Satisfação dos utentes de uma Unidade Funcional de Cardiologia de um centro hospitalar da área de Lisboa

Mestrado em Gestão e Avaliação de Tecnologias em SaúdeIntrodução: Atualmente a qualidade dos serviços de saúde tem recebido renovada atenção, sendo essencial para a eficácia da cobertura universal da saúde e a melhoria da vida dos cidadãos. Avaliando o grau de satisfação dos utentes, torna-se possível identificar áreas que necessitam de melhorias, propor soluções para os problemas existentes e adequar os serviços de saúde às necessidades e expectativas dos cidadãos. Objetivos: Conhecer o grau de satisfação dos utentes de uma Unidade Funcional de Cardiologia num Centro Hospitalar da área de Lisboa e verificar se existem associações entre a satisfação e algumas variáveis sociodemográficas. Métodos: Realizou-se um estudo prospetivo, transversal, descritivo-correlacional, utilizando uma perspetiva quantitativa. Foi utilizado um questionário como técnica de recolha de dados, aplicado a 142 utentes. O questionário engloba quatro dimensões: experiência prévia na Unidade, admissão e receção da Unidade, atendimento dos profissionais de saúde e condições físicas das instalações da Unidade. Resultados: A análise dos dados indicou uma avaliação global situada entre o “Muito Bom” e o “Excelente” relativamente ao grau de satisfação dos utentes em relação aos serviços prestados pela Unidade Funcional de Cardiologia. A dimensão com maiores níveis de satisfação foi “atendimento dos profissionais de saúde” e a dimensão “condições físicas da Unidade” obteve as avaliações mais baixas. Os resultados obtidos mostraram que as variáveis sociodemográficas não possuem qualquer influência sobre o grau de satisfação global dos utentes. Conclusão: Os utentes estão muito satisfeitos com os cuidados de saúde prestados pela Unidade Funcional de Cardiologia. Avaliar o grau de satisfação dos utentes é essencial para medir a qualidade dos cuidados. Recomenda-se uma monitorização frequente da satisfação dos utentes para promover a melhoria contínua.ABSTRACT: Introduction: The quality of healthcare services has been receiving renewed attention, being essential for the effectiveness of universal health coverage and the improvement of citizens' lives. By evaluating patient satisfaction, it becomes possible to identify areas in need of improvement, propose solutions to existing problems, and adapt healthcare services to meet the needs and expectations of citizens. Objectives: To assess the satisfaction level of patients in a Functional Cardiology Unit in a Hospital Center in the Lisbon area and to verify if there are associations between satisfaction and some sociodemographic variables. Methods: This prospective, cross-sectional, descriptive-correlational study was conducted using a quantitative perspective. 142 patients were surveyed using a questionnaire, which encompassed four dimensions: prior experience in the Unit, admission and reception at the Unit, care provided by healthcare professionals, and the physical conditions of the Unit's facilities. Results: Data analysis indicated an overall assessment ranging from very good to excellent regarding patient satisfaction with the services provided by the Functional Cardiology Unit. The dimension with the highest satisfaction levels was "care provided by healthcare professionals," while the "physical conditions of the Unit" received the lowest ratings. The results showed that sociodemographic variables do not have any influence on the patient's overall satisfaction level. Conclusion: Patients are highly satisfied with the healthcare provided by the Functional Cardiology Unit. Assessing patient satisfaction is essential for measuring the quality of care. Frequent monitoring of patient satisfaction is recommended to promote continuous improvement

Female representation among editorial boards of social, clinical, and educational pharmacy journals

Background: Recent studies on editorial team members of healthcare journals have been showing disparities in this distribution. However, there are limited data with respect to pharmacy journals. Thus, the aim of this study was to investigate the distribution of women among editorial board members of social, clinical, and educational pharmacy research journals around the globe. Methods: A cross-sectional study was conducted between September and October 2022. Data were extracted from Scimago Journal & Country Rank and Clarivate Analytics Web of Science Journal Citation Reports The top 10 journals in each region of the world (continents) were analyzed. Editorial board members were categorized into four groups and determined based on information available on the journal's website. The sex was classified in binary form through name and photography, the personal and institutional web pages, or the Genderize program. Results: A total of 45 journals were identified in the databases, of which 42 of them were analyzed. We identified 1482 editorial board members with only 527 (35.6%) being female. Analyzing the subgroups, there were 47 total editors-in-chief, 44 total co-editors, 272 associate editors, and 1119 editorial advisors. Of these, 10 (21.27%), 21 (47.72%), 115 (42.27%), and 381 (34.04%) were female, respectively. Only 9 journals (21.42%) presented more females among their editorial board members. Conclusion: A notable sex disparity among social, clinical, and educational pharmacy journals' editorial board members was identified. Efforts should be made to involve more female sex in their editorial teams.info:eu-repo/semantics/publishedVersio

The outcomes of empowering individuals after total knee arthroplasty: a randomized controlled trial

Background: The rehabilitation of individuals after total knee arthroplasty is essential to optimize outcomes. The number of surgeries has been increasing significantly worldwide, overburdening healthcare systems with rising associated costs. Purpose: This study aims to demonstrate the effectiveness and cost-effectiveness of a rehabilitation plan consisting of two weekly physiotherapy sessions, supplemented by a home exercise program, in individuals over 65 years of age undergoing primary Total Knee Arthroplasty, compared to conventional rehabilitation with three weekly sessions. Methods: A single-centre randomized experimental study with intervention evaluated the efficiency and cost of two rehabilitation plans for individuals aged 65 and over who underwent primary Total Knee Arthroplasty and were referred for outpatient physiotherapy in the period from September 27 to December 31, 2022. Twenty-four Individuals were randomly assigned to two groups: the experimental group (15 individuals), which received face-to-face physiotherapy twice per week, supplemented by a home exercise program, and the control group (9 individuals), which received face-to-face physiotherapy three times per week without additional exercises. Both groups received treatment for 5 weeks and were assessed at the beginning and the end of the 5-week treatment period. The effectiveness of the interventions was measured through the assessment of pain and functionality using the Oxford Knee Score (scored from 12 to 60 points), active range of movement measured in degrees with a goniometer, and muscle strength evaluated by the number of repetitions in the 30-second chair stand test. The economic evaluation was conducted from the hospital’s perspective, using cost-effectiveness analysis, with the incremental cost-effectiveness ratio calculated to compare the costs of the two rehabilitation plans. Results: There were no significant differences between the groups in the initial assessment. After the 5-week treatment, both groups demonstrated improvements in all effectiveness indicators, with the experimental group achieving better outcomes. However, no statistical significance was found in the comparisons between the two groups (p > 0.05 for all indicators). The resulting incremental cost-effectiveness ratio of -3.71€/effectiveness unit was favorable to the experimental group. Conclusion(s): The rehabilitation plan of the experimental group emerged as the cost-effective alternative compared to the control group, highlighting a potential strategy for optimizing health resources in the hospital department where the study was conducted. No participant expressed any concerns about the home treatment. Implications: The empowerment of individuals through the teaching of home exercises is a useful tool for individuals following total knee arthroplasty, providing the same health benefits at a lower cost to the hospital. It also reduces the need for hospital visits, resulting in economic savings for individuals and families, as well as a reduction in environmental footprint

Modelos não radiais de eficiência e de super-eficiência na DEA - Aplicação ao setor bancário

A DEA (Data Envelopment Analysis) é uma metodologia destinada à avaliação do desempenho organizacional. É uma técnica não paramétrica baseada na programação linear destinada a avaliar a eficiência relativa de um conjunto de entidades similares, designadas de DMUs (Decision Making Units), que usam múltiplos inputs para produzir múltiplos outputs. Os modelos da DEA podem basicamente ser classificados em modelos radiais, caracterizados por tratarem com alterações nos inputs ou nos outputs, e não radiais, caracterizados por tratarem diretamente com folgas associadas a excessos nos valores dos inputs e/ou défices nos valores dos outputs. A maioria destes modelos foram concebidos para dados não negativos (em alguns casos positivos) e, em geral, permitem identificar várias DMUs como eficientes. Para ultrapassar estas duas limitações, alguns modelos para tratar valores negativos e alguns métodos de ranking têm sido propostos. Este trabalho tem por objetivo apresentar um estudo sobre modelos de eficiência e de supereficiência não radias, com enfoque nos modelos não radiais SBM (Slack Based Measure), que permitem tratar todo o tipo de dados (positivos, nulos e negativos). Este estudo inclui a aplicação destes modelos à avaliação da eficiência relativa e ao estabelecimento de rankings de vinte e uma instituições bancárias que operavam em Portugal durante o período de 2019 a 2022.DEA (Data Envelopment Analysis) is a methodology aimed at evaluating organizational performance. It is a non-parametric technique based on linear programming, designed to assess the relative efficiency of a set of similar entities, referred to as DMUs (Decision Making Units), which use multiple inputs to produce multiple outputs. DEA models can essentially be classified into radial models, characterized by dealing with changes in inputs or outputs, and non-radial models, characterized by directly addressing slacks associated with excesses in input values and/or deficits in output values. Most of these models have been designed for non-negative data (in some cases positive), and generally allow for the identification of several DMUs as efficient. To overcome these two limitations, some models for handling negative values and some ranking methods have been proposed. This work aims to present a study on non-radial efficiency and super-efficiency models, with a focus on nonradial SBM (Slack Based Measure) models, which allow for the handling of all types of data (positive, zero, and negative). This study includes the application of these models to the evaluation of the relative efficiency and the establishment of rankings of twenty-one banking institutions operating in Portugal during the period from 2019 to 2022

Critical insights on fungal contamination in schools: a comprehensive review of assessment methods

The author(s) declare that financial support was received for the research and/or publication of this article. This work is also supported by national funds through FCT/MCTES/FSE/UE, and Instituto Politécnico de Lisboa, national support through IPL/2022/InChildhealth/BI/12M; projects IPL/IDI&CA2024/WWTPSValor_ESTeSL and IPL/IDI&CA2024/MycoSOS_ESTeSL. This work was also supported by the Academy of Medical Sciences Springboard award Round 7 (SBF007\100130). Funded by the European Union (grant agreement: 101056883). Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the European Health and Digital Executive Agency (HaDEA). Neither the European Union nor the granting authority can be held responsible for them. InChildHealth is also receiving funding from the Swiss State Secretariat for Education, Research and Innovation (SERI grant agreement 22.00324), from the United Kingdom Research and Innovation (UKRI grant agreement 10040524), and from the Australian National Health & Medical Research Council (NHMRC grant agreements APP2017786 and APP2008813).This review addresses the increasing problem of fungal contamination in schools, which has a profound impact on indoor air quality and student health. Fungal contamination creates health problems such as respiratory problems, allergies, which can be particularly harmful in schools (e.g., Aspergillus fumigatus and Fusarium sp. are especially important as they are well-known indoor allergens and can induce serious respiratory diseases). This study aims to determine the effect of geographic location as well as season of filamentous fungi in the school context. Through a comprehensive screening of 6,659 articles, 47 studies were selected for data extraction, detailing sampling techniques, analysis methods, climatic conditions, and relevant fungal species. The study highlights the importance of regularly measuring IAQ and utilizing both active and passive sampling methodologies in addition to molecular genetic analysis to complement identification and improve comparability across studies. A targeted monitoring is also proposed for species such as Aspergillus fumigatus (Aspergillus section Fumigati), Fusarium sp., and Mucorales order, which are therapeutically relevant, as well as Stachybotrys atra and Aspergillus section Flavi, in terms of their toxicological potential. Additionally, the article discusses the importance of consistent data formatting for effective meta-analysis and the need for further research to inform regulatory frameworks protecting student health. Recommendations for minimizing fungal threats include evaluating building structure, ventilation, cleaning practices, and gathering information from parents about school activities. Overall, the study underscores the global health risks posed by fungi in schools and calls for extensive investigations combining various sampling and analytical techniques. Additionally, the article discusses the importance of consistent data formatting for effective meta-analysis and the need for further research to inform regulatory frameworks protecting student health. Recommendations for minimizing fungal threats include evaluating building structure, ventilation, cleaning practices, and gathering information from parents about school activities. Overall, the study underscores the global health risks posed by fungi in schools and calls for extensive investigations combining various sampling and analytical techniques

Spatiotemporal modality in Here, by McGuire: intermedial connections between graphic novel and architecture

O tempo é um dos grandes temas da arte, explorado não como um conceito abstrato, mas por seus profundos efeitos na existência humana. Na graphic novel Here (2017), de Richard McGuire, o tempo interage com o espaço e emerge como uma força narrativa, atuando como narrador-personagem. A obra de McGuire desafia a lógica espaço-temporal convencional, integrando a intermidialidade e perspectiva, à luz da arquitetura. A narrativa se desenrola por meio de temporalidades sobrepostas em quadros estáticos, não lineares. Essa complexidade visual ressoa com as modalidades de Lars Elleström. Assim, o objetivo do artigo é discutir como o narrador se revela como uma câmera fixada pelo tempo, enquanto a quina de uma sala de estar se torna personagem-testemunha de uma longa história. Ao situar Here na interseção entre graphic novels e arquitetura, o uso inovador do espaço estático e da temporalidade dinâmica redefine as possibilidades narrativas na arte sequencial.ABSTRACT - Time is one of the most enduring themes in art, explored not as an abstract concept but through its profound effects on human existence. In Richard McGuire’s graphic novel Here (2017), time intersects with space to emerge as a narrative force, as a narrator-character. McGuire’s work defies conventional spatiotemporal logic, blending intermedial studies with perspective, under the light of architecture. The narrative unfolds through layered temporalities presented within static frames, reflecting a nonlinear storytelling approach. This visual complexity resonates with Lars Elleström’s modalities (2021), highlighting how the graphic novel uniquely transmediates temporal and spatial dimensions. Therefore, the purpose of this essay is to discuss how the narrator shows itself as a camera fixed by time, while the corner of a house’s living room becomes a character-witness throughout history. Besides, the essay explores the material and sensorial modalities of Here, considering its intermedial relations to cinematic and technological paradigms. By situating Here at the intersection of graphic novels, architecture, and time, we also argue that McGuire's innovative use of static space and dynamic temporality redefines narrative possibilities in sequential art

An autonomic parallel strategy for exhaustive search tree algorithms on shared or heterogeneous systems

Backtracking branch-and-prune (BP) algorithms and their variants are exhaustive search tree techniques widely employed to solve optimization problems in many scientific areas. However, they characteristically often demand significant amounts of computing power for problem sizes representative of real-world scenarios. Given that their search domains can often be partitioned, these algorithms are frequently designed to execute in parallel by harnessing distributed computing systems. However, to achieve efficient parallel execution times, an effective strategy is required to balance the nonuniform partition workloads across the available resources. Furthermore, with the increasing integration of servers with heterogeneous resources and the adoption of resource sharing, balancing workloads is becoming complex. This paper proposes a strategy to execute parallel BP algorithms more efficiently on even shared or heterogeneous distributed systems. The approach integrates a self-adjusting dynamic partitioning method in the BP algorithm with a dynamic scheduler, provided by an application middleware, which manages the parallel execution while addressing any issues of imbalance. Empirical results indicate better scalability with efficiencies above 90% for instances of an application case study for the discretizable molecular distance geometry problem (DMDGP). Improvements of up to 38% were obtained in execution speed-ups compared to a more traditional parallel BP implementation for DMDGP

Vagus nerve stimulation for the management of immune-mediated inflammatory diseases

The vagus nerve is a key component of several homeostatic axes including the cholinergic antiinflammatory pathway, hypothalamic–pituitary-adrenergic axis, and the brain-gut axis, all of which play important roles in the regulation of the immune system. Autonomic dysfunction has been described in many immune-mediated inflammatory diseases (IMIDs). In addition, several pilot studies have shown that vagus nerve stimulation leads to improvement in several IMIDs. Taken together, the vagus nerve is a promising novel therapeutic target for the management of IMIDs

O espaço modelado: exposição de fotografia

Catálogo da exposição de fotografia patente no Espaço Almeida Garrett, de 24 de fevereiro a 4 de abril de 202

Fabrico de scaffolds para substituição óssea utilizando pós de titânio e agentes poragéneos

O desenvolvimento de soluções alternativas ao enxerto ósseo é fundamental para o sucesso da engenharia de tecido ósseos, baseada na utilização de scaffolds como alternativa para a substituição e regeneração óssea. Um scaffold é fabricado utilizando materiais biocompatíveis de origem metálica, cerâmica ou polimérica. Os materiais poliméricos possuem propriedades mecânicas adequadas, mas baixa bioatividade; os cerâmicos embora estruturalmente semelhantes ao osso, resultam habitualmente em scaffolds com baixa resistência mecânica. As espumas metálicas surgiram na literatura como uma alternativa viável. Neste contexto, neste trabalho testa-se o fabrico de corpos porosos a partir de pós metálicos de titânio e de diferentes agentes poragéneos. O objetivo é obter uma boa relação entre comportamento mecânico, propriedades físico-químicas e bioatividade do scaffold, o mais semelhantes possível às do osso trabecular humano. O procedimento de fabrico consistiu na mistura e homogeneização de titânio na forma pó com um agente poragéneo. Para este fim testou-se cloreto de sódio (NaCl) e amido de batata, com diferentes relações mássicas metal/poragéneo - 30/70, 50/50, 70/30. As foram compactadas, seguindo-se a eliminação do agente poragéneo por dissolução em água destilada para o sal ou por calcinação, respetivamente no caso do cloreto de sódio e do amido. A última etapa de processamento foi a sinterização dos corpos verdes, testando-se as temperaturas de 800ºC, 900ºC e 1000ºC. Para a compactação das amostras foi necessário projetar e fabricar um molde metálico. Após o fabrico dos scaffolds, caracterizaram-se as respetivas propriedades físicas, químicas, mecânicas e de biocompatibilidade de microscopia eletrónica de varrimento, ensaio mecânico de compressão, testes de citotoxicidade. Os melhores resultados foram obtidos para scaffolds com 30 % em massa de amido de batata, que apresentaram propriedades mecânicas semelhantes às do osso trabecular, nomeadamente módulo de Young de 0.82 GPa e tensão de carga máxima de 115.18 MPa. Estes scaffolds apontam para um efeito de crescimento de células animais. No entanto, a partir de 50 % de amido de batata as amostras perderam integridade estrutural o que inviabilizou o seu fabrico. A utilização de 30 %, 50 % e 70 % em massa de cloreto de sódio como agente poragéneo resultou em scaffolds com integridade estrutural. Os melhores resultados obtiveram-se para 70 % de cloreto de sódio, resultando em poros de grande dimensão, com diâmetro até 3 mm. Os scaffolds com 30 % de cloreto de sódio apresentaram módulo de 0.56 GPa e tensão de carga máxima de 18.86 MPa. Todos scaffolds sinterizados apresentaram uma camada exterior de óxido de titânio e porosidade.Abstract The development of alternative solutions to bone grafting is fundamental for the success of bone tissue engineering, based on the use of scaffolds as an alternative for bone replacement and regeneration. A scaffold is manufactured using biocompatible materials of metallic, ceramic or polymeric origin. Polymeric materials have adequate mechanical properties but low bioactivity; Ceramics, although structurally similar to bone, usually result in scaffolds with low mechanical strength. Metallic foams have emerged in the literature as a viable alternative. In this context, this work tests the manufacture of porous bodies from titanium metal powders and different poragen agents. The objective is to obtain a good relationship between mechanical behavior, physicochemical properties and bioactivity of the scaffold, as similar as possible to those of human trabecular bone. The manufacturing procedure consisted of mixing and homogenizing titanium in powder form with a poragen agent. For this purpose, sodium chloride (NaCl) and potato starch were tested, with different metal/poragen mass ratios - 30/70, 50/50, 70/30. The substances were compacted, followed by the elimination of the poragen agent by dissolution in distilled water for salt or by calcination, respectively in the case of sodium chloride and starch. The last processing step was the sintering of the green bodies, testing the temperatures of 800ºC, 900ºC and 1000ºC. For the compaction of the samples, it was necessary to design and manufacture a metal mold. After the manufacture of the scaffolds, the respective physical, chemical, mechanical and biocompatibility properties of scanning electron microscopy, mechanical compression test, and cytotoxicity tests were characterized. The best results were obtained for scaffolds with 30 % by weight of potato starch, which showed mechanical properties similar to those of trabecular bone, namely Young's modulus of 0.82 GPa and maximum load stress of 115.18 MPa. These scaffolds point to an animal cell growth effect. However, from 50 % potato starch onwards, the samples lost structural integrity, which made their manufacture unfeasible. The use of 30 %, 50 % and 70 % by mass of sodium chloride as a poragen agent resulted in scaffolds with structural integrity. The best results were obtained for 70 % sodium chloride, resulting in large pores, with a diameter of up to 3 mm. The scaffolds with 30 % sodium chloride had a modulus of 0.56 GPa and a maximum load stress of 18.86 MPa. All sintered scaffolds had an outer layer of titanium oxide and porosity