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Background: Recognizing the positive or negative effects of students' mental health promotes personal development, well-being, and academic success. Academic life exposes college students to multiple adjustments, demands, and vulnerabilities that can cause stress and mental health problems. This study aims to identify psychological well-being and psychological distress effects on college students' mental health. Methods: A correlational study was designed involving a non-probabilistic 560 sample of students (446 women) aged 18 to 41 years (M = 19.6; SD = 1.68). An online self-report questionnaire was used including demographic, relational, academic, and health behaviors variables, and the measures: Mental Health Inventory; Satisfaction with Social Support Scale; Academic Life Satisfaction Scale; and Psychological Vulnerability Scale. Results: Regression analyses indicate that male students, dating, good academic performance, exercise, sleeping seven hours, satisfaction with social support, and academic life satisfaction were significant correlates (p < 0.05) of psychological well-being, with the last two having great weight in the model. Females, low income, aged 21–24 years, sleeping less than 6 h, moderate psychological vulnerability, and perception of vulnerability were significant (p < 0.05) negative effects of psychological distress. Conclusions: This study addresses the positive and negative effects of psychological well-being and distress in college students. Specific mental health promotion and morbidity prevention programs can improve students' mental health literacy and resilience. [ABSTRACT FROM AUTHOR]

Background: Decentralization of a health system is a complex and multidimensional phenomenon that demands thorough investigation of its process logistics, predisposing factors and implementation mechanisms, within the broader socio-political environment of each nation. Despite its wide adoption across both high-income countries (HICs) and low-and-middle-income countries (LMICs), empirical evidence of whether decentralization actually translates into improved health system performance remains inconclusive and controversial. This paper aims to provide a comprehensive description of the decentralization processes in three countries at different stages of their decentralization strategies – Pakistan, Brazil and Portugal. Main body: This study employed a systematic analysis of peer-reviewed academic journals, official government reports, policy documents and publications from international organizations related to health system decentralization. A comprehensive search was conducted using reputable databases such as PubMed, Google Scholar, the WHO repository and other relevant databases, covering the period up to the knowledge cutoff date in June 2023. Information was systematically extracted and organized into the determinants, process mechanics and challenges encountered during the planning, implementation and post-decentralization phases. Although decentralization reforms have achieved some success, challenges persist in their implementation. Comparing all three countries, it was evident that all three have prioritized health in their decentralization reforms and aimed to enhance local decision-making power. Brazil has made significant progress in implementing decentralization reforms, while Portugal and Pakistan are still in the process. Pakistan has faced significant implementation challenges, including capacity-building, resource allocation, resistance to change and inequity in access to care. Brazil and Portugal have also faced challenges, but to a lesser extent. The extent, progress and challenges in the decentralization processes vary among the three countries, each requiring ongoing evaluation and improvement to achieve the desired outcomes. Conclusion: Notable differences exist in the extent of decentralization, the challenges faced during implementation and inequality in access to care between the three countries. It is important for Portugal, Brazil and Pakistan to address these through reinforcing implementation strategies, tackling inequalities in access to care and enhancing monitoring and evaluation mechanism. Additionally, fostering knowledge sharing among these different countries will be instrumental in facilitating mutual learning. [ABSTRACT FROM AUTHOR]

Background: The relationship between the nurse and the patient with mental health disorder is crucial to the recovery process. Thus, patients with mental health disorders should be active subjects in this relationship by having autonomy and self-determination. Methods: This study aimed to explore the perspectives of adult patients with mental health disorders on the relationship with nurses. A qualitative, descriptive, and exploratory study was conducted in March 2023, using focus group meetings in an association to support patients with severe mental health disorders in the Northern region of Portugal. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). A total of 8 patients participated in the study. Two focus group meetings were conducted. The inductive method was used, and content analysis of the transcripts was performed. The QDA Miner Lite 4.0 and Microsoft Excel were used for content analysis. Results: Participants considered the relationship with nurses important for their recovery and expected nurses to provide support and help, being able to identify their needs, thus personalising their care. Attitudinal and communication aspects were also considered crucial for establishing a solid, trusting, and meaningful relationship. Conclusion: According to the findings nursing care is expected to focus on the patient, his/her preferences, expectations, and the uniqueness of each individual. The results of this study may be useful for the reflection and improvement of nurses in their relational and communication skills and the driving force for nursing students' awareness of the perspective of the relationship with patients with mental health disorder and its relevance. [ABSTRACT FROM AUTHOR]

To be successfully established on oceanic islands, native ants (Hymenoptera: Formicidae) have to migrate from the mainland or from nearby islands, crossing the ocean barriers, to find a suitable habitat. Despite the general interest on oceanic islands biotas, nothing is known about the deep-time migration and settling of native ants in these insular ecosystems. Palaeoentomological studies on oceanic islands that could provide palaeobiological information on Formicidae are scarce. Here, we describe and illustrate the first fossil of an ant from the Macaronesian archipelagos (Atlantic Ocean), based on a partial forewing found within 1.3 Ma (Calabrian, Pleistocene) lacustrine sediments from Madeira Island, Portugal. Although unidentifiable beyond the family level, this fossil record provides a minimum age for the presence of ants in the Madeira archipelago. Palaeoecologically, this record indicates the presence of suitable habitats for ants during the early Pleistocene. [ABSTRACT FROM AUTHOR]

Background and Purpose: Previous research shows significant benefits resulting from improving culturally competent nursing care. Thus, the purpose of this study was to translate, adapt, and validate the Cultural Competence Assessment (CCA) in a sample of Portuguese nurses. Methods: A psychometric study of the CCA, after translation into European Portuguese, was performed with a snowball sample of 284 nurses. Participants were asked to fill in a sociodemographic questionnaire and the CCA. Results: The four-factor model of the CCA (Portuguese version) exhibited satisfactory indices of fitness without item nine. Cronbach's alpha was 0.85. Correlations between subscales and the total score scale were strong and statistically significant. Conclusions: These data add to the cultural competence knowledge of nurses to promote better practices and culturally competent care. [ABSTRACT FROM AUTHOR]

• Elemental characterisation of roman copper-based artefacts of SW Iberian Peninsula. • Identification of evolved metallurgy with copper, bronze and leaded bronze alloys. • Examples of alloy selection according to object function and type. • Roman metallurgy influenced by technological, symbolic and economic concerns. The work involved the elemental characterisation by micro energy-dispersive X-ray fluorescence spectrometry of copper-based objects recovered during archaeological works at the neighbouring roman sites of Moinho do Castelinho and Quinta da Bolacha (Lusitania province). The set of 9 artefacts comprised ornaments, tools and implements of different type (fibula, shroud pin, punches, spatula, hook and nail), in addition to small fragments of unknown functionality (a fragmented handle and a small bar). Micro-EDXRF point analyses identified a diversified metallurgy including copper, bronze and leaded bronze, in addition to iron, nickel, arsenic and antimony as minor elements. Furthermore, micro-EDXRF elemental mappings identified the presence of Pb-rich inclusions in the bronze alloys with higher lead content. The composition of these roman artefacts suggests a selection of alloys according to the functionality of the artefact, as evidenced by a nail composed of copper, a handle with a more complex shape made with leaded bronze and a bronze fibula with a higher amount of tin. Finally, the choice of distinct alloys for everyday objects was viewed in the light of technological, symbolic and economic concerns, and compared with the use pattern of roman sites in the western end of the Iberian Peninsula. [ABSTRACT FROM AUTHOR]

The global rise in issues related to the invasion of alien tree species is becoming increasingly prominent. Genus Acacia is one of the most pervasive invaders among the non-native flora introduced to Portugal over the centuries. This research aimed to pinpoint the key players engaged in its management, their expertise, and the methodologies applied to control acacias or decrease affected regions. Data were gathered via an online survey and subjected to diverse statistical analyses. Numerous stakeholders have emerged in recent decades, employing various methods to fight acacia invasion. Mechanical, chemical, and combined methods are the most frequently applied. The findings highlight the need for continued funding for long-term acacia control in the same invaded areas, increased training actions and best practices demonstration in the field and increased public awareness and engagement in local communities and the general public. [ABSTRACT FROM AUTHOR]

Simple Summary: This study characterises microplastics ingested by small cetaceans on the coast of Portugal. The intestine contents of 38 stranded cetaceans were processed in the laboratory to remove as much organic matter as possible from the samples and facilitate the detection of microplastics under a stereomicroscope. This study evaluated the possible influence of several biological and health variables (e.g., species, sex, body condition) on the amount of microplastics found in three small cetacean species, particularly on common dolphins, due to the larger number of available samples. Most of the analysed individuals had microplastics, with harbour porpoises revealing a significantly higher median number of microplastics than common dolphins, probably due to their different diets, use of habitat and feeding strategies. However, none of the other tested variables significantly influenced the number of microplastics in either all of the analysed species or in the common dolphin group. The relatively low numbers of microplastics found in the present study should not be enough to cause physical and chemical sublethal effects, although the potential effects of plastic-derived pollutants are not yet completely understood. Future monitoring of biota should rely on improved and standardised protocols for microplastic analyses. This study characterises microplastics in small cetaceans on the coast of Portugal and assesses the relationship between several biological variables and the amount of detected microplastics. The intestines of 38 stranded dead cetaceans were processed in the laboratory, with digestion methods adapted to the amount of organic matter in each sample. The influence of several biological and health variables (e.g., species, sex, body condition) on the amount of microplastics was tested in all analysed species and particularly in common dolphins, due to the larger number of available samples. Most of the analysed individuals had microplastics in the intestine (92.11%), with harbour porpoises revealing a significantly higher median number of microplastics than common dolphins, probably due to their different diets, use of habitat and feeding strategies. None of the other tested variables significantly influenced the number of microplastics. Moreover, the microplastics found should not be enough to cause physical or chemical sublethal effects, although the correlation between microplastic ingestion and plastic additive bioaccumulation in cetacean tissues requires further investigation. Future monitoring in biota should rely on improved and standardised protocols for microplastic analyses in complex samples to allow for accurate analyses of larger samples and spatio-temporal comparisons. [ABSTRACT FROM AUTHOR]

Background: Worsening environmental conditions may amplify people's emotional responses to an environmental crisis (eco-anxiety). In Portugal, young people seem to be especially concerned about climate change. However, this phenomenon needs to be interpreted using accurate instruments. Thus, this study aimed to validate the Portuguese version of the Hogg Eco-Anxiety Scale (HEAS) in young adults and examine the associations among eco-anxiety, sociodemographic characteristics, and pro-environmental behaviours. Methods: A survey was administered to 623 Portuguese university students aged between 18 and 25 years. The survey included our Portuguese translation of the HEAS (obtained through a back-translation and pretesting process), a sociodemographic assessment, and questions related to pro-environmental behaviours. Confirmatory factor analysis was conducted to assess the construct validity of the Portuguese version of the HEAS, and global fit indices were used to assess whether the original four-dimensional structure of the scale was reproduced. The reliability of the Portuguese version of the HEAS was evaluated by Cronbach's alpha and the intraclass correlation coefficient. Measurement invariance examined sex differences in scale interpretation. Linear regressions were used to detect whether sociodemographic variables predict eco-anxiety and whether eco-anxiety predicts pro-environmental behaviours. Results: The factorial structure of the original scale was replicated in the Portuguese version of the HEAS, showing good internal consistency, reliability over time and strict invariance between men and women. A higher paternal education level predicted greater eco-anxiety in children. Two dimensions of eco-anxiety—namely, rumination and anxiety about personal impacts on the environment—predicted higher engagement in pro-environmental behaviours. Conclusions: The translated scale is an appropriate tool to measure eco-anxiety in the Portuguese context and should be used to collect evidence to drive environmental and health policies. An individual's education level should be considered a determinant of their emotional response to environmental conditions. Importantly, eco-anxiety can act as a protective emotional response to preserving the planet. [ABSTRACT FROM AUTHOR]

Simple Summary: The Iberian harbour porpoise is currently threatened by accidental captures in fisheries (bycatch). Because monitoring cetacean bycatch is particularly challenging, marine mammal stranding networks may provide important information. Between 2000 and 2020, 756 porpoises washed ashore (stranded) on Portuguese and Galician coastlines. The post-mortem analyses of stranded porpoises revealed that the most representative cause of stranding (46.98% of the analysed porpoises) was fishery interaction and another 10.99% was identified as probable fishery interaction. Combining this information with porpoise annual abundance estimates in Portugal available for the period between 2011 and 2015, an estimated average of 207 porpoises died each year due to bycatch in Portuguese waters alone. This estimate greatly surpassed the maximum annual number of porpoise strandings due to human interactions (22 porpoises) that were predicted to occur without negatively affecting the population in Portuguese waters. To prevent porpoise bycatch in Portugal and Spain, fishing effort management is needed and new activities at sea must be carefully considered. Moreover, appropriate measures directed at the conservation of the Iberian harbour porpoise are crucial to ensure the restoration and survival of the population. The Iberian harbour porpoise population is small and fisheries bycatch has been described as one of its most important threats. Data on harbour porpoise strandings collected by the Portuguese and Galician stranding networks between 2000 and 2020 are indicative of a recent mortality increase in the western Iberian coast (particularly in northern Portugal). Overall, in Portugal and Galicia, individuals stranded due to confirmed fishery interaction represented 46.98% of all analysed porpoises, and individuals stranded due to probable fishery interaction represented another 10.99% of all analysed porpoises. Considering the Portuguese annual abundance estimates available between 2011 and 2015, it was possible to calculate that an annual average of 207 individuals was removed from the population in Portuguese waters alone, which largely surpasses the potential biological removal (PBR) estimates (22 porpoises, CI: 12–43) for the same period. These results are conservative and bycatch values from strandings are likely underestimated. A structured action plan accounting for new activities at sea is needed to limit the Iberian porpoise population decline. Meanwhile, there is an urgent need for a fishing effort reorganization to directly decrease porpoise mortality. [ABSTRACT FROM AUTHOR]

Candida auris is an opportunistic human pathogen that has rapidly spread to multiple countries and continents and has been associated with a high number of nosocomial outbreaks. Herein, we report the first case of C. auris in Portugal, which was associated with a patient transferred from Angola to an ICU in Portugal for liver transplantation after a SARS-CoV-2 infection. C. auris was isolated during the course of bronchoalveolar lavage, and it was subjected to antifungal susceptibility testing and whole-genome sequence analysis. This isolate presents low susceptibility to azoles and belongs to the genetic clade III with a phylogenetic placement close to African isolates. Although clade III has already been reported in Europe, taking into account the patient's clinical history, we cannot discard the possibility that the patient's colonization/infection occurred in Angola, prior to admission in the Portuguese hospital. Considering that C. auris is a fungal pathogen referenced by WHO as a critical priority, this case reinforces the need for continuous surveillance in a hospital setting. [ABSTRACT FROM AUTHOR]

This article explores the characteristics and contexts for use of the shirt in Portugal between the end of the 14th century and beginnings of the 15th century. The shirt's use as nightwear is discussed, as well as its relationship with the body and nudity. Formats and materials for the shirt are also analysed through the lens of the different social statuses of the wearers, and with regard to the more general social context of Portugal and the Portuguese at that time. [ABSTRACT FROM AUTHOR]

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Wildfires can cause serious imbalances in ecosystems, primarily at the soil level, making it vulnerable to degradation processes such as erosion. During and after a fire, changes occur in soil properties, including pH, which affects the solubility and availability of nutrients. Currently, there is a great diversity of protocols, some involving normalized standards, to determine soil pH, but there is no consensual or universal analytical method for this parameter, especially in burned soils, in which mineral and organic fractions could have been modified. Therefore, the objective of the present work is to evaluate the effect that variations in these analytical protocols may have on pH results. For this, five methods commonly found in the international bibliography for the analysis of pH of soil in water (pHH2O) were selected and compared to propose the most precise procedure. The analytical methods were applied to 43 soil samples, collected in a plot subjected to prescribed burning in the Parque Natural de Montesinho (Northern Portugal). The studied methods differ in the following protocol items: water suspension ratio (1:2.5 or 1:5), mechanical stirring time in the suspension (10 min or 1 h), and in the resting time for the solid particles to settle (15 min or 8 h). The obtained results point to the suitability of the five methods used for soil pH analysis, indicating that there are no statistically significant differences. However, results also allow suggesting a more appropriate method concerning practical reasons, such as labor in a lab. Thus, to make the analysis process more profitable, M2 is a good option because it uses a small amount of sample (5 g), short agitation (10 min) and settling time (15 min). In turn, M1 and M5, which use a lower proportion of soil (1:2.5) show lower pH variation in the measurements. This fact may be explained by a smaller dilution effect. Considering that these two methods differ in the settling time, it is suggested to apply M1, because only 15 min are required. Therefore, the main conclusion reached with this work is that the measurement of soil pH using M1, i.e., a soil:water ratio of 1:2.5, with agitation of 10 min and settling time of 15 min, is a robust and more expeditious protocol to be applied to soil samples after a fire. [ABSTRACT FROM AUTHOR]

Palaearctic Erica sect. Chlorocodon, known as the wind‐pollinated besom heaths (WPBH), includes the Macaronesian E. azorica, E. platycodon subsp. platycodon and E. platycodon subsp. maderincola together with the Mediterranean and North African E. scoparia. Despite the broad extant distribution, the mainland fossil record of this section is scarce and poorly preserved and dated, and Macaronesian fossils were so far unknown. Here we discuss the systematic affinities of the first fossils of a WPBH found in Macaronesia, within a 1.3 Ma (Pleistocene, Calabrian stage) Madeira Island fossiliferous deposit. One flower and dissociated seed fossils were found in the same sediment layer, being preserved as coalified compressions with cuticular preservation. Both the flower and seed fossils present unique WPBH characters. The flower fossil is characterised by an exserted, peltate and discoid stigma – an unequivocal adaptation to anemophily, unique within Palaearctic Erica taxa. The seed fossils are of small size, presenting a testa with channelled anticlinal cell‐walls, a characteristic only found in the extant Macaronesian WPBH. Morphological, anatomical, and biometric comparisons of the fossils to extant flowers and seeds suggest that the fossils are related to the Palaearctic E. sect. Chlorocodon, being morphologically close to E. azorica. Here we assign them to E. aff. azorica. These findings suggest a colonisation to Madeira Island prior to 1.3 Ma, corresponding to the oldest and unambiguous WPBH fossils, at least 0.90–1.2 Ma older than the oldest known record. The fossil flower also indicates the presence of anemophilous traits since at least the early Pleistocene. Finally, the presence of a WPBH could suggest the same ecological role in seral communities, important to the establishment of the Madeiran temperate stink‐laurel forest. [ABSTRACT FROM AUTHOR]

Angiosperms present an astonishing diversity of genome sizes that can vary intra‐ or interspecifically. The remarkable new cytogenomic data shed some light on our understanding of evolution, but few studies were performed with insular and mainland populations to test possible correlations with dispersal, speciation, and adaptations to insular environments. Here, patterns of cytogenomic diversity were assessed among geographic samples (ca. 114) of Crithmum maritimum (Apiaceae), collected across the Azores and Madeira archipelagos, as well as in adjacent continental areas of Portugal. Using flow cytometry, the results indicated a significant intraspecific genome size variation, spanning from reduced sizes in the insular populations to larger ones in the mainland populations. Moreover, there was a tendency for an increase in genome size along the mainland populations, associated with lower temperatures, higher precipitation, and lower precipitation seasonality. However, this gradient might be the result of historic phylogeographical events associated with previous dispersal and extinction of local populations. Overall, our findings provided evidence that smaller genome sizes might play a critical role in the colonization of islands, corroborating other studies that argue that organisms with smaller genomes use fewer resources, having a selective advantage under insular environments. Although further studies are needed to improve our understanding of the mechanisms underlying genome size evolution on islands, conservation strategies must be promoted to protect the rich cytogenomic diversity found among C. maritimum populations, which occur in coastal areas that are particularly threatened by human activity, pollution, invasive species, and climate changes. [ABSTRACT FROM AUTHOR]

The mental health of higher education students is a constant concern, and the pandemic situation caused by COVID-19 has intensified this concern. The social measures imposed to control and minimize the disease have led, among other things, to the reconfiguration of higher education students' academic life habits, which has naturally altered their emotional balance, mental health, and substance abuse. This cross-sectional, descriptive, and correlational study assesses the influence of higher education students' personal characteristics on their (self-reported) use of addictive substances (alcohol, tobacco, drugs, and pharmaceutical drugs) before and during their first compulsory confinement in Portugal, as well as its relationship with mental health. An online questionnaire was applied between 15 April and 20 May 2020, to students from various study cycles of higher education institutions in one region of Portugal (northern area of Alentejo), which included the Mental Health Inventory in its reduced version (MHI-5) and questions (constructed by the authors) on personal characterization and on the use of addictive substances before and during confinement. The convenience sample included 329 mostly female health care students between the ages of 18 and 24. In our results, we found a statistically significant decrease in tobacco, alcohol, and drug use; however, there was an increase in tobacco use among older students and an increase in anxiolytic use among students with higher academic achievement and among students who exhibited more active social behavior in the period prior to confinement. Students who took anxiolytics during confinement had higher MHI-5 scores and students who used the most addictive substances during confinement had lower MHI-5 scores than the other students. [ABSTRACT FROM AUTHOR]

Authors describe some alternative conceptions held by Portuguese physics students about mechanics and compare students' scientific conceptions with the evolution of historical ideas. Authors contend that teacher knowledge about the history of science can facilitate teaching for conceptual change in physics. (over 20 references) (Authors/PR)

Background: Psychological vulnerability (PV) indicates the individual's inability to adapt to stressful situations. Adolescents experience negative impacts on their future mental health if they do not acquire the skills and knowledge necessary to have good mental health during their developmental stage. Aim: To compare the PV index among the three stages of adolescence and to explore the factors involved in good mental health, including the relationship between adolescents' PV indices and sociodemographic variables, and the relationship between adolescents' PV index and their knowledge of the factors that characterize good mental health. Method: An exploratory, cross-sectional, correlational study was carried out in three public schools in a region of Portugal, using online self-completed questionnaires: the Psychological Vulnerability Scale (PVS) and the Mental Health-Promoting Knowledge (MHPK-10). Results: Our convenience sample consisted of 260 adolescents, with a mean age of 14.07 years who were students between 5th and 12th grades, mostly female. Moderate PV indexes were obtained that were higher in late adolescence, i.e., in older adolescents, who were females in a more advanced school year, with worse self-perceptions of their physical and mental health and body image, and who frequently used a health service due to mental health problems. The association between the PV index and the level of knowledge about the factors involved in good mental health did not reach a statistical significance (p = 0.06). Conclusions: These results suggest a need for a design of personalized interventions that promote adolescents' mental health literacy, that prevent PV, and that should be initiated in early adolescence. [ABSTRACT FROM AUTHOR]

Ferric carboxymaltose (FCM) can be used in Patient Blood Management (PBM) to promote the optimization of preoperative haemoglobin (Hb), which aims to minimise the use of allogeneic blood components and improve clinical outcomes, with better cost-effectiveness. This was an observational study conducted in a retrospective and multicentre cohort with adults from elective orthopaedic, cardiac and colorectal surgeries, treated according to local standards of PBM with allogeneic blood product transfusions (ABTs) on demand and with FCM to correct iron deficiency with or without anaemia. In this work, only the first pillar of the PBM model issue by Directorate-General for Health (DGS) was evaluated, which involves optimising Hb in the preoperative period with iron treatment if it's necessary/indicated. Before the implementation of PBM in Portugal, most patients did not undergo preoperative laboratory evaluation with blood count and iron kinetics. Therefore, the existence of Iron Deficiency Anaemia (IDA) or Iron Deficiency (ID) without anaemia was not early detected, and there was no possibility of treating these patients with iron in order to optimise their Hb and/or iron stores. Those patients ended up being treated with ABTs on demand. A total of 405 patients from seven hospitals were included; 108 (26.7%) underwent FCM preoperatively and 197 (48.6%) were transfused with ABTs on demand. In the FCM preoperative cohort, there was an increase in patients with normal preoperative Hb, from 14.4 to 45.7%, before and after FCM, respectively, a decrease from 31.7 to 9.6% in moderate anaemia and no cases of severe anaemia after FCM administration, while 7.7% of patients were severely anaemic before FCM treatment. There were significant differences (p < 0.001) before and after correction of preoperative anaemia and/or iron deficiency with FCM in Hb, serum ferritin and transferrin saturation rate (TS). In the ABT group, there were significant differences between pre- and postoperative Hb levels (p < 0.001). Hb values tended to decrease, with 44.1% of patients moving from mild anaemia before transfusion to moderate anaemia in the postoperative period. Concerning the length of hospital stay, the group administered with ABTs had a longer hospital stay (p < 0.001). Regarding the clinical outcomes of nosocomial infection and mortality, there was no evidence that the rate of infection or mortality differed in each group (p = 0.075 and p = 0.243, respectively). However, there were fewer nosocomial infections in the FCM group (11.9% versus 21.2%) and mortality was higher in the transfusion group (21.2% versus 4.2%). Economic analysis showed that FCM could reduce allogenic blood products consumption and the associated costs. The economic impact of using FCM was around 19%. The preoperative Hb value improved when FMC was used. Patients who received ABTs appeared to have a longer hospital stay. The FCM group reported fewer infections during hospitalisation. The economic results showed savings of around €1000 for each patient with FCM administration. The use of FCM as part of the PBM program had a positive impact on patients' outcomes and on economic results. However, it will be essential to perform studies with a larger sample to obtain more robust and specific results. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify the mortality rate of cardiac arrest in our institution and to determine the association between clinical available variables with early mortality and neurological outcomes. Design, setting, and patients: We performed a retrospective study including all adult patients with the first diagnosis of "cardiac arrest" admitted to the intensive care unit of a Portuguese tertiary hospital, from 2015 to 2020. Outcomes were early mortality, including in-hospital and 1 month after discharge mortality, and neurological function after cardiac arrest as defined by the Cerebral Performance Category score scale. Results: 114 patients were included, 32 suffered from out-of-hospital cardiac arrest, and 82 from in-hospital cardiac arrest. In multivariate logistic analysis, a Glasgow Coma Score after the return of spontaneous circulation less than five and the existence of another cause for cardiac arrest than ST-segment elevation myocardial infarction demonstrated to be predictive factors of early mortality. The poor neurological outcome was associated with a total cardiopulmonary resuscitation length greater than five minutes and a Glasgow Coma Score after the return of spontaneous circulation less than five. Conclusions: Cardiac arrest is still an important cause of morbimortality in our society. Efforts should be made to optimize its approach, minimizing the cardiorespiratory arrest length to reduce mortality and improve the neurologic prognosis of survivors. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of the psychoeducational programme "Living together with dementia" applied to a group of family caregivers of people with dementia. Design and Methods: A quasi‐experimental study with pretest and posttest and a 4‐month follow‐up. Fifteen family caregivers of people with dementia were recruited in a community care unit in northern Portugal. Results: A positive and statistically significant impact on these caregivers' burden was found. Practice Implications: The programme could be an important mechanism to train family caregivers of home‐dwelling people with dementia. [ABSTRACT FROM AUTHOR]

Target species diversification is essential for fisheries sustainability and fish market revitalization. Fish discards are a widely recognized problem resulting from fisheries worldwide, and are of major concern for all sector players, from administrations, to fishermen, and scientists. However, non‐target species are seldom studied, and information on nutritional profiles and seasonal changes in nutritional properties is generally lacking. This study assessed the seasonal nutritional composition of two unexploited (Serranus cabrilla, Capros aper) and three low commercial value fish species (Trachurus picturatus, Spondyliosoma cantharus, and Trigla lyra), captured on the Portuguese coast over 1 year. Significant seasonal variations were observed in the nutritional composition of all the species studied. Moisture and ash contents varied from 70% to 81% and from 5% to 13%, respectively. The maximum fat contents were 5% for C. aper and 4% for T. picturatus, allowing to classify all studied fishes as lean. The highest protein contents were recorded for C. aper (25%) and S. cantharus (20%). The unexploited and low commercial value fish species studied were shown to be good fat and protein sources, comparable to commonly consumed species, such as cod and salmon, having a great potential to become commonly consumed fish in Portugal. [ABSTRACT FROM AUTHOR]

Background: Using data from electronic health registries, this study intended to estimate the COVID-19 vaccine effectiveness (VE) in the population aged 65 years and more, against symptomatic infection, COVID-19-related hospitalizations, and deaths, overall and by time since complete vaccination for the period February to September 2021 Methods: We established a cohort of individuals aged 65 and more years old, resident in Portugal mainland, using the National Health Service User number to link eight electronic health registries. Outcomes included were symptomatic SARS-CoV-2 infections, COVID-19-related hospitalizations or deaths. The exposures of interest were the mRNA vaccines (Comirnaty or Spikevax) and the viral vector (Vaxzevria) vaccine. Complete schedule VE was estimated as one minus the confounder adjusted hazard ratio, for each outcome, estimated by time-dependent Cox regression with time-dependent vaccine exposure. Results: For the cohort of individuals aged 65–79 years, complete scheme VE against symptomatic infection varied 43 (95%CI: 37–49) (Vaxzevria) and 65 (95%CI: 62–68) (mRNA vaccines). This estimate was slightly lower in the ≥80 years cohort (53, 95%CI: 45–60) for mRNA vaccines). VE against COVID-19 hospitalization varied between 89% (95%CI: 52–94) for Vaxzevria and 95% (95%CI: 93–97) for mRNA vaccines for the cohort aged 65–79 years and was 76% (95%CI: 67–83) for mRNA vaccines in the ≥80 years cohort. High VE against COVID-19-related deaths was estimated, for both vaccine types, 95% and 81 (95%CI:76–86) for the 65–79 years and the ≥80 years cohort, respectively. We observed a significant waning of VE against symptomatic infection, with VE estimates reaching approximately 34% for both vaccine types and cohorts. Significant waning was observed for the COVID-19 hospitalizations in the ≥80 years cohort (decay from 83% (95%CI:68 to 91) 14–41 days to 63% (95%CI:37 to 78) 124 days after mRNA second dose). No significant waning effect was observed for COVID-19-related deaths in the period of follow-up of either cohort. Conclusions: In a population with a high risk of SARS-CoV-2 complications, we observed higher overall VE estimates against more severe outcomes for both age cohorts when compared to symptomatic infections. Considering the analysis of VE according to time since complete vaccination, the results showed a waning effect for both age cohorts in symptomatic infection and COVID-19 hospitalization for the 80 and more years cohort. [ABSTRACT FROM AUTHOR]

Worldwide, the COVID‐19 pandemic has had a disruptive effect on daily routines, especially for university students. This study aimed to compare pre‐pandemic domains of students' mental health during the pandemic lockdown. One cross‐sectional study was conducted in two waves with academic students from 20 Portuguese universities, in March 2020 before the COVID‐19 pandemic (n = 3579) and 2 months after the first lockdown in May 2020 (n = 1228). The Positive Mental Health Questionnaire (PMHQ), the Mental Health Knowledge Questionnaire, the Mental Health‐promoting knowledge, and the Psychological Vulnerability Scale were used. Statistical analyses were performed by bivariate associations and multiple linear regression models. Students were mostly women (79%), with an average age of 23.2 years (SD = 6.6), displaced from their family environment (43%), out‐of‐home (43%), and scholarship holders (37%). Higher scores found in the PVS were associated with decreased PMHQ in both moments (P < 0.01). These cross‐sectional studies showed a slight variation in the mental health variables studied in the period before and during the COVID‐19 outbreak. Being a woman, younger, out‐of‐home, and having a scholarship (P < 0.01) seem to increase susceptibility to mental health variation before and during the pandemic. Universities should develop strategies that promote students' mental health. [ABSTRACT FROM AUTHOR]

Simple Summary: The Iberian porpoise inhabits the Atlantic coast of Portugal and Spain. The population is relatively small and there is a high number of individuals accidentally captured in fisheries. Using airplane surveys, we estimated that there were only 2254 porpoises overall between 2011 and 2015 in the coast of Portugal. The highest annual number of porpoises was recorded in 2013 (3207 individuals). However, in the following year, our study revealed that the population had been reduced approximately by half (when an increase in stranded individuals was also registered). The northern area of Portugal presented the most suitable habitat for the Iberian harbour porpoise, where coastal fisheries represent a particularly important socio-economic activity. Measures to decrease fishing effort are urgently needed as well as detailed information on seasonal Iberian harbour porpoises' use of space. The Iberian porpoise population is small and under potentially unsustainable removal by fisheries bycatch. Recently, a marine Site of Community Importance (SCI) was legally approved in Portugal, but no measures ensued to promote porpoise conservation. Information about porpoise abundance and distribution is fundamental to guide any future conservation measures. Annual aerial surveys conducted between 2011 and 2015 show a low overall porpoise abundance and density (2254 individuals; 0.090 ind/km2, CV = 21.99%) in the Portuguese coast. The highest annual porpoise estimates were registered in 2013 (3207 individuals, 0.128 ind/km2), followed by a sharp decrease in 2014 (1653 individuals, 0.066 ind/km2). The porpoise density and abundance estimated in 2015 remained lower than the 2013 estimates. A potential distribution analysis of the Iberian porpoise population was performed using ensembles of small models (ESMs) with MaxEnt and showed that the overall habitat suitability is particularly high in the Portuguese northern area. The analysis also suggested a different pattern in porpoise potential distribution across the study period. These results emphasize the importance of further porpoise population assessments to fully understand the spatial and temporal porpoise habitat use in the Iberian Peninsula as well as the urgent need for on-site threat mitigation measures. [ABSTRACT FROM AUTHOR]

Purpose: To build the final clinical data models regarding the nursing focuses "Delusion" and "Hallucination" with Meleis transitions theory as the theoretical reference model. Design and Methods: A qualitative descriptive design was adopted, using two focus groups. Findings: The clinical data models obtained by this study recognize a perspective centered on the client's transition, which emphasizes the role of nursing in relation to a client suffering from delusion and hallucination. Implications for Nursing Practice: These clinical data models may contribute towards improving nursing clinical decision‐making and nursing care quality regarding these areas. [ABSTRACT FROM AUTHOR]

Recent evidence suggests that both personality traits (PT) and emotion regulation (ER) strategies play an important role in the way people cope with the COVID-19 pandemic. The aim of this study was two folded. First, to longitudinally investigate the psychological distress (depression, anxiety, and stress levels) taking in consideration PT and ER strategies in 3 different moments: during the first lockdown period (April/20), at the first deconfinement (May/20) and 1-month after the first deconfinement (Jun/20)–Experiment I. Second, to cross-sectionally evaluate the impact of the pandemic in psychological distress and the correlates with PT and ER 6-months after the first deconfinement November/20 to February/21 –Experiment II. A total of 722 volunteers (Experiment I = 180; Experiment II = 542) aged 18 years or older participated in this online survey. The findings from Experiment I show that psychological distress decreased after the lockdown period, however, neuroticism traits predicted higher levels of depression, anxiety and stress symptoms, while difficulties in ER strategies were identified as a risk factor for depression and stress. For experiment II, neuroticism traits and being infected with COVID-19 were associated to higher levels of symptomatology, while unemployment and the use of emotional suppression strategies to cope with emotional situations were associated to depressive and anxiety symptoms. Although the psychological impact of the COVID-19 outbreak decreased over time in our sample, the current findings suggest that difficulties in emotional regulation and high levels of neuroticism traits might be potential risk factors for psychiatric symptomatology during the COVID-19 pandemic. Thus, people with difficulties in ER and neuroticism traits would benefit from psychological interventions that provide personality-appropriate support and promote emotion regulation skills during stressful events, such as the case of the global pandemic. [ABSTRACT FROM AUTHOR]

Bulk density for shrubs and tree crowns is an important variable, useful for many purposes, namely estimations for biomass and carbon sequestration and potential fire behavior prediction. In the latter case, bulk density is required to predict the rate of spread and intensity of crown fires. However, bulk density information is scarce. The estimation of bulk density is crucial to help choosing proper pyrosilviculture options to decrease fire susceptibility. Due to the similar environmental conditions and fuel characteristics in Portugal and Spain, we modelled bulk density for the most common woody species in all the Iberian Peninsula. We used 10 different shrub type formations and a set of tree species or groups common to both countries. Equations for bulk density, in both forest canopy and understory layers, were fitted as a function of biometric variables commonly used in forest inventories for the selected species. Standardized estimates of bulk density can be associated with data from the National Forest Inventories from Portugal and Spain, to estimate biomass of the forest ecosystems and to evaluate potential fire behavior involving tree canopies and shrubs. [ABSTRACT FROM AUTHOR]

Mental Health First Aid Training Programmes are educational interventions that aim to disseminate basic first aid skills in the community. Adolescents in the context of their secondary school education are a particularly appropriate population for literacy promotion interventions. This study explores adolescents' perspectives on Mental Health First Aid Training Programmes promoted by nurses in Portuguese upper secondary schools. A qualitative and exploratory study was conducted. Data were collected through semi‐structured interviews with 12 adolescents who participated voluntarily and with the consent of their parents. Data were analysed using content analysis. Fourteen themes were identified around three main areas: (i) Relevance of training programmes, (ii) Content of training programmes and (iii) Intervention methods of training programmes. The results obtained indicate that adolescents consider Mental Health First Aid Training Programmes in school relevant and necessary. Adolescents identified the content they deemed most appropriate and how it could be taught. These results can guide the development of training programmes. Nurses should take the lead in implementing these interventions in schools. Adolescents can take a more active role in mental health issues by improving their literacy. [ABSTRACT FROM AUTHOR]

Theoretical and empirical studies suggest that the structure and position of hybrid zones can change over time. Evidence for moving hybrid zones has been directly inferred by repeated sampling over time, or indirectly through the detection of genetic footprints left by the receding species and the resulting asymmetric patterns of introgression across markers. We here investigate a hybrid zone formed by two subspecies of the Iberian golden‐striped salamander, Chioglossa lusitanica, using a panel of 35 nuclear loci (31 SNPs and 4 allozymes) and one mitochondrial locus in a transect in central Portugal. We found concordant and coincident clines for most of the nuclear loci (n = 22, 63%), defining a narrow hybrid zone of ca. 6 km wide, with the centre positioned ca. 15 km south of the Mondego River. Asymmetric introgression was observed at another 14 loci. Their clines are displaced towards the north, with positions located either close to the Mondego River (n = 6) or further northwards (n = 8). We interpret these profiles as genetic traces of the southward displacement of C. lusitanica lusitanica by C. l. longipes over the wider Mondego River valley. We noted the absence of significant linkage disequilibrium, and we inferred low levels of effective selection per locus against hybrids, suggesting that introgression in the area of species replacement occurred under a neutral diffusion process. A species distribution model suggests that the C. lusitanica hybrid zone coincides with a narrow corridor of fragmented habitat. From the position of the displaced clines, we infer that patches of locally suitable habitat trapped some genetic variants that became disassociated from the southward moving hybrid zone. This study highlights the influence of habitat availability on hybrid zone movement. [ABSTRACT FROM AUTHOR]

This article is an exploratory attempt to address the colonial ambivalence implicit in contemporary moving images in the Portuguese context. The postcolonial turn that emerged in the last decades in Portugal attests to an earnest attempt to problematise the nation's postcolonial condition, which in turn derives from a long-overdue admission that our contemporary societies were built from colonial plunder. Drawing heavily on the critique of Lusophony, I argue that this postcolonial turn is also a consequence of the need to inscribe the Portuguese national narrative within an increasingly global world arising from the subordination of culture to the "laws of the market". In addition, I argue that this post-colonial approach found in Portuguese contemporary visual culture is ambivalent since it tends to ignore the problem of the legitimacy and the speaking position of the artist and/or intellectual. The legitimacy problem -- of who speaks of and about others -- is often paradoxically disregarded in contemporary audiovisual productions that address the Portuguese colonial past and its postcolonial condition. In the same way, the intrinsic relationship between visual production and knowledge is ignored, and consequently, between visual production and power. In this way, I argue that colonial ambivalence continues to pervade cultural discourses and contemporary artistic practices today, even when such practices and discourses appear to articulate a postcolonial critique. [ABSTRACT FROM AUTHOR]

Cervical cancer remains a health concern. Effective screening programs are critical to reduce the incidence and mortality. High‐risk HPV (hr‐HPV) testing as primary screening tool discloses high sensitivity but suboptimal specificity. Adequate triage tests to reduce unnecessary colposcopy referrals and overdiagnosis/overtreatment are crucial. Hence, we aimed to validate a panel of DNA methylation‐based markers as triage test for women hr‐HPV+ in the population‐based Regional Cervical Cancer Screening Program of Northern Portugal. Firstly, CADM1, MAL, FAM19A4 and hsa‐miR124‐2 promoter methylation levels were assessed by multiplex QMSP in a testing set of 402 FFPE tissue samples (159 normal samples and 243 cervical lesions, including 39 low‐grade intraepithelial squamous lesions [LSIL], 59 high‐grade intraepithelial squamous lesions [HSIL] and 145 cancerous lesions). Then, preliminary validation was performed in 125 hr‐HPV+ cervical scrapes (including 59 normal samples, 30 LSIL, 34 HSIL and 2 cancerous lesions). Higher MALme, FAM19A4me and hsa‐miR124‐2me methylation levels were disclosed in histological HSIL or worse (HSIL+) in testing set. Individually, markers depicted over 86% specificity for HSIL+ detection. In validation set, all these genes significantly differed between histological HSIL+ and low‐grade squamous intraepithelial lesions or less. In combination, these markers reached 74% specificity and 61% sensitivity for identification of histological HSIL+. We concluded that host gene methylation might constitute a useful referral triage tool of hr‐HPV+ women enrolled in the Cervical Cancer Screening Program of Northern Portugal. What's new? For cervical cancer screening, high‐risk HPV (hr‐HPV) testing is highly sensitive, but for those who test positive, a more specific test is needed to reduce unnecessary colposcopy. Here, the authors validated a panel of DNA methylation‐based markers to screen hr‐HPV+ women. They measured promoter methylation of four genes, CADM1, MAL, FAM19A4, and hsa‐miR124‐2, in cervical samples including normal tissue, low‐ and high‐grade squamous intraepithelial lesions (LSIL and HSIL) and cancerous lesions. The markers showed 74% specificity for HSIL or cancer, indicating that DNA methylation could be a useful triage tool for hr‐HPV+ women. [ABSTRACT FROM AUTHOR]

Liquidation plays a key role within insolvency proceedings, as it consists in the sale of the assets of the insolvent estate. In this article, we aim to provide an overview of the main issues and difficulties that, in practice, arise at the time of liquidation. Therefore, by providing a framework for the general regime, we seek to address, on the one hand, those cases which, in some way, "deviate" from normal proceedings and, on the other hand, situations which require greater caution. [ABSTRACT FROM AUTHOR]

Aim: To identify and compare workaholism, engagement and family interaction levels among Portuguese and Spanish nurses. Background: The contribution of nursing management and leadership to workers' health and well‐being is cardinal to ensure a healthy work environment. However, factors such as workaholism, engagement and family interaction can strongly influence nurses' performance, well‐being and safety. Method: A multicentre, comparative and cross‐sectional study using 333 Portuguese (54.1%) and Spanish (45.9%) nurses working in hospitals. Results: Portuguese nurses showed higher levels for workaholism, negative work–family interaction and negative family–work interaction, while Spanish nurses presented higher levels of engagement, positive work–family interaction and positive family–work interaction. Gender, age, job experience time, academic training, working schedule and type of employment contract influenced workaholism, engagement and work–family interaction among nurses from both countries. Conclusion: During their professional practice, nurses perceived their stress differently according to each country, with Portuguese nurses presenting worst psychological conditions than Spanish nurses, namely higher workaholism, negative work–family interactions and lower engagement. Implications for Nursing Management: Workaholism, engagement and work–family interaction are important areas in which nursing managers must invest to better respond to the new challenges of work contexts. [ABSTRACT FROM AUTHOR]

Background: Fingolimod, an oral sphingosine 1-phosphate receptor modulator, is approved by EMA for relapsing-remitting multiple sclerosis (RRMS). Objectives: To assess the effectiveness and safety of fingolimod in patients with RRMS in real-world clinical practice in Portugal. Methods: Retrospective, multicentre, non-interventional study, reporting 3 years follow-up of data collected from October 2015 to July 2016. Sociodemographic data and previous treatments at baseline and data regarding disease evolution, including number of relapses, annualised relapse rates (ARR) and Expanded Disability Status Scale (EDSS), were collected. Results: Two-hundred and seventy-five participants were enrolled in the REALMS study. Results showed that the main reason to switch to fingolimod was failure of previous treatment (56.7%) and only 3.6% were naïve patients. In the total population, there was a significant decrease in ARR of 64.6% in the first year of treatment, 79.7% in the second year and 82.3% in the third year, compared with baseline. More than 67.0% of patients had no relapses during the 3 years after switching to fingolimod. EDSS remained stable throughout the study. Conclusions: Therapy with fingolimod showed a sustained effectiveness and safety over the 3 years, particularly on patients switched from first-line drugs (BRACE). No new safety issues were reported. [ABSTRACT FROM AUTHOR]

The History magazine, from the Faculty of Arts of the University of Porto, has published the second volume of the year 2022, which addresses the bicentennial of Brazil's Independence. The objective of the thematic dossier was to analyze Brazil's independence from different aspects, such as political-diplomatic, socio-economic, institutional, and cultural. In addition to the relationship between Portugal and Brazil, the dossier also considered other international connections in the American, European, and African continents. The magazine also included articles on Vintism, the Cortes of Lisbon and the Independence of Brazil, the spread of civic republicanism in the Court of Rio de Janeiro, and the political-diplomatic strategies and recognition of Brazilian sovereignty by Portugal. The edition also features book reviews on current topics. The Editorial Committee thanks the authors and reviewers for their participation and highlights the collaboration of the Library of the Faculty of Arts of the University of Porto. [Extracted from the article]

The emergence of potentially dangerous new psychoactive substances (NPS) is challenging for forensic laboratories, as well as the ability to develop and validate methods for a rapid and unambiguous monitoring of these compounds. Thereupon, the aim of this work was to establish a methodology for the identification and quantification of four synthetic cathinones already seized in Portugal [4-chloroethcathinone (4-CEC), α-pyrrolidinovalerophenone (α-PVP), 4-chloro-pyrrolidinovalerophenone (4-Cl-PVP) and methylenedioxypyrovalerone (MDPV)] in whole blood samples, using gas chromatography coupled to mass spectrometry (GC–MS). The analytes were extracted from blood by solid-phase extraction (SPE) and derivatized with N -methyl- N -(trimethylsilyl)trifluoroacetamide (MSTFA) with 5% trimethylchlorosilane (TMCS). For all analytes, linearity was observed from 25 (lower limit of quantification, LLOQ) to 800 ng/mL, with coefficients of determination higher than 0.99. The limits of detection (LOD) were 5 ng/mL for α-PVP, 4-Cl-PVP and MDPV and 25 ng/mL for 4-CEC. The method was selective, precise and accurate, and the extraction efficiency was higher than 85% for all analytes. The target cathinones were stable under different stock conditions, being MDPV the most stable and 4-CEC the least stable compound. The validated analytical method was then applied to real samples that previously tested positive for amphetamines, but no positive samples were found for the cathinones under study. The present method describes for the first time the quantification of 4-CEC and 4-Cl-PVP in whole blood samples by GC–MS, allowing their accurate determination in forensic situations where the compounds are involved. [ABSTRACT FROM AUTHOR]

Background: This paper fills a gap in the applied research field, for a local context, by addressing the topics of describing cataract surgery' clinical outcomes; quality of life (QoL); and costs of the patients treated after the implementation of the ICHOM standard set.Methods: This is a retrospective observational study using real-world data (RWD). We included all patients subjected to cataract surgery at the Portuguese Institute of oncology - Porto (IPO-Porto), Portugal, after 3 months follow up period completed between 5th June 2017 and 21st May 2018. The following inclusion criteria: corrected visual acuity of ≤ 6/10 or other significant visual disturbance due to lens opacity or the existence of a large anisometropia. A circuit was implemented based on the ICHOM standard for cataract, to measure clinical variables (e.g. visual acuity) and QoL (CATQUEST-9SF) before and after surgery, and cost of treatment. The results were explored by means of a paired-sample t-test, considering normality assumptions.Results: Data refers to 268 patients (73 P25-P75:32-95 years old), regarding 374 eyes. The cataract surgery had a positive effect on visual acuity (p < 0.001), refraction (right and left cylinder; p < 0.001) and all QoL dimensions. The vast majority of patients, around 98%, reported improvements in QoL. Based on IPO-Porto administrative records, the direct cost of treating cataracts (per eye) is of 500€, representing a total cost of 187,000€ for the number of patients operated herein.Conclusion: This study reports the successful implementation of the ICHOM standard set for cataracts in a Portuguese institution and confirms that cataract surgery provides a rapid visual recovery, with excellent visual outcomes and minimal complications in most patients, while also having a positive impact on patients' quality of life. [ABSTRACT FROM AUTHOR]

The aim of this article was to present the preliminary results of a training programme for family caregivers of people with dementia at an early to moderate stage living at home – 'Living Together With Dementia'. In this randomised controlled trial, 27 family caregivers who met the inclusion criteria were recruited from the neurology outpatient consultation clinic of a hospital in the north of Portugal and randomised into two groups (control and experimental) between October 2015 and March 2016. The programme 'Living Together With Dementia' was applied to the participants of the experimental group. The strategies used, overload, difficulties and satisfaction of the caregivers were assessed at three different stages (at the beginning and end of the intervention, as well as at follow‐up). For the data analysis, quantitative parametric measures were applied. The Health Ethical Commission of the Hospital Centre approved the study, and its protocol and Helsinki Declaration ethical principles were considered throughout the process. In the final assessment, an improvement in the overload and difficulties was confirmed, as was an increase in the caregivers' satisfaction level and an improvement in coping/problem‐solving strategies. In the follow‐up stage, the results tended to revert towards those of the initial assessment. The programme 'Living Together With Dementia' appeared to be a major contribution enabling family caregivers of people with dementia, although there is a need to develop an efficacy study using a more substantial sample. The programme contributed to a reduction in the overload and difficulties borne by the family caregivers of people with dementia at an early to moderate stage living at home and to increased caregiver satisfaction. [ABSTRACT FROM AUTHOR]

Background: The impairment of the hepatic enzyme phenylalanine hydroxylase (PAH) causes elevation of phenylalanine levels in blood and other body fluids resulting in the most common inborn error of amino acid metabolism (phenylketonuria). Persistently high levels of phenylalanine lead to irreversible damage to the nervous system. Therefore, early diagnosis of the affected individuals is important, as it can prevent clinical manifestations of the disease. Methods: In this report, the biochemical and genetic findings performed in 223 patients diagnosed through the Portuguese Neonatal Screening Program (PNSP) are presented. Results: Overall, the results show that a high overlap exists between different types of variants and phenylalanine levels. Molecular analyses reveal a wide mutational spectrum in our population with a total of 56 previously reported variants, most of them found in compound heterozygosity (74% of the patients). Intragenic polymorphic markers were used to assess the haplotypic structure of mutated chromosomes for the most frequent variants found in homozygosity in our population (p.Ile65Thr, p.Arg158Gln, p.Leu249Phe, p.Arg261Gln, p.Val388Met, and c.1066‐11G>A). Conclusion: Our data reveal high heterogeneity at the biochemical and molecular levels and are expected to provide a better understanding of the molecular basis of this disease and to provide clues to elucidate genotype–phenotype correlations. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of metacognitive group training in reducing psychotic symptoms and improving cognitive insight and functions in people with schizophrenia. Design: Randomized controlled trial. It was carried out between July 2019 ‐February 2020. Methods: Fifty‐six patients with schizophrenia were enrolled and randomly assigned to either a control group (N = 29) or a metacognitive training group (N = 27). Blinded assessments were made at baseline, 1‐week post‐treatment and at follow‐up 3 months after treatment. The primary outcome measure was psychotic symptoms based on the Psychotic Symptom Rating Scales (PSYRATS). Secondary outcomes were assessed by the Beck Cognitive Insight Scale (BCIS), the Personal and Social Performance (PSP) scale and the World Health Organization Disability Assessment Schedule (WHODAS). Results: Completion at follow‐up was high (92.86%). The intention‐to‐treat analyses demonstrated that patients in the metacognitive training group had significantly greater improvements of the Psychotic Symptom Rating Scales delusion score and total score and the Personal and Social Performance Scale, after 3 months, compared with the control group. The effect size was medium to large. The intention‐to‐treat analyses also demonstrated that patients in the metacognitive training group had significantly greater reductions of the Psychotic Symptom Rating Scales hallucination score and Beck Cognitive Insight Scale self‐certainty score post‐treatment, compared with the control group. The effect size was medium to large. Conclusion: The metacognitive training administered by psychiatric and mental health nurses was effective in ameliorating delusions and social functioning over time and it immediately reduced hallucinations post‐treatment. Impact: Metacognitive training for treating psychosis in patients with schizophrenia is efficacious and administration is clinically feasible in the Portuguese context. Trial Registration Number: ClinicalTrials.gov ID NCT03891186. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to evaluate the content validity of the helping relationship as a nursing psychotherapeutic intervention. Design and Methods: The present research work is a modified e‐Delphi study. A total of 205 experts were identified between January and May 2018, and a questionnaire was sent to all of them in different rounds. Findings: The nurse must have specific knowledge (self‐knowledge and knowledge about the person) and attitudes (empathy and respect) to be able to carry out the intervention. The helping relationship can address different nursing diagnoses, such as anxiety or depressed mood, and it can be developed in a set of sessions with specific objectives and contents. Practice Implications: The systematization of the helping relationship creates the conditions for its implementation in clinical practice enabling an evidence‐based practice that results in the improvement of care. [ABSTRACT FROM AUTHOR]

Objective: To describe nurses' mental health status during the Covid-19 outbreak and to explore the factors that might accentuate the negative consequences on their mental health. Methods: We conducted an online survey to evaluate demographic variables, working conditions, family dynamics, and mental health variables in nurses working in healthcare settings, in Portugal, during the Covid-19 outbreak. Results: Portuguese nurses presented higher depression, anxiety and stress levels, when compared to the Portuguese general population, during the outbreak. Overall, nurses who did not consider the quantity and quality of personal protective equipment as adequate presented significantly higher levels of depression, anxiety, and stress. Conclusions: Our results suggest that nurses' mental health status seems to be particularly affected by the Covid-19 outbreak and that some modifiable elements might accentuate the impacts on their mental health. [ABSTRACT FROM AUTHOR]

Copyright of De Computis is the property of Asociacion Espanola de Contabilidad y Administracion de Empresas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Studies on the service sector in the European Union have identified an economic saving potential between 20 and 30% of current energy consumption, which remains mostly untapped. Although the topic of energy efficiency has been explored in depth before, there is little organized information about service activities and especially about small business, despite its importance in energy consumption. In Portugal, the service sector is responsible for 12% of final energy and 35% of electricity consumption, half of which by small and medium enterprises. This research explores the energy saving potential in the small business service sector at the local scale. The selected case study was Telheiras, a neighborhood of Lisbon, where 47 establishments, out of a universe of 107, were subject to energy audits. The following activities were covered: retail, food services, health and beauty, print shops, and associations. The energy audits indicated an average savings potential of 27% of current energy consumption, with payback time under 3 years, at the cost of 13 €/MWh saved; and a savings potential of 32% of consumption, with payback under 6 years, at 19 €/MWh saved (far below market electricity prices). The main driver for action is the need to cut costs. Main barriers are insufficient knowledge, low priority given to energy, and funding difficulties. The approach to a whole neighborhood proved effective in promoting dialogue with business managers. The introduction of an energy audit program operating at the local scale could provide the needed support for the adoption of energy efficiency measures. [ABSTRACT FROM AUTHOR]

Introduction: Ethical conflict is a phenomenon that has been under study over the last three decades, especially the types moral dilemma and moral distress in the field of nursing care. However, ethical problems and their idiosyncrasies need to be further explored. Aim: The objectives of this study were, first, to obtain a transcultural Portuguese-language adaptation and validation of the Ethical Conflict Nursing Questionnaire–Critical Care Version and, second, to analyse Portuguese critical care nurses' level of exposure to ethical conflict and its characteristics. Methods: A cross-cultural validation and descriptive, prospective and correlational study. The sample was made for 184 critical care nurses in 2016. Ethical Considerations: The study was authorised by Bioethics Commission of the University of Barcelona, the Associaçâo de Apoio ao Serviço de Cuidados Intensivos do Centro Hospitalar do Porto and the Sociedade Portuguesa de Enfermagem de Saúde Mental. Findings: The Portuguese version of the Ethical Conflict Nursing Questionnaire–Critical Care Version was a valid and reliable instrument to measure exposure to conflict. Moral outrage was the most common type of conflict. The most problematic situations were the ineffectiveness of analgesic treatments, the administration of treatments considered futile and the mismanagement of resources. [ABSTRACT FROM AUTHOR]

Copyright of Comunicaçõe Geológicas is the property of Laboratorio Nacional de Energia e Geologia, I.P. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)