Search Results (61)

Background/Objectives: Childhood anemia remains a serious public health issue, negatively affecting cognitive and psychomotor development, with repercussions on school performance and adult productivity. This study aimed to characterize the profile of children aged 6 months to 5 years diagnosed with or at risk of anemia who attended a pediatric hospital in Lisbon, Portugal. Methods: A hospital-based, cross-sectional descriptive study was conducted from September 2023 to September 2024. Descriptive statistics, including frequency distributions and cross-tabulations, summarized participant characteristics and key variables. Results: We observed that 33.3% (74/222) of the children were either anemic or at risk of anemia. Among these, 93.2% (69/74) were confirmed anemic or at risk based on hemoglobin levels. Five children (6.8%) had normal hemoglobin but abnormal red-cell indices, with microcytic (60.0%; 3/5) or normocytic (40.0%; 2/5) patterns. Anemia rates were higher in males (55.1%), children aged 24–59 months, those residing in the Metropolitan Lisbon Area (82.6%), children whose caregivers had only basic or secondary education (58.0%), and those whose mothers were born in foreign countries (48.4%). Microcytic red-cell indices were observed in 63.1% of cases. Serum iron results indicated that 32.0% were pre-anemic and 40.0% anemic. Ferritin levels showed iron-deficiency anemia in 22.2% of tested cases. In addition, 33.3% carried the sickle cell trait, and 35.0% had elevated C-reactive protein, suggesting anemia of inflammation. Conclusions: Anemia is a moderate public health issue, mainly affecting children with less-educated caregivers and migrant mothers. Targeted public health actions, including systematic screening, caregiver education, and multiculturally sensitive interventions, are crucial to address anemia. Full article

Background/Objectives: Oral cancer is a significant global public health concern. Understanding the prevalence and associated risk factors of oral lesions is essential for developing effective preventive strategies. This study aimed to assess the prevalence and risk factors of oral lesions submitted for biopsy in a Portuguese subpopulation. A retrospective cross-sectional analysis was conducted using data from patients who sought dental care at the Egas Moniz Dental Clinic (EMDC) in the Lisbon metropolitan area. Methods: Data analysis was performed on a sample of 264 patients who attended the EMDC between October 2016 and December 2019 to ascertain the presence of oral lesions, their different types, and their correlation with potential risk factors. The analysis included all patients who underwent biopsy, and their pathology reports were reviewed. Results: The prevalence of oral lesions was 10.3%, affecting 58.7% females and 41.3% males, with a mean age of 55 years. The most frequently biopsied site was the buccal mucosa (23.5%). Non-neoplastic lesions accounted for 75.0% of cases, while mesenchymal lesions were the most common neoplastic category (58.5%). The most prevalent diagnosis was fibroepithelial hyperplasia (36.7%). A statistically significant association was observed between neoplastic lesions and statin use, as well as between both neoplastic and non-neoplastic lesions and the use of antidiabetic medications. Conclusions: Oral lesions are prevalent, with non-neoplastic lesions being the most frequent. Understanding their nature, prevalence, and associated risk factors is crucial for early and accurate diagnosis, aiding in disease prevention and management. Full article

Background: The declaration of COVID-19 as a pandemic by the World Health Organization in 2020 led to the widespread suspension of clinical practices, including dentistry. This study aims to evaluate the impact of these restrictions on oral health and dietary habits. Methods: A retrospective cross-sectional study was conducted at Egas Moniz University Clinic (Lisbon Metropolitan Area), covering from June 2019 to June 2021. A total of 3380 participants were included and categorized into two cohorts: pre- and post-COVID-19 restrictions. Data were collected through a structured questionnaire assessing oral health behaviors and dietary habits. Results: Of 3469 incoming patients, 3380 met the inclusion criteria. Statistically significant post-lockdown changes were observed, including increased smoking prevalence, higher coffee with sugar consumption, reduced use of dental floss and mouthwash, and redistribution in tooth brushing frequency, with fewer individuals brushing 2–3 times daily. Conclusions: COVID-19-related restrictions had a heterogeneous impact on oral health and dietary behaviors. While some individuals reported improved hygiene routines, others showed negative changes, such as increased tobacco use or decreased use of oral hygiene products. These contrasting effects call for targeted public health strategies to reduce inequalities and support vulnerable groups during crises. Full article

Background: Being breastfed, following a healthy diet and staying active during childhood shape health trajectories across the life course, promoting long-term well-being. Despite the growing immigrant child population in Portugal, evidence on these behaviours, particularly among preschool-aged children, remains limited. In this context, this study examines the associations between migrant status and breastfeeding patterns, fruit and vegetable consumption, and participation in sports among children living in the Lisbon Metropolitan Area. Methods: A cross-sectional study nested within a cross-sequential cohort was carried out in the Lisbon region between May 2022 and April 2024. Approximately 760 children (49.4% immigrants) born in 2018 and 2020 were enrolled in the study. Data were collected through a face-to-face interview with parents, using a structured questionnaire with information on socioeconomic variables, migration history, breastfeeding habits, and children’s diet (fruit and vegetable consumption) and physical activity. We used parametric and non-parametric tests to compare migrant and non-migrant children. To quantify factors associated with the main outcomes, we estimated a logistic regression model and calculated crude and adjusted odds ratios and their respective 95%CI. Results: Immigrant children were disproportionately represented in socioeconomically disadvantaged families. Breastfeeding initiation rates were higher among immigrant mothers (96.3% vs. 87.6%, p < 0.001). Additionally, immigrant mothers had a longer median duration of any breastfeeding (14 vs. 8 months, p < 0.001) and of exclusive breastfeeding (6 vs. 4 months, p < 0.001). Immigrant children had significantly lower odds of consuming three or more portions of fruit (aOR = 0.700; 95%CI: 0.511–0.959; p = 0.027) and two or more portions of vegetables per day (aOR = 0.489; 95%CI: 0.350–0.684; p < 0.001) compared with non-immigrant children. They were also twice as likely to not engage in sports (aOR = 2.185; 95%CI: 1.512–3.158; p < 0.001). Conclusions: Breastfeeding was better implemented in immigrant children. The findings highlight the need to address social determinants of health and the challenges faced by immigrant families in promoting a balanced diet and sports participation for their children. Multisectoral, culturally appropriate interventions that sustain and promote good breastfeeding practices, improve access to healthy food, and encourage sports are crucial to reducing health inequalities. Full article

Food transition has been widely inspiring regional and local food system transformation strategies to accomplish the Sustainable Development Agenda goals. Considering the urgency required to transform food systems by 2030, actions should be supported by principles of science-based and practical effectiveness. Within the framework of the Food Transition Strategy for the Lisbon Metropolitan Area (FTS-LMA), a methodology to identify the potential to establish Multifunctional Agrofood Parks (MAPs) has been applied to inform decision-makers where this potential is located as an opportunity to transform local food system towards healthier and more affordable food production. The method uses an Analytical Hierarchy Process (AHP) operated in a Geographic Information System (GIS) to integrate a multicriteria environment and socioeconomic variables for determining suitable territories for MAP implementation. The results show the higher suitability for the MAP establishment in the LMA is over 30% of the region, which drives a thorough reflection on how to set up a socio-territorial transformation of the metropolitan food system envisioned by the FTS-LMA by using current results as part of a food system planning exercise to determine where the ecological suitability for sustainable food production overlap with the capacity for intervention by the fabric of producers in each of the 18 municipalities. Full article

Currently, around 60% of the world’s population lives in cities, with about half of Portugal’s population concentrated in the Metropolitan Areas of Lisbon and Porto. In this context, urban spaces need to be planned and managed to accommodate more inhabitants while preserving the urban quality of life and ensuring sustainability for future generations. Responding to these challenges, new urban models are emerging, such as the 15-Minute City model defined by Carlos Moreno. This model is based on four pillars: proximity, diversity, density, and ubiquity, aiming to enable residents to complete daily activities within a maximum of 15 min on foot or by other active transport modes. Through an analysis of two neighborhoods in Lisbon using specific indicators, this research aims to understand how urban planning influences each area’s alignment with the 15-Minute City model. This analysis will guide measures to improve residents’ quality of life by applying the principles of the 15-Minute City while broadening the discussion to include other relevant dimensions beyond travel distances and access, identifying areas that require further urban planning or intervention. Full article

This document presents the initial developments of a research work on sustainable housing and tourism beyond the urban centers of Lisbon and Porto’s metropolitan areas. The preliminary data are taken from the last three Portuguese censuses carried out in the first two decades of the 21st century, in 2001, 2011 and 2021. Maintaining the balance between housing and tourism is a challenge in the governance of these two major cities. Full article

Background/Objectives: The health of migrant populations is strongly influenced by social, cultural, and environmental factors. Promoting health literacy (HL) is essential to empower these populations and reduce health inequalities. We aimed to assess the perceptions and behaviors of migrants residing in a neighborhood within a municipality in the Metropolitan Area of Lisbon regarding health risks arising from environmental conditions, as well as to determine their level of health literacy. Methods: Our cross-sectional, descriptive, exploratory study used the Health Literacy Questionnaire. This study was conducted with ethical approval including a sample of 101 participants. We performed descriptive and inferential statistical analyses using the Statistical Package for the Social Sciences (SPSS) version 29. Results: Most participants were from Portuguese-speaking countries and reported issues with indoor humidity and inadequate thermal comfort in both hot and cold conditions. The primary environmental issues identified included stagnant water, organic waste, and deficient electrical networks. Conclusions: The results revealed precarious housing conditions and inadequate support infrastructure, posing significant environmental health risks. Data revealed low levels of health literacy across most domains assessed. Full article

The ubiquitous use of mobile devices along with the amount of traffic, transportation services, and travel pattern data available has led to the emergence and deployment of smartphone applications for providing information about personal travel management. Several of these travel apps are aimed at voluntary travel behavior change (VTBC) to support and increase sustainable mobility, and have led to the development of research to investigate their influence on travel behavior. Here, the aim is to study the role of technophilia and goal-framing theory in the intention to adopt and situationally use a prospective VTBC travel app. A Structural Equation Model is developed with the aim of empirically testing a sample of 971 respondents collected in two suburban corridors in the Lisbon Metropolitan Area. The results support that goal-framing theory is important for explaining the adoption of VTBC travel apps. Gain and normative motives are more relevant than hedonic motives, pointing to the importance of their tangible benefits. Frequent car users may benefit from VTBC travel apps in terms of encouraging behavioral changes, supporting sustainable mobility management solutions. The results also outline the importance of technophilia and the current use of travel apps in influencing the intention to use VTBC apps. Full article

The 1755 Lisbon earthquake holds significant historical importance in Portuguese history. The subsequent tsunami resulted in extensive destruction and damage, affecting not only Lisbon but also other regions of Portugal, Spain, and North Africa. This significant and hazardous event led to an increase in awareness about earthquake and tsunami risks, not only within Portugal but throughout Europe. This heightened awareness facilitated advancements in scientific developments, including design codes, standards, and earthquake engineering. However, recent studies focusing on hazard assessment for Lisbon are limited. For this reason, this paper aims to present a comprehensive probabilistic seismic hazard analysis (PSHA) for the Lisbon metropolitan area. The first stage of PSHA involves defining applicable and active seismic source models (area and line sources) within the study area. Subsequently, historical and instrumental earthquake records are collected to build a homogenized earthquake catalog, utilizing both global and local earthquake databases. Following this, the completeness level of the earthquake catalog is tested. By incorporating suitable ground motion models to the region and local soil characteristics, seismic hazard maps for various return periods and hazard curves in terms of peak ground acceleration (PGA) are developed. The findings based on the area source model agree with existing literature, indicating PGA values ranging from 0.3 g to 0.9 g, 0.2 g to 0.7 g, 0.2 g to 0.5 g, and 0.1 g to 0.3 g for return periods of 2475, 975, 475, and 50 years, respectively. Full article

Background: The declaration of COVID-19 as a pandemic by the World Health Organization in 2020 led to the suspension of several clinical practices globally, including dentistry. This study investigates the impact of these restrictions on dental caries experience. Methods: A retrospective cross-sectional study was conducted at Egas Moniz University’s dental hospital in the Lisbon Metropolitan Area from June 2019 to June 2021. The study involved 3380 participants who were divided into two cohorts: after and before COVID-19 restrictions. Data collection included a questionnaire, full-mouth clinical examinations, and radiographs (panoramic X-rays, bitewings). Results: Before the COVID-19 restrictions, the prevalence of dental caries was 91.8%, with an average DMFT (decayed, missing, and filled teeth) index of 12.13. Post-restrictions, the prevalence decreased to 84.5%, with a DMFT index of 10.99. There was an increase in missing teeth and a decrease in decayed and filled teeth. Additionally, the frequency of toothbrushing declined among participants. Conclusions: The COVID-19 pandemic restrictions have significantly impacted dental caries experiences and oral health, highlighting a decrease in dental caries, but also a concerning reduction in oral hygiene practices. These results emphasize the importance of customized dental healthcare during public health emergencies to reduce impacts and maintain oral health. Full article

Vaccine hesitancy tends to exhibit geographical patterns and is often associated with social deprivation and migrant status. We aimed to estimate COVID-19 vaccination hesitancy in a high-vaccination-acceptance country, Portugal, and determine its association with sociodemographic risk factors. We used the Registry of National Health System Users to determine the eligible population and the Vaccination Registry to determine individuals without COVID-19 vaccine doses. Individuals older than five with no COVID-19 vaccine dose administered by 31 March 2022 were considered hesitant. We calculated hesitancy rates by municipality, gender, and age group for all municipalities in mainland Portugal. We used the spatial statistical scan method to identify spatial clusters and the Besag, Yorke, and Mollié (BYM) model to estimate the effect of age, gender, social deprivation, and migrant proportion across all mainland municipalities. The eligible population was 9,852,283, with 1,212,565 (12%) COVID-19 vaccine-hesitant individuals. We found high-hesitancy spatial clusters in the Lisbon metropolitan area and the country’s southwest. Our model showed that municipalities with higher proportions of migrants are associated with an increased relative risk (RR) of vaccine hesitancy (RR = 8.0; CI 95% 4.6; 14.0). Social deprivation and gender were not associated with vaccine hesitancy rates. We found COVID-19 vaccine hesitancy has a heterogeneous distribution across Portugal and has a strong association with the proportion of migrants per municipality. Full article

Urban environmental sustainability is a growing concern within the United Nations and the European Union’s ongoing policy agendas to fight climate change. This paper contributes to this debate by presenting the main impacts of the Operational Programme for Sustainability and Use of Resources (POSEUR 2014–2020) in the Lisbon Metropolitan Area (NUTS II). The analysis was completed using the Impact-WEB_GIS platform, specially developed for this study, supported by a territorial impact assessment methodology. In addition to the production of general impact scores, five analytic dimensions were further analysed, supported by state-of-the-art (i) low-emissions economy, (ii) adaptation to climate change, (iii) risk prevention and management, (iv) environmental protection and (v) resource efficiency. At a strategic level, the research created awareness of the need to adjust regional policy to the region’s characteristics on environmental sustainability matters. Full article

Retaining their ancestral footprint, rural settlements anchored developments driven by suburbanisation and became small towns embedded in the generic metropolitan landscape in the late 20th century. In subsequent phases, they integrated the functional diversity necessary to maintain a certain autonomy, while always being rooted in a community whose bonds are densified. In the specific case of Queijas, in the municipality of Oeiras (Lisbon metropolitan area), apart from the recent identification of the historical nucleus and the maintenance of public spaces, one can infer from the Oeiras Municipal Master Plan (2022) the need for an integrated approach to urban design and planning, which is linked to the requalification of place and the community. That is how climate action, well-being and public space took priority as the leading factors in the present study. Full article

Water scarcity is a driver for society to rethink water management and change the paradigm of use to a fit-for-purpose approach—i.e., separating potable water for human consumption (drinking, cooking or personal hygiene) from all non-potable uses that do not require the same quality level. In this context, urban water reuse is a relevant tool for municipalities and metropolitan areas when dealing with pressure on water resources, among several alternative water sources that can be considered in a site-specific and integrated manner. Through the available literature and specific case studies in the Lisbon Metropolitan Area, this paper explores the benefits and barriers of water reuse and intends to support local authorities in including water reuse in their water management strategies. To the best of our knowledge, this is the first paper focusing on Portugal and the Lisbon Metropolitan Area that globally examines governance, economic, legislative and social aspects regarding water reuse and presents specific implementation examples covering potable and non-potable as well as direct and indirect reuse. Full article