Overview of Good Clinical Practices, Barriers, and Gaps for Integrated Care

Albuquerque, M., Meira, B., Barros, R., Pavão, J. F., Lopes, H., & Valverde, A. M. H. (2023). Dementia Appraisal: Overview of Good Clinical Practices, Barriers, and Gaps for Integrated Care. International Journal of Geriatrics and Gerontology, 7(1), 1-22. [173]. https://doi.org/10.29011/2577-0748.100073Introduction: The increasing prevalence of dementia and mild cognitive impairment is a priority for health systems and society in the coming years. The aim of this study was to provide an overview of good clinical practices, barriers, and gaps for integrated dementia care. Methods: An electronic search was conducted on PubMed database for the last five years for articles relevant to the scope of the study, conducted in humans, written in Portuguese or English, and open access. National and international guidelines and consensus documents recognized in Europe were also included. Results: With increasing life expectancy and aging as major risk factors, the number of people living with dementia will become unsustainable for medical, social, and informal care. Ineffective care pathways lead to unnecessary medical interventions and suboptimal care. People with dementia should be involved in all stages of care and research. High-quality epidemiological data by disease severity and dementia subtype are needed. The development of novel technologies to improve clinical assessment of cognition and function that are sensitive and accurate in early stages of dementia and can be used in primary care is also an unmet need. A strategy to improve dementia care from diagnosis to end of life is lacking. Research into effective models of care and new treatment pathways with a more accurate selection of patients in early stages of the disease is crucial. Conclusions: There are currently several gaps in dementia care. Integrated care pathways, patient-centered approaches, and the establishment of a workforce based on a comprehensive and pragmatic framework are priorities that should be included in public health strategies.publishersversionpublishe

Challenges and Opportunities

Valverde, A. M. H., Lopes, H., Pavão, J. F., Barros, R., Meira, B., & Albuquerque, M. (2023). Sustainable Improvements in Dementia Care for an Expectably Increasing Number of Dementia People: Challenges and Opportunities. Medical Research Archives, 11(10), 1-12. https://doi.org/10.18103/mra.v11i10.4518---This paper received a grant from Roche Pharmaceuticals Química Portugal LDA, without any conditionalism, being the result of the sole responsibility of the authorsBackground: Aging, low literacy, and vascular risk factors are agents to boost or maintain the numbers, with more and more elevated costs for informal caregivers and society. Widely public health priority recognition implies changes and challenges in some European countries involving political engagement, needs that in dementia care are unmet. A preliminary diagnosis of the gaps and a prioritization of strategies to be implemented in Portugal should be addressed. The World Health Organization framework for meaningful engagement could work, as it has already done for other chronic diseases to reach some of the goals to improve healthcare. Methods: A review of the current situation and some of the initiatives delivered through healthcare professionals with recognized experience in dementia areas and patients’ associations, in a South Europe country over the last few years. In view of the remaining gaps, proposals from the literature will be provided to improve care experiences. Conclusion: We defend that is essential that Portugal deepen patient-centered care, integrated care pathways, and equal access for rural or marginalized populations to specialist assessment for an early diagnosis. Improving the quality of dementia care in care homes or managing a dementia care program to link resources for patients and caregivers, are key themes that need proactive preparation for the coming years. We present 8 recommendations for dementia care in Portugal.publishersversionpublishe

Cidadania para a saúde: o papel do cidadão na promoção da saúde

Tendo já decorrido alguns anos desde a sua definição pela Organização Mundial de Saúde, os conceitos de Promoção da Saúde e Cidadania em Saúde são temas complexos que vão muito para além do sector da Saúde e que exigem uma ação coordenada entre diferentes stakeholders, devendo servir o objetivo de colocar a saúde na agenda e na prioridade de todas as políticas. As tendências demográficas, os avanços tecnológicos e as exigências orçamentais colocam enormes desafios à Sociedade, sendo essencial que a Promoção da Saúde evolua de forma a tornar-se uma responsabilidade major de todos os Governos e uma área-chave das comunidades, da sociedade civil, das organizações e de cada um dos cidadãos. Falar de cidadania ou de participação do cidadão está na ordem do dia. Esta obra pretende lançar o debate em Portugal e iniciar uma reflexão sobre o papel do cidadão na Promoção da Saúde. Uma iniciativa conjunta do Instituto de Ciências da Saúde da Universidade Católica Portuguesa e da Mundo a Sorrir (ONGD).info:eu-repo/semantics/publishedVersio

Grau de cobertura do solo e dinâmica da vegetação em olivais de sequeiro com a introdução de herbicidas Ground cover and dynamic of weeds after the introduction of herbicides as soil management system in a rainfed olive orchard

São apresentados resultados do grau de cobertura do solo e da dinâmica da vegetação num olival de sequeiro, localizado em Mirandela, após a introdução de herbicidas como estratégia de manutenção do solo. As modalidades em estudo foram: mobilização tradicional; herbicida pós-emergência (glifosato); e herbicida com componentes de acção residual e pós-emergência (diurão+glifosato+terbut ilazina). O grau de cobertura e a composição da vegetação foram avaliados desde 2002 a 2007 pelo método do ponto quadrado. Ambas as soluções herbicidas combateram adequadamente a vegetação herbácea em aplicação única anual. O grau de cobertura no talhão mobilizado, antes da primeira mobilização, oscilou entre 50 a 80 % e 30 a 60 % debaixo e fora da copa, respectivamente. O tratamento com glifosato permitiu um grau de cobertura em Abril entre 60 a 90 % debaixo da copa e 40 a 50 % fora da copa. No tratamento com herbicida residual o grau de cobertura do solo foi sempre muito baixo ao longo do ano. A gestão da vegetação com glifosato permitiu a cobertura do solo durante todo o ano, com vegetação viva desde o Outono à Primavera e um mulching de vegetação morta durante o Verão. Nas restantes modalidades o solo permaneceu descoberto durante grande parte do ano. No talhão gerido com glifosato a vegetação manteve elevada dinâmica. Um ano após o início da aplicação de glifosato apareceu a dominar o coberto Ornithopus compressus. Com o tempo ganharam importância algumas espécies de Inverno de ciclo muito cur-to (como Mibora mínima e Logfia gallica)e outras de elevada produção de sementes e fácil dispersão pelo vento (como Hypochaeris radicata e Conyza canadensis) com origem provável em incultos e caminhos que circundam o olival ou em plantas individuais que escaparam à acção dos herbicidas.Results of the percentage of ground cover by weeds and the dynamic of the vegetation are presented after the introduction of herbicides as soil management strategies in a rainfed olive orchard. The field experiment was carried out in Mirandela, NE Portugal. The soil management treatments included: conventional tillage; post-emergence herbicide (glyphosate); and post-emergence plus residual herbicide (diuron+glyphosate+terb utilazine). The ground cover percentage and the botanical composition of vegetation were monitored since 2002 to 2007 from the point-quadrat method. Both the herbicide formulations killed efficiently the vegetation in a single annual application. The ground cover percentages in conventional tillage, prior to the first tillage event, varied between 50 to 80 % beneath the trees and between 30 to 60 % in the open space. The ground cover percentages in April, in the treatment of glyphosate, were in the range of 60 to 90 % and 40 to 50 % beneath the trees and between rows, respectively. In the residual herbicide plot the ground cover percentages were always very low. The soil of the glyphosate plot was covered with vegetation over all the year. In au-tumn/spring the soil was covered with green weeds and in the summer with a mulching of the dead material. In the glyphosate plot the dynamic of species was high. One year after the first application of herbicide, Ornithopus compressus appeared as the most abundant species. Thereafter, acquired relevance species with short growing cycles which seeds mature before April (e.g. Mibora minima, Logfia gallica) and other that produce a high number of seeds easily spread by wind (e.g. Hypochaeris radicata, Conyza canadensis) and which seeds proceeded from surrounding untilled fields and rural-tracks or from individual plants that escaped to the herbicide control

Olive yields and tree nutritional status during a four year period without nitrogen and boron fertilization

Nitrogen (N) and boron (B) are mobile elements in soil. Therefore, the application of these nutrients is typically performed annually, as a single dose, or even splitting it into several fractions in the case of N. In olive (Olea europaea L.), however, controversial literature has suggested that yearly application of N may not be required. In the case of B some authors indicated that one single application is sufficient for three or four years. Thus, the effect of these elements on olive yield, leaf N and B concentrations, as well as soil available N and B were investigated during a field trial performed in an olive orchard located in NE Portugal, in which N and B were not applied for four consecutive growing seasons. Fertilizer treatments consisted of the following: the control, which was a ‘complete’ fertilization plan where N and B were included (N+B treatment); –N treatment, with N excluded from the fertilization plan; and –B treatment, with B excluded. Available soil N and B were estimated from a pot experiment with Italian ryegrass (Lolium multiflorum L.) and from chemical laboratory extractions. Olive yield decreased significantly in the –N treatment in comparison to the control. A slight yield reduction in the –B treatment in comparison to the control was also observed. Leaf N and B concentrations decreased significantly in the –N and –B treatments, respectively, in comparison to the N+B treatment. Soil available N and B at the end of the experiment were significantly lower in the –N and –B treatments, respectively, in comparison to the N+B control. The results showed a continuous decrease in olive yield and leaf N and B concentrations, which reflected the reduction in soil available N and B in the treatments lacking the respective nutrient. Therefore, it seems prudent the recommendation of adjusted rates of N and B every year to prevent reduction in tree crop performance and improve nutrient use efficiency

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data