A self-regulation intervention conducted by class teachers: impact on elementary students' basic psychological needs and classroom engagement.

Literature has reported a decrease in students' engagement throughout schooling, but more worrying, is that elementary students already show signs of disengagement. This data sets the case to develop interventions at this school level. The narrative-based intervention "Yellow Trials and Tribulations" aimed to promote self-regulation has been proven to positively impact elementary students' school engagement. Acknowledging that classroom engagement is expected to be more closely related to learning and achievement than school engagement, the current study aims to extend the research of the mentioned intervention on elementary students' classroom engagement (i.e., behavioral, emotional, cognitive, and agentic dimensions), as well as on basic psychological needs (i.e., perceived autonomy, competence, and relatedness)-an antecedent of students' engagement. The current intervention was implemented by 4th-grade class teachers trained for that purpose and was assessed following a quasi-experimental design with pretest and posttest data collection. Participants were 90 students in the experimental group, and 91 in the comparison group. A multivariate analysis of variance with repeated measures was run for each construct. At the end of the intervention, children in the experimental group reported higher perceived competence and classroom engagement (all dimensions) than their counterparts in the comparison group (small and medium effect sizes were found). No follow-up was conducted to examine whether the intervention effects were long-lasting. Results are expected to support researchers' and educators' efforts to effectively implement the intervention, and maximize its benefits to students. For example, extra efforts could be made to help implementers better respond to students' psychological needs (in this case, perceived autonomy and relatedness), and consequently increase classroom engagement (especially behavioral and emotional engagement, which revealed lower effect sizes).

A Self-Regulation Intervention Conducted by Teachers in a Disadvantaged School Neighborhood: Implementers' and Observers' Perceptions of Its Impact on Elementary Students.

Self-regulated learning contributes to students' academic success and their future as citizens. However, self-regulation skills are seldom or poorly promoted during instruction. To address this gap, the current article reports data on the implementation of an evidence-based intervention (i.e., a narrative-based intervention called "Yellow Trials and Tribulations") in a disadvantaged school neighborhood. Prior studies showed positive results of this intervention in promoting elementary students' self-regulation skills. Still, the data are mainly quantitative and limited to students' reports or classroom observations made by researchers. Hence, the current study aimed to explore the implementers' and observers' perceptions of the impact of the intervention. Four elementary teachers implemented the intervention in their fourth-grade classes (N = 96 students). For each session, the implementers and observers completed a session sheet collaboratively, as well as individual final reports at the end of the intervention. The records were analyzed through a direct content analysis. The data indicated a perceived increase in knowledge and the use of self-regulation skills in the educational context and in daily life routines. Moreover, the data allowed for the identification of other positive gains of the intervention. The findings extended prior research while helping researchers to further understand the impact of the narrative-based intervention. The implications for research and educational practice are provided.

Direito à saúde, tratamentos experimentais e indústria farmacêutica: breves anotações / Right to health, experimental treatments and pharmaceutical industry: brief notes / Derecho a la salud, tratamientos experimentales y industria farmacéutica: brevesnotas

Objetivo: compreender o excesso de judicialização no Brasil e buscar algumas justificativas que levaram ao estado da arte. Metodologia: utilizou-se o método de pesquisa indutivo, realizando um levantamento bibliográfico e análise documental, com base em dados divulgados pelo Conselho Nacional de Justiça e, de forma complementar, em dados extraídos do sítio institucional da Agência Nacional de Saúde Suplementar. Resultados: a judicialização da saúde tem apresentado um caráter predominantemente individual, o que agrava o alcance da macrojustiça e do atendimento da coletividade. Além disso, as dificuldades estruturais do Sistema Único de Saúde tornam-se cada vez mais evidentes. Observa-se que a judicialização da saúde pode ser perversa do ponto de vista do excesso de concessão de tutelas de urgência, da prioridade da justiça individualizada e do destaque da microjustiça; elementos que prejudicam o funcionamento do sistema de saúde como um todo. Conclusão: a indústria farmacêutica apresenta intensa participação no processo de incorporação de medicamentos. No entanto, a complexidade e demora das etapas procedimentais da incorporação dessas novas tecnologias, não raro, resultam em demandas judiciais que derivam decisões polêmicas e nem sempre acertadas. Todo esse desenho acaba por desencadear pressão no órgão competente de incorporação, incompreensões sobre o funcionamento do SUS e fortalecimento da microjustiça.

Objective: to understand the excess of judicialization in Brazil and seek some justifications that led to the state of the art. Methods: an inductive research method was used, which involved conducting a bibliographic survey and documentary analysis of data released by the National Council of Justice and, in addition, data extracted from the institutional website of the National Supplementary Health Agency. Results: the judicialization of health has presented a predominantly individual aspect, which aggravates the reach of macrojustice and community care. In addition, the structural difficulties of the Unified Health System become increasingly evident. The judicialization of health can be perverse from the point of view of the excess of granting emergency guardianships, the priority of individualized justice, the prominence of microjustice; elements that undermine the functioning of the health system as a whole. Conclusion: the pharmaceutical industry plays an intense role in the drug incorporation process. However, the complexity and delay in the procedural stages of incorporating these new technologies often result in legal demands that result in controversial decisions that are not always correct. This entire design ends up triggering pressure on the competent incorporation body, misunderstandings about the functioning of the SUS and strengthening microjustice.

Objetivo: comprender el exceso de judicialización en Brasil y buscar algunas justificaciones que han llevado al estado del arte. Metodología: se utilizó el método de investigación inductivo, realizando un levantamiento bibliográfico y análisis documental, con base en datos divulgados por el Consejo Nacional de Justicia y, de forma complementaria, en datos extraídos del sitio web institucional de la Agencia Nacional de Salud Complementaria. Resultados: la judicialización de la salud ha presentado un carácter predominantemente individual, lo que agrava el alcance de la macrojusticia y de la atención de la colectividad. Además, las dificultades estructurales del Sistema Único de Salud son cada vez más evidentes. Se observa que la judicialización de la salud puede ser perversa desde el punto de vista de la concesión excesiva de tutelas de urgencia, de la prioridad de la justicia individualizada y del énfasis en la microjusticia; elementos que perjudican el funcionamiento del sistema de salud em su conjunto. Conclusión: la industria farmacéutica juega un papel intenso en el proceso de incorporación de medicamentos. Sin embargo, la complejidad y demora en las etapas procesales de incorporación de estas nuevas tecnologías derivan muchas veces en exigencias legales que derivan en decisiones controvertidas y no siempre correctas. Todo este diseño termina provocando presiones sobre el órgano constitutivo competente, malentendidos sobre el funcionamiento del SUS y fortalecimiento de la microjusticia.

Parenting in Cerebral Palsy: Understanding the Perceived Challenges and Needs Faced by Parents of Elementary School Children.

Cerebral palsy (CP) can be considered the most frequent childhood physical disorder. The severity and type of dysfunction depend on the brain injury. Movement and posture are the most affected areas. CP is a lifelong condition, and parenting a child with this disorder brings additional challenges (e.g., dealing with grief) and needs (e.g., information). Identifying and characterizing their challenges and needs are pivotal to enrich the knowledge in this field and help draw more suitable support for parents. Interviews with 11 parents of children with CP attending elementary school were conducted. The discourse was transcribed, and a thematic analysis was performed. Three themes emerged from the data: (i) challenges of parenting a child with CP (e.g., internal challenges), (ii) crucial needs for parents to cope with a child with CP (e.g., information), and (iii) the intersection between challenges and needs of parents of children with CP (e.g., unawareness). Regarding the challenges and needs characterization, lifespan was the most frequent period of child development, and the microsystem was the context of life most reported. The findings may inform the design of educational and remediation interventions to support families of children with CP attending elementary school.

Building partnerships in education through a story-tool based intervention: Parental involvement experiences among families with Roma backgrounds.

Introduction: School educators are likely to explain the poor educational trajectories of students with Roma backgrounds related to the lack of parental support and interest in children's education. Aiming to understand further the patterns of Roma group's parental involvement in children's school life and their engagement experiences in school-related activities, the current research set an intervention supported by a culturally sensitive story-tool. Method: Grounded in the intervention-based research framework, 12 participants (i.e., mothers) from different Portuguese Roma groups participated in this study. Data was collected through interviews conducted pre-and postintervention. Eight weekly sessions were delivered in the school context, using a story-tool and hands- on activities to generate culturally significant meanings regarding attitudes, beliefs, and values toward children's educational trajectories. Results: Through the lens of acculturation theory, data analysis provided important findings under two overarching topics: patterns of parental involvement in children's school life and participants' engagement in the intervention program. Discussion: Data show the distinct ways Roma parents participate in children's education and the relevance of mainstream contexts providing an atmosphere likely to build collaborative relationships with parents to overcome barriers to parental involvement.

Understanding children's voices about enablers of obesity from a causal attribution's stance: a vignette study.

OBJECTIVE: Childhood obesity is a public health challenge with health, economic and psychosocial consequences. The design of interventions addressing childhood obesity seldom considers children's perspectives on the topic. Weiner's causal attribution framework was used to explore children's perspectives on enablers of obesity. METHODS AND MEASURES: Children (N = 277) responded to a vignette with an open-ended question. Data were analyzed using content analysis. RESULTS: Children perceived internal, unstable and controllable causes (e.g. dietary intake, self-regulation and emotionality) as the main enablers (76.53%) of obesity, while some (11.91%) highlighted external, unstable and controllable causes (e.g. parent food restrictions). A focus on children with healthy body weight showed that they mentioned more internal, stable and controllable causes for obesity than children with unhealthy body weight/obesity did. The latter mentioned more external, unstable and controllable causes than their counterparts. CONCLUSIONS: Understanding children's causal attributions for obesity is expected to deepen our knowledge of obesity enablers and help design interventions matching children's perspectives.

Self-Efficacy to Regulate Eating Behaviors Scale for Children: A Validation Study.

Self-efficacy has a strong influence on children's eating behavior. Feeling capable of regulating one's eating behavior is especially relevant in situations of activation while facing temptations or experiencing negative emotions. Despite the relevance, there is no validated measure to assess children's self-efficacy to regulate eating behaviors in these domains. The present study examines the psychometric properties of the Self-Efficacy to Regulate Eating Behaviors Scale for Children based on a sample of 724 elementary school children in Portugal. The sample was split randomly into two groups, and a principal component analysis with Group 1 and a confirmatory factor analysis with Group 2 were carried out. The scale comprises two distinct but related factors-self-efficacy to regulate eating behaviors in activation and temptation situations and self-efficacy to regulate eating behaviors in negative emotional situations. Moreover, self-efficacy to regulate eating behaviors was positively and statistically related to self-regulation processes toward healthy eating, declarative knowledge about healthy eating, and attitudes and perceptions toward healthy eating. The present study provides preliminary evidence that the Self-Efficacy to Regulate Eating Behaviors Scale for Children is valid and reliable for evaluating children's self-efficacy in regulating their eating behaviors.

Changes in Student's Breakfast and Snack Consumption during the Second COVID-19 Lockdown in Portugal: A Five-Wave Study.

The circumstances of the COVID-19 lockdown affected many students' life spheres, including their feeding patterns and snack intake. The main goals of the present study were to: (a) analyze the changes in students' breakfast and snacking consumption during lockdown, and (b) analyze changes in the content of the students' snacks using the Healthy Eating Index. This study analyzed data from a sample of 726 students from 36 classes from the late elementary (i.e., fifth grade) through high school (i.e., twelfth grade) from two public schools in the north of Portugal. Data were collected in five moments during the 2020/2021 school year, pre-, during, and post-second lockdown moments. Throughout the five moments, almost 90% of the students ate breakfast, and the majority brought snacks from home to eat in school. Surprisingly, there was an increase in the quality of the snacks consumed during lockdown compared to the pre-lockdown moments (e.g., consumption of more whole and total fruits and less consumption of food with added sugar, saturated fats, refined grains, and fatty acids). Suggestions for healthy behavior promotion will be discussed, such as improving the school food environment and teaching children to prepare healthy lunch boxes.

Changes in Physical Fitness Parameters in a Portuguese Sample of Adolescents during the COVID-19 Pandemic: A One-Year Longitudinal Study.

Due to a worldwide response to the COVID-19 pandemic, many changes were imposed on individuals' daily lives, including those related to the physical activity of children and adolescents. The present study aims to comprehend the impact of early COVID-19 pandemic restrictions on Portuguese adolescents' physical fitness parameters during two school years. A total of 640 students from the 5th to the 12th grades participated in the longitudinal study. Data on body composition, aerobic fitness, speed, agility, lower and upper body strength, and flexibility were collected at three moments: 1. before the COVID-19 pandemic (December 2019); 2. after the COVID-19 lockdown when the schools reopened delivering in-person classes (October 2020), and 3. two months after the in-person classes started (December 2020). To analyze the overall changes between the three moments and between two age groups, we conducted repeated measure ANOVAs. The main findings indicate that participants' body composition (i.e., waist circumference) and aerobic fitness (i.e., maximal oxygen uptake) deteriorated after the first lockdown but improved two months after the in-person classes started. However, the same did not happen to neuromuscular fitness (i.e., horizontal Jumps and Sit and Reach). These findings suggest that the COVID-19 lockdown may have negatively impacted adolescents' physical fitness, particularly older adolescents. Altogether, data reinforce the importance of in-person classes and school context in promoting adolescents' physical health.

Reading in COVID-19 Pandemic Times: A Snapshot of Reading Fluency of Portuguese Elementary School Students.

The development of reading skills foresees fluency in reading. Prior research has shown that during periods of absence from school, students are prone to showing setbacks in their learning. However, the literature presents mixed findings, possibly explained by the families' socioeconomic statuses. The present study aims to analyze fluctuations in learning acquisition, specifically in reading fluency, during the pandemic, when all students were absent from school for several months. Data were collected in two waves. The present study combines quantitative and qualitative data with an explanatory sequential approach. Participants were 52 3rd-graders and their teachers. The latter were enrolled in two-member check sessions. Statistically significant differences in speed (lower than expected) and prosody (higher than expected) were found between the two sessions. Considering ASE support (financial support for low-income families from the Portuguese government), data indicate that students benefiting from this support showed performances in accuracy and speed below the expected. Prosody scores were above the expected at both sessions. Findings may provide relevant insights to further understand fluctuations in students' reading fluency during long periods of absence from school; for example, data could help prevent learning setbacks due to summer vacations.

Ultrasonography screening in children and adolescents who have one parent with familial non-medullary thyroid carcinoma.

AIM: To evaluate ultrasonography (US) screening for thyroid cancer in children and adolescents who have one parent with familial non-medullary thyroid carcinoma (FNMTC) unrelated to known genetic syndromes. METHODS: In this prospective study, we selected 72 children and adolescents (age ≤18 years) without a palpable thyroid nodule or history of radiation exposure, but who have one parent diagnosed with FNMTC (i.e. at least one other affected first-degree relative). The children and adolescents were evaluated by US during initial assessment and after 5 years. RESULTS: Initial US revealed pure cysts in five participants and nodules in seven, which were ≥5 mm in five. These patients were submitted to fine needle aspiration, which revealed benign cytology in four and a follicular lesion of undetermined significance in one. Fine needle aspiration was repeated in the last case and in one case with benign cytology but suspicious US. The second cytology was benign in both cases. After 5 years, another two participants with initially normal US had nodules <5 mm in the absence of suspicious findings. The frequency of lesions detected by US was not associated with participant sex or age, number of relatives with thyroid cancer (2 or 3), maternal or paternal origin of tumour, or age of the relatives at diagnosis. CONCLUSION: The present results suggest that US screening is not necessary in children or adolescents when one parent has a diagnosis of FNMTC (≥2 affected relatives).

Parental Involvement in Homework During Covid-19 Confinement.

BACKGROUND: The purpose of this study was to compare parents' involvement in students' homework during COVID-19 confinement and their involvement in normal circumstances. METHOD: 628 parents of elementary and high school students completed a questionnaire about their family and family involvement in their children's homework. To address the objective, data were examined using mean differences and analysis of variance. RESULTS: As predicted, the COVID-19 situation led to more time spent doing homework for students, as well as higher levels of conflict and stress within the family. In addition, parents reported having increased their homework management during confinement in terms of emotional and motivational support for their children compared to normal circumstances. Finally, the data showed more conflicts and family involvement in the families of children with special needs compared to families of children without special needs. CONCLUSIONS: The time spent in confinement posed many challenges to families' routines and the data indicated a lack of resources available for families to manage their children's tasks, as well as an increase in family stress and conflicts.

Bedtime procrastination during the second COVID-19 lockdown in Portugal.

Introduction: Bedtime procrastination is the deliberate delay of the time an individual goes to bed in the absence of external reasons. The COVID-19 pandemic has pushed families to establish new routines and ways of managing newfound roles and responsibilities. This scenario is likely to exacerbate bedtime procrastination due to, for example, a challenge in balancing professional and personal life. Objective: The aim is to present preliminary findings regarding bedtime procrastination and its relation to sociodemographic characteristics, sleep routines, perceived daily fatigue, dinnertime, and activities performed near bedtime, during the second lockdown in Portugal. Material and Methods: A cross-sectional online survey was conducted with a sample of 560 adults. Results: During home confinement, most people (79.46%) delayed their bedtime. However, this delay does not seem to be affecting the number of hours of sleep, as 88.60% were sleeping the recommended or appropriate number of hours. Nevertheless, most of the participants reported feeling tired throughout the day (53.04%), and individuals who reported to have procrastinated their sleep are those who reported more tiredness (r pb=.33, p<.01). Additionally, bedtime procrastination is positively associated with findings related to dinnertime (e.g., dinner between 9 p.m. and 10 p.m., r pb=.19, p<.01) and with engagement in activities near bedtime (e.g., studying/working, r pb=.39, p<.01). Conclusion: Current data shows relationships between bedtime procrastination and most of the studied variables. Specifically, findings indicate that lack of routines, especially scheduled nighttime routines (e.g., studying/working near bedtime), may have contributed to bedtime procrastination during the second lockdown in Portugal.

Short and Long-Term Effects on Academic Performance of a School-Based Training in Self-Regulation Learning: A Three-Level Experimental Study.

An experimental study was designed to analyze the effect of school-based training in self-regulation learning strategies on academic performance (Mathematics, Sciences, Language, and English). Class-level variables (i.e., gender, the teacher's teaching experience, class size) were considered and the effects of the intervention were measured at the end of the intervention and 3 months later. A sample of 761 students from 3rd and 4th grades (356 in the control condition and 405 in the experimental condition), from 14 schools, participated in the study. Data were analyzed using three-level analysis with within-student measurements at level 1, between-students within-classes at level 2, and between-classes at level 3. Data showed a positive effect of the intervention on student performance, both at post-test (d = 0.25) and at follow-up (d = 0.33) considering the four school subjects together. However, the effect was significant just at follow-up when subjects were considered separately. Student performance was significantly related to the students' variables (i.e., gender, level of reading comprehension) and the context (teacher gender and class size). Finally, students' gender and level of reading comprehension, as well as the teacher's gender, were found to moderate the effect of the intervention on students' academic performance. Two conclusions were highlighted: first, data emphasize the importance of considering time while conducting intervention studies. Second, more teaching experience does not necessarily translate into improvements in the quality of students' instruction.

Validity evidence of the Academic Procrastination Scale for undergraduates / Evidências de validade da Escala de Procrastinação Acadêmica para Universitários / Evidencias de validez de la Escala de Procrastinación Académica para universitarios

The objective of this study is to analyze the validity evidence of the Academic Procrastination Scale (APS) in a sample consisting of 1979 students from public and private universities, from different courses, 67% of the students being women, aged 18 to 68 years old (M = 22.84). The principal component analysis revealed two components, also validated by confirmatory analysis, which showed a good overall fit of a two-dimensional model: Daily Study Procrastination (a = 0.75) and Exam Study Procrastination (a = 0.75). Internal consistency was estimated through Cronbach's alpha, obtaining 0.83 for the total scale. The study concludes that APS has satisfactory psychometric properties and suggests further validation studies and also analysis of academic procrastination in higher education students. (AU)

O objetivo deste estudo é analisar as evidências de validade da Escala de Procrastinação Acadêmica (EPA) em uma amostra de 1979 estudantes de universidades públicas e privadas, matriculados em cursos de graduação distintos, sendo 67% mulheres, com idades variando entre 18 e 68 anos (M = 22,84). A análise de componentes principais indicou dois componentes, validados também pela análise confirmatória, a qual confirmou o ajuste dos dados ao modelo de dois fatores: Procrastinação para o Estudo Diário (a = 0,75) e Procrastinação para o Estudo para Provas (a = 0,73). A consistência interna, estimada pelo alfa de Cronbach, foi de 0,83 para a escala total. Conclui-se que a EPA apresenta propriedades psicométricas satisfatórias, com a sugestão da continuidade de estudos de validade e, também, de avaliação da procrastinação acadêmica em estudantes do ensino superior. (AU)

El objetivo de esta investigación es analizar las evidencias de validez de la Escala de Procrastinación Académica (EPA) en una muestra constituida por 1979 estudiantes de universidades públicas y privadas, de diferentes cursos de grado, de los cuales el 67% eran mujeres, con edades comprendidas entre 18 y 68 años (M = 22,84). El análisis de los componentes principales reveló dos componentes, también validados por el análisis confirmatorio, que mostró un buen ajuste general de un modelo bidimensional: Procrastinación del Estudio Diario (a = 0,75) y Procrastinación del Estudio en Exámenes (a = 0,75). La consistencia interna se estimó mediante el alfa de Cronbach, obteniendo 0,83 para la escala total. Se concluye que la EPA cuenta con propiedades psicométricas satisfactorias y sugiere otros estudios de validación y de análisis de la procrastinación académica en los estudiantes de educación superior. (AU)

Diagnostic Utility of Procalcitonin for Sporadic Medullary Thyroid Carcinoma in Patients with Nodular Disease and Mild or Moderate Hypercalcitoninemia.

Many authors recommend the measurement of serum calcitonin (Ctn) to screen for sporadic medullary thyroid carcinoma (MTC) in patients with thyroid nodules. In this situation, procalcitonin (pro-Ctn) would have greater utility in patients with hypercalcitoninemia<100 pg/ml. The aim of this study was to evaluate the utility of pro-Ctn in patients with thyroid nodules and without a suspicion of familial MTC or type 2 multiple endocrine neoplasia who had mild or moderate hypercalcitoninemia without an apparent cause. Consecutive patients with nodular thyroid disease assessed routinely by Ctn measurement were selected. Sixty patients with basal Ctn>10 pg/ml but<100 pg/ml were included. Nine patients (15%) had MTC, with cytology being diagnostic in only four. Among the 51 patients without MTC, pro-Ctn was<0.1 ng/ml in 46 (90.2%). All patients with MTC had pro-Ctn>0.1 ng/ml. Basal Ctn was>24.6 pg/ml in all patients with MTC and in 42 patients (82.3%) without MTC. It is noteworthy that among patients with basal Ctn>24.6 pg/ml (n=18) pro-Ctn>0.1 ng/ml identified all patients with MTC and 64.2% of subjects with these pro-Ctn concentrations had this tumor. In conclusion, we did not find superiority of pro-Ctn over Ctn for the diagnosis of sporadic MTC in patients with nodular disease and mild or moderate hypercalcitoninemia. However, in the case of patients with hypercalcitoninemia in the gray zone, pro-Ctn has an excellent negative predictive value while the data regarding its positive predictive value are not uniform.

Natural history, predictive factors of apparent disease (structural or biochemical) and spontaneous excellent response in patients with papillary thyroid carcinoma and indeterminate response to initial therapy with radioiodine.

BACKGROUND: About 20% of patients with papillary thyroid carcinoma (PTC) submitted to total thyroidectomy followed by radioactive iodine (RAI) exhibit an indeterminate response to therapy. The aim was to evaluate the natural history, predictive factors of apparent disease (structural or biochemical), and spontaneous excellent response in patients with PTC and an initial indeterminate response to RAI therapy defined based on unstimulated Tg (u-Tg). METHODS: We evaluated 164 patients who were initially treated with total thyroidectomy and RAI and who had an indeterminate response to therapy (u-Tg between 0.2 and 1 ng/ml, undetectable anti-Tg antibodies [TgAb], and neck ultrasonography [US] without anomalies). None of the patients received empirical therapy with RAI. The patients were followed up for 24 to 144 months (median 72 months). RESULTS: Apparent disease occurred in 16 patients (9.7%), including 13 with structural disease and 3 with u-Tg elevation > 1 ng/ml, but no tumor was detected by the imaging methods (biochemical disease). A higher frequency of disease was observed in patients with >3 lymph node metastases (LNM) and initial u-Tg >0.35 ng/ml. The frequency was only 2% among patients with ≤3 LNM and u-Tg ≤0.35 ng/ml and 9.7% among patients with > 3 LNM or u-Tg >0.35 ng/ml, while the frequency was 27% in patients with >3 LNM and u-Tg >0.35 ng/ml. In the absence of any additional therapy, u-Tg was <0.2 ng/ml (excellent response) in the last assessment in 70 patients (42.7%). Only initial u-Tg was associated with a higher probability of spontaneously achieving an excellent response: 40/72 patients (55.5%) with u-Tg ≤0.35 ng/ml versus 30/92 patients (32.6%) with u-Tg >0.35 ng/ml. CONCLUSIONS: A minority of patients with PTC and an initial indeterminate response to RAI defined based on u-Tg develop apparent disease (structural or biochemical) and many spontaneously achieve an excellent response. The risk of disease can be refined based on parameters such as the extent of lymph node involvement and initial Tg concentration.

"COVID-19 in Trials and Tribulations" Project: A Self-Regulation-Based Support Response for Confined Families through Social Networks.

The COVID-19 pandemic has placed today's society in an unprecedented scenario. During Portugal's first home confinement period (March-July 2020), the online-based "COVID-19 in Trials and Tribulations" project was implemented to support families with school-aged children. The project was grounded on the self-regulation framework and delivered through Facebook® and Instagram® pages. Being responsive to ongoing developments of the pandemic, activities were conveyed in two phases. Phase 1 occurred during lockdown (school was suspended). Phase 2 occurred while students were enrolled in at-distance (online) school. The present study aimed to examine the reach of the project, while examining the content and format of delivery that generated the most engagement among the users (4500 Facebook® effective followers; 1200 Instagram® effective followers) during the confinement period. Results showed that, at the individual page level, Facebook® had higher reach indicators compared to Instagram®, except for video. At the Facebook® post level, followers and users showed more engagement with the page prior to the at-distance schooling phase; however, videos still generated engagement (p = 0.002). Both the post type (p < 0.01) and frequency (p < 0.001) of publication were suggested to be good predictors of engagement. The information gathered will help design and inform future interventions that may be implemented as new lockdowns are set in place.

Children's Perceived Barriers to a Healthy Diet: The Influence of Child and Community-Related Factors.

A healthy diet influences the promotion and maintenance of health throughout an individual's life. Many individuals struggle to have a healthy diet, despite it being mainly under their control. The current study aims to explore children's perceived barriers to a healthy diet. A qualitative study with the open-ended question, "Please identify the top 5 barriers to a healthy diet", was undertaken between January-June 2019 in which 274 students from the 5-6th grades wrote down their answers to the open-ended question. Content analysis was used to analyze responses with a codebook based on the Six C's Model. Five categories were identified: Child, Clan, Community, Country, and Culture-related barriers. Findings showed that the barriers most highlighted were in the Child sphere (e.g., dietary intake) and the Community sphere (e.g., peer food choices). Children seldom referred to barriers from the Clan sphere, i.e., related to family (e.g., food available at home). Additionally, it seems that girls emphasize more barriers from the Child sphere, while boys emphasize more barriers from the Community sphere. Due to the qualitative nature of this study, interpretation of the data should take into account the specific characteristics and context of the sample. Nevertheless, the current data are helpful in identifying implications for practice, for example, the need to empower children with tools (e.g., self-regulation-based interventions) likely to help them overcome perceived barriers. Finally, advocacy groups may help set environmental and structural changes in the community likely to facilitate children's healthy choices.

Psychometric Properties of Parental Burnout Assessment and Prevalence of Parental Burnout: A Person-Centered Approach / Propiedades psicométricas del Parental Burnout Assessment y prevalencia del burnout parental: un enfoque personal

ResumenAntecedentes/Objetivo: Con esta investigación se pretendió estudiar la estructura del Parental Burnout Assessment (PBA), averiguar si los padres combinan las dimensiones del PBA en términos de perfiles y, finalmente, analizar los niveles de prevalencia. Método: Se analizaron las respuestas de 438 madres y padres con análisis factorial confirmatorio y análisis de perfiles latentes. Resultados: Se obtuvo evidencia tanto de validez (estruc-tural) como de fiabilidad (consistencia interna) del PBA. En base a las cuatro dimensiones del PBA se identificaron cuatro perfiles de agotamiento. Tanto desde una perspectiva centrada en la variable como desde una perspectiva centrada en la persona, se obtuvie-ron niveles muy altos de burnout parental. Conclusiones: Los resultados del estudio indi-can que el PBA es un instrumento válido y fiable (pudiéndose utilizar tanto los puntajes particulares de las dimensiones como el puntaje general). Asimismo, el nivel de las cua-tro dimensiones, en los cuatro perfiles de burnout parental, es similar dentro de cada perfil, pero diferente entre los perfiles. Finalmente, en comparación con el porcentaje indicado por estudios previos (3,2%), el nivel de prevalencia de burnout parental deriva-do de nuestro estudio es muy alto (sobre un 26%).

AbstractBackground/Objetive: The objective of this research is threefold. First, to study the structure of the Parental Burnout Assessment (PBA); second, to learn whether parents combine the dimensions of PBA in profiles; and third, to analyze the prevalence levels of parental burnout. Method: To address these objectives, the responses of 438 mothers and fathers were analyzed with confirmatory factor analysis and latent profile analysis. Results: Strong evidence of validity (structural) and reliability (internal consistency) of the PBA was found. Four parental burnout profiles were identified. Moreover, from a variable-centered perspective and a person-centered perspective, very high levels of parental burnout were found. Conclusions: Data indicate that the PBA is a reliable and valid instrument and suggest that practitioners may use the particular scores of the dimensions or the overall score. Likewise, the level of the four dimensions in the four parental burnout profiles (PBP) is similar within and different between profiles. Finally, the prevalence level of parental burnout is very high (over 26%) compared to data from previous studies (3.2%).