Residents In Portugal Research Articles

Gender Disparities in the Academic Performance of Neurology Residents in Portugal.

Implicit bias has been linked to gender disparities in medical careers, impacting not only access to leadership positions but also early career opportunities. We aimed to evaluate if there were differences in the assessment of Neurology residents according to gender. We collected publicly available grades and rankings of two major evaluations that residents are submitted to, one at the beginning and another at the end of the neurology residency program, the National Board Exam and neurology examination, respectively. The National Board Examination is a multiple-choice gender-blinded evaluation, while the neurology examination is an oral gender-unblinded evaluation. We found that 36.5% of women and 21.6% of men were in the first quartile of the National Board Examination ranking, which reflects a similar representation among top classifications when assessed through a gender-blinded examination. On the other hand, the percentage of men who were in the top classification of NE, a gender-unblinded evaluation, was more than twice as high compared to women (37.8% vs 18.3%, p < 0.05). The findings of the present study may imply that there could be a disparity in women's career progression among neurology residents in Portugal, although the recruitment seems balanced between genders.

Health literacy strengths and needs among migrant communities from Portuguese-speaking African countries in Portugal: a cross-sectional study.

Health literacy among migrants is a matter of public health and social justice. Migrants from diverse backgrounds encounter challenges such as linguistic barriers, cultural disparities, restricted access to health services, and heterogeneous migration statuses. Addressing these challenges requires careful consideration of their unique experiences and needs to promote equitable health outcomes. This can hinder their ability to navigate the healthcare system, understand health information, and engage in health-promoting behaviours. However, there is still a significant gap in our understanding of health literacy within migrant communities. This study has a dual aim: to identify health literacy strengths and needs among migrants from Portuguese-speaking African Countries (PALOP) countries in the Lisbon Metropolitan Area and to examine associations between demographic, socioeconomic, migration and health condition characteristics and the health literacy domains. A cross-sectional survey was conducted. Data were collected from 506 PALOP migrants using the Health Literacy Questionnaire (HLQ). We also collected demographic, socioeconomic, migration, and health condition data. We employed multiple linear regression to understand the relationship between the HLQ nine domains and these characteristics. The HLQ scores revealed distinct patterns of health literacy between the groups. Health literacy needs were particularly evident in the domains related to feeling understood and supported by healthcare providers and navigating the healthcare system. Conversely, higher scores and potential strengths were observed in actively managing one's health and understanding enough health information to make informed decisions. However, in these, the average scores suggest that a high proportion of people recognised difficulties. 'The results also indicated that a higher educational level was associated with increased health literacy. In contrast, low self-perceived health status, living alone, shorter duration of residence in Portugal, and being either undocumented or in the process of obtaining legal status were associated with lower health literacy. Our study highlights the importance of migration-related variables and self-reported health status in understanding health literacy among migrant communities. Factors such as length of stay and low self-perceived health status are associated with potentially disadvantageous levels of health literacy, which could exacerbate health inequalities. Assessing these variables is critical to identify gaps in health literacy and develop tailored interventions to reduce health inequalities.

Hepatitis B Virus Genotypes and Subgenotypes Circulating in Infected Residents in a Country with High Vaccination Rate.

Despite the availability of a vaccine against hepatitis B virus (HBV), this infection still causes public health problems, particularly in susceptible populations. In Portugal, universal free vaccination started in 1994, and most HBV infections are diagnosed in immigrants from high-prevalence countries. Our aim was to assess the pattern of HBV genotypes/subgenotypes in samples collected between 2017 and 2021 from a convenience sample of 70 infected residents in Portugal. The HBV pol/HBsAg region was amplified and sequenced, allowing the analysis of RT sequences submitted to phylogenetic analysis and mutations assessment. A total of 37.1% of samples were from native Portuguese, aged 25-53 years (mean: 36.7 years), and the remaining samples were from individuals born outside of Portugal. A high diversity of HBV was identified: subgenotypes A1-A3 in 41.0% (16/39); D1, D3, and D4 in 30.7% (12/39); E in 23.1% (9/39); and F4 in 2.6% (1/39). Besides genotypes A and D, Portuguese were also infected with genotypes E and F, which are prevalent in Africa and South America, respectively. Resistance mutations in RT sequences were not found. The findings provide valuable insights for updating the HBV molecular epidemiology in Portugal. However, successful strategies to prevent and control the infection are still needed in the country, especially among susceptible and vulnerable populations.

Dietary Adequacy in Older Adult Nursing Home Residents of the Northern Iberian Peninsula.

According to the latest data, Spain (19.4%) and Portugal (21.8%) are the two European countries with the highest percentage of older adults. Concerns about diet quality are increasing, especially among institutionalized older people, who are at the greatest risk of malnutrition. To assess the adequacy of dietary intake of 186 older adults (>65 y) institutionalized in public nursing homes (NH) in Galicia (Northwest Spain) and the Porto district (Northern Portugal), a cross-sectional study has been carried out. The double-weighing method and a country-specific food composition database were employed for nutritional assessment. Nutritional adequacy was assessed based on the recommendations of the EFSA and WHO. Caloric intake in Spanish NHs was higher than in Portuguese facilities; 20.3% and 35.8% of Spanish and Portuguese residents, respectively, had a protein intake below the EFSA recommendation, and 46.2% and 44.9% of residents in Portugal and Spain, respectively, had lipid intakes below the reference intake range. Further, 45.5% of the residents in Portugal and 66.9% in Spain had a carbohydrate intake within the recommended range. Salt intake was higher than the recommendation for 67.0% and 32.3% of the residents in Spain and Portugal, respectively. This study supports the notion that institutionalized older adults are prone to significant nutritional inadequacies.

Migrant Pathology Screening in the Pediatric Population: A Five-Year Retrospective Study From a Level II Hospital.

The migrant population residing in Portugal has been growing. In 2015, the pediatrics department at ProfessorDoutor Fernando Fonseca Hospital,a level II hospital, implemented a screening for endemic pathologies in asymptomatic migrant children to enable their timely diagnosis and treatment. This study aimed to identify and characterize the main findings in the migrant pathology screening. This was a retrospective and descriptive study of asymptomatic children and adolescents who underwent opportunistic screening for migrant pathology in a hospital setting between January 2016 and April 2021. Data analysis was performed using Microsoft Excel®. A total of 256 individuals were included in the study; 53.5%(137/256) were female, with a median age of eight years and two months (minimum five months; maximum 17 years and 10 months). The majority of the participants were from Guinea-Bissau (29.7%, 76/256), Angola (19.1%, 49/256) and Cape Verde (12.1%, 31/256) and had been residents in Portugal for a median time of five months (minimum two days; maximum three years and five months). A total of 42.6% (109/256) participants did not have the Portuguese vaccination scheduleupdated. Screening was carried out in an outpatient setting in 71.9% (184/256) of individuals. A total of 38.7% (99/256) presented screening alterations, including 65 anemia cases (18 caused by iron deficiency and one by sickle cell anemia), 5 cases of tuberculosis infection and 1 case of pulmonary tuberculosis, 1 of human immunodeficiency virus infection, 3 hepatitis B virus infection cases, 20 of parasitic infections and 2 cases of female genital mutilations. The revised migrant pathology screening protocol enabled the detection of diseases with a significant impact on the health of individual children and adolescents. This protocol serves as a practical tool for accurately monitoring the health status of this population.

Predictors of perceived wrongfulness and harmfulness of crime among residents in Portugal

The present study aims to examine crime seriousness perceptions by scrutinising their key components – perceived wrongfulness and harmfulness of crime. It also seeks to examine the extent to which these concepts are related to sociodemographic characteristics, conservation values, legal cynicism, religiosity, and exposure to media coverage of crime. A survey was administered to 408 residents in Portugal containing vignettes pertaining to two seriousness levels of both conventional and white-collar crime. The twenty resulting offence scenarios were grouped into four groups: heavier scenarios of conventional crimes, lighter scenarios of conventional crimes, heavier scenarios of white-collar crime, and lighter scenarios of white-collar crime. The results show that only legal cynicism has a consistent influence on crime wrongfulness perceptions for the four crime groups and some influence on crime harmfulness perceptions for lighter scenarios of conventional crimes. As for conservation values and religiosity, the only effects observed are on the perceived wrongfulness and perceived harmfulness of heavier scenarios of conventional crimes. Exposure to media coverage of crime does not seem to have an impact on the assessment of these two perceptual variables. Sociodemographic characteristics and victimization experiences explain only minor differences in the assessment of the seriousness, wrongfulness, and harmfulness of crimes.

Shaping citizenship: Dynamic relations between the reified and the consensual universes in defining the “good foreign resident”

A social and political psychology of citizenship can be furthered by the analysis of the values and representations through which citizenship is constructed in the text of laws and reconstructed during implementation and how these (re)constructions best serve some groups. This article views laws as facts from the reified/institutional universe whose texts operate a simplification process by prioritizing certain values from the plurality existent in the consensual universe and sees institutions in charge of law implementation as mediating systems operating re-complexification processes. Using this perspective, it (1) explores how the values and social representations prioritized in Portuguese foreign residency laws exclude/include certain groups and define rights and duties of “the good foreign resident/citizen”; (2) illustrates with interviews with experts from a mediating system (n = 6) the re-complexification of the laws in implementation. It highlights how the “worthiness” of foreign residents in Portugal depends upon three central values (work, study, and investment) keeping, however, some ambiguity of these values in the legal texts. Interviews illustrate how mediating systems re-signify the laws, amplifying the ambiguities by resorting to other values and representations. We discuss how the analysis of the dynamic relation between the reified and the consensual universes contributes to a better understanding of how macro-level factors interact with everyday citizenship.

Industry payments to family medicine residents in Portugal: a descriptive analysis of the national transparency database

ObjectiveTo analyse payments made to family medicine residents by the pharmaceutical industry during their residency in Portugal, using mandatory disclosure data.Design and participantsCohort study of residents starting their family medicine...

Percepção de Estresse em Tempos de Pandemia COVID-19

ntroduction: The COVID-19 pandemic impacted the mental health of the population. Objective: We aimed to analyze the perceived stress levels and the peritraumatic stress index in two diff erent samples with Portuguese nationality, one residing in Portugal (study 1) and the other living abroad (study 2). We also verifi ed the eff ect of gender and place of residence in these two samples for the two stress indicators. Method: Data collection took place from May 6th to June 8th. A snowball sampling method was applied to recruit participants. A web-based survey was developed to collect sociodemographic information and data on the perceived stress scale (PSS-10) and COVID-19 peritraumatic distress index (CPDI). The population living in Portugal include 369 subjects, and the population living abroad was 44 subjects. Results: From study 1, 43% of the sample manifested high levels of perceived stress, and 46.3% severe psychological distress, resulting from COVID-19 (peritraumatic stress). In study 2, the results showed that 50% of the subjects had high levels of perceived stress, and 50% had severe psychological distress because of the most recent pandemic. Residents in Portugal showed higher values in all measures studied; female gender also showed higher values in the 2 studies, in all measures. Conclusion: The fi ndings of this study suggest that the pandemic situation caused psychological distress in the Portuguese people. Therefore, we hope that this study can help develop intervention strategies to reduce psychological distress and prevent future vulnerabilities in the mental health of the Portuguese population.Keywords:Stress, pandemic, mental health, COVID-19

More insights into the interaction between age, exposure, and attitudes in language attrition and retention from the perspective of bilingual returnees

Aims and Objectives: The study investigates the effects of age, language use, and attitudes on Portuguese returnee bilinguals’ knowledge of German nominal morphology. We focused on language attrition. In addition, we compared whether the results of returnee bilinguals differ in relevant ways from the performance of L1 speakers of German and, if so, in which domains. Methodology: A background questionnaire and offline tasks that elicit lexical knowledge, case, gender, and plural marking in German were applied to a group of Portuguese–German bilingual returnees ( N = 20) and a group of German L1 speakers ( N = 20). Data and Analysis: The elicited data were analyzed through non-parametric tests (Mann–Whitney tests, Wilcoxon tests, and Spearman correlation tests), since not all the requirements for running mixed models could be fulfilled. Findings: The results show that bilingual returnees have very stable knowledge of the analyzed properties: parts of morphosyntactic knowledge are acquired and stabilized in childhood and remain highly invulnerable to loss of contact throughout the speakers’ lifetime. However, returnees’ knowledge of the German case system is constrained by age of input loss, language use, and attitudes. Ungrammatical plural marking is correlated with the speakers’ bonds to the German language and culture. No cross-linguistic influence from Portuguese was found in the domain of plural marking. Originality: This study resumes the question of differential attrition effects in returnee bilinguals by using a more controlled methodology. It extends the investigation to returnees’ performance in the lexical domain and with regard to case, gender, and number morphology in German, also quantifying other variables, such as the age of onset of bilingualism, the amount of contact with German after return, and the length of residence in Portugal. In addition, it focuses the less researched question regarding the role of the returnees’ attitudes toward both their languages. Significance/Implications: The study highlights the multi-dimensional factors that constrain language proficiency over a bilingual speaker’s lifetime.

O1-5 Digital tools for physical activity assessment and brief counselling in Primary Health Care: The Portuguese model

Issue/problemImplementation of national systems for patients' physical activity (PA) assessment and counselling is a cost-effective strategy recommended in the WHO Global Action Plan for PA 2018-2030. Although Primary Health Care (PHC) professionals are recognized as key agents for PA promotion, challenges remain on how to develop feasible and scalable tools to support them in promoting patients' PA. The Portuguese model could help other countries improve PA assessment and brief counselling in PHC settings. This study aims to describe the tools' development and usage.Description of the problemThe Portuguese Directorate-General of Health developed two evidence-based digital tools to support PA promotion by healthcare professionals: a) PA brief assessment tool; and b) brief counselling tool. The assessment tool was incorporated within the electronic medical health record software ?SClínico? in September 2017. It includes three questions: 1) how many days per week the patient performs any kind of PA (work, commuting or leisure-time); 2) how much time per day; and 3) how many hours per day the patient spends in sedentary behaviours. The PA brief counselling tool is available through the electronic medical prescription software ?PEM? since December 2017 and consists of five inter-related self-explanatory guides that can be delivered to patients (printed or by email), according to their motivation and PA levels. They facilitate person-centered and autonomy-supportive PA counselling, targeting specific behaviour change mediators, and using validated techniques.ResultsFrom September 2017 to December 2021, 159,179 patients had their PA assessed (2235 per 100,000 users of the National Health Service) and, from these, 16133 received PA brief counselling guides (177 per 100000 residents in Portugal, ≥ 15 years old), with a six-fold and three-fold increases, respectively, between 2018 and 2019 (previous to the COVID-19 pandemic). Future actions will address cost-effectiveness of this policy.LessonsThe brief assessment and brief counselling tools were well-accepted and are increasingly being used, with potential for generalized adoption within the Portuguese Health Care System.Main messagesPortugal has taken a decisive action to promote PA using PHC as a priority setting. PA tools usage is increasing considerably, highlighting the importance of making available easy-to-use PA promotion tools.

The Impact of the COVID-19 Pandemic on the Intensive Care Residency Program in Portugal

In 2020, critical care departments underwent profound changes imposed by the COVID-19 pandemic. The aim of this study was to evaluate the impact of the pandemic on the intensive care residency program in Portugal. The Association of Critical Care Residents (AIMINT) prepared a questionnaire using the Google Forms® tool, which was applied during August 2020 to the Critical Care residents in Portugal. A descriptive analysis was performed with the data collected. Eighty-five residents participated in the questionnaire, yieldinga response rate of 62%. Three-quarters of all participants provided care to COVID-19 patients. More than 80% of the surveyed participants were on rotations, and these were canceled in 59% of cases. Seventy-eight percent reported a workload greater than 40 hours per week. The COVID-19 pandemic had an impact on the Critical Care Residency program in Portugal. Most residents surveyed provided care to COVID-19 patients and not only saw their rotations suspended but also experienced difficulties in rescheduling them.

Sustainability and holidays plans in Covid times: an analysis of Portuguese residents' intentions

Abstract: This study focuses on micro-environmental factors (Casado-Aranda et al, 2021) related to changes in consumers' travel behaviours, arising from COVID-19. It seeks to understand if risk perception associated with COVID had an impact on travel intentions of residents in Portugal and if there are changes, regarding more sustainable choices, in 2021 summer holiday’s intentions. Data was collected through an online questionnaire between December 2020 and March 2021 (overlapping the first 3 months of the vaccination process, corresponding to 5% of the full vaccination of the Portuguese (Our World in Data, 2021) and reflects short-term effects (Miao et al, 2021) on the travel behaviours of residents in Portugal (n=610). Almost half of the participants (48,5%) responded positively to the probability of going on holidays in 2021. From these, the majority (64,2%) intended to travel only to domestic destinations, mostly justified by the willingness to help the country (54,5% of those who considered likely to go on holidays) and not as much as a risk perception associated to the pandemic (only referred by 26,8%). As for holiday’s consumption intentions, residents expressed concerns that may have a positive impact on the socio economical sustainability of the destinations. In fact, from those who considered likely to travel, 71,6% referred that they will prefer national products, 64,5% will value more than before certified touristic services and 57,4% intends to shop mostly in small traditional business. In terms of environmental sustainability, 59,5% will have an increased concern in reserving touristic services environmentally responsible. Results emphasize the need for reflection on the effective positioning of sustainability issues concerning the tourism sector’s future. COVID-19 has created an opportunity for tourism to review and relaunch itself, based on more responsible and sustainable approaches (Brouder, 2020; Casado-Aranda et al, 2021; Jones and Confort, 2020). It’s important to understand to what extent consumers are willing to assume more sustainable behaviours in their future travel options. These results ask for future research regarding the importance of understanding the difference between tourists’ stated intentions and effective actions when it comes to sustainable travel behaviour.

Sociodemographic and Clinical Determinants of Multimorbidity of Underlying Conditions That Increase the Risk of Severe Illness from COVID-19 in Chronic Adult Individuals

Multimorbid patients represent a special population of vulnerable individuals who suffer from two or more long-term conditions. They are a very prevalent group with an increased risk of death from COVID-19. The present study aimed to identify the sociodemographic and clinical determinants of multimorbidity of underlying conditions that increase the risk of severe COVID-19 in chronic adult individuals by analyzing data from the Portuguese National Health Survey 2019. The inclusion sample consisted of 7859 adult residents in Portugal who had at least one chronic condition. The health conditions considered for multimorbidity were CKD, COPD, heart conditions, diabetes mellitus, obesity, and smoking. In Portugal, approximately 6 out of every 10 individuals with chronic diseases suffer from one or more conditions that are on the list of those at increased risk of severe COVID-19 disease, and approximately 2 out of every 10 individuals have multimorbidity. Obesity and diabetes are the most frequent risk factors. Timely interventions (e.g., regular medical follow-up for preventive health services and health information) targeting multimorbidity in males and individuals with low educational levels, a poor health status, and low functionality may help to reduce the risk of severe COVID-19 and post-COVID-19 sequelae, and to improve health in a large proportion of the population.

How the COVID-19 pandemic changed urology residency - a nationwide survey from the Portuguese resident's perspective.

IntroductionThe aim of this article was to evaluate the impact of the COVID-19 pandemic on urology residency.Material and methodsA 30 question online survey was sent to all urology residents in Portugal between the 25th of April and the 25th of May 2020. Reduction in different areas of clinical activity during the COVID-19 period were evaluated and their perceived impact on their residency program was quantified.ResultsForty-three (54.4%) Portuguese urology residents responded to our inquiry. Eighty-one percent report having supressed their activity by more than 75% in the outpatient clinic; 48.8% in diagnostic procedures; 29.3% in endoscopic surgery; 67.5% in laparoscopic/robotic surgery and 17.5% in major open surgery. There were no differences in clinical activity reduction across residency years. Considering the impact of COVID-19 on urology training programs, 32.6% plan on prolonging residency. During the COVID-19 period, a larger number of residents report having spent more time developing research projects or on continuing medical education, as compared with the pre-COVID-19 period (p = 0.012).ConclusionsCOVID-19 had a major impact on Urology residency in Portugal, with major short- and long-term consequences. A large proportion of residents are considering prolonging their residency as a result.

Association of Use of a Meningococcus Group B Vaccine With Group B Invasive Meningococcal Disease Among Children in Portugal

A 4-component meningococcus group B vaccine (4CMenB) is the only vaccine in use to prevent group B invasive meningococcal disease in young children, but no matched controlled studies have evaluated it. To determine the association between receipt of 4CMenB and invasive group B meningococcal disease. Matched incidence density case-control study. Patients presenting from October 2014 to March 2019 were ascertained, with follow-up until death or discharge (last follow-up in June 2019) in 31 pediatric services in Portugal. Children and adolescent residents in Portugal with laboratory-confirmed invasive meningococcal disease were included. Controls, usually 2 per case, with unrelated conditions who were at the same hospital at the same time were matched for sex, age, and residence. Immunization with 4CMenB, ascertained from the national database (2-4 doses are recommended, depending on age). The primary outcome was group B invasive meningococcal disease in fully vaccinated cases compared with controls. The secondary outcomes were all serogroup invasive meningococcal disease in fully vaccinated cases compared with controls and group B and all serogroup invasive meningococcal disease in cases compared with controls who received at least 1 vaccine dose. Of 117 patients with invasive meningococcal disease, 98 were eligible for inclusion and 82 had group B invasive meningococcal disease; 69 were old enough to have been fully vaccinated and considered protected. Among these 69 cases, the median (interquartile range) age was 24 (4.5-196) months, 42 were male, and the median (interquartile range) duration of hospitalization was 8 (0-86) days. Five of 69 cases (7.2%) and 33 of 142 controls (23.1%) were fully vaccinated (difference, -16.0% [95% CI, -26.3% to -5.7%]; odds ratio [OR], 0.21 [95% CI, 0.08-0.55]). For all serogroup invasive meningococcal disease, 6 of 85 cases (7.1%) and 39 of 175 controls (22.3%) were fully vaccinated (difference, -15.2% [95% CI, -24.3% to -6.1%]; OR, 0.22 [95% CI, 0.09-0.53]). For group B disease, 8 of 82 cases (9.8%) and 50 of 168 controls (29.8%) received at least 1 vaccine dose (difference, -20.0% [95% CI, -30.3% to -9.7%]; OR, 0.18 [95% CI, 0.08-0.44]) and for all serogroup invasive meningococcal disease, 11 of 98 cases (11.2%) and 61 of 201 controls (30.3%) received at least 1 vaccine dose (difference, -19.1% [95% CI, -28.8% to -9.5%]; OR, 0.23 [95% CI, 0.11-0.49]). During the first 5 years of vaccine availability in Portugal, vaccination with 4CMenB was less likely among children who developed invasive meningococcal disease compared with matched controls without invasive meningococcal disease. These findings may help inform the use of the 4CMenB vaccine in clinical practice. ISRCTN Identifier: ISRCTN10901628.

Awareness and Knowledge of Portugal Residents about Natura 2000

Natura 2000 is the European Union’s key strategy to address the current sharp decline in biodiversity. However, according to a recent survey, most Europeans have never heard about it. The present study intended to further explore the perceptions of residents in Portugal about this network of protected areas through the nationwide implementation of a survey. Overall, 232 questionnaires were fulfilled, which showed that most respondents (n = 126, 54%) had never heard of Natura 2000. Furthermore, even the respondents who knew what Natura 2000 is were not well-informed about it. For instance, on average, they were only able to name 2.8 ± 2.2 sites within Portugal; plus, 66% (n = 65) could not correctly name any wild species that inhabited their favourite site. Surprisingly, literacy levels were not significantly correlated with the number of visits to the network (rs = 0.181, p = 0.082), and they were only weakly correlated with the frequency that the respondents engaged in ecological behaviours (rs = 0.277, p = 0.007). Overall, the current findings are in agreement with similar studies carried out in Poland that revealed that the population was poorly informed about this important network of protected areas. This scenario is especially worrisome, considering that public participation is regarded as a key factor for successful nature conservation initiatives.

Healthy immigrant effect in non–European Union immigrants in Portugal: after a decade of (non-)integration!

ObjectivesThe aim of the study was to characterise the existence of the healthy immigrant effect (HIE; better health initially, worsening with an increase in the length of residence) in a big city from a Western European country, particularly in a non–European Union immigrant population. Study designThis is a cross-sectional study. MethodsWe used data from the National Health Survey 2014 to compare the health status of the immigrant and Portuguese populations with different lengths of residence. After descriptive statistics, binary logistic regressions models, with adjusted levels and 95% confidence intervals, were used. ResultsImmigrants were healthier than the Portuguese population (<10 years: odds ratio [OR] = 0.07; 95% confidence interval [CI] = [0.01; 0.51]; ≥10 years: OR = 0.62; 95% CI = [0.19; 2.03]), but had an increased likelihood of suffering from chronic diseases and risk behaviours with the increase in their length of stay in Portugal. After living in Portugal for more than 10 years, the immigrants showed no statistical difference in the main health indicators. ConclusionsThere was a tendency for the health status of immigrants to deteriorate over 10 years of residence in Portugal. To better understand the reasons behind the HIE, specific and tailored studies must be developed.

Patients and Informal Caregivers as Healthcare User Innovators

Patients, as well as their informal caregivers, often develop new innovative solutions to help them cope with their health disorders. This activity might increase and improve the availability and diversity of health solutions, decrease costs in healthcare, and improve individual well-being and social welfare. Despite its growing importance, little is known about the factors contributing to the process. Also, peer adoption of the solutions developed by patients or caregivers has not been studied. Given easy access to vast internet resources and peers globally, it is increasingly important to understand what may influence user innovation and its adoption in health, for improving individual well-being and ensuring their safety. In particular, how interactions with peers, with physicians, or search behavior, along with socio-demographics, may influence the decision to develop a solution or adopt one developed by a peer. In this paper we investigate the development of user innovations in healthcare (by patients and their caregivers), as well as the adoption by other patients, and identify individual-level factors associated with these processes. A large, random, and representative sample of adult residents in Portugal of over 6200 respondents was collected via computer-assisted phone survey. 1.3% of the respondents reported having developed a solution for own use and 3.3% reported to have adopted a solution developed by another patients. Three groups (Developers, Adopters, Remaining population) has distinctive characteristics. Gender plays an important role in the solution development, as women are less likely to develop one. Education is positively associated with the development activity, but also with the intentions to adopt a peer-developed solution. Search for health-related information is positively associated with the development, adoption, and the intentions to adopt a solution. Interactions with peers over the internet and rare, but in-person interactions are frequent and have positive association with the dependent variables in all three groups. The results also suggest that the trust in doctors represents an important dimension that shapes the attitudes of the population towards peer-developed solutions. The study has important implications for the practice and theory.

Migração feminina brasileira e a experiência do envelhecimento em Portugal: sexismo e outros “ismos”

Este artigo busca compreender como migrantes brasileiras, maiores de 50 anos, residentes em Portugal, percebem os estereótipos que lhes são imputados a partir do olhar do endogrupo, neste caso, a sociedade de acolhida. Por meio de entrevistas de Histórias de Vida, as quais analisamos sob o viés interseccional e o paradigma descolonial, contextualizamos os temas de maior recorrência nas falas destas migrantes, a saber: os meta-estereótipos, o mercado laboral, o envelhecer e algumas das estratégias de agência utilizadas nas tentativas de integração.&#x0D; Palavras-chave: migrantes; gênero; racismo; idadismo; interseccionalidade.