Portuguese Institutions Research Articles

Effects of an individual cognitive stimulation intervention on global cognition, memory, and executive function in older adults with mild to moderate Alzheimer's disease.

To determine the efficacy of a 12-week individual cognitive stimulation (iCS) intervention on global cognition, memory, and executive function of older adults with mild to moderate Alzheimer's disease (AD). Protocolized analysis using data from a multicenter, single-blind, randomized, parallel two-arm RCT of iCS for older adults with probable AD. A sample of 142 people with probable Alzheimer's disease attending 13 Portuguese institutions providing care and support services for older adults were selected. Intervention group (n = 72) received 24 iCS sessions, twice a week for 12 weeks. Control group (n = 70) maintained their activities as usual. Outcomes included global cognitive function (Mini-Mental State Examination, and Alzheimer's Disease Assessment Scale-Cognitive Subscale), memory (Memory Alteration Test, and Free and Cued Selective Reminding Test), and executive functioning (Frontal Assessment Battery). All participants were assessed at baseline (T0), after the intervention (T1), and 12 weeks follow-up (T2). The results showed significant improvements in memory performance at follow-up for the intervention group and greater stability in global cognition in the intervention relative to the control group. The current iCS protocol shows effectiveness in cognitive functioning in older adults with probable AD, particularly for memory upon completion of the intervention and at follow-up, adding further support to previous iCS studies showing similar results and to the effectiveness of the current intervention.

From evidence to practice: real-world insights into outpatient management of acute uncomplicated diverticulitis.

Diverticulitis is experiencing a significant increase in prevalence and its widespread in-hospital management results in a high burden on healthcare systems worldwide. This study compared inpatient and outpatient approach of acute non-complicated diverticulitis using a non-selected population in a real-world setting. This observational retrospective study included all consecutive patients from two Portuguese institutions diagnosed between January 2017 and December 2021 with non-complicated diverticulitis according to the modified Hinchey Classification. The primary endpoints were to identify criteria for inpatient treatment and compare the outcomes on the basis of the treatment regimen. The secondary endpoints were to determine the predictive factors for clinical outcomes, focusing on treatment failure, pain recurrence, and the need for elective surgery following the initial episode. A total of 688 patients were included in this study, 437 treated as outpatients and 251 hospitalized. Inpatient management was significantly associated with higher preadmission American society of anesthesiologists (ASA) score (p = 0.004), fever (p = 0.030), leukocytosis (p < 0.001), and elevated C-reactive protein (CRP) (p < 0.001). No significant association was found between failure of conservative treatment and patient's age, ASA score, baseline CRP, presence of systemic inflammatory response syndrome (SIRS), and inpatient or outpatient treatment regimen. Pain recurrence was significantly associated with higher CRP levels (p = 0.049), inpatient treatment regime (p = 0.009) and post index episode mesalazine prescription (p = 0.006). Moreover, the need for elective surgery was significantly associated with the presence of previous episodes (p = 0.004) and pain recurrence (p < 0.001). The majority of patients with uncomplicated diverticulitis of the left colon experience successful conservative approach and can be safely managed in an ambulatory setting. Neither treatment failure, recurrence of pain, or need for posterior elective surgery are associated with outpatient treatment regimen.

A maturity model for omnichannel adoption in health care institutions

Omnichannel adoption in healthcare service has recently become widely discussed as healthcare institutions struggle to keep up with changing patient expectations and technological advances. However, the need for a standard model for addressing this issue has left many healthcare institutions working to implement effective strategies. This study aims to establish a comprehensive model to evaluate adopting an omnichannel strategy in healthcare. To this purpose, two main objectives were pursued: i) identify and describe the different stages of maturity in adopting omnichannel strategy by healthcare institutions; ii) address the gaps identified in the literature and propose a roadmap to be followed to attain greater maturity levels. This roadmap is presented to healthcare institutions based on a gap analysis done regarding the adoption of an omnichannel strategy by healthcare institutions. Thus, a survey was conducted through online questionnaires in which ten Portuguese public hospitals participated. The survey data were collected, transformed, and analyzed using statistical methods to evaluate and make the proof-of-concept of the proposed model to identify the level of maturity regarding omnichannel strategy adoption. The results showed that Portuguese institutions participating in this survey are between the early and mid-stage of omnichannel adoption. Among the participants, it was possible to identify the healthcare institution's current level and the dimensions they lagged off and should improve to reach the next level regarding adopting the omnichannel strategy. Lastly, the findings and insights obtained from the data analysis provided valuable indications regarding omnichannel strategy in Portuguese healthcare institutions that participated in this study. Guidelines and directions were provided for future research on omnichannel maturity in healthcare.

Barriers and facilitators of evidence-based practice in the Portuguese context: perceptions of formal nursing leaders.

Formal nursing leaders play an important role in promoting and sustaining evidence-based practice (EBP) in the clinical context, particularly by creating a conducive environment for change and increasing clinicians' awareness of the positive results of EBP. However, nursing leaders encounter both barriers and facilitators in their work; therefore, it is important to understand their perceptions on this topic. The objective of this study was to understand the perceptions of formal nursing leaders about barriers and facilitators for EBP. A descriptive exploratory study with a qualitative approach was conducted. A convenience sample was obtained, consisting of formal nursing leaders from three Portuguese health care institutions. Data were collected through semi-structured interviews. Content analysis was conducted using MAXQDA Analytic Pro 2022 software. Seventeen formal nursing leaders were interviewed. Five categories of EBP barriers were identified: (1) scarce resources and inefficient resource management; (2) non-conducive organizational culture; (3) distance between academia and the clinical context; (4) demotivation; and (5) resistance to change. Seven categories of EBP facilitators were identified: (1) availability of resources and efficient resource management; (2) conducive organizational culture; (3) partnerships between academia and the clinical context; (4) motivation and commitment; (5) leadership; (6) organization that regulates professional practice; and (7) multidisciplinary meetings. This study identified barriers and facilitators for EBP through the perceptions of formal nursing leaders. Collaborative multidisciplinary efforts by leaders, direct care professionals, academics, and researchers should be conducted to overcome barriers and strengthen facilitators for EBP. http://links.lww.com/IJEBH/A242.

Bank Reputation and Trust: Impact on Client Satisfaction and Loyalty for Portuguese Clients

The aim of this article is to assess the most relevant factors influencing customer trust in the Portuguese banking sector following the Global Financial Crisis. It also aims to evaluate the impact of trust on satisfaction and satisfaction on loyalty. To address the research objectives and the hypotheses posed, a quantitative study with a descriptive design was conducted. Data was collected through an online survey administered to a sample of bank clients residing in Portugal. The findings indicate that respondents generally trust Portuguese banking institutions, although this trust has been affected by the Global Financial Crisis. The bank’s reputation and financial performance were identified as critical factors in the respondents’ choice of bank. Additionally, the results suggest that both global and domestic financial conditions, bank reputation, client satisfaction, and overall trust significantly influence client loyalty to the bank. This study provides valuable insights into client behavior and perceptions of banks, emphasizing the importance of factors such as trust, client satisfaction, and bank reputation in shaping client loyalty.

The Determinants of Education-Job Matching for Portuguese Graduates

This paper deals with the determinants of education-job match for higher-education graduates, using a logistic regression model to identify explanatory variables related to sociodemographic, academic trajectory and institutional characteristics. The empirical analysis is based on an anonymous online questionnaire administered to a sample of graduates, from 2014 to 2019, in Portuguese institutions, of which about five hundred observations were made. Although the boundaries between universities and polytechnics are less obvious today, there are still some differences between the two higher-education subsystems regarding education-job match. The main ones are related to the field of study, gender, and the need to move away from home to study and work. Factors that improve the probability of education-job matching, common to both subsystems, were also found, such as having i) studied ‘social sciences, commerce, and law’ and ‘engineering, manufacturing and construction’, ii) attained good final grades, and iii) participated in extracurricular activities involving complementary training.

Fostering university-public administration links through local case studies in executive education

The gap between public managers and academics has long been a topic of discussion in the field of public affairs. This article presents a successful strategy to bridge this gap: the creation and use of local case studies in executive education for Portuguese public managers. We found that the creation process, which included interviews with practitioners, allowed them to reflect on their work from the framework of academic theories. As for the use of cases in the classroom, the local aspect of the case studies - set in Portuguese institutions, and shaped by the local values, mores, and norms - fostered the appropriation of the subject matter and enhanced the sharing of experiences and ideas, combining academic theory with tacit knowledge from the field. We discuss examples of the observed benefits, as well as the challenges and possibilities of replicating the strategy in other contexts.

Primary thromboprophylaxis in cancer outpatients - real-world evidence.

Cancer-associated thrombosis (CAT) is a significant concern among patients with malignant diseases, leading to increased mortality. While current guidelines recommend primary thromboprophylaxis for venous thromboembolism (VTE) in medium-to-high-risk outpatients, this practice remains controversial. A better understanding of primary thromboprophylaxis is crucial, yet there is a lack of Real-World Evidence (RWE) in Portugal. This RWE study aimed to elucidate primary thromboprophylaxis practices among cancer outpatients in Portugal. A five-year observational multicentric study in eight Portuguese health institutions enrolled 124 adult cancer outpatients under primary thromboprophylaxis for VTE. The endpoints were CAT, bleeding, cancer progression and death. High thrombotic risk tumours were prevalent, with 57% (71) of the patients presenting with pancreatic and gastric cancers. Regarding primary thromboprophylaxis, 55% (68) received Low-Molecular-Weight Heparin (LMWH). VTE was presented in 11% (14) of the patients and major bleeding in 2% (2). Vascular compression, elevated D-dimer and previous VTE were significantly associated with VTE occurrence under primary thromboprophylaxis. The Onkotev model was shown to be the best risk assessment model (RAM) in this population (p = 0.007). CAT patients exhibited a lower progression-free survival than non-CAT patients (p = 0.021), while thrombosis did not influence overall survival (p = 0.542). Primary thromboprophylaxis in medium-to-high-risk cancer outpatients is a safe and effective practice in real-world settings. This study is the first Portuguese RWE on primary thromboprophylaxis, highlighting evidence for improving prophylactic strategies in this population.

Online learning, perceived difficulty and the role of feedback in COVID-19 times

ABSTRACT The closure of higher education institutions as a result of the COVID-19 pandemic has necessitated a sudden and unexpected transition from face-to-face to online teaching and learning. This paper draws on data from a broader study focusing on higher education students’ perceptions and experiences of online learning during the first lockdown in 2020. In total, 2,718 students from different Portuguese institutions participated in the study. Findings indicate that students who felt they had been provided with more feedback reported less difficulty in online teaching and learning. Students reported more perceived difficulty than perceived feedback in online teaching and learning. Findings point to the importance of feedback in fostering self-regulation of learning, thereby helping students better adapt to online teaching and learning.

Exploring the Impact of Quality in Higher Education on Student Engagement: A Study Focused on Critical Success Factors in Portuguese Institutions

Exploring the Impact of Quality in Higher Education on Student Engagement: A Study Focused on Critical Success Factors in Portuguese Institutions

Healthcare students’ attitudes toward addressing sexual health: validation of the European Portuguese version

BackgroundTo tailor curriculum and training programs on sexual health for undergraduate health students, assessing students' attitudes toward working with sexual health is necessary. The Students’ Attitudes Toward Addressing Sexual Health Questionnaire (SA-SH) provides adequate measurement proprieties to assess health students' attitudes toward sexual health. This questionnaire has yet to be available for use in European Portuguese-speaking countries. ObjectiveTranslate, culturally adapt, and validate the European Portuguese version of the SA-SH. MethodsCross-sectional, observational study. The translation was performed according to international guidelines; a panel of four sexuality experts was invited for content validity purposes; construct validity was obtained with the results of 122 questionnaires submitted online to health students and correlation with the Sexuality Attitudes and Beliefs Survey. Internal consistency reliability was also calculated. ResultsThe European Portuguese version showed a Cronbach's alpha between 0.669 and 0.770, and four items were removed after factorial analysis. A significant correlation was found with the results of the Sexuality Attitudes and Beliefs Survey. ConclusionThe SA-SH European Portuguese version is a valid and reliable instrument to use among the Portuguese population and institutions.

The fish collection of Jos Mariano da Conceio Veloso (17421811) and the beginning of ichthyological research in Brazil, with a taxonomic description of the extant specimens.

Two Portuguese institutions, the Museu Maynense da Academia das Cincias de Lisboa (ACL), and the Museu da Cincia da Universidade de Coimbra (MCUC), house a collection of 85 dried fish specimens prepared in what can be called a fish-herbaria following a process similar to that developed by the Dutch naturalist Johan Frederic Gronovius (16901762). These specimens date back to the late eighteenth century and represent Brazilian taxa. Previous authors assumed that they were part of the collections amassed by the Brazilian-Portuguese naturalist Alexandre Rodrigues Ferreira (17561815) during his philosophical voyage to the Amazon. Here we present a review of these specimens, suggesting that they belonged to Friar Jos Mariano da Conceio Veloso (17421811) and describe the history of dispersal of these collections up the present day. A total of 58 species in 50 genera, 32 families and 19 orders are represented in the collection. Only 8.6% of these specimens represent freshwater species, while 91.4% are marine or brackish water species. The present known distribution of these taxa is focused on southwestern Brazil, which agrees with the area where Veloso collected natural history specimens. A good percentage of the species were undescribed at the time Veloso collected them, and had they been published by him, would have had priority over species described decades later by famous eighteenth and nineteenth century ichthyologists. We also present a brief discussion on the challenges and opportunities of studying historical natural history specimens, with special focus on those amassed during the late eighteenth and early nineteenth century by Brazilian-Portuguese naturalists.

Sustainable development in Portuguese higher education institutions from the faculty perspective

Higher education institutions play a fundamental role and have great responsibility in promoting sustainability and achieving sustainable development goals. It is therefore essential to study the teacher's perceptions of incorporating sustainability since they are responsible for promoting competences and preparing citizens to respond with solutions to future challenges. The aim of this research is to analyse the perceptions of sustainability held by teachers at Portuguese public higher education institutions. A descriptive and exploratory study was conducted by administering an online questionnaire. The sample is made up of 444 teachers from different Portuguese public higher education institutions (54.1% women and 45.9% men). The results show that while most teachers believe higher education institutions promote the integration of sustainability in their activities, only 16% consider that sustainable development is holistically integrated in the institutions' different activities. About 30% of the teachers report that they largely or extensively integrate sustainable development in their curricular units, but only 20% of them state that higher education institutions provide regular or systematic training in SD. Teachers prefer to increase students' sustainable development education through conferences, seminars, or research projects. Almost 90% of teachers are concerned about climate change or the environment, but only 40% or less engage in sustainable development-related activities. Four clusters are also identified, representing teachers' different perceptions of the higher education institutions' promotion of sustainability, teachers' participation in sustainable development issues and concerns about climate change. Although teachers feel that sustainability is starting to be integrated in higher education institutions, this is not done holistically; moreover, differences are found between teachers in polytechnics and universities and between different scientific areas.

Sustainable development practices in public higher education: A new conceptual framework for nurturing student satisfaction and reinforcing attractiveness to international students

AbstractUsing a multi‐layer review based on stakeholder, institutional and legitimacy theories, the current study presents and empirically analyses a novel conceptual framework addressing the relationship between sustainable development practices, internationalization and students' satisfaction in public higher education institutions. Based on participants' self‐perception, a questionnaire was distributed to 738 students at seven Portuguese public higher education institutions. Structural equation modeling was utilized to estimate the multivariate causal relationships. The evidence shows that SDP are positively, directly, and significantly related to internationalization and students' satisfaction. Students' satisfaction is directly and significantly associated with internationalization, also revealing a moderating effect on the relationship between sustainable development practices and internationalization. To achieve legitimacy among their stakeholders, public higher education institutions must build an institutional commitment to sustainability by adopting and disseminating sustainable development practices with actions on a livable campus.

The Impact of Meat Consumption on Human Health, the Environment and Animal Welfare: Perceptions and Knowledge of Pre-Service Teachers

Although meat was considered fundamental for human health in the past, in recent decades, it has come to be considered a poison. The present study involved 197 pre-service primary teachers from two Portuguese institutions: one in an urban context and the other in a smaller city. It aimed to ascertain the main diet of the participants and their perceptions and knowledge about the impact of meat consumption on human health, the environment and animal welfare. It also aimed to identify which type of meat was considered better and worse for health, how important meat consumption is for adults and children, and to determine whether the participants would consider it important to reduce meat consumption in their diets and the reasons for doing so. The study uses mainly a methodological quantitative approach, and a questionnaire was designed and applied. The participants showed their preference for an omnivorous diet with no restrictions, considering this diet the best for human health, but the worst for the environment and animal welfare. Although meat consumption was considered important for human health, most participants considered that it would be important to consume less meat. From the answers given for the open questions, it was concluded that some respondents had difficulties in justifying their answers, revealing a certain lack of knowledge about the subject, which has important implications for teacher training courses.

Impact of a simulation-based interprofessional workshop (LINKS) on Portuguese healthcare students’ perception of roles and competencies: a quasi-experimental pilot study

There is a scarcity of simulation-based interprofessional (IP) programs in Portugal, with a notorious absence in undergraduate education. This paper describes the first step towards the development of an interprofessional education (IPE) undergraduate program, namely the implementation and preliminary assessment of the workshop LINKS – Lifting INterprofessional Knowledge through Simulation. The aim of this pilot study was to assess the educational effect of LINKS, in medical and nursing undergraduate students’ attitudes towards IP teamwork and collaborative practices, and their perception of roles and competencies within an IP team. A total of 23 final-year students participated in the workshop. Teams of three or four elements (medical and nursing students) were exposed to two critical patient management simulation scenarios. To assess the impact of the workshop on students’ perception of IP collaborative practice, two surveys (ATTITUDES and IPEC) were applied before and after the workshop. Additionally, students’ opinion/satisfaction towards the workshop and its curricular integration was explored. Students’ awareness of the relevancy of IP learning and self-competency in IP practice improved. For all subdomains and overall scores, statistically significant differences were found when comparing the pre- and post-scores, for both medical and nursing students, in both surveys. All students agreed that the workshop added educational value to their training, and recommended its integration in the formal curriculum, with a first round in the penultimate year and repeated in the last year. Considering the pre–post test results and anecdotal comments shared during the session, we may infer that this single IPE event contributed to a clearer understanding of the team dynamic and individual role definition, increased the motivation to engage in collaborative practice between physicians and nurses and potentially challenged pre-existent stereotypes of each professional group. These findings corroborate the need for sustainable simulation-based IP programs, integrated in the undergraduate curricula, promoting early clinical interactions of different professional groups. We envision that the results of this study can help to inform future curriculum planning and provide useful insights that can be used within and between Portuguese institutions to develop a common IP undergraduate program.

International Student Mobility in Psychology: an Analysis of Brazilian Students in Portuguese Higher Education

Student mobility has been one of the most impactful manifestations of higher education (HE) internationalization. Recently, many studies have looked at this phenomenon, although few have focused on mobility from countries which are not major student exporters and to countries that are not main recruiters. This paper aims to uncover how the increasing internationalization of HE is reflected in the mobility of Brazilian Psychology postgraduate students to Portugal, two countries which share a metropolis-colony past. Two objectives are pursued: first, to carry out a characterization of Psychology postgraduate students from Brazil who study in Portugal; second, to analyze the assignment of scholarships by the Brazilian government. Descriptive analysis and a social network analysis technique were performed to official statistical data available in both countries. Social Sciences, Business and Law is the most sought-after area by Brazilian students in mobility, and within this area, Psychology students are third in absolute numbers. The majority of Psychology students were in degree mobility, being almost ten times more than those in credit mobility, and a constant preference for public institutions was observed. The Portuguese institutions most sought-after are the University of Porto, the University of Coimbra and the University of Lisbon. Institutions located in Brazil’s South and southeast regions stand out with the number of mobility grants. This work contributes to shed light on realities of international mobility beyond the major recruiting and/or sending countries. Its novelty also resides in the contribution to knowledge about mobility between spaces where a colonial logic leads students’ flows.

Staying Connected with Aged Populations in Times of COVID-19: An Interview Study of the Role of Portuguese Institutions and Municipalities

In times of social confinement frequently associated with COVID-19 pandemics, an increasing dependence of aged populations on digital media to maintain social interactions and participation in society was observed. Although courses for action on the access to digital media by aged populations and the potential harms of digital inclusion have been acknowledged in the literature, far too little attention has been devoted to the challenges and in situ measures undertaken by local entities targeted to aged populations. The purpose of this study is to analyze the strategies adopted by Portuguese Universities of the Third Age, Municipalities, among other Institutional Care for Aged Populations to ensure communication and active participation of older adults in society and the role of digital media in that process. A total of 72 Portuguese entities developing initiatives addressed to aged populations were interviewed, including Municipalities and Universities of the Third Age, aiming at gathering their perspectives on the challenges and practices of using digital media to involve the ageing population in the community. Data was collected employing a semi-structured interview and content analysis was performed. Findings indicate that although participants found difficulty in adhering to activities owing to the financial and social consequences of the pandemic, most had to restructure their activities to maintain connections and routines. Conclusions offer some important insights into practices to foster participation within the communities using digital platforms.

P086 - Predictive factors of response to Cabazitaxel in heavily pretreated patients with metastatic castration resistant prostate cancer: RWD from eight Portuguese institutions

P086 - Predictive factors of response to Cabazitaxel in heavily pretreated patients with metastatic castration resistant prostate cancer: RWD from eight Portuguese institutions

Portuguese versus Fenton Curve: Which one better explains maternal and neonatal outcomes in Portuguese women with gestational diabetes?

Background and aimsGrowth charts are commonly used to identify foetal growth alterations, playing an important role as extreme growth centiles correlate with worse foetal and neonatal outcomes. This study aim was to compare birthweight classification (small for gestational age (SGA), adequate for gestational age and large for gestational age (LGA)) from women with gestational diabetes mellitus (GDM) by applying the population-based growth chart (Fenton Curve) and the standard chart customised for our country (Portuguese Curve). Moreover, we compared obstetric and neonatal outcomes according to birthweight classification between these curves. MethodsA multicentre observational study with prospectively collected data from 19,470 pregnant women diagnosed with GDM (30 Portuguese institutions) was conducted. ResultsThe proportion of SGA neonates was higher with Fenton Chart than with Portuguese standard chart (12.7% vs 10.9%) and the prevalence of LGA was higher using the Portuguese Chart (4.1%vs 10.9%).Statistically significant differences in the classifications given by the two curves and for maternal/neonatal outcomes were found.The Area Under the Curve and Akaike Information Criterion pointed out to a better correlation between weight classification of the Portuguese Curves and the majority of expected maternal and neonatal outcomes: gestational hypertension, preeclampsia, hydramnios, vaginal dystocic labour, hyperbilirubinemia, respiratory distress syndrome, trauma from delivery, admission in neonatal intensive care unit, prematurity and neonatal morbidity. ConclusionOur study highlights the importance of having a standard birthweight curve specifically designed for each population. Neonates’ weight classification carries prognostic implication and misclassification could lead to potential mistreatment or overtreatment.