[Exploratory and Confirmatory Validation of the Connor-Davidson Resilience Scale (CD-RISC-10) in a Sample of Individuals Registered in Job Centers]. / Validação Exploratória e Confirmatória da Escala de Resiliência Connor-Davidson (CD-RISC-10) numa Amostra de Inscritos em Centros de Emprego.

INTRODUCTION: Bonanno defined resilience as the individual's capacity to cope with traumatic events, namely, the ability to maintain the levels of physical and psychological functioning relatively stable. The aim of this study was to evaluate the psychometric properties of 10-item Connor-Davidson resilience scale. The Connor-Davidson resilience scale short version has good psychometric qualities (Cronbach α - 0.85) when compared with the long version (Cronbach α - 0.89). MATERIAL AND METHODS: We obtained a convenience sample of individuals registered in job centers which was randomly divided into two subsamples (sample 1 = 5127 and sample 2 = 5114). We applied the principal component analysis in sub-sample n1. With subsample n2 a confirmatory factorial analysis was performed using the maximum likelihood method. We used the multigroup analysis to compare the factorial model between genders and professional situation. We performed a convergent and discriminant analysis through Pearson's correlation analysis. RESULTS: The principal component analysis extracted one factor with an explained variance of 53.97%. The confirmatory factor analysis confirmed the unidimensionality of the scale. The invariance between genders and professional situation was confirmed. The Connor-Davidson resilience scale correlated positively with the SF-36 scale and negatively with the GHQ-12 scale. DISCUSSION: The exploratory and confirmatory analysis revealed one dimension, and good psychometric properties, which is similar to the original 10-item scale. CONCLUSION: To our knowledge, this is the first validation study of this scale among the Portuguese population (Portugal). Its results are highly satisfactory, and its use is recommended among the Portuguese population.

Introdução: Bonanno definiu resiliência como a capacidade do indivíduo em lidar com os eventos traumáticos, nomeadamente a capacidade de manter os níveis de funcionamento físico e psicológico relativamente estáveis. O objetivo do estudo foi avaliar as propriedades psicométricas da escala de resiliência Connor-Davidson de 10 itens. A escala resumida apresenta boas qualidades psicométricas (α Cronbach ­ 0,85) quando comparada com a escala longa (25 itens) (α Cronbach ­ 0,89).Material e Métodos: Obtivemos uma amostra de conveniência de inscritos em centros de emprego que foi aleatoriamente dividida em duas subamostras (amostra 1 = 5127 e amostra 2 = 5134). Aplicámos a análise de componentes principais na amostra 1. Com a amostra 2 procedeu-se à análise fatorial confirmatória usando o método da máxima verosimilhança. Usámos a análise multigrupo para a comparação do modelo fatorial entre os géneros e a situação profissional. Efetuámos a análise convergente e divergente através da análise de correlação de Pearson.Resultados: A análise de componentes principais extraiu um fator com uma variância explicada de 53,97%. A análise fatorial confirmatória comprovou a unidimensionalidade da escala. Confirmámos a invariância entre géneros e situação profissional. A escala de resiliência Connor-Davidson de 10 itens correlacionou-se positivamente com as medidas da escala SF-36 e negativamente com a escala GHQ-12.Discussão: A análise exploratória e confirmatória corroborou a unidimensionalidade e boas propriedades psicométricas, semelhantes à escala original de 10 itens.Conclusão: Trata-se do primeiro estudo de validação desta escala na população portuguesa (Portugal), de acordo com a pesquisa efetuada. Os seus resultados são muito satisfatórios, recomendando-se o seu uso na população portuguesa.

One Health-ness Evaluation of Cysticercosis Surveillance Design in Portugal.

The increasing occurrence of human cysticercosis, a zoonotic neglected disease, is challenging the traditional prevention and control paradigm and calling for One Health (OH) solutions in industrialized countries. OH solutions for health interventions are increasingly being used to capture expected and unexpected outcomes across people, animals, and the environment. The Network for Evaluation of One Health (NEOH) proposes an evidence-based framework, relying on systems and mixed methods approaches to evaluate the One Health-ness. In this case study, this tool is used to evaluate the design of the Observatory of Taeniasis and Cysticercosis, as an example of intersectorial collaboration for surveillance in Portugal. The OH Initiative (drivers and expected outcomes) and its system (boundaries, aim, dimensions, actors, and stakeholders) were described. The different aspects of this Initiative were scored with values from 0 (=no OH approach) to 1 (=perfect OH approach). The OH index was 0.31. Its OH ratio is 1.98. Overall scores were as follows: OH thinking 0.75; OH planning 0.60; OH working 0.60; OH sharing 0.35; OH learning 0.50; and systemic organization 0.50. Operational levels of the Initiative are the main strengths, indicating a comprehensive multidimensional innovative approach and transdisciplinarity. Critical issues in the supporting infrastructure were observed, related to communication, learning and organizational gaps in the project, with the evaluation being conducted as the project is being designed and implemented. The strengths and weaknesses detected may be used to refine the Initiative. This case study therefore exemplifies and supports OH assessment also for ongoing projects, at design and early implementation stages for guiding and guaranteeing an OH-oriented perspective.

Psychological well-being of Portuguese expatriates in Sub-Saharan Africa: a cross-sectional study.

BACKGROUND: Psychological health problems are highlighted among the most relevant disease patterns in expatriates. The purpose of this study was to determine the psychological well-being in Portuguese expatriates in Angola and Mozambique, considering the increasing expatriation wave. METHODS: A cross-sectional self-administered web survey was conducted in a sample of 352 Portuguese civil expatriates in Angola and Mozambique. Clinically significant psychological distress was determined using General Health Questionnaire (GHQ)-12 and associated factors were studied using multiple logistic regression analysis. RESULTS: GHQ-12 items showed good internal consistency as reflected by the Cronbach's alpha. One-third of the screened expatriates corresponded to cases of clinically significant psychological distress. Age, country of birth, self-reported psychological symptoms and self-perception of general health in the previous 3 months were identified as independent variables associated with psychological distress. CONCLUSIONS: Increasing awareness and monitoring expatriates mental health should be in the health agenda, furthermore considering them a risk group in need of evidence-based mental health expatriate preparedness. The use of user-friendly validated tools, such as GHQ-12, allowing objective assessment and surveillance of these hard to reach populations should be reinforced.

Portuguese expatriates' health in Angola and Mozambique-a cross-sectional study: increasing awareness and need for more surveillance.

BACKGROUND: Increasing numbers of expatriates are working in sub-Saharan Africa. There is little published data on the complex population and this survey aimed at understanding expatriate morbidity by accessing self-reported health problems and malaria preventive practices. METHODS: A cross-sectional web-based survey was conducted targeting Portuguese expatriates in Angola and Mozambique. Logistic regression analysis explored factors associated with self-reported health problems and psychological symptoms in the previous 3 months. RESULTS: A total sample of 352 adult Portuguese urban civil occupational expatriates was obtained. Median length of expatriation was 3 years. Considering a 3-month timeframe, one in five expatriates reported new health problems and need of medical assistance, 5% were hospitalized and 64% reported general psychological symptoms. Less than 2% of subjects were on malaria chemoprophylaxis. Having chronic health conditions doubled the reporting of new health problems. Increasing length of expatriation was associated with decreasing reporting of general psychological symptoms. Directors and executive managers and expatriates living alone tended to report more general psychological symptoms. CONCLUSION: Expatriate communities deserve enhanced surveillance for the health issues that affect them. This will improve evidence-based preparation and intervention by public and travel health practitioners.

Surveillance of imported hospital requiring malaria in Portugal: can it be improved?

Although eradicated in Portugal, malaria keeps taking its toll on travellers and migrants from endemic countries. Completeness of hospital requiring malaria notification in Portugal 2000-11 was estimated, using two-source capture-recapture method. Data sources were: national surveillance database of notifiable diseases and the national database of the Diagnosis-Related Groups resulting from National Health Service (NHS) hospital episodes. The completeness of notification was 21,2% for all malaria cases and 26,5% for malaria deaths, indicating significant underreporting and urging for complementary data source in surveillance, for disease burden estimates and retrospective monitoring, namely hospital episodes statistics.

Evaluation of salt content in school meals / Avaliação do conteúdo de sal em refeições escolares

OBJECTIVE: High blood pressure is a major rick factor for cardiovascular disease, and it is closely associated with salt intake. Schools are considered ideal environments to promote health and proper eating habits. Therefore the objective of this study was to evaluate the amount of salt in meals served in school canteens and consumers' perceptions about salt. METHODS: Meals, including all the components (bread, soup, and main dish) were retrieved from school canteens. Salt was quantified by a portable salt meter. For food perception we constructed a questionnaire that was administered to high school students. RESULTS: A total of 798 food samples were analysed. Bread had the highest salt content with a mean of 1.35 g/100 g (SD=0.12). Salt in soups ranged from 0.72 g/100 g to 0.80 g/100 g (p=0.05) and, in main courses, from 0.71 g/100 to 0.97 g/100g (p=0.05). The salt content of school meals is high with a mean value of 2.83 to 3.82 g of salt per meal. Moreover, a high percentage of students consider meals neither salty nor bland, which shows they are used to the intensity/amount of salt consumed. CONCLUSION: The salt content of school meals is high, ranging from 2 to 5 times more than the Recommended Dietary Allowances for children, clearly exceeding the needs for this population, which may pose a health risk. Healthy choices are only possible in environments where such choices are possible. Therefore, salt reduction strategies aimed at the food industry and catering services should be implemented, with children and young people targeted as a major priority. .

OBJETIVO: Considerando que a pressão arterial elevada constitui um dos maiores fatores de risco para as doenças cardiovasculares e sua associação ao consumo elevado de sal, bem como o fato de as escolas serem considerados ambientes de excelência para fomentar a aquisição de bons hábitos alimentares e promover a saúde, o objetivo deste estudo foi avaliar o conteúdo de sal presente nas refeições escolares e a percepção dos consumidores sobre o sabor salgado. MÉTODOS: Foram recolhidas refeições nas cantinas das escolas, analisando-se todos os seus componentes (pão, sopa e prato principal). A quantificação de sal foi realizada com um medidor de sal portátil. Para a avaliar a percepção dos consumidores foi desenvolvido e aplicado um questionário aos alunos das escolas preparatórias e secundárias. RESULTADOS: Foram analisados 798 componentes de refeições. O pão apresentou o valor mais elevado de sal, com média de 1,35 g/100 g (SD=0.12). O conteúdo de sal nas sopas apresentou média de 0,72 g/100 g a 0,80 g/100 g (p=0,05) e, nos pratos principais, de 0,71 g/100 a 0,97 g/100 g (p=0,05). Em média, as refeições escolares disponibilizaram entre 2,83 e 3,82 g de sal por porção servida, o que representa de duas a cinco vezes mais em relação à dose diária recomendada para crianças e jovens. Para a maioria dos estudantes, o sabor das refeições foi percebido como sendo nem salgado nem insosso, o que parece demonstrar adaptação à intensidade/ quantidade de sal consumida. CONCLUSÃO: Escolhas alimentares saudáveis e adequadas só são possíveis se sustentadas por um ambiente que as facilite. Considerando o impacto que o consumo de sal tem na saúde, em particular nas doenças crônicas, a implementação de estratégias de redução de sal - nas indústrias, serviços de catering e restaurantes -, é imperativa, em particular direcionada para o público mais jovem. .

Imported malaria in portugal 2000-2009: a role for hospital statistics for better estimates and surveillance.

Background. Although eradicated in Portugal, malaria keeps taking its toll on travelers and migrants from endemic countries. Disease notification is mandatory but is compromised by underreporting. Methods. A retrospective study on malaria hospitalizations for 10 consecutive years (2000-2009) was conducted. Data on hospitalizations and notifications were obtained from Central Administration of Health System and Health Protection Agency, respectively. For data selection ICD-9 CM and ICD-10 were used: codes 084(*), 647.4, and B50-B54. Variables were gender, age, agent and origin of infection, length of stay (LOS), lethality, and comorbidities. Analysis included description, hypothesis testing, and regression. Results. There were 2003 malaria hospitalizations and 480 notified hospitalized cases, mainly in young male adults. P. falciparum was the main agent of infection acquired mainly in sub-Saharan Africa. Lethality was 1.95% and mean LOS was 8.09 days. Older age entailed longer LOS and increased lethality. Discussion. From 2000 to 2009, there were 2003 malaria hospitalizations with decreasing annual incidence, these numbers being remarkably higher than those notified. The national database of diagnosis related groups, reflecting hospitalizations on NHS hospitals, may be an unexplored complementary source for better estimates on imported malaria.

The burden of imported malaria in Portugal 2003 to 2012.

Increasing international travel and expatriation to sub-Saharan countries where malaria is endemic has raised public health concerns about the burden of imported malaria cases in Portugal. From 2009 to 2012, there was a 60% increase in malaria hospitalizations, contradicting the declining trend observed since 2003. Older age was associated with longer length of stay in hospital and higher lethality.

[Breast cancer at Pico Island (1998-2008): an epidemiological perspective]. / Cancro da mama na ilha do pico (1998-2008): uma perspectiva epidemiológica.

INTRODUCTION: Neoplasic disease has been assuming an increasingly relevant role in the world's public health. Breast cancer is the most common cancer and the second cause of death by neoplasia in women. In the Portuguese population, breast cancer is the main cause of death by neoplasia in females. Among the Azorean women, the most frequently diagnosed malignant tumor is breast cancer, Pico Island being the third in terms of cancer incidence in the region. The risk factors are well known, well established and some of them can be prevented. Despite the great incidence of breast cancer, in the general population, particularly among the youngest, the knowledge about the disease is quite limited. The aims of this study are to characterize and identify the risk factors of women with breast cancer diagnose between 1998 and 2008 residing in Pico's island and, simultaneously to evaluate the knowledge of the students in Pico island about this disease. METHODS AND POPULATION: The method used for the gathering of the data in both cases was an anonymous and confidential questionnaire. In study 1 the questionnaire was conducted by an interviewer after the women's consent. Study 2 was performed in the three secondary schools of Pico island. RESULTS: The incidence rate of breast cancer in Pico island women is higher than the national incidence rate. There was an enormous variability in the incidence rates calculated for each year, with no clear tendency. The main responsible for the appearance of breast cancer in this population could be a conjugation of factors and not only a single isolated factor. The risk factors that stand out are: sedentariness (71.4%), family history (47.6%) and obesity (44.4%). The 295 students interviewed aged between 15 and 21 years. Of the total, 43 had relatives with breast cancer, however the majority (56.3%) assumes to be little informed about this disease. CONCLUSIONS: Through study 1 we conclude that there is a combination of hereditary and environmental risk factors, modifiable and non modifiable risk factors that may contribute to the onset of breast cancer. It is important to encourage changes in the life style of the women and rising of awareness towards risk factors. For the study of the student population, we conclude that the students have a very limited degree of knowledge of the disease; however, they assumed the will to more information, which leaves an open door for future formation and awareness actions.

Predictors of mortality in HIV-associated hospitalizations in Portugal: a hierarchical survival model.

BACKGROUND: The beneficial effects of highly active antiretroviral therapy, increasing survival and the prevention of AIDS defining illness development are well established. However, the annual Portuguese hospital mortality is still higher than expected. It is crucial to understand the hospitalization behaviour to better allocate resources. This study investigates the predictors of mortality in HIV associated hospitalizations in Portugal through a hierarchical survival model. METHODS: The study population consists of 12,078 adult discharges from patients with HIV infection diagnosis attended at Portuguese hospitals from 2005-2007 that were registered on the diagnosis-related groups' database.We used discharge and hospital level variables to develop a hierarchical model. The discharge level variables were: age, gender, type of admission, type of diagnoses-related group, related HIV complication, the region of the patient's residence, the number of diagnoses and procedures, the Euclidean distance from hospital to the centroid of the patient's ward, and if patient lived in the hospital's catchment area. The hospital characteristics include size and hospital classification according to the National Health System. Kaplan-Meier plots were used to examine differences in survival curves. Cox proportional hazard models with frailty were applied to identify independent predictors of hospital mortality and to calculate hazard ratios (HR). RESULTS: The Cox proportional model with frailty showed that male gender, older patient, great number of diagnoses and pneumonia increased the hazard of HIV related hospital mortality. On the other hand tuberculosis was associated with a reduced risk of death. Central hospital discharge also presents less risk of mortality.The frailty variance was small but statistically significant, indicating hazard ratio heterogeneity among hospitals that varied between 0.67 and 1.34, and resulted in two hospitals with HR different from the average risk. CONCLUSION: The frailty model suggests that there are unmeasured factors affecting mortality in HIV associated hospitalizations. Consequently, for healthcare policy purposes, hospitals should not all be treated in an equal manner.

Host- and microbe-related risk factors for and pathophysiology of fatal Rickettsia conorii infection in Portuguese patients.

BACKGROUND: The pathophysiologic mechanisms that determine the severity of Mediterranean spotted fever (MSF) and the host-related and microbe-related risk factors for a fatal outcome are incompletely understood. METHODS: This prospective study used univariate and multivariate analyses to determine the risk factors for a fatal outcome for 140 patients with Rickettsia conorii infection admitted to 13 Portuguese hospitals during 1994-2006 with documented identification of the rickettsial strain causing their infection. RESULTS: A total of 71 patients (51%) were infected with the Malish strain of Rickettsia conorii, and 69 (49%) were infected with the Israeli spotted fever (ISF) strain. Patients were admitted to the intensive care unit (40 [29%]), hospitalized as routine inpatients (95[67%]), or managed as outpatients (5[4%]). Death occurred in 29 adults (21%). A fatal outcome was significantly more likely for patients infected with the ISF strain, and alcoholism was a risk factor. The pathophysiology of a fatal outcome involved significantly greater incidence of petechial rash, gastrointestinal symptoms, obtundation and/or confusion, dehydration, tachypnea, hepatomegaly, leukocytosis, coagulopathy, azotemia, hyperbilirubinemia, and elevated levels of hepatic enzymes and creatine kinase. Some, but not all, of these findings were observed more often in ISF strain-infected patients. CONCLUSIONS: Although fatalities and similar clinical manifestations occurred among both groups of patients, the ISF strain was more virulent than the Malish strain. Multivariate analysis revealed that acute renal failure and hyperbilirubinemia were most strongly associated with a fatal outcome.

Rickettsia conorii Israeli tick typhus strain isolated from Rhipicephalus sanguineus ticks in Portugal.

This report describes the first establishment of five isolates of R. conorii Israeli tick typhus (ITT) strain from Rhipicephalus sanguineus ticks in different regions of Portugal. Ticks were collected on two separate expeditions that took place in Bragança, Montesinho Natural Park, and Portalegre City.

Intralesional expression of mRNA of interferon- gamma , tumor necrosis factor- alpha , interleukin-10, nitric oxide synthase, indoleamine-2,3-dioxygenase, and RANTES is a major immune effector in Mediterranean spotted fever rickettsiosis.

BACKGROUND: The mechanisms of immunity to Rickettsia conorii that have been elucidated in mouse models have not been evaluated in human tissues. METHODS: In this study, quantitative real-time polymerase chain reaction was used to determine the levels of expression of inflammatory and immune mediators in skin-biopsy samples collected from 23 untreated patients with Mediterranean spotted fever (MSF). RESULTS: In all 23 patients, the levels of intralesional expression of mRNA of tumor necrosis factor (TNF)- alpha , interferon (IFN)- gamma , interleukin (IL)-10, RANTES, and indoleamine-2,3-dioxygenase (IDO), an enzyme involved in limiting rickettsial growth by tryptophan degradation, were higher than those in control subjects; 6 of the 23 patients had high levels of inducible nitric oxide synthase (iNOS), a source of microbicidal nitric oxide. Positive correlations between TNF- alpha , IFN- gamma , iNOS, IDO, and mild/moderate MSF suggest that type 1 polarization plays a protective role. Significantly higher levels of intralesional expression of IL-10 mRNA were inversely correlated with levels of intralesional expression of IFN- gamma mRNA and TNF- alpha mRNA. The mRNA-expression level of the chemokine RANTES was significantly higher in patients with severe MSF. CONCLUSION: Mild/moderate MSF is associated with a strong and balanced intralesional proinflammatory and anti-inflammatory response, with a dominant type 1 immunity, whereas severe MSF is associated with increased expression of chemokine mRNA. Whether these factors are simply correlates of mild and severe MSF or contribute to antirickettsial immunity and pathogenesis remains to be determined.

Rickettsia sibirica isolation from a patient and detection in ticks, Portugal.

We report the first isolation of Rickettsia sibirica (strain mongolotimonae) from the blood of a patient and detection by polymerase chain reaction (PCR) of the rickettsia in a Rhipicephalus pusillus tick collected from a dead mongoose (Herpestes ichneumon) in the Alentejo region, Portugal. We describe also the first PCR detection of a new Rickettsia strain that is related to R. sibirica.

The presence of eschars, but not greater severity, in Portuguese patients infected with Israeli spotted fever.

In Portugal, Mediterranean spotted fever (MSF) is caused by R. conorii Malish and Israeli spotted fever (ISF) strains. It has been suggested that the ISF strain isolated from patients with MSF causes different clinical manifestations compared to those caused by Malish strain, namely the absence of eschar and greater severity. The aim of this study was to analyze the presence or absence of eschar and of fatality in Portuguese patients infected with either Malish or ISF strain. Of 94 patients with a clinical diagnosis of MSF between 1994 to 2004, 47 were infected with Malish strain and 47 with ISF strain. Eschars were reported in 20 patients (49%) infected with Malish strain, and in 17 (39%) with ISF strain. The presence of eschar is not statistically associated to a greater extent with either R. conorii strain (P=0.346). A total of 22 patients died, 9 infected with Malish strain and 13 infected with ISF strain, and no statistically significant difference was found (P=0.330). This study showed that the concepts of absence of the eschar and greater severity in Israeli spotted fever infection should be revised.

Mediterranean spotted fever in Portugal: risk factors for fatal outcome in 105 hospitalized patients.

Mediterranean spotted fever (MSF) is the most important tick-borne disease in Portugal. It is a notifiable disease and during 1989-2000 the annual incidence rate in Portugal was 9.8/10(5) inhabitants. Although recognized as a benign acute disease and treated mainly with ambulatory procedures, some cases are severe and fatalities have increased in the last few years. In 1997, MSF mortality became more evident in Beja, a Portuguese southern district, with a case fatality rate of 32.3% in hospitalized patients. Analysis of 55 variables regarding epidemiologic, clinical, laboratory, and therapeutic data of fatal and nonfatal MSF cases were compared to identify risk factors in 105 patients hospitalized in Beja District Hospital, between 1994 and 1998. It was statistically significant that the patients dying in 1997 were younger than those in other years. The risk of dying is statistically significant in those who presented with diabetes, vomiting, dehydration, and uremia. The interval between the onset of symptoms to administration of anti-rickettsial therapy was the same for all patients. Therapy delay, reported by some authors to be associated with mortality of MSF, was not a risk factor in our study. The patients who died in 1997 died faster than those in other years. The variables studied could not explain the higher mortality rates observed in our study. Although one may speculate that the pathogenic strain of Israeli tick typhus, isolated in 1997, could be responsible for this increase of fatality rate, inherited patient factors might also be strongly associated with mortality.

[Epidemiologic features of Mediterranean spotted fever in Portugal]. / Sobre a realidade da febre escaro-nodular em Portugal.

Mediterranean spotted fever (MSF) is a tick-borne rickettsial disease. It is endemic in Portugal and Ricardo Jorge recognized it in 1930. Rhipicephalus sanguineus is the main vector and reservoir of the disease. In Portugal the etiologic agents are two strains of Rickettsia conorii complex: R. conorii Malish and "Israeli tick typhus". MSF is clinically characterized by a vasculitis process with the classical clinical triad of fever, rash, and lesion at the site of tick bite. Although the majority MSF cases are considered benign, last years some districts presented more severe cases than expected. The reported incidence of MSF in Portugal for 1989 to 2000 was 9.8/10(5) inhabitants, the highest incidence compared to other mediterranean countries. Alentejo was the region who presents the highest incidence with 31/10(5) inhabitants. Nevertheless, Bragança was the district which appears with greater number of cases, 62/10(5) inhabitants. The highest annual incidence rate reported was among children, peaking in those 1-4 years of age with 60.2/10(5) inhabitants. Observation of mortality rates have shown that Beja district have the highest mortality rates for MSF in Portugal, but in 1997 in this district, mortality have unexpected values with 7.6 deaths per 100,000 inhabitants have occurred. Although is an obligatory notifiable disease, high number of underreported cases are detected.

Infarmed: regulação e monitoramento de produtos de saúde em Portugal (Política do Medicamento) - Jorge Torgal

Abordou a necessidade de uma avaliação criteriosa de todo produto antes de sua introdução no mercado, por meio de licenciamento e inspeções periódicas dos estabelecimentos de produção, distribuição e venda. Também realiza monitoramento e controle da qualidade dos medicamentos disponíveis no mercado, através de análise periódica com informações atualizadas e confiáveis voltadas para consumidores e profissionais de saúde. Vale lembrar que a validade inicial de um medicamento que entra no mercado é de cinco anos. Arquivo disponível para leitura e/ou download no ícone ao lado.

Infarmed: regulação e monitoramento de produtos de saúde em Portugal (O Sistema de Avaliação de Medicamentos) - Jorge Torgal

Revelou que entre seus objetivos estão a promoção de um mercado único para medicamentos em todo o continente, bem como a proteção e promoção da saúde pública, garantindo a qualidade, segurança e eficácia dos medicamentos; e melhoria no acesso a novos e melhores medicamentos. "A atuação do Sistema Europeu abrange o campo da informação e uniformização do uso dos medicamentos na Europa com o objetivo de a minimizar divergências em matérias de avaliação de medicamentos e equidade do acesso. Arquivo disponível para leitura e/ou download no ícone ao lado.