Exploring behavioral sleep problems in children with ADHD and comorbid Autism Spectrum Disorder

OBJECTIVE: This study (a) compared behavioral sleep problems in children with comorbid ADHD and autism spectrum disorder (ASD) with those with ADHD and (b) examined child/family factors associated with sleep problems. METHOD: Cross-sectional study comparison of 392 children with a confirmed ADHD diagnosis (ADHD+ASD, n=93, ADHD, n=299) recruited from 21 peadiatric practises in Victoria, Australia. Data were collected from parents. Key measures included the Child Sleep Habits Questionnaire (CSHQ). RESULTS: Children with ADHD + ASD experienced similar levels and types of behavioral sleep problems compared with those with ADHD. In both groups, the presence of co-occurring internalizing and externalizing comorbidities was associated with sleep problems. Sleep problems were also associated with parent age in the ADHD + ASD group and poorer parent mental health in the ADHD group. CONCLUSION: Findings suggest comorbid ASD is not associated with increased behavioral sleep problems in children with ADHD and that co-occurring internalizing and externalizing comorbidities may flag children in these groups with sleep problems.

Community factors influencing child and adolescent depression: A systematic review and meta-analysis

OBJECTIVE: Depression has been identified as a priority disorder among children and adolescents. While numerous reviews have examined the individual and family factors that contribute to child and adolescent depressive symptoms, less is known about community-level risk and protective factors. The aim of this study was to complete a systematic review to identify community risk and protective factors for depression in school-aged children (4-18 years). METHOD: The review adopted the procedures recommended by the Cochrane Non-Randomised Studies Methods Working Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted to identify both observational and intervention study designs in both peer-reviewed and non-peer reviewed publications. RESULTS: A total of 21 studies met the inclusion criteria. Seventeen of the 18 community association studies and 2 of the 3 intervention studies reported one or more significant effects. Results indicated that community safety and community minority ethnicity and discrimination act as risk factors for depressive symptoms in school-aged children. Community disadvantage failed to achieve significance in meta-analytic results but findings suggest that the role of disadvantage may be influenced by other factors. Community connectedness was also not directly associated with depressive symptoms. CONCLUSION: There is evidence that a number of potentially modifiable community-level risk and protective factors influence child and adolescent depressive symptoms suggesting the importance of continuing research and intervention efforts at the community-level.

Parent and family factors associated with service use by young people with mental health problems: a systematic review

AIM: To conduct a systematic review of parent and family factors associated with service use for young people with mental health problems, to inform early intervention efforts aimed at increasing service use by young people. METHODS: A systematic search of academic databases was performed. Articles were included in the review if they had: a sample of young people aged between 5 and 18 years; service use as the outcome measure; one or more parental or family variables as a predictor; and a comparison group of non-service using young people with mental health problems. In order to focus on factors additional to need, the mental health symptoms of the young person also had to be controlled for. Stouffer's method of combining P-values was used to draw conclusions as to whether or not associations between variables were reliable. RESULTS: Twenty-eight articles were identified investigating 15 parental or family factors, 7 of which were found to be associated with service use for a young person with mental health needs: parental burden, parent problem perception, parent perception of need, parent psychopathology, single-parent household, change in family structure and being from the dominant ethnic group for the United States specifically. Factors not found to be related to service use were: family history of service use, parent-child relationship quality, family functioning, number of children, parent education level, parent employment status, household income and non-urban location of residence. CONCLUSIONS: A number of family-related factors were identified that can inform effective interventions aimed at early intervention for mental health problems. Areas requiring further research were also identified.

Avaliando questionários de risco e o comportamento do investidor sobre a ótica de behavioral finance

Tolerância ao risco é fundamental quando se tomam decisões financeiras. No entanto, a avaliação da tolerância ao risco tem se baseado ao longo dos anos em diferentes metodologias, tais como julgamentos heurísticos e a teoria da utilidade esperada que tem como base a hipótese dos mercados eficientes. Foi dentro desta ótica que este trabalho se desenvolveu. O objetivo é analisar três diferentes questionários de avaliação ao risco que são na prática amplamente utilizados por consultores financeiros. Foi assumido para isso que os investidores são considerados racionais, conhecem e ordenam de forma lógica suas preferências, buscam maximizar a "utilidade" de suas escolhas, e conseguem atribuir com precisão probabilidades aos eventos futuros, quando submetidos a escolhas que envolvam incertezas. No entanto, em uma análise preliminar dos questionários, estes poderiam estar utilizando conceitos de behavioral finance para avaliarem a tolerância ao risco, ao invés de utilizarem somente a metodologia tradicional da teoria da utilidade esperada. Dessa forma tornou-se necessário o estudo dos conceitos de behavioral finance. O primeiro capítulo então trata dos aspectos psicológicos do investidor, procurando entender como este se comporta e como este forma suas preferências. Apesar do estudo assumir racionalidade nas decisões, se a teoria de behavioral estiver correta e os investidores apresentarem desvios a racionalidade, como a teoria prospectiva afirma, o questionário poderia ser o veículo ideal para identificar tais desvios, sendo possível então educar e orientar o indivíduo em suas escolhas financeiras, afim de maximizá-las. O capitulo dois coloca a análise dos questionários inserida no contexto da teoria moderna de finanças, falando das escolhas de portfólio para investidores de longo prazo. O capítulo mostra de forma bem resumida e simplificada como o investidor maximiza a sua utilidade da riqueza. A idéia desse capítulo é entender como alguns julgamentos heurísticos assumidos na prática por consultores financeiros afetam as escolhas de portfólio e em quais condições esses julgamentos heurísticos são verdadeiros. Isso se torna importante pois os questionários mesclam medidas de risco com horizonte de investimentos do investidor. Estes questionários são utilizados para traçar uma política de investimentos completa para o investidor. Para cada perfil de risco encontrado a instituição traça um modelo de alocação de portfólio. O capítulo três trata da avaliação dos questionários em si tendo como base a teoria da utilidade esperada, os conceitos de behaviral finance e as lições tiradas das escolhas de portfólio para investidores de longo prazo.

Exploring attitudes and behavioral intention of brazilian consumers towards fair trade and fair trade products

As vendas globais de produtos FT cresceram de forma consistente nos últimos anos. De acordo com a FLO, as vendas cresceram de menos de € 1 bilhão em 2004 para cerca de € 5,5 bilhões em 2013. Apesar do movimento ainda estar engatinhando no Brasil, alguns esforços visando a institucionalização da FT estão sendo tomados. Por exemplo, o Schneider (2012) mostrou que existe um mercado potencial para os produtos FT no Brasil. Entretanto, ele ainda não é bem desenvolvido. Portanto, há uma necessidade de compreender melhor as variáveis que afetam a intenção de compra destes produtos. Estudos anteriores identificaram fatores que são considerados previsores de intenção de comprar produtos FT. Considerando esses fatores, o presente estudo tem como objetivo determinar as variáveis que estão mais relacionadas com a intenção de compra e disposição para pagar por produtos FT no Brasil. Com base nas respostas de 124 entrevistados, os resultados mostram que a intenção de compra de produtos FT no Brasil está ligada a atitudes de consumo éticas dos consumidores, o interesse e qualidade dos produtos, baixo ceticismo e percepção de relevância acerca do conceito FT. Os resultados também mostraram dois grupos antagônicos de consumidores a respeito de suas atitudes. O grupo dos "ativistas" tem atitudes positivas, de alta intenção de compra e disposição a pagar mais. Por outro lado, os "incrédulos" têm atitudes negativas, baixa intenção de compra e não estão dispostos a pagar mais. Com base nos resultados deste estudo, organizações e indivíduos que visam fomentar o mercado FT no Brasil podem entender melhor o consumidor e tomar decisões de marketing mais assertivas, considerando a relevância dos fatores que afetam a intenção de comprar, como também as diferenças entre os consumidores.

Evidências de validade do Millon Behavioral Medicine Diagnostic (MBMD) na avaliação psicológica de candidatos à cirurgia bariátrica

the Millon Behavioral Medicine Diagnostic is an instrument, developed from a consensus among health professionals, to identify psychological factors that may compromise the conducting of medical treatment in order to allow a better adhesion. As it has been one of the most used tools to assess bariatric surgery, the objective of this research is to verify the evidence validity of Millon Behavioral Medicine Diagnostic (MBMD) for psychological assessment of candidates for bariatric surgery. Method: males and females volunteers, aged 18 to 70, grouped in 150 patients admitted for surgical procedures or suffering from chronic diseases (control group) and 426 patients candidates for bariatric surgery, contacted in person or by the internet. For the study in the face group were also administered Millon Index of Personality Styles (MIPS), the Millon Clinical Multiaxial Inventory-III (MCMI-III) and the General Health Questionnaire of Goldberg, just in bariatric surgery patients. Results: there are indicators of semantic adaptation of the instrument, with 27 factors in five areas of the instrument, all with satisfactory levels of validity. The reliabitity indicators were satisfactory in 18 of the 32 scales that comprise the MBMD, while relations with the other three instruments showed significant variations compared to the original indicators. The MBMD was sensitive to differences between groups about gender, age, education, marital status, body mass index, comorbidities and chronic disease patients and with or without obesity. The use of this instrument in the assessment of candidates for bariatric surgery presents indicators of validity in view the limitations as to the realiability of certain scales

Walking for leisure among adults from three Brazilian cities and its association with perceived environment attributes and personal factors

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effects of diethylpropion treatment and withdrawal on aorta reactivity, endothelial factors and rat behavior

Diethylpropion (DEP) is an amphetamine-like compound used as a coadjutant in the treatment of obesity and which presents toxicological importance as a drug of abuse. This drug causes important behavioral and cardiovascular complications; however, the vascular and behavioral alterations during DEP treatment and withdrawal, have not been determined. We evaluated the effects of DEP treatment and withdrawal on the rat aorta reactivity to noradrenaline, focusing on the endothelium, and the rat behavior during DEP treatment and withdrawal. DEP treatment caused a hyporreactivity to noradrenaline in aorta, reversible after 2 days of withdrawal and abolished by both the endothelium removal and the presence of L-NAME, but not by the presence of indomethacin. Furthermore, DEP treatment increased the general activity of rats. Contrarily, DEP withdrawal caused a decrease in the locomotor activity and an increase in grooming behavior, on the 2nd and 7th days after the interruption of the treatment, respectively. DEP treatment also caused an adaptive vascular response to noradrenaline that seems to be dependent on the increase in the endothelial nitric oxide system activity, but independent of prostaglandins synthesis. The data evidenced chronological differences in the adaptive responses of the vascular and central nervous systems induced by DEP treatment. Finally, a reversion of the adaptive response to DEP was observed in the vascular system during withdrawal, whereas a neuroadaptive process was still present in the central nervous system post-DEP. These findings advance on the understanding of the vascular and behavioral pathophysiological processes involved in the therapeutic and abusive uses of DEP. (C) 2003 Elsevier B.V. (USA). All rights reserved.

Longitudinal study of the spectral composition of behavioral rhythms in the rat

Four. male Wistar rats were housed in pairs of siblings, on LD 12:12h and 22 degrees C + 2 degrees C. Food and water were provided ad libitum. Behavior was videotaped from the 1st to the 3rd month of life. In each age-bracket the spectral composition of rhythmic expressions of the following behavioral categories was analyzed: rest, eat, drink, cage exploration, self-grooming, and social interaction. Rats maintained a stable rank order of time engaged in different behaviors through development, despite modification of time spent in grooming, drinking and social interaction as they got older. Spectral composition of behaviors followed a general ontogenetic pattern: ultradian frequencies of 12-h and 8-h were the strongest in the 1st month and circadian periodicity was predominant in the 3rd month. The increase of circadian power compared with ultradian power components agrees with literature findings. To our knowledge, self-grooming and social interaction have not been investigated before in this context. The similarities between siblings suggest the mutual influence of partners and/ or the existence of genetic factors. Ongoing studies are examining the importance of the social surroundings in which animals develop to the acquisition of adult rhythmic pattern.

Behavioral evaluation during dental care in children ages 0 to 3 years

Purpose: Many studies concluded that the behavior of babies complicated dental care because of child immaturity or the difficulty of establishing acceptable communication and comprehension. Methods: The records of 696 babies were randomly selected from the baby clinic of Araçatuba in Brazil. Patient age ranged from 0 to 36 months. They were divided into 6 groups according to age: Group I-0 to 6 months; Group II-7 to 12 months; Group III-13 to 18 months; Group IV-19 to 24 months; Group V-25 to 30 months; Group VI-31 to 36 months. The behavior of the child was evaluated upon entrance in the dental office and during the first 4 clinical appointments with a clinical exam and oral physiotherapy. The baby was classified as collaborator (C) or noncollaborator (NC). Statistical analysis was performed using Pearson's chi-square method (P< .05). Results: The percentage of NC for Groups II, III, IV, and V (66%), was significantly higher than for groups I (30%) and VI (50%). Conclusions: Babies from 0 to 6 months showed a collaborative behavior; babies from 7 to 30 months showed noncollaborative behavior; and babies from 31 to 36 months showed no statistically significant difference between the percentage of C and NC.

Secretion of middle ear in infants - Occurrence, recurrence and related factors

Objective: The present study aimed at evaluating the occurrence and recurrence of middle ear effusion and possible associated factors in the first two years of life of 190 newborns and infants, participants in the interdisciplinary prevention, detection, and intervention program at the Clínica de Educação para Saúde of Universidade do Sagrado Coração, Methods: Newborns and infants were monthly submitted to anamneses, otoscopy, behavioral hearing assessment using sound instruments and pure tones (pediatric audiometry) and tympanometry. Results: The results revealed that 68.4% of infants presented one or more episodes of middle ear effusion during their two first years, with more recurrence among males. Peak occurrence was between four and 12 months of age and, the earlier the first episode, the higher the probability of recurrence. Greatest incidence was during May and August. It was found that, of the variables investigated, the period of exclusive breastfeeding actuated as a protector factor. With respect of risk factors, it was observed that passive smoking, gastro-esophageal reflux and respiratory allergy were related with the recurrences of effusion. Conclusion: Findings revealed the importance of periodic auditory follow-up for infants during their first two years of life, considered to be the critical period of auditory system maturation, during which sensory deprivation can be responsible for damage to the development of speech, language and other auditory abilities. Copyright © 2005 by Sociedade Brasileira de Pediatria.

Longitudinal behavioral analysis during dental care of children aged 0 to 3 years

Abstract: When and how the dentist intervenes have repercussions on children's physical and emotional patterns. The objective of the present study was to conduct a longitudinal behavioral analysis during dental care of babies aged 0 to 3 years. A total of 216 patients seen at the Baby Clinic of the School of Dentistry at Araçatuba, São Paulo State University (UNESP), were selected. The selection criterion was attendance at ten dental care sessions at bimonthly intervals for routine procedures such as clinical examination and oral hygiene. There was a predominance of cooperative behavior compared to uncooperative behavior when each visit was analyzed separately. The behavior of the patients must have been directly influenced by their psychomotor development. Constant attendance and exposure of the baby to non-stressful dental stimuli are factors that favor a cooperative behavior.

Prevalence of anogenital warts in Men with HIV/AIDS and associated factors

Infection with human papilloma virus (HPV) is the most common sexually transmitted disease in the world. Among the 630 million new cases of HPV that occur each year, 30 million develop anogenital warts. Although subclinical infection with HPV is the most common cause, genital warts are also associated with immunosuppression caused by HIV. In view of the high prevalence of HPV/HIV co-infection particularly among men who have sex with men, the objectives of this study were to determine the prevalence of anogenital warts in men with HIV/AIDS and to identify associated factors. A cross-sectional study was conducted on 159 men with HIV/AIDS consecutively selected at a referral service in Botucatu, São Paulo, Brazil, in which the association between sociodemographic, behavioral and clinical variables and the presence of anogenital warts was evaluated. After hierarchical analysis of the data, variables presenting a p value ≤ 0.2 were entered into an unconditional multivariate logistic regression model. Forty-nine (31%) of the HIV-positive patients had anogenital warts. The mean age was 44.6 ± 9.6 years. The main factors associated with the presence of anogenital warts were irregular antiretroviral treatment and genital herpes(HSV). The present study demonstrate that anogenital warts occur in almost one-third of the male population infected with HIV and factors associated with a higher risk of being diagnosed with anogenital warts were irregular cART use and co-infection with HSV, other variables could not be associated.

Teachers' sick leave due to mental and behavioral disorders and return to work

This manuscript presents a review of the literature about medical leaves due to mental and behavioral disorders and return to work of teachers. There are scarce published manuscripts. Most articles relate with prevalence of mental disorders and factors associated with the work organization, and did not mention intervention proposals and or changes in the work organization and teaching work. Proposed actions are discussed.