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Studies exploring the experience of patients receiving home respiratory therapies (HRT), such as long-term oxygen therapy (LTOT) and home mechanical ventilation (HMV), are still limited. This study focused on patients’ and carers’ experience with LTOT and HMV. An exploratory, cross-sectional qualitative study, using semi-structured focus groups, was carried out with 18 patients receiving HRT (median 71y, 78% male, 56% on both LTOT and HMV) and 6 carers (median age 67y, 67% female). Three focus groups were conducted in three regions of Portugal. Thematic analysis was performed by two independent researchers. Patients’ and carers’ experience was reflected in seven major topics, linked to specific time points and settings of the treatment: Initial symptoms/circumstances (n = 41), Prescription (n = 232), Implementation (n = 184), Carer involvement (n = 34), Quality of life impact (n = 301), Health care support/navigability (n = 173) and Suggestions (n = 14). Our findings demonstrate a general good perception of the HRT by patients and carers recognizing a significative quality of life impact improvement, while identifying specific points where improvements in healthcare are needed, particularly about navigability issues, articulation between the hospital, primary care and homecare teams, especially regardingprescriptionrenewal. This knowledge is crucial to promote a long-term HRT adherence and to optimize HRT delivery in line with patients’ experience, needs, and values. Moreover, these key points can inform the development of a specific patient-reported experience measure (PREM) for patients on HRT, which is not currently available, and foster a more integrated respiratory care model.
Cátia Caneiras; Cristina Jácome; Emília Moreira; Daniela Oliveira; Cláudia Camila Dias; Liliane Mendonça; Sagrario Mayoralas-Alises; João Almeida Fonseca; Salvador Diaz-Lobato; Joan Escarrabill; João Carlos Winck. A qualitative study of patient and carer experiences with home respiratory therapies: Long-term oxygen therapy and home mechanical ventilation. Pulmonology 2021, 1 .
AMA StyleCátia Caneiras, Cristina Jácome, Emília Moreira, Daniela Oliveira, Cláudia Camila Dias, Liliane Mendonça, Sagrario Mayoralas-Alises, João Almeida Fonseca, Salvador Diaz-Lobato, Joan Escarrabill, João Carlos Winck. A qualitative study of patient and carer experiences with home respiratory therapies: Long-term oxygen therapy and home mechanical ventilation. Pulmonology. 2021; ():1.
Chicago/Turabian StyleCátia Caneiras; Cristina Jácome; Emília Moreira; Daniela Oliveira; Cláudia Camila Dias; Liliane Mendonça; Sagrario Mayoralas-Alises; João Almeida Fonseca; Salvador Diaz-Lobato; Joan Escarrabill; João Carlos Winck. 2021. "A qualitative study of patient and carer experiences with home respiratory therapies: Long-term oxygen therapy and home mechanical ventilation." Pulmonology , no. : 1.
Home-based models represent one of the solutions to respond to the poor accessibility of pulmonary rehabilitation (PR) services in patients with chronic respiratory disease (CRD). The main goal of this protocol is to present the implementation of the first nationwide home-based PR program—reabilitAR—in Portugal and the strategies to assess its benefits in patients with CRD. The program consists of 2 phases: a 12-week intensive phase and a 40-week maintenance phase (total: 52 weeks, 1 year). The intervention in both phases is composed of presential home visits and phone-call follow ups, including exercise training and the self-management educational program Living Well with COPD. Dyspnea, impact of the disease, emotional status, and level of dyspnea during activities of daily living are used as patient-reported outcomes measures. A one-minute sit-to-stand test is used as a functional outcome, and the number of steps as a measure of physical activity. To ensure safety, fall risk and the cognitive function are assessed. Data are collected at baseline, at 12 weeks, at 26 weeks and at 52 weeks. This is the first nationwide protocol on enhancing access to PR, providing appropriate responses to CRD patients’ needs through a structured and personalized home-based program in Portugal.
Sarah Bernard; Rui Vilarinho; Inês Pinto; Rosa Cantante; Ricardo Coxo; Rosa Fonseca; Sagrario Mayoralas-Alises; Salvador Diaz-Lobato; João Carvalho; Cátia Esteves; Cátia Caneiras. Enhance Access to Pulmonary Rehabilitation with a Structured and Personalized Home-Based Program—reabilitAR: Protocol for Real-World Setting. International Journal of Environmental Research and Public Health 2021, 18, 6132 .
AMA StyleSarah Bernard, Rui Vilarinho, Inês Pinto, Rosa Cantante, Ricardo Coxo, Rosa Fonseca, Sagrario Mayoralas-Alises, Salvador Diaz-Lobato, João Carvalho, Cátia Esteves, Cátia Caneiras. Enhance Access to Pulmonary Rehabilitation with a Structured and Personalized Home-Based Program—reabilitAR: Protocol for Real-World Setting. International Journal of Environmental Research and Public Health. 2021; 18 (11):6132.
Chicago/Turabian StyleSarah Bernard; Rui Vilarinho; Inês Pinto; Rosa Cantante; Ricardo Coxo; Rosa Fonseca; Sagrario Mayoralas-Alises; Salvador Diaz-Lobato; João Carvalho; Cátia Esteves; Cátia Caneiras. 2021. "Enhance Access to Pulmonary Rehabilitation with a Structured and Personalized Home-Based Program—reabilitAR: Protocol for Real-World Setting." International Journal of Environmental Research and Public Health 18, no. 11: 6132.
Patients with chronic obstructive pulmonary disease (COPD) in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) B group can be included in pulmonary rehabilitation (PR) settings outside the hospitals. This study aimed to explore the feasibility of a home-based pulmonary rehabilitation (HBPR) program and assess its impact on patients with COPD in the GOLD B group. A real-world, pre–post intervention study was conducted with 12 weeks of HBPR (presential home visits and phone calls) using the self-management program Living Well with COPD. The 1-min sit-to-stand test (1MSTS), modified Medical Research Council Questionnaire (mMRC), COPD Assessment Test (CAT), Hospital Anxiety and Depression Scale (HADS), and London Chest Activity of Daily Living (LCADL) were used to assess the impact. Pre–post differences and correlations between changes in outcomes were calculated. In 30 patients (71.6 years, FEV1 (%) 52.8), significant improvements (p < 0.05) were observed on 1MSTS (Pre 17.2, Post 21.2), mMRC (Pre 2.0, Post 1.0), CAT (Pre 16.3, Post 9.9), HADS (Pre 14.4, Post 9.6), and LCADL (Pre 21.0, Post 15.8), with no adverse events reported. When significant, correlations between changes in outcomes were moderate or strong (0.48 ≤ ρ ≤ 0.66). HBPR can be feasible and safe, and it shows the potential to significantly improve outcomes of patients with COPD in the GOLD B group.
Rui Vilarinho; Lúcia Serra; Ricardo Coxo; João Carvalho; Cátia Esteves; António Montes; Cátia Caneiras. Effects of a Home-Based Pulmonary Rehabilitation Program in Patients with Chronic Obstructive Pulmonary Disease in GOLD B Group: A Pilot Study. Healthcare 2021, 9, 538 .
AMA StyleRui Vilarinho, Lúcia Serra, Ricardo Coxo, João Carvalho, Cátia Esteves, António Montes, Cátia Caneiras. Effects of a Home-Based Pulmonary Rehabilitation Program in Patients with Chronic Obstructive Pulmonary Disease in GOLD B Group: A Pilot Study. Healthcare. 2021; 9 (5):538.
Chicago/Turabian StyleRui Vilarinho; Lúcia Serra; Ricardo Coxo; João Carvalho; Cátia Esteves; António Montes; Cátia Caneiras. 2021. "Effects of a Home-Based Pulmonary Rehabilitation Program in Patients with Chronic Obstructive Pulmonary Disease in GOLD B Group: A Pilot Study." Healthcare 9, no. 5: 538.
Wastewater treatment plants (WWTPs) are significant reservoirs of bacterial resistance. This work aims to identify the determinants of resistance produced by Gram-negative bacteria in the influent and effluent of two WWTPs in Portugal. A total of 96 wastewater samples were obtained between 2016 and 2019. The numbers of total aerobic and fecal contamination bacteria were evaluated, and genomic features were searched by polymerase chain reaction (PCR) and Next-Generation Sequencing (NGS). Enterobacteriaceae corresponded to 78.6% (n = 161) of the 205 isolates identified by 16sRNA. The most frequent isolates were Escherichia spp. (57.1%, n = 117), followed by Aeromonas spp. (16.1%, n = 33) and Klebsiella spp. (12.7%, n = 26). The remaining 29 isolates (14.1%) were distributed across 10 different genera. Among the 183 resistant genes detected, 54 isolates produced extended spectrum β-lactamases (ESBL), of which bla CTX-M-15 was predominant (37 isolates; 68.5%). A KPC-3 carbapenemase-producing K. oxytoca was identified (n = 1), with bla KPC-3 included in a transposon Tn4401 isoform b. A higher number of virulence genes (VG) (19 genes) was found in the E. coli 5301 (O25b-ST131-B2) isolate compared with a commensal E. coli 5281 (O25b-ST410-A) (six genes). Both shared five VG [Enterobactin; Aerobactin, CFA/1 (clade α); Type1 (clade γ1); Type IV]. In conclusion, this work highlights the role of relevant clinical bacteria in WWTPs, such as KPC-3-producing K. oxytoca, and, for the first time, a CTX-M-15-producing Ochromobactrum intermedium, a human opportunistic pathogen, and a SED-1-producing Citrobacter farmeri, an uncommon CTX-M-type extended-spectrum beta-lactamase.
Elsa Mesquita; Rita Ribeiro; Carla Silva; Rita Alves; Rita Baptista; Sílvia Condinho; Maria Rosa; João Perdigão; Cátia Caneiras; Aida Duarte. An Update on Wastewater Multi-Resistant Bacteria: Identification of Clinical Pathogens Such as Escherichia coli O25b:H4-B2-ST131-Producing CTX-M-15 ESBL and KPC-3 Carbapenemase-Producing Klebsiella oxytoca. Microorganisms 2021, 9, 576 .
AMA StyleElsa Mesquita, Rita Ribeiro, Carla Silva, Rita Alves, Rita Baptista, Sílvia Condinho, Maria Rosa, João Perdigão, Cátia Caneiras, Aida Duarte. An Update on Wastewater Multi-Resistant Bacteria: Identification of Clinical Pathogens Such as Escherichia coli O25b:H4-B2-ST131-Producing CTX-M-15 ESBL and KPC-3 Carbapenemase-Producing Klebsiella oxytoca. Microorganisms. 2021; 9 (3):576.
Chicago/Turabian StyleElsa Mesquita; Rita Ribeiro; Carla Silva; Rita Alves; Rita Baptista; Sílvia Condinho; Maria Rosa; João Perdigão; Cátia Caneiras; Aida Duarte. 2021. "An Update on Wastewater Multi-Resistant Bacteria: Identification of Clinical Pathogens Such as Escherichia coli O25b:H4-B2-ST131-Producing CTX-M-15 ESBL and KPC-3 Carbapenemase-Producing Klebsiella oxytoca." Microorganisms 9, no. 3: 576.
Chester step test (CST) estimates the exercise capacity through a submaximal response, which can limit its application in the prescription of exercise. This study aimed to assess whether an adaptation of the CST (with a progressive profile) can have maximal response characteristics in young women and compare it to the incremental shuttle walk test (ISWT). Another aim was to determine its within-day test–retest reliability. A cross-sectional study was conducted with 25 women (20.3 ± 1.5 years) who performed the field tests twice on two different days (48 h apart). The maximal effort attainment was assessed by the heart rate (HR), perception of exertion (Borg scale), and blood lactate concentration. For the performance variables, Pearson’s correlation and intraclass correlation coefficient (ICC2,1) were used. In the best test, mean values of maximal response were observed in the adapted CST (94.0 ± 6.5% of age-predicted HRmax, 11.3 ± 4.5 mmol/dl of blood lactate, and 18.4 ± 1.5 of Borg rating). The correlations between the adapted CST and the ISWT were weak to moderate (0.38 ≤ r ≤ 0.55; p < 0.05). Fair to good reliability was found for the adapted CST (ICC2,1 = 0.48–0.61). The adapted CST showed mean values of maximal response, weak to moderate association with the ISWT, and low within-day test–retest reliability in young women.
Rui Vilarinho; Ana Mendes; Mariana Gomes; Rui Ferreira; Fabíola Costa; Marcela Machado; Márcia Neves; Cátia Caneiras; António Montes. Adapted Chester Step Test Can Have Maximal Response Characteristics for the Assessment of Exercise Capacity in Young Women. Healthcare 2021, 9, 308 .
AMA StyleRui Vilarinho, Ana Mendes, Mariana Gomes, Rui Ferreira, Fabíola Costa, Marcela Machado, Márcia Neves, Cátia Caneiras, António Montes. Adapted Chester Step Test Can Have Maximal Response Characteristics for the Assessment of Exercise Capacity in Young Women. Healthcare. 2021; 9 (3):308.
Chicago/Turabian StyleRui Vilarinho; Ana Mendes; Mariana Gomes; Rui Ferreira; Fabíola Costa; Marcela Machado; Márcia Neves; Cátia Caneiras; António Montes. 2021. "Adapted Chester Step Test Can Have Maximal Response Characteristics for the Assessment of Exercise Capacity in Young Women." Healthcare 9, no. 3: 308.
The evolutionary epidemiology, resistome, virulome and mobilome of thirty-one multidrug resistant Klebsiella pneumoniae clinical isolates from the northern Vila Real region of Portugal were characterized using whole-genome sequencing and bioinformatic analysis. The genomic population structure was dominated by two main sequence types (STs): ST147 (n = 17; 54.8%) and ST15 (n = 6; 19.4%) comprising four distinct genomic clusters. Two main carbapenemase coding genes were detected (blaKPC-3 and blaOXA-48) along with additional extended-spectrum β-lactamase coding loci (blaCTX-M-15, blaSHV-12, blaSHV-27, and blaSHV-187). Moreover, whole genome sequencing enabled the identification of one Klebsiella variicola KPC-3 producer isolate previously misidentified as K. pneumoniae, which in addition to the blaKPC-3 carbapenemase gene, bore the chromosomal broad spectrum β-lactamase blaLEN-2 coding gene, oqxAB and fosA resistance loci. The blaKPC-3 genes were located in a Tn4401b transposon (K. variicolan = 1; K. pneumoniaen = 2) and Tn4401d isoform (K. pneumoniaen = 28). Overall, our work describes the first report of a blaKPC-3 producing K. variicola, as well as the detection of this species during infection control measures in surveillance cultures from infected patients. It also highlights the importance of additional control measures to overcome the clonal dissemination of carbapenemase producing clones.
João Perdigão; Cátia Caneiras; Rita Elias; Ana Modesto; Anton Spadar; Jody Phelan; Susana Campino; Taane G. Clark; Eliana Costa; Maria José Saavedra; Aida Duarte. Genomic Epidemiology of Carbapenemase Producing Klebsiella pneumoniae Strains at a Northern Portuguese Hospital Enables the Detection of a Misidentified Klebsiella variicola KPC-3 Producing Strain. Microorganisms 2020, 8, 1986 .
AMA StyleJoão Perdigão, Cátia Caneiras, Rita Elias, Ana Modesto, Anton Spadar, Jody Phelan, Susana Campino, Taane G. Clark, Eliana Costa, Maria José Saavedra, Aida Duarte. Genomic Epidemiology of Carbapenemase Producing Klebsiella pneumoniae Strains at a Northern Portuguese Hospital Enables the Detection of a Misidentified Klebsiella variicola KPC-3 Producing Strain. Microorganisms. 2020; 8 (12):1986.
Chicago/Turabian StyleJoão Perdigão; Cátia Caneiras; Rita Elias; Ana Modesto; Anton Spadar; Jody Phelan; Susana Campino; Taane G. Clark; Eliana Costa; Maria José Saavedra; Aida Duarte. 2020. "Genomic Epidemiology of Carbapenemase Producing Klebsiella pneumoniae Strains at a Northern Portuguese Hospital Enables the Detection of a Misidentified Klebsiella variicola KPC-3 Producing Strain." Microorganisms 8, no. 12: 1986.
Mild cognitive impairment (MCI) is characterized by cognitive, psychological, and functional impairments. Digital interventions typically focus on cognitive deficits, neglecting the difficulties that patients experience in instrumental activities of daily living (IADL). The global conjecture created by COVID-19 has highlighted the seminal importance of digital interventions for the provision of healthcare services. Here, we investigated the feasibility and rehabilitation potential of a new design approach for creating highly realistic interactive virtual environments for MCI patients’ neurorehabilitation. Through a participatory design protocol, a neurorehabilitation digital platform was developed using images captured from a Portuguese supermarket (NeuroVRehab.PT). NeuroVRehab.PT’s main features (e.g., medium-sized supermarket, the use of shopping lists) were established according to a shopping behavior questionnaire filled in by 110 older adults. Seven health professionals used the platform and assessed its rehabilitation potential, clinical applicability, and user experience. Interviews were conducted using the think-aloud method and semi-structured scripts, and four main themes were derived from an inductive semantic thematic analysis. Our findings support NeuroVRehab.PT as an ecologically valid instrument with clinical applicability in MCI neurorehabilitation. Our design approach, together with a comprehensive analysis of the patients’ past experiences with IADL, is a promising technique to develop effective digital interventions to promote real-world functioning.
Filipa Ferreira-Brito; Sérgio Alves; Osvaldo Santos; Tiago Guerreiro; Cátia Caneiras; Luís Carriço; Ana Verdelho. Photo-Realistic Interactive Virtual Environments for Neurorehabilitation in Mild Cognitive Impairment (NeuroVRehab.PT): A Participatory Design and Proof-of-Concept Study. Journal of Clinical Medicine 2020, 9, 3821 .
AMA StyleFilipa Ferreira-Brito, Sérgio Alves, Osvaldo Santos, Tiago Guerreiro, Cátia Caneiras, Luís Carriço, Ana Verdelho. Photo-Realistic Interactive Virtual Environments for Neurorehabilitation in Mild Cognitive Impairment (NeuroVRehab.PT): A Participatory Design and Proof-of-Concept Study. Journal of Clinical Medicine. 2020; 9 (12):3821.
Chicago/Turabian StyleFilipa Ferreira-Brito; Sérgio Alves; Osvaldo Santos; Tiago Guerreiro; Cátia Caneiras; Luís Carriço; Ana Verdelho. 2020. "Photo-Realistic Interactive Virtual Environments for Neurorehabilitation in Mild Cognitive Impairment (NeuroVRehab.PT): A Participatory Design and Proof-of-Concept Study." Journal of Clinical Medicine 9, no. 12: 3821.
Home respiratory care (HRC) is the provision of healthcare services at the place of residence of patients or their families, with the aim of meeting needs mainly resulting from chronic respiratory conditions, permanent disability, or terminal illness. In 2016, an innovative electronic prescription system, PEM-CRD, was fully implemented for HRC services in Portugal. To date, no study has addressed the impact of the execution of this digital innovation. For this purpose, we carried out an analysis of the prevalence and number of prescriptions for people with chronic respiratory diseases receiving HRC in the Lisbon metropolitan area, during 2014–2018, using the information obtained from the PEM-CRD database. The data analysis shows that while the number of patients receiving HRC treatment with a prescription has remained stable over the last four years, the number of prescriptions has significantly dropped since 2016 (2016–2018), with consequent paper and processes efficiency. The implementation of the digital Medical Electronic Prescription for Home Respiratory Care tool (PEM-CRD) and consequent dematerialization of these processes has increased the efficiency of prescribing in HRC. Additionally, the possibility of obtaining data through the PEM-CRD allows the monitoring of the evolving prevalence of therapies, improving the health services optimization and allowing reporting on data other than medicines.
Ricardo Alves; Cátia Caneiras; Ana Santos; Patricia Barbosa; João Cardoso; Paulo Caseiro; Maria Vitorino; João Pereira; Ana Escoval. Medical Electronic Prescription for Home Respiratory Care Services (PEM-CRD) at a Portuguese University Tertiary Care Centre (2014–2018): A Case Study. Sustainability 2020, 12, 9859 .
AMA StyleRicardo Alves, Cátia Caneiras, Ana Santos, Patricia Barbosa, João Cardoso, Paulo Caseiro, Maria Vitorino, João Pereira, Ana Escoval. Medical Electronic Prescription for Home Respiratory Care Services (PEM-CRD) at a Portuguese University Tertiary Care Centre (2014–2018): A Case Study. Sustainability. 2020; 12 (23):9859.
Chicago/Turabian StyleRicardo Alves; Cátia Caneiras; Ana Santos; Patricia Barbosa; João Cardoso; Paulo Caseiro; Maria Vitorino; João Pereira; Ana Escoval. 2020. "Medical Electronic Prescription for Home Respiratory Care Services (PEM-CRD) at a Portuguese University Tertiary Care Centre (2014–2018): A Case Study." Sustainability 12, no. 23: 9859.
This systematic review aimed to systematise the different designs used to deliver pulmonary rehabilitation during acute exacerbations of COPD (AECOPD) and explore which ones are the most effective. PubMed, Scopus, Web of Science, EBSCO and Cochrane were searched. Randomised controlled trials comparing pulmonary rehabilitation or at least one of its components with usual care or comparing different components of pulmonary rehabilitation were included. Network meta-analysis was conducted in MetaXL 5.3 using a generalised pairwise modelling framework. Pooled effects compared each treatment to usual care. 42 studies were included. Most studies were conducted in an inpatient setting (57%) and started the intervention 24–48 h after hospital admission (24%). Exercise training (71%), education and psychosocial support (57%) and breathing techniques (55%) were the most used components. Studies combining exercise with breathing techniques presented the larger effects on exercise capacity (weighted mean difference (WMD) −41.06, 95% CI −131.70–49.58) and health-related quality of life (WMD 14.64, 95% CI 8.73–20.54), and breathing techniques presented the larger effects on dyspnoea (WMD 1.90, 95% CI 0.53–3.27) and length of hospitalisation (effect size =0.15, 95% CI −0.28–0.57). A few minor adverse events were found. Pulmonary rehabilitation is a safe intervention during AECOPD. Exercise, breathing techniques, and education and psychosocial support seem to be the core components for implementing pulmonary rehabilitation during AECOPD. Studies may now focus on comparisons of optimal timings to start the intervention, total duration of the intervention, duration and frequency of sessions, and intensity for exercise prescription.
Ana Machado; Pedro Matos Silva; Vera Afreixo; Cátia Caneiras; Chris Burtin; Alda Marques. Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis. European Respiratory Review 2020, 29, 200039 .
AMA StyleAna Machado, Pedro Matos Silva, Vera Afreixo, Cátia Caneiras, Chris Burtin, Alda Marques. Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis. European Respiratory Review. 2020; 29 (158):200039.
Chicago/Turabian StyleAna Machado; Pedro Matos Silva; Vera Afreixo; Cátia Caneiras; Chris Burtin; Alda Marques. 2020. "Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis." European Respiratory Review 29, no. 158: 200039.
Objective: To determine the level of evidence of the measurement properties (validity, reliability, and responsiveness) and interpretability of the step tests available for assessing the exercise capacity in patients with chronic obstructive pulmonary disease. Data sources: The data sources Web of Science, MEDLINE, PubMed, PEDro, CENTRAL of Cochrane Library, and Scopus were searched up to June 26, 2020. Review methods: Studies of any design that reported results for any measurement property of the step tests for assessing the exercise capacity in COPD patients were selected. One reviewer extracted the data, and two reviewers independently rated the level of evidence by using the Consensus-Based Standards for the Selection of Health Measurements Instruments recommendations. Results: Thirty-one studies were included in the data synthesis. Chester Step Test, Modified Incremental Step Test, two-, three-, four-, and six-Minute Step Test, Paced Step Test, and six-Minute Stepper Test were identified. A step test protocol was also found. The level of evidence of their results for the measurement properties was mostly determined as “low” to “very low.” The best level of evidence found was for the six-minute stepper test: “high” on construct validity ( r = 0.56–0.71); and “moderate” on criterion validity ( r = 0.36–0.69), and responsiveness ( r = 0.26–0.34). Conclusion: The general level of evidence of the measurement properties of the step tests is “low” to “very low” for assessing exercise capacity in patients with chronic obstructive pulmonary disease, which can limit their application in clinical practice. The six-minute Stepper Test is currently the most appropriate step test available.
Rui Vilarinho; Cátia Caneiras; António Mesquita Montes. Measurement properties of step tests for exercise capacity in COPD: A systematic review. Clinical Rehabilitation 2020, 35, 578 -588.
AMA StyleRui Vilarinho, Cátia Caneiras, António Mesquita Montes. Measurement properties of step tests for exercise capacity in COPD: A systematic review. Clinical Rehabilitation. 2020; 35 (4):578-588.
Chicago/Turabian StyleRui Vilarinho; Cátia Caneiras; António Mesquita Montes. 2020. "Measurement properties of step tests for exercise capacity in COPD: A systematic review." Clinical Rehabilitation 35, no. 4: 578-588.
Environmental health is at the intersection between health and the environment. However, it still has a recent (and narrow) history as a scientific area, mainly addressing human biomonitoring and toxicological issues. Only recently additional environmental ‘layers’, other than the traditional chemical, biological and physical environmental determinants, have been considered. This broader perspective of environmental health also encompasses digital, psychosocial, political, socioeconomic and cultural determinants, all of them relevant when considering human health from a planetary health paradigm. This reflects the progressive adoption of a systemic perspective regarding the impact of gains for human health and well-being towards a sustainable environment. It also implies a multi-method and participatory approach to understand the intertwined relationship between environmental changes and human health. In this paper, the broader approach to environmental health is discussed in order to ‘set the stage’ for introducing the Institute of Environmental Health (ISAMB) of the Lisbon School of Medicine, Portugal. Each of the research groups and labs that compose ISAMB are presented, as well as their main lines of research. Present and planned contributions of ISAMB to advance knowledge on environmental health and for promoting human health gains in an environmentally sustainable way are also discussed.
Ana Virgolino; Francisco Antunes; Osvaldo Santos; Andreia Costa; Margarida Matos; Cristina Bárbara; Manuel Bicho; Cátia Caneiras; Raquel Sabino; Maria Núncio; Olga Matos; Ricardo Santos; Joana Costa; Violeta Alarcão; Tânia Gaspar; Joana Ferreira; António Carneiro. Towards a Global Perspective of Environmental Health: Defining the Research Grounds of an Institute of Environmental Health. Sustainability 2020, 12, 8963 .
AMA StyleAna Virgolino, Francisco Antunes, Osvaldo Santos, Andreia Costa, Margarida Matos, Cristina Bárbara, Manuel Bicho, Cátia Caneiras, Raquel Sabino, Maria Núncio, Olga Matos, Ricardo Santos, Joana Costa, Violeta Alarcão, Tânia Gaspar, Joana Ferreira, António Carneiro. Towards a Global Perspective of Environmental Health: Defining the Research Grounds of an Institute of Environmental Health. Sustainability. 2020; 12 (21):8963.
Chicago/Turabian StyleAna Virgolino; Francisco Antunes; Osvaldo Santos; Andreia Costa; Margarida Matos; Cristina Bárbara; Manuel Bicho; Cátia Caneiras; Raquel Sabino; Maria Núncio; Olga Matos; Ricardo Santos; Joana Costa; Violeta Alarcão; Tânia Gaspar; Joana Ferreira; António Carneiro. 2020. "Towards a Global Perspective of Environmental Health: Defining the Research Grounds of an Institute of Environmental Health." Sustainability 12, no. 21: 8963.
Physical inactivity may be a consequence of chronic diseases but also a potential modifiable risk factor. Therefore, it should be clinically assessed as a vital sign of patients’ general physical condition prior to any exercise-based intervention. This cross-sectional study describes physical activity in the daily life of 100 chronic respiratory patients before pulmonary rehabilitation, comparing subjective and objective measures. The assessment combined the International Physical Activity Questionnaire (IPAQ) and 4-day accelerometer and oximeter telemonitoring with SMARTREAB technology, assessing heart rate, transcutaneous oxygen saturation and activity-related energy expenditure by metabolic equivalent of task (MET). According to IPAQ, 49% of patients had a moderate level of physical activity in daily life (PADL), a weekly mean level of 2844 ± 2925 MET.min/week, and a mean sedentary time of 5.8 ± 2.7 h/day. Alongside this, SMARTREAB telemonitoring assessed maximum activity ranging from 1.51 to 4.64 METs, with 99.6% daytime spent on PADL below 3 METs and 93% of patients with daily desaturation episodes. Regardless of the self-reported IPAQ, patients spend at least 70% of daytime on PADL below 2 METs. SMARTREAB was demonstrated to be an innovative methodology to measure PADL as a vital sign, combining oximetry with accelerometry, crossmatched with qualitative patient data, providing important input for designing patient-tailored pulmonary rehabilitation.
Catarina Duarte Santos; Rui César Das Neves; Ruy M. Ribeiro; Cátia Caneiras; Fátima Rodrigues; Martijn A. Spruit; Cristina Bárbara. Novel Input for Designing Patient-Tailored Pulmonary Rehabilitation: Telemonitoring Physical Activity as a Vital Sign—SMARTREAB Study. Journal of Clinical Medicine 2020, 9, 2450 .
AMA StyleCatarina Duarte Santos, Rui César Das Neves, Ruy M. Ribeiro, Cátia Caneiras, Fátima Rodrigues, Martijn A. Spruit, Cristina Bárbara. Novel Input for Designing Patient-Tailored Pulmonary Rehabilitation: Telemonitoring Physical Activity as a Vital Sign—SMARTREAB Study. Journal of Clinical Medicine. 2020; 9 (8):2450.
Chicago/Turabian StyleCatarina Duarte Santos; Rui César Das Neves; Ruy M. Ribeiro; Cátia Caneiras; Fátima Rodrigues; Martijn A. Spruit; Cristina Bárbara. 2020. "Novel Input for Designing Patient-Tailored Pulmonary Rehabilitation: Telemonitoring Physical Activity as a Vital Sign—SMARTREAB Study." Journal of Clinical Medicine 9, no. 8: 2450.
Introduction: Telemonitoring in Home Respiratory Therapies, namely in home mechanical ventilation, is an important tool that could enhances adherence. Healthcare professional could access to patients data using a virtual platform and detect early problems and readily create optimal strategies. Aims and Objectives: 1) Analyse the number and the type of detected problems in therapy for the non-adherence patients with mechanical ventilation at home with telemonitorization. 2) Identify and characterize the intervention made for the resolution of the problems. Methods: A prospective cohort pilot study was performed during 3 months (November 2018 to January 2019) using the telemonitorization platform data available, especially the level of leak and Apnea–Hypopnea Index. The number of detected problems, the type of contact and specific intervention made by healthcare professional to solve the problem was registered. Results: In a sample of 3,400 telemonitored patients, was identified a relevant clinical situation to act in 270 (8%) patients. High level of leak (47%) and high AHI (35%) were the most detected problems. According to the level of severity, the actuation was performed by a control phone call (87%), or a home visit (13%) in the most relevant incidences. Readjustments in mask and reinforcement of adherence (education) were the most common strategies to increase the adherence to the therapy, when additional home visits were performed. Conclusions: The early activation of troubleshooting by the use of Telemonitoring technology could enhance the compliance of long-term therapy acceptance in Home Respiratory Therapies.
Rui Vilarinho; Teresa Magalhães; Marta Silva; Cátia Esteves; Cátia Caneiras. Promotion of adherence to home-mechanical ventilation by Telemonitoring technology: a pilot study. M-health/e-health 2019, 54, 1 .
AMA StyleRui Vilarinho, Teresa Magalhães, Marta Silva, Cátia Esteves, Cátia Caneiras. Promotion of adherence to home-mechanical ventilation by Telemonitoring technology: a pilot study. M-health/e-health. 2019; 54 ():1.
Chicago/Turabian StyleRui Vilarinho; Teresa Magalhães; Marta Silva; Cátia Esteves; Cátia Caneiras. 2019. "Promotion of adherence to home-mechanical ventilation by Telemonitoring technology: a pilot study." M-health/e-health 54, no. : 1.
Introduction: Non-invasive ventilation (NIV) is commonly selected for patients with neuromuscular disease. However, there is a lack of home-based patient-centered protocols as instrument for specific and continuous monitorization with a record of the evolution of the disease and symptoms manifestations. Objectives: 1) Describe a differentiated protocol for the evaluation, implementation and monitorization of neuromuscular patients with home-mechanical ventilation. 2) Characterize the first patients included in protocol (diagnosis and therapy). Methods: The protocol was made according to national and international guidelines available. The dependence level considered was: Level I 16h. Results: The Figure 1 describes the procedures implemented according to the timeline defined. To date, the protocol was applied to 36 patients. 29 (81%) were classified in Level I, 3 (8%) in Level II and 4 (11%) in Level III. The most common diagnosis were Myotonic Dystrophy (Steinert) and Amyotrophic lateral sclerosis (ALS). Pressure assist control ventilation mode was the most common intervention in Level I. On the other hand, the pressure support ventilation-volume guaranteed is the most common therapy in Level III. Better compliance to therapy was achived. Conclusion: The development of a home-based patient-centered protocol to neuromuscular patients reveals to be useful in order to promote complementarity between the hospital prescriber and the healthcare professional responsible to monitor the patient at home, contributing to a better compliance to NIV.
Rui Vilarinho; Teresa Magalhães; Cláudia Maciel; Joana Sampaio-Silva; Cátia Esteves; Cátia Caneiras. Home-based monitorization of neuromuscular patients with non-invasive ventilation: implementation of a patient-centered protocol. Noninvasive ventilatory support 2019, 54, 1 .
AMA StyleRui Vilarinho, Teresa Magalhães, Cláudia Maciel, Joana Sampaio-Silva, Cátia Esteves, Cátia Caneiras. Home-based monitorization of neuromuscular patients with non-invasive ventilation: implementation of a patient-centered protocol. Noninvasive ventilatory support. 2019; 54 ():1.
Chicago/Turabian StyleRui Vilarinho; Teresa Magalhães; Cláudia Maciel; Joana Sampaio-Silva; Cátia Esteves; Cátia Caneiras. 2019. "Home-based monitorization of neuromuscular patients with non-invasive ventilation: implementation of a patient-centered protocol." Noninvasive ventilatory support 54, no. : 1.
Cátia Caneiras; Cristina Jácome; Sagrario Mayoralas-Alises; José Ramon-Calvo; João Almeida Fonseca; Salvador Diaz-Lobato; Joan Escarrabill; João Carlos Winck. Patient experience with home respiratory therapies in Portugal: it is time to move forward. Pulmonology 2019, 25, 311 -312.
AMA StyleCátia Caneiras, Cristina Jácome, Sagrario Mayoralas-Alises, José Ramon-Calvo, João Almeida Fonseca, Salvador Diaz-Lobato, Joan Escarrabill, João Carlos Winck. Patient experience with home respiratory therapies in Portugal: it is time to move forward. Pulmonology. 2019; 25 (6):311-312.
Chicago/Turabian StyleCátia Caneiras; Cristina Jácome; Sagrario Mayoralas-Alises; José Ramon-Calvo; João Almeida Fonseca; Salvador Diaz-Lobato; Joan Escarrabill; João Carlos Winck. 2019. "Patient experience with home respiratory therapies in Portugal: it is time to move forward." Pulmonology 25, no. 6: 311-312.
Game-based interventions (GBI) have been used to promote health-related outcomes, including cognitive functions. Criteria for game-elements (GE) selection are insufficiently characterized in terms of their adequacy to patients’ clinical conditions or targeted cognitive outcomes. This study aimed to identify GE applied in GBI used for cognitive assessment, training or rehabilitation. A systematic review of literature was conducted. Papers involving video games were included if: 1) presenting empirical and original data; 2) video games were used for cognitive intervention; and 3) attention, working memory or inhibitory control were considered as outcomes of interest. Ninety-one papers were included. A significant difference between the number of GE reported in the assessed papers and those composing video games was found (p < .001). The two most frequently used GE were: score system (79.2% of the interventions using video games; for assessment, 43.8%; for training, 93.5%; and for rehabilitation, 83.3%) and narrative context (79.2% of interventions; for assessment, 93.8%; for training, 73.9%; and for rehabilitation, 66.7%). Usability assessment was significantly associated with six of the seven GE analyzed (p-values between p ≤.001 and p. = 027). The use GE that act as extrinsic motivation promotors (e.g., numeric feedback system) may jeopardize patients’ long-term adherence to interventions, mainly if associated with progressive difficulty-increase of gaming experience. Lack of precise description of GE and absence of a theoretical framework supporting GE selection are important limitations of the available clinical literature.
Filipa Ferreira-Brito; Mónica Fialho; Ana Virgolino; Inês Neves; Ana Cristina Miranda; Nuno Sousa Santos; Cátia Caneiras; Luís Carriço; Ana Verdelho; Osvaldo Santos. Game-based interventions for neuropsychological assessment, training and rehabilitation: Which game-elements to use? A systematic review. Journal of Biomedical Informatics 2019, 98 .
AMA StyleFilipa Ferreira-Brito, Mónica Fialho, Ana Virgolino, Inês Neves, Ana Cristina Miranda, Nuno Sousa Santos, Cátia Caneiras, Luís Carriço, Ana Verdelho, Osvaldo Santos. Game-based interventions for neuropsychological assessment, training and rehabilitation: Which game-elements to use? A systematic review. Journal of Biomedical Informatics. 2019; 98 ():.
Chicago/Turabian StyleFilipa Ferreira-Brito; Mónica Fialho; Ana Virgolino; Inês Neves; Ana Cristina Miranda; Nuno Sousa Santos; Cátia Caneiras; Luís Carriço; Ana Verdelho; Osvaldo Santos. 2019. "Game-based interventions for neuropsychological assessment, training and rehabilitation: Which game-elements to use? A systematic review." Journal of Biomedical Informatics 98, no. : .
The rapid and complex evolution of bacterial resistance mechanisms in Klebsiella pneumoniae producing extended-spectrum β-lactamases and carbapenemases in Klebsiella pneumoniae is one of the most significant threats to public health. However, questions and controversies regarding the interactions between resistance and virulence in multidrug-resistant K. pneumoniae isolates remain unclear. A retrospective cohort study was performed with 100 K. pneumoniae isolates recovered from a tertiary care university hospital centre in Lisbon over a 31-year period. Resistance and virulence determinants were screened using molecular methods (PCR, M13-PCR and MLST). The predominant virulence profile (fimH, mrkDv1, khe) was shared by all isolates, indicative of an important role of type 1 and 3 fimbrial adhesins and haemolysin, regardless of the type of β-lactamase produced. However, accumulation of virulence factors was identified in KPC-3-producers, with a higher frequency (p < 0.05) of capsular serotype K2 and iucC aerobactin when compared with non-KPC-3 β-lactamases or carbapenemases. Additionally, 9 different virulence profiles were found, indicating that the KPC-3 carbapenemase producers seem to adapt successfully to the host environment and maintain virulence via several pathways. This study describes an overlapping of multidrug-resistance and virulence determinants in ST-14K2 KPC-3 K. pneumoniae clinical isolates that may impose an additional challenge in the treatment of infections caused by this pathogen. La rápida y compleja evolución de los mecanismos de resistencia de Klebsiella pneumoniae productora de beta-lactamasas de espectro extendido y carbapenemasas en Klebsiella pneumoniae es una de las amenazas más importantes para la salud pública. Sin embargo, aun existe controversia sobre la interacción entre la resistencia y la virulencia en aislados de K. pneumoniae resistentes a múltiples antimicrobianos. Se realizó un estudio de cohorte retrospectivo con 100 aislados de Klebsiella pneumoniae de un centro hospitalario universitario en Lisboa durante 31 años. Los determinantes de la resistencia y virulencia se rastrearon utilizando métodos moleculares (PCR, M13-PCR y MLST). Todos los aislados compartían un perfil de virulencia predominante (fimH, mrkDv1, khe), lo que indica un papel importante de las adhesinas fimbriales de tipo 1 y 3, y de la hemolisina, independientemente del tipo de β-lactamasa producida. Sin embargo, la acumulación de factores de virulencia del serotipo capsular K2 y la aerobactina iucC se identificó con una mayor frecuencia en las cepas productoras de KPC-3 (p < 0,05) en comparación con las productoras de otras β-lactamasas o carbapenemasas. Además, se encontraron 9 perfiles de virulencia diferentes, indicativos de que las cepas productoras de carbapenemasa KPC-3 parecen adaptarse con éxito al entorno y mantener la virulencia por varias vías. Este estudio describe la unión de resistencia a múltiples antimicrobianos junto con determinantes de virulencia en aislados clínicos de K. pneumoniae ST-14K2 KPC-3 lo que puede suponer un desafío adicional en el tratamiento de infecciones causadas por este patógeno.
Cátia Caneiras; Luís Lito; Sagrario Mayoralas-Alises; Salvador Díaz-Lobato; José Melo-Cristino; Aida Duarte. Virulence and resistance determinants of Klebsiella pneumoniae isolated from a Portuguese tertiary university hospital centre over a 31-year period. Enfermedades infecciosas y microbiologia clinica (English ed.) 2019, 37, 387 -393.
AMA StyleCátia Caneiras, Luís Lito, Sagrario Mayoralas-Alises, Salvador Díaz-Lobato, José Melo-Cristino, Aida Duarte. Virulence and resistance determinants of Klebsiella pneumoniae isolated from a Portuguese tertiary university hospital centre over a 31-year period. Enfermedades infecciosas y microbiologia clinica (English ed.). 2019; 37 (6):387-393.
Chicago/Turabian StyleCátia Caneiras; Luís Lito; Sagrario Mayoralas-Alises; Salvador Díaz-Lobato; José Melo-Cristino; Aida Duarte. 2019. "Virulence and resistance determinants of Klebsiella pneumoniae isolated from a Portuguese tertiary university hospital centre over a 31-year period." Enfermedades infecciosas y microbiologia clinica (English ed.) 37, no. 6: 387-393.
Klebsiella pneumoniae is a clinically relevant pathogen and a frequent cause of hospital-acquired (HA) and community-acquired (CA) urinary tract infections (UTI). The increased resistance of this pathogen is leading to limited therapeutic options. To investigate the epidemiology, virulence, and antibiotic resistance profile of K. pneumoniae in urinary tract infections, we conducted a multicenter retrospective study for a total of 81 isolates (50 CA-UTI and 31 HA-UTI) in Portugal. The detection and characterization of resistance and virulence determinants were performed by molecular methods (PCR, PCR-based replicon typing, and multilocus sequence typing (MLST)). Out of 50 CA-UTI isolates, six (12.0%) carried β-lactamase enzymes, namely blaTEM-156 (n = 2), blaTEM-24 (n = 1), blaSHV-11 (n = 1), blaSHV-33 (n = 1), and blaCTX-M-15 (n = 1). All HA-UTI were extended-spectrum β-lactamase (ESBL) producers and had a multidrug resistant profile as compared to the CA-UTI isolates, which were mainly resistant to ciprofloxacin, levofloxacin, tigecycline, and fosfomycin. In conclusion, in contrast to community-acquired isolates, there is an overlap between virulence and multidrug resistance for hospital-acquired UTI K. pneumoniae pathogens. The study is the first to report different virulence characteristics for hospital and community K. pneumoniae pathogens, despite the production of β-lactamase and even with the presence of CTX-M-15 ESBL, a successful international ST15 clone, which were identified in both settings. This highlights that a focus on genomic surveillance should remain a priority in the hospital environment.
Cátia Caneiras; Luis Lito; José Melo-Cristino; Aida Duarte. Community- and Hospital-Acquired Klebsiella pneumoniae Urinary Tract Infections in Portugal: Virulence and Antibiotic Resistance. Microorganisms 2019, 7, 138 .
AMA StyleCátia Caneiras, Luis Lito, José Melo-Cristino, Aida Duarte. Community- and Hospital-Acquired Klebsiella pneumoniae Urinary Tract Infections in Portugal: Virulence and Antibiotic Resistance. Microorganisms. 2019; 7 (5):138.
Chicago/Turabian StyleCátia Caneiras; Luis Lito; José Melo-Cristino; Aida Duarte. 2019. "Community- and Hospital-Acquired Klebsiella pneumoniae Urinary Tract Infections in Portugal: Virulence and Antibiotic Resistance." Microorganisms 7, no. 5: 138.
The increasing number of patients receiving home respiratory therapy (HRT) is imposing a major impact on routine clinical care and healthcare system sustainability. The current challenge is to continue to guarantee access to HRT while maintaining the quality of care. The patient experience is a cornerstone of high-quality healthcare and an emergent area of clinical research. This review approaches the assessment of the patient experience in the context of HRT while highlighting the European contribution to this body of knowledge. This review demonstrates that research in this area is still limited, with no example of a prescription model that incorporates the patient experience as an outcome and no specific patient-reported experience measures (PREMs) available. This work also shows that Europe is leading the research on HRT provision. The development of a specific PREM and the integration of PREMs into the assessment of prescription models should be clinical research priorities in the next several years.
Cátia Caneiras; Cristina Jácome; Sagrario Mayoralas-Alises; José Ramon Calvo; João Almeida Fonseca; Joan Escarrabill; João Carlos Winck. Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go. Journal of Clinical Medicine 2019, 8, 555 .
AMA StyleCátia Caneiras, Cristina Jácome, Sagrario Mayoralas-Alises, José Ramon Calvo, João Almeida Fonseca, Joan Escarrabill, João Carlos Winck. Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go. Journal of Clinical Medicine. 2019; 8 (4):555.
Chicago/Turabian StyleCátia Caneiras; Cristina Jácome; Sagrario Mayoralas-Alises; José Ramon Calvo; João Almeida Fonseca; Joan Escarrabill; João Carlos Winck. 2019. "Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go." Journal of Clinical Medicine 8, no. 4: 555.
Portable oxygen therapy is a major challenge for patients and clinicians. Additionally, the available evidence on this subject is poor considering that only a few studies have been published and the results have not been encouraging. We explored the current trends, habits and beliefs among patients receiving portable oxygen therapy in a geographical area of Madrid, Spain (4 051 862 inhabitants). A telephone-based survey was conducted among patients selected from a database who were undergoing portable oxygen therapy. The number of patients on home respiratory therapies on December 31, 2017 was 81 559 (prevalence 2013.30 per 100 000 inhabitants). A total of 19 492 patients were on home oxygen therapy (HOT) (prevalence 481.16 per 100 000 inhabitants). Of these, 4015 patients (20% of the total of patients on HOT) received ambulatory oxygen therapy. In the analysed period, 1942 patients were selected (57.31% male and 42.69% female). The mean±sd age was 73.89±11.67 years. Most of patients had portable oxygen concentrators (99.59%). The survey was completed by 1777 patients. Most of patients thought they had been prescribed HOT for respiratory failure. 55% of the participants surveyed reported having carried out a walking test with oxygen to know the amount of oxygen they needed. 71% of the participants reported leaving the home for between 1 and 3 h a day. Most of them were carrying portable devices in a wheeled cart (51.94%). Our study data obtained from a large sample of oxygen-dependent individuals provide valuable information regarding domiciliary and portable oxygen usage in Madrid.
Sagrario Mayoralas Alises; Catia Caneiras; Salvador Díaz-Lobato. A telephone-based survey of current trends, habits and beliefs in patients receiving portable oxygen therapy in Madrid, Spain. ERJ Open Research 2019, 5, 00059-2018 .
AMA StyleSagrario Mayoralas Alises, Catia Caneiras, Salvador Díaz-Lobato. A telephone-based survey of current trends, habits and beliefs in patients receiving portable oxygen therapy in Madrid, Spain. ERJ Open Research. 2019; 5 (2):00059-2018.
Chicago/Turabian StyleSagrario Mayoralas Alises; Catia Caneiras; Salvador Díaz-Lobato. 2019. "A telephone-based survey of current trends, habits and beliefs in patients receiving portable oxygen therapy in Madrid, Spain." ERJ Open Research 5, no. 2: 00059-2018.