Sensory Profile-2 in Autism Spectrum Disorder: An Analysis within the International Classification of Functioning, Disability and Health Framework.

Autism spectrum disorder (ASD) is characterized by impairments in many functional areas requiring long-term interventions to promote autonomy. This study aims to map The Sensory Profile™ 2 (SP-2), one of the most widely used assessment tools in children with ASD, with the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), developed by the World Health Organization (WHO). This will allow the identification of the functional dimensions covered by this instrument and the comparison with the ICF shortlist proposed for autism (ICF Core Set [ICF-CS]). The deductive content analysis described in the ICF Linking Rules was followed, along with a systematized process including statistical and reasoning techniques that could contribute to the improvement of ICF linking studies (Cohen's Kappa and percentage of agreement). 218 codes were identified, 71% of them were codes related to the body functions chapters, mainly linked to perceptual functions (b160), emotional functions (b152), and temperament and personality functions (b126). Concerning activities and participation chapters (29%) the most frequently used codes were: focusing attention (d160), carrying out daily routine (d230), and walking (d450). Even though the SP-2 items do not assess most of the functional features regarded as essential in the ASD ICF-CS, SP-2 encompasses a majority of problems concerning body functions. This instrument may be considered as part of a multidimensional assessment approach, to complement other sources that are more likely to assess activity and participation dimensions and guide a functional intervention.

Effects of a Portuguese social-emotional learning program on the competencies of elementary school students.

Introduction: It is widely recognized that socio-emotional learning (SEL) interventions can contribute to supporting students' positive development of socio-emotional skills (SES) and positive relationships with peers and teachers. Thus, interest in promoting students' SES through universal evidence-based programs is spreading around the world, including in Portuguese schools. Methods: This quasi-experimental study examines the efficacy of a SEL classroom-based program, infused into the curriculum, on students' communication, self-regulation, and classroom peer relationships. Participants included 208 third- to fourth-grade students from three Portuguese public elementary schools: 143 in the intervention group (54.5% boys; Mage = 8.72; SD = 0.61); 65 in the comparison group (52.3% boys; Mage = 8.66; SD = 0.59). Measures included: Study on Social and Emotional Skills, parent, child, and teacher versions; and Classroom Peer Context Questionnaire, completed by students. The study followed a pre- and post-test design, with a 16-week intervention. Results: For the overall participants, results show a positive effect of the program on students' assertiveness (family report), peer conflict and peer cooperation. Effects were analyzed separately by school grade. A statistically significant positive effect of the program on third-grade students' assertiveness and sociability was found. For fourth-grade students, a positive effect was found on - emotional control). classroom conflicts, isolation, cooperation and cohesion behaviors. Discussion: These positive effects support the expansion of universal interventions when aiming at strengthening SEL in Portuguese school settings, underlining the relevance of embedding SEL into the curricula and daily practices at schools.

Environment Mediates the Relationship Between Preschoolers Functioning and Involvement in Out-of-School Activities.

This study aims to understand the associations between child functioning and environmental barriers and the involvement of preschool children, with and without disabilities, in out-of-school activities, namely, home and community activities. Particularly, we aimed to investigate if environmental barriers mediate the relationship between child functioning and their involvement in these activities. Parents of 116 preschool-aged children (42 children with disabilities) reported on children's involvement and environmental factors at home and in the community. Preschool teachers assessed child functioning. Multiple linear regressions and mediation analysis were performed. Results indicated significant associations between child functioning, perceived environmental barriers, and involvement at home and in the community. A significant indirect association of child functioning on involvement through the perception of environmental barriers was found in both contexts. Findings support the biopsychosocial model of participation and a focus on environmental features by practitioners designing and implementing intervention strategies.

Social accountability and health systems' change, beyond the shock of Covid-19: drawing on histories of technical and activist approaches to rethink a shared code of practice.

BACKGROUND: Recognition of the value of "social accountability" to improve health systems performance and to address health inequities, has increased over the last decades, with different schools of thought engaging in robust dialogue. This article explores the tensions between health policy and systems research and practice on the one hand, and health equity-focussed activism on the other, as distinct yet interacting processes that have both been impacted by the shock effects of the Covid-19 pandemic. This extended commentary brings multidisciplinary voices seeking to look back at health systems history and fundamental social-institutional systems' behaviors in order to contextualize these current debates over how best to push social accountability efforts forward. ANALYSIS: There is a documented history of tension between long and short processes of international health cooperation and intervention. Social accountability approaches, as a more recent strategy to improve health systems performance, intersect with this overarching history of negotiation between differently situated actors both global and local on whether to pursue sustained, slow, often community-driven change or to focus on rapid, measurable, often top-down interventions. Covid-19, as a global public health emergency, resulted in calls for urgent action which have unsurprisingly displaced some of the energy and aspiration for systemic transformation processes. A combination of accountability approaches and mechanisms have their own legitimacy in fostering health systems change, demanding collaboration between those that move both fast and slow, top-down and bottom-up. CONCLUSION: We argue that social accountability, much like all efforts to strengthen health systems, is "everybody's business" and that we must understand better the historical processes that have shaped the field of practice over time to move forward. These differences of perspective, knowledge-base and positioning vis-a-vis interventions or longer-term political commitment should not drive a conflict of legitimacy but instead be named, subsequently enabling the development of a shared code of conduct that applies to the breadth of actors involved in social accountability work. If we are concerned about the state of/status of social accountability within the context of "building back better" we must approach collaboration with a willingness to create dialogue across distinct disciplinary, technical and politically-informed ways of working.

Contextos Pré-Escolares Inclusivos: Organização do Grupo, Interações e Envolvimento / Inclusive Preschool Contexts: Group Organization, Interactions and Engagement

RESUMO: Este estudo correlacional pretende caracterizar os contextos pré-escolares inclusivos portugueses relativamente aos formatos de atividade, analisar relações entre eles e a qualidade do tom emocional e estimulação cognitiva e da linguagem do educador, e as relações entre formatos de atividade e envolvimento de crianças com incapacidades, em risco e com desenvolvimento típico. Participaram do estudo 198 crianças (47 com incapacidades; 60 em risco; 91 com desenvolvimento típico). O envolvimento das crianças e os formatos de atividade foram observados com o Child Observation in Preschool; tom emocional e estimulação cognitiva com o Teacher Observation in Preschool. Os resultados revelaram que o tom emocional dos educadores nas interações registou valores moderados, sendo mais elevados nas atividades de grande-grupo. O grande-grupo registou níveis de envolvimento mais baixos para todas as crianças. Os três grupos de crianças registam níveis semelhantes de envolvimento em jogo-livre. Concluise que, apesar dos formatos de grande-grupo apresentarem qualidade mais elevada no tom das interações, é nestes que crianças com e sem incapacidades apresentam níveis mais baixos de envolvimento, destacando-se o jogo-livre como um formato onde todas as crianças se envolvem mais. Os resultados salientam a importância da intencionalidade educativa no planeamento das interações e dos formatos das atividades, para assegurar a promoção do envolvimento das crianças.

ABSTRACT: This correlational study aims to characterize the Portuguese inclusive preschool contexts regarding activity-settings, to analyze relationships between them and the quality of the educator's emotional tone and cognitive and language stimulation, and the relationships between activity-settings and involvement of children with disabilities, at-risk and typically developing. A total of 198 children participated in the study (47 with disabilities; 60 at-risk; 91 typically developing). Child engagement and activity-setting were observed with Child Observation in Preschool; emotional tone and cognitive stimulation with Teacher Observation in Preschool. Results revealed that the educators' emotional tone in interactions registered moderate values, being higher in whole-group activities. The whole-group activities registered lower levels of engagement for all children. The three groups of children presented similar levels of engagement in free-play. It was concluded that, although the whole-group activity-settings show higher quality regarding the tone of interactions, it is in these activity-settings that both children with and without disabilities show lower levels of engagement, with free-play emerging as an activity-setting where all children are more engaged. Results highlight the importance of educational intentionality in planning interactions and activity-settings to ensure the promotion of children's engagement.

Beyond command and control: A rapid review of meaningful community-engaged responses to COVID-19.

Responses to COVID-19 have included top-down, command-and-control measures, laissez-faire approaches, and bottom-up, community-driven solidarity and support, reflecting long-standing contradictions around how people and populations are imagined in public health-as a 'problem' to be managed, as 'free agents' who make their own choices, or as a potential 'solution' to be engaged and empowered for comprehensive public health. In this rapid review, we examine community-engaged responses that move beyond risk communication and instead meaningfully integrate communities into decision-making and multi-sectoral action on various dimensions of the response to COVID-19. Based on a rapid, global review of 42 case studies of diverse forms of substantive community engagement in response to COVID-19, this paper identifies promising models of effective community-engaged responses and highlights the factors enabling or disabling these responses. The paper reflects on the ways in which these community-engaged responses contribute to comprehensive approaches and address social determinants and rights, within dynamics of relational power and inequality, and how they are sometimes able to take advantage of the ruptures and uncertainties of a new pandemic to refashion some of these dynamics.

Diversidades e convergências nos indicadores de saúde no Brasil e em Moçambique / Diversity and Convergence in Health Indicators in Brazil and Mozambique

O artigo apresenta um panorama da trajetória recente das desi­ gualdades em saúde nos dois países. Partindo da sistematização de dados produzidos pelos órgãos oficiais, de estatística e saúde, mostra como evoluíram os indicadores de acesso à saúde. Observa­se a redução das desigualdades em período recente em ambos os países, sendo de forma mais acentuada em Moçambique, em função do aumento da atenção primária à saúde nas áreas rurais

The article presents an overview of the recent trends on health inequalities in two countries. It shows how service provision and social health related indicators have progressed using administrative data produced by official authorities. Both countries present reduction on health inequalities. Mozambique has produced further pronounced results due to increasing access to primary health care in rural areas

Beyond diagnosis: the relevance of social interactions for participation in inclusive preschool settings.

Purpose: This study aims to explore the role of three specific factors within the child-environment interaction process - engagement, independence and social interactions - in influencing development and learning of children with disabilities in inclusive preschool settings. The main question is whether children can be categorised in homogenous groups based on engagement, independence and social interactions (proximal variables within a biopsychosocial framework of human development). The study also examined whether children with the same diagnosis would group together or separately, when trying to identify clusters of engagement, independence and social interactions, and additionally whether such clusters vary as a function of individual child characteristics, and/or as a function of structural and process characteristics of preschool environment. Methods: Data was taken from an intervention study conducted in mainstream preschools in Portugal. A person-centered cluster analysis was conducted to explore group membership of children with various diagnoses, based on their engagement, independence and social interaction profiles. Results: Results show that children clustered based on similarity of engagement, independence and social interaction patterns, rather than on diagnosis. Besides, it was found that quality of peer interaction was the only predictor of cluster membership. Conclusion: These findings support the argument that participation profiles may be more informative for intervention purposes than diagnostic categories, and that preschool process quality, namely peer interaction, is crucial for children's participation.

Diversidades e convergências nos indicadores de saúde no Brasil e em Moçambique1 / Diversity and convergence in health indicators in Brazil and Mozambique1

O artigo apresenta um panorama da trajetória recente das desigualdades em saúde nos dois países. Partindo da sistematização de dados produzidos pelos órgãos oficiais, de estatística e saúde, mostra como evoluíram os indicadores de acesso à saúde. Observa­se a redução das desigualdades em período recente em ambos os países, sendo de forma mais acentuada em Moçambique, em função do aumento da atenção primária à saúde nas áreas rurais.

Transição para a creche e bem-estar emocional dos bebês em Portugal / Transition to childcare and infants' well-being in Portugal / Transición a la guardería y bienestar emocional de los bebés en Portugal

O presente estudo analisa a relação entre a implementação de práticas de transição do contexto familiar para a creche e o bem-estar emocional dos bebês durante o primeiro de mês de frequência neste contexto extrafamiliar. Foram recolhidos dados, antes e após a entrada do bebê na creche, junto das mães e das educadoras de 90 bebês.Os resultados indicaram que o número de práticas de transição reportadas pelas educadoras se revela positivamente associado ao bem-estar emocional dos bebês durante o primeiro mês de frequência da creche. Estes resultados recomendam a implementação de um conjunto diversificado de práticas de transição, antes e após a entrada na creche, no sentido de facilitar a adaptação dos bebês ao novo contexto desenvolvimental.

The present study analyzes the relationship between the implementation of transition practices from home to day care center and the emotional well-being of the infants during the first month of attendance in this extrafamiliar environment. Data were collected, before and after the infant entered the day care center, with the mothers and teachers of 90 infants. The results indicated that the number of transition practices reported by teachers is positively associated with the emotional well-being of infants during the first month of day care attendance. These results recommend the implementation of a diversified set of transition practices, before and after entry into the day care center, to facilitate the infants' adaptation to the new developmental setting.

En el presente estudio se analiza la relación entre la implementación de prácticas de transición del contexto familiar a la guardería y el bienestar emocional de los bebés, durante el primer mes de frecuencia de este contexto extra-familiar. Se recolectaron datos, antes y tras la entrada del bebé en la guardería, por intermedio de las madres y de las educadoras de 90 bebés. Los resultados indicaron que el número de prácticas de transición reportadas por las educadoras se revela positivamente asociado al bienestar emocional de los bebés durante el primer mes de frecuencia a la guardería. Estos resultados recomiendan la implementación de un conjunto diversificado de prácticas de transición, antes y tras la entrada en la guardería, en el sentido de facilitar la adaptación de los bebés al nuevo contexto de desarrollo.

Evaluating the impact of contracting out basic health care services in the state of São Paulo, Brazil.

As a means of dealing with shortcomings in the coverage, quality and efficiency of the public health care sector, several municipalities in the state of São Paulo, Brazil, have started to contract pre-certified non-profit or non-governmental organizations to take part in the delivery of health care services.This paper explores the impact of introducing these contracts in the primary health care sector. Using data on the 645 municipalities in the state of São Paulo and difference-in-differences methods, we estimate the effect of contracting out in the primary health care sector on various dimensions of mortality and health care use. The results show that implementation of the contracting out strategy significantly increases the number of primary health care appointments by approximately one appointment per user of the national health care system per year. Point estimates indicate a reducing effect on hospitalization for preventable diseases.

Identification of functional domains in developmental measures: An ICF-CY analysis of Griffiths developmental scales and Schedule of Growing Skills II.

OBJECTIVE: This study aims to identify functioning categories of the International Classification of Functionality, Disability and Health for Children and Youth covered by the Griffiths developmental scales and the Schedule of Growing Skills II (SGS-II), as well as to analyse levels of agreement between coders when assigning its items to the ICF-CY classification system. METHODS: Items were linked to the ICF-CY following a content analysis procedure and the published linking rules. Agreement was calculated with Cohen's Kappa Coefficient. RESULTS: All SGS items assess mostly Activities and Participation, alike most of the Griffiths' scales except for the Language and Eye-hand coordination scales, which assess mostly Body Functions. Consistently with previous studies, agreement levels between coders vary considerably, thus being highly dependent on the nature of the concept analysed. CONCLUSION: Although necessary from a capacity-driven approach to assessment, information collected with these instruments should be complemented with other assessments in order to cover all aspects of the child's life, in line with a systemic approach.

O sonhar social: uma experiência no Brasil / Social dreaming: an experience in Brazil

A matriz do sonhar social é um dispositivo criado com a finalidade de apreender o significado social dos sonhos. Buscamos avaliar sua aplicação no contexto brasileiro e cogitamos sobre suas potencialidades em processos de intervenção psicológica. Foram realizados encontros de compartilhamento de sonhos com dois grupos: 14 profissionais de gestão de pessoas de uma instituição financeira nacional e seis psicólogos formandos e recém-formados de uma universidade pública federal. Utilizamos a técnica de observação participante e questionários de avaliação de reação, procedendo à avaliação qualitativa das informações. Constatamos a aplicabilidade do dispositivo e formulamos hipótese sobre a utilização da matriz em intervenção psicológica.(AU)

The social dreaming matrix is a device created for the purpose of grasping the social meaning of dreams. We tried to evaluate its application in the context of Brazil and theorized about its potential in processes of psychological intervention. Meetings were held to share dreams with two groups: 14 human management professionals of a national financial institution and six trainees and graduates in Psychology of a federal public university. The information gathered with the technique of participant observation and reaction evaluating questionnaires was interpreted using qualitative methods. The applicability of the device was verified and a hypothesis was formulated about the use of the matrix in psychological intervention.(AU)

O Sonhar social: uma experiência no Brasil / Social dreaming: an experience in Brazil

A matriz do sonhar social é um dispositivo criado com a finalidade de apreender o significado social dos sonhos. Buscamos avaliar sua aplicação no contexto brasileiro e cogitamos sobre suas potencialidades em processos de intervenção psicológica. Foram realizados encontros de compartilhamento de sonhos com dois grupos: 14 profissionais de gestão de pessoas de uma instituição financeira nacional e seis psicólogos formandos e recém-formados de uma universidade pública federal. Utilizamos a técnica de observação participante e questionários de avaliação de reação, procedendo à avaliação qualitativa das informações. Constatamos a aplicabilidade do dispositivo e formulamos hipótese sobre a utilização da matriz em intervenção psicológica.

The social dreaming matrix is a device created for the purpose of grasping the social meaning of dreams. We tried to evaluate its application in the context of Brazil and theorized about its potential in processes of psychological intervention. Meetings were held to share dreams with two groups: 14 human management professionals of a national financial institution and six trainees and graduates in Psychology of a federal public university. The information gathered with the technique of participant observation and reaction evaluating questionnaires was interpreted using qualitative methods. The applicability of the device was verified and a hypothesis was formulated about the use of the matrix in psychological intervention.

Making the right to health a reality for Brazil's indigenous peoples: innovation, decentralization and equity.

This article provides an overview of governance arrangements and changes in the Brazilian public health system since 1988, when the "Citizen's Constitution" declared health to be a universal right. Since then, population coverage has grown substantially and health indicators have improved. Despite these achievements, inequities in access remain an important barrier to universal coverage, in particular for marginalized groups such as indigenous peoples. This article discusses the innovation cycle that produced the gains and recent efforts to guarantee more equitable access to health services for the indigenous population in a continent-sized country historically plagued by great inequalities.

A arte de envelhecer: um estudo exploratório sobre a história de vida e o envelhecimento / The art of aging: an exploratory study on life history and aging / El arte de envejecer: un estudio exploratorio sobre la historia de vida y el envejecimiento

O presente estudo objetivou, a partir da teoria epigenética do ciclo de vida e da perspectiva do desenvolvimento ao longo da vida, (1) conhecer aspectos do envelhecimento à luz da história de vida de oito idosos, (2) investigar o modo como estratégias de seleção, otimização e compensação e envolvimento vital se manifestam e (3) explorar contribuições da geratividade e da participação social no processo de envelhecer de oito idosos. Os idosos participaram de entrevista semiestruturada. A análise dos dados revela que fatores como participação social, geratividade e relacionamento com filhos e netos influenciam a construção de um envelhecimento bem-sucedido. Por outro lado, fatores como estagnação e ausência de envolvimento social parecem contribuir para o aparecimento de sintomas psicopatológicos.(AU)

The present study, based on the life cycle epigenetic model and lifespan psychology, was designed to (1) understand aspects of the aging process from eight elders’ life stories, (2) investigate the way selective optimization with compensation strategies and vital involvement aspects appear in old age as well as (3) the contributions of generativity and social participation to the aging process. The subjects participated in a semi-structured interview. A qualitative analysis of the data pointed out the influence of several factors on the construction of a successful aging such as generativity, social participation and relationship with their children and grandchildren. Factors such as stagnation and lack of social involvement seem to contribute to the development of psychopathology symptoms.(AU)

El presente estudio objetivó, a partir de la teoría epigenética del ciclo de vida y de la perspectiva del desarrollo a lo largo de la vida, (1) conocer aspectos del envejecimiento a la luz de la historia de vida de ocho personas de edad, (2) investigar el modo como estrategias de selección, optimización y compensación e involucración vital se manifiestan y (3) explotar contribuciones de la generatividad y de la participación social en el proceso de envejecer de ocho personas de edad. Estas personas de edad participaron de entrevistas semi-estructuradas. El análisis de los datos revela que factores como participación social, generatividad y relacionamiento con hijos y nietos influencian la construcción de un envejecimiento bien llevado. Por otro lado, factores como estancamiento y ausencia de envolvimiento social parecen contribuir para el aparecimiento de síntomas psicopatológicos.(AU)

A arte de envelhecer: um estudo exploratório sobre a história de vida e o envelhecimento / The art of aging: an exploratory study on life history and aging / El arte de envejecer: un estudio exploratorio sobre la historia de vida y el envejecimiento

O presente estudo objetivou, a partir da teoria epigenética do ciclo de vida e da perspectiva do desenvolvimento ao longo da vida, (1) conhecer aspectos do envelhecimento à luz da história de vida de oito idosos, (2) investigar o modo como estratégias de seleção, otimização e compensação e envolvimento vital se manifestam e (3) explorar contribuições da geratividade e da participação social no processo de envelhecer de oito idosos. Os idosos participaram de entrevista semiestruturada. A análise dos dados revela que fatores como participação social, geratividade e relacionamento com filhos e netos influenciam a construção de um envelhecimento bem-sucedido. Por outro lado, fatores como estagnação e ausência de envolvimento social parecem contribuir para o aparecimento de sintomas psicopatológicos....(AU)

The present study, based on the life cycle epigenetic model and lifespan psychology, was designed to (1) understand aspects of the aging process from eight elders’ life stories, (2) investigate the way selective optimization with compensation strategies and vital involvement aspects appear in old age as well as (3) the contributions of generativity and social participation to the aging process. The subjects participated in a semi-structured interview. A qualitative analysis of the data pointed out the influence of several factors on the construction of a successful aging such as generativity, social participation and relationship with their children and grandchildren. Factors such as stagnation and lack of social involvement seem to contribute to the development of psychopathology symptoms....(AU)

El presente estudio objetivó, a partir de la teoría epigenética del ciclo de vida y de la perspectiva del desarrollo a lo largo de la vida, (1) conocer aspectos del envejecimiento a la luz de la historia de vida de ocho personas de edad, (2) investigar el modo como estrategias de selección, optimización y compensación e involucración vital se manifiestan y (3) explotar contribuciones de la generatividad y de la participación social en el proceso de envejecer de ocho personas de edad. Estas personas de edad participaron de entrevistas semi-estructuradas. El análisis de los datos revela que factores como participación social, generatividad y relacionamiento con hijos y nietos influencian la construcción de un envejecimiento bien llevado. Por otro lado, factores como estancamiento y ausencia de envolvimiento social parecen contribuir para el aparecimiento de síntomas psicopatológicos....(AU)

Social participation in health in Brazil and England: inclusion, representation and authority.

AIM: This article offers a brief description and analysis of public participation in health in Brazil and England in order to highlight different motivators and tensions within an acceptance of participation as official policy. SOURCES/METHODS: The article draws on a range of research in both countries and an analysis of official documents relating to participation. It is based on collaboration between researchers deriving from broad programmes of work on public participation in which the authors are involved. ARGUMENT: There is a tension between different principles underpinning collective public involvement in health both within and between countries. Different aspirations or claims have been made about what such participation will achieve and there are trade-offs between design principles that have consequences for issues such as who takes part and thus also for what can be achieved. The democratic origins of public participation are more evident in the Brazilian situation than in England, but there are still questions about the inclusivity of the practices through which this is achieved. The English picture is both more diverse and dynamic, but formal decision-making power of participatory forums is less than in Brazil. Whilst social justice claims for participation have been made in both countries, there is as yet limited evidence that these have been realized.