How sociodemographic features impact subjects' opinion on packages leaflets of medicines?

BackgroundPackages leaflets (PLs) are essential for the safe use and efficacy of medicines.AimsTo quantify the opinion of users of medicines on PLs through the application of a self-administered Likert scale, taking into consideration subjects’ sociodemographic data.Methods Participants were enrolled from two Portuguese regions: urban/littoral (Lisbon) and rural/interior (Centre). 503 participants were included: 53 per cent males, 45 per cent 12 years of schooling). A questionnaire was used to collect the sociodemographic data. A Likert scale was self-administered to rate the characteristics of 12 randomized PLs (6 from prescription medicines and 6 from over-the-counter medicines) (August-December 2014). An invitation was send to several institutions (e.g., municipal councils). The inclusion criteria were: agreeing, be capable of reading/writing, and be more than 17 years old.Results In the Likert scores obtained, no significant differences were found related to region, sex, marital status, age group (≥65 years and other), and employment status of participants. By contrast, significant differences were found related to education (2=42.747; p 12 years of schooling, more regular reading habits (2 or more books/year), higher income and less frequent medicines use, showed a more negative global opinion on PLs.ConclusionSociodemographic data are important to understand users’ opinion on PLs. It seems that more educated subjects are more demanding. A lower socio-economic status positively influenced the participants’ opinion, with subjects’ poorer education being a relevant factor in this population. A higher frequency of taking medicines also positively contributed to a better opinion, probably due to a greater familiarity with PLs

How Do Patients Expect Apps to Provide Drug Information?

Patients use various sources to obtain information on pharmaceutical drugs. Mobile health care applications (apps) providing drug information to users are increasingly made available and of rising importance for the health care domain. However, apps usually offer functionality that only medical professionals or vendors consider useful for patients, although their considerations are not likely to meet patient expectations. In our exploratory study, we identify 33 features patients expect in apps for drug information provision with interviews and empirically assess their perceived importance in an online survey. Results indicate that patients desire personalization features for provided information but not for the app interface. This work contributes to research and practice by identifying and empirically ranking drug information provision features patients find important. We furthermore establish a foundation for future research on effective mobile drug information provision and provide insights for practice on development of patient-centered mobile health apps

Inclusion in digital environments for people with aphasia

PhD ThesisBackground: Individuals with aphasia may wish to engage with the Internet for work, communication, or leisure. Pre-stroke Internet skills will vary, as will other factors such as availability of equipment and support. This thesis aims to investigate how aphasia influences Internet use and skills. Further, it aims to explore and evaluate assessment, intervention, and outcome measurement to support Internet use with aphasia. Method: A supported questionnaire was used to compare Internet and technology use between people with and without aphasia post-stroke (stage one). Forty-two participants were recruited, twenty-five of whom had aphasia. The two groups shared known risk factors for digital exclusion. A series of four experimental single case studies followed using a structured assessment and decision-making process with a focus on exploring interventions for participants with post-stroke aphasia who had particular goals around Internet use (stage two). Results: There was a very broad spectrum of levels of independent and supported Internet use amongst people with and without aphasia. Age was a stronger predictor than aphasia for Internet use/non-use. People with aphasia were less likely to use linguistic tools such as emailing, text messaging, and e-readers. Level of education influenced self-perception of Internet skills. Case-study interventions differed according to individual needs and goals. Clinical decision-making and interventions were guided by a specific focus on cognitive and Internet skills alongside environmental factors relevant to Internet use. Assessment demonstrated that, for three of four participants, change was evident, with gains linked to their Internet related goals. Discussion: This study adds to knowledge by enhancing understanding of how people with aphasia may face specific risks related to digital exclusion. It demonstrates that a holistic understanding of factors influencing Internet use and skills can support the design and evaluation of tailored interventions to enable iv Internet use with aphasia. This provides guidance for clinical practice and for future aphasia research.Stroke Associatio

Atrioventricular septal defect : advanced imaging from early development to long-term follow-up

The aim of this thesis is to review the current knowledge on atrioventricular septal defect (AVSD) (Part 1), to study the pathogenesis of AVSD (Part 2) and finally to analyze cardiac outcome long-term after AVSD correction (Part 3). Studies are performed with novel imaging techniques. In part 2 it is made plausible that AVSD is a sliding scale and that patients with Down syndrome without AVSD also have abnormalities of the membranous septum and atrioventricular valves. High frequency ultrasound in mouse embryos shows to be a promising technique to study cardiovascular flow in early stages of heart development. In a mouse model with disturbed VEGF signalling, the heart rate is reduced and the sinoatrial node develops abnormally. Finally, in part 3 of this thesis, 4DFlow MRI data reveals that patients with an abnormal left atrioventricular valve (LAVV) after AVSD correction have aberrant intra-cardiac flow patterns. During diastole the inflow into the left ventricle is directed more towards the lateral wall, more towards the apex and vortex formation is abnormal. During systole the dynamic and eccentric regurgitation of the LAVV disturbs the normal recirculating flow patterns in the left atrium.4DFlow MRI can be used to reliably quantify flow over the LAVV.UBL - phd migration 201

Measuring outcomes from a peer-led social communication skills intervention for adults following acquired brain injury

Background: Reduced social competence and social integration following acquired brain injury (ABI) is well-documented. There is evidence that group social communication interventions for people with ABI and training for neuro-typical communication partners can be more effective than training the person with ABI alone. This study explores the effectiveness of a peer-led group intervention based on claims that peer models are a more powerful mechanism for learning and behaviour change than interventions led by a clinician. A peer-led training model for social communication has not previously been tested in ABI. Method: Twenty-four participants with severe ABI were recruited from a residential post-acute neurorehabilitation centre. An experimental parallel group design was used to compare a peer-led group intervention to a social activity group (usual care). A pilot study tested the feasibility of the approach followed by a main study. The groups ran for 8 weeks. A peer facilitator was trained in sixteen individual sessions over 4 weeks with a clinician. Behaviour was measured twice at baseline, after intervention and at maintenance. Four primary outcome measures, including the Adapted Measure of Participation in Conversation (MPC), and a newly devised measure of conversational interaction evaluated change in group communication behaviours. Results: Groups did not differ in baseline behaviour. There were significant differences in the treated group on the MPC and the measure of conversational interaction post-intervention. The treated group showed a more balanced interaction post-intervention and at follow-up. However, outcome measures showed differential sensitivity. Conclusion: There is preliminary evidence of advantage for peer-led groups in ABI intervention. The new conversational measure shows promise as a method to detect change in group communication behaviour