Catarina Leitão

Purpose: Prostate cancer (PCa) remains a significant health burden as one of the most common cancers among men worldwide. Given the growing evidence of lifestyle’s impact on PCa progression, this study evaluates multidisciplinary experts’ feedback on a novel questionnaire assessing lifestyle factors potentially influencing PCa progression. Methods: Developed through systematic literature reviews and insights from focus groups with clinical practice professionals, namely interns and specialists in urology and family medicine (FM), the questionnaire covers four domains: sociodemographic data, dietary habits, lifestyle factors, and clinical data. Results: The questionnaire was evaluated by 25 professionals from the fields of public health, epidemiology, urology, and family medicine (FM), as well as by two linguists and two clinical psychologists. The questionnaire was first evaluated using a 5-point Likert scale for adequacy, accuracy, completeness, format, interest, usefulness, and confidence. Subsequently, each domain was also assessed individually for adequacy, accuracy, and completeness, using the same Likert scale, with qualitative feedback refining the questionnaire. Overall, this questionnaire received positive evaluations, with a mean score of 4.47 ± 0.72 and a median score of 4 or higher for each assessment. All domains achieved median scores of 5 for adequacy and accuracy, though completeness scored slightly lower in the lifestyle domain. Qualitative feedback highlighted the questionnaire’s relevance and clarity, while suggesting minor refinements. Conclusion: These findings underscore the potential of this structured data collection protocol for exploring lifestyle-PCa associations, supporting future case-control studies, and advancing targeted prevention and intervention strategies for PCa risk management.

Purpose Digital health (DH) has undergone rapid expansion in recent years, driven by new innovations aimed at improving healthcare quality, service efficiency, and patient empowerment. However, DH adoption and usage remains inconsistent, shaped by disparities in individual and contextual factors. This study explores key perceptions, barriers, and experiences with DH in Portugal to identify systemic challenges and opportunities for equitable integration. Methods A qualitative research design was employed, utilizing focus groups discussions. Participants were recruited via institutional e-mail campaigns and social media outreach. Five focus group sessions were conducted, with six to eight participants each, via Zoom videoconference. Sessions were recorded, transcribed verbatim, and inductive thematic analysis to identify emergent patterns. Results Thirty-four participants engaged across five focus groups, with data saturation achieved by the fifth session. Thematic analysis revealed seven core themes: 1) DH concepts; 2) experiences with DH; 3) health information; 4) advantages of DH; 5) concerns towards DH; 6) barriers to DH access and use; 7) solutions to improve the DH framework. Conclusion Despite the digital health framework improvement throughout the years, a lot needs to be done to make digital health truly accessible to everyone in Portugal, as significant gaps persist in accessibility, equity, and user-centric design. Concerns regarding equitable access, digital health literacy, infrastructure, patient-healthcare professional relationship and AI are some of the many dimensions that must be considered when working towards digital transformation in healthcare. Future policies must balance technological innovation with equitable access to ensure all population segments take advantage of digital health.

Purpose of Review: Prostate cancer (PCa) is the most prevalent cancer and the third deadliest in Europe among men. PCa has several well-established risk factors; however, the influence of lifestyle factors remains under investigation, which may hinder efforts to encourage healthier behavior adoption. Thus, this systematic review explored the general population’s perceptions, knowledge, and attitudes regarding PCa-related risk factors. Recent Findings: Eighteen qualitative studies were included after searching PubMed, Scopus, Web of Science, and EMBASE scientific databases between January 2013 and February 2023. Five major themes emerged from the 18 included studies: PCa knowledge, risk factors, lifestyle pattern changes, motivation/barriers to changing habits, and lifestyle advice support. Participants identified age, family history, genetics, and race/ethnicity as risk factors for PCa, but no consensus has been reached regarding lifestyle. However, most of the participants were willing to adopt healthier habits. Support from healthcare professionals (HPs), family, and friends, the desire for more time with loved ones, and fear of PCa consequences were cited as motivators for habit changes. However, poor economic conditions, work schedules, age, and PCa limitations hamper lifestyle changes. Summary: Effective interventions require personalized support and credible information from healthcare providers. Collaboration between family, friends, and HPs is crucial for promoting healthier behaviors and enhancing PCa management. This systematic review highlights the need for further research and innovative approaches to empower individuals towards healthier lifestyles, which could help prevent PCa or, at the very least, promote better treatment outcomes. Graphical

Prostate cancer (PCa) accounts for 20% of new cancer cases and 10.5% of cancer-associated mortality in Portugal. Associated risk factors include advanced age, family history, genetic alterations, and race/ethnicity. However, the role of lifestyle factors is often underestimated. To explore health professionals’ perceptions of PCa risk factors, a qualitative study with three focus groups (FG), with a total of twenty-one general practitioners and urologists, was conducted via videoconference between February and April 2023. Seven themes emerged, including general perceptions of PCa; PCa risk factors; nutritional impact; the role of physical activity; alcohol consumption and smoking; sexual activity and sexually transmitted diseases roles in PCa; and screening, diagnosis, and treatment methods. Despite agreeing that healthy lifestyles could promote better PCa outcomes and quality of life, participants did not specify any lifestyle factors that could promote or prevent this disease, posing challenges to lifestyle changes, particularly among older adults. Non-invasive screening methods, such as biomarkers and alternative treatments, are crucial for future research. This study underscores the need for further investigation into the correlation of lifestyle factors with PCa and highlights the necessity of health professionals in encouraging their patients to adopt healthier lifestyles, while offering important insights into awareness, prevention, and alternative screening, diagnosis, and treatment methods, which could help reduce false positives and treatment side effects.

Background: Vaccination against COVID-19 has had a major impact over the course of the pandemic, leading to a reduced number of hospitalizations and deaths. However, the mass vaccination process has been accompanied by skepticism and hesitancy since its beginning. As health professionals and teachers are important public health actors who can strongly intervene to reduce vaccination hesitancy among their patients and students, respectively, this study aimed to assess their main perceptions towards COVID-19 vaccination. Methods: Two focus group sessions, one with health professionals and the other with teachers, were conducted according to the COREQ checklist. Qualitative data were analyzed through theoretical thematic analysis. Results: In general, none of the groups showed vaccine hesitancy, although both groups had concerns regarding the safety and efficacy of the vaccines. The main concerns of health professionals were mostly related to the long-term impact of the COVID-19 pandemic, while teachers were more worried about the lack of access to reliable information about the COVID-19 vaccination. Conclusions: It is plausible to conclude that it is imperative to provide clear and accurate information for the population in order to avoid vaccination hesitancy.

Prostate cancer (PCa) is one of the most common cancers among men, and its incidence has been rising through the years. Several risk factors have been associated with this disease and unhealthy lifestyles and inflammation were appointed as major contributors for PCa development, progression, and severity. Despite the advantages associated with the currently used diagnostic tools [prostate-specific antigen(PSA) serum levels and digital rectal examination (DRE)], the development of effective approaches for PCa diagnosis is still necessary. Finding lifestyle-associated proteins that may predict the development of PCa seems to be a promising strategy to improve PCa diagnosis. In this context, several biomarkers have been identified, including circulating biomarkers (CRP, insulin, C-peptide, TNFα-R2, adiponectin, IL-6, total PSA, free PSA, and p2PSA), urine biomarkers (PCA3, guanidine, phenylacetylglycine, and glycine), proteins expressed in exosomes (afamin, vitamin D-binding protein, and filamin A), and miRNAs expressed in prostate tissue (miRNA-21, miRNA-101, and miRNA-182). In conclusion, exploring the impact of lifestyle and inflammation on PCa development and progression may open doors to the identification of new biomarkers. The discovery of new PCa diagnostic biomarkers should contribute to reduce overdiagnosis and overtreatment.

Despite the increasing life expectancy, an individual’s later years tends to be accompanied by a decrease in the quality of life. Though biological changes that occur through the natural process of aging cannot be controlled, the risk factors associated with lifestyle can. Thus, the main goal of this systematic review was to evaluate how nutrition can modulate aging. For this purpose, thirty-six studies were selected on (i) the efficiency of nutrition’s effect on aging, (ii) the evaluation of biomarkers that promote healthy aging, and (iii) how to increase longevity through nutrition, and their quality was assessed. The results showed that choosing low carbohydrate diets or diets rich in vegetables, fruits, nuts, cereals, fish, and unsaturated fats, containing antioxidants, potassium, and omega-3 decreased cardiovascular diseases and obesity risk, protected the brain from aging, reduced the risk of telomere shortening, and promoted an overall healthier life. With this study, the conclusion is that since the biological processes of aging cannot be controlled, changing one’s nutritional patterns is crucial to prevent the emergence and development of diseases, boost longevity, and, mostly, to enhance one’s quality of life and promote healthy aging.