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Nunes AR. Resilience: conceptualisations and challenges for effective heatwave public health planning. Public Health 2024; 230:113-121. [PMID: 38531233 DOI: 10.1016/j.puhe.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/02/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVES This article examines diverse perspectives on heatwave resilience in public health planning, interviewing stakeholders from various sectors. It identifies challenges, including operational, political, economic, and cultural aspects, hindering effective strategies. The study advocates for a holistic approach to heatwave resilience, emphasising interdisciplinary research and collaboration for targeted interventions. Enhancing resilience is crucial to mitigating adverse health impacts and safeguarding vulnerable populations during heatwaves. Conceptualisations of resilience related to heatwave public health planning and heatwave resilience vary significantly. There is a need to unveil the multifaceted nature of resilience in the context of heatwaves and identify key challenges that hinder effective public health planning efforts. STUDY DESIGN Qualitative study to explore key stakeholders' conceptualisations of resilience and highlight challenges and opportunities needed for greater heatwave resilience and public health planning. METHODS Interviews were conducted with a diverse group of key stakeholders involved in local, regional, and national heatwave planning, academics, civil sector and private sector representatives. RESULTS The findings of this study highlight diverse conceptualisations of resilience. Conceptualisations of resilience mainly differ on the following: 'whom'; 'what'; 'how'; 'when'; and 'why'. This analysis shows that the concept of resilience is well understood but has different functions. The analysis of challenges revealed several key problems, such as operational and technical; political and governance; organisational and institutional; economic; linguistic; cultural, social, and behavioural; and communication, information, and awareness. These significantly hinder effective heatwave public health planning strategies. CONCLUSIONS The study emphasises the need for a holistic and integrated approach to heatwave resilience. Addressing these challenges is crucial for enhancing heatwave public health planning. This study provides valuable insights into the complexities of heatwave resilience, offering guidance for different sectors of society to develop targeted interventions and strategies. The development of new resilience interdisciplinary and intersectoral research, practice, and governance will prove crucial to ongoing efforts to strengthen national heatwave resilience public health planning. By fostering resilience, societies can mitigate the adverse impacts of heatwaves and safeguard the health and well-being of vulnerable populations.
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Affiliation(s)
- Ana Raquel Nunes
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom.
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Flores-Félix JD, Gonçalves AC, Meirinho S, Nunes AR, Alves G, Garcia-Viguera C, Moreno DA, Silva LR. Differential response of blueberry to the application of bacterial inoculants to improve yield, organoleptic qualities and concentration of bioactive compounds. Microbiol Res 2024; 278:127544. [PMID: 37988818 DOI: 10.1016/j.micres.2023.127544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/23/2023]
Abstract
The application of bacterial biofortifiers is an increasingly common technique. In recent years, some strains have been shown to improve the nutraceutical qualities of crops. This work analyses the impact of biofortification with 3 bacterial strains of the genera Rhizobium, Paenibacillus and Lactiplantibacillus on the nutritional characteristics and organic composition of blueberry in Portugal. Paenibacillus sp. VMFR46 treatment showed increase of 71.36 % and 79.88 % in total production. Biofortified treatments were able to increase Brix degree, maturity index (up to 48.05 % for cv. Legacy and up to 26.04 % for cv. Duke) and CIEL*a*b* index respect to uninoculated control. In this way, (poly)phenolic compounds concentration increased in biofortified treatment, and their (poly)phenolic profile was modified, some compounds such as myricetin aglycone or myricetin derivative are exclusive of the fruits from biofortified plants, with increases in (poly)phenolic concentrations related with R. laguerreae PEPV16 or Paenibacillus sp. VMFR46 inoculation in cv. Legacy. These modifications resulted in the improvement of the nutraceutical characteristics of the fruits obtained.
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Affiliation(s)
- José David Flores-Félix
- Microbiology and Genetics Department, University of Salamanca, 37007 Salamanca, Spain; CICS-UBI - Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal.
| | - Ana Carolina Gonçalves
- CICS-UBI - Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal; CIBIT - Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
| | - Sara Meirinho
- CICS-UBI - Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal
| | - Ana Raquel Nunes
- CICS-UBI - Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal; CNC - Centre for Neuroscience and Cell Biology, University of Coimbra, Faculty of Medicine, 3004-504 Coimbra, Portugal
| | - Gilberto Alves
- CICS-UBI - Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal
| | - Cristina Garcia-Viguera
- Laboratorio de Fitoquímica y Alimentos Saludables (LabFAS), CEBAS, CSIC, Campus Universitario de Espinardo -25, 30100 Murcia, Spain
| | - Diego A Moreno
- Laboratorio de Fitoquímica y Alimentos Saludables (LabFAS), CEBAS, CSIC, Campus Universitario de Espinardo -25, 30100 Murcia, Spain
| | - Luís R Silva
- CICS-UBI - Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal; CPIRN-UDI/IPG - Centro de Potencial e Inovação em Recursos Naturais, Unidade de Investigação para o Desenvolvimento do Interior do Instituto Politécnico da Guarda, Guarda, Portugal; University of Coimbra, CIEPQPF, Department of Chemical Engineering, Rua, Sílvio Lima, Pólo II - Pinhal de Marrocos, 3030-790 Coimbra, Portugal
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Koehler IB, Galli MP, Geraldo A, Oliveira SW, Nunes AR, Melo RRF, Arceno KH, Bueno EC, Chagas LA. AVALIAÇÃO DAS SUGESTÕES E RECLAMAÇÕES ATRIBUÍDAS A EFICIÊNCIA DO ELENCO DE DOIS HEMOCENTROS DE SANTA CATARINA SOB A PERSPECTIVA DO DOADOR DE SANGUE UTILIZANDO A MATRIZ DE INTEGRAÇÃO DO INSTITUTO DISNEY. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.629] [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] Open
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Nunes AR. General and specified vulnerability to extreme temperatures among older adults. Int J Environ Health Res 2020; 30:515-532. [PMID: 31081378 DOI: 10.1080/09603123.2019.1609655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 04/01/2019] [Indexed: 06/09/2023]
Abstract
Extreme temperatures pose significant risks to human health and well-being. Older adults are particularly at risk and their susceptibility is a function of vulnerability to general daily life circumstances and to specified events or threats. For the first time, this paper develops a combined general and specified approach to understand the determinants of vulnerability. The findings show that most participants exhibit high levels of heat-related vulnerability, followed by cold-related vulnerability and lastly, general vulnerability. General vulnerability was shown to be primarily shaped by financial, physical and social assets. Whilst, specified vulnerability was found to be mainly shaped by human, physical and placed based assets. Such findings present opportunities to focus on the types of assets that contribute to reducing vulnerability. These findings also suggest that the role assets play in shaping vulnerability must be attended to if we are to fully understand and effectively implement strategies to reduce vulnerability.
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Nunes AR. Misdiagnosing vulnerability to heatwaves in the media. Lancet Planet Health 2019; 3:e293. [PMID: 31326069 DOI: 10.1016/s2542-5196(19)30107-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Ana Raquel Nunes
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
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Abstract
Background Climate change and extreme temperatures pose increasing challenges to individuals and their health with older adults being one of the most vulnerable groups. The aim of this paper is to better understand the roles that tangible assets (e.g., physical or financial) and intangible assets (e.g., human or social) play in the way older adults adapt to extreme temperatures, the types of adaptive responses they implement, limits and constraints, as well opportunities for better adaptation. Rather than focusing exclusively on extremes of heat, or considering each type of asset in isolation, the important and novel contribution of this paper is to take an integrated and multi-seasonal qualitative and quantitative approach, that conjointly investigates all categories of assets in relation to the adaptations that independently-living older adults make to both extreme heat and extreme cold. Methods and findings The paper examines the contribution of assets to adaptation to extreme temperatures among older adults living independently in their homes. An innovative mixed methods study with an inter-seasonal approach was implemented in Lisbon, Portugal with interviews and surveys during summer for extreme heat and winter for extreme cold. The ability of participants to adapt to extreme temperatures was found to be dependent on asset context and diversity, and the dynamics through which extreme temperatures enhanced or reduced the stock of assets available. As a result, participants engaged in activities of assets replacement, exchange or substitutions. Despite this, many participants recognised many constraints and limits to their ability to adapt and protect their health and well-being ranging from reduced income, high energy costs and lack of social networks. Opportunities for improving older adults’ adaptation were found to exist and strategies, action and investment have been identified by older adults which included life-long education, incentives to improve insulation and local activities. Conclusions The paper suggests that the implementation of the proposed asset-based approach linking assets and adaptation to extreme temperatures, illustrates the key pathway that individuals, their families and carers, governments, policymakers, researchers and practitioners can follow to ensure effective adaptation and promote health and well-being. Supporting older adults’ adaptation to extreme temperatures is possible and can be complemented with efforts to reduce older adults’ vulnerability and building resilience to extreme temperatures. These findings pose concrete implications for policy and practice, including for example the need for implementation of measures and actions to reduce poverty, reduce energy costs, improve the quality of the housing stock and improve older adults’ social networks.
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Affiliation(s)
- Ana Raquel Nunes
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- * E-mail:
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Nunes AR. Bioethical Insights into Values and Policy – Climate Change and HealthCheryl C.MacPherson,
Editor
Springer International Publishing, Switzerland, 2016, vii + 220 pp. £58.99 (eBook), £80 (hardback) ISBN 978‐3‐319‐26165‐2. Dev World Bioeth 2018. [DOI: 10.1111/dewb.12193] [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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Nunes AR, Lee K, O'Riordan T. The importance of an integrating framework for achieving the Sustainable Development Goals: the example of health and well-being. BMJ Glob Health 2017. [PMID: 28588955 DOI: 10.1136/bmjgh-2016-000068.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The 2030 Agenda for Sustainable Development came into force in January 2016 as the central United Nations (UN) platform for achieving 'integrated and indivisible' goals and targets across the three characteristic dimensions of sustainable development: the social, environmental and economic. We argue that, despite the UN adoption of the Sustainable Development Goals (SDGs), a framework for operationalising them in an integrated fashion is lacking. This article puts forth a framework for integrating health and well-being across the SDGs as both preconditions and outcomes of sustainable development. We present a rationale for this approach, and identify the challenges and opportunities for implementing and monitoring such a framework through a series of examples. We encourage other sectors to develop similar integrating frameworks for supporting a more coordinated approach for operationalising the 2030 Agenda for Sustainable Development.
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Affiliation(s)
| | - Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Tim O'Riordan
- School of Environmental Sciences, University of East Anglia, Norwich, UK
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Nunes AR, Lee K, O'Riordan T. The importance of an integrating framework for achieving the Sustainable Development Goals: the example of health and well-being. BMJ Glob Health 2016; 1:e000068. [PMID: 28588955 PMCID: PMC5321355 DOI: 10.1136/bmjgh-2016-000068] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 09/01/2016] [Accepted: 09/02/2016] [Indexed: 11/03/2022] Open
Abstract
The 2030 Agenda for Sustainable Development came into force in January 2016 as the central United Nations (UN) platform for achieving 'integrated and indivisible' goals and targets across the three characteristic dimensions of sustainable development: the social, environmental and economic. We argue that, despite the UN adoption of the Sustainable Development Goals (SDGs), a framework for operationalising them in an integrated fashion is lacking. This article puts forth a framework for integrating health and well-being across the SDGs as both preconditions and outcomes of sustainable development. We present a rationale for this approach, and identify the challenges and opportunities for implementing and monitoring such a framework through a series of examples. We encourage other sectors to develop similar integrating frameworks for supporting a more coordinated approach for operationalising the 2030 Agenda for Sustainable Development.
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Affiliation(s)
| | - Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Tim O'Riordan
- School of Environmental Sciences, University of East Anglia, Norwich, UK
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Nunes AR. OP21 Developing a new Mixed Methods Individual Resilience Measure (MMIRM) to environmental and health risks. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.21] [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: 11/04/2022]
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Nunes AR, Lorenzoni I, Lake I, Few R. PP71 The role of assets on the vulnerability, resilience and adaptation of older adults to extreme temperatures: evidence from a mixed method study. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.167] [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: 11/04/2022]
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Nunes AR, Lorenzoni I, Lake I, Few R. PP26 Growing old: the impact of health inequalities on the vulnerability, resilience and adaptation of older adults to extreme temperatures. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.123] [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: 11/03/2022]
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Nunes AR, Monteiro EC, Johnson SM, Gauda EB. Bicarbonate-regulated soluble adenylyl cyclase (sAC) mRNA expression and activity in peripheral chemoreceptors. Adv Exp Med Biol 2009; 648:235-41. [PMID: 19536486 DOI: 10.1007/978-90-481-2259-2_27] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
UNLABELLED Peripheral arterial chemoreceptors in the carotid body (CB) are modulated by pH/CO(2). Soluble adenylyl cyclase (sAC) is directly stimulated by bicarbonate ions (HCO(3)). Because CO(2)/HCO(3) mediates depolarization in chemoreceptors, we hypothesized that sAC mRNA would be expressed in the CB, and its expression and function would be regulated by CO(2)/HCO(3).Sprague-Dawley rats at postnatal days 16-17 were used to compare sAC mRNA gene expression between CB and non-chemosensitive tissues: superior cervical (SCG), petrosal (PG) and nodose ganglia (NG) by quantitative real time-PCR. Rat sAC gene expression was standardized to the expression of GAPDH (housekeeping gene) and the data were analyzed with the Pfaffl method. Gene and protein expression, and sAC regulation in the testis was used as a positive control. To determine the regulation of sAC mRNA expression and activity, all tissues were exposed to increasing concentrations of bicarbonate (0, 24, 44 mM, titrated with CO(2) and maintained a constant pH of 7.40). RESULTS sAC mRNA expression was between 2-11% of CB expression in the SCG, PG and NG. Furthermore, only in the CB did HCO(3) upregulate sAC gene expression and increase cAMP levels. CONCLUSION sAC mRNA and protein expression is present in peripheral arterial chemoreceptors and non-chemoreceptors. In the CB, CO(2)/HCO(3) not only activated sAC but also regulated its expression, suggesting that sAC may be involved in the regulation of cAMP levels in response to hyper/hypocapnia.
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Soares M, Morais MF, Soares I, Pinheiro N, Nunes AR, Aguiar P, Abecasis P. [Anticardiolipin antibodies in patients with cerebral vascular accident]. Rev Port Cardiol 1998; 17:525-30. [PMID: 9677830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Through a prospective controlled study of 81 non-selected patients with acute cerebral ischemia, admitted to the hospital over the period of one year, anticardiolipin antibodies (IgG and IgM) were compared to a control group with the objective of evaluating their place as independent risk factors for stroke. Stroke patients' anticardiolipin antibodies (ACA) were again measured at 6 months and compared to the initial values. At the time of the acute ischemic event, the patients' mean ACA IgM was significantly higher than that of the controls and, at 6 months, the patients' mean ACA IgG and IgM were significantly lower than at the time of stroke. Furthermore, through logistic regression analysis and taking into account all other stroke risk factors present in the patient population, ACA IgM's association with stroke was statistically significant. We conclude that ACA may have a role in the pathogenesis of acute cerebral ischemia. Their cross-reactivity with anti-oxidised LDL antibodies may constitute a link between atherosclerosis and thrombosis.
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Affiliation(s)
- M Soares
- Serviço de Medicina II, Hospital de Egas Moniz, Lisboa
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