Parents' anxiety and depression symptoms after successful infertility treatment and spontaneous conception: does singleton/twin pregnancy matter?

Does mode of conception [spontaneous/after infertility treatment (IT)], type of pregnancy (singleton/twin) and parent gender have an effect on anxiety and depression levels and trajectories during pregnancy and the post-partum period?This work was supported by a grant (SFRH/BD/40146/2007) to the first author from the FCT, Foundation for Science and Technology (Portuguese Ministry of Education and Science), by the Operational Program Science and Innovation 2010 (POCI 2010) of the Community Support Board III, by FEDER Funds through the Operational Competitiveness Programme, COMPETE, and through national funding from the FCT under the projects: POCI/SAU-ESP/56397/2004 and PTDC/SAU/SAP/116738/2010. The authors have no conflicts of interest.info:eu-repo/semantics/publishedVersio

Actividade física e qualidade de vida na gravidez

Pouco se conhece acerca da actividade física e qualidade de vida da mulher na gravidez. Este estudo teve como objectivos 1) comparar os padrões de actividade física antes e durante a gravidez, 2) avaliar a percepção da qualidade de vida relacionada com a saúde durante os primeiros seis meses de gestação, e 3) comparar a percepção da qualidade de vida nas mulheres activas e insuficientemente activas considerando as recomendações de saúde pública. Método: Estudo longitudinal com 59 grávidas seleccionadas em consultórios médicos privados. Às 10-15 semanas foi recolhida informação sociodemográfica e médica, bem como informação sobre a actividade física três meses antes da concepção. Medidas de auto-relato foram administradas entre as 10-15 semanas e as 19-24 semanas de gestação para avaliar o tempo de actividade física (QAFG) (no trabalho, lazer, deslocações) e a qualidade de vida (SF-36). Resultados: A prevalência de actividade física recomendada é menor durante do que antes da gravidez (16.7% e 17.5% nos 1.º e 2.º trimestres, respectivamente vs. 47.4% antes da gravidez). Com a gravidez, não se verificaram alterações no tempo médio em diferentes tipos de actividade física, mas a actividade física no lazer registou uma diminuição significativa no 1.º trimestre face ao período anterior à concepção. Em comparação com uma amostra normativa de mulheres portuguesas, as grávidas apresentam, nos dois primeiros trimestres de gestação, uma percepção de qualidade da vida mais positiva na generalidade das dimensões do SF-36. No 2.º trimestre, o nível de limitação é significativamente maior nas dimensões físicas, à excepção da Dor Corporal, e nos resultados sumários do Componentes Físico e Mental. As mulheres que no 1.º trimestre atingem os níveis recomendados de actividade física no lazer (≥150 minutos por semana) apresentam melhor estado de saúde geral e estados de humor mais positivos do que as menos activas. Conclusão: A actividade física no lazer, embora diminua após a concepção, tem um impacto positivo na percepção do estado saúde geral e estados de humor da grávida, o que sugere a sua importância para a saúde da mulher também durante este período da vida.Background: Little is know about the impact of pregnancy in health-related quality of life (HRQoL) and in physical activity patterns. The objectives of this study were 1) to compare physical activity patterns before and during pregnancy, 2) to evaluate HRQoL among pregnant women until six months pregnancy and 3) to compare HRQoL between sufficiently and insufficiently active women considering the public health recommendations. Methods: Longitudinal study with 59 pregnant women (20-39 years of age) recruited in private obstetric clinics. At 10-15 weeks gestation, socio-demographic and medical information was collected, as well as physical activity levels three months prior to conception. Self-report measures were administered at 10-15 weeks and 19-24 weeks gestation to assess work, leisure and transportation-time physical activity and HRQoL. Results: The prevalence of recommended activity is lower during pregnancy than prepregnancy (16.7% and 17.5% in 1st and 2nd trimesters, respectively, vs. 47.4% prepregnancy). After conception, there were no changes in physical activity time, but leisure-time physical activity showed a decrease from prepregnancy to 1st trimester of gestation. Compared to Portuguese normative data, pregnant women demonstrate a more positive HRQoL on almost every domains of SF-36 in the first two trimesters of pregnancy. In the 2nd trimester of pregnancy, the level of impairment is significantly higher in physical HRQoL, with the exception of Bodily Pain, as well as on the SF-36 physical and mental component summary score. Women meeting recommended levels of leisure physical activity at 10-15 weeks (≥150 minutes per week) reported better general health and more positive mood states compared to less active women. Conclusions: In spite of the decline observed during pregnancy, leisure-time physical activity has a positive impact in pregnant’s general health status and mood states suggesting its importance for women’s health also during this life period

Nail pitting and onycholysis

info:eu-repo/semantics/publishedVersio

Maternal adjustment and maternal attitudes in adolescent and adult pregnant women

Study Objective: This study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy. Design, Setting, and Participants: A sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24th and 36th weeks of gestation. Main Outcome Measures: Maternal Adjustment and Maternal Attitudes Questionnaire. Results: Adolescent pregnant women show lower maternal adjustment (poorer body image and worse marital relationship) and poorer maternal attitudes (more negative attitudes to sex) than adult pregnant women. When controlling for socio-demographics, age at pregnancy predicts poorer body image and more negative attitudes to sex, but not a worse marital relationship, more somatic symptoms or negative attitudes to pregnancy and the baby. A worse marital relationship was better predicted by living without the partner, and more somatic symptoms and negative attitudes to pregnancy and the baby was predicted by higher education. Conclusion: Adolescent pregnant women show lower maternal adjustment and poorer maternal attitudes than adult pregnant women according to socio-demographics and unfavorable developmental circumstances.This research was supported by FEDER Funds through the COMPETE (Programa Operacional Factores de Competitividade) and by National Funds through FCT (Fundacão para a Ciência e a Tecnologia) under the project PTDC/SAU/SAP/116738/2010

[Fetal growth and activity at 20 to 24 weeks of gestation (preliminary study)].

BACKGROUND: Recent researches show that psychological development begins much before birth and prenatal influences can explain a significant part of the future variability in infants' behaviour and development. AIMS: The aim of this study was to characterize the fetal development between 20 and 24 weeks of gestation, related to the measures of fetal growth-- iparietal diameter, abdominal circumference, head circumference, femur length and fetal weight-- and fetal activity--fetal heart rate and fetal movements. We also tried to establish if there are any differences in these measures related to the mothers' and fetus' sociodemographic features, obstetrical conditions and exposure to drugs. METHOD: The sample of this study involved 48 fetus (52.1% female and 47.9% male) with an estimated gestational age (GA) between 20-24 weeks (Mean = 21 weeks and 1 day), whose mothers had appointments at the Obstetric and Gynaecological medical consultation of Júlio Dinis Maternity Hospital (MJD, Oporto). A video tape of the fetal behaviour was made and ultrasound biometry measurements were collected from the morphological ultrasound report. RESULTS: A statistical analysis of fetal data, after gestational age control, showed differences in fetal growth measures related to mothers' occupational status [F(1,41) = 7.28; p = .000], marital status [F(1,41) = 2.61; p = .04], household arrangements [F(1,41) = 2.91; p = .03] and coffee consumption [F(1,40) = 2.55; p = .05]. Differences in fetal activity measures (fetal heart rate) associated to fetus gender [F(1,16) = 5.84; p = .009] were also found. CONCLUSIONS: We can conclude about the sensibility of fetal development to prenatal factors related to the mothers' and fetus' sociodemographic features and exposure to drugs.Esta investigação foi financiada pela Fundação para a Ciência e a Tecnologia, no âmbito do projecto FCT POCTI/SAUESP, 56397/2004 e da Bolsa de Doutoramento SFRH/BD/13768/200

Integrating children ́s values in policymaking: Challenges and opportunities in a diverse society

Values are a central dimension of human social life, they are core to a person’s self-concept and identity and drive individual actions towards both personal enhancement and social transformation. At a social level, values govern how individuals relate to others and shape the organization of societies being, therefore, powerful guidelines to face new societal challenges like inclusion/exclusion issues, social justice or cultural diversity. Research with adults in this field has demonstrated that human values are powerful predictors of a wide range of behaviours, attitudes and beliefs. However, research with children is still very recent and has mostly focused on adolescents and older children, probably due to concerns about young children's capabilities to produce reliable information and discourse. In the same way, children's voices regarding political issues have been frequently dismissed even when children's right to participate fully in political and cultural life is specifically recognized in the United Nations Convention on the Rights of the Child. Therefore, giving voice to children is ultimately a matter of respecting their rights. To address this gap we introduce in this presentation a project that seeks to respond to this need by mapping the basic human values (e.g. Schwartz, 1992) of children and young adolescents (6 to 14 years) and its associations with the representations of justice and attitudes towards different social groups. Also, we intend to propose further directions to incorporate values and children’s views in education policies and decision-making.info:eu-repo/semantics/publishedVersio

Challenges of the psychological evaluation of children and adolescents at psychosocial risk

A investigação com crianças e adolescentes em risco psicossocial coloca múltiplos desafios que se estendem desde o desenho de investigação até à divulgação dos resultados. Questões éticas (e.g., proteção dos participantes, intrusão/privacidade, consentimento informado das crianças, gestão de informação e conteúdos sensíveis), metodológicas (ex. relação do investigador com as instituições, mortalidade da amostra e envolvimento, acesso e participação, preparação dos investigadores) e culturais (e.g., viés cultural dos instrumentos, risco de estigmatização, linguagem e literacia dos participantes) serão abordadas. Quando não atendidas, estas questões poderão comprometer a qualidade da investigação e dos dados obtidos. Neste workshop os participantes deverão identificar, refletir e discutir estas questões a partir de casos práticos, definindo um conjunto de práticas promotoras da ética e qualidade nos estudos com grupos socialmente vulneráveis. Metodologia: Através de casos práticos baseados na nossa experiência de investigação na área da pobreza infantil e da delinquência juvenil, serão partilhados e discutidos alguns dos desafios encontrados, inclusive os relacionados com o trabalho com equipas multidisciplinares e internacionais. Resultados: Capacitação dos participantes na identificação de questões relevantes na investigação com crianças e adolescentes em risco psicossocial, bem como a formulação de estratégias que otimizem a qualidade de investigações futuras. Conclusões: Através da partilha e reflexão este workshop poderá ser útil para profissionais com diferentes níveis de experiência de investigação. A prevenção de problemas e a aplicação de metodologias e práticas orientadas para a ética e qualidade são fundamentais para uma melhor investigação com e para as crianças e adolescentes em risco psicossocial.Research with children and adolescents at psychosocial risk poses multiple challenges that extent from the research design to the dissemination of results. Ethical (e.g., participant protection, intrusion/ privacy, children´s informed consent, management of sensitive information and contents), methodological (e.g.,relation of the researcher with institutions, sample mortality/engagement, access and participation, researcher´s training) and cultural (e.g., cultural bias of measures, stigmatization risk, language and literacy of participants) issues will be addressed. When not attended, this issues may compromise the quality of the investigation and obtained data. In this workshop participants must identify, reflect and discuss this issues starting from practical examples, defining a set of practices that promote the ethics and quality of studies with socially vulnerable groups. Methodology: Through practical examples emanating from our research experience in child poverty and juvenile delinquency, some of the challenges faced will be shared and discussed, including those relating to the work with multidisciplinary and international teams. Results: Capacitation of the participants in the identification of relevant issues in research with children and adolescents at psychosocial risk, as well as formulation of strategies that optimize the quality of future research projects. Conclusions: Through sharing and reflecting about research experiences, this workshop may be useful to professionals at different levels of research experience. Preventing problems and applying methods and practices oriented towards ethics and quality are fundamental for a better research with and for children and adolescents at psychosocial risk.CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT

Screening for depression and anxiety disorders from pregnancy to postpartum with the EPDS and STAI

The Edinburgh Postnatal Depression Scale (EPDS) and the State Anxiety Inventory (STAI-S) are widely used self-report measures that still need to be further validated for the perinatal period. The aim of this study was to examine the screening performance of the EPDS and the STAI-S in detecting depressive and anxiety disorders at pregnancy and postpartum. Women screening positive on EPDS (EPDS ≥ 9) or STAI-S (STAI-S ≥ 45) during pregnancy (n = 90), as well as matched controls (n = 58) were selected from a larger study. At 3 months postpartum, 99 of these women were reassessed. At a second stage, women were administered a clinical interview to establish a DSM-IV-TR diagnosis. Receiver operator characteristics (ROC) analysis yielded areas under the curve higher than .80 and .70 for EPDS and STAI-S, respectively. EPDS and STAI-S optimal cut-offs were found to be lower at postpartum (EDPS = 7; STAI-S = 34) than during pregnancy (EPDS = 9; STAI-S = 40). EPDS and STAI-S are reasonably valid screening tools during pregnancy and the postpartum.This work was supported by the Operational Program Science and Innovation 2010 (POCI 2010) of the Community Support Board III and by the European Community Fund FEDER. (POCI/SAU-ESP/ 56397/2004; Anxiety and depression in women and men during the transition to parenthood: Effects on fetal and neonatal behavior and development)

Antenatal paternal adjustment and paternal attitudes after infertility treatment

STUDY QUESTION: Do mode of conception [ART versus Natural (NC)] and depression have an interactive effect on antenatal paternal adjustment and paternal attitudes? SUMMARY ANSWER: Depression increased the negative effect of ART on antenatal paternal adjustment and paternal attitudes, specifically on antenatal marital relationship satisfaction. WHAT IS KNOWN ALREADY: Research on antenatal paternal adjustment and paternal attitudes after ART is scarce and has produced inconsistent results. STUDY DESIGN, SIZE, DURATION: This cross-sectional study assessed 197 primiparous men (71 ART and 126 NC) during their partner’s second trimester of gestation. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were derived from three larger longitudinal studies recruited at public Health Services in Northern Portugal. All men, for who this was their first child and had filled in a socio-demographic questionnaire, measures of depression and anxiety, and antenatal paternal adjustment and paternal attitudes were selected. MAIN RESULTS AND THE ROLE OF CHANCE: An interaction effect of mode of conception and depression was found on antenatal paternal adjustment and paternal attitudes. ART men showing high depressive symptomatology had lower antenatal marital relationship satisfaction than ART men showing low depressive symptomatology and NC men showing high or low depressive symptomatology. LIMITATIONS, REASONS FOR CAUTION: Due to the cross-sectional design of this study and the small sample size in the depression groups, the findings should be interpreted with caution. WIDER IMPLICATIONS OF THE FINDINGS: Specialized psychological support should be available for ART men screened with high depressive symptomatology as part of routine prenatal care appointments.This study was conducted at Psychology Research Centre (UID/PSI/ 01662/2013), University of Minho, and at the Unidade de Investigação em Epidemiologia—Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (UID/DTP/04750/2013). It was supported by the Foundation for Science and Technology (Portuguese Ministry of Education and Science) through National funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653) and through the Operational Programme Factors of Competitiveness–COMPETE within the project ‘Health, Governance and Accountability in Embryo Research: Couples’ Decisions About the Fates of Embryos’ (FCOMP-01-0124-FEDER-014453), the FCT Investigator contract IF/01674/2015 and PhD grants (SFRH/BD/115048/2016, SFRH/BD/75807/2011 and SFRH/BD/40146/2007).info:eu-repo/semantics/publishedVersio

Espaços verdes urbanos e saúde mental durante o confinamento causado pela Covid-19

Na ausência de intervenções farmacológicas eficazes contra a COVID-19, muitos governos implementaram confinamentos e outras medidas de isolamento social. Porém, estas medidas estão associadas a uma deterioração da saúde mental e do bem-estar da população. Os efeitos deletérios do confinamento na saúde mental da população poderão ser mais acentuados nas cidades, em comunidades socialmente desfavorecidas e entre grupos demográficos vulneráveis, como crianças e idosos. No entanto, a utilização e contacto com espaços verdes urbanos (ex.: parques urbanos, jardins públicos e privados) e outros espaços naturais (ex.: praias, zonas ribeirinhas) poderá reduzir o stress causado pelo confinamento e proporcionar oportunidades de relaxamento, promovendo a resiliência urbana. Este artigo pretende discutir os modelos teóricos subjacentes a esta hipótese, sumariar evidência científica sobre o tema e lançar possíveis soluções.info:eu-repo/semantics/publishedVersio