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Aim: We compared the efficacy of hand-arm bimanual intensive training (HABIT) in two doses (90 vs. 45 hours) and two schedules of the same dose (90 vs. 2 × 45 hours) on hand and daily functioning. Method: Eighteen children with unilateral cerebral palsy were randomized to receive 6 hours of daily training over 3 weeks, totaling 90 hours (Group 90, n = 9) or receive 6 hours of daily training over 1.5 weeks, totaling 45 hours (Group 2 × 45, n = 9). After 6 months, Group 2 × 45 received an additional 45 hours. Hand (Jebsen-Taylor Test of Hand Function, Assisting Hand Assessment) and daily functioning tests (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory) were administered before, immediately after, and 6 months after interventions. Results: Both groups demonstrated significant improvements in hand and daily functioning after 90 hours (Group 90) or the first 45 hours (Group 2 × 45), without differences between groups. However, more children from Group 90 obtained smallest detectable differences in the Assisting Hand Assessment. The addition of the second bout of 45 hours (Group 2 × 45) did not lead to further improvements. Conclusions: As this study was powered to test for large differences between groups, future investigations on larger samples will be needed to compare differences at the two dosage levels. [ABSTRACT FROM AUTHOR]

Aim: To describe the sociodemographic, clinical, and behavioral characteristics of women who seek treatment for smoking cessation and to investigate the relationship between these characteristics and the nicotine dependence level and treatment duration. Methods: Data were collected using questionnaires that were administered to 655 women. Regression of generalized linear model and regression logistic ordinal were used to assess the correlation between the variables being studied. Findings: The average age of women in the study was 49 years. Among them were those who were employed (54.9%), who had high levels of nicotine dependence (78.5%), and whose primary reason for seeking treatment was related to health concerns (62%). The treatment duration was positively correlated with depression (p = 0.04), hypertension (p < 0.01), and with seeking treatment due to health concerns (p = 0.02). Conclusions: Our study indicates that adherence in women can be increased by providing treatment that is accessible to the lower class. It also indicates the need to reconceptualize the way therapeutic group sessions are conducted. We hypothesize that the reason for the high dropout rate after 6 months of treatment could be related to the way that group sessions operate. [ABSTRACT FROM AUTHOR]

The study examined the validity of the Line Drill test (LD) in male adolescent basketball players (10–15 years). Sensitiveness of the LD to changes in performance across a training and competition season (4 months) was also considered. Age, maturation, body size and LD were measured (n = 57). Sensitiveness of the LD was examined pre- and post-competitive season in a sub-sample (n = 44). The time at each of the four shuttle sprints of the LD (i.e. four stages) was modelled with Bayesian multilevel models. We observed very large correlation of performance at stage 4 (full LD protocol) with stage 3, but lower correlations with the early LD stages. Players’ performance by somatic maturity differed substantially only when considering full LD protocol performance. Substantial improvements in all stages of the protocol were observed across the 4-month competitive season. The LD protocol should be shortened by the last full court shuttle sprint, remaining sensitive to training exposure, and independent of maturity status and body size. [ABSTRACT FROM PUBLISHER]

Purpose: to evaluate the relationship between unplanned pregnancy (UP), a common problem in high and low income countries and maternal depression (MD).Methods: Secondary analysis of data from a prospective cohort study with pregnant women recruited from 10 primary care clinics of the public sector in São Paulo, Brazil. Participants were questioned about pregnancy intention at 20–30 weeks of gestation. The Self Report Questionnaire score >7 was used to evaluated the presence of depression during pregnancy and 11 months after childbirth. Four groups of MD were defined: never; antenatal only; postnatal only; persistent (both antenatal/postnatal). Multinomial logistic regression was used to assess the relationship between UP and MD, controlling for confounding.Results: Data were analysed for 701 at the postpartum period. Five hundred and sixty-two (67.8%) women did not plan the pregnancy. Women with UP had 2.5 more risk of being depressed during both assessments (during pregnancy and postpartum) when compared to women with a planned pregnancy (RR: 2.5; 95% CI: 1.47:4.30). In the adjusted models, women with UP were significantly more likely to have persistent depression (RR: 2.3; 95% CI: 1.2:4.3).Conclusion: UP is an independent risk factor for persistent depression, but not for postpartum depression [ABSTRACT FROM PUBLISHER]

The app for the System for Observing Play and Recreation in Communities (iSOPARC®) was developed to enhance System for Observing Play and Recreation in Communities data collection and management. The study aim was to examine the usability and inter-rater reliability of iSOPARC®. Trained observers collected data in 16 park areas in two Latin America cities (Curitiba, Brazil; Bogotá, Colombia) using both the original System for Observing Play and Recreation in Communities (mechanical counter) and new iSOPARC® (electronic counter) methods. A total of 8,707 park users (3,958 females and 4,749 males) were observed. Reliabilities among observers were determined using the intraclass correlation coefficient and relative overall agreement (%) in three ways: (a) mechanical versus mechanical, (b) mechanical versus electronic, and (c) electronic versus electronic. When both used mechanical counters comparisons overall agreement was over 78% (intraclass correlation coefficient  = .982;p < .001) for variables in all analysis. When one used a mechanical counter and the other used electronic (iSOPARC®) comparisons overall agreement was higher for age (84%;p < .001) than for physical activity (83%;p < .001) variables and average intraclass correlation coefficient was .965. Using both used iSOPARC® comparisons overall agreement was 81% to physical activity and 83% to age group. Results suggest iSOPARC® can be used reliably for examining variables previously validated in System for Observing Play and Recreation in Communities. [ABSTRACT FROM PUBLISHER]

Background: Common mental disorder (CMD) and sleep disturbance are two common conditions among women in late pregnancy, affecting up to 20% and 63% of women, respectively, and may adversely affect their quality of life. Aim: The aim of this study is to examine the relationship between sleep disturbance in pregnancy and persistent CMD among low-income pregnant women living in Brazil. Methods: This was a prospective cohort study conducted with pregnant women recruited from public primary care clinics in São Paulo, Brazil. We performed a longitudinal analysis of 219 women who had CMD from the Self-Report Questionnaire during the 20–30 weeks of pregnancy. Two groups were examined: (1) those who had CMD remission in the postpartum and (2) those who had persistent CMD in the postpartum (measured once in the postpartum period). Poisson regression was used to estimate the degree of association between sleep disturbance in pregnancy and the risk for persistent CMD postpartum. Results: After adjusting for sociodemographic and clinical factors, sleep disturbance during pregnancy is associated with persistent CMD (RR = 1.36, 95% confidence interval: 1.01–1.84). Conclusion: In this sample of low-income pregnant women living in Brazil, the presence of sleep disturbance during pregnancy was associated with persistent common mental disorder in the postpartum period. Identification of sleep disturbance in pregnant women with CMD will be important in order to recognize those women at higher risk of persistent CMD in the postpartum period. [ABSTRACT FROM AUTHOR]

Little is known about the influence of different types and sources of social support on physical activity in adolescents. The aim of this study was to analyse the association between physical activity and different types and sources of social support in adolescents. The sample consisted of 2,859 adolescents between 14–19 years of age in the city of João Pessoa, in Northeastern Brazil. Physical activity was measured with a questionnaire and social support from parents and friends using a 10-item scale five for each group (type of support: encouragement, joint participation, watching, inviting, positive comments and transportation). Multivariable analysis showed that the types of support provided by parents associated with physical activity in adolescents were encouragement for females (P < 0.001) and adolescents between 14–16 years of age (P = 0.003), and transportation (P = 0.014) and comments (P = 0.037) for males. The types of social support provided by friends were: joint participation in male adolescents (P < 0.001) and in these 17–19-year-olds (P < 0.001), and comments in both genders (males:P = 0.009; females:P < 0.001) and 14–16-year-olds (P < 0.001). We conclude that the type of social support associated with physical activity varies according to its source, as well as the gender and age of the adolescents. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse the characteristics of the asymmetries in the dominant and non-dominant limbs when kicking stationary and rolling balls. Ten experienced Brazilian amateur futsal players participated in this study. Each participant performed kicks under two conditions (stationary ball vs. rolling ball) with the dominant and non-dominant limbs (five kicks per condition per limb). We analysed the kicking accuracy, ball and foot velocities, angular joint displacement and velocity. The asymmetry between the dominant and non-dominant limbs was analysed by symmetry index and two-way repeated measures ANOVA. The results did not reveal any interaction between the condition and limb for ball velocity, foot velocity and accuracy. However, kicking with the dominant limb in both kicks showed higher ball velocity (stationary ball: dominant – 24.27 ± 2.21 m · s‒1and non-dominant – 21.62 ± 2.26 m · s‒1; rolling ball: dominant – 23.88 ± 2.71 m · s‒1and non-dominant – 21.42 ± 2.25 m · s‒1), foot velocity (stationary ball: dominant – 17.61 ± 1.87 m · s‒1and non-dominant – 15.58 ± 2.69 m · s‒1; rolling ball: dominant – 17.25 ± 2.26 m · s‒1and non-dominant – 14.77 ± 2.35 m · s‒1) and accuracy (stationary ball: dominant – 1.17 ± 0.84 m and non-dominant – 1.56 ± 1.30 m; rolling ball: dominant – 1.31 ± 0.91 m and non-dominant – 1.97 ± 1.44 m). In addition, the angular joint adjustments were dependent on the limb in both kicks (the kicks with non-dominant limb showed lower hip external rotation than the kicks with the dominant limb), indicating that the hip joint is important in kick performance. In conclusion, the kicks with the non-dominant limb showed different angular adjustments in comparison to kicks with the dominant limb. In addition, kicking a rolling ball with the non-dominant limb showed higher asymmetry for accuracy, indicating that complex kicks are more asymmetric. [ABSTRACT FROM PUBLISHER]

This study examined syntactic assignment for predicates and reflexives as well as working memory effects in the sentence comprehension of children with Specific Language Impairment (SLI), Down syndrome (DS), high functioning Autism (HFA) and Typical Language Development (TLD). Fifty-seven children (35 boys and 22 girls) performed a computerised picture-selection sentence comprehension task. Predicate attachment and reflexive antecedent assignment (with working memory manipulations) were investigated. The results showed that SLI, HFA and DS children exhibited poorer overall performance than TLD children. Children with SLI exhibited similar performance to the DS and HFA children only when working memory demands were higher. We conclude that children with SLI, HFA and DS differ from children with TLD in their comprehension of predicate and reflexive structures where the knowledge of syntactic assignment is required. Working memory manipulation had different effects on syntactic comprehension depending on language disorder. Intelligence was not an explanatory factor for the differences observed in performance. [ABSTRACT FROM AUTHOR]

Background: There has been considerable debate regarding what typically occurs after experimentation with drugs throughout the life of young people who used various drugs. Aims: To evaluate the clinical importance of the most common sequence for the first use of a drug by two models (the 'gateway model' and the 'alternative model', which is the most popular sequence for Brazilian university students according to a previous study) regarding the problematic use of alcohol, tobacco, cannabis and other illegal drugs, assessed by ASSIST. Method: People who had already experimented with three or more drugs across different stages of the two models were selected from a representative sample of university students from 27 Brazilian capitals ( n = 12 711). Findings: There were no differences regarding the problematic use of the most consumed drugs in Brazil (alcohol, tobacco and cannabis) between the models. Multiple drug seekers and violators had more problematic use of illegal drugs other than cannabis than individuals in the model sequence. However, in the case of violators, this was only evident in the alternative model. Conclusions: Multiple drug seekers and violators deserve special attention due to their increased risk of problematic use of other illegal drugs. [ABSTRACT FROM AUTHOR]

Alcohol and other drugs use seem to be common among people infected with HIV on antiretroviral treatment (ART). Their effects on HIV progression is still in debate. This study aimed to assess the association between alcohol and drug use and an HIV disease progression biomarker (CD4 cell count) among patients on ART. A cross-sectional study was carried out at an HIV treatment center affiliated with Medical School of the University of São Paulo, Brazil. Four hundred and thirty-eight HIV-positive patients on ART were interviewed by trained psychiatrists and psychologists using the following instruments: Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Alcohol Use Disorders Identification Test (AUDIT), 17-item Hamilton Rating Scale for Depression, and the Simplified Medication Adherence Questionnaire (SMAQ). In the previous month, 219 (50%) and 41 (9.3%) patients reported use of alcohol and illicit drugs, respectively. Fifty patients (12.6%) were classified as having harmful alcohol use by AUDIT. According to SCID-I, 80 patients (18.3%) were alcohol abusers, 24 (5.5%) alcohol dependents, and 21 (4.2%) had a current depressive disorder. Almost 73% (n= 319–72.8%) of the patients were adherent to ART. Alcohol dependents were nine times (p< 0.01) more likely to have CD4 cell count ≤200/mm3, and this association was independent of ART adherence. In conclusion, alcohol dependence seems to be associated with low CD4 cell count in HIV-positive patients. Based on these data, HIV health care workers should always assess alcohol consumption in the treatment setting, and patients should be advised that alcohol dependence may be linked to low CD4. [ABSTRACT FROM AUTHOR]

People living with mental illness are at increased risk for HIV. There are scarce data on correlates and prevalence of HIV infection, and none with a nationally representative sample. We report on correlates of HIV infection from a cross-sectional national sample of adults receiving care in 26 publicly funded mental health treatment settings throughout Brazil. Weighted prevalence rate ratios were obtained using multiple log-binomial regression modeling. History of homelessness, ever having an STD, early age of first sexual intercourse before 18 years old, having suffered sexual violence, previous HIV testing, self-perception of high risk of HIV infection and not knowing one's risk were statistically associated with HIV infection. Our study found an elevated HIV seroprevalence and correlates of infection were not found to include psychiatric diagnoses or hospitalizations but instead reflected marginalized living circumstances and HIV testing history. These adverse life circumstances (history of homelessness, having suffered sexual violence, reporting a sexually transmitted disease, and early sexual debut) may not be unique to people living with mental illness but nonetheless the mental health care system can serve as an important point of entry for HIV prevention in this population. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the validity (Study 1) and reliability (Study 2) of a novel intermittent running test (Carminatti's test) for physiological assessment of soccer players. In Study 1, 28 players performed Carminatti's test, a repeated sprint ability test, and an intermittent treadmill test. In Study 2, 24 players performed Carminatti's test twice within 72 h to determine test–retest reliability. Carminatti's test required the participants to complete repeated bouts of 5 × 12 s shuttle running at progressively faster speeds until volitional exhaustion. The 12 s bouts were separated by 6 s recovery periods, making each stage 90 s in duration. The initial running distance was set at 15 m and was increased by 1 m at each stage (90 s). The repeated sprint ability test required the participants to perform 7 × 34.2 m maximal effort sprints separated by 25 s recovery. During the intermittent treadmill test, the initial velocity of 9.0 km · h−1 was increased by 1.2 km · h−1 every 3 min until volitional exhaustion. No significant difference (P > 0.05) was observed between Carminatti's test peak running velocity and speed at VO2max (v-VO2max). Peak running velocity in Carminatti's test was strongly correlated with v-VO2max (r = 0.74, P < 0.01), and highly associated with velocity at the onset of blood lactate accumulation (r = 0.63, P < 0.01). Mean sprint time was strongly associated with peak running velocity in Carminatti's test (r = −0.71, P < 0.01). The intraclass correlation was 0.94 with a coefficient of variation of 1.4%. In conclusion, Carminatti's test appears to be avalid and reliable measure of physical fitness and of the ability to perform intermittent high-intensity exercise in soccer players. [ABSTRACT FROM PUBLISHER]

A high incidence of waterborne diseases is observed worldwide and in order to address contamination problems prior to an outbreak, quantitative microbial risk assessment is a useful tool for estimating the risk of infection. The objective of this paper was to assess the probability of Giardia infection from consuming water from shallow wells in a peri-urban area. Giardia has been described as an important waterborne pathogen and reported in several water sources, including ground waters. Sixteen water samples were collected and examined according to the US EPA (1623, 2005). A Monte Carlo method was used to address the potential risk as described by the exponential dose response model. Giardia cysts occurred in 62.5% of the samples (<0.1-36.1 cysts/l). A median risk of 10-1 for the population was estimated and the adult ingestion was the highest risk driver. This study illustrates the vulnerability of shallow well water supply systems in peri-urban areas. [ABSTRACT FROM AUTHOR]