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Research Project
Environmental Health Institute
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Publications
Monkeypox: from a neglected tropical disease to a public health threat
Publication . Antunes, Francisco; Cordeiro, Rita; Virgolino, Ana
Since the first case of human monkeypox was diagnosed in 1970, the disease remained endemic in several countries in West and Central Africa. In 1996, there was a sudden increase in cases in the Democratic Republic of Congo (DRC), and since 2017 an ongoing outbreak in Nigeria took place, probably related to the population growth, human invasion of MPXV animal habitat reservoirs, and the waning of the cross-protection offered from smallpox immunization, later ending in 1980. Since May 2022, an unprecedented outbreak of human monkeypox has rapidly spread around the world, outside endemic regions of Africa, through new modes of transmission, showing differences in clinical features compared with previous reports. The 2022 MPXV strain belongs to the clade of West Africa but diverges from the original strain, making the virus more transmissible. The authors review the main milestones in more than 50 years of history of human monkeypox, from a rare viral zoonotic infection to a public health emergency.
Functional health literacy : psychometric properties of the newest vital sign for Portuguese adolescents (NVS-PTeen)
Publication . Santos, Osvaldo; Stefanovska, Miodraga; Virgolino, Ana; Miranda, Ana Cristina; Costa, Joana; Fernandes, Elisabete; Cardoso, Susana; Carneiro, António Vaz
Self-management of health requires skills to obtain, process, understand, and use health-related information. Assessment of adolescents’ functional health literacy requires valid, reliable, and low-burden tools. The main objective of this study was to adapt and study the psychometric properties of the Newest Vital Sign for the Portuguese adolescents’ population (NVS-PTeen). Classic psychometric indicators of reliability and validity were combined with item response theory (IRT) analyses in a cross-sectional survey, complemented with a 3-month test-retest assessment. The NVS-PTeen was self-administered to students enrolled in grades 8 to 12 (12 to 17 years old) in a school setting. Overall, 386 students (191 girls) from 16 classes of the same school participated in the study (mean age = 14.5; SD = 1.5). Internal reliability of the NVS-PTeen was α = 0.60. The NVS-PTeen total score was positively and significantly correlated with Portuguese (r = 0.28) and mathematics scores (r = 0.31), school years (r = 0.31), and age (r = 0.19). Similar to the original scale (for the U.S.), the NVS-PTeen is composed of two dimensions, reading-related literacy and numeracy. Temporal reliability is adequate, though with a learning effect. IRT analyses revealed differences in difficulty and discriminative capacity among items, all with adequate outfit and infit values. Results showed that the NVS-PTeen is valid and reliable, sensible to inter-individual educational differences, and adequate for regular screening of functional health literacy in adolescents.
Lost in transition: a systematic review of the association between unemployment and mental health
Publication . Virgolino, Ana; Costa, Joana; Santos, Osvaldo; Pereira, Maria Emília; Antunes, Rita; Ambrósio, Sara; Heitor, Maria João; Carneiro, António Vaz
Objective: To understand participation and attrition phenomena variability in European cohorts of individuals born preterm through in-depth exploration of the interplay of situational elements involved.
Study design and setting: Multi-situated qualitative design, using focus groups, semi-structured interviews and collaborative visual methodology with a purposive sample of adults born preterm, parents and professionals (N=124) from eight cohorts in seven European countries.
Results: Most cohort participants were motivated by altruism/solidarity and gratitude/sense of duty to reciprocate (only absent in adults aged 19-21), followed by expectation of direct benefit to one's health and knowledge amongst participating adults. Common deterrents were perceived failure in reciprocity as in insufficient/inadequate interaction and information sharing, and postal questionnaires. Combining multipurpose, flexible strategies for contact and assessment, reminders, face-to-face and shorter periodicity and not simply adding retention strategies or financial incentives favoured participation. Professionals' main challenges entailed resources, funding and, European societal changes related to communication and geopolitical environment.
Conclusion: Retention would benefit from tailoring inclusive strategies throughout the cohorts' life cycle and consistent promotion of reciprocal altruistic research goals. Investing in regular interaction, flexibility in procedures, participant involvement and return of results can help mitigate attrition as well as considering mothers as main facilitators to participating children and impaired adults.
Reducing sexual and reproductive health inequities between natives and migrants: a Delphi consensus for sustainable cross-cultural healthcare pathways
Publication . Candeias, Pedro; Alarcão, Violeta; Stefanovska, Miodraga; Santos, Osvaldo; Virgolino, Ana; Pintassilgo, Sónia; Pascoal, Patrícia M.; Costa, Andreia; Machado, Fernando Luís
The increasing number of international migrants (ranging from 153 million in 1990 to ~272 million in 2019) brought to attention the wide variation of national contexts concerning the policy measures to protect migrants' rights and ensuring their equal access to basic and essential services, namely in health. Sexual and Reproductive Health (SRH) is a key component to the overall health and quality of life and is impacted by power inequities inherent to society's institutions, environment, economics, and culture. In Portugal, guidelines for intervention in SRH are insufficient, a gap that is more pronounced with migrant populations due to the absence of culturally sensitive indicators to assess and monitor SRH. The aim of this work was 2-fold: to identify good practices in the SRH field, with a particular focus, whenever possible, on migrant populations, and to identify relevant and inclusive indicators to monitor SRH in Portugal. A Delphi panel (via online survey) with 66 experts (researchers, teachers, and health professionals) and 16 stakeholders (non-governmental organizations, civil society, and governmental organizations) was implemented in two rounds. Panelists were asked to state their level of agreement (5-point Likert-type scale) regarding four different SRH areas: Sexual Health, Reproductive Health, Social-Structural Factors, and Good Practices. Items were based on literature review and a World Café with 15 experts and stakeholders. Participation rate was 68% and response rate was 97% on the first round. From the initial list of 142 items, a total of 118 (83%) items were approved by consensus. Findings may provide extended opportunities for the healthcare system to engage in better informed decisions and more inclusive and integrative strategies regarding SRH, contributing to build political measures toward sexual and reproductive justice.
Virulence factors in carbapenem-resistant hypervirulent Klebsiella pneumoniae
Publication . Mendes, Gabriel; Santos, Maria Leonor; Ramalho, João Francisco; Duarte, Aida; Caneiras, Catia
Hypervirulence and carbapenem-resistant have emerged as two distinct evolutionary pathotypes of Klebsiella pneumoniae, with both reaching their epidemic success and posing a great threat to public health. However, as the boundaries separating these two pathotypes fade, we assist a worrisome convergence in certain high-risk clones, causing hospital outbreaks and challenging every therapeutic option available. To better understand the basic biology of these pathogens, this review aimed to describe the virulence factors and their distribution worldwide among carbapenem-resistant highly virulent or hypervirulent K. pneumoniae strains, as well as to understand the interplay of these virulence strains with the carbapenemase produced and the sequence type of such strains. As we witness a shift in healthcare settings where carbapenemresistant highly virulent or hypervirulent K. pneumoniae are beginning to emerge and replace classical K. pneumoniae strains, a better understanding of these strains is urgently needed for immediate and appropriate response.
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Funders
Funding agency
Fundação para a Ciência e a Tecnologia
Funding programme
6817 - DCRRNI ID
Funding Award Number
UIDB/04295/2020