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- A review of digital eye strainPublication . Barata, Maria João; Aguiar, Pedro; Grzybowski, Andrzej; Moreira-Rosário, André; Lança, Carla; Centro de Investigação em Saúde Pública (CISP/PHRC); Comprehensive Health Research Centre (CHRC) - Pólo ENSP; Escola Nacional de Saúde Pública (ENSP); Laboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo ENSP); Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS); NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)(1) Background: This study investigates the impact of digital device usage on the visual system, with a focus on binocular vision. It also highlights the importance of objective assessment in accurately diagnosing and guiding therapeutic approaches for Digital Eye Strain Syndrome (DESS). (2) Methods: A comprehensive narrative review was conducted to synthesize existing evidence. The methodological quality of observational and case-control studies was assessed using the Newcastle-Ottawa scale, while randomized controlled trials (RCTs) were evaluated using the Cochrane risk-of-bias (RoB 2) tool. (3) Results: Fifteen articles were included in this review, with a predominant focus on binocular vision anomalies, particularly accommodative and vergence dysfunctions, as well as ocular surface anomalies related to DESS. Clinical assessments relied primarily on symptom-based questionnaires, which represent a significant limitation. The included studies were largely observational, with a lack of longitudinal and RCTs. In contrast, research in dry eye disease has been more comprehensive, with multiple RCTs already conducted. (4) Therefore, it is essential to develop validated objective metrics that support accurate clinical diagnosis and guide evidence-based interventions. Conclusions: It remains unclear whether changes in binocular vision are a cause or consequence of DESS. However, prolonged screen time can exacerbate pre-existing binocular vision anomalies due to continuous strain on convergence and accommodation, leading to symptoms. Future research should prioritize prospective longitudinal studies and well-designed RCTs that integrate objective clinical measures to elucidate causal relationships and improve diagnostic and therapeutic frameworks.
- Co-creation of sexual and reproductive health literacy interventions and access to healthcare services among higher education studentsPublication . Rosário, Jorge; Dias, Sónia; Pedro, Ana Rita; Laboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo ENSP); Centro de Investigação em Saúde Pública (CISP/PHRC); Comprehensive Health Research Centre (CHRC) - Pólo ENSP; Escola Nacional de Saúde Pública (ENSP); KargerINTRODUCTION: Limited sexual and reproductive health literacy (SRHL) among higher education students constitutes a significant public health concern, impeding informed decision-making and equitable access to essential services. This study aimed to identify and prioritise student-informed SRHL interventions to improve health outcomes and reduce structural disparities. METHODOLOGY: A participatory, transdisciplinary approach was employed, combining student focus groups with a structured nominal group technique session involving professionals from health and education sectors. Student insights informed the initial intervention framework. Prioritisation was guided by the APEASE criteria (Acceptability, Practicability, Effectiveness, Affordability, Side effects/Safety, and Equity). RESULTS: An expert panel synthesised twenty-two proposed interventions in SRHL into twenty final interventions, which were subsequently prioritised. The highest priority was assigned to the development of an on-campus integrated health hub, aimed at centralising sexual and reproductive health services and enhancing accessibility. Other top-ranked strategies included peer-led education, interactive seminars with community stakeholders, and targeted screening campaigns. Standalone informational tools were deprioritised as experts perceived them to have limited standalone impact without complementary support mechanisms. CONCLUSION: Co-created, multidisciplinary SRHL strategies, anchored in nursing leadership, peer engagement, and institutional support, are essential to addressing health inequities in academic settings. These models demonstrate strong potential to increase service uptake and promote student well-being. Further research should assess their long-term effectiveness and scalability across diverse educational contexts.
- Maternal health literacy among migrant womenPublication . Gonçalves, Elisa; Dias, Sónia; Marques, Maria J; Escola Nacional de Saúde Pública (ENSP); Laboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo ENSP); Comprehensive Health Research Centre (CHRC) - Pólo ENSP; Centro de Investigação em Saúde Pública (CISP/PHRC); KargerINTRODUCTION: Migrant women often experience significant disparities in maternal health outcomes compared to host populations, due to language barriers, cultural differences, and limited maternal health literacy (MHL). Despite its importance, there is a shortage of tailored interventions specifically designed for migrant communities, namely, African migrant women in Europe. METHODS: This qualitative study applied a co-design approach using the Optimizing Health Literacy and Access (Ophelia) methodology. Two separate idea generation workshops were conducted in Lisbon - one, involving pregnant migrant women (n = 6), and another with community-based healthcare and social professionals (n = 10). Discussions were guided by vignettes developed prior to the sessions to reflect real-life challenges. Thematic analysis of the transcripts was complemented by descriptive analysis of sociodemographic questionnaire data. RESULTS: Three main themes emerged: (1) health literacy barriers (e.g., low digital literacy, lack of information, cultural and bureaucratic obstacles); (2) strengths and resources (e.g., personal resilience, proactive behaviours, and community associations); (3) co-created interventions (e.g., community support groups, culturally sensitive maternal education, and healthcare providers training). CONCLUSION: The study highlights the value of a participatory co-design approach in identifying context-specific, culturally relevant interventions to enhance MHL among African migrant women. The insights gained provide valuable direction for future research and policy development aimed at enhancing access to maternal healthcare for migrant populations.
- Cross-cultural adaptation and validation of the Stroke Self-Efficacy Questionnaire to European PortuguesePublication . Figueira, Carlos; Vieira, André; Pereira, Carla Mendes; Comprehensive Health Research Centre (CHRC) - Pólo ENSP; Centro de Investigação em Saúde Pública (CISP/PHRC); Escola Nacional de Saúde Pública (ENSP); Taylor & FrancisBackground: Self-efficacy is recognized as a key determinant in post-stroke adjustment. Adapting the Stroke Self-Efficacy Questionnaire (SSEQ) into European Portuguese is needed, due to the lack of reliable and valid measures to assess self-efficacy in post-stroke populations within this context. Objective: To conduct the cross-cultural adaptation of the SSEQ to European Portuguese and investigate its validity, reliability, and interpretability for the European Portuguese stroke population. Methods: A two-phase study was conducted: i) translation and cultural adaptation of the English version of SSEQ to European Portuguese (SSEQ-PT); and ii) psychometric assessment ofSSEQ-PT. The initial phase encompassed the content index validation by an expert committee with seven professionals and verbal probing by nine stroke survivors. The second phase involved 103 participants and assessed construct validity through Confirmatory Factor Analysis (CFA) and concurrent validity, test-retest reliability, and interpretability measures. Results: The SSEQ-PT demonstrated adequate content validity and comprehensibility. The original two-factor structure was confirmed through CFA where Chi-Square (χ2)(64) = 114.11, Comparative Fix Index (CFI) = 0.93, Standardized Root Mean Square Residual (SRMR) = 0.06, with factor correlation of 0.63. Adequate construct validity was demonstrated with expected correlations between the SSEQ-PT subscales and selected scales. The activity subscale demonstrated a Cronbach’s α of 0.91 and the self-management subscale of 0.80. The total instrument demonstrated an Interclass CorrelationCoefficient (ICC) of 0.87. Conclusions: The SSEQ-PT proved to be a highly relevant and easily comprehensible measure for assessing self-efficacy in stroke survivors. This study demonstrates that the European Portuguese version of the instrument is valid and reliable for assessing self-efficacy in stroke patients.
- From 10-minute matches to discountsPublication . Gaspar, Ana Catarina; Costa, Ana Pedro; Pires, Ana Matos; Centro de Investigação em Saúde Pública (CISP/PHRC); Comprehensive Health Research Centre (CHRC) - Pólo ENSP; Escola Nacional de Saúde Pública (ENSP); Sociedade Portuguesa de Neurologia
- Social prescribing in PortugalPublication . Dias, Sónia; Figueiredo, Cristiano; Hoffmeister, Louíse Viecili; Marques, Maria João; Pedro, Ana Rita; Canas, Margarida; Ricoca Peixoto, Vasco; Gama, Ana; Escola Nacional de Saúde Pública (ENSP); Laboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo ENSP); Comprehensive Health Research Centre (CHRC) - Pólo ENSP; Centro de Investigação em Saúde Pública (CISP/PHRC); Comprehensive Health Research Centre (CHRC) - pólo NMS; KargerAbstract – Background: Social Prescribing (SP) has gained global momentum as a promising approach of person-centered, integrated care embedded in multisectoral action. By expanding the focus from disease treatment to prevention and health promotion, SP aligns with a broader public health paradigm that emphasizes the addressing of social and behavioral determinants of health to improve health and well-being. Objectives: This brief report introduces the emergence of SP, describes the implementation of SP initiatives in Portugal, and highlights the potential for SP expansion as a strategy to enhance population health and strengthen the sustainability of the National Health Service (NHS). Method: This brief report draws on a review of international SP developments alongside emerging initiatives in Portugal to map the landscape of SP in the country and identify key enablers and barriers to its implementation. Results: There has been a growing interest in SP in Portugal, with pilot projects emerging across regions. The academia has played a central role in providing technical-scientific support to the design, implementation, monitoring, and evaluation of these initiatives, fostering interdisciplinary collaboration and evidence-based practice. However, challenges remain in increasing awareness around SP, boosting intersectoral collaboration, securing resources, and strengthening systematic data collection for monitoring and evaluation. Conclusion: SP represents a timely and promising innovation for advancing person-centered integrated care and health promotion, with potential to contribute to healthy, resilient, equitable, and sustainable communities.
- A framework for integrated safety in safety-management systems in healthcarePublication . Vella Bonanno, Patricia; Srulovici, Einav; Mira, José Joaquín; Strametz, Reinhard; Tella, Susanna; Marinkovic, Valentina; Rafaeli, Anat; Tumelty, Mary Elizabeth; Pitz, Andreas; Guerra Paiva, Sofia; Venesoja, Anu; Buttigieg, Sandra C.; Centro de Investigação em Saúde Pública (CISP/PHRC); Comprehensive Health Research Centre (CHRC) - Pólo ENSP; Escola Nacional de Saúde Pública (ENSP)Purpose – Notwithstanding increased patient safety initiatives, adverse events and their impact on those involved continue. The strategic approaches adopted to manage safety by other high-intensity, high-risk and complex industries, such as aviation, have led to an increase in the systems approach for safety management in healthcare organisations. Professional expertise from members of the European Researchers’ Network for Second Victims (ERNST) highlighted that safety and the second victim phenomenon are interconnected across the healthcare ecosystem, extending beyond individual healthcare organisations. Design/methodology/approach – Evidence from different sources, mainly the literature and practitioner professional expertise, was iteratively aggregated and analysed using theoretical systems-based approaches to conceptualise a framework for integrated safety in safety management systems in health. Findings – A cross-sectional view of the healthcare organisation affected by adverse events was presented as a baseline. The whole system (system levels) approach, representing the healthcare system at the micro-, meso- and macro-level, adapting the model for integrated care, was then adopted. A safety-generating culture was considered to integrate and network across the levels of the healthcare system. The “system” (processes) approach, also considering external factors, was incorporated. This iterative conceptualisation led to a proposed framework for integrated safety. This framework was applied to systematically make recommendations for actions to support safety across the healthcare ecosystem. Originality/value – Aggregation of evidence from the literature, together with expertise from professionals and iterative conceptualisation across models adopting the systems approach, led to a comprehensive framework for integrated safety in safety-management systems.
- Second World Congress on Migration, Ethnicity, Race and HealthPublication . Agyemang, Charles; Kumar, B; Dias, Sónia; Krasnik, Allan; Escola Nacional de Saúde Pública (ENSP); Oxford University Press
- Co-designing health literacy interventions to address non-communicable diseases among migrants in EuropePublication . Seyfulayeva, Ayshe; Marques, Maria J; Lavickova, Jana; Chaloupka, Martin; Matorina, Viktoriya; Hawkins, Melanie; Osborne, Richard; Dias, Sonia; Escola Nacional de Saúde Pública (ENSP); Comprehensive Health Research Centre (CHRC) - Pólo ENSP; Comprehensive Health Research Centre (CHRC) - pólo NMS; Centro de Investigação em Saúde Pública (CISP/PHRC); Oxford University Press
- Validity and reliability of the European Portuguese version of the PainDETECT Questionnaire in patients with musculoskeletal painPublication . Santos, Andreia; Mota, Cristiana; Cruz, Eduardo; Pires, Diogo; Nogueira, Paulo; Sousa, Paulo; Centro de Investigação em Saúde Pública (CISP/PHRC); Comprehensive Health Research Centre (CHRC) - Pólo ENSP; Escola Nacional de Saúde Pública (ENSP); NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Oxford University Press