Universidade Lusófona do Porto

Resource efficiency is a key pillar of the European Union's strategy to address climate change, the energy transition, and sustainable economic growth. This study examines how firm-specific characteristics influence the difficulties EU companies face in implementing resource efficiency strategies. Using multilevel latent class analysis, the study identified four firm-level clusters, ranging from minimal to severe implementation barriers, and five country-level classes reflecting varying degrees of national-level challenges. Findings show that smaller and older firms with lower turnover and limited investment tend to face moderate to severe difficulties, highlighting the critical importance of financial capacity and organizational agility. At the country level, pronounced geographic variation emerges: firms in Northern and Central Europe generally face fewer obstacles, whereas those in Southern and Eastern Europe encounter greater challenges. The results emphasize the need for differentiated policy and managerial interventions, including targeted financial support, capacity-building programs, and cross-regional knowledge exchange, to promote strategic resource allocation and broader adoption of sustainable practices. Overall, the study advances theoretical understanding by linking firm heterogeneity with multilevel contextual factors and provides actionable insights for enhancing resource efficiency across the EU. • Using multilevel latent class analysis, EU firms are grouped into four clusters, with smaller and older firms facing greater limits. • Clear regional gaps emerge: Northern and Central Europe face fewer barriers than Southern and Eastern Europe, notably Spain. • Firms with lower turnover and limited circular investments face more barriers, underscoring finance and strategy as key factors. • Results support tailored policies, combining targeted finance, sector advice, and cross‑regional knowledge sharing.

Background/Objectives: Cancer-related cognitive impairment (CRCI) is a prevalent survivorship concern associated with functional limitations and reduced quality of life. Although cognitive rehabilitation shows beneficial effects, implementation depends not only on efficacy but also on survivors' anticipated willingness to engage. No psychometrically validated instrument currently exists to assess prospective acceptability of cognitive rehabilitation among cancer survivors. This study aimed to: (1) develop the Acceptability of Cognitive Rehabilitation Interventions Survey-Cancer Survivors (ACRIS-CS); (2) examine its structural validity (factor structure), internal consistency, and construct validity; (3) describe prospective acceptability levels; and (4) identify independent predictors. Methods: A cross-sectional study was conducted with 154 cancer survivors reporting cognitive complaints. The ACRIS-CS was developed based on the Theoretical Framework of Acceptability. Structural validity was examined using exploratory factor analysis (EFA); internal consistency was assessed with Cronbach's alpha; and construct validity was evaluated through hypothesis-driven correlational analyses. Multiple linear regression was used to identify independent predictors of prospective acceptability. Results: EFA supported a three-factor structure explaining 68.7% of total variance (KMO = 0.847, Bartlett's χ2 (55) = 864.431, p < 0.001). The total scale demonstrated good internal consistency (α = 0.85; subscales α = 0.73-0.85), and construct validity was supported. Mean prospective acceptability indicated overall moderate-to-high levels. Being in active treatment (β = -0.248, p = 0.001) and having greater prior knowledge of CRCI (β = 0.240, p = 0.002) were independently associated with prospective acceptability (adjusted R2 = 0.113). Conclusions: The ACRIS-CS demonstrated preliminary evidence of structural validity, internal consistency, and construct validity. Prospective acceptability appears to be influenced by treatment status and prior knowledge of CRCI, supporting the need for further confirmatory validation before routine clinical implementation.

Barriers and facilitators to kangaroo care in Portuguese NICUs: A cross-sectional study with health professionals

ABSTRACT Research suggests psychopathic traits may differ by gender, yet comparative studies are limited. This study compared Portuguese incarcerated men and women on psychopathy and examined whether psychopathy and its facets are associated with violent offenses. A total of 131 men and 63 women were assessed with the Revised Psychopathy Checklist (PCL-R). Men scored higher on total psychopathy, interpersonal, and affective facets, while women scored higher on the lifestyle facet. No significant associations were found between psychopathy (total or facets) and violent offenses in either gender. These findings may inform interventions and policies to reduce reoffending among individuals with psychopathic traits.

While there is quite an extensive academic literature on the factors influencing firms’ office-related decisions, there is limited understanding of the effects of the widespread of teleworking brought by the COVID-19 pandemic on firms’ decisions regarding office (re)location, reorganisation of office space, and usage of new working spaces. The recent normalisation of new working regimes, notably remote working, makes it an appropriate time to conduct a review. The increasing significance of this topic and its anticipated impacts on labour and real estate markets poses new challenges for urban economies. The present review aims to be a starting point for future studies.

Rescuer posture, position, and patient height during chest compressions (CC) influence its efficacy and efficiency. No clear recommendations exist on these aspects. It is essential to systematize the existing knowledge, especially for nurses and healthcare providers involved in resuscitation. To conduct a systematic review about the impact of rescuer posture, position, and manikin/patient height on CC efficacy and efficiency. The study followed PRISMA guidelines and was registered on PROSPERO. Eligibility criteria included peer-reviewed articles or conference papers comparing different rescuer postures, positions, or manikin/patient heights during CC performed with both hands, regarding efficacy or efficiency. Databases consulted: MEDLINE Complete, SPORTDiscus, Cochrane Reviews, and CINAHL Complete. Methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies. Of 6539 articles, only 34 met inclusion criteria. All were observational, used manikins, and were classified as weak in global methodological quality. Compared with standing, several studies suggested the kneeling posture may be associated with more effective and efficient CC. Evidence regarding the optimal patient height, including potential anthropometric-based adjustments, remains limited. Findings across the included studies indicated that variations in hand position appeared to have minimal influence on CC quality. Some studies reported decreased CC quality when rescuers performed CC while walking. The available evidence suggested that performing CC while kneeling on a firm surface may be beneficial when feasible. Future research is needed to further evaluate the impact of bed height, self-selected rescuer position, and their relevance to emergency practice.

<h3></h3> <b>Application for ESRA Abstract Prizes:</b> <h3>Background and Aims</h3> Severe aortic stenosis presents major anesthetic challenges during urgent non-cardiac surgery due to the high risk of hemodynamic instability and perioperative cardiac complications. The primary anesthetic concern is to maintain hemodynamic stability by avoiding hypotension, tachycardia, and abrupt changes in preload and afterload. Without prior cardiac intervention, choosing an anaesthetic technique with minimal cardiovascular risk is crucial. Peripheral nerve blocks may offer a safer alternative in this high-risk population. <h3>Methods</h3> We report the case of a 69-year-old female (ASA-PS IV) with symptomatic severe aortic stenosis (mean pressure gradient of 44 mmHg), awaiting surgical aortic valve replacement, who sustained a distal radius fracture requiring urgent surgical fixation. Standard ASA monitoring was applied, along with invasive blood pressure monitoring via a radial arterial catheter. To minimize cardiovascular instability and mitigate the risks associated with general anesthesia, a regional anesthetic technique was selected. An ultrasound-guided axillary brachial plexus block was performed using 25 mL of 0.5% ropivacaine. <h3>Results</h3> The peripheral nerve block provided effective surgical anesthesia, and the patient remained hemodynamically stable throughout the procedure, not requiring any hemodynamic support. The patient was admitted to an intermediate care unit for postoperative surveillance. Postoperative recovery was uneventful, with adequate analgesia and no cardiovascular complications were recorded. <h3>Conclusions</h3> Peripheral nerve blocks represent a valuable anaesthetic approach for orthopaedic surgery in patients with severe aortic stenosis. This case reinforces the role of regional anaesthesia as a safe and effective strategy in high-risk cardiac patients undergoing urgent non-cardiac surgery.