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The incidence of haematological malignancies is increasing in women of childbearing age. Survival rates accompany this increase, making it essential to assess the impact of treatments on their future quality of life, evaluate the impact of each treatment on ovarian reserve and define the fertility preservation techniques used by women with haematologic malignancies. A retrospective study was conducted after data collection from 61 women diagnosed with haematological malignancies and followed-up in a fertility preservation centre between January 2008 and June 2019. Cancer treatments caused a decrease in ovarian reserve, demonstrated by an increase in FSH levels and a decrease in AMH levels. When assessing which treatments have the greatest impact on AMH levels, we found that the BEACOPP regimen, and the agents vincristine, etoposide, procarbazine, prednisone and the haematopoietic stem cell transplantation were mainly responsible. Regarding pregnancy after oncological treatments, of the eleven women who became pregnant, ten did so spontaneously. This study reinforces the importance of referring patients to a fertility preservation consultation before starting oncological treatment, as most of them opt to preserve fertility. This work also helps to clarify the impact of each chemotherapeutic agent on the ovarian reserve. [ABSTRACT FROM AUTHOR]

This study investigates chronic conditions (CC) prevalence among children in mainstream schools, their school experience and life satisfaction in Europe. Data were collected from the 2017/2018 HBSC survey, a cross-national study using self-reported questionnaires administered in classrooms. Nationally representative samples of children aged 11, 13, and 15 years in mainstream schools from 19 European countries (n = 104,812) were used. School experience was assessed using four variables: low school satisfaction, schoolwork pressure, low teacher support, and peer-victimization, which were related to life satisfaction. Latent class analysis (LCA) was conducted to identify patterns of school experience among students with CC. The prevalence of CC varied from 8.4 (Armenia) to 28.2% (Finland). Children with CC (n = 17,514) rated their school experience and life satisfaction lower than children without CC. LCA identified three school experience patterns: "negative on all items" (37%), "negative on all items, except school pressure" (40%) and "overall positive" (23%). The distribution of subgroups varied across countries—in countries with a higher proportion of children with CC in mainstream schools, children reported more negative school experiences. Compared to the "overall positive" group, low life satisfaction was highest for students classified as "negative on all items" (relative risk (RR) = 2.9; 95% CI 2.2–3.8) with a lesser effect for "negative on all items, except school pressure" (RR) = 1.8; 95% CI 1.4–2.4). These findings provide cross-national data documenting the diversity in inclusive educational practices regarding school placement and school experiences, and suggest that efforts are still needed to allow a fully inclusive environment. [ABSTRACT FROM AUTHOR]

The aim of the study was to describe neurological manifestations in children with congenital Zika syndrome (CZS) in the first 2 years of age. In this prospective observational study, children with CZS treated at a university hospital received a neurological assessment and were evaluated using two neurodevelopmental scales (the Denver II test and the assessment of gross motor development of the World Health Organization) by a pediatric neurologist on admission to the study and at 4, 8, 12, 18, and 24 months of age. The data collected were stored in Microsoft Excel version 14.6.3. Thirty-eight children (27 males and 11 females; a median age of 4.3 months (interquartile range (IQR): 1.6–11.4)) with CZS were evaluated. Irritability was present in 50% and 27% of the children at 8 months and 24 months, respectively. Axial hypertonia was highly prevalent at 4 months (77%), with a decrease to 50% at 24 months. At all ages, spastic tetraparesis was the most common motor abnormality (> 80%). Twenty-seven (71%) participants were diagnosed with epilepsy, and the median age at seizure onset was 6 months (IQR: 3.5–8). The most frequent types of seizures were focal seizures and spasms, with spasms being the most frequent in the first year of life (52%) and focal crises being the most frequent in the second year of life (50%). Conclusion: This study allowed observation of neurological abnormalities over time, the evolution of epileptic manifestations, and recognition of new patterns of clinical neurological abnormalities, helping clinicians to recognize CZS earlier, minimizing the impact of new outbreaks. What is Known: • Clinical patterns of SZC patients at pre-established ages or date of data collection • More frequent studies with data collection of clinical-radiological features of patient's over his first year of life What is New: • Comprehensive clinical neurological progression data regarding CZS in the first 2 years of life, recognizing patterns • Hypothesis including a new CZS spectrum with milder clinical-radiological features [ABSTRACT FROM AUTHOR]

This study aims to investigate the current practice patterns of Portuguese oncologists with different clinical specialties regarding female fertility preservation (FP) and to determine the relative endorsement of different barriers to these practices. A total of 111 doctors with different clinical specialties assisting female cancer patients of childbearing age at Portuguese clinical institutions completed a self‐report questionnaire to assess their current practice patterns regarding female FP and their perceptions of the barriers to these practices. Although the majority of the oncologists reported discussing the reproductive future with their patients, 2.8% and 7.2% of these clinicians reported never informing about the risk of infertility and about FP, respectively, and 75.8% of the participants have referred fewer than ten patients to a reproductive medicine doctor. Time with patients was the strongest endorsed barrier to these practices. A stronger endorsement of the barriers “oncologists’ communication skills” and “patient‐related factors” was related to a lower frequency of informing about both the risk of cancer‐related infertility and about FP. It is important to overcome the intrinsic barriers that emerged as being the most relevant to oncologists’ FP practices and that can be modified, namely the lack of communication skills and the oncologists’ perceptions of their patients’ characteristics. [ABSTRACT FROM AUTHOR]

Chronic diseases are the leading cause of morbidity and mortality and are considered to be at epidemic levels worldwide. This is a cross-sectional multi-country study based on data from the European Social Survey round 7, 2014, comprising 30,826 participants (14,813 men) with mean age 50.4 ± 18.0. Physical activity and chronic diseases were self-reported. Men and women who practiced physical activity more often had lower odds of having heart problems, breathing problems, type 2 diabetes, and obesity. Engaged in physical activity 2–4 times/week and ≥5 times/week decrease the odds of having heart problems, high blood pressure, breathing problems, type 2 diabetes, and obesity, compared with men and women who engaged in physical activity 1 or less times per week. For the women, the practice of physical activity ≥5 times/week was significantly and negatively associated with having cancer, when compared with women who engaged in physical activity 1 or less times per week. Physical activity is associated with a lower risk of chronic diseases, in particular: heart problems, high blood pressure, breathing problems, allergies, type 2 diabetes, and obesity. Furthermore, even small amounts of weekly physical activity seem to decrease the risk of chronic diseases. [ABSTRACT FROM PUBLISHER]

Background: The postponement of parenthood may increase the number of couples experiencing infertility and prolonged time to pregnancy. Previous research has revealed that childless people are not well informed regarding fertility, which may threat their childbearing intentions. This study aimed to examine fertility knowledge and childbearing intentions held by Portuguese people and their use and perceived usefulness of information sources on fertility. Methods: Participants were recruited using a random-route domiciliary approach. A total of 2404 individuals aged 18-45 were asked to complete a structured questionnaire evaluating socio-demographic characteristics, childbearing intentions, fertility knowledge and information-gathering sources regarding fertility. Results: In total, 95.5% of the participants indicated the desire to have children in the future, and 61.7% reported that having children would contribute to life satisfaction. Most of the participants expressed the desire to have two children in the future. The discrepancy between the numbers of planned and desired children was higher in men, in participants with lower education levels, in professionally active participants and in the unemployed participants. Relationship stability seemed to be more important in influencing childbearing decisions than financial stability or family support. Participants' knowledge regarding fertility was poor. Women, the participants who were older than 25, the participants with longer education and the participants with higher income exhibited the greatest levels of knowledge of fertility, although this knowledge was only slightly enhanced in these subgroups. Also, the participants overestimated both the chances of spontaneous pregnancy and the success rates of assisted reproduction techniques. Finally, the results revealed that websites were the main information sources used by the participants and only 18.0% of the participants had previously discussed fertility issues with their doctors. Conclusions: Although Portuguese men and women reported the desire to have children in the future, their knowledge regarding fertility and infertility risk was poor. In addition, participants used more general sources of information, such as website, but not specialized sources, such as their doctors. There is a real need to work with general practitioners to empower them to provide adequate fertility information to every childless patient. [ABSTRACT FROM AUTHOR]

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Background: Due to the economic recession, several people in Europe became unemployed. This situation may risk their mental health. Aim: This study explored parents’ perceptions about their unemployment’s effects in daily life during the recession. Methods: A total of 59 unemployed parents (40.7% fathers and 59.3% mothers), ageing 44.4 years (±6.2), answer a question on how the unemployment affected their family lives. Thematic analysis was used to analyse data. Results: The findings suggest that unemployment is a source of adult and youth mental distress and of economic hardship and changes in family relations. Conclusion: Support to unemployed individuals and their families could benefit from these insights when granting the needed financial and socioemotional assistance. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the difference of the contralateral acoustic reflex (AR) threshold between adult subjects with hearing within clinically normal limits, with and without tinnitus. Method: The study sample in this exploratory, descriptive, and comparative study comprised 40 female subjects who were evaluated: 20 had tinnitus and 20 formed the control group. The contralateral AR threshold was evaluated at the frequencies of 500, 1000, and 2000 Hz. Results: Elevated or absent AR thresholds were found only in subjects with complaints of tinnitus. At all frequencies and in either ear, the median AR threshold was higher in the group that complained of tinnitus (100.0 dB; range = 95.0-100.0 dB) compared with the control group (90.0 dB; range = 86.3- 95.0 dB; p < .01). There was a statistically significant difference ( p < .05) in the group with tinnitus, in each of the frequencies studied and in both the right and left ear. Conclusion: The results suggest that evaluation of the efferent system, through AR, could be an important tool for the differential diagnosis of tinnitus in patients whose hearing was within clinically normal limits. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate health-related quality of life and other psychosocial characteristics, including eating self-regulation and body image, in a group of successful long-term weight loss maintainers. Women enrolled in the Portuguese Weight Control Registry ( n = 107) were matched and compared to women at the end of a behavior weight loss treatment program ( n = 107), and also with women in the community who were not trying to lose weight ( n = 107). Successful maintainers displayed higher quality of life and a more positive profile in selected eating and exercise markers of self-regulation compared to similarly-weighed women not attempting weight loss, but not when compared to the ‘weight loss treatment’ group. However, results also suggest that concerns with body shape and size may persist after weight loss and that some aspects of well-being and eating self-regulation can be more successfully targeted in specific weight loss programs. [ABSTRACT FROM AUTHOR]

Introduction: This cross‐sectional exploratory study aimed to examine the female cancer patients' personal and health care‐related variables mostly associated with their decision whether to preserve or not their fertility, in order to know more about the influence of attitudinal and health care‐related variables on this decision where fertility preservation (FP) is fully covered by the National Health System. Methods: Childbearing attitudes, health care‐related information, FP motivations and childbearing motivations were assessed, in a clinical setting, to female cancer patients in childbearing age, who were undergoing the FP decision‐making process. Results: This study included 89 participants (82% response rate). Those who decided to undergo FP attributed more value to the reasons for FP and less value to the reasons against FP than those who decided not to undergo FP. Not having children, strongly valuing pregnancy after cancer and attributing low value to the implications of the postponement of cancer treatments were significant and independently associated with deciding to preserve fertility. Conclusion: The decision to pursue FP is mainly influenced by three factors: the absence of children, attributing high value to trying to ensure future pregnancy and attributing low value to the possible postponement of cancer therapy in order to have time to preserve fertility. [ABSTRACT FROM AUTHOR]

Background: The production of competent oocytes depends on a bi-directional communication between the oocyte and cumulus cells. The goal of this study was to determine whether simple parameters monitored in cumulus cells from individual human oocytes have any predictive value, and thus correlate with clinically relevant parameters. Methods: 97 cumulus-oocyte complexes were recovered from 31 patients undergoing ICSI treatment. After the oocytes were denuded, cumulus cell density from individual oocytes was determined. Cells were probed for viability using propidium iodide and for apoptosis by Annexin V staining or by monitoring caspase activity. These parameters were correlated with oocyte status, fertilization ability and patient age (≤29 years old and ≥30 years old). All variables were checked for normal distribution and then compared by Kruskal-Wallis, Mann-Whitney or one-way ANOVA tests. Results: Mature oocytes were surrounded by more cumulus cells (16073±2595, p=0.026), which were also more viable and less apoptotic than atretic or degenerated oocytes. Mature oocytes that fertilized had higher caspase activity in the surrounding cumulus cells than those that did not fertilize. Younger patients presented lower cumulus cells density (8882±2380 vs. 15036±2143 cells; p=0.034); and cumulus cells had higher apoptosis levels in younger patients than older ones (6775.5±1831.6 RLU vs. 2591±46.5 RLU, p=0.002 for caspase activity). Conclusion: The data suggests that high density and apoptosis of cumulus cells are promising parameters to indirectly predict individual oocyte status. Although more studies and a larger data set are needed, cumulus cells presented the potential to be used as simple predictors of female fertility and/or ovarian ageing. [ABSTRACT FROM AUTHOR]