IntroductionBurnout is characterized by emotional exhaustion, depersonalization and reduced personal accomplishment, resulting from the inability to cope with chronic job stress. The literature suggests that staffs working in adult oncology are at risk of burnout. At the same time, research found that pediatric staff experiences a different set of stressors when compared with colleagues working in adult oncology. However, no studies were identified which directly compared prevalence and sources of Burn-out on pediatric and adult oncology staff.ObjectivesTo compare the differences on prevalence and sources of burnout between pediatric and adult oncology multidisciplinary teams.MethodsPediatric and adult oncology professionals, including medical and nursing from a Portuguese oncology center completed the Portuguese version of the Copenhagen Burnout Inventory. Data was analyzed using SPSS.ResultsSince the study is currently ongoing the authors will only be able to provide final results and conclusions by the time of submission of our work presentation, in March 2016. However, according to the literature available, we are expecting to found symptoms of Burnout in the superior limit of normality, with differences in the major sources of stress between adult and pediatric professionals.ConclusionThe differences in the challenges experienced by adult and pediatric teams highlight the importance of adequate prevention strategies to specific needs of each unit. Further investigation of stress across a wider range of professional disciplines is required in order to explore this gap.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionBurnout is a condition characterized by emotional exhaustion, depersonalization and reduced personal accomplishment, resulting from the inability to cope with chronic job stress. Healthcare providers at pediatric oncology units, who care for children with life-threatening illnesses, are exposure to high levels of stress, which increases the risk for developing burnout, with consequences in their personal health and quality of patient care.ObjectiveTo assess the prevalence and sources of burnout on a multidisciplinary team of a pediatric oncology unit.MethodsParticipants were a convenience sample of 16 pediatric oncology professionals, including medical, nursing, and related health staff from a Portuguese pediatric oncology center. Participants completed the Portuguese version of the Copenhagen Burnout Inventory.ResultsAll three subscales that compose this Inventory were found to have burnout below normal levels (cut-off ≥ 50 points). However, personal and work-related subscales showed mean values in the superior limit of normality (48 ± 14, 18 points and 49, 48 ± 12, 23 points, respectively). Nevertheless, when analyzed the patient-related subscale, we found low levels of burnout in the majority of responders. These findings are similar to the existing literature, which suggests that patient care and interactions with children are the least stressful aspect of working in this specialty.ConclusionDespite the high levels of stress exposure in pediatric oncology units, results suggest that the majority of professionals are not actually in burnout. However, the obtained values advice for the need of prevention and workplace approaches to staff's well-being and stress reduction, in order to avoid burnout development.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Introduction:Hyperkeratosis is characterized by abnormal palmoplantar skin thickening. These lesions can extend to other organs and be associated with a multiplicity of pathologies.Objectives:This paper aims to describe the features of psychosocial maladjustment in a patient firstly diagnosed as having hyperkeratosis of unknown etiology.Methods:We describe a 14-year-old boy admitted to our outpatient clinic after verbalizing suicidal thoughts to his endocrinologist.Results:His medical condition had been evolving since he was six, when his palms and specially soles became grossly thickened and painful and he would be found awake at night clawing at his severely scaly and itchy lesions. He was seen by geneticists, dermatologists and plastic surgeons. However, the thickened patches continued to progress over the years, with almost no response to treatment. He was unable to keep up with his friends walking and had to give up on sports. Due to medication he has a reduced stature and low puberty development. On his first appointment he was reported to be unable to manage routine affairs or handle money matters and his scholastic performance was poor. During mental state examination one could assess restricted interests, social and communication defficits, tantrums, self and hetero aggressions and IQ below normal, despite an extraordinary visuo-spatial memory and no suicidal intent. He was medicated with risperidone and structural family therapy was applied, with good response.Conclusions:Helping individuals and families dealing with behavioural problems improves family dynamics and quality of life even in the presence of such incapacitating diseases.

Results: Biographic, psychopathology, social and family aspects were analyzed. The response time throughout the process, the origin and nature of the request's and the type of process which originated the request were also assessed. The authors identified the involved professionals and whether they needed to go to court. When there were questions, they evaluated the capacity to answer them, the forensic difficulties and solutions found, and the presence of recommendations. Discussion: The obtained results met the clinical experience and literature regarding demography and psychopathology. As for the difficulties, there were a number of aspects which could be improved by both parts, aiming to ameliorate the articulation between Health and Justice. Conclusion: With this study it was possible to reflect on the authors forensic practice, in order to develop a closer partnership with the courts to promote the real 'best interests' of children/adolescents and their families.

Introduction:Since about 30% of children and adolescents attending primary care and pediatric outpatient departments have psychiatric disorders that cause significant distress and social impairment, the proper functioning of National Health System assumes a determinant role on promoting early detection and intervening in the prevention of mental illnesses which can almost only be done through an efficient matching between primary care and hospital care.Objectives:This paper aims to characterize the pediatric population hospitalized sent by their general practitioners to our outpatient clinic, on a level III Pediatric Hospital, evaluating the existence of psychopathology.Methods:Retrospective analyses of 309 cases, at their first appointment on our outpatient clinic from June 2002 to March 2013. Self-reported and parent-reported symptoms of mental health problems and associated impairment were identified by the extended version of the strengths and difficulties questionnaire (SDQ) in children and adolescents.Results:During 10 years, 185 male (45,95% 4–10 years; 54,05% 11–17 years) and 124 female (50,0% on each age group) were evaluated. Eighty-four percent of cases, scored for’any psychiatric disorder’. Correlation between parent-reported and self-reported data was found, slightly higher for male gender. Pronounced divergences were found regarding child and adolescents’ perception and their parents, concerning everyday life difficulties and hyperactivity scores, that is also valid for age group and gender. Total scores: emotional symptoms (51,8%), conduct problems (58,3%), hyperactivity score (59,2%).Conclusions:We observed a positive impact of primary care medicine on referral network since the majority of the evaluated children and adolescents had psychopathology.