Substance abuse and susceptibility to false memory formation: a systematic review and meta-analysis.

Background: Substance abuse has an impact on various cognitive domains, including memory. Even though this impact has been extensively examined across different subdomains, false memory has been sparsely studied. This systematic review and meta-analysis seek to synthesize the current scientific data concerning false memory formation in individuals with a history of substance abuse. Methods: PubMed, Scopus, the Cochrane Library, Web of Science, and PsycINFO were searched to identify all experimental and observational studies in English, Portuguese, and Spanish. Studies were then examined by four independent reviewers and, if they met the inclusion criteria, assessed for their quality. The Cochrane Risk of Bias Tool for randomized controlled trials (RCT) and the Joanna Briggs Institute (JBI) critical appraisal checklists for quasi-experimental and analytic cross-sectional studies were used to assess the risk of bias. Results: From the 443 screened studies, 27 (and two more from other sources) were considered eligible for full-text review. A final 18 studies were included in the present review. Of these, 10 were conducted with alcoholics or heavy drinkers, four focused on ecstasy/polydrug users, three were done with cannabis users and one focused on methadone maintenance patients with current cocaine dependence. Regarding false memory type, 15 studies focused on false recognition/recall, and three on provoked confabulation. Conclusions: None but one of the studies considering false recognition/recall of critical lures found any significant differences between individuals with a history of substance abuse and healthy controls. However, most of the studies taking into account false recognition/recall of related and unrelated events found that individuals with a history of substance abuse showed significantly higher rates of false memories than controls. Future research should continue to consider different types of false memories as well as their potential association with relevant clinical variables. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266503, identifier: CRD42021266503.

Effectiveness of smartphone interventions as continuing care for substance use disorders: A systematic review.

As a chronic disease with consistent relapse rates, substance use disorders (SUD) require a continuity-of-care approach. Unfortunately, many patients do not have access to continuing care. This systematic review analysed the current scientific knowledge to better understand if app-based smartphone interventions can be an effective alternative. The databases Cochrane Library, PubMed, Web of Science, and PsycINFO were used to find experimental and quasi-experimental studies investigating the effectiveness of a smartphone intervention in individuals who had completed treatment for SUD. After removing duplicates, a total of 1488 studies were screened, with 48 being selected for a full-text review. Four studies met all the criteria, with one other being added by identification through other resources, making a total of 5 studies included in the present review. Out of the four studies using a control group, only one found no significant differences in favour of the experimental group. That study used an active control group and compared the smartphone intervention to its therapeutic group equivalent. There were no significant differences between the two experimental groups. Overall, the results indicate that app-based smartphone interventions can be an effective alternative to traditional forms of continuing care. However, literature is still scarce, and more research needs to be made on this subject. This systematic review is registered at PROSPERO with the identifier [CRD42021272070].

Patterns of Medication Management and Associated Medical and Clinical Features among Home-Dwelling Older Adults: A Cross-Sectional Study in Central Portugal.

Ageing is frequently associated with multimorbidity and polypharmacy. The present study aimed to identify the current medication management patterns and the profiles of home-dwelling older adults and to find any association with their conditions, including frailty and cognitive impairment. Within the scope of this cross-sectional study, 112 older adults living in the community were assessed via face-to-face structured interviews. Frailty, cognitive status, medication management and clinical and sociodemographic variables were evaluated. Descriptive and inferential statistics were calculated. The mean participant age was 76.6 ± 7.1 years, 53.6% of participants were women, and 40.2% of participants lived alone. More than half were classified as having frailty (58.9%), almost one-fifth (19.6%) presented with a moderate cognitive impairment had more than one disease, and 60.7% were polymedicated. No associations were found between polymedication and medication self-management, the use of over-the-counter medications, living alone, having a poor understanding of pharmacological therapy and/or pathology, or having more than one prescriber. Self-management was associated with age, the number of medications, frailty and cognitive status. Binary logistic regressions showed that cognitive impairment had statistically significant differences with medication management, having a poor understanding of pharmacological therapy and/or pathology, having one prescriber and the use of medications not prescribed by physicians. Interventions to prevent medication-related problems in home-dwelling older adults are recommended.

An Intervention Program to Reduce Medication-Related Problems Among Polymedicated Home-Dwelling Older Adults (OptiMed): Protocol for a Pre-Post, Multisite, Pilot, and Feasibility Study.

BACKGROUND: Effective medication management is one of the essential preconditions for enabling polymedicated home-dwelling older adults with multiple chronic conditions to remain at home and preserve their quality of life and autonomy. Lack of effective medication management predisposes older adults to medication-related problems (MRPs) and adverse health outcomes, which can lead to the degradation of a patient's acute clinical condition, physical and cognitive decline, exacerbation of chronic medical conditions, and avoidable health care costs. Nonetheless, it has been shown that MRPs can be prevented or reduced by using well-coordinated, patient-centered, interprofessional primary care interventions. OBJECTIVE: This study aimed to explore the feasibility and acceptability of an evidence-based, multicomponent, interprofessional intervention program supported by informal caregivers to decrease MRPs among polymedicated home-dwelling older adults with multiple chronic conditions. METHODS: This quasi-experimental, pre-post, multisite pilot, and feasibility study will use an open-label design, with participants knowing the study's objectives and relevant information, and it will take place in primary health care settings in Portugal and Switzerland. The research population will comprise 30 polymedicated, home-dwelling adults, aged ≥65 years at risk of MRPs and receiving community-based health care, along with their informal caregivers and health care professionals. RESULTS: Before a projected full-scale study, this pilot and feasibility study will focus on recruiting and ensuring the active collaboration of its participants and on the feasibility of expanding this evidence-based, multicomponent, interprofessional intervention program throughout both study regions. This study will also be essential to projected follow-up research programs on informal caregivers' multiple roles, enhancing their coordination tasks and their own needs. Results are expected at the end of 2024. CONCLUSIONS: Designing, establishing, and exploring the feasibility and acceptability of an intervention program to reduce the risks of MRPs among home-dwelling older adults is an underinvestigated issue. Doing so in collaboration with all the different actors involved in that population's medication management and recording the first effects of the intervention will make this pilot and feasibility study's findings very valuable as home care becomes an ever more common solution. TRIAL REGISTRATION: Swiss National Clinical Trials Portal 000004654; https://tinyurl.com/mr3yz8t4.

Helmet-Noninvasive Ventilation for Hospitalized Critically Ill COVID-19 Patients: Has Vaccination and the New Variants Changed Evidence?

Noninvasive ventilation (NIV) is a technique for breathing support that significantly improves gas exchange and vital signs, reducing intubation and mortality rates. Helmets, unlike facemasks, allow for longer-term treatment and better ventilation, also being more cost-effective. As of today, we have found no reviews addressing this topic. This review aims to identify, map, and describe the characteristics of the use of noninvasive ventilation through helmet interface in critically ill COVID-19 adult patients hospitalized in acute care settings throughout the multiple moments that defined the COVID-19 pandemic. This scoping review will follow the methodology for scoping reviews proposed by JBI. A set of relevant electronic databases will be searched using terms such as COVID-19, helmet, and noninvasive ventilation. Two reviewers will independently perform the study selection regarding their eligibility. Data extraction will be accomplished using a researcher's developed tool considering the review questions. Findings will be presented in tables and a narrative description that aligns with the review's objective. This scoping review will consider any quantitative, qualitative, mixed-methods studies and systematic review designs for inclusion, focusing on the use of helmet on critically ill adult patients with COVID-19 hospitalized in acute care settings.

Falls and Preventive Practices among Institutionalized Older People.

The present study about falls among the older adult population essentially explores bio-physiological factors. In light of the complexity of the factors that cause these accidents, it is important to identify the safety and self-care practices of institutionalized older adults and their relationship with falls in order to introduce prevention measures and personalized cognitive-behavioral strategies. The objective of this study was to: (a) determine the frequency of falls and their recurrence among institutionalized older adults, and (b) to associate the occurrence of falls among institutionalized adults with or without cognitive impairment to communication and safety practices. This was a quantitative, correlational, and longitudinal study with 204 institutionalized older adults living in two long-term care facilities in Portugal. The Scale of Practices and Behaviors for Institutionalized Elderly to Prevent Falls was administered to the sample. The prevalence of falls at a 12-month follow-up was 41.6%, of which 38.3% were recurring episodes. Older adults with cognitive decline showed lower mean scores for safety practices. Further research with larger samples should explore the relationships between communication and safety practices and falls, their recurrence, and fear of new falls.

Transcultural Translation and Validation of Lasater Clinical Judgment Rubric©.

OBJECTIVES: to translate and cross-culturally validate the Lasater Clinical Judgment Rubric© (LCJR©) instrument for nursing students. METHODS: the application of LCJR-PT© was preceded by a linguistic translation into Portuguese, based on the translation-back-translation method. This psychometric study involved 32 nursing students from a program in Portugal. Data were collected through observations of two independent observers during the performance of the practices developed by the students, through the scenarios validated by experts of high and of medium-fidelity simulation. RESULTS: of the 64 observations obtained from the practices of nursing students, the value of intra-class correlations in the 4 aspects of the instrument exceeded 0.792. There was a global Cronbach's alpha of LCJR-PT© of 0.921 and 0.876 in Observers 1 and 2 respectively, with a statistically significant level of agreement. CONCLUSIONS: the LCJR-PT© is a valid and reliable instrument, demonstrating a high potential for its use in clinical education and nursing research.

Psychometric Properties of the European Portuguese Version of the Memorial Emergency Department Fall Risk Assessment Tool.

Falls are a public health problem that cause serious damage to people's health and health systems. This study aims to estimate the validity and reliability of the Memorial Emergency Department Fall Risk Assessment Tool for the European Portuguese population. The sample included 186 adults from an emergency department of a District Hospital in Portugal. Reliability and precision (inter-rater reliability) are assessed by two independent raters. The relationship between MEDFRAT and the Morse Fall Risk Scale is evaluated. All items presented a high Kappa index. The MEDFRAT showed a high and significant correlation with the Morse Fall Risk Scale. The influence of sociodemographic and clinical data was also checked. The MEDFRAT is adequate, valid and reliable for the European Portuguese population to assess the risk of falling of emergency department patients.

Evaluation of an e-health platform for informal caregivers and health professionals: the case study of Help2Care.

The Help2Care e-Health platform was developed in order to capacitate informal caregivers with digital, multimedia training materials. Health professionals select these materials according to the needs of the homebound patients under the supervision of these caregivers. In turn, caregiver can then use their smartphones to consult and apply the care procedures illustrated by these materials. In this paper, we present the results of performed usability tests for both web and mobile software applications of the Help2Care platform. These indicate an overall positive outcome, revealing less usable aspects such as the navigation flow in the web application and some design elements in the mobile application. Important written feedback was also collected, which we took into consideration to improve the software features of the platform.

Transcultural Translation and Validation of Lasater Clinical Judgment Rubric© / Tradução e Validação Transcultural da Lasater Clinical Judgment Rubric© / Traducción Transcultural y Validación de la Lasater Clinical Judgment Rubric©

ABSTRACT Objectives: to translate and cross-culturally validate the Lasater Clinical Judgment Rubric© (LCJR©) instrument for nursing students. Methods: the application of LCJR-PT© was preceded by a linguistic translation into Portuguese, based on the translation-back-translation method. This psychometric study involved 32 nursing students from a program in Portugal. Data were collected through observations of two independent observers during the performance of the practices developed by the students, through the scenarios validated by experts of high and of medium-fidelity simulation. Results: of the 64 observations obtained from the practices of nursing students, the value of intra-class correlations in the 4 aspects of the instrument exceeded 0.792. There was a global Cronbach's alpha of LCJR-PT© of 0.921 and 0.876 in Observers 1 and 2 respectively, with a statistically significant level of agreement. Conclusions: the LCJR-PT© is a valid and reliable instrument, demonstrating a high potential for its use in clinical education and nursing research.

RESUMO Objetivos: traduzir e validar transculturalmente o instrumento Lasater Clinical Judgment Rubric© (LCJR©) para estudantes de Enfermagem. Métodos: a aplicação do LCJR-PT© foi precedida por tradução linguística ao português, baseando-se no método de traduçãoretradução. Este estudo psicométrico envolveu 32 estudantes de Enfermagem de um programa em Portugal. Os dados foram recolhidos mediante observações de dois observadores independentes durante o desempenho das práticas desenvolvidas pelos estudantes por meio dos cenários validados por peritos em simulação de alta e média fidelidade. Resultados: das 64 observações das práticas de estudantes de Enfermagem, o valor das correlações por intraclasse nos quatro aspectos do instrumento ultrapassou os 0,792. Identificou-se um alfa de Cronbach global na LCJR-PT© de 0,921 e 0,876 nos observadores 1 e 2, respectivamente, com um nível de concordância estatisticamente significante. Conclusões: a LCJR-PT© é um instrumento válido e confiável, demonstrando um alto potencial para seu uso na educação clínica e pesquisa em enfermagem.

RESUMEN Objetivos: traducir y validar transculturalmente el instrumento Lasater Clinical Judgment Rubric© (LCJR©) para estudiantes de Enfermería. Métodos: aplicación del LCJR-PT© precedida por traducción lingüística al portugués, basándose en el método de traducción y retraducción. Estudio psicométrico involucró 32 estudiantes de Enfermería de un programa en Portugal. Datos recolectados mediante observaciones de dos observadores independientes durante el desempeño de prácticas desarrolladas por estudiantes mediante los escenarios validados por peritos en simulado de alta y mediana fidelidad. Resultados: de las 64 observaciones de prácticas de estudiantes de Enfermería, el valor de correlaciones por intraclase en los cuatro aspectos del instrumento sobrepasó 0,792. Identificado un alfa de Cronbach global en el LCJR-PT© de 0,921 y 0,876 en los observadores 1 y 2, respectivamente, con un nivel de concordancia estadísticamente significante. Conclusiones: el LCJR-PT© es un instrumento válido y confiable, demostrando un alto potencial para su uso en educación clínica e investigación en enfermería.

Gait Ability and Muscle Strength in Institutionalized Older Persons with and without Cognitive Decline and Association with Falls.

Falls are a complex problem, given their multifactorial nature, the comorbidities involved, and due to the dependency of older persons living in nursing homes. Risk, fear of falling, falls themselves, and their recurrence are the main factors behind fragility fractures, lack of independence, and increases in pain prevalence, and other comorbidities in older populations. The objectives of the present quantitative and longitudinal study were: (a) to characterize the cognitive state and fall frequency of older persons living in nursing homes; (b) to analyze the relationship between cognitive status and some fall risk factors; and (c) to associate cognitive decline, gait ability, and muscle strength of the examined institutionalized older persons with fall occurrence and recurrence over 12 months. The participants were 204 older persons who lived in Portuguese nursing homes, and data were collected from January 2019 to February 2020 by consulting medical records and applying the following instruments: the Mini-Mental State Examination, Timed Up and Go Test, and Medical Research Council Manual Muscle Testing Scale. Fall prevalence, assessed in two periods, 12 months apart, was similar in both samples (with and without cognitive decline) and close to 42%, and the annual recurrence rate was 38.3%. Older persons with no cognitive decline showed an association between gait speed and occurrence of first fall and recurrent fall (p < 0.05). Muscle strength and use of gait aid devices were not related to falls and their recurrence, regardless of mental state.

Effectiveness of Mindfulness-Based Relapse Prevention in Individuals with Substance Use Disorders: A Systematic Review.

OBJECTIVES: This systematic review aimed to understand the current state of the art about the effectiveness of mindfulness-based relapse prevention (MBRP) on individuals with substance use disorders (SUD), taking into account not only SUD variables (e.g., cravings, frequency of use) but also other relevant clinical variables (e.g., anxiety and depressive symptoms, quality of life). METHODS: A comprehensive search of electronic databases was conducted to identify studies that investigate MBRP interventions on individuals with SUD. Studies that met the inclusion criteria were synthesized and assessed using systematic review methods. RESULTS: Thirteen studies were included in the present review. The methodological quality of the included studies was moderately strong. Nine studies (69.2%) used the traditional 16 h MBRP program. Six studies (46.1%) chose to use a co-intervention treatment ranging from the treatment as usual (TAU) to cognitive behavioral therapy. All but one study indicated that their interventions produced positive effects on at least one addiction outcome measure. None of the interventions were evaluated across different settings or populations. CONCLUSIONS: Despite some heterogeneity regarding the type of MBRP program used, results support the effectiveness of these interventions in the SUD population, especially in reducing cravings, decreasing the frequency of use, and improving depressive symptoms.

Cognitive Training Effectiveness on Memory, Executive Functioning, and Processing Speed in Individuals With Substance Use Disorders: A Systematic Review.

Background: Cerebral neuroplasticity is compromised due to substance abuse. There is damage to neuronal areas that are involved in memory and executive functioning. Treatments with worse outcomes are often associated with cognitive deficits that have resulted from substance dependence. However, there is evidence that cognitive training can lead to improvements in cognitive functions and can be useful when treating addictions. This systematic review aims to synthesize evidence on the effectiveness of cognitive training in memory, executive functioning, and processing speed in individuals with substance use disorder (SUD). Methods: The Joanna Briggs Institute's PICO strategy was used to develop this systematic literature review. Four databases were searched (PubMed, the Cochrane Library, Web of Science, and PsycINFO) to identify controlled randomized clinical studies and quasi-experimental studies, in English, Portuguese, and Spanish, from 1985 to 2019. The literature found was examined by two independent reviewers, who assessed the quality of studies that met the inclusion criteria. The Cochrane risk-of-bias tool for the randomized controlled trials and the ROBINS-I tool for non-randomized studies were used to assess the risk of bias. In data extraction, the Cochrane Handbook for Systematic Reviews was considered. Results: From a total of 470 studies, 319 were selected for analysis after the elimination of duplicates. According to the inclusion criteria defined, 26 studies were eligible and evaluated. An evaluation was performed considering the participant characteristics, countries, substance type, study and intervention details, and key findings. Of the 26 selected studies, 14 considered only alcoholics, six included participants with various SUD (alcohol and other substances), three exclusively looked into methamphetamine-consuming users and another three into opioid/methadone users. Moreover, 18 studies found some kind of cognitive improvement, with two of these reporting only marginally significant effects. One study found improvements only in measures similar to the training tasks, and two others had ambiguous results. Conclusions: The included studies revealed the benefits of cognitive training with regard to improving cognitive functions in individuals with SUD. Memory was the most scrutinized cognitive function in this type of intervention, and it is also one of the areas most affected by substance use. Systematic Review Registration: [PROSPERO], identifier [CRD42020161039].

Clinical Decision-Making in Nursing Scale (CDMNS-PT©) in nursing students: translation and validation.

OBJECTIVES: to validate, for the Portuguese population, the Clinical Decision-Making Nursing Scale© (CDMNS©). METHODS: this methodological study involved 496 nursing students who filled in a questionnaire created using sociodemographic and academic data, and the scale to evaluate the making of decisions in nursing. RESULTS: the confirmatory factorial analysis showed that the adjustment of the factorial structure has good quality, being made up by three factors (X2/gl = 2.056; GFI = 0.927; CFI = 0.917; RMSEA = 0.046; RMR = 0.039; SRMR = 0.050). For the scale to be reliable, it had to include only the reliability of the scale required it to be constituted by 23 items, with correlation values that varied from 0.184 and 0.610, and a global Cronbach's Alpha of 0.851, which showed its good reliability. CONCLUSIONS: the CDMNS-PT© is valid and reliable, showing a high potential to be used in clinical practice and investigation.

Conhecimentos dos estudantes de enfermagem sobre suporte básico de vida / Nursing students' knowledge about basic life support / Conocimiento de los estudiantes de enfermería sobre el soporte vital básico

Resumo Enquadramento: Os conhecimentos sobre suporte básico de vida (SBV) em estudantes de enfermagem requerem competências técnicas (compressões e ventilações), mas também competências não técnicas (julgamento clínico e tomada de decisão). Objetivos: Avaliar as características sociodemográficas e académicas dos estudantes de enfermagem; avaliar os conhecimentos teóricos sobre SBV dos estudantes de enfermagem e relacionar as características sociodemográficas e académicas dos estudantes de enfermagem, com os seus conhecimentos teóricos sobre SBV. Metodologia: Estudo observacional, descritivo e correlacional, onde participaram 496 estudantes, selecionados através de uma técnica de amostragem não probabilística por conveniência em duas escolas do centro de Portugal. Resultados: Os estudantes evidenciam um bom nível de conhecimentos sobre SBV com uma média de 30,93 ± 2,29, numa escala de 0 a 37 pontos. Destacam-se muito bons conhecimentos sobre as condições de segurança, assim como das componentes técnicas de avaliação da via aérea, das compressões torácicas e ventilações. O nível de conhecimentos está relacionado com a idade, ano de licenciatura e experiência prática de SBV. Conclusão: Os estudantes apresentam um bom nível de conhecimentos sobre SBV.

Abstract Background: Knowledge about basic life support (BLS) in nursing students involves both technical skills (compressions and ventilations) and non-technical skills (clinical judgment and decision-making). Objectives: To assess nursing students' sociodemographic and academic characteristics; to assess nursing students' theoretical knowledge about BLS and analyze the association between nursing students' sociodemographic and academic characteristics and their theoretical knowledge about BLS. Methodology: Observational, descriptive, and correlational study with a sample of 496 nursing students selected using a nonprobability convenience sampling technique in two schools in the central region of Portugal. Results: Students demonstrated a good level of knowledge about BLS, with an average of 30.93 ± 2.29 on a scale from 0 to 37 points. They had a very good level of knowledge about safety conditions, the technical components of airway assessment, chest compressions, and ventilations. The level of knowledge is associated with age, year of undergraduate studies, and practical experience in BLS. Conclusion: Students have a good level of knowledge about BLS.

Resumen Marco contextual: Los conocimientos sobre el soporte vital básico (SVB) en los estudiantes de enfermería requieren competencias técnicas (compresiones y ventilaciones), pero también competencias no técnicas (juicio clínico y toma de decisiones). Objetivos: Evaluar las características sociodemográficas y académicas de los estudiantes de enfermería; evaluar los conocimientos teóricos de los estudiantes de enfermería sobre el SVB, y relacionar las características sociodemográficas y académicas de los estudiantes de enfermería con sus conocimientos teóricos sobre el SVB. Metodología: Estudio observacional, descriptivo y correlacional, con la participación de 496 estudiantes, seleccionados mediante una técnica de muestreo no probabilístico por conveniencia en dos escuelas del centro de Portugal. Resultados: Los estudiantes mostraron un buen nivel de conocimiento sobre el SVB, con una media de 30,93±2,29 en una escala de 0 a 37 puntos. Destaca un muy buen conocimiento de las condiciones de seguridad, así como de los componentes técnicos de la evaluación de las vías respiratorias, las compresiones torácicas y las ventilaciones. El nivel de conocimiento está relacionado con la edad, el año de graduación y la experiencia práctica en SVB. Conclusión: Los estudiantes tienen un buen nivel de conocimiento sobre el SVB.

Hope in a depression therapeutic group: a qualitative case study.

OBJECTIVE: to understand the perceptions of hope for people with depression in the context of a therapy group. METHODS: using a qualitative case study approach, a semi-structured in-depth interview and a self-report questionnaire were conducted with seven women with depression integrated in a therapy group at a Portuguese day-care psychiatric unit. Data collection and analysis used triangulation of sources. RESULTS: the participants evidenced hope founded on the positive experiences of the past with a strong affiliation component. Hope management is done fundamentally through the interpersonal relationships established between the members of the group, based on communicational patterns that are established on a regular basis, mediated by the group therapist. CONCLUSION: the therapy group functioned towards the reinforcement of hope in people who experience depression, and it works as a motivation to manage the implications of illness in the participants' life and health project.

The fear of falls in the caregivers of institutionalized elders.

AIMS: To understand how the fear of falls emerges and manifests itself in caregivers of institutionalized elders. METHOD: It is a qualitative study, based on the Grounded Theory and carried out with 24 informal caregivers, 5 nurses, 2 physicians and 2 directors of two Portuguese nursing homes. Data collection took place through interviews, participant observation, and documentation analysis, between October 2016 and January 2018. Data was collected and analyzed simultaneously, following the stages of open, axial, and selective coding. RESULTS: The comparative analysis of the findings identified the conceptual category "Fear of falls in the caregivers of institutionalized elders". The main category is associated with the categories: maintaining safety, hidden fear of falls, the perceived self-efficacy in the prevention of falls, falls and interpersonal relations, previous experiences, and team support. CONCLUSIONS: The fear has an influence on the self-efficacy perceived in the prevention of falls; the quality of the teamwork, in turn, is affected by previous negative experiences and by the support of the team.

Awareness and Attitudes towards Advance Care Directives (ACDs): An Online Survey of Portuguese Adults.

(1) Background: Evidence shows that facilitated advance decisions can increase the number of meaningful and valid Advance Care Directives (ACDs) and improve the quality of care when End-Of-Life (EOL) is near. Little is known about the awareness and attitudes of Portuguese adults towards ACDs. The present study aims to assess the knowledge, attitudes, and preferences of a sample of Portuguese adults regarding EOL care decisions and ACDs. (2) Methods: A total of 1024 adults were assessed with an online cross-sectional survey collecting information on sociodemographic factors, knowledge, attitudes and preferences regarding advance decisions and EOL care. (3) Results: Participants had a mean age of 40.28 ± 11.41 years. Most were female and had a professional background related to healthcare. While 76.37% of participants had heard of ACDs, only a small percentage (2.34%) had actually ever made an ACD. Knowledge levels were weakly correlated with attitudes regarding ACDs (r = -0.344; p < 0.01). (4) Conclusions: Participants lacked a comprehensive understanding about ACDs, but revealed positive attitudes towards their use and usefulness. Further research can inform efforts to improve ACD engagement in this population. The discussion about ACDs should be part of health promotion education with a focus on planning for a comfortable and peaceful death.

Association Between Food Choices Motivators and Physical Activity in Body Image (dis)Satisfaction in Portuguese Adolescents.

Concerns about weight and body image are common among adolescents since they are particularly vulnerable to body-image dissatisfaction due to the normal physiological, social, and psychological changes they are going through. This study aims to analyse the relationship between food choice motivations and physical activity in body-image perception among adolescents. Twelve to sixteen years old adolescents were recruited from three school districts. The Portuguese version of the Food Choices Questionnaire (FCQ) was used to assess food choice motivators, and the Quantification de l'Activité Physique en Altitude Chez les Enfants was used to assess physical activity and to calculate daily energy expenditure (DEE). Body image perception was measured using Collins' sequence of seven silhouettes. Body image (dis)satisfaction was estimated by the present body shape minus the desired body shape. ANOVA and Kruskal-Wallis tests were performed to compare groups, and the post-hoc Bonferroni test was used to compare target groups. A multinominal logistic regression was performed to analyse the association between gender, age, hours of sport's competition, FCQ, and body dissatisfaction. All analyses were performed in IBM SPSS Statistics 26.0. The sample comprised 286 adolescents (51.4% females). Means of FCQ categories varied between 0.33 and 0.97 (range: -2 to 2). Regarding the categories of FCQ, statistically significant differences were found in the category of body satisfaction and weight control among the three groups (p = 0.004). A preventive effect was found of choosing food regarding body satisfaction and weight control, on body-image dissatisfaction.

Evaluation of the effectiveness of an intervention in a health team to prevent falls in hospitalized elderly people.

OBJECTIVE: To evaluate the effectiveness of an intervention program in practices and behaviors of a health team to prevent falls in hos pitalized elderly people. METHOD: This was an action, mixed-methods, and longitudinal study that applied an intervention based on TeamSTEPPS®, and organized into five domains: team training, communication, leadership, monitoring, and mutual support. The population was nurses and nursing aides who worked at the medical service of a Portuguese hospital center. Data were obtained by consulting process records and interviews, and by applying the Scale of Practices and Behaviors of Teams for Fall Prevention. RESULTS: There was improvement in all indicators of the scale, with evident progress in discussion of risk factors and preventive measures to be implemented. CONCLUSION: This intervention promoted decision-making regarding the preventive measures to be applied to each elderly person and improved communication and the interest in identifying the causes of falls to prevent their recurrence.