Adult ADHD Symptoms in a Large Metropolitan Area From Brazil: Prevalence and Associations with Psychiatric Comorbidity, Bullying, Sexual Abuse, and Quality of Life.

OBJECTIVE: The aim of this study was to investigate the prevalence and psychiatric correlates of symptomatic ADHD in a large metropolitan area of a middle-income country. METHODS: An in-person household survey with randomly selected 2,297 adults aged 19 to 60 from Rio de Janeiro, Brazil, assessed by trained lay interviewers. The Adult Self-Rating Scale Screener (ASRS-6) was used. Chi-square and logistic regression were conducted. RESULTS: ADHD prevalence was 4.59 (95% CI [3.56, 5.44]). Those with ADHD were younger and more often unemployed; they displayed more psychiatric symptoms (depression, anxiety, and alcohol abuse) and a history of bullying and sexual abuse. They also had worse physical health indicators. Findings remained significant when controlling for socioeconomic variables. CONCLUSION: Adults with symptomatic ADHD from a large metropolitan area in Brazil show a pattern of findings consistent with what has been observed in higher-income countries.

Inpatient Screening for Early Identification of Developmental Risk in Infants with Congenital Heart Defects.

OBJECTIVE: To assess the utility of an inpatient standardized developmental screener for early identification of developmental risk in infants with a congenital heart defect (CHD). STUDY DESIGN: This was a retrospective, observational study with convenience sample of postoperative infants with CHD (aged 3-12 months) who underwent neurodevelopmental screening with the Bayley Scales of Infant and Toddler Development Screening Test, Third Edition (Bayley-III Screener) just before discharge. Follow-up testing included outpatient Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) (12-42 mo). RESULTS: The Bayley-III Screener was administered to 325 infants at a median of 5 months, 8 days (IQR 3 months, 28 days, to 7 months, 17 days). Infants scored below age expectations on the Gross Motor (79%), Fine Motor (63%), Receptive Communication (50%), Expressive Communication (38%), and Cognitive (38%) domains. In each domain, children with CHD had greater rates of scores below expectations than the normative sample (each P <.001). The odds of scoring in a greater risk category were increased for infants with genetic syndromes and longer length of hospital stay across all domains. The outpatient Bayley-III (n = 74, 23% follow-up) was completed at a median of 19 months, 9 days (IQR: 17 months, 3 days, to 23 months, 37 days). Individuals falling in greater-risk categories on their initial Bayley-III Screener were significantly more likely to have worse performance on their follow-up outpatient Bayley-III (each domain P < .01). CONCLUSIONS: Inpatient standardized neurodevelopmental screening provides important clinical utility in identifying infants at risk for developmental concern, allows for provision of recommendations for developmental services, and potentially overcomes barriers often noted in returning for outpatient post-discharge assessments.

"Early detection of Spanish-speaking children with developmental language disorders: Concurrent validity of a short questionnaire and a screening test".

BACKGROUND: . Under-identification of Developmental Language Disorder (DLD) is a significant problem in monolingual Latin American Spanish-speaking children. We evaluated the identification utility of the sequential use of two screening tools, the "Parental Questionnaire (PQ)" and the "Screening for Language Problems (TPL)", to identify children who require confirmatory diagnosis of DLD. METHODS: Parents of children (4 to 6 years) were contacted in schools and public health centers in Mexico. Monolingual Spanish-speaking children with no auditory and cognitive disorders were eligible. The reference diagnosis of DLD was established using BESA (Bilingual English-Spanish Assessment) or SCELF-4 (Spanish Clinical Evaluation of Language Fundamentals), combined with data from the narrative samples that yielded the percentage of ungrammaticality and the clinical judgment of two Speech-Language Pathologists (SLPs). Responses to the PQ were obtained as a parental report, and the TPL was applied by a trained SLPs. RESULTS: . Both PQ and TPL presented a significant difference between the groups of children with DLD and typical language development (TLD). By combining the two instruments, a notable improvement in diagnostic utility was shown. CONCLUSION: . The combination of these two procedures provides an efficient method for screening children having the risk of DLD and contributes to resolving the problem of under-identification.

Implicações do processo de trabalho na saúde do triador clínico de doadores de sangue / Implications of the work process on the health of the clinical blood donor screener

A triagem clínica de doadores de sangue é a etapa onde condições clínicas e comportamentais de doadores são avaliadas com objetivo de evitar danos à saúde de quem doa e de quem recebe sangue e hemoderivados. Os profissionais que atuam na triagem clínica estão imersos na relevância da doação de sangue, na dificuldade em se manter estoques seguros e, na situação conflituosa do labor monótono, repetitivo, de baixa densidade tecnológica, em contraponto, na complexidade das tomadas de decisão da função. Esta dissertação teve como objetivo avaliar as implicações do processo de trabalho do triador em sua saúde, no contexto das hemorredes de três estados do sudeste brasileiro. O método adotado se baseou na abordagem quantitativa com análise de dados coletados do questionário socioprofissional e da adaptação do Inventário sobre Trabalho e Risco de Sofrimento. A pesquisa evidenciou que o triador clínico está exposto a vivências críticas de prazer e sofrimento. O domínio 'Realização profissional' demonstra que os triadores clínicos reconhecem a importância do seu trabalho, mas, o domínio 'Falta de reconhecimento' demonstrou que de maneira geral os triadores não tem percepção de reconhecimento externo. Já os critérios que sugerem danos à saúde física, social e psicológica tiveram médias que indicam atividade suportável, embora algumas variáveis indiquem níveis graves de danos como dores de cabeça e dores nas costas, além de variáveis classificadas críticas, como alterações do sono, dores nas pernas, dores nos braços, dores no corpo, impaciência com as pessoas em geral, irritação com tudo e mau-humor, que precisam ser consideradas e trabalhadas pela gestão. A escassez de literatura sobre o tema e o tamanho da amostra dificultaram a amplitude da discussão dos resultados. Por esta razão, sugere-se futuros estudos, inclusive com método de pesquisa qualitativa a fim de ampliar a investigação dos riscos de adoecimento e estratégias defensivas para a categoria profissional. (AU)

Clinical screen of blood donors is the stage where clinical and behavioral conditions of donors are evaluated with the aim of preventing damage to the health of those who donate and those who receive blood and blood products. Professionals who work in clinical screen are immersed in the relevance of blood donation, the difficulty in maintaining safe stocks and, in the conflicting situation of monotonous, repetitive work, with low technological density, in contrast, in the complexity of decision-making. This dissertation aimed to evaluate the implications of the clinical screener's work process on their health, in the context of blood banks in three states in southeastern Brazil. The method adopted was based on a quantitative approach with analysis of data collected from the socio-professional questionnaire and the adaptation of the Inventory on Work and Risk of Suffering. The research showed that the clinical screener is exposed to critical experiences of pleasure and suffering. The 'Professional achievement' domain demonstrates that triagists recognize the importance of their work, but the 'Lack of recognition' domain demonstrated that in general, clinical screeners do not have a perception of external recognition. The criteria that suggest damage to physical, social and psychological health had averages that indicate bearable activity, although some variables indicate serious levels of damage such as headaches and back pain, in addition to variables classified as critical, such as changes in sleep, pain in legs, arm pain, body pain, impatience with people in general, irritation with everything and bad mood, which need to be considered and worked on by management. The scarcity of literature on the topic and the size of the sample made it difficult to discuss the results. For this reason, future studies are suggested, including with a qualitative research method in order to expand the investigation of the risks of illness and defensive strategies for the professional category. (AU)

Propiedades psicométricas y métodos de medición de la escala de autoinforme sobre el trastorno de déficit de atención e hiperactividad en adultos - tamizaje (ASRS- Tamizaje) en la población de Lima / Psychometric properties and measurement methods of the Adult Attention and Hyperactivity Disorder Self-Report Scale Screener (ASRS-Screener) in the population of Lima

RESUMEN Objetivos : Determinar la distribución de puntajes, confiabilidad, validez y asociación con variables sociodemográficas de la Escala de Autoinforme sobre el Déficit de Atención e Hiperactividad en Adultos-Tamizaje (ASRS-Tamizaje) en la población de Lima y Callao, según dos formas de calificación (binaria y Likert), y establecer la concordancia entre ambas. Material y Métodos : Se realizó un análisis secundario de la base de datos del Estudio Epidemiológico de Salud Mental de Lima Metropolitana y Callao 2012 - Replicación, en una muestra de 4445 personas de 18 o más años de edad (42,6±17,4). Resultados : El promedio de la ASRS-Tamizaje en escala Likert fue 3,74+3,9 (rango 0-21), la consistencia interna mediante coeficiente alfa de Cronbach =0,806 y mediante el coeficiente omega de McDonald =0,869; el análisis factorial mostró que 52,95% de la inercia total era explicado por un solo factor. En escala binaria la media fue 0,89+1,27 (rango 0-6), el alfa de Cronbach =0,599, el omega de McDonald =0,753 y el 52,31% de la inercia fue explicado por dos factores. Con ambas escalas, se halló un coeficiente Kappa =0,734 de concordancia de tamizajes positivos. Las dos formas de la escala se asocian con la edad, en tanto que solo la clasificación binaria lo hace con estado civil y grado de educación. Conclusiones: La ASRS-Tamizaje es un instrumento de consistencia interna aceptable. Su estructura factorial y la prevalencia de tamizajes positivos varían según la forma de medición (Likert o binaria).

SUMMARY Objectives: To determine the distribution of scores, reliability, validity and association with sociodemographic variables of the Self-Report Scale of Attention Deficit Hyperactivity Disorder in adults - Screening (ASRS- Screening) in the population of Lima and Callao, according to two rating scales (binary and Likert), and to establish the concordance between both of them. Material and Methods : Study based on data from the Epidemiological Mental Health Study of Metropolitan Lima 2012 - Replication, in a sample of 4 445 people, 18 years or older (42.6 ± 17.4). Results : The average of the ASRS-Likert screening was 3.74 + 3.9 (range 0-21), internal consistency using Cronbach alpha coefficient = 0.806, McDonald's omega coefficient = 0,869, and factor analysis showed 52.95% of the total inertia explained by a single factor. In binary scale. mean = 0.89 + 1.27 (range 0-6), Cronbach alpha = 0.599, McDonald's omega=0,753, and 52.31% of the inertia was explained by two factors. With both scales, Kappa coefficient showed 0.734 of concordance of positive screenings. The two forms of qualification are associated with age whereas only binary classification was with marital status and educational level. Conclusions : ASRS-Screening is an instrument of acceptable internal consistency. Its factorial structure and the prevalence of positive screenings vary in accordance with the Likert or binary measurement form.