In general, students have difficulties in learning Chemistry content, and it is necessary to find teaching strategies to minimize these difficulties. The contextualized teaching approach plays a fundamental role in promoting learning by relating scientific content to real-life situations close to students' daily lives. While teaching the topic Gases and Dispersions with a 10th-grade class, a mixed-methods research project was developed to determine the extent to which high school students are able to interpret real data on air quality in Portugal from the QualAr platform and to critically evaluate the accuracy, clarity, and rigor of the responses generated by ChatGPT to exercises on the same topic. Twenty students participated in this research, and data collection involved questionnaires, interviews, and document analysis of written records. The results demonstrated that students showed interest in using the QualAr platform, benefiting from structured scripts and real data. This research resulted in several indicators that reinforce the added value of promoting hands-on approaches associated with the use of real data to contextualize the topics taught, as well as the integration of technological tools in classes, which have pedagogical potential for developing critical thinking in students and promoting scientific literacy for citizenship.

The rapid growth of the indoor air-cleaner market has introduced significant variability in how pollutant removal performance is reported, limiting the ability to evaluate these technologies as environmental mitigation tools. This study presents a data-driven analysis of 413 commercially available indoor air-cleaning devices, systematically assessing the reporting of particulate matter, gas-phase pollutants (including volatile organic compounds), and biological removal claims. The results reveal widespread inconsistencies, including the use of terms such as “HEPA” without filter class or test reference, gas-phase claims lacking compound specificity or test conditions, and biological efficacy claims without quantitative metrics or defined methods. In addition, key parameters such as operating conditions, energy use, acoustics, and potential by-product emissions are frequently incompletely reported. These limitations hinder the interpretation of air-cleaner performance and may lead to misestimation of pollutant removal effectiveness under real indoor conditions. To address these issues, a harmonized taxonomy and a Minimum Technical Data Sheet (mTDS) are defined, providing a structured framework for transparent and comparable reporting of performance and technical specifications. This approach supports improved interpretation of pollutant removal processes and more reliable assessment of indoor air-cleaning technologies in the context of environmental quality and exposure mitigation.

With this article, we intend to look at the intersection between the experiences of women artists, particularly in terms of their individual and collective practices, in relation to the creation of art products with an artivist or art-based activism slant. Based on the artistic practice of Tuty Moreno Campos - a migrant artist - we intend to highlight and discuss a new type of art-activist work, in other words, to discuss the emergence of concepts such as soft artivism. To do this, we used a qualitative methodology based on techniques such as semi-structured interviews and content and visual analysis.

Stone quarry workers and others exposed to silica are especially vulnerable to tuberculosis (TB). Silicosis is a known risk factor for TB disease, but other common comorbidities and habits such as diabetes and alcohol and tobacco consumption may increase risk. We aimed to estimate the risk of TB infection among stone quarry workers and to identify associated factors. An annual TB infection screening strategy using interferon-gamma release assay (IGRA) was implemented in 2018 for quarry workers in two high-incidence municipalities in Portugal. Workers with a first negative IGRA test were followed up and stratified by age group, preconditions including silicosis, diabetes and hypertension, and alcohol and tobacco abuse. Incidence rates and adjusted risks for TB infection were quantified using Cox regression hazard rates. From 2018 to 2022, 997 stone quarry workers were screened for TB. Of those, 347 were negative in their first and performed at least one additional IGRA test, being included in the analysis. The overall rate of infection was 3.2 per 100 person-year. Silicosis, diabetes, and age above 45 years were independent risk factors for TB infection [adjusted hazard ratio (aHR) 2.9 (95

Indoor air quality (IAQ) in educational facilities is crucial due to the extended time students spend in those environments, affecting their health, academic performance, and attendance. This paper aimed to review relevant parameters (building characteristics and factors related with occupancy and activities) for assessing IAQ in educational facilities, and to identify the parameters to consider when performing an IAQ monitoring campaign in schools. It also intended to identify literature gaps and suggest future research directions. A narrative literature review was conducted, focusing on seven key parameters: building location, layout and construction materials, ventilation and air cleaning systems, finishing materials, occupant demographics, occupancy, and activities. The findings revealed that carbon dioxide (CO2) levels were predominantly influenced by classroom occupancy and ventilation rates, while particulate matter (PM) concentrations were significantly influenced by the building's location, design, and occupant activities. Furthermore, this review highlighted the presence of other pollutants, such as trace metals, polycyclic aromatic hydrocarbons (PAHs), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), and radon, linking them to specific factors within the school environment. Different IAQ patterns, and consequently different parameters, were observed in various school areas, including classrooms, canteens, gymnasiums, computer rooms, and laboratories. While substantial literature exists on IAQ in schools, significant gaps still remain. This study highlighted the need for more studies in middle and high schools, as well as in other indoor microenvironments within educational settings beyond classrooms. Additionally, it underscored the need for comprehensive exposure assessments, long-term studies, and the impacts of new materials on IAQ including the effects of secondary reactions on surfaces. Seasonal variations and the implications of emerging technologies were also identified as requiring further investigation. Addressing those gaps through targeted research and considering the most updated standards and guidelines for IAQ, could lead to define more effective strategies for improving IAQ and safeguarding the students' health and performance.

Most instruments measuring nutrition literacy evaluate theoretical knowledge, not necessarily reflecting skills relevant to food choices. We aimed to develop and validate a photograph-based instrument to assess nutrition literacy (NUTLY) among adults in Portugal. NUTLY assesses the ability to distinguish foods with different nutritional profiles; from each of several combinations of three photographs (two foods with similar contents and one with higher content) participants are asked to identify the food with the highest energy/sodium content. The NUTLY version with 79 combinations, obtained after experts/lay people evaluations, was applied to a sample representing different age, gender and education groups (n=329). Dimensionality was evaluated through latent trait models. Combinations with negative or with positive small factor loadings were excluded after critical assessment. Internal consistency was measured using Cronbach's alpha and construct validity by comparing NUTLY scores with those obtained in the Medical Term Recognition Test and the Newest Vital Sign (NVS), and across education and training in nutrition/health groups. The cut-off to distinguish adequate/inadequate nutrition literacy was defined through ROC analysis using the Youden index criterion, after performing a Latent class analysis which identified a two-class model to have the best goodness of fit. Test-retest reliability was assessed after one month (n=158). The final NUTLY scale was unidimensional and included 48 combinations (energy: 33; sodium: 15; α=0.74). Mean scores (±standard deviation) were highest among nutritionists (39.9±4.4), followed by health professionals (38.5±4.1) and declined with decreasing education (p<0.001). Those with adequate nutrition literacy according to NVS showed higher NUTLY scores (37.9±4.3 vs. 33.9 ±6.9, p<0.001). Adequate nutrition literacy was defined as a NUTLY score≥35 (sensitivity: 89.3%; specificity: 93.7%). Test-retest reliability was high (ICC=0.77). NUTLY is a valid and reliable nutrition literacy measurement tool.

Air pollution negatively impacts human health, yet it is rarely studied inside vehicles. This study aimed to characterise indoor air quality (IAQ) in vehicle cabins, focusing on the concentrations of key pollutants and the influence of various factors on IAQ including vehicle-specific characteristics (self-pollution), traffic intensity, ventilation type, and enclosed spaces like parking garages. It addressed a significant literature gap by using real-world driving data, a multipollutant approach, real-time monitoring, and a detailed log of influencing factors. Additionally, part of the study was conducted during the COVID-19 lockdown, providing an unprecedented opportunity to gather real-world data with reduced traffic emissions. Forty trips were conducted with four diesel vehicles of different ages and emission standards. Concentrations of VOCs, CO, CO₂, NO₂, SO₂, O₃, and PM₁, PM₂.₅, PM₁₀, and TSP were monitored, alongside detailed logbook entries. This study evidenced the formation of O₃ inside vehicle cabins under conditions of high NO₂ and/or VOC concentrations and direct sunlight, a phenomenon not previously reported. Results also showed that IAQ inside vehicle cabins depended largely on vehicle-specific factors, the surrounding environment, and indoor-outdoor air exchange. CO, NO₂, SO₂, and PM levels varied mainly with the external environment and air exchange, while CO₂ levels were influenced primarily by ventilation settings. The concentrations of certain pollutants exceeded reference levels for indoor environments, potentially posing health risks to occupants. Further research is needed to study the pioneer evidence of O3 formation and to develop a comprehensive health risk assessment, thereby contributing to developing specific IAQ guidelines for vehicles.

This publication aimed at the revision of scientific publications on the discovery of ozone, tracing its scientific history and how the early perspectives of the beneficial ozone impact on respiratory diseases and how they shifted with advancements in scientific knowledge: once considered a health index, ozone is now recognized as an atmospheric pollutant with detrimental effects on human health. The global increase in tropospheric ozone exposure, along with the associated rise in morbidity and mortality, highlights the urgent need to reduce emissions of ozone precursors to protect public health. Given the large at-risk population, tropospheric ozone exposure poses a significant public health concern. To address this, it is crucial to implement strategies that mitigate the harmful effects of tropospheric ozone, especially for vulnerable individuals. If these measures are not effectively implemented, a worsening of health impacts can be expected. The October 2024 update on stratospheric ozone recovery reveals its fragility and erratic behaviour, underscoring the need for continued and stringent control measures to protect human health. To our knowledge, no prior publications have addressed such a comprehensive time frame as we have in this study.

Since the onset of the COVID-19 pandemic, strict mobility measures and lockdown periods were implemented globally to curtail the spread of the virus. Thus, this study aimed to estimate the health and economic burden avoided due to the air pollution reduction during the COVID-19 lockdown in Portugal. PM10, NO2, and O3 hourly concentrations were obtained from Portugal's 68 air quality monitoring stations for the 2020 lockdown and historical (2015-2019) periods to estimate the avoided premature deaths, avoided asthma-related morbidity and avoided hospital admissions due to respiratory diseases, and related avoided costs. Overall, a higher number of avoided premature deaths was estimated, especially related to short-term NO2 exposure (less 30%). Moreover, the highest avoided morbidity effects were estimated for the short-term NO2 exposure on hospital admissions due to respiratory diseases (57% of avoided admissions). Economically, €48.3 million were avoided from the averted NO2-related premature deaths, and up to 0.1% of the total health expenditure was saved due to the avoided new asthma cases in children aged 5-19 years old. In sum, the air pollution reduction during the 2020 lockdown relative to the historical period led to human health gains and related avoided economic costs.

A literacia nutricional é um componente fulcral da literacia em saúde, e tem sido associada positivamente à prática de uma alimentação saudável. Os instrumentos atuais de medição deste conceito têm a desvantagem de depender bastante da capacidade dos participantes para ler ou fazer cálculos matemáticos, dificultando a sua aplicação em indivíduos com baixa escolaridade. Avaliam apenas conhecimentos teóricos, pelo que também não refletem diretamente a relação entre estes conhecimentos e a capacidade de fazer escolhas alimentares adequadas. O projeto NUTLY pretendeu ultrapassar algumas destas limitações, através do desenvolvimento de um instrumento de medição da literacia nutricional baseado em fotografias, e validação para aplicação na população adulta residente em Portugal. O instrumento NUTLY tem como premissa a comparação de alimentos com diferentes perfis nutricionais, focando-se em conhecimentos e competências com relevância prática para a escolha alimentar. O objetivo do presente artigo é divulgar esta ferramenta entre profissionais de saúde a exercer funções em Portugal, bem como discutir as suas principais potencialidades de aplicação (nomeadamente nos contextos da educação alimentar, saúde pública, investigação científica e nutrição clínica).

Firefighters perform high-risk activities and during the course of their functions are highly exposed to a wide range of occupational hazards, including air pollution. Thus, this study aimed to assess the exposure of firefighters in prescribed wildland fires and their occupational exposure, as well as to identify and chemically characterise the particles collected during wildland firefighting and inside fire stations. Exposure to wildfire smoke was evaluated in 7 prescribed fires in Portugal, 2 in the north and 5 in the south of Viseu district. The concentrations of PM2.5, NO2, SO2, CO and VOCs were monitored and exceedances to occupational exposure limit values were identified. Moreover, the chemical composition of PM2.5 was analysed.The results showed that firefighters were exposed to high concentrations of these pollutants during prescribed fires and that, in some cases, exceeded occupational exposure limits, both for time-weighted average concentrations for an 8-h working day (a time-weighted average, TWA) of PM2.5, and for short-term exposure values (STEL) of NO2 and SO2. Despite being exposed to very high concentrations of CO, no exceedances to the occupational exposure values were observed. FT-IR and SEM-EDS allowed to chemically characterise the composition of the particles collected inside the fire stations and also during wildland fires, identifying mainly quartz, aluminium and magnesium silicates, characteristic of earth's crust constituents. and also, fibres that have undergone combustion.Concluding, firefighters’ exposure to high concentrations of harmful pollutants, can lead to the degradation of their respiratory health. It is therefore extremely important to increase existing knowledge and conduct further studies, especially longitudinal ones, that can assess their lung function. This will allow an understanding of the impacts of smoke on firefighters' health and develop effective strategies to protect them during wildland firefighting operations.

As SARS-CoV-2 continues to evolve and herd immunity establishes, an increasing number of asymptomatic infections have been reported, increasing the risk of airborne spread of the virus. Most of the studies regarding SARS-CoV-2 RNA presence in air refer to indoor environments, with few studies having reported SARS-CoV-2 RNA in outdoor air. The aim of this study was to assess the presence of SARS-CoV-2 RNA at two different settings, crowded outdoor versus empty outdoor environments in Valladolid, Spain, during winter 2021. Using a Coriolis® air sampler, samples were taken from nine different locations within the city center. RNA extraction and a one-step RT-qPCR were carried out. Six out of the 20 air samples were found to be positive, and they were all obtained from crowded outdoor environments. These results highlight that although in less quantity, SARS-CoV-2 RNA is still present in outdoor air, especially at moments of relaxed mitigation efforts and depending on the number of people present.

Background Tuberculosis (TB) infection screening of high-risk groups is an important strategy for achieving End TB targets. A TB infection screening program was implemented for quarry workers from a Portuguese high-incidence area in 2018-2022. We aimed to calculate the cost-benefit of the screening program from the societal perspective. Methods We calculated medical and non-medical direct and indirect screening costs and compared them with the cost savings from averted cases of TB disease. We estimated the number of potentially averted TB disease cases based on the risk of progression of TB infection to TB disease found in the literature. Results During the screening program, 997 workers were screened. TB infection was diagnosed in 215 workers, 150 of those initiated preventive treatment. Screening program total costs were €136,295. Twenty-nine TB cases were potentially prevented, what would have costed €152,386. Savings of €16,091 were obtained (€4516, €40898, and -€29322 from the workers, employers, and NHS, respectively). Conclusions The monetary benefit of a TB infection screening program directed to quarry workers in a high-incidence area was greater than its cost. Companies and workers saved substantially more money. TB infection tests that are better predictors of progression to TB disease could reduce NHS costs.

Due to the COVID-19 pandemic, governments imposed several mobility restrictions which can be used to evaluate their impact on air quality and generate better-targeted policies to improve it. Therefore, this study aimed to define sustainable mitigation measures to reduce air pollution based on quantifying the impacts of the restrictions imposed during the COVID-19 pandemic on air quality in Portugal. Thus, hourly concentrations of PM10, PM2.5, NO2, O-3, CO and SO2 were obtained from the Portuguese Air Quality Monitoring Network. Data was then divided into six periods (2020-2021) and compared with the corresponding historical periods (2015-2019). Furthermore, the satellite data of NO2, CO, and absorbing aerosol index (AAI) from the sentinel-5P TROPOMI was collected to complement the analysis conducted for the monitoring data. Overall, air quality improved in all study periods and areas, except in industrial sites. The satellite data corroborated the results herein achieved and thus validated the real effect of the measures adopted in the country during the pandemic on air quality. Sustainable policies to improve air quality could include remote (or hybrid) work whenever possible as a long-term measure and prohibition of travelling between municipalities when an extraordinary event of high air pollution is predicted or occurs. Other policies should be adopted for industrial areas. Given this, and as the restrictive mobility measures had a strong effect on reducing air pollution, the post-COVID era represents an opportunity for society to rethink future mobility and other emerging policies, that should favour softer and cleaner means of transportation.

Radon is a carcinogenic compound, and is particularly concerning in the education sector, where children and teachers may be exposed even longer than at home. Thus, this study intended to characterise radon in the indoor air of scholar environments in different provinces/districts of the Euroregion Galicia-Norte de Portugal. With a pioneering approach, this study evaluated the influence of specific factors/characteristics (location, type of management, construction material, season and floor within the building) and quantified their relative contribution to indoor radon levels. Radon was continuously monitored in 416 classrooms from school buildings located in urban and rural sites from different provinces/districts both in the regions of Galicia (A Coruña and Lugo provinces) and Portugal (Porto and Bragança districts), considering rooms for different age groups (from nursery schools to universities). Single and multivariate linear regression models were built considering the radon concentrations as the outcome variable and different room/building characteristics as predictor variables. Mean and median radon concentrations were 332 Bq·m-3 and 181 Bq·m-3, respectively. The radon concentrations observed are a public health concern, as almost 1/3 of the places monitored exceeded the reference limit value of the European legislation (300 Bq·m-3). Moreover, around 50 % of the indoor levels measured could be attributed to room/building characteristics: the building's location and the main construction material, as well as the occupants' age group, the floor within the building and the school's type of management (public/private). This study concluded that radon testing is needed in all school buildings and classrooms without exceptions. Thus, public administrations are urged to dedicate funds for testing, mitigation and public dissemination initiatives in schools. A special protocol for radon sampling in school buildings should also be developed.

The dominant SARS-CoV-2 Delta variant (B.1.617.2) became the main circulating variant among countries by mid 2021. Attention was raised to the increased risk of airborne transmission, leading to nosocomial outbreaks even among vaccinated individuals. Considering the increased number of COVID-19 hospital admissions fueled by the spread of the variant, with Spain showing the highest COVID-19 rates in mainland Europe by July 2021, the aim of this study was to assess SARS-CoV-2 environmental contamination in different areas of a University Hospital in the region of Castile-León, Spain, during the peak of the 5th wave of COVID-19 in the country (July 2021). Air samples were collected from sixteen different areas of the Hospital using a Coriolis® μ air sampler. Surface samples were collected in these same areas using sterile flocked plastic swabs. RNA extraction followed by a one-step RT-qPCR were performed for detection of SARS-CoV-2 RNA. Of the 21 air samples, only one was positive for SARS-CoV-2 RNA, from the emergency waiting room. Of the 40 surface samples, 2 were positive for SARS-CoV-2 RNA, both from the microbiology laboratory. These results may be relevant for risk assessment of nosocomial infection within healthcare facilities, thus helping prevent and minimize healthcare staff's exposure to SARS-CoV-2, reinforcing the importance of always wearing appropriate and well-fit masks at all times and proper PPE when in contact with infected patients.

Background Diagnosis delay contributes to increased tuberculosis (TB) transmission and morbimortality. TB incidence has been decreasing in Portugal, but median patient delay (PD) has risen. Symptom valorisation may determine PD by influencing help-seeking behaviour. We aimed to analyse the association between symptom valorisation and PD, while characterising individuals who disregarded their symptoms. Methods A cross-sectional study was conducted among TB patients in Lisbon and Oporto in 2019 – 2021. Subjects who delayed seeking care because they did not value their symptoms or thought these would go away on their own were considered to have disregarded their symptoms. PD was categorised using a 21-day cut-off, and a 30-day cut-off for sensitivity analysis. We estimated the effect of symptom valorisation on PD through a directed acyclic graph. Then, a multivariable regression analysis characterised patients that disregarded their symptoms, adjusting for relevant variables. We fitted Poisson regression models to estimate crude and adjusted prevalence ratios (PR). Results The study included 75 patients. Median PD was 25 days (IQR 11.5–63.5), and 56.0% of participants had PD exceeding 21 days. Symptom disregard was reported by 38.7% of patients. Patients who did not value their symptoms had higher prevalence of PD exceeding 21 days compared to those who valued their symptoms [PR 1.59 (95% CI 1.05–2.42)]. The sensitivity analysis showed consistent point estimates but wider confidence intervals [PR 1.39 (95% CI 0.77–2.55)]. Being a smoker was a risk factor for symptom disregard [PR 2.35 (95% CI 1.14–4.82)], while living in Oporto [PR 0.35 (95% CI 0.16–0.75)] and having higher household incomes [PR 0.39 (95% CI 0.17–0.94)] were protective factors. Conclusions These findings emphasise the importance of symptom valorisation in timely TB diagnosis. Patients who did not value their symptoms had longer PD, indicating a need for interventions to improve symptom recognition. Our findings also corroborate the importance of the socioeconomic determinants of health, highlighting tobacco as a risk factor both for TB and for PD.

This study investigates the presence of SARS-CoV-2 in indoor and outdoor environments in two cities in Norway between April and May 2022. With the lifting of COVID-19 restrictions in the country and a focus on vaccination, this research aims to shed light on the potential for virus transmission in various settings. Air sampling was conducted in healthcare and non-healthcare facilities, covering locations frequented by individuals across different age groups. The study found that out of 31 air samples, only four showed the presence of SARS-CoV-2 RNA by RT-qPCR, with no viable virus detected after RNAse pre-treatment. These positive samples were primarily associated with environments involving children and the elderly. Notably, sequencing revealed mutations associated with increased infectivity in one of the samples. The results highlight the importance of considering children as potential sources of virus transmission, especially in settings with prolonged indoor exposure. As vaccination coverage increases globally, and with children still representing a substantial unvaccinated population, the study emphasizes the need to re-implement mask-wearing mandates indoors and in public transport to reduce virus transmission. The findings have implications for public health strategies to control COVID-19, particularly in the face of new variants and the potential for increased transmission during the autumn and winter seasons.

Portugal has been affected by wildland fires that destroy thousands of hectares of forest, causing damage to the environment and to the exposed populations. This study aims to assess the influence of wildland fire emissions on air quality, its effect on population health and the related costs, between 2015 and 2018 in Portugal. The cause-specific mortality due to PM2.5 was calculated considering the exposure for five endpoints in adults, twelve age groups for adults and considering children under five years old. The contribution of wildfire emissions to PM2.5 concentrations in Portugal was assessed through EMEP-MSC/W model. Results showed that the average annual fire emissions of PM2.5, CO, CH4, CO2 and NO2 a significant and continuous increase was observed during the first three years (2015, 2016 and 2017) for all pollutants, followed by a decrease in 2018, with values lower than those observed in 2015. Regarding the long-term exposure to PM2.5 emitted by fires a total of 32, 93, 189 and 31 deaths, corresponding to a cost of 59, 174, 360 and 60 million EUR in 2015, 2016, 2017 and 2018, respectively, were estimated. On the other hand, in the first three years an increase in years of life lost (YLL) values of 496, 1608 and 3092 was observed, corresponding to a cost of 16, 54 and 105 million EUR, respectively, followed by a decrease in 2018 with a YLL of 480, corresponding to a cost of 17 M€.

The assessment of weight status is important in many epidemiological studies, but its direct measurement is not always possible. Self-reported weight and height are often used, although previous research reported low accuracy. This study aimed to test the ability of trained observers to accurately estimate weight status in adults using structured observation. A cross-sectional study was conducted. For each participant, height and weight were estimated in categories, and weight status was recorded using Stunkard’s body figures, by two trained observers. Height and weight were also measured, using standardized procedures. Subjects were classified according to World Health Organization body mass index (BMI) cut-offs from objective measurements and from the BMI assigned to each body figure. Sensitivity, specificity, and likelihood ratios were calculated to assess the accuracy of estimating weight status by observation. Kappa was used to test inter-observer reliability. A total of 127 participants were assessed, 70 women and 57 men, aged between 19 and 89 years (mean ± standard deviation: 50.3 ± 16.3 years). Most participants were overweight or obese (64.3% women; 78.9% men). The sensitivity and specificity of overweight/obesity status identification were 72.8% and 78.4%, respectively. Observers’ gender, participants’ gender, and participants’ age were significantly associated with the estimation of overweight/obesity. The agreement between observers was moderate for BMI estimates (κ = 0.52) but substantial when distinguishing normal weight from overweight/obesity (κ = 0.67). Trained observers were able to distinguish normal weight from overweight/obesity with high sensitivity and specificity, and substantial interrater reliability. This innovative methodology showed potential for improvement through enhanced training techniques. The use of structured observation may be a useful and accurate alternative to self-reported weight status assessment, whenever anthropometric measurement is not achievable.