Browsing by Issue Date, starting with "2025-04-23"
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- Medication adherence and glycemic control in older adults with type 2 diabetes: a cross-sectional study in a community settingPublication . Nascimento, Tânia; Andrade, Amanda de Oliveira; Pinto, Ezequiel; Cabrita, Catarina; Pais, Sandra; Puerta, Rocío de laBackground/Objectives: Glycemic control is essential for preventing both short- and long-term complications of type 2 diabetes (T2D), requiring strict adherence to pharmacological therapy. Medication adherence directly influences therapeutic effectiveness, making its assessment in clinical practice crucial. This study aimed to evaluate medication adherence in elderly patients with T2D and its association with glycemic control. Methods: A descriptive cross-sectional study was conducted in the Algarve, Portugal, involving 133 elderly patients (≥60 years) with T2D. Cardiometabolic parameters and medication adherence (global, intentional, and unintentional) were assessed. Statistical analyses were performed using IBM SPSS Statistics 28.0. Results: The study population had a mean age of 71.7 ± 5.7 years, with a predominance of male participants (57.9%) and a high prevalence of dyslipidemia and/or hypertension. Cardiometabolic control was generally poor, with only 26.3% achieving blood pressure targets (≤140/90 mmHg), 8.5% maintaining fasting glycemia within the recommended range (70–110 mg/dL), and 13.6% attaining glycated hemoglobin (HbA1c) values ≤ 7%. Despite this, medication adherence was notably high (97.7%), with no significant association with cardiometabolic control (p > 0.05). Unintentional non-adherence behaviors, such as forgetfulness and inconsistent medication schedules, were the most frequently reported. Conclusions: Although elderly patients with T2D demonstrated high medication adherence rates, their cardiometabolic control remained suboptimal. Unintentional non-adherence behaviors may contribute to poor glycemic control. However, medication adherence alone does not fully explain these outcomes, highlighting the need to assess adherence to other self-care behaviors, particularly dietary and physical activity patterns. Future interventions should integrate comprehensive lifestyle modifications alongside pharmacological management to enhance overall disease control.
- Benchmarking tourism destinations - a contribution to performance measurement and management of tourism organisations in PortugalPublication . Asare, Richmond Takyi; Martins, Ana Isabel Rita; Custódio, Maria João FerreiraTourism has become a major component of the global economy, contributing significantly to employment, GDP growth, and foreign exchange earnings (UNWTO, 2019). Tourism organisations must prioritise effective and efficient performance measures and management strategies to maintain competitiveness and sustainability. This study focuses on benchmarking as a strategic tool for improving the performance of tourism destinations in Portugal by employing a systematic research approach to analyze the methodologies, challenges, and outcomes in this area, specifically in tourism destination image. This study presents a comprehensive literature review on benchmarking, with a particular focus on its application in tourism destinations. It then conducts a systematic literature review of benchmarking research published between 2015 and 2023, with special emphasis on the role of destination image. The research further analyses the impact of benchmarking on performance improvement, identifying the key barriers to its implementation and proposing effective strategies to overcome these challenges. In conclusion, this thesis firmly establishes that benchmarking is an indispensable strategic tool for destinations and tourism organizations in Portugal. Although challenges to its implementation exist, they are not insurmountable. Furthermore, this research addresses the need for a more structured and empirical approach to benchmarking within Portuguese tourism, providing a clearer understanding of how benchmarking practices influence long-term sustainability and performance enhancement. The study also examines the effectiveness of existing benchmarking models and proposes refinements suitable for the Portuguese tourism industry. This research provides evidence-based insights for policymakers, destination managers, and stakeholders in the tourism industry. It is intended to promote sustainable tourism development, improve benchmarking practices, and enhance Portugal's global reputation as a competitive tourism destination.
- Genotyping and susceptibility assessment of bacteria of the ENTEROBACTERIALES isolated from patients suffering from fecal incontinencePublication . Imbundé, Domingos; Faleiro, LeonorThe human intestinal microbiota is composed of large number of microorganisms that reside in our intestine. This community is mainly constituted by a great diversity of bacteria, fungi and bacteriophages. Amidst them, a large proportion of bacteria that live in the gastrointestinal tract are bacteria that belong to the order of Enterobacteriales. When the community of the members of the order Enterobacteriales unbalanced, they can lead to intestinal dysbiosis that can impact the health status of the host. The alteration in the bacterial community of human intestine can be associate to many factors, for instance unproper use of antibiotics, which change the intestinal bacteriome equilibrium. The results can include inflamed intestine, faecal incontinence (FI). The goal of the current study was to isolate and identify members of the order Enterobacteriales followed by their genotyping BOX-PCR and determine their antibiotic susceptibility. For this purpose, 25 faecal samples of women over 60 years that suffered from faecal incontinence that attended in hospitals in the Algarve region. From these 25 samples analyzed, 72 isolates were obtained, which identification was performed using the Remel RapID ONE System. Escherichia Coli, Shigella sp., Klebsiella pneumoniae, and E. coli 0157:H7 were the more prevalent among the samples. Regarding the BOX-PCR profile the bacterial isolates showed a large diversity. Moreover, 80 to 94,7% of similarity was observed between 27 clusters, unveiling high degree of enterobacterial diversity among the isolate. It is important to highlight that only 3 faecal samples showed to carry specific strains. The antibiotic susceptibility was evaluated by using Kirby-Bauer disk diffusion method. The resistance profiles were observed for amoxicillin (AMC), with 72, 20% among the 72 isolates. the Multidrug Resistance profile (MDR) was more frequent for penicillins than other antibiotic class with 79% of MDR. The multidrug resistance observed among these samples will challenge the treatment of the patients. The BOX-PCR technique showed to good distinction between the bacterial genus and species, unfortunately it was no able to discriminate variants in the same species. Thus, more effective genomic studies are require.
- Beyond physical accessibility: a bibliometric analysis about the influence of digital communication and the use of technology on inclusive tourism in WCAG 3.0 era—tourism for all from a more accessible content perspectivePublication . Fernández-Díaz, Elena; de Matos, Nelson Manuel da Silva; Correia, Marisol B.This study aims to analyze the impact of digital communication and the use of technology in tourism. It also evaluates how new digital and technological trends, such as mobile applications and emerging virtual or augmented reality technologies, can be applied to web pages. Information that is not accessible becomes another barrier for travelers with disabilities and does not contribute to the concept of "tourism for all." A bibliometric analysis through Web of Science (WoS) of published articles related to the influence of digital communication and the use of technology in tourism. A total of 290 articles were analysed using VOSviewer and SciMAT. The web accessibility does contemplate the regulations currently in force and therefore progress continues to be slow in this aspect. Also, technology together with new digital communication channels improve the experience of tourists and visitors to a destination, in turn impacting on their quality of life and enhancing "Tourism for all". Furthermore, it is determined that the "phygital" concept takes on special relevance since many studies are aimed at combining both dimensions so that if a space complies with accessibility regulations, they are also considered from the information point of view in its digital sphere. This study provides an evolution of digital accessibility from a technological and communicational perspective by combining two complementary analyses and allows us to understand tourist behavior from a more inclusive aspect. There are important gaps in other areas of study, especially focused on stakeholders' knowledge of the importance of making improvements in tourism for all.