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.

Diagnosing Septate Uterus Using Three-Dimensional Ultrasound Using Three Different Classifications: An Interobserver and Intraobserver Agreement Study.

OBJECTIVE: Currently, there are up to three different classifications for diagnosing septate uterus. The interobserver agreement among them has been poorly assessed. OBJECTIVE: To assess the interobserver agreement of nonexpert sonographers for classifying septate uterus using the European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy (ESHRE/ESGE), American Society for Reproductive Medicine (ASRM), and Congenital Uterine Malformations by Experts (CUME) classifications. METHODS: A total of 50 three-dimensional (3D) volumes of a nonconsecutive series of women with suspected uterine malformation were used. Two nonexpert examiners evaluated a single 3D volume of the uterus of each woman, blinded to each other. The following measurements were performed: indentation depth, indentation angle, uterine fundal wall thickness, external fundal indentation, and indentation-to-wall-thickness (I:WT) ratio. Each observer had to assign a diagnosis in each case, according to the three classification systems (ESHRE/ESGE, ASRM, and CUME). The interobserver agreement regarding the ESHRE/ESGE, ASRM, and CUME classifications was assessed using the Cohen weighted kappa index (k). Agreement regarding the three classifications (ASRM versus ESHRE/ESGE, ASRM versus CUME, ESHRE/ESGE versus CUME) was also assessed. RESULTS: The interobserver agreement between the 2 nonexpert examiners was good for the ESHRE/ESGE (k = 0.74; 95% confidence interval [CI]: 0.55-0.92) and very good for the ASRM and CUME classification systems (k = 0.95; 95%CI: 0.86-1.00; and k = 0.91; 95%CI: 0.79-1.00, respectively). Agreement between the ESHRE/ESGE and ASRM classifications was moderate for both examiners. Agreement between the ESHRE/ESGE and CUME classifications was moderate for examiner 1 and good for examiner 2. Agreement between the ASRM and CUME classifications was good for both examiners. CONCLUSION: The three classifications have good (ESHRE/ESGE) or very good (ASRM and CUME) interobserver agreement. Agreement between the ASRM and CUME classifications was higher than that for the ESHRE/ESGE and ASRM and ESHRE/ESGE and CUME classifications.

OBJETIVO: Atualmente, existem até três classificações diferentes para o diagnóstico de útero septado. A concordância interobservador entre eles tem sido pouco avaliada. OBJETIVO: Avaliar a concordância interobservador de ecografistas não especialistas para classificar úteros septados usando as classificações European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy (ESHRE/ESGE, na sigla em inglês), American Society for Reproductive Medicine (ASRM, na sigla em inglês) e Congenital Uterine Malformations by Experts (CUME, na sigla em inglês). MéTODOS: Foram utilizados 50 volumes tridimensionais (3D) de uma série não consecutiva de mulheres com suspeita de malformação uterina. Dois examinadores não especialistas avaliaram um único volume 3D do útero de cada mulher, mutuamente cegos. As seguintes medidas foram aferidas: profundidade de indentação, ângulo de indentação, espessura da parede do fundo uterino, indentação externa do fundo e relação entre indentação e a espessura da parede (I:WT, na sigla em inglês). Cada observador teve que atribuir um diagnóstico em cada caso, de acordo com os três sistemas de classificação (ESHRE/ESGE, ASRM e CUME). A concordância interobservador em relação às classificações ESHRE/ESGE, ASRM e CUME foi avaliada usando o índice kappa ponderado de Cohen (k). A concordância em relação às três classificações (ASRM versus ESHRE-ESGE, ASRM versus CUME e ESHRE-ESGE versus CUME) também foi avaliada. RESULTADOS: A concordância interobservador entre os 2 examinadores não especialistas foi boa para a classificação ESHRE/ESGE (k = 0,74, intervalo de confiança [IC] 95%: 0,55­0,92) e muito boa para os sistemas de classificação ASRM e CUME (k = 0,95; IC 95%: 0,86­1,00; e k = 0,91; IC95%: 0,79­1,00, respectivamente). A concordância entre as classificações ESHRE/ESGE e ASRM foi moderada para ambos os examinadores. A concordância entre as classificações ESHRE/ESGE e CUME foi moderada para o examinador 1 e boa para o examinador 2. A concordância entre as classificações ASRM e CUME foi boa para ambos os examinadores. CONCLUSãO: As três classificações apresentam concordância interobservador boa (ESHRE/ESGE) ou muito boa (ASRM e CUME). A concordância entre as classificações ASRM e CUME foi maior do que entre as classificações ESHRE/ESGE e ASRM e ESHRE/ESGE e CUME.

Diagnosing Septate Uterus Using Three-Dimensional Ultrasound Using Three Different Classifications: An Interobserver and Intraobserver Agreement Study / Diagnóstico de útero septado com ecografia tridimensional usando três classificações diferentes: Um estudo de concordância interobservador e intraobservador

Abstract Objective Currently, there are up to three different classifications for diagnosing septate uterus. The interobserver agreement among them has been poorly assessed. To assess the interobserver agreement of nonexpert sonographers for classifying septate uterus using the European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy (ESHRE/ESGE), American Society for Reproductive Medicine (ASRM), and Congenital Uterine Malformations by Experts (CUME) classifications. Methods A total of 50 three-dimensional (3D) volumes of a nonconsecutive series of women with suspected uterine malformation were used. Two nonexpert examiners evaluated a single 3D volume of the uterus of each woman, blinded to each other. The following measurements were performed: indentation depth, indentation angle, uterine fundal wall thickness, external fundal indentation, and indentation-to-wall-thickness (I:WT) ratio. Each observer had to assign a diagnosis in each case, according to the three classification systems (ESHRE/ESGE, ASRM, and CUME). The interobserver agreement regarding the ESHRE/ESGE, ASRM, and CUME classifications was assessed using the Cohen weighted kappa index (k). Agreement regarding the three classifications (ASRM versus ESHRE/ESGE, ASRM versus CUME, ESHRE/ESGE versus CUME) was also assessed. Results The interobserver agreement between the 2 nonexpert examiners was good for the ESHRE/ESGE (k = 0.74; 95% confidence interval [CI]: 0.55-0.92) and very good for the ASRM and CUME classification systems (k = 0.95; 95%CI: 0.86-1.00; and k = 0.91; 95%CI: 0.79-1.00, respectively). Agreement between the ESHRE/ESGE and ASRM classifications was moderate for both examiners. Agreement between the ESHRE/ESGE and CUME classifications was moderate for examiner 1 and good for examiner 2. Agreement between the ASRM and CUME classifications was good for both examiners. Conclusion The three classifications have good (ESHRE/ESGE) or very good (ASRM and CUME) interobserver agreement. Agreement between the ASRM and CUME classifications was higher than that for the ESHRE/ESGE and ASRM and ESHRE/ESGE and CUME classifications.

Resumo Objetivo Atualmente, existem até três classificações diferentes para o diagnóstico de útero septado. A concordância interobservador entre eles tem sido pouco avaliada. Avaliar a concordância interobservador de ecografistas não especialistas para classificar úteros septados usando as classificações European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy (ESHRE/ESGE, na sigla em inglês), American Society for Reproductive Medicine (ASRM, na sigla em inglês) e Congenital Uterine Malformations by Experts (CUME, na sigla em inglês). Métodos Foram utilizados50volumes tridimensionais (3D)deuma série não consecutiva de mulheres com suspeita de malformação uterina. Dois examinadores não especialistas avaliaram um único volume 3D do útero de cada mulher, mutuamente cegos. As seguintes medidas foram aferidas: profundidade de indentação, ângulo de indentação, espessura da parede do fundo uterino, indentação externa do fundo e relação entre indentação e a espessura da parede (I:WT, na sigla em inglês). Cada observador teve que atribuir um diagnóstico em cada caso, de acordo com os três sistemas de classificação (ESHRE/ESGE, ASRM e CUME). A concordância interobservador em relação às classificações ESHRE/ESGE, ASRM e CUME foi avaliada usando o índice kappa ponderado de Cohen (k). A concordância em relação às três classificações (ASRM versus ESHRE/ESGE, ASRM versus CUME e ESHRE/ ESGE versus CUME) também foi avaliada. Resultados A concordância interobservador entre os 2 examinadores não especialistas foi boa para a classificação ESHRE/ESGE (k = 0,74, intervalo de confiança [IC] 95%: 0,55-0,92) e muito boa para os sistemas de classificação ASRM e CUME (k = 0,95; IC 95%: 0,86-1,00; e k = 0,91; IC95%: 0,79-1,00, respectivamente). A concordância entre as classificações ESHRE/ESGE e ASRM foi moderada para ambos os examinadores. A concordância entre as classificações ESHRE/ESGE e CUME foi moderada para o examinador 1 e boa para o examinador 2. A concordância entre as classificações ASRM e CUME foi boa para ambos os examinadores. Conclusão As três classificações apresentam concordância interobservador boa (ESHRE/ESGE) ou muito boa (ASRM e CUME). A concordância entre as classificações ASRM e CUME foi maior do que entre as classificações ESHRE/ESGE e ASRM e ESHRE/ESGE e CUME.

Symptomatic Hypokalemia in a 19-Year-Old Student.

Primary hyperaldosteronism (PA) is the most common cause of secondary arterial hypertension and is frequently undiagnosed. It affects all ages but is more frequent between 20 and 60 years old. The clinical presentation is variable, and the diagnosis is based on screening and, in equivocal cases, confirmatory tests. A 19-year-old student presented with complaints of extreme fatigue, arterial hypertension, hypokalemia and metabolic alkalosis, raising a high index of suspicion for PA. Screening tests were performed and its expressiveness excluded the need of confirmatory tests. CT-scan showed a unilateral adrenal adenoma and the patient was submitted to laparoscopic adenectomy without complications. Prompt diagnosis and treatment are essential to avoid long term complications of PA.

Grape pomace as a source of phenolic compounds and diverse bioactive properties.

The bio-residues resulting from the wine industry (grape pomace made up of skins, seeds and stems) are often undervalued but constitute a potential source of bioactive phenolic compounds that can be applied in several industries. In this context, the aim of the present study was to evaluate the phenolic profile of Vitis vinifera L. grape pomace (skins, seeds and their mixture), and correlate them with its antioxidant, cytotoxic and antibacterial activities. The seeds showed the highest amount of phenolic compounds and also the highest antioxidant, cytotoxic and antibacterial activities. The skins revealed the highest levels of anthocyanins and p-coumaric acid hexoside. Strong correlations were observed between the presence of phenolic compounds and all the bioactivities studied. These by-products are good sources of phenolic compounds with high antioxidant and antibacterial activity, and also presenting a moderate cytotoxicity activity. These added-value by-products have great applicability in food, pharmaceutical and cosmetic industries.

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.

Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?

INTRODUCTION: The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries. MATERIAL AND METHODS: Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014. Primary outcomes were maternal and neonatal morbidity or mortality. RESULTS: Sixty five breech fetuses delivered vaginally were compared to 1262 delivered by elective cesarean. Nulliparous women were more common in the elective cesarean group (69.3% vs 24.6%; p < 0.0001). Gestational age at birth was significantly lower in the vaginal delivery group (38 ± 1 weeks vs 39 ± 0.8 weeks; p = 0.0029) as was birth weight (2928 ± 48.4 g vs 3168 ± 11.3 g; p < 0.0001). Apgar scores below seven on the first and fifth minutes were more likely in the vaginal delivery group (1st minute: 18.5% vs 5.9%; p = 0.0006; OR 3.6 [1.9 - 7.0]; 5th minute: 3.1% vs 0.2%; p = 0.0133; OR 20.0 [2.8 - 144.4]), as was fetal trauma (3.1% vs 0.3%: p = 0.031; OR 9.9 [1.8-55.6]). Neither group had cases of fetal acidemia. Admission to the Neonatal Intensive Care Unit, maternal postpartum hemorrhage and the incidence of other obstetric complications were similar between groups. DISCUSSION: Although vaginal breech delivery was associated with lower Apgar scores and higher incidence of fetal trauma, overall rates of such events were low. Admission to the neonatal intensive care unit and maternal outcomes were similar. CONCLUSION: Both delivery routes seem equally valid, neither posing high maternal or neonatal complications' incidence.

Introdução: A melhor via de parto do feto pélvico de termo ainda é controversa. Pretendemos comparar desfechos maternos e neonatais entre partos vaginais e cesarianas de fetos pélvicos de termo. Material e Métodos: Estudo de coorte, multicêntrico e retrospetivo, incluindo gestações de feto único de termo, em apresentação pélvica, que terminaram em parto vaginal ou cesariana eletiva entre janeiro de 2012 e outubro de 2014. Os desfechos primários foram a morbilidade e mortalidade maternas e neonatais. Resultados: Sessenta e cinco partos vaginais foram comparados com 1262 cesarianas eletivas. As nulíparas foram mais frequentes no grupo das cesarianas (69,3% vs 24,6%; p < 0,0001). A idade gestacional foi inferior nos partos vaginais (38 ± 1 semanas vs 39 ± 0,8 semanas; p = 0,0029), verificando-se o mesmo para o peso ao nascer (2928 ± 48,4 g vs 3168 ± 11,3 g; p < 0,0001). Índices de Apgar < 7 foram mais frequentes nos partos vaginais (1º minuto: 18,5% vs 5,9%; p = 0,0006; OR 3,6 [1,9 - 7,0]; 5º minuto: 3,1% vs 0,2%; p = 0,0133; OR 20,0 [2,8 - 144,4]). Verificou-se também uma maior incidência de traumatismo fetal neste grupo (3,1% vs 0,3%; p = 0,031; OR 9,9 [1,8 - 55,6]). Nenhum grupo teve casos de acidemia fetal. As taxas de internamento na unidade de cuidados intensivos neonatais, de hemorragia materna pós-parto ou de outras complicações obstétricas foram idênticas. Discussão: O parto vaginal associou-se a índices de Apgar inferiores e a uma maior incidência de traumatismo fetal, com taxas globalmente baixas. Não se verificaram diferenças nas taxas de internamento neonatal nem nos desfechos maternos. Conclusão: Ambas as vias de parto parecem adequadas, nenhuma condicionando incidências elevadas de complicações maternas ou neonatais.

Comportamento sexual de estudantes de medicina portugueses e seus fatores preditivos / Sexual patterns in Portuguese medical students and its predictive factors

Objetivo. Avaliar a prevalência de comportamentos de risco, comportamento sexual e disfunções sexuais (DS) em estudantes de medicina portugueses. Materiais e métodos. Estudantes da Faculdade de Medicina do Porto foram divididos em 3 grupos de acordo com o ano académico - grupo 1 (1.°/2.° anos, n = 288), grupo 2 (3.°/4.° anos, n = 267) e grupo 3 (5.°/6.° anos, n = 250) - e convidados a preencher um questionário sobre sexualidade e comportamento de risco. A análise estatística foi efetuada com recurso ao programa SPSS®. Resultados. Responderam ao questionário 258 homens e 547 mulheres, com idade mediana de 20 anos. A idade mediana da primeira experiência sexual dos inquiridos foi 17 anos, no entanto, 33,9% dos estudantes ainda não tinha tido qualquer experiência sexual. Verificou‐se que a prática conjunta de sexo oral e vaginal foi a mais comum (56,2%). A disfunção ejaculatória foi a DS mais referida pelos homens (18,2%), seguida da disfunção erétil (DE) (7,8%), particularmente quando associada ao consumo de drogas ilícitas (22,2%). As mulheres reportaram com maior frequência dispareunia (40,8%), dificuldade em atingir um orgasmo (34,7%) e falta de lubrificação (18,5%). Conclusões. Embora os estudantes de medicina representem uma população jovem saudável, a tensão física, emocional e mental a que estão sujeitos afeta negativamente a sua sexualidade. Além disso, a autoconsciência sexual pode afetar futuras interações com doentes com DS. Este estudo transversal demonstra que esta população em particular é globalmente inexperiente, contudo, são necessários mais estudos de avaliação dos padrões sexuais na população portuguesa para melhor esclarecer o seu perfil relativamente aos restantes jovens (AU)

Objective. To assess the prevalence of risk behavior, sexual behavior and sexual dysfunctions in Portuguese medical students. Methods. Students of the Faculty of Medicine of Porto were divided into three groups according to the year they are enrolled: group 1 (1st/2nd year, n = 288), group 2 (3rd/4th year, n = 267) and group 3 (5th/6th year, n = 250). An anonymous questionnaire about sexuality and risk behavior was filled in. Statistical analysis was performed using SPSS®. Results. The questionnaire was answered by 805 students (female = 547; male = 258), with median age of 20 years. The median age of the first sexual experience was 17 years, but 33.9% of the students denied having any sexual experience. The most common sexual practice is the joint practice of oral and vaginal sex (56.2%). Ejaculatory dysfunction was the sexual dysfunction most referred by men (18.2%), followed by erectile dysfunction (7.8%), particularly when associated to illicit drugs consumption (22.2%). The sexual dysfunctions most reported by women were dyspareunia (40.8%), difficulty in attaining an orgasm (34.7%) and lack of lubrication (18.5%). Conclusions. Although medical students represent a healthy young population, the physical, emotional and mental strain they are subjected to affect negatively their sexuality. Furthermore, sexual self‐awareness may negatively impact future interactions with patients with sexual dysfunctions. This cross‐sectional study is very inclusive, and demonstrated that this population is globally inexperienced. However, more studies of Portuguese population are needed in order to better understand their profile in relation to the other youngsters (AU)

Radiopacity and histological assessment of Portland cement plus bismuth oxide.

OBJECTIVE: The present study evaluated the subcutaneous connective tissue reactions and the radiopacity of MTA, Portland cement (PC), and Portland cement plus bismuth oxide (BO). STUDY DESIGN: Forty rats were divided into 5 groups (n = 8 per group): A1: Control (empty capsule); A2: Pro-Root MTA; A3: PC; A4: PC + BO 1:1; and A5: PC + BO 2:1. Polyethylene tubes were filled with the test materials and standardized radiographic images were taken. Histological evaluation was done after 7 and 60 days. Student t test and Fisher's test were used in the statistical analysis (P < .05). RESULTS: The radiopacity of the materials were in decreasing order: A2 > A4 > A5 > A3. No differences were found for the tissue response in the 2 experimental periods. A positive correlation between BO concentration and radiopacity of PC was determined. CONCLUSION: The histological evaluation suggests that all studied materials were biocompatible at 7 and 60 days.