Environmental Health Institute

Funder

Organizational Unit

Publications

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.

2021Journal article

Open access

Genomic characterisation of a novel KPC-98-producing clinical Klebsiella pneumoniae strain conferring resistance to ceftazidime/avibactam

Publication . Mendes, Gabriel; Santos, Maria Leonor; Ramalho, João Francisco; Bruschy-Fonseca, Ana; Lito, Luís; Pedro, Diogo; Duarte, Aida; Cristino, José Melo; Caneiras, Catia

Ceftazidime/avibactam (CZA) is a novel drug that inactivates Ambler class A, including Klebsiella pneumoniae carbapenemases (KPC), class C and class D β-lactamases, but is not active against metallo-β-lactamases (class B). Despite its limited use worldwide, emerging cases of CZA-resistant isolates producing variants of the blaKPC gene have been reported. In this study, we report a novel KPC-98 variant conferring CZA resistance identified in a highly virulent and multidrug-resistant clinical isolate of K. pneumoniae, belonging to the high-risk international clone sequence type 13 (ST13).

2023Journal article

Restricted access

Beyond usual geographical scales of analysis: implications for healthcare management and urban planning

Publication . Morais, Liliane; Lopes, António; Rocha, Jorge; Nogueira, Paulo Jorge

In the context of climate emergency, advances in geographic information systems, geocoding, and geomedicine allow us to go beyond the conventional usual scales and be aligned with people’s needs, improving knowledge and accuracy of the spatial pattern of health outcomes. This study shows that the geographical scale of analysis affects the interpretation of health outcomes. Methods: All mortality that occurred in Portugal in 2014–2017 was geocoded. From 435,291 addresses, 412,608 were geocoded with success. As an example, we use the spatial patterns of the elderly’s heat-related cardiorespiratory mortality. Results: It is shown: (i) it is possible to have high quality and accuracy of spatial data used in health outcomes analysis; (ii) how geographic scales reveal different degrees of detail in health outcomes analysis; (iii) the neighbourhood scale revealed different patterns of cardiorespiratory mortality from the usually available scale (parish). Discussion: Our findings suggest the relevance of geocoding health outcomes with a finer scale in tackling the challenges of the healthcare sector, and in support of planning decision-making, closely matching citizens’ needs. Without running the risk of losing potentially major prospects, better healthcare management is achievable, with optimal resource allocation, and improved detailed and informed policymaking, allowing enhanced climate health equity in cities promotion.

2022Journal article

Open access

Active and healthy aging after COVID-19 pandemic in Portugal and other European countries: time to rethink strategies and foster action

Publication . Costa, Andreia; Câmara, Gisele; Arriaga, Miguel Telo de; Nogueira, Paulo Jorge; Pereira Miguel, José

The population aging in Europe imposes challenges to societies that require adaptations and responses at various levels to minimize impacts and figuring out opportunities. Portugal has been committed to the World Health Organization and European Union’s values and policy frameworks concerning active and healthy aging. In 2017, an inter-ministerial working group developed the National Strategy for Active and Healthy Aging. In the face of the COVID-19 pandemic that exposed the vulnerabilities of older populations, the launch of the Decade of Healthy Aging 2021–2030 and its baseline report and the 2018 Active Aging Index Analytical Report may constitute an opportunity to strategically think about the aging of the population as a national purpose in Portugal and in the other European countries that face similar challenges.

2021Journal article

Open access

Developing healthy eating promotion mass media campaigns: a qualitative study

Publication . Capitão, Carolina; Martins, Raquel; Feteira-Santos, Rodrigo; Virgolino, Ana; Graça, Pedro; Gregório, Maria João; Santos, Osvaldo

Background: Involving consumers in the development and assessment of mass media campaigns has been advocated, though research is still lacking. This study aimed to explore opinions and attitudes of citizens, health professionals, communication professionals, and digital influencers regarding the development and implementation of healthy eating promotion mass media campaigns. Methods: We conducted five semi-structured focus groups, where participants were exposed to the first nationwide mass media campaign promoting healthy eating in Portugal. Through criteria-based purposive sampling, 19 citizens, five health professionals, two communication professionals, and four digital influencers were included. Transcripts were analyzed using Charmaz's line-to-line open coding process. Results: Main identified themes were: considerations about informative-centered campaigns, health/nutritional issues to address, campaign formulation, target audiences, dissemination channels, and influencers' involvement. Participants favored campaigns focused on practical, transformative, and useful information with simple, innovative, activating, and exciting messages instead of strictly informative campaigns. Health and communication professionals mentioned the importance of adapting the message and dissemination channels to the target audience, addressing the most vulnerable and hard-to-reach individuals, and highlighted the importance of short video format. Conclusions: Active involvement of the health promotion target audience is crucial for the development and effectiveness of health campaigns. Campaigns need to convey health messages on simple though exciting communication materials, targeted to the most vulnerable subgroups, including deprived, less educated, younger, and older generations.

2022Journal article

Open access