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- Resident empowerment in all-inclusive context: cost–benefit perception and support for sustainable tourism development in a small island destinationPublication . Santos, Edson Redy Moreira dos; Nobre Pereira, Luis; Pinto, Patrícia; Ribeiro, Manuel AlectorThis study examines the relationships among resident empowerment, perceptions of tourism costs and benefits, and support for sustainable tourism development (SSTD) in a small island destination dominated by all-inclusive resorts. Using survey data from 341 residents in Cape Verde and employing PLS-SEM analysis, results reveal significant relationships between empowerment, benefits, and SSTD. The perception of all-inclusive resorts' positive impacts moderates the relationship between empowerment and SSTD, while the perception of all-inclusive resorts' costs does not moderate any relationships. The study contributes to understanding how all-inclusive tourism development influences resident attitudes and support for sustainability in small island contexts. The findings underscore the importance of empowering residents and managing perceptions of tourism impacts to foster SSTD. Practical implications include the need for policies that promote local empowerment, equitable benefit distribution, and mitigation of negative impacts to ensure long-term sustainability of small island destinations and beyond.
- Home mechanical ventilation in adults: clinical practice recommendations from the Portuguese respiratory society home mechanical ventilation assemblyPublication . Ribeiro, Carla; Gomes, Rita; Carreiro, Alexandra; Vieira, Ana Luísa; Seabra, Bárbara; Conde, Bebiana; Nogueira, Carla; Jácome, Cristina; Lages, Joana; Aguiar, Margarida; Grafino, Mónica; Pamplona, Paula; Cysneiros, Ana; Durães, Célia; Rodrigues, Cidália; Pimenta, Cidália; Cristóvão, Cristina; Rodrigues, Daniela; Ferreira, Diva; Gonçalves, Filipe; helena Chaves Ramos; Cravo, João; Silva, João Paulo; da Silva Cunha Granatin, Karl Jonathan; Méndez, Lucía; Zeller, Mafalda Van; Araújo, Márcia; Barata, Margarida; Raposo, Margarida; Redondo, Margarida; Jacob, Maria; Araújo, Maria João; Gonçalves, Miguel R.; Guia, Miguel; Faria, Nuno; Viegas, Pedro; Conde, Sara; Drummond, Marta; Pinto, PaulaBackground: The use of home mechanical ventilation (HMV) has been increasing worldwide, driven by widening of clinical applications and improved patient survival rates. In Portugal, recent data indicate an even faster growth, although national HMV recommendations have remained unchanged for 25 years. Research question: We aimed to provide an update in clinical practice guidelines for HMV in adults, applicable to the Portuguese context, grounded on the latest available evidence and experts' opinion. Study design and methods: A multidisciplinary panel with experience in HMV in the adult population was assembled. A comprehensive literature search was conducted during March 2023 regarding specific topics: equipment, ventilatory modes and interfaces, HMV initiation, follow-up and monitoring, disease specificities (neuromuscular diseases, obesity-hypoventilation syndrome, restrictive chest wall diseases; chronic obstructive pulmonary disease, and other diseases), home mechanical invasive ventilation, and palliative and end of life care. A 2-round Delphi process was conducted to establish consensus among panel members. A minimum agreement threshold of 80% was required. Results: Out of 88 recommendations initially included in the Delphi process, 61 were selected by consensus. Conclusion: Final recommendations grounded in the current level of evidence are outlined, and the key limitations and proposals for future research are discussed.