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- Digital workplace competencies and their outcomes: A systematic literature reviewPublication . Pinheiro, Sofia; Pinto, Ana; Simões, Ana Correia; Ferraz, Mariana; Domingues, Ana Raquel; Santos, Joana; Ferraz, MarianaThe rapid digital transformation of work environments has heightened the need to understand not only which competencies are essential but also how they influence workplace outcomes. This study presents a systematic literature review (SLR) of 46 peer-reviewed articles published between 2018 and 2023, following the PRISMA methodology across Scopus, Web of Science, and ERIC databases. This review has two objectives: (1) to synthesize how digital competencies are conceptualized and developed in workplace contexts, and (2) to analyze the measurable outcomes associated with their acquisition. Competencies were categorized using the DigComp 2.2 and the European Key Competence Framework for Lifelong Learning, capturing both digital competencies (e.g., communication, collaboration, problem-solving, data literacy) and transversal skills (e.g., STEM, personal, social, and learning). The findings highlight strong associations between competencies and outcomes such as innovation, performance, engagement, and well-being, while also noting risks like job loss, digital fatigue, and peer-to-peer friction. The review underscores the multidimensional and evolving nature of digital workplace competencies, identifies underexplored areas such as AI literacy, ethical awareness, and virtual teamwork, and provides insights for organizational training, policy design, and curriculum development. Future research should establish hierarchical models of competence influence on work performance and broaden the evidence base through interdisciplinary and cross-sectoral perspectives.
- Immersive technology applications in radiation protection for fluoroscopy - A systematic reviewPublication . Videira, Sara; Rodrigues, Matilde A.; Santos, Joana; da Silva, Manuela Vieira; Rodrigues, Matilde; Vieira da Silva, ManuelaImmersive technology is being increasingly incorporated into various professional and educational settings for occupational safety and health training. This review aims to assess the impact of immersive technology on the radiation protection (RP) of workers exposed to ionising radiation during fluoroscopy-guided procedures. Studies were collected from six databases on 3 April 2024: PubMed, Academic Search Complete, Scopus, Web of Science Core Collection, ScienceDirect, and Engineering Village. Additionally, studies were identified through snowball sampling techniques. Eligible studies assessed RP learning via immersive technology among healthcare workers or trainees exposed to ionising radiation from fluoroscopy in operating or interventional rooms. Additionally, only original research articles published in peer-reviewed journals and written in Portuguese, Spanish, English, and French were included. The review followed PRISMA and PICo, using narrative synthesis and bibliometric analysis. Quality was assessed using the Mixed Methods Appraisal Tool checklist. Ten studies involving 358 individuals (37 % trainees/students; 63 % workers) were analysed. All assessed the usefulness of RP education/training, and most (9/10) reported an improved understanding of scattered radiation. Technologies used included virtual reality (7/10), augmented reality (2/10), and mixed reality (1/10). Radiation scatter visualisation was present in the majority (9/10) of the studies, and 1/10 combined immersive technology with clinical training. These technologies enhance learning outcomes, support effective RP teaching, and optimise work practices. Integrating clinical training with RP education is essential. Implications for practice: This study supports healthcare professionals and educators in understanding how immersive technology (virtual, augmented, and mixed reality) is being applied and evaluated in training and real work contexts. Insights into methods, outcomes, and study populations inform practical use, while bibliometric data highlight key sources and authors for future reference and collaboration.
- Physical activity during pregnancy: Associations between levels and types of physical activity and low back pain–related disability in Portuguese pregnant womenPublication . Teixeira, Isabel; Santos, Paula Clara; Festas, Clarinda; Bernardo, Diana; Santos, Paula ClaraLow back pain (LBP) is one of the most prevalent musculoskeletal conditions during pregnancy and frequently impairs daily living activities and quality of life. The association between different levels and types of physical activity (PA) and LBP-related functional disability remains insufficiently explored. This study aimed to examine the association between PA levels and types and functional disability among pregnant women with LBP. A cross-sectional analytical study was conducted involving 192 Portuguese pregnant women. Data were collected through an online questionnaire comprising the Pregnancy Physical Activity Questionnaire and the Oswestry Disability Index (ODI). Most participants engaged predominantly in light-intensity or sedentary activity (69.1%), with minimal participation in vigorous activity (0.8%). Functional disability was generally mild (mean ODI = 11.5 ± 7.35); however, 42.2% of participants reported moderate disability and 11.0% severe disability. Advancing gestational age showed weak associations with increased domestic activity (r = 0.146, p = 0.044), decreased occupational activity (r = −0.295, p = 0.001), and higher functional disability scores (r = 0.142, p = 0.049). Parity was associated with differences in total PA levels (p = 0.005) and domestic activity (p = 0.001). Higher ODI scores were weakly associated with light-intensity and sedentary activity (r = 0.144, p = 0.047), whereas severe disability demonstrated a moderate association with sedentary behavior (r = 0.529, p = 0.014). Overall, lower levels of PA, particularly sedentary behavior, were weakly associated with higher LBP-related disability; however, the observed associations were generally weak and should be interpreted with caution considering the cross-sectional design.
- Towards a safer hospital environment: a multilevel analysis of safety climate and performancePublication . Ferreira, Juliana; Rodrigues, Matilde A.; Rodrigues, MatildeSafety climate is a crucial measure for organizations, predicting occupational accidents, monitoring safety performance, and identifying areas for improvement. However, its application in hospital settings remains limited. This study aimed to analyze safety climate levels and their relationship with other safety performance indicators in hospital settings using a multilevel perspective. The study was conducted in two hospital units located in Northern Portugal and involved 500 health professionals, including doctors, nurses, diagnosis and therapeutics technicians, operational assistants, and technical assistants. A questionnaire was applied to collect data of the variables under study. The questionnaire included a multilevel safety climate scale, which assesses the safety climate at the three different levels: management, team leader and coworkers. Additionally, it included scales to determine safety behaviours, motivation, time pressure and safety knowledge. Results revealed positive levels of safety climate across the three hierarchical subscales. Safety climate was positively associated with safety motivation, safety behaviors, and safety knowledge, and negatively associated with time pressure. Significant differences were observed across professional categories. Technical assistants were observed to reported lower levels for co-workers safety climate, safety knowledge, and safety participation, and higher time pressure. Additionally, work schedule was associated with safety climate perceptions and safety knowledge, with non-shift workers reporting higher safety climate at the management and team leader levels. This study enhances understanding of safety climate in hospital settings, highlighting the importance of addressing specific safety indicators, particularly among distinct professional groups.
- The association between exposure to blue spaces and multidimensional frailty in community-dwelling older adults: A cross-sectional studyPublication . Coelho, Tiago; Leite, Diana; Maciel, Daniela; Ribeiro, Ana Isabel; Rocha, Nuno Barbosa; Rocha, Nuno; Coelho, TiagoContact with blue spaces appears to benefit older adults’ health and well-being, but evidence on its relationship with frailty is scarce. This cross-sectional study investigated associations between exposure to blue spaces and multidimensional frailty in 189 community-dwelling people aged ≥65 years (Portugal). Measurements included the Tilburg Frailty Indicator, questionnaire regarding exposure, and Geographic Information System data for proximity. Purposeful visits once or twice a month were associated with lower physical frailty, as were visits with pets, engaging in physical activity, and spending 1–2 hours or >2 hours in these environments. Visiting with others was associated with lower social frailty. Incidental exposure—passing by visible blue spaces during daily commutes—was linked to lower total and physical frailty. Walking travel times <20 minutes were associated with lower total, physical, and social frailty, with different distances within this range showing domain-specific associations. Results suggest blue spaces may promote healthy aging.
- A comprehensive profile of volunteer firefighters: sociodemographic and occupational dimensionsPublication . Teixeira, Tatiana; Carvalho, Eduardo; Santos, Joana; Vaz, Mário; Guedes, Joana; Santos, JoanaThe European Union prioritizes occupational health and safety, with firefighters—particularly volunteers—facing significant risks. In Portugal, 94% of firefighters are volunteers, often balancing multiple jobs, which increases their exposure to hazards. This study investigates Portuguese firefighters’ occupational risks and identifies tasks with the highest accident incidence to build a comprehensive profile of their health and work conditions. Firefighters are exposed to extreme environments, long shifts, and high-stress situations, especially during wildfires. These conditions contribute to physical and mental health issues, including cardiovascular disease and sleep disturbances. Training and experience are key to improving risk perception and preventing accidents. Understanding firefighters’ main characteristics is essential for risk reduction and improving their quality of life. A sociodemographic questionnaire was developed and administered to firefighters, covering three sections: General Information, Lifestyle and Clinical History, and Firefighting Activity. This enabled the collection of sociodemographic and occupational data. A total of 220 responses were collected from Portuguese volunteer firefighters. Cardiovascular and respiratory diseases were the most commonly reported diagnoses. Wildland and urban/industrial fires were the main operational contexts linked to accidents, with 84 individuals reporting accident history in these scenarios. The study revealed a lack of data on the profile of volunteer firefighters, a group at heightened risk due to cumulative exposures and existing health conditions. Further research is needed to support the development of regulations and health monitoring strategies that protect this workforce without compromising their operational capacity.
- A systematic review of indoor air quality in schools settings: Focus on microbiome and their relation to particulate matter and chemical pollutantsPublication . Ferraz, Mariana; Santos, Joana; Silva, Manuela Vieira da; Santos, Joana; Vieira da Silva, Manuela; Ferraz, MarianaIndoor air quality (IAQ) in schools is a growing concern due to its impact on children's health. Continuous exposure to indoor air pollutants, such as particulate matter (PM), carbon dioxide (CO 2 ), and microorganisms, such as bacteria and fungi, can affect school performance, increase absenteeism, and trigger respiratory problems. This systematic review aimed to analyze the potential correlation between the presence of microorganisms and PM and chemical pollutants in school indoor environments. Study design: A systematic literature review was conducted using the methodology PRISMA and 25 articles were selected. The current systematic review follow the steps: definition of research objectives; selection of the science databases; definition of keywords; establishment of the inclusion and exclusion criteria, evaluation process and evaluation and management of selected studies. The findings highlight the significant presence of airborne microorganisms, including bacteria and fungi, often associated with PM and chemical pollutants such as CO 2 correlations between CO 2 and volatile organic compounds (VOCs). Positive and bacteria were observed in ten studies and were statistically significant in six of them. Both positive and negative correlations between fungi and CO 2 were reported. Fungal genera such as Aspergillus spp. And Cladosporium spp. Were associated with particulate matter (PM). In general, the concentrations of bacteria and fungi were often correlated with PM levels, with larger particles (PM 10 adhesion and transport of microorganisms, while smaller particles (PM 2 . 5 ) favoring the ) remain suspended in the air for longer periods, increasing exposure. Despite the methodological variations among the various studies, the results reinforce the need to create effective interventions to reduce pollutant concentrations to minimize health risks for occupants.
- Chemical safety in academic laboratories: awareness, attitudes, and practices among higher education studentsPublication . Ribeiro, Inês; Ramos, Catarina; Santos, Joana; Carvalhais, Carlos; Santos, Joana; Alberto Alves Carvalhais, CarlosHigher education institutions, particularly those with teaching and research laboratories, play an important role in transmitting knowledge and attitudes regarding chemical safety to their students. As such, this study aims to assess the knowledge and attitudes of higher education students across different study programs regarding laboratory chemical safety. A cross-sectional study was conducted using a questionnaire adapted and translated into Portuguese. The instrument comprised twenty-seven questions and was distributed to students enrolled in undergraduate and graduate programs that include laboratory practices in their curricula in March and July of 2025. A total of 284 students participated in the study, divided among the different study programs (CTeSP = 4.2%; Bachelor’s = 70.4%; Master’s = 21%; Doctorate = 4.2%). The results showed that, although a large percentage of students have a high level of knowledge, their attitudes are not always the most appropriate, which could jeopardize their safety and that of those around them. Our findings revealed that there is room for curriculum adjustments. Early exposure to chemical and laboratory safety concepts can promote the development of students’ awareness and future professionals’ competence. Integrating safety modules into education may enhance knowledge and skills for making informed decisions that reduce accidents/incidents in laboratory environments.
- Consensus on covert awareness: a Delphi studyPublication . Schnakers, Caroline; Overbeek, Berno; Fullmer, Niko; Teixeira, Liliana; Zandalasini, Matteo; Yatsko, Kseniia; Morrissey, Ann-Marie; Zasler, Nathan; Estraneo, AnnaIdentifying wilful brain activity in patients with disorders of consciousness is critical, as some patients fail to exhibit behavioural signs of consciousness at the bedside but respond to active tasks via neuroimaging or electrophysiological measures. Standardized terminology for this subgroup is absent while it is essential for advancing research and clinical care. The objective of this study was to determine the level of consensus among a large group of international experts on terminology and definitions for this clinical entity, as described by terms such as covert awareness, cognitive motor dissociation, functional locked-in syndrome, and non-behavioural minimally conscious state. A Delphi study was conducted using REDCap to evaluate expert agreement on terminology and definitions. The study was conducted among international experts, primarily from Europe/UK, the USA and other regions. Ninety-six experts participated. Among these, 75 (78%) completed both rounds. Participants were predominantly clinical scientists (71%) working in rehabilitation settings (63%). A Delphi method was followed. Consensus on terminology and related definitions was defined as a median score of 5, an interquartile range ≤1 and ≥75% agreement (scores of 4 or 5). Within two rounds, consensus was achieved for over two- thirds of the statements. The term ‘Covert Awareness’ and its associated definition were identified as the preferred terminology by an international expert panel. We recommend the use of ‘Covert Awareness’ since our large group of international experts consistently agreed on such preferred term for this subgroup of patients with disorders of consciousness. This consensus (>75% agreement) establishes a foundation both for future research and clinical standardization. The findings have implications for improving diagnostic accuracy and advancing understanding of covert awareness, although further study is needed to refine and apply the agreed-upon definition in clinical practice.
- Movement behaviours, air pollution and health in school-aged children: a cross-sectional study to guide the co-creation of healthier environments – the MOVE-AIR projectPublication . Martins, Clarice; Rufo, João Cavaleiro; Fonseca, Hélder; Padrão, Ana; Baptista, Liliana C.; Santos, Maria Paula; Sousa, Miguel; Zacca, Rodrigo; Silva, José Pedro; Ribeiro, Ana Isabel; Cavaleiro Rufo, JoãoThe MOVE-AIR study was designed to explore the moderating role of movement behaviours on the association between air pollutants and health outcomes in Portuguese children. Secondarily, it aims to characterise the settings (both indoor and outdoor) where children are exposed to air pollutants and to co-create solutions with participants to mitigate the exposure to air pollutants in children’s daily life. This study aims to describe the MOVE-AIR study protocol in detail. Data from 52 primary school children aged 9–11 years will be assessed for indoor and outdoor air pollutants (particulate matter (PM)2.5 and PM10, and carbon dioxide), geo-tracked for distinct settings (ie, home/school, indoor/outdoor) along the day, through an optical monitoring sensor with Global Positioning System incorporated. Health-related biological outcomes, such as interleukin-6, tumour necrosis factor alpha and oxidative parameters, including total antioxidant status and total oxidant status, will be evaluated and the Oxidative Stress Index will be calculated. Children’s cardiopulmonary fitness will be assessed through the shuttle run test, and movement behaviours will be evaluated through accelerometers (wGT3X). Children’s sex, age and parental socioeconomic status will be provided by parents through a questionnaire. The influence of movement behaviours in the link between pollution and health will be analysed through moderating regression models using process for SPSS R software (V.30.0.0). A subsample of class teachers, school leaders, parents and children will be invited to a co-creation process to create solutions to mitigate their daily exposure to air pollutants. The results will contribute to further understanding the moderating role of movement behaviours in the association between air pollution and health, adding a biological layer to the mechanistic links underlying these potential relationships that have not been explored in this target population. Finally, enhancing our comprehension of the living environments and contexts where children are more exposed to air pollution can help to cooperatively create solutions to mitigate their daily exposure to those harmful pollutants.