Portuguese Journal of Public Health最新文献

{"title":"Perceived Impacts and Concerns in the Daily Life of People with Chronic Kidney Disease: A Qualitative Study.","authors":"Ana Rita Pedro, Beatriz Raposo, Ana Soraia Cunha, Catarina Simões, Daniela Brandão, Hugo Martinho, Filipa Bernardo, Marisa Pardal, João Couceiro, Edgar Almeida","doi":"10.1159/000551770","DOIUrl":"10.1159/000551770","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) significantly impacts individuals' daily lives, affecting physical health, psychological well-being, social interactions, and autonomy. Understanding the concerns and impacts of CKD is essential to creating patient-centred care strategies. This study aimed to explore the perceived impacts and concerns of individuals living with CKD.</p><p><strong>Methods: </strong>A qualitative study was conducted using semi-structured interviews with individuals with CKD and healthcare professionals in Portugal. Data were analysed using Framework Analysis to identify key perceived concerns and impacts of CKD on daily life.</p><p><strong>Results: </strong>The findings are structured around two main analytical themes - perceived impacts and perceived concerns. Within each theme, analytical categories were identified to capture the range of participants' accounts. The study revealed that CKD has a significant impact on multiple aspects of daily life. Eighteen categories of perceived impacts were identified, encompassing challenges in maintaining social relationships, family dynamics and professional responsibilities, as well as impacts on autonomy, quality of life, and economic stability. Psychological and emotional distress were also frequently reported. Physical health impacts included fatigue, dietary restrictions, sleep disturbances and limitations in physical activity. Regarding perceived concerns, nine categories comprising a total of sixty-six items were identified. Participants reported concerns related to personal, social and family life, lifestyle changes, and the preservation of autonomy. Concerns related to the disease itself and to complications arising from it were also highlighted. The remaining categories focused on concerns regarding treatment, including haemodialysis/dialysis, kidney transplantation and pharmacological treatment.</p><p><strong>Conclusion: </strong>This study highlights the complex and multidimensional impact of CKD on daily life. By providing insight into patient-defined concerns and perceived impacts, the findings support the discussion of more holistic and person-centred approaches to CKD care. Addressing personal needs alongside clinical management may contribute to improvements in quality of life and long-term outcomes for individuals with CKD.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"140-151"},"PeriodicalIF":0.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental Sustainability in Healthcare: The Major Goal of the AmbiSaúde Project.","authors":"José Chen-Xu, Sílvia Lopes, Marta M Marques, Julian Perelman, Susana Viegas","doi":"10.1159/000553426","DOIUrl":"10.1159/000553426","url":null,"abstract":"","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"107-108"},"PeriodicalIF":0.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertical Integration in Healthcare Systems: A Systematic Review of the Literature.","authors":"Carlos J Afonso-Henriques, Francisco-Jesús Ferreiro-Seoane, Francisco Reyes-Santias","doi":"10.1159/000553358","DOIUrl":"https://doi.org/10.1159/000553358","url":null,"abstract":"<p><strong>Background: </strong>Vertical integration is being implemented in various health systems to improve quality, accessibility, and efficiency. This article seeks to further existing research on vertical integration by introducing the type of health system as a new perspective to better understand how it relates to healthcare integration.</p><p><strong>Method: </strong>Articles in English were searched in Web of Science and Scopus from 2014 to 2024 using the following terms: \"Vertical Integration\", \"Hospital care\", \"Primary care\", \"Tertiary care\", \"Health care\", \"Social care\", \"Price\", \"Cost\", \"Quality\", \"Efficiency\", \"Access\". Relevant areas for the research were selected. PRISMA was used to improve the reporting quality of our work, and the STROBE matrix was used for assessing the completeness of the selected articles.</p><p><strong>Results: </strong>From an initial pool of 157 articles, 18 met the inclusion criteria after screening and full-text analysis. Among these, thirteen studies focused on private health systems, four on national health systems, and one on a national health insurance system. Patterns observed indicate that in private health systems, vertical integration can be associated with increased market concentration, which may lead to higher prices and potential negative effects. Conversely, in national health systems, vertical integration might be linked to improvements in quality, access, and efficiency. Evidence regarding vertical integration in national health insurance systems remains limited and inconclusive.</p><p><strong>Conclusion: </strong>The results of vertical integration appear to vary according to the type of health system. While private systems may face challenges related to market power and cost increases, national health systems show potential benefits in service quality and efficiency. However, these conclusions are based on a narrative synthesis of heterogeneous studies. Due to scarce data, further research is needed to clarify the results of vertical integration within national health insurance systems.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Vertical Transmission of Human Immunodeficiency Virus in Angola: A Case-Control Study.","authors":"Paulo Ney Solari, Pedro Aguiar, Gonçalo Figueiredo Augusto","doi":"10.1159/000553265","DOIUrl":"10.1159/000553265","url":null,"abstract":"<p><p>Vertical transmission of human immunodeficiency virus (HIV) remains a public health challenge in Angola despite the expansion of prevention of mother-to-child transmission (PMTCT) programmes. This study aimed to identify factors associated with vertical HIV transmission in a referral maternity hospital in Luanda. An observational case-control study was conducted using retrospective clinical and laboratory records from 2019 to 2024. A total of 204 mother-infant pairs were included, comprising 68 cases (HIV-infected infants) and 136 controls (HIV-exposed but uninfected infants), frequency-matched at a 1:2 ratio by infant year of birth and maternal age group. Infant HIV status was determined up to 18 months of age, or after breastfeeding cessation when applicable, according to the national diagnostic algorithm. Multivariable unconditional binary logistic regression was used, with matching variables retained in the model. Several factors were independently associated with lower odds of vertical transmission, including suppressed maternal viral load (adjusted odds ratio [aOR] = 0.07; 95% confidence interval [CI]: 0.03-0.20), adequate paediatric follow-up (aOR = 0.08; 95% CI: 0.02-0.27), caesarean delivery (aOR = 0.13; 95% CI: 0.04-0.37), maternal age over 25 years, formal education, adequate initiation of antiretroviral therapy during pregnancy, and attendance at four or more antenatal consultations. These findings suggest that gaps in the PMTCT cascade may be associated with residual vertical HIV transmission in this referral maternity setting. Given the observational design, these associations should not be interpreted as causal. Strengthening virological monitoring, treatment adherence support, and retention of mother-infant pairs in care remains an important programmatic consideration for PMTCT services.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenge of Public Participation in European Hospitals: A Portuguese Case Study.","authors":"Mauro Serapioni, Sofia Crisóstomo, Margarida Santos, Alfredo Campos, David Tavares","doi":"10.1159/000553116","DOIUrl":"10.1159/000553116","url":null,"abstract":"<p><strong>Introduction: </strong>This article presents the results of an empirical study designed to examine the current state of public participation in hospital institutions of Portugal's National Health Service (NHS) and to assess the level of implementation and functioning of Advisory Councils.</p><p><strong>Methods: </strong>The study combines a review of the literature on participation experiences in hospitals across several European countries with a questionnaire administered to the presidents of hospital institutions within the Portuguese NHS. Together, these methods provide a basis for identifying the status of public participation in Portugal in light of relevant European experiences.</p><p><strong>Results: </strong>The findings indicate that participation is largely confined to communication and the provision of information to users, as well as consultation processes through which patients can express their preferences. However, the active involvement of patients and their representatives in healthcare decision-making remains limited and underdeveloped.</p><p><strong>Conclusion: </strong>Hospitals across Europe, and particularly in Portugal, face the challenge of fostering more effective forms of user participation. This requires moving beyond consultation towards meaningful involvement of patients and their representatives in healthcare decision-making processes.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"181-192"},"PeriodicalIF":0.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Trends in Mortality in Portugal, 1913-2022.","authors":"Carlos Aniceto, Andreia Leite, Madalena Rodrigues, Carlos Matias Dias","doi":"10.1159/000552045","DOIUrl":"10.1159/000552045","url":null,"abstract":"<p><strong>Introduction: </strong>Demographic and epidemiological transitions have transformed mortality patterns, with declines observed up to the present. Long-term time series studies on mortality evolution in Portugal are scarce. We aimed to estimate and describe annual crude and age-standardized mortality rates (ASMRs) in Portugal from 1913 to 2022 and to analyse temporal trends from 1940.</p><p><strong>Methods: </strong>A time series study was conducted using official statistics on deaths and resident population, between 1913 and 2022. Annual crude mortality rates (CMRs), overall and stratified by sex and age group, were calculated for the entire period. ASMRs were estimated for 1920, 1930, and the period from 1940 onwards. Trends in CMR and ASMR, overall and by sex, from 1940 onwards were analysed using joinpoint regression.</p><p><strong>Results: </strong>Between 1913 and 2022, the annual CMR decreased by 42.1%. From 1940 to 2022, CMR decreased an average of 0.4% annually (95% CI: -0.5% to -0.3%). We observed a decrease during most of the study period for older age groups (≥60) and a substantial reduction in mortality in the youngest group (0-9 years), particularly in the early years under analysis and until the 1990s. The period 1940-1982 showed a decreasing trend, with a growing trend from 1982 to 2022. Sex-stratified analysis revealed different trends for men and women. Between 1920 and 2022, the overall ASMR declined by 70.9%. From 1940 to 2022, the ASMR had an average annual decrease of 1.4% (95% CI: -1.6% to -1.3%), interrupted in the 1960s and 2017-2022. Distinct temporal trends by sex were also identified between 1940 and 2022.</p><p><strong>Conclusion: </strong>We showed an overall decreasing trend in CMR and ASMR, although with different magnitudes and trajectories during the study period. To the best of our knowledge, this is the first study to describe long-term trends in both crude and age-adjusted mortality rates in Portugal from 1940 to 2022, contributing to the knowledge on mortality.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"152-163"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacillus Calmette-Guérin Vaccination and SARS-CoV-2 Infection among Healthcare Workers: A Case-Control Study in Cape Verde.","authors":"Jesús Cortes, Tamar Jaaziel Monteiro, Kleidi Monteiro, Jacqueline Monteiro, Ofélia Monteiro, José Luis Spencer, Janaína Vicente, Lidia Nhamússua, Elsi Ca, Isaquel Silva, Sebastian Nielsen, Frederik Schaltz-Buchholzer, Maria da Luz Lima Mendonça, Paulo de Lyz Girou Martins Ferrinho, António Pedro Delgado, Christine Stabell Benn, Pedro Aide, Isabel Inês Monteiro de Pina Araújo, Inês Fronteira","doi":"10.1159/000550531","DOIUrl":"10.1159/000550531","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare workers (HCWs) faced a heightened risk of SARS-CoV-2 infection compared to the general population. The Bacillus Calmette-Guérin (BCG) vaccine, used for over a century, is known to modulate immune responses to various pathogens, including the SARS-CoV-2. This study examines the association between lifetime BCG vaccination and the risk of SARS-CoV-2 infection among HCWs in Cape Verde.</p><p><strong>Methods: </strong>We conducted a case-control study among HCWs in Cape Verde in 2021. Cases were HCWs, 18 years or older who tested positive for SARS-CoV-2 via PCR or Rapid Antigen Test, identified by Public Health Authorities, while controls were HCWs, 18 years or older with no reported or suspected SARS-CoV-2 infection, confirmed by POC Rapid Antigen Test. Both were selected from HCWs of three hospitals on Santiago and São Vicente islands in Cape Verde. The primary outcome measured was the status of SARS-CoV-2 infection (yes/no), and the primary exposure examined was BCG vaccination status (yes/no). The study also considered sociodemographic, epidemiological, and employment variables. Data collection was conducted using an electronic questionnaire applied to all participants, and analysis employed a maximum likelihood forward selection logistic regression model to assess the impact of BCG vaccination on the odds of SARS-CoV-2 infection.</p><p><strong>Results: </strong>The study included 215 cases and 250 controls. Most cases of SARS-CoV-2 infection that occurred before completion of COVID-19 vaccination were identified through epidemiological surveillance or among people who reported being quarantined and/or absent from work after diagnosis. Hospitalization for COVID-19 was required for 7.7% of the cases. Persistent symptoms following COVID-19 were reported in fewer than 1% of cases. Having at least one child in the house, not having double employment, and being of normal weight were more likely to be observed among cases than controls. BCG vaccination showed no association with SARS-CoV-2 infection (aOR of BCG-vaccinated vs. not BCG-vaccinated = 0.76 [0.48; 1.20]). Completing the COVID-19 vaccination regimen was associated with reduced odds of SARS-CoV-2 infection, but there was likely some reversed causation, as vaccination was postponed for 6 months post-COVID-19 infection for cases.</p><p><strong>Conclusions: </strong>Lifetime BCG vaccination did not reduce the likelihood of SARS-CoV-2 infection among HCWs.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"109-119"},"PeriodicalIF":0.9,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Supervision and Positive Practice Environments: A Scoping Review.","authors":"Pedro Alexandre-Sousa, Cristina Costeira, Cristina Santos, Ana Carolina Saraiva, Joana Sequeira Santos, José Mendes","doi":"10.1159/000552254","DOIUrl":"10.1159/000552254","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of clinical supervision (CS) is to assist healthcare providers in performing effective professional activities and providing the best care for patients, which has been described as associated with improved performance and quality indicators. Additionally, CS was found to be beneficial for the mental health of healthcare professionals in terms of their job satisfaction, levels of stress, and burnout.</p><p><strong>Objective: </strong>The aim of the study was to map and synthesize existing evidence on how CS has been associated with positive practice environments for healthcare teams.</p><p><strong>Methods: </strong>Scoping review was conducted in accordance with the Joanna Briggs Institute guidelines. Searches were conducted in July 2024 using CINAHL, MEDLINE, Cochrane Database of Systematic Reviews, Scopus, and Web of Science. Both primary research and review studies were considered, as well as relevant gray literature. Studies were included if they addressed CS in relation to positive practice environments, well-being, or work conditions among healthcare teams. Data were analyzed thematically and through content analysis.</p><p><strong>Results: </strong>This review included 37 studies, highlighting eight key categories: (i) mental health promotion; (ii) organizational culture; (iii) supervisor qualities; (iv) performance; (v) professional development; (vi) leadership/management; (vii) job satisfaction; and (viii) communication.</p><p><strong>Conclusion: </strong>The findings indicate that CS is frequently described in the literature in relation to professional competencies, workplace well-being, psychological safety, job satisfaction, and communication within healthcare teams.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"193-212"},"PeriodicalIF":0.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Epidemiological Profile of Climate-Related Disasters in Spain between 1950 and 2024.","authors":"Andrea Fernández García, José Antonio Cernuda Martínez, Pedro Arcos González","doi":"10.1159/000552050","DOIUrl":"10.1159/000552050","url":null,"abstract":"<p><strong>Introduction: </strong>Climate-related disasters are the result of meteorological, hydrological, and climatological hazards. The increasing frequency of such disasters is closely linked to anthropogenic climate change, alongside other factors such as changes in land use and population exposure. The objective of the present study was to analyze the epidemiological profile of climate-related disasters in Spain and their temporal trends.</p><p><strong>Methods: </strong>A retrospective descriptive study of climate-related disasters in Spain was performed for the period between January 1950 and December 2024. Data were compiled from various international and national sources to ensure comprehensive coverage of events. Both absolute and relative frequencies were analyzed, and mean mortality, injury, and affected person rates per million inhabitants were calculated for each disaster type. Temporal trends were assessed through the Mann-Kendall test, while differences in total mean rates across disaster categories were evaluated using the ANOVA test.</p><p><strong>Results: </strong>A total of 224 climate-related disasters were documented. Statistically significant increasing trends were identified in the total absolute frequency of disasters (tau = 0.558; <i>p</i> < 0.001), the mean mortality rate (tau = 0.239; <i>p</i> < 0.001), the mean injury rate (tau = 0.144; <i>p</i> = <i>p</i> < 0.001), and the mean rate of affected individuals (tau = 0.481; <i>p</i> = <i>p</i> < 0.001). The mean mortality rate exhibited statistically significant differences according to the type of disaster (F = 4.40; <i>p</i> = 0.013).</p><p><strong>Conclusions: </strong>From 1950 to 2024, a statistically significant increasing trend was observed in the number of climate-related disasters and their associated human toll. Data recorded through December 2024 indicate that this upward trajectory continues, particularly regarding mortality and affected individuals.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"164-180"},"PeriodicalIF":0.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commercial Determinants of Health: Economic and Health Interests Can Be Aligned.","authors":"Julian Perelman","doi":"10.1159/000551981","DOIUrl":"10.1159/000551981","url":null,"abstract":"","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}