S1 Health literacy and health education in adolescence Catarina Cardoso Tomás S2 The effect of a walking program on the quality of life and well-being of people with schizophrenia Emanuel Oliveira, D. Sousa, M. Uba-Chupel, G. Furtado, C. Rocha, A. Teixeira, P. Ferreira S3 Diagnosis and innovative treatments - the way to a better medical practice Celeste Alves S4 Simulation-based learning and how it is a high contribution Stefan Gisin S5 Formative research about acceptability, utilization and promotion of a home fortification programme with micronutrient powders (MNP) in the Autonomous Region of Príncipe, São Tomé and Príncipe Elisabete Catarino, Nelma Carvalho, Tiago Coucelo, Luís Bonfim, Carina Silva S6 Safety culture of the patient: a reflexion about the therapeutic approach on the patient with vocal pathology Débora Franco S7 About wine, fortune cookies and patient experience Jesús Alcoba González O1 The psychological impact on the emergency crews after the disaster event on February 20, 2010 Helena G. Jardim, Rita Silva O2 Musculoskeletal disorders in midwives Cristina L. Baixinho, Mª Helena Presado, Mª Fátima Marques, Mário E. Cardoso O3 Negative childhood experiences and fears of compassion: Implications for psychological difficulties in adolescence Marina Cunha, Joana Mendes, Ana Xavier, Ana Galhardo, Margarida Couto O4 Optimal age to give the first dose of measles vaccine in Portugal João G. Frade, Carla Nunes, João R. Mesquita, Maria S. Nascimento, Guilherme Gonçalves O5 Functional assessment of elderly in primary care Conceição Castro, Alice Mártires, Mª João Monteiro, Conceição Rainho O6 Smoking and coronary events in a population of Spanish health-care centre: An observational study Francisco P. Caballero, Fatima M. Monago, Jose T. Guerrero, Rocio M. Monago, Africa P. Trigo, Milagros L. Gutierrez, Gemma M. Milanés, Mercedes G. Reina, Ana G. Villanueva, Ana S. Piñero, Isabel R. Aliseda, Francisco B. Ramirez O7 Prevalence of musculoskeletal injuries in Portuguese musicians Andrea Ribeiro, Ana Quelhas, Conceição Manso O8 Hip fractures, psychotropic drug consumption and comorbidity in patients of a primary care practice in Spain Francisco P. Caballero, Jose T. Guerrero, Fatima M. Monago, Rafael B. Santos, Nuria R. Jimenez, Cristina G. Nuñez, Inmaculada R. Gomez, Mª Jose L. Fernandez, Laura A. Marquez, Ana L. Moreno, Mª Jesus Tena Huertas, Francisco B. Ramirez O9 The role of self-criticism and shame in social anxiety in a clinical SAD sample Daniel Seabra, Mª Céu Salvador O10 Obstruction and infiltration: a proposal of a quality indicator Luciene Braga, Pedro Parreira, Anabela Salgueiro-Oliveira, Cristina Arreguy-Sena, Bibiana F. Oliveira, Mª Adriana Henriques O11 Balance and anxiety and depression symptoms in old age people Joana Santos, Sara Lebre, Alda Marques O12 Prevalence of postural changes and risk factors in school children and adolescents in a northern region (Porto) Clarinda Festas, Sandra Rodrigues, Andrea Ribeiro, José Lumini O13 Ischemic stroke vs. haemorrhagic stroke survival rate Ana G. Figueiredo O14 Chronobiological factors as responsible for the appearance of locomotor pathology in adolescents Francisco J. Hernandez-Martinez, Liliana Campi, Mª Pino Quintana-Montesdeoca, Juan F. Jimenez-Diaz, Bienvenida C. Rodriguez-De-Vera O15 Risk of malnutrition in the elderly of Bragança Alexandra Parente, Mª Augusta Mata, Ana Mª Pereira, Adília Fernandes, Manuel Brás O16 A Lifestyle Educational Programme for primary care diabetic patients: the design of a complex nursing intervention Mª Rosário Pinto, Pedro Parreira, Marta L. Basto, Ana C. Rei, Lisete M. Mónico O17 Medication adherence in elderly people Gilberta Sousa, Clementina Morna, Otília Freitas, Gregório Freitas, Ana Jardim, Rita Vasconcelos O18 Hospitalization for cervical cancer of residents in the metropolitan region of Porto Alegre, Southern Brazil, 2012 to 2014 Lina G. Horta, Roger S. Rosa, Luís F. Kranz, Rita C. Nugem, Mariana S. Siqueira, Ronaldo Bordin O19 Oncologic assistance of high complexity: evaluation of regulating accesses Rosiane Kniess, Josimari T. Lacerda O20 Perceived barriers for using health care services by the older population as seen by the social sector: findings from the Vila Nova de Gaia Gerontological Plan Joana Guedes, Idalina Machado, Sidalina Almeida, Adriano Zilhão, Helder Alves, Óscar Ribeiro O21 Sleep difficulties and depressive symptoms in college students Ana P. Amaral, Ana Santos, Joana Monteiro, Mª Clara Rocha, Rui Cruz O22 Psychopathological symptoms and medication use in higher education Ana P. Amaral, Marina Lourenço, Mª Clara Rocha, Rui Cruz O23 Sexually transmitted diseases in higher education institutions Sandra Antunes, Verónica Mendonça, Isabel Andrade, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes O24 Alcohol consumption and suicide ideation in higher education students Lídia Cabral, Manuela Ferreira, Amadeu Gonçalves O25 Quality of life in university students Tatiana D. Luz, Leonardo Luz, Raul Martins O26 Male and female adolescent antisocial behaviour: characterizing vulnerabilities in a Portuguese sample Alice Morgado, Maria L. Vale-Dias O27 Risk factors for mental health in higher education students of health sciences Rui Porta-Nova O28 International classification of functioning disability and health as reflexive reasoning in primary attention in health Tânia C. Fleig, Éboni M. Reuter, Miriam B. Froemming, Sabrina L. Guerreiro, Lisiane L. Carvalho O29 Risk factors and cardiovascular disease in Portalegre Daniel Guedelha, P....

Type 2 Diabetes Mellitus (T2D) is defined as a chronic condition caused by beta cell loss and/or dysfunction and insulin resistance (IR). The discovering of novel biomarkers capable of identifying T2D and other metabolic disorders associated with IR in a timely and accurate way is critical. In this review, 2-hydroxybutyric acid (2HB) is presented as that upheaval biomarker with an unexplored potential ahead. Due to the activation of other metabolic pathways during IR, 2HB is synthesized as a coproduct of protein metabolism, being the progression of IR intrinsically related to the increasing of 2HB levels. Hence, the focus of this review will be on the 2HB metabolite and its involvement in glucose homeostasis. A literature review was conducted, which comprised an examination of publications from different databases that had been published over the previous ten years. A total of 19 articles fulfilled the intended set of criteria. The use of 2HB as an early indicator of IR was separated into subjects based on the number of analytes examined simultaneously. In terms of the association between 2HB and IR, it has been established that increasing 2HB levels can predict the development of IR. Thus, 2HB has demonstrated considerable promise as a clinical monitoring molecule, not only as an IR biomarker, but also for disease follow-up throughout IR treatment.

Purpose: This paper aims at identifying obstacles, benefits, leading practices and lessons learned in the transition/certification of the revised standard for quality management systems ISO 9001:2015 for organizations in various sector, countries and spanning a range of sizes.Design/methodology/approach: Based on literature review and inputs from experts in management systems certification, a quantitative survey was launched in Portugal, Romania, Switzerland, and Turkey in April 2018, addressed at quality and organizational managers and CEOs from ISO 9001:2015-certified organizations by certification bodies partners of the leading International Quality Network (IQNet). The answers were collected anonymously through an automated online database, until the end of April 2018. The overall response rate was 3.1%, encompassing 222 organizations already certified according to ISO 9001:2015.Findings: The surveyed organizations reported significant benefits from ISO 9001:2015 implementation. Only 3.9% of the respondents considered the 3-year transition period (from September 15, 2015, to September 15, 2018) as too short. The respondents’ organizations attended ISO 9001:2015 training and seminars, and collected information from websites, newsletters, books and interpretation guides and directly from certification bodies. Some (29.8%) relied on their own internal resources for the transition processes, while external consultants supported 22.7%. The respondents considered the adoption of risk-based thinking the major difficulty to be overcome, but simultaneously as the major benefit to be realized. The alignment with other management systems, the increased top management commitment, the identification of risks and opportunities and the knowledge management were also reported as significant benefits.The initial timing when organizations started working on the transition process and the activities carried out seem to differ between countries, while the adjustments performed to the existing management systems seem to differ by sector and size of the organization. The benefits attained by the organizations vary according to the perception regarding the information resources made available and organizations should be aware of the advantages of early planning. The organizations that rated the benefits of ISO 9001:2015 adoption higher considered the information resources as adequate and started working with ISO 9001:2015 at an earlier stage, while those that rated the benefits lower stated that the information resources were made available too late. The organizations that successfully managed the ISO 9001:2015 transition/certification process were the ones that attended ISO 9001:2015 training courses and seminars and got useful information from their certification body.This research highlights the relevance of the geographical context, of the organization size and the sector for successful adoption of ISO 9001:2015. The identification and promotion of resources that led to the highest benefits are worth pursuing. The replication of this study can add a time perspective and the assessment if these perceptions are expected to materialize into tangible results such as cost benefits and higher customer satisfaction.Research limitations/implications: Due to the novelty of ISO 9001:2015, these results should be subjected to additional validation and longitudinal analyses. Although measures have been taken to minimize possible bias errors from both non-respondents’, and respondents’ subjectivity, these limitations of the survey methodology should be acknowledged.Practical implications: The findings of this research provide standardization and certification bodies and quality management systems practitioners with leading practices in the implementation of ISO 9001:2015 and guidance for an efficient and effective transition/adoption.Originality/value: This investigation contributes to the ISO 9001:2015 body of knowledge by mapping the transition/certification processes with a multi-country perspective. The results empirically validate the potential value of transitioning or adopting ISO 9001:2015 and give insights on the implementation methodologies, leading practices to follow, difficulties to overcome and benefits to realize, to maximize the success of ISO 9001:2015 adoption.

Purpose: The implementation and certification of Management Systems International Standards, such as ISO 9001 and ISO 14001, achieved a high international recognition, with more than 1 million organizations with their Quality Management Systems certified worldwide. Researchers have been paying considerable attention to this theme and the number of published articles has robustly growth. Although, on an overall basis, the research results support the existence of positive impacts on the use and certification of these International Standards, there are various inconsistency and contradictory results, leading to some controversy over its impacts for organizations. This study aims to bring a longitudinal time perspective to this area of research, analyzing the articles published since 1996, on the benefits of Management Systems Certification. A longitudinal perspective of countries of authors origin, keywords and journals is presented, complemented with an evaluation of the research results.Design/methodology/approach: The research was supported with a Bibliometric Study, with data collected from Web of Science, SCOPUS, and Research Gate data bases. Following the detailed analysis of the journal titles, articles abstracts and their full content, an evaluation scale was applied to access if the results support the existence of a positive relationship between MSC and economic, financial or stakeholder results.Findings: The results evidence a steep increase in the number of publications addressing Management Systems Certification benefits, that mainly originate from Europe (48%) and East Asia and Pacific (23%), with Spain as the clear leading country accounting (43% of the total number of articles published between 1996 and April 2017). Journal of Cleaner Production (EMSC) and Total Quality Management and Business Excellence journal (QMSC) are the leading journals for disseminating the research and the most used keywords are “Quality/Environment”, “ISO 9001/14001”, “Performance”, “Management Systems” and “Certification”. There are also insights that the research is now open to other Management Systems either than Quality and Environment. The systematic review of the selected papers shows that the Management Systems adoption and certification brings fairly positives benefits (average 2,34 in a 1 to 5 Likert type scale) for the certified organizations, although some variations are observed. Some avenues for future research should consider the reliability and validation of measures; sampling and biases errors; the use of control, moderating and mediating variables; the consideration of time and situational contingencies; and the search for explanations for cause and effect relationships.The results of this research support the view that the investigation of Management Systems Certification benefits is indeed an issue of high academic and practitioners interest. This research, although subject to some subjective evaluation of the authors, and acknowledging that the research articles are not always comparable, aims to give some insights for this continuous research field. Research limitations/implications: Although the authors took measures to reduce subjectivity, it should be noted that the evaluation could be subject to the authors own interpretation and the research articles are not always comparable.Originality/value: This research makes a longitudinal and comprehensive evaluation of the articles published since 1996 on the benefits of Management System Certification. It highlights trends and gives contribution for future research, on a field of intense academic and practitioners interest.

The gut microbiota refers to bacteria lodges in the gastrointestinal tract (GIT) that interact through various complex mechanisms. The disturbance of this ecosystem has been correlated with several diseases, such as neurologic, respiratory, cardiovascular, and metabolic diseases and cancer. Therefore, the modulation of the gut microbiota has emerged as a potential therapeutic tool; of the various forms of gut microbiota modulation, fecal microbiota transplantation (FMT) is the most approached. This recent technique involves introducing fecal material from a healthy donor into the patient’s gastrointestinal tract, aiming to restore the gut microbiota and lead to the resolution of symptoms. This procedure implies a careful donor choice, fine collection and handling of fecal material, and a balanced preparation of the recipient and consequent administration of the prepared content. Although FMT is considered a biological therapy with promising effects, side effects such as diarrhea and abdominal pain have also been claimed, making this a significant challenge in the application of FMT. Bearing this in mind, the present review aims to summarize the recent advances in understanding FMT mechanisms, their impact across different pathological conditions, and the associated side effects, emphasizing the most recent published data.