Cristina Jácome is an assistant researcher at CINTESIS, Faculty of Medicine of the University of Porto (FMUP), where she integrates the PaCeIT – Patient-Centered Innovation and Technologies group and is currently responsible for the EPI-Asthma project within CINTESIS, an innovative project which partners academic institutions and the pharmaceutical industry.

She was born in Nine, Vila Nova de Famalicão, in 1987, into a humble family that instilled in her the value of work and wanted her to fly higher. She had a happy childhood, getting actively involved in the life of the community. She attended Sunday school, was a girl scout, was part of a choral group, and practiced ballroom dancing. She studied in a public school in Barcelos where her father worked as a civil servant, and in the 10th grade, she went to the Externato Infante D. Henrique, in Braga, where she was president of the Students’ Association.

She finished high school on the board of excellence. She did not go on to study Nursing, like her sister, and she did not move to Porto, as her parents suggested. She went ahead and studied Physiotherapy at the School of Health of the University of Aveiro, completing the degree in 2009. “I knew that Medicine and Nursing would not be a good fit for me because I am easily impressed, but I thought Physical Therapy, with less acute pictures, might be the way,” she recalls.

In the last year of her degree, as a graduate, she started working at a Physiotherapy clinic in Aveiro, did her first research work, and published her first scientific paper. In 2009, with her diploma, she returned to Braga to work in a Cardiorespiratory Physiotherapy clinic, but she wanted to “improve her skills”. Therefore, she enrolled in the Master in Cardiorespiratory Physiotherapy at the Health School of the Polytechnic of Porto. Meanwhile, she obtained a grant from the Portuguese Foundation for Science and Technology (FCT), within a funded project aiming to develop respiratory rehabilitation programs for COPD patients and their caregivers, an area in which she was working. She then returned to the University of Aveiro at the end of 2010 and finished her master’s degree in 2011.

“Among physical therapists, it was not common to do research. It was very challenging. In addition to participating in the development of respiratory rehabilitation programs and psycho-educational programs for patients and their families, and having contact with professionals from the region’s health centers, I was able to continue my clinical practice,” she emphasizes.

In 2012, she won a fellowship from the European Respiratory Society (ERS) to spend three months at one of the world’s most renowned respiratory rehabilitation centers. In Leuven, Belgium, she had the opportunity to learn from the best.

“This was a milestone in my life. Three magnificent months. In addition to learning and the ideas I brought to the project, I collaborated on two scientific publications. I realized then that these international networks are fundamental. It was also very important for my confidence as a researcher because I never felt inferior to my colleagues,” she assures.

Upon returning to Portugal, she applied for a Ph.D. grant from the FCT, with the intention of continuing in the same line of research, the respiratory rehabilitation of patients with COPD. At the time, she wanted to understand whether rehabilitation should begin early and, at the same time, validate the electronic auscultation for monitoring these patients. In 2013, she obtained the scholarship and entered the Ph.D. in Physiotherapy at the Faculty of Sport of the University of Porto (FADEUP), which was opening its 1st edition. She was a member of CIAFEL and finally arrived at CINTESIS, still as a doctoral student.

She finished her Ph.D. in April 2016 and, in May, she joined a project on electronic auscultation for the diagnosis of respiratory pathologies at the University of Tromsø, Norway. Once again, she felt she was not behind his foreign colleagues. At the same time, she was teaching at the University of Aveiro.

Meanwhile, in 2017, she won another FCT grant, this one for post-doctoral studies, joining the areas of computed auscultation and mHealth, integrating the team of João Fonseca, a researcher at CINTESIS and professor at the Faculty of Medicine of the University of Porto, who had been part of his doctoral examination board. She is a founding member of the research group PaCeIT – Patient-Centered Innovation and Technologies, interested in the design, validation, evaluation, and implementation of user-friendly technologies and personalized, patient-oriented services for diagnosis, classification, and management of chronic diseases and their risk factors.

In September 2019, after completing her post-doctoral studies, she became an assistant researcher at CINTESIS/FMUP, with the responsibility of increasing the studies in the area of digital solutions and the connection with the business world and the community. She is currently the researcher responsible for the EPI-Asthma project at CINTESIS (Prevalence and characterization of people with asthma, according to the severity of the disease, in Portugal). The project, which started in late 2020, is a consortium of two academic institutions, FMUP, via CINTESIS, and the University of Minho, via the Research Institute of Life and Health Sciences (ICVS), with Astrazeneca, and with the U.Porto spin-off MEDIDA – Serviços de Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Lda.

At this moment, the pilot study in Matosinhos, in collaboration with three Family Health Units (USF) is almost concluded. The study, which includes telephone interviews (phase 1), clinical evaluations and exams (phase 2), and the use of a mobile application (phase 3), will be replicated in other regions. More than 7,500 people are expected to participate in the first phase alone. The study should extend until the end of 2023, but the first results should be published this year. Cristina Jácome also participates in other PaCeIT group studies, namely INSPIRERS and AIRDOC.

As for INSPIRERS, since 2017 she has been responsible for implementing feasibility studies of the InspirerMundi mobile application in secondary care units in Portugal and Spain. The latest study, carried out in 2020, in the middle of the pandemic, took place in 30 FHUs (Family Health Units) in the North and Center of the country. The aim is to evaluate the acceptability of InspirerMundi, an application that aims to improve adherence to inhaled medication in asthma patients and disease control.

One of the app’s innovative features is that it allows the automatic and objective reading of the dose counter of the asthma inhaler, using only the smartphone’s camera. In addition, it generates notifications according to each patient’s therapeutic plan, adding gamification and social network components that allow the sharing of experiences.

“I had experience in implementing projects, in the field, but this was the first time I managed a multi-center study in different national centers and with different specialties, to test a mobile technology in the real world. In this latest study we achieved our recruitment goals, even in such a difficult phase. We are now analyzing the results and designing a pilot clinical trial to start in 2021, in Secondary Care and Primary Health Care,” she says.

As for the project AIRDOC – Intelligent mobile application for individualized support and monitoring of the function and breathing sounds of Chronic Obstructive Patients, funded by Norte2020 (Portugal2020), the novelty is the use of innovative technology to record the forced expiratory maneuver and lung auscultation, using only the microphone of the smartphone.

“If we can transfer electronic auscultation from digital stethoscopes to smartphones, we will make life easier for clinicians and patients, safely and at no extra cost. In the future, doctors should be able to listen to these sounds, detect changes, and alert if there is a need. We have to evolve in terms of automatic methods to analyze these sounds. The first studies, with about 100 patients, show that auscultation with a smartphone allows the detection of sounds indicative of pathology, namely adventitious sounds (wheezing and wheezing or crackles)”, she explains.

Besides being a researcher, with more than 70 published articles, Cristina Jácome is also a professor at FMUP, where she teaches in the Master of Medicine and in two doctoral programs, PDICSS and HEADS, as well as in the Winter and Summer Schools and BLICS.  “Teaching is something I really enjoy doing, although I have more of a researcher profile. However, I don’t see myself just doing research either. I think passing on knowledge is very enriching,” she says.

She participates in a Cost Action (ENABLE) related to the use of technologies in medication adherence and is a member of two Tasks Forces of the European Respiratory Society, one on palliative care for patients with respiratory diseases (non-oncological) and another on bronchial hygiene in patients with bronchiectasis. She is a co-author of guiding documents for this type of health care. Since 2020, the researcher is also the president of the Interest Group in Cardiorespiratory Physiotherapy of the Portuguese Association of Physiotherapists. Her term has coincided with one of the most critical moments experienced in the profession, facing the challenges of COVID-19, and she has been in the genesis of guiding documents, videos and courses for physiotherapists and patients, including telerehabilitation. 

1-Year Ambition

I have been in charge and managing research projects, but I hope to be the principal investigator of a funded project.

10-Year Ambition

When I look back at the last 10 years, I see that such wonderful things have happened that I never thought possible. Of course, I have worked hard, but ten years ago if you told me I would do what I have done, I probably wouldn’t believe it. So I don’t need to imagine the next 10 years because I think they will be just as wonderful. As long as I feel this constant challenge, I will be very happy.

Life Beyond Research

I live again in the parish where I was born. It is very nice. I spend a lot of time with my family, especially with my godson. Both in the family and with friends, I feel I am an aggregator and conciliator. This is a role that I really enjoy having. I also love dancing, traveling, reading, going to shows and concerts. Culture helps me get away from earthly problems and allows me to dream. I need these moments that take my feet off the ground.