/or sexual orientation, on their future prospects, emotional state, sexuality, risk behaviors, and their perception of health care and its accessibility. Adolescents who identify as non-cisgender/heterosexual seem to have higher future aspirations, however, they have a more unstable emotional state, higher risky behaviors, and fear being prejudiced by health care professionals. The undefined group appears to be undefined about their sexuality and future aspirations, while reporting less risky behaviors.
- Adventitious respiratory sounds to monitor lung function in pulmonary rehabilitationPublication . Jácome, Cristina; Cruz, Joana; Marques, AldaBackground: Peak expiratory flow (PEF) has been traditionally used to monitor lung function in patients with chronic obstructive pulmonary disease (COPD) before pulmonary rehabilitation (PR) sessions. However, PEF mainly reflects changes in large airways and it is known that COPD primarily targets small airways. Adventitious respiratory sounds (ARS - crackles and/or wheezes), are related to changes within lung morphology and are significantly more frequent in patients with acute exacerbations of COPD. Thus, ARS may be also useful for the routine monitoring of lung function during PR programs. Objective: This study explored the convergent validity of ARS and PEF in patients with COPD. Methods: 24 stable patients (66±9y; FEV1 71±19% pred) participating in a PR program were included. Assessments were conducted immediately before one PR session. Presence of ARS (crackles and/or wheezes) at posterior right chest was first assessed by a physiotherapist using a digital stethoscope (ds32a, ThinkLabs, CO, USA). Resting dyspnea was collected using the modified Borg scale (0-10) and PEF with a peak flow meter (Micro I, Carefusion, UK). Independent t-tests, Pearson and point-biserial correlations were used. Results: ARS were present in 5 participants (20.8%). Patients with ARS had a lower PEF than patients without ARS (294±62 l/min vs. 419±128l/min; p=0.048). PEF was negatively correlated with presence of ARS (r=-0.41; p=0.048). Resting dyspnea was negatively correlated with PEF (r=-0.41; p=0.039), but not with ARS (r=0.21; p=0.32). Conclusions: Findings suggest that both ARS and PEF offer complementary information before a PR session, but that ARS provide additional information on the patents’ respiratory status. Further research correlating ARS and PEF with patients’ performance and progression during PR is needed to strengthen the usefulness of assessing these parameters in PR.
- Algorithm for transitional care for caregivers of dependent older adults: A validation studyPublication . Gomes, Thawanna Jeremias Barbosa; Ferreira, Bruna Alexandra da Silva; Baixinho, Cristina Lavareda; Ferreira, ÓscarTo construct and validate an algorithm for transitional care for caregivers of dependent older adults. Method: This was a methodological study developed in three phases: a literature review, designing an algorithm, and its validation by a peer panel with twentyseven experts selected according to pre-defined inclusion criteria. Results: The algorithm predicted interventions in transitional care (hospital stay, at discharge, and 30 days at home post-discharge) aimed at the exercise of the caregiver role; needs assessment; training in care management of dependent older adults and management of self-care, and ensuring continuity of care (of older adults and caregivers). Conclusion: Agreement between expert raters and a reliability test of 0.92 indicate that the algorithm can be used by professionals to decide the transitional care interventions to be administered to the caregivers of dependent older adults. Future studies should be conducted to perform its clinical validation.