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Silva MR, Rodrigues D, Machado-Rodrigues A, Nogueira H, Gama A, Padez C. Household Food Insecurity In Portuguese Children. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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2
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Marques MJ, Gama A, Cheng C, Osborne R, Dias S. Addressing health literacy to reduce inequalities among migrants: which profiles need our attention? Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Health literacy, the ability to access, understand, appraise, remember and use health information and services, has great potential to reduce inequalities in access to and outcomes of care. People may have different patterns of health literacy needs and strengths. Yet, the design of interventions is frequently not responsive to the specificities of different segments of the population, including migrant groups. We aimed to identify profiles of migrants to inform the co-design of interventions targeting people at risk of poor outcomes. A cross-sectional survey was conducted with 1126 adult migrants living in Portugal. Data were collected using the 9-dimension HLQ (Health Literacy Questionnaire), and a sociodemographic questionnaire. A cluster analysis of data was performed. Semi-structured interviews were conducted with 15 migrants, stratified by the clusters. The optimal cluster solution yielded 16 profiles revealing diversity in combinations of strengths and needs across the HLQ domains. While 29.8% of migrants scored moderate to high on all 9 domains (profiles 2, 6, 8, 16), 63.4% of participants struggled with 1 or several aspects of health literacy, namely ‘Feeling understood and supported by healthcare providers'. Notably, 36.8% (6 profiles) exhibited difficulty across most of health literacy domains. The interviews provided a tangible description of the health literacy needs and resources with five main themes (access, understand, appraise, retrieve and use). Regarding ‘access', migrants expressed different preferred learning styles and needed to access different sorts of information at distinct times. The ‘use’ of information was rarely a one-time decision but a decision that people needed to make repeatedly. Health literacy is a highly diverse concept where subgroups exhibited diverse patterns. The cluster analysis can be used to inform the co-design, prioritisation and implementation of locally designed, fit-for-purpose solutions to improve health literacy.
Key messages
• Health literacy profiles can inform interventions to mitigate health inequalities among vulnerable migrant groups.
• The identification of distinct profiles can contribute to minimise the disconnect between what people/communities need and what is developed to improve health and equity.
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Affiliation(s)
- MJ Marques
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - C Cheng
- Centre of Global Health and Equity, School of Health Sciences, Swinburne University of Technology , Melbourne, Australia
| | - R Osborne
- Centre of Global Health and Equity, School of Health Sciences, Swinburne University of Technology , Melbourne, Australia
| | - S Dias
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
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Gama A, Marques MJ, Pedro AR, Hoffmeister LV, Rodrigues F, Ribeiro JS, Dias S. Which effects had the pandemic in migrants’ health and well-being? A mixed-methods approach. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The COVID-19 pandemic affected populations’ health, with a disproportionate impact on those most socially vulnerable such as migrants. The way these populations experienced the pandemic lockdowns and its effects on daily life are yet to be known. This study aimed to understand the effects of the pandemic on health and well-being of migrants in Portugal.
Methods
In a mixed-methods approach, a survey was conducted with a community-based sample of 1126 migrants in the Lisbon Metropolitan Area, assessing sociodemographics, migration-related characteristics and the perceived impact of the pandemic on health. In addition, n = 12 migrants purposively recruited were invited to participate in a photovoice study, sharing photographs about their daily life during the lockdowns. Following semi-structured interviews were conducted. Quantitative data were analysed using multivariable analysis and qualitative data were analysed through content analysis.
Results
A fifth of the participants perceived having worse health condition since the pandemic, which was more likely among women (OR = 1.58, CI95% 1.13-2.20), those >45 years old (OR = 1.78, CI95% 1.02-3.16), with lower education (Basic education: OR = 1.57, CI95% 1.01-2.47) and with lower monthly income (<EUR 650: OR = 1.69, CI95% 1.18-2.44). Two themes emerged from the photovoice: effects of the pandemic lockdowns on daily life (routines, social relations, work) and on health and well-being (eating habits, physical exercise, leisure). Strategies to cope with the adverse effects included social activation and changes in lifestyles.
Conclusions
The pandemic had disproportionate effects on some migrant groups, intensifying social and health inequalities, with consequences for their well-being. Participatory methods can contribute to further understand migrants’ experiences while involving and empowering them for health promotion.
Key messages
• The pandemic had adverse effects on migrants’ health and well-being, disproportionately affecting most socially vulnerable migrant groups.
• Participatory research methods as photovoice are valuable to gain access to individual experiences and perspectives, while involving and empowering participants.
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Affiliation(s)
- A Gama
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - MJ Marques
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - LV Hoffmeister
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - F Rodrigues
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - JS Ribeiro
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - S Dias
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
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Marques MJ, Gama A, Pedro AR, Magano R, Tiessen C, Hollanders P, Dias S. Mental health of migrants during the COVID-19 pandemic: additional stressors, increased inequalities. Eur J Public Health 2022. [PMCID: PMC9594497 DOI: 10.1093/eurpub/ckac131.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The COVID-19 pandemic has resulted in an unprecedent range of negative mental health outcomes across populations worldwide. Such effects are increasingly being documented, however an evidence gap persists on the consequences on most vulnerable groups, as certain subgroups of migrants. These populations already suffer from increased psychological burden, and the pandemic effects may potentially exacerbate adverse experiences and outcomes. This study aims to uncover the perceived impact of the COVID-19 pandemic on the mental health of migrants in Portugal and the associated sociodemographic aspects. A survey was conducted with a community-based sample of 1126 adult migrants in Portugal, assessing sociodemographics, migration-related characteristics and the perceived impact of the pandemic on mental health. Association between sociodemographics and mental health indicators was measured through bivariable analysis. In total, 1126 adult migrants were surveyed: 53.4% female, mean age of 35.8 years (range 18-77), 48.9% from African countries, 29.5% from Middle East/Asian countries, 21.6% from Brazil. Most participants (80%) reported feelings of agitation, anxiety or sadness during the pandemic period with 26.4% experiencing these feelings most days. The pandemic had a disproportionate impact on women (86.9% reported negative impact compared to 72.5% of men, p < 0.05), those undocumented (83.3% vs 75.4%, p < 0.05), those whose financial situation got worse since the pandemic (82.8% vs. 77.3%, p < 0.05) and those who had increased food shortages (84.4% vs 79%, p < 0.05). Migrants perceived an elevated deterioration of their mental health during the COVID-19 pandemic. In addition, particular groups such as women and those with a more insecure income or residence status are particularly susceptible to experiencing negative mental health outcomes. Key messages • There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular migrant groups and to develop interventions that target their unique needs. • Investigating sociodemographic and migration aspects could help identifying migrants at a higher risk of experiencing mental health distress.
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Affiliation(s)
- MJ Marques
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - R Magano
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - C Tiessen
- Universiteit Amsterdam Vrije , Amsterdam, Netherlands
| | | | - S Dias
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
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de Noronha N, Moniz M, Gama A, Laires PA, Goes AR, Pedro AR, Dias S, Soares P, Nunes C. Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal. Public Health 2022; 211:5-13. [PMID: 35988506 PMCID: PMC9271418 DOI: 10.1016/j.puhe.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 11/15/2022]
Abstract
Objectives The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal. Study design Cross-sectional study. Methods This study used data from a Portuguese community-based survey entitled ‘COVID-19 Barometer: Social Opinion’. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown. Results Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate. Conclusions Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.
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Affiliation(s)
- N de Noronha
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal.
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P A Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
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Seixas F, Gama A, Alvura N, Lourenço L, Pires M. Uterine Adenomyosis, Pyometra and Leiomyoma in a Lion. J Comp Pathol 2022. [DOI: 10.1016/j.jcpa.2021.11.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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7
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Machado A, Vilhena H, Gama A. Impact of Lymph Node Micrometastases and Isolated Tumour Cells in Canine Mammary Cancer Prognosis. J Comp Pathol 2022. [DOI: 10.1016/j.jcpa.2021.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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8
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Gama A, Castro M, Pires I, Seixas F, Pinto M, Pires M, Coutinho T, Lopes A, Bastos E. Parasitic Pneumonia Iin Roe Deer (Capreolus capreolus): First Molecular Identification of Dictyocaulus Capreolus in Portugal. J Comp Pathol 2022. [DOI: 10.1016/j.jcpa.2021.11.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Silva MR, Rosado-Marques V, Nogueira H, Rodrigues D, Machado-Rodrigues A, Gama A, Padez C. Household food insecurity in portuguese young children after the financial crisis. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Goes AR, Soares P, Moniz M, Gama A, Pedro AR, Laires P, Dias S, Nunes C. Factors associated with motivation to avoid meeting family and friends during the COVID-19 pandemic. Eur J Public Health 2021. [PMCID: PMC8574604 DOI: 10.1093/eurpub/ckab164.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The widespread adherence to behaviours that prevent the transmission of the SARS-CoV-2 virus depends on human will. There is a paucity of research on the factors that influence adherence to social distancing. Available research suggests that it varies with the specific behaviour and that reducing contact with family and friends is the hardest one. This study aims to identify factors associated with motivation to avoid meeting with family and friends during the second lockdown of the COVID-19 pandemic in Portugal. Methods We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes sociodemographics, psychosocial variables, and subjective health and wellbeing indicators from 20th February to 19th March 2021. We included 1336 participants who answered the question “To what extent is it easy for you to avoid visiting family and friends?”. Logistic regression analysis was used to identify factors associated with difficulty to avoid visiting family and friends. Results Preliminary data shows that 38.4% (513) had difficulties avoiding meeting with family and friends. Those with greater difficulty were the ones who have less education, higher negative emotionality, do not work remotely, have more difficulties to stay home and practice physical distancing and consider the Government's measures inadequate. Contrarily, those who have less difficulty avoiding visiting friends and family are older and have low risk perception of COVID-19 infection. Conclusions This study suggests higher difficulty in avoiding visiting friends and family for those whose routines demand not staying at home, with low agreement with Government measures, and struggle with higher negative emotionality, confirming the personal costs of these behaviours and the importance of habits. Older people had less difficulty, suggesting that these measures may be closer to their usual routines. Interventions should consider the specificities of social interaction. Key messages Social distancing comes at an enormous cost to people's livelihoods and it also depends on people living circumstances. Interventions to improve adherence to social distancing should consider the specificity of social interaction and the potential dissonance created by the overall routines.
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Affiliation(s)
- AR Goes
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Moniz
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Pedro
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Laires
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Gama A, Marques MJ, Pedro AR, Mendonça J, Fernandes AC, Dias S. Perceived need of health care and barriers in access to health services among migrants in Portugal. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Health care has been pointed out as a key determinant of migrants' health and social integration, but there is evidence of disparities in its access across subgroups. A deeper understanding of the barriers in access to health care, particularly among vulnerable groups, is needed. Our study aims to examine perceived need of health care, access to health services and barriers among migrants in Portugal. A cross-sectional survey was conducted with 1126 adult migrants (53.4% females), originated from African, Middle East, Asian countries and Brazil, living in Portugal for no longer than 10 years. The collected data included sociodemographic characteristics, perceived need of health care, access to health services and difficulties experienced. Differences between groups were analysed through chi-square tests. Results showed that most of the participants (64.7%) have needed health care in the previous 12 months in Portugal. Of these, 87.8% accessed a health care service. However, even needing health care, 3.3% decided not to seek care and 8.8% were not able to access a health care service. Reporting no access to health care was more frequent among migrants with shorter length of stay in the country (<1 year: 19.4% vs. 1 to 5 years: 7.3% and 6 to 10 years: 4.6%; p = 0.001) and those with non-regular migration status (in regularisation process: 11.5% and undocumented: 9.5% vs. documented: 7.2%; p = 0.040). Most common barriers were lack of the National Health Service user card (38%), financial constraints (15%), undocumented status (11%) and language difficulties (7%). Although efforts have been made over the past decades in Portugal to adopt inclusive policies and promote migrants' access to health care, strategies are needed to improve information on migrants' health rights, especially of those undocumented and recently arrived. Economic and language difficulties should be further addressed in comprehensive interventions to promote equal access to health care.
Key messages
Migrants residing in the country for less than a year and those with non-regular migration status reported more frequently not being able to access health care. Despite the efforts to adopt inclusive policies and promote migrants’ access to health care, strategies are needed to improve information on migrants’ health rights and promote equal access to care.
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Affiliation(s)
- A Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - MJ Marques
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - J Mendonça
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AC Fernandes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
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Dias S, Figueiredo C, Hoffmeister L, Gama A. Developing evidence on social prescribing initiative in Lisbon: Challenges and insights for improving. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Social prescribing is recent in Portugal and evidence is needed on the potential of this complex intervention to improve health and wellbeing outcomes but also to inform the commissioning of these programmes. In a collaborative approach, an evaluation protocol of the social prescribing in two primary healthcare units in Lisbon was developed, aiming to assess its implementation and impact at three levels: patients, health system and health-social sector intersection, within a mixed-methods approach. Exploring the social prescribing contribution to enhance patients' quality of life, well-being and activation involves assessing these outcomes throughout a longitudinal perspective. In an exploratory, prospective study, baseline data collection and three follow-ups are included. Secondary data comprise health status indicators collected from patients' medical records as well as referral and social responses elaborated within the intervention. Patients' experiences on the social prescribing activities performed, perceived changes in lifestyle, and perspectives about positive and negative aspects are assessed in semi-structured interviews. The need for further understanding the impact at the health system' level calls for an attentive look at the processes of change in patients' patterns of healthcare services use (appointments in primary healthcare units, hospital admissions and emergency episodes), but also changes in the services' reorganization to better integrative health care. At a broader level, insights will be obtained on the effects on the intersection between the health and social sectors and the experiences of networking, through focus group discussions with all the stakeholders involved. The social prescribing implementation process, barriers, facilitators and suggestions for improvement will also be explored. In this presentation, challenges will be debated, as well as insights for reflection about opportunities for improving evidence development.
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Affiliation(s)
- S Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - C Figueiredo
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Central Lisbon Health Center Cluster, Lisbon, Portugal
| | - L Hoffmeister
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
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13
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Marques P, Gama A, Geraldes M, Silva J, Vaccari N, Dias S. Sociocultural factors of cervical cancer screening uptake among migrant women: a mixed methods study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Cervical cancer has a high mortality in Europe despite being preventable by cervical cancer screening (CCS). Migrant women have a lower CCS attendance compared to non-migrants. This study aims to describe CCS uptake among migrant women in Portugal and explore sociocultural influences. Within a mixed-methods approach, an online survey and focus group discussions (FGs) were conducted. The survey included 655 migrant women and collected data on sociodemographics, attendance and attitudes toward CCS. Four FGs with 12 healthcare workers and a FG with 5 community workers were conducted exploring perceptions on CCS attendance and barriers among migrant women. Quantitative data was analyzed using descriptive analysis and Chi-Square test and qualitative data through content analysis. Survey data shows that 24.9% of women never had CCS or had it over 5 years ago, more Asian and African women (51.3% and 36.7%, respectively) (p < 0.001). Non-attenders reported significantly more often embarrassment towards CCS (21.7% vs. 18.8% of CCS attenders, p = 0.002) and being unaware of their risk of cancer and the relevance of CCS (28.8% vs. 12.5%, p < 0.001). Around 24% of non-attenders reported concern with having a consultation with a male doctor. For FGs participants, CCS is a taboo in some communities, particularly African, Asian and Muslim. Lack of information about CCS along with feelings of embarrassment and discomfort related to pap smear and with being seen by a male doctor were referred as reasons for avoidance of CCS. Participants also stated that some women have low autonomy and often their husbands have a key role in deciding whether they should attend CCS. Lack of a preventive mindset was also stated as reason for low CCS attendance. The sociocultural background can influence migrant women's attendance to CCS. A culturally grounded approach is needed to provide tailored information on CCS and to create opportunities to engage migrant communities on CCS and improve their uptake.
Key messages
Lack of information, embarrassment and low autonomy hinder some migrant women’s attendance to CCS. The sociocultural influences on CCS uptake call for a culturally grounded approach to provide tailored information and engage migrant communities on CCS.
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Affiliation(s)
- P Marques
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Geraldes
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - J Silva
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - N Vaccari
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Lopes S, Soares P, Gama A, Pedro AR, Moniz M, Laires P, Goes AR, Nunes C, Dias S. Factors associated with avoidance of emergency department visits in Portugal during the pandemic. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Avoiding an emergency department (ED) visit risks irreversible negative consequences for patients' health. EDs are a frequent access point to the Portuguese health system. Previous studies have shown that patients may avoid visiting ED during the pandemic. This study aims to identify factors associated with avoidance of ED visits in Portugal during the COVID-19 pandemic.
Methods
We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes healthcare utilisation, health status, and risk perception in Portugal from 11th April 2020 to 16th April 2021. We included respondents that reported having needed ED care. Data were collected on sociodemographics, health status (comorbidities, mental health), risk perception (COVID-19 and complications), level of trust in health services and self-assessment of the severity of the reason for ED visit. The outcome of interest was the decision to avoid ED care. We used logistic regression to identify factors associated with the decision to avoid ED.
Results
Preliminary data showed that 914 respondents reported needing ED care (74.8% female; mean age 43 years). From those, 224 (25%) decided to avoid ED care. ED visits avoidance was higher during lockdowns (28%). People reporting specific comorbidities (cardiac, autoimmune, respiratory) avoided ED more than those without them. Perception of no severe reason for ED visit, poor mental health, perception of higher risk of COVID-19 and complications, and low trust in health services response to the pandemic were associated with higher odds of ED visit avoidance.
Conclusions
People avoiding ED visits represented a considerable share. The decision to avoid ED visit was associated with clinical characteristics, but the perception of risk and assessment of the context and health system response also played a role in decision making.
Key messages
The effect of avoided ED visits on health should be a research and policy concern. People with certain comorbidities or perception of high risk of COVID-19 and complications may be closely monitored.
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Affiliation(s)
- S Lopes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Silva MR, Rosado-Marques V, Nogueira H, Machado-Rodrigues A, Rodrigues D, Gama A, Padez C. Food (IN)security in Portuguese preschool and school children in time of financial crisis. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Dias S, Gama A, Simões D, Carreiras E, Mora C, Ferreira AP. Correlates of HIV, STI and TB among sub-Saharan African migrants in Lisbon: a biobehavioral study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Sub-Saharan African migrants (SAMs) have been disproportionately affected by infectious diseases such as HIV, other sexually transmitted infections (STIs) and Tuberculosis infection (TB). Research on infectious diseases and related factors among migrant populations is critical to further understand these populations' health needs and inform prevention strategies. However, migrants are often underrepresented in national statistics and research. This study aimed to examine correlates of HIV, past STI and past TB among SAMs.
A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Uni- and multivariable logistic regression analyses were performed to examine factors associated with HIV, past STI and past TB.
Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive increased by age (OR 1.07, 95%CI 1.03-1.11) and were higher among those who experienced violence from a partner (OR 2.77, 95%CI 1.08-7.10). Increased odds of having a past STI were found among migrants with low income (OR 2.86, 95%CI 1.48-5.56), long-term migrants (>25 years residing in Portugal: OR 2.16, 95%CI 1.06-4.38) and those who reported sexual risk behaviors (≥3 sexual partners: OR 2.06, 95%CI 1.14-3.70; inconsistent condom use: OR 2.61, 95%CI 1.32-5.17). In total, 4.1% of participants had TB in the past; these were more likely male (OR 3.42, 95%CI 1.29-9.06) and HIV positive (OR 11.48, 95%CI 4.55-28.94). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past.
Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases.
Key messages
High levels of HIV, STI and TB infection among SAMs were found to be strongly associated with socioeconomic disadvantage and poor living conditions in the host country. Social inequalities are persistently a major factor affecting risk for HIV, STIs and TB, and thus addressing social determinants of infectious diseases must remain a public health priority.
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Affiliation(s)
- S Dias
- NOVA National School of Public Health, Public Health Research Centre & Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Centre & Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - D Simões
- Grupo de Ativistas em Tratamentos, Lisbon, Portugal
| | - E Carreiras
- Associação de Intervenção Comunitária, Desenvolvimento Social e de Saúde, Amadora, Portugal
| | - C Mora
- Associação de Intervenção Comunitária, Desenvolvimento Social e de Saúde, Amadora, Portugal
| | - A P Ferreira
- Ser + - Associação Portuguesa para a Prevenção e Desafio à Sida, Cascais, Portugal
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Dias S, Loos J, Gama A, Simões D, Nöstlinger C. Risk for HIV acquisition among sub-Saharan African migrant travelers in Belgium and Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Migrants often travel back to the origin countries and to other European states after settling in the residence country. Mobility along with structural vulnerabilities may increase HIV acquisition risk. Knowledge on HIV risk exposure when traveling is limited, yet crucial to inform prevention. This study aims to explore risky sexual behaviors and assess HIV prevalence among sub-Saharan African migrants (SAMs) who travel, residing in two European cities.
Two cross-sectional biobehavioral surveys were conducted in Lisbon and Antwerp with a venue-based sample of 1508 SAMs. Descriptive and multivariable logistic regression analyses were performed to examine travel patterns and associated sexual risk behaviors.
Overall, 68.4% of participants had traveled to other countries after settling in the residence country; 41% had traveled back to Africa and within Europe, 25.2% only to Africa and 33.8% only to Europe. Among travelers who reported sexual encounters abroad (49.2%), condomless sex at last intercourse was high both abroad (62.5%) and in the host country (70.7%). Odds of condomless sex at the last sexual encounter in the host country were five times higher among those who also reported no condom use abroad [OR: 5.32; 95% CI: 2.98-9.25], controlling for gender, age, educational level, relationship status, survey country, partner type and origin, and number of sexual partners over the last year. Condomless sex was higher with a regular partner and with an African partner, both abroad (79.9% and 67.5%, respectively) and in the host country (81.3% and 74.6%, respectively). Among the 75 participants who tested HIV-positive (around 5%), more than half had travelled to other countries; of these, about half reported condomless sex with their last sexual partner abroad.
SAMs are a mobile population and are exposed to sexual HIV risk both while traveling and in host countries. Prevention interventions should address the complex interplay between migrants' mobility and HIV risk.
Key messages
Migrants often travel to their origin home countries and other destinations after having settled in host countries, and this mobility increases exposure to HIV risk. A transnational perspective on HIV prevention and sexual health promotion is needed for effectively reducing migrants’ HIV risk related to their mobility.
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Affiliation(s)
- S Dias
- NOVA National School of Public Health, Public Health Research Centre & Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - J Loos
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - A Gama
- NOVA National School of Public Health, Public Health Research Centre & Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - D Simões
- Grupo de Ativistas em Tratamentos, Lisbon, Portugal
| | - C Nöstlinger
- Grupo de Ativistas em Tratamentos, Lisbon, Portugal
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Vasconcelos J, Siqueira R, Clementino I, Gama A, Alves A, Lucena R, Dantas A. Frequência das doenças de pele não tumorais em cães no município de João Pessoa, Paraíba, Brasil (2014-2016). ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Diante da carência de estudos sobre a frequência de dermatopatias que acometem cães por região geográfica no Brasil, o presente estudo objetivou conhecer a frequência das principais doenças cutâneas que afetam cães na região metropolitana de João Pessoa, Paraíba, Brasil. Os dados foram coletados de cães que passaram por atendimento dermatológico no período de setembro de 2014 a dezembro de 2016. Além dos exames clínicos e dermatológicos os cães foram submetidos a exames complementares (citológico, raspado de pele, parasitológico, tricograma, bacteriológico, micológico, histopatológico e molecular). No período do estudo, foram atendidos 1.083 cães, em que 18,65% (202/1.083) apresentavam algum tipo de dermatopatia não tumoral. Dos 202 cães acometidos, 51,49% (104/202) eram machos e 48,51% (98/202), fêmeas. Desses 202 cães, 13 tinham dois diagnósticos, totalizando 215 dermatopatias. Dos cães afetados, 62,87% (127/202) eram de raça definida e 37,13% (75/202), sem raça definida (SRD). As lesões observadas com mais frequência caracterizaram-se por áreas alopécicas, hipotricoicas, maculosas, erosivas e ulcerativas, placoides, eritematosas, assim como comedões, colaretes, seborreia. As dermatopatias parasitárias foram as mais frequentes (35,35%; 76/215), seguidas pelas dermatopatias bacterianas (24,19%; 52/215), dermatopatias alérgicas (20,00%; 43/215), dermatopatias fúngicas (17,21%; 37/215), dermatopatias por outras causas (2,32%; 5/215) e pelas dermatopatias autoimunes (0,93%; 2/215). Os exames físicos e dermatológicos, incluindo anamnese detalhada, histórico clínico apurado, associado a exames complementares, são ferramentas importantes para o diagnóstico das dermatopatias em cães. Presume-se que a frequência de dermatopatias em cães na região de estudo possa ser maior do que a observada.
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Affiliation(s)
| | | | | | - A. Gama
- Universidade de Trás-os-Montes e Alto Douro, Portugal
| | - A. Alves
- Universidade de Trás-os-Montes e Alto Douro, Portugal
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19
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Vieira Ferreira L, Ferreira Machado I, Gama A, Lochte F, Socoteanu R, Boscencu R. Surface photochemical studies of nano-hybrids of A3B porphyrins and Fe3O4 silica-coated nanoparticles. J Photochem Photobiol A Chem 2020. [DOI: 10.1016/j.jphotochem.2019.112152] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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20
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Tavares AM, Garcia AC, Gama A, Abecasis AB, Viveiros M, Dias S. Perceptions of primary care providers on TB care for migrants: a mixed methods study in Portugal. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Tuberculosis (TB) is one of the main causes of death worldwide. In 2017, the proportion of TB cases among foreign-born individuals in Portugal was of 19%, and this proportion has been increasing. TB control among migrant populations largely depends on the role of the healthcare providers and their close contact with the patients. We aimed to explore the perspectives of primary care providers on the provision of TB care for migrant patients in Portugal.
Methods
An online survey and semi-structured interviews were conducted with healthcare providers from primary care settings in Portugal. Overall, 120 participated in the survey, and 17 were interviewed. Data from the survey and interviews were analysed using descriptive statistics and thematic analysis, respectively.
Results
Many participants (36.9%) considered that migrants arrive at an advanced stage of TB disease, and the main reason referred was migrants’ unawareness of the disease and its symptoms. Moreover, half (50.0%) of the providers considered that migrants frequently interrupt treatment, mainly due to their mobility, which causes difficulties in follow-up, and their social isolation that hampers social support. Overall, three main barriers for migrants’ access and use of TB care were mentioned: migrants’ low socioeconomic status, great bureaucracy required to register at services, and obstacles to benefit from social protection. Providers also suggested more training to improve their cultural competence and updating training on TB care.
Conclusions
Our study have shown social and economic factors that must be addressed to improve migrants’ access and use of TB care. In addition, increased health literacy for migrants and more training initiatives for providers can also contribute to improve TB care for migrants.
Key messages
Perspectives from primary care providers in Portugal highlighted social, economic, and administrative obstacles hampering the provision of TB care for migrants. With this work we expected to contribute with evidence to improve TB care for migrant patients in Portugal.
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Affiliation(s)
- A M Tavares
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A C Garcia
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, I.P., Lisbon, Portugal
| | - A Gama
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A B Abecasis
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Viveiros
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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21
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Dias S, Figueiredo C, Coelho A, Hoffmeister L, Gama A. Implementation process of social prescribing to improve primary care patients’ health and well-being. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Social prescribing (SP) is an innovative approach to tackle social determinants of health. It enables general practitioners (GPs) to address non-medical causes of ill-health by linking primary care patients with non-medical community sources of support. Despite convincing results from punctual evaluations, comprehensive evaluation of SP is needed to provide guidance on what works and evidence on its impact.
A SP pilot-project started in 2018 in a primary care service in Lisbon. Its implementation process and outcomes are being evaluated through a longitudinal mixed-method evaluation study assessing patients’ wellbeing, quality of life, anxiety and depression in key stages of the intervention and stakeholders’ perspectives on facilitators/barriers to the intervention implementation.
GPs refer patients to a social worker of the service, who defines with the patient the individual intervention plan using community resources. Initially, GPs and social workers were trained on SP, a network of community partners was built, SP information was distributed to patients, a referral online platform was created and a baseline study is being conducted. In the 1st semester, 130 patients were referred: 39.2% were ≥65 years old, 70.8% were female, 45.4% had foreign nationality. Over two thirds were referred for multiple reasons mostly social isolation, immigration/social integration, mental health, sedentary lifestyle, access to social benefits and employment/skills training.
The project has enabling to support patients with multiple complex psychosocial needs. Regular meetings between GPs and partners have improving collaboration and patients’ supervision. The participatory approach and training emerged as facilitators of the intervention. Yet, the increased burden on social workers due to growing referral profile and some stakeholders’ scepticism toward SP need to be addressed. The triangulation of sources, methods and data provide evidence on the intervention impact and scalability.
Key messages
The social prescribing intervention has been effective in tackling multiple social determinants of health. Intervention evaluation is being key to identify facilitators and opportunities for scale up.
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Affiliation(s)
- S Dias
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Figueiredo
- Unidade de Saúde Familiar da Baixa, ACES Lisboa Central, Lisbon, Portugal
| | - A Coelho
- Unidade de Saúde Familiar da Baixa, ACES Lisboa Central, Lisbon, Portugal
| | - L Hoffmeister
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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Costa D, Cunha M, Ferreira C, Gama A, Rodrigues AMN, Rosado-Marques V, Nogueira H, Silva MRG, Padez C. The impact of the economic crisis on the mental health of Portuguese primary-school children. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
To measure the impact of the economic crisis on the mental health correlates of Portuguese children attending primary school during 2016.
Methods
Cross-sectional analysis of primary school-aged children and their parents (n = 1157), conducted in public and private schools of three Portuguese districts. Parent reports of children mental health symptoms (Strengths and Difficulties Questionnaire - SDQ) and children self-reports of health-related quality of life (KIDSCREEN-27) and depressive, anxiety and stress symptoms (Depression, Anxiety and Stress Scales, Children version - DASS-C), were compared according to a set of yes/no questions on how the economic crisis changed the normal aspects of routine life (e.g. During the financial crisis did you had to use savings? Started buying cheaper food?). Linear regression models were fitted for the SDQ, the KIDSCREEN-27 and the DASS-C as dependent variables adjusted for children sex, socioeconomic status and district of residence.
Results
Affirmative answers to the crisis impact questions were associated with more frequent psychosocial functioning problems in children, with poorer self-reported health-related quality of life and with more frequent symptoms of depression, anxiety and stress.
Conclusions
Portuguese children mental health correlates show significant worse scores for those whose parents declared having to change daily routine habits as a result of the recent macroeconomic financial crisis, compared to those who did not change habits. Public Health programs should be developed to mitigate the potential negative impact of the financial crisis to the mental health of children.
Key messages
A negative impact on children mental health was observed as a result of the economic crisis. Public health programs designed to mitigate the impact of the economic crisis should include primary-school aged children.
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Affiliation(s)
- D Costa
- University of Coimbra, Coimbra, Portugal
| | - M Cunha
- University of Coimbra, Coimbra, Portugal
| | - C Ferreira
- University of Coimbra, Coimbra, Portugal
| | - A Gama
- University of Coimbra, Coimbra, Portugal
- University of Lisbon, Lisbon, Portugal
| | - A M N Rodrigues
- University of Coimbra, Coimbra, Portugal
- Polytechnic Institute of Viseu, Viseu, Portugal
| | - V Rosado-Marques
- University of Coimbra, Coimbra, Portugal
- University of Lisbon, Lisbon, Portugal
| | - H Nogueira
- University of Coimbra, Coimbra, Portugal
| | - M R G Silva
- University of Coimbra, Coimbra, Portugal
- Fernando Pessoa University, Porto, Portugal
| | - C Padez
- University of Coimbra, Coimbra, Portugal
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23
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Machado-Rodrigues A, Mascarenhas L, Gama A, Mourão I, Nogueira H, Rosado-Marques V, Padez C. SUN-PO247: Childhood Obesity Risk and its Association with Eating Away-From-Home. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32879-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Machado-Rodrigues A, Mascarenhas L, Gama A, Mourão I, Nogueira H, Rosado V, Padez C. Can the parental perceptions of built environment influence children’s sleep habits? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz035.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Machado-Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
- High School of Education of Viseu, Polytechnic Institute of Viseu, Portugal
| | | | - A Gama
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - I Mourão
- Research Centre in Health and Human Development, University of Tras-os-Montes and Alto Douro, Portugal
| | - H Nogueira
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - V Rosado
- Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - C Padez
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
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25
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Rodrigues A, Mascarenhas L, Gama A, Mourão I, Nogueira H, Rosado V, Padez C. Waist-to-height ratio and its association with sedentary behaviour in a sample of Portuguese male children. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz035.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
- High School of Education of Viseu, Polytechnic Institute of Viseu, Portugal
| | | | - A Gama
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - I Mourão
- Research Centre in Health and Human Development, University of Tras-os-Montes and Alto Douro, Portugal
| | - H Nogueira
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - V Rosado
- Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - C Padez
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
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26
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Machado-Rodrigues AM, Fernandes RA, Silva MR, Gama A, Mourão I, Nogueira H, Rosado-Marques V, Padez C. Overweight Risk and Food Habits in Portuguese Pre-school Children. J Epidemiol Glob Health 2019; 8:106-109. [PMID: 30864750 PMCID: PMC7377571 DOI: 10.2991/j.jegh.2017.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 10/18/2017] [Indexed: 11/08/2022] Open
Abstract
The relationship between dietary intake and overweight-risk was assessed in 4349 children aged 3–5 years. Eating and sedentary behaviours were assessed by questionnaire. Logistic regressions were used. Children who consumed daily soft-drinks were 1.52 times more likely to be obese, and 72% more likely to be classified as overweight children.
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Affiliation(s)
- A M Machado-Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Portugal.,High School of Education, Polytechnic Institute of Viseu, Viseu, Portugal
| | - R A Fernandes
- Institute of Biosciences and Technology, São Paulo State University - UNESP, Brazil
| | | | - A Gama
- Research Centre for Anthropology and Health, University of Coimbra, Portugal.,Faculdade de Ciências, Universidade de Lisboa, Portugal
| | - I Mourão
- Research Centre in Health and Human Development, University of Tras-os-Montes and Alto Douro, Portugal
| | - H Nogueira
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - V Rosado-Marques
- Research Centre for Anthropology and Health, University of Coimbra, Portugal.,Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - C Padez
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
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Gonçalves A, Martins M, Pires M, Alves A, Schmitt F, Bastos E, Gama A. Epidermal growth factor receptor expression in primary and metastatic canine mammary carcinomas. J Comp Pathol 2019. [DOI: 10.1016/j.jcpa.2018.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dias S, Gama A, Roxo L, Simões J, Pita Barros P, Fronteira I. 7.5-O3Migrants' access to primary health care in Portugal: the impact of the financial crisis. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Dias
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - A Gama
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - L Roxo
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - J Simões
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - P Pita Barros
- School of Business and Economics, Universidade Nova de Lisboa, Portugal
| | - I Fronteira
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
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Dias S, Gama A, Abrantes P, Akpogheneta O, Reigado V, Ferreira A, Carreiras E, Mora C, Simões D, Martins M. 5.5-O3Examining sexual risk, HIV infection and health services use: a cluster analysis with sub-Saharan African migrants. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Dias
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - A Gama
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - P Abrantes
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - O Akpogheneta
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - V Reigado
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - A Ferreira
- Ser + - Associação Portuguesa para a Prevenção e Desafio à Sida, Cascais, Portugal
| | - E Carreiras
- AJPAS - Associação de Intervenção Comunitária, Desenvolvimento Social e de Saúde, Portugal
| | - C Mora
- AJPAS - Associação de Intervenção Comunitária, Desenvolvimento Social e de Saúde, Portugal
| | - D Simões
- GAT - Grupo de Ativistas em Tratamentos, Portugal
| | - M Martins
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
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Dias S, Loos J, Roxo L, Gama A, Simões D, Noestlinger C. 5.5-O2Understanding the links between mobility, risky sexual behaviors and HIV among sub-Saharan African migrants (SAMs): a study in two European cities. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Dias
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - J Loos
- Institute of Tropical Medicine, Department of Public Health, Antwerp, Belgium
| | - L Roxo
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - A Gama
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Portugal
| | - D Simões
- GAT - Grupo de Ativistas em Tratamentos, Portugal
| | - C Noestlinger
- Institute of Tropical Medicine, Department of Public Health, Antwerp, Belgium
- University of Vienna, Faculty of Psychology, Austria
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Machado-Rodrigues A, Fernandes R, Silva MR, Gama A, Mourão I, Nogueira H, Rosado-Marques V, Padez C. Overweight Risk and Food Habits in Portuguese Pre-school Children. J Epidemiol Glob Health 2018. [DOI: 10.1016/j.jegh.2017.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- A.M. Machado-Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
- High School of Education, Polytechnic Institute of Viseu, Viseu, Portugal
| | - R.A. Fernandes
- Institute of Biosciences and Technology, São Paulo State University – UNESP, Brazil
| | | | - A. Gama
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
- Faculdade de Ciências, Universidade de Lisboa, Portugal
| | - I. Mourão
- Research Centre in Health and Human Development, University of Tras-os-Montes and Alto Douro, Portugal
| | - H. Nogueira
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - V. Rosado-Marques
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
- Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - C. Padez
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
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Nascimento V, Silva A, Seixas F, Pinto M, Gama A, Lourenço L, Vieira A, Pires M. Evaluation of Antigenic Preservation in Histological Slides Stored at Different Temperatures. J Comp Pathol 2018. [DOI: 10.1016/j.jcpa.2017.10.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Faustino-Rocha A, Oliveira P, Gama A, Vala H, Esteves F, Ferreira R, Ginja M. Walking Against Cancer: The Impact of Long-term Exercise Training on Mammary Tumours. J Comp Pathol 2018. [DOI: 10.1016/j.jcpa.2017.10.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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van Ginkel R, Gama A, Machado N, Teixeira E, Pires M. Association Between the Number of Leishmania spp. and T-lymphocyte Infiltration in Cutaneous Granulomatous Lesions in Dogs. J Comp Pathol 2018. [DOI: 10.1016/j.jcpa.2017.10.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Marques O, Canadas A, Faria F, Oliveira E, Amorim I, Seixas F, Gama A, Lobo-da-Cunha A, Silva BMD, Porto G, Lopes C. Expression of iron-related proteins in feline and canine mammary gland reveals unexpected accumulation of iron. Biotech Histochem 2017; 92:584-594. [PMID: 29172705 DOI: 10.1080/10520295.2017.1369160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Dysregulation of cellular iron homeostasis in human breast cancer is reflected by the altered expression of regulatory proteins. The expressions of iron-related proteins in the mammary glands of cats and dogs have not been assessed. We evaluated the expressions of ferritin, ferroportin, hepcidin and transferrin receptor 1 in benign and malignant mammary gland lesions in cats and dogs. Iron deposition was detected using Perls' Prussian blue staining. We found no major differences in the expression of iron-related proteins between benign and malignant mammary gland lesions in either cats or dogs; however, these species exhibited accumulation of iron in benign lesions. Our findings provide an explanation for the absence of higher iron requirements by tumor cells in these animals. Further investigation of local iron homeostasis in cats and dogs and differences in their physiology compared to human breast cancer is required.
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Affiliation(s)
- O Marques
- a Unit for Multidisciplinary Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,c Basic and Clinical Research on Iron Biology, Molecular and Cell Biology Institute (IBMC) University of Porto , Porto.,d Institute for Research and Innovation in Health Sciences (i3S), University of Porto , Porto
| | - A Canadas
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - F Faria
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - E Oliveira
- a Unit for Multidisciplinary Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,e Laboratory of Cell Biology, Department of Microscopy , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - I Amorim
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,d Institute for Research and Innovation in Health Sciences (i3S), University of Porto , Porto.,f Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), University of Porto , Porto
| | - F Seixas
- g Centre of Animal and Veterinary Sciences, University of Trás-os-Montes e Alto Douro (CECAV-UTAD) , Vila Real
| | - A Gama
- g Centre of Animal and Veterinary Sciences, University of Trás-os-Montes e Alto Douro (CECAV-UTAD) , Vila Real
| | - A Lobo-da-Cunha
- a Unit for Multidisciplinary Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,e Laboratory of Cell Biology, Department of Microscopy , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - B Martins da Silva
- a Unit for Multidisciplinary Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - G Porto
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,c Basic and Clinical Research on Iron Biology, Molecular and Cell Biology Institute (IBMC) University of Porto , Porto.,d Institute for Research and Innovation in Health Sciences (i3S), University of Porto , Porto.,e Laboratory of Cell Biology, Department of Microscopy , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,f Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), University of Porto , Porto.,g Centre of Animal and Veterinary Sciences, University of Trás-os-Montes e Alto Douro (CECAV-UTAD) , Vila Real.,h Hematology Service, Santo António Hospital, Porto Hospital Centre
| | - C Lopes
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,i Department of Pathology , Portuguese Oncology Institute (IPO) , Porto , Portugal
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Gama A, Carrillo-Casas EM, Hernández-Castro R, Vázquez-Aceituno VA, Toussaint-Caire S, Xicohtencatl-Cortes J, Fernández-Martínez R, Moreno-Coutiño G. Treponema pallidum ssp. pallidum identification by real-time PCR targetting the polA gene in paraffin-embedded samples positive by immunohistochemistry. Int J STD AIDS 2017; 28:1299-1304. [DOI: 10.1177/0956462417704123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Syphilis is a systemic and sexually transmitted infection caused by Treponema pallidum ssp. pallidum. This spirochete causes different clinical and subclinical stages depending on the duration of infection and immune status of the host. Several tests have been developed for diagnosis, and are classified into direct and indirect methods. The first one includes dark field microscopy, direct fluorescent antibody test in fluids or tissue, and molecular biology techniques. In the indirect method (serologic), the routine tests are used, and are divided in two categories: non-treponemal and treponemal ones. The objective of this work was to identify T. pallidum ssp. pallidum in paraffin-embedded skin biopsies positive by immunohistochemistry, using conventional polymerase chain reaction (PCR) and quantitative real time PCR (qPCR). We included a sample of 17 paraffin-embedded biopsies. DNA was extracted and processed by conventional PCR and real-time PCR with a TaqMan® probe to identify the polA gene. Using PCR, 11 tested positive (64.7%) and 6 (35.3%) were negative. With qPCR and TaqMan® probe, 100% of samples tested positive. The minimum number of spirochetes detected in each sample was 2. With this work, we can conclude that qPCR is a fast and very accurate method for diagnosis of syphilis in tissue specimens.
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Affiliation(s)
- A Gama
- Dermatology Service, General Hospital Dr. Manuel Gea González, Tlalpan, Mexico
| | - EM Carrillo-Casas
- Department of Biology and Histocompatibility, General Hospital Dr. Manuel Gea González, Tlalpan, Mexico
| | - R Hernández-Castro
- Department of Ecology of Pathogen Agents, General Hospital Dr. Manuel Gea González, Tlalpan, Mexico
| | - VA Vázquez-Aceituno
- Department of Ecology of Pathogen Agents, General Hospital Dr. Manuel Gea González, Tlalpan, Mexico
| | - S Toussaint-Caire
- Dermatology Service, General Hospital Dr. Manuel Gea González, Tlalpan, Mexico
| | - J Xicohtencatl-Cortes
- Intestinal Bacteriology Laboratory, Childrens Hospital of Mexico Dr. Federico Gómez, Mexico
| | | | - G Moreno-Coutiño
- Mycology Service, General Hospital Dr. Manuel Gea González, Tlalpan, Mexico
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Padrão AI, Figueira ACC, Faustino-Rocha AI, Gama A, Loureiro MM, Neuparth MJ, Moreira-Gonçalves D, Vitorino R, Amado F, Santos LL, Oliveira PA, Duarte JA, Ferreira R. Long-term exercise training prevents mammary tumorigenesis-induced muscle wasting in rats through the regulation of TWEAK signalling. Acta Physiol (Oxf) 2017; 219:803-813. [PMID: 27228549 DOI: 10.1111/apha.12721] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 01/27/2016] [Accepted: 05/24/2016] [Indexed: 12/27/2022]
Abstract
AIM Exercise training has been suggested as a non-pharmacological approach to prevent skeletal muscle wasting and improve muscle function in cancer cachexia. However, little is known about the molecular mechanisms underlying such beneficial effect. In this study, we aimed to, firstly, examine the contribution of TWEAK signalling to cancer-induced skeletal muscle wasting and, secondly, evaluate whether long-term exercise alters TWEAK signalling and prevents muscle wasting. METHODS Female Sprague-Dawley rats were randomly assigned to control and exercise groups. Fifteen animals from each group were exposed to N-Methyl-N-nitrosourea carcinogen. Animals in exercise groups were submitted to moderate treadmill exercise for 35 weeks. After the experimental period, animals were killed and gastrocnemius muscles were harvested for morphological and biochemical analysis. RESULTS We verified that exercise training prevented tumour-induced TWEAK/NF-κB signalling in skeletal muscle with a beneficial impact in fibre cross-sectional area and metabolism. Indeed, 35 weeks of exercise training promoted the upregulation of PGC-1α and oxidative phosphorylation complexes. This exercise-induced muscle remodelling in tumour-bearing animals was associated with less malignant mammary lesions. CONCLUSION Data support the benefits of an active lifestyle for the prevention of muscle wasting secondary to breast cancer, highlighting TWEAK/NF- κB signalling as a potential therapeutic target for the preservation of muscle mass.
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Affiliation(s)
- A. I. Padrão
- QOPNA; Department of Chemistry; University of Aveiro; Aveiro Portugal
- CIAFEL; Faculty of Sport; University of Porto; Porto Portugal
| | | | - A. I. Faustino-Rocha
- CITAB; Department of Veterinary Sciences; University of Trás-os-Montes e Alto Douro; Vila Real Portugal
| | - A. Gama
- CITAB; Department of Veterinary Sciences; University of Trás-os-Montes e Alto Douro; Vila Real Portugal
| | - M. M. Loureiro
- QOPNA; Department of Chemistry; University of Aveiro; Aveiro Portugal
| | - M. J. Neuparth
- CIAFEL; Faculty of Sport; University of Porto; Porto Portugal
| | - D. Moreira-Gonçalves
- CIAFEL; Faculty of Sport; University of Porto; Porto Portugal
- Department of Physiology and Cardiothoracic Surgery; Faculty of Medicine; University of Porto; Porto Portugal
| | - R. Vitorino
- QOPNA; Department of Chemistry; University of Aveiro; Aveiro Portugal
- Department of Medical Sciences and Institute for Biomedicine - iBiMED; University of Aveiro; Aveiro Portugal
| | - F. Amado
- QOPNA; Department of Chemistry; University of Aveiro; Aveiro Portugal
| | - L. L. Santos
- Experimental Pathology and Therapeutics Group; Portuguese Institute of Oncology; Porto Portugal
| | - P. A. Oliveira
- CITAB; Department of Veterinary Sciences; University of Trás-os-Montes e Alto Douro; Vila Real Portugal
| | - J. A. Duarte
- CIAFEL; Faculty of Sport; University of Porto; Porto Portugal
| | - R. Ferreira
- QOPNA; Department of Chemistry; University of Aveiro; Aveiro Portugal
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Pina J, Gama A, Pires M, Seixas F. Immunohistochemical Expression of TGF-β1 in Feline and Canine Mammary Lesions. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Faustino-Rocha A, Gama A, Oliveira P, Ferreira R, Ginja M. Mast Cells as Targets in Mammary Carcinogenesis. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Alonso A, Ramos A, Roccabianca P, Pérez-Alenza M, Tecilla M, Avallone G, Garrido M, Gama A, Peña L. Canine Spindle Cell Mammary Tumours: Diagnosis, Grading and Clinical Behaviour. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Faustino-Rocha A, Silva A, Gabriel J, Gil da Costa R, Oliveira P, Gama A, Ferreira R, Ginja M. Long-Term Exercise Training and Mammary Tumour Vascularization: Thermography, Ultrasonography and Immunohistochemistry. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nogueira H, Gama A, Machado-Rodrigues A, Mourão I, Rosado Marques V, Padez C. Deprivation, sport facilities, physical activity: the obesogenic environment of Portuguese children. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Machado-Rodrigues A, Gama A, Nogueira H, Mourâo I, Rosado V, Padez C. SUN-P209: Overweight Risk, Physical Activity and Nutritional Habits in Female Pre-School Children. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30552-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Li L, Peters H, Gama A, Carvalhal MIM, Nogueira HGM, Rosado‐Marques V, Padez C. Maternal smoking in pregnancy association with childhood adiposity and blood pressure. Pediatr Obes 2016; 11:202-9. [PMID: 26178147 PMCID: PMC4949567 DOI: 10.1111/ijpo.12046] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 03/04/2015] [Accepted: 05/01/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maternal smoking during pregnancy has been associated with increased risk of childhood overweight/obesity defined by body mass index (BMI). We examined its association with a range of adiposity measures and cardiovascular indicators in children aged 3-10 years. METHODS We used data from a cross-sectional study of schoolchildren across mainland Portuguese districts (2009-2010). We applied quantile regressions to examine maternal smoking associations with adiposity (n = 17 286), blood pressure (BP) and resting pulse rate (RPR) (n ≈ 2500) measures across the age range, adjusting for prenatal and early life factors. RESULTS Maternal smoking during pregnancy was associated with increases in offspring adiposity levels. The difference in median BMI between children of smokers and non-smokers was 0.39 kg m(-2) (95% confidence interval: 0.25, 0.53) in boys and 0.46 kg m(-2) (0.31, 0.62) in girls; 0.55 cm (0.24, 0.87) and 0.82 cm (0.45, 1.19), respectively, in median waist circumference; and 0.94 mm (0.49, 1.40) and 1.47 mm (0.87, 2.07) in median sum of (triceps, subscapular, suprailiac) skin-folds. The associations appeared to be stronger with increasing age. The differences in the 90th centile tended to be greater than those in median. There was no consistent association of maternal smoking with BP and RPR. CONCLUSIONS Children whose mother smoked during pregnancy had higher adiposity levels than children of non-smokers, across several measures, particularly among older children. Although there was no consistent association with cardiovascular indicators, maternal smoking association with childhood obesity may have implications for cardiovascular risk factors over the life course.
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Affiliation(s)
- L. Li
- Population, Policy, and Practice ProgrammeInstitute of Child HealthUniversity College LondonLondonUK
| | - H. Peters
- Population, Policy, and Practice ProgrammeInstitute of Child HealthUniversity College LondonLondonUK
| | - A. Gama
- Departamento de Biologia AnimalFaculdade de CiênciasUniversity of LisbonLisbonPortugal,Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal
| | | | - H. G. M. Nogueira
- Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal,Department of GeographyUniversity of CoimbraCoimbraPortugal
| | - V. Rosado‐Marques
- Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal,Tropical Research Institute of LisbonLisbonPortugal
| | - C. Padez
- Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal
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Faustino-Rocha AI, Silva A, Gabriel J, Gil da Costa RM, Moutinho M, Oliveira PA, Gama A, Ferreira R, Ginja M. Long-term exercise training as a modulator of mammary cancer vascularization. Biomed Pharmacother 2016; 81:273-280. [PMID: 27261604 DOI: 10.1016/j.biopha.2016.04.030] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/12/2016] [Accepted: 04/12/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Breast cancer remains a leading cause of death by cancer worldwide. It is commonly accepted that angiogenesis and the expression of angiogenic factors such as vascular endothelial growth factor-A (VEGF-A) is associated with the increased risk of metastasis and poor patient outcome. OBJECTIVE This work aimed to evaluate the effects of long-term exercise training on the growth and vascularization of mammary tumors in a rat model. MATERIALS AND METHODS Fifty female Sprague-Dawley rats were divided into four groups: two N-methyl-N-nitrosourea (MNU)-exposed groups (exercised and sedentary) and two control groups (exercised and sedentary). MNU was administered once, intraperitoneally at 7 weeks-old. Animals were then exercised on a treadmill for 35 weeks. Mammary tumors were evaluated using thermography, ultrasonography [Power Doppler (PDI), B Flow and contrast-enhanced ultrasound (CEUS)], and immunohistochemistry (VEGF-A). RESULTS Both, MNU sedentary and exercised groups showed 100% of tumor incidence, but exercised animals showed less tumors with an increased latency period. Exercise training also enhanced VEGF-A immunoexpression and vascularization (microvessel density, MVD) (p<0.05), and reduced histological aggressiveness. Ultrasound and thermal imaging analysis confirmed the enhanced vascularization of tumors on exercised animals. CONCLUSION Long-term exercise training increased VEGF-A expression, leading to enhanced tumor vascularization and reduced tumor burden, multiplicity and histological aggressiveness.
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Affiliation(s)
- A I Faustino-Rocha
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal; Center for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), UTAD, Vila Real, Portugal; Animal and Veterinary Research Center (CECAV), UTAD, Vila Real, Portugal; Organic Chemistry, Natural Products and Foodstuffs (QOPNA), Mass Spectrometry Center, Department of Chemistry, University of Aveiro, Aveiro, Portugal.
| | - A Silva
- Institute of Science and Innovation in Mechanical and Industrial Engineering (INEGI), Faculty of Engineering (FEUP), University of Porto, Porto, Portugal
| | - J Gabriel
- Institute of Science and Innovation in Mechanical and Industrial Engineering (INEGI), Faculty of Engineering (FEUP), University of Porto, Porto, Portugal
| | - R M Gil da Costa
- Laboratory for Process Environment Biotechnology and Energy Engineering (LEPABE), FEUP, University of Porto, Porto, Portugal; Molecular Oncology and Viral Pathology Group, CI-IPOP, Portuguese Institute of Oncology, Porto, Portugal
| | - M Moutinho
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - P A Oliveira
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal; Center for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), UTAD, Vila Real, Portugal
| | - A Gama
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal; Animal and Veterinary Research Center (CECAV), UTAD, Vila Real, Portugal
| | - R Ferreira
- Organic Chemistry, Natural Products and Foodstuffs (QOPNA), Mass Spectrometry Center, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - M Ginja
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal; Center for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), UTAD, Vila Real, Portugal
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Alonso A, Ramos A, Roccabianca P, Pérez-Alenza M, Tecilla M, Avallone G, Gama A, Peña L. Canine Spindle Cell Mammary Tumours: A Multicentre Study. J Comp Pathol 2016. [DOI: 10.1016/j.jcpa.2015.10.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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47
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Silva J, Nascimento JL, Santos MB, Gama A, Queiroz MA, Yano-Melo A. Biofertilizante caprino no desenvolvimento de Urochloa ruziziensis. ARCH ZOOTEC 2015. [DOI: 10.21071/az.v64i248.416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Plantas de Urochloa ruziziensis constituem recurso forrageiro devido a sua produção de biomassa aérea e composição químico-bromatológica. Incrementos nesses atributos podem ser obtidos por meio da melhoria da fertilidade do solo e nutrição vegetal. Nesse sentido, os biofertilizantes constituem uma fonte de adubo orgânico com potencialidade para aplicação na produção de plantas forrageiras, possibilitando melhorias no seu desenvolvimento morfogênico, produtividade e composição químico-bromatológica. Dessa forma, objetivou-se avaliar o efeito da aplicação de biofertilizante oriundo de dejetos caprinos nas características estruturais e morfogênicas, produção inicial de biomassa aérea e composição químico-bromatológica das plantas de Urochloa ruziziensis. Realizou-se experimento em delineamento inteiramente casualizado, com tratamentos consistentes de cinco doses do biofertilizante caprino (0, 3, 5, 7 e 9 %) em seis repetições. De modo geral, a aplicação do biofertilizante a partir da dose de 5 % proporcionou maior acúmulo de biomassa seca da parte aérea atrelado à melhoria nos teores de matéria seca, orgânica, fibra em detergente neutro e ácido. Por outro lado, efeito contrário foi constatado para a matéria mineral e hemicelulose. Para os parâmetros de crescimento das plantas, o biofertilizante estudado promoveu aumento (p
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Gama A, Larbes C, Malek A, Yettou F. Study and Realization of Device of Solar Sensitive Tracking for a Prototype of Cylindro-Parabolic Concentrator. J Fundam and Appl Sci 2015. [DOI: 10.4314/jfas.v2i1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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49
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Faustino-Rocha AI, Rodrigues D, Ferreira R, Colaço B, Gomes PS, Pires MJ, Gama A, Oliveira PA. The effects of intense pulsed light in a mouse model of skin carcinogenesis. Br J Dermatol 2015; 174:216-8. [PMID: 26147791 DOI: 10.1111/bjd.14010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A I Faustino-Rocha
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal.,Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal
| | - D Rodrigues
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal
| | - R Ferreira
- Organic Chemistry of Natural Products and Agrifood (QOPNA), Mass Spectrometry Centre, Department of Chemistry, University of Aveiro, 3810-193, Aveiro, Portugal
| | - B Colaço
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal.,Department of Zootechnics, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal
| | - P S Gomes
- Laboratory of Pharmacology and Cellular Biocompatibility, Faculty of Dental Medicine, University of Porto, UP, 4200-393, Porto, Portugal
| | - M J Pires
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal.,Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal
| | - A Gama
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal.,Animal and Veterinary Research Centre (CECAV), School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal
| | - P A Oliveira
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal.,Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, UTAD, 5001-911, Vila Real, Portugal
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Mata D, Amaral M, Fernandes AJS, Colaço B, Gama A, Paiva MC, Gomes PS, Silva RF, Fernandes MH. Diels-Alder functionalized carbon nanotubes for bone tissue engineering: in vitro/in vivo biocompatibility and biodegradability. Nanoscale 2015; 7:9238-9251. [PMID: 25928241 DOI: 10.1039/c5nr01829c] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The risk-benefit balance for carbon nanotubes (CNTs) dictates their clinical fate. To take a step forward at this crossroad it is compulsory to modulate the CNT in vivo biocompatibility and biodegradability via e.g. chemical functionalization. CNT membranes were functionalised combining a Diels-Alder cycloaddition reaction to generate cyclohexene (-C6H10) followed by a mild oxidisation to yield carboxylic acid groups (-COOH). In vitro proliferation and osteogenic differentiation of human osteoblastic cells were maximized on functionalized CNT membranes (p,f-CNTs). The in vivo subcutaneously implanted materials showed a higher biological reactivity, thus inducing a slighter intense inflammatory response compared to non-functionalized CNT membranes (p-CNTs), but still showing a reduced cytotoxicity profile. Moreover, the in vivo biodegradation of CNTs was superior for p,f-CNT membranes, likely mediated by the oxidation-induced myeloperoxidase (MPO) in neutrophil and macrophage inflammatory milieus. This proves the biodegradability faculty of functionalized CNTs, which potentially avoids long-term tissue accumulation and triggering of acute toxicity. On the whole, the proposed Diels-Alder functionalization accounts for the improved CNT biological response in terms of the biocompatibility and biodegradability profiles. Therefore, CNTs can be considered for use in bone tissue engineering without notable toxicological threats.
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Affiliation(s)
- D Mata
- CICECO, Materials and Ceramic Eng. Dept., Univ. of Aveiro, 3810-193 Aveiro, Portugal.
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