eHealth e a adoção da inovação em assisted living technologies : o caso das demências

RESUMO - Assistimos hoje a um contexto marcado (i) pelo progressivo envelhecimento das sociedades ocidentais, (ii) pelo aumento da prevalência das doenças crónicas, de que as demências são um exemplo, (iii) pelo significativo aumento dos custos associados a estas patologias, (iv) por orçamentos públicos fortemente pressionadas pelo controlo da despesa, (v) por uma vida moderna que dificulta o apoio intergeracional, tornando o suporte proporcionado pelos filhos particularmente difícil, (vi) por fortes expectativas relativamente à prestação de cuidados de saúde com qualidade. Teremos assim de ser capazes de conseguir melhorar os serviços de saúde, ao mesmo tempo que recorremos a menos recursos financeiros e humanos, pelo que a inovação parece ser crítica para a sustentabilidade do sistema. Contudo a difusão das Assistive Living Technologies, apesar do seu potencial, tem sido bastante baixa, nomeadamente em Portugal. Porquê? Hamer, Plochg e Moreira (2012), no editorial do International Journal of Healthcare Management, enquadram a Inovação como “podendo ser imprevisível e mesmo dolorosa, pelo que talvez possamos não ficar surpreendidos se surgirem resistências e que, inovações bastante necessárias, capazes de melhorar os indicadores de saúde, tenham sido de adoção lenta ou que tenham mesmo sido insustentáveis”. Em Portugal não há bibliografia que procure caracterizar o modelo de difusão da inovação em eHealth ou das tecnologias de vivência assistida. A bibliografia internacional é igualmente escassa. O presente projeto de investigação, de natureza exploratória, tem como objetivo principal, identificar barreiras e oportunidades para a implementação de tecnologias eHealth, aplicadas ao campo das demências. Como objetivos secundários pretendemse identificar as oportunidades e limitações em Portugal: mapa de competências nacionais, e propor medidas que possa acelerar a inovação em ALT, no contexto nacional. O projeto seguirá o modelo de um estudo qualitativo. Para o efeito foram conduzidas entrevistas em profundidade junto de experts em ALT, procurando obter a visão daqueles que participam do lado da Oferta- a Indústria; do lado da Procura- doentes, cuidadores e profissionais de saúde; bem como dos Reguladores. O instrumento utilizado para a recolha da informação pretendida foi o questionário não estruturado. A análise e interpretação da informação recolhida foram feitas através da técnica de Análise de Conteúdo. Os resultados da Análise de Conteúdo efetuada permitiram expressar a dicotomia barreira/oportunidade, nas seguintes categorias aqui descritas como contextos (i) Contexto Tecnológico, nas subcategorias de Acesso às Infraestruturas; Custo da Tecnologia; Interoperabilidade, (ii) Contexto do Valor Percecionado, nas subcategorias de Utilidade; Eficiência; Divulgação, (iii) Contexto Político, compreendendo a Liderança; Organização; Regulação; Recursos, (iv) Contexto Sociocultural, incluindo nomeadamente Idade; Literacia; Capacidade Económica, (v) Contexto Individual, incluindo como subcategorias, Capacidade de Adaptação a Novas tecnologias; Motivação; Acesso a equipamentos (vi) Contexto Específico da Doença, nomeadamente o Impacto Cognitivo; Tipologia Heterogénea e a Importância do Cuidador. Foi proposto um modelo exploratório, designado de Modelo de Contextos e Forças, que estudos subsequentes poderão validar. Neste modelo o Contexto Tecnológico é um Força Básica ou Fundamental; o Contexto do Valor Percecionado, constitui-se numa Força Crítica para a adoção de inovação, que assenta na sua capacidade para oferecer valor aos diversos stakeholders da cadeia de cuidados. Temos também o Contexto Político, com capacidade de modelar a adoção da inovação e nomeadamente com capacidade para o acelerar, se dele emitir um sinal de urgência para a mudança. O Contexto Sociocultural e Individual expressam uma Força Intrínseca, dado que elas são características internas, próprias e imutáveis no curto-prazo, das sociedade e das pessoas. Por fim há que considerar o Contexto Específico da Doença, nesta caso o das demências. Das conclusões do estudo parece evidente que as condições tecnológicas estão medianamente satisfeitas em Portugal, com evidentes progressos nos últimos anos (exceção para a interoperabilidade aonde há necessidade de maiores progressos), não constituindo portanto barreira à introdução de ALT. Aonde há necessidade de investir é nas áreas do valor percebido. Da análise feita, esta é uma área que constitui uma barreira à introdução e adoção das ALT em Portugal. A falta de perceção do valor que estas tecnologias trazem, por parte dos profissionais de saúde, doentes, cuidadores e decisores políticos, parece ser o principal entrave à sua adoção. São recomendadas estratégias de modelos colaborativos de Investigação e Desenvolvimento e de abordagens de cocriação com a contribuição de todos os intervenientes na cadeia de cuidados. Há também um papel que cabe ao estado no âmbito das prioridades e da mobilização de recursos, sendo-lhe requerida a expressão do sentido de urgência para que esta mudança aconteça. Foram também identificadas oportunidades em diversas áreas, como na prevenção, no diagnóstico, na compliance medicamentosa, na terapêutica, na monitorização, no apoio à vida diária e na integração social. O que é necessário é que as soluções encontradas constituam respostas àquilo que são as verdadeiras necessidades dos intervenientes e não uma imposição tecnológica que só por si nada resolve. Do estudo resultou também a perceção de que há que (i) continuar a trabalhar no sentido de aproximar a comunidade científica, da clínica e do doente, (ii) fomentar a colaboração entre centros, com vista à criação de escala a nível global. Essa colaboração já parece acontecer a nível empresarial, tendo sido identificadas empresas Portuguesas com vocação global. A qualidade individual das instituições de ensino, dos centros de investigação, das empresas, permite criar as condições para que Portugal possa ser país um piloto e um case-study internacional em ALT, desde que para tal pudéssemos contar com um trabalho colaborativo entre instituições e com decisões políticas arrojadas.

Launching platforms for user-generated content

Field lab: Entrepreneurial and innovative ventures

Guidelines on how to assess the validity of results presented in subgroup analysis of clinical trials

In observational studies, identification of associations within particular subgroups is the usual method of investigation. As an exploratory method, it is the bread and butter of epidemiological research. Nearly everything that has been learned in epidemiology has been derived from the analysis of subgroups. In a randomized clinical trial, the entire purpose is the comparison of the test subjects and the controls, and when there is particular interest in the results of treatment in a certain section of trial participants, a subgroup analysis is performed. These subgroups are examined to see if they are liable to a greater benefit or risk from treatment. Thus, analyzing patient subsets is a natural part of the process of improving therapeutic knowledge through clinical trials. Nevertheless, the reliability of subgroup analysis can often be poor because of problems of multiplicity and limitations in the numbers of patients studied. The naive interpretation of the results of such examinations is a cause of great confusion in the therapeutic literature. We emphasize the need for readers to be aware that inferences based on comparisons between subgroups in randomized clinical trials should be approached more cautiously than those based on the main comparison. That is, subgroup analysis results derived from a sound clinical trial are not necessarily valid; one must not jump to conclusions and accept the validity of subgroup analysis results without an appropriate judgment.

Unilever food solutions new digital CRM platform- what is the combination of tools, processes and content that will help Unilever food solutions grow his business?

Unilever Food Solutions new digital CRM1 Platform - What is the combination of tools, processes and content that will help Unilever Food Solutions grow his business? Unilever Food Solutions (UFS) intend to create a new online platform to enable it to communicate with segments of the markets, which have previously been too difficult to reach. Specifically targeted at Chefs and other food professionals, the aim is to create an interactive website, which delivers value to its intended users by providing a variety of relevant content and functions, while simultaneously opening up a potential transactional channel to those same users.

Seasonal changes of leaf Nitrogen content in trees of Amazonian floodplains

In Amazonian floodplains the trees are exposed to extreme flooding of up to 230 days a year. Waterlogging of the roots and stems affects growth and metabolic activity of the trees. An increased leaf fall in the aquatic period and annual increment rings in the wood indicate periodical growth reductions. The present study aims at documenting seasonal changes of metabolism and vitality of adult trees in the annual cycle as expressed by changes of leaf nitrogen content. Leaves of six tree species common in floodplains in Central Amazonia and typical representants of different growth strategies were collected every month between May 1994 and June 1995 in the vicinity of Manaus, Brazil. Mean leaf nitrogen content varied between 1.3% and 3.2% in the non-flooded trees. Three species showed significantly lower Ν content in the flooded period (p=0.05, 0.001, 0.001), the difference ranging 20-25% lower than in the non-flooded period. Two species showed no significant difference while Nectandra amazonum showed 32% more Ν in the flooded season (p=0.001). Leaf nitrogen content was generally high when new leaves were flushed (in the flooded period) and decreased continuously thereafter in all species. Three species showed an additional peak of nitrogen during the first month of the terrestrial phase, in leaves which had flushed earlier, indicating that flooding may disturb nitrogen uptake.

Eco-efficient self-compacting concrete with reduced Portland cement content and high volume of fly ash and metakaolin

The eco-efficient, self-compacting concrete (SCC) production, containing low levels of cement in its formulation, shall contribute for the constructions' sustainability due to the decrease in Portland cement use, to the use of industrial residue, for beyond the minimization of the energy needed for its placement and compaction. In this context, the present paper intends to assess the viability of SCC production with low cement levels by determining the fresh and hardened properties of concrete containing high levels of fly ash (FA) and also metakaolin (MK). Hence, 6 different concrete formulations were produced and tested: two reference concretes made with 300 and 500 kg/m3 of cement; the others were produced in order to evaluate the effects of high replacement levels of cement. Cement replacement by FA of 60% and by 50% of FA plus 20% of MK were tested and the addition of hydrated lime in these two types of concrete were also studied. To evaluate the self-compacting ability slump flow test, T500, J-ring, V-funnel and L-box were performed. In the hardened state the compressive strength at 3, 7, 14, 21, 28 and 90 days of age was determined. The results showed that it is possible to produce low cement content SCC by replacing high levels of cement by mineral additions, meeting the rheological requirements for self-compacting, with moderate resistances from 25 to 30 MPa after 28 days.

Interaction paradigms versus age-related user profiles: an evaluation on content selection

Novel input modalities such as touch, tangibles or gestures try to exploit human's innate skills rather than imposing new learning processes. However, despite the recent boom of different natural interaction paradigms, it hasn't been systematically evaluated how these interfaces influence a user's performance or whether each interface could be more or less appropriate when it comes to: 1) different age groups; and 2) different basic operations, as data selection, insertion or manipulation. This work presents the first step of an exploratory evaluation about whether or not the users' performance is indeed influenced by the different interfaces. The key point is to understand how different interaction paradigms affect specific target-audiences (children, adults and older adults) when dealing with a selection task. 60 participants took part in this study to assess how different interfaces may influence the interaction of specific groups of users with regard to their age. Four input modalities were used to perform a selection task and the methodology was based on usability testing (speed, accuracy and user preference). The study suggests a statistically significant difference between mean selection times for each group of users, and also raises new issues regarding the “old” mouse input versus the “new” input modalities.

Satisfaction with Life Scale among adolescents and young adults in Portugal: extending evidence of construct validity

The paper presents three empirical studies designed to extend the test of the construct validity of the Satisfaction With Life Scale (SWLS) among Portuguese students. In the first study, the responses of 461 elementary and secondary education students were submitted to a principal component analysis. A solution of one single factor was chosen, accounting for 55.7 % of the total variance, with Cronbach alpha coefficient and inter-item correlation above .70 and .20, respectively. The second study used a sample of 317 undergraduate students and registered a similar factor solution for SWLS (/pq = 0.99), which accounted for 65.6 % of the total variance (Cronbach alpha .89 and inter-item correlation above .20). A test–retest analysis registered coefficients of .70 (T2) and .77 (T3) and no significant statistically differences between T2, T3 and T1. The third study used a sample of 107 foster care youths from elementary and secondary education. Confirmatory factor analysis results indicate adequate fit indexes for the one-factor solution (v2/df = 2.70, GFI = .96, CFI = .96), which showed convergent validity, reliability and homogeneity. In conclusion, there is psychometric evidence for the one-factor structure of the SWLS in Portugal.

Nonsolvent induced phase separation preparation of poly(vinylidene fluoride-co-chlorotrifluoroethylene) membranes with tailored morphology, piezoelectric phase content and mechanical properties

Poly(vinylidene fluoride-co-chlorotrifluoroethylene) – P(VDF-CTFE) membranes are increasingly interesting for a wide range of applications, including battery separators, filtration membranes and biomedical applications. This work reports on the morphology, hydrophobicity, thermal and mechanical properties variation of P(VDF-CTFE) membranes processed by nonsolvent induced phase separation technique (NIPS) as a function of the main processing parameters. All membranes show a porous structure composed of large spherulites, (interconnected) micropores and/or microvoids depending on the processing conditions used that in turn affect their hydrophobicity and mechanical properties. The degree of crystallinity of the membranes remains approximately constant with a value of about 15 %, except for the membranes immediately immersed in ethanol, which is of about 23 %. In turn, the crystalline phases present in the copolymer is mainly affected by the temperature and nonsolvent characteristics of the coagulation bath, the β-phase content ranging from 33 to 100 %, depending on those processing parameters. It was show that the temperature of water-based coagulation bath plays an important role in order to produce structurally uniform and homogeneous porous membranes, which is particularly important from the point of view of technological applications.

Ion exchange dependent electroactive phase content and electrical properties of poly(vinylidene fluoride)/Na(M)Y composites

Different metal-ion exchanged NaY zeolite, Na(M)Y, were used to prepare poly(vinylidene fluoride) based composites by solvent casting and melting crystallization. The effect of different metal ion-exchanged zeolites on polymer crystallization and electrical properties was reported. Cation-framework interactions and hydration energy of the cations determined that K+ is the most efficient exchanged ion in NaY zeolite, followed by Cs+ and Li+. The electroactive phase crystallization strongly depends on the ions present in the zeolite, leading to variations of the surface energy characteristics of the Na(M)Y zeolites and the polymer chain ability of penetration in the zeolite. Thus, Na(Li)Y and NaY induces the complete electroactive -phase crystallization of the crystalline phase of PVDF, while Na(K)Y only induces it partly and Na(Cs)Y is not able to promote the crystallization of the electroactive phase. Furthermore, different ion size/weigh and different interaction with the zeolite framework results in significant variations in the electrical response of the composite. In this way, iinterfacial polarization effects in the zeolite cavities and zeolite-polymer interface, leads to strong increases of the dielectric constant on the composites with lightest ions weakly bound to the zeolite framework. Polymer composite with Na(Li)Y show the highest dielectric response, followed by NaY and Na(K)Y. Zeolite Na(Cs)Y contribute to a decrease of the dielectric constant of the composite. The results show the relevance of the materials for sensor development.

Effect of butadiene/styrene ratio, block structure and carbon nanotube content on the mechanical and electrical properties of thermoplastic elastomers after UV ageing

Thermoplastic elastomers based on a triblock copolymer styrene-butadiene-styrene (SBS) with different butadiene/styrene ratios, block structure and carbon nanotube (CNT) content were submitted to accelerated weathering in a Xenontest set up, in order to evaluate their stability to UV ageing. It was concluded that ageing mainly depends on butadiene/styrene ratio and block structure, with radial block structures exhibiting a faster ageing than linear block structures. Moreover, the presence of carbon nanotubes in the SBS copolymer slows down the ageing of the copolymer. The evaluation of the influence of ageing on the mechanical and electrical properties demonstrates that the mechanical degradation is higher for the C401 sample, which is the SBS sample with the largest butadiene content and a radial block structure. On the other hand, a copolymer derivate from SBS, the styrene-ethylene/butadiene-styrene (SEBS) sample, retains a maximum deformation of ~1000% after 80 h of accelerated ageing. The hydrophobicity of the samples decreases with increasing ageing time, the effect being larger for the samples with higher butadiene content. It is also verified that cytotoxicity increases with increasing UV ageing with the exception of SEBS, which remains not cytotoxic up to 80 h of accelerated ageing time, demonstrating its potential for applications involving exposition to environmental conditions.

Cooking process evaluation on mercury content in fish

This study evaluated different cooking processes (roasted, cooked and fried) on total mercury (Hg) content in fish species most consumed by Manaus residents and surrounding communities, Amazon region. The results obtained for total Hg in natura and after the three types of preparation (roasted, cooked and fried) for 12 fish species showed a significant Hg concentration variation. In the present study the cooked and frying processes resulted in higher Hg losses for Pacu, Pescada, Jaraqui, Curimatã, Surubin and Aruanã fish species, most of them presenting detritivorous and carnivorous feeding habits. The higher Hg losses in the roasting process occurred for Sardinha, Aracu, Tucunaré, Pirapitinga, Branquinha and Tambaqui fish species, most of them being omnivorous and herbivorous fish species. Some micronutrients (Ca, Fe, K, Na, Se and Zn) in fish species in natura were also determined in order to perform a nutritional evaluation regarding these micronutrients.

Radio mobility in the digital era: interactivity, participation and content share possibilities in Iberian broadcasters

In the context of the scientific research into radio, recent years have encouraged many theories about the meaning of a post-radio (Oliveira & Portela, 2011), thus enlisting several parameters regarding the inclusion of contemporary radio in the digital and online environments. This digital migration has led to the development of mobile applications for radio, broadening the communicative potential of audiences (Aguado, Feijoo & Martínez, 2013), as well as promoting convergence of interactive content among listeners-users. Aware of this opportunity, the main broadcasters in Spain and Portugal have broadened their radiophonic scope to the mobile platform, especially geared towards smartphones through the development of mobile applications, commonly known as apps (Cerezo, 2010). As a symbol of a culture in permanent changing, smartphones not only provide greater easiness in terms of access and interaction, but also afford larger opportunities for disseminating content among audiences, a phenomenon that some studies have labelled as user distributed content (Villi, 2012). This article presents an exploratory analysis of the current policies of the main Spanish and Portuguese radio broadcasters regarding mobile applications, evaluating the different levels of interaction and participation in these platforms. This observation led to the conclusion, among other findings, that the mobile platform represents a supplementary channel for traditional FM radio, rather than a new medium with its own language and expression.

Yield of essential oil and safrole content based on fresh and dry biomass of long pepper in the Brazilian Amazon

Long pepper (Piper hispidinervum) is an Amazonian species of commercial interest due to the production of safrole. Drying long pepper biomass to extract safrole is a time consuming and costly process that can also result in the contamination of the material by microorganisms. The objective of this study was to analyze the yield of essential oil and safrole content of fresh and dried biomass of long pepper accessions maintained in the Active Germoplasm Bank of Embrapa Acre, in the state of Acre, Brazil, aiming at selecting genotypes with best performance on fresh biomass to recommend to the breeding program of the species. Yield of essential oil and safrole content were assessed in 15 long pepper accessions. The essential oil extraction was performed by hydrodistillation and analyzed by gas chromatography. A joint analysis of experiments was performed and the means of essential oil yield and safrole content for each biomass were compared by Student's t-test. There was variability in the essential oil yield and safrole content. There was no difference between the types of biomass for oil yield; however to the safrole content there was difference. Populations 9, 10, 12 and 15 had values of oil yield between 4.1 and 5.3%, and safrole content between 87.2 and 94.3%. The drying process does not interfere in oil productivity. These populations have potential for selection to the long pepper breeding program using oil extraction in the fresh biomass

Single-function approach to calibrating whatman n.º 42 filter paper based on suction versus water content relationships

Several suction–water-content (s-w) calibrations for the filter paper method (FPM) used for soil-suction measurement have been published. Most of the calibrations involve a bilinear function (i.e., two different equations) with an inflection point occurring at 60 kPacontent range of 30 %