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Introduction: The years preceding school entry are pivotal for children to develop fundamental skills that bolster their learning in literacy and math in the following years. Skills like counting and subitizing stand as key predictors of future math abilities. Hence, the availability of universal screening tools is vital to promptly identify children who are lacking in these skills, allowing for tailored classroom practices to meet their needs. This study aimed to develop a mathematical screening tool and assess its psychometric properties. Methods: The tool encompasses both group and individual tasks, to evaluate counting, cardinality, subitizing, quantity discrimination, addition, and subtraction. The tool was administered twice to 257 children, aged 5-6, in their final year of kindergarten in Portugal, at both the start and end of the school year. Results: The findings reveal that the tasks generally present a low level of difficulty, especially by the end of kindergarten. Factor analysis demonstrated an adequate structure, and all dimensions showed high internal consistency (>0.80). There was a medium-to-high intercorrelation among the various tasks. Correlations between task scores at the beginning and end of the school year were high. Furthermore, scores across all tasks correlated with math achievement in the first grade of primary education. Discussion: These outcomes suggest that the tool is both valid and reliable, making it a useful resource for assessing and intervening in math skills during the critical years before school entry. [ABSTRACT FROM AUTHOR]

It is important to identify children who are struggling with emergent literacy skills as early as possible to provide them with the support they need to prevent future academic failure. Screening tools administered in groups are more cost-effective than those administered individually, but few are available in Portugal. The goal of this study was to explore the psychometric properties (difficulty, reliability, and validity) of a group emergent literacy screening test for Portuguese-speaking children. The test includes two phonological awareness tasks, one vocabulary task, and one concepts of print task. The sample comprised 1379 children from pre-K (n = 314), kindergarten (n = 579), and first grade of primary education (n = 486). Measures of emergent literacy, reading and writing skills, and academic achievement were used to test the validity of the screening test. The Rasch model results suggest that the tasks were suitably difficult for the kindergarten group, but had varying levels of difficulty for pre-K and first grade. Reliability was adequate for the tasks with an appropriate level of difficulty. Scores for the screening test were highly correlated with measures of literacy and with academic achievement. These findings suggest that the presented emergent literacy screening test is valid and reliable, making it a useful tool for practice and research. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic challenged countries, regions, schools, and individuals. School closures due to lockdowns forced changes in the teaching practices and the learning support provided to children at home. This study aimed to provide insights on the changes between the first and the second lockdowns in Portugal, concerning remote teaching practices and family support to children's education. A self-report questionnaire was filled by 144 parents of third grade students. The results show that, between the two lockdowns, there was a significant decrease in the amount of support provided at home to school assignments and activities, as well as in the amount of time spent by students in TV broadcasted lessons and in reading training supported by the family. Inversely, families reported a significant increase in the amount of time spent by students in independent reading activities and in the time spent in training reading guided by teachers. The number of synchronous lessons with a teacher and the number of times students trained reading during a synchronous lesson also increased in the second lockdown. Additionally, in the second lockdown, parents perceived synchronous lessons to bemore effective at improving their child's reading skills and perceived themselves as more capable of supporting their child in reading acquisition. These findings are used to discuss school responses and remote teaching and learning practices during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background To make effective progress towards a global reduction in obesity prevalence, there needs to be a focus on broader structural factors, beyond individual-level drivers of diet and physical activity. This article describes the use of a systems framework to develop obesity prevention policies with adolescents. The aim of this research was to use the group model building (GMB) method to identify young people's perceptions of the drivers of adolescent obesity in five European countries, as part of the EU-funded Co-Create project. Methods We used GMB with four groups of 16–18-year-olds in schools in each of the five European countries (The Netherlands, Norway, Poland, Portugal and the UK) to create causal loop diagrams (CLDs) representing their perceptions of the drivers of adolescent obesity. The maps were then merged into one, using a new protocol. Results Two hundred and fifty-seven participants, aged 16–18 years, engaged in 20 separate system mapping groups, each of which generated 1 CLD. The findings were largely congruent between the countries. Three feedback loops in the merged diagram particularly stand out: commercial drivers of unhealthy diets; mental health and unhealthy diets; social media use, body image and motivation to exercise. Conclusions GMB provides a novel way of eliciting from young people the system-based drivers of obesity that are relevant to them. Mental health issues, social media use and commercial practices were considered by the young people to be key drivers of adolescent obesity, subjects that have thus far had little or no coverage in research and policy. [ABSTRACT FROM AUTHOR]

This study examines the ethical dilemmas and difficulties encountered by Portuguese school psychologists. As part of a larger survey, participants were asked about ethical issues faced in daily practice and asked to describe ethical incidents. Of the 477 respondents, 274 reported 441 ethically troubling or challenging situations. Responses were coded into a six-category system based on the code of ethics of Portuguese psychologists. Most of the reported dilemmas concerned privacy and confidentiality principles (53%). Results are discussed in light of relevant literature and international findings. Implications for the development of the profession and future research are provided. [ABSTRACT FROM PUBLISHER]

Introduction: health literacy has an increasing relevance as the disseminated access to online contents may impact on community health. This study aimed to evaluate the suitability of the online content of benign proctological disorders., Methods: the platforms Google© and YouTube™ were searched using the keywords hemorrhoidal disease, anal fistula, anal fissure, anal pruritus and fecal incontinence. Each page was analyzed for: interactivity, credibility, readability and content adequacy. For each video, the content, reactions and comments of the users were analyzed. Three validated scales were applied: Simple Measure of Gobbledygook (SMOG); Suitability Assessment of Materials (SAM), and quality criteria for consumer health information on treatment choices (DISCERN)., Results: a total of 127 webpages and 113 videos were evaluated. Forty webpages (31.50 %) included images and ten (37.04 %) had informative videos. The SMOG scale had an average value of 9.91 ± 0.94, which estimates the need for ten years of schooling for comprehension and 64 webpages (52.07 %) presented a reading level higher than the recommended B1. The mean SAM score was 39.46 ± 11.2 % and the DISCERN scale averaged 40.33 ± 5.69, corresponding to a reasonable content. Only 20 pages (15.75 %) included interactivity tools and 44 (34.64 %) contained bibliographic references. The videos posted by patients (n = 67, 59.2 %) had the highest number of views and positive comments whereas videos from health professionals (n = 21; 18.75 %) had the highest proportion of requests for additional information., Discussion: online content regarding benign proctological disorders is globally inappropriate for the health literacy level of the Portuguese population, both at the written and reading levels.

Background: Chronic constipation (CC) is a major public health condition and CC management remains challenging., Objective: We aimed to evaluate the CC (and subtypes) prevalence in a Southern Europe Mediterranean country using Rome IV criteria, and to assess related factors, toilet and healthcare seeking behaviours., Methods: Cross-sectional epidemiological survey, conducted in general community and representing the Portuguese population according to sex and age. The questionnaire covered bowel habits, factors potentially associated with CC (demographic, health/lifestyle, toilet behaviours) and data regarding healthcare seeking., Results: From the study data of 1950 individuals were analyzed. The answer rate was 68% and 1335 questionnaires were available for calculation. The CC prevalence was 17.8%, with respectively 9.3% of Functional Constipation (FC) and 8.5% of Irritable Bowel Syndrome - subtype constipation (IBS-C). The likelihood of constipation was significantly higher in younger (OR 1.01; 95% confidence interval [CI], 1.007-1.031), solo (OR 2.48; 95% CI, 1.7-3.47) and low-income (OR 2.40; 95% CI, 1.77-3.47) individuals. Constipated individuals spent more time at defecation, longer than 5 min (p = 0.001), and had particular toilet behaviours (absence of a morning pattern [p = 0.008], the use of triggers [p = 0.001] and reading/technological material [p = 0.006]) to facilitate the evacuation. Only 39% of affected individuals sought medical advice, mainly IBS-C patients (p = 0.018)., Conclusion: Chronic constipation seems to impact 1 in each 5 Portuguese. Constipated patients are younger, solo, less active and with low income. They develop a clear toilet behaviour profile. FC and IBS-C patients assume particular behaviours., (© 2022 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)

Objective: The aim of this study was to validate the IBD-Disk in a Portuguese cohort according to the COnsensus-based Standards for the selection of the health Measurement INstruments (COSMIN) recommendations., Methods: After translation of the original IBD-Disk to Portuguese, a group of IBD patients was invited to complete the IBD-Disk at baseline (T0), after 1-4 weeks (T1) and after more than 3 months (T2), from July 2020 to February 2021. At T0 and T2, the patients also completed the IBD Disability Index. We evaluated reliability (internal consistency, test-retest, interrater reliability and measurement error), construct validity, responsiveness, interpretability of IBD-Disk, sociodemographic and clinical factors associated with IBD-Disk., Results: At T0, 154 patients (107 - Crohn's disease; 46 - ulcerative colitis) completed the IBD-Disk; 1 - IBD-unclassified). At T1 and T2, 64 and 114 patients repeated the questionnaire, respectively. Factor analysis confirmed the unidimensionality of the scale and reduced the final version to 10 items. Internal consistency was excellent with a Cronbach's α of 0.916. The intraclass correlation coefficient was 0.95 for test-retest (T0 and T1). To evaluate construct validity, the IBD-Disk was compared with the IBD Disability Index and Manitoba IBD Index with a significative positive correlation (r = 0.850 and r = 0.459, respectively; P < 0.001 for both). IBD-Disk scores ranged from 0 to 93 with a mean of 38.18 ± 25.39. Female sex, professional inactivity, longer IBD duration and clinical activity were associated with significantly higher IBD-Disk scores., Conclusion: The Portuguese version of IBD-Disk is a reliable and valid tool to assess disability in Portuguese IBD patients., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

High sodium (salt) consumption is associated with an increased risk of developing non-communicable diseases. However, in most European countries, Portugal included, sodium intake is still high. This study aimed to assess the sodium content of school meals before and after the Eat Mediterranean (EM) intervention-a community-based program to identify and correct nutritional deviations through the implementation of new school menus and through schools' food handlers training. EM (2015-2017) was developed in 25 schools (pre to secondary education) of two Portuguese Municipalities, reaching students aged 3-21 years old. Samples of the complete meals (soup + main course + bread) from all schools were collected, and nutritional quality and laboratory analysis were performed to determine their nutritional composition, including sodium content. Overall, there was a significant decrease (-23%) in the mean sodium content of the complete school meals, which was mainly achieved by the significant reduction of 34% of sodium content per serving portion of soup. In conclusion, EM had a positive effect on the improvement of the school meals' sodium content, among the participant schools. Furthermore, school setting might be ideal for nutrition literacy interventions among children, for flavors shaping, and for educating towards less salty food acceptance.

Background/objectives: Ready-to-eat cereal (RTEC) breakfasts have been increasing in Portugal, among children. Eat Mediterranean (EM), a Portuguese comprehensive community-based intervention, proposed to improve breakfast patterns of children and adolescents and to evaluate the healthiness of RTEC according to WHO/Europe nutrient profile model (Euro-NP)., Subjects/methods: EM Program was developed during two scholar years (15/16 and 16/17) toward 2333 students (pre to secondary education). Data on breakfast was provided using a family record form. The intervention consisted of 257 educational sessions addressing the principles of Mediterranean Diet, and promoting a "healthy breakfast at home". To check for compliance with Euro-NP, RTEC package food labels' nutritional composition was used., Results: After intervention 92.9% of children/adolescents had breakfast daily with no report of breakfast skippers. RTECs were one of the most frequent (66.5%) breakfasts. Statistically significant improvements were showed for: daily qualitative and complete breakfast frequency (5.6%) and fruit (11.2%). Consumption of RTEC decreased 28%. According to Euro-NP, 84.6% of the RTECs were non-compliant, regarding sugar content. Children's RTECs presented 5% more of energy and 26% more sugar than the "non-children's" RTECs., Conclusion: EM strategy showed to be a successful program to improve patterns and quality of breakfast of the children and adolescents, reinforcing the importance of school-based nutritional programs in changing lifestyles. Nutrient profiling can be a useful tool to provide a selection of foods to be part of a healthy diet and can be used by policy-makers to design policies to identify the foods to which marketing restrictions to children, will apply.