Portuguese Public Research Articles

Psychiatric comorbidity and hospitalization outcomes for AMI in portuguese public hospitals

Abstract Background Severe mental health disorders directly affect quality of life but may also indirectly relate to physical diseases and their prognosis. We test this hypothesis for the specific case of acute myocardial infarction (AMI), postulating a longer in-patient stay and an excess in-hospital mortality among patients suffering psychiatric comorbidities (PC). Methods A retrospective observational study was conducted using secondary data from public Portuguese hospitals, for all patients with a primary diagnosis of AMI (12,213 patients aged 18-80, for the years 2017-18). We used linear and logistic regression to model length of stay (LoS) and in-hospital mortality, respectively. Having at least one psychiatric comorbidity was the explanatory variable, and models were adjusted for age, sex, and the Charlson Comorbidity Index. Results The prevalence of PC was 12.95%. The in-hospital mortality rate was significantly higher in the group with PC (4.43%, OR = 1.372, 95%CI=1.041-1.784), than in the group without PC (3,38%). Stays were significantly longer among those with PC (mean=7.69 days), compared to those without PC (mean=6.87 days; adjusted β-coefficient=0.098, 95%CI=0.056-0.141). Conclusions Patients with AMI and comorbid mental disorders have poorer hospitalization outcomes than those without PC. This emphasizes the importance of promoting effective management strategies for comorbid psychiatric disorder, for instance, by improving the integration of mental health care in general hospitals, and empowering healthcare professionals to recognize and manage patients with PC. Key messages • Psychiatric comorbidity is related to longer inpatient stays and higher mortality risk among patients with AMI. • Efforts to integrate mental health care in general hospitals should be maintained.

Exploring the Relationship between Decision-Making Styles and Emotion Regulation: A Study of Police Officials in Portuguese Public Security

In public security policing, where pressure is constant, effective decision-making and emotion regulation are critical, especially for leaders. These processes significantly impact upon work results, performance, officials’ health, employee well-being, and the organizational environment. This study aims to broaden the understanding of decision-making styles and emotion-regulation strategies used by police officials in the Portuguese Public Security Police (PSP). We surveyed 138 Portuguese high-ranking police officials using two self-response questionnaires, namely the Emotion Regulation in the Workplace (ReTrab) and the Melbourne Decision Making Questionnaire (MDMQ), both translated, adapted, and validated for the Portuguese police context. A confirmatory factor analysis was conducted, followed by correlations to explore the relationship between emotion-regulation strategies and decision-making styles. Finally, through a regression analysis, the potential impact of this relationship was assessed. The results reveal that specific emotion-regulation strategies, except for adaptive ones, significantly influence and modify the decision-making styles of PSP officials. Dysfunctional and maladaptive emotion-regulation strategies lead to less adaptive decision-making styles, while functional strategies promote more adaptive styles. These findings have theoretical and practical implications, offering valuable insights for targeted training programs and interventions in the law-enforcement sector, benefiting the police personnel, the communities they serve, and public perceptions about police.

REJUVENESCIMENTO FACIAL NA BIOMEDICINA ESTÉTICA FACIAL

The general objective of the theme was to investigate the impact of facial rejuvenation on aesthetic biomedicine, addressing aspects related to safety, effectiveness and patient satisfaction. Thus, he sought to discuss facial aging; evaluate the main facial rejuvenation procedures available in aesthetic biomedicine, including techniques, products and technologies used; analyze the clinical and scientific aspects involved in facial rejuvenation treatments, considering the benefits, risks and limitations of each approach. The methodology adopted consists of carrying out a literature review, through a bibliographic survey. Studies will be searched in the Virtual Health Library (VHL), PubMed and Google Scholar databases. To select articles, the following descriptors are used: biomedicine; aesthetics; aging. The inclusion criteria established were direct relevance to the topic; publication in Portuguese and/or English; publication period between 2010 and 2024; availability of the full article. Articles that fell outside the scope of the study, were published in languages other than Portuguese and English, published before 2010, available only as abstracts and duplicates in different databases were excluded from the analysis. With the results of the research, it was possible to conclude that facial rejuvenation in aesthetic biomedicine offers a variety of techniques, from chemical peelings to laser procedures and dermal fillers, adapted to the individual needs of each patient. The personalized approach ensures effective and safe results, driven by a comprehensive understanding of scientific principles and a multidisciplinary approach. These innovative treatments promote not only aesthetic improvements, but also patients' self-esteem and well-being.

Subjective well-being perceptions of Portuguese Public Relations practitioners: a gender and stages of life analysis

PurposeThis research aims to explore perceptions of subjective well-being (SWB) in public relations (PR) practitioners, focusing on dimensions of job satisfaction, networking, relationships and work–life balance, while addressing the under-researched area of gender and age – related to stages of life – disparities in SWB within the PR industry.Design/methodology/approachEmploying a mixed-methods sequential explanatory design, this study utilised a survey, followed by semi-structured interviews to investigate SWB among PR professionals in Portugal, considering gender and stages of life differences.FindingsUsing a gendered and stages of life lens, this study found nuanced perceptions of SWB among Portuguese PR professionals. Older women showed higher emotional well-being but lower work evaluations than men, while young professionals exhibited less gender disparities in SWB. Men reported greater job satisfaction, emphasising passion, while women faced challenges like work overload and valued recognition. Gender differences were seen in networking, with men favouring teamwork and women valuing friendships for career advancement. Work–life balance issues, especially among older women, related to mental health.Originality/valueThis study contributes to filling the research gap regarding SWB in the PR industry, particularly in Portugal, offering insights into gender and stages of life dynamics that influence SWB perceptions, thereby informing strategies for enhancing well-being and productivity in PR workplaces.

Portuguese Public Finances in the Golden Age, 1950–1973: an Illustrated Overview

Portuguese Public Finances in the Golden Age, 1950–1973: an Illustrated Overview

Silenced Voices in Portuguese Public TV News: An Intersectional Analysis of the Representation of Women with Disabilities in RTP’s Telejornal

(1) Background: Studies on women with disabilities (WwD) are rare and tend to reveal certain representation patterns. This study aims to understand how and to what extent WwD and chronic diseases are deemed newsworthy in the Portuguese public news TV station RTP1 primetime news program. Feminist disability, standpoint, agenda-setting, and framing theories are used alongside the concept of intersectionality. (2) Methods: A mixed-method approach is adopted, combining quantitative content analysis of all broadcasted news in January 2020 (n = 704), and qualitative discourse analysis of news items on PwD (n = 5). (3) Results: The results reveal that disability is a reduced issue in Telejornal’s agenda. PwD, in general, are often portrayed in secondary roles and without a voice. The protagonists of news stories about disability or persons with disabilities are predominantly women without disabilities, occupying traditional roles as caregivers (mothers, nurses), while men are more often portrayed as public agents. Discourse analysis deepens understanding by uncovering the prevalence of negative news values and a problem-centred framing, often associated with negativity, rather than presenting solutions. (4) Conclusions: Consequently, WwD were found to be deprived of news representation with a more positive or ‘normal’ focus and an intersectional approach reveals a lack of inclusion, with the few existing news tending to focus on exclusion issues, portraying only white Portuguese women. This study underscores the urgent need for a more equitable approach in media representation, recognising the diversity and positive contributions of WwD to promote an inclusive narrative.

Notes on Portuguese Publications Dedicated to International Law of the Sea in the 19th and 20th Centuries

Abstract The doctrinal production of the ils in Portugal took place only from the eighties of the nineteenth century. During the 19th century and in the 20th century until the 1980s, ils matters were not subject to specialist teaching in the Faculties of Law in Portugal. Professor Barbosa de Magalhães, of the Faculty of Law of the University of Lisbon, particularly during the 1920s, is the only jurist with recognized merits who studied the ils until the 1980s. Professor Marques Guedes must be considered the “founding father” of academic studies of the ils taking into account his teaching on the subject from 1980s in the Faculty of Law of the University of Lisbon. The contribution of authors from the Navy, with an emphasis on Eduardo Serra Brandão, constitutes a very significant part of the ils writings published in Portugal in the second half of the twentieth century.

Pesquisas sobre o jogo de damas: uma revisão de literatura

Draughts, considered an intellectual sport, has an interdisciplinary characteristic, presenting itself as a leisure sport, school sport and performance sport. The objective was to carry out a literature review aiming to identify and analyze the scientific and academic production on the modality, especially on the topic of modality Management. A narrative review of the literature was carried out through a survey of records in Portuguese, English, Spanish, Russian, Italian and French on Google Scholar, up to the year 2023, analyzing the areas of knowledge; themes of publications and countries and/or authors that produce studies on the topic. 39 works were obtained in different formats, with emphasis on the areas of Computer Science and Artificial Intelligence. Brazil is responsible for publications in Portuguese and leads the number of studies identified. The gap in studies in the area of Physical Education, Sport and Sport Management is confirmed, and new studies are suggested in order to expand knowledge on the topic.

Predicting construction project compliance with machine learning model: case study using Portuguese procurement data

PurposeFactors like bid price, submission time, and number of bidders influence the procurement process in public projects. These factors and the award criteria may impact the project’s financial compliance. Predicting budget compliance in construction projects has been traditionally challenging, but Machine Learning (ML) techniques have revolutionised estimations.Design/methodology/approachIn this study, Portuguese Public Procurement Data (PPPData) was utilised as the model’s input. Notably, this dataset exhibited a substantial imbalance in the target feature. To address this issue, the study evaluated three distinct data balancing techniques: oversampling, undersampling, and the SMOTE method. Next, a comprehensive feature selection process was conducted, leading to the testing of five different algorithms for forecasting budget compliance. Finally, a secondary test was conducted, refining the features to include only those elements that procurement technicians can modify while also considering the two most accurate predictors identified in the previous test.FindingsThe findings indicate that employing the SMOTE method on the scraped data can achieve a balanced dataset. Furthermore, the results demonstrate that the Adam ANN algorithm outperformed others, boasting a precision rate of 68.1%.Practical implicationsThe model can aid procurement technicians during the tendering phase by using historical data and analogous projects to predict performance.Social implicationsAlthough the study reveals that ML algorithms cannot accurately predict budget compliance using procurement data, they can still provide project owners with insights into the most suitable criteria, aiding decision-making. Further research should assess the model’s impact and capacity within the procurement workflow.Originality/valuePrevious research predominantly focused on forecasting budgets by leveraging data from the private construction execution phase. While some investigations incorporated procurement data, this study distinguishes itself by using an imbalanced dataset and anticipating compliance rather than predicting budgetary figures. The model predicts budget compliance by analysing qualitative and quantitative characteristics of public project contracts. The research paper explores various model architectures and data treatment techniques to develop a model to assist the Client in tender definition.

Characterization of the oral microbiota and the relationship of the oral microbiota with the dental and periodontal status in children and adolescents with nonsyndromic cleft lip and palate. Systematic literature review and meta-analysis

ObjectiveTo identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic cleft lip and palate (CLP).Materials and methodsA systematic review of the literature was carried out. Five databases were consulted, including publications in English, Spanish and Portuguese. The evaluations of the quality of the observational studies and the experimental studies were carried out with the Newcastle–Ottawa scale and CONSORT guidelines, respectively. The risk of bias of the studies was determined using Rev Manager 5.4, and 5 publications were meta-analyzed.ResultsThe cariogenic microbiota of children and adolescents with cleft lip and palate was similar to that of children without clefts, although with higher counts of Streptococcus mutans and Lactobacillus spp. The periodontopathogenic microbiota was related to the presence of Campylobacter spp, Fusobacterium spp, Fusobacterium nucleatum, Prevotella intermedia/nigrescens, Parvimonas micra and Porphyromonas gingivalis, considered microorganisms with high pathogenic capacity. Heterogeneity was shown in relation to the microbiota and the type of fissure, presenting numerous microorganisms associated with the pre- and post-surgical condition (cheilorrhaphy and palatorrhaphy) such as Staphylococcus aureus, Streptococcus beta hemolyticus, Klebsiella pneumoniae and Klebsiella oxytoca, Moraxella catarrhalis, Candida spp, Candida albicans, Candida krusei and Candida tropicalis. The meta-analysis revealed that patients with cleft lip and palate were 2.03 times more likely to have caries than the control group (p<0.005).ConclusionIn the microbiota, there was a great diversity of microorganisms that can vary according to the type of fissure and surgical interventions predisposing patients to a greater probability of dental caries, it is important to take into account the technique used to describe the oral microbiota in order to be able to compare the different studies.Clinical relevanceStudying the microbiota and the relationship of dental caries and periodontal status in children and adolescents with cleft lip and palate can facilitate the comprehensive care of patients with these conditions.

Fast Healthcare Interoperability Resources-Based Support System for Predicting Delivery Type: Model Development and Evaluation Study.

The escalating prevalence of cesarean delivery globally poses significant health impacts on mothers and newborns. Despite this trend, the underlying reasons for increased cesarean delivery rates, which have risen to 36.3% in Portugal as of 2020, remain unclear. This study delves into these issues within the Portuguese health care context, where national efforts are underway to reduce cesarean delivery occurrences. This paper aims to introduce a machine learning, algorithm-based support system designed to assist clinical teams in identifying potentially unnecessary cesarean deliveries. Key objectives include developing clinical decision support systems for cesarean deliveries using interoperability standards, identifying predictive factors influencing delivery type, assessing the economic impact of implementing this tool, and comparing system outputs with clinicians' decisions. This study used retrospective data collected from 9 public Portuguese hospitals, encompassing maternal and fetal data and delivery methods from 2019 to 2020. We used various machine learning algorithms for model development, with light gradient-boosting machine (LightGBM) selected for deployment due to its efficiency. The model's performance was compared with clinician assessments through questionnaires. Additionally, an economic simulation was conducted to evaluate the financial impact on Portuguese public hospitals. The deployed model, based on LightGBM, achieved an area under the receiver operating characteristic curve of 88%. In the trial deployment phase at a single hospital, 3.8% (123/3231) of cases triggered alarms for potentially unnecessary cesarean deliveries. Financial simulation results indicated potential benefits for 30% (15/48) of Portuguese public hospitals with the implementation of our tool. However, this study acknowledges biases in the model, such as combining different vaginal delivery types and focusing on potentially unwarranted cesarean deliveries. This study presents a promising system capable of identifying potentially incorrect cesarean delivery decisions, with potentially positive implications for medical practice and health care economics. However, it also highlights the challenges and considerations necessary for real-world application, including further evaluation of clinical decision-making impacts and understanding the diverse reasons behind delivery type choices. This study underscores the need for careful implementation and further robust analysis to realize the full potential and real-world applicability of such clinical support systems.

Strategic Communication for Local Public Health Services in Portugal: A Delphi Study.

Strategic communication plays a decisive role in public health planning and project implementation. However, Portuguese Local Public Health Units, which are responsible for community interventions, still lack guidance models, tools, specialized resources, and training in health communication. The aim of this study was to develop a conceptual model of strategic organizational communication for local public health services, in Portugal. This study presents a conceptual model of strategic organizational communication for Local Public Health Units, which was developed through a three-round, modified Delphi online panel. Thirty-seven Portuguese specialists in public health, communication, and community members were invited to analyse a proposed framework, based on an up-to-date literature review. High retention rates were observed in all rounds (first = 22 valid participations; second = 21 valid participations; third = 18 valid participations). Most participants believed that Portuguese Public Health Units were not prepared to communicate effectively and that they would benefit from adequate planning and identification of a communication lead or team. Websites and social media were also identified as essential for effective communication. The validated conceptual model integrated different partners in health and in the community, with emphasis on the relationships with the national network of health authorities, other Public Health Units, primary health care units, municipalities, and schools. The preferred channels identified for communicating with these partners included interpersonal relationships, email, and mobile phone. No consensus was obtained for preferred communication channels between Local Public Health Units and the media. Strategic planning based on the proposed conceptual model involving different stakeholders, has potential to improve the effectiveness of internal and external communication and facilitate the implementation of public health programs and projects. The proposed model needs to be validated in Local Public Health Units, considering the potential human, material, and financial constraints.

Evaluation of the Scientific Production in the Field of General Practice and Family Medicine in Portugal

The Portuguese publications in the field of General Practice and Family Medicine have not yet been assessed in bibliometric studies. The aim of this study was to analyze that production between 2012 and 2022. The Web of Science Core Collection was used to gather the number of articles, journals and citations obtained; the Journal Citation Reports to obtain the Impact Factor and quartile of journals; and Scimago Journal & Country Rank, for the comparison of data with other European countries. The search was based on the following query: "usf OR unidade de Saude Familiar OR centro de Saude OR ACeS OR medicina geral familiar OR Gen Practice Family SAME Portugal", and a time window between 2012 and 2022 was defined. The study considered the following quantitative indicators: total number of publications, typology, language, affiliation, co-authors, geographical distribution, thematic areas, and the number of publications/inhabitant and publications/physician from European countries; the qualitative indicators selected were the Impact Factor (IF), the quartile and the number of citations. Between 2012 and 2022, the national scientific production had an average annual growth rate of 36.6%. Of 389 publications, 73.8% were 'Articles' and 11.8% were 'Review Articles', predominantly in English (88.4%). The fields of 'General Internal Medicine' (24.7%) and 'Public Environmental Health' (14.9%) had the highest publication rates among the journals. The 389 publications received 5354 citations, for an average of 13.76 citations per article, and the average yearly citation growth was 115%. According to IF, 22.5% of the 222 journals belonged to Q4, 27.5% to Q3, 29.7% to Q2 and 20.3% to Q1, and therefore no significant bias regarding the journals where Portuguese doctors publish was observed. The bibliometric analysis allowed us to examine the evolution of the scientific production in the field of Portuguese General Practice and Family Medicine by observing an increasing publication trend and with a high potential for publication growth.

Multipluralism with education in Google books: Mechanisms descriptive about transsexuality and social representations and rights of adolescents

The work presented was prepared according to the need to understand the representations of human beings in their recognized historical rights identified throughout mainly adolescence as an important stage of life. This research is also motivated to understand public health policies identified in alignment with the representations of the human being in the phases of life, especially those aimed at transsexuals. I used the following lexical items added in English using the search engine through Google Books and, concomitantly, scanning in Brazilian Portuguese in a correspondence search engine called Brazilian Corpus made available by the Linguateca1 initiative. Therefore, these are recognized masculine genders, women, gays, lesbians, homosexuals, transgender people; person, transgender, transgender person, transsexual person, spiritual person, transgender person, transsexual person, gender queer, gender dysphoria, gender identity, gender diverse, gender non-conforming minors, gender non-conforming, gender affirming, non-binary; non-binary; transgender, gender diversity, non-conforming adolescents, LGBTQ, non- conforming people, minority genders, gender transition, family, adopted family (as well as their own plural forms). The phases of life have been operationalized by the following measures: man, woman, adolescent, adolescence, adult, boy, girl, child, elderly, child, young person and adolescent (as well as their plural forms). The data for the analysis consists of publications made available by Google Books in the period 1800 to 2008, totaling approximately 500 million words, in addition to the use of the SKETCH ENGINE Corpus which brings together publications in English and Brazilian Portuguese in this analysis. The Portuguese Corpus contains around 1 billion words of data from newspapers and magazines on the Internet in four Portuguese-speaking countries between 2012 and 2019 and is called the Portuguese Web (ptTenTen20). To this end, several analyzes were carried out, focusing in particular on the results related to the rights of transsexual people and when these rights began to be recognized in publications and the possible health policies addressed to adolescents and education.

Organizational Competence of Public Hospitals in Project Management

Health organizations are challenged every day to manage their projects in a dynamic context of multifactorial complexity, are intrinsically linked to the organizational competences for PM and project success (on time and budget, with quality, in alignment with the requirements defined by the project owner and stakeholders), through articulation between people, resources, processes and project support structures.The aim of this research was to study the Competence of Portuguese Public Hospitals in PM, carrying out a diagnosis of organizational competences in PM, reflecting on the existing competences and those that are needed, proposing strategies for its development. This study was carried in three public hospitals (51 respondents) and evidence that they can improve their organizational competence in PM. It also shows that there is a statistically significant association between the organizational competence in PM, the role of professionals in projects and their experience. On the other hand, the results also show that the success of projects is influenced by the existence of a PMO dedicated to supporting the project management activity in the organization. Likewise, the existence of a PMO, combined with certification or specific training in PM, and having already managed projects in the organization, didn´t revealed a strong influence on the state of development of organizational competence to manage projects. The results demonstrate that these health organizations need to invest in the development of organizational competence for the success of their projects and that there are not many professionals with certification or specific training in PM. Hospital´s need to improve people´s competences and create internal structures to support PM.

Once Colonizing Territories: the Disputed Lands at the Portuguese Official Public Works Records

Colonial archives congregate intricate webs of information and knowledge articulating numerous historical public and private services. What may represent a colonial public works archive? Are these archives solely collections of historical administrative documents? It seems that these archives can’t be merely the result of colonial administrative and bureaucratic procedures as they perform similarly to territory. Public works records testify to a dense landscape, summoning actors from numerous arenas – politicians, architects, engineers, entrepreneurs, and subalterns – with European uses, customs, and technology overseas. To provide answers to some interrogations surrounding disputed land, we will address Portuguese colonial Public Works records as references to the debate on colonizing territories.&#x0D;

Review: Kaczorowski, B. (2022). Wojna Salazara. Polityka zagranicz-na Portugalii w okresie drugiej wojny światowej

The book written by Bartosz Kaczorowski depicts Portuguese foreign policy in the period of World War II which is silhouetted against the international situation and the ideological rudiments of Estado Novo. The author presents the goals of Salazar’s policy and its methods in this period. This topic, as Kaczorowski shows, was almost unknown not only to Polish historiography, but also did not find an objective and holistic approach nor in Portuguese publications, nor in texts of other foreign scholars. Even though, some aspects of Portuguese foreign policy during World War II have their comprehensive studies (the question of the Azores, relations with the Jewish population). That is why the author was supposed to conduct the extensive query in libraries and archives primarily abroad (the archive of Portuguese Foreign Office, other archives in Portugal, USA, Spain, Great Britain, France, Italy and Ireland). Thanks to this query was completed significantly the source material known by historians and thorough and conscientious work of the author is definitely commendable. The big advantage of the book is also the presence of original quotes (mainly in English or Portuguese) in the notes, because they can help in better understanding of the test.

Risk factors for low humoral response to BNT-162b2 in hemodialysis patients.

Maintenance hemodialysis (HD) patients are at higher risk of both infection and mortality associated with the new SARS-CoV-2. Immunization through large-scale vaccination is the cornerstone of infection prevention in this population. This study aims to identify risk factors for low response to the BNT-162b2 (Pfizer BioNTech) vaccine in an HD cohort. Observational prospective study of an HD group followed in a Portuguese Public Founded Hemodialysis Center who received BNT-162b2 vaccination. Specific anti-Spike IgG was evaluated as arbitrary units per milliliter (AU/mL) and compared against risk factors. Humoral response evaluated by IgG anti-Spike levels showed a strong correlation with Charlson comorbidity index (CCI) and intact parathormone (iPTH) after each inoculation (1st dose: rho = -0.64/0.54; 2nd dose: rho = -0.66/0.63, respectively; p < 0.01 throughout). After completing both doses: 1) no response (NR) was associated with female sex (p < 0.01), lower albumin and iPTH (p = 0.01); 2) weak response (WR) showed higher CCI, older age, lower iPTH, and lower albumin (p = < 0.01, p = 0.03, p < 0.01, p = 0.05, respectively). A binary regression model using CCI, sex (male), and central venous catheter (CVC) was statistically significant in prediction of WR after the 2nd dose with OR (95% CI): 1.81 (1.06 - 3.08); 0.05 (0.01 - 0.65); 13.55 (1.06 - 174.18), respectively (p = 0.01). Older age, higher CCI, lower iPTH and albumin as well as CVC as vascular access were associated with lower response to vaccination in our study. Comorbidity burden is suggested as a preferred indirect method to predict worst response when compared to age alone.

PALLIATIVE CARE IN HIGHER EDUCATION INSTITUTIONS: A PROMISING CHALLENGE

The new epidemiological profile of the Brazilian population requires changes in the curriculum of Higher Education Institutions concerning the process of training medical professionals. The study aimed to investigate palliative care teaching in Brazilian medical schools. It was guided by the research question: What is the current status of palliative care education in medical schools across Brazil? Searches were carried out in the electronic databases of the Virtual Health Library, using the Descriptors in Health Sciences and Medical Subject Headings: Palliative care; Medical Education and Diseases. As inclusion criteria, English, Portuguese, and Spanish publications were chosen in articles with full-text availability and free access to the searched databases. Results: 55 publications were identified from 2016-2021, of which only 25 documents met the inclusion criteria. The topic of palliative care emerges as an educational incentive capable of promoting essential and surprising discussions throughout graduation and providing educational strategies that can provide opportunities for improving skills and competencies based on integral models centered on the person. This requires a demand for training in this subject as a multidisciplinary approach that prepares the team to deal with patients with life-threatening incurable chronic diseases and infinitude.

The Portuguese Public Hospitals Performance Evolution before and during the SARS-CoV-2 Pandemic (2017–2022)

COVID-19 is a disease caused by SARS-CoV-2, which has spread worldwide since the beginning of 2020. Several pharmaceutical and non-pharmaceutical strategies were proposed to contain the virus, including vaccination and lockdowns. One of the consequences of the pandemic was the denial or delay of access to convenient healthcare services, but also potentially the increase in adverse events within those services, like the number of hospital infections. Therefore, the main question here is about what happened to the performance of Portuguese public hospitals. The main goal of this work was to test if the Portuguese public hospitals’ performance has been affected by the SARS-CoV-2 pandemic. We used the Benefit-of-Doubt method integrated with the Malmquist Index to analyze the performance evolution over time. Then, we employed a multiple regression model to test whether some pandemic-related variables could explain the performance results. We considered a database of 40 Portuguese public hospitals evaluated from January 2017 to May 2022. The period 2017 to 2019 corresponds to the baseline (pre-pandemic), against which the remaining period will be compared (during the pandemic). We also considered fourteen variables characterizing hospital quality, divided into three main performance definitions (efficiency and productivity; access; safety and care appropriateness). As potential explanatory variables, we consider seven dimensions, including vaccination rate and the need for intensive care for COVID-19-infected people. The results suggest that COVID-19 pandemic features help explain the drop in access after 2020, but not the evolution of safety and appropriateness of care, which surprisingly increased the whole time.