Search

Funding This study had the support of Fundação para a Ciência e a Tecnologia (FCT) through the Strategic Project UID/MAR/04292/2020 to MARE, UIDB/50011/2020 & UIDP/50011/2020 to CICECO, and the University of Aveiro and FCT/MCT for the fnancial support for LAQV-REQUIMTE research Unit (FCT UIDB/50006/2020) through national founds, and, where applicable, co-fnanced by the FEDER, within the PT2020 Partnership Agreement. This work was also funded by the project “Valorização dos subprodutos do processo biotecnológico de produção de esqualeno e DHA pela microalga Aurantiochytrium sp.” (AlgaValue) (POCI-01-0247-FEDER-017680) supported by COMPETE 2020, and Integrated Programme of SR&TD “SmartBioR” (reference Centro-01–0145-FEDER-000018) cofunded by Centro 2020 program, Portugal2020, European Union, through the European Regional Development Fund. The authors also thank the funding from Project AgroForWealth (CENTRO-01–0145-FEDER-000001), funded by Centro2020, through FEDER and PT2020 and University of Aveiro. Aurantiochytrium sp. is an emerging alternative source of polyunsaturated fatty acids (PUFAs), docosahexaenoic acid (DHA), and squalene, playing an important role in the phasing out of traditional fish sources for these compounds. Novel lipid extraction techniques with a focus on sustainability and low environmental footprint are being developed for this organism, but the exploration of other added-value compounds within it is still very limited. In this work, a combination of novel green extraction techniques (high hydrostatic pressure extraction (HPE) and supercritical fluid extraction (SFE)) and traditional techniques (organic solvent Soxhlet extraction and hydrodistillation (HD)) was used to obtain lipophilic extracts of Aurantiochytrium sp., which were then screened for antioxidant (DPPH radical reduction capacity and ferric-reducing antioxidant potential (FRAP) assays), lipid oxidation protection, antimicrobial, anti-aging enzyme inhibition (collagenase, elastase and hyaluronidase), and anti-inflammatory (inhibition of NO production) activities. The screening revealed promising extracts in nearly all categories of biological activity tested, with only the enzymatic inhibition being low in all extracts. Powerful lipid oxidation protection and anti-inflammatory activity were observed in most SFE samples. Ethanolic HPEs inhibited both lipid oxidation reactions and microbial growth. The HD extract demonstrated high antioxidant, antimicrobial, and antiinflammatory activities making, it a major contender for further studies aiming at the valorization of Aurantiochytrium sp. Taken together, this study presents compelling evidence of the bioactive potential of Aurantiochytrium sp. and encourages further exploration of its composition and application. info:eu-repo/semantics/publishedVersion

The ability to empathize with another person's inner experience is believed to be a central element of our social interactions. Previous research has focused on cognitive (e.g., theory of mind) and emotional (e.g., emotional contagion) empathy, and less on behavioral factors (i.e., the ability to respond empathically). Recent studies suggest that the Default Mode Network (DMN) mediates individual variability in distinct empathy-related behaviors. However, little is known about DMN activity during actual empathic responses, understood in this study as the ability to communicate our understanding of the others' experience back to them. This study used an empathy response paradigm with 28 participants (22-37 years old) to analyze the relationship between the quality of empathic responses to 14 empathy-eliciting vignettes and patterns of attenuation in the DMN. Overall, the results suggest that high levels of empathic response, are associated with sustained activation of the DMN when compared with lower levels of empathy. Our results demonstrate that the DMN becomes increasingly involved in empathy-related behavior, as our level of commitment to the other's experience increases. This study represents a first attempt to understand the relation between the capacity for responding in a supportive way to others' needs and the intra-individual variability of the pattern of the DMN attenuation. Here we underline the critical role that the DMN plays in high-level social cognitive processes and corroborate the DMN role in different psychiatric disorders associated with a lack of empathy.

Background: Healthcare systems in low-resource settings need simple, low-cost interventions to improve services and address gaps in care. Though routine data provide opportunities to guide these efforts, frontline healthcare workers (HCW) are rarely engaged in analyzing them for facility-level decision making. The Systems Analysis and Improvement Approach (SAIA) is an evidence-based, multi-component implementation strategy that engages HCW in use of facility-level data to promote systems-level thinking and quality improvement (QI) efforts within multi-step care cascades. SAIA was originally developed to address HIV care in resource-limited settings, but has since been adapted to a variety of clinical care systems including cervical cancer screening, mental health treatment, and hypertension management, among others; and across a variety of settings in sub-Saharan Africa and the United States. We aimed to extend the growing body of SAIA research by defining the core elements of SAIA using established specification approaches, and thus improve reproducibility, guide future adaptations and lay the groundwork to define its mechanism of action. Methods: Specification of the SAIA strategy was undertaken over 12 months by an expert panel of SAIA-researchers, implementing agents and stakeholders using a three-round, modified nominal group technique approach to match core SAIA components to the Expert Recommendations for Implementing Change (ERIC) list of distinct implementation strategies. Core implementation strategies were then specified according to Proctor’s recommendation for specifying and reporting, followed by synthesis of data on related implementation outcomes linked to the SAIA strategy across projects.Results: Based on this review and clarification of the operational definitions of the components of the SAIA, the four components of SAIA were mapped to 13 ERIC strategies. SAIA strategy meetings encompassed external facilitation, organization of provider implementation meetings, and provision of ongoing consultation. Cascade analysis mapped to three ERIC strategies; facilitating relay of clinical data to providers, use of audit and feedback of routine data with healthcare teams, and modelling and simulation of change. Process mapping tied to local needs assessment, local consensus discussions and assessment of readiness and identification of barriers and facilitators. Finally, continuous quality improvement encompassed tailoring strategies, developing a formal implementation blueprint, cyclical tests of change and purposefully re-examining the implementation process.Conclusions: Specifying the components of SAIA provides improved conceptual clarity to enhance reproducibility for other researchers and practitioners interested in applying the SAIA across novel settings.

Background: The Systems Analysis and Improvement Approach (SAIA) is an evidence-based package of systems engineering tools designed to improve patient flow through the prevention of mother-to-child transmission of HIV (PMTCT) cascade. SAIA is a potentially scalable model for maximizing benefits of universal antiretroviral therapy (ART) for mothers and their babies. SAIA-SCALE was a stepped wedge trial implemented in Manica province, Mozambique, to evaluate SAIA’s effectiveness when led by district health managers, rather than by study nurses. We present results of a qualitative assessment of implementation determinants of the SAIA-SCALE strategy during two intensive and one maintenance phases.Methods: We used an extended case study design that embedded the Consolidated Framework for Implementation Research (CFIR) to guide data collection, analysis, and interpretation. From March 2019 through April 2020, we conducted in-depth individual interviews (IDIs) and focus group discussions (FGDs) with district managers, health facility Maternal and Child Health (MCH) managers and frontline nurses at 21 health facilities and seven districts of Manica Province (Chimoio, Báruè, Gondola, Macate, Manica, Sussundenga, and Vanduzi).Results: We included 85 participants: 50 through IDIs and 35 from three FGDs. Most study participants were women (98%), frontline nurses (49.4%) and MCH health facility managers (32.5%). An identified facilitator of successful intervention implementation (regardless of intervention phase) was related to SAIA’s compatibility with organizational structures, processes, and priorities of Mozambique’s health system at the district and health facility levels. Identified barriers to successful implementation included (a) inadequate health facility and road infrastructure preventing mothers from accessing MCH/PMTCT services at study health facilities and preventing nurses from dedicating time to improving data quality and service provision, and (b) challenges in managing intervention funds.Conclusions: The SAIA-SCALE qualitative evaluation suggests that the scalability of SAIA for PMTCT is enhanced by its fit within organizational structures, processes, and priorities at the primary level of healthcare delivery and health system managers in Mozambique. Barriers to implementation that impact scalability of SAIA include district-level financial management capabilities and lack of infrastructure at the health facility level. SAIA cannot be successfully scaled-up to adequately address PMTCT needs without leveraging central level resources and priorities. Trial registration: ClinicalTrials.gov NCT03425136 (registered 02/06/2018).

A terapia do riso comecou a ser difundida devido a hospitalizacao ser hostil para os pacientes. Manter a integridade do individuo, levando em consideracao seu humor e considerada uma atribuicao do enfermeiro. Identificar como a intervencao terapia do riso em adultos e idosos hospitalizados atua nas respostas de bem-estar, qualidade de vida e humor. Revisao integrativa da literatura. Foram selecionados sete artigos apos a busca, com utilizacao dos criterios de inclusao e exclusao. Estudos relatam a comprovacao dos efeitos beneficos acerca do humor, podendo reduzir estresse, ansiedade, e influenciando diretamente nos sinais vitais. Ressalta-se a importância do desenvolvimento de pesquisas sobre a tematica, devido a escassez na literatura de estudos, sobretudo brasileiros. O uso da risoterapia e necessaria no ambiente hospitalar, por isso, estudos como esse ajudam a incentivar os profissionais a implementar essa estrategia e assim melhorar a qualidade da assistencia prestada. Descritores: Terapia do Riso, Saude do Adulto, Saude do Idoso. Laughter therapy in adults and hospitalized elderly: integrative review Abstract : Laughter therapy started to be widespread due to hospitalization being hostile to patients. Maintaining the individual's integrity, taking into account his mood is considered a nurse's responsibility. To identify how the laughter therapy intervention in hospitalized adults and elderly acts on responses to well-being, quality of life and mood. Integrative literature review. Seven articles were selected after the search, using the inclusion and exclusion criteria. Studies report evidence of beneficial effects on mood, which can reduce stress, anxiety, and influence directly on vital signs. The importance of developing research on the subject is emphasized, due to the scarcity in the literature of studies, especially Brazilians. The use of risotherapy is necessary in the hospital environment, therefore, studies like this help to encourage professionals to implement this strategy and thus improve the quality of care provided. Descriptors: Laughter Therapy, Adult Health, Health of the Elderly. Terapia de risa en adultos y personas hospitalizadas: revision integrativa Resumen : Terapia de risa comenzo a generalizarse debido a que la hospitalizacion era hostil. Mantener la integridad del individuo, y su estado de animo, se considera responsabilidad de la enfermera. Identificar como la intervencion de terapia de risa en adultos hospitalizados y ancianos actua sobre las respuestas al bienestar, calidad de vida y estado de animo. Revision integral de literatura. Se seleccionaron siete articulos despues de la busqueda, con criterios de inclusion y exclusion. Estudios informan efectos beneficiosos sobre estado de animo, que pueden reducir estres, ansiedad e influir en los signos vitales. Se destaca la importancia de desarrollar investigaciones sobre el tema, debido a la escasez en la literatura de estudios, especialmente brasilenos. Uso de risoterapia es necesario en hospital, por lo tanto, estudios como este ayudan a alentar a los profesionales a implementar esta estrategia y asi mejorar la calidad de atencion brindada. Descriptores: Risaterapia, Salud del Adulto, Salud del Anciano.

This chapter presents insights about how NOS Inovação has reshaped their teams to get a more horizontal and holistic overview about their services (from development to operations) and how this change has positively impacted the development of new services targeting internet personalisation. Furthermore, this chapter also describes the NOS vision about Industry 5.0, where digital transition is a key enabler and presents a critical role in the future.

BACKGROUND Optimal delivery of prevention of mother to child transmission of HIV (PMTCT) programs is challenging, including in Mozambique. The Systems Analysis and Improvement Approach (SAIA) is a multi-component, systems engineering strategy that has demonstrated PMTCT cascade improvement in a previous cluster randomized trial. To facilitate scale-up and improve integration into routine management systems, the SAIA-SCALE trial (NCT03425136) evaluates delivery of SAIA to health facilities by maternal and child health district supervisors, with minimal external support. SAIA-SCALE uses the RE-AIM framework to evaluate essential ingredients for public health impact that are infrequently reported. In this article we report intervention reach, adoption, implementation, and maintenance.METHODS SAIA-SCALE is a stepped-wedge trial in 36 facilities covering all 12 districts of Manica province, central Mozambique, from 2018—2021. Each district received a one-year intensive phase with external research staff support and financial support, followed by a maintenance phase with only limited financial support. We used data from health management information systems and implementation tracking to assess reach, adoption, implementation, and maintenance of the SAIA strategy using descriptive statistics.RESULTS SAIA-SCALE reached 36 facilities covering over 146,000 institutional births and 206,000 first antenatal care visits during the study period. Mean scores on two organizational readiness predictors of adoption were 4.82/5 for change commitment and 4.78/5 for change efficacy. Program adoption was 100%—all 12 targeted districts attended initial training, and all targeted 36 facilities initiated the SAIA strategy. Intensive and maintenance phases comprised equal facility-months. Each facility received an average of 1.1 and 1.0 mentorship visits per month from district supervisors during the intensive and maintenance phases, respectively. Across all facilities, 429 workplans were developed during the intensive and 432 during the maintenance phase. Facility staff reported implementing 91.8% of intensive phase workplans, and 85.9% of maintenance phase workplans. Facilities reported adopting into routine practice 70% and 62% of micro-interventions tested during the intensive and maintenance phases, respectively.CONCLUSIONS Assessment of reach, adoption, implementation, and maintenance revealed the successful integration of a systems engineering strategy for PMTCT into routine healthcare management systems in Mozambique. R-AIM should more frequently be reported alongside effectiveness for a deeper understanding of sustained public health impact of HIV prevention programs.Trial registration:ClinicalTrials.gov NCT03425136 (registered 02/06/2018).

Background: The Systems Analysis and Improvement Approach (SAIA) is an evidence-based, multi-component implementation strategy that engages service providers in the use of routinely-available service data to optimize service delivery cascades and promote systems-level thinking. SAIA was originally developed to address bottlenecks in HIV care in low-and middle-income countries, but has since been adapted and applied to a variety of care systems including: cervical cancer screening, mental health treatment, hypertension management, family planning, and community-based naloxone distribution. These projects have been implemented across a variety of settings in sub-Saharan Africa and the United States. Given the diversity of implementation experience, our consortium aimed to define the core elements of SAIA, to improve reproducibility, guide future adaptations, and lay the groundwork to evaluate mechanisms of action. Methods: Specification of the SAIA strategy was undertaken over 12 months by an expert panel of SAIA researchers, implementing agents and stakeholders, using a three-round, modified nominal group technique approach to match core SAIA components to the Expert Recommendations for Implementing Change (ERIC) list of distinct implementation strategies. Core implementation strategies were then specified according to Proctor’s recommendation for specifying and reporting, followed by synthesis of data on related implementation outcomes linked to the SAIA strategy across projects.Results: The four components of the SAIA strategy: (1) SAIA strategy meetings; (2) cascade analysis; (3) process mapping; and (4) continuous quality improvement, mapped to 13 distinct ERIC strategies. The SAIA strategy meetings component mapped to external facilitation, organization of provider implementation meetings, and provision of ongoing consultation. Cascade analysis mapped to facilitating relay of clinical data to providers, use of audit and feedback, and modelling and simulation of change. Process mapping tied to local needs assessment, local consensus discussions, and assessment of readiness and identification of barriers and facilitators. Continuous quality improvement encompassed tailoring strategies, developing a formal implementation blueprint, cyclical tests of change and purposefully re-examining the implementation process.Conclusions: Formally specifying the core components of SAIA provides improved conceptual clarity to enhance reproducibility for other researchers and practitioners interested in applying the SAIA across novel settings. Furthermore, this work provides a structured framework to examine potential mechanisms of SAIA and its component implementation strategies.

Visceral leishmaniasis is a rare disease in Western countries. We present the case of a 72-year-old male recipient of a related live donor renal transplant 41 years earlier and a past medical history of visceral leishmaniasis, who presented with progressive malaise, diarrhea, weight loss and darkening of skin, 11 months after the first episode. The main finding on blood work was severe hyponatremia and pancytopenia. He was diagnosed with relapsing visceral leishmaniasis and treated with liposomal amphotericin B (L-AmB), reduction of immunosuppressive therapy and supportive therapy. Throughout treatment he had worsening bradycardia and hyponatremia accompanied with liver failure and acute congestive heart failure. The patient survived the leishmaniasis episode but had sequels of chronic liver disease and chronic heart failure. The authors report the case due to its clinical challenge and due to the fact that data on how to treat immunodeficient patients with relapsing leishmaniasis is scarce.

Background Cascades have been used to characterize sequential steps within a complex health system and are used in diverse disease areas and across prevention, testing, and treatment. Routine data have great potential to inform prioritization within a system, but are often inaccessible to frontline health care workers (HCWs) who may have the greatest opportunity to innovate health system improvement. Methods The cascade analysis tool (CAT) is an Excel-based, simple simulation model with an optimization function. It identifies the step within a cascade that could most improve the system. The original CAT was developed for HIV treatment and the prevention of mother-to-child transmission of HIV. Results CAT has been adapted 7 times: to a mobile application for prevention of mother-to-child transmission; for hypertension screening and management and for mental health outpatient services in Mozambique; for pediatric and adolescent HIV testing and treatment, HIV testing in family planning, and cervical cancer screening and treatment in Kenya; and for naloxone distribution and opioid overdose reversal in the United States. The main domains of adaptation have been technical-estimating denominators and structuring steps to be binary sequential steps-as well as logistical-identifying acceptable approaches for data abstraction and aggregation, and not overburdening HCW. Discussion CAT allows for prompt feedback to HCWs, increases HCW autonomy, and allows managers to allocate resources and time in an equitable manner. CAT is an effective, feasible, and acceptable implementation strategy to prioritize areas most requiring improvement within complex health systems, although adaptations are being currently evaluated.

Aurantiochytrium sp. is an emerging alternative source of polyunsaturated fatty acids (PUFAs), docosahexaenoic acid (DHA), and squalene, playing an important role in the phasing out of traditional fish sources for these compounds. Novel lipid extraction techniques with a focus on sustainability and low environmental footprint are being developed for this organism, but the exploration of other added-value compounds within it is still very limited. In this work, a combination of novel green extraction techniques (high hydrostatic pressure extraction (HPE) and supercritical fluid extraction (SFE)) and traditional techniques (organic solvent Soxhlet extraction and hydrodistillation (HD)) was used to obtain lipophilic extracts of Aurantiochytrium sp., which were then screened for antioxidant (DPPH radical reduction capacity and ferric-reducing antioxidant potential (FRAP) assays), lipid oxidation protection, antimicrobial, anti-aging enzyme inhibition (collagenase, elastase and hyaluronidase), and anti-inflammatory (inhibition of NO production) activities. The screening revealed promising extracts in nearly all categories of biological activity tested, with only the enzymatic inhibition being low in all extracts. Powerful lipid oxidation protection and anti-inflammatory activity were observed in most SFE samples. Ethanolic HPEs inhibited both lipid oxidation reactions and microbial growth. The HD extract demonstrated high antioxidant, antimicrobial, and anti-inflammatory activities making, it a major contender for further studies aiming at the valorization of Aurantiochytrium sp. Taken together, this study presents compelling evidence of the bioactive potential of Aurantiochytrium sp. and encourages further exploration of its composition and application.

The degree to which romantic partners’ autonomic responses are coordinated, represented by their pattern of physiological synchrony, seems to capture important aspects of the reciprocal influence and co-regulation between spouses. In this study, we analyzed cou-ple´s cardiac synchrony as measured by heart rate (HR) and heart rate variability (HRV). A sample of twenty-seven couples (N = 54) performed a structured interaction task in the lab where they discussed positive and negative aspects of the relationship. During the interaction, their cardiac measures (HR and HRV) were recorded using the Biopac Sys-tem. Additional assessment, prior to the lab interaction task, included self-report measures of empathy (Interpersonal Reactivity Index and Interpersonal Reactivity Index for Couples) and relationship satisfaction (Revised Dyadic Adjustment Scale). Synchrony computation was based on the windowed cross-correlation of both partner´s HR and HRV time series. In order to control for random synchrony, surrogate controls were cre-ated using segment-wise shuffling. Our results confirmed the presence of cardiac syn-chrony during the couple´s interaction when compared to surrogate testing. Specifically, we found evidence for negative (anti-phase) synchrony of couple´s HRV and positive (in-phase) synchrony of HR. Further, both HRV and HR synchronies were associated with several dimensions of self-report data. This study suggests that cardiac synchrony, partic-ularly the direction of the co-variation in the partners´ physiological time series, may have an important relational meaning in the context of marital interactions

The peripersonal space (PPS) is a multisensory representation of the near-body region of space where objects appear at hand. It also represents a buffer zone protecting the body from external threats and as such it contributes to the organization of social interactions. However, how the combination of embodied objects processing and constraints inherent to social interactions contributes to PPS representation remains an open issue. By using a cooperative task where two male (N = 22) or female (N = 18) participants, sharing the same action space, were requested to select a number of stimuli on a touch-screen table, we investigated the effect of non-uniform distribution of reward-yielding stimuli on selection strategy and perceptual judgments of reachability, used as a proxy of PPS representation. The probability to select a reward-yielding stimulus (50% of the stimuli) was 75% in the proximal space of one of the two confederates. Results showed that participants initially prioritized stimuli in their proximal space and were progressively influenced by the spatial distribution of reward-yielding stimuli, thus invading their confederate’s action space when associated with higher probability of reward. The distribution of reward-yielding stimuli led to an increase of reachability threshold, but only when biased towards the participants’ distal space. Although the invasion of others’ PPS was more pronounced in male participants, the biased distribution of reward-yielding stimuli altered the reachability threshold similarly in males and females. As a whole, the data revealed that reward expectations in relation to motor actions influence both PPS exploration and representation in social context, but differently in males and females., This work was funded by the French National Research Agency (ANR-11-EQPX-0023) and also supported by European funds through the program FEDER SCV-IrDIVE. M-F G was supported by a Ph.D. grant from the University of Lille and Région Hauts-de-France.

Microanalysis is a method for recording and coding interactional behavior. It has been often compared to a social microscope, for its power in detailing the second-by-second dynamics of social interaction. Microanalysis has deep multidisciplinary foundations, that privilege the description of interactions as they naturally occur, with the purpose of understanding the relations between multiple and simultaneous streams of behaviors. In developmental science, microanalysis has uncovered structural and temporal elements in mother-infant interactions, improving our understanding of the effects of mother-infant interpersonal adaptation in the infant’s cognitive and social-emotional development. Detailed manual coding is time intensive and resource demanding, imposing restrictions to sample size, and the ability to analyze multiple behavioral modalities. Moreover, recent increases in the density of multivariate data require different tools. We review present-day techniques that tackle those challenges: (1) sensing techniques for motion tracking and physiological recording; (2) exploratory techniques for detecting patterns from high-density data; and (3) inferential and modeling techniques for understanding contingencies between interactional time series. Two illustrations, from recent developmental research, reveal the power of bringing new lenses to our social microscope: (1) egocentric vision, the use of head mounted cameras and eye-trackers in capturing the infant’s first-person perspective of a social exchange; and (2) daily activity sensing, wearable multimodal sensing that brought mother-infant interaction research to the environments where it naturally unfolds.

The ability to regulate our own physiological arousal when dealing with the emotional expression of our partner is crucial for satisfactory and stable intimate relationships. In previous physiological studies of marital interactions, researchers have found greater levels of psychophysiological arousal for members of the couple in conflictual interactions in comparison with positive interactions. Past researchers have established that intense and prolonged autonomic and neuroendocrine arousal during marital conflict can have negative consequences for mental and physical health. In this study we examined the physiological reactivity, as measured by skin conductance level, heart rate and cortisol levels, from both partners during a couple's interaction task consisting of a structured conversation about positive and negative aspects of their relationship. Participants were thirty-two heterosexual couples (N = 64) in a committed monogamous relationship with a minimum duration of one year. We found higher heart rate and cortisol levels during negative interaction condition when compared with the positive condition. Skin conductance was higher in the positive interaction condition, when compared with the negative interaction condition. In addition, we found a significant negative association between heart rate variability and autonomic arousal evoked by the interaction task. The implications of these findings for the effects of marital strain on health as well as for the design of risk-reducing interventions, namely biofeedback are discussed., This study was funded by BIAL Foundation (Grant number: 87/12). Joana Coutinho was funded by a FCT postdoctoral grant (No. SFRH/BPD/75014/2010). This study was conducted at Psychology Research Centre (UID/PSI/01662/2013), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Education and Science through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653)., info:eu-repo/semantics/publishedVersion

The Self-Report Psychopathy Scale-Short Form (SRP-SF) is a brief measure of psychopathy, developed via model-based test theory. The SRP-SF has a 4-factor structure with items reflecting affective, interpersonal, lifestyle, and antisocial domains, in line with the Psychopathy Checklist-Revised (PCL-R), which can be aggregated to form the traditional F1 and F2 dimensions of psychopathy. Previous research indicates the SRP is a viable tool for examining the prevalence of psychopathic propensities and their correlates in nonoffender populations. Currently, a substantial amount of nonoffender research on psychopathy is conducted in North America. Here, we inspect the psychometric properties of the SRP-SF and probe its association with general personality and empathy in a large southern European (Portuguese) community sample. Consistent with previous studies, results indicated good fit for the 4-factor model, including for separate female and male subsamples, good internal consistency across its scales and subscales, and the predicted pattern of associations with the correlates of psychopathy. The results of this cross-cultural study provide further evidence of the validity of the SRP-SF in the assessment of psychopathy in community samples, and help to extend the nomological net on the larger construct to a southern European sample., Preparation of this article was supported by the Portuguese Foundation for Science and Technology (FCT) grants awarded to Ana Seara-Cardoso (PTDC/MHC-PCN/2296/2014; SFRH/BPD/94970/2013), co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-016747). Joana Coutinho was supported during the writing of this article by an FCT postdoctoral grant (SFRH/BPD/75014/2010). This work was conducted at Psychology Research Center (UID/PSI/01662/2013), University of Minho, supported by the FCT, cofinanced by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653). This study was not preregistered.

Nowadays, we are witnessing an increase of innovation both on start-up and SME. The implementation of innovation has a strong impact in the knowledge of economy. The ability of human being in creating it can be defined as a basic skill in a global economy, involving learning as an essential dynamism of the competition. Furthermore, the research and development activities are very important not only for universities and companies but also for the global economy. This paper presents a new conceptual approach for innovation process in start-ups and a new methodology to know how long the innovation process must take. The conceptual approach proposed is divided into seven interactive steps: 1) Have an idea (product, service, process, business/marketing; 2) Analyze the state-of-the-art and the market; 3) R&D activities and Intellectual Property; 4) Listen the market; 5) Define a flexible business plan; 6) Find a business partner; and 7) Go-to-market. Regarding the time of innovation, the presented methodology is based on five Porter's Forces.

There is long-standing evidence that thyroid disease and kidney disease have a two-way relationship, as they can aggravate and lead to each other. The exact nature of this association and its clinical implications have been a matter of debate, as co-sharing of risk factors and appropriate prospective studies that allow for causal relationships to be inferred are lacking. Hypothyroidism is currently regarded by the American Heart Association as a modifiable cardiovascular risk factor and a reversible cause of heart failure. Among the nephrology community, while hypothyroidism has been an increasingly prevalent issue, formal guidelines on how to proceed when such association occurs are lacking and its clinical implications are often underappreciated among practitioners. Whether renal disease caused the thyroid disturbance or vice-versa, there is evidence pointing to thyroid dysfunction being a risk factor for incident chronic kidney disease and its progression and it is linked to increased overall mortality in CKD patients. The authors provide a review of current scientific evidence on this complex relationship.

The peripersonal space (PPS) is a multisensory representation of the near-body region of space where objects appear at hand. It also represents a buffer zone protecting the body from external threats and as such it contributes to the organization of social interactions. However, how the combination of embodied objects processing and constraints inherent to social interactions contributes to PPS representation remains an open issue. By using a cooperative task where two male (N = 22) or female (N = 18) participants, sharing the same action space, were requested to select a number of stimuli on a touch-screen table, we investigated the effect of non-uniform distribution of reward-yielding stimuli on selection strategy and perceptual judgments of reachability, used as a proxy of PPS representation. The probability to select a reward-yielding stimulus (50% of the stimuli) was 75% in the proximal space of one of the two confederates. Results showed that participants initially prioritized stimuli in their proximal space and were progressively influenced by the spatial distribution of reward-yielding stimuli, thus invading their confederate's action space when associated with higher probability of reward. The distribution of reward-yielding stimuli led to an increase of reachability threshold, but only when biased towards the participants' distal space. Although the invasion of others' PPS was more pronounced in male participants, the biased distribution of reward-yielding stimuli altered the reachability threshold similarly in males and females. As a whole, the data revealed that reward expectations in relation to motor actions influence both PPS exploration and representation in social context, but differently in males and females.

BACKGROUND Prevention of mother-to-child HIV transmission (PMTCT) care cascade failures drive pediatric HIV infections in sub-Saharan Africa. As nurses’ clinical and management role in PMTCT expand, decision-support tools for nurses are needed to facilitate identification of cascade inefficiencies and solutions. The mobile phone–based PMTCT cascade analysis tool (mPCAT) provides health facility staff a quick summary of the number of patients and percentage drop-off at each step of the PMCTC care cascade, as well as how many women-infant pairs would be retained if a step was optimized. OBJECTIVE The objective of this study was to understand and improve the mPCAT’s core usability factors and assess the health workers’ experience with using the mPCAT. METHODS Overall, 2 rounds of usability testing were conducted with health workers from 4 clinics and leading experts in maternal and child health in Kenya and Mozambique using videotaped think aloud assessment techniques. Semistructured group interviews gauged the understanding of mPCAT’s core usability factors, based on the Nielsen Usability Framework, followed by development of cognitive demand tables describing the needed mPCAT updates. Post adaptation, feasibility was assessed in 3 high volume clinics over 12 weeks. Participants completed a 5-point Likert questionnaire designed to measure ease of use, convenience of integration into work, and future intention to use the mPCAT. Focus group discussions with nurse participants at each facility and in-depth interviews with nurse managers were also conducted to assess the acceptability, use, and recommendations for adaptations of the mPCAT. RESULTS Usability testing with software engineers enabled real-time feedback to build a tool following empathic design principles. The revised mPCAT had improved navigation and simplified data entry interface, with only 1 data entry field per page. Improvements to the results page included a data visualization feature and the ability to share results through WhatsApp. Coding was simplified to enable future revisions by nontechnical staff—critical for context-specific adaptations for scale-up. Health care workers and facility managers found the tool easy to use (mean=4.3), used the tool very often (mean=4.1), and definitely intended to continue to use the tool (mean=4.8). Ease of use was the most common theme identified, with emphasis on how the tool readily informed system improvement decision making. CONCLUSIONS The mPCAT was well accepted by frontline health workers and facility managers. The collaborative process between software developer and user led to the development of a more user-friendly, context-specific tool that could be easily integrated into routine clinical practice and workflow. The mPCAT gave frontline health workers and facility managers an immediate, direct, and tangible way to use their clinical documentation and routinely reported data for decision making for their own clinical practice and facility-level improvements.

BackgroundPrevention of mother-to-child HIV transmission (PMTCT) care cascade failures drive pediatric HIV infections in sub-Saharan Africa. As nurses’ clinical and management role in PMTCT expand, decision-support tools for nurses are needed to facilitate identification of cascade inefficiencies and solutions. The mobile phone–based PMTCT cascade analysis tool (mPCAT) provides health facility staff a quick summary of the number of patients and percentage drop-off at each step of the PMCTC care cascade, as well as how many women-infant pairs would be retained if a step was optimized. ObjectiveThe objective of this study was to understand and improve the mPCAT’s core usability factors and assess the health workers’ experience with using the mPCAT. MethodsOverall, 2 rounds of usability testing were conducted with health workers from 4 clinics and leading experts in maternal and child health in Kenya and Mozambique using videotaped think aloud assessment techniques. Semistructured group interviews gauged the understanding of mPCAT’s core usability factors, based on the Nielsen Usability Framework, followed by development of cognitive demand tables describing the needed mPCAT updates. Post adaptation, feasibility was assessed in 3 high volume clinics over 12 weeks. Participants completed a 5-point Likert questionnaire designed to measure ease of use, convenience of integration into work, and future intention to use the mPCAT. Focus group discussions with nurse participants at each facility and in-depth interviews with nurse managers were also conducted to assess the acceptability, use, and recommendations for adaptations of the mPCAT. ResultsUsability testing with software engineers enabled real-time feedback to build a tool following empathic design principles. The revised mPCAT had improved navigation and simplified data entry interface, with only 1 data entry field per page. Improvements to the results page included a data visualization feature and the ability to share results through WhatsApp. Coding was simplified to enable future revisions by nontechnical staff—critical for context-specific adaptations for scale-up. Health care workers and facility managers found the tool easy to use (mean=4.3), used the tool very often (mean=4.1), and definitely intended to continue to use the tool (mean=4.8). Ease of use was the most common theme identified, with emphasis on how the tool readily informed system improvement decision making. ConclusionsThe mPCAT was well accepted by frontline health workers and facility managers. The collaborative process between software developer and user led to the development of a more user-friendly, context-specific tool that could be easily integrated into routine clinical practice and workflow. The mPCAT gave frontline health workers and facility managers an immediate, direct, and tangible way to use their clinical documentation and routinely reported data for decision making for their own clinical practice and facility-level improvements.

Supplemental Digital Content is Available in the Text., Background: Despite large investments to prevent mother-to-child-transmission (PMTCT), pediatric HIV elimination goals are not on track in many countries. The Systems Analysis and Improvement Approach (SAIA) study was a cluster randomized trial to test whether a package of systems engineering tools could strengthen PMTCT programs. We sought to (1) define core and adaptable components of the SAIA intervention, and (2) explain the heterogeneity in SAIA's success between facilities. Methods: The Consolidated Framework for Implementation Research (CFIR) guided all data collection efforts. CFIR constructs were assessed in focus group discussions and interviews with study and facility staff in 6 health facilities (1 high-performing and 1 low-performing site per country, identified by study staff) in December 2014 at the end of the intervention period. SAIA staff identified the intervention's core and adaptable components at an end-of-study meeting in August 2015. Two independent analysts used CFIR constructs to code transcripts before reaching consensus. Results: Flow mapping and continuous quality improvement were the core to the SAIA in all settings, whereas the PMTCT cascade analysis tool was the core in high HIV prevalence settings. Five CFIR constructs distinguished strongly between high and low performers: 2 in inner setting (networks and communication, available resources) and 3 in process (external change agents, executing, reflecting and evaluating). Discussion: The CFIR is a valuable tool to categorize elements of an intervention as core versus adaptable, and to understand heterogeneity in study implementation. Future intervention studies should apply evidence-based implementation science frameworks, like the CFIR, to provide salient data to expand implementation to other settings.

Este estudo teve como principal objetivo traduzir e adaptar para lingua portuguesa o Indice de Reatividade Interpessoal para Casais (IRIC), analisando as propriedades psicometricas da versao portuguesa. Esse e um instrumento de avaliacao da empatia em casais, que resultou da adaptacao de uma das mais usadas escalas de empatia, o Indice de Reatividade Interpessoal de Davis, para o contexto das relacoes intimas. O IRIC avalia dimensoes de empatia cognitiva (tomada de perspetiva) e emocional (preocupacao empatica), importantes para a estabilidade e satisfacao das relacoes conjugais. A escala original foi traduzida para portugues e administrada a 148 sujeitos que estavam numa relacao amorosa ha pelo menos um ano. A maioria dos sujeitos eram mulheres com uma media de idades de 27 anos. Os resultados revelam uma estrutura fatorial semelhante a escala original, valores adequados de consistencia interna (alfa de Cronbach=0,82) e bons niveis de validade externa com uma escala de ajustamento diadico.

Social interactions require the capacity to understand both our and other’s internal states. These semi-independent skills, the ability to understand oneself and others, seem to rely on the same type of representations and recruit similar brain areas. In this study, we looked at the neural basis of self and other processing in the context of an interaction with a significant other. Fourty-two participants in a monogamous relationship completed an fMRI task in which they watched a set of video-vignettes of his/her romantic partner expressing emotional contents. Participants were asked to elaborate on his/her spouse´s experience (other condition) and on his/her own experience when watching the video-vignettes (self-condition). The results showed a significant overlap in the brain activation for both conditions (e.g. anterior insula, posterior cingulate/precuneus, inferior frontal gyrus, inferior parietal lobule). In addition, the self-condition recruited brain areas associated with interoceptive processing and affect sharing (e.g., posterior insula), whereas the other-condition engaged brain areas involved in the cognitive representation of another’s internal states and self-other distinction (e.g., fusiform, supramarginal gyrus, angular gyrus and temporoparietal junction)., This work was supported by the Fundação para a Ciência e a Tecnologia [UID/CEC/00319/2019].

Previous studies about romantic relationships have shown that the reciprocal influence between partners occurs not only at the behavioral and socio-emotional levels, but also at the psychophysiological level. This reciprocal influence is expressed in a pattern of physiological synchrony between partners (i.e., coordinated dynamics of the physiological time series). The main aim of the present study was to explore the presence of a pattern of physiological synchrony in electrodermal activity (EDA) during a couple interaction task. A second objective was to compare the synchrony levels during a negative interaction condition versus a positive interaction condition. Finally, we analyzed the association between synchrony and self-perception of empathy, dyadic empathy, and relationship satisfaction. Thirty-two couples (64 individuals) participated in this study. Each couple performed a structured interaction task while the EDA of both partners was being registered. The quantification of synchrony was based on the cross-correlation of both members' EDA time-series. In order to control for coincidental synchrony, surrogate datasets were created by repeatedly shuffling the original data of spouses X and Y of a dyad and computing synchronies on the basis of the shuffled data (pseudosynchrony values). Our results confirmed the presence of significant EDA synchrony during the interaction. We also found that synchrony was higher during the negative interactions relative to the positive interactions. Additionally, physiological synchrony during positive interaction was higher for those couples in which males scored higher in dyadic empathy. The clinical implications of these findings are discussed., This study was funded by BIAL Foundation (Grant number 87/12); by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Education and Science through National Funds and cofinanced by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01- 0145-FEDER-007653).

Na presente comunicação apresenta-se uma análise de um corpus constituído por manuais de Português que estão a ser usados em escolas do ensino básico em Portugal, focando-se o recurso a um cruzamento entre a poética e a crítica literárias e, por outro lado, a didática do texto literário. Trabalha-se igualmente no âmbito de uma interseção entre metodologias de natureza estatística (pelo levantamento de ocorrências de textos de autores africanos em relação ao total de textos presentes nos manuais que constituem o corpus selecionado) e uma perspetiva de natureza qualitativa, pela análise de conteúdo focada tanto nos textos (ou excertos) encontrados, como nas propostas didáticas apresentadas nestes manuais a propósito dos referidos textos. Salienta-se a importância dos manuais para a instituição do cânone literário, o qual decorre de fatores como seletividade, continuidade e formatividade (Reis, 1999) e que se configura como um espaço da institucionalização do literário, onde se manifesta de forma ostensiva a dialética entre forças de estabilização e forças de inovação. Sendo um trabalho focado na análise da presença de autores africanos de língua portuguesa, visa uma reflexão acerca da criação de um cânone literário do mundo lusófono, apontando algumas virtudes do caminho que se está a fazer e alertando para os perigos da visão redutora do outro pela reiteração de determinados traços tipificado(re)s. info:eu-repo/semantics/publishedVersion