The purpose of this study was to assess how knowledge and empowerment impact the quality of life (QoL) of a person with type 2 diabetes, leading to better communication and disease management. We conducted a descriptive and observational study of individuals with type 2 diabetes. The Diabetes Empowerment Scale-Short Form (DES-SF), Diabetes Knowledge Test (DKT), and EQ-5D-5L were used, in addition to sociodemographic and clinical characteristics. Evaluating the variability in the DES-SF and DKT in relation to the EQ-5D-5L and identifying possible sociodemographic and clinical determinants were conducted using univariate analyses followed by a multiple linear regression model to test whether the factors significantly predicted QoL. A total of 763 individuals were included in the final sample. Patients aged 65 years or older had lower QoL scores, as well as patients who lived alone, had less than 12 years of education, and experienced complications. The insulin-treated group showed higher scores in DKT than the non-insulin-treated group. It was also found that being male, being under 65 years of age, having no complications present, and having higher levels of knowledge and empowerment predicted higher QoL. Our results show that DKT and DES are still determinants of QoL, even after adjusting for sociodemographic and clinical characteristics. Therefore, literacy and empowerment are important for the improvement of the QoL of people with diabetes, by enabling them to manage their health conditions. New clinical practices focused on education, increasing patients’ knowledge, and empowerment may contribute to better health outcomes.

Introduction: While biosimilar medicines can contribute to the sustainability of healthcare systems, their utilization rate varies across European countries. This study aims to identify and systematize policy measures and instruments used in European countries to increase biosimilar market share.Methods: A systematic review was conducted according to PRISMA 2020 recommendations. Medline-PubMed, Web of Science and ScienceDirect databases were searched using inclusion criteria that required full articles published in English between January 2006 and November 2023. Reviews, letters, reports, editorials and comments or opinion articles were excluded from this study.Results: Of the 1,137 articles, only 13 met the eligibility criteria for analysis, which covered a total of 28 European countries. Pricing regulation measures were found in 27 of these countries with tendering, price-linkage and internal reference price being the most used. Tendering was used by 27 countries to procure biosimilars in inpatient setting. Prescribing guidelines and recommendations were the widely used instrument. Some European countries adopted physician incentives, quotas, and prescription by international non-proprietary name.Conclusion: Automatic substitution was not commonly recommended or applied. Interchangeability and switching will become increasingly relevant issues. It is important that the positive results from some countries serve as an example for the future of these medicines in the European market.Systematic review registration: https://inplasy.com/, Identifier INPLASY2023120032.

Rehabilitation involves all types of patients, including people with schizophrenia. Schizophrenia is considered a complex syndrome characterized in general by fundamental and characteristic distortions of thinking and perception. The quality of life of a person with schizophrenia can be compromised by difficulty in carrying out their daily tasks and by the social stigma of their condition. The importance of training and sensitizing students in rehabilitation areas to this type of problem to improve the rehabilitation processes in which they will participate as future professionals involves empathy and the ability to communicate with these populations. It is possible through virtual reality to create immersive environments to simulate some psychotic symptoms characteristic of people with schizophrenia, such as visual hallucinations and hearing voices. The aim of this study was to test the effect of exposure to experiences characteristic of schizophrenia through two different types of immersive environments, graphical computational virtual reality and 360° video, on students from areas of social rehabilitation regarding empathy, social distance, and attitudes towards people with schizophrenia. Although the results were positive for the three parameters under study, no significant differences were found for each of them between the environments to which the participants were exposed. This study concluded that the choice between the two types of immersive environments should be based on the project’s objectives, the target audience’s needs, and available resources, rather than the type of environment itself, as their impact was similar.

Background: The number of people suffering from chronic kidney disease undergoing hemodialysis in Portugal has been increasing over the last decade, highlighting the need to assess the quality of life of these patients. Objective: To assess the quality of life of patients with chronic kidney disease undergoing regular hemodialysis. Methodology: A quantitative, cross-sectional descriptive study was conducted using the Kidney Disease Quality of Life Instrument (KDQOL-SF Version 1.3). The non-probability convenience sample consists of 268 patients aged 25 to 90 years undergoing regular hemodialysis in seven clinics in Portugal. Results: The Dialysis staff encouragement (82.46) and social support (77.49) dimensions had the highest scores. Male patients had higher scores in the physical functioning (p = 0.023), bodily pain (p = 0.011), and emotional well-being (p = 0.020) dimensions. This sample had statistically significan lower scores in all domains of the 36-Item Health Survey (SF-36) than the general Portuguese population. Conclusion: It is essential to develop strategies to improve the quality of life of patients with chronic kidney disease. Marco contextual: En la última década ha aumentado el número de personas con insuficiencia renal crónica que se someten a un programa de hemodiálisis, lo que plantea la necesidad de evaluar la calidad de vida de estos pacientes. Objetivo: Evaluar la calidad de vida de los pacientes renales crónicos en programa regular de hemodiálisis. Metodología: Se trata de un estudio cuantitativo, transversal y descriptivo que utiliza el KDQOL-SF. Muestra de conveniencia no probabilística, con 268 pacientes en programa regular de hemodiálisis con edades comprendidas entre los 25 y los 90 años, en siete clínicas de Portugal. Resultados: La motivación del personal de diálisis (82,46) y el apoyo social (77,49) fueron las dimensiones con las mejores puntuaciones. Los individuos del sexo masculino presentan mejores puntuaciones en calidad de vida, en las dimensiones: función física (p = 0,023), dolor (p = 0,011) y bienestar emocional (p = 0,020). El análisis del SF-36 demostró que todos los dominios presentaban una puntuación peor y con significación estadística en comparación con la población portuguesa. Conclusión: Es esencial idear estrategias que puedan mejorar la calidad de vida de las personas com insuficiencia renal. Enquadramento: Ao longo da última década observou-se um aumento no número de pessoas que sofrem de doença renal crónica em programa de hemodiálise, imergindo a necessidade de aferir a qualidade de vida destes doentes. Objetivo: Avaliar a qualidade de vida dos doentes renais crónicos em programa regular de hemodiálise. Metodologia: Estudo de abordagem quantitativa, descritivo transversal utilizando o KDQOL-SF.Amostra não probabilística de conveniência, com 268 doentes em programa regular de hemodiálise com idades entre 25 e 90 anos, em sete clínicas de Portugal. Resultados: O encorajamento do pessoal da diálise (82,46) e o apoio social (77,49) foram as dimensões com melhores scores. Os indivíduos do sexo masculino apresentam melhores pontuações na qualidade de vida, nas dimensões: função física (p = 0,023), dor (p = 0,011) e bem-estar emocional (p = 0,020). A análise do SF-36 demostrou que todos os domínios apresentavam pior score e com significado estatístico quando comparados com a população portuguesa. Conclusão: É fundamental arranjar estratégias que possam melhorar qualidade de vida da pessoa com insuficiência renal.

In various fields, such as economics, finance, bioinformatics, geology, and medicine, namely, in the cases of electroencephalogram, electrocardiogram, and biotechnology, cluster analysis of time series is necessary. The first step in cluster applications is to establish a similarity/dissimilarity coefficient between time series. This article introduces an extension of the affinity coefficient for the autoregressive expansions of the invertible autoregressive moving average models to measure their similarity between them. An application of the affinity coefficient between time series was developed and implemented in R. Cluster analysis is performed with the corresponding distance for the estimated simulated autoregressive moving average of order one. The primary findings indicate that processes with similar forecast functions are grouped (in the same cluster) as expected concerning the affinity coefficient. It was also possible to conclude that this affinity coefficient is very sensitive to the behavior changes of the forecast functions: processes with small different forecast functions appear to be well separated in different clusters. Moreover, if the two processes have at least an infinite number of π- weights with a symmetric signal, the affinity value is also symmetric.

Introduction: Peripheral arterial disease (PAD) is an occlusive atherosclerotic disease of the arteries of the extremities of the body that affects more than 230 million people worldwide. The most common symptom is intermittent claudication, described as leg pain which occurs mainly while walking. The symptoms impair the ambulation and functional capacity of patients, leading to loss of mobility, disease deterioration, increased risk of other cardiovasculardiseases, and lower quality of life (QoL). Therefore, the aim of this study was to perform a cross-cultural adaptation and validation of the VascuQol-6 questionnaire for the Portuguese population to obtain a quick, sensitive, and easy-to-use way to assess the QoL of Portuguese patients diagnosed with PAD.Methods: The Vascular Quality of Life-6 Questionnaire (VascuQoL-6) was adapted and translated into European Portuguese using standard validation methodology, including 115 patients with a mean age of 64.67 (7.23) years, with PAD with IC stable for more than three months; and ABI < 0.9 at rest. VascuQoL-6, SF-36, International Physical Activity Questionnaire (IPAQ), and the PAD Knowledge Questionnaire (PADKQ) were used. Reliability, construct validity analysis through convergent and discriminant validity, known-group validity, and responsiveness analysis were tested.Results: The Cronbach’s alpha was 0.64 and the average inter-item correlation was 0.27, indicating acceptable internal consistency. VascuQoL-6 was positively associated with SF-36 Physical Component Summary and Mental Component Summary scores (r = 0.64, p < 0.01 and r = 0.42, p < 0.01, respectively). In turn, there was no significant correlation between VascuQoL-6 scores and the PADKQ or IPAQ. A statistically significant difference between groups according to IC severity [F(2.47) = 8.35, p < 0.001] was found. A paired samples t-test showed differences between VascuQol-6 scores before a walking program (M = 15.65, SD = 3.09), and after a walking program (M = 17.41, SD = 2.71), t(67) = 3.94, p ≤ 0.001.Conclusion: The VascuQoL-6 is a six-item instrument to assess the QoL associated with PAD with good psychometric properties, convergent and discriminant validity with SF-36, PADKQ and IPAQ. The instrument proved to have known group validity and responsiveness.