Search Results (6)

The student–patient relationship represents the cornerstone of medical education, shaping future doctors’ knowledge, skills and attitudes. While most patients allow student involvement in their care, some may express discomfort. Thus, obtaining explicit consent is essential to respect patients’ right of autonomy. This study mainly aims to assess the practical application of informed consent by medical students and teachers regarding students’ presence and participation in patients’ care. An observational cross-sectional study was performed, and an online questionnaire was given to students and teachers at a single medical school, via institutional email. The study included 289 participants, namely 232 students and 57 teachers. While 81% of teachers reported always asking the patient’s consent for students’ presence, only 28% of students claimed this to be the case. Despite challenges like overcrowding and limited time, involving students in healthcare benefits both students and patients. Moreover, medical ethics education is crucial to foster compassionate care and promote ethical reasoning. The disparities found between teachers’ practices and students’ perspectives highlight the need to intervene and provide them with an adequate education on ethical values in clinical practice. Strategic interventions at institutional levels are required for a simultaneous high quality of patient care and clinical training. Full article

The main goal of this research is to study the impact of uncertainty on export performance, from a resource-based perspective. Despite the ample research on how economies behave during periods of high uncertainty, there is still a poor understanding of how this affects smaller sectors, particularly the most exposed to global competition. In this paper, we perform an evaluation of export performance for the Portuguese pharmaceuticals sector (PPI), before and after a period of considerable uncertainty. This study’s results show strong incremental performance gains, during this period. It also confirmed the importance of marketing capabilities, innovation and networking resources in developing international businesses. Full article

The pharmaceutical industry is facing the pressure of a global economy, loss of value in local markets and the highly intense innovation that characterizes this sector. This has a heavy impact, particularly in smaller economies. With this investigation, we intend to identify the determinants of internationalization as levers for sustainability in the pharmaceutical export sector of a small economy. Data was collected from a sample representing 63% of the total universe, Portuguese pharmaceutical organizations with exporting activity. A contextualization of the sector and a bibliographic review were previously carried out, which laid the groundwork for the empirical framework. This study revealed a deeply internationalized sector conditioned by a few shortcomings, namely a certain lack of sustainable competitive advantages, relatively low investment in research and development (R&D), insufficient innovation in internationalization strategies as well as scarce institutional support. Our findings may help pave the way for a more complete understanding of the dynamics of internationalization in highly competitive sectors. Full article

Introduction: The renin–angiotensin system (RAS) is involved in cell proliferation, immunoinflammatory response, hypoxia and angiogenesis, which are critical biological processes in lung cancer. Our aim was to study the association of putatively functional genetic polymorphisms in genes coding for proteins involved in RAS, hypoxia and angiogenesis with non-small cell lung cancer (NSCLC) prognosis. Methods: Genotyping of 52 germline variants from genes of the RAS and hypoxic/angiogenic factors/receptors was performed using MassARRAY iPLEX Gold in a retrospective cohort (n = 167) of advanced NSCLC patients. Validation of the resulting genetic markers was conducted in an independent group (n = 190), matched by clinicopathological characteristics. Results: Multivariate analysis on the discovery set revealed that MME rs701109 C carriers were protected from disease progression in comparison with homozygous T (hazard ratio (HR) = 0.5, 95% confidence interval (CI) = 0.2–0.8, p = 0.010). Homozygous A and T genotypes for KDR rs1870377 were at increased risk for disease progression and death compared to heterozygous (HR = 1.7, 95% CI = 1.2–2.5, p = 0.005 and HR = 2.1, 95% CI = 1.2–3.4, p = 0.006, respectively). Carriers of homozygous genotypes for ACE2 rs908004 presented increased risk for disease progression, only in the subgroup of patients without tumour actionable driver mutations (HR = 2.9, 95% CI = 1.3–6.3, p = 0.010). Importantly, the association of homozygous genotypes in MME rs701109 with risk for disease progression was confirmed after multivariate analysis in the validation set. Conclusion: This study provides evidence that MME polymorphism, which encodes neprilysin, may modulate progression-free survival in advanced NSCLC. Present genetic variation findings will foster basic, translational, and clinical research on their role in NSCLC. Full article

In recent years, tourism has experienced remarkable growth worldwide. This sector is rapidly becoming the main export activity and the most important source of GDP growth in several countries. In Portugal, it represented around 19.7% of exports in 2019. The internet and online platforms contributed decisively to this growth. Generation Z already represents a considerable portion of society and, in the coming years, will become the central consumer segment. With this research, we intend to identify the key factors in the decision to purchase online, in Generation Z individuals, in the Portuguese tourism sector. We carried out a characterization of the sector, a bibliographic review and the identification of key variables. We applied a structured questionnaire to a sample of 233 individuals aged between 10 and 25 years. Subsequently, the data were processed using descriptive methodologies and association tests between variables. The key factors in the decision to purchase tourism products/services in Generation Z are Trust, Price, the use of aggregating websites, WOM/EWOM, the Offer of products/services online and the Online experience. In the opposite direction, it was given less importance to Convenience, Reviews on tourism websites, Tourism Advertising, Social networking and the possibility of Canceling the reservation. This study allows us to establish the bases for future research, to help researchers to understand Generation Z consumption habits. Full article

Olive mill wastewater is a challenging effluent, especially due to its toxicity related to the presence of phenolic compounds. Fenton’s process was analysed on the abatement of phenolic acids typically found in this kind of effluents. To overcome the main drawback of Fenton’s process, a waste from the aluminium industry commonly called red mud was used as a heterogeneous source of iron. The adsorption of simulated effluent on the red mud was negligible. Therefore, the degradation of phenolic acids during Fenton’s process was due to oxidation by hydroxyl radicals. The amount of red mud and hydrogen peroxide were optimized regarding phenolic acids degradation. The optimal conditions leading to the highest removal of contaminants (100% of phenolic acids degradation and 25% of mineralization after 60 min of reaction) were 1 g/L of catalyst and 100 mg/L of hydrogen peroxide. The possibility of recovering treated water for agricultural purposes was evaluated by assessing the toxic impact over a wide range of species. The toxicity observed for the treated samples was mainly related to the residual hydrogen peroxide remaining after treatment. Full article