An Overview of Systematic Reviews

Funding Information: Funding: R.M.C., L.V. and I.C. were supported by Fundação para a Ciência e a Tecnologia for funds to GHTM-UID/04413/2020. R.M.C was supported by Fundação para a Ciência e a Tecnologia for funds to her Doctoral Program (UI/BD/151065/2021). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Introduction: Globally, anemia is still a public health issue faced by people in low and high-income countries. This study gives an overview of published scientific articles related to the prevalence, nutritional indicators, and social determinants of anemia in pregnant women and children aged 6 to 59 months living in Mozambique and Portugal. Methods: We performed a review of scientific literature in April 2021, searching for published indexed articles in the last 15 years (2003–2018) in electronic databases. Subsequently, quality assessment, data extraction, and content analysis were performed. Results: We have identified 20 relevant publications. Unsurprisingly, anemia plays a relevant role in disability and life imbalances for these subgroups in Mozambique compared with Portugal. For both countries, data on anemia and iron deficiency in pregnant women and children aged 6 to 59 months old are either outdated or remain unclear. Similarly, studies on social determinants and anemia are also still scarce. Conclusions: A gap of information on anemia, other nutritional indicators, and social determinants in pregnant women and children between 6 and 59 months of age living in Mozambique and Portugal is highly observed. More research is crucial to help achieve the goals established by the Sustainable Development Goals.publishersversionpublishe

Conceptualizing a credits trading approach towards corporate social responsibility credits

Life Cycles of both products and services significantly consume renewable and non-renewable resources across a worldwide scale. Thus, eliciting an enormous environmental impact, that is known to disproportionately instigate crises into the socio-economic and political domains of our civilization. Therefore, Creation of Shared Value and Corporate Social Responsibility (CSR) have been considered by Policy makers, Public and Private Institutions. In addition to Corporate Philanthropy, CSR practices also encompass a wide spectrum of activities, including Stakeholder safety/welfare, designing sustainable products and ecological restoration to name a few which are ascertained to capital and knowledge intensive in nature. Therefore, this paper primarily structures the scope of CSR and proposes a mechanism for trading Corporate Social Responsibility credits in order to incentivize stakeholder centered business practices. Furthermore, the CSR credits trading methodology would entail similar mechanisms used by its remotely successful predecessors namely, tax incentives, tradable credits/certificates and flexible mechanisms for implementing sustainable projects. The CSR credits trading methodology is envisioned to entail a more holistic approach towards overall Sustainability when compared to Carbon Offsets/Renewable Energy Certificates which are more focused towards reducing the environmental footprint.The author acknowledges the contribution of MIT Portugal Program, University of Minho and Fundação para a Ciência e Tecnologia (FCT), Portugal (Foundation Of Science and Technology, Portugal) for the scholarship grant SFRH / BD / 33794 / 2009

Detection of atovaquone-proguanil resistance conferring mutations in Plasmodium falciparum cytochrome b gene in Luanda, Angola

BACKGROUND: The fixed dose combination atovaquone-proguanil is a recently introduced antimalarial for treatment and prophylaxis of Plasmodium falciparum malaria. It is highly effective with a good tolerability profile and a convenient prophylactic regimen. Nevertheless, cases of treatment failure have already been reported, which have been associated to mutations in the cytochrome b gene of the Plasmodium (pfcytb). The presence of atovaquone-proguanil in vivo resistance conferring mutations in pfcytb gene in Luanda, Angola, was investigated, in order to make recommendations on prescribing this antimalarial as prophylaxis for travellers. METHODS: Two hundred and forty nine blood samples from children hospitalized at Luanda Pediatric Hospital for malaria were studied. The PCR-RFLP methodology was used in order to identify pfcytb wild type codon 268 and two point mutations: T802A and A803C. RESULTS: All samples were identified as wild type for pfcytb gene at codon 268. In the studied population, no mutations associated to atovaquone-proguanil treatment failure were found. Prevalence of the studied mutations in the region was estimated to be less than 0.77% (99% significance level). CONCLUSION: Atovaquone-proguanil can be recommended for use by travellers to Luanda with expected high efficacy. This represents an improvement compared to other currently used prophylatic antimalarials in this region. However, it is imperative to continue surveillance

Hospitalization of Children with Rotavirus Infection

Introdução. A infecção por rotavírus é a principal causa de diarreia aguda em todo o mundo. Nos países desenvolvidos não constitui uma causa importante de morte, mas cursa com uma alta morbilidade. Objectivo. Caracterizar a infecção por rotavírus em crianças hospitalizadas em dois Departamentos de Pediatria de Lisboa. Material e métodos. Revisão casuística dos internamentos com o diagnóstico de infecção por rotavírus, num hospital central especializado e num hospital geral na Zona Metropolitana de Lisboa, entre Janeiro e Dezembro de 2005. O diagnóstico foi efectuado através da identificação de antigénios virais nas fezes por “enzyme immunoassay”. Resultados. Foram analisados 92 casos; 82% ocorreram entre Dezembro e Março e 52,8% em crianças entre os três e os doze meses. Em metade dos casos registou-se bom nível socio-económico. Os factores de risco epidemiológicos encontrados foram: frequência de instituição de ensino ou ama em 21/38 (55%), contacto com pessoas com sintomatologia semelhante em 10/53 (19%) e irmãos com idade inferior a cinco anos em 25/76 (33%) das crianças. As infecções nosocomiais foram responsáveis por 26% dos casos estudados. A clínica cursou com: diarreia aquosa (96%), vómitos (87%) e febre (69%). Ocorreram complicações em 19/92 (21%) crianças e estas foram mais frequentes em lactentes com menos de seis meses de idade (35% vs. 16%, p=0,058). A mediana da duração de internamento foi cinco dias e o custo hospitalar directo variou entre 629,63 e 2342,38 euros. Discussão. O número de internamentos por infecção por rotavírus, especialmente em lactentes, a frequência de infecções nosocomiais por este agente, as complicações inerentes e os elevados custos, reflectem a importância da infecção por este agente em países desenvolvidos como Portugal

Evidence based practice as an indicator of clinical supervision in nursing in context of ambulatory surgery

Clinical supervision and evidence-based practice in nursing should be understood as complementary and indissociable as they go hand in hand towards the same objectives. Therefore, the supervising process, should boost the evidence-based practice in order to promote better nursing care. The purpose of this study is to evaluate nurse’s predisposition to incorporate evidence-based practice into their care and to identify barriers to its application with the purpose of propose contributions for the implementation of a nursing clinical supervision model that encourages the use of the best evidence available into the daily practice. The study is integrated into the research project “SAFECARE – Supervisão Clínica para a segurança e qualidade dos cuidados”. It was developed an exploratory-descriptive study in an ambulatory surgery unit of a University Hospital in Porto, Portugal. It had a target population of 59 nurses, and it was used the “Evidence-Based Practice Questionnaire” as a method of collecting data. From the 49 questionnaires collected, we find that the subscale “Practices” has an average score of 4.89, the subscale “Attitudes” 5.36 and the subscale “knowledge/skills and competences” 5.08. These results showed that nurses have a low use of evidence-based practice when compared with the level of knowledge, skills and competences shown, although they seem to have a positive attitude towards this subject. These results can be partially explained by the overburden felt by the nurses, which identified the lack of time and motivation, but also inappropriate training and scarcity of team meetings and proper tools in the workplace as barriers.info:eu-repo/semantics/publishedVersio

Admission for Imported Malaria in Children, in Two Hospitals of Lisbon Urban Area

Introdução: Apesar de em Portugal não haver malária endógena,a crescente mobilidade das populações e os laços históricos com África possibilitam a importação de casos para o nosso país. O presente estudo pretende contribuir para melhorar o conhecimento epidemiológico e clínico da malária importada na região de Lisboa. Métodos: Realizou-se um estudo descritivo das crianças com malária, internadas em dois hospitais da Grande Lisboa, durante um período de seis anos (1999-2004). Resultados: Foram identificados 134 casos, sendo a mediana das idades de sete anos. A maioria (93,3%) era de origem africana e referia estadia em região endémica (90%). O Plasmodium falciparum foi o agente etiológico mais frequente (73%). A febre foi a manifestação clínica mais frequente, seguida de manifestações gastrointestinais e cefaleias. Ocorreram complicações em 42% dos doentes, sendo a trombocitopenia (19,4%) e a anemia grave (9%) as mais frequentes. A halofantrina e o quinino foram os anti-maláricos mais usados. Conclusões: A malária importada é uma patologia relativamente comum na Grande Lisboa e, dada a inespecificidade do quadro clínico, todas as crianças febris ou doentes com estadia recente num país endémico devem ser rastreadas para esta entidade

Acute Hepatitis of Unknown Origin in Children: Two Cases in a Portuguese Hospital

Several cases of paediatric acute hepatitis of an unknown aetiology have been described in these last few months and in several countries worldwide. We present two patients, a 7-month-old girl and an 8-year-old boy, with gastrointestinal symptoms and lethargy, associated with elevation of transaminase levels. Serologies for hepatitis A-E virus and PCR test to SARS-CoV-2 were all negative. In the first case, an adenovirus serotype C could be isolated in a respiratory sample as well as cytomegalovirus (CMV) in the blood (100 copies/mL). In both children, there was a progressive decrease in the hepatic markers and symptomatic resolution, compatible with a good prognosis, also seen globally in most cases. To date, infection remains the most plausible cause to consider, especially when it is presumed to be linked to adenovirus. Other potential agents and causes are still being evaluated, thus emphasizing the importance of continuous epidemiological surveillance, notification, and detailed study of all hepatitis cases

Adverse events in Portuguese hospitals in 2008

RESUMO - Introdução: A criação pela Organização Mundial de Saúde da World Alliance for Patient Safety em 2004, é resultado da preocupação crescente face ao domínio da segurança do doente, sendo a ocorrência de erros reconhecida como um grande problema de saúde pública e uma ameaça à qualidade dos cuidados prestados. Objectivo, material e métodos: Tendo por base os códigos da Classificação Internacional de Doenças, 9.ª Revisão, Modificação Clínica (subclasses 996-999, E870-E876 e E878-879), esta investigação procurou conhecer a dimensão dos eventos adversos, decorrentes da prestação de cuidados de saúde nos hospitais públicos de Portugal Continental, relatados no sistema de classificação de doentes em Grupos de Diagnóstico Homogéneo, no ano de 2008. Resultados e discussão: Os resultados revelaram a ocorrência de eventos adversos em 2,5% dos episódios de internamento hospitalar, surgindo na sua maioria como diagnósticos secundários de internamento. A frequência de eventos adversos foi ligeiramente superior nos indivíduos do sexo masculino (2,6%) quando comparada com o sexo feminino (2,4%). A idade dos indivíduos com eventos adversos é em média cinco anos superior à dos restantes indivíduos. O tempo de internamento nos casos de eventos adversos foi em média 4,14 vezes superior quando comparado com o tempo médio de internamento dos restantes episódios. Foi possível também estimar que os custos associados a eventos adversos correspondam a cerca de 4.436€ por episódio de internamento, tendo como referência o custo unitário total por dia de hospitalização no Serviço Nacional de Saúde. A frequência de destino após alta para outra instituição com internamento foi 2,5 vezes superior nos casos de eventos adversos, enquanto o número de falecimentos foi 2,44 vezes superior, quando comparados com os restantes episódios de internamento. Verificou-se ainda que o destino após alta para o domicílio foi menos frequente nos episódios com eventos adversos. As diferenças de frequência de eventos adversos por região foram ligeiras, sendo superior na região centro (3,0%) e inferior na região do Alentejo (1,7%). Conclusão: Os dados sugerem que a ocorrência de eventos adversos possa estar associada a períodos de internamento mais prolongados, maiores custos e maior mortalidade. A frequência de eventos adversos foi maior em indivíduos mais velhos e a diferença entre sexo ou região hospitalar não se mostrou substancial. Neste sentido, é urgente conhecer o real impacto dos eventos adversos, nomeadamente em indicadores como morbilidade e mortalidade dos portugueses.ABSTRACT - Introduction: The establishment of the World Alliance for Patient Safety by the World Health Organization in 2004, results from the increased concern about patient safety, with the occurrence of errors being recognized as a major public health problem and a threat to quality of health care. Objective, material and methods: Although the Portuguese reality is not yet studied in a systematic way, it is possible to approach the problem through the study of secondary data sources. Thus, based on the International Classification of Diseases, 9th Revision, Clinical Modification (996-999, E870-E876 and E878-879 subclasses), this research sought to know the extent of adverse events resulting from health care in Portuguese public hospitals, reported on the patient classification system Diagnosis Related Groups, during the year 2008. Results and discussion: Adverse events occurred in 2.5% of the hospital admissions and mainly as secondary diagnosis. 2.6% of the men and 2.4% of the women were harmed by adverse events during inpatient care. The individuals with adverse events were on average five years older than the individuals without adverse events. The length of stay was on average 4.14 times longer in the cases with adverse events when compared with the average length of stay in the remaining episodes. The costs related to adverse events totals about 4.436€ per hospital admission, bearing in mind the cost per hospitalization day within the National Health Service. After hospital discharge, the destination to another institution was 2.5 times more frequent among patients with adverse events, while the number of deaths was 2.44 times higher in this group when compared with the remaining individuals. It was also possible to verify that patients impaired by adverse events went home less frequently than the other patients. Adverse events occurred more in the Centro of Portugal Region (3.0%) and less in the Alentejo Region (1.7%). Conclusion: Adverse events seem to be related with longer length of stay, higher costs and higher mortality rates. Adverse events occurred mainly in older individuals and the difference between sex or region hospital was not substantial. The results of this study urgently requires a better knowledge of the real impact of adverse events in Portugal, namely through the Portuguese morbidity and mortality indicators.info:eu-repo/semantics/publishedVersio

Acoustic barriers as an acoustic deterrent for native potamodromous migratory fish species

This study focused on the use of sound playbacks as acoustic deterrents to direct native potamodromous migratory species away from all kind of traps. The effects of two acoustic treatments, a repeated sine sweep up to 2 kHz (sweep-up stimulus) and an intermittent 140 Hz tone, were tested in three fish species native to Iberia: Salmo trutta, Pseudochondrostoma duriense and Luciobarbus bocagei. In contrast with S. trutta, the endemic cyprinids P. duriense and L. bocagei exhibited a strong repulse reaction to the frequency sweep-up sound. The 140 Hz stimulus did not seem to alter significantly the behaviour of any of the studied species. These results highlight the potential of acoustic stimuli as fish behavioural barriers and their application to in situ conservation measures of native Iberian fish populations, to protect them from hydropower dams. In addition, this study shows that acoustic deterrents can be used selectively on target species.The project n 13737: Original Solutions - ENI and CITAB-UTAD was funded project: ANI/QREN/FEDER. The Science and Technology Foundation, Portugal funded M.C.P.A. (strategic projects UID/MAR/04292/2013 granted to MARE) and P.J.F. (UID/BIA/00329/2013 granted to cE3c). The scientific plan was achieved under European Investment Funds by FEDER/ COMPETE/POCI– Operational Competitiveness and Internationalization Programme, under Project POCI- 01-0145-FEDER-006958 and National Funds by FCT - Portuguese Foundation for Science and Technology, under the project UID/AGR/04033.info:eu-repo/semantics/publishedVersio