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- Digital proficiency and educational needs of Portuguese radiation therapistsPublication . Barbosa, B.; Oliveira, C.; Couto, J. G.; Bravo, I.; Antunes, Luís; Fadden, S. Mc; Hughes, C.; McClure, P.; Dias, A. G.; Lopes Botelho Antunes, Luís JorgeAs radiotherapy (RT) becomes increasingly digitised, the digital skills (DS) proficiency of Therapeutic Radiographers/Radiation Therapists (RTTs) is essential for ensuring patient safety and quality care. This study is part of larger sequential multi-phase mixed-methods research; previous research by the same research team has shown that DS proficiency varies among European RTTs. The current study aimed to assess stakeholders' perceptions of proficiency, influencing factors, challenges, and strategies to bridge the digital gap in Portugal. A qualitative, hybrid (inductive and deductive), descriptive, cross-sectional, prospective design was used. Online focus group and individual interviews were performed with 16 Portuguese stakeholders (RTTs, managers, industry representatives, students, and educators), using an interview guide based on previous research. Interview transcripts were thematically analysed. Results: Seven themes were identified: proficiency levels, influencing factors, challenging areas, essential DS for practice, strategies for integration into education, concerns about technological evolution, and impact on RTTs' roles. The study underscores the critical need for DS proficiency among RTTs, emphasising gaps in specialised areas and multifaceted influencing factors. It stresses the urgency of improving RTTs' digital training across all educational stages. Adaptation and constant learning are imperative in radiotherapy's dynamic landscape, ensuring optimal patient care. Implications for practice: Addressing DS gaps is imperative for RTTs to ensure quality and safety of RT treatments. Essential strategies include DS integration and education adaptation and CPD. Recognizing concerns, such as job losses, highlights the need for a balanced technological approach. Patient-centred care remains paramount in guiding RTTs through evolving roles in the dynamic field of radiotherapy.
- Integrating PET for tumour hypoxia in radiotherapy planning: Insights from Portuguese radiotherapy and nuclear medicine technologistsPublication . Sousa, Ruben Diogo Oliveira; Faria, Brígida Mónica; Bravo, Isabel; Costa, Pedro; Costa, Pedro; Faria, Brigida MonicaIn the era of personalised medicine, tumour hypoxia (TH) is critical in radiotherapy (RT) response due to its role in tumour resistance. Positron Emission Tomography (PET) enables non-invasive assessment of TH and supports heterogeneous dose-escalation to hypoxic sub-volumes, improving treatment efficacy. This study explores Nuclear Medicine Technologists (NMT) and Radiotherapy Technologists (RTT) perceptions of PET-based TH (PET-TH) assessment and implementation in RT planning in Portugal. We conducted an observational cross-sectional survey of RTTs and NMTs currently working in Portuguese healthcare institutions. Statistical tests were used to assess associations and compare distributions using IBM® SPSS®. A total of 66 participants, 57 (86.4 %) females, with a mean age of 33.68 (±8.13) years, were included: 23 (34.8 %) NMTs and 43 (65.2 %) RTTs. While 65.2 % of NMT departments had PET scans with RT-compatible settings, only 8.7 % had performed PET-TH studies. Among RTTs, 88.4 % reported that their treatment planning systems were compatible with PET/CT fusion, yet only 9.3 % had used PET in RT planning. RTTs received more training in TH (p = 0.006) and rated their knowledge higher than NMTs (p = 0.042). Greater professional experience and higher perceived knowledge were associated with better performance on evaluation items (p = 0.027; p = 0.037). Regardless of institution type, 92.4 % expressed interest in interprofessional collaboration to support individualised planning. The assessed departments possess infrastructures for PET-TH integration, yet clinical implementation remains limited. Knowledge and professional experience are associated with competency. Targeted training for Technologists and interdisciplinary workflows may improve PET-TH adoption. Addressing knowledge and workflow could facilitate PET integration into RT planning and potentially enhance treatment outcomes. Future efforts should focus on interdisciplinary collaboration.
- Extended reality in medical educationPublication . Veloso, Rita; Magalhães, RenatoExtended Reality (XR)—including Virtual, Augmented and Mixed Reality—is reshaping medical education by providing immersive, interactive tools for anatomy, surgical training, clinical skills and emergency preparedness. These technologies enhance learning, improve outcomes and foster collaboration. Despite challenges like high costs, limited access and lack of standardisation, XR shows strong global growth and potential for personalised, efficient medical training.
- Effectiveness of an intervention program for informal carers of children admitted to a rehabilitation centrePublication . Morais, Sónia; Pimenta, Rui Esteves; Morais, Carminda; Macedo, Rui; Ribeiro, Inês; Ferreira, Pedro Lopes; Pimenta, Rui; Macedo, RuiHealth literacy improves informal caregivers’ knowledge and ability to provide care. The aim of this study is to analyze the impact of a group-based intervention on the health literacy of informal caregivers of children with special health needs (SHNs). The intervention focuses on movement, hydrotherapy, walking, and relaxation, with three evaluation stages. Participants included 34 informal caregivers of children with SHNs, recruited at a Physical Medicine and Rehabilitation Service. We collected sociodemographic data of the participants and measured their health literacy through the short-form version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). Around 70% of the participants were female, with a mean age of 41.06 ± 4.98 years, and nearly 85% were married or in a de facto union. About 26% were unemployed, and more than 65% had completed secondary education or higher. The mean scores of the HLS-EU-Q16 were statistically significantly higher throughout the intervention, with differences over the evaluation stages [F(2,56) = 75.55; p < 0.05]. A structured, dynamic, and group-based intervention plan showed improvements in the health literacy of the participants, with an increase in the percentage of participants with sufficient and excellent levels of health literacy at the end of the intervention.
- Is endometriosis staging related to the type and intensity of patients’ complaints? A systematic review and meta-analysisPublication . Alves, João Sequeira; Meneses, Tânia; Mariano, Mafalda; Serra, Sofia Silvério; Costa, Teresa; Martins, João Paulo; Rabishong, Benoit; Lima, Jorge; Oliveira Martins, João PauloTo evaluate the association between the endometriosis staging and the type and intensity of pain reported by patients, describing the pain intensity across different pain types. On January 27, 2025, a systematic search was conducted in PubMed, Scopus, Web of Science, EMBASE, and the Cochrane Library. The search terms included endometriosis, pain, dysmenorrhea, dyspareunia, pelvic pain, dyschezia, dysuria, and classification. Eligible studies examined women with endometriosis, assessing how endometriosis staging (rASRM or ENZIAN classification) correlated with pain symptoms (dysmenorrhea, dyspareunia, dyschezia, dysuria, and chronic pelvic pain) measured with validated tools. Two reviewers extracted data independently, with a third verifying results. Pain scores were log-transformed to stabilize variance, and proportions of women with advanced endometriosis were analyzed on the logit scale. Given high heterogeneity, random-effects models with restricted maximum likelihood were used. Of 2527 records, 112 studies were reviewed and eight met inclusion criteria (seven using rASRM, one using ENZIAN). Dysmenorrhea showed the highest mean intensity (6.61, 95% CI: 4.43–10.10), while dysuria was lowest (1.08, 95% CI: 0.62–1.89). Pain intensity did not differ significantly between rASRM stages I/II and III/IV (p > 0.05), though chronic pelvic pain was more frequent in advanced disease (p < 0.05). Dysmenorrhea is linked to higher pain intensity in women with endometriosis, while dysuria is linked to lower intensity. Pain intensity is not associated with the rASRM stage; however, chronic pelvic pain seems more prevalent in advanced stages of the disease.
- Gender beliefs and dating violence practices among university students in PortugalPublication . Neves, Sofia; Correia, Ariana; Borges, Janete; Borges, JaneteThe aim of the present article is to present and discuss the results of a Portuguese national study with 4696 university students, 3846 (81.9%) self-identified as females, 843 (17.8%) self-identified as males, and 16 (0.3%) non-binary people (M = 22.4 years old; SD = 5.132). With the objective of characterizing the relationship between gender beliefs and dating violence practices, an online questionnaire was administered. Results show that 2524 (53.7%) students had suffered an episode of dating violence and 1599 (34%) had perpetrated one at least once during their life. Female students were more victimized than male students, while male students perpetrated more dating violence than female participants. An association between gender beliefs legitimizing violence and gender was found, with male students endorsing more gender beliefs legitimizing violence than female students. Additionally, those who suffered from and perpetrated dating violence presented higher levels of gender beliefs legitimizing violence than those who did not suffer from or perpetrate it.
- Emotion networks in individuals with high and low social anxiety symptomsPublication . Oliveira, Cláudia; Liebowitz, Michael; Calaboiça, Cláudia; Castro, Daniel; Borges, Janete; Santos, Anita; Meira, Liliana; Borges, JaneteSocial Anxiety Disorder (SAD) is a highly prevalent mental health disorder. Theoretical models of SAD emphasize the role of cognitive and behavioral factors in the development and maintenance of the disorder, although emotional experiences are equally relevant. Most studies focus on the relationship between SAD and affect broadly (positive and negative affect), or address specific emotions separately, rather than examining multiple positive and negative emotions in one integrated model. Network analysis can provide important insights into the emotional system underlying SAD and how it is organized differently between individuals with high and low social anxiety. Therefore, we aimed to identify the central emotions and compare several macro-network properties (e.g., connectivity) between high and low socially anxious individuals. Two networks were estimated using a Mixed Graphical Model (MGM). The Positive and Negative Affect Schedule (PANAS) was used to assess emotional states, and social anxiety symptoms were measured with the Liebowitz Social Anxiety Scale– self-report version (LSAS-SR), previously adapted and validated. Participants recruited from the community were divided into two groups based on the LSAS-SR cut-off score: with high (N=306, Mage=28.50; SDage=10.59) and low social anxiety symptoms (N=306, Mage=34.30; SDage=13). Results Network connectivity distinguished the two groups. Participants with higher social anxiety symptoms showed a more interconnected emotion network. Feeling scared, disturbed, and guilty were central emotions and were identified as valuable treatment targets. The results contribute to the understanding of emotional experience in the context of SAD from a network perspective, and to the growing literature on network theory, by clarifying which network properties are promising markers of an emotional system resistant to change.
- Medication review improves pain management and quality of life in chronic pain: a pilot randomized controlled studyPublication . Duarte, Nuno; Martins, João Paulo; García-Domingo, Mónica; A. García-Pedraza, Jose; Santos, Marlene; Santos, Marlene; Oliveira Martins, João Paulo; Duarte, NunoChronic pain is a complex condition that benefits from a multidisciplinary approach. This pilot parallel-group single-blinded randomized controlled study evaluated the feasibility, acceptability and adherence by patients and physicians of pharmacist-led medication review on chronic pain patients. Trends in pain intensity, quality of life and patient satisfaction were examined. Twenty adults were recruited from two primary care units in Porto, Portugal, and randomly assigned to either the medication review (MR) group, (n=10) using the Dader method, or the usual care (UC) group, (n=10) and given general advice, for 16-weeks. Pain intensity decreased by 2.07 (MR group) and increased by 0.52 (UC group), yielding an adjusted mean difference of 2.77 (95% CI, -4.93 to -0.62; p=0.008). Pain relief was reported by 62.5% in the MR group versus 37.5% in UC (p=0.357). The MR group showed significant improvement in physical functioning (p=0.019) and higher treatment satisfaction (p=0.029). The acceptance rate of MR interventions was 71%, which resolved 63% of negative medication outcomes. Acceptability was high (>90% of planned interviews). Conducting pharmacist led MR for chronic pain management in primary care is feasible and well accepted by patients and physicians. Observed trends toward improved pain and QoL warrant confirmation in a larger trial. This pilot trial was registered in clinicaltrials.gov (NCT06997861).
- Response to: Does reliability benefit from superior visualization of epileptiform discharges on inferior temporal electrodes?Publication . Batista, Carla; Soares, Joana Isabel; Coelho, Paulo; Ferreira, Simão; Rosenzweig, Ivana; Borges, Daniel Filipe; Borges, Daniel Filipe; Ferreira, SimãoWe thank Dr. Kleine for his thoughtful letter regarding our study and for highlighting both the anatomical rationale and the recognized clinical relevance of inferior-temporal electrodes. We welcome the opportunity to clarify specific numerical points and to provide the inter-reviewer agreement data he requested. Our study was intentionally designed as a prospective, blinded, within-subject technical validation comparing the IFCN-recommended 25-electrode 19-channel 10–20 International System (10–20 IS) in consecutive(IFCN-25) array with the conventional 19-channel 10–20 International System (10–20 IS) in consecutive adult EEGs. Importantly, it was not framed as a diagnostic or superiority trial: no external gold standard was applied, and both montages were treated methodologically as equivalent acquisition systems. The primary endpoint was patient-level detection of any abnormality (IEDs or focal slow activity) under blinded real-world conditions. In this reply, we address exclusively the point raised by Dr. Kleine concerning inter-reviewer agreement for temporal-lobe IEDs, providing the 2 × 2 tables and κ values requested. These analyses represent a clear subset of the broader dataset already published and are provided here for transparency.
- Exploring alternative potentialities of portuguese and spanish craft beers: antioxidant and photoprotective activitiesPublication . Pereira, Maria João; Santos, Diana; Cruz, Agostinho; Jesus, Ângelo; Martins, João P.; Moreira, Fernando; Santos, Marlene; Pinho, Cláudia; Oliveira, Ana Isabel; Cruz, Agostinho; Santos, Diana; Pereira, Maria João; Pinho, CláudiaCraft beer has gained popularity due to its unique sensory characteristics and complex matrix with nutritional and potential health benefits. Studies linking beer consumption to skin conditions are limited, however, the high content of bioactive compounds is related to biological activities such as antibacterial, anti-inflammatory, anti-oxidative, and anti-carcinogenic. This study aims to evaluate the antioxidant, photoprotective and metabolic activity in human keratinocytes (HaCaT). Eighteen craft and four industrial beers were analyzed after dealcoholizing, degassing and freeze-drying. Total phenolic content (TPC) and antioxidant activity were determined. The most promising craft beer was studied for its photoprotective and metabolic activity. An India Pale Ale beer (ALM-IPA) presented the second best TPC (8.96 ± 0.64 mg of GAE/g) and promising antioxidant activity by ABTS (IC50 = 55.21 ± 4.68 µg/mL), H2O2 (IC50 = 23.54 ± 1.53 µg/mL) and FRAP (53.74 ± 1.27 µmol TE/g) assays. Regarding photoprotective activity, a solar photoprotection factor of 48.85 ± 0.39 was obtained. ALM-IPA showed no cytotoxicity up to a concentration of 250 µg/mL after 24 and 48 h of incubation. The potential benefits of beer extracts on skin can be seen, but further studies are essential to corroborate the findings and guarantee the safety of the extracts.