Tackling ageism in the healthcare system: A community perspective

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Tackling ageism in the healthcare system: a community perspective

The UNAIDS political declaration of June 2021 [1] calls for transformative action to end inequalities and end HIV transmission by 2030, and explicitly recognizes that ageing people with HIV face stigma and discrimination across multiple aspects of their lives. UNAIDS is unambiguous in its call to reinforce responses to HIV across the age spectrum, to ensure that the needs of ageing people with HIV are met and that their lives are free from stigma and discrimination. Research into ageing people with HIV that examines the intersectionality of stigmas will play a part in advancing the United Nations 2030 Agenda. This contribution frames ageism as one of the last remaining pillars of stigma and one of the main barriers hindering the ability of ageing people living with HIV to achieve and sustain a good health-related quality of life (HRQOL). For people living with HIV, sexual health and intimate partner relationships are important components of HRQOL and emotional well-being across the life span [2, 3]. Although their importance has been increasingly recognized in the literature [4, 5], the sexuality of ageing people living with HIV is often considered of little importance when assessing HRQOL, despite evidence that older adults continue to desire romantic relationships, intimacy and sexual activity [6, 7]. This would suggest that sexuality, sexual health and sexual desires need to be considered in the assessment of HRQOL

Managing multimorbidity: how can the patient experience be improved?

The patient’s experience of their own healthcare is an important aspect of care quality that has been shown to improve clinical and other outcomes. Very little is currently known about patient experience in the management of multimorbidity, although preliminary evidence suggests that it may be poor. Individuals with multimorbidity report better experiences of care when they are knowledgeable and involved in the decision-making, when their care is well coordinated, and communication is good. A greater focus on disease prevention, stronger collaboration between health and social care services, and the provision of more integrated care for people with mental and physical health problems would also help to improve the patient experience. Advocacy groups can amplify the patient voice and improve access to care, as well as provide information and support to patients and their families. Patients have an important role in preventing multimorbidity and improving its management, and should be involved in the development of health policies and the delivery of healthcare services. Inequalities in access to quality healthcare must also be addressed.Journal of Comorbidity 2016;6(1)28–3

Determinantes do nível de Liquidez das empresas exportadoras portuguesas

Os temas relacionados com a tesouraria e liquidez das empresas têm sido estudados por diversos autores ao longo dos tempos, devido à sua maior relevância na gestão das organizações, derivada das maiores dificuldades de financiamento consequentes das recentes crises económicas e financeiras que condicionaram bastante o setor bancário e entidades associadas. Assim, o objetivo desta dissertação, é estudar as variáveis que influenciam positivamente ou negativamente, a gestão de tesouraria e os níveis de liquidez necessários para o normal funcionamento das empresas analisadas. Começou-se por realizar um enquadramento teórico sobre os temas base do estudo, desenvolvendo-se uma reflexão sobre os principais conceitos associados à tesouraria das empresas e uma interligação entre autofinanciamento, liquidez e meios financeiros líquidos. Concluiu-se o enquadramento teórico com uma caracterização sobre as principais teorias desenvolvidas ao longo do tempo para explicar os determinantes do nível de liquidez das empresas. No primeiro ponto incluído no estudo empírico foi efetuada uma caracterização da evolução recente das exportações portuguesas, tendo-se observado que nos últimos anos o valor das vendas para o exterior tem aumentado progressivamente, destacando-se o mercado comunitário como o principal destino dos produtos nacionais, representando em 2018, cerca de 74% do total das exportações portuguesas. De seguida, foi realizado o estudo dos determinantes do nível de liquidez das 250 maiores empresas exportadoras portuguesas para o mercado comunitário. As variáveis analisadas, que apresentaram relações relevantes com o nível de liquidez foram: Peso dos meios libertos líquidos retidos no ativo total líquido; Z score da Análise Discriminante de Altman, representativo do nível de restrições de financiamento das empresas; Dimensão do ativo líquido total;Peso dos ativos correntes corrigidos dos meios financeiros líquidos no ativo total líquido; Rendibilidade operacional.Issues related to corporate treasury and liquidity have been studied by various authors over the years, due to their greater relevance in the management of organizations, related to the greater financing difficulties resulting from the recent economic and financial crises that severely conditioned the banking sector. and associated entities. Thus, the objective of this dissertation is to study the variables that positively or negatively influence the cash management and the liquidity levels necessary for the normal operation of the analyzed companies. It began by providing a theoretical framework on the basic themes of the study, developing a reflection on the main concepts associated with corporate treasury and an interconnection between self-financing, liquidity and liquid financial means. The theoretical framework was concluded with a characterization of the main theories developed over time to explain the determinants of companies' liquidity level. In the first point included in the empirical study, was made a characterization of the recent evolution of Portuguese exports, and it has been observed that in recent years the value of foreign sales has increased steadily, with the Community market being the main destination of domestic products, representing in 2018, about 74% of total Portuguese exports. Next, the liquidity determinants of the 250 largest Portuguese exporting companies to the Community market were studied. The variables analyzed, which presented relevant relations with the liquidity level were: Weight of net assets retained in total net assets; Z score from Altman's Discriminant Analysis, representative of the level of corporate funding constraints; Dimension of total net assets; Weight of current assets adjusted for net financial assets in total net assets; Operating profitability

Hepatitis C antibody prevalence and behavioral correlates in people who inject drugs attending harm reduction services in Lisbon, Portugal

Copyright © 2022 Curado, Nogueira, Virgolino, Santa Maria, Mendão, Furtado and Antunes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.The hepatitis C virus (HCV) infection is an important public health problem, affecting millions of people worldwide. People who inject drugs (PWID) are at increased risk of HCV infection due to, among other factors, widespread unsafe injecting practices, such as sharing of infected equipment or unprotected sexual practices. In Portugal, there is a lack of data regarding the proportion of infected persons through injecting drug use. This study aimed to evaluate the anti-HCV prevalence and behavioral correlates of infection in PWID attending harm reduction services in the Metropolitan Area of Lisbon, Portugal. A cross-sectional study with a purposive sample of PWID was undertaken between March 2018 and March 2020. Participants were recruited through the harm-reduction services of a nongovernmental organization. A rapid diagnostic test for anti-HCV screening was performed. Data on drug consumption history and current practices, past HCV testing, care and treatment history, and knowledge regarding hepatitis C were also collected through a questionnaire applied by trained inquirers. A total of 176 PWID participated in this study. An overall prevalence of 70.5% of anti-HCV positive in this population was found. Those with an anti-HCV positive testing result tended to start consuming at a younger age and have a higher consumption of benzodiazepines in the last 30 days. Sharing needles and other injecting material is a frequent risk behavior among this group. Also, they are more likely to have attended an opioid agonist treatment and to have undertaken previous hepatitis C and HIV tests in the past. This study represents an important effort to better understand the HCV prevalence and behavioral correlates of infection among PWID in Portugal, as well as to better estimate those in need of HCV treatment.This study was funded by Gillead Sciences Portugal (https://www.gilead.com/utility/global-operations/europe/portugal/portugal-translation) and Fundação para a Ciência e a Tecnologia (https://www.fct.pt/), grant numbers UIDB/04295/2020 and UIDP/04295/2020.info:eu-repo/semantics/publishedVersio

Risk of HIV infection in a cohort of men who have sex with men attending CheckpointLX in Lisbon, Portugal

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Acceptability of PrEP among HIV negative Portuguese men who have sex with men that attended 2014 Lisbon pride fair

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Sexual behaviour patterns and STI risk: results of a cluster analysis among men who have sex with men in Portugal

Objectives Portugal has the highest HIV incidence rate in Western Europe. The proportion assigned to sexual contact between men recently increased to more than 30% of all HIV infections. Men who have sex with men (MSM) are vulnerable to the acquisition of other sexually transmitted infections (STIs), increasing the per-contact risk of HIV infection. Building on syndemic theory, the aim of this analysis was to identify patterns of current sexual behaviour in MSM, and explore their relationship with self-reported current, past STI diagnoses and HIV positive serostatus. Design A cross-sectional behavioural survey was conducted in Portugal among MSM, using a community-based participatory research approach. Hierarchical cluster analysis was used to identify patterns including behavioural and demographic factors. Results The analysis resulted in six clusters. Three clusters showed higher rates of current STI diagnosis (ranging from 11.7% to 17.1%), past STI diagnosis (ranging from 25.5% to 41.5%) and HIV positive serostatus (ranging from 13.0% to 16.7%). From the three clusters scoring lower on current and past STI and HIV diagnoses, one was characterised by a high number of sexual partners (62% had more than 12 partners in the last year), a high proportion (94.6%) of frequent visits to gay venues to meet sexual partners and high alcohol use (46.1%). The other two clusters scored lower on high risk sexual behaviour. Conclusion Factors other than sexual behaviour appear to reinforce the vulnerability to STIs and HIV of some MSM in this study, suggesting a syndemic of STIs, HIV and other adverse conditions. More research is needed to better understand the drivers of the STI/HIV epidemic in Portuguese MSM, using a concept that goes beyond risk behaviour, to develop effective combination prevention interventions.info:eu-repo/semantics/publishedVersio

Utilização de serviços de saúde relacionados com a infecção VIH por parte de homens gays: Acesso a informação, prevenção e teste

O estudo tem como objectivo descrever a utilização de serviços de saúde para informação, prevenção e teste do VIH por parte de homens gays em Portugal e identificar factores associados a ter efectuado o teste VIH em diferentes serviços. Para este estudo de abordagem participativa foi aplicado um inquérito por questionário a 1046 homens gays. Cerca de 27% dos participantes refere que recorreu ao CAD para obter informação sobre VIH/sida. Cerca de 83% recebeu gratuitamente preservativos no último ano. A maioria (88%) já efectuou o teste do VIH. Destes, 74% realizou­?o no SNS, 22.5% num serviço privado e 6.5% numa ONG, verificando­?se diferenças significativas quanto à idade, escolaridade, rendimento e nacionalidade. Os resultados indicam uma utilização dos serviços de saúde para informação, prevenção e teste do VIH pela maioria dos participantes. No entanto, é importante continuar a desenvolver esforços para promover a utilização dos serviços, em especial pelos grupos desta população que se encontram em maior vulnerabilidade, trabalhando em proximidade com as comunidades.info:eu-repo/semantics/publishedVersio

Different guidelines for pre-exposure prophylaxis (PrEP) eligibility estimate HIV risk differently: an incidence study in a cohort of HIV-negative men who have sex with men, Portugal, 2014-2018

Introduction Guidelines for pre-exposure prophylaxis (PrEP) provide criteria to identify individuals at higher risk of HIV infection. We compared the ability to predict HIV seroconversion of four guidelines: the World Health Organization (WHO), the United States Public Health Service and Centers for Disease Control and Prevention (US CDC), the European AIDS Clinical Society (EACS) and the Portuguese National Health Service (PNHS). Aim We aimed to measure the association between guideline-specific eligibility and HIV seroconversion. Methods We studied 1,254 participants from the Lisbon Cohort of men who have sex with men with at least two evaluations between March 2014 and March 2018, corresponding to 1,724.54 person-years (PY) of follow-up. We calculated incidence rates (IR) according to each guideline eligibility definition and incident rate ratios (IRR) to test the association between eligibility at baseline and HIV seroconversion. Results We found 28 incident cases (IR: 1.62/100 PY; 95% confidence interval (CI) 1.12–2.35). Guidelines’ sensitivity varied from 60.7% (EACS) to 85.7% (PNHS) and specificity varied from 31.8% (US CDC) to 51.5% (EACS). IR was highest among those defined as eligible by the PNHS guideline (2.46/100 PY; IRR = 4.61; 95% CI: 1.60–13.27) and lowest for the WHO guideline (1.89/100 PY; IRR = 1.52; 95% CI: 0.69–3.35). Conclusions Being identified as eligible for PrEP was associated with a higher risk of infection. The magnitude of risk varied according to the guideline used. However, the number of HIV infections identified among ineligible participants highlights the potential for missing people who need PrEP.info:eu-repo/semantics/publishedVersio