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1.
Vet Pathol ; 60(5): 667-677, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37060322

RESUMO

Madagascar hissing cockroaches (MHC, Gromphadorhina portentosa) are members of the Blaberidae (giant cockroaches) family of the Insecta class. They are native to the African island of Madagascar where they live within leaf litter on the rainforest floor. Due to their large size, relative tameness, and general easy keeping, they have become popular in classrooms, zoological collections, museums, research laboratories, and as private exotic pets; however, descriptions of diseases of MHC in the literature are rare. The objective of this study is to describe and characterize postmortem histological findings in 18 captive MHC from a single zoological collection. In this retrospective study, 18 (4 females and 14 males) adult MHC necropsies were submitted to Northwest ZooPath between 2016 and 2020 for evaluation. The main organs with histological lesions were chitinous gut (foregut and/or hindgut; n = 17), tracheae (n = 15), fat body (n = 14), ventriculus (midgut) (n = 13), body wall (n = 12), Malpighian tubules (n = 12), and hemolymphatic sinuses (n = 12). All animals had inflammatory lesions affecting various organs. Inflammatory lesions typically consisted of aggregates of hemocytes with variable amounts of melanization and/or encapsulation. Bacterial, fungal, and parasitic infections were common and variably associated with hemocytic inflammation. Many of these organisms may represent symbiotic organisms of the MHC that cause opportunistic infections. This study contributes to the current knowledge of pathological findings and disease response of MHC and reviews diseases reported in multiple cockroach species.


Assuntos
Baratas , Masculino , Feminino , Animais , Baratas/microbiologia , Baratas/fisiologia , Madagáscar , Estudos Retrospectivos
2.
BMC Vet Res ; 18(1): 182, 2022 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-35578341

RESUMO

BACKGROUND: A number of etiologies for different canine chorioretinal lesions have been proved or suggested but some fundic lesions remain unclear in terms of an etiologic diagnosis, treatment options and prognosis. The purpose of this case series is to describe atypical chorioretinal lesions observed in dogs with primary angle-closure glaucoma (PACG). CASE PRESENTATION: Two spayed-female Siberian Huskies (3- and 4-year-old) and one Siberian Husky/Australian Shepherd mixed breed dog (11-month-old) that had multifocal depigmented retinal lesions and PACG were included. PROCEDURES: Ophthalmic examination, gross, and histopathologic examination findings are described. One of the dogs underwent further clinical diagnostics. Advanced clinical diagnostics on the fellow, presumed to be non-glaucomatous eye of a dog revealed: pectinate ligament dysplasia by gonioscopy, retinal thinning in the depigmented area and wedge shaped retinal thinning with delayed choroidal vascular perfusion by optical coherence tomography, confocal scanning laser ophthalmoscopy, fluorescein and indocyanine green angiography. Quantifiable maze testing for the same eye revealed mild nyctalopia but the full-field electroretinogram showed no generalized decrease of retinal function. Genetic testing for mutations within the retinitis pigmentosa GTPase regulator gene causing X-linked progressive retinal atrophy in Siberian Huskies was negative. Histopathologic evaluations on enucleated eyes in two dogs confirmed goniodysgenesis, PACG with optic nerve head cupping, and diffuse inner retinal atrophy. In addition, segmental profound retinal atrophy, loss of retinal pigment epithelium, and adhesion of the retina to Bruch's membrane was observed and coincided with multifocal depigmented lesions noted on fundic examination. CONCLUSIONS: To our knowledge, this is the first case series with clinical and histopathologic data of chorioretinal lesions, most likely caused by severely impaired choroidal perfusion. Further studies are warranted to elucidate the etiology and pathophysiology, including its possible association with PACG.


Assuntos
Doenças do Cão , Glaucoma de Ângulo Fechado , Disco Óptico , Animais , Atrofia/complicações , Atrofia/patologia , Atrofia/veterinária , Austrália , Corioide/patologia , Doenças do Cão/diagnóstico , Doenças do Cão/genética , Doenças do Cão/patologia , Cães , Feminino , Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Fechado/genética , Glaucoma de Ângulo Fechado/veterinária , Disco Óptico/patologia
3.
BMC Vet Res ; 15(1): 75, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832652

RESUMO

BACKGROUND: Open angle glaucoma is the only type of primary glaucoma reported in Beagles. This case report describes a primary angle-closure glaucoma in a Beagle and its diagnostic and prognostic relevance. CASE PRESENTATION: A 12-year-old, neutered male Beagle presented to the Michigan State University (MSU) Comparative Ophthalmology Service for evaluation of suspected visual impairment. Complete ophthalmic examination of the left eye (OS) revealed: blepharospasm, absent menace response, moderate episcleral congestion, mild diffuse corneal edema, mydriasis, asteroid hyalosis, decreased myelination and cupping of the optic nerve head, and mild retinal vascular attenuation. Examinations of the right eye (OD) were within normal limits. Intraocular Pressure (IOP) were 24 mmHg OD and 49 mmHg OS. Gonioscopy OD revealed a narrow iridocorneal angle with moderate pectinate ligament dysplasia characterized by broad-based pectinate ligament strands (fibrae latae) and solid sheets (laminae) throughout all 4 quadrants. DNA testing revealed that the dog did not carry the Gly661Arg ADAMTS10 mutation responsible for primary open angle glaucoma (POAG) in Beagles. The OS was medically managed with latanoprost 0.005% and dorzolamide HCl 2% /timolol malate 0.5% ophthalmic solutions for 7 months and then enucleated due to uncontrolled IOP. Histopathologic evaluation was consistent with goniodysgenesis with a broad, non-perforate, sheet-like band of uveal stroma bridging from the base of the iris to the terminal arborization of Descemet's membrane. Approximately 14 months from the initial diagnosis of glaucoma OS, OD also developed glaucoma and was enucleated. Histopathologic findings were consistent with goniodysgenesis OD. CONCLUSIONS: To our knowledge, this is the first reported case of PACG with goniodysgenesis in a Beagle supported by clinical, genetic, and histopathologic data. It highlights the importance of gonioscopy in Beagles with glaucoma. Further studies with a larger number of dogs are warranted to characterize clinical manifestations and inheritance of PACG in this breed.


Assuntos
Doenças do Cão/diagnóstico , Anormalidades do Olho/veterinária , Glaucoma de Ângulo Fechado/veterinária , Animais , Doenças do Cão/terapia , Cães , Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Fechado/terapia , Gonioscopia/veterinária , Pressão Intraocular , Masculino , Resultado do Tratamento
4.
Can Vet J ; 59(8): 851-854, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30104774

RESUMO

A 10-year-old greyhound dog was presented because of an incidental finding of a tonsillar mass. Excisional surgical biopsy was performed and the dog was diagnosed with an incompletely resected plasma cell tumor. Adjuvant therapy was declined. One year later there was no local recurrence or distant metastasis of the mass or clinical signs associated with the tonsillar plasmacytoma.


Plasmacytome tonsillaire chez un chien. Un chien Greyhound âgé de 10 ans a été présenté en raison de la découverte fortuite d'une masse tonsillaire. Une biopsie par excision chirurgicale a été réalisée et le chien a été diagnostiqué avec une tumeur à plasmocytes avec résection incomplète. Le traitement avec adjuvant a été refusé. Une année plus tard, il n'y avait aucune récurrence locale ou de métastase distante de la masse ou de signes cliniques associés au plasmacytome tonsillaire.(Traduit par Isabelle Vallières).


Assuntos
Doenças do Cão/cirurgia , Plasmocitoma/veterinária , Neoplasias Tonsilares/veterinária , Animais , Biópsia/veterinária , Cães , Feminino , Plasmocitoma/cirurgia , Neoplasias Tonsilares/cirurgia
5.
J Zoo Wildl Med ; 49(4): 996-1001, 2018 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-30592939

RESUMO

Hepatocellular carcinomas (HCC) are the most common primary hepatic neoplasm of dogs and occur at a high prevalence in captive fennec foxes ( Vulpes zerda). Of 54 captive fennec fox submissions to Northwest ZooPath, 15 (28%) foxes were diagnosed with HCC. This group consisted of nine males, four females, and two foxes of unspecified gender. Affected foxes ranged in age from 8 to 13 yr (mean 10.3 yr). Clinical signs included weight loss/inappetence ( n = 2), lethargy/weakness/ataxia ( n = 3), and seizures-shaking/tremors ( n = 4). Hematologic abnormalities included elevated liver enzymes ( n = 5), hypoglycemia ( n = 3), anemia ( n = 2), and elevated renal analytes ( n = 2). In eight cases, a palpable or visible hepatic mass was identified. The gross morphologic patterns had been recorded or photodocumented for 13 HCC; these were reclassified according to the human World Health Organization (WHO) classification of hepatic neoplasms as massive ( n = 8), nodular ( n = 4), and diffuse ( n = 1). The histomorphologic pattern according to the WHO classification of hepatic neoplasms was determined for all 15 HCC with the majority of HCC ( n = 12) being classified as mixed and two HCC as trabecular and one as compact. Trabecular ( n = 11), pseudoacinar ( n = 7), compact ( n = 6), and scirrhous ( n = 1) patterns were observed in the 12 mixed HCC. All HCC were well-differentiated, but seven cases had moderate anisokaryosis. In seven HCC, a significant portion of neoplastic cells were identified as clear cells and six cases had a pelioid pattern. Necrosis was detected in six HCC, affecting between 5-40% of the neoplastic cells. As no metastases were noted at time of diagnosis, based on morphologic similarities to canine HCC, complete surgical removal of the affected liver lobe is suspected to be associated with a favorable prognosis.


Assuntos
Carcinoma Hepatocelular/veterinária , Raposas , Neoplasias Hepáticas/veterinária , Animais , Animais de Zoológico , Carcinoma Hepatocelular/patologia , Feminino , Neoplasias Hepáticas/patologia , Masculino , Washington
6.
J Zoo Wildl Med ; 48(3): 906-909, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28920823

RESUMO

A renal tubular cystadenoma was diagnosed in a 14-yr-old male African lion (Panthera leo). During a routine health evaluation, a left renal mass was identified via physical examination, radiographs, and abdominal ultrasonography. The mass was 30 × 15 cm in size and had a thin capsule with central hypoechoic fluid, suggestive of a perirenal cyst. An exploratory celiotomy with partial nephrectomy was performed without complications. Histologically, the tumor was characterized by a thick fibrous capsule surrounding multiple, variable-sized cysts that markedly compressed the adjacent fibrotic and atrophied renal cortex. Immunohistochemical labeling for Aquaporin-1 and Tamm-Horsfall protein was consistent with a renal tubular cystadenoma of proximal tubule origin. Renal cystadenomas are an uncommon benign epithelial neoplasm. There are only two documented case reports in domestic cats. This report represents the first documentation, to the authors' knowledge, of a renal cystadenoma in a lion.


Assuntos
Cistadenoma/veterinária , Neoplasias Renais/veterinária , Leões , Animais , Animais de Zoológico , Cistadenoma/diagnóstico , Cistadenoma/cirurgia , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Masculino
7.
Front Cell Infect Microbiol ; 14: 1284701, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38585652

RESUMO

Bacterial obligate intracellular parasites (BOIPs) represent an exclusive group of bacterial pathogens that all depend on invasion of a eukaryotic host cell to reproduce. BOIPs are characterized by extensive adaptation to their respective replication niches, regardless of whether they replicate within the host cell cytoplasm or within specialized replication vacuoles. Genome reduction is also a hallmark of BOIPs that likely reflects streamlining of metabolic processes to reduce the need for de novo biosynthesis of energetically costly metabolic intermediates. Despite shared characteristics in lifestyle, BOIPs show considerable diversity in nutrient requirements, metabolic capabilities, and general physiology. In this review, we compare metabolic and physiological processes of prominent pathogenic BOIPs with special emphasis on carbon, energy, and amino acid metabolism. Recent advances are discussed in the context of historical views and opportunities for discovery.


Assuntos
Parasitos , Animais , Bactérias/genética , Vacúolos , Células Eucarióticas
8.
AIDS Behav ; 17(9): 2999-3012, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23673793

RESUMO

Young men who have sex with men (YMSM) are disproportionately infected with HIV/AIDS and there are few prevention programs with published efficacy for this population. This study evaluated the feasibility, acceptability, and preliminary efficacy of an online, interactive, and highly engaging HIV prevention program called Keep It Up! The intervention was designed to be delivered to diverse YMSM upon receiving an HIV negative text result, with the goal for them to "Keep It Up" and stay negative. In a randomized clinical trial, the intervention was compared to an online didactic HIV knowledge condition. The study sample included 102 sexually active YMSM. Participants reported completing online modules in settings that were private and not distracting. Mixed methods data showed intervention participants felt the program was valuable and acceptable. Compared to the control condition, participants in the intervention arm had a 44 % lower rate of unprotected anal sex acts at the 12-week follow-up (p < 0.05).


Assuntos
Infecções por HIV/prevenção & controle , Promoção da Saúde , Homossexualidade Masculina , Serviços Preventivos de Saúde , Comportamento de Redução do Risco , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Terapia Comportamental , Chicago/epidemiologia , Estudos de Viabilidade , Seguimentos , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Educação de Pacientes como Assunto , Projetos Piloto , Serviços Preventivos de Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde , Assunção de Riscos , Autoeficácia , Comportamento Sexual/psicologia
9.
Cogn Neurosci ; 14(4): 127-136, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37707299

RESUMO

Selective attention and conflict monitoring are daily human phenomena, yet the spatial and temporal neurological underpinnings of these processes are not fully understood. Current literature suggests these executive functions occur via diverse and highly interconnected neural networks, including top-down, bottom-up, and conflict-control loops. To investigate the spatiotemporal activity of these processes, we collected neuromagnetic data using magnetoencephalography (MEG) in 28 healthy adults (age 19-36), while they performed a computerized Stroop task based on color naming. We focused on low-frequency oscillations in the context of top-down control and hypothesized that conflict monitoring-related activity would first be observed in the left anterior cingulate cortex, followed by the left dorsolateral prefrontal cortex, and subsequently in the parietal and temporal lobes. Significant activity between 600-1000 ms post-stimulus onset was found for incongruent vs. congruent/neutral contrasts. Interestingly, spatiotemporal analysis did not provide evidence for a top-down pattern of activation, instead revealing a simultaneous pattern of activation in the frontal and temporal lobes. Most notable is the involvement of the left posterior inferior temporal cortex (pITC) and the left temporoparietal junction (TPJ), which have not conventionally been considered active players in attentional control. These results may be largely driven by alpha and beta oscillations from our sample population. Our findings challenge early theoretical models of top-down processing in the context of cognitive control from an attention perspective and also suggest a need to investigate attentional centers in the temporal lobe. Furthermore, the study highlights the valuable temporal data provided by MEG, which has been missing from previous studies.

10.
Vet Sci ; 9(3)2022 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-35324843

RESUMO

Chromatophoromas are neoplasms that arise from pigment cells of reptiles, amphibians, and fish. They include melanophoromas (melanomas), iridophoromas, and xanthophoromas. Most chromatophoromas develop spontaneously, but genetic and environmental factors may also play a role in their oncogenesis. The diagnosis is typically through histologic examination. Immunohistochemistry and electron microscopy can be helpful for diagnosing poorly differentiated and/or poorly pigmented neoplasms. Aggressive surgical excision is the current treatment of choice. This review describes the clinical presentation, gross appearance, diagnostic applications, clinical behavior, and treatment of chromatophoromas in reptiles.

11.
J Vet Diagn Invest ; 33(5): 932-938, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34210217

RESUMO

Chromatophoromas are neoplasms that develop from the dermal pigment-bearing and light-reflecting cells (chromatophores) in the skin of reptiles, fish, and amphibians. Seventeen cutaneous chromatophoromas were identified from 851 bearded dragon submissions (2%) to a private diagnostic laboratory in a 15-y period. No sex predilection was found. Ages ranged from 9 mo to 11 y. Chromatophoromas most commonly were single, raised, variably pigmented masses or pigmented scales on the trunk, and less commonly the extremities or head. Microscopically, iridophoromas, melanophoromas, mixed chromatophoromas, and nonpigmented chromatophoromas were identified. Neoplasms were often ulcerated and invaded deep into the subcutis and muscle. Most commonly, nuclear atypia was mild-to-moderate, and mitotic count was low. Six neoplasms had abundant, periodic acid-Schiff-positive, mucinous stroma. Histologic examination was often adequate to diagnose chromatophoromas in bearded dragons given that 11 of 17 had some degree of pigmentation, although it was often scant. IHC for S100 and PNL2 could be helpful to diagnose poorly pigmented neoplasms. No lymphatic invasion or metastases at the time of excision were noted in any of the cases. Follow-up data were available for 6 cases, with no reports of recurrence or neoplasia-related death. Two cases had elevated mitotic counts and nuclear pleomorphism, which has been associated with metastasis in other reports of bearded dragon chromatophoromas. In general, it appears that aggressive surgical excision is often curative, but monitoring may be warranted for cases in which tumors had high mitotic count and nuclear pleomorphism.


Assuntos
Cromatóforos , Lagartos , Neoplasias , Animais , Peixes , Neoplasias/veterinária , Pele
12.
J Vet Diagn Invest ; 33(2): 370-374, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33371794

RESUMO

We diagnosed epitheliotropic T-cell lymphoma of the forestomachs in 2 aged, half-sibling, zoo-managed bontebok (Damaliscus pygargus pygargus). One bontebok also had mesenteric lymph node and cutaneous involvement. Both animals had a history of chronic abdominal distension and diminished body condition that resulted in euthanasia. At autopsy, both animals had marked ruminal distension with diffusely blunted ruminal papillae and reticular crests. In case 1, there was an increased amount and particle length of the ruminoreticular fibrous material with scant fluid, and a 2-cm diameter focus of cutaneous crusting adjacent to a mammary teat. In case 2, the rumen and reticulum were fluid-distended with decreased fibrous material. Histologically in case 1, the rumen, reticulum, omasum, and skin had intraepithelial nests and sheets of neoplastic small lymphocytes; in case 2, the rumen and reticulum had a similar neoplastic cell population. Immunohistochemically, neoplastic lymphocytes were immunoreactive for CD3 and negative for CD20, confirming the diagnosis of epitheliotropic T-cell lymphoma.


Assuntos
Antílopes , Linfoma de Células T/veterinária , Neoplasias Cutâneas/veterinária , Neoplasias Gástricas/veterinária , Animais , Feminino , Linfoma de Células T/diagnóstico , Masculino , Neoplasias Cutâneas/diagnóstico , Neoplasias Gástricas/diagnóstico
13.
J Vet Diagn Invest ; 33(5): 1023-1027, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34166129

RESUMO

A 10-y-old giraffe (Giraffa camelopardalis reticulata) bull developed colic after a 3-mo history of reduced feed consumption. Physical examination and management were performed with 2 standing sedations. The giraffe developed metabolic alkalosis and progressive pre-renal azotemia followed by compensatory respiratory acidosis and paradoxical aciduria. A metallic "ping" sound was auscultated on the left side near ribs 10-12. The giraffe was euthanized given the grave prognosis, and postmortem examination confirmed left displacement of the abomasum (LDA) with fluid sequestration (150-190 L [40-50 gal]) within the rumen. Dental disease was evident at postmortem examination and perimortem skull computed tomography. To ensure cases of LDA are not overlooked, the position of the abomasum must be noted during postmortem examination prior to removal of the gastrointestinal tract. The risk factors for the development of LDA in giraffes are not known, and associations such as those of dairy cattle (hypocalcemia, high-concentrate low-fiber diet, and indoor housing) remain to be elucidated.


Assuntos
Abomaso , Girafas , Abomaso/patologia , Acidose Respiratória/veterinária , Animais , Azotemia/veterinária , Masculino , Rúmen
14.
J Vet Intern Med ; 35(5): 2159-2166, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34473866

RESUMO

BACKGROUND: Primary hyperaldosteronism caused by adrenal neoplasia has been well described in cats. Multiple corticosteroid abnormalities occur in a subset of affected cats, but characterizations of this syndrome are limited to several case reports. OBJECTIVES: To describe a series of cats with adrenal tumors secreting aldosterone and additional corticosteroids. ANIMALS: Ten cats with multiple corticosteroid secreting adrenocortical tumors. METHODS: Retrospective case series. Medical records of cats with adrenal tumors secreting both aldosterone and progesterone were identified. Data concerning historical findings, clinicopathologic features, treatments, and outcomes were retrieved from medical records. RESULTS: All 10 cats had diabetes mellitus in addition to biochemical features of hyperaldosteronism such as hypokalemia. High corticosterone concentrations were observed in all 3 cats in which this corticosteroid was measured. Ultrasound examinations revealed unilateral adrenal tumors in all 10 cases, and the contralateral adrenal gland was either atrophied or not identified in 5 cats. Three of 4 cats developed hypoadrenocorticism after surgical adrenalectomy. Three cats achieved diabetic remission after adrenalectomy. Two cats treated with adrenalectomy survived >1 year, 1 cat survived 6.5 months, and 1 cat was alive 5.5 months after diagnosis. Survival >1 year occurred in 2 of 4 cats treated with medical management alone. Two cats were not treated. CONCLUSIONS AND CLINICAL IMPORTANCE: The presence of multiple corticosteroid abnormalities should be considered in cats with aldosterone secreting adrenal tumors, especially those with concurrent diabetes mellitus. Both surgical and medical management can result in long-term survival, although diabetic remission was documented only in cats undergoing adrenalectomy.


Assuntos
Neoplasias das Glândulas Suprarrenais , Doenças do Gato , Hiperaldosteronismo , Neoplasias das Glândulas Suprarrenais/cirurgia , Neoplasias das Glândulas Suprarrenais/veterinária , Glândulas Suprarrenais/diagnóstico por imagem , Adrenalectomia/veterinária , Aldosterona , Animais , Gatos , Hiperaldosteronismo/cirurgia , Hiperaldosteronismo/veterinária , Progesterona , Estudos Retrospectivos
15.
AIDS Educ Prev ; 31(1): 17-37, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30742481

RESUMO

An embodied conversational agent can serve as a relational agent and provide information, motivation, and behavioral skills. To evaluate the feasibility, acceptability, and preliminary efficacy of My Personal Health Guide, a theory-based mobile-delivered embodied conversational agent intervention to improve adherence to antiretroviral therapy in young African American men who have sex with men, we conducted this prospective pilot study using a 3-month pre-post design. Outcome measures included adherence, acceptability, feasibility, pre versus post health literacy, and pre versus post self-efficacy. There were 43 participants. Pill count adherence > 80% improved from 62% at baseline to 88% at follow-up (p = .05). The acceptability of the app was high. Feasibility issues identified included loss of usage data from unplanned participant app deletion. Health literacy improved whereas self-efficacy was high at baseline and follow-up. This pilot study of My Personal Health Guide demonstrated acceptability and preliminary efficacy in improving adherence in this important population.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade/métodos , Negro ou Afro-Americano/psicologia , Telefone Celular , Infecções por HIV/tratamento farmacológico , Homossexualidade Masculina/psicologia , Adesão à Medicação/psicologia , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Estudos de Viabilidade , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Letramento em Saúde , Homossexualidade Masculina/etnologia , Humanos , Masculino , Adesão à Medicação/etnologia , Motivação , Projetos Piloto , Estudos Prospectivos , Adulto Jovem
16.
JMIR Mhealth Uhealth ; 6(7): e10211, 2018 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-30064971

RESUMO

BACKGROUND: Avatars and embodied agents are a promising innovation for human health intervention because they may serve as a relational agent that might augment user engagement in a behavioral change intervention and motivate behavioral change such as antiretroviral adherence and retention in care. OBJECTIVE: This study aimed to develop a theory-driven talking avatar-like embodied agent mobile phone intervention guided by the information-motivation-behavioral skills model to promote HIV medication adherence and retention in care in young African American men who have sex with men (MSM). METHODS: We performed 5 iterative focus groups in Chicago with HIV-positive African American MSM aged 18-34 years to inform the ongoing development of a mobile phone app. Participants for the focus groups were recruited from 4 University of Illinois at Chicago Community Outreach Intervention Project sites located in different high HIV incidence areas of the city and the University of Illinois at Chicago HIV clinic using fliers and word of mouth. The focus group data analysis included developing an ongoing list of priorities for app changes and discussion between two of the investigators based on the project timeline, resources, and to what extent they served the app's objectives. RESULTS: In this study, 16 men participated, including 3 who participated in two groups. The acceptability for an embodied agent app was universal in all 5 focus groups. The app included the embodied agent response to questions and antiretroviral regimen information, adherence tracking, CD4 count and viral load tracking, motivational spoken messages, and customizability. Concerns that were identified and responded to in the development process included privacy, stigma, avoiding the harsh or commanding tone of voice, avoiding negative motivational statements, and making reminder functions for a variety of health care interactions. CONCLUSIONS: An avatar-like embodied agent mHealth approach was acceptable to young HIV-positive African American MSM. Its relational nature may make it an effective method of informing, motivating, and promoting health behavioral skills. Furthermore, the app's ease of access, stigma-free environment, and audiovisual format may help overcome some adherence barriers reported in this population.

18.
Artigo em Inglês | MEDLINE | ID: mdl-25584346

RESUMO

BACKGROUND: Diabetes is a serious worldwide public health challenge. The burden of diabetes, including prevalence and risk of complications, is greater for minorities, particularly African Americans. Internet-based immersive virtual worlds offer a unique opportunity to reach large and diverse populations with diabetes for self-management education and support. OBJECTIVE: The objective of the study was to examine the acceptability, usage, and preliminary outcome of a virtual world intervention, Diabetes Island, in low-income African Americans with type 2 diabetes. The main hypotheses were that the intervention would: (1) be perceived as acceptable and useful; and (2) improve diabetes self-care (eg, behaviors and barriers) and self-care related outcomes, including glycemic control (A1C), body mass index (BMI), and psychosocial factors (ie, empowerment and distress) over six months. METHODS: The evaluation of the intervention impact used a single-group repeated measures design, including three assessment time points: (1) baseline, (2) 3 month (mid intervention), and (3) 6 month (immediate post intervention). Participants were recruited from a university primary care clinic. A total of 41 participants enrolled in the 6 month intervention study. The intervention components included: (1) a study website for communication, feedback, and tracking; and (2) access to an immersive virtual world (Diabetes Island) through Second Life, where a variety of diabetes self-care education activities and resources were available. Outcome measures included A1C, BMI, self-care behaviors, barriers to adherence, eating habits, empowerment, and distress. In addition, acceptability and usage were examined. A series of mixed-effects analyses, with time as a single repeated measures factor, were performed to examine preliminary outcomes. RESULTS: The intervention study sample (N=41) characteristics were: (1) mean age of 55 years, (2) 71% (29/41) female, (3) 100% (41/41) African American, and (4) 76% (31/41) reported annual incomes below US $20,000. Significant changes over time in the expected direction were observed for BMI (P<.02); diabetes-related distress (P<.02); global (P<.01) and dietary (P<.01) environmental barriers to self-care; one physical activity subscale (P<.04); and one dietary intake (P<.01) subscale. The participant feedback regarding the intervention (eg, ease of use, interest, and perceived impact) was consistently positive. The usage patterns showed that the majority of participants logged in regularly during the first two months, and around half logged in each week on average across the six month period. CONCLUSIONS: This study demonstrated promising initial results of an immersive virtual world approach to reaching underserved individuals with diabetes to deliver diabetes self-management education. This intervention model and method show promise and could be tailored for other populations. A large scale controlled trial is needed to further examine efficacy.

20.
PLoS Curr ; 52013 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-23653102

RESUMO

The advent of technologically-based approaches to disaster response training through Virtual Reality (VR) environments appears promising in its ability to bridge the gaps of other commonly established training formats. Specifically, the immersive and participatory nature of VR training offers a unique realistic quality that is not generally present in classroom-based or web-based training, yet retains considerable cost advantages over large-scale real-life exercises and other modalities and is gaining increasing acceptance. Currently, numerous government departments and agencies including the U.S. Department of Homeland Security (DHS), the Centers for Disease Control and Prevention (CDC) as well as academic institutions are exploring the unique advantages of VR-based training for disaster preparedness and response. Growing implementation of VR-based training for disaster preparedness and response, conducted either independently or combined with other training formats, is anticipated. This paper reviews several applications of VR-based training in the United States, and reveals advantages as well as potential drawbacks and challenges associated with the implementation of such training platform.

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