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- Autoperceção dos enfermeiros face à avaliação do risco de infeção no adulto hospitalizadoPublication . Faria, Beatriz; Carreira, Maria João; Figueiras, Diana; Jardim, André; Mata, Ema; Loureiro, Ricardo; Cunha, MadalenaIntrodução: As infeções associadas aos cuidados de saúde têm impacto na morbilidade, mortalidade e custos. A avaliação sistemática do risco é essencial para implementar medidas preventivas. Objetivo: Avaliar a autoperceção dos enfermeiros relativamente à avaliação e ao controlo do risco de infeção no adulto hospitalizado e analisar a relação dessa perceção com variáveis sociodemográficas e profissionais. Métodos: Estudo quantitativo, transversal e descritivo-correlacional, com amostra de mestrandos de uma Escola Superior de Saúde portuguesa, enfermeiros de um hospital da região Oeste de Portugal e enfermeiros recrutados via plataformas sociais. Os dados foram recolhidos por questionário de caracterização sociodemográfica e escala de Likert sobre práticas de prevenção e controlo de infeções. Resultados: A média global foi de 1,95 (DP=0,466), indicando integração frequente dos itens na prática. Não se verificaram diferenças significativas entre enfermeiros com/sem especialidade ou formação específica. Encontraram-se correlações fracas, mas significativas, entre idade/experiência nos itens: dias de antibioterapia (ρ = −0,294; p = 0,017), rastreio de SAMR (idade: ρ = 0,297; p = 0,026; experiência: ρ = 0,308; p = 0,021), reconhecimento de risco em doentes reoperados (ρ = −0,270; p = 0,042) e classe de antibiótico (ρ = −0,314; p = 0,013). Conclusão: Os enfermeiros valorizam a avaliação do risco de infeção referindo práticas alinhadas com as recomendações, embora passíveis de melhoria. Recomendam-se reforço formativo e uso de métodos observacionais para avaliar a prática real.
- Feasibility and Acceptability of an eHealth-Based Physical Activity Coaching Intervention During Pulmonary Rehabilitation for People With Chronic Obstructive Pulmonary Disease: Mixed Methods StudyPublication . Flora, Sofia; Grave, Ana Sofia; Pimenta, Sara; Baptista, Fátima; Burtin, Chris; Cruz, Joana
- Challenges on the usability of digital platforms for informal caregivers and health professionals: the case study of Help2CarePublication . Ferreira Caroço, João Eduardo; Marques Gomes, Nuno Miguel; Martinho, Ricardo; Rijo, Rui; Peralta, Teresa; Carvalho, Daniel; Querido, Ana; Dixe, Maria dos AnjosThe usability of digital platforms assumes an important role in the support of health business processes. This is particularly relevant when these platforms automate previously manually-executed activities in a certain process, with the purpose of bringing time, cost and quality benefits both to end-users and health professionals. This is the main objective of the Help2Care e-Health digital platform, where informal caregivers can use a mobile app to access digital training materials on how to properly take care of their patients. Health professionals can, in turn, suggest these materials to their caregivers through a web application, communicate directly with them through a messaging system, and even perform remote health assessment and monitoring. However, the informal caregiver population presents specific attributes which, in general, require special attention for usability. Health professionals can also be challenged by such platforms and their inherent complexity. In this paper, we report the results and challenges of the usability studies performed on both mobile and web applications of the Help2Care platform.
- Digi&Mind: Development and validation of a multi-domain digital cognitive stimulation program for older adults with cognitive declinePublication . Couto, Filipa; Almeida, Maria de Lurdes; Dixe, Maria dos Anjos; Ribeiro, Jaime; Braúna, Mónica; Gomes, Nuno; Caroço, João; Monteiro, Luís; Martinho, Ricardo; Rijo, Rui; Apóstolo, João; Rijo, RuiOlder adults present a decline on their cognitive function. Digital cognitive interventions are related to the maintenance of cognitive function and are associated with better health-related outcomes. This study aims to describe the development process of a multi-domain digital cognitive stimulation program for older adults with cognitive decline. The digital program was developed in four phases: preliminary phase (conceptualization), modeling (experts panel), field test (usability tests), and consensus conference. To ensure software suitability the development process followed also software guidelines for mobile and web applications for older adults. The result was the Digi&Mind digital platform made of a mobile application a backoffice web application. The backoffice web application usability test was conducted with 7 healthcare professionals through the Post-Study System Usability Questionnaire System (PSSUQ). The mobile application test was conducted with 4 older adults and 7 professionals through direct observation user testing. Healthcare professionals considered that the system, the information and the interface had quality. Older adults considered the mobile application as appropriate, useful and easy to use, despite of their low digital experience.
- Effects of umbilical cord tissue mesenchymal stem cells (UCX®) on rat sciatic nerve regeneration after neurotmesis injuriesPublication . Gärtner, A.; Pereira, T.; Armada-da-Silva, P. A. S.; Amado, S.; Veloso, A. P.; Amorim, I.; Ribeiro, J.; Santos, J. D.; Bárcia, R. N.; Cruz, P.; Cruz, H.; Luís, A. L.; Santos, J. M.; Geuna, S.; Maurício, A. C.Abstract Peripheral nerves have the intrinsic capacity of self-regeneration after traumatic injury but the extent of the regeneration is often very poor. Increasing evidence demonstrates that mesenchymal stem/stromal cells (MSCs) may play an important role in tissue regeneration through the secretion of soluble trophic factors that enhance and assist in repair by paracrine activation of surrounding cells. In the present study, the therapeutic value of a population of umbilical cord tissue-derived MSCs, obtained by a proprietary method (UCX®), was evaluated on end-to-end rat sciatic nerve repair. Furthermore, in order to promote both, end-to-end nerve fiber contacts and MSC cell-cell interaction, as well as reduce the flush away effect of the cells after administration, a commercially available haemostatic sealant, Floseal®, was used as vehicle. Both, functional and morphologic recoveries were evaluated along the healing period using extensor postural thrust (EPT), withdrawal reflex latency (WRL), ankle kinematics analysis, and either histological analysis or stereology, in the hyper-acute, acute and chronic phases of healing. The histological analysis of the hyper-acute and acute phase studies revealed that in the group treated with UCX® alone the Wallerian degeneration was improved for the subsequent process of regeneration, the fiber organization was higher, and the extent of fibrosis was lower. The chronic phase experimental groups revealed that treatment with UCX® induced an increased number of regenerated fibers and thickening of the myelin sheet. Kinematics analysis showed that the ankle joint angle determined for untreated animals was significantly different from any of the treated groups at the instant of initial contact (IC). At opposite toe off (OT) and heel rise (HR), differences were found between untreated animals and the groups treated with either UCX® alone or UCX® administered with Floseal®. Overall, the UCX® application presented positive effects in functional and morphologic recovery, in both the acute and chronic phases of the regeneration process. Kinematics analysis has revealed positive synergistic effects brought by Floseal® as vehicle for MSCs.
- Happiness Measured by a Single Item: Psychometric Evaluation of the Arabic Version of Fordyce Global Happiness Scale Among University Students and Mothers of Children With Intellectual DisabilitiesPublication . Ali, Amira Mohammed; Al‐Dossary, Al‐Dossary, Saeed A.; Fekih‐Romdhane, Feten; Atout, Maha; Fakhrou, Abdulnaser; Suliman, Mohamed M. H.; Gaballa, Abdalla S. M.; Zayed, Ahmad M. A.; Hallit, Souheil; Laranjeira, CarlosObjectives: Aiming to validate the Fordyce Global Happiness Scale in Arabic, this cross‐sectional study recruited two conve-nience Saudi samples of 422 university students and 85 mothers of children with intellectual disabilities.Methods: Among students, a latent variable model was used to examine scale convergent/divergent validity relative to lifesatisfaction and depressive symptomatology. Scale cutoffs were assessed in the two samples through cluster analyses and ROCanalysis. Differences in happiness were evaluated between mothers and students and across student groups of gender, academicdegree, and type of study (practical vs. theoretical).Results: The latent variable model expressed good fit, showing satisfaction with life and positive affect as significant positivepredictors of happiness, which was inversely associated with somatic complaints and negative affect. Two‐step cluster analysisresulted in a two‐cluster solution, which revealed three cutoffs (among students: < 5, 5–8, > 8 and among mothers: < 4, 4–8, >8), which significantly classified the samples according to the levels of happiness into low/mild, moderate, and high. ROCanalysis revealed an optimal cutoff of 4.5 with high sensitivity (100%) and acceptable specificity (74% and 62%) among studentsand mothers, respectively. The highest and lowest levels of all depressive symptoms were noticed in participants with happinessscores (< 4.5 or < 5) and > 8, respectively. Known‐group validity was signaled by lower overall happiness scores in the mothersample relative to university students.Conclusions: Fordyce Global Happiness Scale captures happiness as a distinct construct, which relates to the cognitive andemotional components of well‐being and physical symptoms of psychopathology.
- Early Post-Discharge Predictors of Sedentary Behavior Following COPD Exacerbation: An Observational Study. Authors’ ResponsesPublication . Colucci, Maria Gabriela; Cruz, Joana; Brusaca, Luiz Augusto; Kawakami, Débora Mayumi de Oliveira; Araujo, Gustavo Henrique Guimarães; Karlohm, Manuela; Mendes, Renata Gonçalves; Di Lorenzo, Valéria Amorim PiresDear Editor, We sincerely appreciate the interest in our article entitled “Early predictors of sedentary behavior after hospital discharge in COPD exacerbation: an observational study” (Citation1), published in the journal COPD: Journal of Chronic Obstructive Pulmonary Disease. We appreciate the pertinent comments from Sen et al. (Citation2) and Priya et al. (Citation3), which offer valuable perspectives on our work. We are grateful for the opportunity to further clarify certain methodological and interpretative aspects of the study.
- Influence of commensal bacteria on the proteolytic and antigenic profiles of INFOGEST-like digested wheat gliadinPublication . Pereira-Costa, Flávio; Domingues, Vanessa S.; Roque, Ana; Almeida, Zaida L.; Cruz, Pedro F.; Cordeiro, Rachel; Trindade, Daniela; Moura, Carla; Melo, Joana B.; Pereira, Sónia G.; Vaz, Daniela C.Introduction: Celiac disease (CeD) is a chronic autoimmune enteropathy developed by genetically predisposed individuals when exposed to gluten. Gluten gliadins, along with gut microbiota, may influence CeD onset and progression through mechanisms that remain unclear. Methods: Gliadin-degrading bacterial isolates obtained from CeD patients, and their 1st-degree relatives’ stool and blood were identified (Bacillus tropicus, Enterococcus faecalis, Micrococcus sp., Cronobacter sakazakii, Pseudomonas aeruginosa, and Serratia marcescens) and used in an INFOGEST-like protocol to simulate gliadin digestion after 4 h (digested gliadin, d-gliadin). The d-gliadin digesta were analyzed by fast protein liquid chromatography (FPLC), dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), fluorescence spectroscopy, and polyclonal and monoclonal (R5 and G12) enzyme-linked immunosorbent assays (ELISA). Results and discussion: In the absence of the bacterial isolates, gliadin is poorly digested and self-assembles within 1 day into intermediate and large protein oligomers/aggregates, enriched in β-sheet structure (FTIR amide I band between 1,600 and 1,700 cm−1) and able to bind thioflavin T and Congo red. Conversely, in the presence of the bacterial isolates, gliadin is further digested, leading to an increase in protein fragments. After 4 h, the P. aeruginosa, C. sakazakii, and B. tropicus d-gliadin digesta presented a mixture of d-gliadin peptides and aggregates that showed higher antigenicity (associated with the exposure of the 5-amino acid QQPFP and 6-amino acid QPQLPY epitopes, present in the 25-mer and 33-mer, respectively) than control digestions (without bacteria), while E. faecalis led to lower antigenicity. In turn, within 24 h of incubation, all bacterial isolates led to the formation of undigested material with lower antigenicity, either due to fewer 33-mers and 25-mers in solution, or to fragment aggregation into amorphous material, not exposing antigenic sequences. Hence, intestinal flora may enhance or diminish the antigenicity of gliadin, thereby modulating the immunogenic response to gliadin/gluten.
- Imported Malaria in Portugal 2000–2009: A Role for Hospital Statistics for Better Estimates and SurveillancePublication . Fonseca, Ana Glória; Dias, Sara S.; Baptista, João Luis; Torgal, JorgeBackground. Although eradicated in Portugal, malaria keeps taking its toll on travelers and migrants from endemic countries. Disease notification is mandatory but is compromised by underreporting. Methods. A retrospective study on malaria hospitalizations for 10 consecutive years (2000–2009) was conducted. Data on hospitalizations and notifications were obtained from Central Administration of Health System and Health Protection Agency, respectively. For data selection ICD-9 CM and ICD-10 were used: codes 084∗, 647.4, and B50–B54. Variables were gender, age, agent and origin of infection, length of stay (LOS), lethality, and comorbidities. Analysis included description, hypothesis testing, and regression. Results.There were 2003 malaria hospitalizations and 480 notified hospitalized cases, mainly in young male adults. P. falciparum was the main agent of infection acquired mainly in sub-Saharan Africa. Lethality was 1.95% and mean LOS was 8.09 days. Older age entailed longer LOS and increased lethality. Discussion. From 2000 to 2009, there were 2003 malaria hospitalizations with decreasing annual incidence, these numbers being remarkably higher than those notified. The national database of diagnosis related groups, reflecting hospitalizations on NHS hospitals, may be an unexplored complementary source for better estimates on imported malaria.
- Velocidade do alcance em tarefas de atenção e memória: validação do teste como marcador funcional na população geriátricaPublication . Rosa, Marlene; Pires, Miguel; Michelle, DanianaOBJETIVO: Validar a velocidade do alcance durante tarefas de atenção e memória como um indicador funcional na população geriátrica. MÉTODOS: Idosos institucionalizados residentes em 4 instituições no centro de Portugal foram caraterizados quanto ao seu perfil funcional, constando as seguintes variáveis: (i) cognição; (ii) independência nas atividades da básicas da vida diária (AVD); (iii) independência nas atividades instrumentais da vida diária (AIVD); (iii) força de preensão, (iv) diagnóstico de depressão; (v) função sensório-motora membro superior; (vi) funções executivas. Os vários instrumentos foram submetidos a um processo de linking com a Classificação Internacional de Funcionalidade e Saúde (CIF). A amostra foi dividida em quatro grupos funcionais considerando os valores abaixo e superiores à média da velocidade de alcance em tarefas de atenção (Grupo 1 - G1, Grupo 2 - G2) e a velocidade de alcance em tarefas de memória (Grupo 3 - G3, Grupo 4 - G4). A caraterização dos grupos de amostra foi realizada utilizando medidas de estatística descritiva dos qualificadores da CIF e a diferença entre grupos (G1/G2 e G3/G4) foi testada utilizando testes t para amostras independentes. RESULTADOS: Os resultados mostraram diferenças significativas entre grupos de baixo e elevado perfil nos testes de alcance (p<0.05), identificando as seguintes áreas prioritárias de intervenção em idosos institucionalizados: d6. Vida doméstica, d1. Aprendizagem e aplicação de conhecimento, d4. Mobilidade, d5. Autocuidados e d8. Áreas significativas da vida. Idosos com velocidade no teste de alcance em tarefas de atenção <0.06m/s ou com valores <0.07m/s no teste de alcance em tarefas de memória tendem a apresentar uma incapacidade moderada a grave em áreas como a Mobilidade e os Autocuidados e uma incapacidade grave a completa na participação de tarefas da Vida Doméstica. CONCLUSÃO: Este estudo foi um importante contributo para a validação da velocidade do alcance (um teste para a função do membro superior) durante tarefas de atenção e memória como um indicador funcional, possibilitando a avaliação funcional de um largo espectro de idosos, incluindo os não ambulantes.