Evaluating an interactive tool that reasons about quality of life to support life planning by older people.

Objectives: In response to the lack of digital support for older people to plan their lives for quality of life, research was undertaken to co-design and then evaluate a new digital tool that combined interactive guidance for life planning with a computerised model of quality of life. Method: First, a workshop-based process for co-designing the SCAMPI tool with older people is reported. A first version of this tool was then evaluated over eight consecutive weeks by nine older people living in their own homes. Four of these people were living with Parkinson's disease, one with early-stage dementia, and four without any diagnosed chronic condition. Regular semi-structured interviews were undertaken with each individual older person and, where wanted, their life partner. A more in-depth exit interview was conducted at the end of the period of tool use. Themes arising from analyses of content from these interviews were combined with first-hand data collected from the tool's use to develop a description of how each older person used the tool over the 8 weeks. Results: The findings provided the first evidence that the co-designed tool, and in particular the computerised model, could offer some value to older people. Although some struggled to use the tool as it was designed, which led to limited uptake of the tool's suggestions, the older people reported factoring these suggestions into their longer-term planning, as health and/or circumstances might change. Conclusions: The article contributes to the evolving discussion about how to deploy such digital technologies to support quality of life more effectively.

People with long-term conditions sharing personal health data via digital health technologies: A scoping review to inform design.

The use of digital technology amongst people living with a range of long-term health conditions to support self-management has increased dramatically. More recently, digital health technologies to share and exchange personal health data with others have been investigated. Sharing personal health data with others is not without its risks: sharing data creates threats to the privacy and security of personal data and plays a role in trust, adoption and continued use of digital health technology. Our work aims to inform the design of these digital health technologies by investigating the reported intentions of sharing health data with others, the associated user experiences when using these digital health technologies and the trust, identity, privacy and security (TIPS) considerations for designing digital health technologies that support the trusted sharing of personal health data to support the self-management of long-term health conditions. To address these aims, we conducted a scoping review, analysing over 12,000 papers in the area of digital health technologies. We conducted a reflexive thematic analysis of 17 papers that described digital health technologies that support sharing of personal health data, and extracted design implications that could enhance the future development of trusted, private and secure digital health technologies.

Collecting and sharing self-generated health and lifestyle data: Understanding barriers for people living with long-term health conditions - a survey study.

Background: The growing popularity of collecting self-generated health and lifestyle data presents a valuable opportunity to develop our understanding of long-term health conditions and improve care. Barriers remain to the effective sharing of health and lifestyle data by those living with long-term health conditions which include beliefs around concepts of Trust, Identity, Privacy and Security, experiences of stigma, perceptions of risk and information sensitivity. Method: We surveyed 250 UK adults who reported living with a range of long-term health conditions. We recorded data to assess self-reported behaviours, experiences, attitudes and motivations relevant to sharing self-generated health and lifestyle data. We also asked participants about their beliefs about Trust, Identity, Privacy and Security, stigma, and perceptions of risk and information sensitivity regarding their health and lifestyle data. Results: Three-quarters of our sample reported recording information about their health and lifestyle on a daily basis. However, two-thirds reported never or rarely sharing this information with others. Trust, Identity, Privacy and Security concerns were considered to be 'very important' by those with long-term health conditions when deciding whether or not to share self-generated health and lifestyle data with others, with security concerns considered most important. Of those living with a long-term health condition, 58% reported experiencing stigma associated with their condition. The greatest perceived risk from sharing with others was the potential for future harm to their social relationships. Conclusions: Our findings suggest that, in order for health professionals and researchers to benefit from the increased prevalence of self-generated health and lifestyle data, more can be done to address security concerns and to understand perceived risks associated with data sharing. Digital platforms aimed at facilitating the sharing of self-generated health and lifestyle data may look to highlight security features, enable users to control the sharing of certain information types, and emphasise the practical benefits to users of sharing health and lifestyle data with others.

XAI-Explainable artificial intelligence.

Explainability is essential for users to effectively understand, trust, and manage powerful artificial intelligence applications.

The use of online forums by people living with HIV for help in understanding personal health information.

PURPOSE: Effective self-management of the human immunodeficiency virus/acquired immune deficiency virus (HIV/AIDS) requires constant vigilance over personal health information. Little is known about the contribution of online communities to this endeavour. This paper reports a study to investigate how people living with HIV/AIDS use an online community to try to understand their personal health information by analysing how health information is shared and asked about, and how the community responds to questions. METHODS: A webscraper was used to gather all messages in the 200 most recently active threads in an online forum for people living with HIV/AIDS, resulting in a total of 2455 messages. These were filtered for all instances of individuals sharing their personal health information and asking the community for help in understanding it. Thematic analysis was used to determine the types of questions asked, the personal health information shared and the information that was asked about. Messages from the community aiming to address the questions were analysed using a framework of social support. RESULTS: Approximately 10% of the 2455 messages were found to be involved in this activity: 60 messages contained questions, and 192 messages responded to address the questions. The most frequent type of question was about causation. While users shared a wide variety of information about their health, they most commonly asked about reactions, lab results, and other conditions. Nearly all the messages from the community that aimed to answer the questions provided informational support, which is a type of social support, and the community shared their own personal experiences in these responses. CONCLUSIONS: This study demonstrates that online forums are used by people living with HIV to ask specific questions as a means of understanding their personal health information. The analysis provides a better understanding of the questions that people living with HIV have about their health information, and the types of support they receive from the community. The results provide a basis for further research into community support and self-management and will enable improved tools to support self-management.

[Endothelial damage after planned extracapsular cataract extraction and phacoemulsification of hard cataracts]. / Estudo do endotélio corneano em cirurgias de cataratas duras: extração extracapsular planejada da catarata e facoemulsificação.

PURPOSE: To evaluate and compare the endothelial damage after planned extracapsular cataract extraction (ECCE) and phacoemulsification of very hard cataracts. METHODS: In this prospective, randomized study, 41 patients with age-related and very hard cataract were divided into two groups: in group 1 (21 patients) an extracapsular cataract extraction was performed and in group 2 (20 patients), phacoemulsification. In both groups, intraocular lenses were implanted in the capsular bag. Preoperatively and 1, 3 and 6 months postoperatively, a complete ophthalmological examination, endothelial specular microscopy, and ultrasonic pachymetry were done. Endothelial cell loss, pleomorphism, polymegathism and corneal thickness were studied. RESULTS: Both groups presented an endothelial cell loss in the postoperative time, as compared with the preoperative values, but there were no significant differences among the postoperative values (1, 3 and 6 months). Six months after surgery, mean cell loss was 28.50% in group 1 and 34.77% in group 2. There were no differences among the indexes of pachymetry, polymegathism and pleomorphism between the two groups. CONCLUSIONS: Endothelial response was not statistically different between the two studied groups.

Rapid detection of "highly virulent" Group B Streptococcus ST-17 and emerging ST-1 clones by MALDI-TOF mass spectrometry.

MALDI-TOF MS identified a 6250-Da protein specific to Sequence Type-1 (ST-1) strains and a 7625-Da protein specific to ST-17 strains when used for identification of Group B streptococci. The strains of these STs are major causes of meningitis and late-onset-disease in neonates. This rapid method of identification could thus be valuable in the evaluation of risk of neonatal diseases.

Estudo do endotélio corneano em cirurgias de cataratas duras: extração extracapsular planejada da catarata e facoemulsificação / Endothelial damage after planned extracapsular cataract extraction and phacoemulsification of hard cataracts

OBJETIVO: Avaliar o dano endotelial em cirurgias de catarata com núcleo duro, comparando as técnicas da extração extracapsular planejada da catarata e a facoemulsificação. MÉTODOS: Estudo prospectivo, incluindo 41 pacientes com catarata senil e núcleo muito duro, que foram divididos aleatoriamente em dois grupos: grupo 1 (21 pacientes) foi submetido à extração extracapsular da catarata (EECC) e grupo 2 (20 pacientes) à facoemulsificação (FACO); em todos casos foram implantadas lentes intra-oculares no saco capsular. Exame oftalmológico completo, microscopia especular e paquimetria foram realizados no pré-operatório e com um, três e seis meses de pós-operatório. Perda endotelial, pleomorfismo, polimegatismo e paquimetria foram aspectos estudados. RESULTADOS: Nos dois grupos, ocorreu perda endotelial significativa, comparando os valores pré e pós-operatórios, mas não houve diferença entre os tempos pós-operatórios (um, três e seis meses). Não houve diferença estatística da perda endotelial entre os grupos da extração extracapsular da catarata e facoemulsificação, em todos tempos estudados. A média de perda endotelial com seis meses de cirurgia no grupo 1 (EECC) foi de 28,50 por cento e no grupo 2 (FACO), de 34,77 por cento. Não houve diferença significativa nas medidas da paquimetria, polimegatismo e pleomorfismo, entre os dois grupos. CONCLUSÕES: As diferenças percentuais da densidade endotelial, polimegatismo, pleomorfismo e paquimetria não foram estatisticamente significantes entre o grupo da extração extracapsular da catarata e da facoemulsificação, em todos tempos estudados.

PURPOSE: To evaluate and compare the endothelial damage after planned extracapsular cataract extraction (ECCE) and phacoemulsification of very hard cataracts. METHODS: In this prospective, randomized study, 41 patients with age-related and very hard cataract were divided into two groups: in group 1 (21 patients) an extracapsular cataract extraction was performed and in group 2 (20 patients), phacoemulsification. In both groups, intraocular lenses were implanted in the capsular bag. Preoperatively and 1, 3 and 6 months postoperatively, a complete ophthalmological examination, endothelial specular microscopy, and ultrasonic pachymetry were done. Endothelial cell loss, pleomorphism, polymegathism and corneal thickness were studied. RESULTS: Both groups presented an endothelial cell loss in the postoperative time, as compared with the preoperative values, but there were no significant differences among the postoperative values (1, 3 and 6 months). Six months after surgery, mean cell loss was 28.50 percent in group 1 and 34.77 percent in group 2. There were no differences among the indexes of pachymetry, polymegathism and pleomorphism between the two groups. CONCLUSIONS: Endothelial response was not statistically different between the two studied groups.

Reconstruçäo palpebral com reconstituiçäo da margem ciliar / Eyelid reconstruction with eyelash line reconstitution

Os autores apresentam os dois primeiros casos em que utilizaram uma nova técnica de reconstruçäo de pálpebra, que reconstitui também a borda ciliar, evitando assim a madarose segmentar, comum a várias outras técnicas. Além destas vantagens estéticas, a técnica permite menor mobilizaçäo de tecidos, sem necessidade de retalhos que exigiram um segundo tempo cirúrgico. E, em especial, indicada para reconstruçäo tanto da pálpebra superior quanto da inferior pós-exérese de lesöes benignas de mais de 1/4 da extensäo palpebral total, e que envolvam margem ciliar. A originalidade da técnica desenvolvida pelos autores está justamente em terem conseguido agrupar vários princípios técnicos de reconstruçäo palpebral já existentes em um só procedimento

Correçäo de pterígio recidivado com enxerto córneo-limbo-conjuntival / Corneal-limbus-conjuntival graft procedure to treat recurrent pterygium-A four a half years experience

Os autores apresentam sua experiência de quatro anos e meio com a técnica cirúrgica em que se realiza um enxerto ceratolomboconjuntival para o tratamento de pterígios recidivados e pseudopterígios, associados ou näo a simbléfaro. Foram realizadas 19 cirurgias, obtendo-se um bom resul;tado sem recidivas em 16 procediemntos 88,9 (por cento). O tempo de observaçäo pós-operatória variou de 1 a 63 meses (média de 18 meses). Concluímos que esta é uma técnica confiável, quando indicada em casos de pterígio recidivado ou com várias cirurgias prévias que apresentam comprometimento cicatricial e retracional

Trissomia parcial proximal do cromossomo 15(Cromossomo marcador): relato de caso / Partial proximal trisomy 15 (marker chromosome): case report

Os autores relatam um caso de trissomia parcial proximal do cromossomo 15 resultante de translocacao materna 46,XX,t(15;16) (15pter - 15q15::16q24-16qter; 16pter-16q24::15q15-15qter). A paciente veio a consulta genetica por apresentar retardo do crescimento e do desenvolvimento neuropsicomotor. Ressalta-se a importancia da correlacao cariotipo-fenotipo nos casos de presencade cromossomo marcador, bem como a variabilidade etiopatogenica da anomalia e, consequentemente, o risco de recorrencia familiar.