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There are several motives underlying the process of deciding to become an adoptive family. However, research exploring this issue is scarce and essentially focused on infertility as the main motivation. The present mixed‐method study aims to fill in this gap by exploring, retrospectively, the motives to adopt of 126 Portuguese adoptive parents. The Parents' Interview on the Adoption Process was used to identify the motives to adopt and describe the adoption decision‐making process. Seven main motives (biological issues, filling in a void/loneliness, adoption as a life project, expanding the family, philanthropy, contact with the child protection system and parenthood) were identified. These motives can be centred on the self, the child or both simultaneously and are characterized by dynamism, permeability and interconnection. Findings allowed for establishing conceptual considerations on motivations to adopt and recommendations for adoption practice. [ABSTRACT FROM AUTHOR]

Introduction: Smokers are frequent users of healthcare services. Admissions to hospital can serve as a "teachable moment" for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatients receive a brief intervention for smoking cessation. Objectives: The aims of this study were (i) to examine rates of smoking abstinence during and after hospitalization; (ii) to measure changes in smoking patterns among persons who continued smoking after discharge; and (iii) to identify predictors of abstinence during hospitalization and after discharge. Methods: A cohort study of a representative sample of current adult smokers hospitalized in two Spanish and two Portuguese hospitals. We surveyed smokers during hospitalization and recontacted them one month after discharge. We used a 25‐item ad hoc questionnaire regarding their smoking pattern, the smoking cessation intervention they have received during hospitalization, and hospital and sociodemographic characteristics. We performed a descriptive analysis using the chi‐square test and a multivariate logistic regression to characterize the participant, hospital, and smoking cessation intervention (5As model) characteristics associated with smoking abstinence. Results: Smoking patients from both countries presented high abstinence rates during hospitalization (Spain: 76.4%; Portugal: 70.2%); however, after discharge, their abstinence rates decreased to 55.3% and 46.8%, respectively. In Spain, smokers who tried to quit before hospital admission showed higher abstinence rates, and those who continued smoking reduced a mean of five cigarettes the number of cigarettes per day (p ≤ 0.001). In Portugal, abstinence rates were higher among women (p = 0.030), those not living with a smoker (p = 0.008), those admitted to medical‐surgical wards (p = 0.035), who consumed their first cigarette within 60 min after waking (p = 0.006), and those who were trying to quit before hospitalization (p = 0.043). Conclusions: Half of the smokers admitted into the Spanish hospitals are abstinent one month after discharge or have reduced their cigarettes per day. Nevertheless, success rates could be increased by implementing evidence‐based tobacco cessation programs at the organizational‐level, including post‐discharge active quitting smoking support. Clinical relevance: Three‐quarters of the inpatients who smoke remain abstinent during hospitalization and over half achieve to maintain their abstinence or at least reduce their consumption one month after discharge, proving that admission to hospitals is an excellent teachable moment to quit smoking. [ABSTRACT FROM AUTHOR]

Aim: To assess the association of food neophobia (FN) with food preferences, dietary intake and dietary quality. Methods: A cross‐sectional study was conducted in a non‐probabilistic sample of 229 Portuguese adults, aged 18 to 84 years. FN was measured with the FN Scale. Dietary intake over the previous 12 months was assessed by a validated semi‐quantitative food frequency questionnaire. We defined a dietary pattern the Healthy Diet Indicator, to summarise the effects of overall dietary intake. Generalised linear models were performed to test associations in multivariate analyses (controlled for sex, age and education). Results: FN was negatively associated with a general liking for the act of eating (β^=−2.976,95%CI:−5.324;−0.993) and with reduced preferences for specific foods (fruit and vegetables, some types of meat and fish and traditional Portuguese dishes with blood). Those with higher FN showed a lower consumption of fruits and vegetables, but a higher consumption of milk and codfish, a popular Portuguese ingredient. However, FN did not affect the macronutrients and energy intake, as well as sodium, added sugars and fibre intake. Adherence to a healthy dietary pattern was not significantly associated with FN. Conclusions: FN was associated with a decreased consumption and preference for specific foods, but it had no impact on a healthy dietary pattern. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (Ptrend =.020) and 1.00, 0.64, 047, and 0.64 for high body fat (Ptrend =.012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries. [ABSTRACT FROM AUTHOR]

In Portugal, cardiovascular diseases stand out among the main causes of morbidity, disability, and mortality, with an expectation of growth up to the year 2025. A descriptive, exploratory study was carried out with patients in a cardiac rehabilitation program from an institution in the northern region of Portugal; 103 participants were randomly selected for the study. The data collection took place from February to April 2017. The majority of respondents presented a low level of literacy (inadequate and problematic). The profiles of the participants were characterized by the predominance of married males, with a mean age of 69 years. The participants considered doctors and nurses as the professionals who contribute the most to the increase of their health literacy. These health professionals have the opportunity and the responsibility to increase the health literacy levels of patients. It is known that low levels of health literacy are a problem throughout the European Union. Portugal's general population reflects this reality, and this study contributed to the conclusion that cardiac rehabilitation patients also present worrying levels of health literacy. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study examined the combined influence of gender variables (specifically gender stereotypes, sexism, and genderism/transphobia) as well as racism/xenophobia and attitudes toward bullying roles on gender‐bashing. METHODS: A trans‐cultural sample of 2410 Spanish and Portuguese students participated in the study (mean age = 15.13). Structural equation modeling and multiple group analyses were used to examine the relationships among variables. RESULTS: The model revealed a good fit with the data for the whole sample. Results showed that instrumentality, hostile sexism, genderism/transphobia, racism/xenophobia, and positive attitudes toward the bully were positively correlated with gender‐bashing. An inverse pattern was also observed: expressiveness, benevolent sexism, and positive attitudes toward the defender were negatively correlated with gender‐bashing. Overall, the eight variables explained 48% of the variance of gender‐bashing. Structural relationships among the assessed constructs were equivalent for girls and boys, and for Spain and Portugal. CONCLUSIONS: These results reveal the need to implement inclusive educational policies to improve school health, which promote expressiveness, egalitarian attitudes, and sexual and cultural diversity. [ABSTRACT FROM AUTHOR]

Background and aims: The World Health Organization's (WHO's) proposed International Classification of Diseases, 11th edition (ICD‐11) includes several major revisions to substance use disorder (SUD) diagnoses. It is essential to ensure the consistency of within‐subject diagnostic findings throughout countries, languages and cultures. To date, agreement analyses between different SUD diagnostic systems have largely been based in high‐income countries and clinical samples rather than general population samples. We aimed to evaluate the prevalence of, and concordance between diagnoses using the ICD‐11, The WHO's ICD 10th edition (ICD‐10) and the Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th editions (DSM‐IV, DSM‐5); the prevalence of disaggregated ICD‐10 and ICD‐11 symptoms; and variation in clinical features across diagnostic groups. Design Cross‐sectional household surveys. Setting: Representative surveys of the general population in 10 countries (Argentina, Australia, Brazil, Colombia, Iraq, Northern Ireland, Poland, Portugal, Romania and Spain) of the World Mental Health Survey Initiative. Participants: Questions about SUDs were asked of 12 182 regular alcohol users and 1788 cannabis users. Measurements Each survey used the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview version 3.0 (WMH‐CIDI). Findings Among regular alcohol users, prevalence (95% confidence interval) of life‐time ICD‐11 alcohol harmful use and dependence were 21.6% (20.5–22.6%) and 7.0% (6.4–7.7%), respectively. Among cannabis users, 9.3% (7.4–11.1%) met criteria for ICD‐11 harmful use and 3.2% (2.3–4.0%) for dependence. For both substances, all comparisons of ICD‐11 with ICD‐10 and DSM‐IV showed excellent concordance (all κ ≥ 0.9). Concordance between ICD‐11 and DSM‐5 ranged from good (for SUD and comparisons of dependence and severe SUD) to poor (for comparisons of harmful use and mild SUD). Very low endorsement rates were observed for new ICD‐11 feature for harmful use ('harm to others'). Minimal variation in clinical features was observed across diagnostic systems. Conclusions: The World Health Organization's proposed International Classification of Diseases, 11th edition (ICD‐11) classifications for substance use disorder diagnoses are highly consistent with the ICD 10th edition and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM‐IV). Concordance between ICD‐11 and the DSM 5th edition (DSM‐5) varies, due largely to low levels of agreement for the ICD harmful use and DSM‐5 mild use disorder. Diagnostic validity of self‐reported 'harm to others' is questionable. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between individual and school characteristics associated with the number of school days children comply with moderate-to-vigorous physical activity ( MVPA) recommendations. Sample comprises 612 Portuguese children, aged 9-11 years, from 23 schools. Time spent in MVPA was measured by accelerometry, while individual-level correlates were obtained by anthropometry and questionnaires. School-level variables were collected by questionnaire, and accelerometer wear time and season were also considered. Maximum likelihood estimates of model parameters were obtained via a multilevel analysis with children as level-1, and school as level-2. Children who spent more time in sedentary activities and girls were less likely to comply with MVPA/daily. More mature children and those who use active transportation to school were more likely to attain the PA recommendation. Furthermore, greater accelerometer wear time and spring season increased the chance to achieve the recommended MVPA. In terms of school-level correlates, a greater number of available facilities was negatively associated with children MVPA compliance. Given the set of variables, our results showed that individual characteristics seem to be more relevant for children's compliance rates with PA/day than school context variables, which should be taken into account in the implementation of school policies and practices. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to examine the point prevalence of eating disorders and picking/nibbling in elderly women. Methods This was a two-stage epidemiological study that assessed 342 women aged 65-94 years old. In Stage 1, the following screening measures were used to identify possible cases: the Mini-Mental State Examination, to screen and exclude patients with cognitive impairment; Weight Concerns Scale; SCOFF (Sick, Control, One, Fat, Food) Questionnaire; Eating Disorder Examination Questionnaire-dietary restraint subscale; and three questions to screen for picking/nibbling and night eating syndrome. Women selected for Stage 2 ( n = 118) were interviewed using the diagnostic items of the Eating Disorder Examination. Results According to the DSM-5, the prevalence of all eating disorders was 3.25% (1.83-5.7, 95% C.I.). Prevalence of binge-eating disorder was 1.68% (0.82-3.82, 95% C.I.), of other specified feeding or eating disorders was 1.48% (0.63-3.42, 95% C.I.), and of bulimia nervosa 0.3% (.05-1.7, 95% C.I.)]. Binge-eating episodes were reported by 5.62% of women. No cases of anorexia nervosa or night eating syndrome were identified. The prevalence of picking/nibbling was 18.9%. Picking/nibbling was associated with increased body mass index ( t(322) = −3.28, p < .001) and binge-eating episodes ( χ2(1) = 5.65, p < .017). Discussion Prevalence rates of eating disorders on elderly Portuguese women were comparable to those found on young women. Our data support the literature that suggests that binge-eating disorder is particularly prevalent in older adults. Picking/nibbling was the most prevalent eating behavior and we provide further evidence for its association with weight and disordered eating. [ABSTRACT FROM AUTHOR]

This study examined the association of family and maternal characteristics with preschool children's dietary patterns. Trained interviewers evaluated subsample 3422 mothers and children enrolled in the population-based birth cohort Generation XXI (Porto, Portugal, 2005-2006). Maternal characteristics and behaviours (exercise, smoking habits, diet and child-feeding practices) and family characteristics were evaluated. Maternal diet was classified by a dietary score, and children's dietary patterns were identified by latent class analysis. Odds ratios (OR) and confidence intervals (95% CI) were estimated by multinomial regression models. The analysis was based on a framework with four conceptual levels: maternal socio-economic position (SEP) at 12 years, maternal socio-economic and demographic characteristics at child's delivery, family characteristics and maternal behaviours at child's 4 years. Three dietary patterns were identified in children: high in energy-dense foods (EDF); low in foods typically consumed at main meals and intermediate in snacks (Snacking); higher in healthy foods; and lower in unhealthy ones (Healthier, reference). Lower maternal SEP had an overall effect on children's diet (low vs. high SEP; EDF, OR = 1.76, 95% CI: 1.42-2.18; Snacking, OR = 1.73, 95% CI: 1.27-2.35), while maternal education was directly associated with it (≤9 vs. >12 schooling years, EDF, OR = 2.19, 95% CI: 1.70-2.81; Snacking, OR = 2.22, 95% CI: 1.82-3.55). Children whose mothers had worse dietary score were significantly more likely to follow unhealthier patterns (first vs. fourth quartile; EDF, OR = 9.94, 95% CI: 7.35-13.44, P-trend < 0.001; Snacking, OR = 4.21, 95% CI: 2.94-6.05, P-trend < 0.001). Maternal diet was the key factor associated with children's diet, above and beyond socio-economic and demographic characteristics, accounting for one-third of the determination coefficient of the fully adjusted model. At preschool age, interventions should give a particular focus on maternal diet and low SEP groups. [ABSTRACT FROM AUTHOR]

The job of health professionals, including nurses, is considered inherently stressful, and thus, it is important to improve and develop specific measures that are sensitive to the demands that health professionals face. This study analysed the psychometric properties of three instruments that focus on the professional experiences of nurses in aspects related to occupational stress, cognitive appraisal and mental health issues. The evaluation protocol included the Stress Questionnaire for Health Professionals (SQHP), the Cognitive Appraisal Scale (CAS) and the General Health Questionnaire ‐ 12 (GHQ ‐ 12). Validity and reliability issues were considered with statistical analysis (i.e.   confirmatory factor analysis, convergent validity and composite reliability) that revealed adequate values for all of the instruments, namely a six ‐ factor structure for the SQHP, a five ‐ factor structure for the CAS and a two ‐ factor structure for the GHQ ‐ 12. In conclusion, this study proposes three consistent instruments that may be useful for analysing nurses' adaptation to work contexts. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Previous research revealed that mouth movements influence attitudes. Covert subvocal articulations inducing muscular contractions resembling ingestion movements were preferred over expectoration-like movements, unveiling a relationship between vocal muscles' wandering and motivational states such as approach and avoidance. These findings, explained in terms of embodied cognition, suggest that specific movements are directly connected to, and more importantly, automatically activate concordant motivational states. The oral approach-avoidance effect was replicated using the original stimulus set and a new set of stimulus developed for Portuguese. Results from two high-powered (total N = 407), independent replications, revealed that the preference for inward words (over outwards) exists in both sets but to a greater extent in the pool phonetically adapted for Portuguese. [ABSTRACT FROM AUTHOR]

This study proposed a new perspective to look at the consequences of the formation of immigrant communities in globalized societies, by investigating the impact of two forms of group indispensability on majority attitudes towards immigrants. Specifically, it explored whether perceived indispensability of different immigrant groups to the national identity and their contributions to the functioning of the host society are related to the development of more positive attitudes towards them. We also explored whether such effects would be mediated by the inclusion of immigrants within the national common identity and whether these effects would be stronger among host country members with a stronger civic than ethnic conception of national citizenship. Results supported these predictions among a sample of native Portuguese citizens ( N = 118). As predicted, these effects were driven by perceptions of different types of indispensability for three immigrant groups in Portugal, who differed in their historical relations with the host society. [ABSTRACT FROM AUTHOR]

Objectives An ex vivo model was designed to profilometrically and histologically assess root changes resulting from scaling with a new ultrasonic device, designed for bone piezoelectric surgery, in comparison with curettes. Methods Three groups of 10 periodontal hopeless teeth were each subjected to different root instrumentation: Gracey curettes ( CUR); ultrasonic piezoelectric device, Perio 100% setting, level 8 (P100); and ultrasonic piezoelectric device Surg 50% setting, level 1 (S50). After extraction, all teeth were photographed to visually assess the presence of dental calculus. The treated root surfaces were profilometrically evaluated (Ra, Rz, Rmax). Undecalcified histological sections were prepared to assess qualitative changes in cementum thickness. Statistical analysis was carried out using one-way anova test with a significance level of 95%. Results Both instruments proved to be effective in the complete removal of calculus. The CUR group presented the lowest Ra [2.28 μm (±0.58)] and S50 the highest [3.01 μm (±0.61)]. No statistically significant differences were detected among the three groups, for Ra, Rz and Rmax. Histologically, there was a cementum thickness reduction in all groups, being higher and more irregular in S50 group. Conclusions Within the limits of this study, there were no statistically significant differences in roughness parameters analyzed between curettes and the ultrasonic piezoelectric unit. This new instrument removes a smaller amount of cementum, mainly at the Perio 100% power setting, which appears to be the least damaging. The ultrasonic device is effective in calculus removal, proving to be as effective as curettes. [ABSTRACT FROM AUTHOR]

Background Recent evidence suggests that specific language impairment (SLI) might be secondary to general cognitive processing limitations in the domain of executive functioning. Previous research has focused almost exclusively on monolingual children with SLI and offers little evidence-based guidance on executive functioning in bilingual children with SLI. Studying bilinguals with SLI is important, especially in the light of increasing evidence that bilingualism can bring advantages in certain domains of executive functioning. Aims To determine whether executive functioning represents an area of difficulty for bilingual language-minority children with SLI and, if so, which specific executive processes are affected. Methods & Procedures This cross-cultural research was conducted with bilingual children from Luxembourg and monolingual children from Portugal who all had Portuguese as their first language. The data from 81 eight-year-olds from the following three groups were analysed: (1) 15 Portuguese-Luxembourgish bilinguals from Luxembourg with an SLI diagnosis; (2) 33 typically developing Portuguese-Luxembourgish bilinguals from Luxembourg; and (3) 33 typically developing Portuguese-speaking monolinguals from Portugal. Groups were matched on first language, ethnicity, chronological age and socioeconomic status, and they did not differ in nonverbal intelligence. Children completed a battery of tests tapping: expressive and receptive vocabulary, syntactic comprehension, verbal and visuospatial working memory, selective attention and interference suppression. Outcomes & Results The bilingual SLI group performed equally well compared with their typically developing peers on measures of visuospatial working memory, but had lower scores than both control groups on tasks of verbal working memory. On measures of selective attention and interference suppression, typically developing children who were bilingual outperformed their monolingual counterparts. For selective attention, performance of the bilingual SLI group did not differ significantly from the controls. For interference suppression the bilingual SLI group performed significantly less well than typically developing bilinguals but not monolinguals. Conclusions & Implications This research provides further support to the position that SLI is not a language-specific disorder. The study indicates that although bilingual children with SLI do not demonstrate the same advantages in selective attention and interference suppression as typically developing bilinguals, they do not lag behind typically developing monolinguals in these domains of executive functioning. This finding raises the possibility that bilingualism might represent a protective factor against some of the cognitive limitations that are associated with SLI in monolinguals. [ABSTRACT FROM AUTHOR]