The aim of this study was to assess the effect on birth-weight of continuing a programme of vigorous exercise into late pregnancy. 'Potential exercisers' were women who had been doing vigorous exercise prior to pregnancy and intended to continue exercising during pregnancy. Controls were healthy pregnant women who did not do regular vigorous exercise. Both groups kept 2, 7-day food +/- exercise diaries at 25 and 35 weeks. The primary outcome variable was birth-weight. Women who continued doing at least 30 minutes of vigorous exercise at least 3 times weekly at 25 weeks and either maintained this minimum level or had delivered by 35 weeks were classified as 'exercisers'. Women doing more than 4 sessions of vigorous exercise weekly at 25 weeks had babies whose mean birth-weight was 315 g lower than the mean birth-weight of babies born to controls.

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This paper describes methods used and results obtained from a study that measured the accuracy of a routinely collected population-based data set. Data on a random sample of births were extracted from the 2003 Victorian Perinatal Data Collection (VPDC) and compared with information in the original medical record. Accuracy was calculated for 111 items related to diverse aspects of maternity and neonatal health and care. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for dichotomous items. Seventynine items were accurate in at least 97% of cases, 45 of them in at least 99% of cases, and accuracy was below 90% for five items. Very high specificities demonstrate that conditions were rarely reported in error. Lower sensitivities indicate that some events that occurred went unreported on the perinatal form. The excellent results for specifi city indicated that the dataset is appropriate for a conservative analysis of relationships between factors. The lower sensitivities could result in true relationships between factors remaining unidentified. Reasons for discrepancies between the VPDC and the original medical record are described.

Does strenuous antenatal exercise reduce birthweight? Does reducing maternal exercise increase birthweight? What to advise about exercise during pregnancy? We recruited 117 women who intended to exercise 5 or more times weekly during pregnancy to a study of whether reducing the amount of maternal exercise during pregnancy is associated with an increase in birthweight. Only 61/117 (52%) of women agreed to be randomised to either continue or to reduce (to 3 or fewer sessions of exercise weekly) their intended pregnancy exercise program. Most women who refused randomisation did not want to risk being asked to reduce their exercise during pregnancy. Within the randomised trial, there was no statistically significant difference between the mean birthweight of babies born to women who continued and those who reduced their intended exercise program. The high rate of refusal of randomisation limits the power of the study to find a difference in birthweight, limits the generalisability of the results and shows that many women intending to exercise at this level during pregnancy have an uncompromising attitude to exercise.

-The aim of this study was to evaluate clinical and neuropsychological findings in children with suspicion of attention deficity hyperactivity disorder (ADHD). The assessment involved 150 children aged 7 to 14 referred to NANI at UNIFESP. Results: 75 children (55 M and 20 F) fulfilled the criteria for ADHD, among which 35 were of the inattentive type, 28 of combined type and 12 were hyperactive/impulsive. There was negative correlation between the digit score and the Corsi test. Children with hyperactivity and impulsivity had a low performance for functional memory. Children with oppositional defiant disorder presented pattern changes in adaptability when there was a change in the rhythm the stimuli were presented and lower adaptation to time variability (Hit RT), in addition to higher rates of omission in the continuous performance test. Conclusion: This study suggests multiple interrelations between the scores of neuropsychological battery useful for detailed delimitation of the clinical profile of children with ADHD.KEy woRDS: attention deficit disorder, children, hyperactivity, multidisciplinary, comorbities. perfil clínico e neuropsicológico de crianças com transtorno do deficit de atenção e hiperatividadeResumo -o objetivo deste trabalho foi delimitar indicadores clínicos e neuropsicológicos em crianças com suspeita de transtorno do déficit de atenção e hiperatividade (TDA/H). Foram avaliadas 150 crianças (idade de 7 a 14 anos) encaminhados ao NANI da UNIFESP. Resultados: 75 crianças (55 M e 20 F) preenchiam os critérios para o TDA/H, dentre os quais 35 (46,6%) pacientes eram desatentos, 28 do tipo combinado e 12 do tipo hiperatividade/impulsivo. observou-se correlação negativa com o escore de dígitos e no escore do teste de Corsi. Crianças com hiperatividade e impulsividade apresentaram baixo desempenho nas funções relacionadas à memória operacional. Crianças com transtorno opositor desafiante apresentaram alterações nos padrões de adaptação às mudanças do ritmo com menor adaptação às variações do tempo de exposição aos estímulos (Hit RT), além de maiores taxas de omissão no teste contínuo de performance. Conclusão: Este estudo sugere múltiplas interrelacões entre os escores em provas neuropsicológicas que são úteis para uma delimitação do perfil clínico de crianças com TDAH.PAlAvRAS-CHAvE: transtorno do déficit de atenção, crianças, hiperatividade, multidisciplinar, comorbidades. The attention deficit hyperactivity disorder (ADHD) is one of the most frequent neurodevelopmental disorders, with an estimated occurrence of 3% to 5% in schooling children 1,2 . Such oscillation is partially due to the heterogeneity and complexity of the required criteria for a precise diagnosis, which involves neuropsychological aspects as well as the delimitation of organic and neurobiological bases 3,4 . Environmental risk factors are considered fundamental in epidemiological studies on ADHD because socio-demographic variables such as the number of siblings, educational level of the family, comorbities with neuropsy...

Among 1500 children under 4 years of age admitted consecutively to two paediatric teaching hospitals in Victoria in 1985 the prevalence of birth defects was 20%. Fewer than half of these defects had been notified to the Victorian Congenital Malformations Register. Only chromosomal anomalies and, to a lesser extent, major structural malformations present at birth were adequately ascertained. The implications for birth defects monitoring and for service planning are discussed.

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There is a considerable gap between the offer and the demand for mental health treatment of children and adolescents, especially in low- and middle-income countries (LMICs). Permanent education in these countries is a promising and needed strategy to reduce this gap. This study was designed to evaluate the perceived impact of an educational intervention for child and adolescent mental health professionals in Brazil, the Child and Adolescent Mental Health Specialization Course (CESMIA). The intervention consisted of a 360-hour interprofessional postgraduation course. The CESMIA offered lectures and small-group case discussions for exchanging their experiences in dealing with the patients. The students were placed in these groups according to their professions in order to ensure a proportional distribution of healthcare professionals in each group. The evaluation employed a quasi-experimental design by the use of a knowledge, attitude, and practice (KAP) survey. The 39 participants reported significant improvement in all KAP dimensions. More specifically, the data indicated a 17% improvement for attitudes, a 9.4% increase for knowledge, and a 14% improvement for the practice dimensions. The CESMIA appeared to improve the level of knowledge of participants and their attitudes and actions towards patients, which reinforces the relevance of similar courses.