Health literacy, a more complex concept than knowledge, is a required capacity to obtain, understand, integrate and act on health information [1], in order to enhance individual and community health, which is defined by different levels, according to the autonomy and personal capacitation in decision making [2]. Medium levels of Health literacy in an adolescent population were found in a study conducted in 2013/2014, being higher in sexual and reproductive health and lower in substance use. It was also noticed that the higher levels of health literacy were in the area adolescents refer to have receipt more health information. The health literacy competence with higher scores was communication skills, and the lower scores were in the capacity to analyze factors that influence health. Higher levels were also found in younger teenagers, but in a higher school level, confirming the importance of health education in these age and development stage. Adolescents seek more information in health professionals and parents, being friends more valued as a source information in older adolescents, which enhance the importance of peer education mainly in older adolescents [3]. As a set of competences based on knowledge, health literacy should be developed through education interventions, encompassing the cultural and social context of individuals, since the society, culture and education system where the individual is inserted can define the way the development and enforcement of the health literacy competences [4]. The valued sources of information should be taken into account, as well as needs of information in some topics referred by adolescents in an efficient health education. Schizophrenia is a serious and chronic mental illness which has a profound effect on the health and well-being related with the well-known nature of psychotic symptoms. The exercise has the potential to improve the life of people with schizophrenia improving physical health and alleviating psychiatric symptoms. However, most people with schizophrenia remains sedentary and lack of access to exercise programs are barriers to achieve health benefits. The aim of this study is to evaluate the effect of exercise on I) the type of intervention in mental health, II) in salivary levels of alpha-amylase and cortisol and serum levels of S100B and BDNF, and on III) the quality of life and selfperception of the physical domain of people with schizophrenia. The sample consisted of 31 females in long-term institutions in the Casa de Saúde Rainha Santa Isabel, with age between 25 and 63, and with diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Physical fitness was assessed by the six-minute walk distance test (6MWD). Biological variables were determined by ELISA (Enzyme-Linked Immunosorbent Assay). Psychological variables were assessed using SF-36, PSPP-SCV, RSES and SWLS tests. Walking exercise has a positive impact on physical fitness (6MWD -p = 0.001) and physical components of the psychological test...

Background: Phlebitis is a major adverse event. It has a high prevalence, ranging from 25.8% to 55.6%, which makes it an epidemiologically relevant phenomenon. Objective: To identify the prevalence of peripheral intravenous catheter-related phlebitis in patients admitted to a hospital unit in the North region of Portugal in May 2017, as well as to analyze its associated risk factors. Methodology: Prospective cohort study. Data were collected in May 2017 at a hospital unit in the North region of Portugal using the Portuguese version of the Phlebitis Scale, as well as patients' medical records for the collection of sociodemographic and clinical data. The sample was composed of 58 patients. Results: The participants had a mean age of 64 years, 53.4% of them were women, and the mean dwell time of the peripheral venous catheter (PVC) was 3.25 days. The prevalence of phlebitis was 36.7%, with a predominance of Grade 1 phlebitis (63%). Conclusion:The occurrence of phlebitis was associated with the PVC dwell time. Further studies and interventions should be conducted to raise nurses' awareness of the importance of assessing the type and severity of phlebitis.

Facial pressure ulcers in inpatients undergoing non-invasive ventilation in intermediate care units Úlceras de pressão na face em doentes submetidos a ventilação não invasiva hospitalizados em cuidados intermédios Úlceras por presión en la cara en pacientes sometidos a ventilación no invasiva hospitalizados en cuidados intermédios

Aims To study the correlation between the workload of intensive care nursing teams and the sociodemographic, anthropometric and clinical characteristics of patients in critical condition in a Portuguese Intensive Care Unit (ICU) during a 5‐year period. Background Currently, indices of nursing workload quantification are one of the resources used for planning and evaluating ICUs. Evidence shows that there are several factors related to critical patients and their hospitalisation which potentially influence the nursing workload. Design Retrospective cohort analysis of a health record database from adult patients admitted to a Portuguese ICU between 1 January 2015–31 December 2019. Methods Simplified Therapeutic Intervention Scoring System (TISS‐28) scores of 730 adult patients. Three TISS‐28 assessments were considered: first assessment, last assessment and average. The STROBE guidelines were used in reporting this study. Results The TISS‐28 has an average of 34.2 ± 6.9 points at admission, which is considered a high nursing workload. A somewhat lower result was found for the discharge and average assessments. It shows that basic activities accounted for the highest percentage of time spent (38.0%), followed by the cardiovascular support category (26.5%). The TISS‐28 shows consistent results throughout the study period, despite a small trend reduction in the last 2 years. Conclusions Lower workloads were found for age ≤44 years and with a shorter length of stay. Higher workload was more probable in patients classified in Cullen Class IV (OR = 2.5) and with a normal to higher weight percentile (OR = 1.9 and 1.5, respectively). Relevance to clinical practice Knowledge of the factors influencing the nursing workload facilitates the implementation of rules to improve performance in nursing interventions, based on the redefinition of care priorities, increased productivity, human resources management and reduction of additional costs to the organisation, related to possible adverse events, among others.

In order to describe accidents at work at a hospital in Northern Portugal and analyze their main impact in the period from 2008 to 2010, we conducted a retrospective cross-sectional study. The information was obtained from the notification records of accidents at work for 387 workers. The highest prevalence levels of accidents referred to superior health technician (56.1%), female workers (81.9%), in the age group 30-39 years (37.2%), with a secondary education degree (55.8%), working in shifts (72.4%) and in-patient services (35.9%). Needle pricks were the main cause (45.7%) and hands were the main injury location (37.5%). Wounds (32.6%) were the most frequent type of injury, followed by sprains and strains (23%). In total, 27.4% resulted in absence from work, with sprains and strains as the main reason. Preventive strategies should be adopted, aiming to promote these workers' health.

Background: Ventilator-associated pneumonia is an infection susceptible to prevention with the compliance of measures (bundle), whose prevention is a huge challenge for nursing practice. Objectives: To identify nursing procedures in patients undergoing invasive mechanical ventilation and the development of pneumonia in intensive care medicine. Methods: Longitudinal and descriptive study carried out in the Intensive Care Unit of a hospital in the north of Portugal, between 01/11/2017 and 28/02/2018, with a sample of 20 nurses and a total of 102 observations. The data collection instrument used was a questionnaire for the characterization of the sample and a grid of direct observation. Data were entered and analyzed using Microsoft Excel 2016. Results: The verification of the cuff pressure and the aspiration of secretions were the procedures with lower participation. A 0.3% rate of ventilator-associated pneumonia occurred. Conclusion:The frequency of pneumonia in ventilated patients was low, as there was a high rate of adherence to the bundle.

Resultados da implementação do protocolo da via verde do acidente vascular cerebral num hospital português Resultados de la implementación del protocolo código ictus en un hospital portugués

FucoPol, a fucose-rich polyanionic polysaccharide, was used for the first time for the preparation of hydrogel membranes (HMs) using Fe3+ as a crosslinking agent. This study evaluated the impact of Fe3+ and FucoPol concentrations on the HMs’ strength. The results show that, above 1.5 g/L, Fe3+ concentration had a limited influence on the HMs’ strength, and varying the FucoPol concentration had a more significant effect. Three different FucoPol concentrations (1.0, 1.75 and 2.5 wt.%) were combined with Fe3+ (1.5 g/L), resulting in HMs with a water content above 97 wt.% and an Fe3+ content up to 0.16 wt.%. HMs with lower FucoPol content exhibited a denser porous microstructure as the polymer concentration increased. Moreover, the low polymer content HM presented the highest swelling ratio (22.3 ± 1.8 g/g) and a lower hardness value (32.4 ± 5.8 kPa). However, improved mechanical properties (221.9 ± 10.2 kPa) along with a decrease in the swelling ratio (11.9 ± 1.6 g/g) were obtained for HMs with a higher polymer content. Furthermore, all HMs were non-cytotoxic and revealed anti-inflammatory activity. The incorporation of FucoPol as a structuring agent and bioactive ingredient in the development of HMs opens up new possibilities for its use in tissue engineering, drug delivery and wound care management.