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The use of embodied conversational agents in mental health has increased in the last years. Several studies exist describing the benefits and advantages of this technology as a complement to psychotherapeutic interventions for the prevention and treatment of depression, anxiety, or post-traumatic stress disorder, to name a few. A small number of these works implement capabilities in the virtual agent focused on the detection and prevention of suicidality risks. The work presented in this paper describes the development of an embodied conversational agent used as the main interface in HelPath, a mobile-based application addressed to individuals detected with any of the suicidal behaviours: ideation, planning or attempt. The main objective of HelPath is to continuously collect user's information that, complemented with data from the electronic health record, supports the identification of risks associated with suicidality. Through the virtual agent, the users also receive information and suggestions based on cognitive behaviour therapy that would help them to maintain a healthy condition. The paper also presents the execution of an exploratory pilot to assess the acceptability, perception and adherence of users towards the virtual agent. The obtained results are presented and discussed, and some actions for further improvement of the embodied conversational agent are also identified.
Assuntos
Ideação Suicida , Prevenção do Suicídio , Interface Usuário-Computador , Adulto , Comunicação , Depressão , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Software , Inquéritos e Questionários , Adulto JovemRESUMO
Introducción: las infecciones transmisibles por vía transfusional presentan divergencias en su magnitud y factores asociados, en correspondencia con el perfil epidemiológico de la población de referencia de cada banco de sangre. Objetivo: establecer la prevalencia de marcadores de infecciones transmisibles por vía transfusional y sus factores demográficos relacionados en un banco de sangre de Antioquia, en el periodo 2010-2013. Métodos: estudio transversal en donantes de un banco de sangre de Antioquia en quienes se aplicaron los criterios de inclusión de la resolución 901 de 1996. La fuente de información fue secundaria y los análisis de los marcadores de infecciones y sus factores relacionados se basaron en el cálculo de medidas de resumen, prueba chi cuadrado, razones de prevalencia y evaluación de la confusión por regresión logística binaria. Resultados: se incluyeron 15 461 donantes con edad promedio de 36 años.La prevalencia de positividad para cualquier marcador fue 1,18 %, de infecciones virales 0,15 %, de Treponema pallidum 1,00 % y de T. cruzi del 0,02 %. La prevalencia global de infecciones y de T. pallidum fue estadísticamente mayor en hombres, personas de mayor edad, donantes de reposición y ocupación de "servicios, deportes y recreación" y amas de casa; en el análisis multivariado se demostró que estas asociaciones no presentaron confusión. Conclusión: la prevalencia de infecciones fue muy baja y menor en comparación con investigaciones previas, los subgrupos con una prevalencia estadísticamente mayor fueron los hombres, donantes de reposición y personas de mayor edad; esto permite la orientación de investigaciones y acciones sanitarias posteriores.
Introduction: Transfusion transmissible infections present differences in magnitude and associated factors according to the epidemiological profile of the reference population of each blood bank. Objective: To determine the prevalence of markers of transfusion transmissible infections and associated factors in a Blood Bank Antioquia, 2010-2013. Methods: Cross-Sectional study of prevalence in donors from a blood bank Antioquia in whom inclusion criteria of resolution 901 of 1996 were applied. The source information was secondary and the analyzes were based on the calculation of summary measures, proportions, chi square test, prevalence ratios and evaluation of confusing by binary logistic regression. Results: We included 15 461 donors with a mean age of 36 years. The prevalence of positivity for any marker was 1.18 %, viral infections 0.15 %, Treponema pallidum 1.00 % and T. cruzi 0.02 %. The overall prevalence and of T. pallidum infection was statistically higher in men, elderly, replacement donors and persons with occupation of "services, sports and recreation" and housewives, in the multivariate analysis it showed that these associations did not present confusion. Conclusion: The prevalence of infection was lower compared to previous researches; the subgroups with statistically higher prevalence were men, replacement donors and elderly, this constitute a finding of interest for targeting investigations and health actions.
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INTRODUCTION: It is well established that type 1 diabetes (T1D) is an autoimmune disease. Controversial data exists regarding the differential control of the immune system in T1D patients compared to unaffected individuals. MicroRNAs (miRNAs) are involved in the control of gene expression (by negative regulation of gene expression at post-transcriptional level, by mediating translational repression or degradation of the mRNA targets). Their potential role in T cell activation and autoimmunity is controversial. AIM: We investigated the expression profile of miR-21a and miR-93 in PMC samples of 20 T1D patients and 20 healthy controls by means of qPCR in different glucose concentrations (basal, 11 nM and 25 mM), and we analyzed the possible relationship of this expression pattern with autoimmunity. RESULTS: MiR-21a was significantly underexpressed in T1D samples (media values expression 0.23 ± 0.05, p < 0.01) compared to controls (values less than 1 indicate a decrease in gene expression). When the PMCs were incubated with glucose 11 mM and 25 mM, miR-21a expression decreased in controls and increased in T1D samples (0.506 ± 0.05, p < 0.04). MiR-93 was underexpressed in T1D patients (0.331 ± 0.05, p < 0.02) compared to control samples. However, when the PBMCs were incubated with glucose, no changes were observed. No association with autoimmunity was observed. CONCLUSION: We demonstrated that miRNAs have a differential expression in PBMCs from T1D patients compared to controls, suggesting that these miRNAs or others could be involved in T cell regulation.
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Diabetes Mellitus Tipo 1/genética , Glucose/metabolismo , Leucócitos Mononucleares/metabolismo , MicroRNAs/genética , Adolescente , Adulto , Estudos de Casos e Controles , Células Cultivadas , Criança , Pré-Escolar , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/patologia , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Glucose/farmacologia , Humanos , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/patologia , Ativação Linfocitária/efeitos dos fármacos , Masculino , MicroRNAs/sangueRESUMO
UNLABELLED: Type 1 diabetes mellitus (T1D) is an autoimmune disease characterized by a progressive destruction of pancreatic ß cells. It has been reported that patients with autoimmune diseases exhibit decreased expression of caspase 3 and other pro-apoptotic markers in peripheral blood mononuclear cells (PBMC). AIM: To estimate the expression of apoptosis markers in PBMC from T1D patients cultured with high glucose concentration. RESULTS: At 11 mM of glucose, the pro-apoptotic gene fas showed a 7-fold decreased expression in the T1D group compared to controls, while bax showed a 50-fold decreased expression (medians 0.14 and 0.02, respectively, considering patients as 1). At 44 mM of glucose, there is a decreased expression of the same genes, but less abrupt (medians 0.75 and 0.47). Only the anti-apoptotic gene xiap showed a 2-fold increased expression at 11 mM of glucose (median 2.3). Regarding the clinical history, no relationships were observed with age of diagnosis, ketoacidosis, glucose at debut or GAD-65 and IA-2 titles. CONCLUSION: We can conclude that the apoptotic mechanisms in PBMC of T1D patients under high glucose conditions are altered, and this is proved by the decreased expression of the pro-apoptotic genes fas and bax and by the increased expression of the anti-apoptotic gene xiap.