The longitudinal effect of the quality of participation experiences in a voluntary organization on youth psychological empowerment.

Research shows its limitations by not capturing the specificities of individual experiences, which result either from the participation of or interaction among different people in a given context across time. This study explores the effect that the quality of youth participation experiences in a Portuguese voluntary organization can have on the development of their psychological empowerment (PE). This study adopted a longitudinal, quantitative design where the same cohort of 481 participants (62.4% female; Mage = 17.26 years) was followed across three time points. Latent growth curve modeling was performed to examine the effect of the quality of participation experiences (QPE) on the developmental trajectories of PE components. Findings show that the QPE had the most powerful effect on developmental trajectories in PE. The study shows how youth perceptions of opportunities for reflection and action in interaction in a climate of openness to dialogue and the emergence of different ways of thinking and doing affect their PE.

Primary adrenal insufficiency due to bilateral adrenal infarction in COVID-19: a case report.

CONTEXT: Coronavirus disease 2019 (COVID-19) is a proinflammatory and prothrombotic condition, but its impact on adrenal function has not been adequately evaluated. CASE REPORT: A 46-year-old woman presented with abdominal pain, hypotension, skin hyperpigmentation after COVID-19 infection. The patient had hyponatremia, serum cortisol <1.0 ug/dL, ACTH of 807 pg/mL and aldosterone <3 ng/dL. Computed tomography (CT) findings of adrenal enlargement with no parenchymal and minimal peripheral capsular enhancement after contrast were consistent with bilateral adrenal infarction. The patient had autoimmune hepatitis and positive antiphospholipid antibodies, but no previous thrombotic events. The patient was treated with intravenous hydrocortisone, followed by oral hydrocortisone and fludrocortisone. DISCUSSION: Among 115 articles, we identified nine articles, including case reports, of new-onset adrenal insufficiency and/or adrenal hemorrhage/infarction on CT in COVID-19. Adrenal insufficiency was hormonally diagnosed in five cases, but ACTH levels were measured in only three cases (high in one case and normal/low in other two cases). Bilateral adrenal non- or hemorrhagic infarction was identified in five reports (two had adrenal insufficiency, two had normal cortisol levels and one case had no data). Interestingly, the only case with well-characterized new-onset acute primary adrenal insufficiency after COVID-19 had a previous diagnosis of antiphospholipid syndrome. In our case, antiphospholipid syndrome diagnosis was established only after the adrenal infarction triggered by COVID-19. CONCLUSIONS: Our findings support the association between bilateral adrenal infarction and antiphospholipid syndrome triggered by COVID-19. Therefore, patients with positive antiphospholipid antibodies should be closely monitored for symptoms or signs of acute adrenal insufficiency during COVID-19.

Engagement in civic organisations in old age: Motivations for participation and retention.

Although the importance of older citizens' civic engagement has been highlighted in research and policy, the topic remains underexplored. In this study, we discuss older Portuguese citizens' motivations for civic engagement. The research is based on interviews with eighteen participants aged over 60, who are retired but active in civic organisations, in which they hold or have held leadership positions. We employed thematic analysis to examine the qualitative data. The findings suggest a range of motivations for participation, with personal and ideological/political motives emerging as relevant for involvement, retention and leaving, and interpersonal relationships motivating involvement and retention. However, the specific motivations differ as a function of not only the stages of involvement/retention/leaving, but also the type of organisation and the participants' life experiences. There are notable differences between the motivations for involvement in cultural and recreational organisations, neighbourhood organisations and volunteer programmes, where the emphasis is on fostering interpersonal relationships, and the more ideological/political motivations that appear as determinant within political and activist organisations. As such, this study brings a more complex understanding of the range of motivations for civic engagement in later life, with significant implications for fostering older citizens' mobilisation and sustained engagement.

University Social Responsibility, Service Learning, and Students' Personal, Professional, and Civic Education.

The long-standing vision of universities as the "alma mater" of students and graduates is a demonstration of its role as sustaining the person, the expert/professional, and the citizen. This role has persisted in the face of rising global challenges such as the emergence of new learning spaces, the growing diversity of publics, the call for productivity and performativity, and the hope for a significant engagement with the community and the public good. These sometimes conflicting tendencies have also stimulated higher education institutions to further pedagogical strategies that articulate in novel ways the classical elements of learning: action/experience and reflection/theory. In this context, service learning received a new impetus, particularly in the post-Bologna European Higher Education Area, as universities were looking for ways in which to articulate the social dimension of HEI and their "third mission" as institutions not only committed to addressing and solving societal problems, but also committed to fostering public-minded alumni through powerful experiences of engagement for both the students and the community. This paper is based on the experience of Erasmus+project ESSA, a service earning based project focused on University social responsibility (USR). ESSA engaged four groups of students from three European universities (Edinburgh, Porto, and Kaunas) in conducting a 1-week on-site USR audit based on an ecologic and situated concept of social responsibility. We will consider the perceived impact of ESSA on 44 students through a thematic analysis of focus group discussions and student self-assessment reports produced during and after their participation in the USR audit.

How do we live with chronic disease? A rights-based approach promoting the wellbeing of children with chronic disease.

This paper focuses on the life experiences of children with chronic disease, a group whose invisibility involves particular challenges in their relationship with professionals in important life contexts, such as family, school and hospital. The study includes two complementary phases: i) Phase 1, composed of 15 interviews with parents, education and health professionals and two focus group discussions with children, and children and their mothers; and ii) Phase 2, which included self-report questionnaires administered to parents (n = 152) and children with chronic disease (n = 176). Based on a mixed methodology, this study combines quantitative and qualitative methods assuming that plural approaches allow for a deeper understanding of the life conditions of children with chronic disease and their families. The results reinforce the reproduction of social stereotypes and the tendency to focus on the individual ability to solve problems, which still remain to be circumscribed to the people's chronic disease sphere. Moreover, this paper reveals the central role that inclusive contexts have on children's wellbeing.

How do we live with chronic disease? A rights-based approach promoting the wellbeing of children with chronic disease / Como é que vivemos com doenças crônicas? Uma abordagem baseada em direitos para promover o bem-estar de crianças com doenças crônicas

Abstract This paper focuses on the life experiences of children with chronic disease, a group whose invisibility involves particular challenges in their relationship with professionals in important life contexts, such as family, school and hospital. The study includes two complementary phases: i) Phase 1, composed of 15 interviews with parents, education and health professionals and two focus group discussions with children, and children and their mothers; and ii) Phase 2, which included self-report questionnaires administered to parents (n = 152) and children with chronic disease (n = 176). Based on a mixed methodology, this study combines quantitative and qualitative methods assuming that plural approaches allow for a deeper understanding of the life conditions of children with chronic disease and their families. The results reinforce the reproduction of social stereotypes and the tendency to focus on the individual ability to solve problems, which still remain to be circumscribed to the people's chronic disease sphere. Moreover, this paper reveals the central role that inclusive contexts have on children's wellbeing.

Resumo Este artigo foca-se nas experiências de vida de crianças com doenças crônica, cuja invisibilidade envolve desafios particulares no que respeita à sua relação com profissionais, em importantes contextos de vida, como sejam a família, a escola e o hospital. Este estudo inclui duas fases complementares: i) Fase 1, composta por 15 entrevistas com pais, profissionais de educação e de saúde, e dois grupos de discussão focalizada com crianças e com crianças e suas mães; e ii) Fase 2, a qual inclui questionários autoadministrados a pais (n = 152) e a crianças com doença crônica (n = 176). Baseado numa metodologia mista, este estudo combina métodos qualitativos e quantitativos, assumindo que abordagens plurais permitem um conhecimento mais aprofundado das condições de vida das crianças com doença crônica e suas famílias. Os resultados reforçam a reprodução de estereótipos sociais e a tendência para enfatizar a capacidade individual para resolver problemas, a qual parece estar ainda circunscrita à esfera das pessoas com doença crônica. Para além disso, este artigo revela o papel central que os contextos inclusivos têm no bem-estar das crianças.

Benign Presentation of a Potentially Fatal Disease.

Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital cardiovascular defect that can range from being fatal early in life to presenting in adulthood asymptomatically. We report the case of a teenager whose diagnosis was incidental and underwent surgery, consisting in coronary artery button transfer, with excellent result.

A origem anómala da artéria coronária esquerda a partir da artéria pulmonar é uma cardiopatia congénita que pode ser fatal precocemente ou apresentar-se na vida adulta de forma assintomática. Apresentamos o caso clínico de um adolescente cujo diagnóstico foi incidental e que foi submetido a cirurgia, com translocação da artéria coronária, com excelente resultado.

[Health and school: thoughts on the medicalization of education]. / Saúde e escola: reflexões em torno da medicalização da educação.

Children and youth reach school with different starting points. It is not known for sure how far these children and youth will go, and what path the school holds for them, particularly at a stage in which teachers are divided in multi-tasking (with some tasks that are merely administrative). Meanwhile, it is increasingly common to explain students' "inappropriate" behavior in biomedical terms. The increasing emergence of disorders and deficits calls for critical reflection on what they actually involve in public health terms. Thisarticle addresses the school's role in the educational achievement and comprehensive development of students flagged for or with clinical indication of medication based on "fuzzy" diagnoses. The concept of medicalization acquires a central position, and the article discusses its implications based on a set of field notes and interviews with parents and teachers in the North of Portugal.

Linking Learning Contexts: The Relationship between Students' Civic and Political Experiences and Their Self-Regulation in School.

This paper considers the relationship between self-regulation strategies and youth civic and political experiences, assuming that out-of-school learning can foster metacognition. The study is based on a sample of 732 Portuguese students from grades 8 and 11. Results show that the quality of civic and political participation experiences, together with academic self-efficacy, are significant predictors of young people's self-regulation, particularly regarding cognitive and metacognitive strategies (elaboration and critical thinking). Such effects surpass even the weight of family cultural and school variables, such as the sense of school belonging. Therefore, we argue that the pedagogical value of non-formal civic and political experiences is related to learning in formal pedagogical contexts. This is because civic and political participation with high developmental quality can stimulate higher-order cognitive engagement and, thus, contribute to the development of learning strategies that promote academic success.

[Congenital Heart Disease in Children with Down Syndrome: What Has Changed in the Last Three Decades?] / Cardiopatia Congénita em Crianças com Síndrome de Down: O que Mudou nas Últimas Três Décadas?

INTRODUCTION: The prevalence of Down syndrome has increased in the last 30 years; 55% of these children have congenital heart disease. MATERIAL AND METHODS: A retrospective longitudinal cohort study; clinical data from 1982 to 2013 databases with the diagnosis of Down syndrome or trisomy 21 in a reference hospital in pediatric cardiology and cardiac surgery. OBJECTIVE: to assess the progress in the last three decades of cardiological care given to children with Down syndrome and congenital heart disease. RESULTS: We studied 102 patients with Down syndrome and congenital heart disease subjected to invasive therapy: corrective or palliative cardiac surgery and therapeutic catheterization. The referral age was progressively earlier in patients referred in the first year of life. The most frequent diagnosis was complete atrioventricular sptal defect (41%). There was a trend towards increasingly early corrective surgery in patients under 12 months (p < 0.001). Since 2000, the large majority of patients were operated before reaching six months of age. The main cardiac complications were rhythm dysfunction and low output. More frequent noncardiac complications were pulmonary and infectious. The 30-day mortality rate was 3/102 cases (2.9%). Of patients in follow-up, 89% are in NYHA class I. DISCUSSION AND CONCLUSION: The early surgical correction seen over the past 15 years follows the approach suggested in the literature. The observed 30-day mortality rate is overlapping international results. Patients with Down syndrome subjected to corrective surgery of congenital heart disease have an excellent long-term functional capacity.

Introdução: A prevalência da síndrome de Down tem aumentado nos últimos 30 anos; 55% destas crianças apresentam cardiopatia congénita. Material e Métodos: Estudo retrospetivo longitudinal de coorte; dados clínicos obtidos em bases de dados de 1982 a 2013 com o diagnóstico de síndrome de Down ou trissomia 21 num hospital de referência em cardiologia pediátrica e cirurgia cardíaca. Objetivo: Avaliar a evolução, nas últimas três décadas, dos cuidados cardiológicos prestados às crianças com síndrome de Down ecardiopatia congénita.Resultados: Estudámos 102 doentes com síndrome de Down e cardiopatia congénita submetidos a terapêutica invasiva: cirurgiacardíaca corretiva, paliativa e cateterismo terapêutico. Em doentes referenciados no primeiro ano de vida, a referenciação foi cada vez mais precoce. O diagnóstico mais frequente foi o defeito completo do septo aurículo-ventricular (41%). Verificou-se uma tendência para cirurgia corretiva cada vez mais precoce em doentes abaixo dos 12 meses (p < 0,001). A partir de 2000, a grande maioria dos doentes foi operada antes dos seis meses de idade. As principais complicações cardíacas foram alterações de ritmo e baixo débito e as principais não cardíacas foram pulmonares e infeciosas. A taxa de mortalidade a 30 dias foi de 3/102 casos (2,9%). Dos doentes em follow-up, 89% estão em classe funcional I da NYHA. Discussão e Conclusão: A correção cirúrgica mais precoce verificada nos últimos 15 anos vai ao encontro do proposto na literatura. A taxa de mortalidade a 30 dias verificada é sobreponível aos resultados internacionais. Os doentes com síndrome de Down submetidos a cirurgia corretiva de cardiopatia congénita apresentam uma excelente capacidade funcional a longo prazo.

Saúde e escola: reflexões em torno da medicalização da educação / Health and school: thoughts on the medicalization of education / Salud y escuela: reflexiones en torno a la medicalización de la educación

Resumo: É sabido que à escola chegam crianças e jovens com diferentes pontos de partida. O que não se sabe ao certo é até onde chegam essas crianças e jovens, e que percurso a escola lhes reserva, particularmente numa altura em que os profissionais de educação se veem divididos entre inúmeras tarefas (algumas meramente administrativas) e parece cada vez mais comum atribuir-se ao comportamento "pouco adequado" dos alunos explicações de natureza tendencialmente biomédica. Face à emergência crescente de transtornos e déficits torna-se, assim, inevitável refletir criticamente acerca do que efetivamente acarretam em termos de saúde pública. Este artigo centra-se numa investigação acerca do papel da escola no sucesso educativo e no desenvolvimento integral dos alunos sinalizados ou com indicação médica para ingestão de medicação a partir de diagnósticos "nebulosos". O conceito de medicalização adquire uma dimensão central e as suas implicações são discutidas baseando-se num conjunto de notas de campo e entrevistas realizadas com pais e profissionais de educação da Zona Norte de Portugal.

Abstract: Children and youth reach school with different starting points. It is not known for sure how far these children and youth will go, and what path the school holds for them, particularly at a stage in which teachers are divided in multi-tasking (with some tasks that are merely administrative). Meanwhile, it is increasingly common to explain students' "inappropriate" behavior in biomedical terms. The increasing emergence of disorders and deficits calls for critical reflection on what they actually involve in public health terms. Thisarticle addresses the school's role in the educational achievement and comprehensive development of students flagged for or with clinical indication of medication based on "fuzzy" diagnoses. The concept of medicalization acquires a central position, and the article discusses its implications based on a set of field notes and interviews with parents and teachers in the North of Portugal.

Resumen: Es sabido que a la escuela llegan niños y jóvenes con diferentes puntos de partida. Lo que no se sabe con seguridad es hasta dónde llegan esos niños y jóvenes, y qué trayectoria les depara la escuela, particularmente, en el estadio en el que los profesionales de educación se ven divididos entre innumerables tareas (algunas meramente administrativas), y donde parece que es cada vez más común atribuirle al comportamiento "poco adecuado" de los alumnos explicaciones de naturaleza tendencialmente biomédica. Frente a la emergencia creciente de trastornos y déficits es, de este modo, inevitable reflexionar críticamente a cerca de lo que efectivamente suponen en términos de salud pública. Este artículo se centra en una investigación sobre el papel de la escuela en el éxito educativo, y en el desarrollo integral de los alumnos señalados o con indicación médica para la ingestión de medicación a partir de diagnósticos "nebulosos". El concepto de medicalización adquiere una dimensión central y sus implicaciones se discuten basándose en un conjunto de notas de campo y entrevistas realizadas con padres y profesionales de educación de la Zona Norte de Portugal.

[Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis]. / Cardiopatias Congénitas Complexas: Influência do Diagnóstico Pré-Natal.

INTRODUCTION: Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease. MATERIAL AND METHODS: Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012. RESULTS: There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%)were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality. DISCUSSION: Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease. CONCLUSION: prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease werenâÄôt diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease.

Introdução: As cardiopatias congénitas complexas são patologias graves, e o diagnóstico pré-natal poderá ter implicações sobre a morbilidade e a mortalidade. O objetivo deste trabalho foi estudar a influência do diagnóstico pré-natal e da distância do local de parto a um centro de referência, na morbilidade imediata e mortalidade precoce de um grupo de doentes com cardiopatias congénitas complexas.Material e Métodos: Análise retrospetiva dos doentes com cardiopatias congénitas complexas, seguidos no nosso hospital, nascidos entre 2007 e 2012.Resultados: Identificaram-se 126 doentes com cardiopatias congénitas complexas. Em 95% a gravidez foi vigiada desde o primeiro trimestre existindo diagnóstico pré-natal em 42%. Houve relação estatisticamente significativa entre o local do parto e a existência de diagnóstico pré-natal. A cardiopatia congénita complexa mais frequente foi a transposição das grandes artérias (45,2%), seguida da atresia da pulmonar com comunicação interventricular (17,5%) e ventrículo esquerdo hipoplásico (9,5%). Oitenta e dois doentes (65,1%) foram medicados com prostaglandinas e 38 (30,2%) foram ventilados antes de uma intervenção. A cirurgia ocorreu no período neonatal em 73%. A sobrevida atuarial aos 30 dias, 12 e 24 meses foi 85%, 80% e 75%, respetivamente. Não houve relação estatisticamente significativa entre diagnóstico pré-natal e mortalidade.Discussão: A maioria dos doentes com cardiopatias congénitas complexas não teve diagnóstico pré-natal. Nos casos com diagnóstico pré-natal houve referenciação e parto num centro terciário. Não houve associação estatisticamente significativa entre diagnóstico prénatal e mortalidade neonatal, como já descrito em séries heterogéneas de cardiopatia congénita complexa.Conclusão: A maioria dos doentes com cardiopatias congénitas complexas não teve diagnóstico pré-natal. Estes dados devem ser tomados em conta no planeamento do diagnóstico pré-natal das cardiopatias congénitas.

Participação cívica e política: jovens imigrantes brasileiros/as em Portugal / Participación cívica y política: la juventud inmigrante de Brasil en Portugal / Civic and political participation: young people of Brazilian origin in Portugal

Neste artigo analisamos visões, experiências e níveis de participação cívica e política de jovens imigrantes brasileiros/as em Portugal. Num primeiro momento, apresenta-se as visões dos/as jovens (5 grupos de discussão, N=29) sobre a participação, direitos políticos e principais fontes de influência. De seguida, com base nos resultados dos questionários (N=357) examina-se formas e níveis de participação cívica e política. Para além disso, analisa-se os níveis de interesse e atenção política e as perceções de eficácia da participação. Os resultados, discutidos à luz de uma perspetiva abrangente, integram os dados qualitativos com os indicadores quantitativos. Conclui-se que a participação de jovens brasileiros/as em Portugal é um fenômeno complexo, que inclui dimensões do interesse político, e que varia de acordo com um conjunto de fatores (idade, o gênero e o capital cultural).(AU)

En este artículo se analizan las visiones, experiencias y niveles de la participación cívica y política de la juventud inmigrante brasileña en Portugal. Inicialmente, se presentan los puntos de vista de jovens (cinco grupos de discusión, N = 29) sobre la participación, los derechos políticos y las principales fuentes de influencia. Luego, basándose en los resultados de los cuestionarios (N = 357) son reportados formas y niveles de participación cívica y política. Además, se analizan los niveles de atención política y interés, y las percepciones de eficacia de la psrticipación. Los resultados, que se analizan a la luz de una visión abrangente, integram los datos cualitativos con los indicadores cuantitativos. Llegamos a la conclusión de que la participación de los jóvenes brasileños en Portugal es un fenómeno complejo, que incluye dimensiones de interés político, y varía de acuerdo a una serie de factores (edad, sexo y el capital cultural).(AU)

In this paper we analyse views, levels and experiences of participation of young people of Brazilian origin living in Portugal. Using data collected through focus groups discussions (N=29) we present youth views and meanings about participation, knowledge about their political rights and main sources of influence. Additionally, using results from the survey (N= 357) we report types and levels of civic and political participation. In addition, we explore levels of political interest, political attentiveness and perceived effectiveness of participation. The results are discussed through a broad conception of civic and political participation and contrasting the results from the focus groups and the survey. Based on the results, we conclude that participation of young Brazilian is a complex issue that includes cognitive dimensions and varies according age, gender and cultural capital.(AU)

Participação cívica e política: jovens imigrantes brasileiros/as em Portugal / Participación cívica y política: la juventud inmigrante de Brasil en Portugal / Civic and political participation: young people of Brazilian origin in Portugal

Neste artigo analisamos visões, experiências e níveis de participação cívica e política de jovens imigrantes brasileiros/as em Portugal. Num primeiro momento, apresenta-se as visões dos/as jovens (5 grupos de discussão, N=29) sobre a participação, direitos políticos e principais fontes de influência. De seguida, com base nos resultados dos questionários (N=357) examina-se formas e níveis de participação cívica e política. Para além disso, analisa-se os níveis de interesse e atenção política e as perceções de eficácia da participação. Os resultados, discutidos à luz de uma perspetiva abrangente, integram os dados qualitativos com os indicadores quantitativos. Conclui-se que a participação de jovens brasileiros/as em Portugal é um fenômeno complexo, que inclui dimensões do interesse político, e que varia de acordo com um conjunto de fatores (idade, o gênero e o capital cultural)...

En este artículo se analizan las visiones, experiencias y niveles de la participación cívica y política de la juventud inmigrante brasileña en Portugal. Inicialmente, se presentan los puntos de vista de jovens (cinco grupos de discusión, N = 29) sobre la participación, los derechos políticos y las principales fuentes de influencia. Luego, basándose en los resultados de los cuestionarios (N = 357) son reportados formas y niveles de participación cívica y política. Además, se analizan los niveles de atención política y interés, y las percepciones de eficacia de la psrticipación. Los resultados, que se analizan a la luz de una visión abrangente, integram los datos cualitativos con los indicadores cuantitativos. Llegamos a la conclusión de que la participación de los jóvenes brasileños en Portugal es un fenómeno complejo, que incluye dimensiones de interés político, y varía de acuerdo a una serie de factores (edad, sexo y el capital cultural)...

In this paper we analyse views, levels and experiences of participation of young people of Brazilian origin living in Portugal. Using data collected through focus groups discussions (N=29) we present youth views and meanings about participation, knowledge about their political rights and main sources of influence. Additionally, using results from the survey (N= 357) we report types and levels of civic and political participation. In addition, we explore levels of political interest, political attentiveness and perceived effectiveness of participation. The results are discussed through a broad conception of civic and political participation and contrasting the results from the focus groups and the survey. Based on the results, we conclude that participation of young Brazilian is a complex issue that includes cognitive dimensions and varies according age, gender and cultural capital...

Community as locus for health formal and non-formal education: the significance of ecological and collaborative research for promoting health literacy.

The World Health Organization (2002) considers that a balance between government, community, and individual action is necessary for health education and promotion, recognizing that non-governmental organizations, local groups, and community institutions are central in this process. This argument reinforces the idea that individuals should be empowered and encouraged to make use of accurate health-related information. This paper highlights the potential of a socio-political perspective for the development of health literacy within children and adolescents and presents two studies conducted in two daily life contexts: a community organization and a school. Both studies are based on methodological pluralism and collaborative research approaches and explore the promotion of health knowledge in formal and informal settings. Study 1 is based on a mixed methodology, using focus group discussions and questionnaires with children and youth with chronic diseases to explore the perceived impact of their participation in support associations. Study 2 presents four intensive case-studies in schools where adolescents used community profiling, a participatory research methodology, to explore health rights and access to healthcare in both a historical and prospective vision. The results enable a deeper understanding on how powerful tool ccommunity resources can be for individual and collective empowerment on health issues.

Quality of life in disability: validation of Schalock's multi-dimensional model in the Portuguese context.

This paper aims to evaluate the validation of Schalock's quality of life multi-dimensional model (1996) in the Portuguese context. We also analyze the quality of life of disabled people by adding a political dimension (adapted from the Minorities' Rights Support Scale by Nata & Menezes, 2007) to this construct and seeking to understand the impact of discrimination. The sample is composed of 217 participants, most of whom have a physical disability, aged 16 to 81. Validation procedures of the Quality of Life Questionnaire (Schalock & Keith, 1993) and descriptive statistics and correlation analysis were conducted. Confirmatory Factor Analysis revealed good local and global fit indices, and the internal consistency of the scales was satisfactory. An adapted version of the instrument composed of five scales-satisfaction, competence, empowerment, equality of rights and positive discrimination-is proposed. The results reveal the importance of rights and empowerment for the quality of life of disabled people and indicate a strong critical consciousness concerning the experience of discrimination in different contexts. Taken together, the findings indicate the strong need for social and political changes in this domain.

Quality of life in disability: validation of schalock’s multi-dimensional model in the Portuguese context

This paper aims to evaluate the validation of Schalock’s quality of life multi-dimensional model (1996) in the Portuguese context. We also analyze the quality of life of disabled people by adding a political dimension (adapted from the Minorities’ Rights Support Scale by Nata & Menezes, 2007) to this construct and seeking to understand the impact of discrimination. The sample is composed of 217 participants, most of whom have a physical disability, aged 16 to 81. Validation procedures of the Quality of Life Questionnaire (Schalock & Keith, 1993) and descriptive statistics and correlation analysis were conducted. Confirmatory Factor Analysis revealed good local and global fit indices, and the internal consistency of the scales was satisfactory. An adapted version of the instrument composed of five scales-satisfaction, competence, empowerment, equality of rights and positive discrimination-is proposed. The results reveal the importance of rights and empowerment for the quality of life of disabled people and indicate a strong critical consciousness concerning the experience of discrimination in different contexts. Taken together, the findings indicate the strong need for social and political changes in this domain (AU)

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