Search

Your search keyword '"Jaime Correia-de-Sousa"' showing total 168 results
Start Over Author "Jaime Correia-de-Sousa"
168 results on '"Jaime Correia-de-Sousa"'

51. Teaching inhalation technique in COPD outpatients: Can a sustained improvement be achieved?

Author

Jaime Correia-de-Sousa, Pedro Teixeira, A. Duarte-de-Araújo, Venceslau Hespanhol, and Universidade do Minho

Subjects
Male, Pulmonary and Respiratory Medicine, Respiratory Therapy, medicine.medical_specialty, MEDLINE, Pulmonary disease, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, Drug Delivery Systems, 0302 clinical medicine, Patient Education as Topic, Administration, Inhalation, Humans, Medicine, 030212 general & internal medicine, Intensive care medicine, Aged, COPD, Science & Technology, Portugal, Inhalation, business.industry, Disease progression, medicine.disease, Bronchodilator Agents, 3. Good health, Inhalation technique, 030228 respiratory system, Ciências Médicas::Medicina Básica, Disease Progression, Female, business
Abstract

(undefined)

Published
2019

52. Helsinki by nature: The Nature Step to Respiratory Health

Author

Mohamed Tag Eldin, Maria Do Ceu Teixeira, Peter Hellings, J Rosado-Pinto, Anahí Yáñez, Bilun Gemicioglu, Eric D. Bateman, Paulo Augusto Moreira Camargos, K. S. Bennoor, Josep M. Antó, Tuula Vasankari, Leena von Hertzen, Jean Bousquet, Tari Haahtela, Elizabete Nunes, Hironori Sagara, Tonya Winders, Tamaz Maglakelidze, Florin Mihaltan, Nils Billo, V. Kolek, Arunas Valiulis, Talant Sooronbaev, Arzu Yorgancioglu, Teresa To, Alvaro A. Cruz, Eeva Furman, Digambar Behera, Niels H. Chavannes, Giovanni Viegi, Marina Erhola, Nikolai Khaltaev, Stefania La Grutta, Dean E. Schraufnagel, Bolesław Samoliński, Jorge Quel, Chunxue Bai, Mohamed R. Masjedi, Cherian Varghese, Pekka Jousilahti, Le Thi Tuyet Lan, Sandra Diaz, Abay Baigenzhin, Piotr Kuna, Osman Yusuf, Arvid Nyberg, Yousser Mohammad, Jaime Correia de Sousa, HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, University of Helsinki, and Universidade do Minho

Subjects
Respiratory diseases, Allergy, Medicina Básica [Ciências Médicas], Review, 0302 clinical medicine, Multidisciplinary approach, Planetary health, 11. Sustainability, Health care, Immunology and Allergy, NCDs, Everyday life, SDGs, media_common, 0303 health sciences, CLIMATE-CHANGE, Biodiversity, HUMAN MICROBIOTA, 3. Good health, PREVALENCE, SENSITIZATION, nature, biodiversity, immune regulation, lifestyle, respiratory disease, environment, planetary health, CRD, NCD, Ciências Médicas::Medicina Básica, Life Sciences & Biomedicine, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Immune regulation, media_common.quotation_subject, Immunology, Environment, 12. Responsible consumption, 03 medical and health sciences, Urban planning, FINNISH, Development economics, CRDs, medicine, 030304 developmental biology, Sustainable development, Consumption (economics), Civilization, Science & Technology, business.industry, Public health, ALLERGY PROGRAM 2008-2018, AIR-POLLUTION, RC581-607, Lifestyle, PREVENTION, Nature, 030228 respiratory system, 13. Climate action, 3121 General medicine, internal medicine and other clinical medicine, ASTHMA, Immunologic diseases. Allergy, business
Abstract

The Nature Step to Respiratory Health was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs. Background: The Nature Step to Respiratory Health was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defned as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be consid‑ ered by individuals and governments while addressing several SDGs. Results: The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, afects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking “nature” to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, trafc arrangements, energy production, and impor‑ tantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously. Conclusions: In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory

Published
2019

53. Late Breaking Abstract - Identifying and addressing patient beliefs driving SABA use and over-reliance

Author

Sian Williams, John Haughney, Amy Hai Yan Chan, Jaime Correia de Sousa, Alan Kaplan, and Rob Horne

Subjects
medicine.medical_specialty, business.industry, Inhaled corticosteroids, medicine.disease, Asthma management, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Family medicine, medicine, 030212 general & internal medicine, business, Asthma
Abstract

Background: Reliance on and overuse of short-acting beta-agonists (SABA ROU) increases the risk of asthma attacks1 and is recognised by GINA as a key issue in asthma management. Patient beliefs can drive SABA ROU – assessing these can identify those at risk of ROU. Aim: To assess patient beliefs influencing SABA ROU and whether such beliefs can be changed by brief, behaviourally-intelligent messages. Method: 446 people with self-reported asthma, recruited via Amazon mTurk, completed validated questionnaires assessing perceptions of SABA and anti-inflammatory reliever (Necessity Beliefs and Concerns)2 and reported adherence. We examined whether beliefs about SABA and anti-inflammatory reliever were amenable to change in a subset of 55 patients who, after completing the baseline questionnaires, were exposed to brief messages designed to change their beliefs. The questionnaire assessments were repeated immediately after exposure to the messages, and 2 weeks later. Results: Many patients held beliefs about SABA that were consistent with over-reliance. For example, 71.7% (320/446) believed that ‘using their reliever was the best way to ‘keep on top of their asthma’ and 59.9% (267/446) agreed that ‘the benefits of the reliever markedly outweighs any risks’. Over-reliance on SABA correlated with low adherence to inhaled corticosteroids (p Conclusion: Patient beliefs driving SABA ROU are amenable to change using brief behaviourally-intelligent messages. References: 1. Pavord et al. Lancet 2018;391:350-400. 2. Horne et al. Psychology & Health 1999;14:1-24.

Published
2019

54. Is an Early Diagnosis of COPD Clinically Useful?

Author

Venceslau Hespanhol, Pedro Fonte, A. Duarte-de-Araújo, Jaime Correia-de-Sousa, and Pedro Teixeira

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, COPD, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, business.industry, medicine, 030212 general & internal medicine, General Medicine, Intensive care medicine, business, medicine.disease
Published
2019

56. ARIA pharmacy 2018 'Allergic rhinitis care pathways for community pharmacy' AIRWAYS ICPs initiative (European Innovation Partnership on Active and Healthy Ageing, DG CONNECT and DG Sante) \nPOLLAR (Impact of Air POLLution on Asthma and Rhinitis)\nGARD Demonstration project

Author

Karin C. Lødrup Carlsen, Ralph Mösges, María Antonieta Guzmán, Bolesław Samoliński, Olga Lourenço, Mario Sánchez-Borges, Giuseppe De Carlo, Violeta Kvedariene, Errka Valovirta, Mario E. Zernotti, Osman M. Yusuf, Juan Carlos Sisul, Ana Todo-Bom, Enrica Menditto, Robyn E O'Hehir, Yoshitaka Okamoto, Joaquim Mullol, Aziz Sheikh, Johanna Salimäki, Bassam Mahboub, P. Manning, Petr Panzner, Vicky Kritikos, Susan Waserman, Désirée Larenas-Linnemann, Kimi Okubo, Todor A. Popov, Juan Carlos Ivancevich, W. Carr, Elísio Costa, Davor Plavec, Vitalis Briedis, Piotr Wroczyński, Teresa To, Regina Roller-Wirnsberger, Nikolaos G. Papadopoulos, Torsten Zuberbier, Heather J. Zar, João Fonseca, Ioana Agache, Valentina Orlando, Holger J. Schünemann, Slawomir Bialek, Dermot Ryan, Ettore Novellino, Peter Hellings, Ema Paulino, Rojin Söderlund, Susanna Palkonen, Biljana Cvetkovski, Cristiana Stellato, Henry Chrystyn, Piotr Kuna, Mihaela Zidarn, Kristof Nekam, Carsten Bindslev-Jensen, Jean Bousquet, Tari Haahtela, Josep M. Antó, Arzu Yorgancioglu, Stefania Di Capua, Sinthia Bosnic-Anticevich, Dieter Maier, Ignacio J. Ansotegui, Alpana Mair, Lars Münter, Martin Wagenmann, L. T. T. Le, Jim Phillips, Marek L. Kowalski, David Somekh, Thomas B. Casale, M. Bewick, Jan Brozek, Menachem Rottem, Wienczyslawa Czarlewski, Ken Ohta, Jocelyne Just, Ludger Klimek, Mark S. Dykewicz, Peter Valentin Tomazic, Maddalena Illario, Philippe Devillier, Nikolai Khaltaev, Leyla Namazova-Baranova, Roland Buonaiuto, Pascal Demoly, Niels H. Chavannes, Wytske Fokkens, Alvaro A. Cruz, Robert M. Naclerio, Emmanuel P. Prokopakis, Anna Bedbrook, Panayiotis K. Yiallouros, Dana Wallace, Sanna Toppila-Salmi, Daniel Laune, Magnus Wickman, Igor Kaidashev, Yehia El-Gamal, Hae-Sim Park, Mário Morais-Almeida, Musa Khaitov, Giorgio Walter Canonica, Antonio Valero, Arunas Valiulis, Ruth Murray, Claus Bachert, Maria Teresa Ventura, Paul C. Potter, Gabrielle L. Onorato, Victoria Cardona, Jaime Correia de Sousa, Oliver Pfaar, Mina Gaga, Rachel Tan, João O. Malva, Thomas Keil, Ruby Pawankar, Luo Zhang, Tshipukane Dieudonné Nyembue, Dennis M. Williams, HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, University of Helsinki, and Department of Pathology

Subjects
0301 basic medicine, IMPACT, pharmacist, Psychological intervention, Pharmacists, Medical and Health Sciences, 0302 clinical medicine, QUALITY-OF-LIFE, Health care, Immunology and Allergy, Public Health Surveillance, Community Health Services, MASK-RHINITIS, Rhinitis, Disease Management, Telemedicine, 3. Good health, care pathways, SUBLINGUAL IMMUNOTHERAPY, 317 Pharmacy, Care pathways, Critical Pathways, Pharmacist, Symptom Assessment, medicine.medical_specialty, Referral, Immunology, education, Pharmacy, VALIDATION, Medication Adherence, MACVIA-ARIA, 03 medical and health sciences, INTERMITTENT, Professional Role, Quality of life (healthcare), rhinitis, medicine, MANAGEMENT, Humans, Asthma, Pharmacies, ARIA, business.industry, Decision Support Systems, Clinical, medicine.disease, Rhinitis, Allergic, Allergic Rhinitis and its Impact on Asthma, Integrated care, 030104 developmental biology, SEVERITY, 030228 respiratory system, 13. Climate action, Family medicine, 3121 General medicine, internal medicine and other clinical medicine, UPDATE, Clinical Medicine, business
Abstract

Pharmacists are trusted health care professionals. Many patients use over-the-counter (OTC) medications and are seen by pharmacists who are the initial point of contact for allergic rhinitis management in most countries. The role of pharmacists in integrated care pathways (ICPs) for allergic diseases is important. This paper builds on existing studies and provides tools intended to help pharmacists provide optimal advice/interventions/strategies to patients with rhinitis. The Allergic Rhinitis and its Impact on Asthma (ARIA)-pharmacy ICP includes a diagnostic questionnaire specifically focusing attention on key symptoms and markers of the disease, a systematic Diagnosis Guide (including differential diagnoses), and a simple flowchart with proposed treatment for rhinitis and asthma multimorbidity. Key prompts for referral within the ICP are included. The use of technology is critical to enhance the management of allergic rhinitis. However, the ARIA-pharmacy ICP should be adapted to local healthcare environments/situations as regional (national) differences exist in pharmacy care. ispartof: ALLERGY vol:74 issue:7 pages:1219-1236 ispartof: location:Denmark status: published

Published
2019

57. COPD: Analysing factors associated with a successful treatment

Author

A. Duarte-de-Araújo, Pedro Teixeira, Venceslau Hespanhol, and Jaime Correia-de-Sousa

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Treatment adherence, Negative association, Critical Care and Intensive Care Medicine, Medication Adherence, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Internal medicine, Surveys and Questionnaires, Administration, Inhalation, Medicine, Humans, Statistical analysis, 030212 general & internal medicine, Intensive care medicine, Aged, COPD, business.industry, Inhaler, Nebulizers and Vaporizers, medicine.disease, Inhalation technique, 3. Good health, Bronchodilator Agents, Cross-Sectional Studies, 030228 respiratory system, Current medication, Ambulatory, Female, Cardiology and Cardiovascular Medicine, business, Factor Analysis, Statistical
Abstract

Objectives To evaluate if non-adherence to inhaled medications, inhalers mishandling or the prescribers’ non-adherence to GOLD strategy are associated with mMRC grade, CAT score, COPD acute exacerbations or FEV1%. Methods A cross-sectional study on COPD was conducted in the ambulatory pulmonary clinic of Hospital de Guimaraes. Patients ≥40 years diagnosed according to GOLD criteria were recruited consecutively. A survey of demographic and clinical data was used. Adherence was assessed by using the Measure of Treatment Adherence (MTA) questionnaire. Inhalation technique was evaluated by using checklists of correct steps and critical errors, and inhalers’ misuse was defined when one or more critical errors were made, whatever the number or types of inhalers in use. To evaluate the prescriber non-adherence to GOLD strategy, the patients’ current medication was compared with therapeutic standards proposed by the GOLD 2017 strategy for the same ABCD groups. A statistical analysis was performed with IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. Results We studied 303 participants, 79.5% males, mean age = 67.5 years. A total of 285 completed the MTA questionnaire. Non-adherence was referred by 47 (16.5%) patients, and a significant negative association was found between adherence and CAT score and FEV1%. 285 patients performed 499 inhalations manoeuvres with 10 different IDs. Inhaler misuse was observed in 113 (39.6%) patients, and was not associated with CAT score, mMRC grade, ECOPD or FEV1%. We found deviations from the GOLD strategy in 133 (44.3%) patients, which were negatively related to CAT score, mMRC grade and ECOPD. Conclusions In the present study we failed to prove a positive association between non-adherence to medication, inhalers mishandling or prescribers’ non-adherence to GOLD strategy with symptoms, exacerbations and airflow limitation. Conversely, more symptomatic and more obstructed patients were more adherent to medication, previous ECOPD seems to improve prescribers’ adherence to treatment guidelines, and symptoms, ECOPD and FEV1% were not significantly associated with inhaler technique.

Published
2019

58. Discordância de critérios novos e antigos de classificação de pacientes com DPOC

Author

Pedro Teixeira, António Manuel Silva Duarte De Araújo, Venceslau Hespanhol, Jaime Correia-de-Sousa, and Universidade do Minho

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Cross-sectional study, Severity of Illness Index, 03 medical and health sciences, Diseases of the respiratory system, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Internal medicine, Forced Expiratory Volume, Surveys and Questionnaires, Severity of illness, Medicine, Humans, 030212 general & internal medicine, Reference standards, Letter to the Editor, Aged, COPD, Science & Technology, RC705-779, business.industry, Middle Aged, Reference Standards, medicine.disease, Cross-Sectional Studies, 030228 respiratory system, Practice Guidelines as Topic, Ciências Médicas::Medicina Básica, Female, business
Abstract

(undefined)

Published
2019

59. Helsinki by nature: The Nature Step to Respiratory Health

Author

Tari Haahtela, Leena von Hertzen, Josep M Anto, Chunxue Bai, Abay Baigenzhin, Eric D Bateman, Digambar Behera, Kazi Bennoor, Paulo Camargos, Niels Chavannes, Jaime Correia de Sousa, Alvaro Cruz, Maria Do Céu Teixeira, Marina Erhola, Eeva Furman, Bilun Gemicio?lu, Sandra Gonzalez Diaz, Peter W Hellings, Pekka Jousilahti, Nikolai Khaltaev, Vitezslav Kolek, Piotr Kuna, Stefania La Grutta, Le Thi Tuyet Lan, Tamaz Maglakelidze, Mohamed R Masjedi, Florin Mihaltan: Yousser Mohammad, Elizabete Nunes, Arvid Nyberg, Jorge Quel, Jose Rosado-Pinto 31, Hironori Sagara, Boleslaw Samolinski, Dean Schraufnagel, Talant Sooronbaev, Mohamed Tag Eldin, Teresa To, Arunas Valiulis, Cherian Varghese, Tuula Vasankari, Giovanni Viegi, Tonya Winders, Anahi Yañez, Arzu Yorgancio?lu 44, Osman Yusuf, Jean Bousquet, and Nils E Billo

Subjects
Respiratory diseases, Immune regulation, Planetary health, CRDs, Biodiversity, Environment, NCDs, Lifestyle, Nature, SDGs
Abstract

BACKGROUND: The Nature Step to Respiratory Health was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs. RESULTS: The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, affects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking "nature" to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, traffic arrangements, energy production, and importantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously. CONCLUSIONS: In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory.

Published
2019

60. Characterisation of morbidity in a COPD hospital cohort

Author

Pedro Teixeira, A. Duarte-de-Araújo, Venceslau Hespanhol, Jaime Correia-de-Sousa, and Universidade do Minho

Subjects
Pulmonary and Respiratory Medicine, Spirometry, Male, medicine.medical_specialty, Exacerbation, Comorbidity, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, FEV1, 0302 clinical medicine, Internal medicine, Forced Expiratory Volume, Surveys and Questionnaires, medicine, Humans, COPD, In patient, 030212 general & internal medicine, Stage (cooking), Asthma, Aged, lcsh:RC705-779, Science & Technology, medicine.diagnostic_test, Portugal, business.industry, Smoking, lcsh:Diseases of the respiratory system, Middle Aged, medicine.disease, Hospitals, 3. Good health, respiratory tract diseases, Cross-Sectional Studies, 030228 respiratory system, Cohort, Disease Progression, Female, Morbidity, business
Abstract

Objectives: To characterise the morbidity of COPD out-patients based on symptoms, acute exacerbations, FEV1 and comorbidities, and to explore the association between different patients’ characteristics such as social, demographic, clinical history or exposure. Methods: Stable COPD outpatients over 40 years old diagnosed according to GOLD criteria were included consecutively; the exclusion criteria were only refusal to participate and inability to understand clinical questionnaires. A survey of demographic and clinical data was conducted. Symptoms were evaluated using the CAT and mMRC questionnaires. The number of COPD acute exacerbations reported in the previous year was assessed, and spirometry performed on all participants according to ATS/ERS recommendations. Different variables were collected and then related to each other. Results: We studied 303 COPD outpatients, all Caucasians, 79.5% males and mostly elderly. 65.7% of participants reported having low monthly income and 87.8% a low education level. Tobacco smoking was the most common exposure identified but a substantial proportion of COPD patients were non-smokers (26%). Frequent acute exacerbations were reported by 38.0% of patients. The mean post-bronchodilator FEV1 was 53.2%. The distribution of patients according to GOLD 2017 stage and classification was respectively 9.9%, 41.9%, 35.0% and 13.2% from 1 to 4 and 23.1%, 39.6%, 2.3% and 35.0% from GOLD A to D. Only 29 patients (9.5%) presented no comorbid conditions, and the most common were hypertension, heart diseases and dyslipidaemia. Conclusions: Our data confirms COPD as a complex and heterogeneous disorder, with a significant morbidity due to the nature of symptoms, frequent comorbidities and exacerbations. A substantial proportion of COPD patients were never-smokers, mainly women, calling attention to the need for COPD recognition in these cases. COPD in women, in never-smokers and in patients with a previous diagnosis of asthma presented some specific characteristics. Some patient characteristics are associated with frequent acute exacerbations. FEV1 was strongly related both to symptoms and exacerbations. Keywords: COPD, FEV1, Exacerbation, Comorbidity

Published
2019

62. SABA Reliance Questionnaire (SRQ): Identifying Patient Beliefs Underpinning Reliever Overreliance in Asthma

Author

Sian Williams, Caroline Brigitte Katzer, John Haughney, Alan Kaplan, Rob Horne, Amy Hai Yan Chan, and Jaime Correia de Sousa

Subjects
Azides, Serotonin, Visual analogue scale, Inhaled corticosteroids, 03 medical and health sciences, 0302 clinical medicine, Cronbach's alpha, Surveys and Questionnaires, Asthma control, Administration, Inhalation, medicine, Criterion validity, Humans, Immunology and Allergy, 030212 general & internal medicine, Inverse correlation, Asthma, business.industry, Reproducibility of Results, medicine.disease, 3. Good health, 030228 respiratory system, B2 receptor, business, Clinical psychology
Abstract

Patient overreliance on short-acting betaTo develop and validate a brief questionnaire to elicit patients' perceptions of SABA (eg, belief that asthma is best managed by SABA alone) that could lead them to be overly reliant on SABA.The 5-item SABA Reliance Questionnaire (SRQ) was adapted from the well-validated Beliefs about Medicines Questionnaire assessing patient perceptions of the importance of, and necessity for, SABA in managing their asthma. The psychometric properties of the questionnaire were studied using Amazon Mechanical Turk, an online survey platform, in 446 people with self-reported asthma. Internal reliability and criterion-related validity were assessed on the basis of relationships between SRQ scores and other variables, including self-reported adherence to ICSs and perceived importance of reliever inhalers.Internal reliability was good with Cronbach α = 0.74. Criterion-related validity was demonstrated by an inverse correlation between SRQ scores and self-reported adherence to ICSs (r = -0.291; P.0001), and significant correlation between SRQ scores and perceived reliever importance (r = 0.216; P.0001), as well as by significant differences in SRQ scores between those with high and those with low self-reported ICS adherence (adherence to ICS t = 4.825; P.0001).The SRQ demonstrated acceptable internal reliability, and criterion validity, supporting its potential use as a pragmatic tool for identifying patients whose beliefs are indicative of overreliance on SABA for asthma.

Published
2020

63. Inhaler Review in Older Adults with Asthma or COPD: A Cost-Effectiveness Study and a Perspective in Portugal

Author

Jaime Correia-de-Sousa, Tiago Maricoto, Luís Taborda-Barata, João Marques-Gomes, and Universidade do Minho

Subjects
Male, medicine.medical_specialty, Exacerbation, Cost effectiveness, Cost-Benefit Analysis, Medicina Básica [Ciências Médicas], 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Patient Education as Topic, Cost Savings, Intervention (counseling), Health care, Cost‐effectiveness, Administration, Inhalation, medicine, Humans, 030212 general & internal medicine, Anti-Asthmatic Agents, health care economics and organizations, Asthma, Aged, COPD, Science & Technology, Portugal, business.industry, Inhaler, Chronic obstructive pulmonary disease, Nebulizers and Vaporizers, Perspective (graphical), Decision Trees, medicine.disease, 3. Good health, 030228 respiratory system, Older adults, Emergency medicine, Ciências Médicas::Medicina Básica, Female, Geriatrics and Gerontology, business
Abstract

Objectives Older patients with asthma or chronic obstructive pulmonary disease are particularly susceptible to exacerbations that may be associated with incorrect use of inhalers. Educational programs with inhaler technique review seem to be effective, but no studies have addressed their cost-effectiveness in older adult patients. The objective was to perform a cost-effectiveness analysis of education programs in older patients and estimate the cost benefit of applying such a program in Portugal. Design We developed a decision tree analysis from a healthcare perspective, according to intervention costs and the exacerbation rates and costs described in a previous meta-analysis. A sensitivity analysis of worst and best case scenarios was performed to estimate thresholds for intervention affordable limits, as well as cost-saving estimations and incremental cost-effectiveness ratios (ICERs) for a Portuguese scenario. Setting and participants We estimated cost-effectiveness thresholds applicable in all settings and performed a sensitivity analysis of a theoretical intervention model in all patients including an inhaler technique review at an annual appointment with a doctor and a nurse. Results In the best case scenario, the intervention affordable budget could be up to almost 1800€ (US $1585.24) per patient per year. Mean intervention-associated savings in Portugal would be 311.88€ (US $274.68) per patient per year, representing annual savings up to €131 million (US $150 million) for the whole health system, already including intervention costs. ICERs for Portugal vary between 93.73€ (US $82.55) and 437.43€ (US $385.25) per exacerbation avoided. Conclusion A model of an intervention program with an inhaler technique review in older adult patients suggests that this intervention is cost-effective and can generate significant savings. J Am Geriatr Soc 1-7, 2019.

Published
2018

64. A charter to improve patient care in severe asthma

Author

John W. Upham, Andrew Menzies-Gow, Tonya Winders, Antje-Henriette Fink-Wagner, Jaime Correia de Sousa, G-Walter Canonica, and Universidade do Minho

Subjects
medicine.medical_specialty, Severe asthma, macromolecular substances, Patient care, Severity of Illness Index, Patient advocacy, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Health care policy, immune system diseases, Health care, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Intensive care medicine, Adverse effect, Asthma, Science & Technology, business.industry, Health Policy, Charter, General Medicine, medicine.disease, Quality Improvement, Patient Care Management, 3. Good health, respiratory tract diseases, 030228 respiratory system, Quality of Life, Commentary, Respiratory, business, Needs Assessment
Abstract

Severe asthma is a subtype of asthma that is difficult to treat and control. By conservative estimates, severe asthma affects approximately 5-10% of patients with asthma worldwide. Severe asthma impairs patients' health-related quality of life, and patients are at risk of life-threatening asthma attacks. Severe asthma also accounts for the majority of health care expenditures associated with asthma. Guidelines recommend that patients with severe asthma be referred to a specialist respiratory team for correct diagnosis and expert management. This is particularly important to ensure that they have access to newly available biologic treatments. However, many patients with severe asthma can suffer multiple asthma attacks and wait several years before they are referred for specialist care. As global patient advocates, we believe it is essential to raise awareness and understanding for patients, caregivers, health care professionals, and the public about the substantial impact of severe asthma and to create opportunities for improving patient care. Patients should be empowered to live a life free of symptoms and the adverse effects of traditional medications (e.g., oral corticosteroids), reducing hospital visits and emergency care, the loss of school and work days, and the constraints placed on their daily lives. Here we provide a Patient Charter for severe asthma, consisting of six core principles, to mobilize national governments, health care providers, payer policymakers, lung health industry partners, and patients/caregivers to address the unmet need and burden in severe asthma and ultimately work together to deliver meaningful improvements in care., Funding for this study, the article processing charges, and the open access charge was provided by AstraZeneca.

Published
2018

65. COPD: understanding patients' adherence to inhaled medications

Author

Venceslau Hespanhol, A. Duarte-de-Araújo, Jaime Correia-de-Sousa, Pedro Teixeira, and Universidade do Minho

Subjects
Adult, Male, medicine.medical_specialty, Treatment adherence, Copd patients, Negative association, Disease, International Journal of Chronic Obstructive Pulmonary Disease, Medication Adherence, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Sex Factors, Internal medicine, Surveys and Questionnaires, Administration, Inhalation, medicine, COPD, Humans, adherence, 030212 general & internal medicine, Aged, Science & Technology, Smokers, business.industry, inhaled medications, Reproducibility of Results, Mean age, adherence behaviors, General Medicine, Middle Aged, medicine.disease, Obstructive lung disease, respiratory tract diseases, 3. Good health, Cross-Sectional Studies, 030228 respiratory system, Socioeconomic Factors, beliefs, Smoking status, Female, business
Abstract

António Duarte-de-Araújo,1–3 Pedro Teixeira,1,2 Venceslau Hespanhol,4,5 Jaime Correia-de-Sousa1,2,6 1Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; 2ICVS/3B’s, PT Government Associate Laboratory, Braga, Portugal; 3Respiratory Department, H. Sª Oliveira, Guimarães, Portugal; 4Department of Pneumology, Centro Hospitalar de S. João, Porto, Portugal; 5Faculty of Medicine (FMUP), University of Porto, Porto, Portugal; 6Horizonte Family Health Unit, Matosinhos, Portugal Background and objective: Adherence to inhaled medications by COPD patients is a challenging issue, but relatively understudied. The aim of this study is the characterization of adherence to inhaled medications by COPD patients, with a focus on patient-related determinants. Methods: Stable COPD outpatients ≥40 years of age from a respiratory unit and diagnosed according to the Global Initiative for Chronic Obstructive Lung Disease criteria were included in a cross-sectional study. The Measure of Treatment Adherence (MTA), the Beliefs about Medications Questionnaire (BMQ) and demographic, clinical, and COPD questionnaires were used. After completing these questionnaires, semi-structured interviews were carried out and participants were encouraged to justify their opinions and behaviors. Field notes were made during the interviews and each interview was analyzed before the next one. Quantitative and qualitative analyses of the variables were then performed. Results: A total of 300 out of 319 participants (mean age =67.7 years, 78.1% males) completed the MTA questionnaire. Of these, 31.3% were considered poorly adherent and 16.7% as non-adherent to the inhaled therapy. A statistically significant negative association was found between adherence and current smoking status (P=0.044), and between adherence and FEV1% (P=0.000). The mean BMQ Necessity score was higher in adherent patients (P=0.000), but the the mean Concern score was similar for both (P=0.877). We found nine patterns of poor-adherence, six reasons given for poor-adherence behaviors, five reasons for good-adherence behaviors and three patient-related domains on adherence to medications. Conclusion: Adherence is related to need perception and to the functional severity of the disease. A non-adherent patient is usually a current smoker with lower degree of airflow limitation and lower perception of medication necessity. New information obtained was related to the patterns and reasons for different adherence behaviors, which are based on three major groups of patient related-determinants: health-related experiences, health-related behaviors and health-related beliefs. Keywords: COPD, adherence, inhaled medications, adherence behaviors, beliefs

Published
2018

66. Using a rapid prioritisation process to identify health research priorities in LMICs

Author

Jaime Correia de Sousa, Sue Jowett, Alice M Turner, Andy Dickens, Rafael Stelmach, Amanda Farley, Radmila Ristovska, Alexandra Enocson, Kate Jolly, KK Cheng, Tamaz Maglakelidze, Alice J Sitch, Brendan G Cooper, Mariam Maglakelidze, Rachel Jordan, Sonia Martins, Sian Williams, Peymane Adab, Chunhua Chi, Katarina Stavrikj, and Nicola Gale

Subjects
Process management, Process (engineering), business.industry, Medicine, business
Published
2018

68. Improving care for people with asthma: building capacity across a European network of primary care organisations – the IPCRG’s Teach the Teacher Programme

Author

Juliet McDonnell, Hilary Pinnock, Jaime Correia de Sousa, Dermot Ryan, and Siân Williams

Subjects
Medical education, Evidence-based practice, business.industry, education, Needs assessment, Health care, Context (language use), Special Interest Group, Programme level, Educational evaluation, Psychology, business, Health policy
Abstract

Background The International Primary Care Respiratory Group (IPCRG) is a global network of organisations committed to improving assessment/treatment of chronic respiratory disease (CRD) in primary care. As a charity IPCRG supports improvements in health systems within member countries by disseminating research evidence and offering evidence-based resources, such as the U-BIOPRED (Unbiased BIOmarkers in PREDiction of respiratory disease outcomes) research into different phenotypes of asthma and IPCRGs desktop helper - which is short practical guidance distilled from the evidence on structured asthma review -- termed "SIMPLES". # Methods We ran a pilot educational programme -- called "Teach the Teacher: Difficult to Manage Asthma" designed to build capacity for teaching knowledge and skills in asthma management to primary healthcare workers in eight member countries. We used a cascade approach, which allowed for adaptation to local contexts to address local challenges, overcome barriers and optimise facilitators within various political, financial and healthcare systems. We explored impact using an educational evaluation framework. # Results Seven in-country programmes were delivered within project timescales March - December 2015. An important feature of the programme level evaluation shows considerable variation in the design and focus of in-country events. Over 230 health professionals participated in these educational events in seven countries, including specialist nurses, physiotherapists, general practitioners (GP), early career GPs, and GPs with a special interest in respiratory disease. Findings from a survey of in-country leads showed the importance of local needs assessment to ensure it was responsive to local social and healthcare context and allowed local variation and needs to be highlighted. Needs assessment also engaged the potential audience and ensured their buy-in to the programme at an early stage. Evidence based resources were adapted to different contexts which allowed them to be integrated to the routine training of primary care clinicians thus ensuring sustainability. # Conclusions Variation in the design and focus of in-country events was crucial to local implementation. Teams encountered, and found local solutions for, challenges in assessing learning needs, setting up education programmes and in supporting clinical practice change. Project funding enabled national programmes, but sustainability will require additional resource and a longer-term strategy.

Published
2018

69. Fostering the exchange of real world data across different countries to answer primary care research questions: an UNLOCK study from the IPCRG

Author

Mike Thomas, Thys van der Molen, Liza Cragg, Jaime Correia de Sousa, Siân Williams, Niels H. Chavannes, and Universidade do Minho

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Databases, Factual, International Cooperation, education, Medicina Básica [Ciências Médicas], Psychological intervention, Primary care, Article, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Health care, medicine, Humans, Multiple morbidities, 030212 general & internal medicine, Retrospective Studies, lcsh:RC705-779, Medical education, Science & Technology, Primary Health Care, Information Dissemination, business.industry, Public health, Public Health, Environmental and Occupational Health, lcsh:Diseases of the respiratory system, medicine.disease, Asthma, 3. Good health, RESEARCH NEEDS, Data sharing, 030228 respiratory system, Ciências Médicas::Medicina Básica, Research questions, HEALTH, Health Services Research, business, Real world data, Follow-Up Studies
Abstract

There is growing awareness amongst healthcare planners, providers and researchers of the need to make better use of routinely collected health data by translating it into actionable information that improves efficiency of healthcare and patient outcomes. There is also increased acceptance of the importance of real world research that recruits patients representative of primary care populations and evaluates interventions realistically delivered by primary care professionals. The UNLOCK Group is an international collaboration of primary care researchers and practitioners from 15 countries. It has coordinated and shared datasets of diagnostic and prognostic variables for COPD and asthma to answer research questions meaningful to professionals working in primary care over a 6-year period. Over this time the UNLOCK Group has undertaken several studies using data from unselected primary care populations from diverse contexts to evaluate the burden of disease, multiple morbidities, treatment and follow-up. However, practical and structural constraints have hampered the UNLOCK Group's ability to translate research ideas into studies. This study explored the constraints, challenges and successes experienced by the UNLOCK Group and its participants' learning as researchers and primary care practitioners collaborating to answer primary care research questions. The study identified lessons for future studies and collaborations that require data sharing across borders. It also explored specific challenges to fostering the exchange of primary care data in comparison to other datasets such as public health, prescribing or hospital data and mechanisms that may be used to overcome these., The IPCRG provided funding for this research project as an UNLOCK Group study for which the funding was obtained through an unrestricted grant by Novartis AG, Basel, Switzerland. Novartis has no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript, info:eu-repo/semantics/publishedVersion

Published
2018

70. Inhaler Technique Education and Exacerbation Risk in Older Adults with Asthma or Chronic Obstructive Pulmonary Disease: A Meta-Analysis

Author

Tiago, Maricoto, Luís, Monteiro, Jorge M R, Gama, Jaime, Correia-de-Sousa, and Luís, Taborda-Barata

Subjects
Aged, 80 and over, Male, Pulmonary Disease, Chronic Obstructive, Respiratory Therapy, Treatment Outcome, Patient Education as Topic, Risk Factors, Nebulizers and Vaporizers, Disease Progression, Humans, Female, Asthma, Aged
Abstract

To evaluate the effect of inhaler education programs on clinical outcomes and exacerbation rates in older adults with asthma or chronic obstructive pulmonary disease (COPD).Systematic review and meta-analysis.Older adults with asthma or COPD, either in primary or secondary health care and pharmacy setting.We searched the Medline, Embase, and Central databases according to the main eligibility criteria for inclusion: systematic reviews, meta-analysis, clinical trials and quasi-experimental studies; participants aged 65 and older; education on inhaler technique and reporting of disease control and exacerbation rates. We used the Grading of Recommendations, Assessment, Development and Evaluations scale for quality assessment and used a random-effect model with Mantel-Haenszel adjustment to perform a meta-analysis.We included 8 studies (4 randomized, 4 quasi-experimental) with a total of 1,812 participants. The most frequent type of intervention was physical demonstration of inhaler technique, training with placebo devices. Five studies showed significant reduction in exacerbation rates (pooled risk ratio=0.71, 95% confidence interval=0.59-0.86; p .001), although effect on disease control and quality of life showed high discrepancy in the reported results, and all randomized studies revealed uncertainty in their risk of bias assessment.All interventions seemed to improve inhaler performance and clinically relevant outcomes, but a placebo device could be the most effective. There is evidence that interventions reduce exacerbation risk in older adults, although to an overall moderate degree. J Am Geriatr Soc 67:57-66, 2019.

Published
2018

71. Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Author

Karin C. Lødrup Carlsen, L. Cecchi, F. Portejoie, T. Vontetsianos, Olivier Vandenplas, M. van Hague, D. Mora Bogado, M. Illario, Dana Wallace, L. Namazova-Baranova, E. Asayag, I. Ribeirinho, E. Costa, Shona Pedersen, Inger Kull, Davor Plavec, M. Morais-Almeida, Mickael Bewick, N.H. Chavannes, I. J. Ansotegui, G. De Carlo, K. S. Bennoor, Faradiba Sarquis Serpa, S. Arnavielle, F. Corti, Moises A. Calderon, Martín Bedolla-Barajas, Mette Sørensen, Isabella Annesi-Maesano, Elaine Colgan, Przemyslaw Kardas, M. van Eerd, Jorge Maspero, Valérie Siroux, Isabelle Momas, Ralph Mösges, Yves Dauvilliers, T. Keil, T. Bieber, Marit Westman, Rachel Nadif, O. Pfaar, A.C. Carvalho Coehlo, R. M. Cortés-Grimaldo, I. Skrindo, Piotr Kuna, Nicola Scichilone, Antonella Muraro, Kimihiro Okubo, Paulo Augusto Moreira Camargos, C. Cartier, Oliver Pfaar, K. Ohta, Barbara P. Yawn, Igor Kaidashev, Michel Thibaudon, X. Basagana, I. Kaidashev, Bilun Gemicioglu, S. Genova, Hae-Sim Park, J.J. Matta Campos, Simon Walker, Ulf Darsow, Fulvio Braido, J. Salimäki, T. Zuberbier, Raphaël Chiron, Mohammad Reza Masjedi, G.D. Marshall, Branislava Milenkovic, W. J. Fokkens, Eric D. Bateman, Robert M. Naclerio, Steve Montefort, M. de Fátima Emerson, T. Werfel, Cemal Cingi, A. Szylling, Martin Wagenmann, I. Baiardini, L. T. T. Le, N. Khaltaev, Ki-Suck Jung, Agnieszka Lipiec, Panayiotis K. Yiallouros, A Valero, R. Gerth van Wijk, L. Hernández, Marek L. Kowalski, C. Zubrinich, Sinthia Bosnic-Anticevich, Miguel A. Sierra, Erik Melén, T. Haahtela, Rute Almeida, Violeta Kvedariene, R. Pawankar, T.A. Popov, Flore Amat, Sanna Toppila-Salmi, M. Gotua, A. Sheikh, A. Bedbrook, Torsten Zuberbier, B. De Martino, Gérard Dray, Francesca Avolio, E. Mandajieva, B. Samolinski, Petr Panzner, P. Kuna, Philippe-Jean Bousquet, T. D. Nyembue, Luo Zhang, Leyla Namazova-Baranova, Ana Maria Carriazo, João Fonseca, E. Van Ganse, Roland Buhl, M. Bochenska Marciniak, Cristiana Stellato, J. da Silva, J. E. Gereda, Han-Jung Park, M.C. Costa-Dominguez, W. Carr, Dirceu Solé, S. Forti, Nanshan Zhong, Jordi Sunyer, Alain Didier, Y. Z. Chen, Thomas B. Casale, Jim Phillips, Isabelle Bosse, Manuel Teixeira Veríssimo, D. Y. Wang, U. Trama, Cristina Bárbara, David Somekh, T. Camuzat, R. N. Naclerio, Enrico Novellino, Leszek Klimek, M. Rodriguez Gonzalez, Holger J. Schünemann, Mario Barbagallo, D. Larenas-Linnemann, Mario Sánchez-Borges, Massimo Triggiani, Y. Okamoto, E. Mathieu-Dupas, N. Di Carluccio, S. Toppila-Salmi, Omer Kalayci, Rudolf Valenta, J. Coll, F. de Blay, Wienczyslawa Czarlewski, W. Pohl, Piotr Wroczyński, Kian Fan Chung, Nikolaos G. Papadopoulos, Pascal Demoly, Hubert Blain, M. Crescenzo, O. Kalayci, Leocadio Rodríguez-Mañas, G. Moda, L. Cox, Z. Gutter, A. Mair, Andrew Bush, Maria-Dolores Mogica-Martinez, Giorgio Walter Canonica, Antonio Valero, Daniel Laune, A. Zurkuhlen, Paul C. Potter, D. Wallace, Gabrielle L. Onorato, Mihaela Zidarn, E.P. Prokopakis, Anne Lise Courbis, Sergio Bonini, Ruta Dubakiene, A. Papi, Y. El-Gamal, Jacques Mercier, Wytske Fokkens, Rodolphe Bourret, S. Palkonen, A. Yorgancioglu, G. Vezzani, J. A. Rizzo, D. Plavec, D. Caillot, G. De Feo, E. Menditto, Caterina Bucca, A. C. Pozzi, Hironori Sagara, I. Grisle, I. Pin, Christopher E. Brightling, Ludger Klimek, F.F. Morato-Castro, Désirée Larenas-Linnemann, Alessandro Vatrella, A. A. Cruz, Guy Joos, E.D. Bateman, Erendira Rodriguez-Zagal, H. Douagui, T. To, Edgardo Jares, C. Bindslev-Jensen, G. Levato, J. O. B. Hourihane, R. Rajabian-Soderlund, C. Odzhakova, J. Bousquet, M. T. Ventura, Arzu Yorgancioglu, Osman M. Yusuf, H. J. Zar, Giovanni Rolla, Sebastian L. Johnston, M.S. Dykewicz, Esben Eller, A. Gamkrelidze, Filip Raciborski, Renzo Angles, Rafael Stelmach, M. Nogues, David Price, Mário Morais-Almeida, Tari Haahtela, Teresa To, D. Conforti, Stephen R. Durham, S. Gonzalez Diaz, V. Cardona, Werner Aberer, B. Milenkovic, Luigi Napoli, K. C. Bergmann, P W Hellings, M. Lessa, P. Panzner, Alfonso M. Cepeda Sarabia, M. Guidacci, A.L. Matos, Todor A. Popov, C. Suppli Ulrik, Diana Deleanu, N. de Paula Motta Rubini, Carsten Bindslev-Jensen, I. Majer, Ioana Agache, B. A. Barreto, R. Picard, Erkka Valovirta, A. Fink-Wagner, L. Colas, João O. Malva, Thomas Keil, M. T. Burguete Cabañas, Bolesław Samoliński, M.H. Garcia-Cruz, L.P. Boulet, K. Nekam, Edyta Krzych-Fałta, P. Devillier, J. Ferreira de Mello, Jussi Karjalainen, I. Bogus-Buczynska, Susan Waserman, Marcus Maurer, Tomas Chivato, Elena Bacci, M. Przemecka, Olga Lourenço, José Miguel Fuentes-Pérez, M. Zidarn, Talant Sooronbaev, J.M. Anto, W. Czarlewski, R. Murray, Luís Nogueira-Silva, G. Passalacqua, E. Chkhartishvili, Oscar Mayora, Victoria Cardona, M. Sondermann, Piotr Lacwik, S. Ouedraogo, I. Baroni, Artur Z. Białoszewski, G Scadding, J. Strozek, R. Emuzyte, Neven Miculinic, Ruby Pawankar, Ken Ohta, I. Agache, J.L. Gálvez-Romero, Nikos G. Papadopoulos, E. O. Meltzer, I. Annesi-Maesano, E. De Manuel Keenoy, Jorge A. Luna-Pech, Ana Margarida Pereira, Paul Potter, M. Ortega Cisneros, J. Li, K. F. Rabe, M. Rottem, Mikael Benson, Ali Fuat Kalyoncu, Dermot Ryan, Dieter Maier, C.Y. García-Cobas, S. Bialek, G. Du Toit, S. Shamai, S. Mavale-Manuel, Rojin Rajabian-Soderlund, Maddalena Illario, Philippe Devillier, F. Rodenas, Emmanuel P. Prokopakis, De Yun Wang, Niels H. Chavannes, E.H.D. Bel, Bianca Beghe, Sietze Reitsma, John Wright, O. Lourenço, L.T.T. Le, Josep M. Antó, T. Casale, Paul K. Keith, K. C. Lødrup Carlsen, P. Demoly, Mikael Kuitunen, Marc Humbert, A. M. Cepeda Sarabia, Ignacio J. Ansotegui, M.C. Rizzo, Davide Caimmi, Milan Sova, Nick A. Guldemond, P. Yakovliev, Judah A. Denburg, Jaime Correia de Sousa, Elisabete Melo-Gomes, Aziz Sheikh, I. Bosse, M. M. Ciaravolo, S. Di Capua Ercolano, Alpana Mair, P. Lieberman, Isabella Pali-Schöll, Leif Bjermer, G. De Vries, M. Roman Rodriguez, Johanna Salimäki, Carmen Panaitescu, F. Mihaltan, Giulia De Feo, F. E. R. Simons, A. Blua, B. Mahboub, D. Ryan, M. Bewick, Anabela Mota-Pinto, J.A. Fonseca, Neil Wilson, Marek Jutel, Dennis M. Williams, M. Akdis, Menachem Rottem, Marcello Persico, J. C. Ivancevich, Nelson Rosario, A. Farsi, Alvaro A. Cruz, Liguo Zhang, Anna Bedbrook, L. Bertorello, Magnus Wickman, Marilyn Urrutia-Pereira, O. Spranger, René Maximiliano Gómez, C. Bachert, Renaud Louis, Musa Khaitov, C. Stellato, Constantinos Pitsios, Roland Buonaiuto, A. Romano, Sîan A Williams, R. Puy, Daniela Rivero-Yeverino, Y. Mohammad, J. Farrell, Jan Brozek, Ricardo Pio Monti, E. Paulino, J. Correia de Sousa, Miguel Alejandro Medina-Ávalos, Jocelyne Just, Peter Valentin Tomazic, Jean-François Ferrero, Antoine Magnan, S. Waserman, J Rosado-Pinto, Maciek Kupczyk, C.S. Bosnic-Anticevich, T. Dedeu, Tommi Vasankari, R. Mösges, Robin O'Hehir, Ema Paulino, Peter Hellings, A. Neou, M. Wickman, D. Lauri, Jean Bousquet, A. Ciceran, Jacques Bouchard, Yehia El-Gamal, M.G. Dominguez-Silva, M.R. Alberti, Jean-Louis Pépin, Kimi Okubo, Juan Carlos Ivancevich, Patrik Eklund, Benoit Pugin, C. Dario, Mussa Khaitov, Luisa Brussino, A.G. Chuchalin, Elísio Costa, Susanna Palkonen, Lars Münter, Pedro Carreiro-Martins, R.E. Pulido Ross, Ettore Novellino, Kai-Håkon Carlsen, María Antonieta Guzmán, G.W. Canonica, Gabriel Onorato, Giuseppe De Carlo, R.E. Roller-Wirnsberger, Brian J. Lipworth, M. A. Guzman, J.N. Tebyriçá, Adnan Custovic, Yoshitaka Okamoto, Rimantas Stukas, P. Manning, J. Sastre-Dominguez, Caroline L.S. George, Robyn E O'Hehir, K. Maciej, Bassam Mahboub, J. F. Fontaine, Arũnas Valiulis, Xavier Rodó, D. Vicheva, G. Canfora, Vitalis Briedis, S. Rodrigues Valle, Mark S. Dykewicz, Joanne Rimmer, G. Castellano, B. Pigearias, A. L. Boner, Yunuen Rocío Huerta-Villalobos, Christine Rolland, H. Neffen, H. Arshad, Javier Gómez-Vera, P. Moura Santo, Frederic Viart, F. Blasi, J. Garcia-Aymerich, Lorenzo Cecchi, V. Niedeberger, Giorgio Ciprandi, F. Caballero-Fonseca, Jean-François Fontaine, J Mullol, Maurizio Romano, M. Viegi, Mario E. Zernotti, Arunas Valiulis, Anna Asarnoj, Antonio Nieto, J. Lavrut, D. Dokic, V. Kvedariene, Ewa Jassem, Cezmi A. Akdis, Ruth Murray, Claus Bachert, Peter Schmid-Grendelmeier, Emilie Burte, Joaquim Mullol, Guido Iaccarino, J. Kleine-Tebbe, P. V. Tomazic, E. Eller, Alessandro Fiocchi, H.J. Schunemann, M. Sorlini, C. Robalo-Cordeiro, Ana-Maria Todo-Bom, J. Brozek, Marco Nalin, Matteo Bonini, J. C. Sisul, S.E. Dahlen, F. Amat, Juan Carlos Sisul, Jawad Hajjam, Ana Todo-Bom, Enrica Menditto, Bousquet J., Hellings P.W., Agache I., Amat F., Annesi-Maesano I., Ansotegui I.J., Anto J.M., Bachert C., Bateman E.D., Bedbrook A., Bennoor K., Bewick M., Bindslev-Jensen C., Bosnic-Anticevich S., Bosse I., Brozek J., Brussino L., Canonica G.W., Cardona V., Casale T., Cepeda Sarabia A.M., Chavannes N.H., Cecchi L., Correia de Sousa J., Costa E., Cruz A.A., Czarlewski W., De Carlo G., De Feo G., Demoly P., Devillier P., Dykewicz M.S., El-Gamal Y., Eller E.E., Fonseca J.A., Fontaine J.-F., Fokkens W.J., Guzman M.-A., Haahtela T., Illario M., Ivancevich J.-C., Just J., Kaidashev I., Khaitov M., Kalayci O., Keil T., Klimek L., Kowalski M.L., Kuna P., Kvedariene V., Larenas-Linnemann D., Laune D., Le L.T.T., Carlsen K.L., Lourenco O., Mahboub B., Mair A., Menditto E., Milenkovic B., Morais-Almeida M., Mosges R., Mullol J., Murray R., Naclerio R., Namazova-Baranova L., Novellino E., O'Hehir R.E., Ohta K., Okamoto Y., Okubo K., Onorato G.L., Palkonen S., Panzner P., Papadopoulos N.G., Park H.-S., Paulino E., Pawankar R., Pfaar O., Plavec D., Popov T.A., Potter P., Prokopakis E.P., Rottem M., Ryan D., Salimaki J., Samolinski B., Sanchez-Borges M., Schunemann H.J., Sheikh A., Sisul J.-C., Rajabian-Soderlund R., Sooronbaev T., Stellato C., To T., Todo-Bom A.-M., Tomazic P.-V., Toppila-Salmi S., Valero A., Valiulis A., Valovirta E., Ventura M.-T., Wagenmann M., Wang D.Y., Wallace D., Waserman S., Wickman M., Yorgancioglu A., Zhang L., Zhong N., Zidarn M., Zuberbier T., Aberer W., Akdis C.A., Akdis M., Alberti M.R., Almeida R., Angles R., Arnavielle S., Asayag E., Asarnoj A., Arshad H., Avolio F., Bacci E., Baiardini I., Barbara C., Barbagallo M., Baroni I., Barreto B.A., Basagana X., Bedolla-Barajas M., Beghe B., Bel E.H., Bergmann K.C., Benson M., Bertorello L., Bialoszewski A.Z., Bieber T., Bialek S., Bjermer L., Blain H., Blasi F., Blua A., Bochenska Marciniak M., Bogus-Buczynska I., Boner A.L., Bonini M., Bonini S., Bouchard J., Boulet L.P., Bourret R., Braido F., Briedis V., Brightling C.E., Bucca C., Buhl R., Buonaiuto R., Panaitescu C., Burguete Cabanas M.T., Burte E., Bush A., Caballero-Fonseca F., Caillot D., Caimmi D., Calderon M.A., Camargos P.A.M., Camuzat T., Canfora G., Carreiro-Martins P., Carriazo A.M., Carr W., Cartier C., Castellano G., Chen Y., Chiron R., Chivato T., Chkhartishvili E., Chuchalin A.G., Chung K.F., Ciaravolo M.M., Ciceran A., Cingi C., Ciprandi G., Carvalho Coehlo A.C., Colas L., Colgan E., Coll J., Conforti D., Cortes-Grimaldo R.M., Corti F., Costa-Dominguez M.C., Courbis A.L., Cox L., Crescenzo M., Custovic A., Dahlen S.E., Dario C., da Silva J., Dauvilliers Y., Darsow U., De Blay F., Dedeu T., de Fatima Emerson M., De Vries G., De Martino B., de Paula Motta Rubini N., Deleanu D., Denburg J.A., Di Capua Ercolano S., Di Carluccio N., Didier A., Dokic D., Dominguez-Silva M.G., Douagui H., Dray G., Dubakiene R., Durham S.R., Du Toit G., Eklund P., Emuzyte R., Farrell J., Farsi A., Ferreira de Mello J., Ferrero J., Fink-Wagner A., Fiocchi A., Forti S., Fuentes-Perez J.M., Galvez-Romero J.L., Gamkrelidze A., Garcia-Aymerich J., Garcia-Cobas C.Y., Garcia-Cruz M.H., Gemicioglu B., Genova S., George C., Gereda J.E., Gerth van Wijk R., Gomez R.M., Gomez-Vera J., Gonzalez Diaz S., Gotua M., Grisle I., Guidacci M., Guldemond N.A., Gutter Z., Hajjam J., Hernandez L., Hourihane J.O., Huerta-Villalobos Y.R., Humbert M., Iaccarino G., Jares E.J., Jassem E., Johnston S.L., Joos G., Jung K.S., Jutel M., Kalyoncu A.F., Karjalainen J., Kardas P., Keith P.K., Khaltaev N., Kleine-Tebbe J., Kuitunen M., Kull I., Kupczyk M., Krzych-Falta E., Lacwik P., Lauri D., Lavrut J., Lessa M., Levato G., Li J., Lieberman P., Lipiec A., Lipworth B., Lodrup Carlsen K.C., Louis R., Luna-Pech J.A., Maciej K., Magnan A., Maier D., Majer I., Malva J., Mandajieva E., Manning P., De Manuel Keenoy E., Marshall G.D., Masjedi M.R., Maspero J.F., Mathieu-Dupas E., Matta Campos J.J., Matos A.L., Maurer M., Mavale-Manuel S., Mayora O., Medina-Avalos M.A., Melen E., Melo-Gomes E., Meltzer E.O., Mercier J., Miculinic N., Mihaltan F., Moda G., Mogica-Martinez M.D., Mohammad Y., Momas I., Montefort S., Monti R., Mora Bogado D., Morato-Castro F.F., Mota-Pinto A., Moura Santo P., Munter L., Muraro A., Nadif R., Nalin M., Napoli L., Neffen H., Niedeberger V., Nekam K., Neou A., Nieto A., Nogueira-Silva L., Nogues M., Nyembue T.D., Odzhakova C., Ortega Cisneros M., Ouedraogo S., Pali-Scholl I., Papi A., Passalacqua G., Pedersen S., Pepin J.L., Pereira A.M., Persico M., Phillips J., Picard R., Pigearias B., Pin I., Pitsios C., Pohl W., Portejoie F., Pozzi A.C., Price D., Puy R., Pugin B., Pulido Ross R.E., Przemecka M., Rabe K.F., Raciborski F., Reitsma S., Ribeirinho I., Rimmer J., Rivero-Yeverino D., Rizzo J.A., Rizzo M.C., Robalo-Cordeiro C., Rodenas F., Rodo X., Rodriguez Gonzalez M., Rodriguez-Manas L., Rolland C., Rodrigues Valle S., Roman Rodriguez M., Romano A., Rodriguez-Zagal E., Rolla G., Roller-Wirnsberger R.E., Romano M., Rosado-Pinto J., Rosario N., Sagara H., Sastre-Dominguez J., Scadding G.K., Scichilone N., Schmid-Grendelmeier P., Serpa F.S., Shamai S., Sierra M., Simons F.E.R., Siroux V., Skrindo I., Sole D., Somekh D., Sondermann M., Sova M., Sorensen M., Sorlini M., Spranger O., Stelmach R., Stukas R., Sunyer J., Strozek J., Szylling A., Tebyrica J.N., Thibaudon M., Trama U., Triggiani M., Suppli Ulrik C., Urrutia-Pereira M., Valenta R., van Eerd M., van Ganse E., van Hague M., Vandenplas O., Vezzani G., Vasankari T., Vatrella A., Verissimo M.T., Viart F., Viegi M., Vicheva D., Vontetsianos T., Walker S., Werfel T., Westman M., Williams D.M., Williams S., Wilson N., Wright J., Wroczynski P., Yakovliev P., Yawn B.P., Yiallouros P.K., Yusuf O.M., Zar H.J., Zernotti M.E., Zubrinich C., Zurkuhlen A., Bousquet, Jean, Hellings, Peter W., Agache, Ioana, Amat, Flore, Annesi-Maesano, Isabella, Ansotegui, Ignacio J., Anto, Josep M., Bachert, Clau, Bateman, Eric D., Bedbrook, Anna, Bennoor, Kazi, Bewick, Mickael, Bindslev-Jensen, Carsten, Bosnic-Anticevich, Sinthia, Bosse, Isabelle, Brozek, Jan, Brussino, Luisa, Canonica, Giorgio W., Cardona, Victoria, Casale, Thoma, Cepeda Sarabia, Alfonso M., Chavannes, Niels H., Cecchi, Lorenzo, Correia de Sousa, Jaime, Costa, Elisio, Cruz, Alvaro A., Czarlewski, Wienczyslawa, De Carlo, Giuseppe, De Feo, Giulia, Demoly, Pascal, Devillier, Philippe, Dykewicz, Mark S., El-Gamal, Yehia, Eller, Esben E., Fonseca, Joao A., Fontaine, Jean-Françoi, Fokkens, Wytske J., Guzmán, Maria-Antonieta, Haahtela, Tari, Illario, Maddalena, Ivancevich, Juan-Carlo, Just, Jocelyne, Kaidashev, Igor, Khaitov, Musa, Kalayci, Omer, Keil, Thoma, Klimek, Ludger, Kowalski, Marek L., Kuna, Piotr, Kvedariene, Violeta, Larenas-Linnemann, Desiree, Laune, Daniel, Le, Lan T. T., Carlsen, Karin Lodrup, Lourenço, Olga, Mahboub, Bassam, Mair, Alpana, Menditto, Enrica, Milenkovic, Branislava, Morais-Almeida, Mario, Mösges, Ralph, Mullol, Joaquim, Murray, Ruth, Naclerio, Robert, Namazova-Baranova, Leyla, Novellino, Ettore, O'Hehir, Robyn E., Ohta, Ken, Okamoto, Yoshitaka, Okubo, Kimi, Onorato, Gabrielle L., Palkonen, Susanna, Panzner, Petr, Papadopoulos, Nikos G., Park, Hae-Sim, Paulino, Ema, Pawankar, Ruby, Pfaar, Oliver, Plavec, Davor, Popov, Ted A., Potter, Paul, Prokopakis, Emmanuel P., Rottem, Menachem, Ryan, Dermot, Salimäki, Johanna, Samolinski, Boleslaw, Sanchez-Borges, Mario, Schunemann, Holger J., Sheikh, Aziz, Sisul, Juan-Carlo, Rajabian-Söderlund, Rojin, Sooronbaev, Talant, Stellato, Cristiana, To, Teresa, Todo-Bom, Ana-Maria, Tomazic, Peter-Valentin, Toppila-Salmi, Sanna, Valero, Antonio, Valiulis, Aruna, Valovirta, Erkka, Ventura, Maria-Teresa, Wagenmann, Martin, Wang, De Yun, Wallace, Dana, Waserman, Susan, Wickman, Magnu, Yorgancioglu, Arzu, Zhang, Luo, Zhong, Nanshan, Zidarn, Mihaela, Zuberbier, Torsten, Bousquet, J., Hellings, P. W., Aberer, W., Agache, I., Akdis, C. A., Akdis, M., Alberti, M. R., Almeida, R., Amat, F., Angles, R., Annesi-Maesano, I., Ansotegui, I. J., Anto, J. M., Arnavielle, S., Asayag, E., Asarnoj, A., Arshad, H., Avolio, F., Bacci, E., Bachert, C., Baiardini, I., Barbara, C., Barbagallo, M., Baroni, I., Barreto, B. A., Basagana, X., Bateman, E. D., Bedolla-Barajas, M., Bedbrook, A., Bewick, M., Beghé, B., Bel, E. H., Bergmann, K. C., Bennoor, K. S., Benson, M., Bertorello, L., Białoszewski, A. Z., Bieber, T., Bialek, S., Bindslev-Jensen, C., Bjermer, L., Blain, H., Blasi, F., Blua, A., Bochenska Marciniak, M., Bogus-Buczynska, I., Boner, A. L., Bonini, M., Bonini, S., Bosnic-Anticevich, C. S., Bosse, I., Bouchard, J., Boulet, L. P., Bourret, R., Bousquet, P. J., Braido, F., Briedis, V., Brightling, C. E., Brozek, J., Bucca, C., Buhl, R., Buonaiuto, R., Panaitescu, C., Burguete Cabañas, M. T., Burte, E., Bush, A., Caballero-Fonseca, F., Caillot, D., Caimmi, D., Calderon, M. A., Camargos, P. A. M., Camuzat, T., Canfora, G., Canonica, G. W., Cardona, V., Carlsen, K. H., Carreiro-Martins, P., Carriazo, A. M., Carr, W., Cartier, C., Casale, T., Castellano, G., Cecchi, L., Cepeda Sarabia, A. M., Chavannes, N. H., Chen, Y., Chiron, R., Chivato, T., Chkhartishvili, E., Chuchalin, A. G., Chung, K. F., Ciaravolo, M. M., Ciceran, A., Cingi, C., Ciprandi, G., Carvalho Coehlo, A. C., Colas, L., Colgan, E., Coll, J., Conforti, D., Correia de Sousa, J., Cortés-Grimaldo, R. M., Corti, F., Costa, E., Costa-Dominguez, M. C., Courbis, A. L., Cox, L., Crescenzo, M., Cruz, A. A., Custovic, A., Czarlewski, W., Dahlen, S. E., Dario, C., da Silva, J., Dauvilliers, Y., Darsow, U., De Blay, F., De Carlo, G., Dedeu, T., de Fátima Emerson, M., De Feo, G., De Vries, G., De Martino, B., de Paula Motta Rubini, N., Deleanu, D., Demoly, P., Denburg, J. A., Devillier, P., Di Capua Ercolano, S., Di Carluccio, N., Didier, A., Dokic, D., Dominguez-Silva, M. G., Douagui, H., Dray, G., Dubakiene, R., Durham, S. R., Du Toit, G., Dykewicz, M. S., El-Gamal, Y., Eklund, P., Eller, E., Emuzyte, R., Farrell, J., Farsi, A., Ferreira de Mello, J., Ferrero, J., Fink-Wagner, A., Fiocchi, A., Fokkens, W. J., Fonseca, J. A., Fontaine, J. F., Forti, S., Fuentes-Perez, J. M., Gálvez-Romero, J. L., Gamkrelidze, A., Garcia-Aymerich, J., García-Cobas, C. Y., Garcia-Cruz, M. H., Gemicioğlu, B., Genova, S., George, C., Gereda, J. E., Gerth van Wijk, R., Gomez, R. M., Gómez-Vera, J., González Diaz, S., Gotua, M., Grisle, I., Guidacci, M., Guldemond, N. A., Gutter, Z., Guzmán, M. A., Haahtela, T., Hajjam, J., Hernández, L., Hourihane, J. O. 'B., Huerta-Villalobos, Y. R., Humbert, M., Iaccarino, G., Illario, M., Ivancevich, J. C., Jares, E. J., Jassem, E., Johnston, S. L., Joos, G., Jung, K. S., Jutel, M., Kaidashev, I., Kalayci, O., Kalyoncu, A. F., Karjalainen, J., Kardas, P., Keil, T., Keith, P. K., Khaitov, M., Khaltaev, N., Kleine-Tebbe, J., Klimek, L., Kowalski, M. L., Kuitunen, M., Kull, I., Kuna, P., Kupczyk, M., Kvedariene, V., Krzych-Fałta, E., Lacwik, P., Larenas-Linnemann, D., Laune, D., Lauri, D., Lavrut, J., Le, L. T. T., Lessa, M., Levato, G., Li, J., Lieberman, P., Lipiec, A., Lipworth, B., Lodrup Carlsen, K. C., Louis, R., Lourenço, O., Luna-Pech, J. A., Maciej, K., Magnan, A., Mahboub, B., Maier, D., Mair, A., Majer, I., Malva, J., Mandajieva, E., Manning, P., De Manuel Keenoy, E., Marshall, G. D., Masjedi, M. R., Maspero, J. F., Mathieu-Dupas, E., Matta Campos, J. J., Matos, A. L., Maurer, M., Mavale-Manuel, S., Mayora, O., Medina-Avalos, M. A., Melén, E., Melo-Gomes, E., Meltzer, E. O., Menditto, E., Mercier, J., Miculinic, N., Mihaltan, F., Milenkovic, B., Moda, G., Mogica-Martinez, M. D., Mohammad, Y., Momas, I., Montefort, S., Monti, R., Mora Bogado, D., Morais-Almeida, M., Morato-Castro, F. F., Mösges, R., Mota-Pinto, A., Moura Santo, P., Mullol, J., Münter, L., Muraro, A., Murray, R., Naclerio, R., Nadif, R., Nalin, M., Napoli, L., Namazova-Baranova, L., Neffen, H., Niedeberger, V., Nekam, K., Neou, A., Nieto, A., Nogueira-Silva, L., Nogues, M., Novellino, E., Nyembue, T. D., O'Hehir, R. E., Odzhakova, C., Ohta, K., Okamoto, Y., Okubo, K., Onorato, G. L., Ortega Cisneros, M., Ouedraogo, S., Pali-Schöll, I., Palkonen, S., Panzner, P., Papadopoulos, N. G., Park, H. S., Papi, A., Passalacqua, G., Paulino, E., Pawankar, R., Pedersen, S., Pépin, J. L., Pereira, A. M., Persico, M., Pfaar, O., Phillips, J., Picard, R., Pigearias, B., Pin, I., Pitsios, C., Plavec, D., Pohl, W., Popov, T. A., Portejoie, F., Potter, P., Pozzi, A. C., Price, D., Prokopakis, E. P., Puy, R., Pugin, B., Pulido Ross, R. E., Przemecka, M., Rabe, K. F., Raciborski, F., Rajabian-Soderlund, R., Reitsma, S., Ribeirinho, I., Rimmer, J., Rivero-Yeverino, D., Rizzo, J. A., Rizzo, M. C., Robalo-Cordeiro, C., Rodenas, F., Rodo, X., Rodriguez Gonzalez, M., Rodriguez-Mañas, L., Rolland, C., Rodrigues Valle, S., Roman Rodriguez, M., Romano, A., Rodriguez-Zagal, E., Rolla, G., Roller-Wirnsberger, R. E., Romano, M., Rosado-Pinto, J., Rosario, N., Rottem, M., Ryan, D., Sagara, H., Salimäki, J., Samolinski, B., Sanchez-Borges, M., Sastre-Dominguez, J., Scadding, G. K., Schunemann, H. J., Scichilone, N., Schmid-Grendelmeier, P., Serpa, F. S., Shamai, S., Sheikh, A., Sierra, M., Simons, F. E. R., Siroux, V., Sisul, J. C., Skrindo, I., Solé, D., Somekh, D., Sondermann, M., Sooronbaev, T., Sova, M., Sorensen, M., Sorlini, M., Spranger, O., Stellato, C., Stelmach, R., Stukas, R., Sunyer, J., Strozek, J., Szylling, A., Tebyriçá, J. N., Thibaudon, M., To, T., Todo-Bom, A., Tomazic, P. V., Toppila-Salmi, S., Trama, U., Triggiani, M., Suppli Ulrik, C., Urrutia-Pereira, M., Valenta, R., Valero, A., Valiulis, A., Valovirta, E., van Eerd, M., van Ganse, E., van Hague, M., Vandenplas, O., Ventura, M. T., Vezzani, G., Vasankari, T., Vatrella, A., Verissimo, M. T., Viart, F., Viegi, M., Vicheva, D., Vontetsianos, T., Wagenmann, M., Walker, S., Wallace, D., Wang, D. Y., Waserman, S., Werfel, T., Westman, M., Wickman, M., Williams, D. M., Williams, S., Wilson, N., Wright, J., Wroczynski, P., Yakovliev, P., Yawn, B. P., Yiallouros, P. K., Yorgancioglu, A., Yusuf, O. M., Zar, H. J., Zhang, L., Zhong, N., Zernotti, M. E., Zidarn, M., Zuberbier, T., Zubrinich, C., Zurkuhlen, A., CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Laboratory of clinical immunology, Department of Allergy and Clinical Immunology, Transylvania University of Brasov, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Epidémiologie, Systèmes d'Information, Modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia [Bilbao], Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hacettepe University = Hacettepe Üniversitesi, Mechanobiology Institute [Singapore] (MBI), National University of Singapore (NUS), Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University [Hamilton, Ontario], Department of Dermatology [Graz, Austria], Medical University Graz, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Department Engineering Quimica (ICEMS), Ghent University Hospital, Istituto Nazionale di Fisica Nucleare, sezione di Bari (INFN, sezione di Bari), Istituto Nazionale di Fisica Nucleare (INFN), IMIM-Hospital del Mar, Generalitat de Catalunya, University of Cape Town, Divisions of Human Genetics Infection, Inflammation and Repair, University of Southampton-School of Medicine, Centre de gérontologie, Department of Pathophysiology and Transplantation, Università degli Studi di Milano = University of Milan (UNIMI), Istituto di Geoscienze e Georisorse, Pavia, Institute of Neurobiology and Molecular Medicine, CNR, Rome, Italy and Department of Medicine-University of Naples Federico II = Università degli studi di Napoli Federico II, Woolcock Institute of Medical Research [Sydney], The University of Sydney, Université Laval [Québec] (ULaval), Departments of Clinical Epidemiology and Biostatistics and Medicine [Ontario], Service greffe de moelle osseuse, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Royal Brompton Hospital, Région Languedoc-Roussillon-Midi-Pyrénées, Vall d'Hebron University Hospital [Barcelona], University of South Florida [Tampa] (USF), Università degli Studi di Firenze = University of Florence (UniFI), University of Michigan, Department of Atmospheric, Centres de Ressources et de Compétences de la Mucoviscidose [Montpellier] (CRCM [Montpellier]), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Service des Maladies Respiratoires, Russian State Medical University, Universidade do Porto, Instituto de Biologia Molecular e Celular (IBMC), UCB Pharma, Colombes, Hôpital Gui de Chauliac [CHU Montpellier], CHU Strasbourg, European Federation of Allergy (EFA), Airways Diseases Patients' Associations, Università degli Studi di Salerno = University of Salerno (UNISA), Laboratoire de recherche sur les mécanismes moléculaires et pharmacologiques de l’obstruction bronchique (LOBIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Laboratoire de Génie Informatique et Ingénierie de Production (LGI2P), IMT - MINES ALES (IMT - MINES ALES), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Linköping University (LIU), Department of Dermatology and Allergy Centre, Odense University Hospital, Vilnius University [Vilnius], Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto = University of Porto, Institut d'Electronique du Solide et des Systèmes (InESS), Centre National de la Recherche Scientifique (CNRS), Son Pisa Primary Care Centre, IB-Salut Balearic Health Service, Center for Allergy and Immunology Research [Tbilisi], Department of Dermatology, Helsinki University Hospital-Skin and Allergy Hospital, Swedish Meteorological and Hydrological Institute (SMHI), CORYSS-TESS, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Institute of Social Medicine, Epidemiology and Health Economics-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Biologie des organismes marins et écosystèmes (BOME), Muséum national d'Histoire naturelle (MNHN)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), NRC Institute of immunology FMBA, Moscow Russian federation, Allergy and Asthma Center Westend, German Society for Otorhinolaryngology HNS, Rheinische Friedrich-Wilhelms-Universität Bonn, The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], Medical University of Łódź (MUL), Hospital Medica Sur, Institut de Recherche en Infectiologie de Montpellier (IRIM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Applied Physical Chemistry Laboratory (APCLab), Institute of Geophysics and Planetary Physics [Los Angeles] (IGPP), University of California [Los Angeles] (UCLA), University of California (UC)-University of California (UC), Équipe de Recherche en Textes, Informatique, Multilinguisme (ERTIM), Institut National des Langues et Civilisations Orientales (Inalco), Institute of Oceanology [China], University of Beira Interior [Portugal] (UBI), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Pulmonary and allergy unit, American University of Sharjah-Rashid Hospital-Dubai Health Authority (DHA), Astrophysique Interprétation Modélisation (AIM (UMR7158 / UMR_E_9005 / UM_112)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Sysdiag-Modélisation et Ingénierie des Systèmes Complexes Biologiques pour le Diagnostic (SysDiag ), BIO-RAD-Centre National de la Recherche Scientifique (CNRS), 'Federico II' University of Naples Medical School, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Pneumology Department, Marius Nasta Institute of Pneumology, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw - Poland-Faculté de Pharmacie de Paris, Allergy and Clinical Immunology Department, Hospital CUF Descobertas, Universität zu Köln = University of Cologne, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Section of Otolaryngology-Head & Neck Surgery (OHNS), University of Chicago, Department of Pharmacy Naples, Université de Naples, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital-Monash University Building, AMREP, Dept. of Electronic Engineering, Chubu University, Department of Otorhinolaryngology, Chiba University Hospital, Department of Allergology and Clinical Immunology, Charles University [Prague] (CU)-Medical Faculty in Pilsen, Department of Earth and Planetary Sciences [Cambridge, USA] (EPS), Harvard University, Allergy and Respiratory Diseases, Università degli studi di Genova = University of Genoa (UniGe), Department of Pediatrics, Nippon Medical School, Centre Hospitalier Universitaire [Grenoble] (CHU), Department of Otorhinolaryngology, Head and Neck Surgery [Mannheim, Germany], University Hospital Mannheim, Laboratoire de physique et chimie des nano-objets (LPCNO), Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT)-Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT)-Institut de Chimie de Toulouse (ICT), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), CHU Grenoble, Children’s Hospital Srebrnjak [Zagreb, Croatia], Department of Physics [UMIST Manchester], University of Manchester Institute of Science and Technology (UMIST), Laboratori Nazionali del Sud (LNS), Getafe University Hospital, Madrid, Karl-Franzens-Universität Graz, Ecologie comportementale (EC), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Rennes (UR)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS), Allergy Asthma and Immunology [Haifa, Israel], Ha'Emek Medical Center, Afula-Rappaport Faculty of Medicine, University of Edinburgh, Medical University of Warsaw - Poland, Department of Allergy and Clinical Immunology [Caracas, Venezuela], Centro Médico Docente La Trinidad, Department of Computer Science [Haifa], University of Haifa [Haifa], Allergy and Respiratory Research Group, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), National Centre of Cardiology and Internal Medicine, Ministry of Health Kyrgyz Republic, Réseau National de Surveillance Aérobiologique (RNSA), Berkeley Seismological Laboratory, Division of Clinical Immunology and Allergy, University of Naples Federico II = Università degli studi di Napoli Federico II, CIRCE, Ctr Res Energy Resources & Consumpt, Zaragoza 50018, Spain, Vilnius University Clinic of Children's Diseases, Suomen Terveystalo Allergy Clinic, Health Service and Performance Research (HESPER), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre d'EPistémologie et d'ERgologie Comparatives (CEPERC), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institute for Climate and Atmospheric Science [Leeds] (ICAS), School of Earth and Environment [Leeds] (SEE), University of Leeds-University of Leeds, Nova Southeastern University (NSU), Department of Otolaryngology, National University of Singapore (NUS)-Yong Loo Lin School of Medicine, Sachs' Children's Hospital, IAES, Department of Pulmonology, Manisa Celal Bayar University, Center for Evolutionary and Theoretical Immunology [Albuquerque, New Mexico] (CETI), The University of New Mexico [Albuquerque], National Key State Laboratory for ThermoStructural Composites (TSCM), Northwestern Polytechnical University [Xi'an] (NPU), Respiratory and Allergic Diseases, University Clinic of Respiratory and Allergic Diseases Golnik, University Hospital of Cologne [Cologne], Supported by the European Innovation Partnership on Active and Healthy Ageing and POLLAR (EIT Health, European Union)., European Project: 643803,H2020,H2020-HCO-2014,PROEIPAHA(2015), UCL - (MGD) Service de pneumologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospital Quiròn Bizkaia Erandio, Université Pierre et Marie Curie - Paris 6 (UPMC), University of Milan, University of Naples Federico II-CNR, Rome, Italy and Department of Medicine, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Università degli Studi di Salerno (UNISA), Institut de Physique du Globe de Paris (IPGP), Centre National de la Recherche Scientifique (CNRS)-Université de La Réunion (UR)-Université Paris Diderot - Paris 7 (UPD7)-IPG PARIS-Institut national des sciences de l'Univers (INSU - CNRS), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]-Epidemiology and Health Economics, Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Muséum national d'Histoire naturelle (MNHN), University of California-University of California, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Astrophysique Interprétation Modélisation (AIM (UMR_7158 / UMR_E_9005 / UM_112)), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospital CUF-Descobertas, Universität zu Köln, Medical Faculty in Pilsen-Charles University in Prague - the First Faculty of Medicine, Harvard University [Cambridge], University of Genoa (UNIGE), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut de Chimie de Toulouse (ICT-FR 2599), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), University of Graz, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université Claude Bernard Lyon 1 (UCBL), Centro Medico-Docente La Trinidad, Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Università degli studi di Napoli Federico II, Center for Evolutionary and theoretical Immunology, Biology, National Institute for Health Research, CNR, Rome, Italy and Department of Medicine-University of Naples Federico II, Institut national des sciences de l'Univers (INSU - CNRS)-IPG PARIS-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Karl-Franzens-Universität [Graz, Autriche], Department of Dermatology, Allergology and Venereology, Clinicum, University of Helsinki, Children's Hospital, Faculty of Law, HUS Children and Adolescents, HUS Inflammation Center, University Hospitals Leuven [Leuven], Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, University of Zürich [Zürich] (UZH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), University of South Florida (USF), Università degli Studi di Firenze = University of Florence [Firenze], Laboratoire Magmas et Volcans (LMV), Observatoire de Physique du Globe de Clermont-Ferrand (OPGC), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), Universidade do Porto [Porto], Charité - Universitätsmedizin Berlin / Charite - University Medicine Berlin -Epidemiology and Health Economics, Université Pierre et Marie Curie - Paris 6 (UPMC)-Muséum national d'Histoire naturelle (MNHN)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre de Biologie pour la Gestion des Populations (UMR CBGP), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Université de Montpellier (UM)-Institut de Recherche pour le Développement (IRD [France-Sud])-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Sondra, CentraleSupélec, Université Paris-Saclay (COmUE) (SONDRA), ONERA-CentraleSupélec-Université Paris Saclay (COmUE), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Toulouse III - Paul Sabatier (UT3), RNSA, Centre d'EPistémologie et d'ERgologie Comparatives - UMR 7304 (CEPERC), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Ear, Nose and Throat, AII - Inflammatory diseases, Pulmonology, Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), National Institute for Nuclear Physics (INFN), Université Laval, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Università degli Studi di Firenze [Firenze], University of Salerno (UNISA), Centre National de la Recherche Scientifique (CNRS)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Observatoire de Physique du Globe de Clermont-Ferrand (OPGC), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Sondra, CentraleSupélec, Université Paris-Saclay (SONDRA), ONERA-CentraleSupélec-Université Paris-Saclay, Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), École normale supérieure - Paris (ENS Paris)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Rennes 1 (UR1), Universidade do Minho, İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, uBibliorum, and Internal Medicine

Subjects
Allergy, Medicina Básica [Ciências Médicas], asthma -- guideline, Allergic asthma, DECISION-MAKING, Allergic Rhinitis and Its Impact on Asthma, GUIDELINES, Medical and Health Sciences, Medical Records, 0302 clinical medicine, Health care, Immunology and Allergy, 030212 general & internal medicine, asthma, Change management, rhinitis, Immunology, MASK-RHINITIS, ComputingMilieux_MISCELLANEOUS, Rinitis, mobilne aplikacije, upravljanje sprememb, Medical record, GLOBAL STRATEGY, WORK PRODUCTIVITY, Telemedicine, mobile applications, 3. Good health, Asma alérgica, rhiniti, 1107 Immunology, Ciências Médicas::Medicina Básica, klinične poti, allergic -- guideline, Life Sciences & Biomedicine, Human, PATIENT PARTICIPATION, Allergic Rhinitis, medicine.medical_specialty, animal structures, multimorbidity, EUROPEAN INNOVATION PARTNERSHIP, Change Management, [object Object], Settore MED/10 - Malattie Dell'Apparato Respiratorio, Asthma/diagnosis, CHRONIC DISEASES, MACVIA-ARIA, 03 medical and health sciences, medicine, multimorbidnost, QUALITY, Humans, critical pathways, astma -- smernica, Patient participation, Asma, udc:616.2, Asthma, Science & Technology, ARIA, business.industry, Multimorbidity, Rhinitis, Allergic, Settore MED/09 - MEDICINA INTERNA, change management, Mobile Airways Sentinel Network (MASK) Study Group, Guideline, ta3121, medicine.disease, Rinite alérgica, Rhinitis, Allergic/diagnosis, Integrated care, alergijski rinitis -- smernica, Allergic Rhinitis and Its Impact on Asthma, asthma, Change management, rhinitis, Immunology and Allergy, Immunology, 030228 respiratory system, Family medicine, 3121 General medicine, internal medicine and other clinical medicine, Medical Record, Clinical Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Impact on Asthma
Abstract

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional., EAACI -European Academy of Allergy and Clinical Immunology(undefined), info:eu-repo/semantics/acceptedVersion

Published
2018

72. Understanding patient adherence to inhaled medication: The social representations of COPD

Author

António Manuel Silva Duarte De Araújo, Venceslau Hespanhol, Pedro Teixeira, M.M. Figueiredo, Jaime Correia-de-Sousa, and Universidade do Minho

Subjects
Male, medicine.medical_specialty, MEDLINE, Pulmonary disease, Medication Adherence, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Administration, Inhalation, Materials Chemistry, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Psychiatry, Aged, Ciências Médicas::Medicina Clínica, lcsh:RC705-779, COPD, Science & Technology, Inhalation, business.industry, lcsh:Diseases of the respiratory system, medicine.disease, Sociological Factors, 3. Good health, Bronchodilator Agents, 030228 respiratory system, Sociological Factor, Female, business, Attitude to Health
Abstract

(undefined), info:eu-repo/semantics/publishedVersion

Published
2017

73. Organizational challenges in strengthening Primary Health Care in Portugal

Author

Adriano Maia dos Santos, Ligia Giovanella, Jaime Correia de Sousa, and Henrique Botelho

Subjects
Controle de Acesso, Primary health care, Context (language use), Estratégia Saúde da Família, Health Services Accessibility, lcsh:Education (General), Health centre, Nursing, Environmental protection, Family Health Strategy, Medicine, Family health, Medicina de Família e Comunidade, Gatekeeping, lcsh:R5-920, Primary Health Care, Health professionals, Acesso aos Serviços de Saúde, business.industry, Continuidade da Assistência ao Paciente, General Medicine, Continuity of Patient Care, Atenção Primária à Saúde, Integração de Sistemas, Educação Médica, Systems Integration, Intervention (law), Medical Education, Family Practice, lcsh:L7-991, lcsh:Medicine (General), business
Abstract

RESUMO Este artigo analisa os principais aspectos da Reforma da Atenção Primária à Saúde (APS) em Portugal, que culminaram na implantação das Unidades de Saúde Familiar (USF), ampliação do acesso e melhoria no processo de coordenação dos cuidados. Identifica avanços e limites da reforma na APS portuguesa, que, apesar do contexto social e histórico distinto, podem subsidiar as políticas de saúde no Brasil. Realizou-se um estudo de caso com abordagem qualitativa, em Portugal, elegendo-se quatro USF na Região Norte, uma USF na Região de Lisboa/Vale do Tejo e dois Agrupamentos de Centros de Saúde (Aces) na Região Norte. Foram realizadas 20 entrevistas semiestruturadas, com observação sistemática e análise documental. O sucesso da reforma destaca-se na dimensão micropolítica, ou seja, na criação das USF como processo voluntário de adesão dos profissionais de saúde, o que permite certa estabilidade mesmo em tempos de crise. A Reforma da APS em Portugal é considerada um “evento extraordinário”, um exemplo bem-sucedido de intervenção nas reformas organizacionais na Europa em favor da coordenação dos cuidados por médicos generalistas. ABSTRACT This article examines key aspects of Portugal’s primary health care (PHC) reform, which culminated in the introduction of family health clinics (Unidades de Saúde Familiar, USF), expanded access and improved care coordination processes. It aims to identify advances and constraints on PHC reform in Portugal which, despite the differences in social and historical context, may serve to inform health policies in Brazil. A qualitative case study was conducted in Portugal at four USFs in the Lisbon/Vale do Tejo region and two health centre clusters (Agrupamentos de Centros de Saúde, ACES) in the North region. The data collection techniques comprised twenty semi-structured interviews, systematic observation and documentary analysis. The reform was particularly successful at the micro-policy level, that is, in introducing USFs as a process which health professionals could join voluntarily, which afforded a certain stability even in times of crisis. Portugal’s PHC reform is considered an “extraordinary event”, an example of successful intervention in organisational reforms in Europe to promote coordinated care by general practitioners.

Published
2015

74. Misuse of inhalers devices in clinical practice

Author

Pedro Teixeira, M.M. Figueiredo, Venceslau Hespanhol, Jaime Correia-de-Sousa, and António Manuel Silva Duarte De Araújo

Subjects
Clinical Practice, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, 030228 respiratory system, business.industry, Medicine, 030212 general & internal medicine, business, Intensive care medicine, 3. Good health
Published
2017

75. The modified patient enablement instrument: a Portuguese cross-cultural adaptation, validity and reliability study

Author

Mafalda Remelhe, Jaime Correia de Sousa, Irene Lopes, Luís Silva, Pedro Teixeira, and Universidade do Minho

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, Psychometrics, Validity, Article, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Cronbach's alpha, Surveys and Questionnaires, Content validity, Medicine, Humans, Translations, 030212 general & internal medicine, Reliability (statistics), Aged, Aged, 80 and over, Science & Technology, Portugal, business.industry, Self-Management, Public Health, Environmental and Occupational Health, Construct validity, Reproducibility of Results, Middle Aged, Culturally Competent Care, language.human_language, Exploratory factor analysis, Asthma, United Kingdom, Test (assessment), 030228 respiratory system, language, Female, Portuguese, business, Factor Analysis, Statistical, Clinical psychology
Abstract

"Article number: 16087", Enabling patients with asthma to obtain the knowledge, confidence and skills they need in order to assume a major role in the management of their disease is cost effective. It should be an integral part of any plan for long-term control of asthma. The modified Patient Enablement Instrument (mPEI) is an easily administered questionnaire that was adapted in the United Kingdom to measure patient enablement in asthma, but its applicability in Portugal is not known. Validity and reliability of questionnaires should be tested before use in settings different from those of the original version. The purpose of this study was to test the applicability of the mPEI to Portuguese asthma patients after translation and cross-cultural adaptation, and to verify the structural validity, internal consistency and reproducibility of the instrument. The mPEI was translated to Portuguese and back translated to English. Its content validity was assessed by a debriefing interview with 10 asthma patients. The translated instrument was then administered to a random sample of 142 patients with persistent asthma. Structural validity and internal consistency were assessed. For reproducibility analysis, 86 patients completed the instrument again 7 days later. Item-scale correlations and exploratory factor analysis were used to assess structural validity. Cronbach's alpha was used to test internal consistency, and the intra-class correlation coefficient was used for the analysis of reproducibility. All items of the Portuguese version of the mPEI were found to be equivalent to the original English version. There were strong item-scale correlations that confirmed construct validity, with a one component structure and good internal consistency (Cronbach's alpha >0.8) as well as high test-retest reliability (ICC=0.85). The mPEI showed sound psychometric properties for the evaluation of enablement in patients with asthma making it a reliable instrument for use in research and clinical practice in Portugal. Further studies are needed to confirm its responsiveness., Financial support for this work was provided by FEDER funds through the Operational Programme Competitiveness Factors-COMPETE and National Funds through FCT-Foundation for Science and Technology under the project POCI-01-0145-FEDER-007038, and by the project NORTE-01-0145-FEDER-000013, supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF)., info:eu-repo/semantics/publishedVersion

Published
2017

76. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision

Author

G. Walter Canonica, Peter Schmid-Grendelmeier, Sergio Kowalski, Behnam Sadeghirad, Joaquim Mullol, Antonella Muraro, Juan José Yepes-Nuñez, Peter J. Manning, Ruby Pawankar, Itziar Etxeandia-Ikobaltzeta, Torsten Zuberbier, Yuan Zhang, Gianni Passalacqua, Sinthia Bosnic-Anticevich, Holger J. Schünemann, Peter Hellings, Ivan D. Florez, Désirée Larenas-Linnemann, David Price, Wojtek Wiercioch, Jean Bousquet, Antonio Valero, Ioana Agache, Matthew Ventresca, Arunas Valiulis, Dermot Ryan, Ken Ohta, Romina Brignardello-Petersen, Karin C. Lødrup Carlsen, Erkka Valovirta, Claus Bachert, Ludger Klimek, Petr Panzner, Aziz Sheikh, Thomas B. Casale, Piotr Kuna, Alkis Togias, Pascal Demoly, Jan Brozek, Nikolaos G. Papadopoulos, John J. Riva, Wytske Fokkens, Dana Wallace, Niels H. Chavannes, Susan Waserman, Eli O. Meltzer, Hae-Sim Park, Mark S. Dykewicz, Arnav Agarwal, Bolesław Samoliński, Luo Zhang, Robyn E O'Hehir, Yetiani Roldan, Jaime Correia de Sousa, João Fonseca, Mihaela Zidarn, Carlos A. Cuello-Garcia, Alvaro A. Cruz, Magnus Wickman, Kaja-Triin Laisaar, AII - Inflammatory diseases, Ear, Nose and Throat, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Department of Allergy and Clinical Immunology, Transylvania University of Brasov, Ghent University Hospital, Woolcock Institute of Medical Research [Sydney], The University of Sydney, Allergy & Respiratory Diseases Clinic - DIMI, University of Genoa (UNIGE), University of South Florida [Tampa] (USF), Department of Public Health and Primary Care [leiden], Leiden University Medical Center (LUMC), ProAR – Nucleo de Excelencia em Asma, Universidade Federal da Bahia (UFBA), Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto, Laboratory of clinical immunology, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), German Society for Otorhinolaryngology HNS, Medical University of Łódź (MUL), Department of Paediatrics [Oslo], Oslo University Hospital [Oslo], Allergy & Asthma Medical Group & Research Center, University of California [San Diego] (UC San Diego), University of California-University of California, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Universita degli Studi di Padova, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital-Monash University Building, AMREP, Department of Allergology and Clinical Immunology, Medical Faculty in Pilsen-Charles University in Prague - the First Faculty of Medicine, Allergy & Respiratory Diseases, University of Genoa (UNIGE)-Department of Internal Medicine (DIMI), Department of Pediatrics, Nippon Medical School, Allergy and Respiratory Research Group, University of Edinburgh, Medical University of Warsaw - Poland, Allergy Unit - Department of Dermatology, Universität Zürich [Zürich] = University of Zurich (UZH), National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH), National Institutes of Health [Bethesda] (NIH), Vilnius University Clinic of Children's Diseases, Department of Lung Diseases & Clinical Allergology, University of Turku, Sachs' Children's Hospital, National Institute of Environmental Medicine, Karolinska Institutet [Stockholm], National Key State Laboratory for ThermoStructural Composites (TSCM), Northwestern Polytechnical University [Xi'an] (NPU), Respiratory and Allergic Diseases, University Clinic of Respiratory and Allergic Diseases Golnik, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Departments of Clinical Epidemiology and Biostatistics and Medicine [Ontario], McMaster University [Hamilton, Ontario], and Universidade do Minho

Subjects
medicine.medical_specialty, Practice guideline, [SDV]Life Sciences [q-bio], Population, Immunology, Clinical Decision-Making, Medicina Clínica [Ciências Médicas], Allergic rhinitis, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Allergic, Health care, Anti-Allergic Agents, medicine, Journal Article, Immunology and Allergy, Humans, Animals, 030212 general & internal medicine, Intensive care medicine, Grading (education), education, Child, Ciências Médicas::Medicina Clínica, Asthma, Rhinitis, education.field_of_study, Science & Technology, business.industry, practice guideline, Guideline, ta3121, medicine.disease, Rhinitis, Allergic, 3. Good health, Work performance, Evidence-Based Practice, Histamine H1 Antagonists, Quality of Life, Systematic review, 030228 respiratory system, business
Abstract

Article in press, Background: Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and school and work performance and is a frequent reason for office visits in general practice. Medical costs are large, but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in 2010, prompting its update. Objective: We sought to provide a targeted update of the ARIA guidelines. Methods: The ARIA guideline panel identified new clinical questions and selected questions requiring an update. We performed systematic reviews of health effects and the evidence about patients' values and preferences and resource requirements (up to June 2016). We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence-to-decision frameworks to develop recommendations. Results: The 2016 revision of the ARIA guidelines provides both updated and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H-1-antihistamines, intranasal H-1-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the rationale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient. Conclusions: Appropriate treatment of AR might improve patients' quality of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment., J. L. Brozek has received support for the development of systematic reviews in these guidelines from the ARIA Initiative. J. Bousquet has received personal fees from Almirall, Meda, Merck, MSD, Novartis, Sanofi-Aventis, Takeda, Teva, Uriach, Chiesi, GlaxoSmithKline, and Menarini. S. Bosnic-Anticevich is on the advisory board for TEVA; has consultant arrangements with MEDA and GlaxoSmithKline; has received grants from TEVA; has received payment for lectures from TEVA, GlaxoSmithKline, and AstraZeneca; has received payment for manuscript preparation from MEDA; and has received payment for development of educational presentations from GlaxoSmithKline. T. Casale is the executive vice president of the American Academy of Allergy, Asthma & Immunology. J. Correia de Sousa has board memberships with Boehringer Ingelheim and Novartis, has received payment for lectures from Boehringer Ingelheim, and has received payment for development of educational presentations from Boehringer Ingelheim. A. A. Cruz has board memberships with Novartis, Boehringer Ingelheim, AstraZeneca, MEDA Pharma, and GlaxoSmithKline; has consultant arrangements with Boehringer Ingelheim; has provided expert testimony for Boehringer Ingelheim; has received grants from GlaxoSmithKline; and has received payment for lectures from Eurofarma, Chiesi, MEDA Pharma, and Hypermarcas-Ache. C.A. Cuello-Garcia has consultant arrangements with and has received payment for manuscript preparation and travel support from the World Allergy Organization. P. Demoly has received consulting fees from ALK-Abello, Stallergenes Greer, Thermo Fisher Scientific, MEDA, Chiesi, and Ysslab and has received grants from AstraZeneca. M. Dykewicz has consultant arrangements with Alcon and Merck and is the Workgroup Char for the Rhinitis Practice Parameter Update of the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma & Immunology ACAAI Joint Task Force on Practice Parameters. I. Etxeandia-Ikobaltzeta has received a consulting fee or honorarium from, info:eu-repo/semantics/publishedVersion

Published
2017

77. Fatores determinantes da qualidade de vida numa população de doentes com doença pulmonar obstrutiva crónica

Author

Marlene Barros, Jaime Correia de Sousa, Flávio Manuel Gomes Guimarães, and Universidade do Minho

Subjects
Quality of life, Spirometry, medicine.medical_specialty, Chronic bronchitis, Chronic Obstructive Pulmonary Disease, Population, Hospital Anxiety and Depression Scale, Qualidade de vida, medicine, education, General Environmental Science, 2. Zero hunger, COPD, education.field_of_study, medicine.diagnostic_test, business.industry, Chronic obstructive pulmonary disease, Doença pulmonar obstrutiva crónica, medicine.disease, respiratory tract diseases, 3. Good health, Quality of Life, Physical therapy, General Earth and Planetary Sciences, Marital status, Anxiety, Doença Pulmonar Obstrutiva Crónica, medicine.symptom, business, Qualidade de Vida, Demography
Abstract

Objetivos: Analisar a relação entre a Qualidade de Vida (QdV) e os seguintes fatores: género, idade, índice de massa corporal, estado civil,situação profissional, volume expiratório forçado no 1. o segundo, ansiedade, depressão e dispneia numa população de indivíduos com Doença Pulmonar Obstrutiva Crónica (DPOC). Tipo de estudo: Observacional, analítico transversal. Local: Unidade de Saúde Familiar (USF) Manuel Rocha Peixoto e USF Gualtar, Braga, Portugal. População: Doentes com idade igual ou superior a 40 anos, diagnosticados com DPOC ou bronquite crónica, inscritos nas USF Gualtar e Manuel Rocha Peixoto. Métodos: Os dados sociodemográficos foram recolhidos através de um formulário, composto também pelas versões portuguesas do Hospital Anxiety and Depression Scale, Medical Research Council Dyspnea Questionnaire e COPD Specific Saint George’s Respiratory Questionnaire (SGRQ-C). O diagnóstico de DPOC foi confirmado através da realização de espirometria, determinando-se o volume expiratório forçado no 1. o segundo. Foi realizada uma análise bivariada entre as variáveis em estudo e a QdV. Posteriormente submeteram-se as variáveis estatisticamente significativas à regressão linear múltipla. Resultados: Sessenta e cinco doentes foram incluídos no estudo. Na análise bivariada, a depressão, ansiedade e dispneia relacionaram-se com todos os domínios do SGRQ-C. O género e a situação profissional também mostraram uma relação significativa nos domínios Atividade, Impacto e no valor total do SGRQ-C. Posteriormente, na análise com a regressão linear múltipla, o género e a ansiedade perderam a sua influência, revelando-se, como principais determinantes, a dispneia no domínio Sintomas e, no domínio Impacto, situação profissional e dispneia no domínio Atividade e, no valor Total do SGRQ-C, a situação profissional, depressão e dispneia. Conclusões: A situação profissional, a depressão e a dispneia deverão ser consideradas nas estratégias para melhorar a QdV nesta população de doentes com DPOC., Objectives: To test the association between quality of life (QoL) and gender, age, body mass index, marital status, employment status, forced expiratory volume in 1 second, anxiety, depression and dyspnoea in patients with chronic obstructive pulmonary disease (COPD). Type of study: Observational, cross-sectional study. Location: Manuel Rocha Peixoto Family Health Unit and Gualtar Family Health Unit, Braga, Portugal. Population: Patients over 40 years of age, diagnosed with COPD or chronic bronchitis, registered in the Gualtar and Manuel Rocha Peixoto Family Health Units. Methods: Demographic data were collected and the Portuguese versions of the HospitalAnxiety and Depression Scale,the Medical Research Council Dyspnoea Questionnaire and the COPD-specific Saint George’s Respiratory Questionnaire (SGRQ-C) were administered. The diagnosis of COPD was confirmed by spirometry, determining the forced expiratory volume in 1 second. A bivariate analysis of the study variables and QoL was performed. Statistically significant associations were tested by multiple linear regression. Results: Sixty-five patients were included in the study. In the bivariate analysis, depression, anxiety and dyspnoea were related to all domains of the SGRQ-C. Gender and employment status also showed a significant bivariate correlation with “Activity”, “Impact of disease” and the total SGRQ-C score. In the multiple linear regression analysis, gender and anxiety were not found to be significant predictors of outcomes. In the regression analysis, depression was a significant predictor for“Symptoms” and “Impact”, employment status and dyspnoea were significant predictors for“Activity” and employment status, depression and dyspnoea were significant predictors for the SGRQ-C score. Conclusion: Employment status, depression and dyspnoea should be considered in intervention strategies to improve QoL in patients with COPD.

Published
2014

78. Rastreio do câncer do colo do útero: limites etários, periodicidade e exame ideal: revisão da evidência recente e comparação com o indicador de desempenho avaliado em Portugal

Author

Bárbara Castro, Joana Oliveira, Miguel Basto Pereira, John Yaphe, Jaime Correia de Sousa, Daniela Pinheiro Ribeiro, and Universidade do Minho

Subjects
Periodicity, medicine.medical_specialty, Uterine cervical neoplasms, Ciências da Saúde [Ciências Médicas], Ciências Médicas::Ciências da Saúde, MEDLINE, Neoplasias do colo do útero, 03 medical and health sciences, 0302 clinical medicine, Conventional cytology, Periodicidade, medicine, Screening method, 030212 general & internal medicine, 10. No inequality, Gynecology, Cervical cancer, Science & Technology, business.industry, lcsh:Public aspects of medicine, Health Policy, Grupos etários, Public Health, Environmental and Occupational Health, Age brackets, lcsh:RA1-1270, Retrospective cohort study, Esfregaço vaginal, medicine.disease, language.human_language, 3. Good health, Surgery, Clinical trial, Rastreio, Systematic review, 030220 oncology & carcinogenesis, Screening, language, Vaginal smears, Portuguese, business
Abstract

Esta revisão teve por objetivo avaliar a força de evidência do indicador de desempenho português relativo ao rastreio do Câncer do Colo do Útero (CCU): (1) limites etários das mulheres da população geral que o devem realizar, a (2) periodicidade com que deve ser realizado e (3) qual o melhor exame de rastreio. Foram pesquisados os seguintes termos MeSH: vaginal smears, age groups, periodicity, methods, uterine cervical cancer. Foram excluídos os artigos que não abordavam o objetivo da investigação ou que não fossem redigidos em Inglês, Português ou Espanhol. Para interpretar os artigos selecionados foi utilizada a classificação SORT. Foram encontrados 197 artigos, dos quais seleccionados 9: 1 revisão sistemática (RS), 1 estudo clínico controlado aleatorizado, 2 estudos observacionais retrospectivos e 5 normas de orientação clínica (NOC). Os autores optaram por incluir nesta revisão mais 4 NOCs e 2 RSs por considerarem ser relevantes para a população Portuguesa, apesar de não resultarem da pesquisa efectuada. Os estudos sugerem realização do rastreio entre os 21 e 25 até aos 65 anos, com uma periodicidade trienal usando a citologia convencional. Existe ainda controvérsia no que toca aos 3 objetivos deste artigo (limites etários, frequência e método)., The scope of this review was to assess the strength of evidence of Portuguese performance indicators on Cervical Cancer screening: (1) age group of the women that should be screened for cervical cancer; (2) frequency of screening; and (3) the best method for screening. The following MeSH terms were searched: vaginal smears, age groups, periodicity, methods, uterine cervical cancer. Articles not reflecting the study objectives or not available in English, Portuguese or Spanish were excluded. The SORT classification was used to rate the articles selected.Of the 197 articles found, 9 that met all study criteria were selected for inclusion in this review. These included 1 systematic review, 1 randomized controlled clinical trial, 2 retrospective studies and 5 clinical guidelines. The authors also chose to include 4 clinical guidelines and two systematic reviews relevant to the Portuguese population even though they did not appear in the initial search of the literature. The studies suggest screening women between the ages of 21 to 25 years and 65 years of age, once every three years using conventional cytology. There is still controversy regarding the three objectives of this study (target age bracket, screening frequency and screening method).

Published
2014

79. Symptoms irregularity and increased risk of COPD acute exacerbations

Author

Jaime Correia-de-Sousa, Venceslau Hespanhol, Pedro Teixeira, and A. Duarte-de-Araújo

Subjects
Male, Pulmonary and Respiratory Medicine, COPD, medicine.medical_specialty, business.industry, medicine.disease, Risk Assessment, Pulmonary Disease, Chronic Obstructive, Cross-Sectional Studies, Increased risk, Internal medicine, Disease Progression, Humans, Medicine, Female, Symptom Assessment, business, Aged
Published
2018

80. Inhaler technique education in elderly patients with asthma or COPD: impact on disease exacerbations—a protocol for a single-blinded randomised controlled trial

Author

Jaime Correia-de-Sousa, Luís Taborda-Barata, Tiago Maricoto, and Universidade do Minho

Subjects
Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Medicina Básica [Ciências Médicas], Population, Subgroup analysis, Medication Adherence, Single-Case Studies as Topic, chronic obstructive pulmonary disease, law.invention, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Patient Education as Topic, Randomized controlled trial, law, Administration, Inhalation, Protocol, medicine, Humans, Multicenter Studies as Topic, Data monitoring committee, Respiratory function, 030212 general & internal medicine, education, Respiratory Medicine, Randomized Controlled Trials as Topic, Asthma, education.field_of_study, Science & Technology, business.industry, Nebulizers and Vaporizers, Inhaler, General Medicine, medicine.disease, Interim analysis, Bronchodilator Agents, 3. Good health, 030228 respiratory system, Ciências Médicas::Medicina Básica, Disease Progression, Quality of Life, Physical therapy, business
Abstract

Chronic Obstructive Pulmonary Disease (COPD)and asthma affect more than 10% of the population. Most patients use their inhaler incorrectly, mainly the elderly, thereby becoming more susceptible to poor clinical control and exacerbations. Placebo device training is regarded as one of the best teaching methods, but there is scarce evidence to support it as the most effective one to improve major clinical outcomes. Our objective is to perform a single-blinded RCT to assess the impact of this education tool in these patients. Introduction Chronic Obstructive Pulmonary Disease (COPD)and asthma affect more than 10% of the population. Most patients use their inhaler incorrectly, mainly the elderly, thereby becoming more susceptible to poor clinical control and exacerbations. Placebo device training is regarded as one of the best teaching methods, but there is scarce evidence to support it as the most effective one to improve major clinical outcomes. Our objective is to perform a single-blinded RCT to assess the impact of this education tool in these patients. Methods and analysis A multicentre single-blinded Randomised Controlled Trial (RCT) will be set up, comparing an inhaler education programme with a teach-to-goal placebo-device training versus usual care, with a 1-year follow-up, in patients above 65 years of age with asthma or COPD. Intervention will be provided at baseline, and after 3 and 6 months, with interim analysis at an intermediate time point. Exacerbation rates were set as primary outcomes, and quality of life, adherence rates, clinical control and respiratory function were chosen as secondary outcomes. A sample size of 146 participants (73 in each arm) was estimated as adequate to detect a 50% reduction in event rates. Two-sample proportions χ² test will be used to study primary outcome and subgroup analysis will be carried out according to major baseline characteristics, Faculty of Health Sciences at the University of Beira Interior and Life and Health Sciences Research Institute (ICVS)/3B’s at University of Minho in Portugal. This work was prepared with scientific support from Harvard Medical School, in accordance with the Portuguese Clinical Scholarship Research Training Program.

Published
2019

81. Asthma control, quality of life, and the role of patient enablement: a cross-sectional observational study

Author

Ana Margarida Cruz, Ana Quelhas, Filipa Almada-Lobo, Pedro Oliveira, Joana Melo Cabrita, John Yaphe, Jaime Correia de Sousa, Alexandra Pina, and Universidade do Minho

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Peak Expiratory Flow Rate, Logistic regression, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Quality of life, immune system diseases, Forced Expiratory Volume, Surveys and Questionnaires, Observational study, Asthma control, Humans, Medicine, Anti-Asthmatic Agents, 030212 general & internal medicine, Asthma, Science & Technology, Primary Health Care, Receiver operating characteristic, business.industry, Public Health, Environmental and Occupational Health, Middle Aged, Primary care, medicine.disease, Management, respiratory tract diseases, 3. Good health, Cross-Sectional Studies, Logistic Models, Treatment Outcome, ROC Curve, 030228 respiratory system, Asthma Control Questionnaire, Concomitant, Quality of Life, Physical therapy, Female, Power, Psychological, business, Research Paper
Abstract

BACKGROUND: Self-assessment of asthma and a stronger doctor-patient relationship can improve asthma outcomes. Evidence for the influence of patient enablement on quality of life and the control of asthma is lacking. AIMS: To assess asthma severity, medication use, asthma control, and patient enablement in patients with asthma treated in primary care and to study the relationship between these variables and quality of life. METHODS: A cross-sectional study was conducted in an urban clinic in northern Portugal. Data were collected from both clinical records and questionnaires from a random sample of asthma patients. The modified Patient Enablement Instrument, the Asthma Quality of Life Questionnaire, and the Asthma Control Questionnaire were used. Peak expiratory flow and forced expiratory volume in one second (FEV1) were measured. Receiver operating characteristic curve analysis was performed to establish cut-off values for the quality of life measurements. The associations between enablement, asthma control, and quality of life were tested using logistic regression models. RESULTS: The study sample included 180 patients. There was a strong correlation between asthma control and quality of life (r=0.81, p, No conflicts of interests are reported for this study. JCS was an unpaid member of the scientific board of AstraZeneca (AZ) Foundation Portugal from June 2009 until August 2011. His department has received research funding from AZ in 2008. He has received sponsorships from or delivered consultancy services to AZ, Nycomed, GSK, MSD, and Novartis. He is a member of the editorial Board of PCRJ.

Published
2013

82. Control of Allergic Rhinitis and Asthma Test (CARAT): dissemination and applications in primary care

Author

Pedro Azevedo, Tiago Jacinto, Miguel Román-Rodrígues, Vanessa Garcia-Larsen, Luís Nogueira-Silva, Jean Bousquet, Ana Margarida Pereira, Ioanna Tsiligianni, Bárbara G Silva, Pascal Demoly, Barbara P. Yawn, Thys van der Molen, Mário Morais-Almeida, João Fonseca, Tari Haahtela, Hakan Yaman, Stefano Del Giacco, António Bugalho-Almeida, Jaime Correia-de-Sousa, Universidade do Minho, and Groningen Research Institute for Asthma and COPD (GRIAC)

Subjects
Discussion Paper, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pediatrics, Rhinitis, Allergic, Perennial, Alternative medicine, Information Dissemination, MEDLINE, Dissemination, Audit, cultural adaptation, dissemination, VALIDATION, Cultural adaptation, 03 medical and health sciences, rhinitis, 0302 clinical medicine, Surveys and Questionnaires, Control, Health care, medicine, Humans, 030212 general & internal medicine, Rhinitis, Asthma, OUTCOMES, Carat, Science & Technology, Primary Health Care, Questionnaire, business.industry, questionnaire, Public Health, Environmental and Occupational Health, asthma, medicine.disease, Rhinitis, Allergic, 3. Good health, RESEARCH NEEDS, 030228 respiratory system, General partnership, Family medicine, PAPER, TRANSLATION, business, control
Abstract

Asthma frequently occurs in association with allergic rhinitis and a combined management approach has been suggested. The Control of Allergic Rhinitis and Asthma Test (CARAT) is the first questionnaire to assess control of both diseases concurrently. However, to have an impact on healthcare it needs to be disseminated and adopted. In this paper we discuss the dissemination of CARAT in different countries and its possible applications in primary care. At present, the adaptation of CARAT for use in different languages and cultures is being led by volunteer researchers and clinicians in 15 countries. Website and smartphone applications have been developed, and a free open model of distribution was adopted to contribute to the dissemination of CARAT. Examples of dissemination activities include distribution of leaflets and posters, educational sessions on the use of the questionnaire in the follow-up of patients, development of clinical studies, collaborations with professional organisations and health authorities, and the inclusion of CARAT in clinical guidelines. The adoption of innovations is an important challenge in healthcare today, and research on the degree of success of dissemination strategies using suitable methods and metrics is much needed. We propose that CARAT can be used in a range of settings and circumstances in primary care for clinical, research and audit purposes, within the overall aim of increasing awareness of the level of disease control and strengthening the partnership between patients and doctors in the management of asthma and rhinitis., No specific funding was received for writing this paper. The CARAT project has received unrestricted grants from Sociedade Portuguese de Alergologia e Imunologia Clinica, Merck Sharp Dohme Portugal and Associacao Portuguese de Asmaticos e Alergicos.

Published
2013

83. The IPCRG's teach the teacher programme: An educational initiative to promote improved management of difficult to manage asthma

Author

Dermot Ryan, Jaime Correia de Sousa, Juliet McDonnell, Siân Williams, Hilary Pinnock, and Universidade do Minho

Subjects
Health professionals, business.industry, 4. Education, Primary care, Special Interest Group, medicine.disease, Research findings, 3. Good health, Resource (project management), Nursing, Medicine, Service user, Early career, business, Asthma
Abstract

The IPCRG is a network of organisations committed to improving primary care assessment and treatment of chronic respiratory disease. We developed an evidence-based resource, SIMPLES (Ryan D, et al. Prim Care Respir J 2013;22:365-73) to aid structured asthma review for difficult to manage asthma. An educational initiative was introduced to disseminate research findings from U-BIOPRED and promote improved primary care management. We aimed to support participants from seven European countries to design and plan local programmes of education:teaching clinical colleagues key messages about difficult to manage asthma, encouraging local adaptation of existing IPCRG resources. These took place in autumn 2015 involving over 230 health professionals - including early career and GPs with a special interest in asthma/COPD, specialist nurses and others. We proposed an evaluation framework(Guskey,T.Teachers&Teaching 2002;8:3, 381-391) which includes - i) participant reaction, ii) learning, iii) organisational changes, iv) use of new knowledge and v) impact on practice and service users. Programmes were well received by participants. There were many challenges encountered: in assessing local learning needs, setting up education programmes and supporting clinical practice change. The impact on participants' clinical practice and service users is more challenging to demonstrate and will require more time to evaluate. We reflect on the challenge of meaningful evaluation of practice change. These insights are important in thinking about the design, implementation and evaluation of clinical educational programmes globally., info:eu-repo/semantics/publishedVersion

Published
2016

84. Routine primary care data—the new crystal ball?

Author

Jaime Correia de Sousa and Universidade do Minho

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pediatrics, business.industry, Future risk, Patient data, Primary care, medicine.disease, Highlights, Asthma control, Blood eosinophils, Medicine, business, Intensive care medicine, Clinical record, Asthma
Abstract

[Excerpt] In their 2014 recommendation update, the Global Initiative for Asthma (GINA) called for a more risk-focused approach to management. If used appropriately primary care records capturing routine data can be used not only to characterize current asthma control and current/prior practice, but also to “predict future risk”. By considering aggregate patient data, it is possible to identify common characteristics associated with future events and to explore combinations of factors that, together, may have a stronger association with specific future risks, such as exacerbations, multiple exacerbations, hospitalisations. Used in this way, clinical records can point to opportunities to modify risk and to intervene to mitigate against future events. [...], (undefined), info:eu-repo/semantics/publishedVersion

Published
2016

85. The respiratory research agenda in primary care in Portugal: a Delphi study

Author

Vera Araújo, Jaime Correia de Sousa, Pedro Teixeira, John Yaphe, and Universidade do Minho

Subjects
medicine.medical_specialty, Biomedical Research, Consensus, Delphi Technique, Ciências da Saúde [Ciências Médicas], Ciências Médicas::Ciências da Saúde, Respiratory Tract Diseases, Delphi method, MEDLINE, Directive Counseling, Disease, Electronic mail, Pulmonary function testing, 03 medical and health sciences, 0302 clinical medicine, Nursing, Humans, Medicine, 030212 general & internal medicine, Medical prescription, Science & Technology, Portugal, Primary Health Care, Respiratory tract infections, Health Priorities, business.industry, Nebulizers and Vaporizers, Smoking, Vaccination, Monitoring and evaluation, Anti-Bacterial Agents, 3. Good health, 030228 respiratory system, Family medicine, Patient Compliance, Family Practice, business, Research Article
Abstract

Background: A research agenda can help to stimulate and guide research. The International Primary Care Respiratory Group (IPCRG) published a Research Needs Statement (RNS) in 2010 in which 145 research questions were identified. In 2012, priorities for respiratory research were established, based on these questions. To date, there has been no statement on primary care respiratory research needs in Portugal. The aim of the study was to develop a national consensus on research priorities in respiratory diseases in primary care in Portugal and to assess the applicability of the priorities for respiratory research set by the IPCRG. Method: We conducted a Delphi study by electronic mail with a panel of experts on respiratory disease from primary and secondary care in Portugal. In the first round, the research needs in respiratory disease in Portugal were identified. In the second round, 196 research questions in six disease areas, derived from the first round and from the IPCRG Respiratory needs statement, were prioritised on a five-point Likert-type scale. In the third round, the questions were prioritized again with feed-back provided on the median scores for each item in the second round. Consensus was considered to have been reached when 80 % of the participants gave a score of 4 or 5 out of five on a given item. Results: The 40 experts identified 121 respiratory research questions in Round 1 and expressed their views on 196 questions in Rounds 2 and 3. Twelve research questions (6 %) reached consensus. There were five questions in the asthma domain on early diagnosis, pulmonary function tests, the use of inhalers, and adherence to treatment. There were four questions in the chronic obstructive pulmonary disease domain on vaccinations, on routine monitoring and evaluation of treatment, on diagnosis, and on adherence to treatments. There was one question in the smoking domain on the effects of brief counselling. There were two questions on respiratory tract infections on the treatment of children and on the prescription of antibiotics. An additional 23 research questions (12 %) achieved consensus between 75 and 79 %. Conclusion: The results reflect the Portuguese reality in response the international agenda for research on respiratory diseases published by the IPCRG. They can support the development of future respiratory disease research in Portugal., Financial support for this work was provided by FEDER funds through the Operational Programme Competitiveness Factors - COMPETE and National Funds through FCT - Foundation for Science and Technology under the project POCI-01-0145-FEDER-007038; and by the project NORTE-01-0145-FEDER-000013, supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). PMT is partially supported by a grant from the International Primary Care Respiratory Group.

Published
2016

86. Twenty-five years of the international Bled course for teachers of family medicine in Europe: glancing back and looking forward

Author

Henry Finnegan, Mateja Bulc, Jaime Correia de Sousa, Igor Švab, Zalika Klemenc-Ketis, John Yaphe, Josephine Buchanan, Marija Petek-Ster, and Universidade do Minho

Subjects
medicine.medical_specialty, Faculty, Medical, 020205 medical informatics, International Cooperation, Context (language use), 02 engineering and technology, Course (navigation), 03 medical and health sciences, 0302 clinical medicine, Physicians, 0202 electrical engineering, electronic engineering, information engineering, medicine, Humans, Family, 030212 general & internal medicine, Staff Development, Curriculum, Science & Technology, Education, Medical, business.industry, 4. Education, Learning environment, Teaching, 3. Good health, Europe, Family medicine, Faculty development, business, Family Practice, Discipline
Abstract

The international Bled course for teacher training has played a central role in faculty development in family medicine for the past 25 years. The course was originally designed to promote faculty development for family medicine teachers in the new academic discipline of family medicine in Slovenia in 1990 and to introduce new topics into the family medicine curriculum. In this background paper, we perform a SCOT analysis (strengths, challenges, opportunities, and threats) of the current course, evaluating participant feedback and reviewing past topics and their impact on local and international teaching programmes. We also review the place of the course in the context of other teacher-training programmes in family medicine in Europe. We found that the structure and learning aims of the Bled course have remained stable over 25 years. It provides a safe, well-structured learning environment for the participants even though the course topic is different every year. The course has had a significant impact on curriculum development and teacher training in Slovenia as well as in many other countries in Europe and beyond. Because of the positive impact of the course and the high degree of satisfaction of the participants and course directors, it seems worthwhile to continue this endeavour. New directions for the course will depend on the learning needs of the participants and the evolving medical curricula in the countries they represent., info:eu-repo/semantics/publishedVersion

Published
2016

87. Operational Definition of Active and Healthy Aging (AHA): The European Innovation Partnership (EIP) on AHA Reference Site Questionnaire: Montpellier October 20-21, 2014, Lisbon July 2, 2015

Author

Karen Ritchie, Daniel Harman, Philippe-Jean Bousquet, Erik Melén, Pierre Senesse, Govert Joan Buijs, Antonio Cano, Claude Jeandel, Timo E. Strandberg, Marieke Van Beurden, Pascal Demoly, G. Moda, Raquel Santiago, Sylvie Arnavielhe, Marie-Eve Joel, Nicola Wilson, Eveline Wouters, Jacques Touchon, Martina O'Neill, Isabelle Momas, Karen Andersen Ranberg, D. Heve, Maddalena Illario, Christina Tischer, Jean Bousquet, Marcel Goldberg, Paola Bertone, Guido Iaccarino, Antoine Avignon, Rodolphe Bourret, Valeria Romano, Laura Calzà, Henriet A. Smit, Mirca Barbolini, David Kula, Jacques-Yves Pelissier, Mario Barbagallo, Bruno Vellas, Ann Scott, C. Robalo-Cordeiro, Gregoire Mercier, Mike Bewick, Bernard Combe, Holger Schulz, Sergio Bonini, P. Viriot-Durandal, Itziar Vergara, M. Nogues, Carol Brayne, João Apóstolo, Jacques Mercier, Vicente Traver-Salcedo, François Puisieux, Julia Coletta, Alessandro Blasimme, Olivier Krys, Niels H. Chavannes, John Farrell, Joël Ankri, Ana Maria Carriazo, Rafaelle Varraso, Marie Zins, Zdenec Gutter, José António Pereira da Silva, Bertrand Fougère, Frédéric Cuisinier, Bolesław Samoliński, Jacques Bringer, Theodore D. Cosco, Jordi Alonso, Ana Todo-Bom, Claudine Berr, Daniel Laune, Esteban De Manuel Keenoy, Judith Garcia-Aymerich, Anna Bedbrook, Anne Hendry, Richard Pengelly, Dagmar Poethig, João O. Malva, Thomas Keil, Sandra N. Slagter, Nick A. Guldemond, Pierre Matignon, Hubert Blain, Leocadio Rodríguez Mañas, Marek L. Kowalski, Susana Fernandez-Nocelo, Alfredo Cesario, Sandra Rebello, Federico Alonso, Catarina R. Oliveira, Dieter Maier, Jean-Pierre Michel, David Somekh, T. Camuzat, Julien Venne, Marc Criton, Jaime Correia de Sousa, Hassan Arshad, Anabella Mota Pinto, Valentina A. Andreeva, François Roubille, Yoav Ben-Shlomo, Asghar Zaidi, Elena Villalba-Mora, Emmanuelle Kesse-Guyot, Dirkje S. Postma, Carel Thijs, Jean-Marie Robine, Danielle Porta, George Crooks, Adrianna Nizinska, Jorge Suanzes, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Bone and Joint Research Group, University of Southampton Medical School, CHU Toulouse [Toulouse], Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Department of Social Medicine, University of Bristol [Bristol], Pathologies du système nerveux : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Electrical Engineering, Mathematics and Computer Science [Delft], Delft University of Technology (TU Delft), Unité de Recherche en Epidémiologie Nutritionnelle (UREN), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), F2ME, PSA Peugeot - Citroën (PSA), PSA Peugeot Citroën (PSA)-PSA Peugeot Citroën (PSA)-Laboratoire Pluridisciplinaire de Recherche en Ingénierie des Systèmes, Mécanique et Energétique (PRISME), Université d'Orléans (UO)-Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges)-Université d'Orléans (UO)-Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges), Department of Epidemiology and Public Health, Imperial College London, CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-École des hautes études en sciences sociales (EHESS), Département Ecologie, Physiologie et Ethologie (DEPE-IPHC), Institut Pluridisciplinaire Hubert Curien (IPHC), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS)-Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS), Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw - Poland, Department of Epidemiology, Maastricht University [Maastricht]-School for Public Health and Primary Care (CAPHRI), Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Kyomed, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Department of Geriatrics - Efficiency and Deficiency Laboratory, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Consiglio Nazionale delle Ricerche (CNR), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Department of Public Health and Primary Care, University of Cambridge [UK] (CAM), Service d'endocrinologie, Departamento de Sistemas Informáticos y Computación [Valencia], Universitat Politècnica de València (UPV), Deputy Scientific Director, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Pisana, Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Laboratoire de chimie biomoléculaire (LCB), Université Montpellier 2 - Sciences et Techniques (UM2)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-MAYOLI SPINDLER SA-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Bioingénierie et NanoSciences (LBN), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Laboratoire de Gérontechnologie [Hôpital La Grave-CHU de Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Gérontopôle, IMIM-Hospital del Mar, Generalitat de Catalunya, Département de Biostatistiques, Agence Régionale de Santé Languedoc Roussillon (ARS), Department of Medicine and Surgery, Università degli Studi di Salerno (UNISA)-RCCS 'Multimedia', Centre de gérontologie clinique, Institute of Social Medicine, Epidemiology and Health Economics-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Institut de Recherche en Infectiologie de Montpellier (IRIM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Institute of Environmental Medicine, Karolinska Institutet [Stockholm]-Karolinska University Hospital [Stockholm]-Astrid Lindgren Children's Hospital, Lab-STICC_TB_CID_TOMS, Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS), Epidémiologie Environnementale : Impact Sanitaire des Pollutions (EA 4064), Université Paris Descartes - Paris 5 (UPD5), Universidad Pública de Navarra [Espagne] = Public University of Navarra (UPNA), Unité de Virologie clinique et fondamentale (UVCF), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Mécanismes adaptatifs : des organismes aux communautés (MAOAC), Muséum national d'Histoire naturelle (MNHN)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Department of Pulmonary Medicine and Tuberculosis, University of Groningen [Groningen], Service de gériatrie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Département de nutrition et d'oncologie digestive, CRLCC Val d'Aurelle - Paul Lamarque, Institute of Epidemiology [Neuherberg] (EPI), German Research Center for Environmental Health - Helmholtz Center München (GmbH), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Bousquet, Jean, Malva, Joao, Nogues, Michel, Mañas, Leocadio Rodriguez, Vellas, Bruno, Farrell, J, Bewick, M, Kowalski, Ml, Strandberg, T, Alonso, J, Ranberg, Ka, Ankri, J, Barbagallo, M, Ben Shlomo, Y, Berr, C, Crooks, G, de Manuel Keenoy, E, Goldberg, M, Guldemond, N, Illario, Maddalena, Joel, Me, Kesse Guyot, E, Michel, Jp, Pengelly, R, Ritchie, K, Robine, Jm, Romano, V, Samolinski, B, Schulz, H, Thijs, C, Touchon, J, Zaidi, A, Apostolo, J, Alonso, F, Andreeva, V, Arnavielhe, S, Arshad, H, Avignon, A, Barbolini, M, Bedbrook, A, Bertone, P, Blain, H, Blasimme, A, Bonini, S, Bourret, R, Bousquet, Pj, Brayne, C, Bringer, J, Buijs, Gj, Calza, L, Camuzat, T, Cano, A, Carriazo, A, Cesario, A, Chavannes, N, Combe, B, Coletta, J, de Sousa, Jc, Cosco, T, Criton, M, Cuisinier, F, Demoly, P, Fernandez Nocelo, S, Fougère, B, Garcia Aymerich, J, Gutter, Z, Harman, D, Hendry, A, Hève, D, Iaccarino, G, Jeandel, C, Keil, T, Krys, O, Kula, D, Laune, D, Maier, D, Matignon, P, Melen, E, Mercier, G, Moda, G, Momas, I, Pinto, Am, Nizinska, A, Oliveira, C, O'Neill, M, Pelissier, Jy, Pereira da Silva, Ja, Poethig, D, Porta, D, Postma, D, Puisieux, F, Rebello, S, Robalo Cordeiro, C, Roubille, F, Santiago, R, Scott, A, Senesse, P, Slagter, S, Smit, Ha, Somekh, D, Suanzes, J, Tischer, C, Todo Bom, A, Traver Salcedo, V, Van Beurden, M, Varraso, R, Venne, J, Vergara, I, Villalba Mora, E, Viriot Durandal, P, Wilson, N, Wouters, E, Zins, M, Mercier, J., Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Cité (USPC)-Université Paris 13 (UP13)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut National de la Recherche Agronomique (INRA), Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges)-Université d'Orléans (UO)-Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges)-Université d'Orléans (UO), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Montpellier, Universidad Politécnica de Valencia, Centre National de la Recherche Scientifique (CNRS)-MAYOLI SPINDLER SA-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Université Montpellier 2 - Sciences et Techniques (UM2), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Gérontopôle-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Toulouse [Toulouse], University of Salerno (UNISA)-RCCS 'Multimedia', Charité - Universitätsmedizin Berlin / Charite - University Medicine Berlin -Epidemiology and Health Economics, Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Universidad Pública de Navarra [Espagne] (UPNA), Unité de Virologie clinique et fondamentale EA 4294, Centre National de la Recherche Scientifique (CNRS)-Collège de France (CdF)-Muséum national d'Histoire naturelle (MNHN), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Bousquet J, Malva J, Nogues M, Mañas LR, Vellas B, Farrell J, MACVIA Research Group [.., L. Calzà, ], Farrell, John, Bonini, Sergio, Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Muséum national d'Histoire naturelle (MNHN)-Collège de France (CdF)-Centre National de la Recherche Scientifique (CNRS), Epidemiologie, RS: CAPHRI School for Public Health and Primary Care, and RS: CAPHRI - R5 - Optimising Patient Care

Subjects
Gerontology, Concept Formation, [SDV]Life Sciences [q-bio], Disability Evaluation, 0302 clinical medicine, SF-12, QUALITY-OF-LIFE, Surveys and Questionnaires, WHODAS 2.0, Medicine, 030212 general & internal medicine, VERSION, POPULATION, PSYCHOLOGICAL DISTRESS, SCALE, General Nursing, Nursing (all)2901 Nursing (miscellaneous), health care economics and organizations, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, education.field_of_study, Operational definition, Medicine (all), Health Policy, PHYSICAL-ACTIVITY QUESTIONNAIRE, PRIMARY-CARE, General Medicine, 3. Good health, Europe, General partnership, Scale (social sciences), Population, SELF-REPORT, VALIDATION, 03 medical and health sciences, Quality of life (healthcare), EQ-5D, Journal Article, Humans, OLDER-ADULTS, education, Geriatric Assessment, Health policy, Aged, business.industry, questionnaire, Active and healthy ageing, United States, Questionnaire, Quality of Life, The Conceptual Framework, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

A core operational definition of active and healthy aging (AHA) is needed to conduct comparisons. A conceptual AHA framework proposed by the European Innovation Partnership on Active and Healthy Ageing Reference Site Network includes several items such as functioning (individual capability and underlying body systems), well-being, activities and participation, and diseases (including non-communicable diseases, frailty, mental and oral health disorders). The instruments proposed to assess the conceptual framework of AHA have common applicability and availability attributes. The approach includes core and optional domains/instruments depending on the needs and the questions. A major common domain is function, as measured by the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). WHODAS 2.0 can be used across all diseases and healthy individuals. It covers many of the AHA dimensions proposed by the Reference Site network. However, WHODAS 2.0 does not include all dimensions proposed for AHA assessment. The second common domain is health-related quality of life (HRQoL). A report of the AHA questionnaire in the form of a spider net has been proposed to facilitate usual comparisons across individuals and groups of interest. (C) 2015 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Published
2015

88. Is COPD Control a Useful Concept? Assessing Treatment Success by Evaluating COPD-Related Health Status

Author

Antonio, Duarte Araújo, Venceslau, Hespanhol, and Jaime, Correia-de-Sousa

Subjects
Health Status, General Medicine, Health Surveys, Risk Assessment, Severity of Illness Index, Asthma, 3. Good health, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, Treatment Outcome, 0302 clinical medicine, 030228 respiratory system, Humans, 030212 general & internal medicine, Precision Medicine
Published
2017

89. ¿Es útil el concepto de control de la EPOC?: evaluación del éxito terapéutico a partir de la valoración del estado de salud en relación con la EPOC

Author

António Manuel Silva Duarte De Araújo, Venceslau Hespanhol, and Jaime Correia-de-Sousa

Subjects
Pulmonary and Respiratory Medicine, COPD, medicine.medical_specialty, business.industry, Control (management), medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Treatment success, 030228 respiratory system, medicine, Physical therapy, 030212 general & internal medicine, Intensive care medicine, business
Published
2017

90. Performance Indicators contracted with Family Health Units: A progress report on the current moment of Primary Health Care Reform in Portugal

Author

Jaime Correia de Sousa and Miguel Melo

Subjects
030503 health policy & services, Reimbursement, 3. Good health, Health Care, 03 medical and health sciences, 0302 clinical medicine, Garantia da Qualidade dos Cuidados de Saúde, Reembolso de Incentivo, Quality Indicators, General Earth and Planetary Sciences, 030212 general & internal medicine, Indicadores de Qualidade em Assistência à Saúde, Quality Assurance, 0305 other medical science, Incentive, General Environmental Science
Abstract

Algum tempo passado sobre a introdução dos Indicadores de Desempenho no processo de contratualização e avaliação de desempenho das USF, importa reflectir sobre a qualidade e seu o impacto na prestação de cuidados na Medicina Geral e Familiar (MGF), com a finalidade de contribuir para a melhoria da qualidade da avaliação de desempenho. Ao restringir a actividade avaliada pelos Indicadores a uma pequena área da prática clínica e ao contratualizar metas com valores muito elevados, pode conduzir ao afunilamento e à focalização da actividade clínica, com eventuais consequências negativas para os utentes. Uma das consequências possíveis é a prática de uma Medicina Baseada em Indicadores em vez de uma Medicina Centrada no Doente. Por outro lado, a fraca evidência científica de alguns Indicadores, a utilidade muito discutível de outros, bem como a dificuldade em medir ganhos em saúde podem originar excessos da Medicina, nomeadamente medicalização, consumismo e iatrogenia. São feitas, neste artigo, algumas sugestões sobre alguns aspectos a melhorar nos Indicadores. Outros aspectos relacionados, tal como o Sistema de Informação e a Contratualização terão de evoluir paralelamente. O Ideal seria que o pagamento por desempenho fosse baseado na medição de Indicadores que representem ganhos em Saúde para as pessoas, respeitando igualmente os princípios e a prática da Medicina Geral e Familiar. Performance indicators have been in use in Portugal for some time now for performance assessment and contractualisation in Family Health Units (USFs). It is important to consider both the quality of the performance indicator and its impact on the delivery of health care in general practice in order to improve performance assessment. When performance indicators assess only a limited area of clinical practice or set very high targets, they may limit the focus of clinical activities with possible negative consequences for patients. One of these consequences may be the replacement of Patient-Centred Medicine with Indicator-Based Medicine. In addition, there is poor scientific evidence for the use of some of the indicators and controversial usefulness of others. The difficulty of measuring some health outcomes can produce medicalisation, consumerism, and iatrogenic disease. In this paper, the authors present some suggestions for improving existing performance indicators. Further developments of related matters, such as the medical information system and contract schemes, are also proposed. Payment for performance should be based on indicators that produce better health outcomes for patients while respecting the principles of family medicine.

Published
2011

91. Mudando a face da medicina de família portuguesa - Uma visão geral da história recente da medicina de família em Portugal

Author

Luís Pisco and Jaime Correia de Sousa

Abstract

Medicina de Familia portugues sempre tentou observar estudo e acompanhar os sucessos de seus colegas no exterior; apesar de seguir um caminho proprio, a influencia cultural de apoio e sistemas onde a medicina de familia ja gozava de grande prestigio e experiencia tem sido fundamental, e sem ele muitos dos as conquistas da medicina da familia Portugues nao teria sido possivel. Este trabalho da um quadro da situacao presente e descreve a importância e posicao realizada pela medicina de familia, os seus pontos fortes e fracos e as oportunidades criadas pelas reformas recentemente propostas.

Published
2007

94. Building capacity to improve respiratory care

Author

Sian Williams, Miguel Román-Rodríguez, Noel Baxter, Hilary Pinnock, Thys van der Molen, Jaime Correia de Sousa, Juliet McDonnell, Universidade do Minho, and Groningen Research Institute for Asthma and COPD (GRIAC)

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Capacity Building, Respiratory Tract Diseases, Context (language use), Primary care, FAMILY MEDICINE, Continuing medical education, WORLD, Global network, Global health, Pulmonary Medicine, medicine, MANAGEMENT, Humans, Respiratory system, Medical education, Science & Technology, Primary Health Care, business.industry, Professional development, Public Health, Environmental and Occupational Health, Capacity building, FACULTY-DEVELOPMENT, 3. Good health, 13. Climate action, Family medicine, Perspective, Emergency medicine, Faculty development, Corrigendum, business, Respiratory care, INTERVENTIONS
Abstract

"Article number: 14072 (2014)", Significant attention has been given to the global burden of noncommunicable diseases including respiratory diseases and the potential of primary care to address this challenge. The International Primary Care Respiratory Group (IPCRG) has a potentially significant role to build capacity through research and education in a complex global network with varying degrees of capability. In this paper we outline a comprehensive strategy, which revisits the IPCRG's educational role, our aims, audiences and approach in this context. The paper was developed through a collaborative process involving experts in global health, primary care and respiratory education, leading to a consensus educational strategy statement. This is further informed by a review of recent trends in continuing medical education. Professional education and training of health-care workers is a core component of the global response to the challenge of managing respiratory conditions in primary care. This paper offers a revised strategy for building capacity and improving clinical practice in IPCRG member countries by revisiting and broadening our aims, exploring the key audiences, focus and approaches.

Published
2014

95. Performance indicators for clinical practice management in primary care in Portugal: consensus from a Delphi study

Author

Francisco Fachado González, John Yaphe, Sara Isabel Félix Furtado, Tito Manuel Vara Fernandes, Miguel Basto-Pereira, Ricardo Silva, Jaime Correia de Sousa, and Universidade do Minho

Subjects
Adult, Male, Consensus, Performance indicators, Delphi Technique, media_common.quotation_subject, Delphi method, Pay for performance, Likert scale, Nursing, Medicine, Humans, Quality (business), Reimbursement, Incentive, media_common, Quality Indicators, Health Care, Science & Technology, Portugal, Primary Health Care, business.industry, Opinion leadership, Middle Aged, language.human_language, 3. Good health, language, Female, Health care reform, Performance indicator, Portuguese, business, Family Practice, Primary healthcare
Abstract

Early Online, Background: Performance indicators assessing the quality of medical care and linked to pay for performance may cause disagreement. Portuguese indicators included in recent health care reform are controversial. Objectives: To obtain consensus from opinion leaders in family medicine regarding the performance indicators for practice management used in the evaluation of Family Health Units in Portugal. Methods: Eighty-nine specialists in primary care were invited to answer the following question in an online Delphi study: 'Which performance indicators should be assessed regarding the organization and management of clinical practice in primary care in Portugal?' A Likert scale was used to evaluate validity, reliability, feasibility and sensitivity to change. Twenty-seven experts participated in the second round and achieved a high degree of consensus. Eight categories were created for analysis. Results: The experts suggested the use of existing indicators as well as new indicators. Thirty-nine indicators suggested by the experts are currently in use in Portugal. The assessment of the number of clinical acts performed, the number of administrative acts, and evaluation of the clinical demographic profile achieved a high degree of consensus. The expert panel suggested fifty new indicators. Five categories of these new indicators had a high degree of consensus, and three categories had a low degree of consensus. Conclusion: The expert panel recommended that performance indicators of practice management should first assess the quantity of clinical and administrative activities undertaken. These indicators must take into account the human and financial resources available to the clinic and its demographic context.

Published
2014

96. Validation of control of allergic rhinitis and asthma test for children (CARATKids)--a prospective multicenter study

Author

Maria Alfaro, José Carlos Cidrais Rodrigues, Cândida Mendes, Maria José Cálix, Carla Moreira, Rodrigo Rodrigues-Alves, Jaime Correia de Sousa, João Fonseca, Luís Miguel Borrego, Eva Rebelo Gomes, Daniela Linhares, Ângela Gaspar, José Manuel Onofre, Rita Amaral, Águeda Matos, Ana Margarida Pereira, Luís Filipe Azevedo, Ana Sá-Sousa, Filomena F. Rebelo, Mário Morais-Almeida, and Universidade do Minho

Subjects
Questionnaires, exhaled breath condensate, Male, medicine.medical_specialty, Psychometrics, Cross-sectional study, Visual analogue scale, Immunology, Allergic rhinitis, Cronbach's alpha, Predictive Value of Tests, Wheeze, Surveys and Questionnaires, cytokine, Immunology and Allergy, Medicine, Humans, Longitudinal Studies, Prospective Studies, Prospective cohort study, Child, Asthma, Observer Variation, Patient-reported outcomes, Science & Technology, Portugal, business.industry, genetic variants, chemokine, Age Factors, Reproducibility of Results, Rhinitis, Allergic, Seasonal, single-nucleotide polymorphism, medicine.disease, Rhinitis, Allergic, 3. Good health, Cross-Sectional Studies, wheeze, intercellular adhesion molecule, Pediatrics, Perinatology and Child Health, Physical therapy, gene expression, Observational study, Female, medicine.symptom, business
Abstract

BACKGROUND: Control of Allergic Rhinitis and Asthma Test for Children (CARATKids) is the first questionnaire that assesses simultaneously allergic rhinitis and asthma control in children. It was recently developed, but redundancy of questions and its psychometric properties were not assessed. This study aimed to (i) establish the final version of the CARATKids questionnaire and (ii) evaluate its reliability, responsiveness, cross-sectional validity, and longitudinal validity. METHODS: A prospective observational study was conducted in 11 Portuguese centers. During two visits separated by 6 wk, CARATKids, visual analog scale scales and childhood asthma control test were completed, and participant's asthma and rhinitis were evaluated by his/her physician without knowing the questionnaires' results. Data-driven item reduction was conducted, and internal consistency, responsiveness analysis, and associations with external measures of disease status were assessed. RESULTS: Of the 113 children included, 101 completed both visits. After item reduction, the final version of the questionnaire has 13 items, eight to be answered by the child and five by the caregiver. Its Cronbach's alpha was 0.80, the Guyatt's responsiveness index was -1.51, and a significant (p < 0.001) within-patient change of CARATKids score in clinical unstable patients was observed. Regarding cross-sectional validity, correlation coefficients of CARATKids with the external measures of control were between 0.45 and -0.69 and met the a priori predictions. In the longitudinal validity assessment, the correlation coefficients between the score changes of CARATKids and those of external measures of control ranged from 0.34 to 0.46. CONCLUSION: CARATKids showed adequate psychometric properties and is ready to be used in clinical practice.

Published
2014

97. Grupo etário e periodicidade recomendados para a mamografia de rastreio : uma revisão sistemática

Author

Miguel Basto Pereira, Joana Oliveira, Bárbara Castro, John Yaphe, Daniela Pinheiro Ribeiro, Jaime Correia de Sousa, and Universidade do Minho

Subjects
medicine.medical_specialty, Breast cancer mortality, MEDLINE, Breast cancer screening, Breast cancer, medicine, Periodicidade, Mammography, 10. No inequality, Science & Technology, medicine.diagnostic_test, business.industry, lcsh:Public aspects of medicine, Health Policy, Câncer da mama, Public Health, Environmental and Occupational Health, Grupos etários, lcsh:RA1-1270, Guideline, Frequency, medicine.disease, Mamografia, 3. Good health, Rastreio, Systematic review, Family medicine, Screening, Age groups, business, Medical literature
Abstract

Esta revisão teve por objetivo avaliar a força de evidência do atual indicador de desempenho português relativo ao rastreio do Câncer da Mama através da mamografia, de modo a determinar o grupo etário e a periodicidade recomendadas. Foram pesquisados artigos nas principais bases de dados internacionais de literatura médica. Incluímos artigos publicados entre Janeiro de 2006 e Janeiro de 2012 que correspondiam aos objetivos da revisão. Foi utilizada a taxonomia SORT para a classificação dos resultados. Dos 253 artigos encontrados foram selecionados cinco que cumpriam os critérios de inclusão. Estes incluem três revisões sistemáticas (RS), uma meta-análise (MA) e uma norma de orientação clínica (NOC) baseada numa RS. Os artigos selecionados avaliaram a redução da mortalidade por câncer da mama através do rastreio com mamografia. A realização do rastreio mamográfico entre os 50 e os 69 anos é recomendado em todos os artigos que avaliam esta faixa etária. A NOC recomenda o rastreio bienal. Em suma, a mamografia deverá ser realizada entre os 50 e os 69 anos com uma periodicidade bienal. Estes resultados vão ao encontro do atual indicador de desempenho do rastreio do câncer da mama em Portugal., The scope of this review was to assess the strength of evidence for the current Portuguese performance indicator on breast cancer screening with mammography in order to determine the recommended age group and periodicity for screening. A search for articles was conducted in the main international databases of medical literature. Articles published between January 2006 and January 2012 addressing the objectives of this review were included. The SORT taxonomy was used to classify the results. Of the 253 articles, five articles met the inclusion criteria and were selected for review. These included three systematic reviews, one meta-analysis and one clinical guideline based on a systematic review. A reduction in breast cancer mortality with mamography screening was the outcome in all articles selected. Mammography screening between 50 and 69 years was recommended in all articles that assess this age group. The clinical guidelines recommended screening every two years. In conclusion, the current literature recommends mammography for women every two years between the ages of 50 and 69 years. This is consistent with the current performance indicator for breast cancer screening in Portugal.

Published
2014

98. P139 The burden of copd across the european union: development of the european copd atlas

Author

Jordi Vilaró, Jaime Correia de Sousa, Job F M van Boven, Kamal Kishore, Siân Williams, Noel Baxter, Shane Fitch, Miguel Román Rodríguez, Joan B. Soriano, Hassan Chaudhury, and Jules Gaughan

Subjects
Pulmonary and Respiratory Medicine, education.field_of_study, business.industry, Population, Psychological intervention, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Systematic review, 030228 respiratory system, Environmental health, Health care, media_common.cataloged_instance, Medicine, Health education, 030212 general & internal medicine, European union, education, business, Health policy, media_common
Abstract

Background Estimating current and future impact of chronic obstructive pulmonary disease (COPD) within the European Union (EU) is essential for targeted and well-informed policy-making, however, current global and regional estimates are contradictory, and comparable standardised data is lacking. Without it the burden felt by individuals and healthcare systems cannot be fully quantified and a collective and coordinated response cannot be achieved to protect economies and communities from further harm. Aim Our purpose was to Collect data to enable a comparative assessment of the COPD burden across EU 28 member states and highlight variation. Show the impact of COPD in the workplace, on healthcare utilisation and on quality of life of the EU population. Use the data to underpin a simulation model to demonstrate future impact on societies, health inequalities and healthcare utilisation depending on which interventions are selected. Methods A systematic literature review was performed to identify regional and national data on COPD prevalence, risk factors (e.g. smoking, air pollution), impact and costs across the EU. Workshops with stakeholders from a range of European countries were convened to test the face validity of the data, and to develop policy-level questions from which a simulation model could be developed. Results Prevalence estimates of COPD varied considerably (1.26% to 13.87%), partly because of different definitions. As smoking rates are less affected by definition differences, these were used in a model that predicts COPD incidence, prevalence and mortality. Correction factors were applied to account for non-smoking related causes and under diagnosis of smoking. Smoking prevalence rates were used to estimate data for equivalent countries for the countries where smoking data were not available. The simulation model is currently in development and first results are expected in Autumn 2016. Conclusion The European COPD Coalition (ECC) will use the results to facilitate dialogue with EU decision makers (European Commission Council and Parliament) on health policy, outlining the problem and providing evidence to support the call for political actions on COPD. It will also be of significant interest to healthcare professionals, patients, and respiratory organisations with a passion to improve COPD care

Published
2016

99. Fostering the exchange of real-life data across different countries to answer primary care research questions: a protocol for an UNLOCK study from the IPCRG

Author

Jaime Correia de Sousa, Thys van der Molen, Mike Thomas, Liza Cragg, Sian Williams, Niels H. Chavannes, Universidade do Minho, and Groningen Research Institute for Asthma and COPD (GRIAC)

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Alternative medicine, Primary care, DISEASE, 03 medical and health sciences, 0302 clinical medicine, Protocol, Medicine, 030212 general & internal medicine, Publication, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Protocol (science), Medical education, Data collection, Science & Technology, Group study, business.industry, Public Health, Environmental and Occupational Health, Real life data, PREVENTION, 3. Good health, RESEARCH NEEDS, PRIORITY, 030228 respiratory system, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Research questions, business
Abstract

[Excerpt] This protocol describes a study that will explore the lessons of UNLOCK (Uncovering and Noting Long-term COPD and asthma to enhance Knowledge) over the past 5 years of sharing real-life primary care data from different countries to answer research questions on the diagnosis and management of chronic respiratory diseases. UNLOCK is an international collaboration between primary care researchers and practitioners to coordinate and share data sets of relevant diagnostic and follow-up variables for chronic obstructive pulmonary disease (COPD) and asthma management in primary care. It was set up by members of the International Primary Care Respiratory Group (IPCRG) in response to the identified research need for research in primary care, which recruits patients representative of primary care populations, evaluates interventions realistically delivered within primary care and draws conclusions that will be meaningful to professionals working within primary care.1,2 [...], The IPCRG provided funding for this research project as an UNLOCK Group study for which the funding was obtained through an unrestricted grant by Novartis AG, Basel, Switzerland. Novartis has no role in study design, data collection and analysis, decision to publish or preparation of the manuscript., info:eu-repo/semantics/publishedVersion

Published
2016

100. [Recommended age groups and frequency of mammography screening: a systematic review]

Author

Miguel Basto, Pereira, Joana, Oliveira, Daniela Pinheiro, Ribeiro, Bárbara, Castro, John, Yaphe, and Jaime Correia, de Sousa

Subjects
Adult, Age Factors, Humans, Breast Neoplasms, Female, Guidelines as Topic, Middle Aged, Early Detection of Cancer, Aged, Mammography
Abstract

The scope of this review was to assess the strength of evidence for the current Portuguese performance indicator on breast cancer screening with mammography in order to determine the recommended age group and periodicity for screening. A search for articles was conducted in the main international databases of medical literature. Articles published between January 2006 and January 2012 addressing the objectives of this review were included. The SORT taxonomy was used to classify the results. Of the 253 articles, five articles met the inclusion criteria and were selected for review. These included three systematic reviews, one meta-analysis and one clinical guideline based on a systematic review. A reduction in breast cancer mortality with mamography screening was the outcome in all articles selected. Mammography screening between 50 and 69 years was recommended in all articles that assess this age group. The clinical guidelines recommended screening every two years. In conclusion, the current literature recommends mammography for women every two years between the ages of 50 and 69 years. This is consistent with the current performance indicator for breast cancer screening in Portugal.

Published
2012

Catalog

Books, media, physical & digital resources
See catalog results