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Sökning: WFRF:(Gomes Inês)

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1.
  • Jung, Christian, et al. (författare)
  • A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention
  • 2019
  • Ingår i: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 52, s. 141-148
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery. 
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2.
  • Neves, Ana Luisa, et al. (författare)
  • Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma : Secondary Analysis of Observational Studies
  • 2021
  • Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871 .- 1438-8871. ; 23:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Health and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients' daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities. Objective: This study aimed to evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. Methods: A secondary analysis of the INSPIRERS observational studies was conducted using data from face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and depression, postcode, socioeconomic level, digital literacy, use of health services, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. Results: A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were <= 40 years old (66.4%), had at least 10 years of education (57.4%), and were in the 3 higher quintiles of the socioeconomic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale [VAS] score>70 in 93.1%) and the prevalence of anxiety and depression was 34.3% and 11.9%, respectively. The proportion of participants who reported using health and fitness mobile apps was 41.1% (n=211). Multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted odds ratio [aOR] 2.22, 95%CI 1.05-4.75 and aOR 1.95, 95%CI 1.12-3.45, respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third, and fourth quartiles reporting aORs of 6.74 (95%CI 2.90-17.40), 10.30 (95%CI 4.28-27.56), and 11.52 (95%CI 4.78-30.87), respectively. Participants with depression symptoms had lower odds of using health and fitness apps (aOR 0.32, 95%CI 0.12-0.83). Conclusions: A better understanding of the barriers and enhancers of app use among patients with lower education, lower digital literacy, or depressive symptoms is key to design tailored interventions to ensure a sustained and equitable use of these technologies. Future studies should also assess users' general health-seeking behavior and their interest and concerns specifically about digital tools. These factors may impact both initial engagement and sustained use.
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3.
  • Amaral, Rita, et al. (författare)
  • Profiling Persistent Asthma Phenotypes in Adolescents : A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:3
  • Tidskriftsartikel (refereegranskat)abstract
    • We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13-17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.
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4.
  • Claudio, Ana Paula, et al. (författare)
  • Sense of presence inside a feared (virtual) tunnel
  • 2015
  • Ingår i: PROCEEDINGS OF THE 2015 10TH IBERIAN CONFERENCE ON INFORMATION SYSTEMS AND TECHNOLOGIES (CISTI 2015). - 9781479983308 ; , s. Art. no. 7170433-
  • Konferensbidrag (refereegranskat)abstract
    • Virtual Reality in Exposure Therapy allows exposing patients to simulations of feared situations, even in cases where actual exposure is not possible or difficult. We have created a Web application that helps therapists performing this type of therapy when dealing with patients that suffer from anxiety of crossing road tunnels. The application contains a set of animations of virtual scenarios recreating a car journey across a tunnel visualized from the point of view of the traveler sitting beside the driver and exhibiting a set of potential anxiety inductors. In this paper we describe the application and report a user study to assess the adequacy of our application as a VRET tool and also to compare the impact of visualizing the animations resorting to two distinct low cost apparatus: a versatile immersive equipment and a big projection.
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5.
  • Gomes Marques, Inês, et al. (författare)
  • Germination and seed traits in common alder (Alnus spp.) : the potential contribution of rear-edge populations to ecological restoration success
  • 2021
  • Ingår i: Restoration Ecology. - 1061-2971 .- 1526-100X.
  • Tidskriftsartikel (refereegranskat)abstract
    • The degradation of riparian ecosystems occurring throughout the past decades has motivated efforts aimed at the restoration of these ecosystems. The success of active revegetation approaches to restoration requires appropriate selection of reproductive material, which in turn requires knowledge of seed traits and germination. Alnus glutinosa (L.) Gaertn. (common alder) is a key riparian tree widely used in restoration projects, and has recently been classified as comprising three species: A. glutinosa; A. lusitanica Vít, Douda, & Mandák; and A. rohlenae Vít, Douda, & Mandák. To help guide restoration species selection, we assessed differences among populations of these species by (1) investigating seed weight, morphology, and germination success from a large population set and (2) modeling germination success in each species in relation to morphological traits and environmental conditions. Seeds were collected from 12 populations encompassing the latitudinal extremes of the species complex, and were then characterized and germinated. Ploidy levels and species were distinguished using cytometric analysis. Site-level climatic data and seed morphology data were used to model germination success for each species. All seed traits differed between populations and one morphological-trait (seed weight-to-area ratio) differed significantly between the three species. Germination modeling showed that the southwestern species, A. lusitanica, responded positively to high temperature extremes, suggesting tolerance to the climate changes projected for southern Europe. Populations of A. lusitanica located at the latitudinal rear edge of common alder's distribution appear to show establishment-facilitating adaptations, and therefore may contribute to ecological restoration efforts under a range of environmental conditions.
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6.
  • Gomes, Victor F., et al. (författare)
  • Impact of tuberculosis exposure at home on mortality in children under 5 years of age in Guinea-Bissau
  • 2011
  • Ingår i: Thorax. - : BMJ Publishing Group. - 1468-3296. ; 66:2, s. 163-167
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To assess mortality related to exposure to tuberculosis (TB) at home among children in urban areas of Guinea-Bissau. Methods In four suburban areas included in the demographic surveillance system of the Bandim Health Project in Bissau, the mortality of children aged <5 years living with an adult with TB was compared with the mortality of children in the general population. Results Children <5 years of age exposed to an adult with intrathoracic TB had 66% higher mortality than unexposed children (HR 1.66, 95% CI 1.2 to 2.3). The risk was higher for children living in the same family as a TB case (HR 2.15, 95% CI 1.3 to 3.7) than for children living in the same house but not belonging to the same family as the TB case (HR 1.51, 95% CI 1.0 to 2.2). For children whose mother had TB, mortality was increased eightfold (HR 7.82, 95% CI 2.1 to 30). The risk of death was particularly increased from 6 months following exposure (HR 2.16, 95% CI 1.5 to 3.2) and the highest rate of excess mortality was found in children aged 3-4 years. Excess mortality was highest among children with close contact with an adult with sputum-positive pulmonary TB (HR 1.90, 95% CI 1.1 to 3.2), but contact with a sputum-negative case was also associated with increased mortality (HR 1.55, 95% CI 1.0 to 2.3). Adjusting for potential confounding factors did not change these results. The mortality among children living in the same houses 3 years earlier was not increased (HR 0.90, 95% CI 0.6 to 1.3). Conclusion Intimate family contact with a TB case represents a significant risk factor for child mortality in a low-income country.
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7.
  • Prudencio, Mercedes, et al. (författare)
  • Toward allele-specific targeting therapy and pharmacodynamic marker for spinocerebellar ataxia type 3
  • 2020
  • Ingår i: Science Translational Medicine. - : American Association for the Advancement of Science (AAAS). - 1946-6242. ; 12:566
  • Tidskriftsartikel (refereegranskat)abstract
    • Spinocerebellar ataxia type 3 (SCA3), caused by a CAG repeat expansion in the ataxin-3 gene (ATXN3), is characterized by neuronal polyglutamine (polyQ) ATXN3 protein aggregates. Although there is no cure for SCA3, gene-silencing approaches to reduce toxic polyQ ATXN3 showed promise in preclinical models. However, a major limitation in translating putative treatments for this rare disease to the clinic is the lack of pharmacodynamic markers for use in clinical trials. Here, we developed an immunoassay that readily detects polyQ ATXN3 proteins in human biological fluids and discriminates patients with SCA3 from healthy controls and individuals with other ataxias. We show that polyQ ATXN3 serves as a marker of target engagement in human fibroblasts, which may bode well for its use in clinical trials. Last, we identified a single-nucleotide polymorphism that strongly associates with the expanded allele, thus providing an exciting drug target to abrogate detrimental events initiated by mutant ATXN3. Gene-silencing strategies for several repeat diseases are well under way, and our results are expected to improve clinical trial preparedness for SCA3 therapies.
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8.
  • Trindade, Inês, et al. (författare)
  • Behavioural response to illness: development and validation of a self-report measure of illness behaviour avoidance
  • 2021
  • Ingår i: Current Psychology. - 1046-1310.
  • Tidskriftsartikel (refereegranskat)abstract
    • A robust scale capable of assessing illness-related experiential avoidance (EA) in any given medical condition is currency lacking. Further, there is no available measure that assesses EA related to illness behaviours, i.e., actions and/or reactions in relation to feeling unwell that have the purpose of defining one's state of health and obtaining physical or emotional relief from perceived or actual illness. This study intends to fill this significant gap by presenting the development and psychometric test of a measure of EA related to illness behaviour, the Illness Behaviour Avoidance Scale (IBAS). A total of 370 Portuguese adults with chronic illness participated in the study. The structure and validity of the IBAS was tested through an Exploratory Factor Analysis (EFA; n = 185), a Confirmatory Factor Analysis (CFA; n = 185), and reliability analyses. The IBAS presented a 7-item unifactorial structure, with good global (CMIN/DF = 2.08; CFI = 0.97; TLI = 0.94; SRMR = 0.04; RMSEA = 0.08, p = 0.139) and local adjustments (SRWs 0.56-0.73; SMCs 0.31-0.53). It also presented a good internal consistency (with alpha s = 0.82), and construct and discriminant validity. The IBAS appears to be a significant improvement from the use of previous EA measures in illness contexts. This scale can provide a measurement of whether the behavioural response to any given condition is a manifestation of EA.
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