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My Strengths My Health (MSMH) is a simplified version of the Omaha System developed for the use of patients and their caregivers. Its main objective is to enable a whole-person assessment with the participation of the patients in understanding the concepts that comprise their care plan. Since 2021, we joined a worldwide initiative to translate MSMH to other languages and this paper reports the Brazilian experience in 3 stages, developed from January 2022 to December 2023: translation and back translation of terms, its validation by freshman nursing students and its adoption by patients at an outpatient facility. Among the results, we highlight the patients' comments on the perceived ease of use of the system. MSMH adoption by caregivers and populations of different cultures and languages can amplify the comprehension of biological, psychological, social, spiritual and environmental determinants of health worldwide specially if issues on digital health literacy are considered.

Introduction/Objective: Pandemic of COVID-19 is a major public health problem. At the time of development of this study, no specific medication/vaccine for this disease was approved. Therefore, preventive measures were the main key to control this pandemic. Health literacy (HL) is the ability to obtain, understand and use the information to make free and informed decisions about the health of an individual and to promote community empowerment. Thus, the HL of COVID-19 is important for community empowerment and the adoption of preventive measures. This article aims to understand possible predictors of HL of COVID-19, functional domain. Material and Methods: A cross-sectional study was designed, applying the Questionnaire of COVID-19 (previously designed and submitted to a preliminary pilot testing) through an online platform from April 23 to June 23, 2020. An Index of Health Knowledge of COVID-19 Questionnaire (IHK-COV19) was constructed. Associations between independent variables ("Gender," "Age," "Education," and "Risk Factor" for COVID-19 codified by ICPC-2) and HL were assessed using multivariate analyses (mixed effects models). The level of significance was set at p < 0.05. Results: Our sample includes 864 subjects (median age, 44.33 years), mostly women ( n = 619; 71.76%), undergraduate ( n = 392; 45.37%) and with at least one risk factor for COVID-19 ( n = 266; 30.79%). Univariate and multivariate analyses demonstrated "Age" as a negative predictor of IHK-COV19 and "Education" and "Risk Factor" as positive predictors of IHK-COV19. Conclusions: Health knowledge regarding COVID-19 is associated with the level of education. Future interventions should consider including HL mechanisms in interventions designed to improve communication., Competing Interests: PM has received in the past 3 years grants, CME-related honoraria, or consulting fees from Angelini, AstraZeneca, Bial Foundation, Biogen, DGS-Portugal, FCT, Janssen-Cilag, Gulbenkian Foundation, Lundbeck, Springer Healthcare, Tecnimede and 2CA-Braga. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Gomes da Silva, Silva, Alexandre and Morgado.)

Rapid worldwide decreases in physical activity (PA), an increase in sedentary behaviour (SB) and poorer dietary patterns have been reported during COVID-19 confinement periods. However, as national variability has been observed, this study sought to describe PA, SB and eating patterns, and to explore their gender as well as other socio-demographic correlates and how they interrelate in a representative sample of Portuguese adults during the COVID-19 first mandatory social confinement. The survey was applied online and by telephone to 5856 adults (mean age = 45.8 years; 42.6% women). The majority reported high (46.0%) or moderate (20.5%) PA levels. Men, younger participants, those with higher education levels and a favourable perception of their financial situation reported higher PA levels, with the opposite pattern for SB. Physical fitness activities and household chores were more reported by women, with more strength training and running activities reported by men. Regarding eating behaviours, 45.1% reported changes, positive (58%) and negative (42%), with 18.2% reporting increases in consumption of fruit, vegetables, and fish and other seafood consumption, while 10.8% (most with lower educational level and less comfortable with their income) reported an increase in consumption of ready-to-eat meals, soft drinks, savoury snacks, and take-away and delivered meals. Two clusters-a health-enhancing vs. risky pattern-emerged through multiple correspondence analysis characterized by co-occurrence of high vs. low PA levels, positive vs. negative eating changes, awareness or not of the COVID-19 PA and dietary recommendations, perceived financial situation, higher vs. lower educational level and time in social confinement. In conclusion, while in social confinement, both positive and negative PA and eating behaviours and trends were displayed, highlighting the role of key sociodemographic correlates contributing to healthy vs. risky patterns. Results may inform future health interventions and policies to be more targeted to those at risk, and also advocate the promotion of PA and healthy eating in an integrated fashion.

Objective: Analyze the agreement of nurses, who work in hospital institutions, about Florence Nightingale's conceptions about nursing, people, health and the environment., Method: Quantitative, observational and cross-sectional study, with the participation of 3,451 nurses from 36 Portuguese hospitals. Data collection took place from July 2015 to March 2016, using a questionnaire. For analysis, descriptive and analytical statistics were used., Results: It was evident that 60% to 70% of participating nurses considered that Florence Nightingale's conceptions of nursing, person, health and environment were partly in agreement or totally in agreement with their practice. The variables that influenced agreement were: service, condition in which they practice the profession, length of professional practice, academic degree and region of the country., Conclusion: Florence Nightingale's conceptions continue to contribute to professional nursing practice, with the region and the service significantly influencing this continuity.

To raise perceived capability (C), opportunity (O) and motivation (M) for physical activity (PA) behaviour (B) among adults, the Portuguese Directorate-General of Health developed a mass media campaign named "Follow the Whistle", based on behaviour change theory and social marketing principles. Comprehensive formative and process evaluation suggests this media-led campaign used best-practice principles. The campaign adopted a population-wide approach, had clear behavioural goals, and clear multi-strategy implementation. We assessed campaign awareness and initial impact using pre ( n = 878, 57% women) and post-campaign ( n = 1319, 58% women) independent adult population samples via an online questionnaire, comprising socio-demographic factors, campaign awareness and recall, and psychosocial and behavioural measures linked to the COM-B model. PA was assessed with IPAQ and the Activity Choice Index. The post-campaign recall was typical of levels following national campaigns (24%). Post-campaign measures were higher for key theory-based targets (all p < 0.05), namely self-efficacy, perceived opportunities to be more active and intrinsic motivation. The impact on social norms and self-efficacy was moderated by campaign awareness. Concerning PA, effects were found for vigorous activity ( p < 0.01), but not for incidental activity. Overall the campaign impacted key theory-based intermediate outcomes, but did not influence incidental activity, which highlights the need for sustained and repeated campaign efforts.

Objective: To conduct a benchmarking comparison of the composites of patient safety culture based on the evaluation of Brazilian and Portuguese nurses working in university hospitals., Method: Quantitative, cross-sectional, comparative survey. Data collected between April and December 2014, in two teaching hospitals, applying the instrument Hospital Survey on Patient Safety Culture, in the versions translated and adapted to the countries., Results: 762 nurses distributed in four services participated in the study, 195 Brazilians and 567 Portuguese. Seven of the 12 composites of safety culture showed significant differences between hospitals. The highlights were those related to: "management support for patient safety" (±17); "handoffs and transitions" (±15); "teamwork across units" (±14); and "overall perceptions of patient safety" (±10)., Conclusion: The dimension that had the highest significant difference between the studied institutions was "management support for patient safety". These data may support the managers of the study hospitals, enabling continuous improvements and advancements.

We performed a retrospective analysis of clinical and laboratory data over 5 years in a tertiary centre to assess clinical and microbiological characteristics of patients with Raoultella spp. infection. Raoultella spp. were deemed responsible for clinical infections in 57 patients (R. planticola, n = 32 and R. ornithinolytica, n = 25). The most prevalent diagnoses for R. planticola were cystitis (50%; n = 16) followed by bacteraemia and pneumonia (9.4%; n = 3); for R. ornithinolytica, cystitis (36%; n = 9) followed by pneumonia (24%; n = 6). Immunodeficiency was present in 18 patients (56.3%) with R. planticola and in 16 patients (64%) with R. ornithinolytica infection. Of these, 55.6% and 37.5% had diabetes and 27.8% and 18.% were solid organ transplant recipients, respectively. All isolates were sensitive to third-generation cephalosporins, fluoroquinolones and aminoglycosides. Mortality of infections with R. planticola (n = 5; 15.6%) was higher than for R. ornithinolytica (n = 2; 8.0%), but the difference was not statistically significant.

This study evaluates metaphase chromosome protein 1 (MCP1), a nuclear antigen, as a diagnostic marker for systemic lupus erythematosus (SLE). Reactivity of sera from 114 Portuguese patients with autoimmune rheumatic disease or from healthy blood donors (HBD), against MCP1, produced in bacteria (bact-MCP1) or in its native form (native-MCP1), was determined by immunoblotting. Predictive and discriminative power of MCP1 reactivity for SLE diagnosis in disease-control groups was evaluated by logistic regression, its diagnostic value determined by receiver-operating characteristic analysis and compared with similar analysis of antinuclear antibody and double-stranded DNA (dsDNA). We demonstrated that native-MCP1, in contrast to bact-MCP1, reacts with SLE sera with significant predictive and discriminative power versus other autoimmune diseases (odds ratio [OR] ≤3.537 and ≥3.265; area under the receiver-operating characteristic curve [AUC] ≤0.643 and ≥0.636) or versus HBD (OR = 5.006; AUC = 0.671), showing a good diagnostic power with high specificity (82.1% versus HBD) and low sensitivity for SLE, similar to those of dsDNA. The reactivity of SLE sera with native-MCP1 was shown to be dependent on the presence of phosphorylated residues. Native-MCP1 was shown to have diagnostic value as a specific marker for SLE diagnosis and, therefore, is a suitable substrate for a new antibody test. The widely reported importance of phosphorylated epitopes as targets for autoantibodies in SLE could also be confirmed for native-MCP1.

Aims: Characterization of newborn visits to the pediatric emergency department (PED). Analysis of the main illnesses and establishment of association between certain conditions and severity of diseases., Methods: Retrospective study information concerning newborns (aged <28 days) who presented to the PED of Hospital Central de Faro during 2005. We studied the clinical and demographic data referring to the PED's episode and to perinatal occurrences., Results: A total of 540 neonates visited the PED (1.5% of the total PED use), with an average age of 14.0 days and a slight prevalence of males (53.1%). Of the total visits, 17.2% were primary physician referrals. The chief complaints were jaundice, excessive crying, and rash. Diagnostic tests were requested in 27.2% cases. The major diagnoses were nonapparent disease, infant colics, and physiologic jaundice. In 13.0%, hospital admission was necessary. Newborns with referral, those with less than 37 weeks of gestation and those whose delivery weight was less than 2500 g, were more likely to be admitted., Conclusions: Most PED visits were because of nonserious diseases, mainly because of insufficient caretaker knowledge and information. This highlights the great need for caretakers' education by health staff. It is also important that physicians are aware of the main illnesses in the newborn period and know how to correctly identify the conditions associated to serious pathology.