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In this study, we describe the relative contributions of and interactions between individual risk factors associated with ineffective pregnancy prevention among female adolescents in Portugal. Our sample consisted of 856 sexually experienced female adolescents (10-19 years) who did not intend to become pregnant. Of these, 379 were pregnant, and the residual (477) had never been pregnant. We used classification tree analysis to describe the interplay among a set of established sociodemographic, familial, reproductive, and relationship factors as predictors of ineffective pregnancy prevention. The tree model showed good predictive properties. Seven profiles predicted one-half to all the cases of ineffective pregnancy prevention. Ineffective pregnancy prevention was predicted by adolescents' grade level and different combinations of variables, specifically female age, age at the time of first sexual intercourse, religious beliefs, place of residence, maternal pregnancy before age 20, household structure in childhood, and partner's age difference. According to our findings, limiting assessments to the cumulative presence of risk factors may be insufficient to accurately identify adolescents at elevated risk of unwanted pregnancy, as the impact of any given risk factor may vary according to other factors. Our findings may contribute to the development of a risk assessment tool that may support healthcare providers' efforts to provide individualized risk assessment for adolescent patients and, thus, to better support pregnancy prevention.

© 2018 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. This is an open access article under the CC-BY-NC-ND license., Introduction: Valvular heart disease (VHD) is increasing worldwide, mostly because of aging. Percutaneous valve intervention is the preferred therapeutic option in high-risk patients. Objective: To characterize the profiles of patients with VHD admitted to the cardiology ward at a tertiary referral center. Methods: On the basis of ICD-9 codes for VHD, the discharge notes of 287 patients hospitalized over a 22-month period were reviewed and analyzed. One hundred characteristics were considered. Results: Median age was 74 (23-93) years, and 145 (51%) were male. The admissions were elective (for valve intervention) in 36%. Heart failure (HF) was the reason for urgent admissions in 29.3%. Multiple comorbidities were observed in 53% of patients. Etiology of VHD was degenerative in 68%, functional in 15.3% and rheumatic (predominantly in women and younger patients) in 8.7%. Aortic valve disease was present in 63% (aortic stenosis in 56%), and was associated with HF (p=0.004), atrial fibrillation (AF) (p=0.01), and left ventricular (LV) dilatation (p=0.003) or hypertrophy (p

© 2021 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espa ̃na, S.L.U. This is an open access article under the CCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/), Background: Cognitive impairment, anxiety and depression are common in heart failure (HF) patients and its evolution is not fully understood. Objectives: To assess the cognitive status of HF patients over time, its relation to anxiety and depression, and its prognostic impact. Methods: Prospective, longitudinal, single center study including patients enrolled in a structured program for follow-up after hospital admission for HF decompensation. Cognitive function, anxiety/depression state, HF-related quality of life (QoL) were assessed before discharge and during follow-up (between 6th and 12th month) using Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS) and Kansas City Cardiomyopathy Questionnaire, respectively. HF related outcomes were all cause readmissions, HF readmissions and the composite endpoint of all-cause readmissions or death. Results: 43 patients included (67±11.3 years, 69% male); followed-up for 8.2±2.1 months. 25.6% had an abnormal MoCA score that remained stable during follow-up (22.6±4.2 vs. 22.2±5.5; p=NS). MoCA score

Aims Sepsis is a potentially fatal systemic inflammatory response and its underlying pathophysiology is still poorly understood. Studies suggest that obesity, a component of metabolic syndrome (MS), is associated with sepsis survival. Therefore, this study focused on investigating the influence of MS on mortality and cardiovascular dysfunction induced by sublethal cecal ligation and puncture (SL-CLP). Main methods Newborn Swiss mice received monosodium glutamate (MSG) (4 mg kg−1 day−1, s.c.) during the first 5 d of life for MS induction, while the control pups received equimolar saline solution. On the 75th day, SL-CLP was used to induce mild sepsis (M-CLP) in the MS (MS-M-CLP) and control (SAL-M-CLP) mice. The effect of MS on sepsis in mice was assessed by determining the survival rate and quantification of nitric oxide (NO) in the plasma, and associating this data with hematological and cardiovascular parameters. Key findings MS improved the survival of septic mice, preventing impairment to hematological and cardiovascular parameters. In addition, MS attenuated plasmatic NO increase, which is a typical feature of sepsis. Significance These findings provide new insights into the relationship between obesity and mild sepsis in mice, thus revealing an approach in favor of the “obesity paradox.”

Adolescent pregnancy remains a public health concern in both developed and developing countries. Portugal and Brazil represent some of the best examples of this phenomenon. The present study aimed to identify sociodemographic, sexual, and reproductive health-related variables associated with adolescent pregnancy among students from low socioeconomic backgrounds in both countries. The sample included 984 female adolescents, among whom 215 became pregnant. Living with a partner and lack of information about sex and contraception from the family were the best explicative factors for pregnancy occurrence in both countries. Country-specific variables were also identified. Our results may contribute to developing global preventive interventions, addressing the school as an ideal setting for primary intervention and considering culture-specific characteristics of high-risk populations.

Objective: To compare the depressive symptoms and quality of life (QoL) among adolescents (

Objectives The literature has been conceptualizing pregnancy occurrence as a multiphase event. However, the different combinations of decisions and behaviors leading to pregnancy that end in abortion remain unexplored in the literature. The aims of the study were to describe the reproductive and relational trajectories leading to pregnancy in women who decide to abort and to explore the differences in this process according to women’s age [adolescents ( Study design In this cross-sectional study, 426 women [246 adolescents (58.4%), 177 adults (41.6%)] who chose abortion were recruited. Data on reproductive and relational characteristics were collected through a self-report questionnaire at 16 healthcare services that provide abortion. The variables were introduced in trajectories according to the criterion of temporal sequence between them: age at first sexual intercourse, relationship type, pregnancy planning, use of contraception, identification of contraceptive failure, and occurrence of pregnancy. Results Seven trajectories leading to pregnancy were identified. The most frequent trajectory (30.8%) included women who 1) were involved in a long-term romantic relationship, 2) did not plan the pregnancy, 3) were using contraception, and 4) did not identify the contraceptive failure that led to pregnancy. Although this was the most frequent trajectory for both age groups, the remaining trajectories showed a different distribution. Compared to adolescents, adult women’s trajectories more frequently included casual relationships with non-use of contraception, or contraceptive use with no contraceptive failure identification. Conclusion Our study highlights the need to recognize the multiplicity of reproductive and relational trajectories leading to pregnancies that end in abortion and their specificities according to women’s age. These findings have important implications for abortion counselling and for the development of age-appropriate guidelines for preventive interventions, by drawing attention to prioritization of different contexts of intervention according women’s age.

Este estudo pretendeu analisar as associações entre locus de controlo (LC) e adesão terapêutica em indivíduos com condições crónicas de saúde, assim como o papel moderador do grupo etário nestas relações. A amostra incluiu 61 adultos emergentes (18-25 anos) e 60 adultos (26-64 anos) com doença crónica e a receberem tratamentos. Os participantes preencheram um questionário de dados clínicos/sociodemográficos e instrumentos de avaliação do LC e da adesão terapêutica. Não foram encontradas diferenças significativas no LC nem na adesão terapêutica entre grupos etários. Uma maior tendência para um LC externo-acaso associou-se a menores níveis de adesão terapêutica, independentemente do grupo etário, enquanto a associação negativa entre LC interno e adesão e a associação positiva entre LC externo-outros poderosos e adesão foram significativas apenas para os adultos emergentes. Estes resultados sugerem que o LC pode influenciar a adesão aos tratamentos, pelo que deve ser considerado como alvo terapêutico nas intervenções psicossociais. This study was aimed at examining the associations between locus of control (LC) and adherence to treatments in individuals with chronic health conditions, as well as the moderating role of age-group on these associations. The sample included 61 emerging adults (18-25 years) and 60 adults (26-64 years) with a chronic condition and who were receiving treatments. Participants completed a clinical/sociodemographic datasheet and self-report questionnaires assessing LC and adherence to treatments. No significant differences were found in LC orientation or adherence to treatments between age-groups. A greater likelihood of having an external LC by chance was associated with lower adherence independently of age-group, while the negative link between internal LC and adherence and the positive link between external LC by powerful others and adherence were statistically significant only for emerging adults. These results suggest that LC may influence adherence to treatments and, therefore, should be considered as an intervention target in psychosocial interventions.

Objectives: The aims of the study were to describe the sociodemographic, sexual, reproductive and relational characteristics of adolescents having an abortion in Portugal and to explore the differences between three adolescent age groups. Methods: We recruited a nationally representative sample of 224 adolescents (

Introdução: Este estudo pretendeu caracterizar as trajetórias relacionais e reprodutivas conducentes à gravidez na adolescência em Portugal, explorando a existência de especificidades regionais. Material e Métodos: O estudo decorreu entre 2008 e 2013 em 42 serviços de saúde públicos. A amostra, nacionalmente representativa, incluiu 459 grávidas com idades entre os 12 e os 19 anos. Os dados foram obtidos por autorrelato, através de uma ficha de caracterização construída para o efeito. Resultados: Independentemente de terem tido um (59,91%) ou múltiplos parceiros sexuais (40,09%), as adolescentes engravidaram de forma mais frequente numa relação de namoro, utilizando contraceção à data da conceção e tendo identificado a falha contracetiva que esteve na origem da gravidez (39,22%). A nível regional, outras trajetórias surgiram com elevada prevalência, refletindo opções como a decisão de engravidar (Alentejo/Açores), a não utilização de contraceção (Centro/Madeira) ou a sua utilização ineficaz sem que a falha contracetiva fosse identificada (Madeira). As relações de namoro revelaram-se maioritariamente duradouras (> 19 meses), com homens mais velhos (> 4 anos) e fora do sistema de ensino (75,16%); estes resultados foram particularmente expressivos quando a gravidez foi planeada. Discussão: O conhecimento gerado por este estudo reflete a necessidade de investir em abordagens preventivas que atendam às necessidades específicas das jovens de cada região e integrem a população masculina de maior risco. Conclusão: Os nossos resultados podem contribuir para o delineamento de políticas de saúde mais eficazes e para uma atuação multidisciplinar mais informada ao nível da educação sexual e do planeamento familiar nas diferentes regiões do país. Introduction: The current study aimed to describe the relational and reproductive trajectories leading to adolescent pregnancy in Portugal, and to explore whether there were differences in this process according to adolescents’ place of residence. Material and Methods: Data were collected between 2008 and 2013 in 42 public health services using a self-report questionnaire developed by the researchers. The sample consisted of a nationally representative group of pregnant adolescents (n = 459). Results: Regardless of having had one (59.91%) or multiple sexual partners (40.09%), the majority of adolescents became pregnant in a romantic relationship, using contraception at the time of the conception and knowing the contraceptive failure which led to pregnancy (39.22%). In some regions other trajectories were highly prevalent, reflecting options such as planning the pregnancy (Alentejo Region/ Azores Islands), not using contraception (Centro Region/Madeira Islands) or using it incorrectly, without identifying the contraceptive failure (Madeira Islands). On average, romantic relationships were longer than 19 months and adolescents’ partners were older than themselves (> 4 years) and no longer in school (75.16%); these results were particularly significant when the pregnancy was planned. Discussion: The knowledge gained in this study shows that prevention efforts must be targeted according to the adolescents’ needs in each region and should include high-risk male groups. Conclusion: Our results may enable more efficient health policies to prevent adolescent pregnancy in different country regions and support educators and health care providers on sexual education and family planning efforts.

The aims of the current study were to examine the indirect effect of the perceived impact of pregnancy on quality of life (QoL) through the severity of depressive symptoms among a sample of pregnant adolescents, and to explore whether adolescents’ satisfaction with support from their mothers (SM) or partners (SP) was a buffer of this effect. Demographic and pregnancy-related data were collected for 395 pregnant adolescents age 12–19 and were controlled for testing the proposed indirect effect. SM and SP were tested as moderators of the links between perceived impact of pregnancy and depressive symptoms and between depressive symptoms and QoL. A computational tool for path analysis-based moderation and mediation analysis as well as their combination was used to test indirect and interaction effects (PROCESS). A significant indirect effect of the perceived impact of pregnancy on QoL through the severity of depressive symptoms was found (0.51, CI = 0.29/0.78). There was no significant direct effect of the perceived impact of pregnancy on QoL after controlling for the severity of depressive symptoms. SM and SP buffered the indirect effect by weakening the association between a negative perception of the impact of pregnancy and higher severity of depressive symptoms. Identifying adolescents with a negative perception of the impact of pregnancy, improving the quality of their relations with their mothers and partners, and promoting satisfactory support from these figures may be extremely important to prevent and treat depressive symptoms and, in so doing, improve adolescents’ QoL during pregnancy.

Gynecological cancer is the fourth most common form of cancer among women. Over the past few decades, the growing number of survivors has been forced to cope with the consequences of the disease. Of these consequences, the impact of cancer on reproduction has been receiving increasing attention. Research shows that the health care of these women poses challenges other than medical ones. Although the inclusion of psychologists in health care teams has been particularly valued, studies focusing on the psychological implications of the impact of gynecological cancer on reproduction are scarce. Therefore, the first aim of this review is to critically reflect on the psychological implications of infertility, decision-making regarding childbirth, and pregnancy in the context of gynecological cancer. The second purpose of this review is to provide practice guidelines that account for the specificities and demands of these patients. Our findings suggest that gynecological cancer entails specific emotional and decisional challenges regarding reproductive issues, highlighting the importance of specialized psychological interventions with patients and their families. Providing emotional support and education about sexual and reproductive difficulties, supporting decision-making about fertility preservation and childbirth, promoting adjustment to cancer during pregnancy and supporting transition to motherhood are the main areas of intervention suggested. A multidisciplinary treatment approach also seems to be essential, and the role of psychological teams can be particularly important because these professionals may enlighten and encourage skills in other health care providers.

In todayâ??s knowledge society it is important to keep people informed about emerging technological developments while at the same time providing an accurate scientific and historical framework for such novelties in order to contribute to eradicate existing misconceptions. Dissemination of science and technology is presently essential to convey information within the research communities as well as among the younger generations and the general public. This paper describes two initiatives which pursue this objective by using multimedia tools. One consists in a set of 250 one-minute programs about engineering topics which were broadcast on TV, radio and the multimedia online platform of a daily journal. The other is a collection of videos produced by a research unit in two alternative formats aimed at specialist and general viewers. Both initiatives, based on two very different budgets, may be instrumental for improving the general perception of the role of engineering and for attracting new vocations. The multimedia contents developed are also valuable teaching tools.