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Extracting key system parameters and their impact on state transition is a necessity for knowledge and data engineering. In Decision Support Systems, the quest for yet more efficient and faster methods of sensitivity analysis (SA) and feature extraction in complex and volatile systems persists. A new improved event tracking methodology, the fastTracker, for real-time SA in large scale complex systems is proposed in this paper. The main feature of fastTracker is its high-frequency analytics using meager computational cost. It is suitable for data processing and prioritization in embedded systems, Internet of Things (IoT), distributed computing (e.g. Edge computing) applications. The presented algorithm’s underpinning rationale is event driven; its objective is to correctly and succinctly quantify the sensitivity of observable changes in the system (output) with respect to the input variables. To demonstrate the performance of the proposed fastTracker methodology, fastTracker was deployed in the Supervisory control and data acquisition (SCADA) system from real cement industry. fastTracker has been verified by system experts in real industrial application. Its performance was compared with other real-time event-based SA techniques. The comparison revealed savings of 98.8% in processing time per sensitivity index and 20% in memory usage when compared with EventTracker, its closest rival. The proposed methodology is more accurate and 80.9% faster than an entropy-based method. Its application is recommended for reinforced learning and/or formulating system key performance indicators from raw data.

One of the big challenges of the 21st century is the utilization of nanotechnology for energy technology. Nanoscale structures may provide novel functionality, which has been demonstrated most convincingly by successful applications such as dye-sensitized solar cells introduced by M. Grätzel. Applications in energy technology are based on the transfer and conversion of energy. Following the example of photosynthesis, this requires a combination of light harvesting, transfer of energy to a reaction center, and conversion to other forms of energy by charge separation and transfer. This may be achieved by utilizing hybrid nanostructures, which combine metallic and nonmetallic components. Metallic nanostructures can interact strongly with light. Plasmonic excitations of such structures can cause local enhancement of the electrical field, which has been utilized in spectroscopy for many years. On the other hand, the excited states in metallic structures decay over very short lifetimes. Longer lifetimes of excited states occur in nonmetallic nanostructures, which makes them attractive for further energy transfer before recombination or relaxation sets in. Therefore, the combination of metallic nanostructures with nonmetallic materials is of great interest. We report investigations of hybrid nanostructured model systems that consist of a combination of metallic nanoantennas (fabricated by nanosphere lithography, NSL) and oxide nanoparticles. The oxide particles were doped with rare-earth (RE) ions, which show a large shift between absorption and emission wavelengths, allowing us to investigate the energy-transfer processes in detail. The main focus is on TiO2 nanoparticles doped with Eu3+, since the material is interesting for applications such as the generation of hydrogen by photocatalytic splitting of water molecules. We use high-resolution techniques such as confocal fluorescence microscopy for the investigation of energy-transfer processes. The experiments are supported by simulations of the electromagnetic field enhancement in the vicinity of well-defined nanoantennas. The results show that the presence of the nanoparticle layer can modify the field enhancement significantly. In addition, we find that the fluorescent intensities observed in the experiments are affected by agglomeration of the nanoparticles. In order to further elucidate the possible influence of agglomeration and quenching effects in the vicinity of the nanoantennas, we have used a commercial organic pigment containing Eu, which exhibits an extremely narrow particle size distribution and no significant agglomeration. We demonstrate that quenching of the Eu fluorescence can be suppressed by covering the nanoantennas with a 10 nm thick SiOx layer.

Introduction: Few studies analysed the impact of COVID-19 on supported accommodations (SAs) for people with serious mental disorders. This study aimed to analyse staff’s assessments of work challenges in SAs during COVID-19, the impact of the pandemic on staff, their perception of the impact on residents, and associated factors. Methods: To assess work challenges and the impact of the pandemic on staff and their perception of the impact on residents, a questionnaire was administered to the staff of SAs. Multilevel logistic regression analyses were conducted, involving work challenges and staff’s sociodemographic characteristics, and impact on staff. Results: In total, 117 staff from 32 SAs responded. A challenging environment was felt by most participants (68.4%). There were significant differences in work challenges experienced by staff, namely, according to profession and years working in mental health. A negative impact of COVID-19 was reported by 26.5% of staff, which was associated with their feeling that residents were no longer getting an acceptable service (OR = 7.04, 95% CI [1.43, 34.65], p = 0.016) and with staff feeling at risk of infection at work (OR = 7.99, 95% CI [1.39, 45.86], p = 0.020). Relapse and deterioration of residents’ mental health were perceived by 43.6% of staff. Conclusions: Several work challenges occurred in SAs during COVID-19, which had a negative impact on staff and reportedly on residents. Implications range from the organisational to the clinical levels and may apply internationally and in similarly challenging situations.

ObjectiveThe quality of the relationship between persons with dementia and family carers influences health and quality-of-life outcomes. Little is known regarding those at higher risk of experiencing a decline in relationship quality, who could potentially benefit the most from interventions. We aimed to identify these risk profiles and explore the underlying factors.MethodsWe applied a latent profile analysis to relationship quality data from a 1-year follow-up of 350 dyads of persons with dementia and their informal carers from the Actifcare cohort in eight European countries. Assessments included sociodemographic, clinical, functional, psychosocial and quality-of-life measures. Relationship quality was assessed with the Positive Affect Index. A discriminant analysis explored factors influencing the risk profiles.ResultsThere were two relationship quality profiles among persons with dementia (gradually decreasing, 74.0%; low but improving, 26%) and two among carers (steadily poor, 57.7%; consistently positive, 42.3%). The ‘gradually decreasing’ profile (persons with dementia) was related to their levels of dependence and unmet needs, along with carers’ social distress and negative feelings, lower baseline RQ and sense of coherence. The ‘steadily poor’ profile (carers) was influenced by their social distress and negative feelings, lower sense of coherence and perceived social support. These two predominant profiles showed significant decreases in quality-of-life over one year.ConclusionsSpecific profiles of persons with dementia and their carers are at risk of worse relationship quality trajectories. By considering modifiable related factors (e.g., carers’ stress), our findings can help develop tailored, effective interventions.

Introduction: Schizophreniform disorder manifests itself with similar symptoms to schizophrenia, but it is distinguished from the latter by its shorter duration, varying between at least one and six months. This study aimed to describe and analyze schizophreniform disorder related hospitalizations in a national hospitalization database. Methods: We planned a descriptive retrospective study using a nationwide hospitalization database containing all hospitalizations registered in Portuguese mainland public hospitals from 2008 to 2015. Hospitalizations with a primary diagnosis of schizophreniform disorder were selected based on the International Classification of Diseases version 9, Clinical Modification (ICD-9-CM) code of diagnosis 295.4x. Data regarding birth date, sex, residence address, diagnoses, length of stay, discharge status, and hospital charges were obtained. Comorbidities were analyzed using the Charlson Index Score. Independent Sample t tests were performed to assess differences in continuous variables with a normal distribution and Mann-Whitney-U tests when no normal distribution was registered. Results: In Portuguese mainland public hospitals, a total of 594 hospitalizations with a primary diagnosis of schizophreniform disorder occurred during the eight-year study period. Most, 72.1% (n = 428), were observed in male patients. The mean age at admission was 34.34 years in male patients and 40.19 years in female patients. The median length of stay was 17.00 days and in-hospital mortality was 0.5% (n = 3). Only 6.1% (n = 36) of the hospitalization episodes had one or more registered comorbidities. Forty-one readmissions were documented. Conclusion: Hospitalizations with a primary diagnosis of schizophreniform disorder occur more frequently in young male patients. This is, to the best of our knowledge, the first nationwide study analyzing all hospitalizations due to this diagnosis in Portugal.

Introduction: Psychiatric comorbidities have a significant impact on patients’ quality of life and often go undetected in neurologic practice. The aim of this study was to describe and characterize psychiatric comorbidities among patients hospitalized due to a neurologic disorder in mainland Portugal. Methods: A retrospective observational study was performed by analyzing hospitalization with a primary diagnosis of neurologic disorder defined as categories 76, 77, 79 - 85, 95, 109 of the Clinical Classification Software for International Classification of Diseases, Ninth Revision, Clinical Modification, occurring between 2008 and 2015 in adult patients (≥ 18 years of age). Psychiatric comorbidities were determined as the presence of a secondary diagnosis belonging to the Clinical Classification Software categories 650 to 670. Results: A total of 294 806 hospitalization episodes with a primary diagnosis of a neurologic disorder were recorded in adult patients between 2008 - 2015 in Portuguese public hospitals. Approximately 26.9% (n = 79 442) of the episodes had a recorded psychiatric comorbidity (22.1%; 32.2%, female versus male hospitalizations). Patients with registered psychiatric comorbidities were younger (66.2 ± 16.2 vs 68.6 ± 17.2 with no psychiatric comorbidities, p < 0.001), presented lower all-cause in-hospital mortality rates, and significantly longer mean hospital stays. ‘Delirium, dementia, amnestic and other cognitive disorders’ were recorded in 7.4% (n = 21 965) of the hospitalizations, followed by alcohol-related disorders in 6.5% (n = 19 302) and mood disorders in 6.1% (n = 18 079). Epilepsy/seizures were the neurologic disorders with the highest proportion of recorded psychiatric comorbidities (39.9%). Conclusion: Psychiatric comorbidities were recorded in more than a quarter of the hospitalizations with a primary diagnosis of a Neurologic disorder. Psychiatric comorbidities varied among neurological disorders and were associated with different demographic and clinical features.

Introduction: The intermediate stages of dementia are relatively under-researched, including in Portugal. The Actifcare (ACcess to TImely Formal Care) EU-JPND project studied people with mild-moderate dementia, namely their needs, access to and use of community services (e.g., day centers, home support). In our baseline assessment of the Portuguese Actifcare cohort, the unmet needs of some participants would call for formal support, which was not always accessible or used. We now report the main results of the 12-month follow-up, analyzing changes in needs, service (non)use, quality of life and related variables. Methods: This was a longitudinal, observational study using a convenience sample of 54 dyads of people with dementia and their family carers. Our main outcomes were the Camberwell Assessment of Need for the Elderly (CANE) and the Resources Utilization in Dementia. Clinical-functional, quality of life, psychological distress and caregiving-related assessments were also used. Results: At follow-up, the cognitive and functional status of people with dementia declined (p < 0.001), and their neuropsychiatric symptoms increased (p = 0.033). Considering CANE interviewers’ ratings, the total needs of people with dementia increased at follow-up (p < 0.001) but not the unmet needs. Quality of life was overall stable. The use of formal care did not increase significantly, but informal care did in some domains. Carers’ depressive symptoms increased (p = 0.030) and perseverance time decreased (p = 0.045). However, carers’ psychological distress unmet needs were lower (p = 0.007), and their stress and quality of life remained stable. Conclusion: People with dementia displayed complex biopsychosocial unmet needs. Their cognitive-functional decline over one year was not accompanied by a corresponding increase in any pattern of unmet need, nor of service use. Reliance on informal care (namely supervision) may have contributed to this. Caregiving-related outcomes evolved according to different trends, although stability was almost the rule. Primary carers were even more present at follow-up, without an apparently heavier toll on their own needs, burden, and quality of life. Overall, this longitudinal study comprehensively assessed Portuguese community-dwelling people with dementia. Despite the lack of generalizability, participants’ needs remained overall stable and partly unmet over one year. Longer follow-up periods are needed to understand such complex processes.

Introduction: Despite policy recommendations worldwide, too often dementia remains outside the scope of primary health care. In the context of Portuguese primary health care services, our group previously explored the experiences of people with dementia, carers, general practitioners (GPs), and other professionals, together with their perspectives on barriers to dementia care. However, we know little about triadic consultations that involve a patient, their carer, and their GP. Objective: To explore dementia care in triadic consultations in general practice. Methods: Analysis of ten consultations with dementia triads across six Portuguese practices from different social contexts. Purposive sampling was used to recruit nine GPs, ten patients, and ten carers. Triadic consultations were digitally recorded, transcribed, and analysed. The analytical framework combined codes derived from the transcripts with codes from the available literature. Themes focused on the corollaries of dementia (e.g. need for information), and coordination of services. Results: Dementia-related content took up only 30% of consultations, despite their length (median 27 min). The GPs did not seem engaged in dementia management, their assessments lacked breadth and person-centredness, and interventions were limited. Carers facilitated GPs’ assessment of dementia consequences, but their needs were poorly assessed. Patients’ self-expression was limited by communication patterns within the triad. Conclusion: It is challenging for GPs to assess dementia among other conditions in a context of fragmented care. Strategies for improving family carers’ assessments are needed. The analysis of triadic consultations may provide potential process measures for assessing the quality of clinical practice and consultation training in general practice, but this requires further study.

Dementia poses major public health challenges, and high-quality epidemiological data are needed for service planning. Published estimates of numbers of people with dementia in Portugal have been based, in most cases, on prevalence rates derived from international studies or expert consensus. As in many other countries, Portuguese community prevalence studies’ results are nongeneralizable to a country level. Moreover, their prevalence estimates differ (not surprisingly, owing to different methodologies, e.g., design, sampling, and diagnostic criteria). Regardless, the Portuguese 10/66 Dementia Research Group (10/66 DRG) population-based survey fulfilled 10 out of 11 Alzheimer’s Disease International quality criteria for prevalence studies. It relied on cross-culturally validated methods, fostering a wide comparability of results. Therefore, we can provide rough estimates of 217,549 community dwellers with dementia in Portugal according to the 10/66 DRG criteria (that would be only 85,162 according to DSM-IV criteria). This refers to people aged 65 years or older who are not institutionalized. Although broadly consistent with international projections, these estimates must be cautiously interpreted. Particularly in the context of scarce funding, which will probably last for years, we need more efficient, evidence-based dementia policies. Concerning further epidemiological studies, high-quality methods are needed but also their comparability potential should be improved at national and international levels. Most of all, fund allocation in Portugal should now privilege routine dementia information systems in both health and social services.

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Este artigo elege como objeto de estudo a relação de co-implicação entre educação, justiça e empoderamento nas sociedades do sistema-mundo onde mais progride a neoliberalização e tem como principal objetivo mostrar que essa relação, ao contrário de certas ideias feitas, e apesar da força excludente da normatividade neoliberal, se abre a vários significados ou a diferentes semânticas analisando e interpretando as tendências em vigor nesses contextos. É com base nessa metodologia que o artigo se focaliza em dois grandes eixos temáticos. Por um lado, o eixo onde se escrutinam as marcas distintivas da visão dominante acerca de educação, justiça e empoderamento. Por outro lado, e já no segundo eixo, apresenta-se a visão subalterna e contra-hegemónica de educação, justiça e empoderamento que se articula, em termos normativos, com as aspirações democrático-igualitárias das classes subprivilegiadas, vítimas de acosso das políticas económicas neoliberais. A conclusão, no termo desse exercício hermenêutico, é que o trabalho de fundamentação da educação deve estar criticamente consciente das consequências desses dois modos de entender a relação em questão e que, caminhar no sentido de uma sociedade mais justa, mais igualitária e mais democrática, não se coaduna, nem prática nem teoricamente, com o entendimento dominante de educação, justiça e empoderamento.

Introdução: As pessoas com demência e os seus familiares deveriam ter acesso atempado a cuidados formais na comunidade (centros de dia, apoio domiciliário). O projecto EU-Actifcare investigou o acesso/utilização destes serviços em países europeus. Descrevemos a implementação do estudo de coorte e a avaliação inicial em Portugal, com foco nas necessidades de cuidados e recurso aos serviços. Material e Métodos: Selecionámos uma amostra de conveniência de 66 pessoas com diagnóstico de demência ligeira a moderada (residindo na comunidade sem cuidados formais relevantes) e respetivos familiares-cuidadores. A avaliação (clínico-funcional e social) incluiu os instrumentos Camberwell Assessment of Need for the Elderly e Resource Utilization in Dementia. Resultados: Identificámos necessidades não-cobertas dos doentes (média 1,1; DP = 1,7), principalmente de companhia (23% dos casos), sofrimento psicológico (20%) e atividades diárias (14%). Os familiares-cuidadores dedicavam 150 minutos/dia (mediana) à prestação de cuidados e 44% apresentavam necessidades não-cobertas de sofrimento psicológico. Quando havia problemas de acesso/utilização dos serviços de saúde e sociais na comunidade, estes estavam frequentemente relacionados com recusa ou desconhecimento de utentes/familiares. Discussão: A seleção dos participantes não foi fácil, pela especificidade dos critérios adotados. Não almejando representatividade nacional, recrutámos uma amostra típica de pessoas em estádios ligeiros a moderados de demência, em serviços e regiões diferentes. Nalguns casos, encontrámos necessidades não-cobertas e repercussões familiares que já justificariam respostas de serviços na comunidade, não fossem os problemas de acesso/utilização. Conclusão: Na área das demências, existem dificuldades no acesso atempado e utilização efectiva de cuidados formais, coexistindo com uma cobertura menor de necessidades específicas.

Abstract Background Cognitive impairment and cerebrovascular pathology are both frequent with ageing. Cognitive impairment due to vascular pathology of the brain, termed vascular cognitive impairment (VCI), is one of the most frequent causes of cognitive impairment in elderly subjects. Thus far, VCI has no specific pharmacological treatment. Recent observational studies have suggested a protective effect of physical activity in cognition, but adequate randomised controlled trials (RCT) are lacking. Methods AFIVASC is a multi-centre randomised controlled trial, with a 6-month intervention treatment and an additional follow-up of 6 months, that aims to estimate the impact of 6 months of moderate intensity physical activity on cognition (the primary outcome) at 6 and 12 months in subjects with VCI. Participants are community dwellers with criteria for VCI without dementia or who have had previous stroke or transient ischaemic attack (TIA). Patients may be self-referred or referred from a medical appointment. After confirming the inclusion criteria, a run-in period of 1 month is conducted to access adherence; only after that are subjects randomly assigned (using a computerised program blinded to clinical details) to two groups (intervention group and best practice usual care group). The intervention consists of three physical activity sessions of 60 min each (two supervised and one unsupervised) per week. The primary outcome is measured by the presence or absence of decline in cognitive status. Secondary outcomes include changes in neuro-cognitive measures, quality of life, and functional and motor status. Primary and secondary outcomes are evaluated at 6 and 12 months by investigators blinded to both intervention and randomisation. A required sample size of 280 subjects was estimated. Statistical analyses will include regression analysis with repeated measures. The study was approved by the Ethics Committee for Health of Centro Hospitalar de Lisboa Norte (ref. no. 1063/13) and by the Ethics Committee for Health of Centro Hospitalar do Porto CHP (ref. no. 2016.055(049-DEFI/048-CES)). Discussion We aim to show whether or not moderate physical activity has a beneficial impact on cognition, quality of life, motor, and functional status in people with vascular cognitive impairment, and to generate new insights on the applicability of implementing physical activity in this specific population. Trial Registration ClinicalTrials.gov, NCT03578614 July 6, 2018.

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Enquadramento: As doenças hemato-oncológicas representam uma importante causa de morbilidade e mortalidade para os adolescentes, pelo que exigem cuidados de enfermagem positivamente diferenciadores e dirigidos. Objetivos: Compreender as vivências dos adolescentes com doença hemato-oncológica na fase diagnóstica. Metodologia: Investigação empírica de tipo qualitativo, de cariz fenomenológico interpretativo (método processual de Giorgi). Foram entrevistados 9 adolescentes portugueses, em tratamento na unidade de oncologia pediátrica. Resultados: Emergiram 3 temas centrais relativos ao fenómeno (antecipando doença grave; confrontando-se com notícia do diagnóstico e entrando na doença como contingência existencial). Conclusão: Os adolescentes vivenciam a doença oncológica de forma particular, devido à sua fase de desenvolvimento; percebem o diagnóstico como ameaça aos seus planos e sonhos; confrontam-se com a contingência pessoal e a ameaça de finitude antecipada. Importa que os profissionais de saúde cuidem dos adolescentes de forma ajustada a cada momento identificado na sequência vivencial e que os incentivem a expressarem os seus estados e expectativas, de modo a ajudá-los a integrar proativamente a sua doença na vida quotidiana.

Objective: To review publish data about human microbiome. It is known to modulate many body functions. In the field of Reproductive Medicine, the main question is in what extent may female genital tract microbiome influence fertility, both by spontaneous conception or after Assisted Reproductive Treatments (ART). The aim of this work is to review publish data about this matter. Materials and methods: This is a systematic review on the effect of the microbiota of the female genital tract on human fertility and on the outcomes of ART. Results: Fourteen articles were retrieved, concerning female lower genital tract and endometrium microbiota, including 5 case-controls studies about its impact on fertility, 8 cohort studies regarding ART outcomes and 1 mixed study. The main variables considered were richness and diversity of species, Lactobacillus dominance and the role of other bacteria. Results and conclusions of the various studies were quite diverse and incoherent. Despite the inconsistency of the studies, it seems that vaginal, cervical and endometrial microbiome may eventually play a role. Whether high richness and diversity of species, low amounts of Lactobacillus spp. or the presence of other bacteria, such as Gardnerella spp., may adversely affect reproductive outcomes is not clear. Conclusion: The influence of female genital microbiota on the ability to conceive is still unclear, due to the paucity and inconsistency of published data.

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The anti-PP1Pk is a rare antibody associated with recurrent miscarriages, mainly in the first half of pregnancy. There seems to be a direct correlation between the antibody titer and risk of miscarriage. As this is a rare entity, few case reports have been published. The most frequently proposed therapeutic approaches are double-filtration plasmapheresis and plasma exchange therapy. The rationale behind them is to remove the cytotoxic antibodies from maternal circulation. Here, we present the case of a 30-year-old woman with a history of two spontaneous miscarriages and a pre-conception anti-PP1Pk antibody titer of 1:4. As soon as she became pregnant, she was placed on prednisolone and low-molecular-weight heparin (LMWH). Biweekly antibody titers were performed throughout the entire gestation and remained below 1:16. As the titers were considered to be low, plasmapheresis was not performed. The pregnancy was uneventful and she delivered a healthy newborn child at 37 weeks of gestation, with no signs of anaemia.

Abstract Background People with dementia and informal carers often access formal care late in the process of dementia. The barriers and facilitators to service use from the perspectives of different stakeholders involved are not well understood. Thus, we aimed to explore the barriers and facilitators of access to and utilisation of formal care from the perspectives of people with dementia, their informal carers and health and social care professionals. Method Focus groups with people with dementia, informal carers and professionals were conducted in eight European countries. Recruitment targeted people with dementia, informal carers with experience of formal care and professionals involved in providing (access to) formal care. Qualitative content analysis using open coding was used on a national level. Cross-national synthesis was based on the translated national reports. Results Overall, 55 focus groups with 261 participants were conducted, involving 51 people with dementia, 96 informal carers and 114 professionals. Sixteen categories describing barriers and facilitators were identified, referring to three global themes: Aspects related to 1) individuals involved, 2) the system or 3) overarching aspects. The attitudes and beliefs of people with dementia and their carers may have a major impact, and they often serve as barriers. Formal care was perceived as a threat to the individual independence of people with dementia and was thus avoided as long as possible. A healthcare professional serving as a constant key contact person could be an essential facilitator to overcome these barriers. Contact should be initiated proactively, as early as possible, and a trusting and consistent relationship needs to be established. Beyond that, the findings largely confirm former research and show that barriers to accessing and using formal care still exist across Europe despite a number of national and European initiatives. Conclusion Further investigations are needed to elaborate how the concept of a key contact person could be integrated with existing case management approaches and how the independence and autonomy of people with dementia can be strengthened when formal care needs to be accessed and used. These may be meaningful facilitators regarding enhanced access to formal care for people with dementia and their families.

Abstract Vaginal cancer is a rare entity. The evidence on its management resides mostly in clinical cases or small case series. Of the histological types, the most frequent is the squamous cell carcinoma, followed by adenocarcinoma. But what to do when identifying an even more infrequent sarcoma in a premenopausal woman? In this study, we describe the case of a 53-year-old woman presenting with metrorrhagia for two months, who was evaluated after an intense episode. A necrotic and ulcerative vaginal swelling was documented and then submitted to biopsy, which revealed a vaginal sarcoma. The patient was referred to radiation therapy with 50 Gy (aiming to control the symptoms and to cause tumor reduction for posterior pelvic exenteration with intraoperative radiotherapy) and developed an extra-pelvic metastization at the end of the treatment, which caused a fast negative outcome. Despite the initial poor prognosis, a chemo-irradiation or primary surgery regimen might have achieved (although with greater side effects) a better survival. This case-report entails a discussion about the strategies to manage vaginal sarcoma in advanced stage and in premenopausal women.

A mera transmissão de conteúdos disciplinares, durante muito tempo porto de abrigo e sinal distintivo do professor, tornou-se problemática e uma via de sentido estreito para definir a identidade desse profissional, especialmente numa altura em que se exige cada vez mais da escola participação ativa no empoderamento dos alunos. É nesse panorama de fundo que se coloca, com alguma premência, a questão da necessária reconceitualização da imagem de marca do professor, e não só por questões de visibilidade e de reconhecimento junto da opinião pública e da comunidade educativa, mas sobretudo porque essa imagem renovada é essencial à definição de um quadro de referência que proporcione modos de ser e fazer a profissão face aos desafios educativos que hoje assediam a escola. O presente texto tem como ponto de amarração essas questões, analisa-as em profundidade à luz de tendências recentes e propõe, de modo inovador, uma nova gramática de ser professor na escola socioeducativa dos nossos dias, mobilizando, para o efeito, o referencial do empoderamento.

Introduction: Patient satisfaction is an important measure of health care quality. Patients’ views have seldom been considered in the construction of measures addressing satisfaction with inpatient facilities in psychiatry. The Views on Inpatient Care - VOICE - is a first service-user generated outcome measure relying solely on their perceptions of acute care, representing a valuable indicator of service users’ perceived quality of care. The present study aimed to contribute to the validation of the Portuguese version of VOICE. Material and Methods: The questionnaire was translated into Portuguese and applied to a sample of eighty-five female inpatients of a psychiatric institution. Data analysis focused on assessing reliability and exploring the impact of demographic and clinical variables on participants’ satisfaction. Results: Internal consistency of the questionnaire was high (α = 0.87). Participants’ age and marital status were associated with differences in scores, with older patients and patients who were married or involved in a close relationship presenting higher satisfaction levels. Discussion: The questionnaire demonstrated good internal consistency and acceptability, as well as construct validity. Further studies should expand the analysis of the psychometric properties of this measure e.g., test-retest reliability. Conclusion: The Portuguese version of VOICE is a promising tool to assess service users’ perceptions of inpatient psychiatric care in Portugal.

Abstract Background Dementia imposes a high burden of disease worldwide. Recent epidemiological studies in European community samples are scarce. In Portugal, community prevalence data is very limited. The 10/66 Dementia Research Group (DRG) population-based research programmes are focused in low and middle income countries, where the assessments proved to be culture and education fair. We applied the 10/66 DRG prevalence survey methodology in Portugal, where levels of illiteracy in older populations are still high. Methods A cross-sectional comprehensive one-phase survey was conducted of all residents aged 65 and over of two geographically defined catchment areas in Southern Portugal (one urban and one rural site). Nursing home residents were not included in the present study. Standardized 10/66 DRG assessments include a cognitive module, an informant interview and the Geriatric Mental State-AGECAT, providing data on dementia diagnosis and subtypes, mental disorders including depression, physical health, anthropometry, demographics, disability/functioning, health service utilization, care arrangements and caregiver strain. Results We interviewed 1405 old age participants (mean age 74.9, SD = 6.7 years; 55.5% women) after 313 (18.2%) refusals to participate. The prevalence rate for dementia in community-dwellers was 9.23% (95% CI 7.80–10.90) using the 10/66 DRG algorithm and 3.65% (95% CI 2.97–4.97) using DSM-IV criteria. Pure Alzheimer’s disease was the most prevalent dementia subtype (41.9%). The prevalence of dementia was strongly age-dependent for both criteria, but there was no association with sex. Conclusions Dementia prevalence was higher than previously reported in Portugal. The discrepancy between prevalence according to the 10/66 DRG algorithm and the DSM-IV criteria is consistent with that observed in less developed countries; this suggests potential underestimation using the latter approach, although relative validity of these two approaches remains to be confirmed in the European context. We improved the evidence base to raise awareness and empower advocacy about dementia in Portugal, so that the complex needs of frail older people may be met in better ways.