Feeding protocol for the Amazonian ornamental cichlid Apistogramma cacatuoides and a histological approach to the nutritional condition of larvae.

The aim of this study was to develop a feeding protocol for the larviculture of Apistogramma cacatuoides, using the histological approach to larval nutrition conditions. For this, three experiments were carried out. Experiment 1 was carried out in a randomized design to determine the optimal amount of Artemia nauplii (AN) per larva, and three treatments were evaluated: P1-feeding with 25 A. nauplii per larva (AN/L) during the first 5 days, followed by 50 AN/L from the 6th to the 10th day and 100 AN/L from the 11th to the 20th day; P2 and P3-37 and 50 AN/L during the first 5 days, 75 and 100 AN/L from the 6th to the 10th day and 150 and 200 AN/L from the 11th to the 20th day. Experiment 2 was carried out in a randomized design to determine the daily frequency of feeding and evaluated four feeding frequencies: F1-feeding only once a day (09:00); (F2)-feeding twice a day (09:00 and 17:00); F3-feeding three times a day (09:00, 11:30 and 17:00); and F4-feeding four times a day (09:00, 11: 30, 14:00 and 17:00). Experiment 3 lasted 40 days and was conducted in a randomized design to evaluate three periods for the beginning of the feeding transition: WE10:AN for 10 days, followed by 3 days of co-feeding and commercial feed until the end of the experimental period; WE15:AN for 15 days, followed by 3 days of co-feeding and commercial feed; WE20:AN for 20 days, followed by 3 days of co-feeding and commercial feed. The results of this study showed that, for the best development of the larvae, they should receive the feeding protocol 50-100-200 AN/L (P3) until the 20th day of exogenous feeding. From the 21st day, the transition to inert food should begin with 3 days of co-feeding, and feeding during larviculture should be carried out at a frequency of twice a day; this protocol provided a good nutritional status for the larvae, as shown by the histological approach.

Does Regular Exercise Impact the Lung Function of Healthy Children and Adolescents? A Systematic Review and Meta-Analysis.

PURPOSE: To assess the quality of the available evidence on the effect of exercise for the improvement of lung function in healthy children and adolescents. METHOD: We performed a systematic review and meta-analysis of intervention studies examining the effects of regular exercise on spirometric parameters of healthy children and adolescents aged ≤18 years. RESULTS: Within the exercise groups, there were significant improvements in forced vital capacity (mean difference: 0.17 L; 95% confidence interval, 0.07 to 0.26; P < .05) and forced expiratory volume in the first second (mean difference: 0.14 L; 95% confidence interval, 0.06 to 0.22; P < .05). Results were consistent across different age groups and duration of interventions. In the between-group analysis, forced vital capacity, forced expiratory volume in the first second, and peak expiratory flow were higher in the exercise group compared with the nonexercise group, but the differences did not reach statistical relevance. There was significant statistical heterogeneity between studies. CONCLUSION: Regular exercise has the potential to improve lung function parameters in healthy children and adolescents; however, the small number of studies and the heterogeneity between them raise concern about the quality of the currently available evidence. These findings bring to attention the need for well-designed trials addressing this important public health issue.

Relationship of the nursing practice environment with the quality of care and patients' safety in primary health care.

BACKGROUND: Nursing practice environment has impact on the quality of nursing care and on patients' and nurses' outcomes, namely better performances of these healthcare workers. Improving the nursing practice environment is a low-cost organizational strategy to achieve better patients' outcomes and retain qualified nurses, thus improving nursing care of units, healthcare organizations and healthcare system. This study aims to analyse the relationship between nursing practice environment and the nurses` perception of quality of care, patient safety, and safety culture in Primary Health Care in Portugal. METHODS: We conducted a descriptive, analytical, and cross-sectional study using data from RN4CAST Portugal. The sample was composed of 1059 nurses from 55 Health Center Groups of the mainland Portugal, 15 Health Centers of the Autonomous Region of Madeira and 6 Health Centers of the Autonomous Region of the Azores. Multivariate analysis and correlation analysis methods were used for data processing. RESULTS: Nurses consider that, in the Portuguese Primary Health Care, there is a mixed and unfavourable nursing practice environment, with a perception of a good quality of care, and both acceptable patients' safety and safety culture. The Collegial Nurse-Physician Relations and Nursing Foundations for Quality of Care dimensions to have the best ratings. The perception of Primary Health Care nurses on the dimension Nurse Participation in Organization Affairs was the one that showed the lowest score, followed by Staffing and Resource Adequacy and Nurse Manager Ability, Leadership, and Support of Nurses. Based on perception of nurses, the relationship between the nursing practice environment and the safety culture is higher, followed by the quality of care and patients' safety. CONCLUSIONS: The perception of Primary Health Care nurses is that there is an unfavourable and mixed nursing practice environment, with good quality of care, and acceptable patient safety and safety culture. The quality of the nursing practice environments is associated to better quality and safety of care. Thus, improving the nursing practice environments in healthcare organizations is a low-cost organizational strategy to achieve greater patients and nurses' outcomes, improving the quality of nursing care to patients in the Primary Health Care units.

Gender differences in the development of childhood obesity in young teenagers in Murcia, Spain.

BACKGROUND: The number of overweight children is increasing at an alarming rate. This issue requires effective action plans, as childhood obesity has become a problem in which addressing environmental factors is decisive. Significant differences have also been shown in lifestyle habits that determine overweight based on sex. This study therefore aimed to examine these risk factors according to sex. METHODS: The sample included first-year high school students from Murcia, Spain. Information was collected through the "Questionnaire on Healthy Habits in Adolescents," validated for this age range, and the weight, height, and waist circumference of the participants were obtained. Data were analyzed through partial least squares structural equation modeling to determine which modifiable risk factors promoted the appearance of excess weight and in what magnitude. RESULTS: A total of 421 students participated in the study, and 40.6% of overweight patients were detected according to their body mass index. No differences were found between the sexes and weights. The environment and the use of new technologies that do not involve sitting were significant only in girls (P < 0.05). Conversely, physical activity was significantly higher in boys (P < 0.05). Dietary factors and sedentary activities did not differ according to sex. CONCLUSIONS: The social and school environment, the use of new technologies (for girls), and physical activity (for boys) condition nutritional status. Identifying gender disparities in behaviors that involve health should be a priority for new prevention programs. Targeting young people's health from a gender perspective has considerable potential to reduce overweight problems in adulthood.

Temperature-induced changes in reproductive variables in the teleost fish Lophiosilurus alexandri.

The present study evaluates whether increased water temperature induces reproduction by Lophiosilurus alexandri under controlled conditions, and investigates the effects of this procedure on sexual steroids, hematological profile and behavior. A 44-week experiment was performed with four wild males and 12 wild females that had been acclimatized to captive conditions. Water temperature was maintained at 24.4 ±â€¯1.0 °C for weeks 1-22, and then at 29.0 ±â€¯1.1 °C for weeks 22-44. Spawn weight, number of eggs/spawn and hatching rate were satisfactory and ranged 27.5-127.5 g, 1209-5183 and 83-89%, respectively. Hematocrit, leukocytes and glucose were not influenced by increased water temperature, while higher values for erythrocytes were observed for both sexes. The lowest value for plasma protein was for females maintained at 29.0 °C, while the lowest value for testosterone was obtained at the end of the study period at a temperature in 29.0 °C. Serum values of 17ß-estradiol were higher in females than in males, however, there was no evidence of variation as a function of experimental temperature or interaction with sex. The reproductive behavior of L. alexandri in captivity is described for the first time. The present study demonstrates that adult individuals are able to maintain a stable hematological profile during an increase in mean water temperature from 24.4 °C to 29.0 °C, even during the reproductive period, and still produce good quality larvae. Nonetheless, whether spawning was associated with increased 17ß-estradiol levels could not be determined.

Impact of Nurse Manager's Attributes on Multi-Cultural Nursing Teams: A Scoping Review.

BACKGROUND: As global migration increases, nurse managers' effectiveness in multi-cultural nursing work environments is crucial due to the rising cultural diversity within healthcare teams. Despite the increasing international recruitment of qualified nurses to address the worldwide nursing shortage, no studies have synthesised the impact of nurse managers' attributes on nurses in multi-cultural nursing teams. Therefore, it was conducted a literature review aimed to synthesise the available literature on how nurse managers' personality traits, competencies, behaviours, and leadership styles influence nurse outcomes in multi-cultural nursing teams. METHODS: Scoping review conducted according to the Joanna Briggs Institute guidelines to map the relationship or influence of nurse managers' personality traits, competencies, behaviours, and leadership styles on the outcomes of nurses in multi-cultural settings across various clinical environments. Searches were conducted across electronic databases such as CINAHL and MEDLINE, along with grey literature. RESULTS: This review included 39 studies, highlighting 29 personality traits, 9 competencies, 115 behaviours, and 5 leadership styles that impact nurses' outcomes. Key findings emphasise the importance of nurse managers being supportive, culturally competent, and effective communicators, with transformational leadership style being particularly beneficial. CONCLUSIONS: These findings provide insights for planning and developing training programmes to equip current and future nurse managers with skills to effectively lead in multi-cultural care settings.

Nurses' Well-Being at Work in a Hospital Setting: A Scoping Review.

The aim of this review was to analyze the scientific evidence about nurses' well-being at work in the hospital context. Well-being is present in our daily experiences, whether in a personal or professional context. Nurses are frequently put under pressure and stressed at work, which can influence their well-being. Nurses' well-being at work in a hospital setting is crucial due to its relevance to occupational health, the quality of patient care, and the identification of stress and satisfaction factors. Methods: This systematic review followed the methodological guidelines of the Joanna Briggs Institute (JBI). The databases searched included CINAHL, MEDLINE, Scopus, Cochrane Database of Systematic Reviews, LILACS, Scientific Electronic Library Online (SciELO), and the Open Access Scientific Repositories of Portugal (RCAAP). The following inclusion criteria were defined: studies in Portuguese or English; with abstracts or full texts available; with a publication date from 2018 to 2022; and research containing the identified keywords in the title (TI) or abstract (AB). To organize and synthesize the data, we used a table to extract the significant information from each included study. Results: Eight studies were included, all of them emphasizing the assessment of well-being at work and the manager's intervention to promote this well-being. We found that most studies indicate that nurses are satisfied with their work. There are several factors that can influence this positive level of well-being at work, such as interaction with management, culture, and organizational commitment. It can be concluded that nurse managers have a decisive role in promoting well-being at work.

Mapping Strategies for Strengthening Safety Culture: A Scoping Review.

BACKGROUND: Twenty years after the "To Err Is Human" report, one in ten patients still suffer harm in hospitals in high-income countries, highlighting the need to strengthen the culture of safety in healthcare. This scoping review aims to map patient safety culture strengthening strategies described in the literature. METHOD: This scoping review follows the JBI methodology. It adhered to all scoping review checklist items (PRISMA-ScR) with searches in the Lilacs, MedLine, IBECS, and PubMed databases and on the official websites of Brazilian and North American patient safety organizations. The research took place during the year 2023. RESULTS: In total, 58 studies comprising 52 articles and 6 documents from health organizations were included. Various strategies were identified and grouped into seven categories based on similarity, highlighting the need for a comprehensive organizational approach to improve patient care. The most described strategies were communication (69%), followed by teamwork (58.6%) and active leadership (56.9%). CONCLUSION: The identified strategies can promote the development of a culture in which an organization can achieve patient safety, involving practices and attitudes that reduce risks and errors in healthcare. However, the identification of strategies is limited because it is restricted to certain databases and websites of international organizations and does not cover a broader spectrum of sources. Furthermore, the effectiveness of these strategies in improving patient safety culture has not yet been evaluated.

Cross-Cultural Validation of the Portuguese Version of the Quality of Oncology Nursing Care Scale.

BACKGROUND: Quality assessment in oncology nursing care has been a growing topic in the literature, gaining relevance as oncological nursing care becomes more complex as the science progresses. However, there are no instruments that assess the perception of the quality of oncology nursing care from the point of view of patients for the Portuguese population. Thus, the cross-cultural translation and validation of the Quality of Oncology Nursing Care Scale (QONCS) was performed for the Portuguese context. This instrument allows nurses to assess patients' self-perception of the quality of nursing care provided in an oncological setting. It also allows researchers to compare the results obtained internationally with the application of this scale. METHODS: This is a methodological study, with two distinct phases: the first corresponded to the translation and cultural adaptation of the scale to the Portuguese context, and the second consisted of the psychometric validation of the QONCS, which included factor analysis and the evaluation of the psychometric properties of the instrument. We obtained responses from 402 patients from a Portuguese oncology hospital. RESULTS: The Portuguese version of the Quality of Oncology Nursing Care Scale (QONCS_PT) consists of 34 items inserted into a tetra-factorial model, which explains a total variance of the instrument of 69.8%. A Cronbach's alpha of 0.93 was obtained for the complete instrument. CONCLUSIONS: QONCS_PT has a competent and reliable structure. The scale's validity was assured and can be used in the Portuguese population, as it is useful for direct care provision but also for researchers and managers.

Translation, Adaptation, and Validation of the Portuguese Version of the Exercise of Self-Care Agency Scale.

Assessing a person's capacity to engage in self-care behaviours is another added value in identifying one's potential to care for oneself in the health domain that contributes to planning person-centred care. This study aimed to translate, adapt, and validate the Exercise of Self-Care Agency (ESCA) Scale by Kearney and Fleischer, revised by Riesch and Hauck for the Portuguese version, using a sample of 625 elderly people living at home in Portugal. A cross-cultural adaptation process follows the stages of translation, synthesis, back-translation, and consensual solution for the translation process and pretesting. Construct validity was tested using exploratory factor analysis, and factor structure was subjected to confirmatory factor analysis. Reliability was determined by analysing internal consistency, resorting to Cronbach's alpha coefficient. This resulted in an instrument formed of 29 items, keeping the factor structure conceptually aligned with the underlying theory. Cronbach's alpha coefficient values were 0.87 for the global scale and varied between 0.65 and 0.84 for the subscales. The final four-factor model showed an acceptable quality of fit. The Portuguese version of the ESCA shows appropriate validity and reliability for use in future research and health contexts.

Translation, Cross-Cultural Adaptation, and Validation of Measurement Instruments: A Practical Guideline for Novice Researchers.

Cross-cultural validation of self-reported measurement instruments for research is a long and complex process, which involves specific risks of bias that could affect the research process and results. Furthermore, it requires researchers to have a wide range of technical knowledge about the translation, adaptation and pre-test aspects, their purposes and options, about the different psychometric properties, and the required evidence for their assessment and knowledge about the quantitative data processing and analysis using statistical software. This article aimed: 1) identify all guidelines and recommendations for translation, cross-cultural adaptation, and validation within the healthcare sciences; 2) describe the methodological approaches established in these guidelines for conducting translation, adaptation, and cross-cultural validation; and 3) provide a practical guideline featuring various methodological options for novice researchers involved in translating, adapting, and validating measurement instruments. Forty-two guidelines on translation, adaptation, or cross-cultural validation of measurement instruments were obtained from "CINAHL with Full Text" (via EBSCO) and "MEDLINE with Full Text". A content analysis was conducted to identify the similarities and differences in the methodological approaches recommended. Bases on these similarities and differences, we proposed an eight-step guideline that includes: a) forward translation; 2) synthesis of translations; 3) back translation; 4) harmonization; 5) pre-testing; 6) field testing; 7) psychometric validation, and 8) analysis of psychometric properties. It is a practical guideline because it provides extensive and comprehensive information on the methodological approaches available to researchers. This is the first methodological literature review carried out in the healthcare sciences regarding the methodological approaches recommended by existing guidelines.

Turnover Intention and Organizational Commitment of Primary Healthcare Nurses.

Turnover intention is a predictor of the decision to leave an organization, which, if carried out, affects the quality of care provided. There is an association between turnover intention and organizational commitment. The more committed nurses are to the unit in which they work, the more committed they become to the unit's organizational goals; thus, they tend to continue working for the organization. Aiming to assess the turnover intention and the organizational commitment of nurses in primary healthcare, we conducted a quantitative, observational, descriptive, and cross-sectional study. The Intention of Turnover Scale and the Organizational Commitment Scale were applied in a sample of 297 nurses. Data were analyzed based on descriptive statistics. About 92.8% of the nurses intend to stay at their current workplace and only 7.3% plan to leave soon, suggesting low turnover intention; 84.5% of the nurses are willing to make an effort beyond what is normal to help their organization succeed, and 88.7% feel really interested in the destiny of the organization, which shows high organizational commitment. Pearson's Coefficient revealed the existence of a significant negative correlation between the factors "Intention to leave" and "Committed to the organization" (r = -0.51, p < 0.01). These findings suggest that, when nurses are more committed to their work and to the organization, they display less intention to leave, keeping the teams committed and motivated towards the organizational goals Our findings may guide nurse managers and policy-makers to develop strategies that retain nurses in organizations, keeping them motivated and engaged, and focusing on higher organizational commitment due to the influence it may have on the turnover intention.

Influencing Factors of Nurses' Practice during the Bedside Handover: A Qualitative Evidence Synthesis Protocol.

Nursing Bedside Handover (NBH) is acknowledged as a nursing practice implemented at the patient's bedside to improve communication safety during the shift change, but it is vulnerable due to inconsistent application among nurses. This synthesis of qualitative evidence aims to review and synthesize the perceptions and experiences of nurses regarding the factors that, in their perspective, influence NBH practice. We will follow the thematic synthesis methodology of Thomas and Harden and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) Statement guidelines. A search will be conducted through the databases of MEDLINE, CINAHL, Web of Science, and Scopus, and we will follow the three-step search process to identify primary studies with qualitative or mixed-method research designs and projects of quality improvement. The screening and selection of the studies will be carried out by two independent reviewers. We will use the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to report the screening, search, and selection of studies. To assess its methodological quality, two reviewers will independently use the CASM Tool. The extracted data will be reviewed, categorized, and summarized in tabular and narrative formats. The findings obtained will allow us to inform future research and change management led by nurse managers.

Evaluating the Methodological Approaches of Cross-Cultural Adaptation of the Bedside Handover Attitudes and Behaviours Questionnaire into Portuguese.

Nurse managers need culturally adapted assessment instruments to support the implementation of change to Nursing Bedside Handover (NBH) in healthcare institutions. This study aimed to cross-culturally adapt the Bedside Handover Attitudes and Behaviours (BHAB) questionnaire to the Portuguese context and evaluate the methodological approaches used for this purpose. To guide this study, we followed a guideline for cross-cultural translation and adaptation measurement instruments in healthcare. The results of the content validity testing suggested that the BHAB questionnaire is a valid instrument for use in the Portuguese context. To obtain these results we showed 1) using of a new methodological approach, the dual focus, to resolve the divergences and ambiguities in the translators' committee and the multi-professional committee; 2) the lack of a conceptual definition of the construct of the instrument as a requirement to retain items with I-CVI <0.70 after validity relevance pretesting and 3) the cognitive debriefing and relevance pretesting as methodological approaches which can be used alone or together to reinforce the evaluation of cultural relevance of the items. We concluded there is a need for guidelines to support the decision-making process of healthcare researchers with comprehensive information about the different methodological approaches they can follow.

The Nursing Practice Environment and Patients' Satisfaction with Nursing Care in a Hospital Context.

Nursing, being a profession in health, aims to improve the quality of the response to patients' demands, which have repercussions on the attitudes, behaviors and performance of nurses. BACKGROUND: The aim of the study was to evaluate the relationships among the nursing practice environment, nurse-patient interactions and patients' satisfaction with nursing care in a hospital context. METHODS: The study applied a descriptive analysis. Based on the initial exploration of the data, we decided to perform a simple linear regression of the dimensions of the scales. RESULTS: The latent variables and interactions between the different dimensions of the three constructs (the nursing practice environment (PES-NWI), nurse-patient interactions (NPIS-22-PT) and patients' satisfaction in the hospital context (SAPSNC-18)) were submitted to confirmatory analysis. The model was statistically significant, with a good fit with the data (χ2/gl = 128.6/41 (0.000); GFI = 0.900; AGFI = 0.831; TLI = 0.910; CFI = 0.907; RMSEA = 0.102). CONCLUSIONS: The study showed favorable rates of overall satisfaction on the part of patients, such as the nurses' skills in dealing with their illness/health situation, ability to solve problems in a timely manner, responsiveness to patients' needs and technical competence.

Transcultural nursing leadership: A concept analysis.

Background: Globalisation, wars, competitiveness, and technological innovation have increased workplace diversity, requiring leaders to conduct multinational projects, lead people from different cultural backgrounds, and deliver appropriate services that meet the needs of clients from different cultures. Several concepts are interchangeably used to define and describe leadership in culturally-diverse work environments; one such concept is transcultural leadership. Because of nurses' global migration and care delivery to patients from different cultural backgrounds, this concept is of interest in the nursing field. While some nurses have been identified as transcultural leaders, no definition of transcultural nursing leadership has been found in the literature. Objective: This study aimed to develop an operational definition of transcultural nursing leadership. Design: A concept analysis was performed using Walker and Avant's method. Methods: A literature search was conducted using electronic databases, including CINAHL and MEDLINE, books, and encyclopaedias. Quantitative, qualitative, mixed- design studies and literature reviews; master's and doctoral theses; interviews; and text and opinion papers published in English, Spanish, or Portuguese that focused on leadership in multicultural work environments overall and in nursing in particular were included. To identify differences and similarities between the concepts, a Correspondence Factor Analysis with the support of the software IRaMuTeQ was undertaken. Results: A total of 45 documents with definitions or descriptions of the concepts was included, of which five were in the nursing area and 40 in other areas of study. The defining attribute of transcultural nursing leadership is guiding the delivery of culturally-congruent care. Its antecedents were culturally-diverse populations, multicultural nursing teams, and the need to prepare healthcare workers, administrators, academics, professors, researchers, and minorities for transcultural nursing. The consequences identified included culturally-congruent care for patients and optimal health outcomes for all populations. The identified attributes, antecedents, and consequences did not cover the complexity of a culturally-diverse nursing work environment. Thus, the antecedents, attributes, and consequences of transcultural leadership identified in the literature were considered and added. Conclusions: Transcultural nursing leadership is a concept grounded in nursing theory that has significant implications for nursing management, education, research, and policy. This holds great promise for advancing culturally-congruent care, addressing health disparities, and building highly inclusive and productive nursing teams in an increasingly diverse world.

The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal's Long-Term Care Units.

BACKGROUND: The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people's quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serious public health problem. This study aims to describe the nursing work environment in Portuguese long-term care (LTC) units and to assess how this environment relates to the quality of PU care. METHODS: A longitudinal study among inpatients with PUs was conducted in LTC units. The Nursing Work Index-Revised Scale (NWI-R) was sent to all nurses in these units. Cox proportional hazard models were used to relate the satisfaction degree with the service (measured by the NWI-R-PT items) to the healing time of the PUs, adjusting for confounders. RESULTS: A total of 165 of 451 invited nurses completed the NWI-R-PT. Most were women (74.6%) and had 1 to 5 years of professional experience. Less than half (38.4%) had education in wound care. Of the 88 patients identified with PUs, only 63 had their PU documented, highlighting the difficulties in updating electronic records. The results showed that the level of concordance with Q28 "Floating so that staffing is equalised among units" is strongly associated with a shorter PU healing time. CONCLUSION: A good distribution of nursing staff over the units will likely improve the quality of wound care. We found no evidence for possible associations with the questions on participation in policy decisions, salary level, or staffing educational development and their relationship with PUs healing times.

Sociocultural differences in the development of obesity in adolescents in Murcia.

BACKGROUND: Childhood obesity presents alarming numbers in our country, being even higher in the population of immigrant origin. The main objective was to analyse the excess weight numbers both in native adolescents and in those children of immigrants and to determine the ethnic influence on lifestyle habits that could condition these differences in weight overload. METHODS: Adolescents from 1st year of Obligatory Secondary Education (E.S.O.) participated; somatometry was determined and classified according to BMI (with WHO references) and parental origin. Parents completed the survey on healthy habits (ENHASA). An analysis of variance was performed for each of the 4 dimensions of the questionnaire. RESULTS: A total of 416 adolescents participated (12.8±0.62 years). Excess weight was detected in 41.2% of the participants, with significant differences between groups (p 0.018): 36.7% in Spanish, 42.9% in North Africa and 58.2% in South America. The ANOVA analysis showed differences in the section "physical activity" (p 0.003), highlighting the maximum disparity in the performance of extracurricular sports activities, with a lower score in both non-native groups. CONCLUSION: We found significant differences according to ethnic origin in the number of overweight children and the amount of physical activity they do; South American adolescents are the most sedentary. We must design interventions that guarantee the access of all adolescents to sports activities to prevent the development of obesity.

Translation and Validation of the Individual Workload Perception Scale-Revised for Portuguese Nurses.

(1) Background: In Portugal, there is no scale to assess nurses' satisfaction with their workload. Therefore, this study aimed to culturally/linguistically adapt and validate the IWPS-R scale, with 29 items, to produce a Portuguese version. (2) Methods: A quantitative, descriptive and cross-sectional study was conducted in two phases: translation and adaptation of the IWPS-R into Portuguese, following the steps recommended by Beaton; and evaluation of its psychometric properties in a non-probability sample of 323 nurses working in a hospital centre of reference in Portugal. (3) Results: The final scale obtained a total explained variance of 62.3% and a KMO of 0.88. The reliability was assured through the determination of an internal consistency of 0.88. The construct validity was determined through confirmatory factor analysis. The factorial model presented a good quality fit (X2/df = 2.118; CFI = 0.925; GFI = 0.900; RMSEA = 0.059; p (RMSEA ≤ 0.05) = 0.041; RMR = 0.078; MECVI = 1.525; SRMR = 0.0631) with five factors. (4) Conclusions: The Individual Workload Perception Scale-Revised-Portuguese version (IWPS-R-PT) is a 21-item tool with five dimensions: Nurse Manager Support, Team Support, Workload, Organizational Resources and Intent to Stay. The IWPS-R-PT was found suitable for hospital-based nurses and may be useful in other settings where nurses work.

International Portuguese Nurse Leaders' Insights for Multicultural Nursing.

Cultural diversity among patients and healthcare workers in the Portuguese healthcare organizations will increasingly challenge nurse managers to develop favorable nursing work environments and to improve culturally congruent care. AIM: This study aimed to identify nurse managers' interventions that improve favorable nursing work environments in multicultural nursing teams and culturally congruent care for patients, based on Portuguese nurse leaders' experience in international settings. METHODS: A qualitative and exploratory study was conducted as the first stage of a sequential exploratory mixed study design. A convenience sample of Portuguese nurses with leadership experience of multicultural teams was recruited to participate in one focus group. Qualitative data were recorded and transcribed for content analysis. Text segments were organized into themes and categories with the support of the qualitative software IRaMuTeQ. RESULTS: Nurse managers' interventions, such as adapting the leadership style, thanking nurses for their work, adjusting the unit to attend to patients' worship practices, and supporting foreign nurses in learning the local language, were categorized into three main themes and five categories-transcultural nursing leadership assumptions, capitalizing nurses, improving culturally congruent care, team problems and strategies, and improving effective communication. CONCLUSIONS: These findings corroborate international studies, advocate for capable nurse managers to lead in a globalized world, and are suitable to develop a transcultural nursing leadership questionnaire.