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Objective: To determine whether early echocardiography screening of low systemic blood flow reduces intraventricular hemorrhage in preterm infants., Study Design: Prospective multicenter study in preterm infants below 33 weeks of gestational age at nine neonatal units. Five units performed early echocardiography screening for low systemic blood flow and guided clinical management (exposure group) and 4 units did not (control group). Our main outcome was ≥grade II intraventricular hemorrhage or death within the first 7 days of life. The main analysis used the inverse probability of treatment weighting., Results: Three hundred and thirty-two preterm infants (131 in the exposure group and 201 in the control group) were included. Exposure to early echocardiography screening was associated with a significant reduction in ≥grade II intraventricular hemorrhage or early death [odds ratio 0.285 (95% CI: 0.133-0.611); p = 0.001]., Conclusions: Early echocardiography screening for low systemic blood flow may reduce the incidence of intraventricular hemorrhage in preterm infants., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Studies have emphasized the importance of social support in mitigating the relationship between psychological distress and mental health effects, with family of origin and family of formation providing key sources of social support over the life course. However, LGBTQ+ people may experience family of origin relationships as a source of distress, while partners and friends may buffer the relationship between minority stress and psychological wellbeing. Through our online survey (March-June 2022), which was conducted when the social restrictions of the COVID-19 pandemic were lifted in the UK, we considered the association between psychological wellbeing and sources of social support by sampling n = 1330 LGBTQ+ and cisgender heterosexual adults. LGBTQ+ adults generally experienced poorer psychological wellbeing outcomes than did cisgender heterosexual people. For LGBTQ+ adults, social support from family of origin, a special person, or friends was not associated with depression, anxiety, or stress levels, but social support from family or a special person was positively associated with higher levels of life satisfaction. Our findings indicate the importance of considering negative as well as positive wellbeing.

Happiness is related to longevity and better health; nevertheless, there is a lack of knowledge about the construct, understood as subjective well-being (SWB), of older adults undergoing hemodialysis. This cross-sectional study investigated the extent to which hemodialysis treatment affects the SWB of older adults, compared to non-dialysis older adults. Regarding this, a total of 126 participants have interviewed: all the older adults in the hemodialysis service, 42 patients, from a city in Brazil, and 84 older adults from the Community, age- and gender-matched, predominantly men (64.3%), aged between 60 and 81 years. Participants respond to pattern questionnaires about SWB (life satisfaction, positive affect, negative affect), depressive symptoms, sociodemographic characteristics, and physical health status. Analysis of variance presented in hemodialysis had no effect on SWB and depressive symptoms. Furthermore, participants in the hemodialysis had fewer years of schooling, and those in the community presented more diseases. The high number of illnesses and low educational level demonstrate effects on SWB, as well the length of hemodialysis is negatively associated with SWB. Therefore, hemodialysis by itself does not make older adults unhappier and depressive, but some variables depending on the socioeconomical status and length of treatment are associated with depression and worst SWB.

A negative school climate resulting from homophobic and transphobic bias and discrimination is associated with poor well-being and mental health among LGBTQ+ youth. However, protective factors and mechanisms may buffer against the impact of stigmatization. Drawing on the socio-ecological model, minority stress theory, and positive youth development and agency perspectives, we carried out a systematic review of research focusing on factors that can promote the well-being of LGBTQ+ students in educational settings, outlining the primary outcomes from studies published between 2012 and 2022. The PRISMA protocol was used for this review, and 64 articles were scrutinized. The results of the thematic analysis revealed that both external factors (school-inclusive policies and extracurricular activities; social support from school, family, and the community; and school connectedness) and internal factors (psychosocial characteristics and personal agency) promote positive school experiences, such as the exploration of sexual and gender identities in a safe environment. The present findings highlight the need for inclusive school policies and strategies and individual-level interventions that target the well-being and positive mental health outcomes of sexual and gender minority students.

Introduction: Pneumothorax in neonates can be life-threatening. In neonates without respiratory distress, spontaneous pneumothorax can also develop under certain conditions., Objectives: To determine the incidence of ultrasonographic signs of pneumothorax in asymptomatic neonates using lung ultrasound as the diagnostic tool., Methods: This was an observational prospective study conducted at the Basurto University Hospital (Bilbao, Spain) between January 2018 and December 2020. Lung ultrasound was performed during routine examination of asymptomatic neonates admitted to the maternity ward., Results: Of a total of 204 asymptomatic neonates included in the study, 21 (10.3%) presented ultrasound signs of pneumothorax (Group A), and 183 (89.7%) had a normal lung ultrasound (Group B). Lung ultrasound was performed after a mean of 19 h of life (range 9-34). The presence of A-lines behind the sternum in the anterior transverse plane, at the intermammillary level, was observed in 100% of patients in Group A compared to no cases in Group B (p < 0.0001). The neonates of Group A presented the lung point located in the midclavicular line, indicative of a mild air leak., Conclusions: Lung ultrasound allows precise detection of suspected small-sized air leaks that can be detected in asymptomatic neonates. The true incidence of pneumothorax in asymptomatic neonates may be substantially higher than previously described in the literature., (© 2023 Wiley Periodicals LLC.)

The COVID-19 pandemic led to major restrictions of everyday life activities. This worsened the social situation of many people, and marginalized groups have been especially affected. This article explores how LGBTQ+ young adults in Sweden have been affected by the COVID-19 pandemic and the subsequent recommendations and restrictions. Fifteen participants between 20-29 years, who self-identified as lesbian, gay, bisexual, transgender, and queer (LGBTQ+), were interviewed about their experiences. A thematic analysis of the data showed that the participants perceived their psychological wellbeing to have been greatly affected by the pandemic. Several reported symptoms of clinical depression, as well as anxiety, worry, rumination, and a heightened sensitivity to stress. Stressors included fear of the disease itself, and fear of spreading the virus, as well as the negative consequences of adhering to the recommendations of social distancing, which constantly interplayed with the marginalized position of being a young LGBTQ+ person. Most participants experienced a decrease in minority stress in face-to-face interaction with social distancing measures in place, but an increase in minority stress online. Those who faced minority stress at home experienced the isolation as particularly stressful. Limited access to the LGBTQ+ community was a common stressor. For transgender participants, the effects on transgender healthcare, such as prolonged waiting times for gender dysphoria assessment and hormone treatment, were a major challenge. Our results have added valuable knowledge to research indicating how vulnerable young adults were highly affected by the COVID-19 pandemic restrictions., (© 2022 The Authors. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.)

The COVID-19 pandemic has been associated with poor mental health symptoms, particularly among vulnerable populations such as LGBTQ+ individuals. In the present study, we aimed to (i) identify different psychological adjustment profiles among LGBTQ+ young adults during the COVID-19 pandemic and compare LGBTQ+ young adults in relation to (ii) sociodemographic characteristics and COVID-19-related experiences and (iii) the internal and external protective resources associated with each adjustment profile. An online questionnaire was administered to 1699 LGBTQ+ young adults from six countries (Brazil, Chile, Italy, Portugal, Sweden, and the UK). A cluster analysis was conducted, and four profiles of psychological adjustment were identified: unchallenged, resilient, distressed, and at-risk. The at-risk cluster scored lowest in social support (particularly from family). The profiles of participants who experienced the highest levels of pandemic adversity (at-risk and resilient) comprised mostly South American participants, those under lockdown at the time of survey completion, those who self-identified as transgender and non-binary, and those with a plurisexual sexual orientation. Interventions should consider strategies to help young adults maintain support systems and reinforce the value of positive family relationships. Specific groups within the LGBTQ+ community that seem to be in a particularly vulnerable situation may need additional tailored support.

Homophobic experiences with traumatic characteristics related to shame are more frequent among sexual minority (SM) than heterosexual individuals. Concurrently, SM individuals present higher levels of psychopathology and transdiagnostic processes (e.g., shame) than heterosexual individuals. Self-compassion has been identified as a protective mechanism that counteracts the effects of shame. The current study aimed to analyse which components of self-compassion affect mental health and test the mediating role of self-compassion in the relationship between feelings of shame in traumatic homophobic bullying experiences (THBEs) and psychopathology indicators (depression, anxiety, and social anxiety symptoms). In this study, 190 Portuguese SM individuals ( M age = 28.3, SD = 7.5) completed self-report measures assessing traumatic experiences, self-compassion, and psychopathology. Data were explored with SPSS and AMOS. Regression analyses showed that internal shame felt during THBE and compassionate actions predicted psychopathology outcomes. Mediation analyses revealed that internal shame during a THBE had a significant indirect effect on all psychopathology outcomes through compassionate actions. In other words, internal shame during a THBE was significantly associated with depression, anxiety, and social anxiety, and these relationships were partially mediated by compassionate actions. Our results reinforce the importance of developing compassionate actions towards the self as a possible protective factor for psychopathology among SM individuals.

Vulnerable populations have been among the most affected by the social consequences of the COVID-19 pandemic; among those, young people and sexual and gender minorities have seen their situation exacerbated by new specific regulations. The aim of the present study was twofold: first, to assess the role of family climate, concerning participants' LGBT+ status during lockdown restrictions, in mediating the impact of the COVID-19 pandemic on personal quality of life and mental health (stress, depression, and anxiety); second, to assess how individual stable traits can moderate the relationship between the individual impact of COVID-19 on mental health outcomes. A total of 407 young adults aged 18 to 35 (M age = 25.03 years; SD = 4.68) who self-identified as being part of a sexual or gender minority took part in this study. Results highlight the association between negative family climate and internalizing symptoms of psychological distress, and its role as a partial mediator of the relationship between the impact of the COVID-19 pandemic at the individual level and mental health outcomes. Additionally, low personality trait levels of neuroticism significantly decreased the strength of the relationship between LGBT+ status during blocking restrictions and internalizing symptoms.

Parental burnout (PB) results from a chronic imbalance between risks and resources and has severe and extended consequences on the wellbeing of parents and their children. Because same-sex (SS) and different-sex (DS) families face partially different stressors (e.g., SS parents are more stigmatized) but have also partially different resources (e.g., more egalitarian task sharing in SS couples), the current research aimed to investigate whether PB differs or not according to family type. Two studies were conducted. In study 1, family type differences in PB were explored among 114 demographically matched SS and DS families from 18 countries. Study 2 further explored the predictive value of family type, age, gender, and balance between risks and resources (BR2) in PB, using a sample of 222 matched SS and DS families. Parental burnout was not associated with family type in either study. Although differentially composed, the global BR2 score did not differ across family type and was a significant predictor of all PB dimensions, while controlling for the effect of family type, age, and gender. Thus, in accordance with reviewed studies, parental sexual identity was not associated with family functioning. Future studies should investigate the impact of specific risks and resources (e.g., social support from chosen social networks or legal climate) on PB levels among SS families.

The coparenting relationship begins with a process of planning and negotiation about having children. Available psychological instruments have not been adapted to sexual minority people, which compromises their ecological validity. This mixed method study aimed to adapt and validate a prospective version of the Co-Parenting Relationship Scale in a Portuguese sample of sexual minority and heterosexual adults who did not have children and who were in a dyadic relationship. In study 1, cognitive interviews were used to gather participants' reflections about the original items and the role played by the family of origin and anticipated stigma in coparenting ( n = 6). In study 2, using a sample of individuals from 18 to 45 years old, two Exploratory Factor Analyses (EFA) were conducted separately for sexual minority ( n = 167) and heterosexual persons ( n = 198), and a Confirmatory Factor Analysis (CFA) was conducted for heterosexual persons ( n = 176). Results showed underscored the importance of families of origin independent of sexual orientation. Different factorial structures for sexual minority and heterosexual persons were observed. Among sexual minority persons, the role of stigma was also highlighted. Implications for practice and research are discussed.

Introduction: Point-of-care lung ultrasound is increasingly used to diagnose pneumothorax efficiently and safely in neonates., Objectives: This study aimed to evaluate the usefulness of the central and anterior transverse thoracic plane in the ultrasound diagnosis of pneumothorax, analyze the diagnostic value of the "mirrored ribs" sign, and evaluate the predictive value of the lung point location for the need of pleural drainage., Methods: Retrospective cohort study of all newborns admitted to the neonatal intensive care unit of the Basurto University Hospital (Bilbao, Spain) due to respiratory distress and with ultrasound, with or without pneumothorax, between January 2014 and December 2020., Results: The presence of A-lines behind the sternum in the anterior transverse plane in newborns with pneumothorax (N = 311) and controls (N = 195) was compared. A-lines were present in 98.9% of newborns with pneumothorax compared to none in the controls (p < .0001). Diagnosis of pneumothorax with the anterior transverse plane presented high interobserver reproducibility (κ = 0.92, 95% confidence interval: 0.84-1.00). In contrast, the "mirrored ribs" sign in the anterior longitudinal plane was observed in 35.6% of patients with pneumothorax and in 36.9% of controls (p = .1505). A significant association was observed between lung point location and the need for pleural drainage (p < .0001)., Conclusions: A-lines in the anterior transverse plane is a simple ultrasound sign which presents high sensitivity, specificity, and reproducibility for the diagnosis of pneumothorax. The mirrored ribs sign showed low diagnostic utility. Patients with severe pneumothorax in lung ultrasound are most likely to require thoracic drainage., (© 2022 Wiley Periodicals LLC.)

Background: The widespread access to medically assisted reproduction (MAR) techniques for all women, regardless of any infertility diagnosis, has led to an increased, but as yet unmet, demand for sperm donors in Portugal. For this study, we deployed an online survey to explore men's motivations for donating and their attitudes toward anonymity and donating for specific groups., Method: The study's sample comprised men who were eligible to donate sperm (N = 282). The relationships between these factors and participants' psychological and sociodemographic characteristics were also explored., Results: The results mostly indicated altruistic reasons for donating, positive attitudes toward anonymity, and a greater willingness to donate to infertile women. Overall, sexual orientation was not associated with the participants' attitudes and motivations. Age, education level, conscientiousness, empathic concern, and conservative and religious values were associated with the participants' motivations and attitudes toward sperm donation., Conclusion: Recruitment campaigns should therefore consider the specific motivations, attitudes, and psychosocial characteristics of potential sperm donors. Indeed, parenthood is a universal right, so sperm donation should be encouraged, regardless of recipients' fertility status. Clear information about the identifiability of sperm donors should also be provided., Competing Interests: Conflict of InterestThe authors declare that they have no conflicts of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021.)

Introduction: The lung ultrasound score (LUS) has been suggested to predict moderate-severe bronchopulmonary dysplasia (msBPD) in preterm infants. We aimed to assess LUS evolution after birth in preterm infants and the effect of gestational age., Methods: This multicentre prospective observational study was performed with newborns born before 33 weeks of gestation. We created two groups: group 1 (23-27 weeks) and group 2 (28-32 weeks). We compared LUSs between the groups from birth until 36 weeks of postmenstrual age, and we estimated the LUS evolution in each group with a linear multilevel mixed-effects regression model. The effects of the need for surfactant or an msBPD diagnosis were also studied., Results: We included 339 patients: 122 (36%) in group 1 and 217 (64%) in group 2. The infants in group 1 showed a steady progression in the LUS from birth until 4 weeks of age and a subsequent decrease; the infants in group 2 showed a progressive decrease in the LUS throughout the study. This progression varied significantly in the first weeks of life in infants who required surfactant at birth and after the first week of life in the patients diagnosed with msBPD., Discussion/conclusions: Extremely preterm infants showed persistently high LUSs during the first weeks of life, regardless of the progression to msBPD. In this group, the infants who did not require surfactant at birth exhibited an increase in their LUSs after the first week until their values were equal to the remaining infants in their group., (© 2022 S. Karger AG, Basel.)

This study compared Israeli, Portuguese, and British childless lesbian, gay, bisexual (LGB) and heterosexual adults on parenthood aspirations as indicated by their desire and intent to become a parent and their concern about childlessness. For this purpose, 168 childless adults (57 self-reported as LGB) in Portugal were matched on sociodemographic variables with 168 participants from the United Kingdom and 168 participants from Israel, resulting in a sample of n = 504 ( M age = 28.26, SD = 6.17). Participants were recruited through convenience sampling and completed online questionnaires assessing parenthood desire, intent, and concern about childlessness. Results indicated that participants from Israel and Portugal reported higher levels of parenthood desire, intent, and concern about childlessness than participants from the United Kingdom. Parallel patterns also appeared separately for LGB and heterosexual participants between the countries. Heterosexual participants from Israel scored higher than counterparts from Portugal on parenthood intention and concern about childlessness. In addition, LGB participants in general reported lower levels of parenthood desire, intentions, and concern about childlessness than did heterosexual participants. The findings are interpreted in light of the different sociocultural contexts of the countries, that is, the individualistic values characterizing the U.K. versus the familistic values characterizing the Israeli and Portuguese contexts, alongside a strongly pronatalist stance evident in Israel and economic context in Portugal. The study contributes to the scant comparative literature on parenthood aspirations among LGB individuals as a function of cultural context by providing a multicontextual viewpoint on parenthood aspirations, sexual orientation, and diverse sociocultural contexts. Implications for clinicians are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Across the world, people have seen their lives interrupted by the COVID-19 pandemic. Using an online survey, we explored how the psychosocial effects of the pandemic affected the mental health of LGBTQ+ young adults who were confined with their parents during the lockdown period ( N = 1,934), from six countries: Portugal, UK, Italy, Brazil, Chile, and Sweden. South American participants experienced more negative psychosocial effects of the pandemic. Depression and anxiety were higher among participants who were younger, not working, living in Europe and who reported feeling more emotionally affected by the pandemic, uncomfortable at home, or isolated from non-LGBTQ friends. Not attending higher education predicted depression while not being totally confined at home, residing habitually with parents, and fearing more future infection predicted anxiety. LGBTQ+ community groups, as well as health and educational services should remain particularly attentive to the needs of LGBTQ+ young adults during health crises.

In the present cross-sectional study, we used a self-report online survey to assess the perceptions of intergenerational solidarity among sexual minority (lesbians, gay men, and bisexuals) ( n  = 239) and heterosexual ( n  = 291) childless adults from Portugal. Gender differences were also explored among sexual minority individuals, regarding their perceptions of received solidarity both from their mothers and fathers. Although sexual orientation had a minor impact on most of the assessed dimensions, compared to heterosexuals, sexual minority participants reported lower levels of normative and affectual solidarity and higher levels of conflictual solidarity. In addition, sexual minority participants experienced higher levels of conflictual solidarity from their fathers compared to their mothers. Among sexual minority participants, women reported lower levels of received functional solidarity compared to men. Findings lend support to interventions to reduce discrimination and improve intergenerational relations among families with LGB adult children.

Parenthood is a highly valued life goal, independent of one's sexual orientation. However, the majority of studies exploring young adults' parenthood plans have relied exclusively on samples of heterosexual individuals. This study aimed (i) to explore differences in parenthood intentions as a function of sexual orientation, (ii) to investigate to what extent sociodemographic and psychological characteristics predict parenthood intentions of lesbian, gay, bisexual (LGB), and heterosexual individuals, (iii) to test the mediating effect of stigma between sexual orientation and parenthood intentions, and (iv) to identify and characterize profiles of prospective parenthood (through cluster analysis). Data were gathered using an online survey from 375 self-identified LGB and heterosexual young adults without children in Portugal, with a mean age of 25.83 years old ( SD = 4.49). Findings indicated that LGB individuals were less likely to intend to have children than heterosexual individuals; furthermore, among LGB individuals, lesbian women expressed stronger intentions to have children than did gay men. Similarities between heterosexual and LGB young adults were observed concerning the psychological determinants of parenthood intentions. Four distinctive profiles of prospective parenthood were identified: aspiring parents not anticipating stigma, aspiring parents anticipating stigma, childfree intent, and childfree ambivalent. Lesbian and bisexual women mostly populated the childfree ambivalent cluster; in contrast, the aspiring parents anticipating stigma cluster contained an overrepresentation of men, including sexual minority men. Professionals may want to attend to communalities and specificities of prospective parenthood as a function of sexual orientation, in order to provide unbiased and culturally competent support to sexual minority individuals., (Copyright © 2020 Gato, Leal, Coimbra and Tasker.)

The idea that people who are transgender or non-binary are not interested in becoming parents has been refuted by several studies. However, both medical unknowns and cisnormativity surround the process of becoming a parent for transgender or non-binary people, with little known about the psychosocial impact on the family formation dilemmas of transgender and non-binary adults. Employing Life Course Theory as our theoretical framework, three focus group interviews were conducted with eleven transgender or non-binary adults. Qualitative data analysis of focus group interview transcripts was conducted through Thematic Analysis. Four overarching interlinked themes were identified concerning the dilemmas perceived by the nine participants who contemplated future parenthood: (i) Balancing a desire for parenthood and desires for other life goals; (ii) Feeling that who I am doesn't fit into the cisgender system of accessing fostering, adoption or fertility services; (iii) Experiencing the conjoined challenges of gender and fertility embodiment as I see them; (iv) Searching for a non-binary or gender appropriate self and the need for flexible future planning centered on reproductive capacity. Overall, thoughts about gender transition were often interwoven with parenthood plans and in a dialectical fashion the desire and intention to have, or not have, children was implicated in satisfaction with gender transition. The significance of these themes is discussed in relation to how hopes for parenthood could be realized without jeopardizing gender identity and the need for a future focused, flexible, and open-minded approach on the part of fertility and adoption services., (Copyright © 2020 Tasker and Gato.)

Portugal is one of the most egalitarian countries in Europe in terms of lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals' legal rights. However, regarding education Portugal still lacks specific policies, plans and interventions to protect LGBTI students. To assess the perceptions of self-identified LGBTI youth regarding their school context, a total of 663 participants (aged from 15 to 20 years old) filled in an on-line questionnaire about their school climate. One hundred and forty-six of them answered an open-ended question about their personal experiences. A thematic analysis of these answers was conducted, and four main categories were identified: (i) victimization, (ii) coming out experiences, (iii) support networks, and (iv) demands. Most participants reported experiences of discrimination, and several sources of prejudice were identified. Furthermore, participants also recognized a lack of LGBTI information in school curriculum and made several demands. Besides inclusive laws, we suggest that the safety and the well-being of LGBTI youths in Portuguese schools depend upon others measures, such as teacher and school staff training, curricula inclusive of LGBTI diversity, and local strategies, such as Gay-Straight Alliances., (Copyright © 2020 Gato, Leal, Moleiro, Fernandes, Nunes, Marinho, Pizmony-Levy and Freeman.)

Event related potentials (ERPs) provide precise temporal information about cognitive processing, but with poor spatial resolution, while functional magnetic resonance imaging (fMRI) reliably identifies brain areas involved, but with poor temporal resolution. Here we use fMRI to guide source localization of the ERPs at different times for studying the temporal dynamics of the neural system for recognizing familiar faces. fMRI activation areas were defined in a previous experiment applying the same paradigm used for ERPs. The Bayesian model averaging (BMA) method was used to estimate the generators of the ERPs to unfamiliar, visually familiar, and personally-familiar faces constraining the model by fMRI activation results. For this, higher prior probabilities in the solution space were assigned to the fMRI-defined regions, which included face-selective areas and other areas related to "person knowledge" retrieval. Source analysis was carried out in three-time windows: early (150-210 ms), middle (300-380 ms) and late (460-580 ms). The early and middle responses were generated in fMRI-defined areas for all face categories, while these areas do not contribute to the late response. Different areas contributed to the generation of the early and middle ERPs elicited by unfamiliar faces: fusiform (Fus), inferior occipital, superior temporal sulcus and the posterior cingulate (PC) cortices. For familiar faces, the contributing areas were Fus, PC and anterior temporal areas for visually familiar faces, with the addition of the medial orbitofrontal areas and other frontal structures for personally-significant faces. For both unfamiliar and familiar faces, more extended and reliable involvement of contributing areas were obtained for the middle compare with early time window. Our fMRI guide ERP source analysis suggested the recruitment of person-knowledge processing areas as early as 150-210 ms after stimulus onset during recognition of personally-familiar faces. We concluded that fMRI-constrained BMA source analysis provide information regarding the temporal-dynamics in the neural system for cognitive processsing.

This study explored the impact of sexual identity on attitudes towards parenthood among childless individuals from Portugal and the United Kingdom (UK). Compared to heterosexuals, lesbians, gay men and bisexuals were less likely to: desire and intend to have children, be concerned about the prospect of childlessness or perceive children as a source of enrichment. They also anticipated more stigma as parents than did heterosexuals. Compared to UK participants, all Portuguese participants, independent of sexual identity, desired and intended more to have children, were more concerned about childlessness, reported higher levels of parental commitment, anticipated less stigma and expected more social support as parents. Portuguese lesbian, gay and bisexual participants expressed greater desire to have children than did those in the UK. Only in the UK did lesbian, gay and bisexual participants perceive children less as a source of enrichment than did heterosexuals and anticipate negative costs associated with parenting. We concluded that the intersectional influence of different cultural climates on parenting aspirations should be taken into account in future research alongside sexual identity.

We explored parenting desires, parenting intentions, and anticipation of stigma upon parenthood in a sample of 257 self-identified lesbian, bisexual, and heterosexual childfree women in Portugal. No differences between the groups were observed concerning parenting desires. However, lesbian and bisexual women reported lower intentions to have children than their heterosexual counterparts. Although lesbian women considered themselves to have a higher chance of being victims of social stigma as mothers, this was not associated with their parenting desires. Furthermore, younger lesbian women intended to have children to a greater extent than did older lesbian women; relational status did not relate to lesbian women's parenting intentions, desires, or anticipation of stigma. Overall, this study contributes to knowledge about family formation processes among Portuguese women diverse in sexual identity.

The present study seeks to ascertain the attitudes of Portuguese psychology students (future psychologists) toward the development of children adopted by lesbian and gay parents. Each participant (N = 182) read a vignette describing an adoption of a child by lesbian and gay persons. After reading the vignette, participants rated four different aspects of the future development of the adopted child (psychosocial adjustment, victimization, psychological disturbance, and normative sexuality). Furthermore, participants were asked about their gender, interpersonal contact with lesbians and gay men, gender role attitudes, and attitudes toward lesbians and gay men. Future psychologists' attitudes toward the developmental outcomes of children adopted by lesbians and gay men were associated with negative attitudes toward non-heterosexuals, which in turn correlated to interpersonal contact with lesbians and gay men and adherence to gender conservative values. These results clearly highlight the central role of social attitudes and the need for cultural competence training of future psychologists that encourages interpersonal contact with non-heterosexuals and discourages traditional gender roles and negative attitudes toward lesbian and gay men.

Introduction: Lesbian, gay, bisexual and transgender people still face discrimination in healthcare environments and physicians often report lack of knowledge on this population's specific healthcare needs. In fact, recommendations have been put forward to include lesbian, gay, bisexual and transgender health in medical curricula. This study aimed to explore factors associated with medical students' knowledge and attitudes towards homosexuality in different years of the medical course., Material and Methods: An anonymous online-based questionnaire was sent to all medical students enrolled at the Faculty of Medicine - University of Porto, Portugal, in December 2015. The questionnaire included socio-demographic questions, the Multidimensional Scale of Attitudes Toward Lesbians and Gay Men (27 items) and a Homosexuality Knowledge Questionnaire (17 items). Descriptive statistics, ANOVAs, Chi-square tests and Pearson's correlations were used in the analysis., Results: A total of 489 completed responses was analyzed. Male gender, religiosity and absence of lesbian, gay or bisexual friends were associated with more negative attitudes towards homosexuality. Attitudinal scores did not correlate with advanced years in medical course or contact with lesbian, gay or bisexual patients. Students aiming to pursue technique-oriented specialties presented higher scores in the 'Modern Heterosexism' subscale than students seeking patient-oriented specialties. Although advanced years in medical course correlated significantly with higher knowledge scores, items related with lesbian, gay or bisexual health showed the lowest percentage of correct answers., Conclusion: There seems to be a lack of exploration of medical students' personal attitudes towards lesbians and gay men, and also a lack of knowledge on lesbian, gay or bisexual specific healthcare needs. This study highlights the importance of inclusive undergraduate curriculum development in order to foster quality healthcare.

This study aims to evaluate the construct validity, internal consistency and cross-cultural invariance of the Generalized Self-Efficacy Scale-Portuguese version (GSE) in a Brazilian and Portuguese sample. The GSE is composed of 10 items, designed to parsimoniously and comprehensively assess self-efficacy beliefs to deal with a wide range of stress-inducing situations. The construct validity (factorial, convergent and discriminant) and internal consistency of the instrument were established within a sample of 304 Portuguese adolescents (study 1) and a sample of 477 Brazilian adolescents (study 2). Then, the invariance of the GSE was tested in a sample of Brazilian adolescents (study 3), using Multigroup Confirmatory Factor Analysis (MGCFA). In the first two studies, the construct validity of the GSE was demonstrated in its three components and the reliability of the scales was confirmed based on satisfactory levels of internal consistency. In the third study, the cross-cultural invariance of the instrument was established. This work adds to previous research on generalized self-efficacy instruments, with good psychometric qualities. Moreover, comparisons can now be made with confidence using this instrument among adolescent samples from Portugal and Brazil.

The present study aimed to characterize beliefs surrounding the sexual and gender development of children adopted by lesbian and gay couples. Participants were 768 Portuguese university students. Using a quasiexperimental design, participants were presented with identical descriptions of a couple interested in adopting a child, manipulating couple sexual orientation and child gender. Participants were then asked to anticipate three aspects of the sexual and gender development of the adopted child: sexual orientation, gender role behavior, and gender identity. MANOVAs and follow-up ANOVAs were conducted in order to analyze the data. Results indicated that participants, particularly males, considered children adopted by either lesbian or gay couples to have a lower probability of developing a normative sexual and gender identity than children adopted by heterosexual couples. Both men and women considered that children would emulate the sexual orientation of their same-sex parents, and that a boy's gender role behavior was more at risk if he was adopted by a lesbian couple. Moreover, men were apprehensive about the gender role behavior of a boy adopted by a gay male couple. Overall, these results indicate persistence of biased evaluations of the sexual and gender development of children adopted by lesbian and gay parents. Furthermore, both gender of the participant and gender of the child play an important role in these evaluations. Results are discussed and interpreted as a way of "doing gender" in the context of hegemonic masculinity.

We evaluated the biological effect of IgG4 antibodies in pollinosis. We studied the ability of IgG4 to mediate histamine release by measuring anti-IgG4 in pollinic patients without previous immunotherapy. We also evaluated the modifications that sera rich in specific IgG4 and IgG itself exert upon antigen-specific histamine release. According to our results, stimulation with anti-IgG4 did not induce histamine release, as opposed to stimulation with anti-IgE, which induced histamine release in all the cases studied. On the other hand, hyperimmune sera from pollinic subjects under immunotherapy and with high levels of specific IgG4 significantly inhibited the release of antigen-specific histamine from basophils of untreated patients. After isolating IgG4 by means of affinity chromatography, preincubation of this fraction with the allergen gave rise to a significant reduction in histamine release compared to preincubation of the antigen with normal sera.

We performed bronchial challenge with ASA lysine in 9 patients with a history of aspirin-induced asthma, 4 asthmatics with no history of hypersensitization to aspirin and 4 control subjects. The test consisted of successive inhalations of increasing concentrations of ASA lysine (11.25, 22.5, 45, 90, 180 and 360 mg/ml) and was interrupted when FEV1 showed a decrease of at least 20%. In order to determine the degree of bronchial hyperreactivity, we first carried out a bronchial challenge with histamine. All patients in the group sensitive to aspirin had a positive reaction to ASA lysine, while this was negative for patients in the two control groups. There was no significant correlation between PC20 to histamine and ASA lysine in any of the groups. On the other hand, 6 patients with sensitivity to ASA repeated the bronchial challenge with ASA lysine after previously inhaling furosemide, and in this second test, none of the 6 had a positive reaction. The variation of ASA lysine PC20 in both tests was positive for these patients (p < 0.001).

We used 56 samples of heparinized blood of patients with asthma and/or allergic rhinitis, which were stimulated with Dermatophagoides pteronyssinus or gramineous pollen and anti-IgE in order to study the effect of furosemide on histamine release in basophils. At the same time, blood samples incubated in furosemide in different concentrations (2.5 microM to 1.49 mM) were also subjected to the same stimuli. Results showed a linear and dose-dependent inhibition of histamine release for antigens (r = 0.96; p < 0.01) and anti-IgE (r = 0.95; p < 0.05), reaching 95% at maximum inhibition. These results support the hypothesis that furosemide may act on mastocytes and basophils, thus inhibiting the release of histamine and other mediators.

For this study, venous blood from 160 patients with a diagnosis of asthma and/or rhinitis was used. Histamine release test (H.R.T.) with anti-IgE at 1/5 and 1/25 dilutions and with causal antigen in the case of atopic patients (144) was carried out on all patients. Basophils from atopic patients released more histamine than those from nonatopic patients (p < 0.001). Basophils of atopic patients released more histamine with 1/5 anti-IgE dilution (p < 0.01), while non-atopic patients did so with the 1/25 dilution (p < 0.05). On grouping atopic patients according to positive or negative results in Ag-specific histamine release, 14% of patients presented negative Ag-specific H.R.T. and 85.7% of the cases did not respond to anti-IgE stimulus; this was 12% of the total number of atopics. On the other hand, 17% of the patients studied did not show positive histamine release against anti-IgE and 70.6% of them had negative Ag-specific release. As for the effect of age on IgE-dependent histamine release, the group of patients who presented greater releasability corresponded to those older than 6 years of age. The discrepancies observed between the clinical history, skin tests, serum IgE and antigen-dependent histamine release in some patients could be related to the individual basophil ability to release histamine. Therefore, this basophil releasability evaluation has an important practical application in discerning false negatives in antigen-specific H.R.T.

Colorectal cancer is increasing due to both a real increase and a better diagnosis. More cases are seen in men than in women (ratio 1.45). The incidence increases with age, reaching the highest point at 75 years of age in men and at 84 years of age in women. Before 50 years of age, the risk of colorectal cancer is higher in women; the contrary happens after this age. Colorectal cancer is localized in the rectum (47.5%), sigmoid flexure (25.3%) and coecum (8.1%). Synchronous colorectal carcinomas are seen in 2.3% of the patients, frequently coexisting with multiple adenomas, and show a tendency to be localized out of the rectum. A higher proportion of carcinomas localized in the descending colon and a diminution of rectum carcinomas are observed in men with increasing age, while in women the number of carcinomas of the ascending colon increases and that of the descending colon decreases. For the considered period (1970-81), a diminution of the ascending colon carcinomas has been registered.

A patient is described who had magnetic resonance imaging (MRI) findings of a left paramedian pontine ischemic stroke. It was associated with right motor sensory and left cerebellar dysfunction and the "one-and-a-half" syndrome of Fisher.