Involvement of the cerebellum in structural connectivity enhancement in episodic migraine.

BACKGROUND: The pathophysiology of migraine remains poorly understood, yet a growing number of studies have shown structural connectivity disruptions across large-scale brain networks. Although both structural and functional changes have been found in the cerebellum of migraine patients, the cerebellum has barely been assessed in previous structural connectivity studies of migraine. Our objective is to investigate the structural connectivity of the entire brain, including the cerebellum, in individuals diagnosed with episodic migraine without aura during the interictal phase, compared with healthy controls. METHODS: To that end, 14 migraine patients and 15 healthy controls were recruited (all female), and diffusion-weighted and T1-weighted MRI data were acquired. The structural connectome was estimated for each participant based on two different whole-brain parcellations, including cortical and subcortical regions as well as the cerebellum. The structural connectivity patterns, as well as global and local graph theory metrics, were compared between patients and controls, for each of the two parcellations, using network-based statistics and a generalized linear model (GLM), respectively. We also compared the number of connectome streamlines within specific white matter tracts using a GLM. RESULTS: We found increased structural connectivity in migraine patients relative to healthy controls with a distinct involvement of cerebellar regions, using both parcellations. Specifically, the node degree of the posterior lobe of the cerebellum was greater in patients than in controls and patients presented a higher number of streamlines within the anterior limb of the internal capsule. Moreover, the connectomes of patients exhibited greater global efficiency and shorter characteristic path length, which correlated with the age onset of migraine. CONCLUSIONS: A distinctive pattern of heightened structural connectivity and enhanced global efficiency in migraine patients compared to controls was identified, which distinctively involves the cerebellum. These findings provide evidence for increased integration within structural brain networks in migraine and underscore the significance of the cerebellum in migraine pathophysiology.

Impact of truncating diffusion MRI scans on diffusional kurtosis imaging.

OBJECTIVE: Diffusional kurtosis imaging (DKI) extends diffusion tensor imaging (DTI), characterizing non-Gaussian diffusion effects but requires longer acquisition times. To ensure the robustness of DKI parameters, data acquisition ordering should be optimized allowing for scan interruptions or shortening. Three methodologies were used to examine how reduced diffusion MRI scans impact DKI histogram-metrics: 1) the electrostatic repulsion model (OptEEM); 2) spherical codes (OptSC); 3) random (RandomTRUNC). MATERIALS AND METHODS: Pre-acquired diffusion multi-shell data from 14 female healthy volunteers (29±5 years) were used to generate reordered data. For each strategy, subsets containing different amounts of the full dataset were generated. The subsampling effects were assessed on histogram-based DKI metrics from tract-based spatial statistics (TBSS) skeletonized maps. To evaluate each subsampling method on simulated data at different SNRs and the influence of subsampling on in vivo data, we used a 3-way and 2-way repeated measures ANOVA, respectively. RESULTS: Simulations showed that subsampling had different effects depending on DKI parameter, with fractional anisotropy the most stable (up to 5% error) and radial kurtosis the least stable (up to 26% error). RandomTRUNC performed the worst while the others showed comparable results. Furthermore, the impact of subsampling varied across distinct histogram characteristics, the peak value the least affected (OptEEM: up to 5% error; OptSC: up to 7% error) and peak height (OptEEM: up to 8% error; OptSC: up to 11% error) the most affected. CONCLUSION: The impact of truncation depends on specific histogram-based DKI metrics. The use of a strategy for optimizing the acquisition order is advisable to improve DKI robustness to exam interruptions.

NeuXus open-source tool for real-time artifact reduction in simultaneous EEG-fMRI.

The simultaneous acquisition of electroencephalography and functional magnetic resonance imaging (EEG-fMRI) allows the complementary study of the brain's electrophysiology and hemodynamics with high temporal and spatial resolution. One application with great potential is neurofeedback training of targeted brain activity, based on the real-time analysis of the EEG and/or fMRI signals. This depends on the ability to reduce in real time the severe artifacts affecting the EEG signal acquired with fMRI, mainly the gradient and pulse artifacts. A few methods have been proposed for this purpose, but they are either slow, hardware-dependent, publicly unavailable, or proprietary software. Here, we present a fully open-source and publicly available tool for real-time EEG artifact reduction in simultaneous EEG-fMRI recordings that is fast and applicable to any hardware. Our tool is integrated in the Python toolbox NeuXus for real-time EEG processing and adapts to a real-time scenario well-established artifact average subtraction methods combined with a long short-term memory network for R peak detection. We benchmarked NeuXus on three different datasets, in terms of artifact power reduction and background signal preservation in resting state, alpha-band power reactivity to eyes closure, and event-related desynchronization during motor imagery. We showed that NeuXus performed at least as well as the only available real-time tool for conventional hardware setups (BrainVision's RecView) and a well-established offline tool (EEGLAB's FMRIB plugin). We also demonstrated NeuXus' real-time ability by reporting execution times under 250 ms. In conclusion, we present and validate the first fully open-source and hardware-independent solution for real-time artifact reduction in simultaneous EEG-fMRI studies.

Impact of susceptibility-induced distortion correction on perfusion imaging by pCASL with a segmented 3D GRASE readout.

PURPOSE: The consensus for the clinical implementation of arterial spin labeling (ASL) perfusion imaging recommends a segmented 3D Gradient and Spin-Echo (GRASE) readout for optimal signal-to-noise-ratio (SNR). The correction of the associated susceptibility-induced geometric distortions has been shown to improve diagnostic precision, but its impact on ASL data has not been systematically assessed and it is not consistently part of pre-processing pipelines. Here, we investigate the effects of susceptibility-induced distortion correction on perfusion imaging by pseudo-continuous ASL (pCASL) with a segmented 3D GRASE readout. METHODS: Data acquired from 28 women using pCASL with 3D GRASE at 3T was analyzed using three pre-processing options: without distortion correction, with distortion correction, and with spatial smoothing (without distortion correction) matched to control for blurring effects induced by distortion correction. Maps of temporal SNR (tSNR) and relative perfusion were analyzed in eight regions-of-interest (ROIs) across the brain. RESULTS: Distortion correction significantly affected tSNR and relative perfusion across the brain. Increases in tSNR were like those produced by matched spatial smoothing in most ROIs, indicating that they were likely due to blurring effects. However, that was not the case in the frontal and temporal lobes, where we also found increased relative perfusion with distortion correction even compared with matched spatial smoothing. These effects were found in both controls and patients, with no interactions with the participant group. CONCLUSION: Correction of susceptibility-induced distortions significantly impacts ASL perfusion imaging using a segmented 3D GRASE readout, and this step should therefore be considered in ASL pre-processing pipelines. This is of special importance in clinical studies, reporting perfusion across ROIs defined on relatively undistorted images and when conducting group analyses requiring the alignment of images across different subjects.

Effectiveness of perioperative family-centered educational interventions in the anxiety, pain and behaviors of children/adolescents and their parents: Systematic Review Protocol / Eficacia de las intervenciones educativas perioperatorias familiares centradas en la ansiedad, el dolor y las conductas de las personas menores y adolescentes y de sus progenitores: protocolo de revisión sistemática

Introduction: Every year, millions of children and adolescents undergo surgery, 50%-75% of them experience fear and anxiety. Children are particularly susceptible to stress and anxiety surrounding surgery as a result of their cognitive development, previous experiences, and knowledge about healthcare; this leads to additional interventions to prevent and reduce these symptoms. Objective: To evaluate the effectiveness of family-centered educational interventions in the children's and adolescents' anxiety, pain, and behaviors and their parents' anxiety during the perioperative period. Methods: This review will follow the Joanna Briggs Institute guidelines for systematic reviews of effectiveness and will consider those studies (experimental and quasi-experimental) in which perioperative educational interventions have been applied to children and adolescents and their parents; these studies measured children and adolescents' pain, anxiety, and behaviors, as well as their parent's anxiety. An initial search of MEDLINE and CINAHL will be followed by a second search for published and unpublished studies from January 2007 on, available in English, Spanish and Portuguese. After all full texts are retrieved, the methodological quality assessment and data extraction will be independently and critically evaluated by two reviewers, and the data will then be presented in a tabular format. An explanatory synthesis will accompany the results. Whenever possible, a meta-analysis will be performed, and a Grading of Recommendations, Assessment, Development, and Evaluation Summary of Findings will be presented. Expected Results: This review will provide guidance on how family-centred educational interventions can be used as a resource to manage anxiety, pain, and behavior in children, adolescents and their relatives during the perioperative processes.

Introducción: Cada año, millones de personas menores y adolescentes se someten a cirugía, de las cuales entre el 50-75 % experimenta miedo y ansiedad. Las niñas y los niños son particularmente susceptibles al estrés y la ansiedad que rodea a la cirugía, como resultado de su desarrollo cognitivo, experiencias previas y conocimiento de la salud, lo que requiere intervenciones para prevenir y reducir estos síntomas. Objetivo: Esta revisión tiene como objetivo evaluar la efectividad de las intervenciones educativas familiares centradas en la ansiedad, el dolor y los comportamientos de las personas menores y adolescentes y de sus progenitores en el período perioperatorio. Métodos: Esta revisión seguirá las pautas del Instituto Joanna Briggs para revisiones sistemáticas de efectividad y considerará estudios experimentales y cuasiexperimentales en los que las intervenciones educativas perioperatorias para medir el dolor, la ansiedad y los comportamientos en niñas, niños y adolescentes y la ansiedad de sus progenitores. Se ha realizado una búsqueda inicial limitada de MEDLINE y CINAHL. Además, una segunda búsqueda de estudios publicados y no publicados de enero de 2007 disponibles en inglés, español y portugués. Una vez recuperados los textos completos, dos revisores evaluarán críticamente, de forma independiente, la calidad metodológica y la extracción de datos y se presentarán en forma de tabla. Una síntesis narrativa acompañará a los resultados y, si es posible, se realizará un metanálisis y se presentará un Grading of Recommendations, Assessment, Development and Evaluation. Resultados esperados: Esta revisión brindará orientación sobre cómo las intervenciones educativas centradas en la familia pueden usarse como un recurso para controlar la ansiedad, el dolor y el comportamiento en niñas, niños, adolescentes y sus familias en el contexto perioperatorio.

Introdução: Todos os anos, milhões de crianças e adolescentes são submetidos a cirurgias e 50-75% apresentam medo e ansiedade. Crianças/adolescentes são particularmente suscetíveis ao stress e ansiedade em torno da cirurgia devido ao seu desenvolvimento cognitivo, experiências anteriores e conhecimento que possuem sobre os cuidados de saúde, necessitando de intervenções para a prevenção/redução destes sintomas. Objetivo: Avaliar a eficácia de intervenções educacionais centradas na família na ansiedade, dor e comportamentos de crianças/adolescentes e ansiedade dos pais no período perioperatório. Métodos: Esta revisão seguirá a metodologia do Instituto Joanna Briggs para revisões sistemáticas de eficácia e considerará estudos (experimentais e quase-experimentais) em que as intervenções educacionais perioperatórias tenham sido aplicadas a crianças/ adolescentes e seus pais e avaliadas a dor, ansiedade e comportamento em crianças/adolescentes e ansiedade dos pais como resultados. Uma pesquisa inicial limitada de MEDLINE e CINAHL foi realizada. Será seguida por uma segunda busca por estudos publicados e não publicados de janeiro de 2007 disponíveis em inglês, espanhol e português. Após a recuperação dos textos completos, a avaliação da qualidade metodológica e a extração de dados serão avaliadas de forma crítica e independente por dois revisores e apresentadas em forma de tabela. Uma síntese narrativa acompanhará os resultados e, se possível, uma meta-análise será realizada e um resumo das Grading of Recommendations, Assessment, Development and Evaluation apresentado. Resultados esperados: Esta revisão fornecerá orientações sobre como as intervenções educativas centradas na família podem ser utilizadas como um recurso para gestão da ansiedade, dor e comportamento em crianças, adolescentes e suas famílias no contexto perioperatório.

Intervenções educativas para crianças, adolescentes e pais no período perioperatório: Revisão sistemática da literatura / Educational interventions for children, adolescents and parents in the perioperative period: A systematic review

Introdução: A cirurgia pediátrica é um evento potencialmente stressante e traumático para a criança e sua família. As intervenções educativas, através de uma abordagem centrada na família, podem servir de recurso aos enfermeiros na gestão da ansiedade perioperatória, dor e ajudar a melhorar as atitudes e comportamentos de pais, crianças e adolescentes submetidos a cirurgia. Objetivo: Avaliar a efetividade das intervenções educativas na dor, ansiedade e comportamentos de crianças/adolescentes (3-19 anos) e na ansiedade dos seus pais, no período perioperatório. Métodos: O estudo seguiu a metodologia do Instituto Joanna Briggs para revisões sistemáticas de efetividade. O protocolo foi elaborado e registado na PROSPERO. Consideraram-se estudos em que foram realizadas intervenções educativas a crianças e adolescentes dos três aos 19 anos, submetidos a cirurgia eletiva, e aos seus pais e cujos resultados se focassem na dor, ansiedade e comportamentos em crianças e adolescentes e ansiedade nos pais. Foram incluídos estudos, publicados e não publicados, entre janeiro de 2007 e abril de 2021, disponíveis em inglês, espanhol e português, pesquisados nas bases de dados MEDLINE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials e SciELO; para estudos não publicados OpenGrey, Open Access Theses and Dissertations e RCAAP ­ Portugal. Os estudos foram avaliados de forma independente por dois revisores. Resultados: Foram incluídos 28 estudos (dois quasi-experimentais e 26 estudos randomizados controlados) de um total de 4500 registos identificados. As intervenções educativas centradas na família incidiram em explicações sobre os cuidados perioperatórios, estratégias para facilitar o contacto da criança com o ambiente cirúrgico e fornecer aos pais informação sobre equipamentos e procedimentos, e utilizaram DVDs, vídeos, jogos, panfletos, livros, visitas guiadas e o brincar terapêutico. Os dados da meta-análise revelaram que as crianças e adolescentes beneficiam das intervenções educativas na gestão da ansiedade perioperatória (SMDpré-operatória=−1,02; SE=0,36; 95% CI [−1,73;−0,32]), demonstraram melhor compliance durante a indução anestésica (SMD=−1,40; SE=0,67; 95% CI [−2,72;−0,09]) e níveis de dor pós-operatória mais reduzidos (SMD=−0,43; SE=0,33; 95% CI [−1,05;−0,19]). Não foi encontrada evidência relativamente à efetividade das intervenções educativas nos comportamentos negativos pós-operatórios, como distúrbios do sono, da alimentação ou emocionais (SMD=0,12; SE=0,15; 95% CI [−0,84; 1,09]). As intervenções educativas também foram efetivas na redução da ansiedade pré-operatória dos pais (SMD=−0,94; SE=1,00; 95% CI [−2,87;−0,99]). Conclusões: As intervenções educativas centradas na família devem ser consideradas na gestão da ansiedade e dor das crianças e adolescentes e na ansiedade dos pais durante o período perioperatório.

Introduction: Paediatric surgery is a potentially stressful and traumatic event for the child and family. Through a family-centred approach, educational interventions can serve as a resource for nurses in the management of perioperative anxiety, pain, and behaviours of parents, children and adolescents undergoing surgery. Objective: Evaluate the effectiveness of family-centred educational interventions in the anxiety, pain and behaviours of children/adolescents (3-19 years old) and their parents' anxiety in the perioperative period. Methods: This review followed the Joanna Briggs Institute methodology for systematic reviews of effectiveness. The protocol was developed and registered in PROSPERO. This review considered studies in which the educational interventions were carried out to children and adolescents between three and 19 years who underwent elective surgery, and their parents, and whose results focused on pain, anxiety and behaviours in children/adolescents and anxiety in parents. The databases MEDLINE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, and SciELO and Sources of unpublished studies OpenGrey, Open Access Theses and Dissertations, and RCAAP ­ Portugal were searched systematically to find both published and unpublished studies from January 2007 to April 2021 available in English, Spanish and Portuguese. Two reviewers independently assessed the studies. Results: Twenty-eight studies (two quasi-experimental studies and 26 randomized controlled trials) were included from a total of 4500 records identified. Family-centred educational interventions focused on explanations about perioperative care, strategies to facilitate children's adaptation to the operating room, and provide parents with knowledge about equipment and procedures; DVDs, videos, games, booklets, leaflets, face-to-face teaching, tour visits and therapeutic play were used among the studies. Data from metaanalysis revealed that children and adolescents benefited from educational interventions in managing perioperative anxiety (SMDpreoperative=−1.02; SE=0.36; 95% CI [−1.73;−0.32]), demonstrating better compliance at induction of anaesthesia (SMD=−1.40; SE=0.67; 95% CI [−2.72;−0.09]) and reduced pain intensity postoperatively (SMD=−0.43; SE=0.33; 95% CI [−1.05;−0.19]). No evidence was found regarding the effectiveness of educational interventions on postoperative maladaptive behaviours, such as sleep disturbances, eating or emotional disorders (SMD=0.12; SE=0.15; 95% CI [−0.84; 1.09]). Educational interventions were also effective in reducing parental preoperative anxiety (SMD=−0.94; SE=1.00; 95% CI [−2.87;−0.99]). Conclusions: Family-centred educational interventions must be considered in the management of anxiety and pain of children and adolescents and parental anxiety in the perioperative period.

The Influence of an Alpha Band Neurofeedback Training in Heart Rate Variability in Athletes.

Neurofeedback training is a technique which has seen a widespread use in clinical applications, but has only given its first steps in the sport environment. Therefore, there is still little information about the effects that this technique might have on parameters, which are relevant for athletes' health and performance, such as heart rate variability, which has been linked to physiological recovery. In the sport domain, no studies have tried to understand the effects of neurofeedback training on heart rate variability, even though some studies have compared the effects of doing neurofeedback or heart rate biofeedback training on performance. The main goal of the present study was to understand if alpha-band neurofeedback training could lead to increases in heart rate variability. 30 male student-athletes, divided into two groups, (21.2 ± 2.62 year 2/week protocol and 22.6 ± 1.1 year 3/week protocol) participated in the study, of which three subjects were excluded. Both groups performed a pre-test, a trial session and 12 neurofeedback sessions, which consisted of 25 trials of 60 s of a neurofeedback task, with 5 s rest in-between trials. The total neurofeedback session time for each subject was 300 min in both groups. Throughout the experiment, electroencephalography and heart rate variability signals were recorded. Only the three sessions/week group revealed significant improvements in mean heart rate variability at the end of the 12 neurofeedback sessions (p = 0.05); however, significant interaction was not found when compared with both groups. It is possible to conclude that neurofeedback training of individual alpha band may induce changes in heart rate variability in physically active athletes.

An Exploratory Study of Training Intensity in EEG Neurofeedback.

Neurofeedback training has shown benefits in clinical treatment and behavioral performance enhancement. Despite the wide range of applications, no consensus has been reached about the optimal training schedule. In this work, an EEG neurofeedback practical experiment was conducted aimed at investigating the effects of training intensity on the enhancement of the amplitude in the individual upper alpha band. We designed INTENSIVE and SPARSE training modalities, which differed regarding three essential aspects of training intensity: the number of sessions, the duration of a session, and the interval between sessions. Nine participants in the INTENSIVE group completed 4 sessions with 37.5 minutes each during consecutive days, while nine participants in the SPARSE group performed 6 sessions of 25 minutes spread over approximately 3 weeks. As a result, regarding the short-term effects, the upper alpha band amplitude change within sessions did not significantly differ between the two groups. Nonetheless, only the INTENSIVE group showed a significant increase in the upper alpha band amplitude. However, for the sustained effects across sessions, none of the groups showed significant changes in the upper alpha band amplitude across the whole course of training. The findings suggest that the progression within session is favored by the intensive design. Therefore, based on these findings, it is proposed that training intensity influences EEG self-regulation within sessions. Further investigations are needed to isolate different aspects of training intensity and effectively confirm if one modality globally outperforms the other.

Characterisation of Benzodiazepine Use in an Older Population Registered in Family Health Units in the Region of Minho, Portugal.

Benzodiazepines are the most frequently consumed psychotropic drugs among older persons. This pharmacological class has been advised against in this group, due to the various risks associated with its use in an older population. This study seeks to determine the prevalence of benzodiazepine use in a non-institutionalized older population over the age of 75 that is registered in Family Health Units (USF) in the region of Minho, Portugal, as well as to characterize these patients and understand the link between benzodiazepine use and chronic medication use, risk of falls, and level of physical and functional dependence. The data extracted from the clinical records registered in the SAM® were analyzed using the Statistical Package for the Social Sciences (SPSS). A sample of 700 patients was obtained. These patients presented a mean age of 82.3 years, 62.7% were female, 95.3% were physically independent, and 38.0% were functionally independent. Almost half of the elder persons presented a moderate (36.9%) or high (11.4%) risk of falls. 37.9% of the patients were chronic benzodiazepines users, using between 1 and 3 active substances belonging to this pharmacological class, with a higher rate of use among women (p < 0.001) and elder persons. There was a statistically significant association among the use of benzodiazepines, a functional independence, and a higher risk of falls. These pioneering findings in Portugal reveal a high prevalence of benzodiazepine use in the population studied and warn about the specific characteristics of said population and the importance in reducing the risks associated with the inappropriate prescription of these drugs.

Comparison of Visual and Auditory Modalities for Upper-Alpha EEG-Neurofeedback.

Electroencephalography (EEG) neurofeedback (NF) training has been shown to produce long-lasting effects on the improvement of cognitive function as well as the normalization of aberrant brain activity in disease. However, the impact of the sensory modality used as the NF reinforcement signal on training effectiveness has not been systematically investigated. In this work, an EEG-based NF-training system was developed targeting the individual upper-alpha (UA) band and using either a visual or an auditory reinforcement signal, so as to compare the effects of the two sensory modalities. Sixteen healthy volunteers were randomly assigned to the Visual or Auditory group, where a radius-varying sphere or a volume-varying sound, respectively, reflected the relative amplitude of UA measured at EEG electrode Cz. Each participant underwent a total of four NF sessions, of approximately 40 min each, on consecutive days. Both groups showed significant increases in UA at Cz within sessions, and also across sessions. Effects subsequent to NF training were also found beyond the target frequency UA and scalp location Cz, namely in the lower-alpha and theta bands and in posterior brain regions, respectively. Only small differences were found on the EEG between the Visual and Auditory groups, suggesting that auditory reinforcement signals may be as effective as the more commonly used visual signals. The use of auditory NF may potentiate training protocols conducted under mobile conditions, which are now possible due to the increasing availability of wireless EEG systems.

Promotion of adjustment to the exercise of parental role in adolescente

Introduction: Parental exercise itself constitutes a very demanding challenge - however, when pregnancy occurs in adolescence, often unplanned, it converges tasks of different stages of development, irreversibly modifying an identity, roles and functions, not only of the young woman, but also of her family. Objectives: Applying the Dynamic Model of Family Assessment and Intervention (MDAIF), by Figueiredo (2012), and assessing the impact of nursing care in the pro-motion of skills for a transition to the parental role's exercise in the teenager and her family. Methods: Qualitative study, conducted based on MDAIF, as a theoretical and ope-rational reference, in clinical and community context in Primary Health Care, based on the process of family intervention who experienced an adolescent pregnancy. Seven nursing consultations to family were carried out, as a unit, from April to May 2016. Results and discussion: Extended family, with several subsystems and strict limits. Middle-class family. Although unplanned, and the antagonistic relationship with her parents, the instrumental and emotional support provided by them became critical in adapting to motherhood and the newborn's development. Conclusions: With MDAIF's use, nurses have developed their skills for a personalized approach to the family, centered on the adaptation and holistic transition to the parental process. It also made it possible to respond to the identified family needs, not only through the restructuring of a parental and personal identity, based on values, personal and professional goals and priorities (the teenager pursued her academic training), but also promoting a family environment based on trust and harmony

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A importância da resiliência e de um suporte social efetivo na vivência da gravidez e maternidade precoces / The importance of resilience and effective social support in the experience of early pregnancy and motherhood / La importancia de la resiliencia y de un soporte social efectivo en la vivencia del embarazo y maternidad precoces

INTRODUÇÃO: Estudo baseado no processo de intervenção de uma família que vivenciou uma gravidez e maternidade adolescente, não planeada, fruto de uma relação ocasional através de correspondência virtual. A resiliência constitui uma das variáveis descritas na literatura que parece conferir proteção para a adaptação à maternidade e que interfere no processo de vinculação. OBJETIVO: Avaliar a influência da resiliência e de um suporte social efetivo numa adolescente que tenha experienciado gravidez e/ou maternidade precoces. METODOLOGIA: Estudo de caso não experimental, qualitativo, de follow-up. Avaliação e intervenção familiar desenvolvida em 3 momentos distintos, tendo sido utilizados como instrumentos de recolha de dados: entrevista, questionários, escalas e observação, tendo como referencial teórico-operativo o Modelo Dinâmico de Avaliação e Intervenção Familiar (Figueiredo, 2013). RESULTADOS: Numa primeira fase: Relação conflituosa com os progenitores, prévia à gestação precoce. No final da mesma, a jovem interrompe o seu percurso escolar. Após o parto, verificou-se uma (in)definição do papel parental: a avó exercia um papel superprotetor sobre o recém-nascido, sobrepondo-se à mãe nas diversas esferas (prestação de cuidados, vinculação). Follow-up: Exercício do papel parental da adolescente adequado, sem sobreposição de papéis. Vinculação forte e saudável entre jovem mãe e filho. Recém-nascido bem cuidado. Adolescente resiliente e satisfeita com o apoio que recebe da comunidade envolvente. Retoma o seu percurso escolar, pessoal, familiar e social. CONCLUSÕES: Mães adolescentes que beneficiam de um apoio social e familiar adequado, e que possuem fatores protetores de ordem individual e relacional conseguem atingir um nível favorável de adaptação à maternidade.

BACKGROUND: Study based on the intervention process of a family that experienced an unplanned adolescent pregnancy and motherhood, as a result of an occasional relationship through virtual correspondence. Resilience is one of the variables described in the literature that seems to confer protection for adaptation to motherhood and that interferes in the bonding process. OBJECTIVE: Evaluating the influence of resilience and effective social support in an adolescent who has experienced early pregnancy and / or maternity. METHODS: Non-experimental, qualitative, follow-up case study. Evaluation and family intervention developed in 3 different moments, using as data-gathering instruments: interview, questionnaires, scales and observation, using as a theoretical-operational reference the Dynamic Model of Family Assessment and Intervention (Figueiredo, 2013). RESULTS: In a first phase: Conflict relationship with the parents, prior to the early gestation. At the end of it, the young woman interrupts her school journey. After parturition, there was an (in) definition of the parental role: the grandmother played an overprotective role over the newborn, overlapping the mother in the various spheres (care, bonding). Follow-up: Adequate adolescent parental role exercise, without overlapping roles. Strong and healthy bonding between young mother and son. Well-baby newborn. Teen resilient and satisfied with the support she receives from the surrounding community. It resumes its school, personal, familiar and social journey. CONCLUSIONS: Adolescent mothers who benefit from adequate social and family support and who have protective factors of an individual and relational nature manage to reach a favorable level of adaptation to motherhood.

INTRODUCCIÓN: Estudio basado en el proceso de intervención de una familia que vivió un embarazo y maternidad adolescente, no planeada, fruto de una relación ocasional a través de correspondencia virtual. La resiliencia constituye una de las variables descritas en la literatura que parece conferir protección para la adaptación a la maternidad y que interfiere en el proceso de vinculación. OBJETIVO: Evaluar la influencia de la resiliencia y de un soporte social efectivo en una adolescente que haya experimentado embarazo y / o maternidad precoces. METODOLOGIA: Estudio de caso no experimental, cualitativo, de seguimiento. La evaluación e intervención familiar desarrollada en 3 momentos distintos, habiendo sido utilizados como instrumentos de recogida de datos: entrevista, cuestionarios, escalas y observación, teniendo como referencial teórico-operativo el Modelo Dinámico de Evaluación e Intervención Familiar (Figueiredo, 2013). RESULTADOS: En una primera fase: Relación conflictiva con los progenitores, previa a la gestación precoz. Al final de la misma, la joven interrumpe su recorrido escolar. Después del parto, se verificó una (in) definición del papel parental: la abuela ejercía un papel superprotector sobre el recién nacido, superponiéndose a la madre en las diversas esferas (prestación de cuidados, vinculación). Seguimiento: Ejercicio del papel parental de la adolescente adecuado, sin superposición de papeles. Vinculación fuerte y saludable entre joven madre y hijo. Recién nacido bien cuidado. Adolescente resiliente y satisfecha con el apoyo que recibe de la comunidad circundante. Retoma su recorrido escolar, personal, familiar y social. CONCLUSIONES: Las madres adolescentes que se benefician de un apoyo social y familiar adecuado, y que poseen factores protectores de orden individual y relacional logran alcanzar un nivel favorable de adaptación a la maternidad.