Avaliação de aptidões sociais e problemas de comportamento em idade pré-escolar : retrato das crianças portuguesas

Tese de doutoramento em Psicologia (Avaliação Psicológica) apresentada à Faculdade de Psicologia e Ciências da Educação da Universidade de CoimbraA idade pré-escolar é um período de acelerado desenvolvimento, nomeadamente, ao nível físico, motor, cognitivo, linguístico, moral e socioemocional. Inicialmente colocada num segundo plano, em comparação com a idade escolar, tem-se denotado um interesse crescente por esta faixa etária. Por conseguinte, associado ao aumento significativo de pedidos de avaliação psicológica a crianças em idade pré-escolar, diversos estudos têm demonstrado que a existência de défices ao nível das aptidões sociais e problemas de comportamento, em idade pré-escolar, poderá reflectir-se negativamente no decorrer da infância, adolescência e vida adulta. No entanto, em Portugal, a avaliação e intervenção precoces carecem de instrumentos de avaliação socioemocional devidamente adaptados e validados para esta faixa etária, ferramentas singulares na resposta a esta realidade. Neste sentido, o presente estudo tem por objectivo proceder à adaptação e validação de uma escala de avaliação de aptidões sociais e problemas de comportamento para as crianças portuguesas em idade pré-escolar, as Preschool and Kindergarten Behavior Scales – 2nd Edition (PKBS-2; Merrell, 2002a). Vários factores abonam a favor da utilização das PKBS-2 na avaliação socioemocional de crianças em idade pré-escolar: foram especificamente desenhadas para esta faixa etária mais nova; através de uma medida única, possibilitam a avaliação de potencialidades (aptidões sociais) e problemas de comportamento das crianças; e recorrem aos mesmos itens para a avaliação de pais e educadores. Após uma primeira fase de tradução e adaptação das PKBS-2, realizou-se um estudo exploratório (N = 320). Posteriormente, procedeu-se à recolha de uma amostra normativa de 1.000 crianças dos 3 aos 6 anos de idade, avaliadas por informadores dos dois contextos mais influentes na vida da criança (familiar e escolar). A amostra, recolhida em todo o país, foi estratificada atendendo a diversas variáveis demográficas (e.g., idade, género, região geográfica). Foram efectuados vários estudos de análises de itens, até se chegar à versão final do instrumento. As boas qualidades psicométricas da versão portuguesa são enfatizadas através da apresentação de diversos estudos de precisão (e.g., consistência interna, acordo entre informadores, estabilidade temporal) e evidência de validade (e.g., validade interna, validade convergente e discriminante). Também foram desenvolvidos estudos, com vista à elaboração de normas (médias, desvios-padrão, resultados padronizados, percentis e níveis de risco) para facilitar a interpretação dos resultados obtidos com a versão portuguesa. Os resultados alcançados são congruentes não só com os da versão original das PKBS-2, mas também, em geral, com a literatura sobre aptidões sociais e problemas de comportamento na idade pré-escolar, o que permite considerar a versão portuguesa das PKBS-2 como uma ferramenta útil e uma mais-valia para a avaliação socioemocional das crianças portuguesas em idade pré-escolar.Preschool age is an accelerated period of development, specifically, at physical, motor, cognitive, linguistic, moral and social-emotional levels. Initially left behind the school age children, there has been a growing interest on this age group. In this field, linked to the increasing number of requests for psychological assessment of preschool children, several studies had revealed that deficits in social skills and problem behaviors at preschool age can predict negative outcomes across childhood, adolescence or adulthood. However, in Portugal, assessment and early intervention lack of social-emotional assessment instruments well adapted and validated for this age group, singular tools to provide an answer to such a reality. The purpose of the current study is to provide the standardization and validation of a social skills and problem behaviors rating scale for Portuguese children at preschool age, the Preschool and Kindergarten Behavior Scales – 2nd Edition (PKBS-2; Merrell, 2002a). Several factors support the use of the PKBS-2 in social-emotional assessment with preschool children: it was specifically designed for this younger age group; within a measure, it allows for the assessment of children’s social and emotional strengths (social skills) and behavior problems; and the same set of items are used for assessments provided by parents and teachers. Succeeding the process of translation and adaptation of the PKBS-2, an exploratory study was conducted (N = 320). After, a normative sample of 1.000 children between the ages of 3 to 6, inclusive was collected. This sample was rated by informants from the two most influent settings in the child’s life (home and school). The sample was collected from all regions of Portugal, and was stratified on basis of several demographic variables (e.g., age, gender, geographic region). Several items analysis studies were conducted until we reach the final version of the instrument. The psychometric properties of the Portuguese version are documented by the presentation of several reliability indices (e.g., internal consistency, informant agreement, temporal stability) and evidence supportive of validity (e.g., internal validity, convergent and discriminant validity). Normative data are also presented (medias, standard-deviations, standard scores, percentiles and risk levels) to help with the interpretation of the results obtained with the Portuguese version. It is important to note that the results of these analyses are in agreement with the ones obtained with the original version of the PKBS-2. Also, the results are in agreement with the literature about social skills and behavior problems in preschool age. All these outcomes allow us to view the Portuguese version of the PKBS-2 as a useful tool and a positive feature for the socialemotional assessment of Portuguese preschool children

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Avaliação de aptidões sociais e problemas de comportamento em idade pré-escolar : retrato das crianças portuguesas

Tese de doutoramento em Psicologia (Avaliação Psicológica) apresentada à Faculdade de Psicologia e Ciências da Educação da Universidade de CoimbraA idade pré-escolar é um período de acelerado desenvolvimento, nomeadamente, ao nível físico, motor, cognitivo, linguístico, moral e socioemocional. Inicialmente colocada num segundo plano, em comparação com a idade escolar, tem-se denotado um interesse crescente por esta faixa etária. Por conseguinte, associado ao aumento significativo de pedidos de avaliação psicológica a crianças em idade pré-escolar, diversos estudos têm demonstrado que a existência de défices ao nível das aptidões sociais e problemas de comportamento, em idade pré-escolar, poderá reflectir-se negativamente no decorrer da infância, adolescência e vida adulta. No entanto, em Portugal, a avaliação e intervenção precoces carecem de instrumentos de avaliação socioemocional devidamente adaptados e validados para esta faixa etária, ferramentas singulares na resposta a esta realidade. Neste sentido, o presente estudo tem por objectivo proceder à adaptação e validação de uma escala de avaliação de aptidões sociais e problemas de comportamento para as crianças portuguesas em idade pré-escolar, as Preschool and Kindergarten Behavior Scales – 2nd Edition (PKBS-2; Merrell, 2002a). Vários factores abonam a favor da utilização das PKBS-2 na avaliação socioemocional de crianças em idade pré-escolar: foram especificamente desenhadas para esta faixa etária mais nova; através de uma medida única, possibilitam a avaliação de potencialidades (aptidões sociais) e problemas de comportamento das crianças; e recorrem aos mesmos itens para a avaliação de pais e educadores. Após uma primeira fase de tradução e adaptação das PKBS-2, realizou-se um estudo exploratório (N = 320). Posteriormente, procedeu-se à recolha de uma amostra normativa de 1.000 crianças dos 3 aos 6 anos de idade, avaliadas por informadores dos dois contextos mais influentes na vida da criança (familiar e escolar). A amostra, recolhida em todo o país, foi estratificada atendendo a diversas variáveis demográficas (e.g., idade, género, região geográfica). Foram efectuados vários estudos de análises de itens, até se chegar à versão final do instrumento. As boas qualidades psicométricas da versão portuguesa são enfatizadas através da apresentação de diversos estudos de precisão (e.g., consistência interna, acordo entre informadores, estabilidade temporal) e evidência de validade (e.g., validade interna, validade convergente e discriminante). Também foram desenvolvidos estudos, com vista à elaboração de normas (médias, desvios-padrão, resultados padronizados, percentis e níveis de risco) para facilitar a interpretação dos resultados obtidos com a versão portuguesa. Os resultados alcançados são congruentes não só com os da versão original das PKBS-2, mas também, em geral, com a literatura sobre aptidões sociais e problemas de comportamento na idade pré-escolar, o que permite considerar a versão portuguesa das PKBS-2 como uma ferramenta útil e uma mais-valia para a avaliação socioemocional das crianças portuguesas em idade pré-escolar.Preschool age is an accelerated period of development, specifically, at physical, motor, cognitive, linguistic, moral and social-emotional levels. Initially left behind the school age children, there has been a growing interest on this age group. In this field, linked to the increasing number of requests for psychological assessment of preschool children, several studies had revealed that deficits in social skills and problem behaviors at preschool age can predict negative outcomes across childhood, adolescence or adulthood. However, in Portugal, assessment and early intervention lack of social-emotional assessment instruments well adapted and validated for this age group, singular tools to provide an answer to such a reality. The purpose of the current study is to provide the standardization and validation of a social skills and problem behaviors rating scale for Portuguese children at preschool age, the Preschool and Kindergarten Behavior Scales – 2nd Edition (PKBS-2; Merrell, 2002a). Several factors support the use of the PKBS-2 in social-emotional assessment with preschool children: it was specifically designed for this younger age group; within a measure, it allows for the assessment of children’s social and emotional strengths (social skills) and behavior problems; and the same set of items are used for assessments provided by parents and teachers. Succeeding the process of translation and adaptation of the PKBS-2, an exploratory study was conducted (N = 320). After, a normative sample of 1.000 children between the ages of 3 to 6, inclusive was collected. This sample was rated by informants from the two most influent settings in the child’s life (home and school). The sample was collected from all regions of Portugal, and was stratified on basis of several demographic variables (e.g., age, gender, geographic region). Several items analysis studies were conducted until we reach the final version of the instrument. The psychometric properties of the Portuguese version are documented by the presentation of several reliability indices (e.g., internal consistency, informant agreement, temporal stability) and evidence supportive of validity (e.g., internal validity, convergent and discriminant validity). Normative data are also presented (medias, standard-deviations, standard scores, percentiles and risk levels) to help with the interpretation of the results obtained with the Portuguese version. It is important to note that the results of these analyses are in agreement with the ones obtained with the original version of the PKBS-2. Also, the results are in agreement with the literature about social skills and behavior problems in preschool age. All these outcomes allow us to view the Portuguese version of the PKBS-2 as a useful tool and a positive feature for the socialemotional assessment of Portuguese preschool children

Psychological morbidity in family caregivers of people living with terminal cancer: Prevalence and predictors

Objective. The issues surrounding a patient's terminal phase of cancer and the imminent death of the individual represent a major family crisis affecting all its members. The goal of this study was to assess the prevalence of psychological morbidity in family caregivers of persons with terminal cancer in terms of psychological distress, depression, anxiety, somatization, and complicated anticipatory grief, and to determine which factors may influence these responses. Method. One hundred and twelve family caregivers of individuals with terminal cancer completed an assessment protocol comprising the Brief Symptom Inventory (depression, anxiety, somatization, and a computed score for global distress), the Marwit-Meuser Caregiver Grief Inventory - Short Form (anticipatory grief), the Family Inventory of Needs (importance and satisfaction of needs), and the Systemic Clinical Outcome Routine Evaluation -15 (family functioning). Prevalence of psychological morbidity was determined through descriptive and frequency statistics. Predictors of psychological morbidity were ascertained through structural equation modelling methods. Result. Regarding the prevalence of psychological morbidity in family caregivers, 66.1% reported high levels of distress, 68.8% showed high risk of depression, 72.3% showed high risk of anxiety, 50.9% reported high levels of somatization, and 25.9% showed high risk of complicated anticipatory grief. It was found that the predictors of age, gender, relationship to the family member with terminal cancer, the caregiving role played (i.e., primary vs. nonprimary), the satisfaction of needs by healthcare professionals, and family functioning play an important role in terms of one’s risk of developing psychological morbidity. Significance of results. This study revealed an alarming prevalence of psychological morbidity in family caregivers of individuals living with terminal cancer, making it crucial to move forward from a patient-centered approach to a family-centrad approach to reduce the risk of family maladjustment when facing the imminent death of a family member and to prevent postdeath unadjusted responses

Promotion of positive parenting in primary health care settings: Training of professionals

Objetivo: Compreender o impacto de uma formação breve centrada em estratégias de parentalidade positiva e gestão do comportamento de crianças em idade pré-escolar no aconselhamento realizado por profissionais dos cuidados de saúde primários (CSP). Método: Participaram 152 profissionais (e.g., enfermeiros, médicos, psicólogos) de unidades dos CSP do distrito de Coimbra, numa ação de formação com duração de nove horas. O nível de satisfação com a formação, as estratégias recomendadas aos pais antes e três meses após a formação e a necessidade de formação percecionada foram avaliados através de três Inventários de Autorreflexão e de um Ficha de Avaliação de Satisfação. Resultados: Observaram-se níveis elevados de adesão à formação e de satisfação com os respetivos conteúdos e estratégias de ensino/aprendizagem. Os profissionais reportaram ter passado a aconselhar com mais frequência aos pais as estratégias de parentalidade positiva abordadas na formação e referiram a necessidade de formação adicional. Conclusão: Ações de formação junto de profissionais dos CSP poderão contribuir para preencher uma importante lacuna ao nível da literacia em saúde mental, capacitando estes profissionais de primeira linha para darem uma resposta de maior qualidade e baseada em evidência a questões colocadas pelos pais relativas à gestão do comportamento dos seus filhos.Aim: To understand the impact of a brief training focused on positive parenting strategies and behavior management of pre-school children. Method: 152 professionals (e.g., nurses, doctors, psychologists) from primary health care units (PHCU) in the district of Coimbra have participated in a nine-hour training course. The level of satisfaction with the training, the strategies recommended to parents before and three months after the training and the perceived need for additional training were assessed through three Self-Reflection Inventories and a Satisfaction Assessment Sheet. Results: There were high levels of adherence to training and satisfaction with its content and teaching/learning strategies. After the training, professionals reported having more frequently recommended positive parenting strategies to parents and mentioned the urge of additional training. Conclusion: Training professionals from PHCU could contribute to filling an important gap in mental health literacy, enabling these first-line professionals to provide a higher quality and evidence-based response to questions raised by parents regarding the management of their children's behavior

Observação da interação professor-aluno no jardim de infância: O Teacher-Pupil Observation Tool

Este estudo teve como objetivo apresentar a versão portuguesa do Teacher-Pupil Observation Tool (T-POT), no que diz respeito ao acordo e fidedignidade entre observadores e às categorias de comportamentos observadas nos professores na sua utilização em contexto pré-escolar. Três observadores receberam treinamento na cotação de 11 categorias de comportamentos do professor do T-POT. Posteriormente, 65 professoras de jardim de infância foram observadas durante 25 minutos, numa situação de interação nas suas salas com um pequeno grupo de crianças. Obteve-se uma média de acordo entre observadores de 74% nas sessões de treinamento e coeficientes de correlação intraclasse de 0,90-0,99. Os resultados indicam que as categorias do T-POT mais utilizadas pelas professoras nas suas interações com as crianças são questões, confirmações e ordens. A discussão salienta as implicações para a prática e a pesquisa da utilização de medidas de observação na avaliação da interação professor-aluno nas salas de jardim de infância.The purpose of this study was to present the Portuguese version of the Teacher-Pupil Observation Tool (T-POT), in terms of agreement and reliability among observers and the categories of behaviors observed in teachers when used in preschool setting. Three observers were trained in scoring 11 T-POT teacher’s behavior categories. Subsequently, 65 preschool teachers were observed with T-POT during 25 minutes, while interacting in their classrooms with a small group of children. A mean of 74% of agreement was reached between observers for the training sessions and intraclass correlation coefficients of 0,90-0,99. The results indicate that the T-POT categories most used by teachers in their interactions with children are questions, acknowledgments and commands. The discussion highlights the implications for practice and research on the use of observation measures in the assessment of teacherstudent interaction in preschool classrooms.Este estudio tuvo como objetivo presentar la versión portuguesa del Teacher-Pupil Observation Tool (T-POT), en lo que se refiere al acuerdo y la confiabilidad entre observadores y, por otro lado, las categorías de comportamiento observadas en los profesores en la utilización del test en el contexto preescolar. Tres observadores recibieron entrenamiento en la cotización de 11 categorías de comportamiento del profesor del T-POT. Posteriormente, 65 profesoras de la educación infantil fueron observadas utilizando el T-POT durante 25 minutos, en una situación de interacción en sus aulas con un pequeño grupo de niños. Se obtuvo un acuerdo medio del 74% entre observadores en las sesiones de entrenamiento y coeficientes de correlación intraclase de 0,90-0,99. Los resultados indican que las categorías del T-POT más utilizadas por las profesoras en sus interacciones con los niños son cuestiones, confirmaciones y órdenes. La discusión destaca las implicaciones para la práctica y la investigación de la utilización de medidas de observación en la evaluación de la interacción profesoralumno en la educación infantil

Coping with global uncertainty: Perceptions of COVID-19 psychological distress, relationship quality, and dyadic coping for romantic partners across 27 countries

Article first published online: August 26, 2021Following the global outbreak of COVID-19 in March 2020, individuals report psychological distress associated with the “new normal”—social distancing, financial hardships, and increased responsibilities while working from home. Given the interpersonal nature of stress and coping responses between romantic partners, based on the systemic transactional model this study posits that perceived partner dyadic coping may be an important moderator between experiences of COVID-19 psychological distress and relationship quality. To examine these associations, self-report data from 14,020 people across 27 countries were collected during the early phases of the COVID-19 pandemic (March–July, 2020). It was hypothesized that higher symptoms of psychological distress would be reported post-COVID-19 compared to pre-COVID-19 restrictions (Hypothesis 1), reports of post-COVID-19 psychological distress would be negatively associated with relationship quality (Hypothesis 2), and perceived partner DC would moderate these associations (Hypothesis 3). While hypotheses were generally supported, results also showed interesting between-country variability. Limitations and future directions are presented