Mediating effect of eating pattern on the relationship between television exposure and caries in children.

Behavioral characteristics may also take part in the etiology of dental caries. Sedentary behavior, especially watching television, is associated with increased intake of foods high in fat or free sugar, which could influence the occurrence of dental caries. The aim of this study was to assess the mediating effect of eating pattern on the relationship between television exposure time and the presence of dental caries in children. A cross-sectional study was conducted with a representative sample of 580 parent-child dyads with children aged 7 to 8 years in 20 public schools in Pelotas, Brazil. Parents or legal guardians were interviewed and provided information on demographic/socioeconomic data, children's daily television exposure time, and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-eating pattern domain). Caries was evaluated through clinical examination. The mediating effect of eating pattern on the relationship between television exposure and presence of dental caries was estimated using the parametric g-formula. Prevalence of dental caries was 63%, and 22% of children watched TV 4 or more hours per day. Television exposure had no direct effect on the dental caries experience [odds ratio (OR): 1.05 (95% confidence interval (95%CI): 0.92-1.19)]. Nevertheless, difficulty maintaining regular eating pattern mediated the natural indirect effect of television exposure time (≥ 4 hours/day) on dental caries experience [OR: 1.07 (95%CI): 1.01-1.14)]. The results of this study confirm the indirect pathway between television viewing and dental caries and the role of disordered eating patterns in this association.

Early Sugar Introduction Associated with Early Childhood Caries Occurrence.

Consensus has yet to be reached on the impact of early sugar introduction on early childhood dental caries (ECC). This study aimed to evaluate the association between the time of introduction of sugar in the infant's diet and ECC at 48 months, using data from the 2015 Pelotas Birth Cohort Study. This cohort comprises 4,275 children. At 48 months, 3,654 (91.1%) children had their oral health clinically evaluated by a team of 12 trained and calibrated dentists and their dental caries experience and cavitated lesions were assessed. The period of life in which sugar was first introduced into the child's diet was considered the primary exposure of the study, collected through questionnaires at 3, 12, 24, and 48 months of age. Analyses were conducted using Stata, version 15.0. Descriptive analyses were initially performed. Poisson regression with robust variance adjustment for the crude and adjusted analysis was used to estimate the effect of the sugar introduction on ECC. The highest prevalence of caries experience (43.3%) was in children in which sugar was introduced into the infant's diet before 12 months of age. A higher prevalence of caries experience was found for less educated (49.8%) and younger (51.7%) mothers, and in poorer families (48.3%). In the adjusted analysis, the experience of caries was 48% greater in the group with sugar introduction before 12 months of age, compared to those where sugar was introduced after 24 months of age In conclusion, our results support the adoption of preventive measures to delay the supply of sugar in early life in order to reduce the caries experience in children.

Perfil de crianças de 0 a 18 meses vacinadas em um centro de especialidades / Profile of children aged 0 to 18 months vaccinated in a speciality center / Perfil de los niños de 0 a 18 meses vacunados en un centro de especialidades

Objetivo: descrever o perfil das crianças de 0 a 18 meses que utilizam um serviço de vacinação. Método: Trata-se de uma pesquisa descritiva com abordagem quantitativa, realizada com 234 pais e responsáveis de crianças de 0 a 18 meses que utilizaram o serviço de vacinação de um Centro de Especialidades, no período de julho a setembro de 2019. Os dados foram analisados no programa Stata versão 15.0. Resultados: os formulários foram, em sua maioria, respondidos pelas mães e a média de idade das crianças foi 7,9 meses. Conclusão: apesar da maior parte das carteiras vacinais estarem atualizadas de acordo com a idade, a temática em questão, pela relevância que possui para as políticas públicas de saúde, deve seguir sendo monitorada, visando ampliar o acesso às vacinas e também a abrangência de crianças vacinadas (AU).

Objective: to describe the profile of children aged 0 to 18 month who use a vaccination service. Method: this is a descriptive research with a quantitative approach, carried out with 234 parents and guardians of children aged 0 to 18 months who used the vaccination servisse of a Speciality Center, from Jluy to September 2019. The data were analysed in the Stara program version 15.0. Results: the forms were mostly answered by the mother and the children's avarage age was 7.0 months. Conclusion: despite the fact that most vaccine portfolios are up-to-date according to age, the theme in question, due to its relevance to public health policies, should continue to be monitored, aiming to expand access to vaccines and also the reach of vaccinated children (AU).

Objetivo: describir el perfil de los niños que utilizan un servicio de vacunación. Método: se trata de una investigación descriptiva con enfoque cuantitativo, realizada con 234 padres y tutores de niños de 0 a 18 meses que utilizaron el servicio de vacunación de un Centro de Especialidades, de julio a septiembre de 2019. Los datos fueran analizados en el Versión 15.0 del programa Stata. Resultados: los formularios fueran respondidos mayoritariamente por las madres y la edad promedio de los niños fue de 7,9 meses. Conclusión: a pesar de que la mayoría de los portafolios de vacunas de actualizan por edad, el tema en cuestión, por su relevancia para las políticas de salud pública, debe seguir siendo monitoreado, con el objetivo de ampliar el acceso a las vacunas y también el alcance de los niños vacunados (AU).

Mediating effect of eating pattern on the relationship between television exposure and caries in children

Abstract Behavioral characteristics may also take part in the etiology of dental caries. Sedentary behavior, especially watching television, is associated with increased intake of foods high in fat or free sugar, which could influence the occurrence of dental caries. The aim of this study was to assess the mediating effect of eating pattern on the relationship between television exposure time and the presence of dental caries in children. A cross-sectional study was conducted with a representative sample of 580 parent-child dyads with children aged 7 to 8 years in 20 public schools in Pelotas, Brazil. Parents or legal guardians were interviewed and provided information on demographic/socioeconomic data, children's daily television exposure time, and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-eating pattern domain). Caries was evaluated through clinical examination. The mediating effect of eating pattern on the relationship between television exposure and presence of dental caries was estimated using the parametric g-formula. Prevalence of dental caries was 63%, and 22% of children watched TV 4 or more hours per day. Television exposure had no direct effect on the dental caries experience [odds ratio (OR): 1.05 (95% confidence interval (95%CI): 0.92-1.19)]. Nevertheless, difficulty maintaining regular eating pattern mediated the natural indirect effect of television exposure time (≥ 4 hours/day) on dental caries experience [OR: 1.07 (95%CI): 1.01-1.14)]. The results of this study confirm the indirect pathway between television viewing and dental caries and the role of disordered eating patterns in this association.

Which social, gestational and mental health aspects are associated to maternal-fetal attachment? / Quais aspectos sociais, gestacionais e de saúde mental materna estão associados ao apego materno-fetal?

Abstract Objectives: this study aimed to explore a set of factors associated with lower maternal-fetal attachment (MFA) in pregnant women. Methods: this is a cross-sectional study corresponding to the second wave of a cohort study with a population-based sample of pregnant women in the South of Brazil. The maternal-fetal attachment scale (MFAS) was used to measure MFA. Bivariate analysis was performed using the t-test and ANOVA. The variables that presented p<0.20 were taken for multivariate analysis, through linear regression, in order to control possible confounding factors. Results: a total of 840 pregnant women were included. Pregnant women who had lower MFA means were those who did not live with a partner (B=-3.8 [CI95%=-6.0; -1.7]), those between the first and second trimester of pregnancy (B=-4.3 [CI95%=-5.9; -2.6]), those who did not have support from their mother during pregnancy (B=-2.4 [CI95%=-4.6; -0.2]), and those with depressive symptoms (B=-4.9 [CI95%=-7.4; -2.5]). Conclusions: the results showed that a higher MFA it is associated with an adequate support network during pregnancy, better maternal mental health, and with an advanced pregnancy. Early evaluation of MFA and effort to promote an adequate prenatal bond, focusing on maternal psychological and emotional aspects are strongly suggested.

Resumo Objetivos: explorar um conjunto de fatores associados ao menor apego materno-fetal (AMF) em gestantes. Métodos: trata-se de um estudo transversal, correspondente à segunda fase de um estudo de coorte com uma amostra de base populacional de gestantes no sul do Brasil. Foi utilizada a Escala de Apego Materno-Fetal (EAMF) para medir o AMF. A análise bivariada foi realizada através do teste t e ANOVA. As variáveis que apresentaram p<0,20 foram levadas para análise multivariada, por meio de regressão linear, a fim de controlar possíveis fatores de confusão. Resultados: foram incluídas 840 gestantes. As gestantes que apresentaram menores médias de AMF foram aquelas que não moravam com um companheiro (B=-3,8 [IC95%=-6,0; -1,7]), que estavam entre o primeiro e o segundo trimestre de gestação (B=-4,3 [IC95%=-5,9; -2,6]), que não tiveram o apoio da mãe durante a gestação (B=-2,4 [IC95%=-4,6; -0,2]) e que apresentaram sintomas depressivos (B=-4,9 [IC95%=-7,4; -2,5]). Conclusões: os resultados mostraram que um maior AMF está associado a presença de uma rede de apoio adequada na gravidez, melhor saúde mental materna e a uma gestação avançada. A avaliação precoce do AMF e a promoção de um vínculo pré-natal adequado, com foco nos aspectos psicológicos e emocionais maternos são fortemente sugeridos.

Antenatal depression: Efficacy of a pre-post therapy study and repercussions in motor development of children during the first 18 months postpartum. Study: "Pregnancy care, healthy baby".

AIMS: To evaluate the efficacy of brief psychotherapeutic interventions of cognitive behavioral therapy to treat antenatal depression and verify the association between interventions and motor development of infants at 3 and 18 months of age. METHODS: Pre-post-intervention study nested a randomized clinical trial, both of which are extracts from a population-based cohort study of a southern Brazilian city. The major depressive episode was measured through Mini Plus, the severity of depressive symptoms by BDI-II and motor development using Bayley-III and AIMS. The follow-ups occurred during the gestational period (T2) and at 3 (T3) and 18 months (T4) after delivery. RESULTS: Data were analyzed from 336 women in the control group (not intervened) and 108 from the group of depressed women who received intervention for antenatal depression. The effectiveness of the interventions for a major depressive episode was around 80% for both models in the two follow-up stages (3 and 18 months postpartum). In addition, the children whose mothers received intervention presented 3.7 (95% CI 0.7-6.6) points higher in Bayley-III at 3 months old when compared to the children in the control group (p = 0.01). There was no difference between the two psychotherapy models tested, both being equally effective (p > 0.05). CONCLUSIONS: We found that the brief psychotherapeutic interventions of cognitive behavioral therapy for gestational depression were effective in causing remission of the condition both in the short and long term, besides indirectly causing benefits also to the children, with regard to their motor development.

Associação entre vínculo parental e qualidade da vinculação amorosa em universitários no sul do Brasil / Association between parental bond and quality of love bonding in university students in southern Brazil / Asociación entre el vínculo parental y la calidad del vínculo amoroso en estudiantes universitarios del sur de Brasil

A partir das primeiras experiências de vinculação, serão internalizados modelos representacionais que servirão de protótipo para as relações amorosas no futuro. Este estudo investigou a associação entre a percepção de vínculo parental e a qualidade da vinculação amorosa em universitários no sul do Brasil. Trata-se de um estudo transversal, no qual foram utilizados o Questionário de Vinculação ao Pai e à Mãe e o Questionário de Vinculação Amorosa. A análise estatística foi baseada no modelo de Regressão Linear Múltipla. Foram avaliados 89 universitários. A cada aumento de um ponto no escore da inibição da exploração e da individualidade no vínculo materno, houve uma diminuição no escore da confiança e um aumento no escore da ambivalência no vínculo amoroso. Os resultados demonstram que dificuldades no estabelecimento de um vínculo precoce saudável podem ocasionar sentimento de insegurança, ambivalência e baixa confiança nos relacionamentos amorosos futuros.

From the first experiences of bonding, representational models will be internalized that will serve as a prototype for loving relationships in the future. This study investigated the association between the perception of parental bond and the quality of love bonding in university students in southern Brazil. This is a cross-sectional study, in which the Questionário de Vinculação ao Pai e à Mãe and the Questionário de Vinculação Amorosa were used. The statistical analysis was based on the Multiple Linear Regression model. We assessed 89 university students. For each increase of one point in the mean of inhibition of exploitation and individuality in the maternal bond, there was a decrease in the mean of confidence and an increase in the mean of ambivalence in the love bond. The results demonstrate that difficulties in establishing a healthy early bond can lead to feelings of insecurity, ambivalence and low confidence in future relationships.

A partir de las primeras experiencias de vinculación, se internalizarán modelos representativos que servirán como prototipo de relaciones amorosas en el futuro. Este Estudio investigó la asociación entre la percepción del vínculo parental y la calidad del vínculo amoroso entre los estudiantes universitarios del sur de Brasil. Este es un estudio transversal, en el que se utilizaron el Questionário de Vinculação ao Pai e à Mãe y e l Questionário de Vinculação Amorosa. El análisis estadístico se basó en el modelo de Regresión Lineal Múltiple. Se evaluaron 89 estudiantes universitarios. Por cada aumento de un punto en el promedio de inhibición de la exploración e individualidad en el vínculo materno, hubo una disminución en el promedio de confianza y un aumento en la promedio de ambivalencia en el vínculo amoroso. Los resultados demuestran que las dificultades para establecer un vínculo temprano saludable pueden generar sentimientos de inseguridad, ambivalencia y poca confianza en las relaciones futuras.

Socioeconomic status and body mass index life course models: the 1993 Pelotas (Brazil) birth cohort.

This article aims to assess the relationship between an individual's socioeconomic status over their life-course and their body mass index (BMI) at 22 years of age, according to the hypotheses generated by risk accumulation, critical period, and social mobility models. This was a population-based prospective study based on the Pelotas (Brazil) 1993 birth cohort. The risk accumulation, critical period, and social mobility models were tested in relation to a saturated model and compared with a partial F-test. After the best model was chosen, linear regression was carried out to determine the crude and adjusted regression coefficients of the association between socioeconomic status over the life-course and BMI at 22 years of age. The sample was comprised of 3,292 individuals (53.3% women). We found dose-response effect for both men and women, although the results were opposite. Among men, a lower score in socioeconomic status accumulation model led to a lower BMI average at 22 years of age; whereas among women, a lower score in socioeconomic status accumulation model caused an increase in BMI at 22 years of age.

Brief cognitive behavioral therapy in pregnant women at risk of postpartum depression: Pre-post therapy study in a city in southern Brazil.

BACKGROUND: Postpartum depression (PPD) affects a high number of women, often the first manifestation of a mood disorder that will occur later in life, bringing serious consequences for the patient and her offspring. Depression today is the leading cause of disability worldwide. The aim of this study was to evaluate the effectiveness of a preventive cognitive behavioral therapy (CBT) for PPD. METHODS: Pre-post therapy study, as part of a population-based cohort study. Pregnant women without a diagnosis of depression participated, who were divided into two groups: risk of depression (CBT) and a control group (without therapy). The preventive therapy consisted of six sessions of CBT, administered weekly. The Outcome Questionnaire (OQ-45) was used in all sessions. The Mini International Neuropsychiatric Interview and Beck Depression Inventory-II were used on three occasions. The final statistical analyses were performed by Poisson regression. RESULTS: The prevalence of PPD in the risk group was 5.5% and in the control group 2.2%, with no difference between the groups (PR 1.66 95% CI 0.44-6.18). The OQ-45 averages gradually reduced during the therapy sessions, indicating therapeutic progress. Schooling was an associated factor, both with the manifestation of PPD and with the greater effectiveness of the therapy. LIMITATIONS: Rate of 40.5% refusal to preventive treatment and absence of a group with similar characteristics in another therapy model. CONCLUSIONS: Brief cognitive behavioral therapy applied by mental health professionals with basic training was effective in preventing the manifestation of PPD.

Maternal-fetal attachment and perceived parental bonds of pregnant women.

BACKGROUND: The parental bond is characterized by the perception of care and protection received by parental figures throughout human development. During the gestational period, the intensity in which the woman manifests behaviors and feelings for the fetus was denominated maternal-fetal attachment (MFA). In this perspective, the literature indicates that there is association between MFA and the pregnant woman's perception about the bond established with her parents. AIMS: This study aimed to evaluate the association between MFA and perceived parental bonds of pregnant women in the city of Pelotas/RS (Brazil). STUDY DESIGN: This is a cohort study with 839 women during their gestational period. All women answered to the Parental Bonding Instrument to investigate the perceived parental bonds, and the MFA was assessed through the Maternal-Fetal Attachment Scale. RESULTS: The main results showed that perceived paternal overprotection was associated with a higher MFA after adjustment (B 2.00 CI95% 0.30; 3.70). Additionally, the pregnant women who were in the first trimester of pregnancy (p < 0.001), who did not live with a partner (p = 0.018), and who did not feel supported by the baby's father during pregnancy (p = 0.014) presented lower scores of MFA. CONCLUSION: This study showed the importance of the paternal role in the women's life, considering the perception of the bond with their father during their development, an adequate support by the father of the baby, and the presence of a partner during pregnancy. As a result, the paternal role may influence the feelings and behaviors of greater affection, care, and concern regarding the fetus.

Socioeconomic status and body mass index life course models: the 1993 Pelotas (Brazil) birth cohort / Condição socioeconômica e índice de massa corporal em modelos de curso de vida: coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil / Estatus socioeconómico e índice de masa corporal en modelos de ciclo vital: cohorte de nacimientos de 1993 en Pelotas, Rio Grande do Sul, Brasil

Abstract: This article aims to assess the relationship between an individual's socioeconomic status over their life-course and their body mass index (BMI) at 22 years of age, according to the hypotheses generated by risk accumulation, critical period, and social mobility models. This was a population-based prospective study based on the Pelotas (Brazil) 1993 birth cohort. The risk accumulation, critical period, and social mobility models were tested in relation to a saturated model and compared with a partial F-test. After the best model was chosen, linear regression was carried out to determine the crude and adjusted regression coefficients of the association between socioeconomic status over the life-course and BMI at 22 years of age. The sample was comprised of 3,292 individuals (53.3% women). We found dose-response effect for both men and women, although the results were opposite. Among men, a lower score in socioeconomic status accumulation model led to a lower BMI average at 22 years of age; whereas among women, a lower score in socioeconomic status accumulation model caused an increase in BMI at 22 years of age.

Resumo: O artigo busca avaliar a relação entre condição socioeconômica ao longo da vida e índice de massa corporal (IMC) aos 22 anos de idade, de acordo com as hipóteses geradas pelos modelos de acúmulo de riscos, período crítico e mobilidade social. Este é um estudo prospectivo de base populacional, na coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil. Os modelos de acúmulo de riscos, período crítico e mobilidade social foram testados em relação a um model saturado, e comparados através de um teste F parcial. Após escolher o melhor modelo, a análise de regressão linear foi realizada para determinar os coeficientes de regressão, brutos e ajustados, da associação entre a condição socioeconômica ao longo da vida e o IMC aos 22 anos. A amostra consistia em 3.292 indivíduos (53,3% mulheres). Foram identificados efeitos de dose-resposta em homens e mulheres, embora os efeitos fossem opostos. Entre os homens, um aumento na pontuação baixa no modelo de acúmulo de condição socioeconômica levou a um IMC médio mais baixo aos 22 anos de idade; enquanto isso, nas mulheres, um aumento na pontuação baixa no modelo de acúmulo de condição socioeconômica levou a um aumento no IMC aos 22 anos de idade.

Resumen: El objetivo de este artículo es evaluar la relación entre el estatus socioeconómico a lo largo del ciclo vital y el índice de masa corporal (IMC) con 22 años de edad, según las hipótesis generadas por riesgo de acumulación, período crítico y modelos de movilidad social. Se trata de un estudio prospectivo de base poblacional con la cohorte de nacimiento de 1993 en Pelotas, Rio Grande do Sul, Brasil. Se probaron tanto el riesgo de acumulación, como el período crítico y modelos de movilidad social, en relación con un modelo saturado y comparado mediante un F-test parcial. Tras haber elegido el mejor modelo, se llevó a cabo una regresión lineal para determinar los coeficientes de asociación crudos y ajustados entre estatus socioeconómico, a lo largo del ciclo vital, e IMC a los 22 años de edad. La muestra estuvo compuesta por 3.292 individuos (53,3% mujeres). Se encontraron efectos dosis-respuesta para ambos hombres y mujeres, a pesar de que los efectos fueron opuestos. Entre hombres, el aumento en la puntación del modelo de acumulación en el estatus socioeconómico bajo condujo a un promedio más bajo de IMC a los 22 años de edad, mientras que, entre mujeres, el aumento en la puntuación del modelo de acumulación en el estatus socioeconómico bajo provocó un incremento en el IMC a los 22 años de edad.

Mental disorders, comorbidities, and suicidality at 30 years of age in a Brazilian birth cohort.

BACKGROUND: Studies on mental disorders prevalence and comorbidity, including suicidality, are scarce in low and middle-income settings. We aimed to describe the pattern of comorbidity between mental disorders and their association with suicidality. METHODS: In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified (n = 5914) and have been prospectively followed. Participants were evaluated for the presence of common mental disorders (CMD) at the ages of 18-19, 23 and 30 years. In 2012-13 (30 years of age), trained psychologists evaluated 3657 individuals for disorders using the Mini International Neuropsychiatric Interview. RESULTS: Prevalence of suicidal wishing, suicidal planning and lifetime suicidal attempt was 4.9%, 3.8% and 6.6%, respectively. Suicidal wishing was most strongly associated with having joint major depressive episode (MD) and lifetime suicidal attempt (OR = 26.4, 95%CI:13.9-50.4) with comorbid MD with mania/hypomania (OR = 21.2, 95%CI:6.93-65.1). Suicidal planning was most strongly associated with having joint MD and lifetime suicidal attempt (OR = 44.7, 95%CI:22.6-88.4), with comorbid MD and social anxiety disorder (OR = 30.6, 95%CI:13.0-72.0), and joint social anxiety disorder with lifetime suicidal attempt (OR = 26.3, 95%CI:8.33-82.7). Independently of other disorders, prospective and cross-sectional measures of CMD were associated with higher rates of suicidality. LIMITATIONS: We do not have data on suicide deaths in follow-up and the diagnostic instrument used at 30 years of age was not used in all previous follow-up. CONCLUSION: MD and social anxiety have independent and combined associations with suicidality, and also with they occur with lifetime suicidal attempt and other mental disorders.

Common Mental Disorders and Contemporary Factors: 1982 Birth Cohort.

OBJECTIVE: To describe the association between common mental disorders and socio-demographic variables, smoking habits and stressful events among the 30-year-old members of a 1982 cohort. METHOD: Mental disorder was analyzed by the Self-Reporting Questionnaire (SRQ-20). Poisson regression was used to analyze the unadjusted and adjusted associations. RESULTS: Low level of education and stressful events increased the prevalence of mental disorders for both genders. Lower income for women and unemployment for men also remained associated with CMD. CONCLUSION: It was possible to describe the association between contemporary factors and mental disorders in a young population, to which prevention and control measures, through public policies proposed to the areas of Primary Care, Mental Health and Education, can represent a better quality of life and health.

People living with HIV/AIDS: body image and its important associations with mental health and BMI.

Patients on antiretroviral therapy face new challenges, such as bodily changes. We conducted a cross-sectional study with people living with HIV/AIDS. We investigate the self-perception of body image and its associations. Most of the patients reported negative self-perception of body image (NSPBI), being mostly women, up to 40 years old and with changes in BMI. NSPBI was associated with depressive symptoms and punctual alterations in the redistribution of body fat: face, abdomen and legs, subjects still little elucidated. Assessing neglected aspects can improve the way these patients see themselves, and come to understand the disease as only a part of their lives.

Common Mental Disorders and Contemporary Factors: 1982 Birth Cohort / Trastornos mentales comunes y factores contemporáneos: cohorte de nacimientos de 1982 / Transtornos mentais comuns e fatores contemporâneos: coorte de nascimentos de 1982

ABSTRACT Objective: To describe the association between common mental disorders and socio-demographic variables, smoking habits and stressful events among the 30-year-old members of a 1982 cohort. Method: Mental disorder was analyzed by the Self-Reporting Questionnaire (SRQ-20). Poisson regression was used to analyze the unadjusted and adjusted associations. Results: Low level of education and stressful events increased the prevalence of mental disorders for both genders. Lower income for women and unemployment for men also remained associated with CMD. Conclusion: It was possible to describe the association between contemporary factors and mental disorders in a young population, to which prevention and control measures, through public policies proposed to the areas of Primary Care, Mental Health and Education, can represent a better quality of life and health.

RESUMEN Objetivo: describir la asociación de trastornos mentales comunes a los 30 años en los miembros de cohorte de 1982 con variables sociodemográficas, tabaquismo y eventos estresores. Método: los trastornos mentales se identificaron mediante el Cuestionario de Autorreporte de Síntomas (SRQ-20). La Regresión de Poisson se utilizó para analizar las asociaciones brutas y ajustadas. Resultados: la poca escolarización y los eventos estresores aumentaron la frecuencia de trastornos en ambos sexos. Los ingresos familiares bajos de las mujeres y la falta de trabajo de los hombres también estaban relacionados. Conclusión: Existe una asociación entre los factores contemporáneos y los trastornos mentales padecidos por los jóvenes, en los que las medidas de prevención y control, a través de políticas públicas en las áreas de Atención Primaria, de Salud Mental y de Educación, pueden representar una mejoría en la calidad de vida e influenciar notablemente en su salud.

RESUMO Objetivo: Descrever a associação de transtorno mental comum aos 30 anos nos membros da coorte de 1982 com variáveis sociodemográficas, tabagismo e eventos estressores. Método: Transtorno mental foi identificado pelo Self-Reporting Questionnaire (SRQ-20). Regressão de Poisson foi utilizada para analisar as associações brutas e ajustadas. Resultados: A baixa escolaridade e os eventos estressores aumentaram a frequência de transtorno em ambos os sexos. A menor renda familiar para mulheres e a falta de trabalho para homens também se mantiveram associadas. Conclusão: Permitiu descrever a associação de fatores contemporâneos com os transtornos mentais em população jovem, na qual as medidas de prevenção e controle, por meio de políticas públicas propostas nas áreas de Atenção Básica, Saúde Mental e Educação, podem representar uma melhor qualidade de vida e de saúde.

Emotional and behavioral problems: a school-based study in southern Brazil / Problemas emocionais e comportamentais: um estudo de base escolar no sul do Brasil

Abstract Introduction Mental health assessment in childhood needs to be carried out within a broader context that includes different factors. Objective To assess the prevalence of emotional and behavioral problems in schoolchildren and associated factors. Method A cross-sectional study was conducted with a school-based sample at 20 schools selected by systematic random sampling. Participants consisted of children aged 7-8 year old and their parents or primary caregivers. The Strengths and Difficulties Questionnaire (SDQ) was used to screen for the presence of emotional and behavioral problems in children. Results A total of 596 dyads were evaluated. The prevalence of emotional and behavioral problems was 30.0% among boys and 28.2% among girls. Hyperactivity/inattention were more prevalent among boys (p=0.015). Belonging to economically disadvantaged strata increased the likelihood of emotional and behavioral problems among schoolchildren by 71% (p=0.001), while having parents or caregivers with mental disorder increased by 2.2 times that probability (p<0.001). Conclusion: Our findings showed a high prevalence of emotional and behavioral problems among schoolchildren, as well as the influence of economic conditions and of the mental health of parents and caregivers on child mental health.

Resumo Introdução A avaliação da saúde mental na infância necessita ser realizada dentro de um contexto amplo que considere os diferentes fatores envolvidos. Objetivo Verificar a prevalência de problemas emocionais e comportamentais em escolares, bem como fatores associados. Método Estudo transversal, com amostra de base escolar em que foram selecionadas 20 escolas por amostragem aleatória sistemática. Participaram crianças com 7-8 anos e seus pais ou principais cuidadores. A presença de problemas emocionais e comportamentais nas crianças foi rastreada pelo Strengths and Difficulties Questionnaire (SDQ). Resultados Foram avaliadas 596 díades. A prevalência de problemas emocionais e comportamentais foi de 30,0% entre os meninos e 28,2% entre as meninas. Sintomas de hiperatividade/desatenção foram mais prevalentes entre meninos (p=0,015). Pertencer a camadas menos favorecidas economicamente aumentou em 71% a probabilidade de problemas emocionais e comportamentais entre os escolares (p=0,001), enquanto ter pais ou cuidadores com transtorno mental aumentou 2,2 vezes tal probabilidade (p<0,001). Conclusões: Nossos achados demonstram a elevada prevalência de problemas emocionais e comportamentais entre escolares, bem como a influência das condições econômicas e da saúde mental de pais e cuidadores sobre a saúde mental infantil.

Emotional and behavioral problems: a school-based study in southern Brazil.

INTRODUCTION: Mental health assessment in childhood needs to be carried out within a broader context that includes different factors. OBJECTIVE: To assess the prevalence of emotional and behavioral problems in schoolchildren and associated factors. METHOD: A cross-sectional study was conducted with a school-based sample at 20 schools selected by systematic random sampling. Participants consisted of children aged 7-8 year old and their parents or primary caregivers. The Strengths and Difficulties Questionnaire (SDQ) was used to screen for the presence of emotional and behavioral problems in children. RESULTS: A total of 596 dyads were evaluated. The prevalence of emotional and behavioral problems was 30.0% among boys and 28.2% among girls. Hyperactivity/inattention were more prevalent among boys (p=0.015). Belonging to economically disadvantaged strata increased the likelihood of emotional and behavioral problems among schoolchildren by 71% (p=0.001), while having parents or caregivers with mental disorder increased by 2.2 times that probability (p<0.001). Conclusion: Our findings showed a high prevalence of emotional and behavioral problems among schoolchildren, as well as the influence of economic conditions and of the mental health of parents and caregivers on child mental health.

Prevalência de insegurança e consumo alimentar em famílias do programa de aquisição de alimentos / Prevalence of insecurity and food consumption in families food purchase program

Pouco se monitora e se avalia a situação de insegurança alimentar e nutricional, especialmente, a fim de verificar a efetividade das ações governamentais. O objetivo desse trabalho foi estimar a prevalência de insegurança alimentar e de consumo das famílias inscritas no Programa de Aquisição de Alimentos da Agricultura Familiar em São Lourenço do Sul (RS). Tratou-se de estudo transversal, realizado entre janeiro e março de 2012, envolveu todas as famílias inscritas no Programa de Aquisição de Alimentos de São Lourenço do Sul (RS). A insegurança alimentar foi avaliada com a Escala Brasileira de Insegurança Alimentar, versão longa, classificando as famílias em segurança ou insegurança alimentar (leve, moderada ou grave). O consumo foi identificado pelo questionário de avaliação dos marcadores de consumo alimentar. Das 830 famílias inscritas no Programa, 585 foram entrevistadas (70,5%) e 80% estavam em situação de insegurança alimentar. O consumo familiar de feijão, cereais e ovos foi elevado e, de frutas, legumes e verduras foi reduzido. Conclui-se que a prevalência de insegurança alimentar nas famílias é elevada e o consumo de marcadores da alimentação saudável é baixo para o grupo de frutas. Os dados servirão para direcionar ações a nível municipal.

Little is monitored and assesses the situation of food and nutritional insecurity, especially in order to verify the effectiveness of governmental actions. The aim of this study was to estimate the prevalence of food insecurity and consumption of the families enrolled to the Family Agriculture Food Acquisition Programme in São Lourenço do Sul (RS). A cross-sectional study was conducted between january and march 2012, involved all families enrolled in the Food Acquisition Program of São Lourenço do Sul (RS). Food insecurity was assessed with the Brazilian Food Insecurity Scale, long version, classifying families in food security or insecurity (mild, moderate or severe). Consumption was identified by the questionnaire evaluating food consumption markers. Of the 830 families attached to the program, 585 were interviewed (70.5%) and 80% were food insecure. The household consumption of beans, cereals and eggs was high and fruit and vegetables were reduced. In conclusion, the prevalence of food insecurity in the families is high and the consumption of healthy food markers is low for the fruit group. The data will be used to guide actions at the municipal level

Adolescence and Later Life Disease Burden: Quantifying the Contribution of Adolescent Tobacco Initiation From Longitudinal Cohorts.

PURPOSE: Adolescence is a time of initiation of behaviors leading to noncommunicable diseases (NCDs). We use tobacco to illustrate a novel method for assessing the contribution of adolescence to later burden. METHODS: Data on initiation of regular smoking during adolescence (10-19 years) and current adult smoking were obtained from the 1958 British Birth Cohort, the U.S. National Longitudinal Study of Adolescent Health (Add Health), the Pelotas 1982 Birth Cohort, and the Victorian Adolescent Health Cohort Study. We estimated an "adolescent attributable fraction" (AAF) by calculating the proportion of persisting adult daily smoking initiated < age 20 years. We used findings to estimate AAFs for >155 countries using contemporary surveillance data. RESULTS: In the 1958 British Birth Cohort, 81.6% of daily smokers at age 50 years initiated < age 20 years, with a risk ratio of 6.1 for adult smoking related to adolescent initiation. The adjusted AAF was 69.1. Proportions of smokers initiating <20 years, risk ratio, and AAFs were 83.3%, 7.0%, and 70.4% for Add Health; 75.5%, 3.7%, and 50.2% in Victorian Adolescent Health Cohort Study; and 70.9%, 5.8%, and 56.9% in Pelotas males and 89.9%, 6.4%, and 75.9% in females. Initiation <16 years resulted in the highest AAFs. Estimated AAFs globally ranged from 35% in China to 76% in Argentina. CONCLUSIONS: The contribution of adolescent smoking initiation to adult smoking burden is high, suggesting a need to formulate and implement effective actions to reduce smoking initiation in adolescents. Similar trends in other NCD risks suggest that adolescents will be central to future efforts to control NCDs.

Caesarean section and adiposity at 6, 18 and 30 years of age: results from three Pelotas (Brazil) birth cohorts.

BACKGROUND: Association between caesarian section (C-section) and obesity is controversial and mostly based on body mass index (BMI), which has inherent limitations. Using direct estimates of body fat mass, we aimed to assess the association between C-section and adiposity using fat mass index and BMI z-score in three birth cohort studies from Pelotas, Brazil. METHODS: We measured weight, height and fat mass (using dual X-ray absorptiometry (DXA)) at ages 6, 18 and 30 years among participants in the 2004, 1993 and 1982 population-based Pelotas Birth Cohort Studies, respectively. We used multiple linear regression analysis to examine the crude and adjusted association between C-section and the body composition indicators. We also modelled height as an outcome to explore the presence of residual confounding. RESULTS: We observed that fat mass index and BMI z-score were strongly and positively associated with C-section in the crude analysis. However, when we adjusted for socioeconomic characteristics, maternal BMI, parity, age and smoking during pregnancy, effect estimates were attenuated towards the null, except for 30-year-old women. In those women from the 1982 cohort, C-section remained associated with fat mass index (ß = 0.82; CI95% 0.32;1.32) and BMI z-score (ß = 0.15; CI95% 0.03;0.28), even after adjusting for all potential confounders, suggesting an increase in fat mass index and BMI at 30 years among those born by C-section. CONCLUSION: We found no consistent association of C-section with fat mass index measured by DXA and BMI z-score in individuals aged 6, 18 and 30 years, except for women in the latter group, which might be explained by residual confounding. Confounding by socioeconomic and maternal characteristics accounted for all the other associations.