CHRC – Research Groups (Petals)
The members of the team will investigate, collaborate and teach across 4 thematic lines (I-IV) and 17 research groups (1-17):
I. Health Promotion, population health and lifestyle;
1. Environmental and occupational health;
2. Nutrition and health promotion;
3. Exercise, sports sciences and human development;
4. Sleep, chronobiology and sleep disorders;
5. Smoking and addictions;
6. Healthy and active ageing;
II. High burden and high mortality diseases;
7. Cardiovascular and respiratory;
9. Mental health determinants, needs and interventions;
10. Sensation and hearing disorders;
11. Clinical studies in immune dysregulation from pregnancy to adulthood;
12. Infection, sepsis and antibiotics resistance;
III. Health policies and healthcare services research;
13. Patient-centered care research;
14. Efficiency, incentives and sustainability;
15. Health services research and equity;
16. Global and population mental health;
Thematic line I - Health Promotion, population health and lifestyle
Maria Isabel Guedes Loureiro
This thematic line will provide evidence on health determinants across life cycle, in particular those ones related with lifestyles behaviours, providing important knowledge for the design of strategies to promote health and prevent chronic diseases. This is in line with the societal challenges of Horizon 2020 and with the health goals proposed by the Portuguese National Health Plan.
There is an urgent need to orient health systems more towards health promotion and research groups of this thematic line intend to strength the capacity to promote health by providing knowledge of effective interventions programs to promote healthy lifestyle behaviours.
The team’s priorities of this thematic line are to contribute for:
1. The study of the association between risk factors exposure and health;
2. A healthy and active ageing;
3. Development of strategies to promote healthy eating habits among children and their families;
4. The development of new and innovative models and strategies to promote healthy lifestyles, health and wellbeing.
Group 1 - Environmental and occupational health
Nuno Manuel Barreiros Neuparth
This research group includes pulmonologists, immunoallergologists, biologists, toxicologists, engineers, occupational physicians, ergonomists, sociologists and statisticians mainly from NMS, affiliated hospitals and ENSP. The main purpose is the identification and quantification of occupational and environmental hazards and its impact on health/disease of citizens and workers.
Have a major interest on Occupational Health in healthcare workers. This includes:
- Respiratory health and quality of life impact of indoor air quality (IAQ) in persons attending elderly care centres (ECC);
- Impact in respiratory health of air quality in children attending day care centers;
- Impact of air pollution on school aged children with asthma
- Multidisciplinary approach for air quality, exposure and population health impacts assessment, from the emission of industrial pollutants in industrialized urban areas;
- Musculoskeletal disorders, namely occupational acute and chronic low back pain and other injuries related with work;
- Chemical hazards like antineoplastic drugs or anticancer agents exposure and anesthetic agents like sevoflurane in wards and operating rooms;
- Psychosocial risk factors, like stressors, and its impact in health of workers’ health;
- Microbiological hazards namely healthcare associated infections, or infections acquired in health-care settings;
- Ionizing radiation exposure and its possible health effects, namely in eyes.
This team is also addressing social and cognitive influences on risk perception and how to promote adequate risk communication.
Group 2 - Nutrition and health promotion
Luis Manuel Fernandes Pereira da Silva
This research group includes nutritionists, pediatricians, epidemiologists and public health specialists. The main interest is to developing, implementing and testing the efficacy of strategies to change and promote healthy lifestyle behaviours. This group’s researchers regularly collaborate with the Portuguese Government (Directorate of Health and Health Ministry) towards the development and implementation of national food and nutrition policies.
This group has been studying the long-term effects of neonatal and pediatric nutrition and the potential for adverse effects of endocrine disrupting chemicals on metabolic health. Working on data from nationally representative cohort of the Portuguese population (established in 2011 – EpiDoc) better understanding dietary patterns in the Portuguese population, as well as, their determinants and outcomes. They are also focused on the identification of the determinants and outcomes of poor nutrition and the analyse of the economic burden of food insecurity.
Group 3 - Exercise, sports sciences and human development
Armando Manuel de Mendonça Raimundo
Researchers from Évora University, NMS, Jose Mello Saúde and Jamor High Performance Centre joins to pursues three major topics:
- Physical Exercise, focusing on the promotion of healthy lifestyles and well-being mainly throughout sports activities and exercise programs.
- Human development, where the concern falls in the determinants for a healthy and active growth and development, studying the interaction between motor, cognitive and social-emotional dimensions of children with typical and atypical development, as well as the potential of body oriented therapies.
- Sport Sciences, focusing in the manipulation and analysis of training and competition contexts, aiming to promote participants’ adaptation and development.
This research group aims to use and develop technologically advance tools regarding the assessment and monitoring of sports practice.
Group 4 - Sleep, chronobiology and sleep disorders
Maria Teresa Aguiar dos Santos Paiva
The sleep research group mainly located at CENC includes neurologists, pulmonologists, psychiatrists, ENT-specialists, dentists, neuropediatricians, cardiologists, Internal Medicine specialists, clinical psychologists and neuropsychologists, chronobiologists, nutritionists, exercise physiologists, specialists in neuromuscular therapy and sleep technologists.
The research lines are sleep neurophysiology, insomnia, hypersomnia, human circadian rhythms and disorders, movement disorders, parasomnias and sleep related epilepsy, pediatric sleep, sleep apnea, dreaming, sleep awareness and dissemination.
Group 5 - Smoking and addictions
Julian Alejandro Perelman
This research group, mainly from ENSP, aims at understanding tobacco epidemics from a social science viewpoint, with a focus on socioeconomic determinants and tobacco control policies. This is grounded on the evidence that socioeconomic inequalities in smoking are a major driver of inequalities in health and mortality, representing a major concern for public health and social justice. They also interested in other addictions i.e alcohol and other inequalities namely food insecurity.
First, this group aims at understanding which are the groups where smoking is more prevalent, and more vulnerable to second-hand smoke. Investigating how the tobacco epidemics unequally diffuse in the population, and how tobacco control policies often fail to account for the different response of different socioeconomic groups, enlarging the socioeconomic gap in smoking behaviours.
Second, researchers investigate the link between socioeconomic determinants and smoking among adolescents requiring a deep understanding on socioeconomic differentiation during adolescence, which is related to psychosocial factors, and school and family contextual factors. And also, using different tools than the ones used to tackle this issue in adulthood.
Group 6 - Healthy and active ageing
Manuel Maria dos Santos Matroco Gonçalves Pereira
This multidisciplinary group (psychiatrics, neurologists, rheumatologists, nurses, physical therapists, physical activity researchers, psychologists) is composed by 2 major teams, one located at NOVA Medical School and other located at Évora University. This group has large expertise and experience in research and intervention in this vulnerable group and is committed to develop intervention programs at home (living labs) to increase autonomy and quality of life of older individuals.
Interested in a better understanding of intrinsic capacities of older people, as related to their sense of coherence and resilience, and opportunities for well-being, physical and mental health promotion. Also interested in frailty which is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes including falls, incident disability, hospitalization and mortality.
Évora’s team aims to identify effective strategies to promote active and healthy ageing and enjoy an independent and high quality of life namely using information and communication technologies (ICTs). NMS team has identified multimorbidity as high prevalent among older age.
This research group have already developed educational tools to change lifestyles and improve chronic disease burden in this age strata using a patient-centre approach. Now they aim to test its efficacy and cost-effectiveness.
Thematic line II - High burden and high mortality diseases
Jácome de Ornelas Bruges Armas
Promote high quality research on improving clinical practices and health services delivered to people with high burden and high mortality diseases. Available information on mortality and health in Portuguese population is frequently fragmented and sometimes inconsistent. Several health solutions developed by researchers do not reach clinical practice.
This thematic line was created to deliver consistent and robust description of the burden, injuries and risk factors of diseases causing premature death, loss of health and disability. Deliver, in addition, screening tools, pharmacological and non-pharmacological treatments to improve patient care and clinical outcomes.
Develop and test new models of providing care and addressing multimorbid patients’ needs. Also, integrated strategies for optimizing healthy and active aging may improve societal outcomes.
Group 7 - Cardiovascular and respiratory
José Inácio Guerra Fragata
This research group gathers cardiologists, thoracic surgeons and pulmonologists to explore pathophysiological mechanisms of heart and lung diseases and how these can be applied to develop better diagnostic tests, prognostic markers and therapies. Also, very involved in multicentric randomized clinical trials with new drugs.
These researchers have been exploring new biomarkers of inflammation in COPD and asthma and how these are related to environmental exposures. And also, the pathophysiological mechanisms of coronary artery disease development and plaque vulnerability.
This team are particularly interested in the identification of vulnerable patients through cardiac computed tomography. They are exploring the contribution of chronic hyper-activation of the sympathetic nervous system and the impact of an interventional procedure – renal denervation – in both blood pressure control and in surrogate markers of target organ damage.
Group 8 - Musculoskeletal
Jaime da Cunha Branco
This group gathers rheumatologists, orthopedists, pediatricians, rehabilitation therapists, exercise physiologists, epidemiologists, nutritionists, statisticians, geneticists and psychologists from NMS, affiliated hospitals, ENSP, Evora University, SEEBMO Azores and Instituto Politécnico Setúbal.
This research group has the expertise in surveys (EpiReumaPt), registries (Reuma.pt), observational studies and clinical trials on musculoskeletal diseases (MSK). A long-term investment has been made in a population-based cohort (EpiDoC) with imaging and blood samples and have also experience in developing and testing innovative interventional studies through ICTs using patient-oriented strategies.
The group has been dedicated to the study of genetic aspects of bone, ectopic calcifications, DISH, chondrocalcinosis, ankylosing spondylitis, genetic predictors of susceptibility and prognosis in juvenile arthritis (JIA), and pharmacogenetics of rheumatoid arthritis and JIA.
Group 9 - Mental health determinants, needs and interventions
Fernando Miguel Teixeira Xavier
This group is based at NMS and includes psychiatrists, family doctors and other mental health professionals (Mental Health Research Unit, NOVA-MeHRU) and has an extensive experience on clinical and psychosocial assessment of psychiatric disorders, psychiatric epidemiology, mental health policy/services evaluation research, ageing and neuropsychiatric disorders. Researchers have coordinated or collaborated in several multicentre studies funded by European and national funding agencies. They also have been collaborating with the Portuguese government (Ministry of Health, General Directorate of Health) in the development and implementation of mental health plans and policies. There are strong connections with international research networks like INTERDEM and there have been close collaborations and the possibilities of strengthening formal partnerships with Hospital do Mar (Luz Saúde), União das Misericórdias Portuguesas and ARIA.
The first main team of this research group is related with clinical evaluation and the second is related with ageing, mental health and dementia.
Group 10 - Sensation and hearing disorders
João Carlos Lopes Simões Paço
This group includes two teams of ear, nose and throat (ENT)-specialists from NMS. And the main objectives of these teams are to develop effective strategies and treatments to improve or rehabilitate individuals with sensation disorders, particularly elderly individuals, and alleviate communication, social, and economic problems resulting from hearing loss, taste and smell disorders.
These researchers had contributed (in 2013-17) to these objectives by:
1) Developing instruments, valid for European Portuguese speakers, to evaluate the satisfaction of hearing aid users;
2) Analysing Daily Cochlear implant use in adults using datalogging software;
3) Evaluating the contribution of speech reading in the word intelligibility of individuals with age-related hearing loss;
4) Determining the distribution of human olfactory mucosa in the nasal cavities;
5) Defining European tinnitus guidelines, to establish uniformity in the assessment and treatment of adult patients with subjective tinnitus.
Group 11 - Clinical studies in immune dysregulation from pregnancy to adulthood
Luis Miguel Nabais Borrego
This research group includes immunologists, allergologists, obstetricians, and pediatricians from several different hospital and university departments. Main interest in allergic disease, immunodeficiency and reproductive immunology.
First, understanding the underlying immunological mechanisms of allergic pathologies is paramount to establish new laboratory methods for diagnosis, disease monitoring, prognosis and response to therapy.
Second, the team is also deeply involved in both diagnosis and research projects in Primary immunodeficiency (PID). Considering the severe implications of PID in infants and adolescents, a precise diagnostic is critical for therapeutic purposes, in order to prevent the morbidity and mortality associated to these diseases.
There are also a group of investigators in the area of reproductive immunology. From these studies, they hope to identify normal profiles that can be applied to the diagnosis and prevention of obstetric pathologies, but also to approach the fetal period as a relevant point for the development of the child’s immune system, particularly as a result of the subsequent development of diseases with immune dysregulation, such as allergic asthma or autoimmune diabetes.
Group 12 - Infection, sepsis and antibiotics resistance
Pedro Manuel Sarmento Rodrigues Póvoa
This research group is a multidisciplinary team of physicians, statisticians, epidemiologists and biologists from NMS, affiliated hospitals, INSA and ENSP, that addresses highly-lethal infections and infections which are global public health concerns.
The main objectives include improving diagnosis and therapy of highly-lethal infections and helping to better identify vulnerable populations and novel health policies for transmissible diseases.
The group researches on how to:
1) Prevent exposure to the infection agent
2) Making otherwise susceptible individuals or population, immune to the infections agent;
3) Better understand the pathophysiology of infectious diseases, exploring the interaction between infectious agent and host;
4) Improving the diagnosis of infected individuals and develop prognostic markers of poor outcomes;
5) Treating infected individuals to prevent illness and transmission of the agent to others;
6) Epidemiology of neonatal infection, providing knowledge about antibiotics prescription and strategies to improve antibiotics prescription;
7) Improving the timeless and appropriateness of care for symptomatic individuals to minimize morbidity and mortality and, in some instances, to reduce the likelihood of transmission to others.
Thematic line III - Health policies and healthcare services research
Alexandre Vieira Abrantes
This research line departs from the idea that health and treatments cannot be conceived without understanding the context in which they occur. There is extended evidence that people´s health highly depends on the place they live, namely, the neighbourhood and/or the country. In regard to treatments, their effectiveness depends also on contextual characteristics of health services and systems. This research line will be devoted to understanding how these contextual factors influence populations’ health and the appropriate delivery of clinical interventions, focused by the two other research lines.
The link between context and health is currently focused on a better understanding on how health and healthy lifestyles are shaped on the one hand by macro socioeconomic policies, which we intend to evaluate.
This thematic line aims at pursuing and developing the study of the most efficient investments in the health system, in order to improve quality while preserving sustainability.
In regard to treatments, it will contribute to longstanding efforts in Portugal to evaluate new drugs and medical devices, following the requirements of regulatory agencies. In regard to public health interventions, it will develop this new research avenue, traditionally neglected by health economists, of evaluating population-based interventions.
Group 13 - Patient-centred care research
Maria Isabel Pereira dos Santos
The Person-centred care research group is mostly interest on how to centre healthcare on people/patients. It includes physicians, nurses, social scientists and patient-experts.
This research group is using qualitative methods to understand patients’ experiences of illness and to identify patient-relevant outcomes that should be assessed in healthcare research and what are the minimal clinically important differences associated to such outcomes.
They are also focusing on how to provide better care for common health problems presenting in primary healthcare and to disseminate clinical research into everyday clinical practice.
Group 14 - Efficiency, incentives and sustainability
João António Catita Garcia Pereira
The research group includes health economists, social scientists and public health specialists from ENSP. The group aims at developing research in two areas related to health economics, namely economic evaluation and providers´ payment mechanisms.
The researchers aim at studying population-based public health interventions. This way they have been working on the cost-effectiveness of tobacco control policies. The research will be devoted to exploring and understanding the impact of pay-for-performance, with a particular focus on primary care, aiming also at formulating recommendations for the most adequate design of pay-for-performance schemes.
Group 15 - Health services research and equity
Ana Maria Escoval
The Health Services Research Group includes health managers, public health specialists, and experts on organizational studies and public policies from ENSP and affiliated hospitals.
This research group has long developed research on organizational and financing aspects that will allow reaching this objective of high-quality care, with a particular focus on primary care models, vertical integration of primary and secondary care providers, hospital performance measurement, and quality measurement and comparison (including risk adjustment).
Group 16 - Global and population mental health
José Miguel Barros Caldas de Almeida
This group includes psychiatrists, psychologists, social scientists and epidemiologists and is based at the Lisbon Institute of Global Mental Health (LIGMH), founded in 2014 by the Gulbenkian Foundation, NMS and ENSP. It aims at generating innovative knowledge, building capacity and providing technical collaboration to governments worldwide in the areas of: mental health, social determinants and vulnerable populations; mental ill health and chronic diseases; mental health policy; and mental health and human rights.
The main objectives for the next 3 years are:
- To continue studying the effects of socio-economic crises and other emergencies on mental health of the populations;
- To assess accessibility and capacity of care in countries with diverse mental health systems;
- To continue monitoring of mental health policies and systems in the EU;
- To develop new approaches on capacity building of mental health leaders and researchers.
They will also initiate a World Mental Health Surveys Initiative´s study on university students’ mental health, as well as projects addressing psychosocial problems related to new vulnerabilities, and mental health and human rights.
Thematic line IV - Health innovation
Helena Cristina de Matos Canhão
CHRC will put a great investment in this cross-sectional thematic line. Innovation should be implemented across all thematic lines, research groups and activities.
Particularly, health innovation, patient and user innovation, free and open innovation, digital health, new ICTs, new methods to analyse big data and entrepreneurship are key areas to develop and foster.
In healthcare, due to all inherent circumstances, the innovation process is effortful and long-lasting. Academic researchers develop in-lab innovative approaches and solutions to current clinical challenges that end up failing through development process, either by not being able to translated research into commercially viable solutions, or not having a strong and stable clinical trial environment to improve the efficacy and usability of them. On the other hand, citizens are developing solutions and new strategies to cope with needs not addressed by the industry and academia.
Therefore, CHRC will open the doors of our centre to citizens that motivated by a need imposed by a health condition want to engage in the development of a solution, dedicated to prototyping and testing.
Patient Innovation project, Saude.come, and the AI-based framework for radiology image pre-reading empowered this unit with new proficiencies in ICT and Artificial Intelligence in order to develop and improve health management information systems, and biomedical devices.
It will be also organized both efforts and investments of CHRC researchers involved in health promotion, diagnosis improvement, and treatment strategies and prognosis.
Finally, the research group of this thematic line is committed to both diffusion and adoption stages of research-based innovative outcomes. Their mission is to translate research into adoptable health policies, products and technology, and services that improve people’s health. Therefore, they will identify high-impact innovations, apply proven business strategies that will support and scale them and seek collaborations (partners in production, health regulatory agencies’ compliance, distribution, and marketing) within and outside the Portuguese healthcare system.
Group 17 - Health innovation, digital health and entrepreneurship
Liliana Catarina Cândida Laranjo Silva
This multidisciplinary and multicentre research group´s main objectives are
1) To facilitate patient-engagement in healthcare;
2) To use machine learning and other methods to process big data generated by electronic medical records (EMR), registries, health platforms and medical imaging technologies;
3) Apply ICTs to collect data and promote intervention studies;
4) To incorporate simulation in pre and post-graduate training of healthcare professionals.
They engaged patients in healthcare through the use of consume digital technologies. Designing trials of m-health technologies to assist on behaviour change, and to support person-centred care.
This group is developing a deep machine learning framework to be used for radiology image pre-reading, with the purpose of releasing human resources for more complex tasks, increase human productivity on a radiology digital environment and to bring-up radiology care to underdeveloped regions. They also applied narrative learning processing to assess rheumatoid arthritis’ disease activity in EMR, to establish treatment response predictors upon Reuma.pt and are applying these techniques to retrieve more relational data from patient innovation network.
NMS and CHLC host a Simulation Centre for training of healthcare professionals. The researchers will implement several educational research studies, including trials to compare classical and EMBS resuscitation training, training in obstetrics and neonatal care, validation of competence-assessment instruments, and impact assessment of the simulation training in patient-outcomes.