Green supply chain management is an important organizational approach to reducing strain on the environment. Many companies are under pressure from customers, media, governments, and investors, among others, to implement green practices. This exploratory paper investigates the relationships between internal and external green practices of eight Portuguese companies from different industrial sectors and their impact on economic and environmental performance. The relationship was analyzed based on the data collected from 22 semi‐structured interviews with general managers, procurement and environmental/safety managers, and through secondary data collected from reports, websites and companies' internal documentation. The analysis identifies the most important green practices considered by managers, as well as the performance measures that are most appropriate and most widely used to evaluate the influence of green practices on corporate performance. A conceptual model was derived to assess the influence of green practices on focal company economic and environmental performance. The results support four of five propositions of this research, and it is possible to conclude that the companies believe that with the adoption of green supply chain practices, they can be more competitive in the market. Due to the scope of the green practices, the relationship between green practices and economic performance was inconclusive. Internal and external green supply chain practices contribute to improved environmental performance because for all companies, there is a positive relationship between green practices and environmental performance in terms of energy, water consumption, waste, and air emissions reduction.

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Purpose: This research aims to investigate which are the green purchasing practices that Portuguese manufacturing companies have been using and the relationship with company overall performance. This paper focuses on green-purchasing practices, such as green products, green suppliers, environmental collaboration with suppliers, green packaging, and reverse logistics, to ensure sustainable practices in the supply chain, and the influence of those practices on firm’s performance was investigated from the perspective of managers perception.Design/methodology/approach: A qualitative approach was adopted, based on eight case studies. Data was collected from semi-structured interviews with procurement managers from Portuguese manufacturing industry and from reports, websites and companies’ internal documentation. To analyze the impact of green purchasing practices on company overall performance a conceptual model was proposed.Findings: The results support three out of five propositions of this research, and evidence reveals that green purchasing practices improves company overall performance. Provides evidence that the implementation of those practices positively influences overall company performance, it also identifies the most frequent green purchasing practices that may help businesses in adopting environmental initiatives.Research limitations/implications: While the sample included organizations from several economic sectors, it was based on just a sample of eight case studies and the findings may not be valid in different sectors. This research focuses on green procurement from a country's perspective, which reduces the ability to generalize the findings to other countries.Practical implications: Managers might utilize the results of this study to develop and implement green purchasing practices and enhance organizations' overall performance via their adoption.Social implications: This research contributes to the current discussion in green supply chain literature.Originality/value: This study contributes to the existing body of research on the effects of implementing green purchasing practices into the procurement function.

Objective To evaluate the use of external cephalic version (ECV) in Portuguese public hospitals with maternity services, as well as exploring the main motives for not offering the technique. Methods A cross‐sectional observational study was conducted involving an online survey with 34 questions, accessed via an email addressed to all Heads of Department of Portuguese state‐owned hospitals with maternity services. In centers where the technique was performed, information was requested on success rates, contraindications for the procedure, and practical aspects related to its use. In centers where ECV was not offered, the underlying reasons for this were queried. Results Answers were received from 41 out of the 43 state hospitals with maternity services (95.3%). Sixteen hospitals perform the technique (39%), with reported annual numbers ranging from 3 to 51, and success rates ranging from 25% to 85% (12 respondents). The main reasons for not offering the technique were lack of experience and lack of conditions to perform it safely. Most centers (87.8%) reported that they would welcome hands‐on training in ECV. Conclusion ECV is used in a minority of Portuguese state‐owned hospitals. Efforts are needed to achieve a wider implementation of the technique, with a particular focus on simulation‐based training.

PurposeThe choroidal circulation receives nearly 95% of ocular blood flow and it is essential for a normal retinal structure and function. Recently, several clinical studies showed a variation in choroidal thickness (CT) even before the presence of diabetic retinopathy (DR), which the meaning remains uncertain and questionable. Our objective was to analyze and correlate the CT with the disease duration, systemic blood pressure (SBP) and analytic evaluation.MethodsProspective, observational case–control study. A complete ophthalmological examination was performed, including dynamic contour tonometry and axial length. CT was assessed by a non‐invasive procedure using an OCT (Spectralis Heidelberg Engineering) with an enhanced depth mode (EDI) at 13 different locations (subfoveal and 3 measurements 500 μm apart in all 4 directions – nasal, temporal, superior and inferior). The SBP was measured and an analytical evaluation was performed, including glycemia, glycosylated hemoglobin – HbA1c, lipid parameters, renal function, ionogram and microalbuminuria. Correlation between variables was explored using Spearman correlations.ResultsThe study included 65 diabetic patients without DR (36 females; mean age 67.23 ± 9.08 years), with an average disease duration of 90.42 ± 81.82 months. The CT didn't showed a correlation with disease duration, SBP, glycemia, HbA1c, renal function, lipid parameters, homocysteinemia, natremia or microalbuminuria. However, the CT was positively correlated with potassium and chlorine serum levels in 5 points, with statistic significance (r between 0.26 and 0.31, p < 0.05).ConclusionsCT may be positively influenced by serum levels of potassium‐chlorine in diabetic patients but not in healthy controls. These abnormal CT relationships can be detected even with no visible DR. Further studies are needed to explore these differences.

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