Observing the neighborhood multidimensionality and overweight in children of different developmental stages-the emergence of an unusual association.

The present study examines whether the association of the neighborhood environment and overweight in children is moderated by age. This was a cross-sectional study of 832 children aged 3 to 10 years living in the city of Oporto (Portugal). Children were recruited under the scope of the project "Inequalities in Childhood Obesity: The impact of the socioeconomic crisis in Portugal from 2009 to 2015." Overweight was defined according to the International Obesity Task Force criteria. Parents completed a self-administered questionnaire capturing sociodemographic characteristics and their perceptions of their neighborhood environment. Logistic regressions were used to examine the influence of parental perceived neighborhood characteristics (latent variables: attractiveness, traffic safety, crime safety, and walkability) on overweight in children. A stratified analysis by age category was conducted. Overall, 27.8% of the children were overweight, 17.4% were aged 3 to 5 years, and 31.8% were aged 6 to 10 years. Children aged 3 to 5 years were more sensitive to the neighborhood environment than children aged 6 to 10 years. For children aged 3 to 5 years, the risk of overweight was inversely associated with neighborhood crime safety (OR = 1.84; 95% CI 1.07-3.15; p = 0.030).    Conclusion: Our study suggests the existence of a sensitive age period in childhood at which exposure to a hostile neighborhood environment is most determining for weight gain. Until today, it was thought that the impact of the neighborhood environment on younger children would be less important as they are less autonomous. But it may not be true. What is Known: • The neighborhood environment may adversely affect children's weight status. However, the moderating role of child age in the association between neighborhood environment and overweight is uncertain. What is New: • The study highlights that the association between the neighborhood environment and child overweight is attenuated by age. It is stronger for preschoolers than for early school-age children.

Body size, form, composition, and a healthy lifestyle associates with health-related quality of life among Portuguese children.

OBJECTIVES: This study aimed to describe the relationship between body size, form, and composition, and children's lifestyle on health-related quality of life (HRQoL). METHODS: This cross-sectional study comprised 1333 children (9.05 ± 0.75 years; 683 females) living in mainland Portugal. Objective anthropometric measures were collected. Parents answered a standardized questionnaire related with children's lifestyle (e.g., sport participation, screen- and sleep-time) and family socioeconomic status (e.g., parental education). HRQoL was measured using the Portuguese version of the KIDSCREEN-27. Scores were categorized into low and high using a sex-specific normative cut-off from European children. A healthier score was created including positive scores for body weight, abdominal obesity, sport participation, sleep- and screen-time. RESULTS: Body size, form and composition were correlated with children's physical wellbeing. However, sex differences were found in which parameters were associated with wellbeing. Among boys, the body mass index, waist circumference, waist-to-height ratio, subscapular and suprailiac skinfold were most correlated with wellbeing, while waist circumference and subscapular skinfold showed the strongest correlations for girls. Sleep duration and sport participation revealed a significant relationship with girls' HRQoL. A logistic regression analysis (adjusted for parental education) revealed that boys scoring 4 or 5 in the healthier index had an increased likelihood of high HRQoL level compared to those fulfilling none. CONCLUSIONS: Future programs aimed at reducing obesity, particularly central obesity, and incorporating multiple health indicators and behaviors, such as sport participation and sleep duration may help improve children's health and wellbeing.

The Portuguese economic crisis is associated with socioeconomic and sex disparities on children's health-related behaviors and obesity: A cross-sectional study.

OBJECTIVES: Our objective was to examine the relationship between the 2008 and 2015 economic crisis and children's physical activity (PA) outcomes, eating behaviors and obesity prevalence, while considering sex inequalities and familial socioeconomic status. METHOD: This is a cross-sectional study, including data collected in 2016/2017 among 5134 children aged 6-11 years (mean age: 8.11 ± 1.24; 50.0% boys). Children's height, weight, and waist circumference were objectively measured. Children's sleep- and screen-time, participation in organized sports, and specific dietary habits were reported parental-reported using a standardized questionnaire. An economic crisis impact score, with data from 10 indicators of economic needs in the family, was used to characterize the crisis' impact. RESULTS: First, the prevalence of overweight and obesity was higher in children whose families had a higher impact of the crisis. Second, children's intake of fruit and high-fat food, screen-time, sleep-time, and participation in organized sports differed according to the level of impact of the economic crisis. Third, the association between health-related behaviors and the impact of the economic crisis was stronger for girls compared to boys. CONCLUSION: Our findings give us an indication of how economic crises may drive changes in health outcomes.

Socioeconomic inequalities in the prevalence of overweight and obesity among Portuguese preschool-aged children: Changes from 2009 to 2016.

OBJECTIVES: We evaluated, for the first time in Portugal, the prevalence of overweight and obesity according to parental education in a population of preschool-aged Portuguese children in 2009/2010 and 2016/2017. METHODS: Anthropometric data were collected in public and private preschools (n = 1996 in 2009/2010; n = 2077 in 2016/2017). Body mass index was calculated and weight status categories were based on the International Obesity Task Force cutoff points. Parental education level was self-reported. RESULTS: Prevalence of overweight (17.1%-14.1%; p < 0.001) and obesity (6.6%-3.9%, p < 0.001) was lower in 2016/2017 than in 2009/2010, with higher rates being found in the north of the country. Parental education was significantly associated with childhood overweight and obesity and inequalities between low- and high-education increased between the two periods. CONCLUSIONS: While a decrease in childhood overweight and obesity were positive findings, the prevalence is still high and shows pronounced socioeconomic differences. Policies for obesity prevention need to be inclusive and tackle inequalities, with interventions tailored to suit local contexts.

Household Food Security and Associated Factors among Portuguese Children.

This study investigated the household food insecurity (HFI) among Portuguese children following the last world financial crisis. A cross-sectional study was conducted on 4737 Portuguese children (3-11 yrs). Socio-demographics, food insecurity, and household geographic location were assessed via questionnaire. Nutritional status was measured. Following the economic crisis, 14.2% of school children and 12.0% of preschool children experienced HFI. Preschool children having parents with low and medium parental education (paternal: OR = 4.4; 95% CI 2.7-7.1 and OR = 2.4; 95% CI 1.5-3.6; maternal: OR = 2.2; 95% CI 1.4-3.5 and OR = 1.6; 95% CI 1.1-2.3), living in the south (OR = 1.4; 95% CI 1.0-2.0) and being overweight/obese (OR = 1.1; 95% CI 0.7-1.3) were more likely to experience HFI than food secure household peers. Higher OR of belonging to a food insecure household were observed in school-aged children with low and medium parental education (paternal: OR = 2.9; 95% CI 1.9-4.6 and OR = 1.7; 95% CI 1.1-2.5; maternal: OR = 2.5; 95% CI 1.6-3.9 and OR = 2.3; 95% CI 1.6-3.3), living in Coimbra (OR = 1.7; 95% CI 1.1-2.6) and being overweight/obese (OR = 1.3; 95% CI 0.8-1.5) compared to food secure household peers. Data are instructive and support the need to increase awareness of HFI, reduce its incidence in overweight/obese children from low socio-economic status families and specific geographic areas, and increase food availability based on local ecology.

Socioeconomic inequalities in children's health-related quality of life according to weight status.

OBJECTIVES: This study explores the association between socioeconomic position (SEP) and health-related quality of life (HRQoL) among Portuguese children according to their weight status. METHODS: A total of 1215 primary school-aged children (mean age 8.78 years) from three Portuguese districts (Lisbon, Porto, Coimbra) were assessed during 2016/2017. Father and mother's education (low, medium, high) and work status (employed, unemployed/retired) were used as SEP indicators. Self-reported HRQoL was assessed with the KIDSCREEN-27. Height and weight were objectively measured and body mass index categorized in normal, overweight or obese. Age, sex, and district-adjusted linear regression models were fitted to estimate associations between SEP indicators and HRQoL dimensions, according to weight status. RESULTS: We found that 24.9% of children were categorized as having overweight/obesity. The mean scores of the Physical Well-Being, and School Environment dimensions of HRQoL were lower among children classified with overweight/obesity compared to children with normal weight (57.21 vs 54.11, P < .001 and 57.85 vs 56.04, P = .010, respectively). Father's education was significantly associated with all HRQoL dimensions in children with a normal weight, but the same was not observed among children presenting overweight/obesity. An increase in the level of maternal education was also significantly associated with all HRQoL dimensions among children classified with a normal weight, and only for the School Environment dimension among children classified with overweight/obesity. CONCLUSIONS: These results suggest the presence of socioeconomic inequalities in self-reported HRQoL from early age, particularly among children with normal weight.

Screen media use by Portuguese children in 2009 and 2016: a repeated cross-sectional study.

BACKGROUND: Few studies have examined how access to mobile media is disrupting more traditional forms of media use. AIM: To examine screen-time in 2009/10 and 2016/17 among children aged 3-6 years and assess potential socio-economic determinants of adherence to screen-time recommendations. SUBJECTS AND METHODS: Two independent cross-sectional studies included 6874 Portuguese children. Screen-time (including television, computer, tablet, and smartphone) and proxy measures to calculate socioeconomic position (SEP) were parent-reported using a standardised questionnaire. Screen-time and adherence to screen-time recommendations were calculated for both periods. Determinants of excessive screen-time were identified using adjusted logistic regression models. RESULTS: In 2009/10 screen-time averaged 107 min/day for pre-school children and 149 min/day for school-aged children. In 2016/17 values were 142 min/day and 173 min/day, respectively. Screen-time allocated to television was the highest, independently of children's age. In 2016/17, mobile media use was common among pre-school (37 min/day) and school-aged children (43 min/day). Exceeding the recommended screen-time was more prevalent in boys than girls (adjusted odds ratio (aOR) between 1.02 and 1.59) and in children whose parents had lower education levels or were unemployed (aOR between 1.00 and 2.23). CONCLUSION: Screen-time was high among pre-school children, emphasising the need for earlier interventions, particularly among those from lower-SEP who had higher risk of exceeding the screen-time recommendations.

Self-reported symptoms of depression, anxiety and stress in Portuguese primary school-aged children.

BACKGROUND: Symptoms of depression, anxiety and stress experienced during childhood might have a negative impact on development. This study explores factors associated with such symptoms among Portuguese primary school-aged children. METHODS: A sample of children (n = 1022, mean age = 8.77 years old) was recruited in public and private schools from the cities of Coimbra, Lisbon and Porto, Portugal. The children's version of the Depression, Anxiety and Stress Scale (DASS-C) was self-administered. Multivariate logistic regression models were fitted to measure associations (expressed as Odds Ratio, OR and 95% Confidence Intervals, CI) between each DASS-C subscale, dichotomized by its 4th vs. 3rd or less quartiles (symptoms increase with scores), and covariates: child sex, age, socioeconomic status (SES), sports activity beyond school, children self-assessed health status, child and mother's body mass index and mother's DASS scores. RESULTS: Age was negatively associated with anxiety symptoms (adjusted OR, 95% CI: 0.70, 0.57-0.87) and girls, compared to boys, presented lower odds of depressive and stress symptoms (adjusted OR, 95% CI: 0.65, 0.47-0.92 and 0.57, 0.41-0.80, respectively). A low socioeconomic status was associated with more frequent symptoms of stress (adjusted OR, 95%CI for low compared to high SES: 1.61, 1.01-2.56). Children with poorer self-assessed health status and whose mothers scored higher in the DASS also presented significantly higher odds of scoring in the 4th quartile (vs. 3rd or less) of the three DASS-C subscales. CONCLUSIONS: These results suggest the need to tailor preventive efforts targeting childhood mental health symptoms.

Influence of parental perceived environment on physical activity, TV viewing, active play and Body Mass Index among Portuguese children: A mediation analysis.

OBJECTIVES: The environment is believed to be key in obesity prevention, yet it is unclear how factors in the neighborhood influence weight-related behaviors. The present study aimed to investigate the influence of parental perceived environment on physical activity (PA), television (TV) time, active play and Body Mass Index (BMI) z score, and the mediating role of these weight-related behaviors on the relationship between neighborhood characteristics and children's BMI. METHODS: Data of 8472 Portuguese preschool (aged 3-6, n = 3819) and school-aged children (aged 7-11 years, n = 4653) were collected during 2016/2017. Structural equation modeling was used to estimate the associations between parents perceived neighborhood characteristics (latent variables: unsafety and built/physical environment) and child's BMI z score, PA and TV time. RESULTS: Among preschoolers, the latent variables of the perceived environment were not associated with the BMI, TV time, extracurricular PA, and active play. Among schoolchildren, the unsafety environment was positively associated with both the BMI (SC = 0.050, P = .008) and the time spent watching TV (SC = 0.052, P = .031) and negatively associated with extracurricular PA (SC = -0.125, P < .001). The latent variable Favorable Built Environment for PA (ie, environmental facilitating elements) was positively associated with active play (SC = 0.041, P = .031). Moreover, the TV time was a marginally significant mediator of the relationship between the perceived unsafe environment and the BMI of school-aged children (B = 0.002, P = .096). CONCLUSIONS: In conclusion, changes in the environment to targeting parental perception of neighborhood safety could have positive effects on the promotion of healthy weight and the adoption of a healthy lifestyle in school-aged children.

Social inequalities in traditional and emerging screen devices among Portuguese children: a cross-sectional study.

BACKGROUND: Children are often exposed to too much screen time but few studies have explored the use of old and new digital media among young children. This study assesses screen time, including traditional and mobile devices, in pre-school and elementary school-aged children, according to their gender, age, and socioeconomic position (SEP). METHODS: A total of 8430 children (3 to 10 years; 50.8% boys) from the north, center and south-central Portugal were included in the present study. Data was collected by a parental questionnaire during 2016/2017. Children's screen time (by media device, weekdays and at the weekend; calculated by mean minutes per day) were reported by parents. Analysis were carried to compare screen time by children's age, gender and family SEP (classified using father's educational degree). RESULTS: Daily screen time was high both in children aged 3 to 5 and 6 to 10 years - 154 min/day (95% CI: 149.51-158.91) and 200.79 min/day (95% CI: 197.08-204.50), respectively - and the majority of children, independently of their gender, exceed the recommended 2 h/day of screen viewing. Children are still primarily engaging in screen time through television but the use of mobile devices, particularly tablets, were already high among 3 year-old children and increased with age. SEP was a negative predictor of screen time in the linear regression analysis, including after adjustment. CONCLUSIONS: Considering the negative health impacts of excessive screen time, recognizing subgroups at risk of excessive screen time and identifying how each device is used according to age is fundamental to enable appropriate future interventions. The screen time in children aged 3-10 years is longer than the recommended, particularly among boys and in those children from lower SEP. Parents and policymakers should have in mind that children spend most of their screen time watching television but mobile devices are becoming extremely popular starting at a young age.

Sleep duration, body composition, dietary profile and eating behaviours among children and adolescents: a comparison between Portuguese acrobatic gymnasts.

Sleep, body composition and dietary intake are crucial for athletes' health and performance but have never been investigated in acrobatic gymnasts. Thus, this study aimed to evaluate sleep, body composition, dietary intake and eating behaviours of acrobatic gymnasts. Using a cross-sectional study, 82 Portuguese acrobatic gymnasts (12.8 ± 3.1 years, 61 females and 21 males) were evaluated during the competitive period to collect training data, sleep duration, body composition, dietary intake and eating behaviours before, during and after practices. Most of the gymnasts (91.5%) slept less than 8 h/night. Female adolescents slept significantly less on weekdays than female children (P = 0.024). Female adolescents' mean body mass was below the normal and 60.0% showed menstrual irregularities; 4.9% of females bases were overweight and 2.4% obese. Male adolescents slept significantly less on weekdays than male children (P = 0.001); significant differences were shown for fat-free mass (P = 0.014); however, 3.7% were overweight. All daily energy and macronutrient intakes were significantly different according to age and gender, with exception for fibre and energy intake in females (P = 0.057 and P = 0.052, respectively), and for protein in males (P = 0.068). Female and male adolescents demonstrated significant lower energy availability (32.8 ± 9.4 kcal/kg FFM/day and 45.1 ± 14.7 kcal/kg FFM/day) than children (45.8 ± 8.7 kcal/kg FFM/day and 53.8 ± 9.1 kcal/kg FFM/day), respectively. Significant low intakes of important vitamins and minerals were reported. Most of the participants did not eat or drink during or immediately after training sessions. CONCLUSION: Acrobatic gymnasts revealed low BF, short sleep duration and macro- and micronutrients inadequate intakes. The Female Athlete Triad was demonstrated by female adolescent gymnasts. What is Known: • Adequate dietary intake is an important resource for athletes' short and long-term health and performance. • There are no published studies in acrobatic gymnasts' sleep, body composition or dietary intake. What is New: • This study provides the first data on significant differences in energy intake and availability between acrobatic gymnasts; overweight and obesity were present in females. • Macro and micronutrients were inappropriate. Female Athlete Triad was observed in female adolescent acrobatic gymnasts.

Comparison of body composition and nutrients' deficiencies between Portuguese rink-hockey players.

We evaluated dietary intake and body composition of child and adolescent rink-hockey players and controls. Seventy-two male rink-hockey players (38 children and 34 adolescents) and 79 male controls (43 children and 36 adolescents) were evaluated in order to collect training data, detailed dietary intake and body composition. Rink-hockey players presented significantly lower body fat (BF) and higher fat-free mass (FFM) than controls. Mean intakes of carbohydrate and protein were considered to be adequate, but mean intakes of fat were above the recommended levels in athletes. Significant differences were found for energy intake (EI) and exercise energy expenditure (EEE) between athletes and controls (P < 0.05), resulting in some cases of low energy availability in rink-hockey players. Significant group differences (P < 0.05) were also observed for vitamins and mineral intakes in child and adolescent rink-hockey players due to higher mean intakes in control groups. Low intakes of vitamins D, E and K, calcium, iron, boron and magnesium were reported in athletes, with exception for thiamine (P = 0.449), riboflavin (P = 0.246), pantothenic acid (P = 0.065), magnesium (P = 0.061) and phosphorus (P = 0.051) in children and for niacin (P = 0.652), vitamin D (P = 0.406) and zinc (P = 0.783) in adolescents. CONCLUSION: Nutritional deficiencies in macronutrients and micronutrients observed in very young rink-hockey players can impair their growth and development with negative consequences upon athletic performance. What is Known: • Adequate dietary intake is an important resource for athletes' short- and long-term health, performance and recovery. • There are no published studies in rink-hockey players' energy availability. What is New: • This study provides the first data on significant differences in energy intake between very young athletes and controls, resulting in low energy availability in rink-hockey players. • Mean intakes of fat were above the recommended levels, and micronutrients intakes were inappropriate in athletes with consequences for their health and performance.

Nutritional Knowledge about Maternal and Newborn Health among Physiotherapists during the COVID-19 Pandemic in Minas Gerais, Brazil.

Adequate nutrition before and during pregnancy, as well as postpartum, is among the major contributors to maternal and newborn health. Physiotherapists' knowledge of this area is still scarce, although their clinical practice has been linked to newborns' neuropsychomotor development, which, in turn, is influenced by maternal health and nutritional status. Therefore, this study aimed to evaluate the nutritional knowledge of physiotherapists regarding maternal and newborn health. A total of 70 Brazilian physiotherapists (32.2 ± 6.0 years; 72.9% females) were evaluated between November 2019 and February 2020 for their sociodemographic characteristics, professional experience, and nutritional knowledge about maternal and newborn health through a validated questionnaire personally administered by the same trained researcher. Most of the physiotherapists had graduated but had no specialization in maternal and child physiotherapy (96.1% of the females and all the males). The nutritional knowledge about maternal and newborn health was significantly different between the female and male health professionals, as well as between the less and more experienced participants, i.e., female physiotherapists and the more experienced ones had more correct answers on the nutritional questionnaire than the male and less experienced physiotherapists, respectively (p < 0.05). Our results open an interesting window for the future education and training of Brazilian physiotherapists in nutrition.

Should organized sport characteristics be considered as a strategy for meeting physical activity guidelines in children?

BACKGROUND: A clearer understanding of the relationships between specific sport context with overall physical activity (PA) and sedentary time (ST) may contribute to the development of more accurate preventive strategies to increase children's engagement in PA. PURPOSE: This study aimed to examine how different organized sports contributed to children's daily PA and ST. METHODS: PA was measured for seven days via accelerometers, in 410 children aged 6-10 years (49.8% boys). Of those, 332 (53.0% boys) were engaged in an organized sport and were further considered for statistical analyses. Parents reported children's sport participation (e.g. which sport, number of times per week, duration). The sports were classified into: indoor vs. outdoor; individuals vs. team; combat vs. individual aesthetic vs. racing vs. invasion. Children's height and weight were objectively collected. Multiple one-way analyses of covariance were used to examine the effects of sport characteristics on PA and ST. A linear regression, adjusted for children's sex, age, body mass index and father's educational level, determined the relationship between being involved in multiple PA and sedentary behaviours with Moderate to Vigorous PA (MVPA) levels. RESULTS: Although engaged in an organized sport, only 30% of the children achieved the PA recommendations. Sport (compared with active commute and active play) was the best contributor to daily MVPA. Outdoor sports (vs. indoor) contributed the most to vigorous PA (VPA) and MVPA. Team sports (vs. individual) were significantly associated with lower ST. Children in combat sports accumulated more VPA and MVPA, while those in racing sports showed a higher ST. CONCLUSIONS: Sport participation alone does not guarantee children will reach the PA guidelines, and the type of sport can influence children's PA levels. Gender-stereotypes in sports may prevent girls from achieving their 60 minutes of MVPA daily.

Association of FAAH rs324420 (C385A) Polymorphism with High-Level Performance in Volleyball Players.

Genetic variants are recognized to affect athletic performance, partially by modulating competition-facilitating behavior. In this study, the role of three genetic variants previously linked to athlete status was investigated among elite volleyball players. A total of 228 players (26.7 ± 8.1 years old) participating in the Portuguese championship and with multiple medalists in national and international competitions were evaluated in terms of anthropometrics, training regime, sports experience, and a history of sports lesions. SNP genotyping was conducted by means of TaqMan® Allelic Discrimination Methodology. Volleyball players showed significantly different anthropometric indicators and training habits according to sex (p < 0.05). The A allele of the genetic variant Fatty Acid Amide Hydrolase (FAAH) rs324420 (C385A) was shown to be significantly associated with superior athletic achievements under a dominant genetic model (AA/AC vs. CC, odds ratio (OR) = 1.70; 95% Cl, 0.93-3.13; p = 0.026; p < 0.001 after Bootstrap), which was corroborated by a multivariable analysis (AA/AC vs. CC adjusted OR = 2.00; 95% Cl, 1.04-3.82; p = 0.037). Age and hand length were also found to be independently associated with high-level performance (p < 0.05). Our results confirm the role of FAAH in athletic performance. More investigation into this polymorphism's potential impact on stress coping, pain, and inflammation regulation in sport, particularly in the scope of lesions prevention and treatment, is required.

FAAH rs324420 Polymorphism: Biological Pathways, Impact on Elite Athletic Performance and Insights for Sport Medicine.

Gene variation linked to physiological functions is recognised to affect elite athletic performance by modulating training and competition-enabling behaviour. The fatty acid amide hydrolase (FAAH) has been investigated as a good candidate for drug targeting, and recently, its single-nucleotide polymorphism (SNP) rs324420 was reported to be associated with athletic performance. Given the implications, the biological pathways of this genetic polymorphism linked to elite athletic performance, considering sport type, psychological traits and sports injuries, need to be dissected. Thus, a narrative review of the literature concerning the biological mechanisms of this SNP was undertaken. In addition to its role in athletic performance, FAAH rs324420 is also involved in important mechanisms underlying human psychopathologies, including substance abuse and neural dysfunctions. However, cumulative evidence concerning the C385A variant is inconsistent. Therefore, validation studies considering homogeneous sports modalities are required to better define the role of this SNP in elite athletic performance and its impact on stress coping, pain regulation and inflammation control.

Excessive Noise in Neonatal Units and the Occupational Stress Experienced by Healthcare Professionals: An Assessment of Burnout and Measurement of Cortisol Levels.

Excessive noise in the work environment has been associated with extra-auditory symptoms, which can have harmful long-term effects on individuals. The purpose of this study was to identify noise levels in neonatal intensive care units and investigate their impact on the occurrence of stress among healthcare professionals, using cortisol levels as a biomarker for Burnout Syndrome. This descriptive, observational, and cross-sectional study was conducted in four public teaching hospitals in Fortaleza, Ceará, Brazil. Sound pressure levels in the environment were measured, and questionnaires were administered to collect sociodemographic data and assess perceptions of the work environment and Burnout symptoms. Saliva samples were collected at the beginning and end of work shifts for cortisol quantification. The average sound pressure ranged from 59.9 to 66.4 dB(A), exceeding the recommended levels set by Brazilian and international legislation. Among the 256 participants, the average age was 39.4 years, with 95% being female. The majority (70.9%) were nurses, and 22.7% were physicians. There was no significant association found between noise and Burnout Syndrome, nor with changes in cortisol levels. However, a significant association was observed between the perception of excessive noise and the sensation of a stressful work shift (p = 0.012). All evaluated professionals displayed symptoms of Burnout. The high sound pressure levels indicated that the assessed environments did not meet the recommended standards for acoustic comfort, and this was associated with the participants' perception of stressful work shifts. While Burnout symptoms were evident in our participants, it was not possible to confirm a correlation with high noise levels.

Stress exposure in specific growth periods associates with children's weight, height, and body mass index.

OBJECTIVES: We investigate associations between children exposure to stressful events, considering: (1) the period in which the event took place, (2) the type of event, and (3) the cumulative effect of the events on children's weight, height and body mass index (BMI). METHODS: A total of 8429 Portuguese children (3349 exposed to at least one stressful event during their lifetime; 50.2% males; mean age = 7.21 ± 1.85 years) were included in the analysis. The occurrence of stressful (i.e., adverse) events was reported in a parental questionnaire; children's weight and height were objectively measured. RESULTS: When the stress event took place in the first 2 years of life, compared with during pregnancy or after the 2 years, children were shorter; but the association was weak and only significant for boys. After adjustment for child's birthweight, gestational age, breastfeeding duration, number of siblings, and father's education, the experience of 3+ stressful events (vs. 1 or 2) was associated with higher weight and height in boys. No interaction effect was found between stress and BMI. DISCUSSION: We found some evidence of associations between exposure to stressful events and physical growth of boys. We highlight the complex relationship between exposure to stressful experiences and children's physical growth, particularly the different effects of specific characteristics of the stress event and the sex differences.

Health Professionals' Chronotype Association with Salivary Cortisol and Occupational Stress in Neonatal Intensive Care Units.

Burnout syndrome has been reported among health workers, particularly those working in critical areas, and is considered a significant public health problem. This study aimed to investigate the relationship between chronotype and work-related stress, as measured by salivary cortisol levels and burnout, among health professionals working in neonatal intensive care units. A cross-sectional study was conducted across four public hospitals in Fortaleza, Ceará, Brazil. Two hundred and fifty-six health professionals were administered the brazilian version of the Burnout Characterization Scale, the morningness-eveningness questionnaire, for chronotype, a sociodemographic questionnaire that included lifestyle habits and a salivary cortisol test. The results indicated that morning chronotype workers were significantly associated with the following: advanced age (p < 0.001), female gender (p = 0.032), married status (p = 0.014), and having children (p = 0.030) compared to those with evening and intermediate chronotypes. However, no significant association was found between signs of burnout syndrome and chronotype (p = 0.316). Participants whose work shift did not match their chronotype had significantly higher initial salivary cortisol levels (p = 0.013). The findings suggest that adapting working hours to an individual's biological rhythm can help mitigate potential negative effects on physical and mental health. Thus, it is recommended that professionals' working hours be adjusted accordingly.

Tri-axial accelerometer-assessed physical activity and its association with weight status in a sample of elementary-school children.

BACKGROUND AND AIMS: Objective assessment of physical activity (PA) using accelerometers and pedometers has become more accurate and common practice in the study of childhood overweight. The study aimed: i) to compare PA levels and body shape of boys and girls, and assess compliance of active children with the PA recommendation; ii) to analyse associations between the risk of overweight and the moderate-to-vigorous physical activity (MVPA) in children. METHODS: The sample comprised 395 children (198 girls) aged 6-10 years. Height and weight were measured, and BMI was calculated subsequently. A tri-axial accelerometer was used to obtain seven consecutive days of MVPA, as well as the weekly time being sedentary. Logistic regression analysis was used to examine the afore-mentioned relationship among the risk of obesity and MVPA, controlling for confounders. RESULTS: After controlling for wearing time, boys spent significantly more minutes in the moderate-to-vigorous portion of PA than their female counterparts. About 47% of boys were active on week days by achieve the mean value of 60 min/day of MVPA; corresponding percentage for the weekend was just 32%. Among girls, only 22% were active on week days and 29% at the weekend. MVPA was not significantly associated with the risk of being overweight nor in female neither in male children. The final regression model revealed that girls of mothers with high educational level were less likely to be classified as overweight girls. CONCLUSIONS: Findings revealed no significantly relation between MVPA and obesity risk among Portuguese children. Future research should extend similar design to other lifestyle features of children to clarify potential predictors of being overweight at early ages.