Portuguese Journal of Public Health最新文献

Introduction: This study protocol aims to develop a validated competency framework to address the absence of a contemporary, Australasian-specific framework for public health graduates, aligning their education with workforce demands in an evolving public health landscape.

Methods: A mixed-methods approach, combining qualitative and quantitative methods, will be used across three phases. Phase 1 will involve semi-structured interviews with public health experts, academics, and students to capture insights on essential competencies. In phase 2, a systematic synthesis of competencies from existing frameworks will be conducted, triangulating these findings with interview data to develop a preliminary framework. Phase 3 will employ a modified Delphi process and Content Validity Index (CVI) to assess and refine the framework's content validity with Australasian public health experts.

Results: Expected outcomes from the interviews and framework synthesis include a draft competency framework detailing core public health skills, knowledge, and attributes required to address contemporary challenges. The Delphi rounds are anticipated to confirm the framework's relevance, clarity, and importance, achieving strong content validity metrics.

Conclusions: The resulting competency framework is expected to provide a validated structure for guiding public health education and workforce development within Australasia. By equipping graduates with competencies aligned with current and future public health needs, this framework aims to enhance the region's capacity to address significant health challenges and disparities. Dissemination of findings across Council of Academic Public Health Institutions Australasia (CAPHIA) member institutions will support the integration of this framework into curricula, thereby informing public health education and workforce initiatives in Australasia.

Objective: The aim of this study was to demonstrate the state of the art in the effect of income inequalities on the relationship between dental caries and nutritional status in children and adolescents and provide an overview of the countries investigated.

Methods: Seven databases, along with gray literature (Google Scholar), were searched to identify studies based on the acronym PCC (population: children and/or adolescents; concept: relationship of nutritional status with dental caries experience; context: income classifications (high, middle, and low) and the countries considered. Two independent reviewers performed study selection and data collection. The results were presented in table, graphic, and narrative formats.

Results: After the eligibility assessment, 37 studies were included in 21 countries. Nineteen studies indicated that income inequalities may have repercussions on the relationship between nutritional status and dental caries, while 11 studies suggested a possible absence of effect on the relationship between these variables. Seven studies were considered inconclusive regarding children and adolescents.

Conclusion: Although the evidence remains inconclusive in specific contexts, most of the included studies suggest a potential influence of income inequalities on the relationship between dental caries experience and nutritional status in children and adolescents.

Introduction: People experiencing homelessness (PEH) are more susceptible to developing musculoskeletal (MSK) conditions. However, they often lack access to adequate healthcare due to factors such as stigmatization and discrimination by healthcare professionals, which impacts their social integration. This study aimed to improve the attitudes of physiotherapy students toward PEH through a program focused on enhancing MSK health among PEH, implemented in homeless shelters.

Methods: The project involved PEH from (shelter name) and undergraduate physiotherapy students from (institution name). MSK health in PEH was assessed using the Musculoskeletal Health Questionnaire and the Work Ability Index. Students' attitudes were measured using the Escala de Atitudes Face à População em Situação de Sem-Abrigo (EAFPSSA) and a survey with six open-ended questions subjected to thematic analysis.

Intervention: The program consisted of 20 sessions led by the students and defined by the coordinator, combining MSK health education with strength and aerobic training. Prior to this, students participated in sessions on education about homelessness, the program's presentation, and a simulation of a session.

Results: None of the PEH met the criteria for project completion. All students demonstrated positive attitudes in 11 of the 17 ATHS items, but no significant improvements were observed in any domain. By the end of the project, students perceived PEH as individuals and reported enhanced interaction, which was shaped throughout the project. Students recognized the role of physiotherapy in social inclusion, education, and promoting self-efficacy among PEH. Participation impacted students as citizens, enhancing their appreciation for the psychosocial domain and improving skills such as communication and flexibility.

Conclusion: Given the students' perceptions, the implementation of projects aimed at bringing healthcare professionals closer to PEH is considered beneficial. It is recommended that PEH be involved in the design and implementation of such projects to increase their engagement.

Background: The COVID-19 pandemic and its consequent confinement have caused a major impact on people living with dementia (PLD). We aimed to ascertain the use of antipsychotic medication in this population due to behavioural symptoms during confinement.

Methods: We conducted a retrospective study evaluating clinical registrations, namely the use of psychoactive medication, of PLD followed regularly in a Portuguese dementia outpatient clinic during two different confinement periods.

Results: A total of 101 patients were included. Alzheimer's disease was the most frequent diagnosis, most of them in moderate/severe stage. Antipsychotics were used in 21.7% of patients. During confinement, a residual number of patients needed antipsychotic dose increase.

Conclusion: Confinement due to COVID-19 in this population was not associated with a significant increase of antipsychotics use. We hope our work may help clarify issues related to the need for antipsychotic medication in behavioural symptoms during confinement in PLD.

Introduction: Limited sexual and reproductive health literacy (SRHL) among higher education students constitutes a significant public health concern, impeding informed decision-making and equitable access to essential services. This study aimed to identify and prioritise student-informed SRHL interventions to improve health outcomes and reduce structural disparities.

Methodology: A participatory, transdisciplinary approach was employed, combining student focus groups with a structured nominal group technique session involving professionals from health and education sectors. Student insights informed the initial intervention framework. Prioritisation was guided by the APEASE criteria (Acceptability, Practicability, Effectiveness, Affordability, Side effects/Safety, and Equity).

Results: An expert panel synthesised twenty-two proposed interventions in SRHL into twenty final interventions, which were subsequently prioritised. The highest priority was assigned to the development of an on-campus integrated health hub, aimed at centralising sexual and reproductive health services and enhancing accessibility. Other top-ranked strategies included peer-led education, interactive seminars with community stakeholders, and targeted screening campaigns. Standalone informational tools were deprioritised as experts perceived them to have limited standalone impact without complementary support mechanisms.

Conclusion: Co-created, multidisciplinary SRHL strategies, anchored in nursing leadership, peer engagement, and institutional support, are essential to addressing health inequities in academic settings. These models demonstrate strong potential to increase service uptake and promote student well-being. Further research should assess their long-term effectiveness and scalability across diverse educational contexts.

Introduction: Few local-level studies have examined population needs for emergency medical service (EMS) within specific districts during pandemics. This study used geographic information systems (GISs) to analyze 312,707 EMS calls in Astana, Kazakhstan, examining changes before, during, and at the peak of the COVID-19 pandemic.

Methods: This study retrospectively evaluated EMS data in Astana, Kazakhstan, to assess the impact of the COVID-19 pandemic. Data were extracted from two automated systems used by the Astana ambulance station: "Komek 103" (introduced in late 2019) and the ADIS information system. These systems collect comprehensive call data, including caller demographics, address, time, seasonality, and emergency outcome. Moreover, we detected the geographical distribution of EMS calls during COVID-19.

Results: The results show a substantial increase in EMS calls during the COVID-19 pandemic in Astana, Kazakhstan. Before the pandemic (Jan 1-Mar 13, 2020), there were 50,488 calls, compared to 126,308 calls at the onset and 135,911 calls at the peak. The peak period saw the highest call volume on Mondays (21,329 calls), a 35.7% increase in calls from individuals aged 65+, and a significant rise (51%) in complaints of fever. Within the 65+ age-group, men accounted for a 26.6% larger proportion of EMS users compared to women. Moreover, the number of requests for emergency medical care varied by district in Astana.

Conclusion: The main trends in EMS calls showed that during the peak of the pandemic, the number of calls significantly increased. GIS technologies made it possible to determine the main flow and needs of EMS calls.

Background: Social Prescribing (SP) has gained global momentum as a promising approach of person-centered, integrated care embedded in multisectoral action. By expanding the focus from disease treatment to prevention and health promotion, SP aligns with a broader public health paradigm that emphasizes the addressing of social and behavioral determinants of health to improve health and well-being.

Objectives: This brief report introduces the emergence of SP, describes the implementation of SP initiatives in Portugal, and highlights the potential for SP expansion as a strategy to enhance population health and strengthen the sustainability of the National Health Service (NHS).

Method: This brief report draws on a review of international SP developments alongside emerging initiatives in Portugal to map the landscape of SP in the country and identify key enablers and barriers to its implementation.

Results: There has been a growing interest in SP in Portugal, with pilot projects emerging across regions. The academia has played a central role in providing technical-scientific support to the design, implementation, monitoring, and evaluation of these initiatives, fostering interdisciplinary collaboration and evidence-based practice. However, challenges remain in increasing awareness around SP, boosting intersectoral collaboration, securing resources, and strengthening systematic data collection for monitoring and evaluation.

Conclusion: SP represents a timely and promising innovation for advancing person-centered integrated care and health promotion, with potential to contribute to healthy, resilient, equitable, and sustainable communities.

Introduction: Healthcare professionals who engage in physical activity tend to prescribe it more frequently, reinforcing their potential role in influencing patients' behaviors. In this regard, promoting physical activity among healthcare professionals is identified as a strategy to increase the level of physical activity in the community. This study aimed to characterize the level of physical activity and sedentary behavior and assess motivation for exercise in healthcare professionals from the Health Centers Group of Alto Ave.

Methods: A cross-sectional study was conducted on physicians and nurses. A questionnaire, consisting of three validated instruments for the Portuguese adult population, namely, the short form of the International Physical Activity Questionnaire, Activity Choice Index, and Behavioral Regulation in Exercise Questionnaire-3, was sent to participants via email for self-completion. Bivariate and multivariate analyses were conducted to identify associations between variables.

Results: A total of 126 healthcare professionals responded to the questionnaire. Of the total healthcare professionals, 29.6% were physically inactive. The prevalence for most non-sedentary activities was low. The time spent sitting had a median value of 10 h per day. Healthcare professionals scored higher in autonomous motivation, which was independently associated with the level of physical activity.

Conclusion: The level of physical activity among healthcare professionals may be positive considering the described relationship between their own physical activity levels and the likelihood of recommending regular physical activity to patients. Additionally, the personal value and utility of physical exercise are recognized and accepted by the participants. Attention should be given to the sedentary behavior of these professionals. The results of this study may serve as a reference and foundation for potential interventions to be implemented to promote healthier and more active lifestyles among healthcare professionals.