Sleep Problems Before and During the COVID-19 Pandemic in Children with Autism Spectrum Disorder, Down Syndrome, and Typical Development.

Sleep problems are common in children and adolescents, particularly those with Neurodevelopmental Disorders. With the changes in daily habits resulting from the COVID-19 pandemic, we have analyzed sleep characteristics, during social isolation, in Brazilian children and adolescents aged between 4 and 12 years with Autism Spectrum Disorder (N = 267), Down Syndrome (N = 74), and typical development (N = 312). The ASD group presented with worse indicators of sleep habits in the Children's Sleep Habits Questionnaire (CSHQ-BR) and fell asleep later during the pandemic. The entire group started fall asleep and waking up later during the pandemic - as well as waking up more often during the night. These results may contribute to parental guidance and sleep habit-related interventions during and after the COVID-19 pandemic.

Translation and adaptation into Brazilian Portuguese and investigation of the psychometric properties of the Children's Sleep Habits Questionnaire (CSHQ-BR).

OBJECTIVES: To translate to Brazilian Portuguese, culturally adapt and confirm the psychometric parameters of validity and reliability of the Children's Sleep Habits Questionnaire (CSHQ-BR) in children. METHODS: A sample of 314 typically developing children, 51% girls, mean age 7.12 years (SD = 2.04 years) were assessed, comprising 227 from São Paulo and 87 from the Amazon region. Translation, back translation, cultural adaptation, a pilot study and item review were carried out, yielding the final version of the CSHQ. Psychometric parameters were determined based on content validity coefficient (CVC), test-retest, internal consistency, evidence of convergent validity and internal structure. RESULTS: The final CVC for the scale was 0.88. Intraclass correlation was 0.98 for the overall questionnaire and ranged from 0.88 to 0.98 for subscales. CSHQ-BR internal consistency was α = 0.81 for the CSHQ-BR total score (95% CI) and from 0.51 to 0.75 for subscales. Exploratory factor analysis suggested a novel 4-factor structure. A positive correlation was found between the CSHQ and the Questionnaire on Sleep Behavior. Mean total CSHQ score in Brazilian children was 46.85 (SD = 9.43), and boys had a higher mean total score than girls, although not statistically significant. CONCLUSION: The CSHQ-BR exhibited satisfactory equivalence for the original English abbreviated form and the Brazilian Portuguese version, proving a useful sleep screening instrument for identifying sleep problems in Brazilian children aged 4-10 years.

Aplicação do método clínico centrado na pessoa (MCCP) com dor crônica / Application of patient-centered clinical method (PCCM) to a chronic pain patient

Propõe-se uma radical transformação do método clínico.O MCCP é dividido em seis componentes: exploraçãoda doença e da experiência de doença; entendimentodo ser na totalidade; elaboração de plano conjunto demanejo dos problemas; incorporação das dimensões depromoção e prevenção; intensificação da relação médico-paciente e ?sendo realista?. Este artigo busca desvelaro itinerário terapêutico de uma pessoa encaminhada aoAmbulatório de Diagnóstico Diferencial da UniversidadeRegional de Blumenau (FURB) para acompanhamento eavaliação, sob visão do MCCP. Trata-se de pesquisa qualitativadocumental realizada a partir do atendimento deuma pessoa do sexo feminino (M.), com dor osteomuscularcrônica e incapacitante. Foram analisados registrosmédicos e realizadas entrevistas gravadas e transcritascom a devida autorização. O foco esteve na vida conjugale laboral e a pauta nas intercorrências médicas. Foramdiscutidas expectativas, pactuados os problemas a seremenfrentados e revisada a sua experiência com medicações.Antes da aplicação do MCCP, M. não sabia dizerpor que havia feito tantos exames, cirurgias e tomadotantos remédios. Agora entende informações a respeitode sua doença, expressa suas opiniões e compartilha decisões.Ao usar o MCCP entende-se melhor o processo deadoecimento, proporcionando consulta mais satisfatóriapara as partes envolvidas na aliança terapêutica. Há umaevidente relação entre a inclusão das várias dimensõesreferentes à perspectiva da pessoa e o resultado da consultamédica. Essa vantagem justifica as propostas deatendimento médico apoiado no modelo centrado napessoa.

A radical transformation of the clinical method isproposed. The PCCM is divided into six components: assessmentof the illness and its experience; comprehensionof the individual as a whole; design of a commonproblem management; incorporating promotion andprevention dimensions; intensification of the doctor--patient relationship and ?being realistic?. This articleaims at unveiling the therapeutic itinerary of a personreferred to the Differential Diagnostics Ambulatoryof the Regional University of Blumenau (FURB) for assessmentand follow-up, under the PCCM perspective.This is a qualitative documental research conductedfrom the care of a female person (M.), with chronic anddisabling osteomuscular pain. Medical records wereanalyzed and with due consent interviews were recordedand transcribed. The focus was on the marital andthe working affairs, and the schedule on the medical intercurrences.The expectancies were discussed, the problemsto be dealt with were agreed, and her experiencewith the medication was revised. Before the applicationof the PCCM, M. wasn?t aware of the reason she had undergoneso many exams and taken so many medicines.Currently she comprehends information about her disease,expresses her opinion and shares decisions. Byusing the PCCM the process of sickening is better understood,providing a more satisfying consultation forthe involved parts in the therapeutic alliance. Thereis an evident relation between the inclusion of manydimensions concerning the person?s perspective andthe results of the medical consultation. This advantagejustifies the proposals of medical care/service based onthe person-centered model.

Termos psicopatológicos em bandas e músicas de rock and roll / Psychopathological terms in bands and songs of rock and roll

OBJETIVO: Investigar o uso de termos psicopatológicos nos nomes de bandas de rock and roll e em suas músicas. MÉTODO: Termos psicopatológicos do glossário do DSM-IV foram digitados em português e inglês na página do YouTube. Bandas e músicas de rock and roll foram identificadas. O mesmo procedimento foi realizado, a título de comparação, com o glossário de termos neurológicos da CID-10. RESULTADOS: Foram encontrados nomes de bandas ou músicas referentes a 62 termos psiquiátricos e a 24 termos neurológicos. Os termos psiquiátricos foram mais frequentes, apresentando diferença estatisticamente significativa. Foram encontradas 60 bandas de rock com nomes inspirados na psiquiatria e na neurologia. Dessas, 44 bandas usavam nomes psiquiátricos e 16 bandas usavam termos neurológicos. Bandas e músicas de rock usam mais nomes psiquiátricos que neurológicos. Predominaram nas músicas nomes relacionados ao uso de substâncias. Ao se compararem nomes de bandas e canções brasileiras e estrangeiras, não se encontrou diferença estatisticamente significativa. CONCLUSÃO: Bandas de rock and roll usam com maior frequência termos psicopatológicos em seus nomes e em suas músicas. Bandas brasileiras apresentam resultados semelhantes.

OBJECTIVE: To investigate the use of psychopathology terms in the names of rock and roll bands and in their songs or musics. METHOD: Psychopathological terms from the DSM-IV glossary were typed in Portuguese and English on the YouTube page. Bands and music of rock and roll were identified. The same procedure was performed, for comparison, with the glossary of neurological terms of ICD-10. RESULTS: Sixty-two psychiatry and 24 neurology related words were used by rock and roll bands and songs. A frequent use of psychiatric and neurological terms in band names and songs of rock was found. The psychiatric terms were more frequent. Sixty bands used psychiatric and neurology related names (44 bands used psychiatry names and 16 neurology). The names predominant in music were related to substance use. When comparing names and songs of Brazilian and other countries bands no difference was found. CONCLUSION: Rock and Roll bands use with greater frequency psychopathology and psychiatric terms in their names and musics. Brazilian bands held similar results.

Óbito pós inversão uterina: relato de caso / Death after uterine inversion: a case report

A inversão uterina é uma patologia rara, ocorre comocomplicação grave do terceiro estágio do trabalho departo. O aspecto mais importante reside no diagnósticoprecoce e como consequência uma conduta terapêuticametódica e urgente; quanto maior o atraso no tratamentomais alto a taxa de mortalidade. Descreve-se um casode inversão uterina não responsiva ao tratamento mesmosem apresentar intercorrências desde o pré-natalaté o parto. As autoras abordam em seguida os fatoresetiológicos, o diagnóstico e a terapêutica.

The uterus inversion is a rare pathology, occurs as aserious complication of the third labor stage. The mainlyaspect is an early diagnosis and consequently an therapeuticmethodical and urgent conduct; as longer isthe delay in treatment, as highest is the mortality rate.A case of uterine inversion that was unresponsive tothe treatment even without presenting complicationsfrom prenatal until delivery is described. The authorsthen discuss the etiologic factors, the diagnosis and thetherapeutic.