Acta Medica Port
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Hyperglycaemia affects more than 30% of adults hospitalized for non-critical illness and is associated with an increased risk of adverse clinical outcomes. Insulin therapy is widely used for its safety and efficacy. However, given the growing availability of new drugs and new classes of antidiabetic agents with benefits beyond glycaemic control, challenges arise regarding their use in the hospital setting. ⋯ There are concerns regarding the increased risk of acidosis with metformin use, especially in cases of acute illness, although there is no evidence to support its suspension in selected patients with relative clinical stability. Sodium-glucose cotransporter-2 inhibitors should be discontinued in clinical situations that may predispose to ketoacidosis, including episodes of acute illness. The hospital use of sulfonylureas and thiazolidinediones is not advised.
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Randomized Controlled Trial
[A Cognitive Behavioural-Based Intervention in Reducing Test Anxiety in High School Students: A Pilot Cluster Randomized Controlled Trial].
School-age test anxiety is an important risk factor for school performance. Notwithstanding, few studies seek to identify which strategies are effective in improving test anxiety. The aim of this study was to assess whether a cognitive-behavioural intervention for high school students could significantly reduce test anxiety. ⋯ A cognitive-behavioural intervention specifically designed to reduce test anxiety, using a combination of mindfulness, psychoeducation and relaxation techniques, was effective in reducing test anxiety levels.
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There are several barriers discouraging clinicians from undertaking research, including insufficient funding, lack of time, organizational issues and lack of support. The strengthening of research capacity is perceived from three levels: characteristics of the researcher, the environment, and organizational issues. To date, Portugal is lacking studies on this subject. The aim of this study was to identify the best practices to promote research in Portuguese Primary Health Care. ⋯ Overall, a greater proportion of interviewees identified the following as the most relevant strategies for research promotion: institutional support, including technical and scientific support from public institutions, private entities and academic centers; the reorganization of working hours with protected time for research; increased funding directed towards research and breaking isolation in research, promoting teamwork with clinicians within the same area or from different professional backgrounds.