Unidade de Investigação - ciTechCare - Center for Innovative Care and Health Technology
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Browsing Unidade de Investigação - ciTechCare - Center for Innovative Care and Health Technology by Sustainable Development Goals (SDG) "03:Saúde de Qualidade"
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- Abieta-7,13-Diene in Nematode-Infected Pinewood Pinus pinaster Branch Extracts: Isolation and the Elucidation and Characterization of Its StructurePublication . Gaspar, Marisa C.; Cruz, Pedro F.; Brito, Rui M. M.; Sousa, Hermínio C. de; Braga, Mara E. M.The oleoresin and volatile fraction produced by conifers, such as Pinus pinaster, play a crucial role in plant defence, acting as precursors to resin acids and adapting in response to environmental stress or pathogen attacks. Abietadiene (abieta-7,13-diene), the biosynthetic precursor to abietic acid, has been identified as the most abundant compound in extracts from pinewood nematode (PWN)-infected P. pinaster trees. As abietadiene is not commercially available, this study aimed to achieve, for the first time, its isolation, structure elucidation, and detailed characterization from readily available forestry residues. Abietadiene was successfully isolated using thin-layer chromatography (TLC), and its purity and identity were evaluated using multiple analytical techniques: gas chromatography (GC), liquid chromatography (LC), nuclear magnetic resonance (NMR), and Fourier-transform infrared spectroscopy (FTIR). GC analysis indicated a purity of over 70% for the isolated compound, while LC provided the higher purity value of 98%. The identity of abietadiene was unequivocally confirmed through LC, FTIR, and NMR analysis. This work represents the first isolation and comprehensive characterization of abietadiene from a natural source, making detailed chemical data on this compound available to the scientific community. These findings may be used for future studies on the biological interactions and ecological roles of abietadiene, particularly in the context of plant defence and pathogen resistance.
- The Arabic Version of the Patient Health Questionnaire‐2 (PHQ‐2): Psychometric Evaluation Among Mothers of Children With Intellectual DisabilitiesPublication . Ali, Amira Mohammed; Al-Dossary, Saeed A; Aljaberi, Musheer A.; El-Gazar, Heba Emad; Laranjeira, Carlos; Khatatbeh, Haitham; Zoromba, Mohamed Ali; Alamer, Rasmieh; Amer, Faten; Pakai, Annamaria; Fekih-Romdhane, Feten; Lidoriki, EiriniAim: Mothers of children with intellectual disabilities are particularly vulnerable to mental distress due to demanding and exhausting caregiving. However, in the Arab world, they are seldom screened for depression because of limited diagnostic resources. Addressing the urgent need for brief and reliable screening tools, this study evaluated the psychometric properties of the Arabic version of the Patient Health Questionnaire-2 (PHQ-2) among 85 Saudi mothers. Design: A cross-sectional study. Methods: The construct, convergent, and divergent validity of the PHQ-2 was examined through a latent variable model (LVM), while its cutoff score was examined through receiver-operating characteristic (ROC) curve analysis. Results: The unidimensional PHQ-2 (item loadings > 0.7) was positively predicted by stress and negatively predicted by high mood and happiness, supporting its convergent and divergent validity. The PHQ-2 effectively predicted low mood, poor sleep quality, nightmares, high stress, low general physical health, and willingness to join a psychological support program (area under the curve [AUC] range = 0.72–0.84, p values < 0.001). The best balance between sensitivity and specificity was achieved at the PHQ-2 threshold ≥ 2.5, while the cutoff ≥ 3.5 demonstrated a higher positive predictive value (PPV) for all outcomes (range = 30.0–78.8 vs. 23.0–70.8). Conclusions: The PHQ-2 is a brief, valid tool, which at cutoffs ≥ 2.5 and ≥ 3.5 can reliably detect clinically significant depression and related psychological and physical adverse effects. Mothers scoring ≥ 3.5 may require a clinician-based examination for depression, and they may benefit from specific mental health literacy interventions. However, the results should be interpreted with caution given convenience sampling, a small sample size, and elevated distress levels in the current population. These limitations highlight the need to replicate the study with larger, randomly selected samples from more diverse populations. Implications for Practice: Nurses can efficiently screen for depression and its mental/physical sequelae, as well as monitor response to treatment using only two items. The study provided two well-interpreted cutoffs of the PHQ-2, with real-world implications for mental health screening in under-resourced settings. Reporting Method: The study adhered to STROBE guidelines. Patient or Public Contribution: No patient or public contribution. Copyright © 2025 Amira Mohammed Ali et al. Nursing Research and Practice published by John Wiley & Sons Ltd.
- Burnout protective patterns among oncology nurses: a cross-sectional study using machine learning analysisPublication . Rocha, Ana; Costeira, Cristina; Barbosa, Raul; Gonçalves, Florbela; Castelo-Branco, Miguel; Viana, Joaquim; Gaudêncio, Margarida; Ventura, FilipaBackground Oncology nurses face unique and intense demands due to the nature of their work, caring for patients with life-threatening illnesses. The emergence of professional burnout among these nurses is influenced by several factors, highlighting the importance of identifying protective and risk factors to mitigate its impact. This study aims to identify burnout profiles and protective socio-demographic and work-related patterns associated with reduced burnout among oncology nurses. Methods A cross-sectional study was conducted with 150 oncology nurses at a specialized hospital exclusively dedicated to adult oncology treatment in Portugal. Data collection included a self-administered questionnaire incorporating the validated Portuguese version of Maslach Burnout Inventory (MBI). Statistical analyses were performed using SPSS and machine learning tools, specifically KMeans clustering and Random Forest algorithms. Results Six protective patterns against burnout were identified, characterized by conditions of permanent contracts, work-life balance, and supportive work environments. Moreover, factors such as holding management roles and being a parent of two or more children might even be protective in some circumstances, suggesting a nuanced relation between personal and professional factors. Machine learning analyses made apparent the unpredictability of burnout and highlighted the critical role of protective factors in mitigating its impact. Conclusions This study underscores the importance of resilience-building strategies and promoting protective factors, such as job stability, learned experience, and adequate rest, to reduce burnout risk among oncology nurses. Future research should validate these findings through hypothesis-driven analyses to inform targeted and context-specific burnout prevention programs.
- CLC-CPC Creating learning communities for compassionate palliative care cultures - Train-the-trainer-course CurriculumPublication . Schuchter, Patrick; Buchegger, Marianne; Jurka, Johannes; Fupun, Claudia; Adascalitei, Irina; Dreglea , Ina; Gaicu, Elena; Lazar, Alina; Dixe, Maria dos Anjos; Querido, Ana; Laranjeira, CarlosiCare - an International Integrated perspective in palliative CARE for dignity and proper support in ageing and approaching end of life" is an interprofessional and participatory project led by Organizatia Umanitaria Concordia, Romania, in cooperation with the Kardinal König Haus, Vienna and the Polytechnic University of Leiria, Portugal. The European Union financially supports this initiative under the Erasmus+ program (Grant No. 2023-1-RO01-KA220-VET-000166902). The Train-the-Trainers (TOT) course curriculum in Palliative care is focused on Death Literacy and Creating Learning Communities from the Plublic Health Palliative Care perspective. The document presents TOT conceptual foundations, adult learning Philosophy, learning fields and objectives, learning outcomes per content, and evaluation.
- Cold atmospheric plasma activation of human gingival fibroblasts for improved wound healingPublication . Silva, Neusa; Marques, Joana; Brito da Cruz, Mariana; Luis, Henrique; Mata, António; Sério, SusanaSoft tissue regeneration plays a crucial role after oral surgery, as the successful healing of the soft tissue is a primary indicator of an efficacious intervention. Cold atmospheric plasma (CAP) has recently emerged as a promising therapeutic modality, exhibiting notable effects on cell migration and proliferation. Despite its potential, the dental application of CAP remains underexplored. This in vitro study aims to elucidate the impact of CAP activated medium on human gingival fibroblast responses, for future wound healing strategies. The study was divided into four parts: initial characterization of the plasma Jet, assessment of cell concentration, exploration of treatment distance effects, and treatment time dynamics. Human gingival fibroblasts were exposed to complete DMEM medium (without sodium pyruvate) activated with CAP at treatment distances of 2, 5, 7, and 9 mm, and treatment times of 15, 60, 120, 180, and 300 s for 1, 2 and 3 d of culture. The cell viability was evaluated using resazurin-based method, while wound healing dynamics was assessed via the scratch assay technique using phase-contrast microscopy. The cell morphology was characterised through fluorescence microscopy using propidium iodide and phalloidin staining, complemented by scanning electron microscopy. The results revealed that treatment distances and exposure times can influence the cell behaviour depending on the cell concentration. For the selected concentration of 1 × 104 cells ml−1, a treatment distance of 9 mm appeared to enhance human gingival fibroblast viability compared to a treatment distance of 2 mm and the control group. The images revealed adherent cells with a pattern typical of fibroblasts. However, no differences were observed for exposure times of 15 s and 180 s. The observed results further evidence that the exposure of the medium to the CAP device promoted an increase in cell viability, proliferation, and attachment in human gingival fibroblasts.
- Collaborative Practices in Mental Health Care: A Concept AnalysisPublication . Pinheiro, Eslia; Laranjeira, Carlos; Harmuch, Camila; Graça, José Mateus Bezerra; Ali, Amira Mohammed; Fekih-Romdhane, Feten; Yıldırım, Murat; Severo, Ana Kalliny; Franco, ElisângelaBackground/Objectives: Collaboration in mental health care is essential for implementing a model oriented towards the psychosocial rehabilitation of people based on multifaceted interventions involving different actors and sectors of society to respond to demands. Despite the benefits presented by the scientific evidence, there are still many barriers to collaborative care, and professionals continue to struggle in reorienting their conduct. The current situation demands organization and the framing of well-founded action plans to overcome challenges, which in turn requires a detailed understanding of collaborative practices in mental health care and their conceptual boundaries. A concept analysis was undertaken to propose a working definition of collaborative practices in mental health care (CPMHC). Methods: This paper used the Walker and Avant concept analysis method. This includes identifying the defining concept attributes, antecedents, consequences, and empirical referents. A literature search was carried out from November 2024 to February 2025 in three databases (Medline, CINAHL, and LILACS), considering studies published between 2010 and 2024. Results: The final sample of literature investigated consisted of 30 studies. The key attributes were effective communication, building bonds, co-responsibility for care, hierarchical flexibility, articulation between services, providers and community, monitoring and evaluating of care processes, and attention to the plurality of sociocultural contexts. Conclusions: This comprehensive analysis contributes to guiding future research and policy development of collaborative practices in mental health, considering the individual, relational, institutional, and social levels. Further research is possible to deepen the understanding of the production of collaborative practices in mental health in the face of the complexity of social relations and structural inequities.
- Comparative Analysis of Pressure Platform and Insole Devices for Plantar Pressure AssessmentPublication . Amaro, Catarina M.; Paulino, Maria F.; Valvez, Sara; Roseiro, Luis; Castro, Maria António; Amaro, Ana M.Foot plantar pressure refers to the pressure or force that the foot generates in contact with the ground, varying across different regions of the foot. This parameter is essential in static and dynamic analyses to access accurate diagnoses, study the human body biomechanics, create functional footwear designs, aid in rehabilitation and physiotherapy, and prevent injuries in athletes during sports practice. This study presents an experimental comparison between two different plantar pressure measurement devices, Pedar® (sensorized insoles) and Physiosensing® (pressure platform). The devices were selected based on their capacity to measure contact area and peak pressure points. Results showed that Physiosensing® provided a more uniform measurement of the contact area, proving its efficiency for weight distribution and stability analysis applications, particularly in posture assessment and balance studies. The Pedar® system showed higher capacity in peak pressure point detection. Therefore, the insole system is more suitable for applications requiring precise high-pressure zone localization. Comparative analysis highlights the strengths and limitations of each device and offers insights regarding its optimal usage in clinical, sports, and research settings.
- A Complex Intervention to Minimize Medication Error by Nurses in Intensive Care: A Case StudyPublication . Coelho, Fábio; Furtado, Luís; Tavares, Márcio; Pereira, Joana SousaBackground/Objectives: Medication errors are the most frequent and critical issues in healthcare settings, often leading to worsened clinical outcomes, increased treatment costs, extended hospital stays, and heightened mortality and morbidity rates. These errors are particularly prevalent in intensive care units (ICUs), where the complexity and critical nature of the care elevate the risks. Nurses play a pivotal role in preventing medication errors and require strategies and methods to enhance patient safety. This study aims to develop a comprehensive and evidence-based intervention to minimize medication errors by nurses in ICUs. Methods: This qualitative case study forms a part of a broader research project that commenced with a scoping review. Building on the review findings, a complex intervention was designed to address nurses’ medication errors. A focus group of experts was conducted to validate the intervention designed, evaluating its contextual feasibility and relevance. Results: This study led to the development of a complex intervention whose relevance lies in its potential implementation within the studied context. The resulting intervention was structured around four main components—educational interventions, verification and safety methods, organizational and functional modifications, and an error reporting system—meticulously designed to leverage the ICU’s existing resources. Conclusions: In conclusion, the proposed intervention has the potential to positively impact healthcare quality by reducing errors and promoting a culture of safety. Furthermore, this study’s findings provide a relevant foundation for future research and practical applications, driving advancements in healthcare service excellence.
- Compreensão Leitora em Pessoas com Trissomia 21 – Revisão de EscopoPublication . Barradas, Beatriz; Correia, Maria Rodrigues; Taveira, Luísa; Rodrigues, Inês TelloO objetivo deste trabalho foi analisar os fatores que influenciam a compreensão leitora nas pessoas com Trissomia 21. Revisão de escopo elaborada de acordo com as diretrizes da Prefered Reporting Items for Systematic Reviews and Meta-Analyses. A pesquisa foi realizada nas bases de dados PubMed Central, LILACS, SciELO e via EBSCOHost. Os registos foram analisados por dois investigadores independentes. Os descritores utilizados foram: síndrome de Down e Reading combinados com termos de linguagem natural e operadores booleanos. O nível de evidência foi realizado segundo a classificação de Oxford Centre for EvidenceBased Medicine, e a qualidade metodológica através do Methodological Index for Non-Randomized Studies. A pesquisa resultou em um total de 637 estudos, dos quais sete foram incluídos. A qualidade metodológica dos estudos não comparativos variou entre baixa e média, enquanto a dos estudos comparativos, variou entre médio e alto risco de viés. A compreensão leitora encontra-se alterada nas pessoas com Trissomia 21. A compreensão auditiva foi o fator com mais impacto, existindo outros como a consciência fonológica, a memória de trabalho, a leitura isolada e o vocabulário. Os fatores que demonstram influência na compreensão leitora são heterogéneos, mas devem ser considerados para uma intervenção adequada.
- Coronary septic embolism presenting as acute myocardial infarction. A case report of a singular manifestation of infective endocarditisPublication . Carvalho, Mariana Ferreira; Gonçalves, Carolina; Santos, Beatriz Saldanha; Morais, João; Søholm, Helle; Galyavich, Albert; Rroku, Andi; Luo, EltonBackground Acute ST-elevation myocardial infarction (STEMI) complicated by infective endocarditis (IE) presents a unique challenge in clinical management, especially when associated with septic embolism leading to coronary artery occlusion. Case summary The current clinical report describes the case of a 72-year-old male with a history of arterial hypertension, dyslipidaemia, and severe obstructive sleep apnea. The patient presented with anterior STEMI due to an embolic occlusion in the left anterior descending (LAD) artery, secondary to IE. Coronary angiography revealed embolic occlusion at the LAD origin, and balloon angioplasty without stent placement was performed, considering the embolic and infectious nature of the occlusion. Despite targeted interventions, including broad-spectrum antibiotics and support for cardiogenic shock, the patient's condition deteriorated, leading to cardiac arrest and subsequent death on the fourth day of hospitalization. Conclusion This case emphasizes the critical need for adapting STEMI management in the presence of IE. It highlights the importance of considering IE in STEMI differential diagnosis and adjusting intervention strategies accordingly.