Early life socioeconomic circumstances and cardiometabolic health in childhood: Evidence from the Generation XXI cohort.

Social adversity is thought to become biologically embedded during sensitive periods of development which could set children on a trajectory of increased risk for later diseases. This study estimated the association between early socioeconomic circumstances and cardiometabolic biomarkers during childhood. We analyzed data from 2962 participants in the birth cohort Generation XXI. Early socioeconomic circumstances included parental education and occupation and household income measured at the child's birth; cardiometabolic biomarkers included a set of parameters that were determined at seven and 10years old. The association between early socioeconomic circumstances and cardiometabolic biomarkers in children aged seven and 10years old was estimated using generalized estimating equations. We observed, after adjustment for birth weight, sex, five-a-day fruit and vegetable intake and sedentary activity, that children with low educated mothers presented higher body mass index z-score (ß=0.22; 95%CI: 0.12, 0.33), higher waist circumference (ß=1.14; 95%CI: 0.55, 1.73) and increased systolic blood pressure z-score (ß=0.15; 95%CI: 0.08, 0.22) at the age of seven. At 10years, children with mothers with low education, presented higher body mass index z-score (ß =0.32; 95%CI: 0.21, 0.43), higher waist circumference (ß=2.79; 95%CI: 1.94, 3.64), increased diastolic blood pressure z-score (ß=0.11; 95%CI: 0.06, 0.17) and increased systolic blood pressure s-score (ß=0.20; 95%CI: 0.12, 0.28). When repeated measures of cardiometabolic biomarkers were taken into account, the association between socioeconomic circumstances and cardiometabolic biomarkers remained significant. Low socioeconomic circumstances have a possible detrimental effect on children's cardiometabolic health. Thus, socioeconomic adversity might impact health outcomes already in the first decade of life, emphasizing the early social patterning of cardiometabolic health and the need of social policies targeting children and families to modify or reverse its negative impact on health.

Exposure to violence and suicidal ideation among school-going adolescents.

Objective: Despite growing international interest in the area of violence and suicidal ideation among school-going adolescents, epidemiological data are scant in Portugal. The objective of this study was to measure the prevalence of suicidal ideation among Portuguese adolescents from 7th to 12th grade and to estimate the association of violence exposure with suicidal ideation. Method: A cross-sectional survey was conducted among 2 602 adolescents enrolled in public schools in Porto, Portugal. Sampling was performed in four school groups consisting of seven schools, during the 2014/2015 academic year. Results: The results revealed that 11.4% of Portuguese school-going adolescents reported suicidal thoughts during the past 12 months. Moreover, adolescents who had been involved in physical fighting were two times more likely to have suicidal thoughts. These odds substantially increased when bullying and cyberbullying victimisation were included. Conclusion: Effective interventions with multidisciplinary efforts involving parents, school teachers, principals, and mental health professionals, should be integrated into school-based programmes to improve adolescents' mental health and strengthen them against suicidal ideation.

Time From Smoking Cessation and Inflammatory Markers: New Evidence From a Cross-Sectional Analysis of ELSA-Brasil.

INTRODUCTION: The time for inflammatory markers of former smokers to revert to never smoker levels is still controversial, ranging from 5 to 20 years. We aimed to determine the time from smoking cessation for white blood cell (WBC) count and serum C-reactive protein (CRP) levels to return to those of never-smokers, after adjusting for confounding factors and for secondhand smoke (SHS) exposure among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Cross-sectional analysis of baseline participants of ELSA-Brasil. We used linear regression analysis and generalized linear models with gamma distribution and logarithmic link function to estimate the association of WBC count and CRP levels with time from smoking cessation. The following confounding factors were considered: sex, age, education, SHS, alcohol consumption, leisure-time physical activity, BMI, total cholesterol/HDL ratio, hypertension, diabetes, cardiovascular disease, and chronic obstructive pulmonary disease (COPD). Results: After all adjustments, time from smoking cessation <10 years remained associated with higher WBC count (eg, time from smoking cessation ≥ 5 and <10 years: ß: 167.92; 95%CI: 23.52 312.31), while only time from smoking cessation <1 year remained associated with higher arithmetic mean of CRP (AMR: 1.26, 95%CI: 1.03‒1.54). CONCLUSIONS: Levels of inflammatory markers were similar to those of never-smokers 1 year after smoking cessation for CRP and 10 years after for WBC. IMPLICATIONS: The results may add to the arsenal health professionals have to encourage their patients to quit smoking, as some harms from smoking appear to revert to never-smokers' level sooner than previously reported. Longitudinal studies should confirm our findings.

Household Dysfunction Is Associated With Bullying Behavior in 10-year-old Children: Do Socioeconomic Circumstances Matter?

This study measured the prevalence of bullying behavior in 10-year-old children and investigated the effect of the socioeconomic context on the impact of household dysfunction on bullying. We studied 5,338 members of the Portuguese Generation XXI birth cohort. Information on involvement in bullying, socioeconomic characteristics, and household dysfunction was collected by trained interviewers using structured questionnaires. Being a victim of bullying was reported by 14.4% of participants, being a bully by 1.4%, and being a bully-victim by 3.9%. Being a victim or both bully-victim, simultaneously, was more frequent among children from medium-high income families. Also, children from low-income families who reported household substance abuse, witnessed parents' intimate partner violence, and were victims of physical violence, were more frequently victims of bullying; and those who experienced family violence were more frequently involved as bully-victims. Among children from medium-high income families, all these household adversity experiences significantly increased the odds of being victim, bully, or bully-victim. Thus, although children from medium-high income families are less likely to experience adversity at home, when it happens, there is a greater effect on their behavior, suggesting that better socioeconomic circumstances do not seem to act as a protective factor.

Docentes de enfermagem e terminalidade em condições dignas / Nursing professors and the terminality in conditions of dignity

Este estudo teve como objetivo compreender o significado atribuído por um grupo de docentes enfermeiros sobre o fenômeno da ortotanásia. Trata-se de pesquisa qualitativa, com inspiração fenomenológica. Do estudo participaram cinco enfermeiros de uma universidade privada do Estado de Minas Gerais e emergiram quatro categorias: despreparo da equipe em situações que remetem à finitude humana; enfrentamento dos familiares no processo da finitude; prolongamento do sofrimento humano nas unidades de tratamento intensivo; perspectiva dos cuidados paliativos nas unidades de tratamento intensivo. Conclui que a reflexão acerca da terminalidade vem aumentando, mas ainda é insuficiente no tocante à prática dos profissionais da enfermagem. Percebe-se que a dificuldade em lidar com a morte é um problema comum aos profissionais de saúde. Novas pesquisas são necessárias à exploração das dificuldades e do conhecimento dos enfermeiros, englobando a ortotanásia e a assistência humanizada na terminalidade.

This study aimed to understand the meaning assigned by a group of nursing professors on orthotanasia. Thisis a qualitative study with a phenomenological perspective. The study included five nurses from a privateuniversity of Minas Gerais State. Four categories emerged: Unpreparedness team in situations that refer tohuman finitude; Confronting the family in the process of finitude; Extension of human suffering in intensivecare units; the perspective of palliative care in intensive care units. It may be concluded that reflections onthe finality has been increasing but are still insufficient in contemplating the practice of professional nursing.It is observed that the difficulty in dealing with death is a common problem for health professionals. Furtherresearch is necessary to explore the difficulties and knowledge of nurses, encompassing orthotanasia andhumanized in terminality.