Systematically Developing a Web-Based Tailored Intervention Promoting HPV-Vaccination Acceptability Among Mothers of Invited Girls Using Intervention Mapping.

Background: Currently, the eHealth field calls for detailed descriptions of theory-based interventions in order to support improved design of such interventions. This article aims to provide a systematic description of the design rationale behind an interactive web-based tailored intervention promoting HPV-vaccination acceptability. Methods: The 6-step Intervention Mapping (IM) protocol was used to describe the design rationale. After the needs assessment in Step 1, intervention objectives were formulated in Step 2. In Step 3, we translated theoretical methods into practical applications, which were integrated into a coherent intervention in Step 4. In Step 5, we anticipated future implementation and adoption, and finally, an evaluation plan was generated in Step 6. Results: Walking through the various steps of IM resulted in a detailed description of the intervention. The needs assessment indicated HPV-vaccination uptake remaining lower than expected. Mothers play the most important role in decision-making about their daughter's immunization. However, they generally feel ambivalent after they made their decisions, and their decisions are based on rather unstable grounds. Therefore, intervention objectives were to improve HPV-vaccination uptake and informed decision-making, and to decrease decisional conflict among mothers of invited girls. Computer-tailoring was chosen as the main method; virtual assistants were chosen as a practical application to deliver interactive tailored feedback. To maximize compatibility with the needs of the target group, a user-centered design strategy by means of focus groups and online experiments was applied. In these, prototypes were tested and sequentially refined. Finally, efficacy, effectiveness, and acceptability of the intervention were tested in a randomized controlled trial. Results showed a significant positive effect of the intervention on informed decision-making, decisional conflict, and nearly all determinants of HPV-vaccination uptake (P < 0.001). Mothers evaluated the intervention as highly positive. Discussion: Using IM led to an innovative effective intervention for promoting HPV-vaccination acceptability. The intervention maps will aid in interpreting the results of our evaluation studies. Moreover, it will ease the comparison of design rationales across interventions, and may provide leads for the development of other eHealth interventions. This paper adds to the plea for systematic reporting of design rationales constituting the process of developing interventions

International Committee on Systematics of Prokaryotes Subcommittee on the Taxonomy of Bifidobacterium, Lactobacillus and related organisms. Minutes of the closed meeting by videoconference, 3 September 2020

International Committee on Systematics of Prokaryotes Subcommittee on the Taxonomy of Bifidobacterium, Lactobacillus and related organisms. Minutes of the closed meeting by videoconference, 3 September 202

Comparative genomics of Streptococcus macedonicus ACA-DC 198 against related species within the Streptococcus bovis/Streptococcus equinus complex

Apart from Streptococcus thermophilus other streptococci that can be found growing in milk belong to the Streptococcus bovis/Streptococcus equinus complex (SBSEC). Interestingly, Streptococcus macedonicus, which is a member of SBSEC, has been suggested to be adapted to milk and to be nonpathogenic. However, the species is phylogenetically related to Streptococcus gallolyticus and Streptococcus pasteurianus (formerly known as S. bovis biotypes I and II.2, respectively), which in turn are considered pathogenic, since they have been implicated in endocarditis and colon cancer in humans. Comparative analysis of the S. macedonicus genome with the complete genomes of its related streptococci (including that of S. infantarius, which is also a dairy isolate) indicated that a significant portion of the genomic organization has been conserved overall. Following a gene presence/absence strategy, we determined that S. macedonicus shows a reduced capacity to reside in the gastrointestinal tract of ruminants when compared to S. gallolyticus since it misses important genes for metabolizing complex carbohydrates of plant origin and for detoxifying this environment. S. macedonicus also lacks several pathogenicity traits found in S. gallolyticus. For example from the three pilus gene clusters (pil1, pil2, pil3), which may mediate the binding of S. gallolyticus to the extracellular matrix, S. macedonicus carries only one (i.e. the pil3). Gene gain events are also evident in the S. macedonicus genome sometimes originating from dairy bacteria, like the acquisition of the lactococcal plasmid pSMA198. Functional analysis of the S. macedonicus genome is necessary to further assess its pathogenic and technological potential

Dietary glycaemic index and cognitive function: prospective associations in adults of the 1946 British birth cohort

OBJECTIVE: Evidence suggests that the rate of glucose release following consumption of carbohydrate-containing foods, defined as the glycaemic index (GI), is inversely associated with cognitive function. To date, most of the evidence stems from either single-meal studies or highly heterogeneous cohort studies. We aimed to study the prospective associations of diet GI at age 53 years with outcomes of verbal memory and letter search tests at age 69 years and rate of decline between 53 and 69 years. DESING: Longitudinal population-based birth cohort study. SETTING: MRC National Survey for Health and Development. PARTICIPANTS: Cohort members (n 1252). RESULTS: Using multivariable linear and logistic regression, adjusted for potential confounders, associations of higher-GI diet with lower verbal memory, lower letter search speed and lower number of hits in a letter search test were attenuated after adjustments for cognitive ability at age 15 years, educational attainment, further training and occupational social class. No association was observed between diet GI at 53 years and letter search accuracy or speed–accuracy trade-off at 69 years, or between diet GI at 53 years and rate of decline between 53 and 69 years in any cognitive measure. CONCLUSIONS: Diet GI does not appear to predict cognitive function or decline, which was mainly explained by childhood cognitive ability, education and occupational social class. Our findings confirm the need for further research on the association between diet and cognition from a life-course perspective

The evaluation of an intervention based on the application of patient self-completion concordance forms in Dutch community pharmacies and the effect on adherence to chronic medication

Objective: To evaluate the use of patient self-completion concordance forms and to determine the effect of patient counselling by using concordance forms on adherence to chronic medication. Methods: Patients with a prescription for new chronic treatment were randomised in an intervention or control group. The intervention group received a concordance form to fill in at home and to discuss during a consultation 2 weeks later in the pharmacy. The control group received the Usual information and instruction on how to use the medicine. Afterwards, all patients were asked to fill in a questionnaire about their use of medicines and contact with the pharmacy employees. Adherence to the medicine was determined using rates of prescription refills after 6 months of use. Results: The questionnaires showed that patients were satisfied about the concordance model. After 6 months of use, 79% of the patients from both intervention and control group were defined as adherent. Conclusions: There was no significant difference found in adherence between intervention and control group. Practice implications: Use five selected questions from the concordance form which provided most answers. Focus on one drug group and have more consultation moments. (C) 2009 Elsevier Ireland Ltd. All rights reserved

Virtual reality cognitive-behavioural therapy versus cognitive-behavioural therapy for paranoid delusions:a study protocol for a single-blind multi-Centre randomised controlled superiority trial

Abstract Background Seventy per cent of patients with psychotic disorders has paranoid delusions. Paranoid delusions are associated with significant distress, hospital admission and social isolation. Cognitive-behavioural therapy for psychosis (CBTp) is the primary psychological treatment, but the median effect size is only small to medium. Virtual reality (VR) has a great potential to improve the effectiveness of CBTp. In a previous study, we found that VR based CBT (VRcbt) for paranoid delusions is superior to waiting list. As a next step, a direct comparison with CBTp is needed. The present study aims to investigate whether VRcbt is more effective and cost-effective than regular CBTp in treating paranoid delusions and improving daily life social functioning of patients with psychotic disorders. Methods A total of 106 patients with DSM-5 diagnosis of psychotic disorder and at least moderate level of paranoid ideations will be recruited for this multicentre randomized controlled trial (RCT). Patients will be randomized to either VRcbt or standard CBTp for paranoid delusions. VRcbt consists of maximum 16 sessions in virtual social situations that trigger paranoid ideations and distress, delivered in an 8–12 week time frame. Standard CBTp also consists of maximum 16 sessions including exposure and behavioural experiments, delivered in an 8–12 week time frame. The two groups will be compared at baseline, post-treatment and six months follow-up. Primary outcome is the level of paranoid ideations in daily life social situations, measured with ecological momentary assessments (EMA) at semi-random moments ten times a day during seven days, before and after treatment. Every session, participants and therapists will rate the level of paranoid ideation and global clinical impression. Discussion Comparison of VRcbt and CBTp will provide information about the relative (cost-) effectiveness of VRcbt for this population. VRcbt may become a preferred psychological treatment for paranoid delusions and social anxiety in patients with psychotic disorder. Trial registration Netherlands Trial Register, NL7758. Registered on 23 May 2019

Effectiveness and cost-effectiveness of an internet intervention for family caregivers of people with dementia: design of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>The number of people with dementia is rising rapidly as a consequence of the greying of the world population. There is an urgent need to develop cost effective approaches that meet the needs of people with dementia and their family caregivers. Depression, feelings of burden and caregiver stress are common and serious health problems in these family caregivers. Different kinds of interventions are developed to prevent or reduce the negative psychological consequences of caregiving. The use of internet interventions is still very limited, although they may be a cost effective way to support family caregivers in an earlier stage and diminish their psychological distress in the short and longer run.</p> <p>Methods/design</p> <p>A pragmatic randomized controlled trial is designed to evaluate the effectiveness and cost-effectiveness of ‘Mastery over Dementia’, an internet intervention for caregivers of people with dementia. The intervention aims at prevention and decrease of psychological distress, in particular depressive symptoms. The experimental condition consists of an internet course with 8 sessions and a booster session over a maximum period of 6 months guided by a psychologist. Caregivers in the comparison condition receive a minimal intervention. In addition to a pre and post measurement, an intermediate measurement will be conducted. In addition, there will be two follow-up measurements 3 and 6 months after post-treatment in the experimental group only. To study the effectiveness of the intervention, depressive symptoms are used as the primary outcome, whereas symptoms of anxiety, role overload and caregiver perceived stress are used as secondary outcomes. To study which caregivers profit most of the internet intervention, several variables that may modify the impact of the intervention are taken into account. Regarding the cost-effectiveness, an economic evaluation will be conducted from a societal perspective.</p> <p>Discussion</p> <p>This study will provide evidence about the effectiveness and cost-effectiveness of an internet intervention for caregivers. If both can be shown, this might set the stage for the development of a range of internet interventions in the field of caregiving for people with dementia. This is even more important because future generations of caregivers will be more familiar with the use of internet.</p> <p>Trial registration</p> <p>NTR-2051/RCT-DDB</p

Analise in silico e in vivo da diversidade nucleotidica em Coffea ssp.

Polimorfismos de modificações nucleotídicas (SNPs ? Single Nucleotide Polymorphisms, INDELs ? Insertion / Deletions) têm uma alta freqüência nos genomas da maioria dos organismos, incluindo plantas. Eles vêm se tornando a escolha principal de marcador para trabalhos de melhoramento, genotipagem e diagnóstico. A identificação destes polimorfismos irá fornecer marcadores que poderão ser utilizados para o mapeamento genético, estudos de genética de população e de associação. Portanto, os objetivos deste trabalho foram: 1) identificar in silico SNPs e INDELS existentes em seqüências de ESTs disponíveis; e 2) analisar a diversidade nucleotídica em Coffea spp. Um pipeline para identificação de SNPs e INDELs foi desenvolvido utilizando seqüências de ESTs disponíveis de Coffea spp. Foi utilizado uma estratégia para detecção de SNPs em dentro de 23.019 contigs. Um total 23.062 SNPs e 2.165 INDELS foram encontrados em 5184 contigs que continham pelo menos quatro ESTs. Analises in silico permitiram a identificação de diferentes alelos de C. canephora e C. eugenioides que estão presentes em C. arabica. A maioria dos ESTs de C. arabica vieram de apenas dois alelos, uma evidência molecular sobre a especiação de C. arabica. De acordo com essas análises cerca de 55% das seqüências de C. arabica são derivadas do genoma de C. eugenioides e 45% de C. canephora. Além disso, foi possível observar que o genoma de C. eugenioides contribui principalmente para genes relacionados a metabolismo basal, enquanto que os genes de C. canephora estão envolvidos com sinais de tradução e regulação da expressão gênica. Análises in vivo estão sendo realizadas através do sequenciamento de diversos genes em 24 genótipos de Coffea sendo 12 de C. arabica, 9 de C. canephora e três de outras espécies de Coffea, para uma analise maior da diversidade nucleotídica do gênero. Resultados referentes ao sequenciamento do gene de sacarose fosfato sintase (SPS) apresentaram 21 polimorfismos, sendo a maioria interespecíficos (C. arabica, C. canephora, C. eugenioides e C. racemosa). Para os genótipos de C. canephora foram observados nove polimorfismos intraespecíficos. Já os polimorfismos encontrados entre os genótipos de C. arabica forma os mesmos detectados entre C. canephora e C. eugenioides