A relationship between overweight and excessive daytime sleepiness (EDS) has been suggested in the adult population, and to a limited extent in the pediatric population. Daytime sleepiness can interfere with various components of daytime function. In light of the increase in the rates of pediatric overweight and obesity, the aim of this study was to investigate the relationship between weight and EDS in a pediatric population. Using a retrospective approach, data collected in a pediatric sleep clinic was analyzed. Objective measures of EDS were correlated with age, gender, body mass index percentile, and overnight sleep test recording variables. In males and in all children under the age of 13 years old, EDS was more common in those weighing above the normal range, EDS was present particularly during mid-morning hours. Additionally, weight above the normal range correlated with evidence of EDS after adjusting for measures of sleep pathologies.

In 2009 and 2010 a split, split, split plot experiment with training system, VSP or Smart-Dyson Ballerina (main plot), N, 0 or 33.6 kg/ha (split), crop level, 14.0, 18.7, or 23.4 clusters/m/canopy (split), clone, Cabernet Franc 1,4, 8 and 214 treatments with five replications were established in Union County, Illinois on mature vines. The Smart-Dyson Ballerina training system produced a Ravaz index that was 89% and 28% bigger compared to the VSP respectively in 2009 and 2010. In 2009, the Smart-Dyson Ballerina produced a 80% bigger yield than VSP and in 2010 yield was also larger, but influenced by both training system and crop level. Maintaining a balanced vineyard can increase profit for the grower by up to $6,356.87/ha.

Made available in DSpace on 2015-12-06T23:47:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2007 / Objetivo: Avaliar de forma objetiva, a sonolência diurna em pacientes com fibromialgia por meio do Teste da Manutenção da Vigília. Método: Foi realizado um estudo casocontrole de 15 pacientes com diagnóstico de fibromialgia com pelo menos 11 de 18 pontos dolorosos e dor difusa nos últimos três meses. O grupo controle foi constituído de 15 indivíduos hígidos pareados por idade e sexo, selecionados sequencialmente. Os participantes responderam à Escala de Sonolência de Epworth e foram submetidos ao Teste da Manutenção da Vigília. Foram realizadas quatro captações, cada uma com duração mínima de 20 minutos com intervalo de 2 horas. Considerou-se como normal a latência para o início do sono maior do que 20 minutos, e patológica a latência menor que 11 minutos. Resultados: O grupo com fibromialgia apresentou significante redução da latência para o início do sono no Teste de Manutenção da vigília, comparado ao grupo controle 9,9±4,6 e 14,9±5,1, respectivamente, p=0,01, sendo que em 66,7% dos casos o resultado foi patológico, em comparação com 26,7% no grupo controle (p=0,03). Não se observou correlação entre o resultado do TMV e a idade dos pacientes. Conclusão: Pacientes com fibromialgia apresentam redução da latência do sono no Teste da Manutenção da Vigília. / Objective: To evaluate in an objective way, the degree of daytime sleepiness in patients with fibromyalgia through the maintenance of wakefulness test (MWT). Methods: Fifteen patients with fibromyalgia, and 15 age and sex-matched healthy controls, were sequentially selected. The inclusion criteria for fibromyalgia were the presence of at least 11 of the 18 tender points and diffuse pain for the three previous months all participants answered to Epworth Sleepiness Scale and underwent four 20- minute sessions of MWT scheduled at 2-hour intervals. Mean sleep latency higher than 20 minutes was considered normal and lower than 11 minutes, pathological. Results: Even though scores at Epworth Sleepiness Scale,in fibromyalgia patients was not significantly higher than in controls, fibromyalgia group showed a significant decrease in sleep latency by MWT (9.9±4.6 and 14.9±5.1, respectively, p=0.01). Pathological results were obtained in 66.7% of the patients, in comparison to 26.7% of controls (p=0.03). Conclusion: Lower sleep latencies obtained by MWT in patients with fibromyalgia suggested impaired wakefulness and excessive daytime sleepiness in this group. / BV UNIFESP: Teses e dissertações

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2016-12-02T13:27:25Z No. of bitstreams: 1 PDF - Millena Cavalcanti Ramalho.pdf: 2320962 bytes, checksum: c0f0fca4e92ed7858fe544a1449b2052 (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2016-12-06T19:14:22Z (GMT) No. of bitstreams: 1 PDF - Millena Cavalcanti Ramalho.pdf: 2320962 bytes, checksum: c0f0fca4e92ed7858fe544a1449b2052 (MD5) / Made available in DSpace on 2016-12-06T19:14:22Z (GMT). No. of bitstreams: 1 PDF - Millena Cavalcanti Ramalho.pdf: 2320962 bytes, checksum: c0f0fca4e92ed7858fe544a1449b2052 (MD5) Previous issue date: 2015-08-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / NTRODUCTION: adolescence is marked by important biological, psychological and social changes, and inadequate quantity or poor sleep has been associated with several problems, including increased risk of developing cardiovascular disease. OBJECTIVE: to investigate the relationship between sleep duration, sleep quality and the presence of excessive daytime sleepiness and cardiovascular risk according to score pathobiological Determinants of Atherosclerosis in Youth (PDAY) and its components in adolescent students. MATERIAL AND METHODS: cross-sectional study with a quantitative approach, performed in public schools in Campina Grande / PB, Brazil, from September/2012 to June/2013 with 563 students from 15 to 19 years, in which we assessed demographic data: age , sex, skin color, economic class and maternal education; Behavioral: smoking, physical activity and sedentary lifestyle; Clinical: weight, height, body mass index and blood pressure; Biochemical: glucose, glycated hemoglobin HbA1c, HDL cholesterol and non-HDL cholesterol; sleep variables: duration, sleep quality (Pittsburgh Sleep Quality Index) and excessive daytime sleepiness (Epworth Sleepiness Scale) and the relationship with the PDAY score and its components. Out performed the chi-square test and t-student to analyze the variables according to sex, and the Pearson correlation test to assess the relationship between sleep disorder indicators and PDAY score and its components sleep disorder indicators and physical activity and sedentary lifestyle. To evaluate the predictors of cardiovascular risk univariate linear regression was used, and independence test multivariate linear regression was performed. This study was conducted in accordance with Resolution 196/96. RESULTS: regarding sleep variables, this study showed that 20% of adolescents had excessive daytime sleepiness and an average of seven hours of sleep a day. The short duration was associated with male gender (p = 0.003), cardiovascular risk (p = 0.032) and inactivity (p = 0.007). The quality of sleep was associated with behavioral variable inactivity (p <0.001) and body mass index (p = 0.022). These teenagers have high cardiovascular risk (10%), being associated with male gender (p <0.001) as well as the highest average systolic blood pressure (p <0.001) and higher glycemic index (p <0.001). In the multivariate linear regression model, the duration of sleep was not an independent factor CONCLUSIONS: the prevalence of sleep disorders and high cardiovascular risk was high in in determining cardiovascular risk among adolescents studied. this population. Despite the sleep disorder not be an independent factor for cardiometabolic risk, this is a factor contributing to the increased cardiovascular risk assessed by PDAY score. This study provides relevant information and unpublished for this population, and demonstrates the importance of sleep as an important predisposing variable in relation to cardiovascular risk factors, especially because it is a modifiable factor that may interfere with behavioral conditions such as sedentary lifestyles and the index rise body weight, conditions associated with demonstrably higher cardiovascular risk score when evaluated using the PDAY. / INTRODUÇÃO: a adolescência psicológicas e sociais, e uma quantidade inadequada ou a má qualidade de sono têm sido associadas a diversos problemas, inclusive a elevação do risco de desenvolvimento de doenças cardiovasculares. OBJETIVO: verificar a relação entre a duração do sono, qualidade é marcada por importantes alterações biológicas, do sono e a presença da sonolência diurna excessiva com o risco cardiovascular de acordo com score Pathobiological Determinants of Atherosclerosis in Youth (PDAY) e seus componentes em adolescentes escolares. MATERIAL E MÉTODOS: estudo transversal, com abordagem quantitativa, realizado em escolas públicas de Campina Grande/PB, Brasil, de setembro/2012 a junho/2013, com 563 escolares, de 15 a 19 anos, no qual se avaliou dados sociodemográficos: idade, sexo, cor da pele, classe econômica e escolaridade materna; comportamentais: tabagismo, atividade física e sedentarismo; clínicos: peso, altura, índice de massa corporal e pressão arterial; bioquímicos: glicemia, hemoglobina glicada HbA1c, colesterol HDL e colesterol não-HDL; variáveis de sono: duração, qualidade do sono (Índice de Qualidade do Sono de Pittsburgh) e sonolência diurna excessiva (Escala de Sonolência de Epworth) e a relação com o score PDAY e seus componentes. Fora realizados os teste de qui- quadrado e t-student para análise das variáveis de acordo com o sexo, e o teste de correlação de Pearson para avaliação da relação entre os indicadores do distúrbio do sono e do escore PDAY, e de seus componentes com os indicadores de distúrbio do sono e com a atividade física e sedentarismo. Para avaliação dos fatores preditores do risco cardiovascular foi utilizada a regressão linear univariada, e para teste de independência foi realizada a regressão linear multivariada. Esse estudo foi desenvolvido em conformidade com a Resolução 196/96. RESULTADOS: quanto às variáveis de sono, esse estudo demonstrou que 20% dos adolescentes apresentaram sonolência diurna excessiva e uma média de sete horas de sono por dia. A curta duração esteve associada ao sexo masculino (p=0,003), ao risco cardiovascular (p=0,032) e ao sedentarismo (p=0,007). A qualidade do sono esteve associada à variável comportamental sedentarismo (p<0,001) e ao índice de massa corporal (p=0,022). Os adolescentes apresentaram risco cardiovascular elevado (10%), estando associado ao sexo masculino (p<0,001), assim como as maiores médias de pressão arterial sistólica (p<0,001) e maiores índices glicêmicos (p<0,001). No modelo de regressão linear multivariada, a duração do sono não se mostrou um fator independente na determinação do risco cardiovascular entre os adolescentes estudados. CONCLUSÕES: a prevalência dos distúrbios do sono e risco cardiovascular alto foi elevada na população estudada. Apesar do distúrbio do sono não ser um fator independente para o risco cardiometabólico, esse é um fator que contribuiu para o aumento do risco cardiovascular avaliado pelo escore PDAY. Esse estudo fornece informações relevantes e inéditas para essa população, e demonstra a importância do sono como variável predisponente importante na relação com fatores de risco cardiovasculares, especialmente por ser um fator modificável, que pode interferir nas condições comportamentais como o sedentarismo e na elevação do índice de massa corporal, condições comprovadamente associadas à elevação do risco cardiovascular quando avaliadas através do score PDAY.

A cólica infantil, caracterizada por choro excessivo e inconsolável do bebê, é um problema comum no período inicial da vida, causando angústia e preocupação às mães. Apesar de ser uma manifestação comum, sua causa ainda é desconhecida. Assim, é necessário propor intervenções ao assistir as mães desses bebês, considerando as necessidades e dificuldades desta clientela no sentido de auxiliá-la a enfrentar e superar este problema. Este estudo teve como objetivo compreender a experiência materna de ter um filho com cólica no período precoce da vida. Optou-se por uma abordagem qualitativa, a Teoria Fundamentada nos Dados e como referencial teórico para análise e interpretação dos dados, o Interacionismo Simbólico. O método de análise de conteúdo baseou-se em 12 discursos de mães que tinham ou tiveram filhos que sofreram de cólica no período inicial da vida e que freqüentavam o seguimento de puericultura e pediatria de um Centro de Saúde Escola, situado na zona oeste da cidade de São Paulo. Os dados foram obtidos por meio de entrevista e observação do contexto, cuja análise permitiu compreender a experiência materna do fenômeno CONVIVENDO COM UM FILHO COM CÓLICA e a categoria central revelou-se como APRENDENDO A LIDAR COM A CÓLICA DO FILHO. O modelo teórico mostra que ter um filho com cólica é uma vivência angustiante e independe de ser mãe de primeiro filho. A compreensão da experiência materna de conviver com um filho acometido de cólica aponta para a necessidade dos profissionais reverem as práticas implementadas no manejo da cólica infantil. O acompanhamento do binômio mãe-filho por meio de atendimento de seguimento no mínimo até o terceiro mês de vida do bebê, incluindo atendimentos domiciliares e a promoção de estratégias de apoio implementadas pelos serviços de saúde podem contribuir para o estabelecimento saudável do vínculo mãe-filho. / The infantile colic, which is characterized by excessive and disconsolate baby’s cry, is a common problem during the initial period of life. It causes the mothers\' distress and worry. Although it is a common manifestation, its cause is still unknown. Then, considering these babies’ mothers’ needs and difficulties, it is necessary to propose an intervention while assisting them, in order to help them to face and overcome the problem. The aim of this study was to understand the experience of the mothers who had a baby with colic during the early period of life. The Theory Based on the Data was the qualitative approach used and the Symbolic Interaction was used as the theoretical reference to analyze and interpret the data. The method used to analyze the content was based on 12 speeches given by mothers who have or had their babies with colic during the initial period of life. These mothers attended the puerile and pediatric segment of a School Health Center located in the west zone of São Paulo city. The data were collected by interviews and observation of the context. The data analysis allowed the understanding of the maternal experience and the phenomenon is LIVING WITH A CHILD WHO HAS COLIC and the central category is LEARNING TO DEAL WITH THE CHILD’S COLIC. The theoretical model shows that having a baby with colic is a distressful experience and it does not matter if it is the mother’s first child or not. The understanding of the mother’s experience who has a child with colic points out that the professionals need to check the practices used while dealing with a child who has colic. The process of following the binomial mother-son by giving them assistance at least until the baby’s third month of life, including homecare and the promotion of supporting strategies implemented by the health services and contributing to the healthy establishment of the mother-child bond.

Este trabalho apresenta uma investigação sobre o alcance da aplicação da teoria da onerosidade excessiva, prevista nos artigos 478 a 480 do Novo Código Civil, aos acordos de acionistas, tipo contratual cada vez mais presente na realidade empresarial brasileira. Especial atenção é dada ao fato de que o acordo de acionistas está inserido em um contexto marcado não só por um ambiente negocial e mercadológico sujeito a acontecimentos imprevisíveis que podem desequilibrar as prestações de forma excessivamente onerosa para uma das partes, mas também marcado por um equilíbrio na composição do conteúdo contratual e na alocação de riscos correspondente combinados pelas partes. Para isso, serão analisadas as questões relativas ao alcance da aplicação do mecanismo de reequilíbrio contratual mencionado em acordo de acionistas, à identificação do objeto do conteúdo contratual que contém o programa de alocação de risco e ao elemento-guia utilizado pela jurisprudência nesse sentido, uma vez que foi o uso desenfreado do reequilíbrio contratual que fez com que este fosse quase expulso da sistemática contratual durante o período clássico. A pesquisa apontou como elemento-guia autorizador da aplicação da onerosidade excessiva pelos órgãos judiciais estudados a conjunção da identificação dos critérios legais com a identificação do fato de a onerosidade excessiva estar além daquele risco implícito e da álea normal da natureza do negócio jurídico celebrado. Tais resultados apontam para uma criteriosa possibilidade de correção de desequilíbrio contratual compatível com a dinâmica e o ambiente dos acordos de acionistas / This work presents an investigation concerning the scope of application of the excessive onerous theory, provided in articles 478 to 480 of the Brazilian Civil Code, in the sharesholders agreement matter, a contractual type increasingly present in the Brazilian business reality. Special attention is given to the fact the sharesholders agreement is inserted in a context characterized not only by the negotial and market environment subject to unpredictable events that may disrupt the provision in an excessive onerous way to a relevant party, but also characterized by a balance in the composition of the content and of the contractual allocation of risks combined by the relevant parties. For this, we analyze the issues related to the scope of application of the mentioned contractual rebalancing mechanism in the shareholders agreement matter, to the identification of the contractual content object that contains the risk allocation program and to the guide-element used in the jurisprudence in this sense, since it was the umlimited use of contractual rebalancing that caused this was almost kicked out of the contractual systematically during the classical period. The survey pointed out as guide-element to the application of excessive onerous by the legal courts studied the association of the legal criteria identification with the identication of the fact that the excessive onerous being beyond that inherent and normal risk concluded of the nature of the legal business. These results point to the possibility of a careful correction of contractual imbalance compatible with the shareholders agreements dynamic and environment.

Etude 1 : La revue de littérature a identifié 16 articles. Plusieurs facteurs prédicteurs du jeu excessif ont été identifiés (le stress, les attributions internes, la dissociation, l’ennui, les émotions négatives, les croyances irrationnelles, l’anxiété et l’impulsivité). Enfin, la validité des outils utilisés pour mesurer le jeu excessif et les croyances irrationnelles dans cette population est remise en question. Etude 2 : Le Tilt serait lié à une perte de contrôle et des émotions négatives (colère, frustration), associées à des expériences dissociatives transitoires. Causé par des évènements tant internes qu’externes, le Tilt affecterait les processus comportementaux, émotionnels et cognitifs.Etude 3 : L’échelle OPTS mesure la fréquence des épisodes de Tilt au poker en ligne. Les items ont été créés à partir de la littérature et de 10 entretiens semi-directifs de joueurs de poker en ligne. L’échelle est composée de 2 facteurs appelés « Tilt émotionnel et comportemental » et « Tilt cognitif ». Etude 4 : Nos résultats indiquent que la fréquence des épisodes de Tilt est un prédicteur significatif de l’utilisation excessive du poker en ligne. La fréquence des épisodes de Tilt est quant à elle prédite par les croyances irrationnelles de type « incapacité à s’abstenir de jouer » et « interprétations favorables à la poursuite du jeu ». Le Tilt et les croyances irrationnelles sont donc fortement associés au jeu excessif au poker en ligne. / Study 1: A total of 16 relevant studies were identified. Several factors predicting excessive gambling were identified (stress, internal attribution, dissociation, boredom, negative emotions, irrational beliefs, anxiety and impulsivity). Finally the validity of the tools used to measure excessive or problematic gambling and irrational belief are not suitable for online poker. Study 2: The Tilt would be related to both loss of control and negative emotions (e.g. anger, frustration) and associated to dissociative experiences but transitive ones. The Tilt, as a result of intern and extern events, would impact behavioral, cognitive and emotional process. Study 3: The OPTS, a 17-item self-report questionnaire, measures the frequency of Tilt episodes associated with online poker. Items were created based on the literature and 10 semi-structured interviews conducted on 10 online poker players. The scale is composed of 2 factors, namely “emotional and behavioral Tilt” and “cognitive Tilt”. Study 4: Our findings evidenced that frequency of Tilt episodes is a significant predictor of excessive online poker gambling. As far as frequency of Tilt episode is concerned, irrational beliefs such as “incapacity of preventing to play” and “positive interpretation for paying” would be predictors. As a consequence, the Tilt and irrational beliefs are strongly associated with excessive online poker gambling.

Le Trouble Obsessionnel-Compulsif (TOC) ainsi que les symptômes sous-cliniques de ce trouble sont fréquemment rencontrés dans la population et entraînent de graves conséquences sur le bien-être psychologique et social des individus concernés. Plusieurs travaux s’inscrivant dans la deuxième vague de l’approche cognitive-comportementale révèlent des liens significatifs entre les symptômes du TOC et différents mécanismes cognitifs, dont l'intolérance à l'incertitude (II) (Norton, Sexton, Walker et Norton, 2005) et la responsabilité excessive (RE) (Arntz, Voncken et Goosen, 2007). Dans une optique transdiagnostique, des chercheurs de la troisième vague de l'approche cognitive-comportementale ont élaboré de nouveaux modèles incluant la pleine conscience (PC) pour expliquer le TOC (Hannan et Tolin, 2005). Toutefois, les études validant ces modèles n'incluent pas l'II et la RE et ce, malgré la force des liens constatés entre le TOC et ces variables. La présente étude a pour but de préciser la manière dont l’II, la RE et la PC sont interreliées dans l’explication des symptômes du TOC. Plus précisément, elle vise à tester un modèle dans lequel l’II influence les symptômes du TOC de manière directe ainsi que de manière indirecte par l’intermédiaire de la RE et de la PC. Afin de tester ce modèle, 400 étudiants âgés entre 18 et 65 ans et provenant de deux universités québécoises ont rempli, de manière volontaire, des questionnaires mesurant les différentes variables à l’étude. À partir de ces données, des analyses de corrélation de Pearson, des analyses de régression hiérarchique multiple ainsi que des analyses de médiation (méthode de rééchantillonnage « Bootstrap ») ont été conduites afin de tester les hypothèses formulées. Les résultats soutiennent que l’II exerce un effet direct sur les symptômes du TOC ainsi qu’un effet indirect par l’intermédiaire de la RE et de la PC. L'examen approfondi des effets indirects permet également de préciser les différentes médiations pour les symptômes spécifiques du TOC. Pour les symptômes de vérification, l’II exerce une influence indirecte par l’intermédiaire de la RE. Pour les symptômes d’obsession, elle exerce une influence indirecte par l’intermédiaire des dimensions attention et non-jugement de la PC. Pour les symptômes d’ordre et de symétrie, elle exerce une influence indirecte par l’intermédiaire de la dimension attention de la PC. Ces résultats confirment les hypothèses de l’étude et apportent des éléments préliminaires permettant de mieux comprendre les rôles respectifs de l’II, de la RE et des dimensions de la PC dans l’explication des symptômes du TOC. Notamment, ils suggèrent que l’II joue un rôle clé dans l’ensemble des symptômes du TOC à l’étude, alors que la PC joue un rôle plus spécifique pour les symptômes d’obsession et que la RE joue un rôle plus spécifique dans les symptômes de vérification. En dépit des limites de cette étude, certaines pistes d’intervention clinique émergent des conclusions de cette recherche. Ces conclusions suggèrent également des pistes de recherche à approfondir pour l’élaboration de modèles explicatifs intégrateurs entre la deuxième et la troisième vague de modèles cognitivo-comportementales.

Hälsa är viktigt för många människor och uppnås vanligen genom regelbunden träning och en bra kost. Men för vissa kan det gå över styr och istället för att uppnå en god psykisk och fysisk hälsa finns det dem som drabbas av ätstörningen ortorexi. Syftet med denna undersökningen var att se om det fanns någon skillnad mellan män och kvinnors risk att drabbas av ortorexi samt om olika relationsstatus och social umgängeskrets med olika högt hälso- och träningsrelaterande intresse och beteende kan öka risken att drabbas av ortorexi. Åttiotvå deltagare svarade på en enkät som bestod av Doninins ORTO-15 samt egenkonstruerade frågor. Resultatet visade att det inte fanns någon signifikant skillnad mellan könen gällande att visa tecken på ortorexi men att relationsstatus och att den sociala umgängeskretsen med högt hälso- och träningsrelaterande intresse och beteende hade en betydelse för risk att drabbas av ortorexi. Varför det inte fanns någon skillnad mellan könen kan tänkas bero på att träning och hälsa vänder sig till alla människor oavsett kön och därav påverkas både män och kvinnor lika mycket.

The objective of this research is to test human capital theory via the earnings announcements through the returns within the for-profit education and training services industry. This theory posits that enrollment levels would rise during recessionary periods and this should be reflected in better earnings announcements of the education firms. Data was retrieved from the Compustat, CRSP, Thompson IBES, Google Finance, and Yahoo! Finance databases spanning the recessionary years of 2008 through 2010. The first hypothesis utilized a price index weighted by the education firms' market capitalization and the Russell 3000 Index as a proxy for the market to assess the daily returns of the education industry relative to the market. The second and third hypotheses involved assessing the quality of the earnings announcements within the education industry on a Friday vs. non-Friday report basis. The fourth hypothesis explored the actual EPS vs. forecasted EPS in consecutive quarters to test for differences in the earnings of that are better-than and those that are the same-or-worse than expected. The final hypothesis utilized the cumulative abnormal returns and cumulative excessive returns methodologies to compare the performance of the periods before and after the announcements. No support for the first four hypotheses was found. Consistent with expectations established by other research using CAR and CER methodologies, the fifth hypothesis was supported. Support for human capital theory was not found because four hypotheses were unsupported. This study was limited to U.S. education firms that were publicly traded on major U.S. exchanges. No private for-profit or non-profit firms were included in this study. Knowledge was gained by exploring the earnings announcements of the education industry for evidence of human capital theory. The absence of support for the theory within the industry during a recession could be an indicator of other issues affecting the industry that need to be researched further before any conclusions can be reached. This study extends the research in earnings announcements by examining the relationship the education industry has with the market. It also contributes to the work in human capital theory by testing the education industry's performance during recessionary years.