Clarifying changes in student empathy throughout medical school: a scoping review

Despite the increasing awareness of the relevance of empathy in patient care, some findings suggest that medical schools may be contributing to the deterioration of students' empathy. Therefore, it is important to clarify the magnitude and direction of changes in empathy during medical school. We employed a scoping review to elucidate trends in students' empathy changes/differences throughout medical school and examine potential bias associated with research design. The literature published in English, Spanish, Portuguese and French from 2009 to 2016 was searched. Two-hundred and nine potentially relevant citations were identified. Twenty articles met the inclusion criteria. Effect sizes of empathy scores variations were calculated to assess the practical significance of results. Our results demonstrate that scoped studies differed considerably in their design, measures used, sample sizes and results. Most studies (12 out of 20 studies) reported either positive or non-statistically significant changes/differences in empathy regardless of the measure used. The predominant trend in cross-sectional studies (ten out of 13 studies) was of significantly higher empathy scores in later years or of similar empathy scores across years, while most longitudinal studies presented either mixed-results or empathy declines. There was not a generalized international trend in changes in students' empathy throughout medical school. Although statistically significant changes/differences were detected in 13 out of 20 studies, the calculated effect sizes were small in all but two studies, suggesting little practical significance. At the present moment, the literature does not offer clear conclusions relative to changes in student empathy throughout medical school.info:eu-repo/semantics/publishedVersio

Do coping responses predict better/poorer mental health in portuguese adults during Portugal's national lockdown associated with the COVID-19?

Background This study aimed at assessing the mental health status of adults living in Portugal during the national lockdown of March 2020 to May 2020, how study participants coped with stress during the national lockdown, as well as the association between coping responses and mental health status. Methods 430 adults from the general population living in Portugal completed measures of mental health status and coping. Results Participants reported a mental health status in the normal range. Most commonly used coping responses were acceptance, planning and active coping. The use of instrumental and emotional support, self-blame, venting, denial, behavioural disengagement, and substance use were associated with poorer mental health. Active coping, positive reframing, acceptance, and humour were associated with better mental health. However, only positive reframing and humour significantly predicted better mental health, while only substance use predicted poorer mental health. Conclusions Findings suggest that there was not a significant negative impact of the Portuguese national lockdown in the adults living in Portugal. Findings supported positive reframing and humour as being adaptive coping responses in this context. These responses should be encouraged by healthcare professionals and targeted in the context of psychosocial intervention programs directed to most vulnerable populations.Fundação para a Ciência e Tecnologia - FCTinfo:eu-repo/semantics/publishedVersio

Are prayer-based Interventions effective pain management options? A systematic review and meta-analysis of randomized controlled trials

This review examined the efects of private and communal participatory prayer on pain. Nine databases were searched. Six randomized controlled trials were included. For private prayer, medium to large efects emerged for 67% to 69% of betweengroup comparisons; participants in the prayer condition reported lower pain intensity (0.59<d<26.17; 4 studies) and higher pain tolerance (0.70<d<1.05; 1 study). Preto post-intervention comparisons yielded medium to large efects (0.76<d<1.67; 2 studies); pain intensity decreased. Although frm conclusions cannot be made because meta-analysis was based on only two studies, the analysis suggested prayer might reduce pain intensity (SMD=−2.63, 95% CI [−3.11, −2.14], I=0%). (PROSPERO: CRD42020221733)Fundação para a Ciência e Tecnologia - FCTinfo:eu-repo/semantics/publishedVersio

12º Congresso Nacional de Psicologia da Saúde: Promover e Inovar em Psicologia da Saúde: Actas

Promover e inovar em psicologia da saúde é o tema proposto para o Nacional de Psicologia da Saúde, que se realiza em Lisboa, no ISPA – Instituto Universitário de Ciências Psicológicas, Sociais e da Vida, numa organização conjunta da Sociedade Portuguesa de Psicologia do Saúde e do William James Center for Research do ISPA – Instituto Universitário. Como habitualmente, o primeiro objectivo deste congresso que se realiza a cada dois anos, e juntar os investigadores e profissionais que desenvolvem a sua actividade neste extenso campo designado como de Saúde e que, cobrindo os tradicionais contextos de saúde – hospitais e centros de saúde – se espraiam depois em direcções muito diversas em que a saúde e considerada um valor de todos os dias: a educação, o mundo organizacional, as instituições de iniciativa privada, empresarial, social, de apoio e assistenciais. Claro que o juntar num mesmo espaço físico todos estes investiga - dores, académicos, professores, alunos e profissionais da psicologia permitindo interacções directas esta ao serviço daquilo que tem sido apanágio da Sociedade Portuguesa de Psicologia da Saúde nestes mais de 20 anos de actividade: a promoção e divulgação da Psicologia da Saúde e da investigação científica. Serve, sobretudo, como forma de partilha de conhecimento e de experiencias. Pretende-se, assumidamente, possibilitar a partilha do estado da arte daquilo que são as práticas, reflexões, contributos teóricos e dados de investigação em direcção ao desenvolvimento continuado e alicerçado do conhecimento científico adentro da Psicologia da Saúde. A Sociedade Portuguesa de Psicologia da Saúde junta-se na organização deste congresso o William James Center for Research do ISPA – Instituto Universitário, numa pratica já consagrada pelos muitos anos de realização de diferentes congressos e que consiste em rodar por diferentes universidades e unidades de investigação o palco desta iniciativa. Em 2018, o 12o Congresso Nacional de Psicologia da Saúde, contara com 461 comunicações, sendo 6 delas conferencias proferidas por conferencistas convidados e 455, submetidas e aceites pela Comissão Cientifica do congresso e apresentadas em simpósios e comunicações livres nos formatos orais e escritos. Das comunicações apresentadas, cujos resumos são apresentados num suplemento da revista Psicologia, Saúde & Doenças, órgão oficial da SPPS, alguns dos autores submeteram os artigos respectivos a apreciação do Conselho Cientifico que procedeu a revisão de todos os trabalhos e escolheu 29 textos para serem apresentados no 1o numero de 2018 da revista Psicologia, Saúde & Doenças e 88 para serem publicados no livro de Actas do Congresso. Algumas das comunicações submetidas, e ainda um maior numero de artigos, não foram aceites para apresentação e publicação, por diversas razoes que vão desde a não observância das normas propostas, a fragilidade teórica e/ ou metodológica, ate a impossibilidade dos autores procederem as alterações propostas no curto tempo disponível para a preparação dos textos. O desafio que a SPPS coloca a si mesma em cada novo congresso e de conseguir num tempo recorde, disponibilizar o livro de atas do congresso no primeiro dia do mesmo, exigindo da parte da Comissão Cientifica, uma notável colaboração que aqui se reconhece e agradece. Promover a Psicologia da Saúde e inovar, num tempo em que a saúde não tem sido uma prioridade dos poderes estabelecidos, e um desafio que se coloca a todos e que esperamos que este 12o Congresso Nacional de Psicologia da Saúde possa ser um marco de encontros, caminhos e soluções.info:eu-repo/semantics/publishedVersio

Biofortified Diets Containing Algae and Selenised Yeast: Effects on Growth Performance, Nutrient Utilization, and Tissue Composition of Gilthead Seabream (Sparus aurata)

Efforts have been made to find natural, highly nutritious alternatives to replace fish meal (FM) and fish oil (FO), which can simultaneously promote fish health and improve the nutritional quality of filets for human consumption. This study evaluated the impact of biofortified diets containing microalgae (as replacement for FM and FO), macroalgae (as natural source of iodine) and selenised yeast (organic source of selenium) on gilthead seabream growth, nutrient utilization, tissue composition and gene expression. A control diet (CTRL) with 15% FM and 5.5% FO was compared with three experimental diets (AD1, AD2, and AD3), where a microalgae blend (Chlorella sp., Tetraselmis sp., and DHA-rich Schizochytrium sp.) replaced 33% of FM. Diet AD1 contained 20% less FO. Diets were supplemented with Laminaria digitata (0.4% AD1 and AD2; 0.8% AD3) and selenised yeast (0.02% AD1 and AD2; 0.04% AD3). After feeding the experimental diets for 12 weeks, growth was similar in fish fed AD1, AD2, and CTRL, indicating that microalgae meal can partially replace both FM and FO in diets for seabream. But AD3 suppressed fish growth, suggesting that L. digitata and selenised yeast supplementation should be kept under 0.8 and 0.04%, respectively. Despite lower lipid intake and decreased PUFAs bioavailability in fish fed AD3, compared to CTRL, hepatic elovl5 was upregulated resulting in a significant increase of muscle EPA + DHA. Indeed, filets of fish fed AD2 and AD3 provided the highest EPA + DHA contents (0.7 g 100 g–1), that are well above the minimum recommended values for human consumption. Fish consuming the AD diets had a higher retention and gain of selenium, while iodine gain remained similar among diets. Upregulation of selenoproteins (gpx1, selk, and dio2) was observed in liver of fish fed AD1, but diets had limited impact on fish antioxidant status. Overall, results indicate that the tested microalgae are good sources of protein and lipids, with their LC-PUFAs being effectively accumulated in seabream muscle. Selenised yeast is a good fortification vehicle to increase selenium levels in fish, but efforts should be placed to find new strategies to fortify fish in iodineThis work has received funding from the European Union’s Horizon 2020 Research and Innovation Programe under Grant Agreement No. 773400 (SEAFOODTOMORROW) and from the project ATLANTIDA (ref. NORTE-01-0145-FEDER-000040), supported by the Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement and through the European Regional Development Fund (ERDF). This work received financial support from REQUIMTE/LAQV national funds (FCT) through project UID/QUI/50006/2019. LV acknowledges national funds provided by FCT to CIIMAR (UIDB/04423/2020 and UIDP/04423/2020), PP-F acknowledges MAR2020 national funds provided to IPMA (DIVERISAQUA project - 16-02-01-FEAM-66) and MF acknowledges FCT for the grant SFRH/BD/144843/2019.info:eu-repo/semantics/publishedVersio

Psychometric properties of the Spanish version of the Jefferson Scale of Empathy: making sense of the total score through a second order confirmatory factor analysis

Background: Empathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JSE) is one of the most used empathy measures of medical students. The development of cross-cultural empathy studies depends on valid and reliable translations of the JSE. This study sought to: (1) adapt and assess the psychometric properties in Spanish students of the Spanish JSE validated in Mexican students; (2) test a second order latent factor model. Methods: The Spanish JSE was adapted from the Spanish JSE-S, resulting in a final version of the measure. A non-probabilistic sample of 1104 medical students of two Spanish medical schools completed a socio-demographic and the Spanish JSE-S. Descriptive statistics, along with a confirmatory factor analysis, the average variance extracted (AVE), Cronbach's alphas and composite reliability (CR) coefficients were computed. An independent samples t-test was performed to access sex differences. Results: The Spanish JSE-S demonstrated acceptable to good sensitivity (individual items - except for item 2 - and JSE-S total score: -2.72 < Sk < 0.35 and -0.77 < Ku < 7.85), convergent validity (AVE: between 0.28 and 0.45) and reliability (Cronbach's alphas: between 0.62 and 0.78; CR: between 0.62 and 0.87). The confirmatory factor analysis supported the three-factor solution and the second order latent factor model. Conclusions: The findings provide support for the sensitivity, construct validity and reliability of the adapted Spanish JSE-S with Spanish medical students. Data confirm the hypothesized second order latent factor model. This version may be useful in future research examining empathy in Spanish medical students, as well as in cross-cultural studies.info:eu-repo/semantics/publishedVersio

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types