Isabel Loureiro

Developing public health competencies through building a problem-based learning project

AimIn order to tackle the major challenges faced by public health over recent decades, there is a pressing need for an appropriately competent work force. Therefore, investment is required in the development of the necessary pedagogical strategies to deliver such competencies and thereby enable public health professionals to effectively perform their core functions. Drawing primarily upon on the work and experiences of the EC-funded PHETICE (Public Health Education and Training in the Context of an Enlarging Europe) and EUMAHP (European Masters in Health Promotion) projects, in this article an appropriate training method that integrates several public health models is introduced and discussed in order to deliver key public health competencies.MethodsA student-centred learning (SCL) approach is recommended, from both theoretical and practical perspectives, as a more effective way of delivering training to achieve these competencies than traditional pedagogical methods. An ecological and educational approach to planning in public health is demonstrated by using a problem-based Learning (PBL) approach to the acquisition of basic public health competencies.ConclusionsIn outlining the PBL approach, the authors go on to explain how it can enable learners to gain systematically the necessary competencies to carry out comprehensive planning and decision making based on a comprehensive assessment, using the practical skills of compromise, negotiation, teamwork, and leadership.

A review of professional competencies in health promotion: European perspectives

Abstract Competencies have been increasingly used in education and the labour market since the 1970s. Within the Health Promotion framework, however, attempts to discuss specific competencies are rather incipient. This paper aims to introduce a discussion on the most essential and desirable health promotion competencies using the EUMAHP (European Masters in Health Promotion) framework. In preparation of this review, we considered three main sources to lead the identification of health promotion competencies: a) a review of the history, culture and identity of health promotion in Europe, b) an analysis of what competencies could be drawn from the health promotion most significant milestones and practice, c) a consultation with health promotion experts, practitioners and trainees. As a result of this exercise a number of competencies were selected and tentatively grouped into the four EUMAHP training core curriculum components: Foundations for Health Promotion (understanding of social, cultural and subjective determinants of health and wellbeing, to identify, document and analyse equity issues, understanding of public sectors, policies and services and understanding of local policies and governments); Health Promotion Practice (to interpret and address cultural and social diversity, to identify, analyse and use scientific evidence; sensitivity towards group and institutional dynamics and ability to deal with such dynamics, democratic and empowering leadership skills, including motivation, dialogue, active and careful listening, empathy and conflict resolution skills, creative and critical thinking, team building and negotiation and partnership building skills, writing skills, to produce and use media resources, language and oratory skills, management skills, planning and monitoring skills); Research Methods (social research skills, to generate and manage socio-economic and epidemiological information, critical appraisal, policy analysis and policy evaluation, technical and report- writing); and European Dimension of Health Promotion (comparative analysis, ability to communicate in a second language, enabling people to use the European context and European cultural diversity as a health promotion resource). Despite the fact that this classification was different to the one used in other competence studies, the results are quite similar to competencies identified by studies made in Australia and New Zealand. Taken into account that these coincidences relate to countries that share cultural similarities with Europe, it can be inferred that the final results are significant and can be useful for further development of the EUMAHP core curriculum and other future developments in health promotion education and training.

The role of parental smoking on adolescent smoking and its social patterning: a cross-sectional survey in six European cities

Background Several studies have observed socio-economic (SE) inequalities in smoking among adolescents, but its causes are not fully understood. This study investigates the association between parental and adolescent smoking, and whether this association is socially patterned. Methods We used data from a survey administered in 2013 to students aged 14-17 years old of six European cities (n = 10 526). Using multilevel mixed-effects logistic regression, we modelled the probability of being a daily smoker as a function of parental smoking and SE status. We tested whether the smoking association differed across social strata. Results The prevalence of parental smoking was higher in low SE status adolescents. Boys and girls were more likely to smoke if they have a father [boys: adjusted odds ratio (AOR) = 1.90, 95% CI = 1.47-2.46; girls: AOR = 1.42, 95% CI = 1.09-1.86] and mother (boys: AOR = 1.77, 95% CI = 1.35-2.31; girls: AOR = 3.36, 95% CI = 2.56-4.40) who smoked. Among boys, the odds of smoking when having a smoking parent were higher in lower SE classes. However, this was not statistically significant, nor was it observed among girls. Conclusions Adolescents are more likely to smoke when their father and mother smoke. Although the susceptibility to parental smoking was similar across social classes, SE differences in parental smoking contribute to the transmission of SE inequalities in smoking.

A obesidade infantil: um problema emergente

Since 2004, formaldehyde (FA) has been classified by the International Agency for Cancer Research as a carcinogen. The FA ranks 25th in the overall United States chemical production, with more than 5 million tons produced each year. Due to its economic importance and varied use, many individuals are exposed to FA at their occupational settings. This study aimed to assess the exposure to FA in two occupational settings – FA production factory and pathology anatomy (PA) laboratories – and relate it to possible health effects by comparing frequency of micronuclei (MN) in peripheral bloodIntroducao: As desigualdades em saude sao reconhecidamente um problema de saude publica. A relacao entre determinantes sociais e as desigualdades em saude sao um achado robusto. Enquanto nos adultos e claro que estas desigualdades socioeconomicas se manifestam no seu estado de saude, a situacao e menos clara nas criancas e adolescentes. Foi entao efetuada uma revisao da literatura sobre a influencia dos determinantes sociais na saude na idade pediatrica. De forma a contribuir para um melhor conhecimento sobre a materia. Metodologia: A pesquisa foi efetuada segundo as normas PRISMA, com base nos termos MeSH: Social Class, Pediatric, Hospital, Emergency Treatment, Socioeconomic factor e Healthcare Disparities, na PubMed, Scielo e nas bases de dados da Cochrane. Foram excluidos artigos de revisao, opiniao bem como artigos que tratavam de questoes de acesso aos cuidados. Foi efetuada uma descricao quantitativa e qualitativa dos resultados. Resultados: Foram selecionadas 17 publicacoes, exceto uma do tipo descritiva, todas referentes a estudos observacionais analiticos, a maioria usando dados retrospetivos. Encontrou-se forte evidencia na relacao entre desigualdades em saude e os fatores socio economicos na idade pediatrica. Conclusao: Apesar de nenhuma das publicacoes selecionadas apresentar dados colhidos em Portugal, e seguro afirmar que e possivel encontrar a mesma relacao na idade pediatrica. E importante estudar mais esta area, identificar os determinantes sociais mais importantes bem como as populacoes mais vulneraveis, para melhor poder planear os cuidados de saude e combater as desigualdades. Palavras-Chave: Desigualdades em Saude, Determinantes Sociais da Saude, Fatores Socio-economicos, Pediatria