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Purpose: To describe the experience of the Ophthalmology Department of Hospital São João (HSJ), a tertiary health care center in North Region, Portugal, in terms of the diagnosis, treatment, and follow-up of retinoblastoma. Methods: This was a retrospective study of patients diagnosed with retinoblastoma in Hospital São João, between 1978 and 2012. Results: Fifty patients with retinoblastoma were evaluated in our institution between 1978 and 2012. Four patients were excluded due to loss of follow-up. Among the 46 retinoblastoma cases, 33 (71.7%) were unilateral and 13 (28.3%) bilateral, with a mean age at diagnosis of 22.19 months and 6.92 months, respectively (P<0.001). Leukocoria was the most common presenting sign (36.9%), followed by strabismus (19.6%), a combination of leukocoria and strabismus (8.7%), and buphthalmia (2.2%). Between 1978 and 1992, nine retinoblastoma cases were referred to our hospital, all of them unilateral, and, in each case, enucleation was performed, with or without salvage therapy. Between 1993 and 2012, 18 eyes with retinoblastoma were successfully managed with conservative treatment. Conclusion: Demographic results were generally coincident with previous reports. It is crucial to screen leukocoria in pediatric practice, even in asymptomatic children. The outcome of retinoblastoma treatment in our hospital is similar to other series in developed countries. [ABSTRACT FROM AUTHOR]

Introduction: The challenges posed by the COVID-19 pandemic were many and daunting. Almost overnight, the lives of millions of people all over Europe was disrupted and people had to adapt to a completely new situation. Healthcare personal were amongst the ones most affected by it, whether by changes in their everyday work routine or by being the people directly in charge of responding to the demands of the pandemic. Trainees are an indispensable part of healthcare personal and, as a result, they were vastly affected by the pandemic. Objectives: Discussing the role of National Trainees Associations (NTAs) in pandemic times, including how they dealt with the new challenges, their successes and hardships, and their steps going forward. Methods: Gathering of institutional information about the work of the Portuguese, Irish and Turkish NTAs during the COVID-19 pandemic. Critical appraisal of each of their contributions and projects. Results: There were impacts to trainees' clinical work, formative activities and even personal lives. Amidst this turmoil, NTAs were precious institutions. Their objective is to represent the trainees of each country, looking for formative opportunities and linking trainees. During the pandemic, the work developed by the NTAs increase in importance, serving as a beacon of important information and as intermediaries in a number of discussions. They also aimed to minimize the impact on formative activities, whether by providing recommendations or by organizing some formof educational activity. Conclusions: We provide some national examples - Portugal, Ireland and Turkey - and draw comparisons and lessons from each one. [ABSTRACT FROM AUTHOR]

Introduction: The possibility of detention for treatment of mental patients may be controversial since introduces the possibility of the judicial power to dominate one''s private life. Objectives: It is made an analysis of the legal problems in compulsory internment and treatment in mental patients in Portugal. Material and Methods: The diplomas mainly analysed were the Portuguese mental health law, Constitution and Penal Code. The study was based in four legal principles: necessity, proportionality, subsidiary and adequacy whenever a compulsory detention for mental treatment is imposed and the requisites for that decision. Results: Compulsory internment may only be determined when it is the only way to guarantee that patient is submitted to treatment, and when is deemed proportional to the danger of the legally protected value in question. Restrictions on patient’s fundamental rights shall be those strictly necessary and suitable to the effectiveness of treatment. Compulsory internment may be petitioned by the Public Attorney, patient''s legal representative, public health authorities or any person. Conclusion: In spite of the diversity of criteria for compulsory mental health care across several countries, Portuguese mental health law emphasizes the need for treatment as an essential condition for detaining patients with mental illness. The compulsory treatment is based on the judge decision supported in the psychiatric report. However, how can we be certain that a mental patient is going to practice a specific crime? Is it fair to punish without crime? Are there scientific criteria capable of ensuring that mental patients cause always violent behavior? [Copyright &y& Elsevier]

Background International professional mobility is a reality, people have skills they can put in the global marketplace. The increasing migration of health professionals to wealthy countries is a phenomenon known as “brain drain”. Objectives/Aims This work aims to present the push factors that pressure people to migrate from Portugal. Methods A cross-sectional survey was carried out with the psychiatric trainees in Portugal. A self-administered structured questionnaire was distributed to collect psychiatry trainees’ demographic and educational characteristics. Results In Portugal, the majority of trainees have a Portuguese citizenship. Almost 2/3 did not have a short-mobility experience, and the majority never migrated to another country. Less than half consider staying in Portugal in the next years, and nearly 4/5 have considered leaving the country. Working conditions ranked first as the priority condition to be improved in psychiatry in Portugal, followed by financial conditions. In fact, an attractive job for psychiatry trainees in Portugal must have as the most important feature a pleasant work environment. Conclusions An alarming percentage of psychiatry trainees from Portugal intend to migrate. Impact on future career, financial conditions of doctors, job opportunities and better working conditions were some of the motivating factors behind the migration. [ABSTRACT FROM AUTHOR]

Introduction: Volunteering represents an opportunity for social transformation and social cohesion. Portugal is one of the European countries with fewer volunteering initiatives. Generally, society distances itself from individuals with mental illness and prison inmates, therefore, stigma becomes one of the barriers to social reintegration. However, volunteering can be a beneficial intervention helping individuals in their reintegration., Objectives: This study aims to compare the differences and similarities in the attitudes of volunteers toward volunteering with people with mental illness and prisoners., Methods: A supplementary qualitative secondary analysis was conducted using transcripts from 39 semi-structured individual interviews with volunteers regarding support of inmates in prison and two focus groups with volunteers regarding support of people with mental illness. Data analysis was conducted through an inductive thematic analysis., Results: Four themes emerged from the analysis: 'Volunteer motivation and characteristics', 'Volunteer's role', 'Volunteering relationship and its impact', and 'Challenges faced by volunteers'. There were several similarities between the perspectives toward volunteering in prisons and in mental health care, including the need for specific training in the area and the positive attitudes and behaviors of both groups of volunteers toward volunteering with the individuals supported. The differences were related to the characteristics necessary to be a volunteer, the activities carried out with the individuals supported and the difficulties faced by volunteers., Conclusion: These findings show overall positive attitudes toward volunteering in mental health and in prisons., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dá Mesquita, Oliveira and Pinto da Costa.)

Maternal influences on children's diet have been widely studied, while paternal and household frameworks require further research. This study aimed to evaluate how individual, socioeconomic and household characteristics at birth and 7 years (y) impact children's fruit and vegetable (FV) and energy-dense foods (EDF) intake at 10y, distinguishing maternal and paternal effects. The sample included 2750 children evaluated at 7 and 10y in the Portuguese birth cohort Generation XXI. The children's food intake was assessed through a Food Frequency Questionnaire at both ages, where 4 food groups were defined: FV, 'Sweet foods', 'Salty snacks', and 'Soft drinks'. The associations between food intake at 7y, parents' and children's characteristics, and food intake at 10y were evaluated via binary logistic regression models. Offspring of older mothers with higher age and education, who live with siblings and had higher family income were likelier to have 5 servings of FV daily at 10y. Children eating 5 portions/day of FV at 7y had higher odds of keeping this pattern at 10y. Higher maternal age and education, and father's education decreased the odds of having soft drinks daily at 10y. Higher family income was linked with lower odds of weekly salty snacks and daily sweet foods at 10y. In conclusion, parental education, maternal age, living with siblings, and higher family income influenced children's FV and EDF intake at 10y. Mothers' effects appear to impact children's food intake more than fathers'., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Domestic violence (DV) is a serious and prevalent public health problem with devastating consequences for the victims and their families. Whilst the number of cases reported to the authorities has risen in recent years, many victims still chose not to present a complaint. In Portugal, to address this, DV became a public crime. As victims of DV present multiple health problems and frequently seek professional help, family doctors are in a privileged position to detect and report cases of DV to the authorities. However, little is known about what motivates these professionals to report or not the DV cases they encounter in their practice to the authorities., Methods: We conducted semi-structured interviews with family doctors from all regional health administrations of continental Portugal. Interviews occurred between July 2020 and September 2022, were conducted in person or remotely, audio recorded, transcribed, and analysed using thematic analysis. Content analysis was conducted to assess the agreement or disagreement regarding mandatory reporting in each of the themes and subthemes., Results: Fifty-four family doctors took part in this study (n = 39 women, n = 15 men). The main themes that arose from the analysis were: "Barriers related to the physician's activity," "Barriers related to the victim or aggressor," "Facilitators related to the physician's activity," "Facilitators related to the victim or aggressor." Although different barriers were described, most doctors agreed with the mandatory reporting of DV cases., Conclusions: Family doctors encounter multiple barriers and facilitators when considering reporting a DV case to the authorities. The results of this study can help develop new interventions to address the barriers described by the doctors, increasing their compliance with mandatory reporting, the protection of victims and the just persecution of the aggressor., (© 2024. The Author(s).)

Background: Hikikomori refers to the extreme isolation of individuals in their own homes, lasting at least six months. In recent years social isolation has become an important clinical, social, and public health problem, with increased awareness of hikikomori around the globe. Portuguese is one of the six most spoken languages in the world, but no studies have analysed the content regarding this phenomenon expressed in Portuguese., Objective: To explore the hikikomori phenomenon on Twitter in Portuguese, utilising a mixed-methods approach encompassing content analysis, emotional analysis, and correlation analysis., Methods: A mixed methods analysis of all publicly available tweets in the Portuguese language using a specific keyword (hikikomori) between 1st January 2008 and 19th October 2022. The content analysis involved categorising tweets based on tone, content, and user types, while correlation analysis was used to investigate user engagement and geographical distribution. Statistical analysis and artificial intelligence were employed to classify and interpret the tweet data., Results: Among the total of 13,915 tweets generated, in terms of tone 10,731 were classified as "negative", and 3184 as "positive". Regarding content, "curiosities" was the most posted, as well as the most retweeted and liked topic. Worldwide, most of the hikikomori related tweets in Portuguese were posted in Europe, while "individuals with hikikomori" were the users most active posting. Regarding emotion analysis, the majority of tweets were "neutral"., Conclusions: These findings show the global prevalence of the discourse on hikikomori phenomenon among Portuguese speakers. It also indicates an increase in the number of tweets on this topic in certain continents over the years. These findings can contribute to developing specific interventions, support networks, and awareness-raising campaigns for affected individuals., (© 2024. The Author(s).)

Background: Compulsory treatment involves the hospital admission of individuals with mental disorders in appropriate facilities through judicial decisions. However, limited information is available regarding the similarities and differences in compulsory treatment legislation in Portuguese-speaking countries., Aims: To analyse the commonalities and differences in compulsory treatment legislation in Portuguese-speaking countries, where Portuguese is the primary official language, including Angola, Brazil, Cape Verde, East Timor, Guinea-Bissau, Mozambique, Portugal, and São Tomé and Príncipe., Methods: A comparative analysis of the specific legislation on compulsory treatment in Portuguese-speaking countries was conducted. National development plans were analysed in countries lacking legislation. A purposive sampling of mental health professionals was contacted to gather information on the countries under study., Results: Among the eight Portuguese-speaking countries examined, specific legislation regarding compulsory treatment was found only in Brazil, Cape Verde, and Portugal. These countries, with the lowest poverty rates, exhibited a notable degree of homogeneity in the criteria supporting compulsory treatment, ensuring the protection of individual rights. In contrast, in Angola, East Timor, Guinea-Bissau, Mozambique, and São Tomé and Príncipe, compulsory treatment primarily relies on mental health development plans, resulting in significant variations in the presented criteria., Conclusions: The significant disparities in compulsory treatment policies among Portuguese-speaking countries, with only Brazil, Cape Verde, and Portugal having specific legislation, underscore the need for a collective effort to establish more consistent procedures and safeguard individual rights., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Domestic violence leads to multiple health problems in victims and their families. Family doctors are in a particularly privileged position to detect, follow up, refer and report cases of domestic violence. However, little is known about the perception of these physicians regarding their role in managing domestic violence cases., Methods: We conducted semi-structured interviews with family doctors from all regional health administrations of continental Portugal. Interviews were audio recorded, transcribed, and analysed using thematic analysis., Results: Fifty-four family doctors participated in this study (n = 39 women, n = 15 men). The themes and subthemes that emerged from the data analysis translated doctors' broad responsibilities when approaching victims and aggressors. These included: "Implement preventive measures", "Empower the victim leading them to recognize the violent situation", "Detect domestic violence cases", "Treat health problems related to violence", "Provide emotional support", "Refer victims to specialized services", "Register the episode on the victims and/or aggressor clinical records", "Incentivize the victim to report", "Report the case to the authorities", "Intervene with the aggressor", "Protect other individuals" and "Follow up the patient and the process"., Conclusions: The results of this study provide an overview of the current practical approaches being adopted by physicians and may provide a base for developing new interventions to support physicians to manage cases of domestic violence., (© 2023. The Author(s).)

The Satisfaction with Family Life Scale (SWFLS) is a measure of a person's satisfaction with their family life as a whole that has been used in different cultural contexts. However, its internal structure and factorial invariance have not been investigated simultaneously in culturally different samples from America and Europe. The current study aims to evaluate the internal structure and factorial invariance of the SWLFS in adolescents from Peru and Portugal, through a multi-group confirmatory factor analysis. The study was conducted on 439 adolescents from Peru ( N  = 232; Age average = 15.50, S.D. = 0.65) and Portugal ( N  = 207; Age average = 16.16, S.D. = 0.81). First, the confirmatory factorial analysis for each group was carried out, followed by the multi-group confirmatory factorial analyses. Results indicated that the one-factor structure of the SWLFS presents a good adjustment to the data, in addition to an adequate internal consistency. Moreover, the presence of configural, metric, scalar and strict invariance is demonstrated across culturally different samples. The SWFLS is a brief and valid measure of satisfaction with family life that is useful for intercultural comparisons between samples of adolescents from Peru and Portugal.

Introduction: In the last few decades, the rates of international medical migration have continuously risen. In Psychiatry, there is great disparity in the workforce between high and low-income countries. Yet, little is known about the 'push' and 'pull' factors and the migratory intentions of trainees. This study aims to assess the factors impacting the decisions of psychiatric trainees in Portugal towards migration., Material and Methods: A questionnaire was developed in the Brain Drain study and was distributed to psychiatric trainees in Portugal., Results: The sample consists of 104 psychiatric trainees (60.6% female). Overall, 40.4% of the trainees had prior experience of living abroad and the majority (96.9%) felt that this experience influenced their attitude towards migration in a positive way. About 75% of trainees had 'ever' considered leaving the country, but the majority (70.0%) had not taken any 'practical steps' towards migration. The main reasons to stay in Portugal were personal, while the main reason to leave was financial. The majority of the trainees (55.7%) were dissatisfied or very dissatisfied with their income, working conditions and academic opportunities., Discussion: Working conditions, salaries and academic opportunities are the main triggers for the migration of psychiatric trainees from Portugal., Conclusion: These results may inform the decisions of stakeholders in the health and education sectors and point out the necessary investments required and the impact it may have on the workforce.

Introduction: Psychiatry is influenced by society changes, so it should be permanently updating itself, foreseeing future behaviours and pathologies. This study aims to describe psychiatry trainee's opinion in Portugal concerning their training and the modifications they would want to witness in the near future., Material and Methods: A structured questionnaire of 26 questions was developed by the Portuguese Association of Psychiatry Trainees and sent via email., Results: The percentage of responses was 41.5%. The majority of the trainees were satisfied with their formation. However, some changes were pointed out concerning obligatory and optional placements. Most trainees claimed psychotherapy should be included in their training, along with an easier access to investigational procedures and clinical training opportunities abroad., Discussion and Conclusion: This detailed perspective can facilitate the transformation of the curricula throughout Portugal and Europe, allowing the improvement of psychiatry training, as well as the enhancement of mental health care.

The application of starchy flours from different origins in food systems depends greatly on information about the chemical and functional properties of such food materials. Acorns are important forestry resources in the central and southern regions of Portugal. To preserve these fruits and to optimize their use, techniques like drying are needed. The effects of different drying temperatures on starch-related functional properties of acorn flours obtained from dried fruits of Quercus rotundifolia (QR) and Quercus suber (QS) were evaluated. Flours were characterized for amylose and resistant starch (RS) contents, swelling ability, and gelatinization properties. Drying temperature mainly affected amylose content and viscoamylographic properties. Amylograms of flours from fruits dried at 60 °C displayed higher consistency (2102 B.U. and 1560 B.U., respectively, for QR and QS). The transition temperatures and enthalpy were less affected by drying temperature, suggesting few modifications in starch structure during drying. QR flours presented different functional properties to those obtained from QS acorn flours. The effect of drying temperatures were more evident in QR.

The presence of Legionella spp. in the water of a Portuguese spa was ascertained during the spa season, between May and November. Simultaneously the prevalence of anti-legionella antibodies in people attending the spa was also investigated. The antibody titres of 172 randomly selected patients and 42 therapists were determined, and compared with a control group of 503 blood donors. Legionellae were present in the spa water at low concentrations, generally lower than 10(3) c.f.u./l. A total of 92 strains representing eight different species or serogroups were isolated; the predominant isolates belonged to Legionella pneumophila serogroup 6 and to L. londiniensis. During the study, no clinical cases of Legionnaires' disease were observed, and the antibody titres were generally low in the groups studied. However, the antibody titres of the patients increased slightly during their stay at the spa, approaching the values for the therapists. Mean antibody titres in the groups related with the spa were significantly higher than those in the blood donors against five of the seven legionella antigens tested. The largest number of elevated antibody titres in the exposed groups were to the L. pneumophila sg 5 and sg 6 antigens.

The humidification trays of five of seven incubators in a neonatology unit of a hospital were found to be colonized with Legionella pneumophila, serogroup 1. Bacteriological analysis of the water in the humidification trays showed very large numbers of heterotrophic bacteria, one of which also contained Pseudomonas aeruginosa. Two hot water systems supply the neonatology unit, either of which is used to add water to the humidification trays; one system (A) is maintained at about 60 degrees C, while the other system (B) is maintained at 45 degrees C. The latter was also found to be colonized with L. pneumophila, Sg1. Monoclonal antibody (Mab) subgrouping of the isolates, indicated that system B was the source of colonization of the humidification trays of the incubators.

In this study we have carried out haplotype analysis on the beta-globin gene cluster and characterized the beta-thalassemia mutation by oligonucleotide hybridization in 14 patients with thalassemia major and 5 with sickle cell/beta-thalassemia originating from southern Portugal. We found that three mutations, namely the beta(0)-39, beta(0) IVS-1 nt 1 and beta(+) IVS-1 nt 110 are prevalent accounting for 53%, 32% and 10% of the beta-thalassemia chromosomes respectively. In general each mutation was associated with a specific chromosomal haplotype; the beta(0)-39 mutation, however, was linked to three different haplotypes. These results indicate that three oligo-probes complementary to the most common mutations allow prenatal diagnosis by oligonucleotide analysis in 96% of the couples at risk of having offspring with thalassemia major in southern Portugal.