O consumo de álcool durante a gestação tem sido associado a alterações no desenvolvimento físico, neurológico e comportamental da criança, sendo que muitas das consequências sobre o desenvolvimento infantil apresentam ampla variação em extensão e gravidade. Os efeitos podem variar desde uma relativa normalidade até a morte perinatal e Síndrome Fetal do Álcool (SFA). No presente estudo foi avaliado o desenvolvimento cognitivo de crianças em idade escolar em relação ao padrão de consumo de álcool materno. Foram avaliadas oitenta e seis crianças de 8 a 9 anos de idade cujas mães (N = 449) haviam sido entrevistadas em 2001 durante o terceiro trimestre de gestação sobre o padrão de consumo de álcool e outras substâncias psicoativas, em um serviço obstétrico municipal da rede pública. Para avaliação cognitiva do grupo de crianças na idade escolar foi utilizada a Escala de Maturidade Mental Columbia (EMMC). O grupo constituído pelas mães ou cuidadores respondeu a um questionário sobre as condições sociodemográficas, saúde geral, e uso materno de álcool durante a gestação e recente. Foi realizada uma anamnese sobre o desenvolvimento neuropsicomotor e condições clínicas pregressas e atuais da criança. Foi utilizado o Child Behavior Checklist (CBCL 6-18 anos) para a identificação de problemas de saúde mental na infância. Resultados mostram que, em relação à avaliação cognitiva das crianças, o RPI (resultado padrão por idade) variou de 64 a 134, com valor médio de 99,95 (± 16,01) e mediana de 103. Associação estatisticamente significativa foi observada entre os escores de RPI acima de 99,95 e maior idade materna e maior peso ao nascimento (p = 0,01 e 0,05 respectivamente). Diferença significativa também foi observada em relação ao número de filhos. Crianças com famílias com três ou mais filhos apresentaram RPI médio de 106,4 versus RPI de 99,10 para aquelas com famílias com menos de três filhos (P=0.04). Separando a amostra por gênero, observamos escores médios menores na Escala de Maturidade Mental Columbia em meninos filhos de mães que declararam cor mulata ou negra (p = 0,02), que fizeram uso em dias de qualquer quantidade de álcool na gestação maior que a média (p = 0.01) e também naqueles em que as mães usaram três ou mais doses de álcool por ocasião durante a gestação acima da média (p < 0.0001). Não foram observadas diferenças significativas para as outras variáveis analisadas. Em relação aos problemas de comportamento quando avaliados pelo CBCL, diferenças significativas foram observadas em relação ao uso de álcool durante a gestação no 2º, 3º trimestres e uso nos três trimestres com dados do GESTA-ÁLCOOL (p = 0,05, p = 0,01 e p = 0,02 respectivamente) e no 1º trimestre da gestação (p = 0,05), uso de qualquer quantidade de álcool em dias acima da média (p = 0,01), uso de três ou mais doses por ocasião acima da média (p = 0,05) com dados do INFANTO-ÁLCOOL. Foram observadas também diferenças significativas em relação ao uso atual de tabaco (p = 0,006), religião (p = 0,03) e escores médios de RPI da Escala de Maturidade Mental Columbia (p = 0,002) e escores de RPI um desvio-padrão abaixo da média (p = 0,03). Não foram observadas diferenças de média para nenhuma das outras variáveis analisadas. O uso leve/moderado de álcool na gestação esteve associado ao menor desempenho cognitivo e problemas comportamentais totais, especialmente em meninos. Estudos controlados com um número maior de casos e a introdução de marcadores biológicos de exposição ao álcool na gestação são necessários, a fim de possibilitar uma detecção precoce dos efeitos adversos, uma melhor compreensão da gravidade e da extensão dos danos no desenvolvimento cognitivo e identificação de funções cognitivas específicas que possam ser mais afetadas pela exposição pré-natal ao álcool, propiciando uma intervenção precoce nos possíveis déficits encontrados. / Prenatal alcohol exposure has been associated to problems in physical, neurological and behavioral child development and many of the consequences on childhood development show a wide range in extension and severity. The effects can vary from relative normality to perinatal death and fetal alcohol syndrome (FAS). In this study we analyzed the cognitive development of children at school age regarding to the maternal alcohol consumption at pregnancy. We evaluated eighty six children from eight to nine years old whose mothers (N = 449) have been interviewed in 2001 during the third trimester of pregnancy about the alcohol and other psychoactives substances pattern consumption, in a public obstetric hospital. Children cognitive status was assessed using the Columbia Mental Maturity Scale (CMMS). The group composed by mothers or caretakers answered a questionnaire about socio-demographic data, general health, prenatal and recent alcohol use. A brief anamnesis on neuropsychomotor development and previous and recent clinical conditions was made. The Child Behavior Checklist (CBCL 6-18 years) was used to identify mental health disorders in childhood. Regarding to the children cognitive evaluation results showed that the ADS (age deviation scores) range from 64 to 134, with a mean value of 99.95 (± 16.01) e median of 103. Statistical significant association was found between RPI scores above 99.95 and older maternal age and birth weight (p = 0.01, p = 0.05 respectively). Analyzing the sample in relation to gender, we observed lower scores in Columbia Mental Maturity Scale in boys whose mothers declared color mulatto or black (p = 0.02), used in days any quantity of alcohol during pregnancy higher than average (p = 0.01) and also in those boys whose mothers used three or more doses of alcohol per occasion during pregnancy above average (p < 0.0001). No significant differences were observed for other variables analyzed. Significant differences were observed in relation to total behavior problems, when evaluated by CBCL, and alcohol use during gestation in 2nd, 3rd trimesters and use in all three trimesters with prospective data (p = 0.05, p = 0.01 and p = 0.02 respectively) and in 1º trimester of pregnancy (p = 0.05), use of any quantity of alcohol in days above average (p = 0.01), use of three or more doses per occasion above average (p = 0.05) with retrospective data. Significant differences were also observed in relation to recent tobacco use (p = 0.006), religion (p = 0.03), mean scores of RPI in Columbia Mental Maturity Scale (p = 0.002) and scores of RPI one standard deviation below the mean (p = 0.03). No differences were observed for other variables analyzed. Our findings suggest that, up to now, low/moderate alcohol use in gestation was associated to lower cognitive performance and total behavior problems, especially in boys. More controlled studies using a larger number of subjects and the introduction of biological markers of alcohol exposure in pregnancy are necessary in order to detect the adverse effects, to understand the extension of damages in cognitive development and to identify specific cognitive functions that could be more affected by prenatal alcohol exposure, contributing for development of early interventions.

INTRODUÇÃO: O abuso no consumo de drogas constitui um problema social e de saúde pública na maioria dos países, pelas consequências negativas que esse consumo provoca sobre o desenvolvimento emocional e físico das pessoas. O início do uso de substâncias tem-se apresentado na população de adolescentes cada vez mais cedo e, como consequência, uma avaliação para identificar comportamentos de risco é imprescindível para triagem e encaminhamentos adequados. Assim, o objetivo deste estudo foi revisar estudos e descrever três importantes instrumentos validados para o Brasil e utilizados para avaliação do abuso de álcool e outras drogas em adolescentes. MÉTODO: Estudo de revisão de literatura, realizado no período de janeiro de 1998 a agosto de 2010, em publicações nas bases de dados: Adolec, MedLine, Lilacs, PubMed e SciELO. Na seleção dos estudos, foram avaliados: artigos com aplicação dos instrumentos DUSI-R, Teen ASI e CBCL; o detalhamento do instrumento utilizado para diagnóstico; utilização de algum indicador de desempenho do instrumento; qualidade do estudo que permita avaliação do desempenho do instrumento, assim como a sua coerência com a literatura. RESULTADOS: Foram encontrados 767 artigos e, de acordo com os critérios de inclusão, foram avaliados 54, após as exclusões daqueles que não atenderam aos critérios. Os artigos com aplicação do instrumento DUSI-R foram 30, sendo 25 referentes a intervenções, prevalência e outros. Os estudos sobre validação do instrumento foram 5, com taxas de sensibilidade variando de 80 a 85% e especificidade variando de 70 a 90%. Outra medida foi a consistência interna com Alfa de Cronbach de 0,91 a 0,9451, apresentada em dois estudos. Já os artigos com aplicação do Teen ASI foram 12, sendo 8 estudos sobre intervenção, prevalência e outros. Para a validação do instrumento, foram encontrados 4 estudos, com taxa de confiabilidade em 2 estudos com r variando entre 0,69 e 0,90, um estudo com consistência interna com Alfa de Cronbach de 0,54 a 0,88 e outro estudo que avaliou a área sobre a curva de ROC = 0,88. Finalmente, os artigos com aplicação do CBCL foram 12, dos quais 8 foram sobre prevalência e fatores de risco. As medidas de desempenho do instrumento foram apresentadas em 4 estudos, sendo que dois mediram a taxa de sensibilidade do instrumento, variando de 80,4 a 87%. Ainda, um estudo apresentou consistência interna com Alfa de Cronbach entre 0,85 e 0,94 e outro estudou as propriedades psicométricas conforme dados da versão alemã do CBCL. CONCLUSÃO: Os resultados dos estudos apontam que os instrumentos pesquisados avaliam o abuso de álcool e outras drogas em adolescentes, possuindo boas propriedades psicométricas, porém de formas diferentes. O Teen ASI e o DUSI-R identificam e avaliam o uso de substâncias e outras áreas da vida. Por sua vez, o CBCL é voltado para avaliar a saúde mental do adolescente, não sendo específico para avaliar o abuso de álcool e outras drogas. Portanto, na escolha de instrumentos de avaliação, é importante considerar: organização do tempo, investimento na formação de profissionais e consolidação dos resultados que contribua efetivamente na melhora do tratamento / INTRODUCTION: The substance abuse is a major social problem in public health in most countries, due to the negative consequences of this behavior on the physical and emotional development of the people involved. The initiation phase of the substance abuse is beginning at earlier ages, and, as a consequence of that, an assessment to identify risk behaviors is very important for an acurate triage and subsequent steps. The objective of this study was to review studies and to describe 3 important instruments validated for Brazil and applied for the assessment of substance abuse in adolescents. METHOD: A literature review study, in the period from January of 1998 to August of 2010, in the databases of: Adolec, MedLine, Lilacs, PubMed and SciELO. In the selection of the studies the following criteria were evaluated: articles with application of the instruments DUSI-R, Teen ASI, and CBCL; the detailing of the instrument utilized for diagnostics; utilization of a performance indicator; quality of the study that enables the performance assessment of the instrument, and its coherence with the literature. RESULTS: 767 articles were found according to the inclusion criteria, and 54 of them were analysed, after the exclusions of the ones that did not meet the detailed criteria. 30 articles for the DUSI-R instrument were found, 25 of them related to interventions, prevalence and others. 5 studies were related to the validation of the instrument, with sensitivity rates varying from 80 to 85% and specificity variying from 70 to 90%. Another measure was the internal consistency with Cronbachs Alpha varying from 0.91 to 0.9451, presented in two studies. For the Teen ASI, 12 articles were found, and 8 of them were related to intervention, prevalence and others. For the validation of the instrument, 4 studies were found, with the reliability in 2 studies varying from r = 0.69 to 0.90, one study with internal consistency with Cronbachs Alpha varying from 0.54 to 0.88 and another study with the area under the ROC curve = 0.88. For the CBCL, 12 studies were found, and 8 of them were related to the prevalence and risk factors. The performance measures were presented in 4 studies, where 2 instruments measured the sensitivity rate varying from 80.4 to 87%. One study report the Cronbachs Alpha between 0.85 and 0.94, and another study studied the psicometric properties for the German version. CONCLUSION: The results of the studies suggest that the instruments included on the research evaluate the substance abuse in adolescents, with good psychometric properties, although in different ways. The Teen ASI and DUSI-R evaluate the substance abuse and other areas of life. The CBCL is useful to evaluate the mental health, and its not specific to conduct an assessment for substance abuse. So, when choosing assessment instruments, its important to consider: time management, investment in the education of the professionals; and consolidation of the results that contribute effectively to the improvement of the treatment

PCR und Fluoreszenz - DNA - Fragment - Analyse zum Nachweis einer monoklonalen B-Zell-Population zur Diagnostik der kutanen B-Zell Lymphome (CBCL) Der Nachweis einer monoklonalen B-Zell Population mittels PCR hat sich seit ca. zehn Jahren ergänzend zu Klinik und Histopathologie in der Diagnostik der kutanen B-Zell Lymphome etabliert. Zu diesem Zweck wurden Primer für die IgH Framework-Regionen (FR1, 2, 3), die Leader-Sequenz und für die JH-Region sequenziert. Alle Primervarianten führen zur Amplifikation der hochvariablen CDR-3 Region, welche für jede B-Zelle spezifisch ist. Die Kapillarelektrophorese mit fluoreszenzmarkierten PCR-Produkten an automatischen Sequenziergeräten (z. B. Genescan ABI Prism 310) ermöglicht eine exakte Größenbestimmung des jeweiligen Fragmentes und ist daher in diesem Zusammenhang die geeignetste Methode. Zunächst wurden alle relevanten Primer mit der Simulationssoftware Oligo hinsichtlich ihrer Bindungseigenschaften geprüft. Danach wurden ausgewählte Primer-Sets an 58 in Paraffin eingebetteten und an 5 Kryoproben von sicher diagnostizierten CBCL-Patienten getestet. Die fluoreszenzmarkierten Produkte wurden mit dem Sequenziergerät ABI Prism 310 analysiert. Die ungeschachtelte FR3/JH-PCR konnte nur in 30% und zusammen mit der halbgeschachtelten FR3/JH-PCR nur in 37% der Fälle klonale B-Zellen nachweisen. Die Detektionsrate erhöhte sich auf 54% unter Einbeziehung der geschachtelten FR1/JH-PCR und schließlich auf 60% mit einer zusätzlichen geschachtelten FR2/JH-PCR. Das Auftreten von Pseudoklonen (variierende Größe des klonalen Peaks bei Wiederholung der PCR) bei den geschachtelten PCR machte eine Prüfung auf Reproduzierbarkeit der Ergebnisse unbedingt erforderlich. Die höchste Rate an Pseudoklonen zeigte die FR2/JH-PCR. Aufgrund der schlechten Qualität der IgH Leader-PCR konnten mit in Paraffin-eingebetteten Proben keine Amplifikate erzeugt werden. Zusammenfassend ist zu sagen, daß gemeinsame Verwendung der in dieser Arbeit entwickelten PCR eine Sensitivitätssteigerung von 30% auf 60% ermöglichen. / Clonality detection in cutaneous B-cell lymphomas (CBCL) using immunoglobulin heavy chain gene PCR assays and fluorescence PCR-fragment analysis on automated DNA sequencer Detection of clonally expanded immunoglobulin heavy chain (Igh) gene rearrangements by PCR and subsequent electrophoresis is increasingly used in the diagnosis of cutaneous B-cell lymphomas (CBCL). To this end, primers for the three Igh framework regions (FR1,2, 3), the leader sequence and the Jh region are applied, all amplifying the highly variable IgH third complementary region (CDR3) Recently, fluorescence PCR-fragment analysis on automated DNA sequencers (GeneScan analysis, GSA), providing an exact sizing has been applied as appropriate seperation technique in this context. We have evaluated all Igh primers hitherto known by a PC primer analysis program. Then, fluorescently labeled products generated from DNAs of 58 paraffin embedded and 5 frozen lesional skin biopsies of confirmed CBCL cases using the primer sets selected, were analysed by GSA on the ABI 310 Prism instrument. Single round or seminested FR3/JH-PCR showed clonal B-cells only in 30 or 37% of cases, respectively. This fraction was increased to 54% including a nested FR1/JH-PCR, and, to 60% applying a supplementary nested FR2/JH-PCR. However false clonal results, indicated by peaks of varying sizes from repeated PCR, have been received by nested PCR, mostly by FR2/JH. Obviously due to their poor quality, the IgH leader-PCR has not yielded amplification products from paraffin-derived DNAs. Our data show that the FR3/JH-PCR only is not sufficient for detecting B-cell clonality in CBCL, but following inclusion of additional IgH-PCR, an increase of detection rate up to 60% is possible. A substantial number of cases still fail to show clonality.

INTRODUÇÃO: O abuso no consumo de drogas constitui um problema social e de saúde pública na maioria dos países, pelas consequências negativas que esse consumo provoca sobre o desenvolvimento emocional e físico das pessoas. O início do uso de substâncias tem-se apresentado na população de adolescentes cada vez mais cedo e, como consequência, uma avaliação para identificar comportamentos de risco é imprescindível para triagem e encaminhamentos adequados. Assim, o objetivo deste estudo foi revisar estudos e descrever três importantes instrumentos validados para o Brasil e utilizados para avaliação do abuso de álcool e outras drogas em adolescentes. MÉTODO: Estudo de revisão de literatura, realizado no período de janeiro de 1998 a agosto de 2010, em publicações nas bases de dados: Adolec, MedLine, Lilacs, PubMed e SciELO. Na seleção dos estudos, foram avaliados: artigos com aplicação dos instrumentos DUSI-R, Teen ASI e CBCL; o detalhamento do instrumento utilizado para diagnóstico; utilização de algum indicador de desempenho do instrumento; qualidade do estudo que permita avaliação do desempenho do instrumento, assim como a sua coerência com a literatura. RESULTADOS: Foram encontrados 767 artigos e, de acordo com os critérios de inclusão, foram avaliados 54, após as exclusões daqueles que não atenderam aos critérios. Os artigos com aplicação do instrumento DUSI-R foram 30, sendo 25 referentes a intervenções, prevalência e outros. Os estudos sobre validação do instrumento foram 5, com taxas de sensibilidade variando de 80 a 85% e especificidade variando de 70 a 90%. Outra medida foi a consistência interna com Alfa de Cronbach de 0,91 a 0,9451, apresentada em dois estudos. Já os artigos com aplicação do Teen ASI foram 12, sendo 8 estudos sobre intervenção, prevalência e outros. Para a validação do instrumento, foram encontrados 4 estudos, com taxa de confiabilidade em 2 estudos com r variando entre 0,69 e 0,90, um estudo com consistência interna com Alfa de Cronbach de 0,54 a 0,88 e outro estudo que avaliou a área sobre a curva de ROC = 0,88. Finalmente, os artigos com aplicação do CBCL foram 12, dos quais 8 foram sobre prevalência e fatores de risco. As medidas de desempenho do instrumento foram apresentadas em 4 estudos, sendo que dois mediram a taxa de sensibilidade do instrumento, variando de 80,4 a 87%. Ainda, um estudo apresentou consistência interna com Alfa de Cronbach entre 0,85 e 0,94 e outro estudou as propriedades psicométricas conforme dados da versão alemã do CBCL. CONCLUSÃO: Os resultados dos estudos apontam que os instrumentos pesquisados avaliam o abuso de álcool e outras drogas em adolescentes, possuindo boas propriedades psicométricas, porém de formas diferentes. O Teen ASI e o DUSI-R identificam e avaliam o uso de substâncias e outras áreas da vida. Por sua vez, o CBCL é voltado para avaliar a saúde mental do adolescente, não sendo específico para avaliar o abuso de álcool e outras drogas. Portanto, na escolha de instrumentos de avaliação, é importante considerar: organização do tempo, investimento na formação de profissionais e consolidação dos resultados que contribua efetivamente na melhora do tratamento / INTRODUCTION: The substance abuse is a major social problem in public health in most countries, due to the negative consequences of this behavior on the physical and emotional development of the people involved. The initiation phase of the substance abuse is beginning at earlier ages, and, as a consequence of that, an assessment to identify risk behaviors is very important for an acurate triage and subsequent steps. The objective of this study was to review studies and to describe 3 important instruments validated for Brazil and applied for the assessment of substance abuse in adolescents. METHOD: A literature review study, in the period from January of 1998 to August of 2010, in the databases of: Adolec, MedLine, Lilacs, PubMed and SciELO. In the selection of the studies the following criteria were evaluated: articles with application of the instruments DUSI-R, Teen ASI, and CBCL; the detailing of the instrument utilized for diagnostics; utilization of a performance indicator; quality of the study that enables the performance assessment of the instrument, and its coherence with the literature. RESULTS: 767 articles were found according to the inclusion criteria, and 54 of them were analysed, after the exclusions of the ones that did not meet the detailed criteria. 30 articles for the DUSI-R instrument were found, 25 of them related to interventions, prevalence and others. 5 studies were related to the validation of the instrument, with sensitivity rates varying from 80 to 85% and specificity variying from 70 to 90%. Another measure was the internal consistency with Cronbachs Alpha varying from 0.91 to 0.9451, presented in two studies. For the Teen ASI, 12 articles were found, and 8 of them were related to intervention, prevalence and others. For the validation of the instrument, 4 studies were found, with the reliability in 2 studies varying from r = 0.69 to 0.90, one study with internal consistency with Cronbachs Alpha varying from 0.54 to 0.88 and another study with the area under the ROC curve = 0.88. For the CBCL, 12 studies were found, and 8 of them were related to the prevalence and risk factors. The performance measures were presented in 4 studies, where 2 instruments measured the sensitivity rate varying from 80.4 to 87%. One study report the Cronbachs Alpha between 0.85 and 0.94, and another study studied the psicometric properties for the German version. CONCLUSION: The results of the studies suggest that the instruments included on the research evaluate the substance abuse in adolescents, with good psychometric properties, although in different ways. The Teen ASI and DUSI-R evaluate the substance abuse and other areas of life. The CBCL is useful to evaluate the mental health, and its not specific to conduct an assessment for substance abuse. So, when choosing assessment instruments, its important to consider: time management, investment in the education of the professionals; and consolidation of the results that contribute effectively to the improvement of the treatment

Doctor of Philosophy / Department of Family Studies and Human Services / Sandra Stith and Jared Durtschi / Controversy still exists in whether parents should or should not use corporal punishment to discipline their young children. The aim of this study was to investigate whether corporal punishment when the child was two years old predicted child externalizing behaviors a year later, and whether or not this association was moderated by parents’ observed positivity and harshness towards their child. A total of 218 couples and their first born child were selected for this study from the Family Transition Project (FTP) data set. Findings indicated that frequency of fathers’ corporal punishment when the child was two years old predicted child externalizing behaviors a year later, while controlling for initial levels of child externalizing behavior. Also, it was found that observed positive parenting and observed harsh parenting moderated the relationship between corporal punishment and child externalizing behaviors. These results highlight the importance of continuing to examine the efficacy of a commonly used form of discipline (i.e., corporal punishment). Furthermore, this study suggests that the parental climate in which corporal punishment is used may also be important to consider because parental positivity and harshness attenuate and amplify, respectively, the association of corporal punishment with child externalizing. Implications for family therapy are offered.

Förbättring av den perinatala vården har lett till att fler barn födda för tidigt (FT) idag överlever. Tidigare forskning har visat att den prematura populationen utgör en riskgrupp för neurologiska och fysiska nedsättningar samt negativa hälsopåverkan, bland annat genom en ökad risk för skolrelaterade problem och mobbning. Syftet med denna studie var att undersöka hälsa och behov av stöd hos 6-8 åriga barn (n = 130) födda FT med avseende på fysiska och kognitiva begränsningar, skolrelaterade svårigheter och mobbning. Föräldrarapporterade fysiska begränsningar, skolrelaterade svårigheter och förekomst av mobbning undersöktes genom skattningsformulären Nordiska hälso och familjeformuläret och Child Behavior Checklist (CBCL). Kognitiv förmåga bedömdes genom Wechsler Intelligence Scale for Children – Fourth edition (WISC-IV). Resultatet visade att synskada, trög mage, aptitlöshet och användande av glasögon förekom i större utsträckning hos barn födda mycket för tidigt (MFT) än hos barn födda fullgånget (FG). Resultatet visade även en skillnad i kognitiv förmåga, där barn födda MFT erhöll ett lägre resultat än barn födda FG, bägge grupper låg dock inom normalspannet.  Till skillnad från tidigare forskning visade resultatet inte att barn födda FT skiljde sig åt från barn födda FG avseende skolrelaterade svårigheter eller förekomsten av mobbning. Sammantaget pekar resultaten på att en MFT födsel inte behöver innebära avsevärt större besvär gällande hälsa, skolrelaterade svårigheter eller mobbning hos barn i tidig skolålder, trots en något sänkt generell kognitiv nivå. Möjliga anledningar till detta kan vara få deltagande barn födda extremt för tidigt (EFT) och/eller en effektiv neonatalvård i Sverige. / Recent improvements in perinatal care have led to increased survival of children born premature. Previous research has shown that the premature population constitutes a risk group for neurological and physical impairments and adverse health effects, including an increased risk of school-related difficulties and bullying. The purpose of this study was to investigate the health and support needs of 6-8 year old children (n = 130) born premature, in terms of physical and cognitive impairments, school related difficulties and bullying. Parental reported physical impairments, school related difficulties and the occurrence of bullying were investigated by the Nordic health and family questionnaire and Child Behaviour Checklist (CBCL). Cognitive ability was assessed by the Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV). The results showed that visual impairment, constipation, loss of appetite and the use of glasses were more frequent in children born very premature than in children born full-term. The results also showed a difference in cognitive ability, where children born very premature received lower results than children born full-term, both groups remained at an average level. In contrast to previous studies, the results did not show a difference between children born premature and children born full-term with regards to school related difficulties or the occurrence of bullying. Overall, the results indicate that a very premature birth need not involve considerably more problems concerning health, school-related difficulties or bullying among children in early school age, despite a slightly lower general cognitive level. Possible reasons for this could be few participating children born extremely premature, and/or an effective neonatal care in Sweden. / The relation between sensory-motor, behaviour functioning and brain development in preterm born children

The researcher examined the relationships between tuberous sclerosis, a multi-system genetic disorder, and school functioning through the use of a parent questionnaire and behavior rating scale. Information was gathered on the typical school experiences of children with tuberous sclerosis, including educational placement and services, behavioral functioning, parent involvement, and parent satisfaction. The results indicated that the majority of students with tuberous sclerosis are in special education and receiving related services. Three-quarters received one or more related services through the public school, and 30% received private related services paid for by their parents. Parent involvement was positively correlated with parent satisfaction, and negatively correlated with t-scores on the Withdrawn/Depressed subscale of the CBCL. Parents of children receiving Autism services were generally less satisfied with their children's school experiences than other parents. Parent satisfaction was negatively correlated with the Attention Problems scale of the CBCL. Student age was negatively correlated with time in inclusion and with related services. This information forms the basis for a discussion of school psychologists' roles in the educational success of students with tuberous sclerosis and the critical areas towards which interventions should be directed.

Objective: The concurrence of prenatal alcohol exposure with other drug exposure, low socioeconomic status and environmental risk factors may obscure associations, if any, between prenatal cocaine exposure and child outcomes. This study evaluates the effects of prenatal cocaine exposure on child behavior in analyses stratified by gender and prenatal alcohol exposure status. Methods: Maternal alcohol, cigarette, and illicit drug use were prospectively assessed by interview during pregnancy and postnatally. Maternal and neonatal urine were tested for drug exposure as clinically indicated. Caregiver report of child behavior was assessed with the Achenbach Child Behavior Checklist (CBCL). Dichotomous cocaine exposure was characterized as no (negative history and biologic markers), and any (positive history and/or biologic markers during pregnancy and/or positive urine screen at delivery from either mother or infant). Results: Prenatal cocaine exposure was associated with adverse effects on offspring behavior that were moderated by the gender of the offspring as well as prenatal alcohol exposure. For girls without prenatal alcohol exposure, 6.5% of the unique variance in behavior was related to prenatal cocaine exposure. For these girls, the odds of scoring in the abnormal range for Aggression was 17 times control levels (95% confidence limits 1.4 to 203). These findings, though significant, have wide confidence intervals and need to be replicated in larger cohorts and on longitudinal follow-up.

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Made available in DSpace on 2016-03-15T19:40:15Z (GMT). No. of bitstreams: 1 Adriana de Fatima Ribeiro.pdf: 1024780 bytes, checksum: d13e14bac4328d6e7a146f7ac32bb833 (MD5) Previous issue date: 2014-02-13 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Attention Deficit Disorder and Hyperactivity (ADHD) is characterized by a pattern of persistent inattention and/ or hyperactivity that it is more severe than normally observed in individuals with an equivalent level of development. It is a disorder in which the symptoms are varied and may interfere in different degrees according to the environment in which the individual is inserted. The identification of the signs of this disorder must take into consideration an assessment of the neuropsychological functions and of the behavioral indicators, preferably from multiple informants such as parents or guardians, teachers and the adolescent itself. This project aims to identify the main agreements relating to the behaviors of adolescents complaining of symptoms of ADHD observed by multiple informants, and correlate them to their performance on neuropsychological tests. It was used the inventories CBCL/6-18, TRF/6-18 and YSR/11-18 belonging to the Achenbach System of Empirically Based Assessment (ASEBA) and WISC-III, Wisconsin and the Concentrated Attention Test (AC). Twenty adolescents participated in this study aged between 11 and 16 years, divided into two groups, ten with diagnostic (ADHD group) and ten without ADHD (control group). All participants were part of the protocol of neuropsychological, behavioral and clinical assessment to identify signs of inattention and hyperactivity/ impulsivity of the Developmental Disorders Post-Graduation Program at Mackenzie Presbyterian University. The results for the concordance rates in the answers provided by multiple informants in the correlation between CBCL versus TRF, CBCL versus YSR and TRF versus YSR, through values of reference (Q corr), according to the ADM program version 7, were high for both groups. In the comparison of the scales of Internalizing, Externalizing and Total Problems in function of the groups and instruments, as much as for the scales of problems of attention and attention deficit disorder and hyperactivity, it was observed in the ADHD group that the parents reported more problems than the teachers and in the control group the teachers reported significantly greater number of problems. In the comparison of the scales of Sluggish Cognitive Tempo in function of the groups and instruments it was verified that the parents also perceive more alterations in the behavior in different instruments constituents of this scale than the teachers. Regarding to correlations of neuropsychological tests and behavioral indicators of problems of behavior in different instruments, no significant differences were observed. It is therefore concluded the need to compose procedures of assessment of people with the complaint of ADHD with different reporting instruments by multiple informants, besides other procedures such as direct observation or neuropsychological testing for the establishment of a cognitive profile as an aid in the process of assessment. / O Transtorno de Déficit de Atenção/Hiperatividade (TDAH) se caracteriza por um padrão de desatenção e/ou hiperatividade persistente e mais grave do que o normalmente observado em indivíduos com nível equivalente de desenvolvimento. Trata-se de um transtorno cujos sintomas são variados e podem interferir em graus diversos conforme o ambiente no qual o indivíduo está inserido. A identificação dos sinais desse transtorno deve levar em consideração uma avaliação das funções neuropsicológicas e de indicadores comportamentais, preferencialmente a partir de múltiplos informantes como pais ou responsáveis, professores e o próprio adolescente. Este projeto tem como objetivo identificar as principais concordâncias referentes aos comportamentos dos adolescentes com queixa dos sintomas de TDAH, observados pelos múltiplos informantes e posteriormente correlacioná-los ao seu desempenho nos testes neuropsicológicos. Foram usados os inventários CBCL/6-18, TRF/6-18 e YSR/11-18 que pertencem ao Sistema de Avaliação Baseado em Evidência do Achenbach (ASEBA) e WISC-III, Wisconsin e Teste de Atenção Concentrada (AC). Participaram desse estudo 20 adolescentes com idades entre 11 a 16 anos, divididos em dois grupos, 10 com diagnóstico (grupo TDAH) e 10 sem TDAH (grupo controle).Todos os participantes fizeram parte do protocolo de avaliação neuropsicológica, comportamental e clínica para identificar sinais de desatenção e hiperatividade/impulsividade do Programa de Pós-Graduação em Distúrbios do Desenvolvimento, da Universidade Presbiteriana Mackenzie. Os resultados para os índices de concordância nas respostas fornecidas pelos múltiplos informantes na correlação entre CBCL versus TRF, CBCL versus YSR e TRF versus YSR, pelo meio dos valores de referência (Q corr), de acordo com o programa ADM versão 7, mostrou-se alta para os dois grupos. Na comparação das escalas de Problemas Internalizantes, Externalizantes e Totais em função dos grupos e instrumentos tanto quanto para as escalas de Problemas de atenção e Problemas de déficit de atenção e hiperatividade, observou-se no grupo TDAH que os pais relataram mais problemas que os professores e no grupo controle os professores é quem relataram um número significativamente maior de problemas. Na comparação das escalas de Ritmo Cognitivo Lento em função dos grupos e instrumentos, verificou-se que os pais também perceberam mais alterações nos comportamentos constituintes dessa escala que os professores. Com relação às correlações dos testes neuropsicológicos e dos indicadores comportamentais de problemas de comportamento nos diferentes instrumentos, não foram observadas diferenças significativas. Conclui-se, assim, a necessidade de compor procedimentos de avalição de pessoas com queixas de TDAH com diferentes instrumentos de relato por múltiplos informantes, além de outros procedimentos como observação direta ou testagem neuropsicológica para o estabelecimento de um perfil cognitivo para auxiliar no processo de avaliação.