some remarks on the experiences of health researchers from Mozambique and Angola

This paper analyzes capacity building in practice, addressing the expectations, imaginaries and experiences of health researchers from Mozambique and Angola. The empirical data stems from the Erasmus+ funded project "University Development and Innovation - Africa (UDI-A)", a consortium established between European and African institutions to promote the mobility and empowerment of African academics, the establishment of North/South research partnerships and the strengthening of African institutions. Through qualitative research methods - semi-structured interviews and a focus group with African participants, and participant observation - this article analyzes the experiences of African academics working in the health field, their perceptions of capacity building and aspirations during their stay in Portugal in 2018. By addressing some of their concerns and achievements, this paper reflects on the performativity of capacity building methodologies, exploring a wide range of issues that emerge within the framework of North/South partnerships, inquiring whether it would be possible to decolonize capacity-building methodologies.publishersversionpublishe

Erosion perceptions, beliefs and the sustainability of coastal areas: an individual or collective endeavour?

Coastal erosion (CE) is a phenomenon that has undergone a conceptual evolution. Nowadays, it is considered a physical and social process that is scientifically studied, quantified, and technically mitigated. It may also be approached by following the individual/collective perceptions of coastal communities. Risk and vulnerability associated with CE may also be addressed by considering different aspects that require a differentiated and trans-disciplinary analysis. A gap regarding the social perception of CE in Portuguese coastal communities was detected in the literature review. Therefore, the initial questions and aim of this study are, as follows: to research the social perceptions of CE and to understand how they impact public decisions/participation aimed at mitigating CE. The purpose of this research, supported by a hypothetical-deductive-approach, is exploratory and followed a multiple-case study strategy. The study was conducted using a mixed methodological paradigm (qualitative and quantitative). The Paramos/Espinho and Costa-da-Caparica cases, which differ environmentally, geographically and socioeconomically, were selected. Social and environmental vulnerability indicators were determined through the Analytical-Hierarchy-Process. These indicators were used to structure/draft the exploratory interviews and a questionnaire. These were applied to three categories of stakeholders: politicians/decision-makers, presidents of recreational associations and fishermen/inhabitants; all chosen by convenience sampling. The interviews identified both the historical and current perception of CE, as well as the public-institutional interaction within the scope of the planned/executed interventions targeting the mitigation of this problem. The questionnaire also revealed memories of damaging events, recognition of the causes of CE and sea encroachment, identification of risk perception, and understanding of the feedback about the strategies developed for mitigating erosion. The results showed that the perception of CE was derived from constructed experience and social memory. For the participants, the erosion «issue» is a serious daily problem. They identified risks and mentioned natural causes that are magnified by both climate change and human causes. Disengagement of the state through inefficient decision-making, inadequate construction and maintenance of defence structures, and through their laxness regarding building new constructions were all mentioned as significant examples of human causes. Participants highlighted the authorities’ lack of sensitivity towards traditional knowledge and their lack of will to welcome/integrate the contribution participants’ experience could make. The main contribution of this work resides in the empirically based development of a model for the social perception of CE, by positioning vulnerability in the context of CE. The perceived vulnerability/risk was deemed to result not only from CE, but also from a variable and dynamic context-specific framework, and from internal/external factors that were identified.info:eu-repo/semantics/acceptedVersio

Perceptions of portuguese family health care teams regarding the expansion of nurses’ scope of practice = Perceções de equipas de saúde familiar portuguesas sobre o alargamento do campo de exercício da enfermagem

Theoretical framework: Expanding primary health care nurses’ scope of practice is a strategy that has been used in various health systems to good advantage. Its feasibility depends on the health professionals’ consensus as to its suitability. Objectives: To find out the perceptions of Portuguese family health care teams regarding the expansion of primary care nurses’ scope of practice. Methodology: Focus groups. Results: The team perception is that citizen expectations, the shortage of nurses and the need for specific training are the main issues to be faced. The teams discussed various roles that the nursing profession could take on in Primary Health Care (PHC) via a work reorganisation included in the regulatory framework. Conclusion: The assignment of wider clinical roles to PHC nurses is not unanimously approved of, since it is perceived by some doctors and nurses as inappropriate and unfair. Some health care teams expressed their willingness to take part in this option, due to its potential contribution to improving the response to care needs not currently being met. Enquadramento: O alargamento do campo de exercício do enfermeiro de cuidados primários tem constituído uma estratégia utilizada em diversos sistemas de saúde com ganhos conhecidos. A sua exequibilidade depende do consenso dos profissionais de saúde sobre a sua adequação. Objetivos: Conhecer as perceções de equipas de saúde familiar portuguesas sobre o alargamento do campo de exercício do enfermeiro de cuidados primários. Metodologia: Grupos focais. Resultados: Na perceção das equipas, as expetativas dos cidadãos, a escassez de enfermeiros e a necessidade de formação específica são os principais problemas a enfrentar. As equipas discutiram vários papéis que a profissão de enfermagem poderia assumir em Cuidados de Saúde Primários (CSP), mediante uma reorganização do trabalho, enquadrada normativamente. Conclusão: A atribuição de papéis clínicos mais vastos ao enfermeiro de CSP não reúne unanimidade, por ser percebida, por alguns médicos e enfermeiros, como desajustada e iníqua. Algumas equipas de saúde manifestaram disponibilidade para aderir a esta opção, face ao seu potencial contributo para melhorar a resposta a necessidades assistenciais atualmente não satisfeitas.publishersversionpublishe

How the metabolic phenotype in adulthood is affected by long-lasting immunological trajectories since adolescence

A close relationship between immune and metabolic systems has been perceived in the recent past. We aimed to assess whether the immunological trajectories of circulating white blood cells (WBC) started in adolescence, affects the metabolic phenotype in adulthood. We used data from 1183 participants of the population-based EPITeen cohort, evaluated at 13, 17, 21, 24 and 27 years of age. The Immunological trajectories from 13 to 27 years old were identified by mixed-effects models, being their association with metabolic features at 27 years old measured by logistic regression. The Higher Inflammatory Activation trajectory (HIA trajectory) had the highest percentage of individuals with metabolic syndrome, while Lowest Levels of WBC trajectory (LLWBC trajectory) showed the lowest percentage. Participants with HIA trajectory had significantly higher triglycerides, waist circumference, serum uric acid and BMI. After adjustment for sex and sports practice and hs-CRP, the odds of having one or more metabolic features in adulthood was significantly lower in LLWBC trajectory. Individuals with immunological trajectories of WBC linked with a pattern of higher immune activation showed a less favorable metabolic profile, while those with the lowest levels of WBC were less likely to have metabolic risk factors in adulthood. © 2022, The Author(s).This study was financed by national funds through the Foundation for Science and Technology (Portuguese public agency that supports science, technology and innovation, in all scientific domains, under responsibility of the Ministry of Science, Technology and Higher Education), under the Project UIDB/04750/2020 and under the scientific Project PTDC/DTP-EPI/6506/2014 and the doctoral studentship PD/BD/149264/2019 (VC)

Immunological Trajectories of White Blood Cells from Adolescence to Adulthood: Description and Determinants

Background: The immune system gradually matures early in life in the face of internal and external stimuli. Whether the immune responses are lasting and stable during the course of life is still unclear. Methods: As part of the EPITeen cohort, 1183 adolescents were prospectively evaluated at the ages of 13, 17, 21, 24 and 27. Sociodemographic, behavioral and clinical data were collected by self- and face-to-face-administered questionnaires, along with a physical examination comprising anthropometric measurements and blood sample collections. Mixed-effects models were used to identify individual trajectories of white blood cells (WBC) and finite Gaussian mixture models were used to identify the clusters of individual trajectories. Results: Participants were allocated into six clusters based on the individual trajectories of WBC distribution. Higher Inflammatory Activation Cluster (11.4%) had the highest total WBC count and neutrophils percentage, as well as the lowest percentage of lymphocytes. These participants had significantly higher odds of being overweight [OR = 2.44, 95%CI:1.51-3.92]. Lowest Levels of WBC Cluster (24.1%) had the lowest total WBC count, being characterized by a higher participation on sports [OR = 1.54, 95%CI:1.12-2.13]. Highest Proportion of Eosinophils Cluster (20.1%) had the highest eosinophils percentage and the highest likelihood of having been diagnosed with a chronic disease [OR = 2.11, 95%CI:1.43-3.13], namely "asthma or allergies" [OR = 14.0 (1.73, 112.2]. Lowest Proportion of Eosinophils Cluster (29.1%) had the lowest percentage of eosinophils and basophils, as well as the highest lymphocyte proportion. Participants in the Undefined Cluster (13.8%) showed the highest percentage of monocytes and basophils and were also characterized by significant lower odds of having parents with 7-9 years of schooling [OR = 0.56, (0.32, 0.99]. Conclusions: In this study we identified distinct immunological trajectories of WBC from adolescence to adulthood that were associated with social, clinical and behavioral determinants. These results suggest that these immunological trajectories are defined early in life, being dependent on the exposures.This study was funded by FEDER through the Operational Programme Competitiveness and Internationalization and by national funding from the Foundation for Science and Technology—FCT (Portuguese Ministry of Science, Technology and Higher Education) (POCI-01-0145-FEDER-016829), under Unidade de Investigação em Epidemiologia—Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref. info:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UID/DTP/04750/2013/PT); and the individual PhD Grant to VC (PD/BD/149264/2019), co-funded by the FCT and the POPH/FSE Program

Descrição de uma abordagem participada com vista ao redesenvolvimento da mina de São Domingos, Alentejo, Portugal

A recuperação de áreas industriais abandonadas tem crescido de importância na Europa. Por um lado, são áreas com problemas ambientais, agravados ou não por problemas económicos e sociais nas comunidades adjacentes. Por outro lado, estas áreas surgem como uma oportunidade para o (re)desenvolvimento local. Este artigo descreve e analisa sucintamente o processo de participação pública implementado no projeto rehmine que, entre outros aspetos, pretendeu contribuir para o planeamento estratégico do redesenvolvimento da Mina de São Domingos. O planeamento espacial estratégico é aqui entendido como uma experiência de aprendizagem social, ambos conceitos úteis na análise crítica das escolhas metodológicas aplicadas.info:eu-repo/semantics/publishedVersio

exploring knowledge, risk perception, and sexual behaviors

High circular mobility creates vulnerability and elevates risk for sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV). We aim to explore knowledge, perceptions of risk, and sexual behaviors in relation to STIs/HIV, in Mozambican women involved in an informal cross border trade (ICBT) and residing in South Mozambique. A cross-sectional quantitative study, in 200 women cross border traders (WICBT), affiliated to the Mukhero Association, using a structured, face-to-face questionnaire, was conducted. Descriptive statistics and Pearson’s Chi-square test were used. The median age of participants was 37.0 years (interquartile range (IQR): 31.0–43.0), 100% were literate, travelled on average six times a month. WICBT with a high education level were more likely to have awareness of Gonorrhea, Syphilis, and Candidiasis; to self-perceive being at risk of getting HIV, Syphilis, and Human Papilloma Virus (HPV); and to test for HIV and Syphilis. Those with a low education level were more likely to have misconceptions about HIV and ever have sex in exchange for money/goods/services. Married participants were more likely to know how to prevent HIV. Participants with a high income were more likely to know about HPV; to self-perceive being at risk of getting Syphilis; to point sex workers as being at higher risk of getting HPV; and to ever test for HIV. WICBT with a low income were more likely to have sex in exchange for money/goods/services. Low and inconsistent knowledge and misconceptions of STIs/HIV, high sexual risky behavior, low perception of risk of getting STIs/HIV among this neglected and key population suggests their increased vulnerability to the STIs/HIV.publishersversionpublishe

Back to replacement migration: a new European perspective applying the prospective-age concept

Background: The UN Replacement Migration report (2000) had a significant impact in academic and civil society. Its approach consisted of estimating the migration volumes required to mitigate the effects of population decline and ageing. The volume of migrants required to prevent population decline and sustain the working-age population was not particularly high, but the vast number of migrants needed to maintain the potential support ratio was highlighted as an unrealistic goal. Objective: In this paper the UN exercise is revisited and updated by deploying the concept of prospective age to overcome a strict chronological definition of the working-age population. The replacement migration approach is developed from a new European perspective, the temporal series is extended for an additional decade, and alternative operative age-group definitions are compared by projecting replacement migration estimations according to both classic (conventional) and dynamic (prospective) age limits. Conclusions: The key conclusions of the original UN publication are reasserted. In many countries the replacement migration volumes needed to sustain the decline in total population and working-age population are of an order of magnitude similar to recent observed migration. However, even under the prospective-age approach the halt of the ageing process – expressed as the maintenance of the current potential support ratio – remains an unrealistic target. Contribution: We propose the deployment of the prospective-age concept to define dynamic age limits in the definition of working-age population. Because the prospective-age concept is flexible it will be possible to explore other dimensions from this perspective in the future, increasing the analytical potential of replacement migration estimations as a valuable contribution to the demographic ageing debate.info:eu-repo/semantics/publishedVersio

Prevalence and Factors Related to Anaemia in Children Aged 6–59 Months Attending a Quaternary Health Facility in Maputo, Mozambique

Globally, anaemia prevails as a public health issue, being also a concern in Mozambique, where about two-thirds of children 6-59 months of age are affected by this condition. We carried out this study to estimate anaemia prevalence and evaluate structural determinants and haematological parameters association among children aged 6-59 months attending pediatric inpatient and outpatient services in a Quaternary Health Facility in Maputo City Province, Mozambique. We collected data from 637 inpatients or outpatients who attended pediatric consultations at the Maputo Central Hospital. The overall rate of anaemia in children aged 6-59 months was 62.2% (396/637), with 30.9% moderate anaemia (197/637), 23.9% mild anaemia (152/637), and 7.4% severe anaemia (47/637). Among our study participants, critical factors for anaemia were those concerning the age group, child´s caregiver schooling, malaria and size of the liver.info:eu-repo/semantics/publishedVersio

Determinants, Health Problems, and Food Insecurity in Urban Areas of the Largest City in Cape Verde.

Urbanization processes are intertwined with nutritional transition because there is easier access to food of low nutritional quality at reduced prices, changing dietary patterns and leading to an increase of non-communicable chronic diseases. This study aims to understand the perceptions for high blood pressure, obesity, and alcoholism, describing some interactions of these dimensions in the problem of food security in the city of Praia. A qualitative study was carried out under the framework of the research project "UPHI-STAT: Urban Planning and Health Inequalities-moving from macro to micro statistics". Ten focus groups were conducted in three urban areas with distinct characteristics in the city of Praia, with a total of 48 participants. Participants reported frequent consumption of foods with poor nutritional quality, understanding the potential danger in terms of food security in the city of Praia. Easy access to and high levels of alcohol consumption, and poor quality of traditional drinks were mentioned by participants in the study areas. The impact of the economic situation on the possibility of access to safe and healthy options emerged as a differentiating factor.publishersversionpublishe