Association of household composition with dietary patterns among adolescents in Brazil.

The present study identified dietary patterns (DP) and analyse their association with household composition. This is a cross-sectional school-based study, with a nationally representative sample of Brazilian adolescent students, aged 11-19 years, with data from National School Health Survey (n 102 072). Food consumption was obtained through the weekly frequency of consumption of food markers, and the confirmatory factor analysis was applied to examine the latent variables 'Healthy' (beans, legumes/vegetables and fresh fruit/fruit salad) and 'Unhealthy' (ultra-processed foods, sweets, soft drinks and snacks) DP. The association between household composition and DP was estimated considering lives with both parents as reference category. Among adolescents aged 11-14 years, adherence to healthy DP was lower for boys who lived only with mother (ß = -2·1), and boys (ß = -4·9) and girls (ß = -4·5) who lived without any parents. Adherence to unhealthy DP was higher among boys (ß = 7·6) and girls (ß = 6·0) who lived only with mother, and boys (ß = 4·6) and girls (ß = 5·3) who lived only with father. For older adolescents (aged 15-19 years), adherence to the unhealthy DP was higher among boys who lived only with mother (ß = 3·9) or only with father (ß = 5·3) and girls who lived only with mother (ß = 6·3). Adherence to healthy DP was lower among girls who lived only with father (ß = -9·0). Thus, adolescents who lived in single-parent households had lower adherence to healthy DP and greater adherence to unhealthy DP. Among younger adolescents of both sexes, living without any parent contributed to lower adherence to healthy DP.

Sedentary behavior is associated with poor sleep quality during the COVID-19 pandemic, and physical activity mitigates its adverse effects.

BACKGROUND: We aimed to evaluate the association of sedentary behavior (SB) and moderate to vigorous leisure-time physical activity (MVPA) with sleep quality during the COVID-19 pandemic. METHODS: Cross-sectional, population-based study in adults, conducted from October to December 2020 in the Iron Quadrangle region, Brazil. The outcome was sleep quality, evaluated with the Pittsburgh Sleep Quality Index. SB was assessed by self-report of total sitting time, before and during the pandemic. Individuals with ≥ 9 h of total sitting time were classified as SB. In addition, the ratio of time spent in MVPA to time in SB was analyzed. A contrasted directed acyclic graph (DAG) model was constructed to adjust logistic regression models. RESULTS: A total of 1629 individuals were evaluated, the prevalence of SB before the pandemic was 11.3% (95%CI: 8.6-14.8), and during the pandemic 15.2% (95%CI: 12.1-18.9). In multivariate analysis, the chance of poor sleep quality was 77% higher in subjects with SB ≥ 9 h per day (OR: 1.77; 95% CI: 1.02-2.97). Furthermore, a one-hour increase in SB during the pandemic, increased the chance of poor sleep quality by 8% (OR: 1.08; 95%CI 1.01-1.15). In the analysis of the ratio of MVPA per SB in individuals with SB ≥ 9 h, practicing 1 min of MVPA per hour of SB reduces the chance of poor sleep quality by 19% (OR: 0.84; 95%CI: 0.73-0.98). CONCLUSION: SB during the pandemic was a factor associated with poor sleep quality, and the practice of MVPA can reduce the effects of SB.

Gender differences in the association of individual and contextual socioeconomic status with hypertension in 230 Latin American cities from the SALURBAL study: a multilevel analysis.

BACKGROUND: Despite global interest in gender disparities and social determinants of hypertension, research in urban areas and regions with a high prevalence of hypertension, such as Latin America, is very limited. The objective of this study was to examine associations of individual- and area-level socioeconomic status with hypertension in adults living in 230 cities in eight Latin America countries. METHODS: In this cross-sectional study, we used harmonized data from 109,184 adults (aged 18-97 years) from the SALURBAL (Salud Urbana en America Latina/Urban Health in Latin America) project. Hypertension was assessed by self-report. Individual-, sub-city- and city-level education were used as proxies of socioeconomic status. All models were stratified by gender. RESULTS: Higher individual-level education was associated with lower odds of hypertension among women (university education or higher versus lower than primary: odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.61-0.74) but higher odds among men (OR = 1.65; 95%CI 1.47-1.86), although in men an inverse association emerged when measured blood pressure was used (OR = 0.86; 95%CI 0.76-0.97). For both genders, living in sub-city areas with higher educational achievement was associated with higher odds of hypertension (OR per standard deviation [SD] = 1.07, 95%CI = 1.02-1.12; OR = 1.11 per SD, 95%CI = 1.05-1.18, for women and men, respectively). The association of city-level education with hypertension varied across countries. In Peru, there was an inverse association (higher city level education was associated with lower odds of hypertension) in women and men, but in other countries no association was observed. In addition, the inverse association of individual-level education with hypertension became stronger (in women) or emerged (in men) as city or sub-city education increased. CONCLUSION: The social patterning of hypertension differs by gender and by the level of analysis highlighting the importance of context- and gender-sensitive approaches and policies to reduce the prevalence of hypertension in Latin America.

Home-based gait speed and the association with sociodemographic and anthropometric variables: A national study (ELSI-Brazil).

OBJECTIVES: To investigate home-based gait speed performance for men and women stratified by age group and its associations with sociodemographic and anthropometric variables. METHODS: Data from the 2nd wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021) were used. Gait speed was tested twice at home over 3.0 meters at usual pace. Associations of sociodemographic and anthropometric variables with gait speed were evaluated using gamma regression. RESULTS: Median gait speed value reduced with increasing age in both sexes [men: 0.70 m/s (50-59 years) to 0.53 m/s (≥80 years); women: 0.68 m/s (50-59 years) to 0.48 m/s (≥80 years)] and was significantly lower in women than men in the age groups of 60-69 and 70-79 years. Age group and education among men and age group, education, and waist circumference among women were significantly associated with gait speed. CONCLUSIONS: Our findings may be helpful as reference values to identify mobility limitation among older Brazilians.

Nationwide handgrip strength values and factors associated with muscle weakness in older adults: findings from the Brazilian Longitudinal Study of Aging (ELSI-Brazil).

BACKGROUND: Handgrip strength (HGS) is a simple, quick, inexpensive, and highly reliable method for the assessment of muscle strength in clinical practice and epidemiological studies. This study aimed at describing the HGS values by age group and sex in Brazilians aged 50 years and over, determining age group- and sex-specific cutoff points for muscle weakness, and investigating sociodemographic and anthropometric variables associated with muscle weakness for each sex. METHODS: Data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) were analyzed. HGS was measured in the dominant hand using a hydraulic hand dynamometer. Fractional polynomial regression models were fitted to estimate the percentiles (P5, P10, P20, P25, P50, P75, P90, and P95) of HGS by age group and sex. The P20 of the maximum HGS by age group and sex was used to define muscle weakness. Associations between sociodemographic (racial self-classification, place of residence, schooling, and monthly household income per capita in tertiles) and anthropometric variables (body mass index and waist circumference) and muscle weakness, by sex, were evaluated using logistic regression. RESULTS: The analytical sample included 7905 participants (63.1 ± 9.1 years; 60% women). HGS reduced with increasing age in both sexes. Men presented higher HGS than women in all age groups. The cutoff points for muscle weakness ranged from 28 to 15 kg for men and from 17 to 9 kg for women. In the adjusted analyses, low schooling (0-4 years) was positively associated with muscle weakness in both sexes (in men, odds ratio (OR) 2.45, 95% confidence interval (CI) 1.46-4.12; in women, OR 1.90, 95%CI 1.18-3.06). Low and middle monthly household income per capita also had a positive association with muscle weakness among women (OR 1.78, 95%CI 1.37-2.32; OR 1.32, 95%CI 1.01-1.73, respectively). Overweight had a negative association with muscle weakness among men (OR 0.66, 95%CI 0.52-0.83), and obesity was inversely associated with muscle weakness in both sexes (in men, OR 0.49, 95%CI 0.31-0.78; in women, OR 0.69, 95%CI 0.52-0.92). CONCLUSIONS: This study provides HGS values and cutoff points for muscle weakness by age group and sex from a nationally representative sample of older Brazilian adults. The variables associated with muscle weakness slightly differed between men and women. HGS values and cutoff points generated can be used as benchmarks in clinical settings and foster future epidemiological research.

Loneliness and social disconnectedness in the time of pandemic period among Brazilians: evidence from the ELSI COVID-19 initiative.

Objectives: This study aimed at estimating the pre-pandemic and pandemic prevalence of loneliness and investigating the association of loneliness with social disconnectedness during social distancing strategies in the time of the COVID-19 pandemic period.Methods: We used data from the ELSI COVID-19 initiative with participants from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which comprised 4,431 participants aged 50 years and over. Loneliness (hardly ever/some of the time/often) was assessed by the question "In the past 30 days, how often did you feel alone/lonely?". Social disconnectedness included information on social contacts through virtual talking (i.e. telephone, Skype, WhatsApp, or social media) and outside-home meetings with people living in another household. Covariates included sociodemographic and health related characteristics. Multinomial logistic regression models were used to estimate odds ratios (OR) with their 95% confidence interval (CI).Results: The overall prevalence of loneliness during the pandemic was 23.9% (95% CI 20.7-27.5); lower than in the pre-pandemic period (32.8%; 95% CI 28.6-37.4). In the pandemic period, 20.1% (95% CI 16.9-23.6) reported some of the time feeling lonely and 3.9% (95% CI 3.1-4.8) reported often feeling lonely. In the fully adjusted model, virtual talking disconnectedness (OR=1.67; 95% CI 1.09-2.56) was positively associated with some of the time feeling lonely and outside-home disconnectedness (OR=0.33; 95% CI 0.18-0.60) was negatively associated with often feeling lonely.Conclusion: Individuals with virtual talking disconnectedness and without outside-home disconnectedness are at higher risk of loneliness during the time of COVID-19 pandemic. Stimulating virtual talking connectedness might have the potential to diminish loneliness despite steep outside-home disconnectedness.

Incidence of depressive symptoms and its association with sociodemographic factors and lifestyle-related behaviors among Brazilian university students.

Entering university brings on changes in lifestyle and psychological stress and has been associated with increased risk of 1988 in college students. This study aimed to investigate the incidence of depressive symptoms and associated sociodemographic and lifestyle factors among university students. A dynamic cohort of freshmen was followed up for three years, starting at their entry to university (baseline) and then annually. A structured auto administered questionnaire was applied to obtain information on age, sex, economic class, living situation, smoking and drinking, sedentary and sleep behaviors, and change in physical activity after university admission. Depressive symptoms were assessed using the Patient Health Questionaire-9. Incidence and incidence rate of depressive symptoms were calculated. Poisson Regression with robust variance was used to identify risk factors associated to these disorders. A total of 1,034 students without depressive symptoms at baseline were investigated. The overall incidence of depressive symptoms was 28.3% and the incidence rate (IR) was 2.12, being greater for females (2.75) than males (1.65). The IR decreased over time for both males (from 2.61 to 0.41) and females (from 4.25 to 0.54). A greater risk of depressive symptoms was observed for younger male students compared to those ≥20 years old (IRRadj = 1.64) and for women who reported concomitant use of alcohol and tobacco compared to those that reported no smoking and no alcohol consumption. For both males (IRRadj = 2.80) and females (IRRadj = 1.91), severe stress level was associated with greater risk of depressive symptoms when compared to mild stress level. Depressive Symptoms occurred more significantly in females, in the early years of undergraduate course, in males <20 years old, and among those with high stress level. Understanding the possible causes of depression is essential to promote mental health and well-being among college student.

Factors associated with Brazilian physical therapists' perception of stress during the COVID-19 pandemic: a cross-sectional survey.

This study aimed to evaluate the stress perception among Brazilian physical therapists (PTs) during COVID-19 pandemic and to identify which psychosocial demands, sociodemographic, professional and clinical factors do associate with the PTs' stress perception. This cross-sectional survey was based on a convenience sample of PTs, who answered a questionnaire about: 1) sociodemographic and professional characteristics, 2) clinical characteristics and information related to COVID-19, 3) psychosocial demands, and 4) 10-item Perceived Stress Scale (PSS-10). Full responses were obtained from 417 PTs. The average PSS-10 score was 19.2 (95% CI 18.5 to 19.9), which was higher than in other Brazilians before COVID-19 and figured among the highest one observed in healthcare workers from different countries during COVID-19 pandemic. After multivariate analysis, PTs' perceived stress remained associated with female sex, younger age, previous diagnosis of depressive or anxiety disorder, worsening in sleep patterns, large reduction in family income, housework, relationship with the partner, concern about close people/family members being infected by SARS-CoV-2, and loneliness.

Spatial inequalities of retail food stores may determine availability of healthful food choices in a Brazilian metropolis.

OBJECTIVE: To examine the association between economic residential segregation and food environment. DESIGN: Ecological: Food stores categorised according to the NOVA classification were geocoded, and absolute availability was calculated for each neighbourhood. Segregation was measured using local Gi* statistic, a measure of the sd between the economic composition of a neighbourhood (the proportion of heads of households in neighbourhoods earn monthly income of 0 to 3 minimum wages) and larger metropolitan area, weighted by the economic composition of surrounding neighbourhoods. Segregation was categorised as high (most segregated), medium (integrated) and low (less segregated or integrated). A proportional odds models were used to model the association between segregation and food environment. SETTING: Belo Horizonte, Brazil. PARTICIPANTS: Food stores. RESULTS: After adjustment for covariates, neighbourhoods characterised by high economic segregation had fewer food stores overall compared with neighbourhoods characterised by low segregation (OR = 0·56; 95 % CI (0·45, 0·69)). In addition, high segregated neighbourhoods were 49 % (OR = 0·51; 95 % CI (0·42, 0·61)) and 45 % (OR = 0·55; 95 % CI (0·45, 0·67)) less likely to have a high number of food stores that predominantly marketed ultra-processed foods and mixed food stores, respectively, as compared with their counterparts. CONCLUSIONS: Economic segregation is associated with differences in the distribution of food stores. Both low and high segregation territories should be prioritised by public policies to ensure healthy and adequate nutrition as a right for all communities. The former must continue to be protected from access to unhealthy commercial food outlets, while the latter must be the locus of actions that limit the availability of unhealthy commercial food store.

Perceived Neighborhood and Walking Among Older Brazilian Adults Living in Urban Areas: A National Study (ELSI-Brazil).

The study goal was to examine the association between perceived neighborhood characteristics and walking in urban older adults in Brazil. A cross-sectional study including 4,027 older adults from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) was performed. Walking was measured using the International Physical Activity Questionnaire. Neighborhood characteristics were questions about physical disorder, noise pollution, safety, violence, social cohesion, services, concerns with community mobility, and pleasantness. Multinomial logistic regression was used. Concern about taking the bus, subway, or train was inversely associated with walking for men. Violence (victim of theft, robbery, or had home broken into) and social cohesion (trust in neighbors) were positively and inversely associated with walking for women, respectively. A significant interaction term between social cohesion and number of chronic diseases was observed for women. These findings demonstrate the need for sex-specific interventions and policies to increase the walking levels among older Brazilian adults.

Associations of the perceived neighborhood environment and screen time in adolescents living in a medium-sized city in Brazil: a cross-sectional study.

Individual attributes have been investigated to explain sedentary behavior. However, few studies have evaluated this association at the neighborhood level. This study aimed to determine the association between screen time (ST) among adolescents and perceived neighborhood characteristics. This cross-sectional study was conducted using a multistage household survey in Vespasiano, Brazil, in 2015-2016. Logistic regression analyses were performed to assess the associations between the adolescent self-reported ST (television, computer, and video game > 2 h/day) and neighborhood characteristics (green space, sidewalk maintenance, street lighting, social disorder, safety during the day, and risk of violence) reported by an adult. Four hundred and twenty-three adolescents aged 11-17 participated in the study. ST was reported by 74.0% of the adolescents. After adjustment for confounder variables, neighborhood characteristics did not remain associated with ST. The results evidence no associations between ST among adolescents and perceived neighborhood environment and indicate the need for future studies of this relation.

Disparities in food consumption between economically segregated urban neighbourhoods.

OBJECTIVE: To examine associations between economic residential segregation and prevalence of healthy and unhealthy eating markers. DESIGN: Cross-sectional. A stratified sample was selected in a three-stage process. Prevalence of eating markers and their 95 % CI were estimated according to economic residential segregation: high (most segregated); medium (integrated) and low (less segregated or integrated). Segregation was measured at the census tract and assessed using the Getis-Ord local $G_i^{\rm{\ast}}$ statistic based on the proportion of heads of household in a neighbourhood earning a monthly income of 0-3 minimum wages. Binary logistic regression using generalized estimating equations were used to model the associations. SETTING: Belo Horizonte, Brazil. PARTICIPANTS: Adults (n 1301) residing in the geographical environment (178 census tracts) of ten units of the Brazilian primary-care service known as the Health Academy Program. RESULTS: Of the 1301 participants, 27·7 % lived in highly segregated neighbourhoods, where prevalence of regular consumption of fruit was lower compared with more affluent areas (34·6 v. 53·2 %, respectively). Likewise, regular consumption of vegetables (70·1 v. 87·6 %), fish (23·6 v. 42·3 %) and replacement of lunch or dinner with snacks (0·8 v. 4·7 %) were lower in comparison to more affluent areas. In contrast, regular consumption of beans was higher (91·0 v. 79·5 %). The associations of high-segregated neighbourhood with consumption of vegetables (OR = 0·62; 95 % CI 0·39, 0·98) and beans (OR = 1·85; 95 % CI 1·07, 3·19) remained significant after adjustments. CONCLUSIONS: Economic residential segregation was associated with healthy eating markers even after adjustments for individual-level factors and perceived food environment.

Built and Social Environment by Systematic Social Observation and Leisure-Time Physical Activity Report among Brazilian Adults: a Population-Based Study.

The aim of this study was to investigate the relationship between built and social environment and leisure-time physical activity (LTPA) among adults living in an urban center. The individual data was from the household survey and the environmental data was assessed through systematic social observation by trained observers on street segments of respondents' residences. The relationship between environmental factors and LTPA was examined using multilevel logistic regression. The prevalence of LTPA was 30.2% (95% CI 27.4-32.9%). Individuals living in census tracts with higher walking environment indicators (OR = 1.20; 95% CI 1.02 to 1.40) and safety (OR = 1.18; 95% CI 1.01 to 1.38) were more likely to be active during leisure time, even after adjusting for individual variables. Improving the built and social environment is an important step for achieving higher levels of LTPA in the population in a middle-income country.

Food environment, social deprivation and obesity among students from Brazilian public schools.

OBJECTIVE: To investigate the relationship between social deprivation and the food environment. Furthermore, to evaluate if the food environment is associated with the prevalence of obesity among students in Brazilian public schools. DESIGN: Cross-sectional. For the classification of obesity, weight and height were measured, and the cut-off point of BMI-for-age Z-score >+2 was adopted. Social deprivation level was determined from the Health Vulnerability Index (HVI). To assess the food environment, the density of food establishments in urban residential areas was calculated. Associations between the food environment and the presence of obesity were estimated by binary logistic regression through a generalized estimating equations model. SETTING: Juiz de Fora, Minas Gerais, Brazil. SUBJECTS: Children and adolescents (n 661) aged 7-14 years. RESULTS: The lowest social deprivation level showed a higher density of all types of establishments that sold predominantly unhealthy foods. An inverse association was found between the density of supermarkets and hypermarkets and the presence of obesity (OR=0·58; 95 % CI 0·36, 0·93). For the other categories of food retailers, no significant differences were found. CONCLUSIONS: The findings reinforce the need for public policies that promote equality in the food environments of the city. Also, further investigations into the influence of the presence of supermarkets on the nutritional status of children and adolescents are required.

A multilevel model of life satisfaction among old people: individual characteristics and neighborhood physical disorder.

BACKGROUND: Considering the lack of studies that examine built environmental factors associated with life satisfaction among old people in developing countries, particularly those focused on Brazil, the aim of this study was to estimate the prevalence of life satisfaction among old adults residents in a Brazilian urban center and to investigate its association with individual characteristics and objective measures of the built environment. METHODS: A household survey (N = 832) in Belo Horizonte, Minas Gerais, Brazil (2008-2009) and a Systematic Social Observation (SSO) was used in this study. Life satisfaction was assessed through Self-Anchoring Ladder Scale, developed by Cantril, in 1965. Participants' answers were categorized as satisfied (rungs 6-10) and dissatisfied (rungs 0-5). A Multilevel Poisson regression analysis with robust variance was performed. RESULTS: The prevalence of satisfaction with life was approximately 82%. Higher prevalence of life satisfaction was significantly associated with old people who reported higher incomes, higher religious participation, who practice physical activity and who perceive their health as good and very good. In contextual level, results showed that when the contextual features were adjusted separately by the individual characteristics they were no longer significant. The results also showed a lower prevalence of life satisfaction among those living in neighborhoods with higher physical disorder, even after adjusting for individual and other contextual characteristics. CONCLUSIONS: The present findings suggest that life satisfaction should be assessed whenever evaluating urban redevelopment programs designed to improve neighborhood characteristics, reducing physical disorder, especially among old adults.

Temporal analysis and spatial distribution of acquired syphilis in the state of Mato Grosso, Brazil, 2010-2021: an ecological study.

OBJECTIVE: To analyze the temporal trend and the spatial distribution of acquired syphilis in Mato Grosso, Brazil, between 2010 and 2021. METHODS: This was an ecological study using notifications of acquired syphilis held on the Notifiable Health Conditions Information System. Detection rates were calculated by health macro-region and three-year periods (2010-2012, 2013-2015, 2016-2018, 2019-2021). The jointpoint method was used to calculate annual percentage change (APC). Thematic maps of Bayesian rates were built and distribution was analyzed using Local Moran. RESULTS: The detection rate increased from 16.2 per 100,000 inhabitants in the first three-year period (2010-2012) to 70.0 in the last three-year period (2019-2021). The Central-North macro-region had the highest rate in the last three years (94.3/100,000 inhab.), while the highest upward trend occurred in the Central-Northwest macro-region, from 2013 to 2018 (APC = 50.2; 95%CI 26.3;78.6). There was an increase in Bayesian rates in most municipalities. CONCLUSION: There was a trend towards an increase in acquired syphilis, especially in the last two three-year periods.

Global Physical Activity, Active Commuting to School, and Sedentary Behavior Among Latin American Adolescents: Global School-Based Student Health Survey and the National School Health Survey.

BACKGROUND: This study aimed to compare the overall prevalence, stratified by sex and age group of global physical activity (GPA), active commuting to school (ACS), and sedentary behavior (SB) among adolescents from ten Latin American countries, and to assess the correlation of Development Index with the indicators. METHODS: This research is grounded on data from the Global School-Based Student Health Survey (2009-2015) and the 2015 Brazilian National School Health Survey. The prevalence and 95% confidence intervals for GPA (≥5 d/wk), ACS (≥1 d/wk), and SB (>2 h/d) were calculated using the chi-square test to compare the sexes (male; female) and age group (≤13 y; 14 y; 15 y; ≥16 y). We also performed Pearson correlation analysis with the Human Development Index. RESULTS: The prevalence of indicators ranged from 16.1% to 28.2% for GPA, from 56.7% to 71.2% for ACS, and from 20.7% to 62.6% for SB. Boys generally had a higher prevalence of GPA and ACS, and girls had a higher prevalence of SB. The prevalence of the indicators by age group varied between countries, with significant differences observed in some, depending on each indicator. A positive correlation was observed between Human Development Index, GPA, and SB. CONCLUSION: Health promotion policies must include guidelines that encourage and promote a more active and less sedentary lifestyle among young people in Latin America, considering specific groups, the local socioeconomic context, and differences between countries.

Factors associated with the recurrence of violence against children and adolescents. Mato Grosso-Brazil, 2013 to 2019. / Fatores associados à recorrência de violência em crianças e adolescentes. Mato Grosso-Brasil, 2013 a 2019.

This study examined factors associated with the recurrence of interpersonal violence against children and adolescents in Mato Grosso state, considering cases recorded in the Notifiable Diseases Information System, from 2013 to 2019. Associations between variables were estimated by logistic regression and stratified by age group (children and adolescents). The frequency of recurrent violence against children was 49.0% and, against adolescents, 42.9%. For both, recurrent violence was positively associated with occurrence at home, psychological or emotional violence, aggressors' being more than two, their being relatives and threats being the means of aggression. Neglect or abandonment and male or both-sex aggressors were positively associated with recurrent violence against children. Against adolescents, poor education, sexual violence and intimate-partner aggressors were positively associated with recurrent violence, while other aggressors and firearms or physical force were negatively associated. The findings offer significant contributions to knowledge of factors associated with recurrent violence, which is still little studied in the national and international literature. This is essential in order to inform strategies to reduce the recurrence of violence and protect children and adolescents.

O objetivo do estudo foi analisar os fatores associados à recorrência da violência interpessoal contra crianças e adolescentes em Mato Grosso. Estudo com casos registrados no Sistema Informação de Agravos de Notificação no período de 2013 a 2019. A associação entre as variáveis foi estimada pela regressão logística, estratificada por faixa etária (crianças e adolescentes). A frequência da violência recorrente em crianças foi de 49,0%, e de 42,9% em adolescentes. Para ambos, a violência recorrente associou-se positivamente com ocorrência em residência, violência psicológica/moral, com mais de dois agressores envolvidos, agressores familiares e meio de agressão, ameaça. Para as crianças, negligência/abandono, sexo do agressor masculino ou ambos associaram-se positivamente com a recorrência da violência. Para adolescentes, baixa escolaridade, violência sexual e agressor parceiro íntimo estiveram associados positivamente à recorrência da violência, enquanto outros agressores e arma de fogo ou força corporal associaram-se negativamente. Os resultados trazem contribuições relevantes para o conhecimento dos fatores associados à violência recorrente, ainda pouco estudada na literatura nacional e internacional, sendo fundamental para apoiar estratégias de redução da recorrência da violência e de proteção às crianças e adolescentes.

Post-COVID-19 syndrome among hospitalized COVID-19 patients: a cohort study assessing patients 6 and 12 months after hospital discharge. / Síndrome pós-COVID-19 entre hospitalizados por COVID-19: estudo de coorte após 6 e 12 meses da alta hospitalar.

Post-COVID-19 syndrome involves a variety of symptoms that last more than 12 weeks after COVID diagnosis. This study aimed to analyze post-COVID-19 syndrome among hospitalized COVID-19 patients 6 and 12 months after hospital discharge. This is an ambidirectional cohort study conducted with individuals who were discharged from three main hospitals in the capital of Mato Grosso State, Brazil, between October and December 2021 and January and March 2022. After data collection from medical records, the individuals were interviewed by telephone 6 and 12 months after hospital discharge, when they were asked about the presence of ongoing or new symptoms and when symptom frequency was evaluated according to sociodemographic and economic characteristics hospitalization, and health conditions. Of all 277 medical records evaluated, 259 patients were eligible to participate in the study, 190 patients six months after discharge and 160 patients 12 months after hospital discharge. At six months, 59% were female patients, 40% were aged 60 years or older, and 87.4% reported at least one symptom. At 12 months, 58.7% were female patients, 37.5% were aged 30 to 49 years, and 67.5% reported at least one symptom. Fatigue was the most common symptom 6 and 12 months after hospital discharge (55.3% and 40.6%, respectively), followed by memory problems (36.8%; 20%), and hair loss (26.8%; 11.2%). The prevalence of post-COVID-19 syndrome was higher among patients of older age, lower income, with hypertension, diabetes, and more severe infection during hospitalization. The risk factors for post-COVID-19 syndrome help understand the long-term effects and the importance of monitoring after the acute phase of the disease.

A síndrome pós-COVID-19 é um termo usado para descrever um conjunto diversificado de sintomas que persistem por mais de 12 semanas da infecção diagnosticada. O objetivo deste estudo foi analisar a síndrome pós-COVID-19 entre hospitalizados por COVID-19 após 6 e 12 meses da alta hospitalar. Trata-se de estudo de coorte ambidirecional, realizado com indivíduos que receberam alta em três dos principais hospitais da capital de Mato Grosso, Brasil, entre outubro e dezembro de 2021 e janeiro e março de 2022. Após coleta de dados em prontuários, os indivíduos foram entrevistados por telefone após 6 e 12 meses da alta hospitalar, sendo questionados sobre a presença de sintomas persistentes ou novos, para a avaliação de sua frequência segundo características sociodemográficas, econômicas, relativas à internação e condições de saúde. Dos 277 prontuários avaliados, 259 pacientes foram elegíveis para o estudo, 190 aos seis meses e 160 após 12 meses da alta hospitalar. Aos seis meses, 59% eram mulheres, 40% com 60 anos ou mais de idade e 87,4% referiram a presença de pelo menos um sintoma. Aos 12 meses, 58,7% eram mulheres, 37,5% com 30 a 49 anos e 67,5% referiram a presença de pelo menos um sintoma. A fadiga foi o sintoma mais comum após 6 e 12 meses de alta hospitalar (55,3% e 40,6%, respectivamente), seguido de problemas de memória (36,8%; 20%) e perda de cabelo (26,8%; 11,2%). Foi maior a prevalência de síndrome pós-COVID-19 entre indivíduos de maior faixa etária, menor renda, hipertensos, diabéticos e com maior gravidade durante a internação. Os fatores de risco da síndrome pós-COVID-19 contribuem para a compreensão dos efeitos a longo prazo e da importância do acompanhamento após a fase aguda da doença.

El síndrome post-COVID-19 es un término utilizado para describir un conjunto diversificado de síntomas que persisten durante más de 12 semanas de la infección diagnosticada. El objetivo fue analizar el síndrome post-COVID-19 entre hospitalizados por COVID-19 tras 6 y 12 meses del alta hospitalaria. Se trata de un estudio de cohorte ambidireccional, realizado con individuos que fueron dados de alta en tres de los principales hospitales de la capital de Mato Grosso, Brasil, entre octubre y diciembre de 2021 y enero y marzo de 2022. Tras recolectar los datos en registros médicos, se entrevistaron los individuos por teléfono tras 6 y 12 meses del alta hospitalaria, cuestionándoles sobre la presencia de síntomas persistentes o nuevos y evaluando su frecuencia conforme las características sociodemográficas, económicas, relacionadas con la hospitalización y condiciones de salud. De los 277 registros médicos evaluados, se eligieron 259 pacientes para el estudio, 190 a los 6 meses y 160 tras 12 meses del alta hospitalaria. A los 6 meses, el 59% eran mujeres, el 40% tenían 60 años o más y el 87,4% refirieron la presencia de al menos un síntoma. A los 12 meses, el 58,7% eran mujeres, el 37,5% tenían entre 30 y 49 años y el 67,5% refirieron la presencia de al menos un síntoma. La fatiga fue el síntoma más común tras 6 y 12 meses del alta hospitalaria (el 55,3% y el 40,6%, respectivamente), seguido de los problemas de memoria (el 36,8% y el 20%) y caída del pelo (el 26,8% y el 11,2%). La prevalencia de síndrome post-COVID-19 fue más alta entre los individuos de mayor edad, menor renta, hipertensos, diabéticos y con mayor gravedad durante la hospitalización. Los factores de riesgo del síndrome post-COVID-19 contribuyen para la comprensión de los efectos a largo plazo y de la importancia del seguimiento tras la fase aguda de la enfermedad.

Near miss neonatal in the capital of the Brazilian Midwest: a case-control study. / Near miss neonatal em capital do Centro-Oeste brasileiro: estudo caso-controle.

We aimed to analyze factors associated with neonatal near-miss in Cuiabá, State of Mato Grosso, Brazil by performing a case-control study of live births in a capital city of central-western Brazil from January 2015 to December 2018 that included 931 cases and 1,862 controls. Data were obtained from the Live Births Information System and the Mortality Information System and variables were organized according to the hierarchical model. Association was analyzed by logistic regression with a 5% significance level. Data were expressed as crude and adjusted odds ratio (OR) and respective confidence intervals (95%CI). The following factors were associated with neonatal near miss: mothers with two (OR = 1.63; 95%CI: 1.01-2.63) or three or more previous pregnancies (OR=1.87; 95%CI: 1.09-3.21), without any live children (OR = 2.57; 95%CI: 1.56-4.24 ) or one live child at birth (OR = 1.53; 95%CI: 1.04-2.26), multiple pregnancy (OR = 4.57; 95%CI: 2.95-7.07), fewer than six prenatal consultations (OR = 2.20; 95%CI: 1.77-2.72), whose deliveries took place in public/university hospitals (OR = 2.25; 95%CI: 1.60-3.15) or philanthropic hospitals (OR = 1.62; 95%CI: 1.16-2.26), with non-cephalic presentation (OR = 2.71 95%CI: 1.87-3.94) and uninduced labor (OR = 1.47; 95%CI: 1.18-1.84).

Objetivou-se analisar fatores associados ao near miss neonatal em Cuiabá, Mato Grosso. Estudo caso-controle de nascidos vivos em capital do Centro-Oeste brasileiro, de janeiro de 2015 a dezembro de 2018, com 931 casos e 1.862 controles. Os dados foram coletados no Sistema de Informações sobre Nascidos Vivos e no Sistema de Informações sobre Mortalidade. As variáveis foram organizadas seguindo o modelo hierárquico. A associação foi analisada por meio de regressão logística, com nível de significância de 5%. Os dados foram expressos em odds ratio (OR) bruta e ajustada e respectivos intervalos de confiança (IC95%). Mantiveram-se associados ao near miss neonatal: mães com duas (OR = 1,63; IC95%: 1,01-2,63) ou três ou mais gestações anteriores (OR = 1,87; IC95%: 1,09-3,21), sem nenhum filho (OR = 2,57; IC95%: 1,56-4,24) ou com um filho vivo ao nascer (OR = 1,53; IC95%: 1,04-2,26), gravidez múltipla (OR = 4,57; IC95%: 2,95-7,07), menos de seis consultas de pré-natal (OR = 2,20; IC95%: 1,77-2,72), partos realizados em hospitais públicos/universitários (OR = 2,25; IC95%: 1,60-3,15) e filantrópicos (OR = 1,62; IC95%: 1,16-2,26), apresentação não cefálica (OR = 2,71; IC95%: 1,87-3,94) e trabalho de parto não induzido (OR = 1,47 IC95%: 1,18-1,84).