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1.
Rural Remote Health ; 20(1): 5424, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32204596

RESUMO

INTRODUCTION: Self-assessment of health status can be considered a good predictor of population morbidity and mortality. Sociodemographic, environmental and health conditions can influence health self-perception. However, in rural areas, the identification of morbidities that affect workers' health and their general health condition is unknown. This study aims to evaluate the relationship between health self-perception and the occurrence of morbidities according to type of work. METHODS: This was a cross-sectional, population-based study of a rural area of Brazil. Health self-perception outcomes were classified as good (very good or good) or not good (fair, poor or very poor). Rural work, classified as yes or no, was considered to be the exposure. Crude and adjusted Poisson regression analyses were performed, obtaining prevalence ratio (PR) estimates and the respective confidence intervals (95%CI). All analyses were stratified by sex and adjusted for confounding factors. RESULTS: The sample comprised 893 individuals. The not good health self-perception prevalence was 27.6%, with a significant difference between the sexes (24.2% of men v 32.5% of women, p=0.014). Although associated with rural work in the crude model, self-perception was not associated with type of work after adjustment (PR: 1.02, 95%CI: 0.83-1.27). The risk of developing obesity (PR: 0.65, 95%CI: 0.47-0.91) and cardiovascular diseases (PR: 0.32, 95%CI: 0.12-0.87) was lower in men who developed rural activities. Also, women who reported doing rural work presented a lower risk for respiratory diseases (PR: 0.47; 95%CI: 0.22-0.97). CONCLUSION: The association between rural work and not good health self-perception, cardiovascular disease and obesity in women, and respiratory diseases in men seems to be highly dependent on sociodemographic context.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32196712

RESUMO

BACKGROUND: Several studies have reported that there is an association between developmental and emotional/behavioural problems in children exposed to acetaminophen during foetal development. However, few studies have focused on development and behavioural outcomes in early life. OBJECTIVES: To test the association between prenatal exposure to acetaminophen and low neurodevelopmental performance at 24 months and behavioural/emotional problems at 48 months of life. METHODS: We used data from the 2004 Pelotas Birth Cohort, a population-based longitudinal prospective study. Neurodevelopment was evaluated at 24 months using Battelle's Developmental Inventory (BDI) (n = 3737). We assessed global function as well as each domain (personal-social, adaptative, motor, cognitive, and communication). Behavioural/emotional problems were assessed at 48 months using the Child Behaviour Checklist (CBCL) (n = 3624). We used the CBCL total, externalising, and internalising symptomatology and individual subscales (withdrawn, somatic complaints, anxious/depressed, social problems, cognitive problems, attention problems, aggressive behaviour, and rule-breaking behaviour). Acetaminophen use during pregnancy was retrospectively assessed at the perinatal follow-up. Poisson regression and multiple linear regression analyses were used to test the association, adjusting for several family and maternal sociodemographic and health factors, medication use during pregnancy, and the sex of the child. RESULTS: Acetaminophen exposure during prenatal development was not associated with low neurodevelopmental performance at 24 months assessed using the BDI or to emotional and behavioural problems assessed at 48 months using the CBCL in the adjusted models. CONCLUSIONS: We cannot confirm the existence of an association between acetaminophen used during pregnancy and low neurodevelopmental performance at 24 months and emotional/behavioural problems at 48 months of life based on the present results.

3.
Artigo em Inglês | MEDLINE | ID: mdl-32169562

RESUMO

Studies on gene x environment interaction (GxE) have provided vital information for uncovering the origins of complex diseases. When considering the etiology of bipolar disorder (BD), the role of such interactions is unknown. Here, we tested whether trauma during childhood could modify the effect of two polymorphisms in the CACNA1C gene (rs1006737 and rs4765913) in terms of susceptibility to BD. The study enrolled 878 Caucasian young adults in a cross-sectional population-based survey. BD diagnosis was performed using a clinical interview MINI 5.0, and trauma was assessed with the childhood trauma questionnaire (CTQ). Binary logistic regression models were employed to test the main effects of polymorphisms, haplotypes, and GxE interactions using sex as a confounder. We did not observe an association between the polymorphisms and diagnosis of BD. However, we noted that childhood trauma modified the effect of the rs4765913 polymorphism (p = .018) and the AA haplotype (rs1006737 - rs4765913) (p = .018) on BD susceptibility. A allele carriers of the rs4765913 polymorphism or the AA haplotype exposed to childhood trauma are more likely to develop BD compared to the individuals without a genetic risk. Thus, this study showed that the risk of developing BD in individuals exposed to childhood trauma was influenced by the individual's genetic background, varying according to the CACNA1C genotypes.

4.
Sleep Med ; 69: 65-70, 2020 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-32045856

RESUMO

OBJECTIVE: To investigate the validity of the Brief Infant Sleep Questionnaire (BISQ), in assessing sleep quality in childhood. METHODS: This was a validation study with children from the Pelotas 2015 Birth Cohort. BISQ was applied to mothers when their children were 3, 6, 12, and 24 months of age. The poor sleep indicators analysed, as defined by BISQ, were >3 wakings per night, nocturnal wakefulness >1 h and total sleep duration <9/24 h, compared to number of wakings per night and nocturnal and total sleep duration defined by actigraphy taken as the gold standard. The Actiwatch wGT3X-BT device was used by the child consecutively during five days at three and six months and for three days at 12 and 24 months. At each age the prevalence, sensitivity, specificity, accuracy, and positive (PPV) and negative predictive values (NPV) of each sleep indicator was calculated. RESULTS: A total of 586 children were enrolled in the study. Nocturnal wakefulness >1 h was the most frequent indicator at all ages, with higher sensitivity (varying from 27.5% at six months to 54.8% at three) and lower specificity (53.4% at three months to 79.4% at six months), in comparison to the other sleep indicators. Specificity for >3 wakings and total sleep duration <9 h was greater than 85.0% at all the ages. Higher accuracies were observed for total sleep <9 h at 3 (85.6%), 6 (88.2%) and 12 months (73.6%) and for > 3 wakings at 24 months (84.5%). The sensitivity for the presence of at least one indicator decreased with age from 56.0% at three months to 35.8% at 24 months, whereas the specificity increased from 50.6% at three months to 63.8% at 24 months. CONCLUSION: The high specificity of the BISQ sleep parameters supports the validity of parents' reports on sleep-related problems in childhood for use in epidemiological studies.

5.
Chronobiol Int ; : 1-10, 2020 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-31958021

RESUMO

Social jetlag (SJL) is defined as the misalignment between the biological clocks and the social clock imposed by work and social constraints. In order to accomplish the workdays duties, people tend to not respect the internally sleep-wake cycle during the week, often using alarm clock to wake-up, which would lead to a chronic form of travel-induced jetlag. This circadian misalignment has been found to be associated with increased health risk and health-impairing behaviors. In this cross-sectional study, we aimed to explore whether the SJL is a valid concept for the travel-induced jetlag symptoms, as well as what is the cutoff point with best parameters for defining the presence of SJL, in a sample of undergraduate students of a university in Southern Brazil. We assessed SJL by the Munich ChronoType Questionnaire (MCTQ) and defined the concept as the difference between the midsleep point on free days and the midsleep point on classes days. The gold standard was defined as having at least one travel-induced jetlag symptom (fatigue, sleepiness or difficulty concentrating). Relative SJL, sensitivity and specificity were calculated for different cutoff points, plotted on ROC curves. A total of 452 students with complete sleep information were included in the analysis. The relative SJL mean was 2 h 23 min (SD = 1 h 24 min; range -3 h to 7 h 58 min) and 63.7% of the students had ≥2 h of relative SJL. All the tested cutoff points of the instrument had low sensitivity and specificity values, covering a small area under the ROC curve (0.487). The best parameters were for the cutoff point ≥2 h, with 63.4% sensitivity and 35.9% specificity. SJL did not revealed to be a valid concept for the studied sample comparing it to travel-induced jetlag symptomatology. One possible explanation for the lack of validity of our results regards the fact that SJL may not have the same apparent wide-term effects as the travel-induced jetlag. Then, the symptoms of SJL do not well represent the symptoms of travel-induced jetlag.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31965601

RESUMO

BACKGROUND: Over-the-counter analgesic use during pregnancy, particularly acetaminophen, may be associated with negative developmental outcomes in children. OBJECTIVE: Estimate associations of prenatal and early-life exposure to acetaminophen in early childhood with cognitive, motor, and language skills in two birth cohorts. METHODS: The American Project Viva cohort (1217 mother-child pairs enrolled 1999-2002) assessed cognition at approximately 3 years using the Peabody Picture Vocabulary Test and the Wide Range Achievement of Visual Motor Abilities (WRAVMA). The Brazilian 2015 Pelotas Birth Cohort (3818 mother-child pairs) assessed cognition at 2 years using the INTERGROWTH-21st Neurodevelopment Assessment. We used linear regression to estimate associations of acetaminophen use during pregnancy (Project Viva and Pelotas) and infancy (Project Viva) with children's cognitive scores adjusted for maternal age, pre-pregnancy body mass index, education, parity, race/ethnicity, smoking and alcohol use during pregnancy, depression during pregnancy, antibiotic and ibuprofen use during pregnancy, household income, and child's sex. RESULTS: In Project Viva, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was associated with lower WRAVMA drawing scores (ß -1.51, 95% CI -2.92, -0.10). However, in Pelotas, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was not associated with INTER-NDA motor scores (ß 0.02; 95% CI -0.05, 0.09) and was associated with higher INTER-NDA total scores (ß 0.08, 95% CI 0.01, 0.16). Other comparisons did not show evidence for any associations. CONCLUSIONS: Inconsistencies and lack of specificity of the findings did not clarify the research question considering that we still have a large variability and uncertainty to define the risk or safety in the use of acetaminophen related to cognition in early childhood. More studies using better exposure assessment and better confounding variables are needed to clarify these associations.

7.
J Atten Disord ; 24(4): 590-600, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31617436

RESUMO

Objective: We aimed to investigate the association between sleep in early life and ADHD in adolescence. As a secondary analysis, we tested whether the associations may be specific to ADHD. Method: Data from 3,467 participants of the 2004 Pelotas Birth Cohort were used. Information on their sleep duration and problems was collected at 12, 24, and 48 months of age. ADHD diagnosis and hyperactivity/inattention problems were assessed with the Development and Well-Being Assessment (DAWBA) and the Strengths and Difficulties Questionnaire (SDQ) among participants at 11 years of age. Results: Difficulty going to sleep at 24 months, nightmares at 24 months and at 48 months, and restless sleep at 48 months were consistently associated with ADHD as well as with other mental disorders. Conclusion: The results suggest that sleep disturbances may be more important ADHD predictors than sleep duration or sleep duration trajectories. However, it may also be considered early markers of other mental disorders.

8.
JAMA Netw Open ; 2(12): e1918062, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31860110

RESUMO

Importance: Poor sleep during early childhood is associated with adverse outcomes, including obesity, cognitive impairment, and mental and behavioral disorders. Objective: To assess the efficacy of an educational intervention in the promotion of nighttime sleep duration. Design, Setting, and Participants: This single-blind, intent-to-treat randomized clinical trial included participants in Pelotas, Brazil, aged 3 months who were followed up until age 24 months. Eligibility criteria included healthy infants aged approximately 3 months who slept less than 15 hours per 24 hours. Infants were randomized to the intervention group or control group. Interventions: Information on sleep characteristics, improvements in the environment, establishment of a nighttime sleep routine, and waiting before attending nocturnal awakenings was delivered to mothers in the intervention group by trained home-visitors at baseline. The intervention group received a telephone call on the first and second day after the intervention and a home visit on the third day after the intervention. The intervention's content was reinforced at health care visits for ages 6 months and 12 months. Mothers allocated to the control group were counseled on the benefits of breastfeeding for the mother's and child's health and given written material with content on breastfeeding. Main Outcomes and Measures: Nighttime sleep duration was measured by interview and actigraphy at baseline and ages 6, 12, and 24 months and diaries at baseline and age 6 months. At ages 3 and 6 months, nighttime sleep self-regulation was calculated by subtracting nighttime sleep duration recorded by actigraphy from nighttime sleep duration recorded in the diaries and at ages 12 and 24 months by subtracting nighttime sleep duration recorded by actigraphy from nighttime sleep duration obtained by interview. Results: Among 1812 mother-infant dyads invited to participate, 798 met the inclusion criteria and 586 agreed to participate. The intervention group included 298 infants (154 [52.9%] boys), and the control group included 288 infants (164 [58.2%] boys). At age 6 months, mean (SD) nighttime sleep duration recorded in diaries was 9.80 (1.85) hours in the intervention group and 9.49 (2.07) hours in the control group, a difference of 19 minutes longer for the intervention group. At age 12 months, mean (SD) nighttime sleep duration based on the Brief Infant Sleep Questionnaire was 8.43 (1.35) hours in the intervention group and 8.52 (1.35) hours in the control group, a difference of 5 minutes shorter for the intervention group. At age 24 months, compared with information from the interview, actigraphy records showed that children in the intervention group stayed awake at night without signalizing for a mean (SD) of 0.52 (2.52) hours, whereas children in the control group stayed awake at night without signalizing for a mean (SD) of 0.23 (2.43) hours. There were no statistically significant difference between groups in any of the sleep parameters investigated. Conclusions and Relevance: This randomized clinical trial found that the educational intervention did not achieve longer nighttime sleep duration among infants in the intervention group. Trial Registration: ClinicalTrials.gov identifier: NCT02788630.

9.
BMC Public Health ; 19(1): 1260, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31510953

RESUMO

BACKGROUND: We evaluated the prevalence and the factors associated with repeated high systolic (SBP) and diastolic blood pressure (DBP) at 6- and 11-year follow-ups of children from the Pelotas (Brazil) 2004 Birth Cohort. METHODS: All live births to mothers living in the urban area of Pelotas were enrolled in the cohort. Blood pressure (BP) values were transformed into Z-scores by sex, age, and height. High SBP and DBP were defined as repeated systolic and diastolic BP Z-scores on the ≥95th percentile at the two follow-ups. Prevalence (95% confidence interval) of repeated high SBP, DBP, and both (SDBP) were calculated. Associations with maternal and child characteristics were explored in crude and adjusted logistic regression analyses. RESULTS: A total of 3182 cohort participants were analyzed. Prevalence of repeated high SBP, DBP and SDBP was 1.7% (1.2-2.1%), 2.3% (1.8-2.9%) and 1.2% (0.9-1.6%), respectively. Repeated high SBP was associated with males, gestational diabetes mellitus (2.92; 1.13-7.58) and obesity at 11 years (2.44; 1.29-4.59); while repeated high DBP was associated with females, family history of hypertension from both sides (3.95; 1.59-9.85) and gestational age < 34 weeks (4.08; 1.52-10.96). Repeated high SDBP was not associated with any of the characteristics investigated. CONCLUSION: Prevalence of repeated high SBP, DBP, and SDBP were within the expected distribution at the population level. Nonetheless, gestational diabetes mellitus, obesity, family history of hypertension, and prematurity increased the risk of repeated high blood pressure measured at two occasions 5 years apart.


Assuntos
Hipertensão/epidemiologia , Brasil/epidemiologia , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco
10.
Genes (Basel) ; 10(8)2019 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-31434288

RESUMO

BACKGROUND: It has been suggested that microRNAs (miRNAs; short non-protein-coding RNA molecules that mediate post-transcriptional regulation), including mir-9 and mir-34 families, are important for brain development. Current data suggest that mir-9 and mir-34 may have shared effects across psychiatric disorders. This study aims to explore the role of genetic polymorphisms in the MIR9-2 (rs4916723) and MIR34B/C (rs4938723) genes on the susceptibility of psychiatric disorders in children from the 2004 Pelotas Birth Cohort. METHODS: Psychiatric disorders were assessed in 3585 individuals using Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), criteria through the application of standard semi-structured interviews (using the Development and Well-Being Assessment, DAWBA) at the six-years-of-age follow-up. The outcome was defined as the presence of any mental disorder. We also considered two broad groups of internalizing and externalizing disorders to further investigate the role of these variants in mental health. RESULTS: We observed an association between rs4916723 (MIR9-2) and the presence of any psychiatric disorder (odds ratios (OR) = 0.820; 95% CI = 0.7130-0.944; p = 0.006) and a suggestive effect on internalizing disorders (OR = 0.830; 95% CI = 0.698-0.987; p = 0.035). rs4938723 (MIR34B/C) was not associated with any evaluated outcome. CONCLUSION: The study suggests that MIR9-2 may have an important role on a broad susceptibility for psychiatric disorders and may be important mainly for internalization problems.


Assuntos
Transtornos Mentais/genética , MicroRNAs/genética , Polimorfismo de Nucleotídeo Único , Criança , Pré-Escolar , Feminino , Humanos , Masculino
11.
Rev Bras Epidemiol ; 22: e190049, 2019 Aug 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31460664

RESUMO

OBJECTIVE: To investigate the role of the domiciliary situation in the prevalence of general and abdominal obesity through the National Health Survey of 2013. METHODOLOGY: General obesity (body mass index ≥ 30 kg/m2) and abdominal obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women) in rural and urban areas were described according to sex and macroregion. Crude and adjusted Poisson regression models were used to test the association between obesity and household situation, with the significance level of 5%. RESULTS: The study included 59,226 individuals. Out of these, 20.7% presented general obesity and 38% abdominal obesity (higher in women: 24.3 and 52%, respectively). The highest prevalences of general obesity were observed in southern urban areas, for both sexes (20.8% in men and 26.5% in women). In rural areas, the highest prevalences were observed for the central-west region (17.2%) in men and in the south region (27.4%) in women. In males, after adjusting for demographic variables, living in rural areas was associated with lower prevalences of general obesity in the North (prevalence ratios - PR = 0.60; confidence interval of 95% - 95%CI 0.40 - 0.89) and Northeast (PR = 0.47, 95%CI 0,38 - 0.59), and for abdominal obesity in all regions. For women in the Midwest, the rural household situation was associated with lower prevalences of obesity. (PR = 1.11, 95%CI 1.01 - 1.23). CONCLUSIONS: The results evidenced the role of the domiciliary situation among outcomes at the national level, with lower prevalence of general and abdominal obesity in men living in rural areas. However, higher prevalences were found among women, especially for abdominal obesity.


Assuntos
Inquéritos Epidemiológicos/estatística & dados numéricos , Obesidade Abdominal/epidemiologia , Obesidade/epidemiologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distribuição por Sexo , Circunferência da Cintura , Adulto Jovem
12.
PLoS One ; 14(5): e0216202, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31071114

RESUMO

BACKGROUND: The literature on the relationship between lifestyle behaviors and inflammatory markers is scarce. METHODS: A birth cohort was followed since birth up to 22 years in Southern Brazil. Interleukin-6 (IL-6), C-reactive protein (CRP) and adiponectin were measured in nonfasting blood samples drawn at 18 and 22 years of age. Exposures including smoking, alcohol intake, physical inactivity and obesity, were collected at 15, 18 and 22 years. Cross sectional analyses were based on the number of follow-up visits with these exposures and the association with IL-6, CRP and adiponectin at 22 years old. We also carried out a longitudinal Generalized Least Squares (GLS) random-effects analysis with outcomes at 18 and at 22 years old. All analyses were adjusted for several covariates. RESULTS: The sample comprised 3,479 cohort members at 22 years. The presence of obesity at ≥ 2 follow-ups showed the highest mean values (SE) for IL-6 [2.45 (1.05)] and CRP [3.74 (1.11)] and the lowest mean value for adiponectin [8.60 (0.37)] (adjusted analyses, females) compared with other exposures; the highest mean of IL-6 [1.65 (1.05)] and CRP [1.78 (1.11)] and the lowest mean of adiponectin [9.98 (0.38)] were for the number of follow-ups with ≥2 exposures compared to those with no exposures at any follow-up (adjusted analyses, females). The longitudinal analysis showed an increase in obesity associated with IL-6 and CRP in both sexes and an inverse association with adiponectin in females; smoking (in males) was associated with IL-6 and CRP, harmful alcohol intake was associated with CRP in males, and increased in physical activity was inversely associated with CRP in men. CONCLUSION: We concluded that obesity is the main exposure positively associated with IL-6 and CRP and inversely associated with adiponectin (mainly in females). Smoking is also associated with these markers in the longitudinal analysis (in males).


Assuntos
Adiponectina/sangue , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Interleucina-6/sangue , Adolescente , Adulto , Brasil , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Inflamação/sangue , Inflamação/metabolismo , Estilo de Vida , Estudos Longitudinais , Masculino , Fatores de Risco , Adulto Jovem
13.
Trials ; 20(1): 253, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046826

RESUMO

BACKGROUND: Children in many low- and middle-income countries (LMICs) are at high risk for exposure to violence and later violent behaviour. The World Health Organization has declared an urgent need for the evaluation and implementation of low-cost parenting interventions in LMICs to prevent violence. Two areas of significant early risk are harsh parenting and poor child cognitive and socio-emotional development. Parenting interventions suitable for LMIC contexts have been developed targeting these risk factors and have been shown to have promising effects. However, their impact on child aggression, a key precursor of violence, has yet to be determined. The Pelotas Trial of Parenting Interventions for Aggression (PIÁ) has been designed to address this issue. METHODS: We are conducting a randomised controlled trial to evaluate two early parenting interventions for mothers of children aged between 30 and 42 months in a Brazilian city. The first of these, dialogic book-sharing (DBS), aims to promote child cognitive and socio-emotional development; and the second, the ACT Raising Safe Kids Program (ACT), is designed to reduce harsh parenting. These interventions are being compared with a control group receiving neither intervention. Three hundred and sixty-nine families in a birth cohort are being randomly allocated to one of the three groups (DBS, ACT, Control). Facilitators deliver the interventions to groups of five to 10 mothers at weekly sessions for 8 weeks in DBS and 9 weeks in ACT. Independent assessments of parenting and child development are being made before the interventions, shortly afterwards, and at follow-up 6 months later. The primary outcome is child aggression, and the two main secondary outcomes are: (1) child cognitive and socio-emotional development and (2) harsh parenting. Longer-term outcomes will be investigated as the birth cohort is followed into late childhood, adolescence, and adulthood. DISCUSSION: The Pelotas Trial of Parenting Interventions for Aggression (PIÁ) aims to evaluate the impact of two early parenting interventions on child aggression and several other key risk factors for the development of violence, including aspects of parenting and child cognition and socio-emotional functioning. The study is being carried out in a LMIC context where violence constitutes a major social and health burden. Since the two interventions are brief and, with modest levels of training, readily deliverable in LMIC settings, a demonstration that they benefit parenting and reduce risk factors for violence would be of major significance. TRIAL REGISTRATION: Brazilian Ministry of Health Register of Clinical Trials, ID: RBR-2kwfsk . Registered on 6 June 2018.


Assuntos
Agressão , Comportamento Infantil , Desenvolvimento Infantil , Educação não Profissionalizante/métodos , Relações Mãe-Filho , Mães/educação , Poder Familiar/psicologia , Violência/prevenção & controle , Fatores Etários , Brasil , Pré-Escolar , Cognição , Emoções , Feminino , Humanos , Masculino , Mães/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Comportamento Social , Fatores de Tempo , Resultado do Tratamento , Violência/psicologia
14.
Artigo em Inglês | MEDLINE | ID: mdl-30946941

RESUMO

The prevalence of anxiety disorders in patients with Attention Deficit/Hyperactivity Disorder (ADHD) is around 15-40%, three times higher than in the general population. The dopaminergic system, classically associated with ADHD, interacts directly with the adenosinergic system through adenosine A2A receptors (A2A) and dopamine D2 receptors (D2) forming A2A-D2 heterodimers. Both dopaminergic and adenosinergic systems are implicated in anxiety disorders. Therefore, the aims of this study were: a) to investigate the main effects of ADORA2A and DRD2 gene variants on anxiety disorders in an ADHD sample of children and adolescents; b) to test potential synergism between ADORA2A and DRD2 genes on the same outcome; c) to explore ADORA2A variants functionality using an in silico approach. The sample consists of 478 children and adolescents with ADHD and their parents, totalizing 1.239 individuals. An association between the ADORA2A rs2298383 TT genotype with the presence of anxiety disorders (P = .004) and an interaction between ADORA2A-DRD2 risk haplotypes with the same outcome (P = .005) was detected. The in silico analyses showed that rs2298383 has the highest score for regulatory function among all variants in the ADORA2A gene described up to date. Altogether, the present findings suggested that the ADORA2A gene and the interaction of ADORA2A and DRD2 genes may play a role in anxiety disorders in children and adolescents with ADHD.


Assuntos
Transtornos de Ansiedade/genética , Transtorno do Deficit de Atenção com Hiperatividade/genética , Predisposição Genética para Doença/genética , Receptor A2A de Adenosina/genética , Receptores de Dopamina D2/genética , Adolescente , Transtornos de Ansiedade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Criança , Feminino , Haplótipos , Humanos , Masculino , Polimorfismo de Nucleotídeo Único/genética , Receptor A2A de Adenosina/fisiologia , Receptores de Dopamina D2/fisiologia
15.
Int J Obes (Lond) ; 43(12): 2500-2508, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31000774

RESUMO

BACKGROUND/OBJECTIVES: Attention-deficit hyperactivity disorder (ADHD), one of the most common neurodevelopmental disorders in childhood and adolescence, is associated with obesity in observational studies. However, it is unclear whether ADHD contributes to, results from or is merely correlated with obesity. This study evaluates the presence and direction of a causal effect between ADHD and obesity. SUBJECTS/METHODS: We performed a bidirectional two-sample Mendelian randomization using summary data from consortia of genome-wide association studies to investigate if ADHD (N = 55,374) has a causal effect on body mass index (BMI) in childhood (N = 35,668) and adulthood (N = 322,154-500,000), and vice-versa. The main analysis was performed using the inverse variance weighted (IVW) method. As sensitivity analyses, we used other Mendelian randomization methods that are more robust to horizontal pleiotropy (i.e., MR-Egger, weighted mode, and penalized weighted median estimators), as well as stratified the analysis by the putative mechanisms of genetic instruments (i.e., pathways involved or not in neurological processes). RESULTS: The IVW method indicated a positive causal effect of BMI on ADHD: ß = 0.324 (95% CI 0.198 to 0.449, p < 0.001; expressed as change in ln(odds ratio) of ADHD per each additional SD unit of BMI). IVW estimates were directionally consistent with other methods. On the other hand, we did not find consistent evidence for a causal effect of ADHD genetic liability on BMI. CONCLUSIONS: The results suggested that higher BMI increases the risk of developing ADHD, but not the other way around.

16.
Int J Epidemiol ; 48(Suppl 1): i4-i15, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30883654

RESUMO

BACKGROUND: Few low-middle-income countries have data from comparable birth cohort studies spanning over time. We report on the methods used by the Pelotas cohorts (1982, 1993, 2004 and 2015) and describe time trends in sociodemographic characteristics of the participant families. METHODS: During the four study years, all maternity hospitals in the city were visited daily, and all urban women giving birth were enrolled. Data on socioeconomic and demographic characteristics were collected using standardized questionnaires, including data on maternal and paternal skin colour, age and schooling, maternal marital status, family income and household characteristics. The analyses included comparisons of time trends and of socioeconomic and ethnic group inequalities. RESULTS: Despite a near 50% increase in the city's population between 1982 and 2015, the total number of births declined from 6011 to 4387. The proportion of mothers aged ≥35 years increased from 9.9% to 14.8%, and average maternal schooling from 6.5 [standard deviation (SD) 4.2] to 10.1 (SD 4.0) years. Treated water was available in 95.3% of households in 1982 and 99.3% in 2015. Three-quarters of the families had a refrigerator in 1982, compared with 98.3% in 2015. Absolute income-related inequalities in maternal schooling, household crowding, household appliances and access to treated water were markedly reduced between 1982 and 2015. Maternal skin colour was associated with inequalities in age at childbearing and schooling, as well as with household characteristics. CONCLUSIONS: During the 33-year period, there were positive changes in social and environmental determinants of health, including income, education, fertility and characteristics of the home environment. Socioeconomic inequality was also reduced.


Assuntos
Saúde da Criança/tendências , Disparidades nos Níveis de Saúde , Saúde Materna/tendências , Adolescente , Adulto , Brasil , Criança , Estudos de Coortes , Escolaridade , Características da Família , Feminino , Fertilidade , Inquéritos Epidemiológicos , Humanos , Masculino , Idade Materna , Gravidez , Fatores Socioeconômicos , Adulto Jovem
17.
Int J Epidemiol ; 48(Suppl 1): i72-i79, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30883659

RESUMO

BACKGROUND: Brazil has made substantial improvements in the duration of breastfeeding. We use data from four population-based cohorts to examine how trends and inequalities in breastfeeding indicators changed over time in a Brazilian city. METHODS: Data from four birth cohorts, each including all births in a calendar year (1982, 1993, 2004 and 2015) in the city of Pelotas were used. Information on breastfeeding was collected when children were aged between 3 and 20 months. The prevalences of continued breastfeeding at 1 year of age and of exclusive breastfeeding at 3 months were calculated according to family income, maternal skin colour and sex. RESULTS: Prevalence of breastfeeding at 12 months increased from 16% to 41% in the 33-year period. The prevalence of exclusive breastfeeding at 3 months increased from 7% in 1993 to 45% in 2015. Increases in exclusive breastfeeding at 3 months were seen in all socioeconomic groups, but the 2015 rates remain highest (57.2%) among the women in the richest quintile, and lowest among those in the poorest quintile (34.6%). Black mothers were more likely to breastfeed at 12 months than Whites in the four cohorts. In the earlier cohorts, breastfeeding at 12 months was more common among the poor, but by 2015 these differences had disappeared. CONCLUSIONS: There were important positive changes in breastfeeding practices during this period, but less than half of the children in 2015 were receiving the full benefits of breast milk. Improved breastfeeding practices are being adopted by high-income women to a greater extent than by poor women.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Cuidado do Lactente , Brasil/epidemiologia , Feminino , Humanos , Renda , Lactente , Recém-Nascido , Masculino , Pobreza , Fatores de Tempo
18.
Genes (Basel) ; 10(2)2019 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-30696097

RESUMO

Circadian and sleep disorders, short sleep duration, and evening chronotype are often present in attention-deficit/hyperactivity disorder (ADHD). CLOCK, considered the master gene in the circadian rhythm, has been explored by few studies. Understanding the relationship between ADHD and CLOCK may provide additional information to understand the correlation between ADHD and sleep problems. In this study, we aimed to explore the association between ADHD and CLOCK, using several genetic markers to comprehensively cover the gene extension. A total of 259 ADHD children and their parents from a Brazilian clinical sample were genotyped for eight single nucleotide polymorphisms (SNPs) in the CLOCK locus. We tested the individual markers and the haplotype effects using binary logistic regression. Binary logistic and linear regressions considering ADHD symptoms among ADHD cases were conducted as secondary analysis. As main result, the analysis showed a risk effect of the G-A-T-G-G-C-G-A (rs534654, rs1801260, rs6855837, rs34897046, rs11931061, rs3817444, rs4864548, rs726967) haplotype on ADHD. A suggestive association between ADHD and rs534654 was observed. The results suggest that the genetic susceptibility to circadian rhythm attributed to the CLOCK gene may play an important role on ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/genética , Proteínas CLOCK/genética , Polimorfismo de Nucleotídeo Único , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Ritmo Circadiano , Feminino , Humanos , Masculino , Sono
19.
J Affect Disord ; 243: 290-296, 2019 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-30257225

RESUMO

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent symptoms of lack of attention, impulsivity and hyperactivity. The association between nutritional exposures and ADHD has been investigated and some studies have identified adverse effects from higher intake of sugar. The objective of the present study was to evaluate the association between change in sugar consumption between 6 and 11 years of age and incidence of attention-deficit/hyperactivity disorder (ADHD). METHODS: Pelotas 2004 Birth Cohort Study in Brazil. A food frequency questionnaire (FFQ) was used to estimate sugar consumption and the Development and Well-Being Assessment (DAWBA) was applied to mothers to assess the presence of ADHD. RESULTS: Only children without ADHD at 6 years and with complete information from FFQ and DAWBA at 6 and 11 years were included in the analyses (n = 2924). Odds ratios with 95% confidence intervals were calculated. Incidence of ADHD between 6 and 11 years was 4.6% (3.6-5.6%) among boys and 1.8% (1.2-2.5%) among girls. Adjusted analyses showed no association between always high sucrose consumption between 6 and 11 years and incidence of ADHD, compared with individuals who always presented low consumption, both among boys (OR = 0.66; 0.21-2.04) and girls (OR = 2.71; 0.24-30.35). LIMITATIONS: Reflect those that are inherent to use of FFQs, such as memory bias and lack of precision in quantifying the diet. CONCLUSIONS: The results suggest that there is no association between sucrose consumption between 6 and 11 years of age and incidence of ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Inquéritos Nutricionais , Açúcares/efeitos adversos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Brasil , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Distribuição por Sexo , Fatores Socioeconômicos , Açúcares/administração & dosagem
20.
Rev. bras. epidemiol ; 22: e190049, 2019. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-1020563

RESUMO

RESUMO: Objetivo: Investigar o papel da situação de domicílio na prevalência de obesidade geral e abdominal, usando dados da Pesquisa Nacional de Saúde de 2013. Metodologia: As prevalências de obesidade geral e abdominal, em zonas rural e urbana, foram descritas de acordo com o sexo e a macrorregião do país. A associação entre situação de domicílio e obesidade foi testada por regressão de Poisson bruta e ajustada com nível de significância de 5%. Resultados: Foram incluídos 59.226 indivíduos. Destes, 20,7% apresentaram obesidade geral e 38% obesidade abdominal (maiores em mulheres: 24,3 e 52%, respectivamente). Em zonas urbanas, as maiores prevalências de obesidade geral foram observadas na Região Sul (20,8 e 26,5% para homens e mulheres, respectivamente). Em zonas rurais, na Região Centro-Oeste (17,2%) em homens e na Região Sul (27,4%) em mulheres. Após ajuste por idade e cor da pele, em homens, viver em zonas rurais foi associado à menor prevalência de obesidade geral nas regiões Norte (razão de prevalência - RP = 0,60; intervalo de confiança de 95% - IC95% 0,40 - 0,89) e Nordeste (RP = 0,47; IC95% 0,38 - 0,59) e para a obesidade abdominal em todas as regiões. Para as mulheres, na Região Centro-Oeste, viver em zona rural foi associado a maiores prevalências de obesidade abdominal (RP = 1,11; IC95% 1,01 - 1,23). Conclusão: Os resultados evidenciam o papel da situação de domicílio entre os desfechos em nível nacional, com menores prevalências em homens residentes em zonas rurais, no entanto maiores prevalências foram encontradas entre as mulheres, principalmente para obesidade abdominal.


ABSTRACT: Objective: To investigate the role of the domiciliary situation in the prevalence of general and abdominal obesity through the National Health Survey of 2013. Methodology: General obesity (body mass index ≥ 30 kg/m2) and abdominal obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women) in rural and urban areas were described according to sex and macroregion. Crude and adjusted Poisson regression models were used to test the association between obesity and household situation, with the significance level of 5%. Results: The study included 59,226 individuals. Out of these, 20.7% presented general obesity and 38% abdominal obesity (higher in women: 24.3 and 52%, respectively). The highest prevalences of general obesity were observed in southern urban areas, for both sexes (20.8% in men and 26.5% in women). In rural areas, the highest prevalences were observed for the central-west region (17.2%) in men and in the south region (27.4%) in women. In males, after adjusting for demographic variables, living in rural areas was associated with lower prevalences of general obesity in the North (prevalence ratios - PR = 0.60; confidence interval of 95% - 95%CI 0.40 - 0.89) and Northeast (PR = 0.47, 95%CI 0,38 - 0.59), and for abdominal obesity in all regions. For women in the Midwest, the rural household situation was associated with lower prevalences of obesity. (PR = 1.11, 95%CI 1.01 - 1.23). Conclusions: The results evidenced the role of the domiciliary situation among outcomes at the national level, with lower prevalence of general and abdominal obesity in men living in rural areas. However, higher prevalences were found among women, especially for abdominal obesity.

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