ASD explained for peers, parents, and professionals

Can the parent of a child with autism or Asperger Syndrome ever really comprehend the experiences of their child? As a greater number of cases are identified and more is understood about these conditions, autism and Asperger Syndrome seem to be increasingly commonly understood terms. Despite the clear definitions provided by diagnostic criteria for the conditions (e.g., American Psychiatric Association [APA], 1994), it often remains difficult for professionals, parents and other carers, particularly those who are newcomers to this field, to truly understand the complexities of these conditions with respect to the day-to-day influences upon the affected individual.

Variáveis psicológicas e percepção do estado de saúde em indivíduos submetidos a ressincronização cardíaca

A insuficiência cardíaca afecta cerca de 261 mil pessoas em Portugal constituindo um problema de saúde pública. Pretendemos avaliar aspectos associados à recuperação do estado de saúde nesta síndrome, em particular a esperança, o afecto e a felicidade. Recorremos a um estudo longitudinal com 128 indivíduos sintomáticos com má fracção de ejecção do ventrículo esquerdo. Utilizámos um questionário para caracterizar os aspectos sóciodemográficos, clínicos e funcionais, o Kansas City Cardiomiopathy Questionnaire (KCCQ) para avaliar a qualidade de vida, a Subjective Hapiness Scale (SHS) para a felicidade, a HOPE Scale (HOPE) para a esperança e a Positive And Negative Afect Schedule (PANAS) para o afecto. Os questionários de caracterização sócio-demográfica, clínica e funcional, KCCQ e o SHS foram aplicados em três momentos: no internamento, prévio à instituição de terapêutica médica na sua totalidade e ao terceiro e sexto mês após a intervenção médica, na consulta externa. A maioria dos participantes eram homens em classe III da classificação da New York Heart Association com etiologia isquémica. No internamento e antes da terapêutica médica, observámos que a esperança, a felicidade e o afecto se relacionaram com a qualidade de vida, a felicidade e o afecto positivo com a esperança. No período avaliado foram submetidos a: terapia de ressincronização cardíaca (n=52), cardioversor-desfibrilhador implantável (n=44), cirurgia valvular com revascularização do miocárdio (n=14), optimização terapêutica farmacológica (n=10), transplante cardíaco (n=8). Foram significativos os resultados da qualidade de vida, da classificação da New York Heart Association, do exercício físico, da fracção de ejecção do ventrículo esquerdo e das arritmias cardíacas (estrasístoles e taquicardias ventriculares). A felicidade foi preditora da qualidade de vida e da funcionalidade. O afecto negativo foi preditor da satisfação com a insuficiência cardíaca. Concluímos da importância das variáveis positivas a par dos procedimentos médicos no tratamento das pessoas com insuficiência cardíaca. ABSTRACT - Heart failure affects about 261 000 people in Portugal constituting a public health problem. We intend to evaluate aspects of the health recovery in this syndrome, in particular hope, affection and happiness. We used a longitudinal study with 128 symptomatic patients with poor ejection fraction of left ventricle. We used a questionnaire to characterize the socio-demographic, clinical and functional aspects, the Kansas City Cardiomiopathy Questionnaire (KCCQ) to assess the quality of life, the Subjective Happiness Scale (SHS) for happiness, the HOPE Scale (HOPE) for hope and the Positive And Negative Affect Schedule (PANAS) for affection. The questionnaires of sociodemographic, clinical and functional KCCQ and SHS were applied on three occasions: on admission, prior to the execution of medical therapy in its totality and in the third and sixth months after medical intervention in the outpatient. Most of the participants were men in Class III New York Heart Association classification with ischemic etiology. At admission and before medical therapy, we observed that the hope, happiness and affection were related to the quality of life, happiness and positive affect with hope. Over the studied period were submitted to: cardiac resynchronization therapy (n=52), implantable cardioverter-defibrillator (n=44), valvular surgery with coronary artery bypass graft surgery (n=14), optimizing drug therapy (n=10), heart transplant (n=8). The significant results were the quality of life, the New York Heart Association classification, the exercise, the ejection fraction and left ventricular cardiac arrhythmias (ventricular tachycardia and estrasistoles). Happiness was a predictor of quality of life and functionality. The negative affect was a predictor of satisfaction with heart failure. We concluded that the positive variables and the medical procedures were important in treating people with heart failure.

Avaliação do perfil hemodinâmico de válvulas aórticas percutâneas: análise comparativa entre os dois dispositivos disponíveis no mercado - válvula auto-expansível e válvula expansível por balão

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular. Área de especialização: Intervenção Cardiovascular.

Avaliação ecocardiográfica da função sistólica ventricular direita em doentes com disfunção ventricular esquerda: parâmetros convencionais versus strain bidimensional

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular.

Qualidade de vida do doente com insuficiência cardíaca do Centro Hospitalar Tâmega e Sousa

A Insuficiência Cardíaca (IC), como uma doença crónica, tem vindo a ser alvo de análise devido ao seu impacto, não só a nível económico, mas também a nível da qualidade de vida (QV). Vários estudos demonstram que os doentes com IC apresentam um comprometimento da QV, em várias dimensões. OBJETIVO: Descrever a QV dos doentes com IC do Centro Hospitalar Tâmega e Sousa (CHTS). METODOLOGIA: O estudo é quantitativo, transversal, prospetivo e descritivo. Foi aplicado, entre janeiro a junho de 2012, o Euro Quality of Life Instrument-5D (EQ-5D) para avaliar o estado de saúde (ES) e o Kansas City Cardiomyopathy Questionnaire (KCCQ) para avaliar a QV de 326 doentes com IC, dos quais 226 seguidos na Consulta Externa (77,9% masculinos, idade média 67,5 ±11,6 anos, desvio padrão) e 100 na Clínica de IC (CIC) (73,0% masculinos, idade média 59,0 anos, desvio padrão ±12,7). Foi usada a estatística descritiva, teste t, qui quadrado e a análise da variância. RESULTADOS: Os doentes do género feminino, do grupo etário 75-100 anos, solteiros, divorciados, separados ou viúvos, que não sabem ler nem escrever, sem apoio dos amigos e sem condições económicas mínimas para o tratamento da IC apresentaram pior ES e QV. Os doentes submetidos à terapia de ressincronização cardíaca e às cirurgias valvular e de revascularização tiveram melhor QV. Os doentes com IC de etiologia isquémica e em classe III-IV da New York Heart Association apresentaram pior ES. Nestas classes e com fração de ejeção ≤35% os doentes tiveram pior QV. Os doentes da CIC evidenciaram melhor ES e QV. CONCLUSÕES: A QV dos doentes com IC do CHTS é influenciada pelos fatores pessoais, clínicos e pelo local de intervenção. É fundamental mensurar a QV, na prática clínica, para evidenciar a perceção do ES dos doentes e o impacto da IC na QV.

The effects of parental sensitivity and involvement in caregiving on mother–infant and father–infant attachment in a portuguese sample

In the present longitudinal study, we investigated attachment quality in Portuguese mother–infant and in father–infant dyads, and evaluated whether attachment quality was related to parental sensitivity during parent–infant social interaction or to the amount of time each parent spent with the infant during play and in routine caregiving activities (e.g., feeding, bathing, play). The sample consisted of 82 healthy full-term infants (30 girls, 53 boys, 48 first born), and their mothers and fathers from mostly middle-class households. To assess parental sensitivity, mothers and fathers were independently observed during free play interactions with their infants when infants were 9 and 15 months old. The videotaped interactions were scored by masked coders using the Crittenden’s CARE-Index. When infants were 12 and 18 months old, mother–infant and father–infant dyads were videotaped during an adaptation of Ainsworth’s Strange Situation. Parents also described their level of involvement in infant caregiving activities using a Portuguese version of the McBride and Mills Parent Responsibility Scale. Mothers were rated as being more sensitive than fathers during parent–infant free play at both 9 and 15 months. There also was a higher prevalence of secure attachment in mother–infant versus father–infant dyads at both 12 and 18 months. Attachment security was predicted by the amount of time mothers and fathers were involved in caregiving and play with the infant, and with parents’ behavior during parent–infant free play.

Origem Anómala da Artéria Coronária Esquerda a Partir da Artéria Pulmonar

OBJECTIVE: To assess the frequency and severity of the anomalous origin of the left coronary artery (ALCA) from the pulmonary artery (PA). DESIGN OF THE STUDY: Prospective study of case series between March 1991 and December 1994. SETTING: Referral-based Paediatric Cardiology Department of a Tertiary Care Center. PATIENTS AND METHODS: Five consecutive patients (pts) with anomalous origin of the LCA from the PA; there were three infants aged 4 months and two children one 8 year and one 9 year old. There were three girls and two boys. All pts had clinical and 2D-echo and Doppler investigation prior to cardiac catheterization (CC). Indication for CC was based in the association of symptoms and signs of myocarditis or dilated cardiomyopathy of acute or subacute onset and electrocardiographic (ECG) signs of ischemia in infants. In older patients (pts) diagnosis was suspected mainly from ECG. During CC in all pts, aortograms and when necessary selective coronary angiograms were performed. Surgical correction was performed in all children. In two pts stress exercise ECG and stress Thallium studies before and after surgery were performed. RESULTS: two pts had "adult" an three had "infantile" type of ALCA from the PA. CC was performed and diagnosis was confirmed at surgery in all cases. In one child, correct diagnosis was made by ECO prior to CC and in one case LCA to PA fistula was suspected on Colour-Doppler study. No complications were attributed to CC. Several types of surgery were performed: reimplantation of the ALCA from the PA to the aorta (three pts); tunnel connection of the aorta to the ALCA via the PA (one pt) and left internal mammary to LCA anastomosis (one pt). Two infants died intraoperatively due to extensive myocardial infarction and poor left ventricular function. All the three survivors are asymptomatic after a mean follow up of 34 months. Two oldest pts are currently in New York Heart Association functional class I with normal ECG and improved myocardial perfusion on Thallium scan despite almost total occlusion of LCA at the site of implantation in the aorta as diagnosed on coronary angiogram. CONCLUSIONS: ALCA from PA is associated with major morbidity and mortality. Diagnosis should be suspected in pts with unexplained myocardial ischemia on ECG and even more if it is associated to clinical signs of dilated cardiomyopathy or myocarditis. Careful assessment on ECO and pulsed Doppler and colour flow mapping should make the diagnosis in most cases. Although surgery can be performed based only on ECO diagnosis, we strongly advise for angiography in all cases as in our experience there are false negative diagnosis by ECO. Preoperative Thallium studies can be useful for the selection of the type of surgery as pts with very little viable myocardium will not survive the establishment of a direct systemic to coronary blood flow and may be candidates for heart transplantation.

Percutaneous Treatment of Mitral Valve Regurgitation: Initial Experience with the MitraClip Device

INTRODUCTION: Mitral regurgitation (MR) is the most common valvular disease and has recently become the target of a number of percutaneous approaches. The MitraClip is virtually the only device for which there is considerable experience, with more than 20,000 procedures performed worldwide. OBJECTIVE: To describe our initial experience of the percutaneous treatment of MR with the MitraClip device. METHODS: We describe the first six MitraClip cases performed in this institution (mean age 58.5 ± 13.1 years), with functional MR grade 4+ and New York Heart Association (NYHA) heart failure class III or IV (n=3), with a mean follow-up of 290 ± 145 days. RESULTS: Procedural success (MR ≤ 2+) was 100%. Total procedure time was 115.8 ± 23.7 min, with no in-hospital adverse events and discharge between the fourth and eighth day, and consistent improvement in the six-minute walk test (329.8 ± 98.42 vs. 385.33 ± 106.95 m) and in NYHA class (three patients improved by two NYHA classes). During follow-up there were two deaths, in two of the four patients who had been initially considered for heart transplantation. CONCLUSION: In patients with functional MR the MitraClip procedure is safe, with both a high implantation and immediate in-hospital success rate. A longer follow-up suggests that the clinical benefit decreases or disappears completely in patients with more advanced heart disease, namely those denied transplantation or on the heart transplant waiting list.

PRACTICING ANTHROPOLOGY IN PORTUGAL

The rise of anthropology in Portugal is examined within the framework of several cycles of development. The chapter discusses how the consolidation of anthropology at university level was the main focus until the 90’s. Applied anthropology, as distinctive from academic anthropology received very little attention. Consequently, there was an absence of an institutionalization of applied anthropology in the country. Nowadays, however, two main trends converge that supports the growth of applied anthropology and is providing work for anthropologists outside academia. First, anthropology departments in Portugal have stabilized their staff quotas resulting in very few positions open for anthropologists at the university level. Second, global changes are impacting the social framework of the country and, consequently, opening up new horizons of research and practice for social scientists. Several examples of these opportunities are discussed which is creating an optimism about the various niches for new and relevant anthropological practices.

Rebalancing frequency and the welfare cost of inflation

Cash-in-advance models usually require agents to reallocate money and bonds in fixed periods. Every month or quarter, for example. I show that fixed periods underestimate the welfare cost of inflation. I use a model in which agents choose how often they exchange bonds for money. In the benchmark specification, the welfare cost of 10 percent instead of 0 inflation increases from 0.1 percent of income with fixed periods to 1 percent with optimal periods. The results are robust to different references, to different compositions of income in bonds or money, and to the introduction of capital and labor.

A avaliação da comunicação da criança com perturbação do espetro do autismo: perspetiva de pais e de profissionais

Dissertação de mestrado em Educação Especial (área de especialização Intervenção Precoce)

A cost study of common surface finish systems for steel structures

This paper presents part of a study aimed at finding a suitable, yet cost-effective, surface finish for a steel structure subject to the car washing environment and corrosive chemicals. The initial, life cycle and average equivalent annual (AEAC) costs for surface finishing methods were calculated for a steel structure using the LCCC algorithm developed by American Galvanizers Association (AGA). The cost study consisted of 45 common surface finish systems including: hot-dip galvanization (HDG), metallization, acrylic, alkyd and epoxy as well as duplex coatings such as epoxy zinc and inorganic zinc (IOZ). The results show that initial, life cycle and AEAC costs for hot dip galvanization are the lowest among all the other methods, followed by coal tar epoxy painting. The annual average cost of HDG for this structure was estimated about €0.22/m2, while the other cost-effective alternatives were: IOZ, polyurea, epoxy waterborne and IOZ/epoxy duplex coating.

Attachment to parents: the mediating role of inhibition of exploration and individuality on health behaviors

This study’s goal was to analyze whether the quality of university students’ relationship with their parents mediated the association between mental health and physical symptoms and health behavior. Participants were 250 university students (66% female and 34% male), aged between 17 and 29 years old (M = 20.88, SD = 2.03) that answered the Father/Mother Attachment Questionnaire (FMAQ), the Physical Symptoms Scale from the Rotterdam Symptom Checklist (RSCL), the Health Behavior Questionnaire (HBQ), and the Hospital Anxiety and Depression Scale (HADS). The results showed that the indirect effect of physical symptoms on health behavior was significantly mediated by the father’s and mother’s inhibition of exploration and individuality (IEI). Also the indirect effect of psychological distress on health behavior was significantly mediated by the father’s and mother’s IEI. These results suggest that young adults who had more restrictions to their individuality show worse health behaviors. Separation Anxiety and Dependence (SAD) and Quality of Emotional Bond (QEB), the other 2 attachment scales, were not mediators of the relationship between physical symptoms/ psychological distress and health behavior. This study shows the importance of promoting positive parenting practices that contribute to healthier behavior choices and less risky behaviors, as well as the need for more studies that clearly identify these practices in young adult populations.

Organic-inorganic hybrid sol-gelcoatings for metal corrosion protection: a review of recent progress

This paper is a review of the most recent and relevant achievements (from 2001 to 2013) on the development of organic–inorganic hybrid (OIH) coatings produced by sol–gel-derivedmethods to improve resistance to oxidation/corrosion of different metallic substrates and their alloys. This review is focused on the research of OIH coatings based on siloxanes using the sol–gel process conducted at an academic level and aims to summarize the materials developed and identify perspectives for further research. The fundamentals of sol–gel are described, including OIH classification, the interaction with the substrate, their advantages, and limitations. The main precursors used in the synthesis ofOIHsol–gel coatings for corrosion protection are also discussed, according to the metallic substrate used. Finally, a multilayer system to improve the resistance to corrosion is proposed, based on OIH coatings produced by the sol–gel process, and the future research challenges are debated.