OBJECTIVE: To analyze the association between neurodevelopment and the family environment
resources of children from the coverage area of a Basic Health Unit (BHU) of Belo
Horizonte, Brazil, using a tool based on the Integrated Management of Childhood
Illness (IMCI) strategy. METHODS: Cross-sectional study with a non-probabilistic sample involving 298 children aged
between 2-24 months old, who attended a BHU in 2010. The assessment of child
development and family resources made at the BHU lasted, in average, 45 minutes
and included two tests - an adaptation of the Handbook for Monitoring Child
Development in the Context of IMCI and an adapted version of the Family
Environment Resource (FER) inventary. The nonparametric tests of Kruskal-Wallis
and Mann-Whitney were used for the statistical analysis.RESULTS: The sample included 291 assessments, with 18.2% of children between 18 and 24
months old, 53.6% male gender, and 91.4% who did not attend day care centers.
According to IMCI, 31.7% of the children were in the risk group for developmental
delay. The total average score in FER was 38.0 points. Although it has been found
an association between the IMCI outcome and the total FER score, all groups had
low scores in the family environment assessment. CONCLUSIONS: The data indicate the need for childhood development screening in the primary
health care and for early intervention programs aimed at this age group.
Although fatigue is an expressive symptom of Parkinson’s disease (PD), few studies have investigated the association between fatigue, mobility and walking capacity of these patients. Objective: To investigate whether fatigue is an independent factor associated with mobility and the walking capacity in patients with PD. Methods: Forty-eight patients with PD (22 with fatigue) were tested for mobility and their walking capacity: Timed Up and Go (TUG), 10-Meter Walk Test (10MWT) at usual and fastest speed, and 6-Minute Walk Test (6MWT). Fatigue was measured with Parkinson’s Fatigue Scale (PFS-16). Linear regression analysis was used to investigate if fatigue is an independent factor contributing to variance in mobility and walking capacity. Results: There was a positive correlation between PFS-16 and TUG (rs=0.385; p=0.007). There was a negative correlation between PFS-16 and 10MWT at comfortable (r=-0.385; p=0.007) and fast speeds (r=-0.396; p=0.005), and 6MWT (r=-0.472; p=0.001). Linear regression analysis revealed that fatigue did not explain the variance of TUG and 10MWT. PFS-16, age and section III of UPDRS explained 49.6% (adjusted R2; p<0.001) variance in the 6MWT, and fatigue was the most significant predictor (F=-32.1; p=0.022). Conclusions: Fatigue is an independent factor contributing to the distance covered during 6MWT in patients with PD. Our results highlight the importance of recognition and management of this symptom.
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