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- Intensive Agriculture Production in Low Consumption Energy EnvironmentPublication . Galvão, J.; Nabais, A.; Correia, H.; Amaro, P.; Negrão, A.; Ribeiro, V.This work involves the study and dissemination of energy management practices for greater energy efficiency in a context of renewable energies, intensive production of flowers in greenhouses and the integration of data sensors, which enables the system to connect and exchange information from these systems to end users in a communication network. These several variavles can be monitored in real time with the support of the Internet of Things (IoT). It is intended to conceive a software and hardware prototype, in one new environment consumption, with the change for renewable energy sources, for better control of the variables involved in plant growth and more sustainability, in this intensive agricultural production sector.
- Does Symptom Recognition Improve Self-Care in Patients with Heart Failure? A Pilot Study Randomised Controlled TrialPublication . Sousa, Joana Pereira; Neves, Hugo; Pais-Vieira, MiguelPatients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group = −0.881; p < 0.001) and in the quality of life (βSlope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure. This randomised controlled trial was retrospectively registered (NCT04892004).
- Practices and Challenges in Portuguese Early Childhood Intervention: A Descriptive StudyPublication . Costeira , Cristina; Lopes, Inês; Lopes, Saudade; Pedrosa, Vanda Varela; Custódio, Susana; Cioga, Elisabete; Silva, Cândida G.Background/Objectives: Early Childhood Intervention (ECI) services are critical for supporting children with developmental needs and their families. Despite an established legislative framework, challenges related to accessibility, equity, resources, and standardization of practices persist. This study aimed to describe the perspectives of early intervention professionals in Portugal regarding current barriers, facilitators, and priority areas for improvement within the system. Methods: A descriptive study was conducted involving 82 professionals working in early intervention in Portugal. Data were collected using a survey specifically developed by the research team, grounded in a comprehensive literature review and professional expertise. The instrument was validated through a Delphi Panel with two rounds involving six experts in ECI. Data from open-ended questions were analyzed using content analysis, identifying categories and sub-categories to describe the responses, and descriptive statistics for the closed-ended questions. Results: Professionals highlighted the need to update the National ECI System (SNIPI), improve accessibility, and ensure equitable access to early intervention services. Participants reported limited resources, a lack of standardization in practices, and emphasized the importance of professional training and continuous professional development. The findings also pointed to the urgent need for investment and functional and structural restructuring of early intervention services. Various barriers and facilitators were identified. Conclusions: The study provides valuable insights into the perspectives of early intervention professionals, identifying critical areas for policy improvement, resource allocation, and practice standardization.
- Mapping the Second Victim Experience Among Western Nurses: A Scoping ReviewPublication . Costeira, Cristina; Junqueira, Helena; Quintas, Pedro; Pragosa, Ângela; Mata, Ema; Duarte, Hugo; Bom, Luís; Pais, NelsonBackground/Objectives: The second victim phenomenon is increasingly recognized as a significant issue affecting nurses involved in adverse events resulting from clinical decisions or interventions. Although patients and families, considered the first victims, are directly impacted, nurses often undergo challenges as second victims. With the growing awareness of these effects, this study aimed to map recent evidence on the second victim phenomenon among nurses in Western countries. Methodology: A Scoping Review was conducted following the Joanna Briggs Institute methodology in September 2024 and updated in November 2025. Eligibility criteria were defined using the PCC (Population, Concept, Context) framework. Searches were performed in PubMed, CINAHL, SciELO, and Scopus. Two independent reviewers carried out study selection, data extraction, and synthesis. Rayyan® supported screening, performed in two phases: title/abstract review and full-text analysis. Data extraction was conducted in Excel®, and data were analyzed using descriptive statistics and categorized into thematic areas. The review followed PRISMA-ScR guidelines and was registered in the Open Science Framework. Results: Of the 111 articles retrieved, 39 met the inclusion criteria. Evidence shows that although several support programs exist for nurses as second victims, they are often perceived as inadequate or inconsistently implemented. Second victim experience is associated with physical (e.g., sleep disturbances), emotional (e.g., fear), and psychological (e.g., distress) symptoms, with consequences such as absenteeism, professional dissatisfaction, loss of meaning in life, and even suicide. Conclusion: Findings highlight the need for more comprehensive, accessible, and consistently implemented support strategies to meet the complex needs of nurses affected by the second victim phenomenon.
- Low-Protein Diets, Malnutrition, and Bone Metabolism in Chronic Kidney DiseasePublication . Pereira, Cidália D.; Guimarães, Carla; Ribeiro, Vânia S.; Vaz, Daniela C.; Martins, Maria JoãoChronic kidney disease (CKD) has a high prevalence worldwide, with increasing incidence in low- and middle-income countries, and is associated with high morbidity and mortality, particularly from cardiovascular disease. Protein-restricted diets are one of the most widely used non-pharmacological approaches to slow the progression of CKD and prevent associated metabolic abnormalities. However, some concerns have been raised about the long-term safety of these diets, particularly with regard to patients’ nutritional status and bone and mineral disorders. Therefore, the aim of this article is to review the most recent scientific evidence on the relevance of using protein-restricted diets (with or without keto-analogue supplementation) and, in particular, their relationships with malnutrition and mineral and bone disorders in people with CKD without kidney replacement therapies. Although protein-restricted diets, especially when supplemented with keto-analogues and highly personalized and monitored, do not appear to be associated with malnutrition, research on their effects on bone and mineral disorders is scarce, deserving further investigation.
- Should Children Drink Water with Very Low Mineral Content? Implications of the Global Expansion of Water Filtration Systems and Relevance of Consumption of Water with Higher Mineralization LevelsPublication . Pereira, Cidália D.; Martins, Maria JoãoThe consumption of water with very low mineral content (W-VLMC; water with total dissolved solids below 50 mg/L), despite limited and inconsistent evidence and the resulting knowledge gaps, has not been associated with health risks for the general population. However, certain population subgroups (those eating very unbalanced diets or avoiding certain foods, engaged in prolonged periods of fasting, and/or doing prolonged or strenuous exercise as well as pregnant or breastfeeding women) should be mindful of maintaining sufficient intake of all essential minerals through their food if regularly using this type of water as their main beverage. The rapid expansion of water filtration systems—often producing W-VLMC—creates a timely and valuable opportunity to advance research on the health implications of W-VLMC intake. As these systems become increasingly common in educational settings and homes, children represent a subgroup experiencing rising exposure to W-VLMC. Additional studies are needed to assess the health effects of such exposure from early childhood. A complementary yet contrasting perspective is that the use of water intended for human consumption—with stringent quality control standards—and natural mineral waters—inherently pure, thus eliminating the need for filtration—with higher mineralization in both types of water, may provide an additional dietary source of essential minerals, especially for all the population subgroups mentioned above.
- Positive parenting by parents of children up to three years of age: development and validation of measurement scalesPublication . Oliveira Custódio Lopes, Maria da Saudade; Dixe, Maria dos AnjosThis study aimed to describe the development and validation of three multidimensional scales in which the same 30 items, distributed among five dimensions, measure parents' self-perceived confidence, difficulties and knowledge needs in the exercise of positive parenting during the first three years of the child's life. The content of the scales resulted from the literature and exploratory studies and was validated by experts. The analysis of its reliability and validity, using Pearson's correlations and Cronbach's alpha, was based on data from a questionnaire administered to a non-probabilistic sample of 1011 parents. In the dimensions and items, α-values ranged between 0.769 and 0.890 and r-coefficients were >0.37;p <0.01. It was concluded that the scales measure three variables that correspond to the practice of positive parenting and their use permits guiding nursing support.
- Insulin resistance: a new consequence of altered carotid body chemoreflex?Publication . Conde, Silvia V.; Ribeiro, Maria J.; Melo, Bernardete F.; Guarino, Maria P.; Sacramento, Joana F.Metabolic diseases affect millions of individuals across the world and represent a group of chronic diseases of very high prevalence and relatively low therapeutic success, making them suitable candidates for pathophysiological studies. The sympathetic nervous system (SNS) contributes to the regulation of energy balance and energy expenditure both in physiological and pathological states. For instance, drugs that stimulate sympathetic activity decrease food intake, increase resting metabolic rate and increase the thermogenic response to food, while pharmacological blockade of the SNS has opposite effects. Likewise, dysmetabolic features such as insulin resistance, dyslipidaemia and obesity are characterized by a basal overactivation of the SNS. Recently, a new line of research linking the SNS to metabolic diseases has emerged with the report that the carotid bodies (CBs) are involved in the development of insulin resistance. The CBs are arterial chemoreceptors that classically sense changes in arterial blood O2 , CO2 and pH levels and whose activity is known to be increased in rodent models of insulin resistance. We have shown that selective bilateral resection of the nerve of the CB, the carotid sinus nerve (CSN), totally prevents diet-induced insulin resistance, hyperglycaemia, dyslipidaemia, hypertension and sympathoadrenal overactivity. These results imply that the beneficial effects of CSN resection on insulin action and glucoregulation are modulated by target-related efferent sympathetic nerves through a reflex that is initiated in the CBs. It also highlights modulation of CB activity as a putative future therapeutic intervention for metabolic diseases.
- Effectiveness of Wearable Devices for Posture Correction: A Systematic Review of Evidence from Randomized and Quasi-Experimental StudiesPublication . Caixeiro, Diogo; Cordeiro, Tomás; Constantino, Leandro; Carreira, João; Mendes, Rui; Silva, Cândida G.; Castro, Maria AntónioIntroduction: The increasing development of wearable devices for postural monitoring (provide feedback on posture) or correction (mechanical or biofeedback to promote change) is partly driven by the rising prevalence of poor posture in the general population and its impact on pain perception and functional capacity. Objective: Examine the effects of wearable devices on posture correction or prevention and on related outcomes, including postural alignment, muscle activity, pain and functional performance. Methods: The review followed the PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, Web of Science, and PEDro for studies published between 2012 and 2025. Eligible studies included randomized controlled trials and quasi-experimental designs involving participants with postural deviations or at risk of developing them, who underwent interventions using wearable devices that provided vibratory, auditory, visual, or tactile biofeedback. Results: Eight studies reported immediate improvements in postural alignment, body awareness, and self-reported pain, particularly with devices providing vibratory or visual biofeedback. Functional task stability improved, and muscle activity during risky postures decreased. However, the strong heterogeneity across devices and protocols, small sample sizes, short intervention durations, and, in some cases, the lack of independent control groups limit the strength and generalizability of these findings. Conclusions: Wearable devices have potential as complementary tools in physiotherapy due to their autonomous and potentially effective nature. Nevertheless, current evidence remains insufficient to support definitive clinical recommendations.
- Functional abolition of carotid body activity restores insulin action and glucose homeostasis in rats: key roles for visceral adipose tissue and the liverPublication . Sacramento, Joana F.; Ribeiro, Maria J.; Rodrigues, Tiago; Olea, Elena; Melo, Bernardete F.; Guarino, Maria P.; Fonseca-Pinto, Rui; Ferreira, Cristiana R.; Coelho, Joana; Obeso, Ana; Seiça, Raquel; Matafome, Paulo; Conde, Silvia V.Aims/hypothesis: We recently described that carotid body (CB) over-activation is involved in the aetiology of insulin resistance and arterial hypertension in animal models of the metabolic syndrome. Additionally, we have demonstrated that CB activity is increased in animal models of insulin resistance, and that carotid sinus nerve (CSN) resection prevents the development of insulin resistance and arterial hypertension induced by high-energy diets. Here, we tested whether the functional abolition of CB by CSN transection would reverse pre-established insulin resistance, dyslipidaemia, obesity, autonomic dysfunction and hypertension in animal models of the metabolic syndrome. The effect of CSN resection on insulin signalling pathways and tissue-specific glucose uptake was evaluated in skeletal muscle, adipose tissue and liver. Methods: Experiments were performed in male Wistar rats submitted to two high-energy diets: a high-fat diet, representing a model of insulin resistance, hypertension and obesity, and a high-sucrose diet, representing a lean model of insulin resistance and hypertension. Half of each group was submitted to chronic bilateral resection of the CSN. Age-matched control rats were also used. Results: CSN resection normalised systemic sympathetic nervous system activity and reversed weight gain induced by high-energy diets. It also normalised plasma glucose and insulin levels, insulin sensitivity lipid profile, arterial pressure and endothelial function by improving glucose uptake by the liver and perienteric adipose tissue. Conclusions/interpretation: We concluded that functional abolition of CB activity restores insulin sensitivity and glucose homeostasis by positively affecting insulin signalling pathways in visceral adipose tissue and liver.