The role of the corticomotorneurons in pathogenesis of amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a progressive, degenerative disease of the motor system clinically defined by the presence of upper and lower motor neuron (LMN) signs. The site of onset of pathophysiology within the motor system in ALS remains unresolved and this thesis examines the role of the corticomotor neuron in the pathogenesis of ALS. The diagnostic utility of the split-hand sign in ALS involving preferential wasting of the ‘thenar’ group of intrinsic hand muscles namely the abductor pollicis brevis (APB) and first dorsal interosseous (FDI) was established by recording the split-hand index (SI) which was noted to reliably differentiate ALS from mimic neuromuscular disorders. The cortical and axonal excitability characteristics of the ‘thenar’ muscles namely the APB and FDI was compared with the hypothenar abductor digiti minimi (ADM) with threshold tracking transcranial magnetic stimulation (TMS) studies revealing cortical hyperexcitability to be a feature of ALS pronounced over the ‘thenar’ muscles while axonal hyperexcitability while a feature of ALS, did not selectively affect the prominently wasted ‘thenar’ muscles. Cortical hyperexcitability was also noted to precede the development of lower motor neuron dysfunction in a clinically and neurophysiologically normal APB muscle. The selective vulnerability of muscles in ALS was further defined by the split hand plus sign with a greater degree of cortical hyperexcitability over the preferentially wasted APB muscle in ALS patients when compared with a similarly innervated and relatively preserved flexor pollicis longus (FPL) muscle. In summary, corticomotorneuronal hyperexcitability as a marker of corticomotorneuronal dysfunction predominates over the muscles which are preferentially wasted in ALS and precedes evidence of lower motor neuron loss. The findings presented in this thesis support the primacy of the corticomotor neuron in the pathogenesis of the split hand phenomenon and suggest a mechanism for the pathogenesis of ALS

Infidelity in Dating Relationships: Gender-Specific Correlates of Face-to-Face and Online Extradyadic Involvement

This study examined the gender-specific correlates of face-to-face and online extradyadic involvement (EDI) in dating relationships. The sample consisted of 561 women (M age = 23.19 years) and 222 men (M age = 23.97 years), all of whom reported being in an exclusive dating relationship for an average of 35 months. Participants completed the following self-report measures: Extradyadic Behavior Inventory, Attitudes toward Infidelity Scale, and Investment Model Scale. During the current relationship, men were more likely than women to report engagement in face-to-face physical/sexual EDI (23.4 vs. 15.5 %) and online sexual EDI (15.3 vs. 4.6 %). Both men and women with a history of infidelity in a prior relationship were more likely to engage in EDI. More positive attitudes toward infidelity, lower relationship satisfaction, lower commitment, and higher quality of alternatives were significantly associated with EDI, regardless of gender. Women reporting infidelity of a partner in a prior relationship were more likely to engage in face-to-face and online emotional EDI; a longer relationship and a younger age at the first sexual encounter were significant correlates of the engagement in face-to-face emotional EDI. Women with higher education were approximately three times more likely to engage in online sexual EDI. Although men and women are converging in terms of overall EDI, men still report higher engagement in physical/sexual extradyadic behaviors, and the correlates of sexual and emotional EDI vary according to gender. This study contributes to a comprehensive approach of factors influencing the likelihood of EDI and encourages future research in this area

Psychometric study of the European Portuguese version of the PedsQL 3.0 Cancer Module

Background: Health-related quality of life (HRQoL) is an important outcome to assess the impact of cancer. This article examines the psychometric properties of the European Portuguese self-report version of the Pediatric Quality of Life InventoryTM Cancer Module (PedsQLTM 3.0 Cancer Module) in children and adolescents with cancer. Methods: The participants, 332 children/adolescents diagnosed with cancer (8–18 years old), completed measures to assess HRQoL (PedsQLTM 3.0 Cancer Module and DISABKIDS Chronic Generic Measure; DCGM-12) and anxiety (Revised Children’s Manifest Anxiety Scale - second edition; RCMAS-2). A subsample (n = 52) completed the PedsQLTM 3.0 Cancer Module a second time following one-week. The pediatric oncologists completed the Intensity of Treatment Rating Scale 3.0 (ITR 3.0). Results: For the whole sample, the PedsQLTM 3.0 Cancer Module demonstrated good item discrimination (rs = .30 to .54). The confirmatory factor analysis testing the presence of eight first-order factors loading significantly in a second-order factor revealed an acceptable fit (CFI = .91; RMSEA = .05). The correlation of PedsQLTM 3.0 Cancer Module with DCGM-12 (rs = .17 to .58), and with RCMAS-2 (rs = −.16 to–.51) attested convergent validity. This inventory demonstrated minimally acceptable to very good internal consistency (αs = .65 to .87) and temporal stability (ICCs = .61 to .81). Conclusions: These findings demonstrate that the European Portuguese self-report version of the PedsQLTM 3.0 Cancer Module is a valid and reliable instrument for assessing HRQoL in pediatric cancer. Keywords: European Portuguese version, PedsQLTM 3.0 Cancer Module, Health-related quality of life, Pediatric cancer, Psychometric propertie

Transactional paths between children and parents in pediatric asthma: Associations between family relationships and adaptation

Introduction. The particular challenges posed by pediatric asthma may have a negative impact on the adaptation of children and their parents. From a transactional approach it is important to examine how reciprocal links between children and parents contribute to explain their adaptation and under which conditions these associations occur. This cross-sectional study aimed at examining the direct and indirect links between children’s and parents’ perceptions of family relationships and adaptation, separately (within-subjects) and across participants (cross-lagged effects), and the role of asthma severity in moderating these associations. Method. The sample comprised 257 children with asthma, aged between 8 and 18 years-old, and one of their parents. Both family members completed self-reported questionnaires on family relationships (cohesion and expressiveness) and adaptation indicators (quality of life and psychological functioning). Physicians assessed asthma severity. Structural Equation Modeling was used to test within-subjects and cross-lagged paths between children’s and parents’ family relationships and adaptation. Results. The model explained 47% of children’s and 30% of parents’ adaptation: family relationships were positively associated with adaptation, directly for children and parents, and indirectly across family members. Asthma severity moderated the association between family relationships and health-related quality of life for children: stronger associations were observed in the presence of persistent asthma. Conclusion. These results highlight the need of including psychological interventions in pediatric healthcare focused on family relationships as potential targets for improving children’s and parents’ quality of life and psychological functioning, and identified the children with persistent asthma as a group that would most benefit from family-based interventions.This study was supported by the R&D Unit Institute of Cognitive Psychology, Vocational and Social Development of the University of Coimbra (PEst-OE/PSI/UI0192/2011) and by the Portuguese Foundation for Science and Technology (PhD Grant SFRH/BD/69885/2010)

Quality of life and social support of the patients of continued care units of Algarve

This study assessed the relations between quality of life and social support network of patients in continuing care units in Algarve, using WHOQOL-BREF and ASSIS. Participants were 92 users of ages between 34-101 years: very elderly (40.2%), female (58.7%), widows (40.2%), upper-middle class (46.8%), cohabiting with spouse (43.2%), and partly dependent (72.5%). Emotional, tangible and informational support networks were mainly composed by family. We found significant associations between informative social support and physical domains, social relations and environment of quality of life (p< 0.05). The results suggest middle levels in self-perception and satisfaction with health, and lower levels in physical domain. Informational support needs were negatively associated with psychological and social relations dimensions of quality of life

Preventing and Treating Women’s Postpartum Depression: A Qualitative Systematic Review on Partner-Inclusive Interventions

Partner-related factors associated with the occurrence of Postpartum Depression (PPD) may justify the partner’s inclusion in preventive and treatment approaches. The aim of this qualitative systematic review was to synthesize the literature on partner-inclusive interventions designed to prevent or treat postpartum depression (PPD) in women. In accordance with the PRISMA guidelines, the systematic search of studies published between 1967 and May 2015 in PsycINFO and PubMed identified 26 studies that met the inclusion criteria, which reported on 24 interventions. The following partner parameters were analyzed: participation type, session content, mental health assessment, attendance assessment, and the effects of partner’s participation on the women’s response to the interventions. Total participation by the partner was mostly reported in the prevention studies, whereas partial participation was reported in the treatment studies. The session content was mostly based on psychoeducation about PPD and parenthood, coping strategies to facilitate the transition to parenthood such as the partner’s emotional and instrumental support, and problem-solving and communication skills. Some benefits perceived by the couples underscore the relevance of the partner’s inclusion in PPD interventions. However, the scarce information about the partner’s attendance and the associated effects on the women’s intervention outcomes, along with methodological limitations of the studies, made it difficult to determine if the partner’s participation was associated with the intervention’s efficacy. Conclusions about the clinical value of including partners in PPD interventions are still limited. More research is warranted to better inform health policy strategies

Avaliação da vinculação do adulto: uma revisão crítica a propósito da aplicação da adult attachment scale-r (aas-r) na população portuguesa

O presente artigo, numa primeira parte, procura esclarecer algumas questões conceptuais em torno do conceito de vinculação do adulto. Seguidamente são referidas algumas implicações dos tópicos abordados para a avaliação da vinculação do adulto, assim como debatidos alguns aspectos mais polémicos associados às metodologias utilizadas. Por último, focando a avaliação da vinculação do adulto através de questionários de auto-resposta, apresentam-se alguns dos estudos psicométricos realizados em Portugal com a Adult Attachment Scale-R (Collins & Read, 1990), que na versão portuguesa recebe a designação de Escala de Vinculação do Adulto (EVA)

Maternal adjustment to the birth of a child: Primiparity versus multiparity

Introduction: The literature has highlighted the birth of a first child as a crisis moment that implies change and reorganisation. None the less, the specificities of maternal adjustment to the birth of another child are not yet completely known. Goals: To understand differences in adjusting to the birth of a child, in primiparous and multiparous mothers. Specifically: (1) identify and describe differences in adjusting at two different moments: 2-5 days after the birth and 8 months post-partum; (2) identify and describe differences or continuities among primiparous and multiparous mothers regarding the temporal evolution of adjustment. Method: 179 mothers (98 primiparous; 81 multiparous) were assessed in two different periods: 2-5 days after the birth and 8 months later, concerning adjustment and need for reorganisation. The assessment protocol included a social-demographic data file, the Emotional Assessment Scale, the Brief Symptom Inventory, the Perceived Stress Scale, and adjectival scales. Results: Primiparous mothers report greater adjustment difficulties right after the birth. Multiparous mothers show a less positive adjustment trajectory, mainly reflected in increasing levels of negative emotional reactivity. Conclusion: Results support the existence of different adjustment trajectories for primiparous and multiparous mothers, suggesting the need for differentiated psychological intervention strategies regarding each group