Publications
80 results found
Irving G, Neves AL, Dambha-Miller H, et al., 2017, International variations in primary care physician consultation time: a systematic review of 67 countries, BMJ Open, Vol: 7, ISSN: 2044-6055
Objective To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes.Design and outcome measures This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes.Results One hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction.Conclusion There are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress.
Neves AL, Roy R, Wadge H, et al., 2017, A framework for evaluating the economic impact of EHR-based interventions
Poovendran D, Wadge H, Roy R, et al., 2017, A qualitative evaluation of the CIE Programme implementation in North West London
Rodriguez-Martinez A, Posma JM, Ayala R, et al., 2017, J-Resolved (1)H NMR 1D-Projections for Large-Scale Metabolic Phenotyping Studies: Application to Blood Plasma Analysis., Analytical Chemistry, Vol: 89, Pages: 11405-11412, ISSN: 0003-2700
(1)H nuclear magnetic resonance (NMR) spectroscopy-based metabolic phenotyping is now widely used for large-scale epidemiological applications. To minimize signal overlap present in 1D (1)H NMR spectra, we have investigated the use of 2D J-resolved (JRES) (1)H NMR spectroscopy for large-scale phenotyping studies. In particular, we have evaluated the use of the 1D projections of the 2D JRES spectra (pJRES), which provide single peaks for each of the J-coupled multiplets, using 705 human plasma samples from the FGENTCARD cohort. On the basis of the assessment of several objective analytical criteria (spectral dispersion, attenuation of macromolecular signals, cross-spectral correlation with GC-MS metabolites, analytical reproducibility and biomarker discovery potential), we concluded that the pJRES approach exhibits suitable properties for implementation in large-scale molecular epidemiology workflows.
Rodriguez Martinez A, Posma JM, Ayala R, et al., 2017, MWASTools: an R/Bioconductor package for metabolome-wide association studies, Bioinformatics, Vol: 34, Pages: 890-892, ISSN: 1367-4803
Summary: MWASTools is an R package designed to provide an integrated pipeline to analyze metabonomic data in large-scale epidemiological studies. Key functionalities of our package include: quality control analysis; metabolome-wide association analysis using various models (partial correlations, generalized linear models); visualization of statistical outcomes; metabolite assignment using statistical total correlation spectroscopy (STOCSY); and biological interpretation of MWAS results.Availability: The MWASTools R package is implemented in R (version > =3.4) and is available from Bioconductor: https://bioconductor.org/packages/MWASTools/
Rodriguez Martinez A, Ayala R, Posma JM, et al., 2016, MetaboSignal, a network-based approach for topological analysis of metabotype regulation via metabolic and signaling pathways, Bioinformatics, Vol: 33, Pages: 773-775, ISSN: 1367-4803
MetaboSignal is an R package that allows merging metabolic and signaling pathways reported in the Kyoto Encyclopaedia of Genes and Genomes (KEGG). It is a network-based approach designed to navigate through topological relationships between genes (signaling- or metabolic-genes) and metabolites, representing a powerful tool to investigate the genetic landscape of metabolic phenotypes.
Pinho-Costa L, Yakubu K, Hoedebecke K, et al., 2016, Healthcare hashtag index development: Identifying global impact in social media, Journal of Biomedical Informatics, Vol: 63, Pages: 390-399, ISSN: 1532-0464
Chilloux J, Neves AL, Boulangé CL, et al., 2016, The microbial-mammalian metabolic axis: a critical symbiotic relationship, Current Opinion in Clinical Nutrition and Metabolic Care, Vol: 19, Pages: 250-256, ISSN: 1473-6519
Purpose of review: The microbial-mammalian symbiosis plays a critical role in metabolic health. Microbial metabolites emerge as key messengers in the complex communication between the gut microbiota and their host. These chemical signals are mainly derived from nutritional precursors, which in turn are also able to modify gut microbiota population. Recent advances in the characterization of the gut microbiome and the mechanisms involved in this symbiosis allow the development of nutritional interventions. This review covers the latest findings on the microbial-mammalian metabolic axis as a critical symbiotic relationship particularly relevant to clinical nutrition.Recent findings: The modulation of host metabolism by metabolites derived from the gut microbiota highlights the importance of gut microbiota in disease prevention and causation. The composition of microbial populations in our gut ecosystem is a critical pathophysiological factor, mainly regulated by diet, but also by the host's characteristics (e.g. genetics, circadian clock, immune system, age). Tailored interventions, including dietary changes, the use of antibiotics, prebiotic and probiotic supplementation and faecal transplantation are promising strategies to manipulate microbial ecology.Summary: The microbiome is now considered as an easily reachable target to prevent and treat related diseases. Recent findings in both mechanisms of its interactions with host metabolism and in strategies to modify gut microbiota will allow us to develop more effective treatments especially in metabolic diseases.
Boulangé CL, Neves AL, Chilloux J, et al., 2016, Impact of the gut microbiota on inflammation, obesity, and metabolic disease, Genome Medicine, Vol: 8, ISSN: 1756-994X
The human gut harbors more than 100 trillion microbial cells, which have an essential role in human metabolic regulation via their symbiotic interactions with the host. Altered gut microbial ecosystems have been associated with increased metabolic and immune disorders in animals and humans. Molecular interactions linking the gut microbiota with host energy metabolism, lipid accumulation, and immunity have also been identified. However, the exact mechanisms that link specific variations in the composition of the gut microbiota with the development of obesity and metabolic diseases in humans remain obscure owing to the complex etiology of these pathologies. In this review, we discuss current knowledge about the mechanistic interactions between the gut microbiota, host energy metabolism, and the host immune system in the context of obesity and metabolic disease, with a focus on the importance of the axis that links gut microbes and host metabolic inflammation. Finally, we discuss therapeutic approaches aimed at reshaping the gut microbial ecosystem to regulate obesity and related pathologies, as well as the challenges that remain in this area.
Neves AL, Chilloux J, Sarafian MH, et al., 2015, The microbiome and its pharmacological targets: therapeutic avenues in cardiometabolic diseases, Current Opinion in Pharmacology, Vol: 25, Pages: 36-44, ISSN: 1471-4892
Consisting of trillions of non-pathogenic bacteria living in a symbiotic relationship with their mammalian host, the gut microbiota has emerged in the past decades as one of the key drivers for cardiometabolic diseases (CMD). By degrading dietary substrates, the gut microbiota produces several metabolites that bind human pharmacological targets, impact subsequent signalling networks and in fine modulate host's metabolism. In this review, we revisit the pharmacological relevance of four classes of gut microbial metabolites in CMD: short-chain fatty acids (SCFA), bile acids, methylamines and indoles. Unravelling the signalling mechanisms of the microbial–mammalian metabolic axis adds one more layer of complexity to the physiopathology of CMD and opens new avenues for the development of microbiota-based pharmacological therapies.
Laranjo L, Neves AL, Costa A, et al., 2015, Facilitators, barriers and expectations in the self-management of type 2 diabetes—a qualitative study from Portugal, European Journal of General Practice, Vol: 21, Pages: 103-110, ISSN: 1381-4788
Laranjo L, Arguel A, Neves AL, et al., 2015, The influence of social networking sites on health behavior change: a systematic review and meta-analysis, Journal of the American Medical Informatics Association, Vol: 22, Pages: 243-256, ISSN: 1067-5027
<jats:title>Abstract</jats:title> <jats:p>Objective Our aim was to evaluate the use and effectiveness of interventions using social networking sites (SNSs) to change health behaviors.</jats:p> <jats:p>Materials and methods Five databases were scanned using a predefined search strategy. Studies were included if they focused on patients/consumers, involved an SNS intervention, had an outcome related to health behavior change, and were prospective. Studies were screened by independent investigators, and assessed using Cochrane's ‘risk of bias’ tool. Randomized controlled trials were pooled in a meta-analysis.</jats:p> <jats:p>Results The database search retrieved 4656 citations; 12 studies (7411 participants) met the inclusion criteria. Facebook was the most utilized SNS, followed by health-specific SNSs, and Twitter. Eight randomized controlled trials were combined in a meta-analysis. A positive effect of SNS interventions on health behavior outcomes was found (Hedges’ g 0.24; 95% CI 0.04 to 0.43). There was considerable heterogeneity (I2 = 84.0%; T2 = 0.058) and no evidence of publication bias.</jats:p> <jats:p>Discussion To the best of our knowledge, this is the first meta-analysis evaluating the effectiveness of SNS interventions in changing health-related behaviors. Most studies evaluated multi-component interventions, posing problems in isolating the specific effect of the SNS. Health behavior change theories were seldom mentioned in the included articles, but two particularly innovative studies used ‘network alteration’, showing a positive effect. Overall, SNS interventions appeared to be effective in promoting changes in health-related behaviors, and further research regarding the application of these promising tools is warranted.</jats:p> <jats:p>Conclusions Our study showed a positive effect of S
Neves AL, Couto L, 2014, Cardiovascular risk in overweight/obese and lean hypertensive patients., Rev Port Cardiol, Vol: 4, Pages: 223-228
Lemes VAF, Neves AL, Guazzelli IC, et al., 2013, Angiotensin converting enzyme insertion/deletion polymorphism is associated with increased adiposity and blood pressure in obese children and adolescents, Gene, Vol: 532, Pages: 197-202, ISSN: 0378-1119
Neves AL, Coelho J, Couto L, et al., 2013, Metabolic endotoxemia: a molecular link between obesity and cardiovascular risk, Journal of Molecular Endocrinology, Vol: 51, Pages: R51-R64, ISSN: 0952-5041
<jats:p>Obesity is associated with significantly increased cardiovascular (CV) risk and mortality. Several molecular mechanisms underlying this association have been implied, among which the intestinal barrier has gained a growing interest. In experimental models of obesity, significant alterations in the intestinal barrier lead to increased intestinal permeability, favoring translocation of microbiome-derived lipopolysaccharide to the bloodstream. This has been shown to result in a two- to threefold increase in its serum concentrations, a threshold named ‘metabolic endotoxemia’ (ME). ME may trigger toll-like receptor 4-mediated inflammatory activation, eliciting a chronic low-grade proinflammatory and pro-oxidative stress status, which may result in high CV risk and target-organ damage. In this review, we discuss the potential molecular implications of ME on several CV risk factors, such as obesity, insulin resistance, dyslipidemia, and oxidative stress, as well as its potential impact on the development of CV target-organ disease.</jats:p>
Neves AL, Laranjo L, Villanueva T, et al., 2013, Patients' access to their medical records, Acta Med Port
Neves AL, 2013, EGPRN: European General Practice Research Network, European Journal of General Practice, Vol: 19, Pages: 62-71, ISSN: 1381-4788
Neves AL, Mohammedi K, Emery N, et al., 2012, Allelic variations in superoxide dismutase-1 (SOD1) gene and renal and cardiovascular morbidity and mortality in type 2 diabetic subjects., Molecular Genetics and Metabolism, ISSN: 1096-7192
Neves AL, Villanueva T, 2011, French boost European telemedicine, Canadian Medical Association Journal, Vol: 183, Pages: E387-E388, ISSN: 0820-3946
Neves AL, Marques MM, Bessa-Monteiro A, et al., 2008, Banning smoking in restaurants: effects on behavioural intentions, Public Health, Vol: 122, Pages: 878-881, ISSN: 0033-3506
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