Repositório RCAAP

A alienação parental despertou-nos um profundo interesse na disciplina de Direito Penal da Família, tendo passado por este tema na disciplina de Direito dos Menores. Verificámos ser a nova epidemia do século, fruto das alterações nas sociedades ocidentais, onde o conceito de família perdeu o seu lado conservador. Fenómeno que foi diagnosticado pela primeira vez em 1985, o seu conceito permanece atual, caracterizando-se pela utilização de várias táticas, por um dos progenitores, sempre com o intuito de impedir que o menor conviva com o progenitor alienado. Este jogo de manipulação acaba por atingir todos os intervenientes. O menor fica com sequelas psicológicas duradouras, privado do direito de estar com um dos progenitores e, ainda que raramente, sofre danos físicos. Do lado dos progenitores são notórias as consequências a nível psicológico, o desgaste emocional, enfrentando um sistema judicial que possui várias falhas e, não tão raro, com consequências físicas. Da análise ao sistema judicial português, verificamos que existem centenas de queixas dos progenitores a que os Tribunais dão pouca relevância, considerando exclusivamente o superior interesse da criança. Destas, várias são consideradas crime à luz do Código Penal Português, sem que tenham a devida sanção. Constatámos que algumas das ações perpetradas pelos progenitores alienantes, não possuem respaldo no ordenamento jurídico português, sendo urgente a sua introdução. As ações protagonizadas pelos progenitores alienantes, bem como os danos que daí advêm, merecem uma profunda reflexão sobre a (des)necessidade de criminalizar a Alienação Parental, apresentando várias soluções para este problema. Partimos para esta dissertação sem qualquer juízo de valor, sem uma opinião pré-definida, tentando chegar a uma conclusão após o estudo do tema, entrevistando magistrados, advogados, progenitores, psicólogos. Com a autorização concedida pelo Conselho Superior da Magistratura, consultámos processos e analisámos posições de juízes, o trabalho de técnicos da Segurança Social e da APAV, de psicólogos e advogados. A conclusão a que chegámos parece ser aquela que salvaguarda o superior interesse da criança e ajuda os progenitores a ultrapassar o fim da relação.

The goals of the present study are: first, to know the space that Schools Text Books of Visual Education occupy in the current school scene, more concretely in the third degree of Basic Education; second what receptivity that has or will be able to have this School Text Books, but in digital format. It’s made the positioning of the discipline of Visual Education in the third degree of Basic Education curriculum and it is presented a brief chronology of Schools Text Books of Visual Education. The questions that arrest with the problem of the adoption of school’s books in disciplines of artistic and physicist-motor expression are boarded. The traditional formats of paper were being gradually complemented for audiovisuals formats and nowadays the digital formats replace the traditional schools books

The COVID-19 pandemic has had a significant impact on global public health, with long-term consequences that are still largely unknown. This study aimed to assess the data regarding acute cardiovascular hospital admissions in five European centers before and during the pandemic. A multicenter, multinational observational registry was created, comparing admissions to the emergency departments during a 3-months period in 2020 (during the pandemic) with the corresponding period in 2019 (pre-pandemic). Data on patient demographics, COVID-19 test results, primary diagnosis, comorbidities, heart failure profile, medication use, and laboratory results were collected. A total of 8778 patients were included in the analysis, with 4447 patients in 2019 and 4331 patients in 2020. The results showed significant differences in the distribution of cardiovascular diseases between the two years. The frequency of pulmonary embolism (PE) increased in 2020 compared to 2019, while acute heart failure (AHF) and other cardiovascular diseases decreased. The odds of PE incidence among hospitalized patients in 2020 were 1.316-fold greater than in 2019. The incidence of AHF was 50.83% less likely to be observed in 2020, and the odds for other cardiovascular diseases increased by 17.42% between the 2 years. Regarding acute coronary syndrome (ACS), the distribution of its types differed between 2019 and 2020, with an increase in the odds of ST-segment elevation myocardial infarction (STEMI) in 2020. Stratification based on sex revealed further insights. Among men, the incidence of AHF decreased in 2020, while other cardiovascular diseases increased. In women, only the incidence of STEMI showed a significant increase. When analyzing the influence of SARS-CoV-2 infection, COVID-positive patients had a higher incidence of PE compared to COVID-negative patients. COVID-positive patients with ACS also exhibited symptoms of heart failure more frequently than COVID-negative patients. These findings provide valuable information on the impact of the COVID-19 pandemic on acute cardiovascular hospital admissions. The increased incidence of PE and changes in the distribution of other cardiovascular diseases highlight the importance of monitoring and managing cardiovascular health during and post pandemic period. The differences observed between sexes emphasize the need for further research to understand potential sex-specific effects of COVID-19 on cardiovascular outcomes.

Importance: Left ventricular (LV) hypertrophy contributes to the onset and progression of heart failure (HF), particularly for patients with pre-HF (stage B) for whom no treatment has yet proven effective to prevent transition to overt HF (stage C). The β3-adrenergic receptors (β3ARs) may represent a new target, as their activation attenuates LV remodeling. Objective: To determine whether activation of β3ARs by repurposing a β3AR agonist, mirabegron, is safe and effective in preventing progression of LV hypertrophy and diastolic dysfunction among patients with pre- or mild HF. Design, setting, and participants: The Beta3-LVH prospective, triple-blind, placebo-controlled phase 2b randomized clinical trial enrolled patients between September 12, 2016, and February 26, 2021, with a follow-up of 12 months. The trial was conducted at 10 academic hospitals in 8 countries across Europe (Germany, Poland, France, Belgium, Italy, Portugal, Greece, and the UK). Patients aged 18 years or older with or without HF symptoms (maximum New York Heart Association class II) were screened for the presence of LV hypertrophy (increased LV mass index [LVMI] of ≥95 g/m2 for women or ≥115 g/m2 for men) or maximum wall thickness of 13 mm or greater using echocardiography. Data analysis was performed in August 2022. Intervention: Participants were randomly assigned (1:1) to mirabegron (50 mg/d) or placebo, stratified by the presence of atrial fibrillation and/or type 2 diabetes, for 12 months. Main outcomes and measures: The primary end points were LVMI determined using cardiac magnetic resonance imaging and LV diastolic function (early diastolic tissue Doppler velocity [E/e'] ratio assessed using Doppler echocardiography) at 12 months. Patients with at least 1 valid measurement of either primary end point were included in the primary analysis. Safety was assessed for all patients who received at least 1 dose of study medication. Results: Of the 380 patients screened, 296 were enrolled in the trial. There were 147 patients randomized to mirabegron (116 men [79%]; mean [SD] age, 64.0 [10.2] years) and 149 to placebo (112 men [75%]; mean [SD] age, 62.2 [10.9] years). All patients were included in the primary intention-to-treat analysis. At 12 months, the baseline and covariate-adjusted differences between groups included a 1.3-g/m2 increase in LVMI (95% CI, -0.15 to 2.74; P = .08) and a -0.15 decrease in E/e' (95% CI, -0.69 to 0.4; P = .60). A total of 213 adverse events (AEs) occurred in 82 mirabegron-treated patients (including 31 serious AEs in 19 patients) and 215 AEs occurred in 88 placebo-treated patients (including 30 serious AEs in 22 patients). No deaths occurred during the trial. Conclusions: In this study, mirabegron therapy had a neutral effect on LV mass or diastolic function over 12 months among patients who had structural heart disease with no or mild HF symptoms.

Introduction: Changes in executive functions associated with alcohol consumption are frequently found in alcohol use disorder. Neuropsychological rehabilitation can play an essential role as an effective treatment in the recovery from these deficits, leading to the maintenance of abstinence. However, there are still some uncertainties regarding its impact on the recovery of deficits in executive functions. Our purpose is to present a protocol for a systematic review aiming to assess which neuropsychological rehabilitation programs are effective in the recovery of executive deficits in patients with alcohol use disorder. Methods: We will search the following databases: PubMed, Cochrane Library (CENTRAL), Web of Science, and Scopus, as well as the list of references of the identified studies. Screening, data extraction, and synthesis, as well as evaluation of the risk of bias, will be carried out by two reviewers independently, using ROBINS-I and RoB 2. Disagreements will be resolved using a third additional reviewer. Primary outcomes will correspond to changes in executive functions, following a neuropsychological rehabilitation program in patients with alcohol use disorder. The evidence will be synthesized using a narrative description of neuropsychological rehabilitation programs and the indicators of their effectiveness will be identified. The neuropsychological rehabilitation programs for executive functions will be assessed considering their different components and their impact on the recovery of these functions. The review described in this protocol will allow the development of guidelines for the design of more effective rehabilitation programs for clinical populations with alcohol use disorder.

In Portugal, like in other European countries, the COVID-19 pandemic aggravated the risk of poverty and social exclusion faced by migrants. This study aimed to assess mental health and well-being, and their social determinants, among Brazilian and Cape Verdean immigrant populations two years after the COVID-19 pandemic while exploring the role of positive psychological factors such as resilience and perceived social support. We conducted a cross-sectional survey combining online and face-to-face questionnaires for data collection between February and November 2022 on dimensions of mental health considered potentially relevant to the post-pandemic context: psychological distress, anxiety, and depression. Overall, 604 immigrants were included (322 Brazilian and 282 Cape Verdean); 58.5% of those surveyed were women and 41.5% were men. The results revealed that gender (being a woman) was associated with both psychological distress and depression, higher education was associated with anxiety, and that, for the three mental health dimensions under analysis, the perception of discrimination and resilience were negative and positive predictors, respectively. Findings can inform the design and implementation of relevant public mental health promotion programs with a focus on equity targeted to the general population. Such programs would help to address the psychological and social impacts of this long-term, insidious global pandemic that has challenged governments, health care systems, health care professionals, individuals, families, and communities worldwide.

Background: During the first epidemic wave, COVID-19 surveillance focused on quantifying the magnitude and the escalation of a growing global health crisis. The scientific community first assessed risk through basic indicators, such as the number of cases or rates of new cases and deaths, and later began using other direct impact indicators to conduct more detailed analyses. We aimed at synthesizing the scientific community's contribution to assessing the direct impact of the COVID-19 pandemic on population health through indicators reported in research papers. Methods: We conducted a rapid scoping review to identify and describe health indicators included in articles published between January 2020 and June 2021, using one strategy to search PubMed, EMBASE and WHO COVID-19 databases. Sixteen experts from European public health institutions screened papers and retrieved indicator characteristics. We also asked in an online survey how the health indicators were added to and used in policy documents in Europe. Results: After reviewing 3891 records, we selected a final sample of 67 articles and 233 indicators. We identified 52 (22.3%) morbidity indicators from 33 articles, 105 severity indicators (45.1%, 27 articles) and 68 mortality indicators (29.2%, 51). Respondents from 22 countries completed 31 questionnaires, and the majority reported morbidity indicators (29, 93.5%), followed by mortality indicators (26, 83.9%). Conclusions: The indicators collated here might be useful to assess the impact of future pandemics. Therefore, their measurement should be standardized to allow for comparisons between settings, countries and different populations.

Introduction: The COVID-19 pandemic significantly impacted global public health. Infant mortality rate (IMR), a vital statistic and key indicator of a population's overall health, is essential for developing effective health prevention programs. Existing evidence primarily indicates a decrease in IMR during the COVID-19 pandemic. We conducted a national-level analysis to calculate IMR and describe its course over the years (from 2016 until 2022), using a month-by-month analysis. Methods: Data on the number of deaths under one year of age was collected from the Portuguese E-Death Certification System (SICO), and data on the number of monthly live births was obtained from Statistics Portugal. The IMR was calculated per month, considering the previous 12 months' cumulative number of deaths under one year of age and the number of live births. Results: In Portugal, the IMR decreased before and during the COVID-19 pandemic. The lowest values were observed in September and October 2021 (2.15 and 2.14 per 1000 live births, respectively). The IMR remained below the threshold of three deaths per 1000 live births during the pandemic's critical period. Conclusion: Portugal has achieved remarkable progress in reducing its IMR over the last 60 years. The country recorded its lowest-ever IMR values during the COVID-19 pandemic. Further studies are needed to fully understand the observed trends.

Background: Estimating the risks and impacts of COVID-19 for different health groups at the population level is essential for orienting public health measures. Adopting a population-based approach, we conducted a systematic review to explore: (1) the etiological role of multimorbidity and frailty in developing SARS-CoV-2 infection and COVID-19-related short-term outcomes; and (2) the prognostic role of multimorbidity and frailty in developing short- and long-term outcomes. This review presents the state of the evidence in the early years of the pandemic. It was conducted within the European Union Horizon 2020 program (No: 101018317); Prospero registration: CRD42021249444. Methods: PubMed, Embase, World Health Organisation COVID-19 Global literature on coronavirus disease, and PsycINFO were searched between January 2020 and 7 April 2021 for multimorbidity and 1 February 2022 for frailty. Quantitative peer-reviewed studies published in English with population-representative samples and validated multimorbidity and frailty tools were considered. Results: Overall, 9,701 records were screened by title/abstract and 267 with full text. Finally, 14 studies were retained for multimorbidity (etiological role, n = 2; prognostic, n = 13) and 5 for frailty (etiological role, n = 2; prognostic, n = 4). Only short-term outcomes, mainly mortality, were identified. An elevated likelihood of poorer outcomes was associated with an increasing number of diseases, a higher Charlson Comorbidity Index, different disease combinations, and an increasing frailty level. Discussion: Future studies, which include the effects of recent virus variants, repeated exposure and vaccination, will be useful for comparing the possible evolution of the associations observed in the earlier waves.

Importance: Cerebral small vessel disease (SVD) causes a quarter of strokes and is the most common pathology underlying vascular cognitive impairment and dementia. An important step to developing new treatments is better trial methodology. Disease mechanisms in SVD differ from other stroke etiologies; therefore, treatments need to be evaluated in cohorts in which SVD has been well characterized. Furthermore, SVD itself can be caused by a number of different pathologies, the most common of which are arteriosclerosis and cerebral amyloid angiopathy. To date, there have been few sufficiently powered high-quality randomized clinical trials in SVD, and inconsistent trial methodology has made interpretation of some findings difficult. Observations: To address these issues and develop guidelines for optimizing design of clinical trials in SVD, the Framework for Clinical Trials in Cerebral Small Vessel Disease (FINESSE) was created under the auspices of the International Society of Vascular Behavioral and Cognitive Disorders. Experts in relevant aspects of SVD trial methodology were convened, and a structured Delphi consensus process was used to develop recommendations. Areas in which recommendations were developed included optimal choice of study populations, choice of clinical end points, use of brain imaging as a surrogate outcome measure, use of circulating biomarkers for participant selection and as surrogate markers, novel trial designs, and prioritization of therapeutic agents using genetic data via Mendelian randomization. Conclusions and relevance: The FINESSE provides recommendations for trial design in SVD for which there are currently few effective treatments. However, new insights into understanding disease pathogenesis, particularly from recent genetic studies, provide novel pathways that could be therapeutically targeted. In addition, whether other currently available cardiovascular interventions are specifically effective in SVD, as opposed to other subtypes of stroke, remains uncertain. FINESSE provides a framework for design of trials examining such therapeutic approaches.

In the period after the 2008 financial crisis, the European Union and Brazil experienced, respectively, periods of regional divergence and convergence. The research developed in these two territories brings new evidence on the importance of non-territorial policies, that worked as indirect regional policy, for these trajectories. In the case of the EU, (direct) regional policy was not strong enough to counteract more non-territorial policies that acted in favour of divergence. In the case of Brazil, the absence of a relevant direct regional policy did not prevent convergence, since the government adopted a set of non-territorial sectoral policies that functioned as indirect regional policy. This is particularly relevant in the current European context, where prolonged social and economic stagnation or decline in many regions has been the source of discontent that is expressed electorally.

Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) are high-incidence, non-melanoma skin cancers (NMSCs). The success of immune-targeted therapies in advanced NMSCs led us to anticipate that NMSCs harbored significant populations of tumor-infiltrating lymphocytes with potential anti-tumor activity. The main aim of this study was to characterize T cells infiltrating NMSCs. Flow cytometry and immunohistochemistry were used to assess, respectively, the proportions and densities of T cell subpopulations in BCCs (n = 118), SCCs (n = 33), and normal skin (NS, n = 30). CD8+ T cells, CD4+ T cell subsets, namely, Th1, Th2, Th17, Th9, and regulatory T cells (Tregs), CD8+ and CD4+ memory T cells, and γδ T cells were compared between NMSCs and NS samples. Remarkably, both BCCs and SCCs featured a significantly higher Th1/Th2 ratio (~four-fold) and an enrichment for Th17 cells. NMSCs also showed a significant enrichment for IFN-γ-producing CD8+T cells, and a depletion of γδ T cells. Using immunohistochemistry, NMSCs featured denser T cell infiltrates (CD4+, CD8+, and Tregs) than NS. Overall, these data favor a Th1-predominant response in BCCs and SCCs, providing support for immune-based treatments in NMSCs. Th17-mediated inflammation may play a role in the progression of NMSCs and thus become a potential therapeutic target in NMSCs.

When visiting a museum, one expects an exchange of values and knowledge. An unique and captivating experience on a subject of interest to both the liaison and the visitor, engaged in the purpose of personal growth. However, due to the lack of time, or will, or even an education that privileged or stimulated visits to museums, a very significant part of the population remains oblivious of its own culture, its potentialities and a knowledge that aims to be universal. The purpose of this presentation is to focus on that meaningless timeline that we create on our day-to-day, weather it’s on our way to work, on our way to school, or even in the city traffic, which takes so many hours from those of us who rely on motor transportation. The filling of this void through several stands of graphic and/or tridimensional content, aims to create a daily pattern of interest, by appealing to our curiosity, by posing ques¬tions, and by arising potential interest on various areas of knowledge. By taking advantage of a routine, the aim is to gather several museological units of a certain city or county, with the common purpose of presenting their cultural demand to a variety of individuals with different academic backgrounds and age groups. The aim is to create an utopia - the creation of a line of presentation accessible to the whole popula¬tion, able to stimulate their intellect on every level and to install new cultural habits in future generations, through the awareness of those living in the present day

Climate change and associated shifts in temperature and precipitation patterns have become an increasing concern as drivers of ongoing biodiversity loss. The Mediterranean region is particularly vulnerable, being both a biodiversity hotspot and a region very prone to desertification. Freshwater mussels are amongst the most threatened invertebrate taxa worldwide. Unio tumidiformis is an endemic and endangered species restricted to the southern Iberian Peninsula, living in temporary Mediterranean-type streams. Freshwater mussels need a fish host for successful larval transformation, meaning U. tumidiformis must belong to the genus Squalius. The main objective of this study was to evaluate the vulnerability of U. tumidiformis to climate change, by studying its population genetics and evolutionary history, its current and future habitat suitability, and that of its hosts. Genetic population structure and diversity were assessed using Single-Nucleotide Polymorphisms through Genotyping by Sequencing and used to infer species evolutionary history. The species potential distribution was modeled using an ensemble forecasting approach, and future shifts in habitat suitability were assessed with the projected climate data layers from Worldclim. Most populations showed extreme genetic differentiation (Fst up to 0.745), even from close neighboring ones. Upper Guadiana populations were more diverse and less differentiated. We hypothesize that U. tumidiformis originated in Upper Guadiana and followed the same colonization routes as their hosts with numerous founder effects and bottlenecks. Our results also predicted a reduction of 99% of climatically suitable areas for U. tumidiformis in the Iberian Peninsula until 2040. For the fish hosts, a maximum 42% reduction in suitable areas was estimated throughout the century, with remaining adequate habitats in the north. Our results suggest that difficult conservation options are necessary, prioritizing the preservation of populations, translocations to the northern area of its historical range and stream engineering to increase resilience to droughts.

The present study aims to explore the associations between perceived maternal attachment security and self-representation of youth in residential care, considering the potential moderator role of individual (i.e., youth’s sex and age), and relational variables (i.e., length of separation from the family and frequency of contact with the family). To this end, a sample of 734 youth (52.7% males) from standard residential care settings in Portugal, with ages between 11 and 25 years old (M = 16.17, SD = 2.24), filled out self-report questionnaires to evaluate their perceptions of maternal attachment and self-representations. Results indicated that youth’s perception of an insecure maternal attachment was associated with lower levels of relational and global positive self-representations and with higher levels of emotional, behavioral, misfit and global negative self-representations. Moreover, compared to males, females with lower levels of secure maternal attachment reported higher emotional and global negative self representations. Additionally, youth with lower levels of secure maternal attachment reported higher emotional self-representations only for low and medium levels of frequency of phone contacts with the family. No moderation effects were found for age and length of separation from the family. This study contributes to the literature with evidence regarding the role of attachment relationships on the self-representations and the moderating role of youth’s sex and frequency of contact with their family, which informs the development of interventions with this vulnerable and under-investigated population.

Nos jogos multijogador, a disparidade dos níveis de habilidades dos jogadores pode levar a experiências frustrantes, tediosas e/ou de exclusão. O Balanceamento surge como uma ferramenta para nivelar as condições de concorrência presentes neste tipo de jogos (por exemplo, providenciando uma assistência de mira aos jogadores de menor desempenho, num jogo de tiros). Todavia, não é claro como é que diferentes escolhas de design afetam a experiência individual dos jogadores. Nesta dissertação, começou-se por conceber um design space para as mecânicas de Balanceamento, que conta com seis categorias: “Determinação”, “Temporalidade”, “Alvo”, “Efeito”, “Feedback” e “Informação”. Seguidamente, realizou-se um estudo de métodos mistos com utilizadores, focado no impacto de duas subcategorias em específico: “Direção do Alvo” e “Dependência nas Habilidades do Efeito”. Neste estudo, oito pares de participantes jogaram um protótipo de jogo (desenvolvido para este fim), tendo experienciado sete mecânicas de Balanceamento. Os dados foram recolhidos através de um questionário individual e de entrevistas aos pares, e os mesmos revelaram implicações para futuros designs no âmbito do Balanceamento, que passam pela importância de uma vitória meritória que não ignore as conquistas individuais dos jogadores, da existência de um senso de arbítrio aquando da “Determinação” do Balanceamento antes e durante o jogo, e de o Balanceamento ser uma parte intrínseca do jogo que não perturbe a jogabilidade nuclear.

No mundo académico atual, urge cada vez mais a necessidade de abordar a saúde mental no Ensino Superior, que impactua o desempenho académico e o bem-estar nos estudantes, nos mais diversos campos da sua vida. O objetivo central do presente estudo foi compreender de que modo variáveis como a ansiedade face a exames, a perceção de autoeficácia e a estratégia de regulação emocional de ruminação afetam o desempenho académico dos estudantes do Ensino Superior em Portugal. Para avaliar os níveis de ansiedade face a exames necessitámos de traduzir uma escala sobre o tema, a Escala Cognitiva de Ansiedade a Testes (ECAT-2, Cassady e colaboradores, 2016), e para as variáveis restantes, nomeadamente a perceção de autoeficácia, a ruminação e as dificuldades emocionais, foram usadas escalas já traduzidas e adaptadas para português: Escala Multidimensional de Auto-eficácia Percecionada (MSPSE, Teixeira, 2008); Escala de Respostas Ruminativas (ERR, Dinis e colaboradores, 2011); Questionário de Regulação Emocional (QRE, Vaz e Martins, 2009); e Escala de Dificuldades de Regulação Emocional (EDRE, Coutinho e Ribeiro, 2010). A amostra global contou com 170 participantes (idade média de 22,77; DP = 6,63), que frequentavam o Ensino Superior Universitário (n = 135) e Politécnico (n = 35). As análises psicométricas da ECAT-2 revelaram uma boa consistência interna das escalas, com poder discriminativo dos itens satisfatório a bom e com evidências significativas de validação convergente e discriminante. Para além da ansiedade, também a perceção de autoeficácia e as dificuldades de regulação emocional influenciam o desempenho académico. Isto traduz-se num pior desempenho académico em estudantes mais ansiosos, com pior perceção de autoeficácia e mais dificuldades de regulação emocional. A ruminação, através do método Stepwise, foi eliminado do modelo. É fundamental que haja uma maior prevenção destes sintomas e características com estes estudantes, para que trabalhe de forma positiva as cognições dos mesmos acerca de si e das suas capacidades.

O savoring define-se como a capacidade para prestar atenção, apreciar e potencializar as experiências emocionais positivas. Os estudos sobre estratégias de savoring em crianças são escassos, contudo estudos sobre promoção destas estratégias em adultos revelam resultados promissores no bem-estar. Os resultados de uma revisão sistemática de literatura sobre intervenções baseadas na promoção de savoring em crianças, revelaram a inexistência deste tipo de programas. O presente estudo pretende desenhar e implementar uma intervenção para promover estratégias de savoring em crianças do 1º ciclo; avaliar a qualidade e a adequação da implementação; e avaliar a eficácia da intervenção e os seus efeitos no bem-estar subjetivo das crianças. Para isso, adotou-se um desenho quase-experimental, sem grupo de controlo, com recolha de dados quantitativos pré e pós intervenção, e recolha de dados quantitativos e qualitativos ao longo da intervenção. A amostra foi constituída por 21crianças entre os 9 e 10 anos de uma escola pública em Almada. Para a avaliação dos efeitos aplicaram-se os questionários Autorregulação das Emoções Positivas para Crianças, Positive And Negative Affect Scale – Children and Adolescents e Mental Health Continuum - Short Form. Para a avaliação da qualidade de implementação, foram preenchidas fichas de avaliação pelas facilitadoras da intervenção e fichas de satisfação pelos participantes em todas as sessões. Realizaram-se testes t para amostras independentes para a verificação de diferenças entre os sexos em pré teste e para amostras emparelhadas para avaliar os efeitos. Calculou-se coeficientes de correlação intraclasse (CCI), para medir o grau de acordo entre as avaliações feitas pelas duas facilitadoras e percentagens do grau de satisfação dos participantes para cada sessão. Embora não havendo diferenças estatisticamente significativas, os resultados revelaram um aumento das estratégias de construção de memórias, e do bem-estar emocional e psicológico, sendo a dimensão do efeito moderada a forte. O CCI revelou um acordo moderado entre as avaliações das sessões, indiciador de boa adequação da intervenção e as percentagens revelaram um elevado nível de satisfação dos participantes. Este estudo piloto, de uma intervenção inovadora, apresenta contributos relevantes ao nível conceptual, metodológico e aplicado, em particular resultados promissores na promoção de estratégias cognitivas de savoring e do bem-estar subjectivo. No final, apresentam-se as limitações do estudo e sugestões para o futuro.

Background: Increasing levodopa (L-dopa)/dopa decarboxylase inhibitor (DDCI) daily dose or adding a catechol-O-methyltransferase (COMT) inhibitor to levodopa/DDCI therapy are strategies used to manage wearing-off symptoms in Parkinson's disease (PD) patients. Objectives: To evaluate the COMT inhibitor opicapone versus an additional dose of levodopa to treat early wearing-off in PD patients. Methods: ADOPTION was a randomized, parallel-group, open-label, Phase 4 study conducted in Korea. At baseline, eligible patients were randomized (1:1) to opicapone 50 mg (n = 87) or L-dopa 100 mg (n = 81) (added to current L-dopa/DDCI therapy) for 4 weeks. The main efficacy endpoint was change from baseline to end of study in absolute off time. Other endpoints included changes in on time, in Movement Disorder Society-Unified Parkinson's Disease Rating Scale and 8-item PD Questionnaire scores, and the Clinical and Patient Global Impression of Improvement/Change. Results: The adjusted mean in absolute off time was significantly greater for opicapone 50 mg than for L-dopa 100 mg (-62.1 vs. -16.7 minutes; P = 0.0015). Opicapone-treated patients also reported a greater reduction in the percentage of off time (P = 0.0015), a greater increase in absolute on time (P = 0.0338) and a greater increase in the percentage of on time (P = 0.0015). There were no significant differences in other secondary endpoints. The L-dopa equivalent daily dose was significantly higher in the opicapone group (750.9 vs. 690.0 mg; P = 0.0247), when a 0.5 conversion factor is applied. Conclusions: Opicapone 50 mg was more effective than an additional 100 mg L-dopa dose at decreasing off time in patients with PD and early wearing-off.

O presente trabalho de investigação teve como principal objetivo verificar se as variáveis sociodemográficas podem ser preditoras do Burnout. Foi constituída uma amostra total de 183 Cuidadores Formais, tendo sido aplicado um inquérito por questionário sociodemográfico, assim como o Inventário de Burnout de Copenhague, para cada um dos cuidadores da referida amostra. Os dados foram analisados através de provas Paramétricas e Não Paramétricas, e igualmente realizadas regressões Lineares Múltiplas para explorar a potencial capacidade preditora das variáveis sociodemográficas. Em contexto real, foi possível concluir que os Cuidadores Formais não apresentaram níveis elevados de Burnout, sendo identificadas 75% das respostas abaixo do índice 50 de IBC. Em relação aos cuidadores femininos, estes demonstraram maior índice de Burnout nas 3 subescalas – Pessoal, relacionada com o Trabalho e com o “Utente”, do que os cuidadores masculinos. As questões “Condição” e “Alvo de Cuidados” manifestaram diferenças significativas nas 3 subescalas de Burnout. Relativamente a possíveis preditores de Exaustão Emocional, destacam-se as variáveis “Sexo” na subescala “Pessoal”; as variáveis “Alvo de Cuidados”, “Escolaridade”, “Ter Filhos” e “Categoria Profissional”, na subescala relacionada com o Trabalho; e as variáveis “Alvo de Cuidados”, “Escolaridade” e “Trabalhar por Turnos”, na subescala relacionada com o Utente.