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- The experiences of mothers in caring for children with complex health conditions during hospitalization in Brazil: a grounded theory analysisPublication . Harmuch, Camila; Laranjeira, Carlos; Lima, Ana Luísa Serrano; Higarashi, Ieda Harumi; Jaques, André Estevam; Paiano, MarcellePurpose Children with Complex Health Conditions (CCHC) require prolonged, specialized, and multidisciplinary care, often demanding prolonged hospitalizations. In this context, mothers generally assume the role of primary caregivers, facing emotional, physical and social overload. However, their experiences during hospitalization remain little explored. This study aimed to understand the experiences and needs of mothers caring for CCHC during hospitalization. Design and methods This qualitative study used an inductive approach based on the Straussian Grounded Theory principles. Data collection took place between September 2024 and March 2025, through individual, in-person, semi-structured interviews, conducted with mothers of CCHC admitted to a Brazilian university hospital. Data analysis followed the constant comparison method, occurring simultaneously with collection, enabling the construction of categories and conceptual refinement. Results Sixteen mothers aged between 23 and 46 years (34.75 ± 7.55) were recruited. Data analysis generated the core category “Care experiences: balancing between light and shadow” around which three categories are anchored: 1) Dealing with the complexity of the disease and hospitalization; 2) Barriers to care dynamics during hospitalization; and 3) Enablers of care for children with complex health conditions. Conclusions The analysis of maternal experiences highlights the urgent need for care practices based on family-centered care models that recognize mothers as protagonists in the care process. Practice implications Findings support the implementation of institutional protocols that ensure effective communication, continuous support and qualification of professionals to promote a welcoming, safe and humanized environment, reducing the emotional and structural vulnerabilities faced by mothers who care for CCHC.
- Early Post-Discharge Predictors of Sedentary Behavior Following COPD Exacerbation: An Observational StudyPublication . Coluccia, Maria Gabriela; Cruz, Joana Patrícia Dos Santos; Brusaca, Luiz Augusto; Kawakami, Débora Mayumi de Oliveira; Araujo, Gustavo Henrique Guimarães; Karloh, Manuela; Mendes, Renata Gonçalves; Lorenzo, Valéria Amorim Pires DiPatients hospitalized due to an exacerbation of chronic obstructive pulmonary disease (ECOPD) often exhibit increased sedentary behavior (SB), which may persist after discharge and negatively affect recovery. However, early determinants of SB during this period remain unclear. To identify the factors at hospital discharge that predict SB 30 days later in patients with ECOPD. This observational longitudinal study included patients hospitalized for ECOPD, assessed during the first week after discharge and reassessed 30 days later. Data collected included sociodemographic information (age, sex, name, telephone number, and address), anthropometric measurements (weight, height, and body mass index [BMI]), clinical history (previous hospitalizations, exacerbations, and smoking status), dyspnea (Medical Research Council scale, mMRC), health status (COPD Assessment Test, CAT), co-morbidities (Charlson Comorbidity Index), and exercise capacity (6-minute walk test, 6MWT). Physical activity and sedentary behavior—including SB, light (LPA), moderate (MPA), and vigorous (VPA) physical activity, step count, and sleep—were measured using a triaxial accelerometer worn for seven consecutive days. Accelerometer data were processed with ActiPASS software, and statistical analyses were performed in RStudio. Stepwise regression analysis was used to identify the discharge variables that could predict SB at 30 days. Forty-four patients (61% female; age 66 ± 8 years; FEV1 53 ± 13%; Charlson 1 [1–2]; hospital stay 5 [3–6] days) were included. At discharge, median mMRC was 3 (2–3), CAT 21 ± 8, 6MWT 274 ± 102 m, steps/day 3,148, SB 619 ± 226 min/day, and LPA 216 min/day. At 30 days, SB was 615 ± 166 min/day. Dyspnea (mMRC) and LPA at discharge explained SB at 30 days (R2 = 0.31, p < 0.001). Higher levels of dyspnea and lower levels of LPA during the first week after discharge are the significant predictors of SB 30 days after hospitalization for ECOPD.
- Fall Prevention and Geriatric NursingPublication . Baixinho, Cristina Lavareda; Henriques, Maria; Costa, Andreia1. Introduction Falls among older people remain one of the most pressing and persistent public health challenges worldwide [1]. Given the increased life expectancy, and prevalence of disability, dependency, and comorbidities in this ageing population, there is a high risk that this will become a pandemic. On the other hand, as populations age the consequences of falls increase, ranging from physical injury and loss of functional independence to psychological distress, fear of falling, social isolation, and increased mortality, posing significant challenges not only to individuals and families but also to healthcare systems and societies [2,3]. Falls are a leading cause of injury-related hospitalizations among older persons and contribute substantially to escalating healthcare costs, long-term care admissions, and diminished quality of life [2]. The growing proportion of older adults, many living with multimorbidity, frailty, cognitive impairment, and social vulnerability, demands a critical rethinking of health, social, and urban policies to support healthy ageing [2,3,4]. While fall prevention is often framed as an individual responsibility, this perspective risks overlooking structural, educational, and systemic barriers that limit older adults’ capacity to engage in effective prevention strategies, such as low health literacy, unequal access to preventive services, and environments that are not age-friendly [4].
- Implementation of a mobile app (TeenPower) to prevent overweight and obesity: Preliminary results regarding lifestyle and usabilityPublication . Dias, Sara Simões; Frontini, Roberta; Sousa, PedroThe world is facing an enormous challenge: the vital need to prevent noncommunicable diseases such as overweight and obesity. Prevention programs must be not only valid and effective, but also attractive to young people. In fact, if the tool or program used is not attractive, the adherence to the treatment may not occur. The TeenPower project intended to create a platform for promoting healthy behaviors and fight overweight/obesity. This paper presents the preliminary results of the program regarding adolescents’ lifestyle and the usability tests. Adolescents from three different schools in the center of Portugal were recruited. Results showed that adolescents presented moderate healthy lifestyles, with the Interpersonal Relationships subscale showing higher values. Boys presented higher values in the subscale of Interpersonal Relationships compared to girls (p<0.001) and there are statistical differences between schools relating to the Stress Management subscale (p=0.014). Most users made a positive assessment in terms of perception of utility, perception of ease and attitude towards the TeenPower app. Nonetheless only 33.2% of the adolescents invited activated their profile at the TeenPower app. This final assessment was important to gather information and feedback to improve future prevention programs, which should focus on motivating these adolescents and their parents to use this type of apps. In a future research it will be also important to understand the reasons for teenager’s refusal to join this kind of programs.
- Effects of Anaesthesia on Insulin Sensitivity and Metabolic Parameters in Wistar RatsPublication . Guarino, Maria Pedro; Santos, Ana Isabel; Mota-Carmo, Miguel; Costa, Pedro FreireWe compared the effects of two different anaesthetics, sodium pentobarbital (65 mg/kg) and ketamine (30 mg/kg) plus xylazine (4 mg/kg) (KX) on insulin sensitivity, fasting glycaemia, insulinaemia and free fatty acids (FFA). Four groups of Wistar rats were used: KX group (n=6), pentobarbital group (n=6), high-sucrose diet group (n=6) and the conscious group (n=6). The insulin tolerance test (ITT) was used to measure insulin sensitivity, and metabolic biomarkers were determined using commercial kits. Pentobarbital did not alter plasma insulin, glucose, FFA or the ITT results compared to conscious animals. In contrast, KX anaesthesia induced hyperglycaemia, increased serum FFA and altered the ITT results compared to the conscious animal group. Moreover, under pentobarbital anaesthesia, the ITT proved to be a suitable method to detect insulin resistance in an animal model of diet-induced insulin resistance. We concluded that sodium pentobarbital anaesthesia should be used in metabolic studies since it does not interfere with plasma glucose, insulin, F FA or insulin sensitivity quantification in Wistar rats.
- Conexões Virtuais e Solidão: Explorando o Envelhecimento Ativo através do Facebook entre os IdososPublication . Ribeiro, Jaime; Reis, Margarida; Vidal Barrantes, Francisco Javier; Custódio, SusanaIntrodução: As trajetórias de desenvolvimento dos idosos são influenciadas pela sua capacidade de lidar bem com as mudanças que ocorrem nas diversas áreas da vida, assim como com eventos como a reforma, a institucionalização e a perda de amigos e cônjuges. Estas transições muitas vezes levam à solidão e ao isolamento social entre os mais velhos. Num contexto de uma sociedade cada vez mais envelhecida e tecnológica, o Facebook destaca-se como a rede social mais utilizada, inclusive em Portugal, sendo cada vez mais adotado pelos idosos. Métodos: Este estudo adotou uma abordagem mista e descritivo-correlacional. Para recolher os dados, foi utilizado um questionário online, que incluiu a Escala de Solidão da UCLA, bem como entrevistas. A amostra consistiu em 269 indivíduos com 55 anos ou mais, aposentados e utilizadores do Facebook. Resultados: Os resultados indicaram que a maioria dos idosos utiliza o Facebook para socializar, comunicar, obter conhecimento e manter contato com familiares distantes, servindo como um meio de evitar a solidão. Conclusões: O Facebook parece desempenhar um papel significativo na redução do isolamento social entre os idosos, facilitando a manutenção de redes sociais e familiares, o que é crucial para um envelhecimento ativo.
- 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.