The All4Children project to assess the initial implementation of the Integrated Model of Family Foster Care in Portugal: A description of the study protocol.

BACKGROUND: The All4Children project addresses the urgent need to transition from institutionalization to family-based care for out-of-home children in Portugal. Despite evidence highlighting the detrimental effects of institutionalization, only a small percentage of children (less than 4%) are currently placed in family foster care in the country. In response to European directives for deinstitutionalization, Portuguese legislation now prioritizes non-kinship family foster care as the preferred alternative for young children in need of care. To facilitate this transition, the Integrated Model of Family Foster Care (MIAF) was developed, offering a comprehensive framework covering the entire spectrum of family foster care. OBJECTIVE: This research aims to investigate the initial implementation stage of the MIAF to promote high-quality family foster care in Portugal. METHOD: The study will conduct a mixed-method and longitudinal research project in family foster care agencies across different regions of Portugal, focusing on evaluating the implementation and outcomes of the MIAF model using a multi-informant and multi-method approach. The participants will include caseworkers, children aged 0-9 years entering foster care, and their respective foster families enrolled in the MIAF program. Process evaluation will assess fidelity, feasibility, appropriateness, and acceptability of MIAF modules, while outcome evaluation will examine child safety, stability, well-being, as well as foster family well-being and quality of relational care. OUTCOMES: The insights gained from this research initiative will serve as a foundation for the ongoing enhancement of MIAF. Consequently, this project has the capacity to advance evidence-based child welfare practices by refining processes and strategies to better serve vulnerable children and youth. CONCLUSION: Facilitated by a multidisciplinary team, this project will contribute to advancing research in the field, enhancing practice, and informing policy during a pivotal stage of deinstitutionalization in Portugal.

Total removal of the buccal flange in maxillary prosthetic preparation: a necessity?: case report / Remoção total do flange vestibular no preparo protético de maxila: uma necessidade?: relato de caso

ABSTRACT Fixed implant-supported complete maxillary dentures aim to rehabilitate aesthetic, phonetic, and functional aspects of edentulous arches. A previous prosthetic preparation without a flange in the anterior sector makes it possible to evaluate the labial support and the existing space for the future prosthesis. Thus, it allows the most appropriate choice of the type of rehabilitation and surgical technique. However, follow-up studies have shown that when proceeding this way, problems in the posterior sector are still occurring, such as the lack of vertical space for an adequate bar design and concave internal designs, which make access to hygiene difficult. Faced with the problem, the aim of this study is to report a clinical case in which the previous prosthetic preparation included the removal of the flange also from the posterior sector during the teeth try-in and the duplication of this assembly in a transparent multifunctional guide that allowed the visualization of the amount of bone removal needed. The osteotomy, performed before the installation of the implants, provided enough space for the bar, acrylic, and prefabricated denture teeth in the prosthesis that was installed, an important fact considering that this is an area with greater chewing efforts. It also allowed for correct internal design in the prosthesis, which will ensure access to correct hygiene. Based on the analysis of the rehabilitated case, it seems fair to conclude that the total removal of the buccal flange at the time of testing the wax try-in of the teeth and its duplication is a differential in the approach of cases and should always be adopted to ensure a lower margin of error and greater longevity in the proposed rehabilitative treatment.

RESUMO Próteses totais fixas implantossuportadas objetivam reabilitar arcos edêntulos nos aspectos estético, fonético e funcional. Um preparo protético prévio sem flange no setor anterior permite avaliar o suporte labial e o espaço presente para a futura prótese, auxilinado na escolha do tipo de reabilitação e da técnica cirúrgica mais adequada. No entanto, estudos de acompanhamento tem mostrado que ao proceder dessa maneira ainda estão ocorrendo problemas no setor posterior, como falta de espaço vertical para um desenho adequado da barra e desenhos internos côncavos, que dificultam o acesso à higienização. Frente ao problema, o objetivo do presente trabalho é relatar um caso clínico no qual o preparo protético prévio incluiu a remoção do flange também do setor posterior durante a prova dos dentes e a duplicação dessa montagem em um guia multifuncional transparente permitindo a visualização da quantidade de remoção óssea necessária. A osteotomia, realizada antes da instalação dos implantes, proporcionou espaço suficiente para a barra, acrílico e dentes de estoque na prótese que foi instalada, fato importante considerando ser essa uma zona com maiores esforços mastigatórios. Também permitiu a confecção de desenho interno correto na prótese, que garantirá o acesso para correta higiene. Com base na análise do caso reabilitado, parece lícito concluir que a remoção total do flange vestibular no momento da prova dos dentes em cera e sua duplicação é um diferencial na abordagem dos casos e que deveria sempre ser adotada para garantir menor margem de erros e maior longevidade no tratamento reabilitador proposto.

Importance of the Diagnostic Wax-up When Planning a Periodontal Surgical Guide in Esthetic Surgery.

Periodontal plastic surgery may be indicated to re-establish smile harmony. The aim of this case report is to emphasize the importance of the diagnostic wax-up in the fabrication of a periodontal surgical guide to achieve success in esthetic surgery. In the case presented, during the preoperative testing of the guide, it was verified that the laboratory planning was incompatible with the patient's biological measures. Therefore, had crown lengthening been performed based solely on the guide, it would have caused irreparable sequelae, such as the removal of keratinized tissue and root exposure, which, in turn, could result in esthetic and functional consequences. In this case report, the periodontal surgical guide that was based on the previous diagnostic wax-up was an instrumental component in accomplishing an esthetic surgical outcome.

Post-Adoption Help-Seeking in Portugal: A Comprehensive Study on Parental Difficulties and Help-Seeking Behaviors and Perceptions.

Effective psychological parenting interventions delivered to adoptive parents may prevent serious adjustment difficulties and promote a healthy functioning; however, less is known about adoptive parents' specific parental difficulties and help-seeking behaviors and perceptions, the understanding of which is deemed necessary to design well-informed interventions. This study aimed to describe parental difficulties, help-seeking behaviors, satisfaction with, and perceived barriers to seek, professional help, and acceptability of psychological parenting interventions among Portuguese adoptive parents. Comparisons with biological parents (Study 1) and between adoptive parents that requested adoption-specialized and non-specialized support (i.e., adoption-specialized vs. non-specialized help-seekers) (Study 2) were explored. A cross-sectional online survey was conducted. Participants were 471 adoptive and 552 biological parents of children aged under 18 years who were recruited through schools, adoption agencies, and social networks. They completed measures assessing parental difficulties, help-seeking behaviors, satisfaction with, and perceived barriers to seek, professional help, and acceptability of psychological parenting interventions. Comparison tests between the study groups, Pearson's correlations, analyses of covariance (ANCOVA) and multivariate logistic regressions (MLR) were performed. Parents' well-being and normative parenting challenges were the most frequent difficulties in both groups, but only associated with adoptive parents' help-seeking. Although difficulties related to a child's problems/parent-child relationship were more frequent among adoptive parents, adoption-related difficulties were rarely reported. Adoptive parents sought professional help more frequently, regardless of parental difficulties. Knowledge-related barriers to seeking help were the most frequent among adoptive parents. Adoption non-specialized help was less satisfactory. Acceptability of psychological parenting interventions was high, but dependent on parental difficulties. Implications for post-adoption services' development are discussed.

The rationality involved in the popular use of coffee (Coffea sp) and sunflower seed (Helianthus annuus) for the treatment of vitiligo: a case report.

INTRODUCTION: Vitiligo is a dermatological disease that affects about 0.38% to 2.9% of the world population. Currently, the main treatments used for vitiligo involve the use of topical drugs such as corticosteroids and calcineurin inhibitors, phototherapy, systemic treatment with steroids and even surgical grafts and, in acute cases, depigmenting treatments. Natural products are an alternative for the treatment of vitiligo: mamacadela (Brosimum gaudichaudii), a plant rich in furanocoumarins, and sowthistle (Sonchus oleraceus), rich in phenolic substances, are already used to treat vitiligo. There are also popular reports of the use of a preparation containing coffee (Coffea sp) and sunflower seed (Helianthus annuus) to treat vitiligo. CASE REPORT: A female patient, 28 years old, diagnosed with vitiligo, reported having obtained a positive result in the repigmentation of the pale white patches after the daily use of a preparation containing coffee and sunflower seed for about one year. DISCUSSION: Data from the scientific literature demonstrated that chemical constituents of these plants, such as chlorogenic acid and its isomers, which have antioxidant and anti-inflammatory action, and substances such as linoleic acid and vitamins E and B, which help in the process of melanin formation on the skin, may be responsible for the observed repigmentation of the patches. Further research on this case report is important for scientific validation and the development of new therapeutic options, especially with less adverse effects, in the treatment of vitiligo.

Perceptions of Portuguese parents about the acceptability of a multicomponent intervention targeted at behavioral inhibition during early childhood.

High and stable behavioral inhibition during early childhood is a risk factor for later anxiety disorders. The few available interventions targeted at behavioral inhibition have not yet been implemented in European countries. Evaluating intervention acceptability is essential when introducing interventions in new cultures. This study aimed to explore the perceptions of parents about the acceptability of the multicomponent Turtle Program in Portugal. Participants were 12 parents (from seven families) of children with a positive screening on the Behavioral Inhibition Questionnaire and no diagnoses of developmental disorders/selective mutism. Children's mean age was 55.86 months and most children were female and first-born. Parents and children participated in the eight-sessions Turtle Program. After each session, parents completed weekly satisfaction checklists. Following completion of the full intervention, parents were invited to participate in individual qualitative in-depth interviews. The thematic analysis revealed that both parents perceived the intervention objectives and contents as relevant. Both parents suggested the introduction of follow-up sessions, the discussion of practical experiences, the need to be sensitive to cultural differences in positive language, and the provision of more feedback about children's activities. These findings support prior research on the acceptability and cultural tailoring needed for parenting and child socioemotional learning interventions.

Una alta y estable conducta de inhibición durante la temprana niñez es un factor de riesgo para posteriores trastornos de ansiedad. Las pocas intervenciones disponibles que se enfocan en la inhibición de la conducta no se han implementado aún en países europeos. Evaluar el nivel de aceptación de la intervención es esencial cuando las intervenciones se introducen en nuevas culturas. Este estudio se propuso explorar las percepciones de los progenitores acerca del nivel de aceptación del multi-compuesto Programa Tortuga en Portugal. Los participantes fueron 12 progenitores (de siete familias) de niños con una positiva detección en el Cuestionario de Inhibición de la Conducta y sin diagnóstico de trastornos de desarrollo/mutismo selectivo. La edad promedio de los niños fue 55.86 meses y la mayoría eran niñas y primogénitas. Los progenitores y los niños participaron en las ocho sesiones del Programa Tortuga. Después de cada sesión, los progenitores completaron listas semanales de chequeo de la satisfacción. Luego de completar la intervención en su totalidad, se invitó a los progenitores a participar en entrevistas cualitativas individuales para profundizar. Los análisis temáticos revelaron que ambos progenitores percibieron como relevantes los objetivos y el contenido de la intervención. Ambos progenitores sugirieron introducir sesiones de seguimiento, la discusión de experiencias prácticas, la necesidad de mostrarse sensible a las diferencias culturales en lenguaje positivo y la provisión de más información sobre las actividades de los niños. Estos resultados apoyan la investigación anterior sobre el nivel de aceptación y la adaptación cultural necesarias en las intervenciones sobre la crianza y el aprendizaje socioemocional del niño.

L'inhibition comportementale élevée et stable durant la petite enfance est un facteur de risque pour des troubles de l'anxiété plus tard. Quelques interventions disponibles ciblant l'inhibition comportementale n'ont pas encore été mises en œuvre dans les pays européens. Evaluer l'acceptabilité de l'intervention est essentiel lorsqu'on introduit des interventions dans de nouvelles cultures. Cette étude s'est donnée pour but d'explorer les perceptions des parents à propos de l'acceptabilité du Programme Tortue à composants multiples au Portugal. Les participants ont consisté en 12 parents (de sept familles) d'enfants ayant eu un dépistage positif au Questionnaire d'Inhibition Comportementale et aucun diagnostic de troubles développementaux / mutisme sélectif. L'âge moyen des enfants était de 55,86 mois et la plupart des enfants étaient des filles et des premières nées. Les parents et les enfants ont participé au Programme Tortue de huit séances. Après chaque séance les parents ont rempli des checklists de satisfaction hebdomadaires. Après avoir terminé l'intervention totale les parents ont été invité à participer à des entretiens individuels en profondeur et qualitatifs. L'analyse thématique a révélé que les deux parents percevaient les objectifs d'intervention et les contenus comme étant pertinents. Les deux parents ont suggéré l'introduction de séances de suivi, la discussion d'expériences pratiques, le besoin d'être sensible aux différences culturelles dans le langage positif et le besoin de plus de commentaires sur les activités des enfants. Ces résultats soutiennent les recherches précédentes sur l'acceptabilité et l'adaptation culturelle nécessaire pour le parentage et les interventions pour le développement socioémotionnel de l'enfant.

Does Dyadic Coping Predict Couples' Postpartum Psychosocial Adjustment? A Dyadic Longitudinal Study.

The way couples jointly manage pregnancy-related demands may prevent both members from experiencing psychosocial maladjustment after childbirth. This study examined (a) changes in dyadic coping (DC) and indicators of psychosocial adjustment [depressive and anxiety symptoms and quality of life (QoL)] from the second trimester of pregnancy (T1) to 6 weeks postpartum (T2), (b) the actor and partner effects of DC at T1 on couples' adjustment at T2, and (c) whether changes in DC over time would be associated with changes in the adjustment of both women and their partners. This study adopted a prospective quantitative dyadic longitudinal design. A total of 303 couples from Portugal answered self-report questionnaires assessing DC, depressive and anxiety symptoms, and QoL at T1, of which 290 were contacted at T2 to complete the same measures (n = 138 couples returned the questionnaires). Results showed that first-time fathers' QoL and both first and experienced fathers' stress communication decreased over time, as did common DC (i.e., the way couples cope together with stress) perceived by both partners. First-time mothers reported higher increases in negative DC. The more positive DC the women provided to men at T1, the higher the internalizing symptoms of women at T2; the more the women communicated stress at T1, the higher the internalizing symptoms of men at T2. Both partners' common DC at T1 positively predicted their QoL at T2. The larger the decrease in common DC over time, the greater the increase in internalizing symptoms of couples and the greater the decrease in their QoL. These findings suggest that DC strategies should be considered into the psychosocial care of couples becoming parents, as a relevant coping resource that partners could use to help each other in situations of stress. More than (exclusively) encouraging the men's role as support providers, couples should be encouraged to reserve time for one another, to discuss each other's concerns, and to seek for solutions as a team. These strategies should be promoted before, and fostered after, childbirth. Likewise, clinicians should be aware that partners might not feel equally comfortable with specific DC strategies and then should be carefully addressed among couples.

Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Results From a Pilot Randomized Controlled Trial.

Be a Mom is a self-guided web-based intervention, grounded in cognitive behavioral therapy, delivered to postpartum women to prevent persistent postpartum depression [PPD] symptoms. We aimed to evaluate Be a Mom in terms of its preliminary efficacy, feasibility, and acceptability. A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention (Be a Mom) or to the waiting-list control group. Participants in both groups completed baseline (T1) and postintervention (T2) assessments. The 194 women presenting risk factors/early-onset PPD symptoms were allocated to the intervention (n = 98) or to the control (n = 96) group. A significant Time × Group interaction effect was found for both depressive and anxiety symptoms, with women in the intervention group presenting a larger decrease in symptoms from T1 to T2 (p < .05). Less than half of the women (41.8%) completed Be a Mom. Most women (71.4%) would use Be a Mom again if needed. Results provide preliminary evidence of the Be a Mom's efficacy, acceptability and feasibility, although further research is needed to establish Be a Mom as a selective/indicative preventive intervention for persistent PPD.

Integração entre cirurgia plástica periodontal e odontologia restauradora em reabilitação estética com resinas compostas (parte 3) - ajuste oclusal, acabamento, áreas de espelho, texturas e polimento / Periodontal surgery and restoring dentistry integration in aesthetic rehabilitation with composite resins (part 3) - occkusal adjustment, finishing, mirror areas, textures and polishing

Restaurações utilizando resinas compostas possibilitam desde resoluções estéticas unitárias até grandes transformações dentárias, permitindo a preservação de estrutura dental sadia. Tais materiais são eleitos devido às suas características mecânicas e ópticas semelhantes aos dentes naturais, bem como sua capacidade de adesão às estruturas dentais. Os passos clínicos que sucedem as restaurações são cruciais na prática odontológica, uma vez que são responsáveis pela sua finalização, estética e naturalidade, longevidade e manutenção da saúde dos tecidos periodontais. Procedimentos esses que promovem uma superfície lisa, reduzindo a retenção de placa bacteriana, irritação gengival, descoloração, pigmentação do corpo da restauração e manchamento marginal, colaborando para a melhoria na estética e integridade marginal das restaurações. O objetivo deste trabalho é exemplificar os passos clínicos de ajuste oclusal, acabamento, delimitação das cristas marginais e áreas de espelho,caracterização secundária e texturização da face vestibular e polimento após a finalização de procedimento de reencontro cosmético com resinas compostas em dentes anteriores em uma paciente que havia realizado, previamente, cirurgia plástica periodontal. (AU).

Restorations using composite resins enable unit aesthetic resolution as well as full tooth transformation allowing dental structure preservation. Such materials are chosen because of their optical and mechanical characteristics similar to the natural teeth, as well as for their ability to adhere to dental structures. Clinical steps after restorations are crucial in the dental practice, as they are responsible for its completion, aesthetic and naturalness, longevity and periodontal tissues health maintenance. These procedures promote a smooth surface, reducing bacxterial plaque retention, gingival irritation, discoloration, restauration body pigmentation and marginal staining, contributing to the aesthetic improvement and marginal restauration integrity. The purpose of this work is to show occlusal adjustment clinical steps, finishing, marginal ridges and mirror areasn delimitation, secondary characterization and texturing of vestibulat face and polishing cosmetic recontour procedure wuthcomposite resins in a patient who had perforned plastic periodontal surgery.

"Choose Today, Live Tomorrow": A Content Analysis of Anti-Substance Use Messages Produced by Adolescents.

Adolescent-produced anti-substance use messaging is an increasingly popular and effective prevention strategy. However, little is known about the content of these messages and the production elements adolescents use to bring that content to life. In this article, we present a content analysis of 95 anti-substance use messages developed by 4-H club members across nine U.S. states as part of their participation in the media literacy program REAL media. Posters and videos were content-analyzed for target substance, prevention goal, message form, message content, persuasion strategies, and production elements. Results of the content analysis revealed that combustible tobacco (smoking) was the most popular target substance in the sample among the choices of alcohol, marijuana, e-cigarettes, and chewing tobacco. More youth developed messages with the goal of preventing substance use, rather than stopping current use. Slogans were used in the majority of messages, and nearly all messages took an informational form, rather than narrative or statistical form. Persuasion strategies covered in the curriculum, including fun with the group, unexpected, style, and endorsement were scantily used. Finally, results showed that production value was high in this sample, reflected by the extensive use of color and variety of fonts and font sizes. Implications for future media literacy interventions and research are discussed.

Integração entre cirurgia plástica periodontal e Odontologia Restauradora em reabilitação estética com resinas compostas (parte 2) ­ estratificação em resinas compostas / Periodontal plastic surgery and restorative dentistry integration in aesthetic rehabilitation with composite resins (part 2) ­ composite resins stratification

As resinas compostas são materiais que possibilitam tratamento odontológicos estéticos mais conservadores, por permitir maior preservação da estrutural dental. Todo o conjunto deve ser analisado e planejado, cuidadosamente, de maneira individualizada e multidisciplinar, analisando os elementos dentários e tecido gengival a fim de estabelecer uma harmonia. Com a evolução dos materiais odontológicos algumas características nas resinas compostas permitem uma reprodução semelhante as características dos elementos dentários, porém demanda habilidade do cirurgião-dentista para a sua execução, bem como o conhecimento das propriedades e características do material restaurador, indicações e limitações. Além dos cuidados com a técnica restauradora, os procedimentos de ajuste oclusal, acabamento, polimento e revisões periódicas são de fundamental importância para a durabilidade e longevidade desses tratamentos. O presente trabalho tem como objetivo relatar os passos clínicos de um recontorno cosmético em resina composta na bateria anterior superior em uma paciente previamente submetida a gengivoplastia. (AU)

Composite resins are materials that enable more conservative aesthetic dental treatments, as they allow greater dental structure preservation. The whole clinical case should be analyzed and planning should be done carefully in an individualized and multidisciplinary way, analyzing dental elements and gingival tissue in order to establish harmony. With dental materials evolution, some composite resins characteristics allow a similar reproduction of dental elements characteristics, however demand ability of the dental surgeon to execute them, as well as knowledge of restorative material properties and characteristics, indications and limitations. In addition to care with restorative technique, occlusal adjustment, finishing, polishing and periodic revision procedures are essential for the durability and longevity of these treatments. The present study aims to report the clinical steps of cosmetic recontour in composite resin in the upper anterior battery in a patient previously submitted to gingivoplasty. (AU)

Prevalence and factors associated with fertility desires/intentions among individuals in HIV-serodiscordant relationships: a systematic review of empirical studies.

INTRODUCTION: Better knowledge about fertility desires/intentions among HIV-serodiscordant partners who face unique challenges when considering childbearing may be helpful in the development of targeted reproductive interventions. The aim of this systematic review was to synthesize the published literature regarding the prevalence of fertility desires/intentions and its associated factors among individuals in HIV-serodiscordant relationships while distinguishing low- and middle-income countries (LMIC) from high-income countries (HIC). METHODS: A systematic search of all papers published prior to February 2017 was conducted in four electronic databases (PubMed/MEDLINE, PsycINFO, Web of Science and Cochrane Library). Empirical studies published in peer-reviewed journals with individuals in HIV-serodiscordant relationships assessing the prevalence of fertility desires/intentions and/or the associated factors were included in this systematic review. This review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS AND DISCUSSION: After screening 1852 references, 29 studies were included, of which 21 were conducted in LMIC and eight in HIC. A great variability in the prevalence of fertility desires/intentions was observed in LMIC (8% to 84% (one member of the dyad included)). In HIC, the results showed a smaller discrepancy between in the prevalence (32% to 58% (one member of the dyad included)); the prevalence was higher when the couple was the unit of analysis (64% to 73%), which may be related to the fact that all these studies were conducted in the context of assisted reproduction. Few studies examined the factors associated with fertility desires/intentions, and all except one were conducted in LMIC. Individuals (e.g. number of children), couple-level (e.g. belief that the partner wanted children) and structural factors (e.g. discussions with health workers) were found to be associated. CONCLUSIONS: The results of this systematic review suggest that many individuals in HIV-serodiscordant relationships have fertility desires/intentions, although the prevalence is particularly heterogeneous in LMIC in comparison to HIC. Well-known factors such as younger age and a fewer number of living children were consistently associated with increased fertility desires/intentions. Different couple-level factors emerged, reflecting the importance of considering both the individual and the couple. However, further studies that specifically focus on the dyad as the unit of analysis are warranted.

Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: The Enhancement of Self-Regulatory Skills and Its Association With Postpartum Depressive Symptoms.

Aim: Be a Mom is a self-guided, web-based intervention to prevent persistent postpartum depression symptoms [PPD], targeting both at-risk postpartum women and/or women presenting early-onset postpartum depressive symptoms (selective/indicated preventive intervention). Be a Mom is grounded on the principles of Cognitive-Behavior Therapy and incorporates the recent contributions of acceptance and compassion-based approaches (third-wave approaches) applied to the perinatal context. This study aimed to explore the processes underlying therapeutic change in the Be a Mom intervention, by: (1) exploring whether participation in the Be a Mom promotes the enhancement of self-regulatory skills (emotion regulation abilities, psychological flexibility and self-compassion) in comparison with women who did not participate in the program; and (2) exploring whether changes in self-regulatory skills are associated with changes in depressive symptoms, among women who participated in the Be a Mom program. Methods: A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention group (Be a Mom, n = 98) or to the waiting-list control group (n = 96). Participants in both groups completed baseline (T1) and post-intervention assessments (T2), including measures of depressive symptoms, emotion regulation abilities, psychological flexibility and self-compassion. Results: From baseline to post-intervention assessment, women in the intervention group showed a significantly greater decrease in the levels of emotion regulation difficulties (p < 0.001) and a significant greater increase in the levels of self-compassion (p < 0.001) compared to the control group. No significant differences were found concerning psychological flexibility. Moreover, a greater decrease in difficulties in emotion regulation and greater increase in self-compassion levels were significantly associated with a greater decrease in depressive symptoms, among women in the intervention group. Discussion: Be a Mom promotes the enhancement of women's emotion regulation abilities and self-compassion, and this seems to exert a protective effect in the presence of PPD risk factors (or early-onset symptoms) because it led to a reduction of depressive symptoms. By providing some insights into the processes that underlie treatment response to Be a Mom, this study highlights the important role of the targeted third-wave processes applied to the perinatal context.

What protects at-risk postpartum women from developing depressive and anxiety symptoms? The role of acceptance-focused processes and self-compassion.

BACKGROUND: Not all women presenting risk factors for postpartum depression (PPD) develop depressive symptoms. Research has shown that acceptance-focused processes (nonjudgmental appraisal of thought content, psychological flexibility) and self-compassion play an important protective role in the development of psychological symptoms. However, considering the perinatal period, little is known about what variables can modify the negative impact of risk. METHODS: The sample consisted of 185 postpartum women at risk of developing PPD (Postpartum Depression Predictors Inventory-Revised > 5.5). Data were collected regarding depressive (Edinburgh Postnatal Depression Scale) and anxiety symptoms (Hospital Anxiety and Depression Scale), psychological flexibility (Acceptance and Action Questionnaire-II), nonjudgmental appraisal of thought content (Postnatal Negative Thoughts Questionnaire) and self-compassion (Self-Compassion Scale-Short Form). RESULTS: Women not presenting depressive and anxiety symptoms reported significantly higher levels of psychological flexibility, nonjudgmental appraisal of thought content and self-compassion than women presenting depressive and anxiety symptoms. Hierarchical logistic regression showed that women with higher levels of psychological flexibility (OR = 1.06, CI: 1.01-1.12) and nonjudgmental appraisal of thought content (OR = 1.33, CI: 1.15-1.53) had a significantly higher likelihood of not presenting depressive and anxiety symptoms. LIMITATIONS: The limitations of this study were the cross-sectional design, the use of self-report questionnaires and the self-selected bias in recruitment. CONCLUSIONS: This study emphasizes the important role of acceptance-based processes, suggesting that at-risk women who are more accepting of their private events may be more protected from developing psychological symptoms. Preventive interventions should consider the promotion of these processes to improve women's adjustment to this period.

Predictive validity of the Postpartum Depression Predictors Inventory-Revised (PDPI-R): A longitudinal study with Portuguese women.

OBJECTIVE: This study examined the predictive validity of the prenatal and postnatal versions of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) in European Portuguese women, considering two gold standards to determine postpartum depression (PPD). DESIGN: Prospective longitudinal study conducted between November 2015 and September 2017. SETTING: One public referral maternity hospital in the central region of Portugal. PARTICIPANTS: A total of 140 Portuguese women participated in the study. MEASUREMENTS: Participants completed the PDPI-R during the second trimester of pregnancy (T1) and at 6 weeks postpartum (T2). At T2, participants also answered the Edinburgh Postnatal Depression Scale (EPDS). During the fourth month postpartum (T3), women were interviewed with the Structured Clinical Interview for DSM-IV Disorders, and between 6 and 9 months postpartum (T4), they completed the EPDS. FINDINGS: Rates of clinically significant depressive symptoms (EPDS ≥ 10) were 16.4% (23/140) at T2 and 23.2% (23/99) at T4. Six (4.3%) women met the criteria for a clinical diagnosis of PPD (major depressive episode) at T3. Overall, the postnatal version of the PDPI-R performed better than did the prenatal version (average area under the curve = 82% vs. 71%), but both versions accurately predicted women who developed a clinical diagnosis of PPD, at a cut-off score of 4.5 for the prenatal version (sensitivity = 83.3%; specificity = 85.8%) and 9.5 for the postnatal version (sensitivity = 83.3%; specificity = 94.8%). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Despite the low prevalence of PPD (albeit consistent with prior estimates of major depression at three months postpartum), this clinical condition has very serious consequences for the mother, the baby and the whole family when present. The PDPI-R is a valid screening tool to estimate the psychosocial risk for developing PPD among Portuguese women and can be used in research (e.g., for cross-cultural comparisons) and clinical practice. The recommended cut-off scores could assist health professionals (namely, midwives) in identifying the women who would benefit from appropriate referrals and/or closer monitoring to prevent them from developing PPD.

Dyadic coping and dyadic adjustment in couples with women with high depressive symptoms during pregnancy.

OBJECTIVE: The present study aimed to compare dyadic coping (DC) and dyadic adjustment in couples in which the woman was experiencing high levels of depressive symptoms and in couples in which the woman presented minimal or no depressive symptoms. BACKGROUND: Pregnancy may be considered a situation of dyadic stress, during which the presence of high levels of depressive symptoms may impair the ways couples cope together with stress; however, this topic has not yet been studied. METHODS: Pregnant women and their partners (n = 289 couples) completed the Edinburgh Postnatal Depression Scale, the Dyadic Coping Inventory, and the Revised Dyadic Adjustment Scale during the second trimester of pregnancy. RESULTS: Couples in which the woman was experiencing high levels of depressive symptoms (n = 57) reported less DC enacted by oneself and by the partner (particularly, less supportive and more negative DC), common DC and overall d5yadic adjustment, compared to couples in which the woman was not experiencing high levels of depressive symptoms (n = 232). CONCLUSION: These findings highlight the need to assess couples' dyadic adjustment and DC strategies, which is particularly important when women screened positive for high levels of depressive symptoms during pregnancy.

Preliminary Psychometric Testing of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) in Portuguese Women.

Introduction Postpartum depression (PPD) is a prevalent condition with a serious impact. The early identification of women at risk for developing PPD allows for primary prevention and the delivery of timely appropriate referrals. This study investigated the validity and reliability of the postnatal version of the Postpartum Depression Predictors Inventory-Revised (PDPI-R), an instrument widely studied internationally, in Portuguese women. Methods The sample consisted of 204 women who participated in an online cross-sectional survey. Participants completed the European Portuguese versions of the PDPI-R, the Edinburgh Postnatal Depression Scale (EPDS), and the Postnatal Negative Thoughts Questionnaire at 1-2 months postpartum. Additionally, ROC analyses were performed to conduct an exploratory analysis of the instruments' predictive validity. Results The prevalence rates of clinical postpartum depressive symptoms were 27.5 and 14.2% using the cut-off scores of 9 and 12, respectively, on the EPDS. The European Portuguese postnatal version of the PDPI-R demonstrated acceptable reliability and satisfactory construct and convergent validity. When using the EPDS > 9 cut-off score, the exploratory analyses yielded a sensitivity of 76.8% and a specificity of 73.0% with a cut-off score of 5.5 [area under the curve = 0.816]. Discussion These preliminary findings encourage the use of the postnatal version of the PDPI-R as a screening tool to identify Portuguese women at high risk for developing PPD. Subsequent assessments are needed to support the routine application of the PDPI-R both in research and for clinical purposes.

The Association of Oral Health Literacy and Oral Health Knowledge with Social Determinants in Pregnant Brazilian Women.

The aim of the present study was to assess oral health literacy (OHL) in pregnant women and its association with social determinants and knowledge regarding eating habits and oral hygiene in infants. This cross-sectional study assessed 175 pregnant women in a hospital in southern Brazil. Socioeconomic and demographic data were obtained using a questionnaire, and OHL was determined by the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Eating habits and oral hygiene knowledge were assessed by statements on a 3-point Likert scale. The data were analyzed using Spearman correlations and the Mann-Whitney U test (α = 0.05). The mean (SD) age was 26.2 (6.17) years. Most of the participants had up to 8 years of education (60.0 %) and belonged to socioeconomic class "C" or lower (56.0 %). The mean (SD) score on the BREALD-30 was 22.4 (4.66). A positive correlation was found between BREALD-30 scores and knowledge (r s  = 0.370, p < 0.001), income (r s  = 0.374, p < 0.001), and the age at which infants first consumed sugar in their diets (r s  = 0.370, p < 0.001). A negative correlation was found between BREALD-30 scores and domicile agglomeration (r s  = -0.237, p = 0.020). BREALD-30 scores were higher among pregnant women who had more than 8 years of education (p < 0.001), who belonged to higher socioeconomic classes (p < 0.001), and who were employed (p = 0.025). A significant correlation was found between OHL and knowledge. Lower social determinants were associated with lower OHL. Oral health literacy should be considered in health education practices to facilitate adherence to health recommendations in pregnant women.

The activation and blockage of CRF type 2 receptors of the medial amygdala alter elevated T-maze inhibitory avoidance, an anxiety-related response.

Previous results show that the activation of CRF type 1 (CRFR1) receptors of the medial amygdala (MeA) induces anxiogenic-like effects. The present study investigates the role played by medial amygdala CRF type 2 receptors (CRFR2) in the modulation of anxiety and panic-related responses. Male Wistar rats were administered into the MeA with the CRFR2 agonist urocortin 2 (0.5 e 1.0µg/0.2µl, experiment 1) or with the CRFR2 antagonist astressin 2-B (60ng/0.2µl, experiment 2) and 10min later tested in the elevated T-maze (ETM) for inhibitory avoidance and escape measurements. In clinical terms, these responses have been respectively related to generalized anxiety and panic disorder. In a third experiment, the effects of the combined treatment with urocortin 2 (1.0µg/0.2µl) and a sub-effective dose of astressin 2-B (30ng/0.2µl) were also investigated. All animals were tested in an open field, immediately after the ETM, for locomotor activity assessment. Results showed that urocortin 2, in the highest dose administered (1.0µg/0.2µl), facilitated ETM avoidance, an anxiogenic-like effect. Astressin 2-B, also in the highest dose (60ng/0.2µl), significantly decreased avoidance latencies, an anxiolytic-like effect. The lower dose of astressin 2-B (30ng/0.2µl) did not induce anxiolytic-like effects but was able to counteract the anxiogenic-like effects of urocortin 2. None of the compounds administered altered escape responses or locomotor activity measurements. These results suggest that CRFR2 in the medial amygdala, as CRFR1, selectively modulate an anxiety-related response.

Gênero e sexualidade na educação física escolar: um balanço da produção de artigos científicos no período de 2004 a 2014 nas bases do Lilacs e Scielo / Gender and sexuality in the scholar physical education: a balance of scientific articles production from the period of 2004-2014 at the databases Lilacs and Scielo / Género y sexualidad en la educación física escolar: la producción de los artículos científicos en el período 2004-2014 en las bases del Lilacs y Scielo

Por meio da revisão de literatura, analisaram-se as principais características presentes nos artigos científicos sobre gênero e sexualidade na Educação Física Escolar publicados no Brasil nas bases de dados do Lilacs e Scielo. Procedeu-se pelo levantamento de artigos produzidos entre 2004-2014. Os resultados apontam que, mesmo evidenciando diferentes referenciais teórico-epistemológicos, os artigos, em sua totalidade, apresentam concepções sobre gênero e sexualidade que rompem com visões naturalizantes ou biologicistas. Eles conferem ênfase ao processo histórico, social e cultural de construção de gênero e sexualidade. Contudo, a temática de gênero tem mais visibilidade nessas produções, enquanto que a de sexualidade, em vários artigos, recebe apenas o papel de coadjuvante.

Through literature review, we analyzed the main features found in scientific articles on gender and sexuality in the Scholar Physical Education published in Brazil at the databases Lilacs and Scielo. The survey proceeded by articles produced between 2004-2014. The results point that, even showing different theoretical and epistemological frameworks, the articles, in their entirety, present conceptions about gender and sexuality that break naturalizing or biologicist views. They give emphasis on the historical, social and cultural process of gender and sexuality construction. However, the gender issue has more visibility in these productions, while the sexuality in several articles, only received the secondary role.

A través de revisión de la literatura, se analizó las principales características presentes en los artículos científicos sobre el género y la sexualidad en la Educación Física Escolar publicados en Brasil en las bases de datos Lilacs y Scielo. Los resultados muestran que incluso mostrando diferentes marcos teóricos y epistemológicos, los artículos, en su totalidad, tienen ideas sobre el género y la sexualidad que rompen con visiones biológicas y de naturalización. Ellos dan énfasis en el proceso histórico, social y cultural de la construcción del género y la sexualidad. Sin embargo, la cuestión de género es más visualizado en estas producciones, mientras que la sexualidad en varios artículos, sólo recibió el papel secundario.