Irony Understanding in Children With Attention-Deficit/Hyperactivity Disorder: A Comparative Analysis.

INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can significantly impact a child's daily life and academic performance. Some studies have noted challenges in social cognition among children with ADHD, specifically in aspects like emotion perception and processing, empathy, Theory of Mind, and pragmatics. One of the lesser-explored aspects of ADHD is its potential impact on higher-level language skills, such as irony understanding. Our goal in this study was to compare irony comprehension in two groups: schoolchildren with normal development and schoolchildren with ADHD. METHODS: We performed a comparative cross-sectional study on a total of 35 children aged between 6 and 12 years: 17 with ADHD and 18 not neurodevelopmentally impaired. Irony comprehension was evaluated using an assessment method validated for the Portuguese population: Turtle on the Island - Battery of Assessment of Executive Functions in Children (TI-BAFEC). We also applied the EACE (Emotional Awareness and Coping in Children) scale. It is the Portuguese adaptation of the Assessment of Children's Emotion Skills and assesses children's emotional knowledge. RESULTS: We obtained two comparable groups concerning sociodemographic data. The analysis of the data, using the Mann-Whitney U Test, showed that in all parameters, the control group consistently exhibited superior performance compared to the ADHD group. However, only TI-BAFEC (p = 0.005) and emotional behavior (p = 0.007) showed a significant statistical variance between the two groups. CONCLUSION: This article shows that children with ADHD encounter challenges in grasping irony. However, the underlying cognitive processes contributing to these difficulties warrant further investigation.

Well-Being at Work: A Cross-Sectional Study on the Portuguese Nutritionists.

This exploratory, nationwide cross-sectional study was performed to investigate the well-being of Portuguese nutritionists, in addition to outlining their professional and demographic profile. Descriptive analyses were carried out to determine the measures relating to centralising tendency and dispersion of the sample. We compared means and proportions through t-tests and Analysis of Variance (ANOVA). The sample size was 206 individuals, respecting a minimum of eight respondents per item to validate the instrument. We recruited Nutritionists from Portugal nationwide using the list of electronic mail provided by the Order of Nutritionists. We sent an electronic mail to all the Nutritionists registered in this Order. We also used messaging applications and social networks (Instagram, Facebook) to reach Nutritionists who were not accessing electronic mail. Most respondents are women (92.5%), young (mean age = 31.4 ± 8.07 years; 54.2% of participants aging under 30 years), single, and with no children. More than half are Catholic (73.8%) and have less than ten years of nutritionist undergraduate completion (55.4%). The only variable that influences well-being at work is the economic variable Household Monthly Income. Those who earn less than €500.00 per month perceive themselves at a lesser state of work well-being than those who earn from €2501.00 to €5000.00 per month.

Scheduling in cloud manufacturing systems: Recent systematic literature review.

Cloud Manufacturing (CMFg) is a novel production paradigm that benefits from Cloud Computing in order to develop manufacturing systems linked by the cloud. These systems, based on virtual platforms, allow direct linkage between customers and suppliers of manufacturing services, regardless of geographical distance. In this way, CMfg can expand both markets for producers, and suppliers for customers. However, these linkages imply a new challenge for production planning and decision-making process, especially in Scheduling. In this paper, a systematic literature review of articles addressing scheduling in Cloud Manufacturing environments is carried out. The review takes as its starting point a seminal study published in 2019, in which all problem features are described in detail. We pay special attention to the optimization methods and problem-solving strategies that have been suggested in CMfg scheduling. From the review carried out, we can assert that CMfg is a topic of growing interest within the scientific community. We also conclude that the methods based on bio-inspired metaheuristics are by far the most widely used (they represent more than 50% of the articles found). On the other hand, we suggest some lines for future research to further consolidate this field. In particular, we want to highlight the multi-objective approach, since due to the nature of the problem and the production paradigm, the optimization objectives involved are generally in conflict. In addition, decentralized approaches such as those based on game theory are promising lines for future research.

Impacto de la COVID-19 en niños con trastorno del espectro autista / The impact of COVID-19 on children with autism spectrum disorder

INTRODUCCIÓN: Los niños con trastorno del espectro autista (TEA) a menudo experimentan el cambio de rutinas como un desafío importante. La necesidad de adaptación durante la pandemia por la COVID-19 puede haber causado problemas a estos niños. OBJETIVO: Conocer cómo vivieron los niños con TEA y sus familias el aislamiento social durante la cuarentena. Sujetos y métodos. Se realizó un estudio observacional, transversal y analítico. Se aplicó un cuestionario anónimo que incluía las características demográficas y clínicas de los niños, junto con el impacto que tuvo la pandemia en diferentes aspectos de la vida diaria de las familias. RESULTADOS: De los 99 cuestionarios obtenidos, 43 eran niños con TEA y 56 niños del grupo control. Los niños con TEA tuvieron predominantemente cambios en el comportamiento, a diferencia de los del grupo control. La mayoría de los niños con TEA tuvo un impacto negativo en el manejo de las emociones frente a los del grupo control, que expresaron un impacto mayoritariamente positivo/nulo. Los cuidadores puntuaron niveles de ansiedad más altos en ellos mismos que en sus hijos. Los niños con TEA y sus padres tenían niveles más altos de ansiedad que los controles. En el grupo con TEA, los niños que no mantuvieron las rutinas tuvieron niveles de ansiedad más altos. CONCLUSIÓN: Los resultados muestran un potencial impacto psicológico de la pandemia de la COVID-19 no sólo en los niños con trastornos del neurodesarrollo, sino también en sus cuidadores. Debe estarse preparado para la vigilancia de los trastornos mentales en las familias tras la pandemia de la COVID-19

INTRODUCTION. Children with autism spectrum disorder (ASD) often experience changing routines as a major challenge. For that reason, the need for adaptation during COVID-19 pandemic may have brought major problems to families with children with this pathology. AIM. To explore how children with ASD and their parents experienced the social isolation during COVID-19 outbreak period. SUBJECTS AND METHODS. We conducted an observational, cross-sectional and analytical study. We applied an anonymous questionnaire that included children’s demographic and clinical characteristics, along with the impact of the COVID-19 outbreak in different aspects of family’s daily life. RESULTS. Out of 99 questionnaires obtained, 43 were related to children with ASD and 56 to control group. Children with ASD predominantly had changes in behavior, while children from control group mostly found no changes. The majority of parents of ASD children reported a negative impact in emotion management against those in control group reporting mostly positive or no impact. Caregivers reported higher mean scores of anxiety levels in themselves than in their children. ASD children and their parents had higher levels of anxiety than healthy ones. In the group with ASD, children that did not maintain routines had higher mean levels of anxiety than children that maintained routines. CONCLUSION. Our results show a potential important psychological impact of the COVID-19 pandemic not only in children with neurodevelopmental disorders but in their caregivers as well. Physicians must be prepared for the post-pandemic surveillance of mental disorders among families

Comparison of three optical biometers: IOLMaster 500, Lenstar LS 900 and Aladdin.

PURPOSE: To evaluate the results of optical biometry using the IOLMaster 500, Lenstar LS 900 and Aladdin in eyes with cataract. METHODS: In 231 eyes of 152 patients with cataract, the measurements of 3 different biometers were retrospectively compared. Paired comparisons were performed for axial length (AL), mean keratometry (mean K) and anterior chamber depth (ACD). RESULTS: In only 197 of the 231 eyes (85.3%), it was possible to obtain reliable measurements of AL with all the three devices. It was not possible to determine AL in 16 eyes (6.9%) with Lenstar LS 900; in 19 eyes (8.2%) with Aladdin; and in 20 eyes (8.6%) with IOLMaster 500 possibly related to the severity of lens opacification (the corneas had good transparency in the eyes included in the study). There was a statistically significant difference in AL between IOLMaster 500 and the remaining two biometers (P = 0.03). However, the amount of difference was considered clinically not significant (0.04 mm). The mean keratometry (mean K) was determined in 203 eyes (87.9%) with all the three devices. Differences in mean K were between - 0.1 and 0.06 Diopters (D), which were considered neither statistically (P > 0.05) nor clinically significant. The anterior chamber depth (ACD) was determined in 197 eyes (85.28%) with all the three biometers. The differences between the three devices (0.03 to 0.13 mm) were not statistically significant and considered also clinically not significant. CONCLUSIONS: There were no clinically significant differences between these 3 biometers in AL, mean K and ACD.

Neurocognitive profiles in adolescents and young adults with congenital heart disease.

INTRODUCTION AND OBJECTIVES: The objectives of this study were to assess the neuropsychological performance (NP) of adolescents and young adults with congenital heart disease (CHD), comparing them with a group of healthy controls, to determine whether there are different neurocognitive phenotypes in CHD, and to identify their relation to sociodemographic, neonatal, clinical and psychological adjustment variables. METHODS: A total of 217 CHD patients (116 male, aged 15.73±2.68 years) and 80 controls (35 male, age 16.76±2.22 years) underwent an extensive neuropsychological assessment and analysis of psychological adjustment. RESULTS: CHD patients had significantly poorer NP than healthy controls in all neurocognitive domains. Three different phenotypes of NP in CHD patients were identified: non-impaired (NI), moderately impaired (MI) and globally impaired (GI). They differed in all dimensions of NP. The GI cluster showed fewer years of schooling (p=0.025) and lower neonatal indicators such as head circumference (p=0.019), 1-min Apgar score (p=0.006), birth weight (p=0.05) and length (p=0.034) than the NI cluster. In the MI and GI clusters, there were more cyanotic forms of disease, including tetralogy of Fallot and transposition of the great arteries. The GI cluster presented more difficulties with psychological adjustment, including social (p=0.038), attention (p=0.001) and aggressive (p=0.003) problems. CONCLUSIONS: CHD patients have poorer NP than controls. NP in the CHD group can be classified in three clusters that reflect different levels of neuropsychological functioning, which is sensitive to social, neonatal and psychological adjustment variables.

Development of an experimental model of schistosomal myeloradiculopathy.

Schistosomal myeloradiculopathy (SMR) is a severe form of presentation of schistosomiasis in which Schistosoma spp. affect the spinal cord. The aims of the present study were to develop an animal model of SMR caused by S. mansoni, to characterize both sensory and motor abnormalities in the infected animals, and to investigate the relationship of the sensory, motor and histological findings with the progression of the infection over time. Mechanical sensitivity and behavioral tests were performed followed by euthanasia in male Wistar rats divided into six groups of five animals each, on days 5, 10, 20 and 30 after infection of S. mansoni eggs. The controls were subjected to the same procedure but were administered phosphate-buffered saline (PBS). The spinal cord was removed and subjected to histological analysis. S. mansoni eggs were found in the spinal cord of 25% of the infected animals, which belonged to the groups that exhibited more significant reduction of the superficial mechanical sensitivity, thermal sensitivity and muscle strength. This model proved to be satisfactory to assess functional changes in Wistar rats and might be used in studies investigating the pathogenesis of SMR. To our knowledge, this is the first experimental model of SMR.

Living with CHD: quality of life (QOL) in early adult life.

AIMS: The aim of this study was to assess the quality of life, psychiatric morbidity, and the psychosocial adjustment of adolescents and young adults with CHD, and determine which variables play a role in buffering stress and promoting resilience and which ones have a detrimental effect; and to investigate the situation on school performance and failures, social and family support, physical limitations, and body image of these patients. METHODS: The study enrolled 137 CHD patients (79 male), with age ranging from 12 to 26 years old (M=17.60±3.450 years). The patients were interviewed regarding social support, family educational style, self-image, demographic information, and physical limitations. They responded to questions in a standardised psychiatric interview (SADS-L) and completed self-reported questionnaires for the assessment of quality of life (WHOQOL-BREF) and psychosocial adjustment (YSR/ASR). RESULTS: We found a 19.7% lifetime prevalence of psychopathology in our patients (27.6% in female and 13.9% in male). Of them, 48% had retentions in school (M=1.61 year±0.82). The perception of quality of life in CHD patients is better compared with the Portuguese population in the social relationships and environmental dimensions. However, it is worse in complex forms of CHD than in moderate-to-mild ones, in cyanotic versus acyanotic patients, in moderate-to-severe versus mild residual lesions, in patients submitted versus those not submitted to surgery, in patients with versus without physical limitations, and patients who have need for medication versus those who do not. Social support is very important in improving quality of life of patients in all dimensions as well as academic performance. CONCLUSIONS: Female patients and patients with poor academic performance and poor social support have worse psychosocial adjustment and perception of quality of life.

Ansiedade social na infância e pré-adolescência: adaptação para o português de Portugal da SASC-R / Social anxiety disorder in childhood and pre-adolescence: adaptation of the SASC-R for european portuguese

A Escala de Ansiedade Social para Crianças (forma revista) - SASC-R destina-se a avaliar as experiências de ansiedade social e de evitamento das crianças e pré-adolescentes no contexto das relações com os pares. Neste estudo, pretende-se validar para a população portuguesa a SASC-R, utilizando a estrutura proposta pelos autores da escala original, através da análise fatorial confirmatória (AFC). Procedemos à aplicação da SASC-R numa amostra de 486 crianças entre os 9 e os 15 anos. Os resultados indicam que a escala replica os fatores da versão original, possui boa consistência interna e uma validade de constructo bastante satisfatória. Este estudo sugere que a SASC-R é uma escala útil na avaliação da ansiedade social em crianças.(AU)

The Social Anxiety Scale for Children (revised form) - SASC-R evaluates the experience of social anxiety and avoidance felt by children and pre-adolescents in the context of relationship with their peers. This study aims to validate the Portuguese version of the SASC-R by confirmatory factor analysis using the structure proposed by the authors of the original scale. In a survey donewith 486 children between the ages of nine and 15 years, the results show that the scale reproduces the original factors, has a good internal consistency and a quite satisfactory construct validity. This study suggests that the SASC-R is a useful scale on the evaluation of social anxiety among children.(AU)

Ansiedade social na infância e pré-adolescência: adaptação para o português de Portugal da SASC-R / Social anxiety disorder in childhood and pre-adolescence: adaptation of the SASC-R for european Portuguese

A Escala de Ansiedade Social para Crianças (forma revista) - SASC-R destina-se a avaliar as experiências de ansiedade social e de evitamento das crianças e pré-adolescentes no contexto das relações com os pares. Neste estudo, pretende-se validar para a população portuguesa a SASC-R, utilizando a estrutura proposta pelos autores da escala original, através da análise fatorial confirmatória (AFC). Procedemos à aplicação da SASC-R numa amostra de 486 crianças entre os 9 e os 15 anos. Os resultados indicam que a escala replica os fatores da versão original, possui boa consistência interna e uma validade de constructo bastante satisfatória. Este estudo sugere que a SASC-R é uma escala útil na avaliação da ansiedade social em crianças.

The Social Anxiety Scale for Children (revised form) - SASC-R evaluates the experience of social anxiety and avoidance felt by children and pre-adolescents in the context of relationship with their peers. This study aims to validate the Portuguese version of the SASC-R by confirmatory factor analysis using the structure proposed by the authors of the original scale. In a survey donewith 486 children between the ages of nine and 15 years, the results show that the scale reproduces the original factors, has a good internal consistency and a quite satisfactory construct validity. This study suggests that the SASC-R is a useful scale on the evaluation of social anxiety among children.

[Long term psychosocial outcomes of congenital heart disease in adolescents and young adults].

OBJECTIVE: Congenital heart disease (CHD) is a chronic illness with a high frequency in the worldwide population, and is normally diagnosed at birth or in uterus. Because of better conditions in diagnosis and early medical and surgical treatment, patients have survival rates of 90% and go further and further in life, facing different challenges in life cycle. In this study, we tested the effects of different demographic, clinical and psychosocial variables on the perception of quality of life (QOL), on psychosocial adjustment (PSA) and psychiatric morbidity (PM) of adolescents and young adults with CHD. We aimed to evaluate QOL, PM and PSA of adolescents and young adults with CHD and to determine which variables (demographic, clinical, and psychosocial) play a role in buffering stress and promoting resilience and which ones have a detrimental effect. METHODS: The study enrolled 150 CHD patients (87 males and 63 females), 12 to 26 years (17.45±3.373 years). The participants were interviewed regarding social support, family educational style, self-image, demographic information and physical limitations. They responded to questions in a standardized psychiatric interview (SADS-L) and completed self-reports questionnaires for assessment of QOL (WHOQOL-BREF) and PSA (YSR/ASR). RESULTS: We found a 18.7% lifetime prevalence of psychopathology in our participants (25.4% in females and 13.8% in males). 57.1% had retentions in school (1.53±0.804 year). The perception of QOL of CHD patients is better compared to the Portuguese population in the social relationships, environmental, physical and general dimensions. However, it is worse in female CHD patients and patients with poor academic performance and social support as well as in patients with complex or cyanotic CHD, moderate-to-severe residual lesions and physical limitations, and undergoing surgery. All of these variables, except presence of cyanosis, are also associated to a worse PSA. CONCLUSIONS: Female patients and patients with poor academic performance and poor social support refer worse PSA and QOL.

[Psychosocial adjustment, psychiatric morbidity and quality of life in adolescents and young adults with congenital heart disease]. / Ajustamento psicossocial, morbilidade psiquiátrica e qualidade de vida em adolescentes e jovens adultos com cardiopatias congénitas.

OBJECTIVES: We aimed to study the psychosocial adjustment (PSA), psychiatric morbidity and quality of life of adolescents and young adults with congenital heart disease (CHD) to determine which demographic and clinical variables negatively affect adjustment and which increase resilience. METHODS: The study included 74 patients with CHD, 41 male and 33 female, aged between 12 and 26 years (mean 18.76±3.86). Demographic information and a complete clinical history were obtained. The participants were interviewed regarding social support, family environment, self-image and physical limitations. A standardized psychiatric interview was conducted, and self-report questionnaires were administered for assessment of PSA (Youth Self Report and Adult Self Report) and quality of life (World Health Organization Quality of Life - Short Version). A caregiver completed an observational version of the PSA questionnaire (Child Behavior Checklist or Adult Behavior Checklist). RESULTS: Female participants showed more feelings of anxiety and depression (U=952.500; p=0.003), thought problems (U=929.500; p=0.005) and aggressive behavior (U=999.000; p=0.000). They also showed a higher rate of psychopathology. Patients with complex forms of CHD reported more thought problems (U=442.000; p=0.027) and internalization (U=429.000; p=0.021). Compared to the Portuguese population as a whole, participants showed better quality of life in the domains of social relationships (t=2.333; p=0.022) and environment (t=3.754; p=0.000). Patients who had undergone surgery had worse quality of life in physical terms (t=-1.989; p=0.050), social relationships (t=-2.012; p=0.048) and general quality of life (U=563.000; p=0.037), compared to those who were not operated. Better social support was associated with better quality of life in physical terms (t=3.287; p=0.002) and social relationships (t=3.669; p=0.000). Better school performance was also associated with better overall quality of life (U=457.000; p=0.046), less withdrawn behavior (U=812.500; p=0.031), fewer feelings of anxiety and depression (U=854.000; p=0.009), fewer attention problems (U=903.500; p=0.001), and lower scores for internalization (U=817.000; p=0.029) and externalization (U=803.500; p=0.042). Physical limitations had a detrimental effect on quality of life (U=947.500; p=0.001). DISCUSSION: Female participants were more prone to worse psychological adjustment and to psychopathology. Patients with complex forms of CHD showed worse PSA, as they need regular care, which restricts social contact with peers and family and integration in school and leisure activities. Patients who had undergone surgery showed worse quality of life as they often have long hospital stays, during which social activities are restricted, making it more difficult for them to develop a good social support network. They require close medical care, and the restrictions on their activities may be life-limiting. Their sense of survival may also be threatened. CONCLUSIONS: Patients with CHD appear to be more prone to psychopathology and female patients are more likely to show worse PSA. Social support was shown to play a crucial role in buffering stress and promoting patients' adjustment.

A cohort study on psychosocial adjustment and psychopathology in adolescents and young adults with congenital heart disease.

OBJECTIVES: Our purpose was to study psychosocial adjustment and psychiatric morbidity of adolescents and young adults with congenital heart disease (CHD). DESIGN: All assessment measures were obtained on a single occasion. Clinical data was obtained through the patient's clinical records. SETTING: A teaching and tertiary care facility in Porto, Portugal. PARTICIPANTS: We evaluated 110 CHD patients (62 male) aged from 12 to 26 years (mean=18.00±3.617), 58 cyanotic. All assessment measures were obtained on a single occasion in a tertiary hospital. Demographic information and clinical history were collected. PRIMARY AND SECONDARY OUTCOME MEASURES: Questionnaires regarded topics such as social support, family educational style, self-image and physical limitations, a standardised psychiatric interview Schedule for Affective Disorders and Schizophrenia-Lifetime version (SADS-L), and a self-report questionnaire on psychosocial adjustment, youth self-report or adult self-report. One of the relatives completed an observational version of the same questionnaire (child behaviour checklist (CBCL) or ABCL (adult behaviour checklist)). RESULTS: We found a 21.8% lifetime prevalence of psychopathology, 31.3%, in females, 14.5% in males, showing a somewhat increased proneness in CHD patients. Females also showed worse psychosocial adjustment, with more somatic complaints (u=260 000; p=0.011), anxiety/depression (u=984 000; p=0.002), aggressive behaviour (u=920 500; p=0.001), attention problems (u=1123 500; p=0.027), thought problems (u=1069 500; p=0.010), internalisation (u=869 000; p=0.0) and externalisation (u=1163 000; p=0.05). Patients with severe CHD (u=939 000; p=0.03) and surgical repair (u=719 000; p=0.037) showed worse psychosocial adjustment. Those with poor social support showed more withdrawal (u=557 500; p=0.0) and social problems (u=748 500; p=0.023), and patients with unsatisfactory school performance revealed more anxiety/depression (u=916 000; p=0.02) and attention problems (u=861 500; p=0.007). CONCLUSIONS: CHD males with good social support and good academic performance have a better psychosocial adjustment.

Long term psychosocial outcomes of congenital heart disease (CHD) in adolescents and young adults.

BACKGROUND: Congenital heart disease (CHD) is a chronic illness with a high frequency in the worldwide population, and is normally diagnosed at birth or in uterus. Because of better conditions in diagnosis and early medical and surgical treatment, patients have survival rates of 90% and go further and further in life, facing different challenges in life cycle. In this study, we tested the effects of different demographic, clinical and psychosocial variables on the perception of quality of life (QOL), on psychosocial adjustment (PSA) and psychiatric morbidity (PM) of adolescents and young adults with CHD. OBJECTIVES: We aimed to evaluate QOL, PM and PSA of adolescents and young adults with CHD and to determine which variables (demographic, clinical, and psychosocial) play a role in buffering stress and promoting resilience and which ones have a detrimental effect. METHODS: The study enrolled 150 CHD patients (87 males and 63 females), 12 to 26 years (M: 17.45±3.373 years). The participants were interviewed regarding social support, family educational style, self-image, demographic information and physical limitations. They responded to questions in a standardized psychiatric interview (SADS-L) and completed self-reports questionnaires for assessment of QOL (WHOQOL-BREF) and PSA (YSR/ASR). RESULTS: We found an 18.7% lifetime prevalence of psychopathology in our participants (25.4% in females and 13.8% in males). 57.1% had retentions in school (M: 1.53±0.804 year). The perception of QOL of CHD patients is better compared to the Portuguese population in the Social Relationships, Environmental, Physical and General Dimensions. However, it is worse in complex forms of CHD, in cyanotic patients, in moderate-to-severe residual lesions, in patients submitted to surgery and in patients with physical limitations. All of these variables, except presence of cyanosis, are also associated to a worse PSA. Social Support is very important in improving QOL of patients in all dimensions as well as academic performance. CONCLUSIONS: Female patients and patients with poor academic performance and poor social support refer worse PSA and QOL.

Quality of life of patients with congenital heart diseases.

OBJECTIVES: To assess the perception of the quality of life of adolescents and young adults with congenital heart disease and to examine the variables that have a negative impact on it and that add a resilience effect. METHODS: A total of 22 male and 18 female patients, aged 12-26 years, of whom 27 were admitted to surgery and 13 were not, participated in this study. All patients had complete medical records and were interviewed once; demographic and clinical data were collected, and patients filled a questionnaire on quality of life, the WHOQOL-BREF, and underwent an interview on social support, educational style, self-image, functional limitations, and emotional adjustment. RESULTS/CONCLUSIONS: Our patients showed a better perception of quality of life than did the general population, on the basis of psychological, social relationship and environment scales. Older patients hold a better perception of quality of life on the psychological scale. Cyanosis did not show any significant impact over perception of quality of life decay; however, the number of surgical procedures and the persistence of moderate-to-severe residual injuries had considerable detrimental effect. Social support had an impact on increasing resilience, promoting adjustment to illness. Several factors may play a role in adjustment to congenital heart disease, either improving the perception of quality of life or worsening it. We may conclude that some buffer variables on congenital heart disease may play roles in increasing the perception of quality of life of patients during their lifetime, social support probably explaining why the perception of quality of life is better than in the normal population. The number of surgeries and the moderate-to-severe residual injuries, however, reverted that effect.

Quality of life experienced by adolescents and young adults with congenital heart disease.

This study aimed to assess the quality of life (QOL) experienced by adolescents and young adults with congenital heart disease (CHD) and to determine which factors negatively affect adjustment and which factors increase resilience. The participants in the study were 74 patients with CHD (41 males and 33 females) ranging in age from 12 to 26 years (mean age, 18.76 ± 3.86 years). Demographic information and a complete clinical history were obtained. The participants were interviewed regarding topics such as social support, family educational style, self-image, and physical limitations. They responded to questions in a standardized psychiatric interview (SADS-L) and completed a self-report questionnaire (WHOQOL-BREF) for assessment of QOL. Compared with the Portuguese population as a whole, the study patients had better QOL, especially with regard to the environmental dimension (t = 3.754; P = 0.000) and social relationships (t = 2.333; P = 0.022). Patients who had undergone surgery experienced poorer QOL in the physical dimension (t = -1.989; P = 0.050), in social relationships (t = -2.012; P = 0.048) and overall (Mann-Whitney U = 563.000; P = 0.037). Social support played a positive role in the QOL of the patients, both in the physical dimension (t = 3.287; P = 0.002) and in social relationships (t = 3.669; P = 0.000). A higher school achievement also was associated with higher levels of QOL overall (Mann-Whitney U = 457.000; P = 0.046) as well as in the physical (t = 2.045; P = 0.045) and environmental (t = 2.413; P = 0.018) dimensions. Physical limitations had a detrimental impact on general QOL (Mann-Whitney U = 947.500; P = 0.001) and on the physical (t = -2.910; p = 0.005) and psychological (t = -2,046; P = 0.044) dimensions. Patients with CHD tended to perceive QOL as better when their social networks were supportive.

[Stress and satisfaction of mothers in neonatal intensive care]. / Stress e satisfação das mães em cuidados intensivos neonatais.

INTRODUCTION: The admission and stay in a Neonatal Intensive Care Unit represents an anxious experience to parents, because of their frustrated expectations and the confrontation with the possibility of newborn's death. The aims of this study were to assess how mothers cope with physical characteristics of the context, with treatments and with the loss of the idealized parental role; to assess how mothers evaluate the medical and nurse staff performance; and to assess the degree of satisfaction with the Service. MATERIAL AND METHODS: A sample of 100 mothers, whose newborns were admitted at the Neonatal Intensive Care Unit,was asked to fulfil a specific survey. RESULTS: In a general way, according to the mean of all stress subscales, the total experienced stress was moderate. Significant associations or differences between scholarity and stress were not found, as well as with mother's age. The loss of parental role was the most anxious factor for mothers. The satisfaction with medical team was inversely related to stress. Mothers were satisfied with nurse team performance. CONCLUSION: The loss of the idealized parental role is the most anxious experience for the mothers. The observed results highlight the need for the continuous change of the neonatal unit in a more warming environment for the mothers and their newborns.

[Self-perception in children with attention-deficit/hyperactivity disorder]. / Auto-conceito em crianças com hiperactividade e défice de atenção.

The Attention-Deficit/ Hyperactivity Disorder (ADHD) is a disorder reflected by significant deficits in multiple domains, interfering with the self-perception and self-esteem of children. However, international studies that assess the relationship between ADHD and self-perception have come to contradictory results, and, in Portugal, this is still a little investigated subject. The present work aims to assess the self-perception in different areas (scholastic competence, athletic competence, physical appearance, behaviour and social acceptance) in children with ADHD, comparing them with a control group. This study also tries to analyze whether the subtype of ADHD could interfere differently with the self-perception. We studied 43 children who had a clinical diagnosis of ADHD and 59 children without this diagnosis. Children with ADHD were divided into different subtypes in view of the revised Conners Scales (Portuguese version). The children completed the Self-Perception Profile for Children. From the analysis of averages comparison, it was found that the group of children with ADHD showed lower values in the different domains of self-perception, with a statistically significant difference in scholastic and behaviour self-perceptions. Regarding the different subtypes of ADHD, the results were not statistically significant, but indicated that children perceive themselves differently depending on the subtype. This discrepancy was most evident in scholastic competence where children predominantly inattentive considered themselves less able than the others. In this study, as in the international literature, children with ADHD have an scholastic and behavioural self-perception statistically inferior to other children of the same age, needing every possible support for a healthy emotional development.