Percorrer por autor "Alves, Sandra Maria"
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- Age-period-cohort effects in the incidence of hip fractures: political and economic events are coincident with changes in riskPublication . Alves, Sandra Maria; Castiglione, Débora; Oliveira, Carla Maria; Sousa, Bruno; Pina, Maria De FátimaIntroduction: Healthcare improvements have allowed prevention but have also increased life expectancy, resulting in more people being at risk. Our aim was to analyse the separate effects of age, period and cohort on incidence rates by sex in Portugal, 2000–2008. Methods: From the National Hospital Discharge Register, we selected admissions (aged ≥49 years) with hip fractures (ICD9-CM, codes 820.x) caused by low/moderate trauma (falls from standing height or less), readmissions and bone cancer cases. We calculated person-years at risk using population data from Statistics Portugal. To identify period and cohort effects for all ages, we used an age–period–cohort model (1-year intervals) followed by generalised additive models with a negative binomial distribution of the observed incidence rates of hip fractures. Results: There were 77,083 hospital admissions (77.4 % women). Incidence rates increased exponentially with age for both sexes (age effect). Incidence rates fell after 2004 for women and were random for men (period effect). There was a general cohort effect similar in both sexes; risk of hip fracture altered from an increasing trend for those born before 1930 to a decreasing trend following that year. Risk alterations (not statistically significant) coincident with major political and economic change in the history of Portugal were observed around birth cohorts 1920 (stable–increasing), 1940 (decreasing–increasing) and 1950 (increasing–decreasing only among women). Conclusions: Hip fracture risk was higher for those born during major economically/politically unstable periods. Although bone quality reflects lifetime exposure, conditions at birth may determine future risk for hip fractures.
- Allergic rhinitis and work productivity: Preliminary analysis of data from the MASK-air applicationPublication . Ferreira, Laura; Pinto, Bernardo Sousa; Alves, Sandra Maria; Amaral, Rita; Alves, Sandra Maria; Amaral, RitaAllergic rhinitis is a health condition more prevalent in developed countries that can impact the activities and quality of life of affected individuals1. Although its impact on work productivity is recognized2, there is still a need for a more detailed understanding and quantification. This cross-sectional observational study investigates the relationship between allergic rhinitis and work productivity, using data from the MASK-air mobile designed for monitoring allergic rhinitis and related respiratory conditions3. To investigate the association between the severity of allergic rhinitis symptoms and the impact on work productivity. Data was collected through the MASK-air mobile application4,5 that contains demographic, environmental and symptom variables on a daily basis, with users providing information on a scale of 0 to 100 each day. A sample of 1000 random observations of users from 30 countries, recorded between May 2015 and December 2023 was analysed. Participants were selected based on specifics criteria, including a minimum age of 15 or 16 (depending on the digital consent age in each country) and self-reported diagnosis of allergic rhinitis. Descriptive statistics and the Spearman correlation coefficient6 between symptoms and impact on productivity were calculated. The sample showed a balanced distribution between sexes, with 435 individuals identified as female (53.5%) and 378 individuals as male (46.5%). The mean age of participants was 41.41 ± 14.50 years. The data included participants from various countries; the most frequent was from Mexico with 141 participants (17.3%), followed by Lithuania with 91 participants (11.9%), and Germany with 79 participants (9.7%). Regarding comorbidities, 535 participants (65.6%) reported having conjunctivitis, and 310 participants (38.1%) reported being asthmatic. Additionally, 200 participants (20%) used immunotherapy. A strong positive correlation was observed between work impact and the severities of global allergic symptoms (ρs= 0.82, p < 0.0001) and nasal symptoms (ρs= 0.77, p < 0.0001); and a moderate correlation was observed between work impact and the severities of ocular symptoms (ρs= 0.69, p < 0.0001) and asthma (ρs= 0.48, p< 0.0001). This study offers an initial understanding of how symptoms of allergic rhinitis affect work productivity. Identifying other associated factors will allow targeting health interventions and policies to improve the well-being and performance of workers affected by this condition.
- Contributions to the cross-cultural validation of “A survey of pharmacist knowledge, attitudes, utilization and barriers toward artificial intelligence”: translation and back translationPublication . Gerardo, Sofia; Pimenta, Rui; Alves, Sandra Maria; Alves, Sandra MariaThe use of Artificial Intelligence (AI) is rapidly transforming various fields, and pharmacy is no exception. AI is increasingly being used to automate, optimize, and personalize various tasks in pharmacy practice, from drug discovery to dispensing to patients. In Community Pharmacy, in addition to these possibilities, it allows for personalized and focused patient care through the selection of more appropriate and personalized therapies, with a lower probability of prescription errors and drug interactions, as well as monitoring of therapy adherence. Despite these potential benefits, its implementation in the pharmaceutical field, as well as in other areas of healthcare, should be carefully considered, as ethical and regulatory issues may pose obstacles. Likewise, the perspective and experience of each professional, which remain highly personal, especially in patient care, should not be overlooked. Therefore, it is increasingly important to know the knowledge, attitudes, utilization, and barriers concerning AI. Firstly, knowledge, as this concept encompasses the level of awareness and understanding that individuals or organizations have regarding AI technologies. Attitudes, which refers to the perceptions, feelings, and predispositions towards AI. It includes both positive and negative sentiments, such as excitement about AI's potential benefits, concerns about ethical implications, and fears about job displacement. Finally, the barriers or obstacles that hinder the adoption and effective utilization of AI. Barriers can be technical, such as lack of expertise or inadequate infrastructure; financial, such as high costs of implementation; or cultural, such as resistance to change or lack of trust in AI systems. This study aimed to translate and validate a survey instrument designed to explore the attitudes of Community Pharmacy professionals towards the implementation of Artificial Intelligence (AI) in their field. According to the COSMIN methodology, the initial translation of the construct from its original language, English, into European Portuguese was executed by two independent translators possessing comprehensive understanding of the questionnaire concepts. Both translators are bilingual healthcare professionals, who perform functions in a hospital environment and with European Portuguese being their native language. In the subsequent step, the two acquired versions were juxtaposed, leading to the formation of a consensus version endorsed by specialists, considering the new context where the construct will be applied, without excluding the original version. In cases where there are discrepancies between the two translations, the expert panel discusses the alternatives and decides on the most suitable option. The questionnaire translation process culminates with back-translation, wherein the consensus version obtained is rendered back into the original language, English, by a bilingual translator. The resultant back-translation should closely mirrors the original questionnaire, signifying the efficacy of the content translation process. Additionally, reliability testing methods like test-retest reliability and internal consistency checks help verify the stability and consistency of the survey results. To assess consensus among different questionnaire versions, techniques such as inter-rater reliability, the Delphi method, and agreement indices are essential. These processes ensure that the survey items are interpreted consistently across different respondents and that any subjective judgments are reliably measured. The results of the translated version questionnaire maintain the intended constructs and adequately capture attitudes toward AI implementation among Community Pharmacy professionals. Understanding the attitudes and perceptions of pharmacy professionals towards AI implementation is crucial for informing policy decisions, designing targeted interventions, and facilitating the successful integration of AI technologies into pharmacy practice. It is intended that this questionnaire contributes to the growing body of literature on AI in healthcare and serves as a foundation for further investigations into this evolving field. Future work includes the validation of the PT-EU questionnaire.
- Empowerment and knowledge as determinants for quality of life: a contribution to a better type 2 diabetes self-managementPublication . Ferreira, Pedro L.; Morais, Carminda; Pimenta, Rui; Ribeiro, Inês; Amorim, Isabel; Alves, Sandra MariaThe purpose of this study was to assess how knowledge and empowerment impact the quality of life (QoL) of a person with type 2 diabetes, leading to better communication and disease management. We conducted a descriptive and observational study of individuals with type 2 diabetes. The Diabetes Empowerment Scale-Short Form (DES-SF), Diabetes Knowledge Test (DKT), and EQ-5D-5L were used, in addition to sociodemographic and clinical characteristics. Evaluating the variability in the DES-SF and DKT in relation to the EQ-5D-5L and identifying possible sociodemographic and clinical determinants were conducted using univariate analyses followed by a multiple linear regression model to test whether the factors significantly predicted QoL. A total of 763 individuals were included in the final sample. Patients aged 65 years or older had lower QoL scores, as well as patients who lived alone, had less than 12 years of education, and experienced complications. The insulin-treated group showed higher scores in DKT than the non-insulin-treated group. It was also found that being male, being under 65 years of age, having no complications present, and having higher levels of knowledge and empowerment predicted higher QoL. Our results show that DKT and DES are still determinants of QoL, even after adjusting for sociodemographic and clinical characteristics. Therefore, literacy and empowerment are important for the improvement of the QoL of people with diabetes, by enabling them to manage their health conditions. New clinical practices focused on education, increasing patients’ knowledge, and empowerment may contribute to better health outcomes.
- A Farmácia Caseira – uma estratégia de desenvolvimento de competências transversais em bioestatística em farmáciaPublication . Cruz, Agostinho; Alves, Sandra Maria; Nascimento, Ana Paula; Santos, Marlene; Correia, Patrícia Carla dos Santos; Jesus, Ângelo; Ferraz Oliveira, Rita; Pinho, Cláudia; Pimenta, RuiEm todas as residências é prática comum a existência de medicamentos e produtos afins, que se encontram a uso, uso esporádico ou que se encontram já fora de uso, como resultado da sua aquisição por prescrição médica ou por iniciativa própria. Se refletirmos na necessidade da existência de boas práticas na organização e gestão desta “Farmácia Caseira”, facilmente verificamos da sua importância em termos não só económicos, mas, principalmente, em termos de saúde pública. Na Escola Superior de Saúde do Instituto Politécnico do Porto (ESS- P.Porto), a utilização da Farmácia Caseira como estratégia pedagógica tem um histórico de mais de 20 anos. Com o objetivo de promover a interdisciplinaridade o grupo de bioestatística utilizou estes dados no desenvolvimento de um conjunto de enunciados de cariz prático na Unidade Curricular (UC) de Fundamentos de Planeamento Experimental do curso de Farmácia, ESS- P.Porto. Estes enunciados permitiram a aplicação prática a dados reais recolhidos pelos estudantes dos conteúdos programáticos da UC (teoria das probabilidades, estatística descritiva e inferencial). Os dados, recolhidos anualmente pelos estudantes, são variáveis de caracterização: i) sociodemográfica do agregado familiar; ii) perfil dos medicamentos existentes na Farmácia Caseira; e iii) condições de armazenamento. A metodologia proposta permitiu: a) integrar a estatística no contexto de atuação dos futuros licenciados; b) enfatizar a componente conceptual da estatística; c) trabalhar com dados reais recolhidos pelos estudantes; d) desenvolver, para além das competências cognitivas, as competências atitudinais, estratégicas e de utilização de novas tecnologias no tratamento da informação. Os instrumentos desenvolvidos foram aplicados com sucesso tornando mais visível a utilidade da bioestatística aplicada à área da farmácia, melhorando a atitude face à aprendizagem da mesma, promovendo uma consciência crítica na análise e aplicação dos métodos estatísticos contribuindo para a formação de profissionais com maior autonomia e capacitados para uma prática baseada na evidência.
- Impact of walking on knee articular cartilage T2 values estimated with a dictionary-based approach - A pilot studyPublication . Coelho, José M.; Fernandes, T.T.; Alves, Sandra Maria; Nunes, R.G.; Nogueira, Luísa; Oliveira, A.Walking is crucial for knee articular cartilage (KAC) health. Routine MRI sequences lack sensitivity for early cartilage changes, and the use of parametric T2 maps to study the effect of walking on KAC composition is limited. This study aimed to evaluate if quantitative T2 maps using an Echo Modulation Curve (EMC) matching algorithm can detect KAC T2 variations due to water content changes after walking. Seven asymptomatic volunteers (3 females, 4 males, mean age 28.3 years) without knee pathologies participated. Sagittal knee MRI scans were performed before and after a 9-min treadmill walk using a Modified Bruce protocol. T2-weighted Multi-Echo Spin-Echo KAC images were acquired at 3T. Tibiofemoral cartilage was segmented semi-automatically on three slices per knee, defining 39 KAC samples. Quantitative T2 maps were created using a dictionary-matching algorithm. Paired t-tests assessed exercise impact on KAC T2 values, independent t-tests compared group differences, and Friedman test with Bonferroni correction evaluated regional T2 changes. Walking increased KAC T2 values (mean difference (md) 0.61 ± 1.71 ms; p ¼ 0.016). Significant differences were observed in “normal” BMI group (md 0.69 ± 1.27 ms; p ¼ 0.021). Regional analysis revealed significant differences in medial femur in males (md 0.9 ± 2.1 ms; p ¼ 0.049) and lateral tibia in females (md 1.4 ± 2.5 ms; p ¼ 0.046). The medial tibia showed significant differences across sub-regions (p ¼ 0.026). Quantitative T2 maps using the EMC matching algorithm detected consistent changes in KAC T2 values after a short walking period. Implications for practice: EMC quantitative T2 maps effectively detected knee cartilage changes postwalking. This technique could improve cartilage hydration assessments, aiding early detection in atrisk patients. It also suggests potential for personalized monitoring and rehabilitation, advancing musculoskeletal imaging and non-invasive joint health monitoring.
- Influência dos fatores psicossociais relacionados com o trabalho na motivação dos trabalhadores: um estudo de caso no setor industrialPublication . Silva, Ana C.; Dores, Artemisa Rocha; Machado, Inês N.; Silva, Miguel R.; Alves, Sandra Maria; Rodrigues, MatildePsychosocial risks are at the origin of negative consequences for organizations and individuals. Despite the potential relationship with the level of workers' motivation, few studies have analyzed this issue in industrial settings. This study aimed to assess work-related psychosocial risk factors and determine their relationship with intrinsic and extrinsic motivation. The study was developed in an industry, and 49 workers were included. The Copenhagen Psychosocial Questionnaire (COPSOQ II) was used to assess psychosocial factors, and the Work Extrinsic and Intrinsic Motivation Scale (WEIMS) was used to assess motivation. The subscales "job insecurity", "cognitive demands", "emotional demands", "social support from superiors" and "influence at work" showed relevant risk values for workers' health, so they should be prioritized in the intervention. The motivational dimensions that presented the highest values were "intrinsic motivation" and "external regulation". Significant associations were found between the variables under study. This study reinforces that work-related psychosocial risk factors are associated with workers' motivation.
- Knowledge about type 2 diabetes: its impact for future managementPublication . Ferreira, Pedro L. ; Morais, Carminda ; Pimenta, Rui; Ribeiro, Inês ; Amorim, Isabel ; Alves, Sandra Maria; Santiago, LuizDiabetes can cause several long-term complications. Knowledge about this disease can play an important role in reducing diabetes-related complications. In addition, the lack of awareness leads to misconceptions, which joined with inadequate knowledge, are relevant barriers to proper diabetes management. In this study, we aimed to assess the diabetes knowledge of a type 2 diabetes (T2D) population and identify major knowledge gaps, in order to prevent complications and to increase quality of life. In a cross-sectional, observational study in a convenience sample, we identified individuals diagnosed with T2D attending ambulatory visits from five health settings, older than 18 years, with a time diagnosis of at least 1 year, and attending multidisciplinary visits for at least 3 months. To assess the knowledge of T2D individuals, we applied the Portuguese version of the Diabetes Knowledge Test. The sample included a total of 1,200 persons, of whom almost half were female. The age range of the participants varied from 24 to 94 years old, and the mean age was 65.6 ± 11.4 years. Most of the sample had a level of education under secondary and lived with someone. In our sample, 479 (39.9%) were insulin-treated. The percentage of correct answers was 51.8% for non-insulin vs. 58.7% for insulin treated (p < 0.05). There were three items with a percentage of correct answers lower than 15%; the item with the lower value of correct answers was the one related to the identification of signs of ketoacidosis with only 4.4% of correct answers, the errors presented a random pattern; the item related to the identification of which food should not be used to treat low blood glucose with 11.9%, where 56.9% of the sample’s participants considered that one cup of skim milk would be the correct answer (53.1% in non-insulin patients and 62.6% in insulin treated patients; p < 0.001). The item regarding the knowledge of free food presented a 13.3% of correct answers (10.8% non-insulin group vs. 17.1% insulin group; p < 0.01). Two of the three items with lower value of correct answers were related to glycemic control and health status monitoring, the other was related to diet and food.
- Marked socioeconomic inequalities in hip fracture incidence rates during the Bone and Joint Decade (2000-2010) in Portugal: age and sex temporal trends in a population based studyPublication . Oliveira, Carla Maria; Alves, Sandra Maria; Pina, Maria De FátimaBackground: Socioeconomic factors may influence changes in hip fracture (HF) incidence over time. We analysed HF temporal trends during the Bone and Joint Decade in Portugal (BJD-Portugal), 2000–2010, by regional socioeconomic status (SES), sex and age. Methods: We selected registers of patients aged 50+ years with HF (International Classification of Diseases, V.9—Clinical Modification, ICD9-CM) caused by traumas of low/moderate energy, from the National Hospital Discharge Database. Annual time series of age-specific incidence rates were calculated by sex and regional SES (deprived, medium, affluent). Generalised additive models were fitted to identify shape/turning points in temporal trends. Results: We selected 96 905 HF (77.3% in women). Women were older than men at admission (81.2±8.5 vs 78.2±10.1 years-old, p<0.001). For women 65–79 years, a continuously decreasing trend (1.7%/year) only in affluent and increasing trends (3.3–3.4%/year) after 2006/2007 in medium and deprived was observed. For men, trends were stable or increased in almost all age/SES groups (only two decreasing periods). For the oldest women, all SES present similar trends: turning points around 2003 (initiating decreasing periods: 1.8–2.9%/year) and around 2007 (initiating increasing periods: 3.7–3.3%/year). Conclusions: There were SES-sex-age inequalities in temporal trends during BJD-Portugal: marked SES inequalities among women aged 65–79 years (a persistent, decreasing trend only in the affluent) vanished among the oldest women; the same was not observed in men, for them, there were almost no declining periods; women aged ≥80 years, presented increasing trends around 2007, as in most deprived/age/sex groups. Despite some successful periods of decreasing trends, incidence rates did not improve overall in almost all age groups and both sexes.
- Modelling therapeutic response in asthmatic adults: a previous exploratory analysisPublication . Alves, Cristina; Faria, Brígida Mónica; Alves, Sandra Maria; Ferreira, Jorge; Faria, Brigida Monica; Alves, Sandra MariaAsthma is a respiratory disease characterized by chronic inflammation of the airways. Effective asthma management is essentially based on choosing the appropriate treatment for each individual (1). Data science and machine learning models offer valuable insights and enhance the outcomes achieved in asthma management (2). The main objective is to develop predictive models for therapy response in patients with asthma, and secondarily to identify clinical, functional and biological characteristics that influence this response. Data from fifty adults with asthma were analyzed, collecting information on anthropometric, clinical, functional, biological, therapeutic, occupational, and allergen exposure factors. The study followed the “Knowledge Discovery in Databases, KDD” methodology. The sample consisted of 50 asthmatic adult participants, aged between 21 and 81 years old mean age=54.02 (s=14.5), from which 20 (40%) were male and 30 (60%) were female. The analysis of the characteristic symptoms of asthma (dyspnea, cough, wheezing and chest tightness), reveals a statistically significant improvement (p<0.001) of all these symptoms after the treatment. The asthma control test, the life quality questionnaire and the asthma and allergic rhinitis control test evaluated before and after treatments, demonstrate a statistically significant difference (p=0.023, p <0.001 and p<0.001, respectively). On respiratory function, only FVC reveals a significant difference (p=0.409), after treatment. However, the average did not reach the minimal important difference (MID) of 200ml. The average number of exacerbations and SU recurrences difference was also significant in both cases (p<0.01), reaching MID (>50%). The majority of the individuals in this group had a positive, clinically important response to treatment. This result may be because they have severe atopic asthma, and Th2-High endotype, and for that reason they are undergoing more differentiated treatments, such as biological treatments.