Time-trends in infant mortality rates in the southern Europe

Infant Mortality Rate (IMR) has been considered an important health indicator in monitoring quality of health care. Objectives: To examine trends in IMR in Southern Europe (SE) over the last two decades. Methods: Number of live births and infant deaths reported for SE (Portugal, Italy, Greece and Spain) between 1990 and 2013 were abstracted from World Health Organization Database. Annual IMR per 1,000 live births was computed for each country and for SE as a whole. Joinpoint regression models were used to estimate average annual percent change (AAPC) in IMR and respective 95% Conidence Interval (95% CI) and to identify points in time when signiicant changes in trend occurred (joinpoints). Results: Between 1990 and 2013, IMR signiicantly decreased from 9.2 to 3.4 in SE and the highest decrease was observed from 1992 to 1998 (AAPC = -6.1%; 95%CI: -6.5%; -5.8%). Signiicant decline in IMR was observed in all countries but the pattern was different across countries. IMR varied across countries between 11.5 and 8.3 and between 3.1 and 3.8 in 2013; highest IMR were observed in Portugal for 1990 and in Greece for 2013. Most notable decreases in IMR were observed from 1990 to 1995 in Portugal (AAPC = -8.4% 95%CI: -8.8; -8.1), from 1993 to 1997 in Italy (AAPC = -6.6% 95%CI: -7.8; -5.5) from 1998 to 2006 in Greece (AAPC = -6.8% 95%CI: -7.0; -6.5), and from 1993 to 1996 in Spain (AAPC = -7.3% 95%CI: -9.0; -5.6). Decreases in IMR were signiicant during all time period in Italy and Greece but in Portugal and Spain IMR became unchangeable after 2010-2011. Conclusions: Decrease in IMR in countries of SE suggests steadily improvement in the quality of health care. However differences in the pattern of decrease across countries during the last years deserve particular attention

Effect of mode of delivery on early oral colonization and childhood dental caries: a systematic review

This review investigated whether mode of delivery influences the colonization of infant’s oral cavity and the risk of early childhood caries (ECC). The search strategy included systematic searching of electronic databases (Web of Science and PubMed) for articles published (1995–2015) and hand searching of references lists. Outcomes of interest were the presence of oral caries-related microorganisms, oral species considered protective against caries, and dental caries. Other outcomes included severity of dental caries, dental claims, and age at first dental visit. Study quality was assessed using the EPHPP tool. For each study, we present odds ratios and respective 95% confidence intervals for the association between these outcomes and the mode of delivery. Fourteen studies were identified. In 5 out of 8 studies addressing oral colonization, children born by cesarean section were less likely to harbor caries-related microorganisms as well as protective bacteria against caries and acquired caries-related microorganisms earlier, when compared with vaginally delivered children. No consistent results were obtained for the association between mode of delivery and dental caries. Although there were differences in oral colonization by mode of delivery, it seems that other determinants rather than mode of delivery could be major contributors to the development of ECC.info:eu-repo/semantics/publishedVersio

Sífilis uma realidade antiga e um desafio atual

A sífilis causada pelo Treponema pallidum e transmitida por contato sexual, transfusão sanguínea e transplacentaria. A transmissão sexual, geralmente ocorre durante as fases primária, secundária ou início da latente; no entanto a transmissão pode ocorrer vários anos após a infeção materna. Apesar de existirem medidas profiláticas eficazes e opções terapêuticas relativamente baratas, como o uso do preservativo, cerca de 12 milhões de pessoas são infetadas anualmente (OMS,2016). O controle da doença tem como fundamento a triagem sorológica e o tratamento adequado de gestantes e parceiros (Campos et al ,2010). Material e métodos: Casos de sífilis registados em Portugal foram recolhidos no sistema de informação centralizado para doenças infeciosas (CISID) da Organização Mundial de Saúde (OMS). A incidência de sífilis precoce e congénita foi calculada (por 100.000 habitantes) para cada dois anos entre 2003 e 2013. A percentagem de variação bianual (%VB) e respetivo intervalo de confiança a 95% (IC95%) obtiveram-se através de regressão baseada nos procedimentos Cochran-Armitage. Resultados:A sífilis precoce variou entre 1.41 em 2003-2004 e 1.67 em 2011-2013, com %VB não significativo de 7.1% (IC95%: -7.8% a +24.4%). A incidência da sífilis congénita apresentou uma evolução decrescente e significativa variando entre 0.18 em 2003-2004 e 0.04 em 2011-2013 com %VB de -19.5% (IC95%: -33.6% a -2.9%). Conclusões: Face ao exposto e apesar das campanhas de divulgação de medidas profiláticas das infeções sexualmente transmissíveis em curso, torna-se necessário um reforço efetivo à população em geral. Apesar de a transmissão de mãe para filho estar em declínio, é necessário um esforço continuo na prevenção assim como a pertinente vigilância pré-natal.info:eu-repo/semantics/publishedVersio

Community land trusts as a resistance instrument to neoliberal urban projects

O Community Land Trust é um modelo estabelecido com vistas à proteção de permanência de comunidades vulneráveis. Ela surge nos Estados Unidos, na década de 1960, atrelada aos movimentos por direitos civis e à população residente em áreas rurais. Este artigo busca avaliar as potencialidades e os limites de sua aplicação no Brasil enquanto resistência e prática biopotente em um espaço urbano marcado por elevados percentuais de irregularidade e por uma grave situação de desigualdade socioespacial. Em um contexto que agrava após os megaeventos no início da segunda década do século XXI e com a ruptura democrática e o aprofundamento da lógica neoliberal nas cidades a partir de 2016, torna-se necessário e urgente o estabelecimento de novas práticas e formas de gestão da propriedade que desenhem possíveis subversões à lógica do Poder. Os Community Land Trusts são propostos aqui como forma de prática jurídica subversiva, seja a partir da defesa da necessidade de uma legislação própria sobre o tema, seja pela utilização dos instrumentos jurídicos já existentes de forma a basear a criação de um modelo proprietário emancipatório.Community Land Trusts are established models designed to protect the maintenance of vulnerable communities in certain territories. The figure emerges in the United States in the 1960s, tied to civil rights movements and the population living in rural areas. The present article will evaluate the potentialities and limits of the application of the Community Land Trusts instrument in Brazil as resistance and biopotent practice in an urban space marked by high percentages of irregularity and by a serious situation of socio-spatial inequality. In a context that worsens after the mega-events at the beginning of the second decade of the twenty-first century and with the democratic rupture and deepening of neoliberal logic in cities from 2016 onwards, it is necessary and urgent to establish new practices and forms of property management in a way to draw possible subversions to the logic of Power. CLTs are proposed here as a form of subversive legal practice, either from the defense of the design of a specific legislation on the subject, or by the use of existing legal instruments in order to base the creation of an emancipatory proprietary model

Attitudes towards to sexuality among older people: a qualitative research

Sexuality is an important component of human being and contributes to the quality of life. Sexual activity dependa on altitudes toward sexuality. Although this is an important issue, the research on attitudes toward sexuatity among older people hás been a neglected topic. Objectives: To understand altitudes towards sexuality among older people and to assess the relationship between sociodemographic factors and such attitudes.Methods: This cross-sectíonal study was conducted on 35 community-dwelltng older individuais (> 65 years old; 66% were men). Data collectíon was based on a questionnaire whtch includes three components: (1) Questíons on sociodemographic characteristícs; (2) A 13-item scale assessment of attitudes toward to sexualtty (SAATS) scored from O to 52, being highervalues related with positive attítudes; and (3) an open question "in your opinton what is sexuality?". Results: In this sample 40% of participants (n = 14) reported that there is no sexuality among older people. For the whole sample, the mean score of SAATS and respective standard deviatíon (± SD) was 28. 9 (± 6. 63). There were no differences in the mean score of SAATS by gender, but such score was lower among oldest people (p = 0. 006), among individuais reporting less schooling years (p = 0. 001) and among those with no companion (p = 0. 012). In regards to the qualitatíve analysis of the open question, the main answers obtained fali into the affectíve dimension, with the majority of partidpants reporting that sexuality is "lave", "respect" and "tenderness". Conclusions: Oldest people, those with lower educatíon levei and those with no companion presenting more negative attítudes towards to sexuality. Among older people sexuality is manly based on the affective dimension

Prevalence of surgical wound infection after surgery for breast cancer: systematic review

One of the known risk factors for abuse and neglect of the elderly is the decrease in functionat capacity, contributíng to self care dependency of instrumental actívities of daily living and basic activities of daily Itving (OMS, 2015). Methods: Cross-sectional study with non probabilistíc sample of 333 elderly, performed in a hospital, homes and day centers for the elderly. The data collectíon protocol tncluded socio-demographic data, Questíons to elicit Elder Abuse (Carney, Kahan B Paris, 2003 adap. By Ferreira Alves & Sousa, 2005), scale of instrumental actívi - ties of daily living Lawton and Brody and Katz index to assess the levei of independence in actívities of daily living. Objectives: To evaluate the assodation between abuse and neglect in the elderly, instrumental actívitíes of daily living and levei of independence in actívitíes of daily living. Results: Emotional abuse is signifícantty correlated with the levei of independence in activities of daity Uving (p = 0. 000), older peopie with less independence tend to have higher leveis of emotional abuse. The total abuse is signtficantly correlated with the leveis of independence in activittes of daily living (p = 0. 002), less independent elderty tend to suffer greater abuse and neglect. There were no statistically significant associations between abuse and neglect and instrumental activities of daily l1v1ng. Conclusions: The less independent elderly are more vulnerable to situatíons of abuse and neglect, being more exposed to emotional abuse. These results point to the need for health professionals/ nurses develop prevention interventions, including strategies to support carers and early screentng tn less independent elderly. Keywords: Elder abuse. Negligence. Nursing care. Frail elderly. PREVALENCE OF SURGICAL WOUND INFECTION AFTER SURGERY FOR BREAST CÂNCER: SYSTEMATIC REVIEW C. Amaral3, C. Teixeira"'1', F. Sousa'', C. Antãoa "Polythecnic Institute o f Bragança, Bragança, Portugal; bEPI Unit, Public Health Institute, University of Porto, Portugal. Contact details: catarinaisabeln.amaraliSsmaU.com Introduction: Breast câncer is one of the most common mahgnant pathology in European countries, as Portugal, where annual inddence is around 90 new cases per 100,000 women. Breast surgery is the usual treatment for this pathology, however such procedure can be complicated by the infection of surgical site. Objectives: To know the prevalence and determtnants of surgtcal wound infection after breast surgery. Methods: We conducted a systematic review by searching of the Web of Sdence electronic database for articles published over the last s1x years 1n developed countries. Over three hundred dtatíons were obtained and after excludtng citations with reasons, fíve artícles met our inclusion criteria and were included in the present review. Results: Prevalence of surgical wound infection varied across studies between 0. 1% and 12. 5%. Bilateral mastectomy is assodated with higher prevalence of wound infectíon than unilateral mastectomy (3. 6% vs 3, 3%), lumpectomy with immediate breast reconstruction (IBR) is related with higher frequency of wound infectíon than surgery with no IBR (0, 5% vs 0, 1%), also, mastectomy with IBR is associated with higher prevalence of wound infectíon than mastectomy wtth no IBR (1, 5% vs 0, 3%) and breast surgery followed by axiltary lymph nade dissectíon is related with higher prevalence of wound infection than surgical procedures wtth no axillary lymph node dissection (2, 82% vs 1, 66%). Conclusions: Nurses that provide post-operatíve care to women after breast surgery should be aware about risk of wound tnfectíon, partícularly after more invasive procedures

The effect of nanocoatings enriched with essential oils on ‘Rocha’ pear long storage

The effect of coating 'Rocha' pears with alginate-based nanoemulsions enriched with lemongrass essential oil (LG) or citral (Cit) was investigated. Fruit were treated with the nanoemulsions: sodium alginate 2% (w/w) + citral 1% (w/w) (Cit1%); sodium alginate 2% (w/w) + citral 2% (w/w) (Cit2%); sodium alginate 2% (w/w) + lemongrass 1.25% (w/w) (LG1.25%); sodium alginate 2% (w/w) + lemongrass 2.5% (w/w) (LG2.5%). Then, fruit were stored at 0 °C and at 95% relative humidity, for six months. Fruit samples were taken after two, four and six months, and then placed at 22 °C. Upon removal and after 7 d shelf-life, fruit were evaluated for colour CIE (L*, h◦), firmness, soluble solids content (SSC), titratable acidity (TA), weight loss, electrolytic leakage, microbial growth, symptoms of superficial scald and internal browning. All nanoemulsions had droplets in the nano range <500 nm, showed uniformity of particle size and stable dispersion. Cit-nanoemulsions had lower droplet size and higher stability than LG. No nanoemulsion showed cytotoxicity. Coatings reduced fruit colour evolution and preserved better firmness than control. After shelf-life, better firmness was found in LG-coated fruit. Coatings did not affect SSC and TA. Microbial growth was below the safety limits in all treatments. Fruit treated with LG-nanoemulsions did not show scald symptoms and panelists preferred LG1.25% coated fruit. Cit2% treated fruit showed the highest scald and internal browning symptoms, while LG1.25% did not show any disorders. This study suggests that LG-nanocoatings have the potential for preserving the quality of 'Rocha' pear.FCT (SFRH/BPD/108831/2015); UID/BIA/04325/2019/ UID/Multi/00631/2019/ UID/AMB/50017/2019info:eu-repo/semantics/publishedVersio

Conhecimentos relativamente à doação de sangue em alunos do ensino superior

A doação de sangue é considerada uma atitude que pode salvar vidas e é atualmente um assunto de relevo dada a crescente necessidade em manter reservas para a transfusão de sangue de emergência. A compreensão de todos aspetos subjacentes à atitude de ser dador permitirá perspetivar metodologias e programas direcionadas para ações específicas, de forma a aumentar o nível de conhecimento da população nesta matéria, bem como para motivar atitudes positivas face à doação de sangue. Objetivo: Avaliar os conhecimentos, atitudes, opiniões e motivações relativamente à doação do sangue em estudantes do ensino superior. Material e métodos: Estudo descritivo tendo como elegíveis os estudantes de uma instituição de ensino superior (Norte de Portugal). Foi construído um questionário com questões em quatro domínios: conhecimentos, atitudes, opiniões e motivações relativamente à doação de sangue. Os dados foram obtidos por auto-aplicação do questionário. Com base nas 17 questões que avaliam os conhecimentos, criaram-se três categorias: baixo (0 a 7 respostas certas), médio (8 a 13 respostas certas) e alto (14 a 17 respostas certas). Resultados: Dos 1140 alunos a frequentar os diferentes cursos 380 (33%), foram convidados a participar e destes apenas 2% (n=8) recusaram. Dos 373 inquiridos, 83% são do género feminino, 84% têm idade inferior a 23 anos e 48% frequentam o 1º ano. Dos participantes 13% (n= 48) doaram sangue pelo menos uma vez e 7% (n=26) fazem-no de forma regular. O nível de conhecimentos revelado é baixo para 16% (n=61) e alto para 13% (n=42). Relativamente a atitudes, 98% (n=366) doariam sangue num apelo urgente, igual percentagem o faria para um familiar ou amigo, 68% (n=254) afirmam que as campanhas de sensibilização influenciam a doação de sangue e 21% (n=79) doariam sangue se recebessem incentivo monetário. No domínio das opiniões, 20% (n=73) dos inquiridos referiram ter receio de contrair doenças ao doar sangue, 83% (n=311) confiam no material utilizado e 60% (n=224) consideram que a informação existente sobre dádiva de sangue é insuficiente. No que respeita à motivação para a dádiva de sangue, os fatores mais referidos como importantes foram, o dever cívico, a falta de sangue nos serviços de saúde e a qualidade de atendimento, respetivamente, para 72% (n=268), 87% (n=323) e 70% (n=259) dos inquiridos. Conclusão: É de salientar a baixa proporção de dadores nesta amostra tendo em conta que são indivíduos pertencentes ao grupo etário onde é mais expectável a dádiva de sangue. No entanto, quase a totalidade estaria disponível para doar sangue. O sentido de dever cívico, a qualidade do atendimento e a falta de sangue nos serviços de saúde são fatores motivacionais para a dádiva de sangue. Considera-se importante fornecer informação e formação sobre a doação de sangue, concretamente no que se refere fatores impeditivos, locais de colheita e riscos associados. São necessárias estratégias de abordagem que realcem o papel do dador na sociedade.info:eu-repo/semantics/publishedVersio

Motivations and attitudes towards the act of blood donation among undergraduate health science students

Undergraduate students are a target for blood donation, as they constitute a young healthy and well-informed group. Aim: To understand motivations and attitudes underpinning the act of blood donation among undergraduate health science students. Materials and methods: Cross-sectional study enrolling undergraduate students of a College of Health Sciences in the Northeast of Portugal (January/February, 2017). Data collection tool was a self-administered questionnaire covering questions about motivations (n = 8) and attitudes (n = 5) towards the act of blood donation. Participants were classified by donation status into donors (one previous donation) and non-donors (never donated). Multiple logistic regression models were used to assess the association between each attitude and motivation on donation status. Odds-ratio (OR) and respective 95% confidence intervals (95%CI) adjusted for potential confounders, were obtained. Results: Out of 362 participants, 12.7% (n = 46) had ever donated blood and 56.5% (n = 26) of them were regular donors. Out of 316 non-donors, 88.0% (n = 278) will donate blood under request. There were no differences between donors and non-donors regarding the attitudes towards blood donation. From all motivations only “be a civic duty” had a significant impact on donor status, such that participants reporting this motivation are more likely to be blood donors (OR = 2.58; IC95%:1.34-4.99) than their counterparts. Conclusion: This study revealed that 80.0% of undergraduate health science students are non-donors, but they are available to donate blood under request. Campaigns and advertising methods focused on the emergent needs for blood donation could play an important role in the recruitment of new donors among undergraduate studentsinfo:eu-repo/semantics/publishedVersio

Family planning: health indicators

Primary health care is the main point of contact of citizens with the health system. Reproductive health program (PF) is a universal and free health program and allows women of childbearing age to monitor their sexual and reproductive health.Methods: The objective was to analyze the evolution of three health indicators from 2018-2022, in the context of the PF program defined in the Identity Card of the health Indicators of the Central Administration of Health Services (ACSS) in a Health Unit in Northeastern Portugal. This is a documental study using data available in the General Directorate of Health (DGS)platform. Results: In the proportion of nursing consultations,in the years of 2018 to 2022 we got a maximum of 42.56% and 31.2% against an accepted minimum value of 30% and the maximum of 80% recommended by the DGS. The proportion of PF medical consultations, the values found were a minimum of 22% and a maximum of 33.6 against the3 5% and the maximum value 65% recommended by the DGS. As for the proportion of women who had Cervical Cancer Screening, year 2018, in all months the score 1 was obtained, identical value until March 2019. From April 2019 to September 2022 it presents a score of 0. Conclusions: Only by maintaining good performance indicators can there be better coverage regarding PF program and sexual and reproductive healthinfo:eu-repo/semantics/publishedVersio