http://hdl.handle.net/10174/29565 2026-05-08T22:40:37Z http://hdl.handle.net/10174/41988 Title: Associations Between Breastfeeding and Early Cognitive Development in Children Aged 2–3 Years: A Rapid Literature Review Authors: Raimundo, Rui; Farinha, Madalena; Guerreiro, Rui; Pereira, Pedro; Pires, Ana; Recto, Teresa; Marques, Lucinda Editors: Moreira, José; Bico, Isabel; Moguel, Enrique; Alves, Elisabete; Fonseca, César; Ferreira, Rogério Abstract: Abstract. Introduction: Breastfeeding is widely recognised as a key determinant of child health and development, with growing evidence suggesting a beneficial role in early cognitive and neurodevelopmental outcomes. However, evidence synthesis focusing specifically on children aged 2 to 3 years remains limited, despite this being a critical period of brain maturation and functional development. Objective: This rapid review aimed to synthesise recent evidence on the associ- ation between breastfeeding practices—including duration and exclusivity—and cognitive and neurodevelopmental outcomes in children aged 2 to 3 years. Methods: A rapid literature review was conducted in accordance with the WHO Rapid Review Guide and reported following PRISMA guidelines. A systematic search of PubMed, CINAHL, and Web of Science was performed for studies pub- lished between January 2021 and December 2025. Eligible studies included obser- vational designs assessing breastfeeding exposure and cognitive or neurodevelop- mental outcomes in children aged 24–36 months. Study selection, data extraction, and methodological quality appraisal were conducted by independent reviewers. Findings were synthesised narratively using a thematic approach. Results: Six studies met the inclusion criteria, comprising four longitudinal cohort studies and two large-scale cross-sectional analyses conducted across diverse geographical settings. Overall, longer breastfeeding duration was consistently associated with more favourable neurodevelopmental outcomes, including higher global developmental scores, improved language and socioemotional develop- ment, and markers of advanced brain microstructural maturation. Evidence of a dose–response relationship was observed, with breastfeeding for 7–12 months showing the most robust associations across multiple developmental domains. Exclusive breastfeeding for six months was particularly associated with improved communication and problem-solving skills in low-resource settings. While exclu- sive breastfeeding was not consistently associated with long-term cognitive trajec- tories, cumulative breastfeeding exposure was linked to higher baseline cognitive performance in early childhood. Conclusions: This rapid review suggests that breastfeeding, particularly when sus- tained beyond the early postnatal period, is positively associated with cognitive, neurobiological, and socioemotional development in children aged 2 to 3 years. Although causal inference is limited by the observational nature of the evidence, the overall consistency and biological plausibility of findings support current pub- lic health recommendations promoting exclusive and continued breastfeeding as part of strategies to optimise early childhood development. 2026-04-30T23:00:00Z http://hdl.handle.net/10174/41979 Title: Mental Health Burden After Cancer Diagnosis: A Rapid Review of Anxiety, Depression, and Determinants of Distress. Authors: Raimundo, Rui; Bico, Isabel; Fonseca, César; Moreira, josé; Pereira, Afonso; Cristo, Anamar Editors: Moreira, José; Isabel, Bico; Enrique, Moguel; César, Fonseca; Rogério, Ferreira Abstract: Introduction: Cancer diagnosis is a highly stressful event, frequently associated with significant psychological distress, particularly anxiety and depression, representing a major public health concern. This rapid review aimed to synthesize the psychological consequences experienced by adults recently diagnosed with cancer and to identify factors associated with increased or reduced distress. Methods: Following WHO guidance for rapid reviews, selected databases were searched using predefined eligibility criteria, resulting in the inclusion of four cross-sectional studies comprising 8,743 patients from diverse countries and clinical settings. Results: Findings revealed high prevalence rates of anxiety (up to 57.1%) and depression (up to 60.2%), with greater vulnerability among patients with poor social support, low performance status, severe pain, multiple physical symptoms, inpatient care, palliative care, and chemotherapy. Protective factors included higher functional status and better quality of life. Gender differences were observed, with women reporting greater emotional distress. Overall, evidence indicates that anxiety and depression are distinct yet correlated dimensions of psychological distress. Conclusions: The review concludes that early identification and targeted psycho-oncological interventions are essential to mitigate suffering and enhance quality of life from the moment of diagnosis. 2026-01-01T00:00:00Z http://hdl.handle.net/10174/41976 Title: Planned Home Birth and the Role of Specialist Nurses in Maternal and Obstetric Care: A Rapid Literature Review of Maternal and Neonatal Outcomes Authors: Raimundo, Rui; Pedro, Filipa; Bastos, Oliveira; Carriço, Margarida; Dias, Maria; Sérvolo, Mariana Editors: Moreira, José; Bico, Isabel; Moguel, Enrique; Alves, Elisabete; Fonseca, César; Ferreira, Rogério Abstract: Abstract. Introduction: The increasing medicalization of childbirth in high- income countries has prompted renewed interest in planned home birth as an alternative for women with low-risk pregnancies. International evidence suggests that home birth may be a safe option when integrated into organized healthcare systems and attended by qualified professionals. Specialist nurses and midwives play a central role in ensuring safety, quality of care, and continuity across birth settings; however, their specific contributions in planned home birth require further synthesis. Objective: To systematically review the evidence on maternal and neonatal out- comes associated with planned home birth and to examine the role of specialist nurses in maternal and obstetric health in delivering care, promoting safety, and ad-dressing challenges in this setting. Methods: A rapid literature review was conducted following PRISMA guidelines. Searches were performed in PubMed, CINAHL, and Web of Science for studies published between 2021 and 2025. Observational, qualitative, mixed-methods studies, and randomized controlled trials addressing planned home birth attended by nurses or midwives were included. Outcomes of interest comprised maternal and neonatal outcomes, quality of care, professional contributions, and systemic challenges. Methodological quality was assessed using the AMSTAR-2 tool. Results: Seventeen studies from Europe, North America, South America, and Aus- tralia were included, predominantly involving women with low-risk pregnancies. Planned home birth attended by specialist nurses or midwives was generally asso- ciated with maternal and perinatal outcomes comparable to planned hospital birth, alongside significantly lower rates of obstetric interventions, including cesarean section, instrumental delivery, episiotomy, epidural analgesia, and labor augmen- tation. Maternal morbidity was reduced, particularly among multiparous women, with no consistent increase in maternal or neonatal mortality. Specialist nurses contributed to quality of care through comprehensive risk assessment, support of physiological birth, continuity of care, informed decision-making, early identifi- cation of complications, and timely referral to hospital services when required. Key challenges included limited integration into public health systems, regulatory barriers, variability in transfer protocols, and sociocultural resistance to home birth. 2026-04-30T23:00:00Z http://hdl.handle.net/10174/41975 Title: Mental and Physical Health Impacts of the COVID-19 Pandemic on Nurses: A Rapid Systematic Review Authors: Raimundo, Rui; Faiões, Bárbara; Gomes, Clara; Gonçalves, Caolina; Magalhães, Margarida; Pascola, Tatiana; Santos, Tiago; Bico, Isabel Editors: Moreira, José; Bico, Isabel; Moguel, Enrique; Alves, Elisabete; Fonseca, César; Ferreira, Rogério Abstract: Introduction: The COVID-19 pandemic placed unprecedented demands on healthcare systems worldwide, with nurses experiencing disproportionate exposure to occupational, psychological, and physical stressors. Due to continuous patient contact, extended working hours, and heightened clinical risk, nurses have been particularly vulnerable to adverse health outcomes. This rapid systematic review aimed to synthesize current evidence on the mental and physical health impacts of the COVID-19 pandemic on professional nurses. Methods: A rapid systematic review was conducted following the Cochrane rapid review methodology and PRISMA reporting standards. Electronic searches were performed in PubMed, CINAHL, and Web of Science for peer-reviewed primary studies published between January 2021 and December 2025. Eligibility criteria were defined using the PICo framework, focusing on professional nurses, mental and physical health outcomes, and the COVID-19 clinical context. Study selection, data extraction, and methodological appraisal were conducted by independent reviewers. Results: Eleven primary studies met the inclusion criteria, predominantly using cross-sectional designs and encompassing diverse clinical settings and geographic regions. The evidence revealed high prevalence rates of psychological distress, anxiety, depression, burnout, and post-traumatic stress symptoms among nurses, particularly those working in frontline and high-exposure units. Physical health outcomes were also significantly compromised, with frequent reports of fatigue, sleep disturbances, musculoskeletal pain, somatization, and reduced health-related quality of life. Several risk and protective factors were identified, including age, career stage, workload, availability of personal protective equipment, social support, psychological capital, and physical activity. Conclusions: The findings demonstrate that the COVID-19 pandemic has had a profound and interconnected impact on both the mental and physical health of nurses. These effects may persist beyond the acute phases of the pandemic, underscoring the need for integrated occupational health strategies that address psychological, physical, and organizational determinants of well-being. Longitudinal and intervention-based research is essential to inform evidence-based policies aimed at strengthening nurse resilience and healthcare system preparedness for future public health crises. 2026-04-30T23:00:00Z