ESS2-Artigos (em revistas ou actas indexadas)
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- Frailty and outcomes in elderly ICU patients: insights from a portuguese cohortPublication . Lourenço, Eva; Rodrigues, Isabel; Sampaio, Mário; da Costa, EmiliaBackground: Frailty is a key determinant of outcomes in critically ill elderly patients, but data from Portugal remain limited. To our knowledge, this is the first study to examine the prevalence and prognostic impact of frailty among elderly ICU patients in a Portuguese hospital setting. Objective: To determine the prevalence of frailty among elderly patients admitted to an intensive care unit (ICU) in southern Portugal and to examine its crude associations with illness severity, organ support, and mortality outcomes. Methods: We conducted a retrospective cohort study including 125 patients aged ≥ 65 years admitted to the polyvalent ICU of Hospital de Faro over the last six months of 2024. Data included demographics, comorbidities, Charlson Comorbidity Index (CCI), severity scores (SOFA, SAPS II, APACHE II), and frailty status assessed by the Clinical Frailty Scale (CFS). Outcomes were the need for organ support, ICU and hospital mortality, and length of stay. Results: Frailty (CFS ≥ 5) was identified in 30.4% of patients. Frail patients were older, had higher comorbidity burden (CCI), and presented with significantly higher severity scores at admission. They also required more invasive support, including vasopressors and invasive mechanical ventilation, while acute kidney injury (AKI) requiring renal replacement therapy (RRT) was similar between groups. ICU mortality was significantly higher among frail patients (50.0% vs. 31.0%), as was hospital mortality (76.3% vs. 33.3%). Length of ICU stay did not differ, although frail patients tended to have longer hospitalizations overall. Conclusions: Frailty was highly prevalent and strongly associated with increased severity, greater need for organ support, and higher mortality. Routine frailty assessment at ICU admission may enhance prognostic accuracy and support patient-centered decision-making.
- Valorisation of gilthead seabream by-products through recovery of antimicrobial proteins for active biopolymer formulationsPublication . Maurizzi, Enrico; Anjos Guerreiro, Liliana Isabel Tomé; Bigi, Francesco; Quartieri, Andrea; Mateus, Ana Patrícia; Volpelli, Luisa Antonella; Pulvirenti, Andrea; Power, Deborah MaryIn the seafish sector, industrial processing and by-catch currently lead to the waste of over 36 % of global fish production by weight. This is largely due to insufficient revalorization of by-products and the underdevelopment of sustainable practices to manage these discarded volumes, which are often disposed of or released into the environment, contributing to pollution. In this study, antimicrobial proteins were extracted from fish by-products for incorporation into biopolymer formulations. Specifically, the focus was on lysozyme, which was targeted using a molecular-proteomic approach. Protein extractions were conducted at various pH levels from Gilthead seabream (Sparus aurata) tissues (skin with scales and mucus, liver, and intestine) normally discarded during processing, to assess recovery of proteins from the selected tissues. The extracted proteins were separated using mild ion-exchange chromatography, followed by quantification and qualitative analysis via SDS-PAGE. The expression levels of lysozyme types-g and-c were quantified through Real-Time qPCR. The antimicrobial activity of the extracted proteins was assessed against Gram-positive (Listeria monocytogenes) and Gram-negative (Escherichia coli) bacteria using a Minimal Inhibitory Concentration (MIC) assay. The proteins were subsequently incorporated into biodegradable film-forming solutions based on hydroxypropyl methylcellulose/chitosan and hydroxypropyl methylcellulose/guar gum mixtures. These films were further tested against the same human pathogens. The results demonstrate the feasibility of extracting proteins from fish by-products using a non-targeted buffer pH extraction approach, which, even without further chromatographic purification, exhibited promising intrinsic antimicrobial activity for potential applications in the food industry.
- The influence of a 12-week yoga program on military aviation pilots' decision-making capacity for operational effectivenessPublication . Santos, Sara; Fernandes, Orlando; Cabo, Carolina A.; Parraca, José A.; Melo, FilipeMilitary aviation demands cognitive performance, emotional stability, and resilience under pressure. Portuguese Airforce pilots face additional challenges: maintaining fitness and readiness independently, without structured exercise regimens. Yoga’s capacity to enhance mindfulness makes it a promising intervention. Despite potential benefits, research on yoga’s impact in military aviation remains limited. This study investigates incorporation of yoga into the training regimen of Portuguese Airforce to verify decision-making effectiveness and performance. A randomized controlled trial was conducted with 18 Portuguese Air Force pilots: Control Group (n = 8) followed standard military training, and Intervention Group (n = 10) received aditional yoga training twice a week, for 12 weeks. Assessments included Five Facet Mindfulness Questionnaire (FFMQ), Multidimensional Assessment of Interoceptive Awareness (MAIA), Aviation Safety Attitude Scale (ASAS), Risk Perception To Self (RPTS), Trail Making Test (TMT) and aviation simulator performance. Data analysis used Jamovi v2.6.13. The yoga group showed significant improvements in mindfulness (FFMQ), interoceptive awareness (MAIA), self-confidence and safety attitudes (ASAS), cognitive flexibility (TMT-B), and simulator performance (fewer flight errors). Enhancements in attention regulation, body awareness, and emotional self-regulation reflect greater readiness for stress management. Improvements in decision-making, calculated risk-taking, and operational safety suggest yoga’s potential to reinforce psychophysiological resilience in high-demand environments. Yoga contributes meaningfully to enhanced performance and safety in high-pressure aviation environments. These findings may inform policy-level decisions toward integrating mandatory mind-body training programs that are cost-effective and time-efficient. The benefits observed may be applicable to Air Force teams globally, as well as commercial aviation, civil aviation, and other high-stress, high-performance domains, including elite sports. Clinical Trial Registry number and website where it was obtained: ClinicalTrials.gov identifier NCT05821270.
- Editorial: Innovative teaching and learning in health education and promotionPublication . da Costa, Emilia; Ruiz Fernández, María Dolores; Fernández Medina, Isabel María; Jimenez Lasserrotte, Maria del Mar; Ventura-Miranda, Maria IsabelHealth education and health promotion are undergoing profound transformation. Demographic transitions, aging populations, increasing multimorbidity, persistent inequities, and rapid technological change are reshaping how learners understand and navigate health. In this evolving context, traditional knowledge-transmission models are no longer sufficient to prepare future professionals for complex, multicultural and digitally mediated environments. Innovation in teaching and learning has therefore become essential, not only to improve learning outcomes, but to strengthen ethical reasoning, equity, and learner autonomy. This global shift echoes recent OECD (1) analyses highlighting how digitalisation, demographic aging and widening social disparities are redefining the competencies required of tomorrow’s health workforce and calling for educational approaches attuned to complexity and uncertainty. It is also consistent with the World Health Organization’s call for transformative health workforce education, which stresses that conventional training models can no longer meet the demands posed by demographic change, chronic disease burdens, technological acceleration and growing inequities.
- Impacto dos grupos de apoio na sobrecarga de cuidadores familiares em PortugalPublication . Bernabéu-Álvarez, Claudia; Costa, Emília IsabelObjetivo: Analisar a relação entre a sobrecarga do cuidador familiar e o apoio social com a participação em grupos de apoio presenciais e virtuais. Métodos: Estudo pré-experimental. Critérios de inclusão: cuidadores informais, maiores de idade, residentes na região centro-sul de Portugal. Variável independente: participação num grupo de apoio presencial (GA), num fórum virtual (FV) ou nenhum grupo (GC). Variáveis dependentes: sobrecarga de cuidado (Índice de Esforço do Cuidador) e apoio social percebido (escala MOS). Análise descritiva, binária e multivariada com o programa estatístico SPSS 22. Resultados: Participaram 109 cuidadores, principalmente mulheres, cuidando dos seus filhos. 47,7% sofreram sobrecarga pelo cuidado, sendo mais alta no GC. O apoio social foi bom em 64,2% dos participantes, sendo maior no GA. Houve uma associação significativa com o género e a rede social (ser mulher está associado a uma maior sobrecarga, enquanto uma ampla rede social diminui a sobrecarga do cuidador). A participação num GA ou FV melhorou significativamente a rede e o apoio social. Conclusão: A participação em grupos de apoio, tanto presenciais quanto virtuais, tem uma relação positiva significativa com a redução da sobrecarga do cuidador e o aumento do apoio social percebido. Estes grupos de apoio são recursos essenciais para os cuidadores informais, ajudando a mitigar os efeitos negativos do cuidado e fortalecendo as suas redes sociais e o apoio. Portanto, promover a participação em tais grupos pode ser uma estratégia eficaz para melhorar o bem-estar dos cuidadores familiares.
- Food insecurity in higher education studentsPublication . Paula, Aline de; Carneiro, Beatriz; Mendes, Inês; Pacheco, Mariana; Gonçalves, Marta; Pinto, Ezequiel; Palma Mateus, MariaFood insecurity (FI) indicates a situation in which there is no regular access to food in satisfactory quantity and quality. To characterize FI in students from Portuguese higher education institutions, a study was conducted in a non-random sample of students, with an online questionnaire consisting of sociodemographic questions and the Portuguese version of the IF scale. There were 200 valid questionnaires and 27.5% of the participants were classified as having some degree of FI. Participants with FI reported fewer visits to the family’s home (p = 0.024) and less financial resources (p < 0.001). The results indicate that interventions are needed in this area.
- On the run—comparing bioimpedance analysis (BIA) using portable devicesPublication . Dias, Carina Vieira; Dias, Joana C.; Laranjo, Céu; Cardoso, Paulo; De Sousa-Coelho, Ana LuísaBioelectrical impedance analysis (BIA) is a non-invasive indirect method that allows for measurement of lean and fat body mass. The main goal of this exploratory study was to compare the results from two different portable BIA devices. We found that only fat-free mass and body fat mass were directly comparable between InBodyS10 (Teprel, Porto, Portugal) and seca mBCA 525 (Bacelar, Porto, Portugal) medical portable BIA devices.
- Bone mineral density and body composition among individuals who practice sports with mechanical impact and sedentary activitiesPublication . Pinheiro, João; Ribeiro, Luís Pedro; Coelho-e-Silva, ManuelThe purpose of this study was to evaluate indicators of bone health associated with sports practice in male adolescents using dual-energy X-ray absorptiometry (DXA) to measure bone mineral content (BMC), density (BMD), and body composition (BC) for the whole body (WB) and specific regions. This cross-sectional study involved 65 individuals (18–35 years). Athletes had higher BMD for WB (1.064 ± 0.121 g/m−2) than sedentary individuals (0.753 ± 0.129 g/cm−2). Differences were also observed within specific regions such as the trunk, upper and lower limbs. Individuals who practice regular sports present improved bone health indicators compared to their sedentary peers.
- Chemical and health risks of swimming pool maintenance workersPublication . Silva, Adriana; Pinto, Ezequiel; Braz, Nídia Maria Dias Azinheira RebeloSwimming pool maintenance workers are exposed to occupational hazards, as it involves the regular handling of toxic chemicals. These exposures can result in acute reactions or chronic complications. The present study, still in the design phase, aims to describe the chemical and biological exposure of workers of a swimming pool maintenance company and to verify its compliance with the safety standards in force. A quantitative questionnaire will identify the use of personal protective equipment, chemical agents, and handling procedures, particularly regarding the time and frequency of use.
- The immune tumor microenvironment in gliomas: may CITED2 play a role?Publication . Teotónio Fernandes, Mónica AlexandraGliomas are the most common brain cancers, resulting from transformed glial cells. CITED2 is a co-transcriptional regulator previously implicated in several types of cancer, affecting both cellintrinsic processes and the microenvironment. Because in breast cancer it was shown to contribute to the recruitment of macrophages and their polarization to an immunosuppressive phenotype, a potential similar role was explored in gliomas. By analyzing publicly available databases using a set of bioinformatics tools, it was found that CITED2 is overexpressed in higher-grade gliomas and contributes to an adverse prognosis. In addition, CITED2 expression correlates with macrophage infiltration and a M2 phenotype.