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1.
Vet Res ; 53(1): 78, 2022 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-36209119

RESUMO

Besides Helicobacter pylori, a Gram-negative bacterium that may cause gastric disorders in humans, non-Helicobacter pylori helicobacters (NHPH) may also colonize the stomach of humans and animals. In pigs, H. suis can induce gastritis and may play a role in gastric ulcer disease, possibly in association with Fusobacterium gastrosuis. In the present study, gastric samples from 71 slaughtered pigs and 14 hunted free range wild boars were tested for the presence of DNA of F. gastrosuis and gastric Helicobacter species associated with pigs, dogs cats and humans, using species-specific PCR assays, followed by sequencing of the amplicon. These gastric samples were also histopathologically evaluated. Almost all the pigs presented gastritis (95.8%). Helicobacter spp. were detected in 78.9% and F. gastrosuis in 35.2% of the animals. H. suis was the most frequently identified Helicobacter species (57.7% of the animals), followed by a H. pylori-like species (50.7%) and less often H. salomonis and H. felis (each in 2.8% of the animals). H. suis was most often detected in the glandular (distal) part of the stomach (pars oesophagea 9.9%, oxyntic mucosa 35.2%, antral mucosa 40.8%), while the H. pylori-like species was mainly found in the non-glandular (proximal) part of the stomach (pars oesophagea 39.4%, oxyntic mucosa 14.1%, antral mucosa 4.2%). The great majority of wild boars were also affected with gastritis (71.4%) and Helicobacter spp. and F. gastrosuis were detected in 64.3% and 42.9% of the animals, respectively. H. bizzozeronii and H. salomonis were the most frequently detected Helicobacter species, while a H. pylori-like species and H. suis were only occasionally identified. These findings suggest that these microorganisms can colonize the stomach of both porcine species and may be associated with gastric pathology. This should, however, be confirmed through bacterial isolation. This is the first description of the presence of F. gastrosuis DNA in the stomach of wild boars and a H. pylori-like species in the pars oesophagea of the porcine stomach.


Assuntos
Doenças do Cão , Gastrite , Infecções por Helicobacter , Helicobacter pylori , Helicobacter , Doenças dos Suínos , Animais , Doenças do Cão/microbiologia , Cães , Fusobacterium , Mucosa Gástrica , Gastrite/microbiologia , Gastrite/veterinária , Helicobacter/genética , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/veterinária , Helicobacter pylori/genética , Humanos , Sus scrofa , Suínos , Doenças dos Suínos/microbiologia
2.
BMC Health Serv Res ; 20(1): 658, 2020 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-32678008

RESUMO

BACKGROUND: Hospitals undertake numerous initiatives searching to improve the quality of care they provide, but these efforts are often disappointing. Current models guiding improvement tend to undervalue the tensional nature of hospitals. Applying a dualities approach that is sensitive to tensions inherent to hospitals' quest for improved quality, this article aims to identify which organizational dualities managers should particularly pay attention to. METHODS: A set of cross-national, multi-level case studies was conducted involving 383 semi-structured interviews and 803 h of non-participant observation of key meetings and shadowing of staff in ten purposively sampled hospitals in five European countries (England, the Netherlands, Portugal, Sweden, and Norway). RESULTS: Six dualities that describe the quest for improved quality, each embracing a seemingly contradictory feature were identified: plural consensus, distributed connectedness, orchestrated emergence, formalized fluidity, patient coreness, and cautious generativeness. CONCLUSIONS: We advocate for a move from the usual sequential and project-based and systemic thinking about quality improvement to the development of meta-capabilities to balance the simultaneous operation of opposing ideas or concepts. Doing so will help hospital managers to deal with major challenges of change inherent to quality improvement initiatives.


Assuntos
Gestão de Mudança , Administração Hospitalar , Hospitais/normas , Melhoria de Qualidade , Europa (Continente) , Modelos Organizacionais , Estudos de Casos Organizacionais , Inovação Organizacional
3.
Int J Qual Health Care ; 32(9): 585-590, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-32797155

RESUMO

OBJECTIVE: To determine to what extent patient health status and recovery in post-acute care organizations (PACO) is related to patient experience of the discharge process from hospital and to patient experience while staying in these facilities. DESIGN: Longitudinal study of patients discharged from hospitals to PACO. SETTING: 12 hospitals and 14 PACO Portuguese organizations. PARTICIPANTS: 181 patients participated in the both stages of data gathering. MAIN OUTCOME MEASURES: Patients' physical and mental health status was measured through the 36-item short form health survey scale. The experience of transition from hospital to PACO was measured with the Care Transition Measure. The Picker Adult In-Patient Questionnaire was used to measure patients' experience in these organizations. RESULTS: Patients reporting better physical condition in PACO had a better experience on discharge [b = 0.21, 95% confidence interval, CI (0.10, 0.31)] and perceive fewer problems inside facilities [b = - 0.19, 95% CI (-0.31, 0.08)]. The experience in PACO is significantly related to patients' mental health status [b = - 0.47, 95% CI (-0.59, - 0.36)]. Patients showing higher levels of physical recovery had a better experience on discharge [b = - 0.18, 95% CI (0.08, 0.28)], while those registering better mental recovery experienced fewer problems during their stay [b = - 0.41, 95% CI (-0.52, - 0.30)]. CONCLUSIONS: PACO play a key role in maintaining and promoting patients' health, and this goal is influenced by their experience both in the transition from hospitals to PACO and while staying in these facilities.


Assuntos
Hospitais , Cuidados Semi-Intensivos , Adulto , Humanos , Estudos Longitudinais , Alta do Paciente , Avaliação de Resultados da Assistência ao Paciente
4.
Exp Parasitol ; 205: 107714, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31279927

RESUMO

The objective of the present study was to evaluate the clinical signs, electrocardiographic signs and evolution of histopathological lesions in the heart of sheep experimentally infected by Trypanosoma vivax during the acute and chronic phases of infection as well as to investigate the presence of parasitic DNA in the heart using polymerase chain reaction (PCR). Twenty-two male sheep were divided into the following four groups: G1, which consisted of six sheep infected by T. vivax that were evaluated until 20 days post-infection (dpi; acute phase); G2, which consisted of six sheep infected by T. vivax that were evaluated until 90 dpi (chronic phase); and G3 and G4 groups, which each consisted of five uninfected sheep. At the end of the experimental period, electrocardiographic evaluations and necroscopic examinations were performed. Fragments of the heart were collected and stained by Hematoxylin-Eosin and Masson's trichrome, and the fragments were also evaluated by PCR for T. vivax. G2 animals presented clinical signs suggestive of heart failure and electrocardiogram alterations characterized by prolonged P, T and QRS complex durations as well as by a cardiac electrical axis shift to the left and increased heart rate. In these animals, mononuclear multifocal myocarditis and interstitial fibrosis were also observed. PCR revealed positivity for T. vivax in two G1 animals and in all G2 animals. Thus, these findings suggested that T. vivax is responsible for the occurrence of cardiac lesions, which are related to heart failure, electrocardiographic alterations and mortality of the infected animals.


Assuntos
DNA de Protozoário/isolamento & purificação , Insuficiência Cardíaca/veterinária , Coração/parasitologia , Doenças dos Ovinos/parasitologia , Trypanosoma vivax/patogenicidade , Tripanossomíase Africana/veterinária , Doença Aguda , Animais , Anticorpos Antiprotozoários/sangue , Doença Crônica/veterinária , Eletrocardiografia/veterinária , Técnica Indireta de Fluorescência para Anticorpo/veterinária , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/parasitologia , Imunoglobulina G/sangue , Masculino , Miocárdio/patologia , Parasitemia/veterinária , Pericardite/parasitologia , Pericardite/patologia , Pericardite/veterinária , Reação em Cadeia da Polimerase/veterinária , Distribuição Aleatória , Ovinos , Doenças dos Ovinos/mortalidade , Doenças dos Ovinos/patologia , Trypanosoma vivax/genética , Trypanosoma vivax/imunologia , Trypanosoma vivax/isolamento & purificação , Tripanossomíase Africana/complicações , Tripanossomíase Africana/mortalidade , Tripanossomíase Africana/patologia
5.
Int J Qual Health Care ; 31(8): G87-G96, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31187862

RESUMO

OBJECTIVE: The aim was to translate the findings of the QUASER study into a reflective, dialogic guide to help senior hospital leaders develop an organization wide QI strategy. DESIGN: The QUASER study involved in depth ethnographic research into QI work and practices in two hospitals in each of five European countries. Three translational stakeholder workshops were held to review research findings and advise on the design of the Guide. An extended iterative process involving researchers from each participant country was then used to populate the Guide. SETTING: The research was carried out in two hospitals in each of five European countries. PARTICIPANTS: In total, 389 interviews with healthcare practitioners and 803 hours of observations. INTERVENTION: None. MAIN OUTCOME MEASURE: None. RESULTS: The QUASER Hospital Guide was designed for leadership teams to diagnose their organization's strengths and weaknesses in the eight QI challenges. The Guide supports organizational dialogue about QI challenges, enables leaders to share perspectives, and helps teams to develop solutions to their situated problems. The Guide includes extensive examples of QI strategies drawn from the data and is published online and on paper. CONCLUSIONS: The QUASER Hospital Guide is empirically based, draws on a dialogical approach to Organizational Development and complexity science and can facilitate hospital leadership teams to identify the best solutions for their organization.


Assuntos
Administração Hospitalar/métodos , Melhoria de Qualidade/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Europa (Continente) , Hospitais , Humanos , Liderança , Segurança do Paciente , Pesquisa Translacional Biomédica
6.
J Equine Sci ; 28(4): 149-152, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29270072

RESUMO

This report describes an ocular mast cell tumor in a 13-year-old female sport horse. Clinical examination revealed a solitary firm mass located in the ocular mucosa, protruding from behind the left lower eyelid. The lesion was surgically removed and submitted to histopathology. Microscopically, the mass was composed of sheets of well-differentiated neoplastic round cells circumscribed by delicate connective tissue. Positive Giemsa and Toluidine Blue staining confirmed the presence of cytoplasmic granules. Neoplastic cells showed strong membranous and mild diffuse cytoplasmic immunoreactivity for c-KIT and a low KI-67 proliferative index. Based on these findings, a diagnosis of ocular mast cell tumor was made. Six months after surgical removal, no evidence of ocular lesion recurrence was detected.

7.
Exp Parasitol ; 167: 17-24, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27130703

RESUMO

The present study aimed to evaluate the effects of Trypanosoma vivax infection on the shape of the lactation curve and the milk quality of dairy goats experimentally infected with T. vivax. In total, twenty Saanen goats, aged 26-30 months and the same number of calving (two calvings), were divided into two experimental groups: an infected group, consisting of ten goats intravenously infected with 0.5 ml of blood containing approximately 1.25 × 10(5) trypomastigotes of T. vivax and ten uninfected animals as the control group. Clinical tests and hematocrit, parasitemia, and serum biochemistry evaluations were performed on all of the goats. Milk production was measured daily for 152 days by hand milking the goats and weighing the milk. Every seven days, physiochemical analyses were performed to evaluate the milk. Wood's nonlinear model was used to analyze the lactation curve parameters. The infected goats had high levels of parasitemia and hyperthermia, significantly reduced hematocrit, serum total protein, albumin, and glucose levels and increased cholesterol and urea concentrations. Wood's model indicated that the milk production of goats in the infected group declined sharply over a short period of time and produced a flattened yield curve and significant difference (P < 0.05) in the rate of increase of peak milk production, rate of decrease of milk production after the peak, day of peak milk production, and maximum peak milk production compared with that of the control group. Trypanosomiasis also affected the persistency of lactation, which was significantly reduced in goats in the infected group. In addition, the physico-chemical properties of the milk, including the fat content, defatted dry extracts (DDE) and protein content, decreased significantly (P < 0.05) in the goats in the infected group compared with those in the control group. The T. vivax-infected goats showed reduction in milk production, persistence of lactation, and fat levels, the defatted dry extract (DDE) content, and protein, changing the quality of milk.


Assuntos
Doenças das Cabras/fisiopatologia , Transtornos da Lactação/veterinária , Leite/normas , Trypanosoma vivax , Tripanossomíase Africana/veterinária , Ração Animal , Animais , Análise Química do Sangue/veterinária , Proteínas Sanguíneas/metabolismo , Temperatura Corporal , Colesterol/sangue , Ingestão de Alimentos , Feminino , Doenças das Cabras/parasitologia , Cabras , Hematócrito/veterinária , Transtornos da Lactação/parasitologia , Leite/química , Parasitemia/veterinária , Distribuição Aleatória , Tripanossomíase Africana/fisiopatologia , Ureia/sangue
8.
Health Expect ; 18(6): 2853-64, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25229450

RESUMO

BACKGROUND: There is little knowledge about how patients perceive and react to the extended role of community pharmacies. AIM: To develop a model describing the expanded role of Portuguese community pharmacies as comprising three roles - medicines supplier, advice provider and community health promoter - and two important patient reactions: satisfaction and loyalty. DESIGN: In 2010, 1200 face-to-face interviews were conducted with patients of community pharmacies in Portugal. A model comprising the three pharmacy roles and the two patient reactions was developed and tested using structural equation modelling. RESULTS: The results showed that the model was appropriate and that the roles of medicines supplier, advice provider and community health promoter were positively related to patients' satisfaction and loyalty. CONCLUSIONS: These results show that patients are aware of the different roles played by community pharmacies in Portugal. The data support the idea that the movement of Portuguese pharmacists' extended role, framed within a global context where society sends expectations regarding the role of organizations in the community in which they operate, is producing positive results for both patients and pharmacists.


Assuntos
Atitude Frente a Saúde , Farmácias , Feminino , Promoção da Saúde , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Portugal
9.
BMC Health Serv Res ; 14: 478, 2014 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-25303933

RESUMO

BACKGROUND: Conceptualization of quality of care - in terms of what individuals, groups and organizations include in their meaning of quality, is an unexplored research area. It is important to understand how quality is conceptualised as a means to successfully implement improvement efforts and bridge potential disconnect in language about quality between system levels, professions, and clinical services. The aim is therefore to explore and compare conceptualization of quality among national bodies (macro level), senior hospital managers (meso level), and professional groups within clinical micro systems (micro level) in a cross-national study. METHODS: This cross-national multi-level case study combines analysis of national policy documents and regulations at the macro level with semi-structured interviews (383) and non-participant observation (803 hours) of key meetings and shadowing of staff at the meso and micro levels in ten purposively sampled European hospitals (England, the Netherlands, Portugal, Sweden, and Norway). Fieldwork at the meso and micro levels was undertaken over a 12-month period (2011-2012) and different types of micro systems were included (maternity, oncology, orthopaedics, elderly care, intensive care, and geriatrics). RESULTS: The three quality dimensions clinical effectiveness, patient safety, and patient experience were incorporated in macro level policies in all countries. Senior hospital managers adopted a similar conceptualization, but also included efficiency and costs in their conceptualization of quality. 'Quality' in the forms of measuring indicators and performance management were dominant among senior hospital managers (with clinical and non-clinical background). The differential emphasis on the three quality dimensions was strongly linked to professional roles, personal ideas, and beliefs at the micro level. Clinical effectiveness was dominant among physicians (evidence-based approach), while patient experience was dominant among nurses (patient-centered care, enough time to talk with patients). Conceptualization varied between micro systems depending on the type of services provided. CONCLUSION: The quality conceptualization differed across system levels (macro-meso-micro), among professional groups (nurses, doctors, managers), and between the studied micro systems in our ten sampled European hospitals. This entails a managerial alignment challenge translating macro level quality definitions into different local contexts.


Assuntos
Pessoal de Saúde/psicologia , Política Organizacional , Qualidade da Assistência à Saúde , Europa (Continente) , Prioridades em Saúde , Humanos , Entrevistas como Assunto , Estudos Longitudinais , Segurança do Paciente , Satisfação do Paciente , Melhoria de Qualidade
10.
Artigo em Inglês | MEDLINE | ID: mdl-38993629

RESUMO

Research at the intersection of human-computer interaction (HCI) and health is increasingly done by collaborative cross-disciplinary teams. The need for cross-disciplinary teams arises from the interdisciplinary nature of the work itself-with the need for expertise in a health discipline, experimental design, statistics, and computer science, in addition to HCI. This work can also increase innovation, transfer of knowledge across fields, and have a higher impact on communities. To succeed at a collaborative project, researchers must effectively form and maintain a team that has the right expertise, integrate research perspectives and work practices, align individual and team goals, and secure funding to support the research. However, successfully operating as a team has been challenging for HCI researchers, and can be limited due to a lack of training, shared vocabularies, lack of institutional incentives, support from funding agencies, and more; which significantly inhibits their impact. This workshop aims to draw on the wealth of individual experiences in health project team collaboration across the CHI community and beyond. By bringing together different stakeholders involved in HCI health research, together, we will identify needs experienced during interdisciplinary HCI and health collaborations. We will identify existing practices and success stories for supporting team collaboration and increasing HCI capacity in health research. We aim for participants to leave our workshop with a toolbox of methods to tackle future team challenges, a community of peers who can strive for more effective teamwork, and feeling positioned to make the health impact they wish to see through their work.

11.
JMIR Res Protoc ; 12: e47119, 2023 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-37883152

RESUMO

BACKGROUND: Clinical trials often use digital technologies to collect data continuously outside the clinic and use the derived digital endpoints as trial endpoints. Digital endpoints are also being developed to support diagnosis, monitoring, or therapeutic interventions in clinical care. However, clinical validation stands as a significant challenge, as there are no specific guidelines orienting the validation of digital endpoints. OBJECTIVE: This paper presents the protocol for a scoping review that aims to map the existing methods for the clinical validation of digital endpoints. METHODS: The scoping review will comprise searches from the electronic literature databases MEDLINE (PubMed), Scopus (including conference proceedings), Embase, IEEE (Institute of Electrical and Electronics Engineers) Xplore, ACM (Association for Computing Machinery) Digital Library, CENTRAL (Cochrane Central Register of Controlled Trials), Web of Science Core Collection (including conference proceedings), and Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports. We will also include various sources of gray literature with search terms related to digital endpoints. The methodology will adhere to the Joanna Briggs Institute Scoping Review and the Guidance for Conducting Systematic Scoping Reviews. RESULTS: A search for reviews on the existing evidence related to this topic was conducted and has shown that no such review was previously undertaken. This review will provide a systematic assessment of the literature on methods for the clinical validation of digital endpoints and highlight any potential need for harmonization or reporting of methods. The results will include the methods for the clinical validation of digital endpoints according to device, digital endpoint, and clinical application goal of digital endpoints. The study started in January 2023 and is expected to end by December 2023, with results to be published in a peer-reviewed journal. CONCLUSIONS: A scoping review of methodologies that validate digital endpoints is necessary. This review will be unique in its breadth since it will comprise digital endpoints collected from several devices and not focus on a specific disease area. The results of our work should help guide researchers in choosing validation methods, identify potential gaps in the literature, or inform the development of novel methods to optimize the clinical validation of digital endpoints. Resolving these gaps is the key to presenting evidence in a consistent way to regulators and other parties and obtaining regulatory acceptance of digital endpoints for patient benefit. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/47119.

12.
Antibiotics (Basel) ; 12(5)2023 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-37237809

RESUMO

Antimicrobial resistance is a major public health concern. The aim of this study was to assess the presence of antibiotic resistance genes, previously reported in Helicobacter pylori, in gastric samples of 36 pigs, in which DNA of H. pylori-like organisms had been detected. Based on PCR and sequencing analysis, two samples were positive for the 16S rRNA mutation gene, conferring tetracycline resistance, and one sample was positive for the frxA gene with a single nucleotide polymorphism, conferring metronidazole resistance. All three amplicons showed the highest homology with H. pylori-associated antibiotic resistance gene sequences. These findings indicate that acquired antimicrobial resistance may occur in H. pylori-like organisms associated with pigs.

13.
Plants (Basel) ; 12(3)2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36771735

RESUMO

Microalgae are important members of the soil and plant microbiomes, playing key roles in the maintenance of soil and plant health as well as in the promotion of plant growth. However, not much is understood regarding the potential of different microalgae strains in augmenting plant growth, or the mechanisms involved in such activities. In this work, the functional and genomic characterization of strain NFX-FRZ, a eukaryotic microalga belonging to the Micractinium genus that was isolated from the rhizosphere of a plant growing in a natural environment in Portugal, is presented and analyzed. The results obtained demonstrate that strain NFX-FRZ (i) belongs to a novel species, termed Micractinium rhizosphaerae sp. nov.; (ii) can effectively bind to tomato plant tissues and promote its growth; (iii) can synthesize a wide range of plant growth-promoting compounds, including phytohormones such as indole-3-acetic acid, salicylic acid, jasmonic acid and abscisic acid; and (iv) contains multiple genes involved in phytohormone biosynthesis and signaling. This study provides new insights regarding the relevance of eukaryotic microalgae as plant growth-promoting agents and helps to build a foundation for future studies regarding the origin and evolution of phytohormone biosynthesis and signaling, as well as other plant colonization and plant growth-promoting mechanisms in soil/plant-associated Micractinium.

14.
Microorganisms ; 11(4)2023 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-37110324

RESUMO

Marine bacteria are a significant source of bioactive compounds for various biotechnological applications. Among these, actinomycetes have been found to produce a wide range of secondary metabolites of interest. Saccharopolyspora is one of the genera of actinomycetes that has been recognized as a potential source of these compounds. This study reports the characterization and genomic analysis of Saccharopolyspora sp. NFXS83, a marine bacterium isolated from seawater from the Sado estuary in Portugal. The NFXS83 strain produced multiple functional and stable extracellular enzymes under high-salt conditions, showed the ability to synthesize auxins such as indole-3-acetic acid, and produced diffusible secondary metabolites capable of inhibiting the growth of Staphylococcus aureus. Furthermore, when Phaeodactylum tricornutum was co-cultivated with strain NFXS83 a significant increase in microalgae cell count, cell size, auto-fluorescence, and fucoxanthin content was observed. Detailed analysis revealed the presence of clusters involved in the production of various secondary metabolites, including extracellular enzymes, antimicrobial compounds, terpenes, and carotenoids in the genome of strain NFXS83. Ultimately, these findings indicate that Saccharopolyspora sp. NFXS83 has a significant potential for a wide range of marine biotechnological applications.

15.
Stud Health Technol Inform ; 177: 254-9, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22942064

RESUMO

Falling is a serious danger to older adults that is usually only addressed after a person has fallen, when doctors administer clinical tests to determine the patient's risk of falling again. Having the technological capability of performing fall risk assessment tests with a smartphone, the authors set out to design a mobile application that would enable users to monitor their risk themselves and consequently prevent falls from occurring. The authors conducted a literature review and two observation sessions before beginning the iterative design process that resulted in the Dance! Don't Fall (DDF) game, a mobile application that enables users to both monitor their fall risk and actively reduce it through fun and easy exercise.


Assuntos
Acidentes por Quedas/prevenção & controle , Dançaterapia/métodos , Terapia por Exercício/métodos , Promoção da Saúde/métodos , Terapia Assistida por Computador/métodos , Jogos de Vídeo , Jogos Experimentais , Serviços de Assistência Domiciliar , Humanos
16.
JMIR Cancer ; 8(1): e33550, 2022 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-35166682

RESUMO

BACKGROUND: Despite the efficacy of psychosocial interventions in minimizing psychosocial morbidity in breast cancer survivors (BCSs), intervention delivery across survivorship is limited by physical, organizational, and attitudinal barriers, which contribute to a mental health care treatment gap in cancer settings. OBJECTIVE: The aim of this study is to develop iNNOV Breast Cancer (iNNOVBC), a guided, internet-delivered, individually tailored, acceptance and commitment therapy-influenced cognitive behavioral intervention program aiming to treat mild to moderate anxiety and depression in BCSs as well as to improve fatigue, insomnia, sexual dysfunction, and health-related quality of life in this group. This study also aims to evaluate the usefulness, usability, and preliminary feasibility of iNNOVBC. METHODS: iNNOVBC was developed using a user-centered design approach involving its primary and secondary end users, that is, BCSs (11/24, 46%) and mental health professionals (13/24, 54%). We used mixed methods, namely in-depth semistructured interviews, laboratory-based usability tests, short-term field trials, and surveys, to assess iNNOVBC's usefulness, usability, and preliminary feasibility among these target users. Descriptive statistics were used to characterize the study sample, evaluate performance data, and assess survey responses. Qualitative data were recorded, transcribed verbatim, and thematically analyzed. RESULTS: Overall, participants considered iNNOVBC highly useful, with most participants reporting on the pertinence of its scope, the digital format, the relevant content, and the appropriate features. However, various usability issues were identified, and participants suggested that the program should be refined by simplifying navigation paths, using a more dynamic color scheme, including more icons and images, displaying information in different formats and versions, and developing smartphone and tablet versions. In addition, participants suggested that tables should be converted into plain textboxes and data visualization dashboards should be included to facilitate the tracking of progress. The possibility of using iNNOVBC in a flexible manner, tailoring it according to BCSs' changing needs and along the cancer care continuum, was another suggestion that was identified. CONCLUSIONS: The study results suggest that iNNOVBC is considered useful by both BCSs and mental health professionals, configuring a promising point-of-need solution to bridge the psychological supportive care gap experienced by BCSs across the survivorship trajectory. We believe that our results may be applicable to other similar programs. However, to fulfill their full supportive role, such programs should be comprehensive, highly usable, and tailorable and must adopt a flexible yet integrated structure capable of evolving in accordance with survivors' changing needs and the cancer continuum.

17.
JMIR Form Res ; 6(4): e32558, 2022 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-35412459

RESUMO

BACKGROUND: Despite the potential of digital mental health to provide cost-effective mental health care, its adoption in clinical settings is limited, and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing these perspectives and practices. OBJECTIVE: This study aims to characterize in depth the perspectives and practices of mental health professionals regarding the implementation of digital mental health and explore the factors affecting such perspectives and practices. METHODS: A qualitative study using in-depth semistructured interviews with Portuguese mental health professionals (N=13)-psychologists and psychiatrists-was conducted. The transcribed interviews were thematically analyzed. RESULTS: Mental health professionals deemed important or engaged in the following practices during the implementation of digital mental health: indication evaluation, therapeutic contract negotiation, digital psychological assessment, technology setup and management, and intervention delivery and follow-up. Low-threshold accessibility and professionals' perceived duty to provide support to their clients facilitated the implementation of digital mental health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programs inhibited digital mental health implementation by mental health professionals. CONCLUSIONS: The publication of practice frameworks, development of evidence-based technology, and delivery of structured training seem key to expediting implementation and encouraging the sustained adoption of digital mental health by mental health professionals.

18.
Artigo em Inglês | MEDLINE | ID: mdl-36429805

RESUMO

Helicobacter species can colonize the gastrointestinal tract of both humans and animals, and are associated with gastrointestinal and extra-gastrointestinal diseases. Some studies indicate that animals, health professionals, and people in close contact with animals might be at higher risk for infection with gastric Helicobacter spp. Considering that veterinarians are professionals at risk for infection with zoonotic gastric Helicobacters and are also seen by many as health communicators concerning zoonoses, the aim of this study was to evaluate the Portuguese veterinarians' perception and knowledge of Helicobacter spp. infection and its zoonotic risk/potential. Therefore, a structured questionnaire composed of 34 dichotomic, multiple-choice, rating scale, matrix, drop-down, and open-ended questions was developed and given to Portuguese veterinarians via an online platform from May 2021 to July 2021, and statistical analysis was used to obtain results. There was a total of 149 respondents, most of them (73.8%) being females. Evidently, Portuguese veterinarians have a limited perception regarding Helicobacter spp. infections. Of the respondents that "have heard of Helicobacter", 17.6% do not know which animal species can be affected by it. Most of the companion animal veterinarians (76.2%) do not consider Helicobacter spp. infection a differential diagnosis when evaluating animals with gastritis. A significant percentage (37.2%) of the respondents that have "heard of H. suis" do not consider it a zoonotic bacterium. There is a need for education and sensitization of veterinarians regarding the potential zoonotic risk of Helicobacter spp. in order to elucidate these professionals to this One Health issue, as the number of reports of non-Helicobacter pylori Helicobacter in livestock, companion, and wild animals is increasing.


Assuntos
Gastrite , Infecções por Helicobacter , Helicobacter heilmannii , Helicobacter pylori , Helicobacter , Saúde Única , Médicos Veterinários , Humanos , Animais , Feminino , Masculino , Portugal/epidemiologia , Infecções por Helicobacter/epidemiologia , Percepção
19.
Syst Appl Microbiol ; 45(2): 126303, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35149280

RESUMO

The process of nitrogen (N) fixation by plant-associated bacteria plays an indispensable role in the development of novel agricultural solutions worldwide. In this sense, it is of extreme importance to identify and understand the properties of efficient plant-growth-promoting bacteria (PGPB) that are able to fix N. In this study, the characterization and detailed genomic analysis of the diazotrophic bacterium Kosakonia radicincitans MUSA4, isolated from the internal leaf tissues of a banana tree in Brazil, were undertaken. K. radicincitans MUSA4 presented several plant-growth-promoting traits, including indoleacetic acid, siderophore, acetoin and polyamine biosynthesis, phosphate solubilization, and nitrogen fixation. The strain was able to increase cucumber plant growth significantly, demonstrating its potential in beneficial interactions with plant hosts. Detailed genomic analysis of strain MUSA4 revealed the abundant presence of genes involved in plant colonization, stress resistance and plant-growth-promoting abilities. Moreover, the genome harbored the nif and anf gene clusters, encoding the Fe-Mo nitrogenase and Fe-Fe nitrogenase systems, respectively. Comparative genomic analysis also showed that strain MUSA4 possessed several strain-specific genes, which could be related to its evolutionary history in Brazilian mangrove environments. The results obtained in the present study revealed the plant beneficial role and biotechnological potential of K. radicincitans MUSA4, and provided new insights into plant colonization and plant growth promoting mechanisms employed by diazotrophic Kosakonia.


Assuntos
Bactérias , Fixação de Nitrogênio , Enterobacteriaceae , Genômica , Fixação de Nitrogênio/genética , Filogenia , RNA Ribossômico 16S/genética
20.
Vet Sci ; 9(5)2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35622756

RESUMO

In addition to Helicobacter pylori, many non-Helicobacter pylori Helicobacters (NHPH) are able to cause gastric disease in humans. Cats are a natural reservoir for many of these species. Accordingly, living in close and intimate contact with animals has been identified as a risk factor, and an important zoonotic significance has therefore been attributed to NHPH. To determine the prevalence and associated gastric histopathological changes of Helicobacter species, the gastric mucosa of 71 cats were evaluated. Only four presented normal histopathological mucosa with the absence of spiral-shaped organisms. Normal gastric mucosa and the presence of spiral-shaped bacteria were observed in 13 cats. The remaining animals presented histopathological changes representative of gastritis. Helicobacter species were detected in 53 cats (74.6%) by at least one detection method. None of the animals were positive for H. pylori or for H. ailurogastricus. Helicobacter heilmannii organisms were identified in 20 animals, predominantly in the body gastric region. Helicobacter salomonis was the second most prevalent species (57.1%), although it was mainly found in association with other NHPH. Helicobacter felis and H. bizzozeronii were less frequently detected. The great majority of the Helicobacter spp. PCR-positive animals presented normal features regarding fibrosis/mucosal atrophy, neutrophils, eosinophils, or other inflammatory cells and lymphofollicular hyperplasia. Given the controversy and the strong evidence of absence of significant histopathological alterations associated with the presence of Helicobacter spp. in cats, it is possible to hypothesize that these bacteria may be able to adapt to the feline gastric microenvironment or even to comprise part of the gastric microbiome of this animal species. Thus, prudency must be taken when prescribing an antibiotic therapy based solely on the presence of these bacteria in the feline stomach.

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