Menstrual health: a health and human rights issue

COPYRIGHT © 2023 Alarcão and Pintassilgo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Menstruation is a natural part of life, but for some people who menstruate it can be a reason for exclusion. Factors that contribute to exclusion include age, gender, poverty level, health conditions, and other societal factors. Menstrual health is a general state of wellbeing during the menstrual cycle, and it is important because everyone has the right to live their experiences with dignity and feel healthy. In this article, we discuss menstrual health, describe how certain groups face situations that can negatively impact their menstrual health, and explain why menstrual health should be a basic human right. We also discuss the links between menstruation and the environment and the roles that schools and everyone in society can play in contributing to menstrual justice, that is, participating in the debate surrounding menstrual health issues, and promoting healthy, inclusive, accessible, and sustainable menstrual management contexts.info:eu-repo/semantics/publishedVersio

Sexual dysfunctions and sexology: social constructions, personal meanings and medicalization of sexuality

In contemporary constructions of sexuality, the discourses and practices of medicine and clinical psychology occupy a primary role. They contribute to the origin of new normative approaches to sexuality, focused on the issue of good sexual functioning. However, despite the growing attention that sexuality is receiving, the study of the social construction of sexual dysfunction remains incipient, especially in a national context. Overall, the results of this thesis, which integrates two studies with mixed methodologies, are presented in the form of four scientific publications. The first article aims to contribute to the discussion of how beliefs regarding sexuality and gender affect the categorization of sexual function as either natural or pathological. The second article provides a view of the dynamics of changing sexual behavior, showing a “model of human sexuality” consisting of four types: rigid conservative, attenuated traditional, adaptive progressive, and confluent transformative. The third article seeks to explore how the growing plurality of sexual scripts affects gender order through the meanings created from personal experiences in everyday life, focusing on representations of sexual problems. Finally, the fourth article analyzes how Portuguese sexologists integrate their professional role in the vast multidisciplinary field of sexual health, providing an overview of the emergence of sexology as scientia sexualis in Portugal. Preceding the four articles, there is an introduction that frames sexuality in the light of two fundamental debates: the medicalization of sexuality and growing individualization in contemporary Western societies.Nas construções contemporâneas da sexualidade, os discursos e as práticas da medicina e da psicologia clínica ocupam um papel principal. Estão na origem das novas abordagens normativas à sexualidade, centradas na questão do bom funcionamento sexual. Porém, apesar da crescente atenção que a sexualidade tem merecido, o estudo da construção social das disfunções sexuais mantem-se incipiente, sobretudo no contexto nacional. Globalmente, os resultados desta tese, que integra dois estudos com metodologias mistas, são apresentados sob a forma de quatro publicações científicas. O primeiro artigo visou contribuir para a discussão acerca da forma como as crenças relativas à sexualidade e género condicionam a categorização da função sexual em natural ou patológica. O segundo artigo forneceu um olhar sobre as dinâmicas de mudança dos comportamentos sexuais, apresentando um “modelo da sexualidade humana” composto por quatro tipos: rígido conservador, tradicional atenuado, progressivo adaptativo, e confluente transformativo. O terceiro artigo procurou explorar como é que a crescente pluralidade de scripts sexuais afeta a ordem de género, através dos sentidos que se tecem a partir das experiências pessoais no quotidiano, com enfoque nas representações sobre os problemas sexuais. Por fim, o quarto artigo analisou como é que os sexólogos portugueses integram o seu papel profissional no vasto campo multidisciplinar da saúde sexual, fornecendo uma visão global da emergência da sexologia enquanto scientia sexualis em Portugal. A preceder os quatro artigos há uma introdução que enquadra a sexualidade à luz de dois debates fundamentais: a medicalização da sexualidade e a individualização crescente nas sociedades ocidentais contemporâneas

Exploring the effects of the COVID-19 pandemic on mental health and well-being of migrant populations in europe: an equity-focused scoping review

© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).The pandemic is aggravating health inequalities, particularly mental health inequalities, while revealing the social determinants of these inequalities, including migration as a social determinant that mediates the interaction of social, economic, cultural, institutional, and structural factors with health indicators. Therefore, it is of most relevance to identify the multiple interconnected factors that influence the mental health and well-being of migrant populations. A scoping review was developed to map the research performed in this area and to identify any gaps in knowledge, following the PRISMA extension for scoping reviews. MEDLINE, Scopus, and WHO Global Health research databases on COVID-19 were searched from January 2020 to October 2021. The review followed the inclusion criteria Population/Concept/Context (PCC): Population-Adult International migrants (including refugees, asylum seekers, and undocumented migrants); Concept-determinants of (and factors influencing) mental health and well-being; Context-COVID-19 anywhere in the world. Of the sixty-five selected studies, eleven were from European countries and were the focus of this review with special attention to health inequalities experienced by migrants in Europe. The results cover a diversity of themes related to the effects of COVID-19 on the mental health of migrants (country-level environmental factors, social determinants of mental health, mental health indicators and outcomes), responses (such as solidarity and resilience), populations, and study methods. The evidence found can inform recommendations and interventions focused on health promotion and mitigation of the inequalities accentuated by the pandemic.The study “Equity in health in times of pandemic: assessment of the impact on mental health and well-being of the Brazilian and Cape Verdean population in Portugal (EQUALS4COVID19)”, is supported by a grant by the Asylum, Migration and Integration Fund (PT/2021/FAMI/697).info:eu-repo/semantics/publishedVersio

Intersections of immigration and sexual and reproductive health : an umbrella literature review with a focus on health equity

Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).Identifying the opportunities and barriers of promoting and fulfilling the sexual health rights of migrants remains a challenge that requires systematic assessment. Such an assessment would include estimating the influence of acculturation processes on sexual and reproductive health, and mapping intersectional inequities that influence migrants’ sexual and reproductive health in comparison with the native population. The aim of this research was to locate, select, and critically assess/summarize scientific evidence regarding the social, cultural, and structural factors influencing migrants’ sexual and reproductive health outcomes in comparison with native population. An umbrella review of systematic reviews and/or meta-analyses, following preferred reporting items for systematic reviews and meta-analysis (PRISMA) standards was undertaken. Medline, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews were searched from their start date until June 2019. The quality of the included articles was determined using the assessment of multiple systematic reviews tool (AMSTAR 2). From the 36 selected studies, only 12 compared migrant with native populations. Overall, the findings indicated that migrants tend to underuse maternal health services and have an increased risk of poor sexual and reproductive health outcomes. Specific intersectional inequities were identified and discussed.info:eu-repo/semantics/publishedVersio

Understanding male (con)tradi(c)tions through an in-depth interview study

This study aims to explore the diversity of male attitudes towards, and experiences of, sexual problems in the context of their relationships, through a qualitative approach on the historically and culturally specific patterns of change in sexual pleasures and experiences over the life course.Merck Sharp & Dohme Foundationinfo:eu-repo/semantics/publishedVersio

SAIMI study : teeth brushing habits among immigrant children and adolescents from the Indian subcontinent in Lisbon

© 2018 Sociedade Portuguesa de Estomatologia e Medicina Dentária. Published by SPEMD. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Objectives: The number of child and adolescent immigrants from the Indian subcontinent has been increasing in Portugal. Dental caries is the most common chronic disease in these ages, and toothbrushing is the most effective prevention measure. The objective was to characterize the toothbrushing habits of immigrant children and adolescents from the Indian subcontinent, living in Lisbon. Methods: In this cross-sectional study, children and adolescents (aged 2 to 16 years) who were 1st and 2nd generation immigrants from the Indian subcontinent (Bangladesh, India and Pakistan) living in Lisbon were selected based on a chain referral sampling technique and using privileged access interviewers. Descriptive analysis of sociodemographic characteristics and toothbrushing habits and a multifactorial logistical model were performed, with toothbrushing twice a day as the dependent variable. Results: Data was obtained from 278 individuals (66% male, mean age of 7.6±3.5 years), 48% of which brushed their teeth twice a day. The probability of toothbrushing twice a day was significantly and independently associated with 1st generation immigrants and older age groups. Conclusions: In immigrant children from the Indian subcontinent, the frequency of toothbrushing twice a day is very low in pre-school ages, making it necessary to strengthen recommendations for starting toothbrushing with the eruption of the first deciduous teeth, as well as the adoption of targeted health promotion programs.Objetivos: O número de crianças e adolescentes imigrantes do subcontinente indiano tem aumentado em Portugal. A cárie dentária é a doença crónica mais frequente nestas idades, sendo a escovagem a sua mais eficaz prevenção. Pretendeu-se caracterizar os hábitos de escovagem dentária das crianças e adolescentes imigrantes do subcontinente indiano, residentes em Lisboa. Métodos: Estudo transversal com crianças e adolescentes (2 a 16 anos de idade), imigrantes de 1.ª e 2.ª geração do subcontinente indiano (Bangladesh, Índia e Paquistão) a residir em Lisboa, selecionados através de uma técnica de amostragem de propagação geométrica, usando inquiridores com acesso privilegiado à população-alvo. Foi realizada uma análise descritiva das características sociodemográficas e hábitos de escovagem e uma análise multifatorial por regressão logística, sendo a variável dependente a escovagem dentária bidiária. Resultados: Obtiveram-se dados relativos a 278 indivíduos (66% do sexo masculino, idade média de 7,6±3,5 anos), 48% dos quais escovava os dentes bidiariamente. A probabilidade de escovagem bidiária foi associada de forma significativa e independente aos imigrantes de 1.ª geração e aos grupos etários mais velhos. Conclusões: Nas crianças imigrantes do subcontinente indiano, a frequência de escovagem dentária bidiária é muito baixa em idade pré-escolar, sendo necessário reforçar as recomendações de que a escovagem se inicie com a erupção dos primeiros dentes decíduos, bem como a adoção de programas de promoção da saúde culturalmente adaptados.info:eu-repo/semantics/publishedVersio

SAIMI Study - health and health care access by immigrants from the indian subcontinent in Lisbon : what recommendations for equitable and culturally adequate health care?

Copyright © Ordem dos Médicos 2015Introdução: O crescimento da população imigrante em Portugal tem sido consistente nas últimas décadas. Apesar disto, a informação sobre a saúde das populações imigrantes é escassa. Esta investigação utiliza dados recolhidos junto da população oriunda do subcontinente indiano a residir no distrito de Lisboa para produzir recomendações para a prestação de serviços de saúde culturalmente adaptados. Material e Métodos: Estudo transversal junto da comunidade imigrante do subcontinente indiano (Bangladesh, Índia e Paquistão) a residir em Lisboa, selecionada com base numa técnica de amostragem bola de neve e recorrendo a inquiridores com acesso privilegiado à população-alvo. O questionário inquiriu sobre a saúde, o acesso aos cuidados de saúde, estilos de vida e atitudes perante a morte. Foi feita uma análise descritiva dos dados e uma comparação entre as três nacionalidades padronizada para a idade. Resultados: Foram administrados questionários a 1011 indivíduos com uma taxa de adesão de 97%. A maioria dos participantes eram adultos do sexo masculino. Os imigrantes indianos relataram mais frequentemente barreiras na utilização dos serviços de saúde e tinham uma maior frequência de doenças crónicas. Os imigrantes paquistaneses tinham piores indicadores de estilos de vida. Discussão: A população imigrante do subcontinente indiano tende a relatar mais dificuldades linguísticas no acesso aos cuidados de saúde quando comparada com outras populações imigrantes. Com base em recomendações da Organização Mundial da saúde, foi possível adaptar este conhecimento para produzir recomendações adaptadas ao contexto português. Conclusão: Existem diversos aspetos na gestão dos serviços de saúde em Portugal que podem ser melhor adaptados à população imigrante do subcontinente indiano.O estudo SAIMI foi financiado pela Direção-Geral da Saúde (DGS)

National survey of the Portuguese elderly nutritional status : study protocol

Acknowledgements We acknowledge the IAN-AF team (in particular to Duarte Torres, Milton Severo and Andreia Oliveira) for the community sampling and their support on dietary assessment methodology and critical discussion along the elaboration of the present protocol. Funding This project (136SI5) was granted by the Public Health Initiatives Programme (PT06), financed by EEA Grants Financial Mechanism 2009-2014.Peer reviewedPublisher PD

Disfunção erétil nos cuidados de saúde primários: a sua abordagem e relação com fatores de risco cardiovasculares em doentes sem eventos cardiovasculares prévios

ABSTRACT - Introduction: Erectile dysfunction (ED) inquiry and treatment could have an important role in cardiovascular prevention. The aims of the present study were to: (1) evaluate the association of ED with cardiovascular risk (CVR) factors among patients with no previous cardiovascular events; (2) assess the inquiry of ED in Portuguese primary care. Methods: Cross-sectional study (January–March 2011) conducted in two Lisbon Primary Healthcare Centers among men aged 18–80 years, sexually active and with no cardiac or cerebrovascular disease. We collected data concerning CVR factors and sexual health inquiry through interviews and clinical records and we used the International Index of Erectile Function to evaluate ED. Logistic regression models were used to study the association between ED and CVR factors. Results: In a sample of 90 men (mean age 49.82 ± 15.65), 32% had ED. Hypertension prevalence and the number of CVR factors was significantly higher among men with ED. However, age was strongly associated with ED and, after age-adjustment, the associations found between ED and hypertension lost their statistical significance. The majority of men evaluated their sexual life as “very important” or “important” (98%) and affirmed that sexual problems should be inquired by the general practitioner (93%) but only a minority were inquired about it (14%). Conclusion: ED is a frequent problem among men with no previous cardiovascular events and, in our study, it was mostly associated with age. ED is still not inquired appropriately in the primary care.RESUMO - Introdução: A abordagem e o tratamento da disfunção erétil (DE) nos cuidados de saúde primários poderiam ter um papel importante na prevenção cardiovascular. Os objetivos deste estudo foram: 1) estudar a relação da DE com os fatores de risco cardiovasculares (FRCV) em indivíduos sem eventos cardiovasculares prévios; 2) avaliar a abordagem da DE nos cuidados de saúde primários portugueses. Métodos: Estudo transversal, exploratório, realizado em 2 centros de saúde de Lisboa, incluindo homens com 18–80 anos de idade sexualmente ativos e sem doença cardíaca ou cerebrovascular. Recolhemos dados relativos à abordagem da DE e dos FRCV através de entrevistas e da consulta de processos clínicos. Avaliámos a DE através do Índice Internacional de Função Eréctil e a associação com os FRCV através de modelos de regressão logística. Resultados: Numa amostra de 90 homens (média de idade 49,82 ± 15,65), 32% apresentavam DE. A prevalência de hipertensão e o número de FRCV foi significativamente superior em homens com DE. Contudo, a idade esteve significativamente associada à DE e, após ajuste para a idade, a associação encontrada entre a hipertensão e a DE deixou de ser significativa. Apesar de a maioria ter reportado que os problemas sexuais deviam ser abordados pelo médico de família (93%), apenas uma minoria afirmou já ter sido inquirida a este respeito (14%). Conclusão: A DE é um problema frequente em homens sem eventos cardiovasculares prévios e, no nosso estudo, associou-se sobretudo à idade. A DE não é suficientemente abordada nos cuidados de saúde primários portugueses.info:eu-repo/semantics/publishedVersio

Prevalência de excesso de peso nos imigrantes brasileiros e africanos residentes em Portugal

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