Comparison of the DSM-IV combined and inattentive types of ADHD in a school-based sample of Latino/Hispanic children

BACKGROUND: The aim of this investigation was to examine the construct validity and distinctiveness of the inattentive type (IT) and combined type (CT) of Attention-Deficit/Hyperactivity Disorder (ADHD) in a Latino/Hispanic sample. METHOD: A comprehensive assessment was conducted with a clinically diagnosed school-based sample of 98 children aged 6 to 11 (CT=44; IT=25; control group=29). RESULTS: Both ADHD groups were impaired on academic achievement measures, presented more ADHD-type behaviors during math and vigilance tasks, and exhibited greater internalizing symptoms. The IT group had a later onset of inattention symptoms, presented more sluggish cognitive tempo symptoms, was less prone to initiate social interactions or to be assertive and more self-controlled in social interchanges, was less likely to have externalizing behaviors, had mothers who reported less child-related family stress, and was less impaired in their adaptive functioning. CONCLUSIONS: Findings supported the construct validity of ADHD in this culturally different sample and suggested that the CT and IT represent distinct disorders.     

Burden and outcome of HIV infection and other morbidities in health care workers attending an Occupational Health Program at the Provincial Hospital of Tete, Mozambique

Objectives To investigate the burden and outcome of HIV infection and other morbidities amongst a Mozambican hospital staff. Methods Within an occupational health service set up in April 2008 in the provincial hospital of Tete, Mozambique, we offered to all staff members an initial clinical, laboratory and radiological screening and followed them up prospectively until April 2010. Results A total of 47.5% of 423 health workers attended the program. The cohort (female‐to‐male ratio: 2.2; mean age: 39 years) consisted mostly of auxiliary staff (43%) and nurses (29.8%). At initial screening, 71% were asymptomatic. HIV infection (28.4%) and tuberculosis (TB) (21%) were the main reported antecedent illnesses. Laboratory screening revealed anaemia (haemoglobin level <10 mg/dl) in 9% participants, abnormal liver enzymes in 23.9% and a reactive non‐treponemal syphilis test in 5%. Of 145 performed chest X‐rays, 13% showed abnormalities. All 113 health workers not recently tested for HIV were screened, and 31 were newly diagnosed with HIV infection (resulting in an overall HIV prevalence of 43.8%). Nine cases of TB were diagnosed at screening/during follow‐up. In April 2010, all but one of the participants were alive. All HIV‐infected health workers under antiretroviral therapy were actively followed‐up. Conclusion Serious conditions were frequently diagnosed in health workers, in particular HIV infection. Mid‐term outcome was favourable within this program. Creation of screening and care services dedicated to caregivers should be of highest priority in similar African settings.     

Time estimation and performance on reproduction tasks in subtypes of children with attention deficit hyperactivity disorder.

This study compared Hispanic children (ages 7 to 11) with combined type (CT, n=33) and inattentive type (IT, n=21) attention deficit hyperactivity disorder (ADHD) and a control group (n=25) on time-estimation and time-reproduction tasks. The ADHD groups showed larger errors in time reproduction but not in time estimation than the control group, and the groups did not differ from each other on their performance on this task. Individual differences could not be accounted for by oppositional-defiance ratings and low math or reading scores. Although various measures of executive functioning did not make significant unique contributions to time estimation performance, those of interference control and nonverbal working memory did so to the time-reproduction task. Findings suggest that ADHD is associated with a specific impairment in the capacity to reproduce rather than estimate time durations and that this may be related to the children's deficits in inhibition and working memory.     

Reproductive health services for populations at high risk of HIV: Performance of a night clinic in Tete province,Mozambique

Background

In recent decades immigration to Norway from Asia, Africa and Eastern Europe has increased rapidly. The aim of this study was to assess the quality of care for type 2 diabetes mellitus (T2DM) patients from these ethnic minority groups compared with the care received by Norwegians.

Methods

In 2006, electronic medical record data were screened at 11 practices (49 GPs; 58857 patients). 1653 T2DM patients cared for in general practice were identified. Ethnicity was defined as self-reported country of birth. Chi-squared tests, one-way ANOVAs, multiple regression, linear mixed effect models and generalized linear mixed models were used.

Results

Diabetes was diagnosed at a younger age in patients from the ethnic minority groups (South Asians (SA): mean age 44.9 years, Middle East/North Africa (MENA): 47.2 years, East Asians (EA): 52.0 years, others: 49.0 years) compared with Norwegians (59.7 years, p < 0.001). HbA1c, systolic blood pressure (SBP) and s-cholesterol were measured in >85% of patients in all groups with minor differences between minority groups and Norwegians. A greater proportion of the minority groups were prescribed hypoglycaemic medications compared with Norwegians (≥79% vs. 72%, p < 0.001). After adjusting for age, gender, diabetes duration, practice and physician unit, HbA1c (geometric mean) for Norwegians was 6.9% compared to 7.3-7.5% in the minority groups (p < 0.05). The proportion with poor glycaemic control (HbA1c > 9%) was higher in minority groups (SA: 19.6%, MENA: 18.9% vs. Norwegians: 5.6%, p < 0.001. No significant ethnic differences were found in the proportions reaching the combined target: HbA1c ≤ 7.5%, SBP ≤ 140 mmHg, diastolic blood pressure (DBP) ≤ 85 mmHg and total s-cholesterol ≤5.0 mmol/L (Norwegians: 25.5%, SA: 24.9%, MENA: 26.9%, EA: 26.1%, others:17.5%).

Conclusions

Mean age at the time of diagnosis of T2DM was 8-15 years younger in minority groups compared with Norwegians. Recording of important processes of care measures is high in all groups. Only one in four of most patient groups achieved all four treatment targets and prescribing habits may be sub-optimal. Patients from minority groups have worse glycaemic control than Norwegians which implies that it might be necessary to improve the guidelines to meet the needs of specific ethnic groups.     

Reproductive health services for populations at high risk of HIV: Performance of a night clinic in Tete province, Mozambique

Background  

Different models exist to provide HIV/STI services for most-at-risk populations (MARP). Along the Tete traffic corridor in Mozambique, linking Malawi and Zimbabwe, a night clinic opening between 4 and 10 PM was established targeting female sex workers (FSW) and long-distance truck drivers (LDD). The clinic offers free individual education and counselling, condoms, STI care, HIV testing, contraceptive services and outreach peer education. To evaluate this clinic model, we assessed relevance, service utilisation, efficiency and sustainability.