Paula Andréa Shinzato Ferreira Martins

Lower resting metabolic rate and higher velocity of weight gain in a prospective study of stunted vs nonstunted girls living in the shantytowns of São Paulo, Brazil.

Objective:Previous studies have shown that stunting increases the risk of obesity in developing countries, particularly among girls and women, but the underlying reasons are not known. This study aimed to investigate the relationship between stunting, weight gain, and resting metabolic rate.Design and subjects:A prospective study was conducted over 36 months with girls from shantytowns in São Paulo, Brazil. A total of 15 stunted girls (S) were compared with 15 nonstunted (N) ones of similar weight for height ratio.Interventions:Resting metabolic rate was measured using indirect calorimetry, and the socioeconomic status was determined by interviews in the household. In addition, body composition was measured by skinfold thickness, while the growth rate was calculated dividing the change in weight and the change in height by the follow-up period.Results:The results of the present study, when combined, revealed that the S group had a lower resting metabolic rate throughout the follow-up period with the differences being significant at 24 and 36 months of follow-up, associated with an increase in the rate of weight gain and a decrease in lean mass, when compared to the N group.Conclusions:These changes are known to be risk factors for obesity and may help to explain the particularly higher prevalence of obesity in women in urban areas of developing countries.

Os dois Brasis: quem são, onde estão e como vivem os pobres brasileiros

Este artigo procura mostrar alguns dados sobre as condicoes nutricionais e de pobreza de duas populacoes moradoras em favelas, nos municipios de Maceio e Sao Paulo. Os resultados apresentados revelam que no Brasil atual, a associacao entre pobreza e estado nutricional (incluindo desnutricao energetico-proteica e obesidade) e complexa e ainda pouco conhecida. Ha um numero elevado de individuos obesos nas populacoes brasileiras que vivem abaixo da linha de pobreza nas zonas urbanas. A obesidade coexiste com altas prevalencias de desnutricao. Esses achados estao associados com alimentacao deficiente, sobretudo em qualidade, levando a alta prevalencia de baixa estatura. Varios estudos mostram que a obesidade encontrada na populacao pobre pode ser sequela de desnutricao precoce e apontam para a necessidade de programas que: sejam focalizados nos individuos realmente desnutridos e consequentemente realizem avaliacao do estado nutricional, cuidados de saude caso a caso, forte atencao ao pre-natal, melhorem as condicoes de moradia e combatam o analfabetismo materno. O artigo recomenda ainda a criacao de Centros de Educacao e Recuperacao Nutricional para combater a desnutricao, visando recuperacao da baixa estatura, com forte enfoque de intervencao na comunidade.

Motivational Interviewing combined with chess accelerates improvement in executive functions in cocaine dependent patients: A one-month prospective study

BACKGROUND In cocaine-dependent individuals, executive function (EF) deficits are associated with poor treatment outcomes. Psychological interventions and pharmacological approaches have produced only modest effect sizes. To date, studies of this topic have been few and limited. The aim of this study was to examine the effects of a new model of intervention, which integrates chess and Motivational Interviewing, Motivational Chess (MC) METHODS: We evaluated 46 cocaine-dependent inpatients (aged 18-45), in two groups-MC (n=26); and active comparison-AC (n=20). Using neuropsychological tests and an impulsivity scale, we assessed the subjects before and after the study period (one month of abstinence monitored by urine toxicology screening). RESULTS The MC and AC groups did not differ at baseline. In the post-intervention assessment (after one month), both groups showed significant improvements in attention, mental flexibility, inhibitory control, abstraction abilities, and decision-making (p<0.01). In addition, the improvement in working memory was more significant in the MC group than in the AC group (group-by-time interaction, p=01). CONCLUSIONS One month of abstinence was sufficient to improve various attentional and executive domains in cocaine-dependent subjects. The MC intervention was associated with greater improvements in EFs, especially working memory, suggesting that tailored interventions focusing on complex EFs accelerate the process of cognitive recovery during the initial period of abstinence.

Cognition and impulsivity in adults with attention deficit hyperactivity disorder with and without cocaine and/or crack dependence

BACKGROUND Substance use disorder (SUD) is a common comorbidity in adults with attention deficit-hyperactivity disorder (ADHD). However,there have been few studies on cognitive profiles of these patients. Impulsivity is also commonly increased in both disorders. The central aim of this study was to compare cognition and impulsivity in subjects who had ADHD and cocaine dependence (ADHD+COC group) to those with ADHD only (ADHD-noSUD group). We hypothesized that the ADHD+COC group would show more marked cognitive dysfunction and greater impulsivity than their counterparts with ADHD only. METHODS A total of 70 adult patients diagnosed with ADHD according to (DSM-IV-TR) criteria were enrolled; 36 with ADHD+COC and 34 with ADHD-noSUD. All study participants were evaluated with a sociodemographic questionnaire; the Mini International Neuropsychiatric Interview; the Adult ADHD Self-Report Scale; the Addiction Severity Index; the Alcohol, Smoking and Substance Involvement Screening Test; the Barratt Impulsiveness Scale; and a comprehensive neurocognitive battery. RESULTS Compared to individuals with ADHD-noSUD, ADHD+COC individuals had significantly lower mean IQ and higher motor impulsivity. On average, the ADHD+COC group also performed more poorly on tasks assessing verbal skills, vigilance, implicit learning during decision making, and ADHD-noSUD performed more poorly on selective attention, information processing, and visual search. CONCLUSIONS Our results support the integrative theory of ADHD based on the cognitive and affective neuroscience model, and suggests that ADHD-noSUD patients have impairments in cognitive regulation, while ADHD+COC patients have impairments in both cognitive and affective regulation.

Sistema de classificação de pacientesna enfermagem psiquiátrica: validação clínica

The scarcity of publications about personnel dimensioning in psychiatric nursing motivated the development of an Instrument to Classify the Level of Dependence in Psychiatric Nursing, the initial stage for the establishment of the ideal number of professionals in the nursing crew of the specialty. The purpose of this study was to look for the clinical validation through reliability and construct validity tests, as well as to verify its applicability in the management practice of nurses. Two samples were used, of which n = 40 pairs of instruments filled in Stage 1 of data collection and n = 100 instruments filled in Stage 3 of the study, with different statistical criteria being applied, among them the Kappa coefficient and the Spearman correlation. The Instrument to Classify the Level of Dependence in Psychiatric Nursing was considered reliable, with good indicators of agreement, and the construct was validated, determining the degree of dependence of mental disorder patients.A escassez de publicacoes a respeito de dimensionamento de pessoal na enfermagem psiquiatrica motivou o desenvolvimento de um Instrumento para Classificar o Nivel de Dependencia na Enfermagem Psiquiatrica, etapa inicial para o estabelecimento da quantidade necessaria de profissionais na Equipe de Enfermagem da especialidade. Os objetivos deste estudo buscaram a validacao clinica, por meio de testes de confiabilidade e validade do constructo, alem da verificacao de sua aplicabilidade na pratica gerencial do enfermeiro. Foram utilizadas duas amostras, sendo n=40 pares de instrumentos preenchidos na Fase 1 da coleta de dados e n=100 instrumentos preenchidos na Fase 3 do estudo, tendo sido aplicados diferentes criterios estatisticos, entre eles, o coeficiente Kappa e a correlacao de Spearman. O Instrumento para Classificar o Nivel de Dependencia na Enfermagem Psiquiatrica foi considerado confiavel com indices satisfatorios de concordância e o constructo foi validado, determinando o grau de dependencia do paciente portador de transtornos mentais.

Sistema de classificaçäo de pacientes na especialidade enfermagem psiquiátrica

Objective: The aim of this paper was to report the validity of an Instrument for Classification of Nursing Care Dependency Levels for Psychiatric Patients. Methods: The development of the instrument was based on the following critical indicators of care: appearance and hygiene, thought expression, humor and affection, social interaction, activities, feeding and hydration, sleep, medication, eliminations, vital signs and others controls, and problems and somatic complaints. Results: The scores for degree of dependence are graded on a 3-point scale which permits to determine dependency levels. The Delphi technic was used to validate the instrument. Experts agreed with the maintenance of 11 critical indicators. Conclusion: The results of this study showed the instrument is valid and may contribute to technological and scientific advances for psychiatric speciality in Brazil.OBJECTIVE: The aim of this paper was to report the validity of an Instrument for Classification of Nursing Care Dependency Levels for Psychiatric Patients. METHODS: The development of the instrument was based on the following critical indicators of care: appearance and hygiene, thought expression, humor and affection, social interaction, activities, feeding and hydration, sleep, medication, eliminations, vital signs and others controls, and problems and somatic complaints. RESULTS: The scores for degree of dependence are graded on a 3-point scale which permits to determine dependency levels. The Delphi technic was used to validate the instrument. Experts agreed with the maintenance of 11 critical indicators. CONCLUSION: The results of this study showed the instrument is valid and may contribute to technological and scientific advances for psychiatric speciality in Brazil.

Patient classification system in psychiatric nursing: clinical validation

The scarcity of publications about personnel dimensioning in psychiatric nursing motivated the development of an Instrument to Classify the Level of Dependence in Psychiatric Nursing, the initial stage for the establishment of the ideal number of professionals in the nursing crew of the specialty. The purpose of this study was to look for the clinical validation through reliability and construct validity tests, as well as to verify its applicability in the management practice of nurses. Two samples were used, of which n = 40 pairs of instruments filled in Stage 1 of data collection and n = 100 instruments filled in Stage 3 of the study, with different statistical criteria being applied, among them the Kappa coefficient and the Spearman correlation. The Instrument to Classify the Level of Dependence in Psychiatric Nursing was considered reliable, with good indicators of agreement, and the construct was validated, determining the degree of dependence of mental disorder patients.A escassez de publicacoes a respeito de dimensionamento de pessoal na enfermagem psiquiatrica motivou o desenvolvimento de um Instrumento para Classificar o Nivel de Dependencia na Enfermagem Psiquiatrica, etapa inicial para o estabelecimento da quantidade necessaria de profissionais na Equipe de Enfermagem da especialidade. Os objetivos deste estudo buscaram a validacao clinica, por meio de testes de confiabilidade e validade do constructo, alem da verificacao de sua aplicabilidade na pratica gerencial do enfermeiro. Foram utilizadas duas amostras, sendo n=40 pares de instrumentos preenchidos na Fase 1 da coleta de dados e n=100 instrumentos preenchidos na Fase 3 do estudo, tendo sido aplicados diferentes criterios estatisticos, entre eles, o coeficiente Kappa e a correlacao de Spearman. O Instrumento para Classificar o Nivel de Dependencia na Enfermagem Psiquiatrica foi considerado confiavel com indices satisfatorios de concordância e o constructo foi validado, determinando o grau de dependencia do paciente portador de transtornos mentais.

Is psychodynamic psychotherapy an effective intervention for individuals at ultra-high risk (UHR) of psychosis?: a case report

OBJECTIVE: To report a case and to discuss the use of psychodynamic psychotherapy (PD-P) to treat individuals at ultra-high risk (UHR) of psychosis. METHODS: An individual at UHR was followed up for 24 months. The baseline evaluation included a psychiatric interview, the Structured Interview for Prodromal Symptoms (SIPS), the Scale of Prodromal Symptoms (SOPS), and neuropsychological assessment. He underwent weekly sessions of PD-P for 12 months and was followed up for 12 months after the end of PD-P. The evaluations were at baseline, after 6-, 12-, and 24-month follow-up. No medication was prescribed during the 24-month follow-up. RESULTS: The prodromal symptoms remitted. The initial total score on the SIPS/SOPS was 37 points. After the first 12 months of PD-P, there was a reduction to 12 points on the SIPS/SOPS score, which stabilized in the 24-month follow-up. There was also a slight improvement in his performance on the neuropsychological evaluations. CONCLUSION: This case report suggests that PD-P can reduce prodromal symptoms; nevertheless, a better understanding of the specificity and efficacy of PD-P as an option of treatment for UHR individuals is needed.

Sistema de clasificación de pacientes en la enfermería psiquiátrica: validación clínica

The scarcity of publications about personnel dimensioning in psychiatric nursing motivated the development of an Instrument to Classify the Level of Dependence in Psychiatric Nursing, the initial stage for the establishment of the ideal number of professionals in the nursing crew of the specialty. The purpose of this study was to look for the clinical validation through reliability and construct validity tests, as well as to verify its applicability in the management practice of nurses. Two samples were used, of which n = 40 pairs of instruments filled in Stage 1 of data collection and n = 100 instruments filled in Stage 3 of the study, with different statistical criteria being applied, among them the Kappa coefficient and the Spearman correlation. The Instrument to Classify the Level of Dependence in Psychiatric Nursing was considered reliable, with good indicators of agreement, and the construct was validated, determining the degree of dependence of mental disorder patients.A escassez de publicacoes a respeito de dimensionamento de pessoal na enfermagem psiquiatrica motivou o desenvolvimento de um Instrumento para Classificar o Nivel de Dependencia na Enfermagem Psiquiatrica, etapa inicial para o estabelecimento da quantidade necessaria de profissionais na Equipe de Enfermagem da especialidade. Os objetivos deste estudo buscaram a validacao clinica, por meio de testes de confiabilidade e validade do constructo, alem da verificacao de sua aplicabilidade na pratica gerencial do enfermeiro. Foram utilizadas duas amostras, sendo n=40 pares de instrumentos preenchidos na Fase 1 da coleta de dados e n=100 instrumentos preenchidos na Fase 3 do estudo, tendo sido aplicados diferentes criterios estatisticos, entre eles, o coeficiente Kappa e a correlacao de Spearman. O Instrumento para Classificar o Nivel de Dependencia na Enfermagem Psiquiatrica foi considerado confiavel com indices satisfatorios de concordância e o constructo foi validado, determinando o grau de dependencia do paciente portador de transtornos mentais.

Sistema de clasificación de los pacientes de la especialidad enfermería psiquiátrica

Objective: The aim of this paper was to report the validity of an Instrument for Classification of Nursing Care Dependency Levels for Psychiatric Patients. Methods: The development of the instrument was based on the following critical indicators of care: appearance and hygiene, thought expression, humor and affection, social interaction, activities, feeding and hydration, sleep, medication, eliminations, vital signs and others controls, and problems and somatic complaints. Results: The scores for degree of dependence are graded on a 3-point scale which permits to determine dependency levels. The Delphi technic was used to validate the instrument. Experts agreed with the maintenance of 11 critical indicators. Conclusion: The results of this study showed the instrument is valid and may contribute to technological and scientific advances for psychiatric speciality in Brazil.OBJECTIVE: The aim of this paper was to report the validity of an Instrument for Classification of Nursing Care Dependency Levels for Psychiatric Patients. METHODS: The development of the instrument was based on the following critical indicators of care: appearance and hygiene, thought expression, humor and affection, social interaction, activities, feeding and hydration, sleep, medication, eliminations, vital signs and others controls, and problems and somatic complaints. RESULTS: The scores for degree of dependence are graded on a 3-point scale which permits to determine dependency levels. The Delphi technic was used to validate the instrument. Experts agreed with the maintenance of 11 critical indicators. CONCLUSION: The results of this study showed the instrument is valid and may contribute to technological and scientific advances for psychiatric speciality in Brazil.