Lígia Moreira Almeida

Diversity of Cyanobacterial Hydrogenases, a Molecular Approach

Abstract. In an effort to elucidate the diversity of cyanobacterial hydrogenases, we used a molecular approach. Filamentous strains from a broad range of sources were screened for the presence of hup (uptake hydrogenase), xisC (rearrangement within hupL), and hox (bidirectional hydrogenase) genes. As expected, an uptake hydrogenase seems to be present in all N2-fixing cyanobacteria. On the other hand, no evidence was found for the presence of a conventional bidirectional enzyme in several strains. Similarly, the presence of xisC is not a characteristic shared by all the heterocyst-forming cyanobacteria. Although tempting, it is not possible to establish a correlation between the presence/absence of the bidirectional hydrogenase and the occurrence of xisC. The natural molecular variation of hydrogenases in cyanobacteria is certainly a field to explore, both to understand the physiological functions of the respective enzymes and to identify a genetic background to be used when constructing a strain for photobiological H2 production in a bioreactor.

Maternal Healthcare in Migrants: A Systematic Review

Pregnancy is a period of increased vulnerability for migrant women, and access to healthcare, use and quality of care provided during this period are important aspects to characterize the support provided to this population. A systematic review of the scientific literature contained in the MEDLINE and SCOPUS databases was carried out, searching for population based studies published between 1990 and 2012 and reporting on maternal healthcare in immigrant populations. A total of 854 articles were retrieved and 30 publications met the inclusion criteria, being included in the final evaluation. The majority of studies point to a higher health risk profile in immigrants, with an increased incidence of co-morbidity in some populations, reduced access to health facilities particularly in illegal immigrants, poor communication between women and caregivers, a lower rate of obstetrical interventions, a higher incidence of stillbirth and early neonatal death, an increased risk of maternal death, and a higher incidence of postpartum depression. Incidences vary widely among different population groups. Some migrant populations are at a higher risk of serious complications during pregnancy, for reasons that include reduced access and use of healthcare facilities, as well as less optimal care, resulting in a higher incidence of adverse outcomes. Tackling these problems and achieving equality of care for all is a challenging aim for public healthcare services.

Migrant Women’s Perceptions of Healthcare During Pregnancy and Early Motherhood: Addressing the Social Determinants of Health

Recent guidelines from the World Health Organization emphasize the need to monitor the social determinants of health, with particular focus on the most vulnerable groups. With this in mind, we evaluated the access, use and perceived quality of care received by migrant women during pregnancy and early motherhood, in a large urban area in northern Portugal. We performed semi-structured interviews in 25 recent mothers, contacted through welfare institutions, who had immigrated from Eastern European countries, Brazil, or Portuguese-speaking African countries. Six native-Portuguese women of equal economic status were also interviewed for comparison. Misinformation about legal rights and inadequate clarification during medical appointments frequently interacted with social determinants, such as low social-economic status, unemployment, and poor living conditions, to result in lower perceived quality of healthcare. Special attention needs to be given to the most vulnerable populations in order to improve healthcare. Challenges reside not only in assuring access, but also in promoting equity in the quality of care.

Obstetric care in a migrant population with free access to health care

To evaluate differences in obstetric care between immigrant and native women in a country with free access to health care.

Assessing maternal healthcare inequities among migrants: a qualitative study

Abstract Considering pregnancy and motherhood as peri -ods of increased vulnerability in migrant wom-en, to characterize the healthcare provided to this collective, we sought to identify and understand patterns of satisfaction and demand of maternal and child healthcare, assessing women’s per-ceptions about its quality. The study followed a qualitative methodology (semi-structured inter-views) for collecting and analysing data (content analysis) and was conducted in Porto, the sec-ond largest city of Portugal. Participants were 25 recent immigrant mothers from Eastern Euro-pean countries, Brazil, Portuguese-speaking Af-rican countries and six native Portuguese recent mothers (for comparison), contacted through so -cial associations and institutions. Data suggests that healthcare depends not only on accessibility but especially on social opportunities. Equitable public health action must provide individuals and groups the equal opportunity to meet their needs, which may not be achieved by providing the same standard if care to all.Equity in Health; Health Inequalities; Maternal Welfare; Social Vulnerability; MigrationConsiderando a gravidez e a maternidade como periodos de maior vulnerabilidade em mulheres migrantes, a fim de caracterizar os cuidados de saude prestados, procurou-se identificar e compreender padroes de satisfacao e procura de cuidados de saude materna e infantil, avaliando as suas percepcoes sobre a qualidade deles. O estudo seguiu uma metodologia qualitativa (entrevistas semiestruturadas) para a coleta e analise de dados (analise de conteudo) e foi realizado no Porto, a segunda maior cidade de Portugal. As participantes foram 25 maes recem-imigradas do Leste Europeu, Brasil, e paises africanos de lingua portuguesa e seis Portuguesas (para comparacao), contatadas pelas associacoes e instituicoes sociais. Os dados sugerem que a saude depende nao so da acessibilidade, mas especialmente das oportunidades sociais. Acoes equitativas de saude publica devem proporcionar aos individuos e grupos oportunidades iguais para satisfazer as suas necessidades, que podem nao ser alcancadas fornecendo o mesmo tratamento padrao para todos.Considering pregnancy and motherhood as periods of increased vulnerability in migrant women, to characterize the healthcare provided to this collective, we sought to identify and understand patterns of satisfaction and demand of maternal and child healthcare, assessing womens perceptions about its quality. The study followed a qualitative methodology (semi-structured interviews) for collecting and analysing data (content analysis) and was conducted in Porto, the second largest city of Portugal. Participants were 25 recent immigrant mothers from Eastern European countries, Brazil, Portuguese-speaking African countries and six native Portuguese recent mothers (for comparison), contacted through social associations and institutions. Data suggests that healthcare depends not only on accessibility but especially on social opportunities. Equitable public health action must provide individuals and groups the equal opportunity to meet their needs, which may not be achieved by providing the same standard if care to all.

The impact of migration on women’s mental health in the postpartum period

ABSTRACT OBJECTIVE To assess the influence of I mmigration on the psychological health of women after childbirth. METHODS In this cross-sectional study, immigrant and Portuguese-native women delivering in the four public hospitals of the metropolitan area of Porto, Portugal, were contacted by telephone between February and December 2012 during the first postpartum month to schedule a home visit and fill in a questionnaire. Most immigrant (76.1%) and Portuguese mothers (80.0%) agreed to participate and with the visits, thus a total of 89 immigrants and 188 Portuguese women were included in the study. The questionnaire included the application of four validated scales: Mental Health Inventory-5, Edinburgh Postpartum Depression Scale, Perceived Stress Scale, and Scale of Satisfaction with Social Support. Statistical analysis included t-test and Chi-square or Fisher’s test, and logistic regression models. RESULTS Immigrants had an increased risk of postpartum depression (OR = 6.444, 95%CI 1.858–22.344), and of low satisfaction with social support (OR = 6.118, 95%CI 1.991–18.798). We did not perceive any associations between migrant state, perceived stress, and impoverished mental health. CONCLUSIONS Immigrant mothers have increased vulnerabilities in the postpartum period, resulting in an increased risk of postpartum depression and lesser satisfaction with the received social support.

Migration and maternal health: experiences of brazilian women in Portugal

OBJECTIVES: to characterize maternal and neonatal healthcare provided to Brazilian population, assessing key factors: access, use and quality of care received during this period. The goal was to assess possible differences regarding womens perceptions regarding the quality and appropriateness of care received, providing qualitative information, as part of a holistic perspective. METHODS: the present study adopted a qualitative methodology (semi-structured interviews) for collecting and analyzing data. Possible differences in womens perceptions regarding the quality and appropriateness of care received were assessed, providing qualitative information, as part of a holistic perspective. The present study was based on privileged information obtained from Brazilian women, residing in the metropolitan area of Porto, regardless of their legal status. RESULTS: a certain dissatisfaction emerged among Brazilian women regarding the quality of information provided by health professionals, the communications skills of these professionals, in addition to a perception of reduced access to medical specialties, especially in primary care. Misinformation about legal rights and inappropriate clarification during medical appointments were frequently reported and interacted with social determinants to result in poorer medical care. CONCLUSIONS: special attention should be given to the specific needs and understanding of immigrants during pregnancy and motherhood in order to improve healthcare. New challenges tend to lie not only in ensuring access, but mostly in promoting equity, as away of providing high-quality care for all.Objectives: to characterize maternal and neonatal healthcare provided to Brazilian population, assessing key factors: access, use and quality of care received during this period. The goal was to assess possible differences regarding women’s perceptions regarding the quality and appropriateness of care received, providing qualitative information, as part of a holistic perspective. Methods: the present study adopted a qualitative methodology (semi-structured interviews) for collecting and analyzing data. Possible differences in women’s perceptions regarding the quality and appropriateness of care received were assessed, providing qualitative information, as part of a holistic perspective. The present study was based on privileged information obtained from Brazilian women, residing in the metropolitan area of Porto, regardless of their legal status. Results: a certain dissatisfaction emerged among Brazilian women regarding the quality of information provided by health professionals, the communications skills of these professionals, in addition to a perception of reduced access to medical specialties, especially in primary care. Misinformation about legal rights and inappropriate clarification during medical appointments were frequently reported and interacted with social determinants to result in poorer medical care. Conclusions: special attention should be given to the specific needs and understanding of immigrants during pregnancy and motherhood in order to improve healthcare. New challenges tend to lie not only in ensuring access, but mostly in promoting equity, as away of providing high-quality care for all.

Intimidad y salud

A intimidade e antecedida de processos ativos, transversais ao ciclo de vida. O vinculo afetivo estabelece-se primariamente na relacao de vinculacao mae-bebe, e os padroes comportamentais e estilos de vinculacao tendem a repercutir-se nas relacoes adultas. O objetivo exploratorio desta investigacao pretende apurar a transcricao fisica (consequencias na saude) de vivencias insatisfatorias de intimidade. Sessenta universitarios (30 do sexo feminino; 30 do sexo masculino), com idades entre 22 e 27 anos, envolvidos numa relacao amorosa fixa (duracao minima: 6 meses) foram contactados para responder a uma bateria de instrumentos (variaveis de interesse: intimidade, identidade, autoconceito e vinculacao). Um bom estado de saude parece associar-se a valores elevados de interdependencia e baixos valores de dependencia na relacao amorosa. Nestes jovens a intimidade baseada na dependencia compromete 14% da saude mental. O impacto de uma intimidade pouco saudavel limita em quase 9% a saude fisica de jovens adultos saudaveis.

Assessing maternal healthcare inequities among migrants: a qualitative study = Avaliando desigualdades de saúde materna em migrantes: um estudo qualitativo = Evaluación de las inequidades en salud materna entre los inmigrantes: un estudio cualitativo

Abstract Considering pregnancy and motherhood as peri -ods of increased vulnerability in migrant wom-en, to characterize the healthcare provided to this collective, we sought to identify and understand patterns of satisfaction and demand of maternal and child healthcare, assessing women’s per-ceptions about its quality. The study followed a qualitative methodology (semi-structured inter-views) for collecting and analysing data (content analysis) and was conducted in Porto, the sec-ond largest city of Portugal. Participants were 25 recent immigrant mothers from Eastern Euro-pean countries, Brazil, Portuguese-speaking Af-rican countries and six native Portuguese recent mothers (for comparison), contacted through so -cial associations and institutions. Data suggests that healthcare depends not only on accessibility but especially on social opportunities. Equitable public health action must provide individuals and groups the equal opportunity to meet their needs, which may not be achieved by providing the same standard if care to all.Equity in Health; Health Inequalities; Maternal Welfare; Social Vulnerability; MigrationConsiderando a gravidez e a maternidade como periodos de maior vulnerabilidade em mulheres migrantes, a fim de caracterizar os cuidados de saude prestados, procurou-se identificar e compreender padroes de satisfacao e procura de cuidados de saude materna e infantil, avaliando as suas percepcoes sobre a qualidade deles. O estudo seguiu uma metodologia qualitativa (entrevistas semiestruturadas) para a coleta e analise de dados (analise de conteudo) e foi realizado no Porto, a segunda maior cidade de Portugal. As participantes foram 25 maes recem-imigradas do Leste Europeu, Brasil, e paises africanos de lingua portuguesa e seis Portuguesas (para comparacao), contatadas pelas associacoes e instituicoes sociais. Os dados sugerem que a saude depende nao so da acessibilidade, mas especialmente das oportunidades sociais. Acoes equitativas de saude publica devem proporcionar aos individuos e grupos oportunidades iguais para satisfazer as suas necessidades, que podem nao ser alcancadas fornecendo o mesmo tratamento padrao para todos.Considering pregnancy and motherhood as periods of increased vulnerability in migrant women, to characterize the healthcare provided to this collective, we sought to identify and understand patterns of satisfaction and demand of maternal and child healthcare, assessing womens perceptions about its quality. The study followed a qualitative methodology (semi-structured interviews) for collecting and analysing data (content analysis) and was conducted in Porto, the second largest city of Portugal. Participants were 25 recent immigrant mothers from Eastern European countries, Brazil, Portuguese-speaking African countries and six native Portuguese recent mothers (for comparison), contacted through social associations and institutions. Data suggests that healthcare depends not only on accessibility but especially on social opportunities. Equitable public health action must provide individuals and groups the equal opportunity to meet their needs, which may not be achieved by providing the same standard if care to all.

Avaliando desigualdades de saude materna em migrantes: um estudo qualitativo

Abstract Considering pregnancy and motherhood as peri -ods of increased vulnerability in migrant wom-en, to characterize the healthcare provided to this collective, we sought to identify and understand patterns of satisfaction and demand of maternal and child healthcare, assessing women’s per-ceptions about its quality. The study followed a qualitative methodology (semi-structured inter-views) for collecting and analysing data (content analysis) and was conducted in Porto, the sec-ond largest city of Portugal. Participants were 25 recent immigrant mothers from Eastern Euro-pean countries, Brazil, Portuguese-speaking Af-rican countries and six native Portuguese recent mothers (for comparison), contacted through so -cial associations and institutions. Data suggests that healthcare depends not only on accessibility but especially on social opportunities. Equitable public health action must provide individuals and groups the equal opportunity to meet their needs, which may not be achieved by providing the same standard if care to all.Equity in Health; Health Inequalities; Maternal Welfare; Social Vulnerability; MigrationConsiderando a gravidez e a maternidade como periodos de maior vulnerabilidade em mulheres migrantes, a fim de caracterizar os cuidados de saude prestados, procurou-se identificar e compreender padroes de satisfacao e procura de cuidados de saude materna e infantil, avaliando as suas percepcoes sobre a qualidade deles. O estudo seguiu uma metodologia qualitativa (entrevistas semiestruturadas) para a coleta e analise de dados (analise de conteudo) e foi realizado no Porto, a segunda maior cidade de Portugal. As participantes foram 25 maes recem-imigradas do Leste Europeu, Brasil, e paises africanos de lingua portuguesa e seis Portuguesas (para comparacao), contatadas pelas associacoes e instituicoes sociais. Os dados sugerem que a saude depende nao so da acessibilidade, mas especialmente das oportunidades sociais. Acoes equitativas de saude publica devem proporcionar aos individuos e grupos oportunidades iguais para satisfazer as suas necessidades, que podem nao ser alcancadas fornecendo o mesmo tratamento padrao para todos.Considering pregnancy and motherhood as periods of increased vulnerability in migrant women, to characterize the healthcare provided to this collective, we sought to identify and understand patterns of satisfaction and demand of maternal and child healthcare, assessing womens perceptions about its quality. The study followed a qualitative methodology (semi-structured interviews) for collecting and analysing data (content analysis) and was conducted in Porto, the second largest city of Portugal. Participants were 25 recent immigrant mothers from Eastern European countries, Brazil, Portuguese-speaking African countries and six native Portuguese recent mothers (for comparison), contacted through social associations and institutions. Data suggests that healthcare depends not only on accessibility but especially on social opportunities. Equitable public health action must provide individuals and groups the equal opportunity to meet their needs, which may not be achieved by providing the same standard if care to all.