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- 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.
- 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.
- 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).
- 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
- 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.
- 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.
- 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.
- 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
- Risk Factors, Length of Stay and In-Hospital Mortality of Methicillin-Resistant Staphylococcus aureus Infections: A Case-Control StudyPublication . Rodrigues, Rúben; Passadouro, Rui; Gomes, Odete; Castro, RicardoThe emergence of strains of methicillin-resistant Staphylococcus aureus is a serious therapeutic challenge in healthcare provision. With this study, we aimed to investigate the risk factors and clinical outcomes (mortality and length of hospital stay) associated with methicillin-resistant Staphylococcus aureus infections in patients admitted to a district hospital in Portugal.