Centro de Investigação Interdisciplinar em Saúde (CIIS)
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- Beyond isolation: social media as a bridge to well-being in old agePublication . Ribeiro, Renato Mendonça; Menezes, João Daniel de Souza; Pompeo, Daniele Alcalá; Diniz, Maria Angélica Andreotti; Lima, Gabriella Santos; Ribeiro, Patrícia Cruz Pontífice Sousa Valente; André, Júlio César; Ribeiro, Rita de Cássia Helú Mendonça; Rodrigues, Rosalina Aparecida Partezani; Kusumota, LucianaPopulation aging and the digital revolution have converged, creating challenges and opportunities for the social inclusion of older adults. This study examined social media usage patterns among Brazilian older adults during the COVID-19 pandemic, exploring their associations with sociodemographic factors, health, and well-being. Through an online survey with 441 participants aged 60 or older, we found that WhatsApp® and Instagram® were the most utilized platforms, with a significant increase in usage during the pandemic. Higher educational attainment and income were associated with more frequent and diverse social media use, while the presence of comorbidities positively correlated with seeking health information online. Notably, greater engagement in social media was associated with an improved perception of well-being. The results highlight the potential of social media as tools for digital inclusion, access to information, and promotion of well-being for older adults, especially in crisis contexts. However, they also reveal socioeconomic disparities in access to and use of these technologies. These findings have significant implications for public policies on digital inclusion and health promotion, suggesting the need for targeted interventions to reduce digital inequality among older adults and maximize the potential benefits of social media for active and connected aging.
- O conceito de vulnerabilidade social e a sua emergência em processos de saúde-doençaPublication . Romeiro, Joana; Caldeira, Sílvia
- Correction to: The role of community pharmacists in managing common headache disorders, and their integration within structured headache services: position statement on behalf of the European Headache Federation (EHF) and Lifting The Burden (LTB: the Global Campaign against Headache), with the formal endorsement of the International Pharmaceutical Federation (The Journal of Headache and Pain, (2025), 26, 1, (100), 10.1186/s10194-025-02021-3)Publication . Banihani, Heba; Lampl, Christian; Maassenvandenbrink, Antoinette; Amin, Faisal Mohammad; Carlsen, Louise Ninett; Coppola, Gianluca; Deligianni, Christina; Gil-Gouveia, Raquel; Holland, Philip R.; Husoy, Andreas K.; Jensen, Rigmor; Plácido, Madalena; Reuter, Uwe; Ryliskiene, Kristina; Rio, Margarita Sanchez del; Schytz, Henrik Winther; Tronvik, Erling; Versijpt, Jan; Steiner, Timothy J.Correction: J Headache Pain 26, 100 (2025) In this article, the text “on behalf of the European Headache Federation, the Norwegian Centre for Headache Research (NorHead) and Lifting The Burden: the Global Campaign against Headache” has been removed from the author list because it erroneously duplicated text from the article title.
- Global fertility in 204 countries and territories, 1950-2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021Publication . GBD 2021 Fertility and Forecasting Collaborators; Bhattacharjee, Natalia V.; Schumacher, Austin E.; Aali, Amirali; Abate, Yohannes Habtegiorgis; Abbasgholizadeh, Rouzbeh; Abbasian, Mohammadreza; Abbasi-Kangevari, Mohsen; Abbastabar, Hedayat; Abd ElHafeez, Samar; Abd-Elsalam, Sherief; Abdollahi, Mohammad; Abdollahifar, Mohammad Amin; Abdoun, Meriem; Abdullahi, Auwal; Abebe, Mesfin; Abebe, Samrawit Shawel; Abiodun, Olumide; Abolhassani, Hassan; Abolmaali, Meysam; Abouzid, Mohamed; Aboye, Girma Beressa; Abreu, Lucas Guimarães; Abrha, Woldu Aberhe; Abrigo, Michael R.M.; Abtahi, Dariush; Abualruz, Hasan; Abubakar, Bilyaminu; Abu-Gharbieh, Eman; Abu-Rmeileh, Niveen ME; Adal, Tadele Girum Girum; Adane, Mesafint Molla; Adeagbo, Oluwafemi Atanda Adeagbo; Adedoyin, Rufus Adesoji; Adekanmbi, Victor; Aden, Bashir; Adepoju, Abiola Victor; Adetokunboh, Olatunji O.; Adetunji, Juliana Bunmi; Adeyinka, Daniel Adedayo; Adeyomoye, Olorunsola Israel; Adnani, Qorinah Estiningtyas Sakilah; Adra, Saryia; Afolabi, Rotimi Felix; Afyouni, Shadi; Afzal, Muhammad Sohail; Afzal, Saira; Aghamiri, Shahin; Agodi, Antonella; Agyemang-Duah, Williams; Bettencourt, Paulo J. G.Background: Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods: To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings: During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation: Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. Funding: Bill & Melinda Gates Foundation.
- Health gains for users of long-term home care services in PortugalPublication . Fonseca-Teixeira, Susana Alexandra; Parreira, Pedro Miguel dos Santos Dinis; Mónico, Lisete Dos Santos Mendes; Amado, João Manuel da CostaOBJECTIVES: to evaluate health gains sensitive to nursing care in the context of long-term home care. METHODS: this was a quantitative, retrospective study carried out in the north of Portugal. The sample consisted of 151 users aged 18 or over. Descriptive and correlational analysis, non-parametric tests and exploratory factor analysis were carried out. RESULTS: the results revealed that the patients admitted were an ageing, dependent population with multimorbidities and low potential for rebuilding autonomy. The care provided by the home care team had a positive impact on improving functionality, controlling symptoms, reducing pressure ulcers and the risk of falls. CONCLUSIONS: there is an urgent need for effective investment in promoting home care, guaranteeing timely and equitable access to health care. It is necessary to invest in effective, efficient public policies, driven by social and economic sustainability, in order to guarantee better health outcomes for the population.
- How spirituality appears in migrant parents’ discourses regarding their experiences with accessing pediatric healthcare?Publication . Romeiro, Joana; Caldeira, Sílvia
- A mulher nos interstícios da maternidade e os papéis de género traçados à luz da cultura portuguesaPublication . Romeiro, Joana; Caldeira, Sílvia
- Retrospetiva sobre a imigração disponibilizada em sítios político governamentais, de saúde e enfermagemPublication . Romeiro, Joana; Caldeira, Sílvia
- The role of community pharmacists in managing common headache disorders, and their integration within structured headache services: position statement on behalf of the European Headache Federation (EHF) and Lifting The Burden (LTB: the Global Campaign against Headache), with the formal endorsement of the International Pharmaceutical FederationPublication . BaniHani, Heba; Lampl, Christian; MaassenvandenBrink, Antoinette; Amin, Faisal Mohammad; Carlsen, Louise Ninett; Coppola, Gianluca; Deligianni, Christina; Gil-Gouveia, Raquel; Holland, Philip R.; Husøy, Andreas K.; Jensen, Rigmor; Plácido, Madalena; Reuter, Uwe; Ryliškienė, Kristina; Río, Margarita Sanchez del; Schytz, Henrik Winther; Tronvik, Erling; Versijpt, Jan; Steiner, Timothy J.In the sustainable development goals (SDG) context of seeking universal health coverage, the expanding gap between the supply of specialized and primary health-care providers of headache-related health care and the care needs of the very large number of people affected by headache is a formidable but not insoluble public-health challenge. Structured headache services provide a cost-effective framework wherein controlled patient flows enable the care needs of people with headache to be met at appropriate levels, but these services may still be overwhelmed by inappropriate demand. Community pharmacists are an underutilized resource, potentially well able to provide the solution. To do so, they must, as a profession, be integrated into structured headache services. What remains to be determined is how to achieve this integration in an encouraging climate for change, which recognises the potential for relieving strained health-care systems and meeting a range of health-care needs by expanding pharmacists’ scope of practice. This position statement on behalf of the European Headache Federation (EHF) and Lifting The Burden (LTB) is formally endorsed by the International Pharmaceutical Federation (FIP).
- A saúde da criança imigrante residente em PortugalPublication . Romeiro, Joana; Caldeira, Sílvia