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Activity Funded

Epidemiology Research Unit - Institute of Public Health, University of Porto

Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto

Reference
UIDB/04750/2020
Project Start Date
2020-01-01
Project End Date
2024-12-31
Principal Investigator
Scientific Area
Medical and health sciences
Funding Program
Concurso de avaliação no âmbito do Programa Plurianual de Financiamento de Unidades de I&D (2017/2018) - Financiamento Base

Abstract

10.2 Summary in English for general dissemination purposes The Epidemiology Research Unit (EPIUnit) includes 70 integrated PhD members organized into seven research groups, and intend to cover the major epidemiological areas, be it according to period of life, diseases or exposures. The Unit is an innovative organization with a strong contingency plan. It is built on four strategic ideas: a) scientifically challenging topics; b) participative networking; c) moving global; d) scientists’ central role; and four research pillars: a life course perspective of aging; systems Public Health; outcomes research and translational epidemiology; and inequalities and social determinants of health. from a "syndemic" perspective. We are interested in the interplay of causes acting at different stages of the life course, from before conception through old age, and the ways in which environment influences gene expression to produce disease. Understanding the causes of disorders and evaluating interventions at appropriate stages in the life course will contribute robust and timely evidence to inform policies. The follow-up of our cohorts, support a life course perspective and makes possible to identify critical and sensitive etiological periods and better understand aging. In population health we use innovative analytical methods and processes that facilitate the linking of actual data records. We will strengthen existing partnerships with civil society organizations, strengthen communication, and promote participatory research and the effective dissemination of results, contributing to community empowerment. We want to train the next generations of epidemiological research leaders and provide independent advice to assist with policy development, decision-making, program implementation, and networking with stakeholders, nationally and internationally The overarching objective of the proposed research is to extend the study of major health conditions and their determinants by incorporating an analysis of the biological and social mechanisms linking lifetime exposures to disease risk and to the uptake of health care. With time, the intersection of all our activities, skills, research tools and scientific curiosity tended to gravitate around seven major poles that exemplify our best and most influential research, our teaching, our training of the public health workforce and our image as perceived by the community we serve. These are obesity, vulnerability and hard-to-reach populations, cardiovascular health, cancer, occupational and environmental health and the evolving landscape of infectious diseases. They permeate individual investigators and research groups in different moments but feature a common continued contribution and promote a rich dialogue as time goes by, internally and with many collaborative labs and partners. Thus, conceptual pillars and cross-cutting themes are the basis for the definition of our objectives and strategical organization. 10.3 Summary in English for evaluation A major concern of EPIUnit is to deliver what is foreseen in its activity plans. Looking back at the years under evaluation we clearly accomplished this and managed to transform our ambitions into realistic goals. We strongly believe that the same will be achieved under the proposed plan for the years 2018-2011. As implicit in the Unit’s designation we center our research on epidemiology and want to quantify and understand the dynamics of health and disease in populations. We elected specific health states and determinants, periods of life, exposures and methodological options, and made clear the relevance of transposing the boundaries between scientific fields that also fuel innovation and challenge our domain. This understanding has shaped our organization into seven research groups, each with their specific core activity and objectives, although interaction and complementary targets are favored. Individual research groups have set their own objectives and provide concise information on how they expect to transform them into novel findings for the duration of this activity plan. The Unit’s general objectives congregate those groups’ interests, follow up our past activity and values, and aspire to open new avenues, address new problems, and develop innovative methodologies. That is why we identified seven cross-cutting thematic lines: obesity, vulnerability and hard-to-reach populations, cardiovascular health, cancer, occupational and environmental health, and the evolving landscape of infectious diseases. These themes emerged naturally as they unite many groups and are simultaneously present in the work of our principal researchers. Since those lines tend to cluster particularly in specific groups, a leader will be appointed to each line, promoting inter-sectorial meetings and evaluating progress and relevance. The increasing importance of the Internet for dissemination poses important challenges for public health interventions. We will focus on the effects of digital communication on public perception of health problems, as well as on the observation and analysis of disease representations in social networks. We will examine the dynamics and social involvement of online communities with public health problems, and address innovation in digital health communication. New ways of promoting health literacy will be developed and given a central role in the Unit. We updated our four scientific streams, or pillars, which contain broad objectives and methods. 1. A life course perspective of aging - We are interested in the interplay of causes acting over the life course, from before conception through old age, and in the ways in which environment modulates gene expression. The follow-up of our birth and adolescent cohorts will allow us to continue identifying sensitive etiological periods in the first decades of life, and we will define life course trajectories of such diverse problems as adiposity, pain, intelligence and lifestyles. Our adult cohort will allow a privileged perspective on aging, namely on the threshold between a healthy ageing heart and overt heart failure, exploring gender effects, and the mediating role of biological pathways, as well as the distal effects of physical and social environments. We will continue to develop accurate methods to study and monitor cognition decline and dementia. 2. Systems Public Health. We will pursue a commitment to the development of conceptual models and analytical approaches that formally address causality, beyond frequentist data science. This will permeate our scientific outputs and teaching approaches, featuring the hypothesis-driven component of epidemiologic research and the counterfactual model as a guiding influence, with structural equation modelling and causal diagramming as tools. One of the most exciting challenges in epidemiology is to extend causal inference to the complex system of population health, contributing to identify leverage points for population interventions that may effectively prevent disease and disability. Complex model building requires multi and transdisciplinary collaborations, especially because systems approaches are still underexplored. 3. Outcomes research and Translational epidemiology - We will strengthen the translation of our research outputs into public and clinical policy, enhancing an implementation research approach, namely in the fields of disease classification, management and outcomes using a cohort study to assess the incidence of cognitive impairment and its relation to treatment options in prostate cancer and a pragmatic trial on the effectiveness of a non-pharmacological approach to diabetes), and quality and safety of care (using such approaches as a pragmatic trial on the comparative effectiveness of different methods of invitation for cancer screening, and rolling-up and testing the Brain-on-track tool in health care centers). 4. Inequalities and social determinants of health - The identification and quantification of social determinants of health is a priority. Within this wide topic, we will focus on developing policy recommendations for people-centered healthcare and innovative approaches to ethical and methodological challenges in research. We aim to co-produce a model for public and patient involvement in health data governance, to investigate how social environment contributes to health inequalities using a life course approach, and to study the biological impact of social adversity (i.e. material and resource deprivation and adverse experiences) on inflammatory processes and epigenetic mechanisms. In addition to the observational and experimental studies currently being set up, most research issues will be answered using our ongoing population cohorts (Generation XXI, EPITeen, EPIPorto, Drug users, TB patients, MSM, Preterm infants – EPICE Portugal, Bitwin), clinical cohorts of patients, and register data (cancer registers, hospital discharge registers, national health statistics).

Institutions

Main Institutions

  • Universidade do Porto Unidade de Investigação em Epidemiologia (UP EPIUnit)
  • Universidade do Porto Instituto de Saúde Pública (ISPUP)

Funding 1.226.225,00 €

Fundação para a Ciência e a Tecnologia (FCT) - Portugal

1.226.225,00 €