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- Intimate partner violence during COVID-19: systematic review and meta-analysis according to methodological choicesPublication . Costa, Diogo; Scharpf, Florian; Weiss, Alexa; Ayanian, Arin H.; Bozorgmehr, KayvanBackground: Intimate Partner Violence (IPV) is the most common form of interpersonal violence and a major public health problem. The COVID-19 pandemic might have contributed to an increase in IPV experiences. To evaluate changes in IPV prevalence during the pandemic, it is important to consider studies’ methodological characteristics such as the assessment tools used, samples addressed, or administration modes (e.g., face-to-face, telephone or online interviews), since they may influence disclosure and were likely affected by pandemic-imposed mobility restrictions. Methods: Systematic review and meta-analysis of empirical studies addressing IPV against women, men, or both, during the COVID-19 period. We searched six electronic databases until December 2021, including articles in English, German, Spanish, French or Portuguese languages. We extracted and synthesised characteristics of studies related to sampling (clinical, community, convenience), type assessment tool (standardised questionnaire, specifically created questions), method of administration (online, telephone, face-to-face), and estimates of different forms of IPV (physical, sexual, psychological). IPV estimates were pooled stratified by study characteristics using random-effects models. Results: Of 3581 publications, we included 103 studies. Fifty-five studies used a standardized instrument (or some adaptations) to assess IPV, with the World Health Organisation Questionnaire and the Revised Conflicts Tactics Scales being the most frequent. For 34 studies, the authors created specific questions to assess IPV. Sixty-one studies were conducted online, 16 contacted participants face-to-face and 11 by telephone. The pooled prevalence estimate for any type of violence against women (VAW) was 21% (95% Confidence Interval, 95%CI = 18%-23%). The pooled estimate observed for studies assessing VAW using the telephone was 19% (95%CI = 10%-28%). For online studies it was 16% (95%CI = 13%-19%), and for face-to-face studies, it was 38% (95%CI = 28%-49%). According to the type of sample, a pooled estimate of 17% (95%CI = 9%-25%) was observed for studies on VAW using a clinical sample. This value was 21% (95%CI = 18%-24%) and 22% (95%CI = 16%-28%) for studies assessing VAW using a convenience sample and a general population or community sample, respectively. According to the type of instrument, studies on VAW using a standardized tool revealed a pooled estimate of 21% (95%CI = 18%-25%), and an estimate of 17% (95%CI = 13%-21%) was found for studies using specifically created questions. Conclusions: During the pandemic, IPV prevalence studies showed great methodological variation. Most studies were conducted online, reflecting adaptation to pandemic measures implemented worldwide. Prevalence estimates were higher in face-to-face studies and in studies using a standardized tool. However, estimates of the different forms of IPV during the pandemic do not suggest a marked change in prevalence compared to pre-pandemic global prevalence estimates, suggesting that one in five women experienced IPV during this period.
- Company views of consumers regarding sustainable packagingPublication . Herbes, Carsten; Mielinger, Ellen; Krauter, Victoria; Arranz, Elena; Hurtado, Rosa María Cámara; Marcos, Begonya; Poças, Fátima; Maya, Salvador Ruiz de; Weinrich, RamonaIn the transition towards more sustainable food packaging, food companies play a key role: they decide what type of packaging to use in their production. Past research posits that corporate decision making on sustainable packaging is driven by perceived consumer demand, making it important to understand how companies see consumers, a topic largely neglected in the literature. Our study aims at uncovering how food packaging professionals see consumer demand for sustainable packaging. We performed qualitative interviews with packaging professionals from food companies in Germany, Austria, Spain, and Portugal; we then performed qualitative content analysis on the responses. The results show that half of our interviewees think that sustainability in packaging does not matter to consumers. Further, pertaining to the packaging life cycle, packaging professionals believe that consumers pay more attention to attributes related to raw materials, i.e. the beginning of the packaging life cycle, preferring paper and rejecting plastics. Interviewees demonstrate scant awareness of consumer research which shows that bio-based materials, biodegradability and recycled materials matter to consumers. Our interviewees frequently criticized consumers, presenting what we identify as narratives of disempowerment whereby responsibility for sustainable packaging is not theirs. First, they perceive consumers as an obstacle. Second, they describe their own position as not very powerful vis-à-vis packaging manufacturers and retailers. And third, they are often unsure about consumer attitudes, knowledge or behavior. This assignment of responsibility for packaging decisions to retailers and consumers emerges as a strong barrier to the expansion of sustainable packaging. Analyzing the perceptions that companies have of consumers may help in better aligning consumer attitudes and behaviors and company strategies for sustainable packaging.
- O 25 de abril, os jovens e a cidadania ativa e global: uma pesquisa exploratóriaPublication . Pinheiro, Generosa; Alves, José Matias
- Validation of ELPO-PT: a risk assessment scale for surgical positioning injuries in the portuguese contextPublication . Salvini, Andreia; Silva, Elsa; Passos, Carmen; Manuel, Tânia; Moraes, Camila; Sousa, Clementina; Alves, PauloBackground/Objectives: Surgical procedures carry inherent risks, including injuries from surgical positioning, which impact patient safety and healthcare quality. An instrument to assess and prevent these injuries is essential. This study aimed to validate and culturally adapt the ELPO-PT for the Portuguese population to ensure its applicability and effectiveness in assessing the risk of injury from surgical positioning. Methods: A validation study was conducted with 126 adult patients undergoing surgical procedures at a central hospital in northern Portugal. Statistical analyses, including the calculation of Cronbach’s alpha coefficient, assessed the internal reliability of the scale. Additionally, sensitivity and specificity analyses evaluated the ELPO-PT’s diagnostic accuracy in identifying patients at risk of developing positioning-related injuries. Results: The validation showed a Cronbach’s alpha coefficient of 0.782, indicating reasonable internal reliability. Sensitivity analysis revealed an 85% accuracy rate in identifying patients at risk of positioning injuries, while specificity analysis demonstrated a 90% accuracy rate for patients not at risk. Conclusions: The ELPO-PT is a valid and reliable instrument for aiding nurses in clinical decision-making, with significant sensitivity and specificity in identifying the risk of positioning-related injuries, including pressure ulcers, in adult patients during the intraoperative period. Its implementation is expected to be beneficial in healthcare settings, contributing to the prevention of complications associated with surgical positioning.
- Tackling sustainable development goals through new spacePublication . Clegg, Stewart R.; Cunha, Miguel Pina e; Lopez, Aníbal; Sirage, Emir; Rego, ArménioAchieving the UN's Sustainable Development Goals (SDGs) constitutes a formidable challenge. Existing solutions may be insufficient to respond to the scale and scope of the endeavour. The 17 SDGs are not discrete but interconnected, sustained by 169 targets. Their cross-level effects require the adoption of a panarchical view of data. New Space projects, still unfamiliar to many managers and organizations, provide such data related to grand challenges capable of addressing the paradoxes that arise from the interaction of a system of systems of multiple scales of spatiality, temporality and social organization. To address these requires project managing developing capabilities that can connect everyday interventions in terrestrial economy and society with high level data findings from Geospatial Information Systems. We contribute to the SDG debate through the articulation of three streams of literature that may radically revise the way wicked problems are addressed: panarchy, paradox, and New Space.
- Integrated analyses of the transmission history of SARS-CoV-2 and its association with molecular evolution of the virus underlining the pandemic outbreaks in Italy, 2019-2023Publication . Cella, Eleonora; Fonseca, Vagner; Branda, Francesco; Tosta, Stephane; Moreno, Keldenn; Schuab, Gabriel; Ali, Sobur; Slavov, Svetoslav Nanev; Scarpa, Fabio; Santos, Luciane Amorim; Kashima, Simone; Wilkinson, Eduan; Tegally, Houriiyah; Mavian, Carla; Borsetti, Alessandra; Caccuri, Francesca; Salemi, Marco; Oliveira, Tulio de; Azarian, Taj; Filippis, Ana Maria Bispo de; Alcantara, Luiz Carlos Junior; Ceccarelli, Giancarlo; Caruso, Arnaldo; Colizzi, Vittorio; Marcello, Alessandro; Lourenço, José; Ciccozzi, Massimo; Giovanetti, MartaBackground: Italy was significantly affected by the COVID-19 pandemic, experiencing multiple waves of infection following the sequential emergence of new variants. Understanding the transmission patterns and evolution of SARS-CoV-2 is vital for future preparedness. Methods: We conducted an analysis of viral genome sequences, integrating epidemiological and phylodynamic approaches, to characterize how SARS-CoV-2 variants have spread within the country. Results: Our findings indicate bidirectional international transmission, with Italy transitioning between importing and exporting the virus. Italy experienced four distinct epidemic waves, each associated with a significant reduction in fatalities from 2021 to 2023. These waves were primarily driven by the emergence of VOCs such as Alpha, Delta, and Omicron, which were reflected in observed transmission dynamics and effectiveness of public health measures. Conclusions: The changing patterns of viral spread and variant prevalence throughout Italy's pandemic response underscore the continued importance of flexible public health strategies and genomic surveillance, both of which are crucial for tracking the evolution of variants and adapting control measures effectively to ensure preparedness for future outbreaks.
- The state of health in the European Union (EU-27) in 2019: a systematic analysis for the Global Burden of Disease study 2019Publication . GBD 2019 EU State of Health Collaborators; Fernandes, João C.Background: The European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010. Methods: We used the Global Burden of Disease 2019 study estimates and 95% uncertainty intervals for the whole EU and each country to evaluate age-standardised death, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) rates for Level 2 causes, as well as life expectancy and healthy life expectancy (HALE). Results: In 2019, the age-standardised death and DALY rates in the EU were 465.8 deaths and 20,251.0 DALYs per 100,000 inhabitants, respectively. Between 2010 and 2019, there were significant decreases in age-standardised death and YLL rates across EU countries. However, YLD rates remained mainly unchanged. The largest decreases in age-standardised DALY rates were observed for “HIV/AIDS and sexually transmitted diseases” and “transport injuries” (each -19%). “Diabetes and kidney diseases” showed a significant increase for age-standardised DALY rates across the EU (3.5%). In addition, “mental disorders” showed an increasing age-standardised YLL rate (14.5%). Conclusions: There was a clear trend towards improvement in the overall health status of the EU but with differences between countries. EU health policymakers need to address the burden of diseases, paying specific attention to causes such as mental disorders. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease.
- Estimation bias and agreement limits between two common self-report methods of habitual sleep duration in epidemiological surveysPublication . Korman, Maria; Zarina, Daria; Tkachev, Vadim; Merikanto, Ilona; Bjorvatn, Bjørn; Bjelajac, Adrijana Koscec; Penzel, Thomas; Landtblom, Anne Marie; Benedict, Christian; Chan, Ngan Yin; Wing, Yun Kwok; Dauvilliers, Yves; Morin, Charles M.; Matsui, Kentaro; Nadorff, Michael; Bolstad, Courtney J.; Chung, Frances; Mota-Rolim, Sérgio; Gennaro, Luigi De; Plazzi, Giuseppe; Yordanova, Juliana; Holzinger, Brigitte; Partinen, Markku; Reis, CátiaAccurate measurement of habitual sleep duration (HSD) is crucial for understanding the relationship between sleep and health. This study aimed to assess the bias and agreement limits between two commonly used short HSD self-report methods, considering sleep quality (SQ) and social jetlag (SJL) as potential predictors of bias. Data from 10,268 participants in the International COVID Sleep Study-II (ICOSS-II) were used. Method-Self and Method-MCTQ were compared. Method-Self involved a single question about average nightly sleep duration (HSDself), while Method-MCTQ estimated HSD from reported sleep times on workdays (HSDMCTQwork) and free days (HSDMCTQfree). Sleep quality was evaluated using a Likert scale and the Insomnia Severity Index (ISI) to explore its influence on estimation bias. HSDself was on average 42.41 ± 67.42 min lower than HSDMCTQweek, with an agreement range within ± 133 min. The bias and agreement range between methods increased with poorer SQ. HSDMCTQwork showed less bias and better agreement with HSDself compared to HSDMCTQfree. Sleep duration irregularity was − 43.35 ± 78.26 min on average. Subjective sleep quality predicted a significant proportion of variance in HSDself and estimation bias. The two methods showed very poor agreement and a significant systematic bias, both worsening with poorer SQ. Method-MCTQ considered sleep intervals without adjusting for SQ issues such as wakefulness after sleep onset but accounted for sleep irregularity and sleeping in on free days, while Method-Self reflected respondents’ interpretation of their sleep, focusing on their sleep on workdays. Including an SQ-related question in surveys may help bidirectionally adjust the possible bias and enhance the accuracy of sleep-health studies.
- The use of calcium phosphate bioceramics for the treatment of osteomyelitisPublication . Oliveira, Cláudia Suellen Ferro; Negut, Irina; Bita, BogdanBone infections, particularly osteomyelitis, present significant clinical challenges due to their resistance to treatment and risk of progressing to chronic disease. Conventional therapies, including systemic antibiotics and surgical debridement, often prove insufficient, especially in cases where biofilms form or infection sites are difficult to access. As an alternative, calcium phosphate bioceramics have emerged as a promising strategy for treating bone infections. These materials offer key advantages such as biocompatibility, osteoconductivity, and the ability to be engineered for controlled drug delivery. Calcium phosphate bioceramics can serve as scaffolds for bone regeneration while simultaneously delivering antibiotics locally, thus addressing the limitations of systemic therapies and reducing infection recurrence. This review provides an overview of osteomyelitis, including its pathogenesis and conventional treatment approaches, while exploring the diverse therapeutic possibilities presented by calcium phosphate bioceramics. Special attention is given to hydroxyapatite, tricalcium phosphate, and their composites, with a focus on their therapeutic potential in the treatment of bone infections. The discussion highlights their mechanisms of action, integration with antimicrobial agents, and clinical efficacy. The dual capacity of calcium phosphate bioceramics to promote both bone healing and infection management is critically evaluated, highlighting opportunities for future research to address current challenges and enhance their clinical application in orthopedics and dentistry. Future research directions should focus on developing calcium phosphate bioceramic composites with enhanced antibacterial properties, optimizing drug-loading capacities, and advancing minimally invasive delivery methods to improve clinical outcomes. Further in vivo studies are essential to validate the long-term efficacy and safety of calcium phosphate bioceramic applications, with an emphasis on patient-specific formulations and rapid prototyping technologies that can personalize treatment for diverse osteomyelitis cases.
- Insights from the EQUALS4COVID19 study on migrant mental health in Portugal: a cross-sectional mixed-methods approachPublication . Alarcão, Violeta; Candeias, Pedro; Stefanovska-Petkovska, Miodraga; Neves, Júlia; Pintassilgo, Sónia; Machado, Fernando Luís; Santos, Osvaldo; Virgolino, Ana; Santos, Ricardo R.; Heitor, Maria João; Costa, AndreiaBackground: The COVID-19 pandemic and related disruptive consequences in the economic, health, and educational sectors have impacted people’s lives, contributing to a context of increased economic and social vulnerability. The pandemic has revealed and accentuated social inequalities and discrimination based on racial or ethnic origin. This study aimed to contribute to the promotion of the mental health and well-being of migrant populations living in Portugal via the definition of an analytical framework and recommendations emerging from the EQUALS4COVID19 project. Methods: To gather information on the impact of the COVID-19 pandemic and resilience determinants among immigrants, a mixed-methods approach was implemented in 2022, combining a cross-sectional survey targeting immigrant adults in Portugal, focus groups with immigrants, focus groups with healthcare professionals, and in-depth individual interviews with stakeholders involved in the implementation of measures related to mental health and well-being during the pandemic. The analysis followed an integrated framework; quantitative data informed the script of qualitative data collection methods, and qualitative analysis informed the reinterpretation of quantitative data. Results: The survey with 604 Brazilian and Cape Verdean immigrants revealed that gender (being a woman) was associated with both psychological distress and depression-related symptomatology and that the perception of discrimination was a major risk factor for psychological suffering, while perceived social support and individuals’ resilience characteristics were protective factors. Qualitative data provided deeper insights into these findings, revealing the ways mental health is affected by social structures, such as gender and ethnic hierarchies. Migrants tend to work in precarious jobs requiring physical presence, which, together with dense housing conditions, puts them at higher risk of infection. The deterioration of the economic conditions of the general population has also increased the perception of ethnic-racial discrimination, which was found to be related to the increase in insecurity and anxiety-related symptomatology among the migrant population. Newly arrived migrants, with reduced support networks, experienced a greater sense of insecurity as well as concern and anguish regarding relatives who live far away, in their home country. Migrant women reported greater family-related distress, including work-life balance problems. Conclusions: Proposals to address mental health inequalities should be considered in the context of the necessary global changes both at the societal level and in the delivery of mental health services. Additionally, they should be considered with the active involvement of migrants, families, and communities in the design and delivery of mental health promotion and care processes.