http://hdl.handle.net/10451/4458 Mon, 06 May 2013 18:12:13 GMT 2013-05-06T18:12:13Z http://hdl.handle.net/10451/8327 Title: Trabalho em equipe na atenção primária: a experiência de Portugal Authors: Souza, Marize Barros de; Rocha, Paulo de Medeiros; Sá, Armando Brito de; Uchoa, Severina Alice da Costa Abstract: Objective. To analyze the work of health care teams delivering primary care in Portugal. Methods. We performed an evaluative research project, with a qualitative case study design. Data were obtained through semi-structured interviews, direct observation, and analysis of documents. We interviewed managers, workers, and users in 11 family health units (USF) in Portugal, for a total of 71 participants. Content analysis was used to assess the interviews. Results. Teams included a physician, a nurse, and an administrative employee. Each team was in charge of 1 250 to 2 060 users. A striking characteristic of the Portuguese experience was the voluntary and autonomous setup of teams at the USF, based on personal affinity. The services provided at the USF included a basic “service package” as well as activities of surveillance, health promotion, disease prevention, care of acute disease, clinical follow-up of patients with chronic or multiple diseases, home care, and networking with other services (hospital care). Difficulties in providing home care were reported. Electronic systems were widely available. According to interviewees, the changes resulting from the implementation of USF included improved user access to services, higher quality of care, and goal-oriented teamwork,guided by an action plan. Conclusions. Even without a coordinating role in the health care network, the delivery of primary health care through teams was positively evaluated in Portugal as promoting increased access, continuity, and humanization of health services.; Objetivo. Analisar o trabalho em equipe na atenção primária em saúde em Portugal. Métodos. Foi realizada uma pesquisa avaliativa de abordagem qualitativa, com desenho de estudo de caso. Os dados foram obtidos por entrevista semiestruturada, observação direta e análise documental. Foram entrevistados gestores, profissionais e usuários de 11 unidades de saúde familiar (USF) portuguesas, totalizando 71 participantes. Utilizou-se a técnica de análise de conteúdo na interpretação das entrevistas. Resultados. Cada equipe era constituída por médico, enfermeiro e funcionário administrativo, atendendo entre 1 250 e 2 060 usuários. Uma característica marcante da experiência portuguesa foi a formação das equipes nas USF de forma voluntária, por meio de afinidades pessoais, com autonomia de composição. Observou-se nessas USF o desenvolvimento de “carteira básica de serviços” juntamente com intervenções de vigilância, promoção da saúde e prevenção de doença, cuidados em situação de doença aguda, acompanhamento clínico de doença crônica e de patologia múltipla, cuidados domiciliares, interligação e colaboração em rede com outros serviços (cuidados hospitalares). Foram relatadas dificuldades no atendimento domiciliar. A informatização era ampla nas USF. De acordo com os entrevistados, as mudanças advindas da implementação das USF foram maior acessibilidade dos usuários aos serviços, maior qualidade do cuidado prestado e trabalho em equipe com objetivos e metas, além da existência de um plano de ação. Conclusões. Mesmo não tendo assumido um papel de coordenação da rede de cuidados, a atenção primária em saúde organizada a partir de equipes foi avaliada positivamente em Portugal, como promotora de maior acesso, continuidade e humanização dos serviços. Tue, 01 Jan 2013 00:00:00 GMT http://hdl.handle.net/10451/8327 2013-01-01T00:00:00Z http://hdl.handle.net/10451/8215 Title: The european and american use of exploratory approaches for first-in-human studies Authors: Silva-Lima, Beatriz; Carlson, David; Jones, David R.; Laurie, David; Stahl, Elke; Maria, Vasco; Janssens, Walter; Robinson, William T. Abstract: Exploratory approaches for fi rst-in-human clinical studies have evolved over the last few years and have stimulated the issuance of national regulatory guidances in some European countries as well as the United States. With the increasing implementation of these approaches and the recent preparation of a multiregional regulatory guidance (ICH M3 rev2), an exchange of experiences on the opportunities and challenges of exploratory clinical trials was desirable; thus, a workshop focusing on the use of this clinical approach was planned and conducted in Lisbon, Portugal, March 18–19, 2009 sponsored by the Portuguese Health Authority (INFARMED) and DIA. The structure of the workshop focused in three main areas. Regulatory representatives from Portugal, Belgium, Germany, the United Kingdom and the United States formally reviewed their experiences. This was followed by a discussion on issues from an ethics review perspective as well as an insight to the opportunities in the area of biologics. The industry perspective was presented by representatives from Merck, Pfizer, J&J, Novartis, Speedel, AstraZeneca, GSK, and Roche. Finally, through break out sessions, issues were identifi ed to be addressed moving forward. It is the purpose of this paper to report on the outcome of this workshop. Fri, 01 Jan 2010 00:00:00 GMT http://hdl.handle.net/10451/8215 2010-01-01T00:00:00Z http://hdl.handle.net/10451/7478 Title: Adherence to antihypertensive treatment among African migrants and Portuguese natives: results from a primary care-based cohort study in Lisbon, Portugal Authors: Souto, Diana; Fernandes, Milene; Simões, Rui; Alarcão, Violeta; Gomez, Verónica; Lopes, Elisa; Nicola, Paulo Jorge; Rocha, Evangelista Abstract: Background Nonadherence to antihypertensive drugs may result in less effective blood pressure (BP) control. Because of significant ethnic disparities in BP control,differences in rates of and reasons for medication nonadherence should be assessed. Objectives To explore the factors associated with antihypertensive medication adherence in African migrants and Portuguese native hypertensive patients and to determine ethnic differences in medication adherence between African migrants and Portuguese natives. Description: © Springer Science+Business Media B.V. 2012 Sun, 01 Jan 2012 00:00:00 GMT http://hdl.handle.net/10451/7478 2012-01-01T00:00:00Z http://hdl.handle.net/10451/7259 Title: Prevalence of obesity in Portugal Authors: Carmo, I. do; Santos, O. dos; Camolas, J.; Vieira, J.; Carreira, M.; Medina, L.; Reis, L.; Galvão-Teles, A. Abstract: Obesity is a serious health problem in developed countries. Knowledge of reliable and nationwide representative data is a must for any public health action. The dimension of this problem in Portugal was first assessed in 1995–1998. A similar populational survey using objective anthropometric measures is now being conducted (field work started in January 2003). A total of 6411 subjects aged 18– 64 years old have already been measured and their respective body mass indexes (BMIs) calculated. Results from 2003 to 2005 show 38.6% is overweight and 13.8% has obesity. The total of overweight and obesity is 52.4%. In 1995–1998 survey, overweight was 35.2% and obesity was 14.4%. The total was 49.6%. These results suggest an increase of the overweight/obesity (altogether) prevalence in the last 10 years. Actual results show that more than half of the adult sample has excessive weight and 2.4% of the sample has low BMI. Finally, 45.6% of the sample suffers increased health risks because of high waist circumference ( ≥80 cm for women; ≥94 cm for men). These results highlight the fact that, although obesity was identified as a public health problem one decade ago, action to reduce it does not seem to have been very effective to date. Description: © 2006 The International Association for the Study of Obesity Sun, 01 Jan 2006 00:00:00 GMT http://hdl.handle.net/10451/7259 2006-01-01T00:00:00Z