Non-pharmacological treatment of Attention Deficit Disorder with or without Hyperactivity (ADHD). Overview and report of the first international symposium on the non-pharmacological management of ADHD.

Attention Deficit Disorder with or without Hyperactivity (ADHD is a neurodevelopmental disorder which affects the day-to-day functioning of children and adults with this condition. Pharmacological treatment can reduce the symptoms associated with ADHD, but it has some limitations. The objective of this symposium is to determine the effects of non-pharmacological approaches on ADHD symptoms. Results indicate that the following intervention are promising approaches: cognitive behavioral therapy (CBT), mindfulness-based interventions (MBI), yoga, cognitive and metacognitive intervention, neurofeedback and parental training programs. Current research advocates multimodal approaches in conjunction with school or work accommodations integrating innovative technologies.

Air Drep-A Retrospective Study Evaluating the Influence of Weather Conditions and Viral Epidemics on Vaso-Occlusive Crises in Patients with Sickle Cell Disease Living in French Guiana.

(1) Objectives: French Guiana is the French territory most affected by sickle cell disease (SCD). This study investigates the associations between different environmental factors relative to climate, infectious outbreaks, and emergency visits or weekly hospital admissions for vaso-occlusive crisis (VOC). The identification of risk factors would lead to better patient care and patient management, and more targeted prevention and therapeutic education for patients with SCD in French Guiana. (2) Methods: This study was performed using data collected from the medicalized information system and emergency medical records of Cayenne General Hospital, between 1 January 2010 and 31 December 2016. ARIMA models were used to investigate the potential impact of weather conditions and flu epidemics on VOC occurrence. (3) Results: During the study period, 1739 emergency visits were recorded among 384 patients, of which 856 (49.2%) resulted in hospitalization, 811 (46.6%) resulted in hospital discharge, and 72 (4.2%) in another orientation. Decreased temperature and decreased humidity were both independent factors associated with an increase of VOC cases (p = 0.0128 and p = 0.0004, respectively). When studying severe VOC (leading to hospitalization, with or without prior emergency visit), 2104 hospital admissions were recorded for 326 patients. The only factor associated with severe VOC, in the multivariate analysis, was flu epidemics (p = 0.0148). (4) Conclusions: This study shows a link between climate, flu epidemics, and VOC in French Guiana. Patient's awareness of risks related to climate and flu epidemics should be encouraged, as home prevention measures can help avoid painful crises. Moreover, physicians should encourage patients to get immunized for influenza every year.

The use of structural equation modelling and behavioural theory to target priority interventions to increase condom use among the intimate partners of sex workers in French Guiana.

French Guiana is the French overseas territory that is most affected by HIV. Sex work seems to be an important driver of the epidemic. Although female sex workers are informed by local NGOs, they still have risky behaviours, including not using condoms with their intimate partner despite knowing HIV is highly prevalent. The objective of this study was to find intervention targets on this specific behaviour. For this, a structural equation model (SEM) was built using assumptions from behavioural theories. Behaviour theories attempt to connect research and practice. Within the health belief model framework, perceived threats, perceived benefits, and self-perceived efficacy were tested. Vulnerability was added because of the particular context of French Guiana. The results highlight that female sex workers' perceived self-efficacy was central in condom use with the intimate partner (with a significant correlation coefficient of 0.52 in the SEM). The perceived self-efficacy was strongly influenced by sociodemographic factors, particularly by nationality. Female sex workers from Brazil seemed to be more comfortable about asking their intimate partner to use condoms (OR: 7.81; CI: 1.87-32.63) than sex workers of other nationalities. These results emphasize that prevention interventions for female sex workers should emphasize their empowerment.

HIV-testing among female sex workers on the border between Brazil and French Guiana: the need for targeted interventions.

The border between Brazil and French Guiana is a place of economic, cultural, social and sexual exchange. Female sex workers represent a high risk population for HIV in this area where sexual tourism is particularly developed. HIV testing seems to be an important element in the fight against the epidemic. Indeed, early HIV testing gives access to treatments and prevention. An HIV/AIDS knowledge, attitudes, behaviors and practices survey was conducted in 2011 among sex workers along the border between Brazil and French Guiana. A total of 213 female sex workers were interviewed. One third (31.5%) of the interviewed had never tested for HIV. Factors associated with non HIV-testing were the lack of knowledge of places where to do an HIV test, to be 30 or older, feeling at risk of HIV, not evaluating one's own risk towards HIV, and living in Oiapoque. These results clearly suggest that targeted interventions are needed to encourage and assist female sex workers to get tested regularly.

HIV-testing among female sex workers on the border between Brazil and French Guiana: the need for targeted interventions / Testes de HIV entre trabalhadoras do sexo na fronteira entre Brasil e Guiana Francesa: a necessidade de intervenções específicas / La prueba del VIH en las trabajadoras sexuales en la frontera entre la Guyana Francesa y Brasil: la necesidad de intervenciones específicas

The border between Brazil and French Guiana is a place of economic, cultural, social and sexual exchange. Female sex workers represent a high risk population for HIV in this area where sexual tourism is particularly developed. HIV testing seems to be an important element in the fight against the epidemic. Indeed, early HIV testing gives access to treatments and prevention. An HIV/AIDS knowledge, attitudes, behaviors and practices survey was conducted in 2011 among sex workers along the border between Brazil and French Guiana. A total of 213 female sex workers were interviewed. One third (31.5%) of the interviewed had never tested for HIV. Factors associated with non HIV-testing were the lack of knowledge of places where to do an HIV test, to be 30 or older, feeling at risk of HIV, not evaluating one's own risk towards HIV, and living in Oiapoque. These results clearly suggest that targeted interventions are needed to encourage and assist female sex workers to get tested regularly.

A fronteira entre Guiana Francesa e Brasil é um lugar de intercâmbio econômico, cultural, social e sexual. Nessa área, onde o turismo sexual é particularmente desenvolvido, as mulheres profissionais do sexo representam uma população de alto risco de contágio pelo HIV. Os testes de HIV parecem ser um elemento importante da luta contra a epidemia. De fato, os primeiros testes de HIV dão acesso à prevenção e aos tratamentos. Foi realizada em 2011 uma pesquisa de conhecimento, atitudes, comportamentos e práticas sobre HIV/AIDS com mulheres profissionais do sexo ao longo da fronteira da Guiana Francesa com o Brasil. Foram entrevistadas 213 mulheres profissionais do sexo. Um terço (31,5%) delas nunca tinha feito o teste de HIV. Fatores associados a não realização do teste de HIV foram: a falta de conhecimento dos locais onde fazer o teste, ter idade igual ou acima de 30 anos, sentir-se em risco de contágio pelo HIV, falta de avaliação do risco de contágio pelo HIV e habitante do Oiapoque. Esses resultados sugerem claramente que intervenções direcionadas às mulheres profissionais do sexo são necessárias para que os testes sejam feitos regularmente.

La frontera entre la Guyana Francesa y Brasil es un lugar de intercambio económico, cultural y sexual. En esta zona, donde se desarrolla sobre todo el turismo sexual, las trabajadoras del sexo son una población de alto riesgo de VIH. La prueba del VIH parece ser un elemento en la lucha de esta epidemia. Además, la prueba inmediata del VIH permite el acceso a los tratamientos y la prevención. Se realizó una Encuesta de Conocimientos, Actitudes y Prácticas sobre el VIH/SIDA en 2011 entre las trabajadoras de sexo, trabajando en la frontera entre la Guyana Francesa y Brasil. Se entrevistaron a un total de 213 trabajadoras del sexo. Un tercio (31,5%) de las entrevistadas nunca se había hecho la prueba del VIH. Los factores asociados con no haberse hecho la prueba del VIH son la ausencia de conocimientos sobre los lugares, donde se realiza la prueba del VIH, tener 30 años o más, sentirse en riesgo de VIH, no evalúan su propio riesgo frente al VIH y viviendo en el Oiapoque. Estos resultados muestran claramente que las intervenciones específicas necesitan incentivos para estimular el uso regularmente de la prueba del VIH.

Predictive factors of unprotected sex for female sex workers: first study in French Guiana, the French territory with the highest HIV prevalence.

French Guiana is the French territory that is most affected by HIV. AIDS incidence is much higher than in mainland France and sex work seems to be an important driver of the epidemic. The objective of this study was to describe consistent condom use among female sex workers with their clients and their intimate partners and to identify determinants of non-use of condoms. An HIV/AIDS Knowledge, Attitudes, Behaviours and Practices survey was conducted in 2009-2010 among sex workers in French Guiana. A total of 477 sex workers were interviewed. Female sex workers were more likely to use condoms with their clients (97%) than with their intimate partners (45%). The factors associated with non-consistent condom use with the intimate partner were having had an abortion, feeling at risk for HIV, not evaluating one's own risk for HIV, living as a couple, being Dominican, and not feeling comfortable asking intimate partners to use condoms. Although a high proportion of female sex workers declared using condoms with commercial partners, there is still room for improvement in the prevention of transmission with both commercial and intimate partners.

Influence of climate and river level on the incidence of malaria in Cacao, French Guiana.

BACKGROUND: The epidemiological profiles of vector-borne diseases, such as malaria, are strongly associated with environmental conditions. An understanding of the effect of the climate on the occurrence of malaria may provide indirect insight into the anopheles mosquito vectors endemic to a particular region. The association between meteorological and hydrographical factors and the occurrence of malaria was studied in a village in French Guiana during an epidemic caused essentially by Plasmodium vivax. METHODS: A cohort of confirmed cases of P. vivax malaria occurring between 2002 and 2007 was studied to search for an association between the number of new infection episodes occurring each month, mean, maximum and minimum monthly temperatures, cumulative rainfall for the month and the mean monthly height of the river bordering the village, with the aid of time series. Cross-correlation analysis revealed that these meteorological factors had large effects on the number of episodes, over a study period of 12 months. RESULTS: Climatic factors supporting the continuance of the epidemic were identified in the short-term (low minimum temperatures during the month), medium-term (low maximum temperatures two months before) and long-term (low maximum temperatures nine months before and high lowest level of the river 12 months before). Cross-correlation analysis showed that the effects of these factors were greatest at the beginning of the short rainy season. CONCLUSION: The association between the river level and the number of malaria attacks provides clues to better understand the environment of malaria transmission and the ecological characteristics of the vectors in the region.