Browsing by Author "Carvalho, Joana"
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- Automatic detection of Parkinson’s disease: an experimental analysis of common speech production tasks used for diagnosisPublication . Pompili, Anna; Abad, Alberto; Romano, Paolo; Martins, Isabel P; Cardoso, Rita; Santos, Helena; Carvalho, Joana; Guimarães, Isabel; Ferreira, JoaquimParkinson’s disease (PD) is the second most common neurodegenerative disorder of mid-to-late life after Alzheimer’s disease. During the progression of the disease, most individuals with PD report impairments in speech due to deficits in phonation, articulation, prosody, and fluency. In the literature, several studies perform the automatic classification of speech of people with PD considering various types of acoustic information extracted from different speech tasks. Nevertheless, it is unclear which tasks are more important for an automatic classification of the disease. In this work, we compare the discriminant capabilities of eight verbal tasks designed to capture the major symptoms affecting speech. To this end, we introduce a new database of Portuguese speakers consisting of 65 healthy control and 75 PD subjects. For each task, an automatic classifier is built using feature sets and modeling approaches in compliance with the current state of the art. Experimental results permit to identify reading aloud prosodic sentences and story-telling tasks as the most useful for the automatic detection of PD.
- Changes in oral microflora in prosthetic patients on hygiene protocolPublication . Carvalho, Joana; Nascimento, Teresa; Proença, Luís; Félix, Sérgio
- Cross-cultural adaptation and validation of the swallowing disturbance questionnaire and the sialorrhea clinical scale in portuguese patients with Parkinson’s diseasePublication . Cardoso, Rita; Guimarães, Isabel; Santos, Helena; Carvalho, Joana; Abreu, Daisy; Gonçalves, Nilza; Ferreira, JoaquimIntroduction: To date, no valid outcome measure has been developed in European Portuguese (EP) to evaluate the Parkinsons’ Disease (PD) patients’ (PwP) reports regarding their swallowing disturbances. Objectives: The aim of this study was to translate and cross-culturally adapt the Swallowing Disturbance Questionnaire (SDQ) and the Sialorrhea Clinical Scale for PD (SCS-PD) into EP and to determine its clinimetric properties in PwP. Materials and Methods: The original English SDQ and SCS-PD versions were cross-culturally adapted following recommendations established in international guidelines. The validation process involved 75 PwP and 65 healthy sex- and age-matched participants. Results: The EP versions of the SDQ and SCS-PD are equivalent to the original versions (content, depth, and scoring). Statistical analyses for the SDQ tool revealed good feasibility (missing data <5%), acceptability (no floor or ceiling effects), excellent internal consistency (Cronbach's = 0.95), good construct validity (78.5% revealed large to moderate loadings), moderate convergent validity (r = 0.60), good divergent validity (r = 0.40), good known-groups validity (p-value<.05) and a fair sensitivity and specificity (AUC = 0.700). Statistical analyses for the SCS-PD tool shows good feasibility, reasonable acceptability (floor effect), good internal consistency (Cronbach's a¼0.85), good construct validity (85.7% showed between large to moderate loadings), good convergent validity (r = 0.78), good divergent validity (r = 0.39), good known groups validity (p-value < .05) and a fair sensitivity and specificity (AUC = 0.704). Conclusions: The EP versions of the SDQ and SCS-PD maintained the characteristics of the original versions and therefore consistent tools to be used in PwP.
- Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma: Secondary Analysis of Observational StudiesPublication . Neves, Ana Luisa; Jácome, Cristina; Taveira-Gomes, Tiago; Pereira, Ana Margarida; Almeida, Rute; Amaral, Rita; Alves-Correia, Magna; Mendes, Sandra; Chaves-Loureiro, Cláudia; Valério, Margarida; Lopes, Cristina; Carvalho, Joana; Mendes, Ana; Ribeiro, Carmelita; Prates, Sara; Ferreira, José Alberto; Teixeira, Maria Fernanda; Branco, Joana; Santalha, Marta; Vasconcelos, Maria João; Lozoya, Carlos; Santos, Natacha; Cardia, Francisca; Moreira, Ana Sofia; Taborda-Barata, Luís; Pinto, Cláudia Sofia; Ferreira, Rosário; Morais Silva, Pedro; Monteiro Ferreira, Tania; Câmara, Raquel; Lobo, Rui; Bordalo, Diana; Guimarães, Cristina; Espírito Santo, Maria; Ferraz de Oliveira, José; Cálix Augusto, Maria José; Gomes, Ricardo; Vieira, Inês; da Silva, Sofia; Marques, Maria; Cardoso, João; Morete, Ana; Aroso, Margarida; Cruz, Ana Margarida; Nunes, Carlos; Câmara, Rita; Rodrigues, Natalina; Abreu, Carmo; Albuquerque, Ana Luísa; Vieira, Claúdia; Santos, Carlos; Páscoa, Rosália; Chaves-Loureiro, Carla; Alves, Adelaide; Neves, Ângela; Varanda Marques, José; Reis, Bruno; Ferreira-Magalhães, Manuel; Almeida Fonseca, JoãoBackground: Health and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients’ daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities. Objective: This study aimed to evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. Methods: A secondary analysis of the INSPIRERS observational studies was conducted using data from face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and depression, postcode, socioeconomic level, digital literacy, use of health services, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. Results: A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were ≤40 years old (66.4%), had at least 10 years of education (57.4%), and were in the 3 higher quintiles of the socioeconomic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale [VAS] score>70 in 93.1%) and the prevalence of anxiety and depression was 34.3% and 11.9%, respectively. The proportion of participants who reported using health and fitness mobile apps was 41.1% (n=211). Multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted odds ratio [aOR] 2.22, 95%CI 1.05-4.75 and aOR 1.95, 95%CI 1.12-3.45, respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third, and fourth quartiles reporting aORs of 6.74 (95%CI 2.90-17.40), 10.30 (95%CI 4.28-27.56), and 11.52 (95%CI 4.78-30.87), respectively. Participants with depression symptoms had lower odds of using health and fitness apps (aOR 0.32, 95%CI 0.12-0.83). Conclusions: A better understanding of the barriers and enhancers of app use among patients with lower education, lower digital literacy, or depressive symptoms is key to design tailored interventions to ensure a sustained and equitable use of these technologies. Future studies should also assess users’ general health-seeking behavior and their interest and concerns specifically about digital tools. These factors may impact both initial engagement and sustained use.
- Dysarthria in individuals with Parkinson’s disease: a protocol for a binational, cross-sectional, case-controlled study in rrench and european portuguese (FraLusoPark)Publication . Pinto, Serge; Cardoso, Rita; Sadat, Jasmin; Guimarães, Isabel; Mercier, Céline; Santos, Helena; Atkinson-Clement, Cyril; Carvalho, Joana; Welby, Pauline; Oliveira, Pedro; D’Imperio, Mariapaola; Frota, Sónia; Letanneux, Alban; Vigario, Marina; Cruz, Marisa; Martins, Isabel Pavão; Viallet, François; Ferreira, JoaquimIntroduction: Individuals with Parkinson’s disease (PD) have to deal with several aspects of voice and speech decline and thus alteration of communication ability during the course of the disease. Among these communication impairments, 3 major challenges include: (1) dysarthria, consisting of orofacial motor dysfunction and dysprosody, which is linked to the neurodegenerative processes; (2) effects of the pharmacological treatment, which vary according to the disease stage; and (3) particular speech modifications that may be language-specific, that is, dependent on the language spoken by the patients. The main objective of the FraLusoPark project is to provide a thorough evaluation of changes in PD speech as a result of pharmacological treatment and disease duration in 2 different languages (French vs European Portuguese). Methods and analysis: Individuals with PD are enrolled in the study in France (N=60) and Portugal (N=60). Their global motor disability and orofacial motor functions is assessed with specific clinical rating scales, without (OFF) and with (ON) pharmacological treatment. 2 groups of 60 healthy age-matched volunteers provide the reference for between-group comparisons. Along with the clinical examinations, several speech tasks are recorded to obtain acoustic and perceptual measures. Patient-reported outcome measures are used to assess the psychosocial impact of dysarthria on quality of life. Ethics and dissemination: The study has been approved by the local responsible committees on human experimentation and is conducted in accordance with the ethical standards. A valuable largescale database of speech recordings and metadata from patients with PD in France and Portugal will be constructed. Results will be disseminated in several articles in peer-reviewed journals and in conference presentations. Recommendations on how to assess speech and voice disorders in individuals with PD to monitor the progression and management of symptoms will be provided.
- In vitro comparative study of microhardness and flexural strength of acrylic resins used in removable denturesPublication . Costa, Marta; Neves, Sara; Carvalho, Joana; Arantes-Oliveira, Sofia; Félix, SérgioPolymethylmethacrylate is the material of choice for prosthetic bases. Depending on the type of polymerization, acrylic resins may present some mechanical weaknesses that may lead to the failure of a prosthesis. The microhardness and flexural strength of a dental material determine its applicability. The objective of the present investigation was to evaluate the in vitro Knoop microhardness and flexural strength of a thermopolymerizable (Probase Hot) and an autopolymerizable (Probase Cold) resin, according to ISO 20759-1: 2013.
- Oral fungal microflora associated with implant-supported VS. mucous-supported denturesPublication . Neto, Bruno; Carvalho, Joana; Oom, Madalena; Félix, Sérgio
- Profiling Persistent Asthma Phenotypes in Adolescents: A Longitudinal Diagnostic Evaluation from the INSPIRERS StudiesPublication . Amaral, Rita; Jácome, Cristina; Almeida, Rute; Pereira, Ana Margarida; Alves-Correia, Magna; Mendes, Sandra; Rodrigues, José Carlos Cidrais; Carvalho, Joana; Araújo, Luís; Costa, Alberto; Silva, Armandina; Teixeira, Maria Fernanda; Ferreira-Magalhães, Manuel; Alves, Rodrigo Rodrigues; Moreira, Ana Sofia; Fernandes, Ricardo M.; Ferreira, Rosário; Pinto, Paula Leiria; Neuparth, Nuno; Bordalo, Diana; Bom, Ana Todo; Cálix, Maria José; Ferreira, Tânia; Gomes, Joana; Vidal, Carmen; Mendes, Ana; Vasconcelos, Maria João; Silva, Pedro Morais; Ferraz, José; Morête, Ana; Pinto, Claúdia Sofia; Santos, Natacha; Loureiro, Claúdia Chaves; Arrobas, Ana; Marques, Maria Luís; Lozoya, Carlos; Lopes, Cristina; Cardia, Francisca; Loureiro, Carla Chaves; Câmara, Raquel; Vieira, Inês; Silva, Sofia da; Silva, Eurico; Rodrigues, Natalina; Fonseca, João A.We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13-17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.
- Speech intelligibility of Parkinson’s disease patients evaluated by different groups of healthcare professionals and naïve listenersPublication . Carvalho, Joana; Cardoso, Rita; Guimarães, Isabel; Ferreira, JoaquimABSTRACT Introduction: Speech intelligibility, how well a listener comprehends the speaker’s message, is related to the listener’ expertise and type of the message conveyed. There is no evidence about speech intelligibility in different groups of healthcare professionals and naïve listeners. Objectives: This study is the first to understand if there were differences in the speech intelligibility of Parkinson’s Disease (PD) patients by different experienced and naïve listeners, according to the speech stimuli and dysarthria severity. Materials and methods: Randomly digitised audio-files (50 words and 50 sentences) of 10 PD patients, one without dysarthria and 9 with different dysarthria severities (3 each: mild, moderate and severe dysarthria), were collected from a database of 60 PD patients’ audio-files. A jury panel was formed by five different listeners groups including 10 speech and language therapists, 10 neurologists, 10 PD relatives, 12 PD patients, and 10 people from the general population. The jury panel transcribed single words and sentences from the audio recordings, the percentage correctly understood was calculated and the results were compared between the groups. Results: Multiple comparisons showed significant speech intelligibility differences between healthcare professionals and naïve listerners in words (highest effect size, n2 = 0.7) and sentences (the highest effect size: n2 = 0.6). Pairwise comparisons revealed that those significant differences were specifically in words with moderate and severe dysarthria and sentences with all severity levels of dysarthria. Conclusion: The groups of healthcare professionals who work with dysarthria are more likely to understand the PD patients’ speech than the groups of naïve listeners.
- Uma tríade em supervisão clínica em enfermagemPublication . Antunes, Ana; Carvalho, Joana; Sousa, Paula CristinaOs enfermeiros são profissionais de eleição na prestação de cuidados de qualidade e excelência, que só é possível com formação sólida, que permita a aquisição de competências, capacidades de reflexão, auto-avaliação, e procura constante de conhecimento, baseado na evidência e cimentado com a utilização do sistema de supervisão clínica em enfermagem. Este artigo, pretende realçar a importância da supervisão clínica em enfermagem, despertando nos enfermeiros a necessidade da sua aplicação e análise baseadas na evidência científica. Deste modo, o desenvolvimento de estratégias de atuação, o pensamento reflexivo e o acompanhamento sistemático e a orientação de estudantes em contexto clínico assente numa relação supervisiva, poderão constituir fatores determinantes para o desenvolvimento pessoal e profissional, assim como para a qualidade e segurança na prestação de cuidados.