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The imposition of telework due to the COVID-19 pandemic brought with it the need for individuals to readjust their work-non-work boundaries. In this crisis situation, individuals’ needs to manage these boundaries may have been influenced by contextual factors, such as family-supportive supervisor behaviors (FSSB) and macro-structural aspects, such as the country to which the teleworkers belong. This study tests the mediating effect of boundary control on the relationship between FSSB and satisfaction with life and examines the moderating effect of the country (Pakistan vs. Portugal) in the relationship between FSSB and boundary control. With a sample of 108 Portuguese and 118 Pakistani individuals, the results were analyzed using Process tool. FSSB was found to be important for teleworkers to control their boundaries and for their satisfaction with life and this control was also seen to contribute to higher levels of life satisfaction. Differences between the two countries were observed: boundary control mediates the relationship between FSSB and satisfaction with life for Pakistani teleworkers and these workers are more dependent on FSSB to exercise boundary control than Portuguese teleworkers. This study highlights the importance of considering contextual factors when implementing telework. Practical implications are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To assess the seroprevalence of SARS-CoV-2 antibodies in municipal employees of Northern Portugal during the first pandemic wave (May-June 2020) and its association with potentially related risk factors for infection.Material and Methods: The authors assessed municipal employees of 2 cities in Northern Portugal, in whom serological tests to SARS-CoV-2 and an epidemiological survey were applied. The authors assessed the proportion of individuals presenting IgM and/or IgG antibodies to SARS-CoV-2, and evaluated the association between having positive serological test results, epidemiologic variables and clinical presentations. Reported symptoms were evaluated on their sensitivity, specificity, and predictive values.Results: The authors assessed 1696 employees, of whom 22.0% were firefighters, 10.4% were police officers, 10.3% were maintenance workers, and 8.1% were administrative assistants. The seroprevalence of SARS-CoV-2 infection was 2.9% (95% CI: 2.1-3.7%). Administrative assistants comprised the professional group with highest seroprevalence of SARS-CoV-2 (OR = 1.9 in the comparison with other occupational groups, 95% CI: 0.8-4.3, p = 0.126). The seroprevalence of SARS-CoV-2 infection among those who were in direct contact with COVID-19 patients in their professional activity was 3.9%, compared to 2.7% among those who were not in direct contact with such patients (OR = 1.5, 95% CI: 0.8-2.8, p = 0.222). The highest risk of infection was associated with the presence of a confirmed SARS-CoV-2 infection in the household (OR = 17.4, 95% CI: 8.3-36.8, p < 0.001). Living with a healthcare professional was not associated with a higher risk of infection (OR = 1.0, 95% CI: 0.4-2.5, p = 0.934). Anosmia/ dysgeusia was the symptom with the highest positive predictive value (52.2%, 95% CI: 31.8-72.6, p < 0.001) and specificity (99.3%, 95% CI: 98.9-99.7, p < 0.001), while cough was the most prevalent symptom among SARS-CoV-2 seropositive participants (36%).Conclusions: The authors observed a SARS-CoV-2 seroprevalence of 2.9% among assessed municipal employees. Anosmia/dysgeusia was the COVID-19 symptom which displayed the highest positive predictive value and specificity. Int J Occup Med Environ Health. 2022;35(3):297-307. [ABSTRACT FROM AUTHOR]

• Temperature thresholds restrict O. cf. ovata distribution range in Iberia. • Lisbon Bay is the current W Iberian northern distribution limit of O. cf. siamensis. • Positive SST anomalies favor the occurrence of Ostreopsis spp. in Lagos Bay. • Low sea state favor the occurrence of Ostreopsis spp. in Lagos Bay. The benthic genus Ostreopsis contains toxic-bloom forming species and is an important cause of concern in warm-temperate and tropical waters. On the coast of Portugal, NE Atlantic, the occurrence of Ostreopsis cf. siamensis and Ostreopsis cf. ovata has been reported since 2008 and 2011, respectively. This work aims to understand the favorable conditions for high concentrations of Ostreopsis cells in the plankton at two sites, Lagos and Lisbon Bays, located in the South and West coast of Portugal, respectively. This study is based on weekly Ostreopsis abundance data in the plankton, from 2011 to 2017, daily satellite and in situ sea surface temperature (SST), and meteorological and sea state parameters, namely wind stress and significant wave height. The molecular identification of local Ostreopsis spp. is also presented. The maximum cell densities occur between late-summer and autumn. The distribution range of Ostreopsis cf. ovata is restricted to the South coast, while Ostreopsis cf. siamensis has a wider distribution range, being also present on the West coast. In the study period, there was only one occurrence of Ostreopsis spp., in Lagos Bay, with concentrations within the alert phase of monitoring. In Lagos Bay, high Ostreopsis spp. concentrations were related with positive SST anomalies. These high concentrations were often recorded after a period of almost 2-weeks to more than 4-weeks of low sea state (<0.6 m), followed by short time events of onshore wind and moderate waves (0.6–1 m). The former conditions are interpreted as favoring bloom development on the substrate and the latter as causing the re-suspension of Ostreopsis cells in the water column. In Lisbon Bay, O. cf. siamensis occurred in the plankton in few occasions and no clear relation could be established with the studied environmental variables. It is here hypothesized that the recent records of O. cf. siamensis in Lisbon Bay may correspond to an early colonization stage of an invasion process. Knowledge gained on Ostreopsis dynamics along the Portuguese coast can be used for both the improvement of benthic harmful algal blooms (BHABs) monitoring in the region and as a basis to design forecasting models. [ABSTRACT FROM AUTHOR]

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Eduardo Batarda (b. 1943, Coimbra, Portugal) is a Portuguese painter, whose work has, by its particular characteristics, been questioning art history, as well as the relation between art and politics throughout the years, since 1964. I propose to focus particularly in some examples of his paintings from the 1970s when Batarda developed a watercolour technique of saturated colours and refined drawing to make an explicit cumulative figuration akin to underground comics. He used it not only to comment the changing in the art world but in the world itself, namely the political changes in Portugal and the colonial war, as well as foreign policies, mixing all up in layers of multiple readings, and intrinsically connecting art history and politics. The fact that he used comics to do it was a way of mocking the art world with a language that was considered “low”. He also used the watercolour technique consciously for its conventional relegation to a less prestigious realm, and both this technique along with the painstaking quality of execution, with highly complex drawing and painting skills, contrasted to an at times explicitly pornographic thematic. There is in these options a constant and deliberate contradiction in terms as a way to show the absurdity of conventions. The paintings from this period have been described by the painter as “permanent commentaries on the state of the arts”. This paper will analyse the way these commentaries used comics as a tool for criticism from within the medium of painting. [ABSTRACT FROM PUBLISHER]

Doubts persist about how to teach medical students to effectively communicate bad news. This study describes and evaluates a pilot class on breaking bad news (knowledge, skills and confidence to communicate bad news) and compares two different teaching Methods: (taught either by tutor or by video-conference). In January 2018, medical students from 4th and 5th course years (UBI-Portugal) participate in pilot class on bad news communication using two teaching Methods: (traditional face-to-face and active class vs. online, video-based, and less active class). Students answered two questionnaires, one before (Q1) and another after (Q2)the class. From a total of 324 students, 268 answered Q1 and 240 attended the class plus answered both questionnaires (Mage=23 years; 73% girls; 51% from 4th year). Student's majority (60%) had previous classes on bad news communication but only taught by a theoretical approach, and 34% never had classes on this topic. Only 3.4% knew the SPIKES protocol. The majority recognized the great importance of this topic in their pre-graduate education and rated their education on this topic as insufficient. Regarding the pilot class, students were globally satisfied (Msatisfaction=6,84±1,73 in a 9 points scale) with higher satisfaction in the expositive-active model taught by a tutor Msatisfaction=7,25±1,45 vs. 6,13±1,93). Comparing with Q1, self-assessment of knowledge, skills and confidence were significantly high in Q2. This study confirms the need of more investment in teaching bad news communication in UBI medical school. Medical students recognize the importance of this topic in their education. The evaluation of the pilot class on bad news communication was positive. Both teaching Methods: had positive evaluation, but the class with a tutor got better results than the class by video-based class. [ABSTRACT FROM AUTHOR]

Many studies demonstrated the presence of diverse environmental contaminants in the Douro River estuary, such as natural and synthetic estrogens, pharmaceuticals, industrial compounds and pesticides. This estuary is located between two densely populated cities and is highly impacted due to anthropogenic activities, such as industry and agriculture. Although the presence of mycotoxins and phytoestrogens, such as lignans and coumestrans, in the aquatic environment is reported by some authors, their occurrence in Portuguese waters was not investigated yet. To evaluate the presence of phytoestrogens, phytosterols and mycotoxins in Douro River estuary, water samples were collected seasonally at nine sampling points, preconcentrated by solid phase extraction and analysed by gas chromatography mass spectrometry. Local flora was collected on the riverside, in the same sampling points, for identification and evaluation of the possible relation to the presence of phytoestrogens and/or phytosterols in the estuarine water. Results showed the ubiquitous presence of mycotoxins, namely deoxynivalenol up to 373.5 ng L. Both phytoestrogens and phytosterols showed a possible seasonal fluctuation, which is in accordance to the life cycle of the local flora and agricultural practices. Physicochemical parameters were also determined for water quality evaluation. This study revealed for the first time the presence of mycotoxins and lignans in estuarine waters from Portugal, and highlights the need to consider natural contaminants in future monitoring programs. [ABSTRACT FROM AUTHOR]

• A wide variation in Na and K contents within the TDS Food groups were observed in our study. • Na contents ranged from 1.20 mg/100 g in bottled water to 2108 mg/100 g in raw cured (or seasoned) meat. • Highest content of K (1583 mg/100 g) was found in cod Atlantic and Na/K ratio was, in general, higher for processed foods. • Data generated through TDS-PT, can be useful to identify contribution of core foods to daily intake of Na, K and Na:K ratio. Eating a varied diet will help ensure an adequate supply of most minerals for healthy people, however excessive sodium (Na) intake leads to an increase in blood pressure, and potassium (K) intake to a balance between the two ions, contributing to the regulation of blood pressure. This work aimed to assess Na and K food sources and evaluate Na:K ratio for the studied food groups. The samples analyzed (n = 169), were selected based on Portuguese food consumption data, and were grouped according to the FoodEx2 level 1 food classification system. Na and K levels were determined using an Inductively Coupled Plasma Optical Emission Spectrometer. Na contents ranged from 1.20 mg/100 g in bottled water to 2108 mg/100 g in raw cured (or seasoned) meat. The highest content of K (1583 mg/100 g) was found in cod Atlantic. The Na/K ratio was, in general, higher for processed foods. The Portuguese Total Diet Pilot Study (PT-TDS), after additional samples are analyzed, could potentially be useful, for evaluating diet-disease risks associated with high Na and low K intake from different foods or food groups. [ABSTRACT FROM AUTHOR]

Familial hemiplegic migraine (FHM) is a rare autosomal-dominant form of migraine with aura. Three disease-causing genes have been identified for FHM: CACNA1A, ATP1A2 and SCN1A. However, not all families are linked to one of these three genes.PRRT2 variants were also commonly associated with HM symptoms; therefore, PRRT2 is hypothesized as the fourth gene causing FHM. PRRT2 plays an important role in neuronal migration, spinogenesis, and synapse mechanisms during development and calcium-dependent neurotransmitter release. We performed exome sequencing to unravel the genetic cause of migraine in one family, and a novel PRRT2 variant (c.938C > T;p.Ala313Val) was identified with further functional studies to confirm its pathogenicity. PRRT2-A313V reduced protein stability, led to protein premature degradation by the proteasome and altered the subcellular localization of PRRT2 from the plasma membrane (PM) to the cytoplasm. We identified and characterized for the first time in a Portuguese patient, a novel heterozygous missense variant in PRRT2 associated with HM symptoms. We suggest that PRRT2 should be included in the diagnosis of HM., (© 2023 The Authors. Clinical Genetics published by John Wiley & Sons Ltd.)

Objectives: Cladribine is a selective and oral immunological reconstitution treatment, approved in Europe for very active multiple sclerosis (MS) with relapses. Aims were to assess the safety and effectiveness of cladribine in real-world setting, during treatment follow-up., Methods: This was a multicentric, longitudinal, observational study with retrospective and prospective data collection of clinical, laboratory, and imaging data. This interim analysis reports data from July 1, 2018 (study onset), to March 31, 2021., Results: A total of 182 patients were enrolled: 68.7% were female; mean age at onset was 30.1 ± 10.0 years, and mean age at first cycle of cladribine treatment was 41.1 ± 12.1; 88.5% were diagnosed with relapse-remitting MS and 11.5% with secondary progressive MS. Mean disease duration at cladribine start was 8.9 ± 7.7 years. Most patients (86.1%) were not naive, and median number of previous disease-modifying therapies was 2 (interquartile range, 1-3). At 12 months, we observed no significant Expanded Disability Status Scale score worsening ( P = 0.843, Mann-Whitney U test) and a significantly lower annualized relapse rate (0.9 at baseline to 0.2; 78% reduction). Cladribine treatment discontinuation was registered in 8% of patients, mainly (69.2%) due to disease activity persistence. Most frequent adverse reactions were lymphocytopenia (55%), infections (25.2%), and fatigue (10.7%). Serious adverse effects were reported in 3.3%. No patient has discontinued cladribine treatment because of adverse effects., Conclusion: Our study confirms the clinical efficacy and the safety profile of cladribine for treating MS patients with a long-term active disease in the real-world setting. Our data contribute to the body of knowledge of the clinical management of MS patients and the improvement of related clinical outcomes., Competing Interests: Conflicts of Interest and Source of Funding: This article was prepared with the medical writing support of W4Research, financially supported by Merck. Merck had no access to the data or any other role in study design, analysis, or decision to submit for publication. Mónica S., J. Sequeira, P.A., R.G., J.F., F.L., L.L., M.J.S., C.C., and J. de Sá have received honoraria from Merck and others for acting as speakers and for attending scientific meetings. J. Sequeira, P.A., R.G., J.F., F.L., L.L., M.J.S., V.S., C.C., and J. de Sá had also received fees for acting as a consultant and/or for participation in advisory boards from several companies, including Merck. The remaining authors did not receive any financial support and have no conflicts of interest to declare., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to changes in healthcare institutions and medical assistance. Non-SARS-CoV-2 related diseases were indirectly affected by the pandemic. Nonetheless, their treatment remains crucial. Cardiovascular conditions such as acute coronary syndrome (ACS) are common, and it was necessary to adjust medical assistance to these diseases during the pandemic. This study aimed to assess the national impact and healthcare system response during the first wave of the pandemic in patients admitted for ACS., Material and Methods: Multicenter retrospective study based on the Acute Coronary Syndrome Portuguese National Registry between the 1st January 2016 and the 28th February 2021. Two groups were defined: the previous year to the SARS-CoV-2 pandemic (March, April, May and June 2019) (952 patients) and the first wave of the pandemic (March, April, May and June 2020) (642 patients). Clinical course, time until reperfusion, in-hospital outcomes and follow-up at one year were compared between both periods., Results: There was a lower incidence of ACS between March and June 2020 compared with the same period in 2019, with a reduction of 32.6%. There were no statistically significant differences between the two periods regarding patient demographic characteristics (except for a higher prevalence of familiar cardi vascular history and chronic obstructive pulmonary disease in 2020 and higher prevalence of diabetes in 2019), clinical features, clinical management, in-hospital major adverse cardiac events, mortality and readmission at one-year follow-up. There was a trend towards longer delays until reperfusion, yet without statistical significance. The patients that developed ACS during the first wave of the SARS-CoV-2 pandemic were less often referred to percutaneous coronary intervention centers (p = 0.034) and were more frequently transferred to another hospital (p < 0.001)., Conclusion: During the first wave of the SARS-CoV-2 pandemic there was a nationwide reduction in demand of healthcare services due to ACS events. Even though the Portuguese healthcare system was under strain and forced to divert resources and medical assistance towards the pandemic management, it was capable of responding adequately to ACS.

Introduction: Several neuroimmunological disorders have distinct phenotypes according to the age of onset, as in multiple sclerosis or myasthenia gravis. It is also described that late onset NMOSD (LONMOSD) has a different phenotype., Objective: To describe the clinical/demographic characteristics of the LONMOSD and distinguish them from those with early onset (EONMOSD)., Methods: From a nationwide Portuguese NMOSD study we analyzed the clinical/demographic characteristics of the LONMOSD., Results: From the 180 Portuguese patients 45 had disease onset after 50 years old, 80% were female. 23 had anti-AQP4 antibodies (51.1%), 13 anti-MOG antibodies (28.9%) and 9 were double seronegative (20.0%). The most common presenting phenotypes in LONMOSD were transverse myelitis (53.3%) and optic neuritis (26.7%), without difference from EONMOSD (p = 0.074). The mean EDSS for LONMOSD was 6.0 (SD=2.8), after a mean follow-up time of 4.58 (SD=4.47) years, which was significantly greater than the mean EDSS of EONMOSD (3.25, SD=1.80)(p = 0.022). Anti-AQP4 antibodies positive LONMOSD patients had increased disability compared to anti-MOG antibodies positive LONMOSD (p = 0.022). The survival analysis showed a reduced time to use a cane for LONMOSD, irrespective of serostatus (p<0.001)., Conclusions: LONMOSD has increased disability and faster progression, despite no differences in the presenting clinical phenotype were seen in our cohort., (Copyright © 2022. Published by Elsevier B.V.)

Hereditary cerebellar ataxia (HCA) comprises a clinical and genetic heterogeneous group of neurodegenerative disorders characterized by incoordination of movement, speech, and unsteady gait. In this study, we performed whole-exome sequencing (WES) in 19 families with HCA and presumed autosomal recessive (AR) inheritance, to identify the causal genes. A phenotypic classification was performed, considering the main clinical syndromes: spastic ataxia, ataxia and neuropathy, ataxia and oculomotor apraxia (AOA), ataxia and dystonia, and ataxia with cognitive impairment. The most frequent causal genes were associated with spastic ataxia ( SACS and KIF1C ) and with ataxia and neuropathy or AOA ( PNKP ). We also identified three families with autosomal dominant (AD) forms arising from de novo variants in KIF1A , CACNA1A, or ATP1A3 , reinforcing the importance of differential diagnosis (AR vs. AD forms) in families with only one affected member. Moreover, 10 novel causal-variants were identified, and the detrimental effect of two splice-site variants confirmed through functional assays. Finally, by reviewing the molecular mechanisms, we speculated that regulation of cytoskeleton function might be impaired in spastic ataxia, whereas DNA repair is clearly associated with AOA. In conclusion, our study provided a genetic diagnosis for HCA families and proposed common molecular pathways underlying cerebellar neurodegeneration.

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a rare disorder in which astrocyte damage and/or demyelination often cause severe neurological deficits., Objective: To identify Portuguese patients with NMOSD and assess their epidemiological/clinical characteristics., Methods: This was a nationwide multicenter study. Twenty-four Portuguese adult and 3 neuropediatric centers following NMOSD patients were included., Results: A total of 180 patients met the 2015 Wingerchuk NMOSD criteria, 77 were AQP4-antibody positive (Abs+), 67 MOG-Abs+, and 36 seronegative. Point prevalence on December 31, 2018 was 1.71/100,000 for NMOSD, 0.71/100,000 for AQP4-Abs+, 0.65/100,000 for MOG-Abs+, and 0.35/100,000 for seronegative NMOSD. A total of 44 new NMOSD cases were identified during the two-year study period (11 AQP4-Abs+, 27 MOG-Abs+, and 6 seronegative). The annual incidence rate in that period was 0.21/100,000 person-years for NMOSD, 0.05/100,000 for AQP4-Abs+, 0.13/100,000 for MOG-Abs+, and 0.03/100,000 for seronegative NMOSD. AQP4-Abs+ predominated in females and was associated with autoimmune disorders. Frequently presented with myelitis. Area postrema syndrome was exclusive of this subtype, and associated with higher morbidity/mortality than other forms of NMOSD. MOG-Ab+ more often presented with optic neuritis, required less immunosuppression, and had better outcome., Conclusion: Epidemiological/clinical NMOSD profiles in the Portuguese population are similar to other European countries., (Copyright © 2021. Published by Elsevier B.V.)

Background: The high-grade atrioventricular block (HAVB) occurrence in acute coronary syndrome (ACS) is a potentially life-threatening complication, that demands a rapid and efficient response regarding reperfusion time and rhythm stabilization. This study aimed to analyse the rate, clinical features, therapeutic approach, complications, in-hospital mortality and follow-up of HAVB in the setting of ACS., Methods: Multicenter retrospective study based on the Acute Coronary Syndrome Portuguese National Registry, including 32157 patients admitted for ACS between 1/10/2010-3/05/2020, classified according to the presence or absence of HAVB during the hospitalization for ACS. Comparison between the two groups was performed. Logistic regression was accomplished to assess predictors of HAVB in ACS patients., Results: Patients with HAVB were older, and had higher rates of females, history of stroke and neoplasia. HAVB patients presented more frequently ST-segment elevation myocardial infarction, syncope as a major symptom, higher Killip-Kimball class and multivessel disease. Furthermore, HAVB patients had more major adverse cardiac events during the hospitalization for ACS, namely heart failure complication, cardiogenic shock complication, new-onset of atrial fibrillation, ACS mechanical complication, sustained ventricular tachycardia, cardiac arrest, stroke complication and in-hospital death. Logistic regression revealed that female gender, age ≥ 75 years old, heart rate < 60 and Killip-Kimball class > I were predictors of HAVB in ACS patients. Also, HAVB patients presented higher rates of all-causes of death at 1-year follow-up (p = 0.011)., Conclusions: Using real-life data, patients with HAVB in the setting of ACS had a worse prognosis during hospitalization and in the short-term follow-up period., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The aim was to determine whether commercial baby foods marketed within Europe (up to 36 months of age) have inappropriate formulation and high sugar content and to provide suggestions to update European regulations and recommendations as part of a nutrient profile model developed for this age group. The latter was produced following recommended World Health Organization (WHO) steps, including undertaking a rapid literature review. Packaging information from countries across the WHO European region was used to determine mean energy from total sugar by food category. The percentage of products containing added sugar and the percentage of savoury meal-type products containing pureed fruit were also calculated. A total of 2,634 baby foods from 10 countries were summarised: 768 sold in the United Kingdom, over 200 each from Denmark (319), Spain (241), Italy (430) and Malta (243) and between 99-200 from Hungary, Norway, Portugal, Estonia and Slovenia. On average, approximately a third of energy in baby foods in these European countries came from total sugar, and for most food categories, energy from sugar was higher than 10%. Use of added sugars was widespread across product categories, with concentrated fruit juice most commonly used. Savoury meal-type purees did not contain added sugars except in United Kingdom and Malta; however, fruit as an ingredient was found in 7% of savoury meals, most frequently seen in UK products. Clear proposals for reducing the high sugar content seen in commercial baby foods were produced. These suggestions, relating to both content and labelling, should be used to update regulations and promote product reformulation., (© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

High sodium (salt) consumption is associated with an increased risk of developing non-communicable diseases. However, in most European countries, Portugal included, sodium intake is still high. This study aimed to assess the sodium content of school meals before and after the Eat Mediterranean (EM) intervention-a community-based program to identify and correct nutritional deviations through the implementation of new school menus and through schools' food handlers training. EM (2015-2017) was developed in 25 schools (pre to secondary education) of two Portuguese Municipalities, reaching students aged 3-21 years old. Samples of the complete meals (soup + main course + bread) from all schools were collected, and nutritional quality and laboratory analysis were performed to determine their nutritional composition, including sodium content. Overall, there was a significant decrease (-23%) in the mean sodium content of the complete school meals, which was mainly achieved by the significant reduction of 34% of sodium content per serving portion of soup. In conclusion, EM had a positive effect on the improvement of the school meals' sodium content, among the participant schools. Furthermore, school setting might be ideal for nutrition literacy interventions among children, for flavors shaping, and for educating towards less salty food acceptance.

Parkinson disease (PD) is the second most common neurodegenerative disorder. Most cases of PD are sporadic, while 5-10% have a known genetic basis. Variants in the PARK2 gene are the most frequent cause of autosomal recessive juvenile-onset PD. PARK2 encodes parkin, a multi-domain protein that functions as an ubiquitin E3 ligase. Numerous variants spanning all parkin domains have been identified, although the pathogenic relevance for several of those remains unclear. In this study, we aimed to functionally characterize two truncating parkin variants: N52Mfs*29, which is highly prevalent in the Portuguese and Spanish populations, and L358Rfs*77, recently identified in the Portuguese population. Our results indicate that both variants are prematurely degraded by the proteasome, even though proteins levels are still moderate. We also showed that they are aggregation-prone and lead to mislocalized parkin. Interestingly, the L358Rfs*77 variant is mislocalized to the nucleus, which was never reported for parkin variants. While N52Mfs*29 impaired self-ubiquitination activity, the L358Rfs*77 variant seemed to retain it. Both variants, however, fail to ubiquitinate p62 substrate and did not relocalize to depolarized mitochondria. Therefore, we conclude that parkin truncating variants cause loss of parkin function, thus showing their causative role in PD pathogenesis.

Therapeutic communities emerged to respond to individuals with substance use disorders. The studies carried out emphasize the importance of the Occupational Therapist in the process of constructing occupational meaning. However, there is a paucity of studies addressing the relevance of this profession in this specific context. To understand the intervention of Occupational Therapy in the Therapeutic Community "Clínica do Outeiro - Portugal", describing the perception of individuals with substance use disorders, Occupational Therapists and other team members. Descriptive-exploratory study with a qualitative approach, by means of a case study research. We used interviews with clients and Occupational Therapists and focus group with the multidisciplinary team to collect data. Occupational Therapy is characterized by the greater proximity it establishes with users, as well as by the dynamism, creativity and motivation it infuses, playing a preponderant role in the (re) structuring of routines, performance of ADL and IADL, leisure and social participation of individuals with substance use disorders. The OT emerges as essential in this community, as a professional who is dedicated to the work of adapting and including the individual in the therapeutic community through the acquisition of the necessary occupational performance skills essential for everyday life in society.

Background/objectives: Ready-to-eat cereal (RTEC) breakfasts have been increasing in Portugal, among children. Eat Mediterranean (EM), a Portuguese comprehensive community-based intervention, proposed to improve breakfast patterns of children and adolescents and to evaluate the healthiness of RTEC according to WHO/Europe nutrient profile model (Euro-NP)., Subjects/methods: EM Program was developed during two scholar years (15/16 and 16/17) toward 2333 students (pre to secondary education). Data on breakfast was provided using a family record form. The intervention consisted of 257 educational sessions addressing the principles of Mediterranean Diet, and promoting a "healthy breakfast at home". To check for compliance with Euro-NP, RTEC package food labels' nutritional composition was used., Results: After intervention 92.9% of children/adolescents had breakfast daily with no report of breakfast skippers. RTECs were one of the most frequent (66.5%) breakfasts. Statistically significant improvements were showed for: daily qualitative and complete breakfast frequency (5.6%) and fruit (11.2%). Consumption of RTEC decreased 28%. According to Euro-NP, 84.6% of the RTECs were non-compliant, regarding sugar content. Children's RTECs presented 5% more of energy and 26% more sugar than the "non-children's" RTECs., Conclusion: EM strategy showed to be a successful program to improve patterns and quality of breakfast of the children and adolescents, reinforcing the importance of school-based nutritional programs in changing lifestyles. Nutrient profiling can be a useful tool to provide a selection of foods to be part of a healthy diet and can be used by policy-makers to design policies to identify the foods to which marketing restrictions to children, will apply.