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Percorrer Unidades e Núcleos Especializados de I&D por Domínios Científicos e Tecnológicos (FOS) "Ciências Médicas::Ciências da Saúde"
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- Advanced practice nursing in Portugal – Where do we stand?Publication . Nunes, Patrícia Fonseca; Almeida, Armando; Tavares, Márcio; Gomes, Luís; Soares, HéliaA força de trabalho na saúde em Portugal tem sido descrita como uma combinação ineficiente de recursos, impactando a produtividade e o acesso aos serviços de saúde. Para resolver estas questões, diversos intervenientes têm defendido a implementação da Prática Avançada de Enfermagem (PAE) para fortalecer o papel dos enfermeiros e melhorar a prestação de cuidados. Objetivo: Analisar a relevância, pertinência, viabilidade, principais barreiras e facilitadores da implementação da PAE em Portugal. Métodos: Foi realizada uma scoping review nas bases de dados CINAHL, MEDLINE Complete, PubMed e ScienceDirect para artigos revistos por pares, em inglês e português, publicados após 2000, sobre configurações de recursos humanos na saúde e expansão do papel dos enfermeiros em Portugal. A pesquisa foi complementada com uma revisão de literatura cinzenta. Resultados: Foram analisados 59 artigos, 31 relatórios técnicos, sete artigos de imprensa e duas teses. Os resultados foram agrupados nos temas de conceptualização da PAE, regulamentação, barreiras e facilitadores, e financiamento. A implementação da PAE depende de consenso sobre conceptualização, regulamentação e âmbito de atuação. As principais barreiras incluem oposição médica, compromisso político limitado e falta de dados abrangentes sobre o impacto social e financeiro da PAE em Portugal. Conclusões: A implementação da Prática Avançada de Enfermagem em Portugal é relevante e necessária, embora a sua viabilidade dependa de uma liderança forte, compromisso político e consenso entre stakeholders. São necessários mais estudos para avaliar os impactos sociais e económicos da PAE no sistema de saúde português.
- Contributos para uma Reflexão sobre a Teoria do Cuidado Humano na Formação em Enfermagem em PortugalPublication . Gomes, Luís Miguel Salvador Machado; Rede Portuguesa da Ciência de Enfermagem para o Cuidado HumanoCompete às instituições de ensino superior no âmbito das propostas de ciclos de estudos desenvolver as estratégias de ensino-aprendizagem que favoreçam a aquisição de competências, conhecimentos e habilidades, pelos estudantes, com significado fundador de aprendizagens com relevância pessoal e profissional.
- Depression and Anxiety of Portuguese University Students: A Cross-Sectional Study about Prevalence and Associated FactorsPublication . Pedro Amaro; César Fonseca; Anabela Afonso; Gonçalo Jacinto; Luís Gomes; Hélder Pereira; Helena JoséABSTRACT: The mental health of university students has worsened over time, and it is young people who have suffered the most from the COVID-19 pandemic in terms of mental health. Anxiety and depression are the most common symptoms reported by university students and are often the cause of disabilities, either in academic performance or in other spheres of life. Aim. The aim of this study was to both assess the prevalence of depressive and anxiety symptoms in Portuguese university students and analyze the factors associated with these symptoms. Methods. A quantitative cross-sectional study with a sample of 3,399 university students from seven Portuguese higher education institutions was conducted. The following questionnaires were used: the generalized anxiety disorder assessment scale (GAD-7), the patient health questionnaire (PHQ-9), and a study-created sociodemographic questionnaire. The Kendall correlation coefficient, chi-square test of independence, Spearman correlation coefficient, Shapiro-Wilk test, Mann–Whitney-Wilcoxon test, and Kruskall-Wallis test were used to analyze the association between variables. The statistical analysis was done using the software R Statistics (Version 4.0.4), using a significance level of 0.05. Results. Mild to severe anxiety symptoms were reported by 75% of the participants, and 61.2% described mild to severe depressive symptoms. Of the sample, 19.5% reported a previous diagnosis of a mental disorder, with 38.7% diagnosed after the pandemic began. Additionally, 23% reported taking medication for mental health issues, and 26.7% had considered self-harm or harbored thoughts of being “better off dead.” The study found lower anxiety and depressive symptoms (p < 0 05) among men, students with higher socioeconomic status, those who frequently traveled home, individuals without prior mental health diagnoses, those with better academic performance, and those who avoided substances like coffee, tobacco, cannabis, and other illegal psychoactive substances. Interestingly, students in romantic relationships exhibited more anxiety symptoms (p < 0 05). Moreover, participants who believed they had experienced moral or sexual harassment displayed higher levels of anxiety and depressive symptoms (p < 0 001). Conclusions. There was a decrease in the mental health of university students after the pandemic compared to prepandemic studies, and the proportion of students with anxiety and depressive symptoms was alarming. There is an urgent need to implement programs in universities to promote students’ mental health.
- Exploring Professional Practice Environments and Organisational Context Factors Affecting Nurses’ Adoption of Evidence-Based Practice: A Scoping ReviewPublication . Luís Furtado; Fábio Alexandre Dinis Coelho; Natália Mendonca; Helia Soares; Luís Gomes; Joana Pereira Sousa; Hugo Miguel Santos DuarteABSTRACT: This scoping review, conducted within the Joanna Briggs Institute (JBI) framework, analysed the recent literature (January 2018 to March 2023) addressing factors inherent to professional practice environments and organisational contexts influencing nurses’ adoption of evidence-based practice (EBP). This review included studies involving nurses regardless of sector, practice setting, and scope of practice. A systematic search was undertaken across the PubMed, Web of Science, CINAHL, and MEDLINE databases, as well as the EThOS, OATD, and RCAAP platforms. The extracted textual elements underwent a content analysis, resulting in a coding structure established through an inductive approach that categorised information into main categories and subcategories linked by similarity and thematic affinity. Forty-one studies were included, revealing four main categories of factors impacting EBP adoption by nurses: (1) organisational dynamics, (2) management and leadership, (3) teamwork and communication, and (4) resources and infrastructure. The study’s limitations acknowledge the subjective nature of categorisation, recognising potential variations based on individual perspectives despite adopting procedures to minimise the risk of bias. The results provide a substantial foundation for developing interventions to cultivate environments conducive to EBP adoption by nurses, thereby enhancing the integration of evidence into nurses’ professional practice contexts. This review was prospectively registered on the Open Science Framework (registration no. osf.io/e86qz)
- Genotoxicity and Cytotoxicity Assessment of Volatile Organic Compounds in Pathology Professionals Through the Buccal Micronuclei AssayPublication . Baptista, Fátima; Garcia, Patrícia; dos Santos Rodrigues, Armindo; Ladeira, Carina; Tranfo, GiovannaABSTRACT: In pathology laboratories, several volatile organic compounds (VOCs) are used, such as formaldehyde, ethanol, and xylene. These substances are recognized as genotoxic and cytotoxic, which is why their handling poses risks to human health. The buccal micronucleus (MN) cytome assay is a non-invasive, useful, and simple method to detect these effects in exposed individuals. The aim of the study was to evaluate the risk of genotoxicity and cytotoxicity of VOCs in pathology professionals of S. Miguel Island, Azores, Portugal. The study comprised two groups: exposed workers (n = 21) from the three laboratories of S. Miguel, and a reference group (n = 50), randomly chosen from other hospital services without known exposure to VOCs. The exfoliated buccal cells were auto-sampled by all the participants using a cytobrush. The samples were processed in ThinPrep®, stained with modified Feulgen with Fast Green, and visualized for MN and other nuclear anomalies (ONAs), such as karyorrhexis, pyknotic, and karyolytic cells. Results showed that VOCs have a predictive significance for MN frequency, leading to the conclusion that their exposure is an increased risk factor for the health of these professionals, approximately four times greater than in the control group.
- Living Under the Volcano: Effects on the Nervous System and Human HealthPublication . Navarro-Sempere, Alicia; Cobo, Raúl; Camarinho, Ricardo; Garcia, Patrícia; dos Santos Rodrigues, Armindo; Garcia, Magdalena; Segovia, Yolanda; Kim, Ki-HyunABSTRACT: Volcanoes, during their explosive and post-explosive phases, as well as through continuous degassing processes, release a range of pollutants hazardous to human health, including toxic gases, fine particulate matter, and heavy metals. These emissions impact over 14% of the global population living in proximity to volcanoes, with effects that can persist for days, decades, or even centuries. Living conditions in these regions often involve chronic exposure to contaminants in the air, water, and soil, significantly increasing the risk of developing neurological disorders. Prolonged exposure to elements such as lead (Pb), mercury (Hg), and cadmium (Cd), among others, results in the accumulation of metals in the brain, which increases oxidative stress and causes neuronal damage and severe neurotoxicity in animals. An examination of metal accumulation in brain cells, particularly astroglia, provides valuable insights into the developmental neurotoxicity of these metals. Moreover, microglia may activate itself to protect from cytotoxicity. In this review, we consider the implications of living near an active volcano for neurotoxicity and the common neurodegenerative diseases. Additionally, we encourage governments to implement public health strategies and mitigation measures to protect vulnerable communities residing near active volcanoes.
- Unpacking Dimensionality and Response Bias in the Environmental Identity Scale: A Methodological Investigation in the Portuguese ContextPublication . Arroz, Ana; Picanço, Ana; Pereira, Enésima; Gabriel, Rosalina; Clayton, SusanUnderstanding individuals’ connection to nature is crucial for promoting sustainable attitudes and behaviors. The environmental identity (EID) scale, widely used to assess this connection, plays a key role in environmental research; however, its cross-cultural application requires rigorous psychometric validation. Although the revised 14-item EID scale has demonstrated good reliability, questions remain regarding its dimensionality and the potential influence of acquiescence due to exclusively positive worded items. This study examined both issues in Portuguese samples. In Study 1, exploratory and confirmatory factor analyses were conducted to test the factorial structure. Results supported a two-factor model with correlated dimensions: Restorative Connection to Nature (RCN) and Ecological Identity (EI), rather than a strictly unidimensional solution. In Study 2 acquiescence was assessed by comparing the original version with a balanced version that included partially reverse-worded items. Item distributions, factor loadings, and reliability were analyzed. The balanced version did not improve control of acquiescence; instead, reversed-worded items showed weaker loadings, lower explanation variance, and method effects, suggesting increased measurement bias. Overall, the findings support the robustness of the revised 14-item EID scale in Portugal while indicating that environmental identity is better conceptualized as a bidimensional construct portraying both reflective connection and identity-based engagement with nature. The results also highlight the limitations of reverse-worded items as a strategy for reducing response bias in value-laden constructs.
- Volcanic environments and thyroid disruption – A review focused on As, Hg, and CoPublication . Coelho, Nádia; Bernardo, Filipe; dos Santos Rodrigues, Armindo; Garcia, Patrícia; Wei, OuyangABSTRACT: The purpose of this review is to explore the link between volcanic environments and thyroid disruption, with focus on the role played by As, Hg, and Co. Volcanoes are the most well-known source of natural pollution, enriching the environment in hazardous elements. It is estimated that about 10 % of world population lives near active volcanoes (Brown et al., 2015). There is evidence supporting a link between living in volcanic environments and thyroid cancer, but it is likely that other types of thyroid disruption are also exacerbated in the populations inhabiting volcanic areas. Arsenic (As) and mercury (Hg) are elements with toxic properties that are present in volcanic environments. Cobalt (Co), which is also present in these environments, is part of the essential cobalamin vitamin (B12). However, exposure to non-cobalamin Co can pose health risks. The effects of these three elements on the thyroid are understudied. A review of 125 publications retrieved from the Web of Science, PubMed, and Scopus databases, covering year 1955 to present, was performed. The known molecular mechanisms underlying thyroid disruption by these elements are discussed. It was found that thyroid cancer incidence, but also that of hypothyroidism are heightened in populations living in volcanic environments, particularly in Iceland, Hawaii, and Italy. Knowledge gaps regarding (i) thyroid disruption in areas with non-eruptive active volcanism, (ii) the toxic effects of As, Hg, and Co on the thyroid, and (iii) the incidence of hypothyroidism and other thyroid pathologies in volcanic environments are highlighted. The need to monitor the population of volcanic areas in terms of health is accentuated.