Apoio social relacionado ao uso de drogas entre universitários / Social support related to drug use among university students

O objetivo da presente pesquisa foi determinar a prevalência do uso de drogas psicoativas e investigar a sua associação com as redes de apoio social entre universitários. Os dados foram coletados por meio da aplicação de um questionário multidimensional em 227 universitários. Os resultados indicam que embora mais da metade já tenham consumido algum tipo de substância ilícita na vida, os índices de apoio social se mantiveram altos em todas as dimensões. Contudo, aqueles que estão expostos ao baixo apoio afetivo estão mais propensos ao uso moderado/alto de álcool e maconha, assim como aqueles que não possuem parentes com quem conversar possuem mais chances de usar álcool ou usar maconha. Outro dado importante consiste no fato de que estudantes que não possuem ou não praticam sua religião possuem mais chances de fazer uso de álcool.

The aim of this research was to determine the prevalence of the use of psychoactive drugs and investigate its association with social support networks among university students. Data were collected through the application of a multidimensional questionnaire in 227 university students. The results indicate that while more than half have already consumed some kind of illegal substance in life, social support levels were high in all dimensions. However, those who are exposed to low emotional support are more likely to moderate / high use of alcohol and marijuana, as well as those who have no relatives to talk to possess more likely to use alcohol or use marijuana. Another important factor is the fact that students who do not have or do not practice their religion have more chances of alcohol use.

Tratamento multicomponente para insônia infantil e seus efeitos nos padrões, hábitos e rotinas de sono / Multicomponent treatment for child insomnia and its effects on patterns, habits and sleeping routines / Tratamiento multicomponente para el insomnio infantil y sus efectos sobre patrones, hábitos y rutinas para dormir

Problemas de sono são frequentes na infância e estão associados a problemas de comportamento. O objetivo deste estudo foi avaliar o efeito de um tratamento multicomponente para a insônia infantil nos padrões, rotina e hábitos de sono das crianças. Participaram 57 crianças com problemas comportamentais relacionados ao sono e suas mães. As mães receberam educação sobre o sono infantil e orientações sobre o estabelecimento de horários e rotinas para dormir e sobre o uso de técnicas de extinção e reforço positivo. Os dados foram avaliados antes e após a intervenção por diários de sono e pela Escala UNESP de Hábitos e Higiene do Sono ­ Versão Crianças. Nossos resultados apontaram que crianças com problemas de sono apresentam em sua maioria, hábitos e rotinas inadequadas antes de dormir e que uma intervenção que focasse na modificação destes hábitos, somada a estratégias de extinção para comportamentos inadequados e reforço positivo para comportamentos adequados no momento de dormir podem ter contribuído na melhora do sono. Espera-se que este trabalho possa estimular a produção de pesquisas nacionais sobre o tema, servindo como incentivo para o desenvolvimento de medidas preventivas e interventivas para os problemas de sono na infância.

Sleep problems are common in childhood and are associated with behavioral problems. The aim of this study was to evaluate the effect of a multicomponent treatment for childhood insomnia on children's patterns, routine and sleep habits. 57 children with behavioral problems related to sleep and their mothers participated. The mothers were educated on their child's sleep, received guidance on the establishment of sleeping schedules and routines and on the use of extinction and positive reinforcement techniques. The data were evaluated before and after the intervention by sleep diaries and by the Escala UNESP de Hábitos e Higiene do Sono ­ Versão Crianças. Our results showed that children with sleep problems mostly present inadequate habits and routines before bedtime and that an intervention that focused on changing these habits, added to extinction strategies for inappropriate behaviors and positive reinforcement for adequate behaviors at bedtime may have contributed to improved sleep. It is hoped that this work can stimulate the production of national research on the subject, serving as an incentive for the development of preventive and interventional measures for childhood sleep problems.

Los problemas de sueño son comunes en la infancia y están asociados con problemas de comportamiento. El objetivo de este estúdio fue evaluar el efecto de um tratamiento multicomponente para el insomnio infantil em los patrones, la rutina y los hábitos de sueño de los niños. Participaron 57 niños con problemas de conducta relacionados com el sueño y sus madres. Las madres recibieron educación sobre el sueño infantil y orientación sobre como estabelecer horarios y rutinas de sueño y sobre el uso de técnicas de extinción y refuerzo positivo. Los datos fueron evaluados antes y después de la intervención por diarios de sueño y por la Escala UNESP de Hábitos e Higiene do Sono - Versão Crianças. Nuestros resultados mostraron que los niños con problemas de sueño em su mayoría presentan hábitos y rutinas inadecuados antes de acostarse y que una intervención que se centróen cambiar estos hábitos, se agregó a las estrategias de extinción por conductas inapropiadas y refuerzo positivo para conductas adecuadas antes de acostarse puede haber contribuido a mejorar el sueño. Se espera que este trabajo pueda estimular la producción de investigación nacional sobre el tema, sirviendo como un incentivo para el desarrollo de medidas preventivas e intervencionistas para los problemas del sueño infantil.

Orientação parental para insônia infantil em irmãos gêmeos: um relato de caso / Parental guidance for childhood insomnia in twins: a case report / Orientación parental para el insomnio infantil en hermanos gemelos: un informe de caso

Resumo A intervenção comportamental, por meio da orientação parental, vem alcançando resultados positivos no manejo da insônia em crianças. Contudo, questiona-se a efetividade de tais intervenções em irmãos gêmeos, pelo fato de os pais partilharem os cuidados de duas crianças da mesma idade e nível de desenvolvimento. O objetivo deste estudo é apresentar um relato de caso de intervenção comportamental para insônia infantil em irmãos gêmeos por meio de um programa dirigido aos pais e verificar o efeito da intervenção no sono e comportamentos diurnos das crianças. A mãe dos gêmeos foi orientada quanto as técnicas de extinção e reforço positivo no manejo do problema de sono infantil. Os resultados demonstraram que depois da intervenção houve melhora nos hábitos de sono, na qualidade do sono e nos comportamentos internalizantes e externalizantes das crianças. Os achados apresentados neste estudo mostraram os efeitos positivos que a intervenção baseada na aprendizagem operante teve sobre o sono e o comportamento infantil. Este aspecto ressalta a importância de uma inserção maior da questão do sono na Psicologia, a partir de práticas preventivas e interventivas.

Abstract Behavioral intervention by means of parental guidance has been achieving positive results in the management of insomnia in children. However, the effectiveness of such interventions in twins is questioned because parents share the care of two children of the same age and level of development. This is a case report of behavioral intervention for childhood insomnia in twins through a program for parents. The objective of this study is to analyze the effect of such intervention on children's sleep and daytime behaviors. The mother of the twins was instructed on the techniques of extinction and positive reinforcement in the management of children's sleep problems. The results showed that after the intervention there was an improvement in the children's sleep habits, sleep quality and internalizing and externalizing behaviors. The findings of this case report show the positive effects that an intervention based on operant learning had on children's sleep and behavior. This highlights the importance of a greater inclusion of issues related to sleep in psychological studies based on preventive and intervention practices.

Resumen La intervención comportamental, por medio de la orientación parental, viene alcanzando resultados positivos en el manejo del insomnio en niños. Sin embargo, se cuestiona la efectividad de tales intervenciones en hermanos gemelos, por el hecho de que los padres comparten los cuidados de dos niños de la misma edad y nivel de desarrollo. El objetivo de este estudio es presentar un relato de caso de intervención comportamental para insomnio infantil en hermanos gemelos por medio de un programa dirigido a los padres y verificar el efecto de la intervención en el sueño y comportamientos diurnos de los niños.. La madre de los gemelos fue orientada en cuanto a las técnicas de extinción y refuerzo positivo en el manejo del problema del sueño infantil. Los resultados demostraron que después de la intervención hubo mejoría en los hábitos de sueño, en la calidad del sueño y en los comportamientos internalizantes y externalizantes de los niños. Los hallazgos presentados en este estudio mostraron los efectos positivos que la intervención basada en el aprendizaje operante tuvo sobre el sueño y el comportamiento infantil. Este aspecto resalta la importancia de una inserción mayor de la cuestión del sueño en la psicología, a partir de prácticas preventivas e interventivas.

Behavioral intervention for sleep problems in childhood: a Brazilian randomized controlled trial.

BACKGROUND: Sleep problems are common in children and can have an effect on behavioral and emotional functioning. Despite the importance of sleep for children's health, there is a lack of studies on this topic in Brazil. The aim of this study was to evaluate the efficacy of behavioral intervention for sleep problems in young children and to investigate the effects on their daytime behavior. METHODS: Sixty-two children (ages 1-5; M = 2.3, SD = 1.3) with bedtime problems and night waking were randomized to a parent-based intervention or a wait list control group. After the waiting period, the wait list participants were offered treatment. The intervention was composed of five sessions over 2 months, during which the parents were educated on their child's sleep and received guidance on the establishment of sleeping schedules and routines and on the use of extinction and positive reinforcement techniques. Sleep patterns and behavior problems were assessed with parent-report measures. Sleep patterns were also assessed with actigraphy. Assessments were completed at pre-intervention, post-intervention, 1-month follow-up, and 6-month follow-up. RESULTS: Children who received intervention showed greater baseline to post-treatment improvements in sleep latency, night waking, behavior such as resisting going to bed, the desire to sleep with their parents, and daytime behavior than the control group. These improvements were maintained at follow-up. CONCLUSIONS: We concluded that behavioral parent-based intervention is effective in improving the quality of sleep and the diurnal behavior of children. This study provides initial support for use of this protocol in psychology clinics/schools. Brazilian clinical trials registration, RBR-4kxxd5. Retrospectively registered on December 13, 2016.

Behavioral intervention for sleep problems in childhood: a Brazilian randomized controlled trial

Abstract Background: Sleep problems are common in children and can have an effect on behavioral and emotional functioning. Despite the importance of sleep for children's health, there is a lack of studies on this topic in Brazil. The aim of this study was to evaluate the efficacy of behavioral intervention for sleep problems in young children and to investigate the effects on their daytime behavior. Methods: Sixty-two children (ages 1-5; M = 2.3, SD= 1.3) with bedtime problems and night waking were randomized to a parent-based intervention or a wait list control group. After the waiting period, the wait list participants were offered treatment. The intervention was composed of five sessions over 2 months, during which the parents were educated on their child's sleep and received guidance on the establishment of sleeping schedules and routines and on the use of extinction and positive reinforcement techniques. Sleep patterns and behavior problems were assessed with parent-report measures. Sleep patterns were also assessed with actigraphy. Assessments were completed at pre-intervention, post-intervention, 1-month follow-up, and 6-month follow-up. Results: Children who received intervention showed greater baseline to post-treatment improvements in sleep latency, night waking, behavior such as resisting going to bed, the desire to sleep with their parents, and daytime behavior than the control group. These improvements were maintained at follow-up. Conclusions: We concluded that behavioral parent-based intervention is effective in improving the quality of sleep and the diurnal behavior of children. This study provides initial support for use of this protocol in psychology clinics/schools. Brazilian clinical trials registration, RBR-4kxxd5. Retrospectively registered on December 13, 2016.

Sono e comportamento em crianças atendidas em um serviço de psicologia / Sleep and behavior in children assisted in a psychology service / El sueño y el comportamiento en los niños atendidos en un servicio de psicología

Problemas de sono são frequentes na infância e podem causar prejuízos à criança. Há uma associação possível entre distúrbios de sono infantil e problemas de comportamento. O objetivo do presente estudo foi avaliar as relações entre problemas internalizantes e externalizantes e problemas de sono em crianças da faixa pré-escolar, avaliadas por suas mães pelo Child Behavior Checklist (CBCL1½-5 anos), quando estas buscaram atendimento em uma clínica-escola de psicologia. Participaram do estudo 83 mães de crianças (sendo seus filhos: 58 meninos e 25 meninas) cujas idades variaram entre 2 e 5 anos. Análises indicaram que 29% das crianças apresentavam problemas com o sono, entre os quais, os mais frequentes foram "não querer dormir sozinho" e "resistir a ir para a cama". Os dados sugeriram ainda uma associação entre problemas de sono e comportamentos internalizantes (RP = 1,4; p < 0,05) e externalizantes (RP = 1,4; p < 0,05).

Sleep problems are common in childhood and can cause damage in children. There is a possible association between childhood sleep disorders and behavioral problems. The aim of this study was to evaluate the relationship between internalizing and externalizing problems and sleep problems in children of pre-school age, assessed by their mothers through the Child Behavior Checklist ( CBCL1 ½ -5 years) when seeking care at a clinic school psychology . The study included 83 mothers of children (and their children were: 58 boys and 25 girls) whose ages ranged between 2 and 5 years. Analysis indicated that 29 % of children had sleep problems among which the most frequent were "not wanting to sleep alone" and "resist the bed". The data also suggested an association between sleep problems and internalizing (PR = 1,4; p < 0,05) and externalizing (PR = 1,4; p < 0,05) behaviors.

Los problemas del sueño son comunes en la infancia y pueden causar daños en los niños. Existe una posible asociación entre los trastornos del sueño de la infancia y los problemas de comportamiento. El objetivo de este estudio fue evaluar la relación entre los problemas de internalización y externalización y los trastornos del sueño en niños en edad preescolar, evaluados por sus madres por medio del Child Behavior Checklist (CBCL1 ½ -5 años) cuando buscaban tratamiento en una clínica-escuela de psicología. El estudio incluyó a 83 madres y sus hijos (y sus niños: 58 niños y 25 niñas), con edades comprendidas entre los 2 y 5 años. El análisis indicó que 29% de los hijos tenían problemas de sueño entre los cuales los más frecuentes fueron "no querer dormir solo" y "resistir a la cama". Los datos también sugieren una asociación entre los trastornos del sueño y comportamientos de internalización (PR = 1,4; p < 0,05) y de externalización (PR = 1,4; p < 0,05).

Free-running circadian rhythms of muscle strength, reaction time, and body temperature in totally blind people.

Light is the major synchronizer of circadian rhythms. In the absence of light, as for totally blind people, some variables, such as body temperature, have an endogenous period that is longer than 24 h and tend to be free running. However, the circadian rhythm of muscle strength and reaction time in totally blind people has not been defined in the literature. The objective of this study was to determine the period of the endogenous circadian rhythm of the isometric and isokinetic contraction strength and simple reaction time of totally blind people. The study included six totally blind people with free-running circadian rhythms and four sighted people (control group). Although the control group required only a single session to determine the circadian rhythm, the blind people required three sessions to determine the endogenous period. In each session, isometric strength, isokinetic strength, reaction time, and body temperature were collected six different times a day with an interval of at least 8 h. The control group had better performance for strength and reaction time in the afternoon. For the blind, this performance became delayed throughout the day. Therefore, we conclude that the circadian rhythms of strength and simple reaction time of totally blind people are within their free-running periods. For some professionals, like the blind paralympic athletes, activities that require large physiological capacities in which the maximum stimulus should match the ideal time of competition may result in the blind athletes falling short of their expected performance under this free-running condition.

Estudo normativo do R-2: Teste Não Verbal de Inteligência para Crianças / Standardization study of the R-2: Non Verbal Intelligence Test for Children / Estudio normativo del R-2: Test de Inteligencia No Verbal para Niños

Este estudo apresenta a padronização do R-2: Teste Não Verbal de Inteligênciapara Crianças, no Município de Assis – SP (Brasil), que é comparada a do Manual doteste referente ao Município de São Paulo. A amostra é composta por 559 crianças,metade de cada sexo, de 5 a 11 anos de idade, sorteadas nas escolas de Assis, respeitandoa proporção de alunos matriculados em escolas municipais e particulares. Os resultadosindicam diferenças entre as idades e os tipos de escola, mas não entre os sexos. Sãoestabelecidas normas em percentis para a amostra total para cada idade. Comparandoos resultados das crianças de Assis com os das de São Paulo as diferenças sãosignificantes, com resultados levemente mais altos para os de Assis. Conclui-se que o R-2 é adequado para avaliação cognitiva das crianças de Assis, sugerindo o uso dasnovas normas para esta região do Estado(AU)

This study presents the standardization of the R-2 Non Verbal IntelligenceTest for Children conducted at the city of Assis – SP, Brazil, and compares it with theSão Paulo city standardization. The sample was composed by 559 children, between 5and 11 years old, half of each sex, students from Assis city, randomly selected accordingto their proportion in private and public schools. Results indicate differences betweenages and school types, but not between sexes. Percentile norms were established forthe total sample at each age. The comparison of Assis and São Paulo city childrenreveals significant differences and Assis’ results slightly higher. The conclusion is that R-2 Test is appropriate to cognitive assessment of Assis children, suggesting the useof new norms for this region(AU)

En este estudio se presenta la normalización del R-2: Test de inteligenciano verbal para niños, en el municipio de Assis - SP (Brasil), siendo comparada con elmanual del Instrumento referente al Municipio de São Paulo. La muestra está conformadapor 559 niños, de ambos sexo, distribuidos simétricamente entre sí, con edades entre5-11 años, seleccionados al azar de las escuelas del Municipio de Assís, respetandola proporción de alumnos matriculados en las escuelas públicas y escuelas privadas.Los resultados indican diferencias entre las edades y tipos de escuela, pero no entrelos sexos. Las normas se expresan en percentiles divididos en edades. Comparandolos resultados de los niños participantes del Municipio de Assís con los del Municipiode São Paulo, se observan diferencias significativas, con resultados un poco máselevados para el Municipio de Assís. Se puede concluir que el Test R-2 es adecuadopara la evaluación cognitiva de los niños de Assís, por lo que se recomienda el uso delas nuevas normas para esta región del estado(AU)

A criança que não dorme: aspectos comportamentais da insônia infantil / The child that does not sleep: behavioral aspects of childhood insomnia

A insônia comportamental é um problema frequente em crianças. Quando não tratada, pode resultar em prejuízos no comportamento, aprendizagem e regulação emocional. O presente artigo aborda a importância da avaliação diagnóstica comportamental em crianças com problemas relacionados ao momento de dormir e aos despertares noturnos. A partir de uma análise funcional detalhada é possível identificar o que mantém os comportamentos inadequados da criança em relação ao sono, e assim traçar um plano de intervenção eficaz. As estratégias comumente usadas para o tratamento da insônia infantil são a extinção e o reforço positivo, consideradas pela literatura como métodos eficazes tanto para a redução de problemas no momento de dormir como para os despertares noturnos.

Sono, qualidade de vida e depressão em mulheres no pós-tratamento de câncer de mama / Sleep, quality of life and depression in women in breast cancer post-treatment

Este trabalho investigou a qualidade de sono de mulheres com câncer de mama e suas relações com qualidade de vida e depressão. Cinqüenta mulheres com câncer de mama (grupo clínico) e cinqüenta controles responderam um questionário médico-demográfico e ao instrumento Pittsburgh Sleep Quality Index. O grupo clínico também respondeu aos instrumentos Quality of Life Cancer-Survivor e Brief Zung Self-Rating Depression Scale. Verificou-se que mulheres com câncer tinham significativamente mais queixas de nictúria, calor e despertares noturnos. O grupo clínico com má qualidade do sono apresentou comprometimento na qualidade de vida e mais sintomas de depressão. Em geral, a qualidade de sono em mulheres com câncer de mama pode predizer a qualidade de vida e o bem estar psicológico.(AU)

This study investigated the sleep quality of women with breast cancer and their relationship with quality of life and depression. Fifty women with breast cancer (clinical group) and a control group of other 50 women without the disease answered a clinical-demographic questionnaire and the Pittsburgh Sleep Quality Index. The clinical group also completed the Quality of Life Cancer-Survivor and the Brief Zung Self-Rating Depression Scale questionnaires. It was found that women with breast cancer had significantly more complaints of nocturia, heat and nighttime awakenings. The clinical group with poor quality of sleep reported impaired quality of life and more symptoms of depression. In general terms, sleep quality in women with breast cancer can predict their quality of life and psychological well-being.(AU)

Sono, qualidade de vida e depressão em mulheres no pós-tratamento de câncer de mama / Sleep, quality of life and depression in women in breast cancer post-treatment

Este trabalho investigou a qualidade de sono de mulheres com câncer de mama e suas relações com qualidade de vida e depressão. Cinqüenta mulheres com câncer de mama (grupo clínico) e cinqüenta controles responderam um questionário médico-demográfico e ao instrumento Pittsburgh Sleep Quality Index. O grupo clínico também respondeu aos instrumentos Quality of Life Cancer-Survivor e Brief Zung Self-Rating Depression Scale. Verificou-se que mulheres com câncer tinham significativamente mais queixas de nictúria, calor e despertares noturnos. O grupo clínico com má qualidade do sono apresentou comprometimento na qualidade de vida e mais sintomas de depressão. Em geral, a qualidade de sono em mulheres com câncer de mama pode predizer a qualidade de vida e o bem estar psicológico.

This study investigated the sleep quality of women with breast cancer and their relationship with quality of life and depression. Fifty women with breast cancer (clinical group) and a control group of other 50 women without the disease answered a clinical-demographic questionnaire and the Pittsburgh Sleep Quality Index. The clinical group also completed the Quality of Life Cancer-Survivor and the Brief Zung Self-Rating Depression Scale questionnaires. It was found that women with breast cancer had significantly more complaints of nocturia, heat and nighttime awakenings. The clinical group with poor quality of sleep reported impaired quality of life and more symptoms of depression. In general terms, sleep quality in women with breast cancer can predict their quality of life and psychological well-being.

Estratégias de coping e o impacto sofrido pela família quando um dos seus está em tratamento contra o câncer / The coping strategies and the impact suffered by the family when one of theirs lies in a cancer treatment / Estrategias de coping y el impacto sufrido por la familia cuando uno de ellos está en tratamiento contra el cáncer

O estudo pretendeu analisar o impacto sofrido por 40 familiares ao descobrir que um dos seus foi diagnosticado com câncer, analisar as estratégias de coping utilizadas pela família em relação à doença do paciente e as perspectivas de futuro em relação a ele. Utilizou-se o Inventário de Estratégias de Coping de Folkman e Lazarus. Os resultados mostram que a maioria dos acompanhantes é formada por filhos dos pacientes, casados, com média de idade de 45,7 (dp=12.67) anos e que exercem atividade remunerada além dos cuidados dispensados ao familiar. Familiares relataram o impacto negativo da notícia do diagnóstico, predominando sentimentos de tristeza e medo da perda. Apesar disso, expressam uma perspectiva positiva quanto ao futuro, esperando a cura ou recuperação do paciente. Em relação às estratégias de enfrentamento funcionais, a mais utilizada foi a resolução de problemas, seguida de suporte social; a menos utilizada foi a de reavaliação positiva. Quanto às estratégias disfuncionais, a mais utilizada foi fuga e esquiva e a menos utilizada foi a de aceitação de responsabilidade. Conclui-se que mesmo sofrendo com o impacto negativo da notícia, os familiares mantêm o otimismo quanto ao futuro do paciente e procuram utilizar estratégias que resolvam o problema de maneira efetiva, além de não se culpar pelo adoecimento do familiar. (AU)

The aim of the present study was to analyze the impact suffered by 40 people when discovering that one of their family members was diagnosed with cancer, to analyze their coping strategies and expectations towards the patient’s illness and future. The study made use of the Coping Strategies Inventory by Folkman and Lazarus. Results show that most of the patients’ caregivers are their married children, with an average age of 45.7 (dp=12.67), and gainfully employed. These family members reported the negative impact of the diagnosis, with the predominant feelings of sadness and fear of loss, even though they had a positive perspective about the future, expecting the patient’s recovery. As to the functional coping strategies, the most used were the resolution of problems, followed by social support; the least used was positive revaluation. As to the dysfunctional strategies, the most used ones were escape and avoidance and the least used was taking the responsibility for the illness. Conclusions are that despite sufferingwith the negative impact of the disease, the family members are optimistic about the patient’s future and seek to usestrategies that solve the problem effectively, without blaming them selves for the patient’s illness. (AU)

El presente estudio pretendió analizar el impacto sufrido por 40 miembros de la familia al descubrir que uno de los familiares fue diagnosticado con cáncer, analizar las estrategias de coping utilizadas por la familia en relación a la enfermedad del familiar y las perspectivas de futuro en relación al paciente. Fue utilizado el Inventario de Estrategias de Coping de Folkman y Lazarus. Los resultados demuestran que la mayoría de los familiares acompañantes es de hijos de los pacientes, casados, con la edad media de 45,7 (dp=12.67) años y ejercen actividad remunerada además de los cuidados que tienen con el familiar. Familiares relataron el impacto negativo de la noticia del diagnóstico, sentimientos de tristeza y miedo de la perdida son predominantes. A pesar de eso ellos refieren una perspectiva positiva en relación al futuro, esperando la cura o recuperación del paciente. Con relación a las estrategias de enfrentamiento funcionales, la más utilizada fue la resolución de problemas, seguida de soporte social, y la menos utilizada fue la reevaluación positiva. En cuanto a las estrategias disfuncionales, la más utilizada fue fuga y esquiva y la menos utilizada fue de aceptación de responsabilidad. Se concluye que mismo sufriendo con el impacto negativo de la noticia, los familiares mantienen el optimismo en relación al futuro del paciente y buscan utilizar estrategias que resuelvan el problema de manera efectiva, además de no culparse por el adolecer del familiar. (AU)

Estratégias de coping e o impacto sofrido pela família quando um dos seus está em tratamento contra o câncer / The coping strategies and the impact suffered by the family when one of theirs lies in a cancer treatment / Estrategias de coping y el impacto sufrido por la familia cuando uno de ellos está en tratamiento contra el cáncer

O estudo pretendeu analisar o impacto sofrido por 40 familiares ao descobrir que um dos seus foi diagnosticado com câncer, analisar as estratégias de coping utilizadas pela família em relação à doença do paciente e as perspectivas de futuro em relação a ele. Utilizou-se o Inventário de Estratégias de Coping de Folkman e Lazarus. Os resultados mostram que a maioria dos acompanhantes é formada por filhos dos pacientes, casados, com média de idade de 45,7 (dp=12.67) anos e que exercem atividade remunerada além dos cuidados dispensados ao familiar. Familiares relataram o impacto negativo da notícia do diagnóstico, predominando sentimentos de tristeza e medo da perda. Apesar disso, expressam uma perspectiva positiva quanto ao futuro, esperando a cura ou recuperação do paciente. Em relação às estratégias de enfrentamento funcionais, a mais utilizada foi a resolução de problemas, seguida de suporte social; a menos utilizada foi a de reavaliação positiva. Quanto às estratégias disfuncionais, a mais utilizada foi fuga e esquiva e a menos utilizada foi a de aceitação de responsabilidade. Conclui-se que mesmo sofrendo com o impacto negativo da notícia, os familiares mantêm o otimismo quanto ao futuro do paciente e procuram utilizar estratégias que resolvam o problema de maneira efetiva, além de não se culpar pelo adoecimento do familiar.

The aim of the present study was to analyze the impact suffered by 40 people when discovering that one of their family members was diagnosed with cancer, to analyze their coping strategies and expectations towards the patient’s illness and future. The study made use of the Coping Strategies Inventory by Folkman and Lazarus. Results show that most of the patients’ caregivers are their married children, with an average age of 45.7 (dp=12.67), and gainfully employed. These family members reported the negative impact of the diagnosis, with the predominant feelings of sadness and fear of loss, even though they had a positive perspective about the future, expecting the patient’s recovery. As to the functional coping strategies, the most used were the resolution of problems, followed by social support; the least used was positive revaluation. As to the dysfunctional strategies, the most used ones were escape and avoidance and the least used was taking the responsibility for the illness. Conclusions are that despite sufferingwith the negative impact of the disease, the family members are optimistic about the patient’s future and seek to usestrategies that solve the problem effectively, without blaming them selves for the patient’s illness.

El presente estudio pretendió analizar el impacto sufrido por 40 miembros de la familia al descubrir que uno de los familiares fue diagnosticado con cáncer, analizar las estrategias de coping utilizadas por la familia en relación a la enfermedad del familiar y las perspectivas de futuro en relación al paciente. Fue utilizado el Inventario de Estrategias de Coping de Folkman y Lazarus. Los resultados demuestran que la mayoría de los familiares acompañantes es de hijos de los pacientes, casados, con la edad media de 45,7 (dp=12.67) años y ejercen actividad remunerada además de los cuidados que tienen con el familiar. Familiares relataron el impacto negativo de la noticia del diagnóstico, sentimientos de tristeza y miedo de la perdida son predominantes. A pesar de eso ellos refieren una perspectiva positiva en relación al futuro, esperando la cura o recuperación del paciente. Con relación a las estrategias de enfrentamiento funcionales, la más utilizada fue la resolución de problemas, seguida de soporte social, y la menos utilizada fue la reevaluación positiva. En cuanto a las estrategias disfuncionales, la más utilizada fue fuga y esquiva y la menos utilizada fue de aceptación de responsabilidad. Se concluye que mismo sufriendo con el impacto negativo de la noticia, los familiares mantienen el optimismo en relación al futuro del paciente y buscan utilizar estrategias que resuelvan el problema de manera efectiva, además de no culparse por el adolecer del familiar.

Increasing trends of sleep complaints in the city of Sao Paulo, Brazil.

OBJECTIVE: The aim of this study was to compare the prevalence of sleep habits and complaints and to estimate the secular trends through three population-based surveys carried out in 1987, 1995, and 2007 in the general adult population of the city of Sao Paulo, Brazil. METHODS: Surveys were performed using the same three-stage cluster-sampling technique in three consecutive decades to obtain representative samples of the inhabitants of Sao Paulo with respect to gender, age (20-80 years), and socio-economic status. Sample sizes were 1000 volunteers in 1987 and 1995 surveys and 1101 in a 2007 survey. In each survey, the UNIFESP Sleep Questionnaire was administered face-to-face in each household selected. RESULTS: For 1987, 1995, and 2007, respectively, difficulty initiating sleep (weighted frequency %; 95% CI) [(13.9; 11.9-16.2), (19.15; 16.8-21.6), and (25.0; 22.5-27.8)], difficulty maintaining sleep [(15.8; 13.7-18.2), (27.6; 24.9-30.4), and (36.5; 33.5-39.5)], and early morning awakening [(10.6; 8.8-12.7), (14.2; 12.2-16.5), and (26.7; 24-29.6)] increased in the general population over time, mostly in women. Habitual snoring was the most commonly reported complaint across decades and was more prevalent in men. There was no statistically significant difference in snoring complaints between 1987 (21.5; 19.1-24.2) and 1995 (19.0; 16.7-21.6), but a significant increase was noted in 2007 (41.7; 38.6-44.8). Nightmares, bruxism, leg cramps, and somnambulism complaints were significantly higher in 2007 compared to 1987 and 1995. All were more frequent in women. CONCLUSIONS: This is the first study comparing sleep complaints in probabilistic population-based samples from the same metropolitan area, using the same methodology across three consecutive decades. Clear trends of increasing sleep complaints were observed, which increased faster between 1995 and 2007 than from 1987 to 1995. These secular trends should be considered a relevant public health issue and support the need for development of health care and educational strategies to supply the population's increased need for information on sleep disorders and their consequences.

Pituitary volume and the effects of phototherapy in patients with seasonal winter depression: a controlled study.

OBJECTIVES: Our aims were to investigate the pituitary volume in patients with seasonal winter depression and healthy volunteers in winter and summer, and to assess the effects of phototherapy in these patients. METHOD: The pituitary volume of 12 patients with winter depression and 12 healthy controls, paired according gender, age and menstrual cycle, were obtained from magnetic resonance imaging in winter and summer. Eight patients were submitted to phototherapy (10000 vs. 2500 lux) in a double-blind crossover fashion during the winter, and reassessed (symptoms and magnetic resonance imaging) after treatment. RESULTS: There were no significant differences in pituitary volume between controls and patients in winter or summer. Exposure to phototherapy (10000 lux) decreased the depressive symptoms (p = 0.004), but the glandular volume did not change (p = 0.5). However, the pituitary volume in winter showed a positive correlation with the severity of depression in these patients (r = 0.69, p = 0.04). CONCLUSIONS: The results suggest that neither winter depression nor the change of seasons is associated with significant change in the pituitary volume. Despite the fact that this study was performed in a tropical area, phototherapy with 10000 lux showed to be an efficient treatment in this SAD patients sample.

Pituitary volume and the effects of phototherapy in patients with seasonal winter depression: a controlled study

OBJECTIVES: Our aims were to investigate the pituitary volume in patients with seasonal winter depression and healthy volunteers in winter and summer, and to assess the effects of phototherapy in these patients. METHOD: The pituitary volume of 12 patients with winter depression and 12 healthy controls, paired according gender, age and menstrual cycle, were obtained from magnetic resonance imaging in winter and summer. Eight patients were submitted to phototherapy (10000 vs. 2500 lux) in a double-blind crossover fashion during the winter, and reassessed (symptoms and magnetic resonance imaging) after treatment. RESULTS: There were no significant differences in pituitary volume between controls and patients in winter or summer. Exposure to phototherapy (10000 lux) decreased the depressive symptoms (p = 0.004), but the glandular volume did not change (p = 0.5). However, the pituitary volume in winter showed a positive correlation with the severity of depression in these patients (r = 0.69, p = 0.04). CONCLUSIONS: The results suggest that neither winter depression nor the change of seasons is associated with significant change in the pituitary volume. Despite the fact that this study was performed in a tropical area, phototherapy with 10000 lux showed to be an efficient treatment in this SAD patients sample.

OBJETIVOS: Nossos objetivos foram investigar o volume da pituitária em pacientes com depressão sazonal de inverno e controles sadios, no inverno e verão, e avaliar os efeitos da fototerapia nesses pacientes. MÉTODO: O volume da pituitária de 12 pacientes com depressão de inverno e 12 controles sadios, pareados quanto ao gênero, idade e fase do ciclo menstrual, foi examinado por meio de imagem por ressonância magnética no inverno e verão. Oito pacientes foram submetidos à fototerapia (10.000 vs 2.500 lux) de forma duplo-cega e cruzada durante o inverno e reavaliados (sintomas e imagem por ressonância magnética) após o tratamento. RESULTADOS: Não houve diferença significativa no volume da pituitária entre controles e pacientes, no inverno e verão. A fototerapia (10.000 lux) reduziu os sintomas depressivos (p = 0,004), mas não alterou o volume glandular (p = 0,5). Contudo, o volume da pituitária, no inverno, mostrou uma correlação positiva com a gravidade da depressão nesses pacientes (r = 0,69, p = 0,04). CONCLUSÕES: Os resultados sugerem que nem a depressão de inverno, nem a mudança das estações estão associadas com a mudança significativa do volume da pituitária. Apesar do fato deste estudo ter sido realizado em uma região tropical, a fototerapia com 10.000 lux mostrou-se um tratamento eficaz nesta amostra.

Seasonal variation of suicide in Brazil.

Most of what is known about the seasonal variation in suicide rate originates from studies conducted in the northern hemisphere; very few studies have been done in the southern hemisphere. The purpose of the present study was to explore the possibility that in Brazil, the seasonal variation of suicides is a function of photoperiod. This was accomplished by analyzing monthly suicide data for a 12 yr period (1979 to 1990), within latitudes ranging from 2 degrees N to 33 degrees S. Single cosinor analyses with periods of 12 or 6 months were applied to time series of monthly total and suicidal deaths, separated by gender and state. Significant spring or early summer peaks of suicide were found only in the south of Brazil for both men and women, except for the latter in one state. These peaks did not coincide with those found for total deaths, which occurred in the autumn or winter in all areas. No significant six-month period was found. In the present study, the chance of a suicide was typically 10-17% higher during the peak period than during the other months of the year. Although this moderate seasonal effect might not be sufficient to justify planning large scale prophylactic interventions, those dealing with patients who have suicide ideation should be aware of this high risk time.

[Excessive daytime sleepiness]. / Sonolência excessiva.

Sleepiness is a physiological function, and can be defined as increased propension to fall asleep. However, excessive sleepiness (ES) or hypersomnia refer to an abnormal increase in the probability to fall asleep, to take involuntary naps, or to have sleep atacks, when sleep is not desired. The main causes of excessive sleepiness is chronic sleep deprivation, sleep apnea syndrome, narcolepsy, movement disorders during sleep, circadian sleep disorders, use of drugs and medications, or idiopathic hypersomnia. Social, familial, work, and cognitive impairment are among the consequences of hypersomnia. Moreover, it has also been reported increased risk of accidents. The treatment of excessive sleepiness includes treating the primary cause, whenever identified. Sleep hygiene for sleep deprivation, positive pressure (CPAP) for sleep apnea, dopaminergic agents and exercises for sleep-related movement disorders, phototherapy and/or melatonin for circadian disorders, and use of stimulants are the treatment modalities of first choice.

Sonolência excessiva / Excessive daytime sleepiness

A sonolência é uma função biológica, definida como uma probabilidade aumentada para dormir. Já a sonolência excessiva (SE), ou hipersonia, refere-se a uma propensão aumentada ao sono com uma compulsão subjetiva para dormir, tirar cochilos involuntários e ataques de sono, quando o sono é inapropriado. As principais causas de sonolência excessiva são a privação crônica de sono (sono insuficiente), a Síndrome da Apnéia e Hipopnéia Obstrutiva do Sono (SAHOS), a narcolepsia, a Síndrome das Pernas Inquietas/Movimentos Periódicos de Membros (SPI/MPM), Distúrbios do Ritmo Circadiano, uso de drogas e medicações e a hipersonia idiopática. As principais conseqüências são prejuízo no desempenho nos estudos, no trabalho, nas relações familiares e sociais, alterações neuropsicológicas e cognitivas e risco aumentado de acidentes. O tratamento da sonolência excessiva deve estar voltado para as causas específicas. Na privação voluntária do sono, aumentar o tempo de sono e higiene do sono, o uso do CPAP (Continuous Positive Airway Pressure) na Síndrome da Apnéia e Hipopnéia Obstrutiva do Sono, exercícios e agentes dopaminérgicos na Síndrome das Pernas Inquietas/Movimentos Periódicos de Membros, fototerapia e melatonina nos Distúrbios do Ritmo Circadiano, retiradas de drogas que causam sonolência excessiva e uso de estimulantes da vigília.

Sleep and sleepiness among Brazilian shift-working bus drivers.

The aim of this study was to evaluate daytime and nighttime sleep, as well as daytime and nighttime sleepiness of professional shift-working bus drivers. Thirty-two licensed bus drivers were assessed by nocturnal and diurnal polysomnography (PSG) recording and multiple sleep latency testing (MSLT) sessions. Sleep length was shorter and sleep efficiency reduced during daytime sleep compared with nighttime sleep. Thirty-eight percent of the drivers had indices of obstructive apnea and hypopnea syndrome (>5/h sleep) during nighttime and daytime sleep; more drivers snored during daytime than nighttime sleep (50% vs. 35%, p < 0.05), and 38% of the drivers evidenced periodic leg movements. The MSLT revealed that 42 and 38% of the bus drivers met the criteria for sleepiness when the test was conducted during the day and night, respectively. The daytime as compared to nighttime sleep of shift-working bus drivers was shorter and more fragmented and was associated in many with evidence of excessive sleepiness. Respiratory disorder was a common finding among the professional shift-working bus drivers. All these sleep deficiencies may adversely affect on the job driving performance.