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- Standardized tools for child development assessment in nursing (0–5years) scoping reviewPublication . Freitas, Carla; Freitas, Carmen; Silva, Raquel; Loureiro, SofiaPurpose Map standardized child development assessment tools used by nurses to identify developmental concerns in children ages 0 to 5 years. Methods This review follows the Joanna Briggs Institute methodology for scoping reviews and is registered with the Open Science Framework. The search drew on MEDLINE, CINAHL, JBI Evidence Synthesis, PROSPERO, PubMed, Scopus, Web of Science, Cochrane, the Portuguese Open Access Scientific Repository, official organization websites, and grey literature via the New York Academy of Medicine and Google. Articles published in Portuguese, English, and Spanish through December 2025 were included. Selection and data extraction were conducted independently by reviewers. Results Eleven sources published between 2010 and 2025 were included, identifying 33 standardized child development assessment tools used by nurses. The tools are categorized as parental-report surveillance tools, direct observation and short-form screening tools, and comprehensive diagnostic evaluation tools. The most frequently cited tools include Denver II, Ages and Stages Questionnaires, and Bayley Scales of Infant Development. Findings reveal tensions among psychometric rigor, practical feasibility, cultural adaptation requirements, and training needs. Conclusion Tool selection requires balancing psychometric strength with clinical practicality. Cultural adaptation and local validation are essential for diagnostic accuracy. Clinical implications Systematic surveillance using standardized tools integrated into routine nursing practice facilitates early detection of developmental concerns, promotes family-centered care, and enables timely referrals to early intervention services, thereby reducing health disparities and supporting children's developmental potential.
- Average pain over time, but not current pain, is associated with salivary secretory immunoglobulin a in chronic back pain: a cross-sectional studyPublication . Shani, Adi; Granot, Michal; Palzur, Eilam; Agostinho, Mariana; Treister, Roi; Rahamimov, NimrodChronic pain is accompanied by widespread physiological dysregulation, yet the mucosal immune system has received little attention. Salivary secretory-immunoglobulin-A (S-IgA) is a non-invasive biomarker of mucosal immunity modulated by sustained stress and autonomic activity. This cross-sectional secondary analysis examined whether pain intensity in chronic back pain is associated with salivary S-IgA in 57 adults enrolled in a parent interventional study (NCT05994118). Pain was assessed on a computerized visual analogue scale (CoVAS, 0-100) at the laboratory visit (current pain and 24-hour average) and via a twice-daily electronic CoVAS diary (1-week, 2-week, and 14-day averages). Two saliva samples collected ∼90 minutes apart were assayed by ELISA, and baseline heart rate variability (HRV) was recorded. Spearman correlations were computed with and without partial adjustment for age, sex, and BMI; Benjamini-Hochberg correction was applied to the ten primary pain × S-IgA tests. Average 24-hour pain was negatively correlated with both S-IgA samples (ρ ≈ -.45 for both, p < .001); the 1-week (ρ ≈ -.34 to -.35, p ≤ .009) and 14-day averages (ρ ≈ -.38 for both, p = .004) showed similar associations. All average-pain associations survived FDR correction and partial adjustment. Current pain was not significantly associated with S-IgA. Baseline high-frequency HRV power was positively associated with S-IgA1 (ρ = .29, p = .033) but not S-IgA2. Sustained pain experience, rather than current pain, appears to track salivary mucosal immune function in chronic back pain. However, these hypothesis-generating findings may reflect unmeasured stress- or mood-related confounding, not a pain-specific effect.
- Sleep habits and electronic device use in primary school childrenPublication . Condeço, Luís; Lopes, Cátia; Pinho, Pedro; Fernandes, Rúben; Santos, SóniaIntroduction and Objectives: Excessive screen use by children may compromise sleep quality, school performance, and overall health. This study aims to explore parents’ and primary caregivers’ perceptions regarding the sleep habits of school-aged children (six to ten years old), as well as to identify the electronic devices they use and their screen exposure. Methods: Quantitative, descriptive-correlational, and cross-sectional study with a non-probabilistic sample of 365 parents or primary caregivers of children attending primary school in a municipality in inland Portugal. A sociodemographic questionnaire, a questionnaire on the use of technologies, and the Children’s Sleep Habits Questionnaire were administered, the latter having been validated for the Portuguese population. Results: On average, children went to bed at 9:33 p.m. on weekdays and at 9:41 p.m. on weekends. The presence of electronic devices in the home was high, with computers, mobile phones, tablets, televisions, and gaming consoles being the most common. During the week, 45.5% of children used screens for less than one hour per day, while on weekends, 38.1% used them for one to two hours per day. Children with higher screen use during the week exhibited greater sleep-related anxiety (p = 0.023). On weekends, screen use exceeding three hours was significantly associated with several sleep disturbances, including anxiety (p = 0.006), daytime sleepiness (p = 0.020), and nighttime awakenings (p = 0.020). Discussion: Prolonged screen time is associated with changes in sleep patterns and quality in school-age children, which reinforces the need for educational strategies aimed at families. Excessive screen use is linked to poorer sleep quality.
- Patient-reported outcome and experience measures in post-ECMO follow-up: a scoping reviewPublication . Costa, Paulo; Ferreira, Amélia; Sá, LuísObjectives: To map the use of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in adult follow-up after extracorporeal membrane oxygenation (ECMO), and to identify measurement gaps relevant to critical care nursing practice. Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute methodology and reported in accordance with the PRISMA-ScR guideline. MEDLINE/PubMed, Web of Science and CINAHL Complete were searched, supplemented by reference-list screening. Eligible studies included adults treated with ECMO or extracorporeal life support and assessed after ICU or hospital discharge. Quantitative, qualitative, and mixed-methods studies published between 2016 and 2026 in English or Portuguese were included. Data were charted on study characteristics, instruments, domains, follow-up timing, and measurement gaps. Critical Appraisal Skills Programme-informed appraisal supported interpretive weighting. Results: The MEDLINE/PubMed, Web of Science, and CINAHL Complete searches retrieved 2357 records. After removal of 86 duplicates, 2271 records were screened. The final review included 32 studies. PROM-focused evidence predominated: 25 studies assessed health-related quality of life, physical or functional recovery, mental health, respiratory burden, disability, cognition, return to work, or social participation. No formal PREM instrument was identified. Seven primary studies provided PREM-like evidence, mainly through qualitative or mixed-methods exploration of survivor and family experience, communication, support needs, decision-making, care transition, and follow-up experience. Conclusions: Post-ECMO follow-up literature measures patient-reported outcomes more consistently than patient-reported experiences. No formal PREM instrument was identified; however, qualitative and mixed-methods PREM-like evidence provides important insight into survivor and family experience. Implications for Clinical Practice: Critical care follow-up after ECMO should integrate PROMs, PREMs, and family perspectives within structured person- and family-centred pathways.
- The role of transformational leadership in clinical nursing contexts: a scoping reviewPublication . Moreira, Cátia Tatiana Pinto; Alves, Paulo Jorge Pereira; Mota, Liliana Andreia Neves daBackground: This scoping review addresses transformational leadership in clinical nursing contexts, a leadership approach associated with relational engagement, empowerment, shared values and collective vision among leaders and teams. Objective: To systematically map the existing evidence on transformational leadership in clinical nursing contexts. Information sources: Data were collated from the databases CINAHL (via EBSCO), MEDLINE (via PubMed), Cochrane, ScIELO, LILACS and MedicLatina; grey literature was researched in RCAAP, DART-Europe and OpenGrey. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute guidance and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The PCC framework comprised nurses, transformational leadership and clinical nursing contexts. Searches were conducted between December 2024 and June 2025, with no publication date restrictions. Eligible studies were peer-reviewed studies published in Portuguese, English or Spanish. A basic methodological quality assessment was conducted using the Mixed Methods Appraisal Tool, Version 2018, to support interpretation of the findings. Results: After screening 1357 records, six studies met the inclusion criteria (n = 6). Four categories emerged from the narrative analysis of the included studies: organisational support, communication, leader characteristics and leadership training. Conclusion: The available evidence suggests that transformational nursing leadership is shaped by leader attributes, relational behaviours, organisational support and opportunities for leadership development. Given the limited number, methodological heterogeneity, geographical concentration and temporal distribution of the included studies, the findings should be interpreted cautiously as a preliminary mapping of the literature rather than as evidence of effectiveness or causal impact.
- Communication skills training for brain death discussions in healthcare education: a scoping review protocolPublication . Pinho, Andreia Salomé Montes; Encarnação, Rúben Miguel Câmara; Lopes, Henrique Joaquim Fonseca Filipe; Ferrreira, Maria Amélia Dias; Neves, Vasco Manuel da SilvaIntroduction: Communication with family members regarding brain death is a critical competency in healthcare practice, requiring healthcare professionals to deliver complex and emotionally sensitive information effectively. Despite its recognized importance, there is limited clarity regarding the educational content, teaching strategies, and assessment methods used to develop these communication skills in healthcare education. Objectives: This scoping review aims to map how communication with families in brain death situations is addressed through educational interventions. Specifically, it will identify teaching strategies, learning objectives, delivery methods, and evaluation approaches, as well as reported outcomes. Methodology: Searches will be conducted in MEDLINE Complete, CINAHL Complete, Education Source, APA PsycArticles, Psychology and Behavioral Sciences Collection, and Nursing and Allied Health databases (via EBSCOhost), as well as Scopus, Web of Science, and PubMed. Additional searches will be conducted in ProQuest databases and the Scientific Open Access Repository of Portugal to identify grey literature. Supplementary searches will include Google Scholar, screening relevant sources, and professional and regulatory organization websites. No language or publication date restrictions will be applied. Study selection, data extraction, and synthesis will follow JBI methodology, with two reviewers. Data will be summarized in tables and narrative form, focusing on teaching strategies, educational content, and outcomes such as communication competence, confidence, and preparedness. Conclusion: This scoping review will map the existing evidence on educational strategies used to prepare healthcare professionals and healthcare students for communication with families about brain death. The findings will identify current educational practices, knowledge gaps, and opportunities to inform evidence-based communication training.
- Boas práticas na administração de injeções intravítreas: uma revisãoPublication . Duarte, Cátia Marranita; Mesquita, Isabel; Cabral, DiogoEste estudo teve como objetivo identificar e analisar as evidências científicas mais recentes sobre as boas práticas na administração de injeções intravítreas, com particular enfoque no contexto (consultório versus bloco operatório), na administração bilateral no mesmo dia e na estratégia de prevenção de complicações. Foi realizada uma revisão da literatura nas bases de dados MEDLINE® Complete, Scopus, Web of Science e Google Scholar, entre 2015 e 2025, com recurso a três estratégias de pesquisa distintas. Foram incluídos estudos que abordassem diretrizes e protocolos, contexto de administração e bilateralidade. A seleção e a análise dos dados foram realizadas com o apoio dos softwares Rayyan e NVivo. Nas pesquisas realizadas, 14 artigos cumpriram critérios de inclusão. Os resultados sugerem que, quando seguidas as práticas asséticas recomendadas, uso de máscara/restrição de conversa, desinfeção com iodopovidona 5% no local da punção por 30 segundos e uso de luvas, a administração em consultório e a bilateralidade são seguras. A padronização de protocolos mostrou-se essencial para a prevenção de complicações.
- In vitro and in vivo biocompatibility and bioactivity of bioceramic repair materialsPublication . Arantes, Lara Cancella de; Reis-Prado, Alexandre Henrique dos; Caiaffa, Karina Sampaio; Delgado, Pedro Augusto Monteiro; Oliveira, Sabrina de Castro; Fonseca, Francielen Oliveira; Tavares, Warley Luciano Fonseca; Duque, Cristiane; Cintra, Luciano Tavares Angelo; Bueno, Carlos Roberto Emerenciano; Mesquita, Ricardo Alves de; Menezes, Gustavo Batista de; Ribeiro-Sobrinho, Antônio Paulino; Benetti, FrancineThis study aimed to evaluate the in vitro cytotoxicity and bioactivity, and the in vivo biocompatibility, collagen maturation, and bioactivity, of PBS Cimmo HP and Bio-C Repair Ion+ in comparison with white MTA-Angelus. Osteoblast-like cell viability was assessed using the Alamar Blue assay, while bioactivity was assessed by alkaline phosphatase (ALP) activity and Alizarin Red staining. For the in vivo analysis, polyethylene tubes containing the materials or empty tubes (control) were implanted in the dorsum of mice. After 7 and 30 days (n = 8), the animals were euthanised and the specimens were processed for haematoxylin-eosin, Picrosirius Red, von Kossa (VK), and polarised light (PL) analyses. Data were statistically analysed (p < 0.05). Most materials extracts were cytocompatible (P > 0.05), except for the PBS Cimmo HP 1:4 extract at 48-h (p < 0.05). All materials showed increased ALP activity (p < 0.05). Mineralized nodules were significantly present in most material extracts (p < 0.05), except in the undiluted PBS Cimmo HP extract and in the white MTA-Angelus 1:4 extract. At 7 days, PBS Cimmo HP induced moderate-to-severe inflammation, whereas the other groups induced moderate inflammation (p > 0.05). At 30 days, all groups showed reduced inflammation (p > 0.05). Overall, the fibrous capsule was thick at 7 days and thin at 30 days. At 7 days, the control and PBS Cimmo HP groups showed a greater presence of immature collagen (p < 0.05); at 30 days, more mature collagen was observed in all groups (p > 0.05). The materials exhibited positivity for VK or PL in both periods. In conclusion, PBS Cimmo HP and Bio-C Repair Ion+ were cytocompatible and biocompatible, and demonstrated bioactivity and collagen maturation similar to those of white MTA-Angelus.
- Headache disorders and the global burden of disease study: deficiencies, challenges and opportunities for bettermentPublication . Husøy, Andreas Kattem; Adarmouch, Latifa; Berring-Uldum, Amalie; Gil-Gouveia, Raquel; Jensen, Rigmor; Shirane, Risako; Steiner, Timothy J.
- Meanings attributed to Hope by children with orofacial clefts through dramatic therapeutic playPublication . Mori, Mariana Martire; Piran, Camila Moraes Garollo; Cargnin, Alana Vitoria Escritori; Marques, Fernanda Ribeiro Baptista; Trettene, Armando Dos Santos; Charepe, Zaida Borges; Furtado, Marcela DemittoObjective: To understand the meanings attributed by children with orofacial clefts to the factors that promote and threaten Hope, through Dramatic Therapeutic Play. Method: A qualitative study, grounded in the theoretical–methodological framework of the Hope-Promoting Mutual Help Intervention Model and the theoretical framework of Symbolic Interactionism. It was conducted between March and April 2025 through Dramatic Therapeutic Play with children aged five to nine years old with orofacial clefts, who were receiving care at a support association in Paraná, Brazil. Data were analyzed using inductive thematic analysis. All ethical principles were respected. Results: Sixteen children participated. Among the aspects that promote Hope, the following stand out: treatment experiences, multiprofessional care, family and social support, spirituality, acceptance of one’s own condition, and playful strategies. Aspects that threaten Hope were related to dissatisfaction with appearance, negative treatment experiences, lack of emotional support, bullying, and social exclusion. Conclusion: The experience of a child with an orofacial cleft is marked by meanings attributed to their own self-image, the treatment, and the social support received. Care actions and family and social interactions can strengthen or threaten Hope during treatment.