Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Identification of clusters of asthma control: A preliminary analysis of the inspirers studies

This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).© 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.publishersversionpublishe

Para uma análise de conteúdo às páginas oficiais de campanha no Facebook: o caso das Autárquicas de 2017

O artigo apresenta um codebook desenvolvido para a análise de conteúdo às páginas oficiais de campanha na rede social Facebook. O objetivo é avaliar o estado da comunicação e do marketing político em Portugal no que ao uso das redes sociais diz respeito e verificar se as campanhas caminham em direção ao paradigma da web 2.0 ou se continuam a desenvolver campanhas de tipo 1.0. Para tal, este codebook olha para a interatividade, o formato e o conteúdo das publicações e contempla quatro dimensões distintas: caracterização geral, envolvimento, conteúdo e sofisticação.The article presents a codebook developed for content analysis on the official campaign Facebook pages. The purpose is to assess the state of communication and political marketing in Portugal in regard of the use of social networks and to verify whether the online campaigns are moving towards the «web 2.0» paradigm or whether they continue to develop the type «1.0» campaigns. To this end, this codebook looks at the interactivity, format and content of posts and contemplates four distinct dimensions: general characterization, involvement, content and sophistication

A política e as redes sociais: o uso do Facebook pelos movimentos independentes na campanha para as eleições autárquicas de 2017

Dissertação de mestrado em Ciência PolíticaO presente estudo de caso analisa o uso da rede social Facebook por parte dos movimentos independentes (ou Grupos de Cidadãos Eleitores) durante o período de campanha eleitoral para as eleições autárquicas a 1 de outubro de 2017. O objetivo é avaliar o estádio da comunicação política e do marketing político em Portugal, no que ao uso das redes sociais diz respeito, com a particularidade de olhar para uma eleição ao nível local. Partindo de uma amostra de trinta e cinco candidaturas, esta investigação apresenta uma tipologia de candidatos independentes (dividida em três grupos: independentes com tradição, independentes recandidatos e “puros independentes”) bem como uma tabela de análise à rede social que contempla quatro dimensões distintas: caracterização geral, envolvimento, conteúdo e sofisticação. Os dados obtidos neste estudo foram recolhidos em tempo real durante o período oficial de campanha através da observação direta às páginas oficiais de campanha no Facebook. Com base nos resultados da investigação, podemos concluir que o uso dado pelos candidatos independentes ao Facebook não é homogéneo consoante os diferentes grupos de independentes e que existe ainda um longo caminho a percorrer no sentido da profissionalização quanto à utilização das redes sociais enquanto ferramentas de campanha eleitoral, assim como, no do efetivo envolvimento e interação com o eleitorado e ainda da criação de uma visão estratégica de comunicação política que saiba integrar o mundo digital, em particular as redes sociais.The present case study analyses the use of the social networking website Facebook by Independent Movements (or Citizen’s Groups) during the election campaign period for the October 1st, 2017 local elections. The goal is to evaluate the stage of political communication and political marketing in Portugal, in which the use of social networks is concerned, with the particularity of looking for an election at the local level. From a sample of thirty-five nominations this research presents a typology of independent candidates: independents with tradition, independent recandidates and “pure independents” as well as a codebook for this social networking site that encompasses four dimensions: general characterization, involvement, content and sophistication. The data obtained in this study were collected in real time during the official campaign period through direct observation of the official campaign pages on Facebook. Based on the results of the research, we can conclude that the use given by independent candidates to Facebook is not homogeneous according to the different groups of independents and that there is a long way to go towards professionalization in relation to the use of social networks as tools of electoral campaigns, as well as towards an effective involvement and interaction with the electorate and also the creation of a strategic vision of political communication that is related to the digital world, in particular the social networks

Validation of a Simple HPLC-Based Method for Lysine Quantification for Ruminant Nutrition

Robust and selective quantification methods are required to better analyze feed supplementation effectiveness with specific amino acids. In this work, a reversed-phase high-performance liquid chromatography method with fluorescence detection is proposed and validated for lysine quantification, one of the most limiting amino acids in ruminant nutrition and essential towards milk production. To assess and widen method applicability, different matrices were considered: namely Li2CO3 buffer (the chosen standard reaction buffer), phosphate buffer solution (to mimic media in cellular studies), and rumen inoculum. The method was validated for all three matrices and found to be selective, accurate (92% ± 2%), and precise at both the inter- and intra-day levels in concentrations up to 225 µM, with detection and quantification limits lower than 1.24 and 4.14 µM, respectively. Sample stability was evaluated when stored at room temperature, 4 °C, and −20 °C, showing consistency for up to 48 h regardless of the matrix. Finally, the developed method was applied in the quantification of lysine on real samples. The results presented indicate that the proposed method can be applied towards free lysine quantification in ruminant feeding studies and potentially be of great benefit to dairy cow nutrition supplementation and optimization

Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence : Mixed Methods Study

Background: Poor medication adherence is a major challenge in asthma, and objective assessment of inhaler adherence is needed. The InspirerMundi app aims to monitor adherence while providing a positive experience through gamification and social support. Objective: This study aimed to evaluate the feasibility and acceptability of the InspirerMundi app to monitor medication adherence in adolescents and adults with persistent asthma (treated with daily inhaled medication). Methods: A 1-month mixed method multicenter observational study was conducted in 26 secondary care centers from Portugal and Spain. During an initial face-to-face visit, physicians reported patients' asthma therapeutic plan in a structured questionnaire. During the visits, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients registered the intake (inhaler, blister, or other drug formulation) by using the image-based medication detection tool. At 1 month, patients were interviewed by phone, and app satisfaction was assessed on a 1 (low) to 5 (high) scale. Patients were also asked to point out the most and least preferred app features and make suggestions for future app improvements. Results: A total of 107 patients (median 27 [P25-P75 14-40] years) were invited, 92.5% (99/107) installed the app, and 73.8% (79/107) completed the 1-month interview. Patients interacted with the app a median of 9 (P25-P75 1-24) days. At least one medication was registered in the app by 78% (77/99) of patients. A total of 53% (52/99) of participants registered all prescribed inhalers, and 34% (34/99) registered the complete asthma therapeutic plan. Median medication adherence was 75% (P25-P75 25%-90%) for inhalers and 82% (P25-P75 50%-94%) for other drug formulations. Patients were globally satisfied with the app, with 75% (59/79) scoring >= 4,; adherence monitoring, symptom monitoring, and gamification features being the most highly scored components; and the medication detection tool among the lowest scored. A total of 53% (42/79) of the patients stated that the app had motivated them to improve adherence to inhaled medication and 77% (61/79) would recommend the app to other patients. Patient feedback was reflected in 4 major themes: medication-related features (67/79, 85%), gamification and social network (33/79, 42%), symptom monitoring and physician communication (21/79, 27%), and other aspects (16/79, 20%). Conclusions: The InspirerMundi app was feasible and acceptable to monitor medication adherence in patients with asthma. Based on patient feedback and to increase the registering of medications, the therapeutic plan registration and medication detection tool were redesigned. Our results highlight the importance of patient participation to produce a patient-centered and engaging mHealth asthma app

Feasibility of a mobile app to improve inhaler adherence in real‐world patients with asthma: A multicentre observational study in Portugal and Spain

InspirerMundi app aims to transform adherence into a positive experience through gamification and social support, while allowing objective monitoring of inhaler adherence. This study assessed the feasibility of the app in adolescents and adults with persistent asthma.info:eu-repo/semantics/publishedVersio

New content management models: use of digital technologies by Mídia NINJA

O presente artigo reflete acerca da utilização das novas tecnologias de rede pelo meio de comunicação independente e ativista Mídia NINJA (Narrativas Independentes, Jornalismo e Ação) como modelo alternativo de gestão de conteúdos que utiliza o tripé: produção, circulação e distribuição. A pesquisa tem como objetivo compreender como funciona este modelo e de que forma ele atrai o público. Para tanto, o método utilizado foi a netnografia (ramo da Etnografia que analisa o comportamento de indivíduos e grupos sociais na internet e as dinâmicas desses grupos no ambiente online), para observar as dinâmicas de dois grupos do Telegram da Mídia NINJA (NINJASP e NINJADF) e a página do Instagram deste meio alternativo. Complementámos a metodologia com uma entrevista semiestruturada. Constatou-se, através da análise dos conteúdos das ferramentas estudadas, que as novas tecnologias de media digital como modelo de produção e distribuição utilizado pela Mídia NINJA provocam no público o interesse na leitura dos conteúdos deste medium, além de promover a participação e a interação.This article reflects on the use of new network technologies by the independent communication and activist Mídia NINJA (Independent Narratives, Journalism and Action) as an alternative model of content management that uses the tripod: production, circulation and distribution. The research aims to understand how this model works and how it attracts the public. For that, the method used is netnography (a branch of Ethnography that analyzes the behavior of individuals and social groups on the internet and the dynamics of these groups in the online environment), to observe the dynamics of two groups of the Telegram of the Mídia NINJA (NINJASP and NINJADF) and the Instagram page of this alternative medium. We complemented the methodology with a semi-structured interview. It was found, through the analysis of the contents of the studied tools, that the new technologies of digital media as a production and distribution model used by the Mídia NINJA provokes in the public an interest in reading the contents of this medium, in addition to promoting participation and interaction