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- Promoting personal and social skills in youth with disruptive behaviors: A systematic review of tertiary programsPublication . Soares, Mónica; Sousa, Jacinta; Cardoso, Leonor G.; Cunha, Olga; Caridade, SóniaDisruptive behavior in youth (i.e., persistent oppositional, aggressive, or delinquent conduct) predicts harm to self and others, as well as long-term social exclusion. Tertiary, skill-oriented programs aim to prevent the escalation of these behaviors and strengthen personal and social skills. However, an up-to-date, comprehensive synthesis of their effectiveness is still lacking. In accordance with PRISMA 2020, we searched Web of Science, Scopus, PubMed, ProQuest, and B-on. Studies included justice-involved, school-referred, community, and/or mixed-setting. Overall, 43 peer-reviewed studies (January 2013–May 2025) evaluating tertiary, skill-focused interventions for youth aged 10–24 met the eligibility criteria. Outcomes primarily indexed reductions in disruptive behavior (e.g., aggression, violent behavior) and/or improvements in skills (e.g., emotion regulation, self-control, empathy, problem solving). Theme-focused, multimodal, and sufficiently intensive programs were most consistently associated with reduced aggression and improved skills. However, findings and methodological quality were heterogeneous, and follow-up data was limited. Digital delivery components were rare. We discuss these findings and propose a modular program architecture that combines a structured, evidence-based core (e.g., manualized content, fidelity monitoring) with planned flexibility (e.g., thematic breadth, dosage) to match youths’ risk-need profiles and the constraints of justice, school, and community settings. Key limitations (e.g., limited follow-up, cultural sensitivity) and future directions (e.g., finer-grained analyses linking youngsters’ needs to specific modules) are also discussed.
- Effects of caffeine on P300: A systematic review and meta-analysisPublication . Pinho, Beatriz B.; Mazer, Prune; Barroso, Beatriz; Pinto, Joana O.; Mazer, PruneCaffeine is a widely consumed psychoactive substance that stimulates the central nervous system, enhancing alertness and concentration. Its effects on brain activity can be examined using neurophysiological techniques such as event-related potentials, with emphasis on the P300 component. Caffeine appears to modulate P300 amplitude and latency, suggesting changes in processing speed and attention, although findings remain inconsistent. The objective of this work was to systematise the literature about the effects of caffeine on the amplitude and latency of the P300. A systematic review and meta-analysis of empirical studies measuring the effect of caffeine on P300 amplitude and latency was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses. Statistical analyses were performed using the meta-analysis package for R. Caffeine intake between 201 and 399 mg was associated with a significant increase in P300 amplitude across anterior, central, and posterior regions, whereas higher doses were associated with smaller effect sizes. No significant differences in P300 latency were observed between pre- and post-caffeine intake. Overall, our findings align with previous reviews showing that caffeine, as a stimulant, can modulate brain activity. The main limitation of this work is the high heterogeneity across studies. Future research directions are discussed.
- Deep technologies for responsible gambling: a narrative review of policies and implementation strategiesPublication . Cardoso, Leonor G.; Barroso, Beatriz C. R.; Rocha, Eduardo; Morgado, Pedro; Marques, António; Rocha, Carla; Griffiths, Mark D.; Corazza, Ornella; Queirós, Ricardo; Dores, Artemisa R.; Dores, Artemisa; Pereira da Silva Marques, António JoséDeep technologies, such as artificial intelligence, blockchain, and behavioural analytics, have emerged as promising tools to address complex social challenges. However, their integration into leisure activities, particularly online gambling, has raised concerns over the enhancement of user engagement, which might promote problem gambling behaviours. This review aimed to map how deep technologies intersect with responsible gambling regulations across jurisdictions. A qualitative scoping review was conducted to synthesise evidence from academic literature, legal and regulatory frameworks, and relevant grey literature. A comparative analysis was performed across key jurisdictions, including the European Union, the United Kingdom, Malta, and selected non-European countries. The review identified very few formal legal instruments that explicitly regulate the use of deep technologies in responsible gambling. The European Union Artificial Intelligence Act introduces binding requirements for high-risk AI systems, including those deployed in gambling, representing a pioneering step toward technology-specific regulation. In contrast, regulatory frameworks beyond Europe were generally non-binding or largely absent, with innovation primarily driven by operators acting voluntarily in the absence of legal mandates. This analysis underscores persistent gaps in legal oversight and advocates for a shift toward proactive, ethics-based governance models that integrate technological accountability and robust consumer protections. Overall, the findings suggest that regulatory frameworks must not only keep pace with rapid technological innovation but also prioritise prevention through enforceable, transparent, and harmonised policies across jurisdictions.
- Towards a multidimensional Model of Neurocognitive Disorders (MOND Model): Integrating evidence from a critical review into a model for future researchPublication . Pinto, Joana O.; Peixoto, Bruno; Dores, Artemisa R.; Barbosa, Fernando; Dores, ArtemisaThe main purpose of this work is to critically review the literature on neurocognitive disorders (ND) diagnosis. A critical review was conducted in PubMed, Scopus, and EBSCO. Systematic reviews and meta-analyses focusing on ND diagnosis were included. The selected studies were critically analyzed and conceptually integrated to identify relevant dimensions for the diagnosis of ND. The review included 88 studies. Most studies focused on Alzheimer’s disease and mild cognitive impairment. The literature remained predominantly centred on isolated diagnostic domains, and important limitations were consistently identified, including methodological heterogeneity, lack of standardized thresholds, and reduced clinical applicability. Based on the identified conceptual and methodological limitations, a Multidimensional Model of Neurocognitive Disorders (MOND model) for ND diagnosis was proposed. The MOND model was developed as a multidimensional, multilevel, transdiagnostic model integrating biological, neurocognitive, neuropsychiatric, motor, functional, frailty, reserve-related, and socio-environmental dimensions. The model may contribute to research, symptom classification, severity characterization, prognosis, and personalized intervention planning across different ND trajectories. Future studies using the MOND model should focus on refining algorithms to estimate the risk of ND.
- Professionals’ perspectives on the role of advanced technologies in responsible gamblingPublication . Barroso, Beatriz C. R.; Cardoso, Leonor G.; Morgado, Pedro; Marques, António; Rocha, Carla; Griffiths, Mark D.; Queirós, Ricardo; Dores, Artemisa R.; Dores, ArtemisaProblematic gambling is associated with substantial individual and societal harms, which may be intensified by the accessibility, anonymity, and captivating design of online gambling products. In this domain, advanced technologies (e.g., artificial intelligence and data analytics) are increasingly recommended for prevention, early detection, and harm reduction. This study aimed to examine the current and potential uses of advanced technologies in gambling. Forty-five semi-structured interviews were conducted with social/legal science (n = 24) and technology (n = 21) experts. Data were analysed using thematic analysis, beginning with a deductive approach followed by an inductive analysis. A total of 182 codes were identified from social/legal science professionals, and 228 from technology experts. Four overarching themes were identified: (i) characterisation of contemporary gambling; (ii) applications and implications of advanced technologies; (iii) regulatory frameworks and challenges; and (iv) recommendations and solutions. Profit-driven design practices, heightened vulnerabilities in online gambling environments, regulatory gaps, and concerns regarding algorithmic opacity and data use were highlighted. Advanced technologies were viewed as having a dual role, with potential both to exacerbate gambling-related harm and to enable earlier identification of risky behaviours and targeted interventions. Findings indicate that responsible gambling cannot rely solely on technological solutions (e.g., behavioural monitoring and limit-setting) and should be instead integrated with community-level strategies, public education, and robust regulatory oversight. Leveraging technological innovation alongside user protection is essential, requiring interdisciplinary collaboration, a public health-oriented approach, and transparent, evidence-based and ethically governed frameworks. Implications, limitations, and future directions are discussed.
- From social media to body image distress: Problematic internet use, exercise addiction, and enhancement drugs use across countriesPublication . Dores, Artemisa R.; Burkaukas,Julius; Dores, ArtemisaSocial media increasingly shapes body image by promoting often unattainable beauty ideals. Concurrently, targeted online marketing of image- and performance-enhancing drugs (IPEDs) exploits these vulnerabilities, intensifying anxiety and fostering maladaptive behaviours such as problematic usage of the internet (PUI), compulsive exercise, and IPEDs consumption. This study explores these behaviours across nine countries and examines how PUI, excessive exercise, and IPEDs use predict appearance anxiety, aiming to inform targeted prevention strategies for at-risk populations. A total of 3,514 participants from nine countries completed a web-based survey assessing sociodemographic data, appearance anxiety (AAI), problematic internet use (PIUQ-9), excessive exercise (EAI-R), and IPEDs intake. Appearance-related anxiety was observed in 12% of the participants, with the highest prevalence in Mexico (20.7%), Japan (13.8%) and Italy (13.6%). Median PUI scores were highest in Mexico (22.57) and Singapore (21.59). Excessive exercise was reported by 3.6% with no significant country differences. IPEDs use was reported by 28.3% of the sample, with the highest rates in Japan (60.6%). Logistic regression analyses revealed that PUI, excessive exercise and IPEDs use were significant predictors of appearance-related anxiety. The strong associations between PUI, excessive exercise, IPEDs use, and appearance anxiety underscore the complex interplay between online exposure, body image concerns and mental health. Crosscountry differences suggest that socio-cultural factors influence appearance-related anxiety. These findings highlight the need for culturally sensitive interventions and policy measures that address the impact of digital media on body image, particularly to protect vulnerable populations.
- The use of virtual environments to prevent or treat behavioral addictions: A systematic reviewPublication . Cunha, Nelson Bruno de Almeida; Peixoto, Miguel; Dores, Artemisa R.; de Faria Távora Moreira Peixoto, Miguel; Dores, ArtemisaGambling Disorder (GbD) and Gaming Disorder (GmD) are associated with negative consequences that affect personal, social, and professional/academic domains. Although various efforts have been made to prevent and treat both conditions, traditional approaches have limitations, particularly given the technological nature of the environments in which these disorders develop. The aim of this review is to examine the characteristics of Virtual Reality (VR) and Augmented Reality (AR) based interventions for primary and secondary prevention of GbD and GmD. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). A search was conducted across PubMed, Web of Science, Scopus, and EBSCO. Study quality was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS). Twelve studies (n = 498; 32.1% female) examined VR and AR interventions for GbD and GmD. Multiple VR therapy sessions significantly reduced craving and anxiety in GbD, while educational and self-regulation approaches promoted responsible gambling. In GmD, VR/AR-based interventions reduced symptom severity, gaming time, and negative emotions, improving physical activity and coping skills. Overall, immersive technologies showed consistent therapeutic and preventive benefits across both disorders, enhancing self-regulation and reducing addictive behaviors. The findings support the feasibility, safety, and therapeutic potential of immersive technologies in managing GbD and GmD, although evidence remains insufficient to determine optimal dosage. Future research should focus on long-term interventions with larger and more diverse samples to ensure generalizable results. Studies should also assess the cost-effectiveness of VR and AR as scalable prevention tools for both disorders.
- Integrating cognitive factors and eye movement data in reading predictive models for children with Dyslexia and ADHD-IPublication . Pereira, Norberto; Costa, Maria Armanda; Guerreiro, ManuelaThis study reports on several specific neurocognitive processes and eye-tracking predictors of reading outcomes for a sample of children with Developmental Dyslexia (DD) and Attention-Deficit/Hyperactivity Disorder – inattentive subtype (ADHD-I) compared to typical readers. Participants included 19 typical readers, 21 children diagnosed with ADHD-I and 19 children with DD. All participants were attending 4th grade and had a mean age of 9.08 years. The psycholinguistic profile of each group was assessed using a battery of neuropsychological and linguistic tests. Participants were submitted to a silent reading task with lexical manipulation of the text. Multinomial logistic regression was conducted to evaluate the predictive capability of developing dyslexia or ADHD-I based on the following measures: (a) a linguistic model that included measures of phonological awareness, rapid naming, and reading fluency and accuracy; (b) a cognitive neuropsychological model that included measures of memory, attention, visual processes, and cognitive or intellectual functioning, and (c) an additive model of lexical word properties with manipulation of word-frequency and word-length effects through eye-tracking. The additive model in conjunction with the neuropsychological model classification improved the prediction of who develops dyslexia or ADHD-I having as baseline normal readers. Several of the neuropsychological and eyetracking variables have power to predict the degree of reading outcomes in children with learning disabilities.
- The impact of a rectal spacer in VMAT Dosimetry in the treatment of Prostate CancerPublication . Oliveira, Susana; Fernandes, Ruben; Baylina, Pilar; Santos, João; Vieira, Guy; Faria, Isabel; Pereira, Norberto; Fernandes, Rúben; BAYLINA MACHADO, PILAR; Sousa Pinho Faria, Isabel MariaAlthough the dosimetric advantages of rectal spacers in prostate cancer radiotherapy have been demonstrated in selected clinical trials, real-world data from routine clinical practice remain limited—particularly within the Portuguese healthcare system. This study offers a detailed dosimetric comparison of Volumetric Modulated Arc Therapy (VMAT), with and without rectal spacer use, in a real-world patient cohort, aiming to assess the clinical relevance of spacer insertion under standard treatment protocols. A retrospective dosimetric evaluation was performed on 80 prostate cancer patients treated at a radiotherapy centre in southern Portugal. Patients were equally divided into two matched groups (n = 40): one receiving VMAT alone, the other receiving VMAT with hydrogel rectal spacer placement. Dose-volume histograms (DVHs) were analysed for the planning target volume (PTV) and key organs at risk (OARs). Standard dosimetric metrics, such as V50–V75 for the rectum and bladder, V50 for femoral heads, and mean dose for the penile bulb, were assessed. PTV coverage was evaluated using conformity and homogeneity indices. Spacer use significantly decreased rectal dose exposure across all evaluated parameters without compromising PTV coverage or increasing dose to other OARs. These findings support routine rectal spacer applications to enhance treatment safety and patient outcomes.
- Towards an automated approach for understanding problematic gamingPublication . Afonso, Ana Paula; Fonseca, Manuel J.; Cardoso, Joana; Vázquez, BeltránVideo games have become increasingly popular worldwide, attracting billions of gamers across diverse demographics. While studies have highlighted their potential benefits, concerns about problematic gaming behaviors have also emerged. Conditions such as Internet Gaming Disorder (IGD) have been recognized by major health organizations, necessitating accurate diagnostic tools. However, existing methods, primarily reliant on self-report questionnaires, face challenges in accuracy and consistency. This paper proposes a novel technological approach to provide gaming behavior indicators, aiming to offer precise insights into gamer behavior and emotion regulation. To attain this objective, we investigate quantifiable gaming behavior metrics using automated, unobtrusive, and easily accessible methods. Our approach encompasses the analysis of behavioral telemetry data collected from online gaming platforms and incorporates automated extraction of gamer emotional states from face video recordings during gameplay. To illustrate the metrics and visualizations and demonstrate our method’s application we collected data from two amateur and two professional gamers, all of whom played Counter-Strike2 on PC. Our approach offers objective insights into ingame gamer behavior, helping health professionals in the identification of patterns that may be difficult to discern through traditional assessment methods. Preliminary assessments of the proposed methodology demonstrate its potential usefulness in providing valuable insights about gaming behavior and emotion regulation. By leveraging automated data collection and visualization analysis techniques, our approach offers a more comprehensive understanding of gamer behavior, which could enhance diagnostic accuracy and inform interventions for individuals at risk of problematic gaming behaviors. Our findings demonstrate the valuable insights obtainable from a tool that collects telemetry data, emotion regulation metrics, and gaming patterns. This tool, utilizing specific indicators, can support healthcare professionals in diagnosing IGD and tracking therapeutic progress, potentially addressing challenges linked to conventional IGD assessment methods. Furthermore, this initial data can provide therapists with detailed information on each player’s problematic behaviors and gaming habits, enabling the development of personalized treatments tailored to individual needs. Future research endeavors will focus on refining the methodology and extending its application in clinical settings to facilitate more comprehensive diagnostic practices and tailored interventions for individuals at risk of problematic gaming behaviors.