ESS2-Artigos (em revistas ou actas indexadas)
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Percorrer ESS2-Artigos (em revistas ou actas indexadas) por Objetivos de Desenvolvimento Sustentável (ODS) "09:Indústria, Inovação e Infraestruturas"
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- Abdominal Ultrasound Phantom – A potential training toolPublication . Pinheiro, João; Ribeiro, A. D. M.; Ribeiro, L. P. V. P. V.The purpose of this educational intervention was to evaluate the effectiveness of abdominal ultrasound phantoms as a simulation-based learning tool in the training of Medical Imaging and Radiology students. Abdominal ultrasonography is a highly operator-dependent modality, yet undergraduate training is often limited by restricted patient access, ethical considerations, and reduced opportunities for supervised practice [3,6]. Simulation-based learning offers a safe and reproducible environment for hands-on training, supporting experiential learning and skill acquisition [3,4].
- O acesso aos serviços públicos de saúde no futuro: Elementos para a realização de uma antropologia antecipatóriaPublication . Pinto da Costa, José CarlosO documento discute como as transformações nos sistemas de saúde, como a medicina de precisão, saúde digital e cuidados baseados em valor, podem afetar a equidade no acesso à saúde no futuro. Apresenta as três discursividades e como contribuem para a eficiência, mas também podem aumentar os custos e dificultar o acesso. Conclui que é preciso antecipar os impactos destas transformações nas populações para promover a equidade no acesso aos cuidados.
- Anticholinergic burden in elderly people in nursing homes: cross-sectional assessment using ACB calculator and CRIDECO anticholinergic load scalePublication . Nascimento, Tânia; Matos, Maria Ana; Pinto, EzequielBackground/Objectives: Anticholinergic burden is an important risk marker in older adults, associated with cognitive decline, falls, and increased mortality. This study aimed to assess anticholinergic burden in institutionalized elderly individuals using two tools (ACB calculator and CALS—CRIDECO Anticholinergic Load Scale), as well as to analyze its relationship with pharmacotherapeutic variables like polypharmacy. Methods: A descriptive cross-sectional study was conducted by analyzing the pharmacotherapeutic profiles of institutionalized elderly individuals (≥65 years) utilizing individualized medication preparation services from a community pharmacy in Alentejo (Portugal). Participants agreed to the study and had complete, up-to-date pharmacotherapeutic profiles. Results: The pharmacotherapeutic profiles of 75 institutionalized elderly people were analyzed; the sample comprised mostly women (72%) who had experienced excessive polypharmacy (≥10 medications) (56%) and had an average age of 85.62 ± 7.62 years. It was found that 90.7% (ACB) and 89.3% (CALS—CRIDECO) of the elderly had anticholinergic burden, with mean values of 3.60 ± 2.84 and 3.33 ± 2.51, respectively. Women exhibited higher anticholinergic burden in unadjusted analyses (p < 0.05). The burden correlated moderately with the total number of medications (p < 0.05). Conclusions: The results show high exposure to anticholinergic medications in the institutionalized elderly population, reinforcing the rationale for systematic therapeutic reviews focused on the pharmacological safety of institutionalized older adults in community pharmacies.
- Commentary on: nurses’ perceptions of artificial intelligence (AI) integration into practice: an integrative reviewPublication . Xavier, Tânia; Oliveira, ClaudiaWe are writing this letter to congratulate you on the paper ‘Nurses’ perceptions of artificial intelligence (AI) integration into practice: An integrative review’ by Lora and Foran, recently published in your journal. In this paper the authors synthesise remarkable, valuable and challenging aspects of the new era of artificial intelligence (AI) in the clinical practice of nursing. AI has been introduced into the most diverse areas of knowledge, opening a vast range of possibilities. This integrative review makes a timely and relevant contribution to the growing body of literature on the intersection between nursing and AI. The authors show that the practice of nursing, especially in the perioperative environment, is no exception.
- Conventional, specific, and robotic instrumentation in total knee arthroplasty. How are we progressing in functional outcomes and patient satisfaction?Publication . de Almeida Fontes, Ana Paula; Sousa, João PauloIn recent years, technological advances in total knee arthroplasty (TKA) have made procedures more precise, reducing complications and accelerating recovery. Although the latest techniques offer several advantages, there are still doubts regarding their true functional efficacy and the level of patient satisfaction they provide. Methods: A retrospective study involving 1,076 patients, distributed as follows: 366 (34.0%) conventional instrumentation (CI), 591 (54.9%) Patient-Specific Instrumentation (PSI), and 119 (11.1%) robotics. All functional outcomes were assessed preoperatively and 90 days postoperatively. Bivariate analyses were performed using ANOVA and the Kruskal- Wallis test, with a significance level of p < 0.05. Results: At 90 days, the robotics maintained the greatest flexion range (p = 0.001) and outperformed the PSI and IC in the walking test (350.3 ± 102.1 vs. 312.5 ± 92.9 and 283.8 ± 84.8, respectively; p < 0.001). On the WOMAC test, PSI performed best (14.5 ± 10.6; p = 0.001), with IC and robotics showing similar results (p = 0.974). There was no difference between the groups in absolute gains. In terms of percentage gains, PSI was higher in WOMAC compared to IC (p=0.041) and robotics (p<0.001). Satisfaction was identical between the instrumentation methods (p=0.199). Conclusion: Absolute gains in functional evolution and satisfaction appear to be independent of the surgical technique, although PSI appears to offer improvements in functional activities. Given the still-limited experience with robotic surgery, the functional benefits and long-term satisfaction remain inconclusive.
- Dotação eficaz de fisioterapeutas em internamento hospitalar: o método WISN como ferramenta de qualidade e gestãoPublication . Vítor Henriques; de Almeida Fontes, Ana Paula; Fidalgo, PedroA dotação de Recursos Humanos (RH) é essencial para a qualidade dos cuidados de saúde e segurança dos doentes. A Fisioterapia enfrenta desafios quanto à alocação eficaz de profissionais, sobretudo em internamento hospitalar. A literatura não identificou ferramentas específicas de gestão de RH aplicáveis à Fisioterapia. Contudo, o Workload Indicators of Staffing Need (WISN) revelou-se uma metodologia promissora, transversal às profissões de saúde. Este estudo apresenta a metodologia WISN como ferramenta de apoio ao cálculo da dotação de Fisioterapeutas em ambiente hospitalar. Trata-se de um estudo observacional, analítico e transversal, baseado em inquéritos a fisioterapeutas, com análise estatística descritiva e inferencial com vistas ao conhecimento dos tempos médios de sessões nas principais áreas funcionais e atividades de apoio e adicionais, os quais no WISN correspondem aos padrões de atividade. Os resultados fornecem parâmetros para aplicação do WISN, como Padrões de Atividade para adultos, que foram de 30, 40 e 30 minutos, e para Pediatria foram 30, 45 e 30 minutos, nas áreas Cardiorrespiratória, Neurológica e Ortotraumatológica, respectivamente. Estes valores são adaptáveis a diferentes unidades de internamento. Conclui-se que o WISN é aplicável à Fisioterapia, contribuindo para uma gestão mais eficaz, cuidados de maior qualidade e segurança para os doentes.
- Early identification of bladder diverticula in pre-hospital settings using screening sonography: a case reportPublication . Miravent, Sérgio; Gomes, Carla; Basescu, Andrea; Martins, Ana; Lobo, Manuel Duarte; Almeida, RuiObjective: Bladder diverticula, while not exceptionally rare in clinical practice, presents a significant diagnostic challenge, particularly in remote pre-hospital emergencies where technological limitations and the absence of specialized medical expertise prevail. This report aims to emphasize the role of screening ultrasound in the pre-hospital setting, Case Presentation: A patient experiencing severe lower abdominal pain presented at a basic emergency service (BES) for the third time presenting the same symptoms. Renal and pelvic ultrasound screening was performed, revealing suspected bladder distention and adjacent fluidfilled cavities, consistent with multiple bladder diverticula. Subsequently, the patient was referred to a referral central hospital for management by medical experts. Comprehensive evaluation confirmed the findings of the BES. Conclusion: The results of the screening ultrasound enabled the BES team to initiate clinical interventions to mitigate the patient’s discomfort. Screening ultrasound was crucial in identifying imaging markers that provided the physician with clinical data for correct and prompt patient orientation.
- Experience and expectation - Digital health implementation in Portugal as present-making via futures imaginationsPublication . Pinto da Costa, José CarlosTraditionally, anthropological analysis has placed emphasis on traditions, customs, and cultural heritage, often overlooking the connection between present actions and future aspirations. Acknowledging the reciprocal influence of present actions in shaping the future and the impact of future visions on shaping present actions, this article aims to redress the neglect of future implications on present social practices within anthropological studies. Through an investigation of the implementation of digital health in Portugal, utilizing discourse analysis, qualitative examination, and critical reflection, this study delves into the impact of digitization on sociotechnical systems within healthcare. It also introduces concepts pertinent to the anthropology of the future and methodological propositions for studying the future within the present context. This inquiry explores the sociotechnical imaginaries stemming from the conceptualization of digital health ideals and their realization in present contexts. Aligned with Koselleck's philosophy of historical time, this examination reveals an essential interplay between present actions and future consequences, advocating for an anticipatory approach in anthropology. This method seamlessly integrates future considerations into present realities, augmenting our understanding of social dynamics and fostering a forward-thinking perspective. This perspective is particularly valuable for scrutinizing the intricate political economies of techno-scientific promises fostered within innovation-oriented endeavours. The analysis, conducted across three dimensions—the utilization, reconfiguration, and evolution of the healthcare system through digitalization—highlights the intricate relationship between current healthcare practices, future aspirations, and the transformative impact of digitalization.
- Frailty and outcomes in elderly ICU patients: insights from a portuguese cohortPublication . Lourenço, Eva; Rodrigues, Isabel; Sampaio, Mário; da Costa, EmiliaBackground: Frailty is a key determinant of outcomes in critically ill elderly patients, but data from Portugal remain limited. To our knowledge, this is the first study to examine the prevalence and prognostic impact of frailty among elderly ICU patients in a Portuguese hospital setting. Objective: To determine the prevalence of frailty among elderly patients admitted to an intensive care unit (ICU) in southern Portugal and to examine its crude associations with illness severity, organ support, and mortality outcomes. Methods: We conducted a retrospective cohort study including 125 patients aged ≥ 65 years admitted to the polyvalent ICU of Hospital de Faro over the last six months of 2024. Data included demographics, comorbidities, Charlson Comorbidity Index (CCI), severity scores (SOFA, SAPS II, APACHE II), and frailty status assessed by the Clinical Frailty Scale (CFS). Outcomes were the need for organ support, ICU and hospital mortality, and length of stay. Results: Frailty (CFS ≥ 5) was identified in 30.4% of patients. Frail patients were older, had higher comorbidity burden (CCI), and presented with significantly higher severity scores at admission. They also required more invasive support, including vasopressors and invasive mechanical ventilation, while acute kidney injury (AKI) requiring renal replacement therapy (RRT) was similar between groups. ICU mortality was significantly higher among frail patients (50.0% vs. 31.0%), as was hospital mortality (76.3% vs. 33.3%). Length of ICU stay did not differ, although frail patients tended to have longer hospitalizations overall. Conclusions: Frailty was highly prevalent and strongly associated with increased severity, greater need for organ support, and higher mortality. Routine frailty assessment at ICU admission may enhance prognostic accuracy and support patient-centered decision-making.
- O futuro como objeto de estudo antropológico: Ensaio sobre o caso da implementação da saúde digital em PortugalPublication . Pinto da Costa, José CarlosTradicionalmente, o foco dos estudos antropológicos tem colocado a ênfase nas tradições, nos costumes e no património cultural, muitas vezes descurando a ligação entre as ações presentes e as aspirações futuras. Reconhecendo a influência recíproca das ações presentes na modelação do futuro e o impacto das visões sobre o futuro na formação das ações presentes, este artigo procura contribuir para contrariar a negligência das implicações do futuro nas práticas sociais presentes denotada nos estudos antropológicos. Através de uma investigação sobre a implementação da saúde digital em Portugal, utilizando a análise de discurso e a reflexão crítica, este estudo ensaia a introdução de conceitos pertinentes à antropologia do futuro e propõe estratégias metodológicas para estudar o futuro no contexto presente. Invocando as principais linhas da filosofia do tempo histórico de Koselleck, explora-se a interação essencial entre as ações presentes e as suas consequências futuras, defendendo-se a introdução de uma abordagem antecipatória em antropologia. As estratégias metodológicas propostas partem da integração das imaginações do futuro na realização das práticas presentes, promovendo uma compreensão mais profunda das dinâmicas sociais e fomentando uma perspetiva orientada para o futuro. Esta perspetiva é particularmente valiosa para escrutinar as intrincadas economias políticas das promessas tecnocientíficas que impulsionam a inovação e marcam o espírito do nosso tempo. A análise, conduzida em três dimensões — utilização, reconfiguração e evolução do sistema de saúde através da digitalização — destaca a relação complexa entre as práticas de saúde atuais, as aspirações futuras e o impacto transformador da digitalização da saúde.
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