Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial

Background: Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. Methods/design: This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants’ motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. Discussion: This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified

Avaliação da satisfação de pacientes oncológicos com atendimento recebido durante o tratamento antineoplásico ambulatorial Evaluación de la satisfaccíon de pacientes oncológicos con la atención recibida durante el tratamiento antineoplásico ambulatorial Evaluation of the satisfaction level of cancer patients with the assistance recieved during ambulatory antineoplastic chemoteraphy

Este estudo descritivo, fundamentado na abordagem de resultados proposta por Donabedian, teve como objetivo avaliar o nível de satisfação de pacientes oncológicos com o atendimento recebido no Ambulatório de Quimioterapia de Adultos do Hospital São Paulo. A amostra incluiu 105 pacientes que aceitaram participar do estudo. A avaliação dos usuários foi positiva, tanto com o atendimento de enfermagem (54% muito bom e 46% bom), quanto com o atendimento global do serviço (50% muito satisfeitos e 46% satisfeitos). O nível de satisfação manifestado pelos usuários relacionou-se, principalmente, com a acessibilidade organizacional, o ambiente acolhedor e o processo assistencial nas dimensões da interação profissional/cliente e do desempenho técnico. No entanto, apontaram como medidas necessárias, evitar a falta de drogas e aumentar o número de vagas.<br>Este estudio descriptivo, fundado en el abordaje de resultados propuesto por Donabedian, tuvo como objetivo evaluar el nivel de satisfacción de pacientes con cáncer con la atención recibida en el Ambulatorio de Quimioterapia de Adultos de Hospital São Paulo. La muestra incluyó 105 pacientes que aceptaron participar de la investigación. La evaluación de los usuarios fue positiva, tanto con la atención de enfermería (54% muy buena y 46% buena), cuanto con la atención general del servicio (50% muy satisfechos y 46% satisfechos).El nivel de satisfacción manifestado por los usuarios se relacionó, principalmente, con la accesibilidad organizacional, el ambiente acogedor y el proceso asistencial en las dimensiones de la interacción profesional/cliente y del desempeño técnico. No obstante, apuntaron como medidas necesarias, evitar la falta de medicinas y aumentar el número de plazas.<br>This descriptive study, grounded upon Donabedian's outcomes approach, had as purpose to evaluate the satisfaction level of cancer patients with the assistance received at the Adult Chemotherapy Ambulatory of Hospital São Paulo. The sample was constituted of 105 patients who accepted to participate in the study. The patients' evaluation was positive both with nursing care (54% very good and 46% good) and with the overall care received in that service (50% very satisfied and 46% satisfied). The level of satisfaction manifested by the clients was related mainly to the organization accessibility, the welcoming environment and the assistance process, in its professional/client interaction and the technical performance dimensions. However, they also pointed out the need for measures aimed at preventing drugs shortage and the lack of vacancies for new patients

Predicting the Proteins of Angomonas deanei, Strigomonas culicis and Their Respective Endosymbionts Reveals New Aspects of the Trypanosomatidae Family

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Endosymbiont-bearing trypanosomatids have been considered excellent models for the study of cell evolution because the host protozoan co-evolves with an intracellular bacterium in a mutualistic relationship. Such protozoa inhabit a single invertebrate host during their entire life cycle and exhibit special characteristics that group them in a particular phylogenetic cluster of the Trypanosomatidae family, thus classified as monoxenics. In an effort to better understand such symbiotic association, we used DNA pyrosequencing and a reference-guided assembly to generate reads that predicted 16,960 and 12,162 open reading frames (ORFs) in two symbiont-bearing trypanosomatids, Angomonas deanei (previously named as Crithidia deanei) and Strigomonas culicis (first known as Blastocrithidia culicis), respectively. Identification of each ORF was based primarily on TriTrypDB using tblastn, and each ORF was confirmed by employing getorf from EMBOSS and Newbler 2.6 when necessary. The monoxenic organisms revealed conserved housekeeping functions when compared to other trypanosomatids, especially compared with Leishmania major. However, major differences were found in ORFs corresponding to the cytoskeleton, the kinetoplast, and the paraflagellar structure. The monoxenic organisms also contain a large number of genes for cytosolic calpain-like and surface gp63 metalloproteases and a reduced number of compartmentalized cysteine proteases in comparison to other TriTryp organisms, reflecting adaptations to the presence of the symbiont. The assembled bacterial endosymbiont sequences exhibit a high A+T content with a total of 787 and 769 ORFs for the Angomonas deanei and Strigomonas culicis endosymbionts, respectively, and indicate that these organisms hold a common ancestor related to the Alcaligenaceae family. Importantly, both symbionts contain enzymes that complement essential host cell biosynthetic pathways, such as those for amino acid, lipid and purine/pyrimidine metabolism. These findings increase our understanding of the intricate symbiotic relationship between the bacterium and the trypanosomatid host and provide clues to better understand eukaryotic cell evolution.84Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)ERC AdG SISYPHEFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq