Cross-cultural adaptation and validation of the Portuguese version of the "European Health and Behaviour Survey-section B".

BACKGROUND: The European Health and Behaviour Survey is a questionaire used to assess a wide range of health-related behaviours, attitudes to health, beliefs concerning the importance of behaviours for health, and health knowledge, using a standardized protocol suitable for translation and administration in different countries of Europe. The objective of this study was to translate and culturally adapt the EHBS-Section B (section used to assess attitudes towards the importance of 25 activities for health) to the Portuguese language and to test its reliability and validity. METHODS: This new version was obtained with forward/backward translations, consensus panels and a pre-test. The Portuguese versions of EHBS-Section B, Health and Risk-taking Behaviour Scale (HRBS), Health Belief Scale (HBS) and a form for the characteristics of the participants were applied to 849 Portuguese adolescents. RESULTS: Reliability was good with a Cronbach's alpha coefficient of 0.867, and an intraclass correlation coefficient (ICC) of 0.96. Corrected item-total coefficients ranged from 0.301 to 0.620 and weighted kappa coefficients ranged from 0.74 to 0.94 for the 17 items of the EHBS-Section B. Construct validity was supported by the confirmation of two predefined hypotheses involving expected significant correlations between EHBS-Section B, HRBS and HBS that represent similar constructs. CONCLUSIONS: The Portuguese EHBS-Section B exhibited suitable psychometric properties, in terms of internal consistency, reproducibility and construct validity. It can be used in educational and research settings.

Psychological wellbeing in teachers. Study in teachers of early childhood and primary education.

Recently, there has been a growing interest in emotional wellbeing, even from the early stages of education. In order to work wellbeing among the students it is essential to analyze the wellbeing of the teachers who are teaching and working with the children. This study examines psychological wellbeing in early childhood (0-6 years) and primary school teachers (6-12 years). The study comprised 236 early childhood and primary school teachers - 76 men (32.2%) and 160 women (67.8%) - with ages ranging from 25 to 61 years (average 37.69 years - s.d.=2.47). The study examined psychological wellbeing (happiness, eudemonic wellbeing, self-esteem, and life satisfaction) and several sociodemographic variables (gender, age, years in the job, type of contract, and educational stage). Participants answered an ad-hoc sociodemographic questionnaire and subjective happiness, eudemonic wellbeing, self-esteem, and life satisfaction standard questionnaires. Early childhood schoolteachers yielded higher wellbeing-related scores. All the wellbeing-related variables were found to be correlated with one another, except for happiness and self-esteem. Teachers working in different educational stages were found to yield significantly different wellbeing-related scores. For the first time, network analysis revealed differences in the associations of the variables under study among Early Childhood Education and Primary Education teachers. Thus, while happiness and satisfaction with life were found to be correlated in both groups, stronger correlations between self-esteem and eudaimonic wellbeing were found in early childhood education teachers, while in primary education teachers the correlation was with satisfaction with life, which indicates that early childhood teachers present greater spiritual and existential understanding, leading to eudaimonic wellbeing. These differences between educational stages are considered greatly significant. It was concluded that more research is needed, ideally with broader and longitudinal studies, to understand and describe the relationship between personal and even structural variables and wellbeing.

Medical ontology for treatment of clinical data from children and youth.

The use of information technologies in the field of biomedical data management has grown considerably and is today one of the main fields of use of these technologies. There are several advantages arising either to an individual's health or to public health, particularly because access to clinical data become available anywhere access via the Internet or individual health card. This card will contain personal data accessible from a terminal card reader, identical to the citizen card. This work focuses on the development of an ontology of universal data structure so that the information is accessible and organized in the same way, regardless of the system that use them. In this context there is the need to incorporate security mechanisms, the respect of ethical principles underlying the management and maintenance of clinical data, ensuring maximum confidentiality. To develop the proposed ontology, for the treatment of clinical data of children and youth is used as reference bulletin health in Portugal. Using this structure, it follows the clear and unambiguous identification of the fields required for registration of clinical information, standardized in a relational model. To ensure the confidentiality of data, identification of the individual is only the number of national health system and are not recorded on the card personal data such as name, address or contact forms.

A comparison of functional academic and daily living skills in males with fragile X syndrome with and without autism.

BACKGROUND: Adaptive behaviors, such as functional academic and daily living skills, are critical for independence in adults with intellectual and developmental disabilities. However, little is known about these skills in fragile X syndrome (FXS), the most common form of inherited intellectual disability. AIMS: The purposes of this study were to describe the functional academic and daily living skills of males diagnosed with FXS across different age groups and compare skill attainment by autism status and other common co-occurring conditions. METHODS AND PROCEDURES: We used survey methods to assess parent-reported functional academic and daily living skills in 534 males with FXS. Functional academic skills included time and schedules, money, math, reading, and writing skills. Daily living skills included hygiene, cooking, laundry and housekeeping, transportation, and safety skills. OUTCOMES AND RESULTS: Analyses examined functional academic and daily living skills in a cross-sectional sample of males between ages 5 and 67. Differences in skill attainment were found by child age, co-morbid autism status, total number of co-occurring conditions, and respondent education. Functional academic and daily living skills were predictive of community employment and independent living. CONCLUSIONS AND IMPLICATIONS: These data provide important information on the mastery of both foundational and more complex adaptive skills in males with FXS. Both functional academic and daily living skills were predictive of measures of independence above and beyond other child and family characteristics. These findings point to the need to focus interventions to support the attainment of independence in males with FXS.

A National Early Intervention System as a Strategy to Promote Inclusion and Academic Achievement in Portugal.

Early intervention with children at risk or facing developmental problems is a practice defined by three fundamental characteristics: being family-centered, being based on the community and on the child's life context, and being conducted by a team with transdisciplinary practice. In this paper we wish to present how the SNIPI-National System of Early Intervention, implemented in Portugal over the past 15 years, contributes to promote maximum development and the full inclusion of children up to 6 years of age and works to prevent school failure. The SNIPI covers the entire territory and intends to respond to the needs of children with developmental disorders or those in at risk situations. This community-based early intervention model is linked to the health, education and social care systems, involving the three responsible Ministries. In the present community case study, we present the implementation of this program in the Alentejo region, involving 31 local teams and almost 2500 children. Through the regional structure's reports and the responses of parents and professionals in impact studies, we demonstrate how the system is established and how it tackles school failure and improves the educational inclusion of these children. The impact of this Early Intervention model has been significant not only on children's developmental outcomes, but also for the health, education and social care professionals who work in a transdisciplinary perspective, as well as for the families who became more skilled at evaluating the children's needs and the support provided. This approach to implementing a family-centered Early Intervention program can contribute to full inclusion. It facilitates the transition to schooling based on a non-discriminatory approach and educational achievement by aiding development and an adapted contextualization in pre-school education. This program system introduces significant innovation within the framework of existing educational policies that promote development and inclusion, and has therefore earned the interest of the scientific community and policy-makers alike. It has been possible to implement some of principles already studied but it had never been tested. The Early Intervention program in Alentejo, as part of the SNIPI, can be an example of good practices, with its own characteristics that allowed to create a network of integrated and comprehensive responses to the needs of the population in this region.

Adaptação parental ao filho com deficiência: revisão sistemática da literatura / Parental adaptation to disabled children: Integrative review of literature

Quando nasce uma criança com deficiência, é necessária a reidealização do filho para que os pais possam lidar com as suas limitações e atender as suas demandas, resultando em uma adaptação parental adequada ao filho real. O presente artigo objetivou realizar uma revisão sistemática sobre a adaptação parental. Para tanto, investigaram-se as bases de dados Pubmed, BVS, Scopus e Cochrane, utilizando os termos Family adaptation, family impact, disabled children, no período de agosto a setembro de 2017. Foram analisados 21 artigos completos. Os resultados apontam que as famílias com um(a) filho(a) com alguma deficiência enfrentam inúmeros desafios, afetando diretamente a adaptação familiar e as estratégias de enfrentamento. Foram elaboradas três categorias para apresentar os resultados: impacto familiar ante o diagnóstico da deficiência; estados emocionais parentais e consequências sociais; fatores que interferem na adaptação familiar e nas estratégias de enfrentamento. Foi possível concluir que são aspectos centrais na adaptação parental: a) a identificação precoce de fatores positivos e negativos que impactam no processo de reidealização do filho; b) a abordagem interventiva precoce centrada na família, que considere esses fatores objetivando a busca de um enfrentamento focado na resolução de problemas; c) a criação de condições sociais de apoio às famílias.

When a child with disability is born, it is necessary to reidealize the child so that the parents can deal with their disabilities and meet their demands, which will result in an adequate parental adaptation to the real child. This article aimed to carry out a systematic review on parental adaptation. To do so, it was investigated the Pubmed, VHL, Scopus and Cochrane database, using the terms: Family adaptation, family impact, disabled children, in the period from August to September 2017. Twenty-one complete articles were analyzed. The results show that families with a child with some disability face numerous challenges, directly affecting family adaptation and coping strategies. Three categories were elaborated to present the results: family impact before the diagnosis of the deficiency; parental emotional states and social consequences; factors that interfere with family adaptation and coping strategies. It was possible to conclude that the central aspects in the parental adaptation are: a) the early identification of positive and negative factors that impact on the reidealization process of the child; b) an early intervention approach centered in the family that considers these factors aiming at the search for a confrontation focused on the resolution of problems; c) the creation of social conditions to support families.

Biological sulphide removal from anaerobically treated domestic sewage: reactor performance and microbial community dynamics.

We developed a biological sulphide oxidation system and evaluated two reactors (shaped similar to the settler compartment of an up-flow anaerobic sludge blanket [UASB] reactor) with different support materials for biomass retention: polypropylene rings and polyurethane foam. The start-up reaction was achieved using microorganisms naturally occurring on the open surface of UASB reactors treating domestic wastewater. Sulphide removal efficiencies of 65% and 90% were achieved with hydraulic retention times (HRTs) of 24 and 12 h, respectively, in both reactors. However, a higher amount of elemental sulphur was formed and accumulated in the biomass from reactor 1 (20 mg S(0) g(-1) VTS) than in that from reactor 2 (2.9 mg S(0) g(-1) VTS) with an HRT of 24 h. Denaturing gradient gel electrophoresis (DGGE) results revealed that the the pink and green biomass that developed in both reactors comprised a diverse bacterial community and had sequences related to phototrophic green and purple-sulphur bacteria such as Chlorobium sp., Chloronema giganteum, and Chromatiaceae. DGGE band patterns also demonstrated that bacterial community was dynamic over time within the same reactor and that different support materials selected for distinct bacterial communities. Taken together, these results indicated that sulphide concentrations of 1-6 mg L(-1) could be efficiently removed from the effluent of a pilot-scale UASB reactor in two sulphide biological oxidation reactors at HRTs of 12 and 24 h, showing the potential for sulphur recovery from anaerobically treated domestic wastewater.

A Síndrome do X Frágil e o estabelecimento de fenótipos cognitivo-comportamentais: uma revisão sistemática de literatura / The Fragile X Syndrome and the development of cognitive-behavioral phenotypes: a literature systematic review

Este artigo consiste em uma revisão sistemática de literatura que tem como objetivo fazer um panorama do conteúdo das publicações sobre cognição, comportamento e Síndrome do X Frágil. Realizou-se o levantamento bibliográfico nas bases de dados Pubmed, Science Direct, SciELO e LILACS, por meio dos descritores pré-estabelecidos cognition, behavior e Fragile X Syndrome. Foram selecionados 9 trabalhos para uma análise mais cuidadosa. Todos eram relevantes em relação às características fenotípicas cognitivo-comportamentais de crianças com a Síndrome do X Frágil, relatavam pesquisas experimentais transversais e descreviam aspectos comportamentais e/ou relacionados às funções executivas. As características cognitivas mais frequentemente apontadas pela revisão realizada foram: baixo coeficiente de inteligência, prejuízos na atenção, linguagem deficitária e motricidade. Já os aspectos comportamentais destacados estavam relacionados ao transtorno do espectro autista, à ansiedade e às dificuldades na socialização. Notou-se a presença de poucos estudos disponíveis na literatura e a necessidade de maiores investimentos nessa área de pesquisa. Mais estudos auxiliarão na maior compreensão da Síndrome do X Frágil e ampliarão as possibilidades de intervenção.

This article consists of a systematic literature review that aims to make an overview of the content of publications on cognition, behavior and Fragile X syndrome. It was conducted the literature review in Pubmed, Science Direct, SciELO and LILACS, usingthe pre-established descriptors cognition, behavior and Fragile X Syndrome. Nine papers were selected for closer examination. All were relevant in relation to cognitive behavioral phenotypic characteristics of children with Fragile X Syndrome, reported cross experimental research and described behavioral aspects and/or related to executive functions. Cognitive characteristics most often highlighted by the review were conducted: low intelligence quotient, impairments in attention, poor motor skills and language. Behavioral aspects were related to autism spectrum disorder, anxiety and difficulties in socialization. The presence of few studies available in the literature and the need for further investments in this area of research it was noted. More studies will assist in better understanding of Fragile X Syndrome and expand the possibilities of intervention.

Push-out bond strength of glass fiber posts luted with two resin cements / Resistência à tração de pinos de fibra de vidro cimentados com dois tipos de cimento resinoso

Objectives: To evaluate the bond strength of a prefabricated glass fiber post to the root dentin with two resin cements using the push-out test. Material and Methods: Thirty fiber posts (White Post ECD) were cemented in human endodontically treated anterior teeth with two resin cements (n=15): RelyxTM ARC and AllCem. The roots were transversely sectioned and divided in cervical, middle and apical thirds after 48 h of cementation. The specimens' retention was tested by push-out method. The results were analyzed by 2-way ANOVA and Tukey's test (p <0.05). Results: There were no significant differences in the bond strength between the resin cements. The bond strength was higher in cervical third than in middle and apical thirds for both resin cements. It was observed higher percentages of adhesive failures followed by mixed. Conclusions: Both resin cements are indicated in the cementation of glass fiber post. (AU)

Objetivo: Avaliar a resistência de união entre dentina radicular e pino pré-fabricado, utilizando dois sistemas cimentantes, por meio do teste push-out. Material e Métodos: Trinta pinos de fibra de vidro (White Post DCE) foram cimentados a dentes humanos anteriores, tratados endodonticamente, com o auxílio de dois sistemas cimentantes (n=15): RelyxTM ARC e AllCem. Após 48 horas da cimentação, as raízes foram seccionadas transversalmente e divididas em terços cervical, médio e apical. Os corpos-de-prova foram submetidos ao teste de cisalhamento por extrusão "push-out". Os resultados foram submetidos aos testes estatísticos de análise de variância (2-way ANOVA) e de Tukey y (p<0,05). Resultados: Não houve diferença estatisticamente significativa na resistência de união entre os dois cimentos resinosos utilizados. A resistência de união foi maior no terço cervical do que nos terços médio e apical. Foi observada maior frequência de falhas adesivas seguida das mistas. Conclusão: Os dois cimentos resinosos são sugeridos para a cimentação de pinos de fibra de vidro (AU)

Paixão-dor-paixão: pathos, luto e melancolia no nascimento da criança com deficiência / Passion-pain-passion: pathos, morning and melancholy on the occasion of a child born with disabilities / Passion-douleur-passion: pathos, deuil et mélancolie à la naissance d’un enfant handicapé / Pasión-dolor-pasión: pathos, luto y melancolía en el nacimiento del niño con discapacidad

O nascimento de um filho com um transtorno grave de desenvolvimento marca, enquanto crise, o percurso evolutivo dos pais. A perda do bebê idealizado, exige um trabalho de elaboração do luto. No entanto, a ligação emocional ao pathos-paixão inicial ergue-se como obstáculo a esse processo e, mais do que isso, à criação de um novo vínculo ao bebê nascido e real, com as suas qualidades e limitações, que corre o risco de não ocupar um espaço na vida emocional dos pais a contas com o seu pathos-dor. Neste trabalho serão discutidas as saídas do lado melancólico e as alternativas de elaboração do sofrimento emocional com vista ao investimento parental e apego à criança com deficiência.

The birth of a child with a severe developmental disorder affects, as a crisis, the development of its parents. The loss of the idealized child requires mourning. However, the emotional identification with the pathos-passion becomes an obstacle to that process and to the bonding to the newborn, who has its qualities and disabilities, and who may not be able to occupy any space in the emotional life of its parents, since they are struggling with their pathos-pain. This paper discusses ways to escape melancholy and alternatives to manage the emotional distress, encouraging parental engagement and attachment to disabled children.

La naissance d’un enfant avec un trouble grave du développement affecte, en tant que crise, le développement des parents. La perte de l’enfant idéalisé demande l’élaboration du deuil. Cependant, le lien émotionnel avec la pathos-passion originale devient un obstacle à ce processus et à l’attachement au nouveau-né, avec ses qualités et insuffisances. Celui-ci risque en effet de rester exclu de la vie affective de ses parents, étant donné qu’ils sont en train d’élaborer leur pathos-douleur. Dans cet article, nous discutons comment échapper à la mélancolie et les alternatives d’élaboration de la détresse émotionnelle en vue de l’engagement des parents et de leur attachement à l’enfant handicapé.

El nacimiento de un hijo con un trastorno grave de desarrollo afecta, como una crisis, el desarrollo de los padres. La pérdida del hijo idealizado requiere la elaboración de un duelo. Sin embargo, la conexión emocional con el primer pathos-pasión se convierte en un obstáculo para este proceso y, más que todo, en un nuevo vínculo con el bebé nacido y real, con sus cualidades y discapacidades, un bebé que corre el riesgo de no tener un espacio en la vida emocional de sus padres que luchan con su pathos-dolor. En este trabajo se discuten los resultados del lado melancólico y las alternativas de gestión de la angustia emocional con miras a la inversión parental y al compromiso con el niño con discapacidad.

Dimensões transdisciplinares do trabalho de equipe em intervenção precoce / Transdisciplinary dimensions of team work in early intervention

O reconhecimento da importância dos primeiros tempos de vida no desenvolvimento da criança mudou significativamente os campos da educação, saúde e proteção social. A Intervenção Precocere presenta a preocupação intencional de intervir ao nível do desenvolvimento, nomeadamente junto das crianças mais pequenas que se encontram em risco de ter o seu percurso afetado. Mais do que a solução para problemas específicos, falhas ou deficiências, o que está em causa é o desenvolvimento global, presente e futuro, da criança, bem como da família e do contexto que a rodeiam. Esta perspectiva global do desenvolvimento exige que o ponto de referência para os cuidados terapêuticos e educativos seja, sempre, a pessoa encarada como um todo. A multiplicidade de profissionais e desaberes não pode implicar o retalhamento da individualidade da criança ou a segmentação das suas necessidades. A abordagem transdisciplinar permite ultrapassar as limitações de cada formação disciplinar específica e ir ao encontro desta criança complexa, mas una, e do seu contexto. Pretendemos refletir sobre as principais características e potencialidades do trabalho transdisciplinar no âmbito da Intervenção Precoce, mostrando exemplos de como a sua utilização pode serconcretizada nos domínios da detecção, avaliação, intervenção e acompanhamento das crianças.

The recognition of the importance of the early life in the development of children has lead to significant changes in care, education and health systems. Early intervention represents an intentional concern to interfere in the development of the children, especially those who, showing a real orpotential disturbance, are in great danger of having their development affected. However, instead of finding solutions to specific problems or handicaps, the aim here is to see the child present and future development as a whole, as well as its family and background. This global approach demands that both therapeutical and educative cares always view the Person as a whole. The multiplicity of professionals and acquirements cannot lead to the fragmentation of the child individuality o its needs.On the other hand, a transdisciplinary perspective allows passing beyond the limitations of each specific subject training in order to meet this complex, yet one only child and its context. We intend to think about the features and potentialities of transdisciplinary work in early intervention, introducing examples on how it can be used on detection, evaluation, intervention and care of these children.