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- Challenge-based innovation immersion in a rural context: qualitative analysis of the students’ perspectivePublication . Lachovicz, Rebeca; Ferro-Lebres, Vera; Barroso, Bárbara; Antão, Celeste; Costa, Cláudia S.The discussion on immersive learning environments requires an in-depth understanding of the concept and its implications for the educational process. Contemporary higher education faces the challenge of adopting methodologies that promote experiential learning. Challenge-Based Innovation (CBI) emerges as a student-centred approach, integrating interdisciplinary collaboration and immersion in real contexts. This study was carried out in Miranda do Douro, a region in the north-east of Portugal known for its traditional agricultural practices and the preservation of the Mirandesa language and music. The aim of this study was to understand, from a qualitative perspective, how students experienced immersive learning in a rural context and to identify the dynamics of co-creation, collaboration and the development of emerging competences. Nineteen students from different nationalities (Portugal, Brazil, Guinea-Bissau, Angola, Cape Verde and Nepal) and academic backgrounds (health, communication, tourism, education and engineering) took part. They were organised into five teams to respond to challenges related to the enhancement of cattle and sheep farming, the promotion of traditional language and music and the rediscovery of the Mirandês donkey as a cultural and educational asset. Over the course of an intensive week, the students took part in daily co-creation activities, followed by individual and peer reflective assessments each evening. The qualitative methodology combined content analysis, discourse analysis and thematic analysis, with cross-checking of the data applied at four points in the reflective evaluations: on the first day, words entered into a collective software generated a word cloud, highlighting key concepts; on the second day, the students selected symbolic images representing their team roles; on the third day, reflective videos documented the maturation of ideas and communication skills; and at the end of the week, intra- and inter-group evaluations completed the data set. The results showed that the students’ word choices and speeches demonstrated a progressive commitment to the territory, centred on concepts such as “culture”, “collaboration”, “learning”, “diversity” and “creativity”, and expressions such as “expanding these projects to reach the whole of Portugal”. The symbolic representation of the team’s roles revealed profiles of creativity, organisation, communication and technical support, with strong alignment between the students’ self-perceptions and peer evaluations. Analysing the videos indicated an affective appropriation of the projects and the evolution of the ideas, visible in expressions such as ‘we want people to use our idea in real life’, ‘our next step is to filter the feedback and improve our solution’ and ‘together we want to guarantee its preservation, this is our project’. However, there were also initial moments of hesitation, expressed by the students through statements such as ‘anticipating the preparation of the project’ and ‘at first, we found it difficult to organise the ideas’, suggesting the need for stronger methodological guidance at the beginning. The co-created solutions were considered by the students to be creative and feasible, with strong potential for application, including the project proposing the use of waste wool for acoustic and thermal insulation, Mirandês cattle management initiatives led by butchers, digital platforms to promote the Mirandesa language and immersive cultural events aimed at revitalising traditional music and rediscovering the role of the Mirandês donkey. In conclusion, CBI was recognised as a transformative educational experience, promoting the development of interpersonal skills, critical thinking and a sense of territorial belonging. These results were confirmed by the students’ speeches and the consistency of the data obtained from different sources. Despite the promising results, there was a need to reinforce initial support for project preparation in order to promote earlier maturation of ideas. Overall, CBI shows potential as an innovative educational strategy by combining co-creative, immersive, multidisciplinary and intercultural practices in authentic learning contexts.
- Phytotherapy: A Systematic Review for the Treatment of HypertensionPublication . Lachovicz, Rebeca; Ferro-Lebres, Vera; Almeida-de-Souza, JulianaIntroduction: Approximately 10 million annual deaths may be associated with hypertension. Adverse effects and non-response to pharmacological treatment limit therapy to a significant proportion of patients; hence, treatment alternatives seem necessary. Our objective was to review data about the impact of herbal medicine on reducing blood pressure (BP) in prehypertensive and hypertensive patients. Methods: A systematic review was conducted (PRISMA guidelines), using PUBMED, SCOPUS, and WEB OF SCIENCE databases, without time restriction. The inclusion criteria were randomised controlled trials and quasiexperimental studies in humans focusing antihypertensive effect of phytotherapeutics: Allium sativum, Apium graveolens, Nigella sativa, Panax ginseng, and Hibiscus sabdariffa on BP in adults with prehypertension or hypertension. The exclusion criteria were the usage of combined medicinal plants. Data about systolic and diastolic BP differences before and after phytotherapy were extracted manually and summarised. The risk of bias was assessed using the JBI tool. Results: Forty-five studies were selected (15 A sativum, 4 A graveolens, 4 N sativa, 9 P ginseng, and 13 H sabdariffa). Antihypertensive effect was observed for A sativum systolic and diastolic BP (−18.1/−9 mmHg), A graveolens (−37.9/−15.4 mmHg), N sativa (−11.8/−8.8 mmHg), P ginseng (−17.4/−7.1 mmHg), and H sabdariffa (−61.4/−66.2 mmHg). Discussion/Conclusions: Herbal medicines can reduce high BP levels in prehypertension and hypertension, when used alone or together with lifestyle changes or antihypertensive drugs. Results interpretation is crucial, given the studies quality variation and the discrepancies. More consistent clinical studies in humans are needed to accurately determine efficacy and safety in the treatment of hypertension.
- Intentions of teaching-learning practices in students after Intensive training in complex learning in healthPublication . Delgado, Jane; Lachovicz, Rebeca; Almeida-de-Souza, Juliana; Ferro-Lebres, Vera; Pereira, Fernando A.Complexity theory investigates complex systems made up of parts that mutually interact in a non-linear way, producing unpredictable results. Inspired by this theoretical approach, ECOLAH - Embracing a Complexity-Orientated Learning Approach in Health is an Erasmus+ project (https://ecolah.eu/about/) whose mission is to develop a better understanding of how the complex societal challenge of building a healthy society can be (better) influenced and co-directed by Higher Education. The ECOLAH project team considered a real-life ecosystem/community involved in complex issues as a starting point for learning. In order to promote a collective and collaborative learning process that takes into account all stakeholders. To this end, four courses were developed to enable students to navigate complexity in the context of complexity-orientated ecosystems in health: (1) Complex Adaptive Systems Applied to Health (CAS) which aims to sensitise students to the patterns of interaction between health actors and between them and the environment, promoting an integrated and systemic understanding; (2) Futures and epistemic literacy in Health (EFL) focuses on developing the capacity to anticipate, i.e.., that health students develop the ability to anticipate the future by preparing for ignorance; (3) Becoming in complexity (BIC) enables students to train critical thinking skills, encouraging self-evaluation and evaluation of the work of others, promoting an integrated understanding; (4) Offering Holding and facilitating environment (HFE) prepares students for a flow of relationships, boundary-crossing and ethics, as well as promoting (collective) sense-making, empathy and intuitive reasoning. These four integrated courses aim to provide training for higher education health students as a holistic learning journey based on a complexity-orientated learning approach. This study aims to evaluate the intentions of students’ teaching-learning practices after the intensive training of the ECOALH course. This is a qualitative study on the results of the five-day ECOALH intensive training held in April 2024, with a total of 46 students and 15 teachers from five European universities in four different countries: The Netherlands, Finland, Portugal and Romania. The training was designed as an experience of immersion in complexity through various workshops and activities organized around the four courses. On the last day of training, students were invited to reflect and write about their intentions anonymously in the learning process, on post-its, in 6 dimensions: doing/thinking/care - more/less. A content analysis of the post-its was carried out to build word clouds using the wordclouds software. As the main results, the students mentioned stress, procrastination, excessive use of technology and unhealthy habits as aspects to do/think/care less about. They also mentioned wanting to reduce negative thoughts, focus on their own goals, control anxiety and emphasize emphaty problem-solving. Aspects to do less of are continuous learning, prioritizing health, getting out of their comfort zone, improving professionally and maintaining a balance between personal and professional life and being informed about global issues. They also value a balanced lifestyle, relevant education, health prevention and making a positive impact through empathy and collaboration. In this sense, students seek a balance between the demands of modern life and their own well-being, while aiming for meaningful personal growth and positive contributions to society.
- Efficacy of Olive Leaf Extract in Improving Blood Pressure in Pre‐Hypertensive and Hypertensive Individuals: A Systematic Review and Meta‐AnalysisPublication . Lachovicz, Rebeca; Ferro-Lebres, Vera; Almeida-de-Souza, Juliana; Pereira, José AlbertoAnnually, approximately 10 million deaths are attributed to hypertension, highlighting the critical need for effective treatments beyond conventional medications due to their limitations. Therefore, the aim of this study was to evaluate the impact of Olea europaea L. on blood pressure in adults with prehypertension and hypertension. The search, conducted from November/2022- October/2024 was performed on EBSCO, CABI, CNKI, Cochrane Library, DOAJ, PUBMED, SCOPUS, and WEB OF SCIENCE databases using Hypertension AND Olea europaea L. Eligible studies included those evaluating the effect of Olea europaea L. on systolic/diastolic blood pressure in hypertensive or pre-hypertensive adults. Exclusion criteria were multi-preparation interventions. Data on reference, country, sample, intervention/control details, duration, and differences in systolic and diastolic blood pressure, adverse effects, and medication use were extracted manually. The mean differences, heterogeneity (I2) and quality of the studies were assessed using Review Manager (version 5.4). From 211 found studies, 3 met the eligibility criteria, considering 248 participants analysed. An antihypertensive effect was observed on systolic and diastolic blood pressure in the pre- vs. post-intervention in the global analysis (systolic −6.03 mmHg, 95% CI: [−11.60, −0.46], I2 = 82%, p = 0.03; diastolic −2.38 mmHg, 95% CI: [−4.96, 0.20], I2 = 50%, p = 0.07) and in the sub-analysis that included the studies with the highest dose (1000 mg/day) (systolic−11.45 mmHg, 95% CI:[−13.99, −8.91], I2 = 0%, p ≤ 0.001; diastolic −4.65 mmHg, 95% CI: [−6.56, −2.74], I2 = 0%, p ≤ 0.001). Olive leaf extract (1000 mg/day) may reduce systolic and diastolic blood pressure by −11.45 and −4.65 mmHg, respectively. However, limitations include variable trial quality and exclusion of studies not written in English. Additional comprehensive clinical studies are essential to confirm its efficacy and safety.
- Empirical Validation of the Dart Model in University Business Collaboration: We Working and Envisioning Co Creation Community of PracticePublication . Rodrigues, Pedro M.; Costa, Cláudia S.; Barbedo, Inês; Pereira, Fernando A.; Almeida-de-Souza, Juliana; Barroso, Bárbara; Antão, Celeste; Lachovicz, Rebeca; Ferro-Lebres, VeraHigher Education faces significant challenges, including internationalization (Msomphora, 2025), digital transformation - in particular the integration of artificial intelligence (AI) into traditional methods and cybersecurity (Parambil et al., 2024), students increasing expectations (Amanzhol et al., 2024), pressure for higher alumni employability rates (Schueller, 2023), the increased need of interdisciplinary approaches and for active faculty involvement in fostering sustainability education (Abo-Khalil, 2024). Higher education institutions (HEIs) are rethinking how they design learning experiences and engage with stakeholders (Gill and Singh, 2020). One of the most promising approaches in this scenario is Work-Integrated Learning (WIL) (Jackson and Dean, 2023), particularly the value co-creation methodologies, where learners, educators, and external partners actively collaborate in the production of educational experiences and innovations (Schmied et al., 2024). Analyzing HEI considering the Service-Dominant Logic (Vargo and Lusch, 2004), co-creation shifts the traditional paradigm of education delivery from a unidirectional model to one where all participants contribute meaningfully to shared outcomes. Beyond the higher-education challenges outlined above, a substantial WIL/WIE literature positions work integrated approaches as curriculum-embedded strategies to build graduate employability and professional identity while offering clear design guidance for programs and partnerships (Rowe & Zegwaard, 2017; Billett, 2024). Recent syntheses further consolidate definitions, models and quality indicators across sectors, providing an authoritative reference point for institutions scaling co-creation with industry (Zegwaard & Pretti, 2023). Within this theoretical landscape, the DART model—comprising Dialogue, Access, Risk Assessment, and Transparency—emerged as a practical framework to operationalize co-creation. The DART elements are designed to foster trust, engagement, and mutual learning, making them particularly relevant for higher education settings, where collaborative innovation and experiential learning are increasingly prioritized (Nagarethenam, Shamim and Ghazali, 2018). Work-Integrated Learning (WIL) and its closely related strand, Work-Integrated Education (WIE), emphasize intentional, curriculum-embedded collaboration among higher education institutions (HEIs), workplaces, and students to enhance employability, relevance, and innovation in teaching and learning. In this perspective, co-creation is not merely a pedagogical add-on but a governance logic that distributes agency and responsibility across actors. The DART model operationalizes co-creation by specifying relational and informational conditions under which HEIs and external partners can jointly design, deliver, and evaluate learning and innovation outcomes. Positioning DART within WIL/WIE clarifies how structured communication, equitable resource access, shared risk governance, and openness enable practical, scalable collaboration between universities and companies. This study extends that conversation by empirically testing a context-adapted DART scale with workplace partners engaged in a university–business co-creation program. A representative case in which the DART model can be applied is the WE: Working and Envisioning Community of Practice, particularly its Complex Challenge Based Learning activities, based on co-creation principles Bragança Polytechnic University | Instituto Politécnico de Bragança. WE is a faculty-led, cross institutional ecosystem that convenes professors-facilitators, students from diverse backgrounds, and external stakeholders to co-create solutions to complex, future-oriented challenges. Grounded in a culture of dialogue, trust, innovation, and critical thinking. WE operates on 8–12-week challenge cycles with a structured cadence: joint scoping with company representatives (week 0–1), iterative problem framing and prototyping with weekly checkpoints (weeks 2–10), and a final review delivering actionable insights or prototypes (weeks 11–12). Roles are codified – teachers acting as facilitators ensure process fidelity and responsiveness; company representatives guarantee access to data, facilities, and decision-makers; student teams own proactive communication and evidence-based proposals. Since 2017, the ecosystem has catalyzed regional engagement by coordinating more than 100 co-creation initiatives - reportedly 115 across research reports, prototypes, professional internships, and patents—thereby strengthening university–industry–society ties and generating practical outcomes for national and international development. Although the DART model has been widely cited in business literature, empirical validations of its structure in the context of educational co-creation are scarce. This study contributes to this gap by translating and testing a Portuguese version of the DART scale among external stakeholders participants in the WE Complex Challenge Based Learning program, aiming to understand how these stakeholders perceive value co-creation practices in a higher education setting. The outcomes offer not only theoretical contributions to the cocreation literature but also practical insights for institutions seeking to optimize their collaboration frameworks with external partners.
- Strategic Co-Design for Territorial Innovation: Defining Challenges within WEPublication . Barroso, Bárbara; Pereira, Fernando A.; Costa, Cláudia S.; Barbedo, Inês; Antão, Celeste; Almeida-de-Souza, Juliana; Rodrigues, Pedro M.; Ferro-Lebres, Vera; Lachovicz, RebecaThis paper explores a strategic co-design process undertaken in the rural municipality of Miranda do Douro, Portugal, aimed at formulating locally grounded innovation challenges. Situated within the framework of a broader initiative [blinded for peer-review], the study highlights the preparatory phase prior to student involvement, emphasizing how collaborative methodologies shaped a community responsive innovation agenda. The research is anchored in theoretical perspectives on social and territorial innovation, drawing from concepts such as situated cocreation, collaborative governance, and active listening in peripheral contexts. These frameworks underscore the relational, adaptive, and context-sensitive nature of cocreation practices in rural and marginalized territories. Methodologically, the process involved an initial phase of internal mapping and stakeholder identification, followed by focus groups to gather local insights. Through iterative synthesis and validation with community actors, five strategic challenges emerged – ranging from cultural heritage preservation to agricultural valorization and linguistic revitalization. The study contributes to the literature by demonstrating how co-design can operate as a strategic tool for territorial innovation, particularly in low-density regions. It offers a replicable model that blends participatory methods with academic facilitation, enabling inclusive governance and reinforcing local agency. By reframing challenge formulation as a dialogic and situated act, the approach enhances legitimacy, ownership, and transformative potential in contexts often excluded from mainstream innovation agendas.
- Learning in complexity: perspective of health sciences students after intensive and immersive training programPublication . Delgado, Jane; Lachovicz, Rebeca; Pereira, Fernando A.; Almeida-de-Souza, Juliana; Ferro-Lebres, VeraThis chapter presents the results of a qualitative study carried out as part of the European project ECOLAH - Embracing a Complexity-Oriented Learning Approach in Health, which evaluated the health student’s perspective an intensive, immersive and co-creation training programme. The programme took place in April 2024 in The Netherlands, involving 46 students and 15 professors from five European countries. The training was structured around four interdependent thematic modules: Complex Adaptive Systems, Futures and Epistemic Literacy, Becoming in Complexity and Holding and Facilitating Environment. Data was collected using questionnaires, written reflections and observations, and analysed using qualitative methodology. The results indicate relevant transformations in the pedagogical development of competences such as empathy, critical thinking, self-reflection, self-care and collaboration. Experiential learning in an immersive environment, combined with the co-creation of content and practices, proved to be a catalyst for future literacy and transformative education. It is concluded that complexity-oriented pedagogical approaches can contribute to the training of health professionals who are more resilient, ethical and prepared to act in uncertain and dynamic contexts.