{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T14:13:39Z","timestamp":1765808019524,"version":"build-2065373602"},"reference-count":87,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["This research was supported by FCT funding UID\/BIM\/04293\/2013 and by FCT\/MEC; PIDDAC; FEDER; COMPETE (POFC) with the following reference FCOMP-01-0124-FEDER-041872 FCT (EXPL\/IVC-PEC\/1302\/2013, RES4MED: Aprender medicina atrav\u00e9s da investiga\u00e7\u00e3o)."],"award-info":[{"award-number":["This research was supported by FCT funding UID\/BIM\/04293\/2013 and by FCT\/MEC; PIDDAC; FEDER; COMPETE (POFC) with the following reference FCOMP-01-0124-FEDER-041872 FCT (EXPL\/IVC-PEC\/1302\/2013, RES4MED: Aprender medicina atrav\u00e9s da investiga\u00e7\u00e3o)."]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Developing the skills and interest in scientific research of medical students is crucial to ensuring effective healthcare systems. As such, in this study, we aimed to assess Portuguese-speaking medical students\u2019 attitudes and perceptions toward scientific research and clinical practice, and how they are influenced by individual characteristics and regional indicators. A total of 455 first-year students from three medical schools in three countries (Portugal, Brazil, and Angola) participated in this study by completing a questionnaire. Portuguese students attributed the most importance to scientific skills and were the most confident in their ability to perform these skills. Angolan students were the most motivated to perform research and integrate it into the curriculum, despite having the most negative attitudes and perceiving themselves as having less ability to perform scientific skills. Brazilian students had the least positive attitudes toward science. In Portugal, attitudes depended on gross domestic product (GDP), while in Angola, they were influenced by the type of secondary school attendance. Portuguese students\u2019 perceptions of scientific skills were related to sex, GDP, type of secondary school, and participation in research. In Brazilian and Angolan students, perceptions were associated with age and research participation, respectively. The findings support the need to promote skills and positive attitudes toward scientific research in future physicians, fostering physician-scientists and improving patient care.<\/jats:p>","DOI":"10.3390\/healthcare10020336","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T04:42:27Z","timestamp":1644468147000},"page":"336","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of Medical Students\u2019 Views toward Research: Insights from a Cross-Cultural Study among Portuguese-Speaking Countries"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4038-5892","authenticated-orcid":false,"given":"Gustavo","family":"Correia","sequence":"first","affiliation":[{"name":"Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"given":"Margarida","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Centre for Research on Pandemics & Society, Oslo Metropolitan University, 0167 Oslo, Norway"}]},{"given":"Andreia","family":"Gomes","sequence":"additional","affiliation":[{"name":"Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"given":"Maria do Ros\u00e1rio","family":"Bragan\u00e7a","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Katyavala Bwila (FMUKB), Benguela 1725, Angola"},{"name":"Faculty of Medicine, University Agostinho Neto, Luanda 64346, Angola"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3194-3039","authenticated-orcid":false,"given":"Silke","family":"Weber","sequence":"additional","affiliation":[{"name":"Botucatu Medical School, S\u00e3o Paulo University, Botucatu 05508-220, Brazil"}]},{"given":"Maria Am\u00e9lia","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1181-9217","authenticated-orcid":false,"given":"Laura","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"I3S-Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, 4200-135 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,10]]},"reference":[{"key":"ref_1","unstructured":"Flexner, A. (1910). Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching, The Carnegie Foundation for the Advancement of Teaching."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1007\/s12026-012-8310-x","article-title":"An innovative portfolio of research training programs for medical students","volume":"54","author":"Zier","year":"2012","journal-title":"Immunol. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1111\/j.1365-2923.2011.03986.x","article-title":"Student views of research training programmes in medical schools","volume":"45","author":"Luz","year":"2011","journal-title":"Med. Educ."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Salgueira, A., Costa, P., Gon\u00e7alves, M., Magalh\u00e3es, E., and Costa, M.J. (2012). Individual characteristics and students engagement in scientific research: A cross-sectional study. BMC Med. Educ., 12.","DOI":"10.1186\/1472-6920-12-95"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/ACM.0b013e3181c88b09","article-title":"Flexner revisited: The role and value of the basic sciences in medical education","volume":"85","author":"Finnerty","year":"2010","journal-title":"Acad. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/j.1365-2923.2004.01735.x","article-title":"Teaching research methodology in medical schools: Students\u2019 attitudes towards and knowledge about science","volume":"38","author":"Hren","year":"2004","journal-title":"Med. Educ."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Amgad, M., Tsui, M.M.K., Liptrott, S.J., and Shash, E. (2015). Medical student research: An integrated mixed-methods systematic review and meta-analysis. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0127470"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1001\/jama.294.11.1343","article-title":"The physician-scientist career pipeline in 2005: Build it, and they will come","volume":"294","author":"Ley","year":"2005","journal-title":"JAMA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2803","DOI":"10.1172\/JCI119470","article-title":"The clinical investigator: Bewitched, bothered, and bewildered--but still beloved","volume":"99","author":"Goldstein","year":"1997","journal-title":"J. Clin. Investig."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"8","DOI":"10.11604\/pamj.2018.29.8.13239","article-title":"The physician-scientists: Rare species in Africa","volume":"29","author":"Adefuye","year":"2018","journal-title":"Pan Afr. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Pereira, M., Correia, G., Severo, M., Ver\u00edssimo, A.C., and Ribeiro, L. (2021). Portuguese Medical Students\u2019 Interest for Science and Research Declines after Freshman Year. Healthcare, 9.","DOI":"10.3390\/healthcare9101357"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1537430","DOI":"10.1080\/10872981.2018.1537430","article-title":"Contemporary global perspectives of medical students on research during undergraduate medical education: A systematic literature review","volume":"23","author":"Stone","year":"2018","journal-title":"Med. Educ. Online"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Dickler, H.B., Korn, D., and Gabbe, S.G. (2006). Promoting translational and clinical science: The critical role of medical schools and teaching hospitals. PLoS Med., 3.","DOI":"10.1371\/journal.pmed.0030378"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/S40037-017-0328-2","article-title":"Scholarly concentration programs and medical student research productivity: A systematic review","volume":"6","author":"Havnaer","year":"2017","journal-title":"Perspect Med. Educ."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"\u00d6cek, Z., Bat\u0131, H., Sezer, E.D., K\u00f6ro\u011flu, O.A., Y\u0131lmaz, O., Y\u0131lmaz, N.D., and Mand\u0131rac\u0131o\u011flu, A. (2021). Research training program in a Turkish medical school: Challenges, barriers and opportunities from the perspectives of the students and faculty members. BMC Med. Educ., 21.","DOI":"10.1186\/s12909-020-02454-1"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1097\/ACM.0000000000000702","article-title":"A review of literature on medical students and scholarly research: Experiences, attitudes, and outcomes","volume":"90","author":"Chang","year":"2015","journal-title":"Acad. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e317","DOI":"10.3109\/0142159X.2012.670324","article-title":"Extracurricular participation in research and audit by medical students: Opportunities, obstacles, motivation and outcomes","volume":"34","author":"Jamjoom","year":"2012","journal-title":"Med. Teach."},{"key":"ref_18","unstructured":"Ribeiro, L., Severo, M., Soares, R., and Ferreira, M.A. (2012, January 2\u20134th). Perspectives of undergraduate medical students about scientific research and its integration into medical curriculum. Proceedings of the 4th International Conference on Education and New Learning Technologies, Barcelona, Spain."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"754","DOI":"10.3109\/0142159X.2012.704438","article-title":"Developing research skills in medical students: AMEE Guide No. 69","volume":"34","author":"Laidlaw","year":"2012","journal-title":"Med. Teach."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Hunskaar, S., Breivik, J., Siebke, M., T\u00f8mmers, K., Figenschau, K., and Hansen, J.B. (2009). Evaluation of the medical student research programme in Norwegian medical schools. A survey of students and supervisors. BMC Med. Educ., 9.","DOI":"10.1186\/1472-6920-9-43"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/ACM.0b013e3181cd3e00","article-title":"Encouraging scholarship: Medical school programs to promote student inquiry beyond the traditional medical curriculum","volume":"85","author":"Green","year":"2010","journal-title":"Acad. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1097\/ACM.0b013e3181cccbd4","article-title":"How to measure success: The impact of scholarly concentrations on students\u2014A literature review","volume":"85","author":"Bierer","year":"2010","journal-title":"Acad. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"187","DOI":"10.2188\/jea.7.187","article-title":"Epidemiology, evidenced-based medicine, and evidence-based public health","volume":"7","author":"Jenicek","year":"1997","journal-title":"J. Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"g3725","DOI":"10.1136\/bmj.g3725","article-title":"Evidence based medicine: A movement in crisis?","volume":"348","author":"Greenhalgh","year":"2014","journal-title":"BMJ"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1001\/jama.289.10.1278","article-title":"Central challenges facing the national clinical research enterprise","volume":"289","author":"Sung","year":"2003","journal-title":"JAMA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.3109\/0142159X.2016.1150981","article-title":"Medical student perceptions of research and research-orientated careers: An international questionnaire study","volume":"38","author":"Funston","year":"2016","journal-title":"Med. Teach."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1038\/nm0502-437","article-title":"Emerging opportunities and career paths for the young physician-scientist","volume":"8","author":"Varki","year":"2002","journal-title":"Nat. Med."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ommering, B.W.C., Wijnen-Meijer, M., Dolmans, D.H.J.M., Dekker, F.W., and van Blankenstein, F.M. (2020). Promoting positive perceptions of and motivation for research among undergraduate medical students to stimulate future research involvement: A grounded theory study. BMC Med. Educ., 20.","DOI":"10.1186\/s12909-020-02112-6"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/ACM.0b013e31819301ab","article-title":"Issues in the mentor-mentee relationship in academic medicine: A qualitative study","volume":"84","author":"Straus","year":"2009","journal-title":"Acad. Med."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Siemens, D.R., Punnen, S., Wong, J., and Kanji, N. (2010). A survey on the attitudes towards research in medical school. BMC Med. Educ., 10.","DOI":"10.1186\/1472-6920-10-4"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Ratte, A., Drees, S., and Schmidt-Ott, T. (2018). The importance of scientific competencies in German medical curricula-the student perspective. BMC Med. Educ., 18.","DOI":"10.1186\/s12909-018-1257-4"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Stockfelt, M., Karlsson, L., and Finizia, C. (2016). Research interest and activity among medical students in Gothenburg, Sweden, a cross-sectional study. BMC Med. Educ., 16.","DOI":"10.1186\/s12909-016-0749-3"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5212","DOI":"10.3402\/meo.v15i0.5212","article-title":"Undergraduate medical research: The student perspective","volume":"15","author":"Burgoyne","year":"2010","journal-title":"Med. Educ. Online"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.36834\/cmej.42084","article-title":"Predictors of medical student interest and confidence in research during medical school","volume":"9","author":"Klowak","year":"2018","journal-title":"Can. Med. Educ. J."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Core Committee, Institute for International Medical Education (2002). Global minimum essential requirements in medical education. Med. Teach., 24, 130\u2013135.","DOI":"10.1080\/01421590220120731"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Barbosa, J., Severo, M., Fresta, M., Ismail, M., Ferreira, M.A., and Barros, H. (2011). How students perceive medical competences: A cross-cultural study between the medical course in Portugal and African Portuguese Speaking Countries. BMC Med. Educ., 11.","DOI":"10.1186\/1472-6920-11-24"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"316","DOI":"10.3109\/01421590903447716","article-title":"The Bologna process, medical education and integrated learning","volume":"32","author":"Cumming","year":"2010","journal-title":"Med. Teach."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1478-4491-9-9","article-title":"The training and professional expectations of medical students in Angola, Guinea-Bissau and Mozambique","volume":"9","author":"Ferrinho","year":"2011","journal-title":"Hum. Resour. Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/1478-4491-12-63","article-title":"The rise of medical training in Portuguese speaking African countries","volume":"12","author":"Fronteira","year":"2014","journal-title":"Hum. Resour. Health"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s12961-015-0021-z","article-title":"Current status on health sciences research productivity pertaining to Angola up to 2014","volume":"13","author":"Sambo","year":"2015","journal-title":"Health Res. Policy Syst."},{"key":"ref_41","unstructured":"World Health Organization (2013). Research for Universal Health Coverage: World Health Report 2013."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/S0140-6736(10)61961-7","article-title":"Medical schools in sub-Saharan Africa","volume":"377","author":"Mullan","year":"2011","journal-title":"Lancet"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1136\/bmj.324.7343.952","article-title":"Factors associated with success in medical school: Systematic review of the literature","volume":"324","author":"Ferguson","year":"2002","journal-title":"Br. Med. J."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Oliveira, C.C., De Souza, R.C., Abe, E.H., M\u00f3z, L.E.S., de Carvalho, L.R., and Domingues, M.A. (2014). Undergraduate research in medical education: A descriptive study of students\u2019 views. BMC Med. Educ., 14.","DOI":"10.1186\/1472-6920-14-51"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1590\/1806-9282.62.07.652","article-title":"Interest in research among medical students: Challenges for the undergraduate education","volume":"62","author":"Moraes","year":"2016","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"282","DOI":"10.2310\/JIM.0b013e3181cb42d9","article-title":"Can teaching research methodology influence students\u2019 attitude toward science? Cohort study and non randomized trial in a single medical school","volume":"58","author":"Vujaklija","year":"2010","journal-title":"J. Investig. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1038\/ni.3010","article-title":"The physician scientist: Balancing clinical and research duties","volume":"15","author":"Morel","year":"2014","journal-title":"Nat. Immunol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1056\/NEJMp1501440","article-title":"Getting the right medical students--nature versus nurture","volume":"372","author":"Schwartzstein","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Mills, J.K., Dalleywater, W.J., and Tischler, V. (2014). An assessment of student satisfaction with peer teaching of clinical communication skills. BMC Med. Educ., 14.","DOI":"10.1186\/1472-6920-14-217"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1097\/00001888-200312000-00007","article-title":"Teaching students how to read and write science: A mandatory course on scientific research and communication in medicine","volume":"78","year":"2003","journal-title":"Acad. Med."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Khan, H., Taqui, A.M., Khawaja, M.R., and Fatmi, Z. (2007). Problem-based versus conventional curricula: Influence on knowledge and attitudes of medical students towards health research. PLoS ONE, 2.","DOI":"10.1371\/journal.pone.0000632"},{"key":"ref_52","unstructured":"Schacter, D., Gilbert, D., Wegner, D., and Hood, B.M. (2011). Psychology: European Edition, Palgrave Macmillan."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"M\u00f6ller, R., and Shoshan, M. (2017). Medical students\u2019 research productivity and career preferences; a 2-year prospective follow-up study. BMC Med. Educ., 17.","DOI":"10.1186\/s12909-017-0890-7"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1136\/bmj.39280.547882.DB","article-title":"Women are still left behind in academic medicine","volume":"335","author":"Hitchen","year":"2007","journal-title":"BMJ"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1080\/09500693.2015.1054919","article-title":"Scientific skills as core competences in medical education: What do medical students think?","volume":"37","author":"Ribeiro","year":"2015","journal-title":"Int. J. Sci. Educ."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"22832","DOI":"10.3402\/meo.v18i0.22832","article-title":"Integration of scientific research training into undergraduate medical education: A reminder call","volume":"18","author":"Alkattan","year":"2013","journal-title":"Med. Educ. Online"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Boyle, S.E., Cotton, S.C., Myint, P.K., and Hold, G.L. (2017). The influence of early research experience in medical school on the decision to intercalate and future career in clinical academia: A questionnaire study. BMC Med. Educ., 17.","DOI":"10.1186\/s12909-017-1066-1"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1001\/jama.2007.26","article-title":"The meaning of translational research and why it matters","volume":"299","author":"Woolf","year":"2008","journal-title":"JAMA"},{"key":"ref_59","first-page":"301","article-title":"Study on Portuguese medical schools\u2019 learning conditions: A national analysis on student satisfaction, student-tutor ratios, and number of admissions","volume":"29","author":"Diogo","year":"2016","journal-title":"Acta Med. Port."},{"key":"ref_60","unstructured":"Faculty of Medicine Botucatu-S\u00e3o Paulo State University (FMB\/Unesp) (2021, April 08). Unesp-Faculty of Medicine-Campus Botucatu. Available online: https:\/\/www.fmb.unesp.br\/#!\/fmb-in-english."},{"key":"ref_61","unstructured":"University of Katyavala Bwila (2021, April 09). Faculty of Medicine-University of Katyavala Bwila. Available online: http:\/\/www.ukb.ed.ao\/Entidade\/faculdade_de_medicina."},{"key":"ref_62","unstructured":"Ministry of Planning and Territorial Administration (2021, April 08). Decree-law 46\/89. Available online: https:\/\/data.dre.pt\/eli\/dec-lei\/46\/1989\/02\/15\/p\/dre\/pt\/html."},{"key":"ref_63","unstructured":"Fernandes, M.A. (2015). Constitui\u00e7\u00e3o da Rep\u00fablica Federativa do Brasil, Rideel. [21st ed.]."},{"key":"ref_64","unstructured":"Feij\u00f3, C.M. (2015). Constitui\u00e7\u00e3o da Rep\u00fablica de Angola Vol. II, Almedina."},{"key":"ref_65","unstructured":"Statistics Portugal (INE) (2021, April 09). National Accounts 2000\u20132013, Base 2011-Gross Domestic Product per Inhabitant by NUTS 3. Available online: https:\/\/www.ine.pt\/ngt_server\/attachfileu.jsp?look_parentBoui=215820499&att_display=n&att_download=y."},{"key":"ref_66","unstructured":"Franklin, D., Rocha, A., Valimamade, S., Santos, R., Paulo, F.M., Londa, E., Fonseca, J., Domingos, P., Pacheco, F., and Po\u00e7as, M. (2021, April 08). Relat\u00f3rio Econ\u00f3mico de Angola 2010. Available online: http:\/\/www.ceic-ucan.org\/wp-content\/uploads\/2014\/03\/ceic-relat\u00f3rio-econ\u00f3mico-2010.pdf."},{"key":"ref_67","unstructured":"Brazilian Institute of Geography and Statistics (IBGE) (2021, April 08). Contas Regionais do Brasil: 2012, Available online: https:\/\/biblioteca.ibge.gov.br\/visualizacao\/livros\/liv89103.pdf."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S0140-6736(09)61124-7","article-title":"The public health effect of economic crises and alternative policy responses in Europe: An empirical analysis","volume":"374","author":"Stuckler","year":"2009","journal-title":"Lancet"},{"key":"ref_69","first-page":"58","article-title":"Knowledge about and attitude towards science of first year medical students","volume":"43","author":"Vodopivec","year":"2002","journal-title":"Croat. Med. J."},{"key":"ref_70","unstructured":"Statistics Portugal (INE) (2021, April 09). Censos 2011 Resultados Definitivos-Portugal. Available online: https:\/\/censos.ine.pt\/ngt_server\/attachfileu.jsp?look_parentBoui=148313382&att_display=n&att_download=y."},{"key":"ref_71","unstructured":"Brazilian Institute of Geography and Statistics (IBGE) (2021, April 09). Directorate of Surveys-DPE Coordination of Population and Social Indicators-Copis. Estimativa da Popula\u00e7\u00e3o Residente nos Munic\u00edpios Brasileiros com Data de Refer\u00eancia em 1\u00b0 de Julho de 2012, Available online: www.ibge.gov.br\/home\/estatistica\/populacao\/estimativa2012."},{"key":"ref_72","unstructured":"National Institute of Statistics of Angola (INE) (2021, April 09). Principais Indicadores de Angola por Prov\u00edncia, Available online: http:\/\/www.ine.gov.ao\/xportal\/xmain?xpid=ine&xpgid=indicators_province."},{"key":"ref_73","unstructured":"Brazilian Institute of Geography and Statistics (IBGE) (2013). Atlas do Censo Demogr\u00e1fico 2010."},{"key":"ref_74","unstructured":"Brazilian Institute of Geography and Statistics (IBGE) (2021, April 09). S\u00edntese de Indicadores Sociais: Uma An\u00e1lise das Condi\u00e7\u00f5es de Vida da Popula\u00e7\u00e3o Brasileira 2015, Available online: https:\/\/biblioteca.ibge.gov.br\/visualizacao\/livros\/liv95011.pdf."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1476-069X-11-4","article-title":"An ecological quantification of the relationships between water, sanitation and infant, child, and maternal mortality","volume":"11","author":"Cheng","year":"2012","journal-title":"Environ. Health"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1093\/ije\/dyr102","article-title":"The effect of water and sanitation on child health: Evidence from the demographic and health surveys 1986\u20132007","volume":"40","author":"Fink","year":"2011","journal-title":"Int. J. Epidemiol."},{"key":"ref_77","unstructured":"Statistics Portugal (INE) (2021, April 08). Inqu\u00e9rito ao Ambiente-Caracteriza\u00e7\u00e3o do Saneamento B\u00e1sico. Available online: https:\/\/smi.ine.pt\/DocumentacaoMetodologica\/Detalhes\/235."},{"key":"ref_78","unstructured":"Brazilian Institute of Geography and Statistics (IBGE) (2011). Atlas de Saneamento: 2011."},{"key":"ref_79","unstructured":"National Institute of Statistics of Angola (INE) (2021, April 08). Inqu\u00e9rito Integrado sobre o Bem-estar da Popula\u00e7\u00e3o (IBEP)-Relat\u00f3rio de Tabelas-Vol. II; 2011, Available online: https:\/\/andine.ine.gov.ao\/nada4\/index.php\/catalog\/11\/download\/82."},{"key":"ref_80","first-page":"537","article-title":"Estimating the burden of disease from water, sanitation, and hygiene at a global level","volume":"110","author":"Kay","year":"2002","journal-title":"Environ. Health Perspect."},{"key":"ref_81","unstructured":"Pr\u00fcss-\u00dcst\u00fcn, A., Bos, R., Gore, F., and Bartram, J. (2008). Safer Water, Better Health: Costs, Benefits and Sustainability of Interventions to Protect and Promote Health."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"208","DOI":"10.2105\/AJPH.2003.034900","article-title":"Equitable child health interventions: The impact of improved water and sanitation on inequalities in child mortality in Stockholm, 1878 to 1925","volume":"95","author":"Macassa","year":"2005","journal-title":"Am. J. Public Health"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S1473-3099(04)01253-8","article-title":"Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: A systematic review and meta-analysis","volume":"5","author":"Fewtrell","year":"2005","journal-title":"Lancet Infect. Dis."},{"key":"ref_84","unstructured":"United Nations (2021, March 21). World Economic Situation and Prospects 2015, Available online: https:\/\/www.un.org\/en\/development\/desa\/policy\/wesp\/wesp_archive\/2015wesp_full_en.pdf."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/jama.2009.155","article-title":"The feminization of medicine and population health","volume":"301","author":"Phillips","year":"2009","journal-title":"JAMA"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1177\/108155890305100317","article-title":"Impact of medical student research in the development of physician-scientists","volume":"51","author":"Solomon","year":"2003","journal-title":"J. Investig. Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/03075070120099359","article-title":"University students\u2019 perceptions of the learning environment and academic outcomes: Implications for theory and practice","volume":"27","author":"Lizzio","year":"2002","journal-title":"Stud. High. Educ."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/2\/336\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:17:23Z","timestamp":1760134643000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/2\/336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,10]]},"references-count":87,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["healthcare10020336"],"URL":"https:\/\/doi.org\/10.3390\/healthcare10020336","relation":{},"ISSN":["2227-9032"],"issn-type":[{"type":"electronic","value":"2227-9032"}],"subject":[],"published":{"date-parts":[[2022,2,10]]}}}