RESUMO
OBJECTIVE: To study the significance of breast size increment in pregnancy, and the impact of metformin during pregnancy on breastfeeding in women with polycystic ovary syndrome (PCOS). DESIGN: A follow-up study of a randomised controlled trial (the PregMet study). SETTING: Eleven secondary care centres. POPULATION: Women with PCOS during pregnancy and postpartum. METHODS: Women with PCOS were randomised to treatment with metformin or placebo from the first trimester to delivery. Questionnaires were sent to 240 participants 1 year postpartum: 186 responded. MAIN OUTCOME MEASURES: Pre-pregnancy and late-pregnancy brassiere size and breastfeeding patterns were registered, and androgen levels were measured in the mothers. RESULTS: No difference in breast size increment and breastfeeding were found between the placebo and metformin groups. Breast size increment correlated positively with the duration of both exclusive and partial breastfeeding, whereas body mass index (BMI) correlated negatively with the duration of partial breastfeeding. Dehydroepiandrostenedione-sulphate (DHEAS), testosterone and free testosterone index (FTI) in pregnancy did not correlate with breast size increment or duration of breastfeeding. Women with no change in breast size were more obese, had higher blood pressure, serum triglycerides and fasting insulin levels, and had a shorter duration of breastfeeding compared with those with breast size increment. CONCLUSIONS: Metformin and androgens had no impact on breastfeeding. Women with PCOS who had no breast size increment in pregnancy seem to be more metabolically disturbed and less able to breastfeed.
Assuntos
Aleitamento Materno , Hipoglicemiantes/uso terapêutico , Metformina/uso terapêutico , Síndrome do Ovário Policístico/tratamento farmacológico , Complicações na Gravidez/tratamento farmacológico , Composição Corporal , Índice de Massa Corporal , Mama , Feminino , Seguimentos , Humanos , Mães , Placebos , Síndrome do Ovário Policístico/fisiopatologia , Período Pós-Parto , Gravidez , Complicações na Gravidez/fisiopatologia , Inquéritos e QuestionáriosRESUMO
Very low birth weight (VLBW) children are at high risk of perinatal white matter injury, which, when subtle, may not be seen using conventional magnetic resonance imaging. The relationship between clinical findings and fractional anisotropy (FA) measurements in white matter of adolescents born prematurely with VLBW was studied in 34 subjects (age = 15 years, birth weight =1500 g) and 47 age-matched controls born at term, who were examined both clinically and with diffusion tensor imaging (DTI). Perceptual and cognitive functions were evaluated by visual motor integration (VMI) with supplementary tests and sub-tests from WISC-III, motor function by movement ABC and Grooved Pegboard test and psychiatric symptoms by the schedule for affective disorders and schizophrenia for school-age children semistructured interview, the Autism Spectrum Screening Questionnaire and attention deficit hyperactivity disorder (ADHD) rating scale IV. Overall functioning was scored on the children's global assessment scale. DTI scans were performed for calculation of FA maps and areas of significant differences in mean FA values between subjects and controls were compared with their clinical data. The VLBW children had reduced FA values in the internal and external capsule, corpus callosum and superior, middle superior and inferior fasciculus. Within this group of children, visual motor and visual perceptual deficits were associated with low FA values in the external capsule, posterior part of the internal capsule and in the inferior fasciculus. Children with low IQ had low FA values in the external capsule and inferior and middle superior fasciculus. Fine motor impairment was related to low FA values in the internal and external capsule and superior fasciculus. Eight VLBW children with inattention symptoms or a diagnosis of ADHD had significantly lower FA values in several areas. Mild social deficits correlated with reduced FA values in the external capsule and superior fasciculus. We conclude that DTI was able to detect differences in FA between VLBW adolescents and controls in several white matter areas at risk of periventricular leucomalacia in VLBW newborns. Our results show that low FA values in these areas were associated with perceptual, cognitive, motor and mental health impairments. These conclusions indicate that perinatal injury of white matter tracts persist with clinical significance in adolescence.
Assuntos
Encefalopatias/diagnóstico , Imagem de Difusão por Ressonância Magnética/métodos , Recém-Nascido de muito Baixo Peso , Adolescente , Anisotropia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/patologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Encéfalo/patologia , Encefalopatias/patologia , Encefalopatias/psicologia , Cognição/fisiologia , Feminino , Seguimentos , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Testes de Inteligência , Masculino , Atividade Motora/fisiologia , Percepção/fisiologia , Testes Psicológicos , Desempenho PsicomotorRESUMO
Infants with low birth weight are at increased risk of perinatal brain injury. Disruption of normal cortical development may have consequences for later motor, behavioural and cognitive development. The aim of this study was to measure cerebral cortical thickness, area and volume with an automated MRI technique in 15-year-old adolescents who had low birth weight. Cerebral MRI for morphometric analysis was performed on 50 very low birth weight (VLBW, birth weight =1500 g), 49 term small for gestational age births (SGA, birth weight <10th percentile at term) and 58 control adolescents. A novel method of cortical surface models yielded measurements of cortical thickness and area for each subject's entire brain and computed cross-subject statistics based on cortical anatomy. The cortical surface models demonstrated regional thinning of the parietal, temporal and occipital lobes in the VLBW group, whereas regional thickening was demonstrated in the frontal and occipital lobes. The areas of change were greatest in those with the shortest gestational age at birth and lowest birth weight. Cortical surface area and cortical volume were lower in the VLBW than in the Control group. Within the VLBW group, there was an association between surface area and estimation of the intelligence quotient IQ (IQ(est)) and between cortical volume and IQ(est). Furthermore, cortical grey matter as a proportion of brain volume was significantly lower in the VLBW, but not in the SGA group compared with Controls. This observed reorganization of the developing brain offers a unique opportunity to investigate any relationship between changes in cortical anatomy and cognitive and social impairments, and the increase in psychiatric disorders that have been found in VLBW children and adolescents.
Assuntos
Córtex Cerebral/patologia , Recém-Nascido de Baixo Peso , Adolescente , Peso ao Nascer , Mapeamento Encefálico/métodos , Cefalometria/métodos , Córtex Cerebral/crescimento & desenvolvimento , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Recém-Nascido de muito Baixo Peso , Inteligência , Imageamento por Ressonância Magnética/métodos , MasculinoRESUMO
BACKGROUND AND AIM: Fecal incontinence quality-of-life scale (FIQLS) is a condition-specific health-related quality-of-life questionnaire composed of four scales: lifestyle, coping/behaviour, depression/self-perception and embarrassment. It has been widely translated and used as an evaluation tool for patients with fecal incontinence. Our aim was to translate the FIQLS, and to test some of the psychometric properties of the Norwegian version of the questionnaire. MATERIAL AND METHODS: The FIQLS was translated to Norwegian, and administered to a sample of 76 patients (73 women) who completed the questionnaire at baseline and again after three weeks. In addition, the severity of incontinence was assessed by phone-interviews (St. Mark's score). RESULTS: Three of four domains had good internal consistency in terms of Cronbach's alpha (.83-.91), the fourth (embarrassment) somewhat lower (.64). Stability over time was acceptable for all domains with ICC ranging from .74 to .86. Correlation with severity of incontinence (St. Mark's score) was medium to large for all four domains (-.46 to -.63) supporting the construct validity of the Norwegian FIQLS. CONCLUSION: The Norwegian version of fecal incontinence quality-of-life scale has been successfully translated and tested.
Assuntos
Incontinência Fecal/fisiopatologia , Incontinência Fecal/psicologia , Qualidade de Vida , Inquéritos e Questionários , Incontinência Fecal/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , TraduçõesRESUMO
The purposes of this study were to review the validity evidence for psychological measures used in pilot selection and to detect possible moderators for the relationship between predictors and pilot performance. A total of 66 independent samples from 50 studies were located and included in the meta-analysis. The best predictors of pilot performance were previous training experience (.30) and combined indexes, a combination of several cognitive and/or psychomotor tests (.37). The next best predictors were tests measuring cognitive (.24) and psychomotor/information-processing abilities (.24), as well as aviation information (.24) and biographical inventories (.23). The personality, intelligence, and academic tests yielded lowest mean validities (.14, .16, and .15, respectively). The analysis indicated that moderators might be operating for all test categories except academics, and the effect of several moderators were examined.
Assuntos
Aviação/educação , Militares/psicologia , Seleção de Pessoal , Testes Psicológicos/estatística & dados numéricos , Análise e Desempenho de Tarefas , Medicina Aeroespacial , Cognição , Humanos , Inteligência , Personalidade , Valor Preditivo dos Testes , Desempenho Psicomotor , Reprodutibilidade dos TestesRESUMO
The purpose of this study was to evaluate the test battery currently used for pilot selection to the Norwegian Air Force. Selection is currently based on a standard battery of 20 different psychological tests as well as on medical tests and on an interview by a licensed psychologist. First, two-factor analyses were conducted to examine the relation between the tests in the battery. Then, a correlation study was conducted to evaluate the predictive validity of the tests against two criteria of pilot performance collected during the basic training period. Finally, a small-scale meta-analysis of previous validation studies in Norway was conducted. me best predictors of success in training, based on the meta-analysis, were Instrument Comprehension (mean r = .29), Mechanical Principles (mean r = .23), and Aviation Information (mean r = .22)
Assuntos
Militares/psicologia , Seleção de Pessoal/métodos , Testes Psicológicos , Psicologia Militar/métodos , Adulto , Medicina Aeroespacial , Avaliação de Desempenho Profissional , Análise Fatorial , Humanos , Metanálise como Assunto , Noruega , Valor Preditivo dos Testes , Reprodutibilidade dos TestesRESUMO
Social intelligence is a construct that not only appeals to laymen as a relevant individual difference but also has shown promising practical applications. Nevertheless, the use of social intelligence in research and applied settings has been limited by definitional problems, difficulties in empirically differentiating social intelligence from related constructs, and the complexity of most existing measures of social intelligence. The goal of the present research was to address some of these obstacles by designing a multi-faceted social intelligence measure that is short and easy to administer. Three studies were conducted to develop and validate the Tromsø Social Intelligence Scale (TSIS). Study 1 examined professional psychologists' interpretations of social intelligence to derive a consensually agreed-upon definition of the construct. In Study 2, a large pool of social intelligence items were tested, and a 3-factor, 21-item scale was identified. In Study 3, the stability of this measure was confirmed.
Assuntos
Testes de Inteligência/normas , Ajustamento Social , Desejabilidade Social , Adulto , Fatores de Confusão Epidemiológicos , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos TestesRESUMO
The purpose of this study was to examine the construct validity of an ipsative personality test (DISCUS), and various effects of the ipsative format of the test. Both an ipsative and a normative version of the DISCUS test was administered to a sample of undergraduate students (N = 103), along with an adjective based personality test that measures the Big-Five personality traits (5PFa). The results indicated that the normative and the ipsative version of DISCUS are not equivalent, and caution is needed when using the ipsative version for psychometric evaluations as in validation studies. The four DISCUS dimensions (Dominance, Influence, Stability, and Carefulness) represented combinations of the Big-Five traits rather than independent traits as indicated by the correlations with the Big-Five measure.
Assuntos
Testes de Personalidade , Adulto , Feminino , Humanos , Masculino , Reprodutibilidade dos TestesRESUMO
Comorbid personality disorders in eating disordered patients may seriously affect the treatment and course of their illness. Several studies show such a comorbidity, though with inconsistent findings. Qualitative reviews attribute this to methodological shortcomings, but the qualitative method may itself create new shortcomings. To circumvent this, the present, more extensive review applies a meta-analytic approach. Using the databases MEDLINE and PSYCHLIT, the 28 articles published between 1983 and 1998 that presented empirical evidence for an eating disorder and personality disorder comorbidity suitable for meta-analysis were included. We found a higher proportion of eating disordered patients with any personality disorder (average proportion = 0.58) related to comparison groups (average proportion = 0.28). Compared with anorexia nervosa patients, a higher proportion of patients with bulimia nervosa had a concurrent cluster B personality (average proportion = 0.44) and a borderline personality disorder (average proportion = 0.31). However, no differences between anorexia nervosa and bulimia nervosa patients in proportions of cluster C were found (average proportion = 0.45 and 0.44 respectively). Patients with eating disorders and patients with bulimia nervosa in particular, should be routinely assessed for a concurrent personality disorder using structured clinical interviews. In future research, more stringent assessment procedures are highly recommended to address the question of causality between eating disorders and personality disorders, and how eating disorder symptoms and personality disorder symptoms are related to treatment effects.
Assuntos
Anorexia Nervosa/epidemiologia , Bulimia/epidemiologia , Transtornos da Personalidade/epidemiologia , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/psicologia , Bulimia/diagnóstico , Bulimia/psicologia , Comorbidade , Humanos , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , PrognósticoRESUMO
Evidence has accumulated over the past 15 years that affect in humans is cyclical. In winter there is a tendency to depression, with remission in summer, and this effect is stronger at higher latitudes. In order to determine whether human cognition is similarly rhythmical, this study investigated the cognitive processes of 100 participants living at 69 degrees N. Participants were tested in summer and winter on a range of cognitive tasks, including verbal memory, attention and simple reaction time tasks. The seasonally counterbalanced design and the very northerly latitude of this study provide optimal conditions for detecting impaired cognitive performance in winter, and the conclusion is negative: of five tasks with seasonal effects, four had disadvantages in summer. Like the menstrual cycle, the circannual cycle appears to influence mood but not cognition.
Assuntos
Cognição , Escuridão , Luz , Periodicidade , Estações do Ano , Adolescente , Adulto , Regiões Árticas , Atenção , Feminino , Humanos , Masculino , Memória , Pessoa de Meia-Idade , Noruega , Testes Psicológicos , Tempo de Reação , Transtorno Afetivo Sazonal/psicologiaRESUMO
We investigated early postnatal changes of the mesenteric circulation and its relationship to the systemic circulation in two groups of newborn infants. Group I (n = 10) was studied before the first feeding at 1 h and preprandially at 6 and 24 h. Group II (n = 10) was studied before the first feeding at 2 h of age and preprandially and postprandially at d 3, 4, and 5. Blood flow velocity was measured with ultrasound Doppler in the superior mesenteric artery (SMA), middle cerebral artery, subclavian artery, and aortic orifice for cardiac output (CO) calculations. Blood pressure and heart rate were monitored. SMA mean velocity (Vmean) decreased from 1 [0.33 +/- 0.07 m/s (mean +/- SD)] to 6 h (0.23 +/- 0.08 m/s, p < 0.005) in group I, probably due to ductal steal, returning to the 1-h value at 24 h. In contrast, middle cerebral artery Vmean remained unchanged in the first 24 h. From d 3, SMA Vmean increased 92% postprandially, with no relation to increasing amounts of food. The postprandial increase in SMA Vmean was not associated with changes in CO and blood pressure; however, a fall in relative mesenteric vascular resistance suggested regional redistribution of CO. Middle cerebral artery Vmean increased from h 2 to d 3 with a further increase on d 4 (p < 0.01). This increase was associated with an increase in blood pressure. The relative fraction of CO to middle cerebral artery increased during the first days of life, suggesting a redistribution of blood flow to the metabolically active organs in the neonatal period.
Assuntos
Adaptação Fisiológica , Hemodinâmica/fisiologia , Recém-Nascido/fisiologia , Circulação Esplâncnica/fisiologia , Velocidade do Fluxo Sanguíneo/fisiologia , Artérias Cerebrais/fisiologia , Permeabilidade do Canal Arterial/fisiopatologia , Humanos , Artéria Mesentérica Superior/fisiologiaRESUMO
Doppler blood flow velocity of the superior mesenteric artery was measured preprandially and postprandially in 12 term neonates during phototherapy and 4 hours after discontinuation of this therapy. The postprandial increase in blood flow velocity was significantly less during than after phototherapy. We suggest that the phototherapy-induced peripheral vasodilation may be responsible for diverting blood from the intestines and limiting the normal neonatal postprandial response.
Assuntos
Artéria Mesentérica Superior/fisiologia , Fototerapia , Velocidade do Fluxo Sanguíneo , Diarreia/etiologia , Idade Gestacional , Humanos , Recém-Nascido , Icterícia Neonatal/fisiopatologia , Icterícia Neonatal/terapia , Fototerapia/efeitos adversosRESUMO
During the first week of life, we examined the changes in the systemic, intestinal and cerebral circulation, and the circulatory responses to feeding in 10 small for gestational age (SGA) infants using the ultrasound Doppler technique. From day 1 to day 3, preprandial cardiac output decreased (p < 0.01), whereas mean blood pressure (p < 0.01), superior mesenteric artery mean flow velocity (Vmean; p < 0.01) and middle cerebral artery Vmean (p < 0.01) increased. On day 1, cardiac output was higher in the SGA than in those of term and preterm appropriate for gestational age infants reported from our laboratory. Preprandial superior mesenteric artery Vmean was inversely related to the degree of growth retardation (r = 0.63, p < 0.05). However, growth retardation did not influence the postprandial increase in superior mesenteric artery Vmean and end-diastolic flow velocity, or the cerebral circulation.
Assuntos
Retardo do Crescimento Fetal/fisiopatologia , Recém-Nascido Pequeno para a Idade Gestacional , Artéria Mesentérica Superior/fisiopatologia , Velocidade do Fluxo Sanguíneo , Débito Cardíaco , Artérias Cerebrais/fisiopatologia , Canal Arterial/fisiopatologia , Feminino , Humanos , Recém-Nascido , Masculino , Volume SistólicoRESUMO
We investigated the early postnatal changes of the mesenteric circulation and its relation to the systemic circulation in 15 preterm infants. The infants were studied before the first feeding on d 1 and pre- and postprandially on d 3, 4, 5, and 7. Blood flow velocity was measured by ultrasound Doppler in the superior mesenteric artery, middle cerebral artery, and the aortic orifice for cardiac output calculations. Blood pressure and heart rate were monitored. From d 1 to d 3, the preprandial stroke volume decreased [1.5 +/- 0.3 to 1.3 +/- 0.2 mL/kg (mean +/- SD), p < 0.05], whereas blood pressure (36 +/- 3 to 50 +/- 7 mm Hg, p < 0.001), superior mesenteric artery mean velocity (Vmean) (0.17 +/- 0.08 to 0.30 +/- 0.11 m/s, p < 0.05), and middle cerebral artery Vmean increased (0.15 +/- 0.05 to 0.22 +/- 0.03 m/s, p < 0.001). From d 3 through d 7, the preterm infants demonstrated higher preprandial end diastolic flow velocity in the superior mesenteric artery than we previously reported in term infants (0.15 +/- 0.05 versus 0.12 +/- 0.04, p < 0.05). Like the term infants, preterm infants increased their superior mesenteric artery Vmean by 83% postprandially and maintained a stable cerebral circulation with feeding. Unlike the term infants, feeding in the preterm infants induced a blood pressure decrease (51 +/- 6 to 48 +/- 6 mm Hg, p < 0.01) and a cardiac output increase (176 +/- 30 to 188 +/- 32 mL/kg/min, p < 0.001). These findings suggest that, in contrast to term infants, healthy preterm infants require compensatory systemic hemodynamic changes in response to feeding.