Disparities in geographical access to hospitals in Portugal

UIDB/04647/2020 UIDP/04647/2020 UIDB/04084/2020Geographical accessibility to health care services is widely accepted as relevant to improve population health. However, measuring it is very complex, mainly when applied at administrative levels that go beyond the small-area level. This is the case in Portugal, where the municipality is the administrative level that is most appropriate for implementing policies to improve the access to those services. The aim of this paper is to assess whether inequalities in terms of access to a hospital in Portugal have improved over the last 20 years. A population-weighted driving time was applied using the census tract population, the roads network, the reference hospitals' catchment area and the municipality boundaries. The results show that municipalities are 25 min away from the hospital-3 min less than in 1991-and that there is an association with premature mortality, elderly population and population density. However, disparities between municipalities are still huge. Municipalities with higher rates of older populations, isolated communities or those located closer to the border with Spain face harder challenges and require greater attention from local administration. Since municipalities now have responsibilities for health, it is important they implement interventions at the local level to tackle disparities impacting access to healthcare.publishersversionpublishe

Integração de Dados Censitários na Classificação de Imagens de Satélite (IDECIS)

A principal finalidade da metodologia apresentada neste documento é o desenvolvimento e a validação, através da aplicação a um caso de estudo, de uma forma eficiente de classificação de imagens de satélite, que integra informação auxiliar (dados dos Censos, do Plano Director Municipal e a rede viária) e dados provenientes de Detecção Remota, num Sistema de Informação Geográfica. O procedimento desenvolvido segue uma estratégia de classificação por níveis, sendo composto por três estágios principais: 1) Estratificação pré-classificação; 2) Aplicação dos classificadores de Bayes e da Máxima Verosimilhança (MV); 3) Aplicação de regras de pós-classificação. As abordagens comuns incorporam os dados auxiliares antes, durante ou depois da classificação. No método proposto recorre-se a esse tipo de informação em todas as etapas. O método consegue, globalmente, melhores resultados que os classificadores clássicos: Mínima Distância, Paralelepípedo e Máxima Verosimilhança. Além disso, melhora substancialmente a exactidão das classes onde o processo de classificação faz uso da informação auxiliar.info:eu-repo/semantics/publishedVersio

Pediatric Cataracts: A Retrospective Study of 12 Years (2004 - 2016)

Introduction: Cataracts are a major cause of preventable childhood blindness. Visual prognosis of these patients depends on a prompt therapeutic approach. Understanding pediatric cataracts epidemiology is of great importance for the implementation of programs of primary prevention and early diagnosis. Material and Methods: We reviewed the clinical cases of pediatric cataracts diagnosed in the last 12 years at Hospital Pedro Hispano, in Porto. Results: We identified 42 cases of pediatric cataracts with an equal gender distribution. The mean age at diagnosis was 6 years and 64.3% of patients had bilateral disease. Decreased visual acuity was the commonest presenting sign (36.8%) followed by leucocoria (26.3%). The etiology was unknown in 59.5% of cases and there was a slight predominance of nuclear type cataract (32.5%). Cataract was associated with systemic diseases in 23.8% of cases and with ocular abnormalities in 33.3% of cases. 47.6% of patients were treated surgically. Postoperative complications occurred in 35% of cases and posterior capsular opacification was the most common (25%). Discussion: The report of 42 cases is probably the result of the low prevalence of cataracts in this age. Although the limitations of our study include small sample size, the profile of children with cataracts in our hospital has characteristics relatively similar to those described in the literature. Conclusion: Given the high proportion of idiopathic pediatric cataracts, prevention of the disease remains a challenge worldwide

When an Easy Thing Goes Wrong: Foreign Body Induced Granuloma-Associated Scleritis Following Pterygium Surgery

Purpose: To report a case of pterygium surgery with conjunctival autograft followed by focal necrotizing scleritis due to foreign body entrapment in the scleral bed. Case Report/Results: This is a case report of a 76-years-old male patient who underwent nasal pterygium surgery and developed focal necrotizing scleritis secondary to foreign body entrapment under conjunctival autograft. One month following surgery, slit-lamp examination demonstrated a progressive thinning of the surgical area with focal inflammatory signs. A small synthetic fiber was identified to be trapped under the graft. A second intervention was performed with foreign body removal and a new conjunctival graft. Despite the surgery, focal scleral melting continued to progress and the patient was placed under systemic corticotherapy and submitted to amniotic membrane graft with epithelial side up. During the follow-up period there was a good tissue response. Conclusion: Despite being a safe and quick procedure, pterygium surgery can sometimes elicit new challenges

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved