Effects of Two Early Parenting Programmes on Child Aggression and Risk for Violence in Brazil: a Randomised Controlled Trial.

Violence is a major public health problem globally, with the highest rates in low- and middle-income countries (LMICs) in the Americas and southern Africa. Parenting programmes in high-income countries can diminish risk for violence, by reducing risk factors such as child aggression and harsh parenting, and increasing protective factors such as child cognitive development and school readiness. However, there is critical need to identify low-cost programmes with replicable benefits that work in real-world LMICs contexts. A three-arm, randomised, single-blind trial evaluated effects of two low-cost, group-based parenting programmes recommended for LMICs (ACT: Raising Safe Kids; DBS: dialogic book-sharing) on child aggression (primary outcome), child development, parenting, maltreatment, and stress. Participants were 369 children with medium-high levels of aggression (mean age 3.1 years at baseline) in poor households. Interventions were implemented in city health and education services in southern Brazil. Maternal reports, filmed observations, child tasks, and hair cortisol were assessed at baseline, 1-month post-intervention, and 8-month follow-up. Intention-to-treat analyses compared each of ACT and DBS with a control group. Three hundred sixty-eight (99.7%) participants completed follow-up assessments 8 months after the interventions. There was no effect of ACT (standardised mean difference, SMD 0.11, 95% CI - 0.05, 0.27) or DBS (SMD 0.05, 95% CI - 0.11, 0.21) on the primary outcome of child aggression. ACT reduced harsh parenting behaviour post-intervention (SMD - 0.23; 95% CI - 0.46, - 0.01), but not at follow-up. DBS improved book-sharing practices at both time points (e.g., maternal sensitivity at follow-up SMD 0.33; 95% CI 0.08, 0.57). There were no benefits of either programme for other parenting, child development, or stress outcomes. Two parenting programmes in Brazil had small effects on parenting practices but did not reduce child aggression or several other important risk/protective factors for violence. Effective early interventions that reduce violence in real-world LMIC settings are highly desirable but may be challenging to achieve.

Functional performance assessment scale for children and adolescents with cancer: cross-cultural study.

OBJECTIVES: to describe the methodological process of cross-cultural adaptation of the PlayPerformance Scale for Children to Brazilian Portuguese. METHODS: methodological study of translation and cross-cultural adaptation in six stages: translation, synthesis of translations, back-translation, evaluation by a committee of judges, evaluation by expert nurses, and pretest. The agreement and representativeness of the items were assessed using the content validity index. A minimum value of 80% agreement was considered. RESULTS: all stages of the translation and cross-cultural adaptation process were satisfactory. In the evaluation performed by the committee of judges, all items obtained agreement above 80%. Fifteen pediatric nurses conducted the content validation, suggesting necessary modifications for understanding and application. Thirty children and adolescents with cancer were assessed with the scale for the pre-test. CONCLUSIONS: the scale was cross-culturally adapted to Brazilian Portuguese. The need for psychometric testing in a consistent sample is emphasized.

Gene - maltreatment interplay in adult ADHD symptoms: main role of a gene-environment correlation effect in a Brazilian population longitudinal study.

Childhood maltreatment correlates with attention-deficit/hyperactivity disorder (ADHD) in previous research. The interaction between ADHD genetic predisposition and maltreatment's impact on ADHD symptom risk remains unclear. We aimed to elucidate this relationship by examining the interplay between a polygenic score for ADHD (ADHD-PGS) and childhood maltreatment in predicting ADHD symptoms during young adulthood. Using data from the 2004 Pelotas (Brazil) birth cohort comprising 4231 participants, we analyzed gene-environment interaction (GxE) and correlation (rGE). We further explored rGE mechanisms through mediation models. ADHD symptoms were assessed at age 18 via self-report (Adult Self Report Scale - ASRS) and mother-reports (Strength and Difficulties Questionnaire - SDQ). The ADHD-PGS was derived from published ADHD GWAS meta-analysis. Physical and psychological child maltreatment was gauged using the Parent-Child Conflict Tactics Scale (CTSPC) at ages 6 and 11, with a mean score utilized as a variable. The ADHD-PGS exhibited associations with ADHD symptoms on both ASRS (ß = 0.53; 95% CI: 0.03; 1.03, p = 0.036), and SDQ (ß = 0.20; 95% CI: 0.08; 0.32, p = 0.001) scales. The total mean maltreatment score was associated with ADHD symptoms using both scales [(ßASRS = 0.51; 95% CI: 0.26;0.77) and (ßSDQ = 0.24; 95% CI: 0.18;0.29)]. The ADHD-PGS was associated with total mean maltreatment scores (ß = 0.09; 95% CI: 0.01; 0.17; p = 0.030). Approximately 47% of the total effect of ADHD-PGS on maltreatment was mediated by ADHD symptoms at age 6. No evidence supported gene-environment interaction in predicting ADHD symptoms. Our findings underscore the significant roles of genetics and childhood maltreatment as predictors for ADHD symptoms in adulthood, while also indicating a potential evocative mechanism through gene-environment correlation.

How much or how often? Examining the screening properties of the DSM cross-cutting symptom measure in a youth population-based sample.

BACKGROUND: The DSM Level 1 Cross-Cutting Symptom Measure (DSM-XC) allows for assessing multiple psychopathological domains. However, its capability to screen for mental disorders in a population-based sample and the impact of adverbial framings (intensity and frequency) on its performance are unknown. METHODS: The study was based on cross-sectional data from the 1993 Pelotas birth cohort in Brazil. Participants with completed DSM-XC and structured diagnostic interviews (n = 3578, aged 22, 53.6% females) were included. Sensitivity, specificity, positive (LR+), and negative (LR-) likelihood ratios for each of the 13 DSM-XC domains were estimated for detecting five internalizing disorders (bipolar, generalized anxiety, major depressive, post-traumatic stress, and social anxiety disorders) and three externalizing disorders (antisocial personality, attention-deficit/hyperactivity, and alcohol use disorders). Sensitivities and specificities >0.75, LR+ > 2 and LR- < 0.5 were considered meaningful. Values were calculated for the DSM-XC's original scoring and for adverbial framings. RESULTS: Several DSM-XC domains demonstrated meaningful screening properties. The anxiety domain exhibited acceptable sensitivity and LR- values for all internalizing disorders. The suicidal ideation, psychosis, memory, repetitive thoughts and behaviors, and dissociation domains displayed acceptable specificity for all disorders. Domains also yielded small but meaningful LR+ values for internalizing disorders. However, LR+ and LR- values were not generally meaningful for externalizing disorders. Frequency-framed questions improved screening properties. CONCLUSIONS: The DSM-XC domains showed transdiagnostic screening properties, providing small but meaningful changes in the likelihood of internalizing disorders in the community, which can be improved by asking frequency of symptoms compared to intensity. The DSM-XC is currently lacking meaningful domains for externalizing disorders.

Evaluation of genomic factors and early childhood stimulation on intelligence in children from a Brazilian birth cohort: The primary role of independent factors.

BACKGROUND: Childhood cognitive abilities are a predictor of health outcomes and adult income potential. Identifying factors associated with childhood intelligence and their interactions is essential in behavioral research. We assessed the impact of genetic variants and early child stimulation (ECS) on child intelligence and examined their possible interaction as potential modifiers of IQ in a population-based longitudinal study. METHODS: Participants of the 2004 Pelotas Birth Cohort study (N = 4231) underwent intelligent quotient (IQ) by WISC-III assessment at 6 years of age. At 24 and 48-months, mothers answered five ECS marker questions, whose sum was used to create a score. The polygenic score for intelligence (IQ-PGS) was constructed from the GWAS-weighted estimate of cognition. Association was assessed using multiple linear regression models adjusted for maternal, family, and child confounding variables. To explore the possible influence of skin color and ethnoracial classification, the regression models were stratified according to the skin color variable, as a sensitivity analysis. RESULTS: In the adjusted analysis, IQ-PGS (ß = 0.79, 95% confidence interval [95% CI] 0.26;1.31) as well as ECS (ß = 2.34; 95% CI: 1.76;2.92) were associated with IQ in this sample. The association between IQ-PGS and IQ was significant only in the white Brazilian group in the sensitivity analysis. However, there was no interaction between IQ-PGS and ECS on IQ (p(IQ-PGS x ECS) = 0.46). CONCLUSIONS: ECS did not modify the impact of genetic potential on intellectual development during childhood, suggesting that genetic factors and ECS exert independent effects on the IQ levels of children.

Functional performance assessment scale for children and adolescents with cancer: cross-cultural study / Escala de evaluación del rendimiento funcional de niños y adolescentes con cáncer: estudio transcultural / Escala de avaliação do desempenho funcional de crianças e adolescentes com câncer: estudo transcultural

ABSTRACT Objectives: to describe the methodological process of cross-cultural adaptation of the PlayPerformance Scale for Children to Brazilian Portuguese. Methods: methodological study of translation and cross-cultural adaptation in six stages: translation, synthesis of translations, back-translation, evaluation by a committee of judges, evaluation by expert nurses, and pretest. The agreement and representativeness of the items were assessed using the content validity index. A minimum value of 80% agreement was considered. Results: all stages of the translation and cross-cultural adaptation process were satisfactory. In the evaluation performed by the committee of judges, all items obtained agreement above 80%. Fifteen pediatric nurses conducted the content validation, suggesting necessary modifications for understanding and application. Thirty children and adolescents with cancer were assessed with the scale for the pre-test. Conclusions: the scale was cross-culturally adapted to Brazilian Portuguese. The need for psychometric testing in a consistent sample is emphasized.

RESUMEN Objetivos: describir el proceso metodológico de adaptación transcultural de la Escala de Rendimiento de Juego para Niños al portugués brasileño. Métodos: estudio metodológico de traducción y adaptación transcultural en seis etapas: traducción, síntesis de traducciones, retrotraducción, evaluación por un comité de jueces, evaluación por enfermeros especialistas y pretest. La concordancia y representatividad de los ítems se evaluaron mediante el índice de validez de contenido. Se consideró un valor mínimo del 80% de concordancia. Resultados: todas las etapas del proceso de traducción y adaptación transcultural fueron satisfactorias. En la evaluación realizada por el comité de jueces, todos los ítems obtuvieron una concordancia superior al 80%. Quince enfermeros pediatras realizaron la validación de contenido, sugiriendo modificaciones necesarias para la comprensión y aplicación. Treinta niños y adolescentes con cáncer fueron evaluados con la escala para el pretest. Conclusiones: la escala fue adaptada transculturalmente al portugués brasileño. Se destaca la necesidad de realizar pruebas psicométricas en una muestra consistente.

RESUMO Objetivos: descrever o processo metodológico de adaptação transcultural da Play-Performance Scale for Children para o português brasileiro. Métodos: estudo metodológico de tradução e adaptação transcultural em seis etapas: tradução, síntese das traduções, retrotradução, avaliação por um comitê de juízes, avaliação por enfermeiros especialistas e pré-teste. A concordância e a representatividade dos itens foram avaliadas por meio do índice de validade de conteúdo. Considerou-se o valor mínimo de 80% de concordância. Resultados: todas as etapas do processo de tradução e adaptação transcultural foram satisfatórias. Na avaliação realizada pelo comitê de juízes, todos os itens obtiveram concordância superior a 80%. Quinze enfermeiros pediatras realizaram a validação de conteúdo, sugerindo modificações necessárias para o entendimento e aplicação. Trinta crianças e adolescentes com câncer foram avaliados com a escala para o pré-teste. Conclusões: a escala foi adaptada transculturalmente para o português brasileiro. Ressalta-se a necessidade da realização de testes psicométricos em uma amostra consistente.

Effects on communication due to face mask use: an integrative review.

OBJECTIVES: to integrate evidence from studies on auditory perceptual and speech production effects in communication situations with face mask use. METHODS: an integrative literature review, in MEDLINE, Cochrane Library and Embase databases. The guiding question was: what effects on communication (perceptual-auditory and speech production) occur with face mask use? RESULTS: searches in electronic databases resulted in 1,478 studies and filtering resulted in 29 final studies. CONCLUSIONS: mask use has effects on communication, both in perception and speech production, factors that are also related to quality of life, stress and socio-emotional factors. These data can impact on indicators and alerts in favor of adopting strategies to manage mask use, involving speech production and perception when wearing a mask in health services.

Physical Activity and Chronic Stress in Early Life: Findings From the 2015 Pelotas (Brazil) Birth Cohort.

BACKGROUND: The association of physical activity through early childhood on children's chronic stress still is unclear. Therefore, the aim of the present study is to test the association of physical activity through early childhood (1-4 y) with chronic stress, measured by hair cortisol at age 4. METHODS: Longitudinal study including children from the 2015 Pelotas (Brazil) Birth Cohort. Cortisol at age 4 was measured using a hair sample, which provided cortisol concentration from the past months. Physical activity was measured using accelerometers at 1, 2, and 4 years. Linear regression models were used to assess the association between physical activity and chronic stress. Trajectory models were also applied to examine chronic stress in relation to physical activity patterns throughout early childhood. RESULTS: Children with valid physical activity and hair cortisol data were included in the analyses (N = 1475). Three groups of physical activity trajectories between 1 and 4 years were identified: low, medium, and high. No association between physical activity at 1, 2, and 4 years and chronic stress at age 4 was observed. However, children in the "high" physical activity trajectory presented low cortisol concentration; the magnitude of the regression coefficient was slightly larger in girls (ß = -0.125; 95% confidence interval, -0.326 to 0.074) than boys (ß = -0.051; 95% confidence interval, -0.196 to 0.09). CONCLUSION: There was no clear association between physical activity and chronic stress in early childhood. Trajectories models suggest that higher activity throughout early childhood may positively impact chronic stress; however, more studies are needed to confirm that hypothesis.

Determinants of hair cortisol in preschool children and their mothers: A Brazilian birth cohort study.

OBJECTIVE: Few large-scale studies have provided population-based estimates of hair cortisol levels and its determinants. Hair cortisol and potential determinants were measured in children and their mothers in a population-based sample in a Brazilian city with large variations in socioeconomic conditions. METHODS: We used data from the 4-year follow-up of the 2015 Pelotas (Brazil) Birth Cohort Study. Hair samples were collected by trained fieldworkers to analyze average levels of cortisol over a 3-month period. Four groups of variables were tested as potential determinants: hair characteristics (natural color, treatment, type, and frequency of wash), use of corticosteroids and oral contraceptives, sociodemographic factors (sex, age, skin color, socioeconomic level, maternal relationship, pregnancy, daycare enrollment), maternal perceived stress, and substance exposure (smoking and illicit drug use). Linear regression with log transformation was used to test associations. RESULTS: 3235 children and 3102 mothers were analyzed (80.7% and 77.4% of those interviewed when children were 4 years of age, respectively), for whom sufficient hair was collected for cortisol analysis. The median of hair cortisol concentration was 7.8 pg/mg (IQR = 5.6 - 11.0) for children, and 5.6 pg/mg (IQR = 4.2 - 7.8) for mothers. In adjusted models, sex and socioeconomic level were associated with child cortisol levels. For mothers, hair cortisol levels were associated with socioeconomic level, skin color, age, hair treatment and hair natural color. CONCLUSION: This study provides estimates of hair cortisol levels in a diverse population in a upper-middle income country. Although just a few predictors were associated with maternal/child cortisol levels, socioeconomic level was the key variable that should be incorporated in studies using hair cortisol to measure biological manifestations of stress, but other variables, such as some hair and sociodemographic characteristics are important to consider when using hair cortisol.

Effects on communication due to face mask use: an integrative review / Efectos en la comunicación por el uso de cubrebocas: revisión integradora / Efeitos na comunicação em razão de uso de máscara facial: revisão integrativa

ABSTRACT Objectives: to integrate evidence from studies on auditory perceptual and speech production effects in communication situations with face mask use. Methods: an integrative literature review, in MEDLINE, Cochrane Library and Embase databases. The guiding question was: what effects on communication (perceptual-auditory and speech production) occur with face mask use? Results: searches in electronic databases resulted in 1,478 studies and filtering resulted in 29 final studies. Conclusions: mask use has effects on communication, both in perception and speech production, factors that are also related to quality of life, stress and socio-emotional factors. These data can impact on indicators and alerts in favor of adopting strategies to manage mask use, involving speech production and perception when wearing a mask in health services.

RESUMEN Objetivos: integrar evidencias de estudios sobre efectos perceptuales auditivos y de producción del habla en situaciones de comunicación con el uso de mascarilla facial. Métodos: revisión integrativa de la literatura, en las bases de datos MEDLINE, Cochrane Library y Embase. La pregunta orientadora fue: ¿qué efectos en la comunicación (perceptivo-auditiva y producción del habla) se producen con el uso de mascarillas? Resultados: las búsquedas en bases de datos electrónicas dieron como resultado 1.478 estudios y el filtrado dio como resultado 29 estudios finales. Conclusiones: el uso de mascarillas tiene efectos en la comunicación, tanto en la percepción como en la producción del habla, factores que también se relacionan con la calidad de vida, el estrés y factores socioemocionales. Estos datos pueden impactar en indicadores y alertas a favor de la adopción de estrategias para gestionar el uso de mascarillas, involucrando la producción y percepción del habla al usar mascarilla en los servicios de salud.

RESUMO Objetivos: integrar evidências de estudos sobre efeitos perceptivos auditivos e de produção de fala em situações de comunicação com o uso de máscara facial. Métodos: revisão integrativa da literatura, nas bases MEDLINE, Cochrane Library e Embase. O questionamento direcionador foi: quais efeitos na comunicação (perceptivo-auditivos e de produção de fala) ocorrem com o uso de máscaras faciais? Resultados: as buscas nas bases de dados eletrônicas resultaram em 1.478 estudos, e a filtragem culminou em 29 estudos finais. Conclusões: o uso de máscaras traz efeitos na comunicação, tanto na percepção quanto na produção da fala, fatores ademais relacionados à qualidade de vida, estresse e socioemocionais. Esses dados podem impactar em indicadores e alertas em prol da adoção de estratégias ao manejo de uso de máscaras, envolvendo a produção e percepção de fala em ocasião de uso de máscara nos serviços de saúde.

Dilemas e peculiaridades da psicologia no Centro de Referência da Assistência Social / Dilemmas and peculiarities of psychology in social assistance reference center / Dilemas y peculiaridades de la psicología en el centro de referencia de la asistencia social

A inserção da Psicologia na Política Nacional de Assistência Social é recente e tem demandado novos saberes e fazeres. Assim, este trabalho tem como objetivo analisar as peculiaridades da inserção da Psicologia no Centro de Referência da Assistência Social (CRAS). Para tanto, realizou-se um estudo exploratório com dez psicólogas vinculadas aos CRAS do Município de Natal/RN. Os resultados indicaram que o CRAS propiciou um novo escopo de práticas para o campo da Psicologia, por meio de um trabalho de caráter psicossocial, uma atuação interdisciplinar e uma maior aproximação comunitária, embora ainda permaneçam os desafios no que tange a demarcação da sua atuação no campo social. Portanto, se torna imprescindível propor uma prática que assegure os direitos sociais dos usuários e um olhar crítico no trabalho cotidiano, transformando os dilemas em pautas de lutas junto com trabalhadores e usuários do Sistema Único de Assistência Social (AU).

The insertion of Psychology in the National Policy of Social Work is recent and has demanded new knowledge and practices. Thus, this paper aims to analyze peculiarities of the insertion of Psychology in CRAS. Therefore, an exploratory study was carried outwith ten psychologists linked to the CRAS of the city of Natal/RN. Results indicated the CRAS provided a new scope of practices for the Psychology field, an interdisciplinary acting and a closer approach to the community, although still remain challenges regarding to the demarcation of CRAS' work in the social field. Therefore, it is essential to propose a kind of practice that ensures users' social rights and a critical look at psychologists' daily work, turning their dilemmas into an agenda with workers and users of the Unified Social Assistance System (SUAS) (AU).

La inserción de la Psicología en la Política Nacional de Asistencia Social es reciente y ha demandado nuevos saberes y quehaceres. Así, este trabajo tiene como objetivo analizar las peculiaridades de la inserción de la Psicología en el CRAS. Para ello, se realizó un estudio exploratorio con diez psicólogas vinculadas a los CRAS de la ciudad de Natal/RN. Los resultados indicaron que el CRAS propició un nuevo escopo de prácticas para el campo de la Psicología, por medio de un trabajo de carácter psicosocial, una actuación interdisciplinaria y una mayor aproximación comunitaria, aunque permanezcan los desafíos en lo que se refiere a la demarcación de su actuación en el campo social. Por lo tanto, se torna imprescindible proponer una práctica que asegure los derechos sociales de los usuarios y una mirada crítica a su trabajo cotidiano, transformando sus dilemas en pauta de luchas junto con trabajadores y usuarios del Sistema Único de Asistencia Social (SUAS) (AU).

Life history trade-offs associated with exposure to low maternal capital are different in sons compared to daughters: Evidence from a prospective Brazilian birth cohort.

Background: Environmental exposures in early life explain variability in many physiological and behavioural traits in adulthood. Recently, we showed that exposure to a composite marker of low maternal capital explained the clustering of adverse behavioural and physical traits in adult daughters in a Brazilian birth cohort. These associations were strongly mediated by whether or not the daughter had reproduced by the age of 18 years. Using evolutionary life history theory, we attributed these associations to trade-offs between competing outcomes, whereby daughters exposed to low maternal capital prioritised investment in reproduction and defence over maintenance and growth. However, little is known about such trade-offs in sons. Methods: We investigated 2,024 mother-son dyads from the same birth cohort. We combined data on maternal height, body mass index, income, and education into a composite "maternal capital" index. Son outcomes included reproductive status at the age of 18 years, growth trajectory, adult anthropometry, body composition, cardio-metabolic risk, educational attainment, work status, and risky behaviour (smoking, violent crime). We tested whether sons' early reproduction and exposure to low maternal capital were associated with adverse outcomes and whether this accounted for the clustering of adverse outcomes within individuals. Results: Sons reproducing early were shorter, less educated, and more likely to be earning a salary and showing risky behaviour compared to those not reproducing, but did not differ in foetal growth. Low maternal capital was associated with a greater likelihood of sons' reproducing early, leaving school, and smoking. High maternal capital was positively associated with sons' birth weight, adult size, and staying in school. However, the greater adiposity of high-capital sons was associated with an unhealthier cardio-metabolic profile. Conclusion: Exposure to low maternal investment is associated with trade-offs between life history functions, helping to explain the clustering of adverse outcomes in sons. The patterns indicated future discounting, with reduced maternal investment associated with early reproduction but less investment in growth, education, or healthy behaviour. However, we also found differences compared to our analyses of daughters, with fewer physical costs associated with early reproduction. Exposure to intergenerational "cycles of disadvantage" has different effects on sons vs. daughters, hence interventions may have sex-specific consequences.

Psicologia e políticas sociais: uma análise marxista / Psychology and social policies: an analysis Marxist

A atuação da Psicologia nas políticas sociais remete às últimas décadas do século XX e tal campo profissional tem se configurado como promissor para a área. Ao passo em que isso representa uma aproximação dos psicólogos a maiores contingentes da população pobre, também revela descompasso entre as práticas realizadas e as demandas que lhes são dirigidas nos serviços. Para contribuir com a superação deste cenário, objetiva-se discutir sobre a necessidade de uma ampla e fundamentada compreensão das determinações macroestruturais que condicionam as políticas sociais para um trabalho efetivo da Psicologia neste campo. Para tanto, a partir da teoria social marxiana e da tradição marxista, é debatida a natureza das políticas sociais, que remete ao Modo de Produção Capitalista, suas características atuais no cenário de crise econômica e o papel da Psicologia nesta conjuntura de retrocesso de direitos sociais e desregulamentação do Estado.

A violência, as mulheres e o Estado: dificuldades e estratégias / Violence, women and the State: difficulties and strategies

Este artigo é parte de uma pesquisa de mestrado que teve como objetivo caracterizar a Rede de Enfrentamento à Violência Contra às Mulheres em um município do Centro-Oeste do Rio Grande do Sul, Brasil. O acesso às participantes ocorreu a partir da estratégia de amostragem Bola de Neve. O estudo contou com 11 participantes provindas de diferentes esferas da Rede de Enfrentamento municipal. Foram analisadas as principais dificuldades e estratégias relatadas pelas participantes no trabalho de Enfrentamento à violência contra a mulher. Como principais dificuldades, foram apontadas: a falta de investimento do Estado, a desestruturação/fragmentação da Rede e a individualização/pessoalização do trabalho prestado. Como principais estratégias: a formação de vínculos pessoais de trabalho e o desenvolvimento do trabalho voluntário para suprir as lacunas. As conclusões apontam para uma rede despolitizada, fragilizada e distante de seus ideais garantidores da cidadania.

Youth depression and inflammation: Cross-sectional network analyses of C-Reactive protein, interleukin-6 and symptoms in a population-based sample.

BACKGROUND: Inflammation-related proteins constitute a promising avenue in studying biological correlates of major depressive disorder (MDD). However, MDD is a heterogeneous condition - a crucial aspect to be considered in association studies. We examined whether inflammatory proteins are associated with categorical diagnosis, a dimensional total sum-score, and specific depressive symptoms among youths. METHODS: We analyzed data from the 1993 Pelotas Birth Cohort, a population-based study in Brazil that followed individuals up to age 22 years. Categorical psychiatric diagnoses were derived using adapted modules of the Mini International Neuropsychiatric Interview (MINI). Dimensional symptomatology was assessed using the Brazilian Portuguese version of the Center for Epidemiological Studies-Depression Scale-Revised (CESD-R). We estimated network structures that included individual depressive symptoms as measured by CESD-R items, peripheral inflammatory markers (C-Reactive Protein [CRP] and Interleukin-6 [IL-6]), as well as relevant covariates. RESULTS: We evaluated 2586 participants (mean age = 22.5[SD = 0.33]) There were no associations between concentrations of inflammatory proteins and categorical diagnosis of MDD or with CESD-R total sum-scores. In symptom-specific analysis, CRP and IL-6 were positively connected to somatic and cognitive items. DISCUSSION: We found cross-sectional connections of two commonly studied inflammatory proteins and specific depressive symptoms. Conducting symptom-specific analyses in relation to biological markers might advance our understanding of the heterogeneity of MDD.

Transformações da ambiência de unidades de terapia intensiva pediátrica na perspectiva dos enfermeiros / Transformaciones del ambiente de las unidades de cuidados intensivos pediátricos desde la perspectiva de los enfermeros / Transformations in the ambience of pediatric intensive care units from the perspective of nurses

RESUMO Objetivo: analisar o discurso dos enfermeiros acerca da ambiência da Unidade de Terapia Intensiva Pediátrica - UTIP e suas transformações com a presença do familiar/acompanhante. Método: pesquisa qualitativa, realizada por meio de um questionário com 28 enfermeiros de 3 UTIPs. Foi utilizado o software Iramuteq para o processamento dos dados. Para a análise, realizaram-se a Classificação Hierárquica Descendente e a análise temática. Resultados: os enfermeiros mencionaram a importância da ambiência da unidade e a necessidade da permanência do familiar. Entretanto, eles afirmam que o espaço físico não é apropriado para essa permanência. Ademais, a UTIP foi caracterizada como estressante, principalmente em relação à iluminação, aos ruídos, à temperatura e à falta de espaços para descanso e refeições. Conclusões: a ambiência influencia na assistência prestada à criança e sua família na UTIP, assim como nas relações interpessoais dos enfermeiros, principalmente com os familiares. Por isso, é imprescindível a participação do enfermeiro no processo de planejamento e construção da unidade, tornando a ambiência da unidade uma ferramenta facilitadora de produção de saúde.

RESUMEN Objetivo: analizar el discurso de los enfermeros sobre el ambiente de la Unidad de Cuidados Intensivos Pediátricos UCIP y sus transformaciones con la presencia del familiar/acompañante. Método: investigación cualitativa, realizada mediante un cuestionario con veintiocho enfermeros de tres unidades de cuidados intensivos pediátricos. Se utilizó el software Iramuteq para el procesamiento de datos. Para el análisis, se realizó la Clasificación Jerárquica Descendente y el análisis temático. Resultados: los enfermeros mencionaron la importancia del ambiente de la unidad y la necesidad de que el familiar permanezca allí. Sin embargo, afirman que el espacio físico no es el adecuado para esta permanencia. Además, la UCIP se caracterizó como estresante principalmente en relación con la iluminación, el ruido, la temperatura y la falta de espacios para el descanso y las comidas. Conclusiones: el ambiente influye en los cuidados prestados al niño y a su familia en la UCIP, así como en las relaciones interpersonales de los enfermeros, especialmente con los familiares. Por lo tanto, es esencial que el enfermero participen en el proceso de planificación y construcción de la unidad, haciendo del ambiente de la unidad una herramienta facilitadora para la salud.

ABSTRACT Objective: to analyze the nurses' discourse about the environment of the Pediatric Intensive Care Unit (PICU) and its transformations with the presence of the family member/caregivers. Method: qualitative research, carried out through a questionnaire with 28 nurses from 3 (PICUs). Iramuteq software was used for data processing. For the analysis, the Descending Hierarchical Classification and the thematic analysis were carried out. Results: the nurses mentioned the importance of the ambience of the unit and the need for the family member to remain. However, they claim that the physical space is not appropriate for this permanence. In addition, the PICU was characterized as stressful, especially in relation to lighting, noise, temperature, and lack of spaces for rest and meals. Conclusions: the environment influences the care provided to children and their families in the PICU, as well as the nurses' interpersonal relationships, especially with family members. Therefore, it is essential for nurses to participate in the process of planning and building the unit, making the environment of the unit a tool that facilitates health production.

Consumption of ultra-processed foods and IL-6 in two cohorts from high- and middle-income countries.

This study evaluated the association between ultra-processed foods (UPF) on serum IL-6 and to investigate the mediation role of adiposity. Participants were 524 adults from the EPITeen Cohort (Porto, Portugal) and 2888 participants from the 1982 Pelotas Birth Cohort (Pelotas, Brazil). Dietary intake was collected using FFQ when participants were 21 years of age in the EPITeen and 23 years in the Pelotas Cohort. Serum IL-6 and body fat mass were evaluated when participants were 27 and 30 years old in the EPITeen and Pelotas, respectively. Generalised linear models were fitted to test main associations. Mediation of body fat mass was estimated using G-computation. After adjustment for socio-economic and behaviour variables, among females from the EPITeen, the concentration of IL-6 (pg/ml) increased with increasing intake of UPF from 1·31 (95 % CI 0·95, 1·82) in the first UPF quartile to 2·20 (95 % CI 1·60, 3·01) and 2·64 (95 % CI 1·89, 3·69) for the third and fourth UPF quartiles, respectively. A similar result was found among males in the Pelotas Cohort, IL-6 increased from 1·40 (95 % CI 1·32, 1·49) in the first UPF quartile to 1·50 (95 % CI 1·41, 1·59) and 1·59 (95 % CI 1·49, 1·70) in the two highest UPF quartiles. The P-value for the linear trend was < 0·01 in both findings. The indirect effect through fat mass was NS. Our findings suggest that the consumption of UPF was associated with an increase in IL-6 concentration; however, this association was not explained by adiposity.

Physical activity and serum interleukin-6 in relation to bone density in young adults / Atividade física e interleucina-6 sérica em relação à densidade óssea em adultos jovens

Physical activity (PA) and inflammation influence bone density through multiple physiological mechanisms, but current evidence is not robust on the structure mediating these relationships. There-fore, the aim of this study was to investigate the associations of PA, and serum interleukin-6 (IL-6) on bone density. Cross-sectional analysis in the Pelotas (Brazil) 1982 Birth Cohort with participants aged 30-years old. PA was objectively measured by accelerometry. Bone mineral density (g/cm2) was evaluated for the lumbar spine and femoral neck using dual-energy X-ray absorptiometry. Crude and adjusted linear regressions and mediation analyses were performed. In both sexes, the overall PA was positively associated with femoral neck bone density, but not lumbar spine. For men, the mean of femoral neck were 0.027, 0.042, and 0.032 higher in the second, third, and fourth quartiles, respectively, compared to the first quartile (reference). Among women, higher bone density values were found in the third (0.021) and fourth (0.027) quartiles of overall PA compared to the lowest quartile. Among females, moderate-to-vigorous intensity physical activity presented a positive rela-tionship with all sites of bone density. The indirect effect through IL-6 was not significant. Physical activity was associated with gains in bone density. The findings reinforce recommendations for PA in adulthood to promote bone health

A atividade física (AF) e a inflamação influenciam a densidade óssea através de múltiplos mecanismos fisiológicos, mas a atual evidência não é robusta sobre a estrutura de mediação dessas relações. Portanto, o objetivo deste estudo foi investigar as associações de AF e interleucina-6 sérica (IL-6) na densidade óssea. Análise transversal na Coorte de Nascimentos de 1982 Pelotas (Brasil) em participantes com 30 anos de idade. AF foi medida objetivamente por acelerometria. Densidade mineral óssea (g/cm2) foi avaliada para a coluna lombar e colo do fêmur usando absorciometria de raios-X de dupla energia. Foram realizadas regressões lineares brutas e ajustadas e análises de mediação. Em ambos os sexos, a AF total foi positivamente associada à densidade óssea do colo do fêmur, mas não à coluna lombar. Para os homens, as médias do colo do fêmur foram 0,027, 0,042 e 0,032 maiores no segundo, terceiro e quarto quartis, respectivamente, em relação ao primeiro quartil (referência). Entre as mulheres, os maiores valores de densidade óssea foram encontrados no terceiro (0,021) e quarto (0,027) quartis de AF total em comparação ao quartil mais baixo. No sexo feminino, a atividade física de intensidade moderada a vigorosa apresentou relação positiva com todos os locais de densidade óssea. O efeito indireto através da IL-6 não foi significativo. A atividade física foi associada a ganhos de densidade óssea. Os achados reforçam recomendações de AF na idade adulta para promover a saúde óssea