Showing papers by "Universidade Federal de Pelotas published in 2006"
TL;DR: A conceptual framework is proposed to outline how adolescent physical activity may contribute to adult health, including the following pathways; and the recognition that domains of PA are different from those of adults may help governmental and non-governmental agencies involved in creating these guidelines.
Abstract: Physical activity in adolescence may contribute to the development of healthy adult lifestyles, helping reduce chronic disease incidence. However, definition of the optimal amount of physical activity in adolescence requires addressing a number of scientifIc challenges. This article reviews the evidence on short- and long-term health effects of adolescent physical activity. Systematic reviews of the literature were undertaken using a reference period between 2000 and 2004, based primarily on the MEDLINE/PubMed database. Relevant studies were identifIed by examination of titles, abstracts and full papers, according to inclusion criteria defined a priori. A conceptual framework is proposed to outline how adolescent physical activity may contribute to adult health, including the following pathways: (i) pathway A — tracking of physical activity from adolescence to adulthood; (ii) pathway B — direct influence of adolescent physical activity on adult morbidity; (iii) pathway C — role of physical activity in treating adolescent morbidity; and (iv) pathway D — short-term benefits of physical activity in adolescence on health. The literature reviews showed consistent evidence supporting pathway ‘A’, although the magnitude of the association appears to be moderate. Thus, there is an indirect effect on all health benefits resulting from adult physical activity. drawing recommendations. Finally, although studies on physical fitness are of interest for understanding the relationships between fitness and health, guidelines should focus on PA rather than fitness. Definition of adolescent PA guidelines is beyond the scope of this article, but our conceptual framework, and the recognition that domains of PA are different from those of adults may help governmental and non-governmental agencies involved in creating these guidelines.
891 citations
TL;DR: The lack of reliable data on perinatal mortality in Brazil, due to poor registration of births and deaths—particularly stillbirths— justified the launch of the study, which led to FCB's PhD thesis.
Abstract: Pelotas is a city in the extreme south of Brazil, near the border of Uruguay, with 214 000 urban inhabitants in 1982. At the time, we were assistant professors, each working in one of the two medical schools in the city, and both undergoing post-graduate training at the University of London. We were inspired by the findings of the British perinatal study, and one of us (FCB) decided to do a similar study for his doctoral thesis. The lack of reliable data on perinatal mortality in Brazil, due to poor registration of births and deaths—particularly stillbirths— justified the launch of the study. Funding from the International Development Research Center (Canada) was obtained for the perinatal survey, which led to FCB’s PhD thesis. 1,2
285 citations
TL;DR: A pesquisa, desenvolvida dentro dos Estudos de Linha de Base do Proesf analisou o desempenho do Programa Saude da Familia (PSF) em 41 municipios dos Estados de Alagoas, Paraiba, Pernambuco, Piaui, Rio Grande do Norte, Río Grande do Sul and Santa Catarina as mentioned in this paper.
Abstract: A pesquisa, desenvolvida dentro dos Estudos de Linha de Base do Proesf analisou o desempenho do Programa Saude da Familia (PSF) em 41 municipios dos Estados de Alagoas, Paraiba, Pernambuco, Piaui, Rio Grande do Norte, Rio Grande do Sul e Santa Catarina. Utilizou delineamento transversal, com grupo de comparacao externo (atencao basica tradicional). Entrevistou 41 presidentes de Conselhos Municipais de Saude, 29 secretarios municipais de Saude e 32 coordenadores de Atencao Basica. Foram caracterizados a estrutura e o processo de trabalho em 234 Unidades Basicas de Saude (UBS), incluindo 4.749 trabalhadores de saude; 4.079 criancas; 3.945 mulheres; 4.060 adultos e 4.006 idosos. O controle de qualidade alcancou 6% dos domicilios amostrados. A cobertura do PSF de 1999 a 2004 cresceu mais no Nordeste do que no Sul. Menos da metade dos trabalhadores ingressaram por concurso publico e o trabalho precario foi maior no PSF do que em UBS tradicionais. Os achados sugerem um desempenho da Atencao Basica a Saude (ABS) ainda distante das prescricoes do SUS. Menos da metade da demanda potencial utilizou a UBS de sua area de abrangencia. A oferta de acoes de saude, a sua utilizacao e o contato por acoes programaticas foram mais adequados no PSF.
277 citations
TL;DR: The clinical performance of posterior resin composite restorations evaluated was acceptable after 17-year evaluation, however, the probability of failure of resin composite Restorations in molars, Class II, and large restorATIONS is higher.
267 citations
TL;DR: In the multivariate analysis, sedentary lifestyle was positively associated with female gender, socioeconomic status, maternal physical inactivity, and television viewing, but inversely correlated with time spent playing videogames.
Abstract: Physical activity in adolescence is associated with several health benefits, including a direct influence on adolescent morbidity and an indirect effect on adult health mediated by physical activity levels in adulthood. This study assessed the prevalence of sedentary lifestyle and associated variables in 4,452 adolescents aged 10-12 years, belonging to the 1993 Pelotas Birth Cohort Study, representing 87.5% of the original cohort. Sedentary lifestyle, defined as < 300 minutes per week of physical activity, was reported by 58.2% (95%CI: 56.7-59.7) of the cohort. In the multivariate analysis, sedentary lifestyle was positively associated with female gender, socioeconomic status, maternal physical inactivity, and television viewing, but inversely correlated with time spent playing videogames. Adolescents with low socioeconomic status were more likely to walk or bicycle to and from school. Effective strategies against sedentary lifestyle in adolescence are needed because of its high prevalence and association with physical inactivity in adulthood.
228 citations
TL;DR: The first report of the Child Survival Countdown, a worldwide effort to monitor coverage of key child-survival interventions in 60 countries with the world's highest numbers or rates of child mortality, shows that tremendous efforts are urgently needed to achieve the MDG for child survival.
225 citations
TL;DR: Physical activity in adolescence does not seem to be programmed by physiological factors in infancy, however, tracking of physical activity from age 4 to 10-12 years suggests that genetic factors or early habit formation may be important.
Abstract: Objective To examine the effects of early social, anthropometric, and behavioural variables on physical activity in adolescence. Design Prospective birth cohort study. Setting Pelotas, southern Brazil. Participants 4453 adolescents aged 10-12 years participating in the Pelotas 1993 birth cohort study (follow-up rate 87.5%). Main outcome measures Sedentary lifestyle ( Results The prevalence of a sedentary lifestyle at age 10-12 years was 58.2% (95% confidence interval 56.7% to 59.7%). Risk factors for a sedentary lifestyle in adolescence were female sex, high family income at birth, high maternal education at birth, and low birth order. Weight gain variables at ages 0-1, 1-4, and 4-11 years and overweight at age 1 or 4 years were not significant predictors of physical activity. Levels of physical activity at age 4 years, based on maternal report, were inversely related to a sedentary lifestyle at age 10-12 years. Conclusions Physical activity in adolescence does not seem to be programmed by physiological factors in infancy. A positive association between birth order and activity may be due to greater intensity of play in childhood and adolescence. Tracking of physical activity from age 4 to 10-12 years, however, suggests that genetic factors or early habit formation may be important.
191 citations
TL;DR: The third Pelotas birth cohort showed an infant mortality rate similar to that of 11 years ago, with most deaths occurring in the neonatal period, and the rates of prematurity and cesarean sections increased substantially.
Abstract: OBJECTIVE: To describe a birth cohort which started in 2004, aiming to assess pre and perinatal conditions of the newborns, infant morbimortality, early life characteristics and outcomes, and access, use and financing of health care. METHODS: All children born in the urban area of Pelotas and Capao do Leao municipalities (Southern Brazil) in 2004 were identified and their mothers invited to join the study. In the first year of the study the children were seen at birth, at three and 12 months of age. These visits involved the application of a questionnaire to the mothers including questions on health; life style; use of health services; socioeconomic situation; estimation of gestational age; anthropometric measurements on the newborn (weight, length, head, chest and abdominal circumferences); anthropometric measurements on the mother (weight and height) and assessment of infant development. RESULTS: Out of the eligible infants (4,558), more than 99% were recruited to the study at birth. Follow-up rates were 96% at three months and 94% at 12 months of age. Among the initial results we highlight the following. Infant mortality rate was 19.7 per thousand, with 66% of infant deaths occurring in the neonatal period. There were frequencies of 15% premature babies and 10% low birthweight. Cesarean sections represented 45% of deliveries. CONCLUSIONS: The third Pelotas birth cohort showed an infant mortality rate similar to that of 11 years ago, with most deaths occurring in the neonatal period. The rates of prematurity and cesarean sections increased substantially.
167 citations
TL;DR: The size of the gap between current practice and recommendations is striking when one considers breast-feeding involves no out-of-pocket costs, that there exists universal consensus on best practices, and that implementing current international recommendations could potentially save 1.45 million children's lives each year.
Abstract: OBJECTIVE We estimate attributable fractions, deaths and years of life lost among infants and children < or = 2 years of age due to suboptimal breast-feeding in developing countries. DESIGN We compare actual practices to a minimum exposure pattern consisting of exclusive breast-feeding for infants < or = 6 months of age and continued breast-feeding for older infants and children < or = 2 years of age. For infants, we consider deaths due to diarrhoeal disease and lower respiratory tract infections, and deaths due to all causes are considered in the second year of life. Outcome measures are attributable fractions, deaths, years of life lost and offsetting deaths potentially caused by mother-to-child transmission of HIV through breast-feeding. SETTING Developing countries. SUBJECTS Infants and children < or = 2 years of age. RESULTS Attributable fractions for deaths due to diarrhoeal disease and lower respiratory tract infections are 55% and 53%, respectively, for the first six months of infancy, 20% and 18% for the second six months, and are 20% for all-cause deaths in the second year of life. Globally, as many as 1.45 million lives (117 million years of life) are lost due to suboptimal breast-feeding in developing countries. Offsetting deaths caused by mother-to-child transmission of HIV through breast-feeding could be as high as 242,000 (18.8 million years of life lost) if relevant World Health Organization recommendations are not followed. CONCLUSIONS The size of the gap between current practice and recommendations is striking when one considers breast-feeding involves no out-of-pocket costs, that there exists universal consensus on best practices, and that implementing current international recommendations could potentially save 1.45 million children's lives each year.
139 citations
TL;DR: The main methodological aspects of a cohort study are described, with emphasis on its recent phases, which may be relevant to investigators planning to carry out similar studies.
Abstract: This paper describes the main methodological aspects of a cohort study, with emphasis on its recent phases, which may be relevant to investigators planning to carry out similar studies. In 1993, a population based study was launched in Pelotas, Southern Brazil. All 5,249 newborns delivered in the city's hospitals were enrolled, and sub-samples were visited at the ages of one, three and six months and of one and four years. In 2004-5 it was possible to trace 87.5% of the cohort at the age of 10-12 years. Sub-studies are addressing issues related to oral health, psychological development and mental health, body composition, and ethnography. Birth cohort studies are essential for investigating the early determinants of adult disease and nutritional status, yet few such studies are available from low and middle-income countries where these determinants may differ from those documented in more developed settings.
134 citations
TL;DR: In this article, the authors focused on the prevalence and factors associated with condom use during sexual initiation and in the most recent sexual relations in young men and women (18-24 years of age).
Abstract: Condom use has increased among Brazilian youth, although condoms are not used in all sexual relations; in addition, their use varies over the course of an individual's affective and sexual history. This study focused on the prevalence and factors associated with condom use during sexual initiation and in the most recent sexual relations in young men and women (18-24 years of age). The data are from the GRAVAD Research Project, a cross-sectional study with a stratified probabilistic sample using household interviews in three Brazilian State capitals. The analysis used multinomial logistic regression with a hierarchical model. Prevalence of condom use in first sexual intercourse among individuals who used any contraceptive method was 80.7% for females and 88.6% for males. This proportion dropped to 38.8% and 56%, respectively, for the most recent intercourse. In both events, and for both genders, condom use was associated with social belonging and age at initiation. Condom use at sexual initiation was correlated with use in the most recent intercourse (OR = 2.42 for males and 1.89 for females). Increased condom use among youth does not mean continuing use. Women used condoms less than men in the events studied here.
01 Jan 2006
TL;DR: In conclusion, several conditions--composite, time and polishing technique--had a significant influence on surface roughness, hardness and microleakage.
Abstract: Clinical Relevance The effects of polishing techniques on surface roughness, microhardness and microleakage of resin composites are material dependent. In general, since immediate polishing has not had a negative influence on the tested properties of the two composites compared to delayed polishing, this procedure could be preferred, reducing the number of clinic sessions and bringing more comfort and satisfaction to the patient.
TL;DR: The prevalence of paternal postpartum depression (PPD) as well as its association with maternal PPD are described and their association with each other is described.
Abstract: Objective: To describe the prevalence of paternal postpartum depression (PPD) as well as its association with maternal PPD.
Method: A population-based random sample of 386 couples was assessed from the sixth to the 12th week postpartum for demographic characteristics, alcohol misuse (AUDIT) and depressive symptoms [Beck Depression Inventory (BDI)]. Logistic regression was employed to control for potential confounders.
Results: In the BDI, 26.3% of mothers and 11.9% of fathers scored above the selected threshold of 10. Mild maternal depression [odds ratio (OR) 3.31, 95% CI 1.52–7.20] and moderate to severe maternal depression (OR 8.44, 95% CI 3.53–20.21) were associated with paternal PPD.
Conclusion: Paternal PPD is a clinically meaningful phenomenon. Fathers should be evaluated for mood disorders in the postpartum, especially when their partner is depressed.
TL;DR: Estiveram associados a consulta e sua superutilizacao ser do sexo feminino, ser hipertenso e ter estado hospitalizado no ano anterior, alem do aumento de idade e piora da autopercepcao de saude.
Abstract: OBJETIVO: Identificar caracteristicas individuais associadas a maior probabilidade de consultar o medico e o fazer em excesso. METODOS: Estudo de base populacional com 3.100 adultos (>20 anos), moradores de Pelotas, Estado do Rio Grande do Sul, de outubro a dezembro de 2003. Foi utilizada amostragem por conglomerados em multiplos estagios. Foi realizada entrevista para obter dados socioeconomicos, demograficos e de saude, alem do numero de consultas no periodo de tres meses anteriores. A referencia de >4 consultas foi considerada superutilizacao. As analises multivariadas foram realizadas por regressao de Poisson baseadas em um modelo conceitual e apresentados em razoes de prevalencia e respectivos intervalos de confianca de 95%. RESULTADOS: A prevalencia de consulta ao medico foi de 55,1%. A maior probabilidade de consultar um medico esteve associada as mulheres, hospitalizacao no ano anterior, ex-tabagismo, diabetes e hipertensao arterial. Verificou-se tendencia de consultas conforme o avanco da idade (p<0,001) e piora da autopercepcao de saude (p<0,001). A prevalencia de superutilizacao de consultas foi de 9%, associada positivamente ao sexo feminino, hospitalizacao no ano anterior e historia de hipertensao. A tendencia de consultas em excesso esteve associada com aumento do indice de massa corporal (p=0,01), avanco da idade (p=0,006) e piora da autopercepcao de saude (p<0,001). CONCLUSOES: Estiveram associados a consulta e sua superutilizacao ser do sexo feminino, ser hipertenso e ter estado hospitalizado no ano anterior, alem do aumento de idade e piora da autopercepcao de saude.
TL;DR: A utilizacao da medida da CC deveria ser incorporada as acoes de promocao a saude, principalmente, no acompanhamento e monitoramento da populacao.
Abstract: Estudo transversal de base populacional na Cidade de Pelotas, Sul do Brasil, entre 1999 e 2000, para descrever a distribuicao de adiposidade abdominal na populacao de acordo com os niveis de intervencao e identificar fatores de risco. O estudo incluiu uma amostra de 1.935 adultos (20-69 anos) residentes na zona urbana do municipio. Obesidade abdominal foi classificada como nivel I para circunferencia da cintura (CCnI) de 80-88cm em mulheres e de 94-102cm em homens; e nivel II (CCnII) > 88cm para mulheres e > 102cm para homens. Apresentavam obesidade abdominal 62% das mulheres e 37% dos homens. Os valores de CCnI foram 23% e 19% e de CCnII 39% e 19%, para mulheres e homens, respectivamente. Apos ajuste para fatores de confusao, o aumento da idade e estar casado ou vivendo em uniao, em homens e mulheres, mantiveram-se fortemente associadas com CCnII. Escolaridade manteve-se como fator de risco apenas para homens e renda familiar apenas para mulheres, nas quais, o efeito da renda manteve-se inversamente associado com a obesidade abdominal. A utilizacao da medida da CC deveria ser incorporada as acoes de promocao a saude, principalmente, no acompanhamento e monitoramento da populacao.
TL;DR: This study examined the effect of 10 and 35% carbamide peroxide bleaching agents on the surface roughness of enamel, feldspathic porcelain, and microfilled and microhybrid composite resins.
Abstract: This study examined the effect of 10 and 35% carbamide peroxide bleaching agents on the surface roughness of enamel, feldspathic porcelain, and microfilled and microhybrid composite resins. Standardized cylindrical specimens were prepared for restorative materials. Enamel samples were obtained from buccal and lingual surfaces of human molars. Samples from each substrate were divided in three subgroups (n=10), according to surface treatment: distilled water (control), and 10 and 35% carbamide peroxide. The 10% agent was applied 3 h daily and the 35% agent was applied for 30 min/week, at 37°C, during 21 days. Control samples remained stored in distilled water, at 37°C. Roughness measurements (Ra, μm) were made at 24 h and repeated after 7, 14 and 21 days of exposure. Data were analyzed using ANOVA (split-plot design) and Tukey's test (5% significance level). Samples from control groups showed no significant alteration during all test periods, while for exposure to 10% agent, only the porcelain presented a rougher surface after 21 days (p<0.05). For the 35% product, roughness means significantly increased during the first and second weeks for enamel (p<0.05), and after 21 days for porcelain (p<0.05) and for the microhybrid composite (p<0.05). Microfilled samples showed no significant alteration throughout the 21-day period, regardless of the surface treatment.
TL;DR: Exclusive breastfeeding throughout the first 3 months of life is an uncommon practice among the population of Pelotas, RS, in particular when the mother works away from home, the father has little education and the child is given a pacifier, which reinforces the need to continue stimulating exclusive breastfeeding during the first months oflife.
Abstract: Objective: To determine the prevalence of exclusive breastfeeding during the first 3 months of life and its determinant factors in a city in the South region of Brazil Methods: Prospective study of a cohort of babies born between September 2002 and May 2003 in the city of Pelotas, RS Data were obtained in interviews, at maternity units and during home visits, with mothers of babies aged between 1 and 3 months Factors related to the cessation of breastfeeding were subjected to univariate, bivariate and multivariate analysis Results: Nine hundred and forty mothers of children aged 3 months or less were interviewed, 39% of whom were still exclusively breastfeeding and around 1/3 of whom no longer breastfed Multivariate analysis by logistic regression demonstrated a significant association between interruption of exclusive breastfeeding before 3 months and maternal employment, use of a pacifier, low family income (between one and three times the minimum wage), and less than 5 yearsi paternal education Conclusions: Exclusive breastfeeding throughout the first 3 months of life is an uncommon practice among the population of Pelotas, RS, in particular when the mother works away from home, the father has little education and the child is given a pacifier, which reinforces the need to continue stimulating exclusive breastfeeding during the first months of life
TL;DR: Interference in environmental conditions by partial dentine caries removal and tooth sealing arrests lesion progression, suggesting that complete dentineCaries removal is not essential to control caries progression.
Abstract: This paper aims to assess radiographic changes after incomplete carious dentine removal and tooth sealing. Thirty-two teeth with deep caries lesions were studied. The treatment consisted of incomplete excavation, application of a Ca(OH)2 layer, sealing temporarily for a 6- to 7-month period and then restoration. Standardised bitewing radiographs were taken immediately after the temporary sealing and at 6- to 7- and 14- to 18-month intervals. The digitised images were analysed blind by image subtraction. The quantitative analyses subtractions were performed in the radiolucent zone (RZ) beneath the restoration and in two adjacent control areas (CA). Two cases were lost during the 6- to 7-month period (one pulp necrosis and one pulp exposure during removal of the provisional sealing). No difference (p>0.05) was observed in the radiographic density of the CA and the RZ in the two experimental periods. The mean and standard deviation (grey tonalities scale) were 129.42±5.83 and 127.65±4.67 (control areas) and 132.96±7.41 and 132.90±5.99 (RZ) for the first and second experimental periods, respectively. The radiographic density of the CA differed from the RZ (Tukey test, p<0.001). Interference in environmental conditions by partial dentine caries removal and tooth sealing arrests lesion progression, suggesting that complete dentine caries removal is not essential to control caries progression.
TL;DR: High socioeconomic level was associated with greatest risk of overweight among boys, and dieting to lose weight during the previous 3 months, 4 or more hours of television viewing per day, and less than 3 formal meals per day were risk factors for overweight among girls.
Abstract: The prevalence of overweight and its association with demographic, socioeconomic, behavioral, and biological variables were evaluated. The sample included 810 adolescents (10-19 years of age) living in the urban area of Pelotas, a southern Brazilian city. Overweight was defined as a body mass index >= the 85th percentile, according to sex and age, and compared to the First National Health and Nutrition Examination Survey, following the WHO recommendation for adolescents. A clustering sampling strategy was used, and both the crude and adjusted analyses (Poisson Regression) took this strategy into account. The prevalence of overweight was 19.3% (95%CI: 16.6-22.0) and there was no difference between the sexes. The following groups presented a greater probability of being overweight: those classified in the wealthiest socioeconomic groups, those who had dieted to lose weight within the previous 3 months, those who watch 4 or more hours of television per day, and those who have less than 3 regular meals per day. After stratification by gender, high socioeconomic level was associated with greatest risk of overweight among boys. Dieting to lose weight during the previous 3 months, 4 or more hours of television viewing per day, and less than 3 formal meals per day were risk factors for overweight among girls.
TL;DR: O maior consumo de psicofarmacos associou-se significativamente a: ser do sexo feminino, o aumento da idade, o diagnostico medico de hipertensao e a utilizacao de servicos medicos, dada a associacao encontrada entre as consultas e o consumo.
Abstract: OBJETIVO: Avaliar a prevalencia e padrao de consumo de psicofarmacos pela populacao e comparar esses resultados com outro estudo de 1994. METODOS: Estudo transversal de base populacional, com 3.542 individuos de 15 anos ou mais, residentes na zona urbana de Pelotas em 2003. Os dados referentes ao consumo de duas semanas foram coletados em entrevistas domiciliares, utilizando um questionario identico ao utilizado em 1994. As variaveis estudadas foram: idade, sexo, cor da pele, situacao conjugal, renda familiar, escolaridade, tabagismo, diagnostico medico de hipertensao e consulta medica nos ultimos tres meses. Na analise bivariada, utilizou-se teste de qui-quadrado de Pearson e de tendencia linear. A analise multivariada foi composta por quatro niveis. RESULTADOS: A prevalencia de consumo de psicofarmacos foi de 9,9% (IC 95%: 8,9-10,9). Ao comparar as prevalencias padronizadas por idade, nao houve diferenca significativa em relacao a prevalencia observada em 1994. O maior consumo de psicofarmacos associou-se significativamente a: ser do sexo feminino, o aumento da idade, o diagnostico medico de hipertensao e a utilizacao de servicos medicos. Dos entrevistados, 74% dos usuarios estavam utilizando psicofarmacos ha mais de tres meses. CONCLUSOES: Apos uma decada, a prevalencia permanece alta, porem o consumo de psicofarmacos nao aumentou. Os achados sugerem a importância da indicacao adequada dos psicofarmacos e do acompanhamento medico regular desses usuarios, dada a associacao encontrada entre as consultas e o consumo.
TL;DR: Socioeconomic trajectories affected both height and overweight, the effect on the latter being different for each gender, and social determination seems to be complex and may involve aspects of lifestyle and behaviour acting differently for eachGender.
Abstract: The social determination of health outcomes is well established in literature. These studies usually show how health outcomes vary on the basis of current socioeconomic position (SEP) However, recent evidence suggests that current health out-comes depend on SEP in different periods in the life course.1 Also, past SEP may modify the effect of the individual’s current socioeconomic situation on health.
Several studies have shown that adverse socioeconomic conditions in childhood determine adult mortality rates, even when present socioeconomic situation is controlled for. Mortality rates from stroke and stomach cancer were 1.87 and 2.03 times higher in men whose fathers were manual workers compared with those whose fathers were not manual workers, while the all-cause mortality rate ratio was 1.22, in a Scottish cohort study of working men.2 In a census-based Finnish study, manual social class in childhood increased all-cause mortality by 20% among non-manual workers in adulthood, while having no effect among manual workers, whose mortality rate was three times higher than for subjects who always belonged to non-manual class. For cardiovascular mortality, childhood manual class was associated with increased rates for both manual and non-manual adult workers.3
Height has been shown to be related to childhood social class and financial hardship in infancy,4 and despite the increase in mean population height, differences between the richest and the poorest have not changed significantly.5 Nutrition and diseases in childhood are believed to be the main environmental factors determining height, and, thus, the effect of childhood social class is probably more important then adulthood social class. However, a study from the UK showed that upward social class mobility (from the age of 7–33 years) was associated with increased height for children originally from lower classes. On the other hand, children from the upper classes who moved down the social ladder were not different from those who remained wealthy.6 This study did not try to establish the causal direction—it could be either the improvement of social position leading to taller young adults or selective social mobility of taller individuals.
Obesity and overweight are increasing in most parts of the world,7 and their relation with SEP has been the focus of many studies. In Brazil, overweight and obesity have shown, overall, a steep increase. From 1975–97, obesity increased from 2.4 to 6.9% among men and from 7 to 12.5% among women.8 This change, however, was not consistent for all socioeconomic groups. Among men, all groups showed an increase in obesity over time, but poorer men present less obesity than the richer. Among women, the poorer show an increase of obesity more than 2-fold. The richer, on the other hand, peak in 1989 (12.8%) and then show a decrease to 9.2%. A similar trend was found, analysing the same surveys, comparing the trends in the poorer North-east of the country with the richer South-east.9 A recent review showed that in developing countries obesity tends to either increase or not to vary with wealth in men, while among women the association tends to be inverse.10
In the present study we explore how past and current SEP affects the height and weight of 19-year-old adults in a Brazilian birth cohort. This analysis may bring new light to the understanding of how these characteristics depend on SEP, not only at one point in time, as most studies have approached, but in terms of SEP change over time.
TL;DR: Results do not support the hypothesis that breastfeeding promotion would reduce overweight or obesity in this population of Brazilian children and existing evidence on many other benefits of breastfeeding for the mother and the child supports its continued promotion, protection and support.
Abstract: The effect of breastfeeding duration on the prevalence of overweight and on mean weight for height z-score (WHZ) was evaluated in Brazilian children. Prospective population-based birth cohort study. In total, 1273 children aged 4 years, corresponding to a follow-up rate of 87.2%. Three explanatory variables were studied: duration of any breastfeeding, duration of exclusive or predominant breastfeeding, and ever breastfeeding. Weight and height were measured using a digital electronic scale and a portable stadiometer. Overweight was defined as WHZ >2 using the National Center for Health Statistics reference curve. Overweight prevalence at the age of 4 years was 10.2% (95% CI 8.4; 11.8). The lowest prevalence (6.5%) was observed among children breastfed for >11 months. Among those breastfed for less than 3 months, the prevalence of overweight was approximately 9.5%. Mean WHZ ranged from 0.38 among children breastfed for less than 1 month to 0.62 among those breastfed for 9–11.9 months. No linear trends were detected in the association between breastfeeding and anthropometric indicators. None of the three breastfeeding variables was significantly associated with the prevalence of overweight or mean WHZ in multivariable analyses. No interactions were detected between breastfeeding and the variables sex, birth weight, socioeconomic status, skin color and pregestational in body mass index. Our results do not support the hypothesis that breastfeeding promotion would reduce overweight or obesity in this population. Existing evidence on many other benefits of breastfeeding for the mother and the child supports its continued promotion, protection and support.
TL;DR: Mulheres de melhor nivel economico, maior escolaridade, menores de 30 anos e com pele branca apresentaram risco mais elevado, while as usuarias de psicofarmacos e as que nao usavam anticoncepcao hormonal apresentam maior prevalencia.
Abstract: OBJETIVO: Estudar a prevalencia e fatores associados a sindrome pre-menstrual, comparando a frequencia encontrada com a auto-referida. METODOS: Foi realizado um estudo transversal, de base populacional, com 1.395 mulheres de 15 a 49 anos no municipio de Pelotas, Rio Grande do Sul, em 2003. Foram aplicados questionarios para medir a prevalencia da sindrome pre menstrual por meio de um escore, construido a partir de cinco sintomas pre-menstruais que interferiam na vida familiar ou levavam a falta ao trabalho ou a escola. Foram investigadas associacoes entre alguns fatores socioeconomicos, demograficos e comportamentais. A sindrome auto-referida foi investigada quanto a sua sensibilidade e especificidade, considerando o escore como padrao-ouro. As analises estatisticas utilizadas foram chi2 de Pearson, Mantel Haenszel e regressao de Poisson, alem do coeficiente de Kappa para verificar concordância de respostas. RESULTADOS: A prevalencia encontrada foi de 25,2% (IC 95%: 22,5-27,9) e auto-referida 60,3% (IC 95%: 57,4-63,3). Os principais sintomas pre-menstruais foram: irritabilidade, desconforto abdominal, nervosismo, cefaleia, cansaco e mastalgia, todos acima de 50% de prevalencia. Mulheres de melhor nivel economico, maior escolaridade, menores de 30 anos e com pele branca apresentaram risco mais elevado. As usuarias de psicofarmacos e as que nao usavam anticoncepcao hormonal apresentaram maior prevalencia. A sensibilidade do teste foi de 94%, a especificidade 51% e a acuracia 62%. CONCLUSOES: Foi alta a prevalencia da sindrome pre-menstrual encontrada. Embora a percepcao das mulheres seja maior do que aquela medida com o escore, ainda assim, um quarto das mulheres apresentou esse problema de saude.
TL;DR: In this article, a trabalho foi conducted to determine as propriedades fisicas and o intervalo hidrico otimo (IHO) of a Argissolo, sob diferentes estados de compactacao, cultivado com feijoeiro.
Abstract: O objetivo deste trabalho foi determinar as propriedades fisicas e o intervalo hidrico otimo (IHO) de um Argissolo, sob diferentes estados de compactacao, cultivado com feijoeiro. Foram utilizados tres experimentos, cujos tratamentos constituiram-se de: plantio direto (PD); plantio direto compactado pelo trafego de quatro passadas de maquina (PDc); e escarificacao em area anteriormente sob plantio direto (Esc). Avaliaram-se a densidade, a porosidade, a umidade volumetrica e a resistencia a penetracao do solo. Nas plantas, avaliaram-se a distribuicao do sistema radicular e a produtividade. A densidade critica obtida pelo IHO foi de 1,75 Mg m-3. No PDc a densidade do solo foi superior a critica na maioria das camadas, enquanto o PD e Esc apresentaram densidade acima da critica em poucas camadas. A umidade do solo ficou fora dos limites do IHO na maior parte do ciclo da cultura. A resistencia a penetracao ficou acima da critica no PDc em todas as avaliacoes. O sistema radicular concentrou-se superficialmente no PDc com melhor distribuicao e desenvolvimento no PD e Esc. Nos tres experimentos, a produtividade do Esc foi de 2 a 12% menor, e a do PDc foi de 30 a 62% menor do que no PD. A escarificacao nao foi necessaria para as condicoes fisicas do PD.
TL;DR: In this paper, a birth cohort study was carried out in Pelotas, Southern Brazil, in 2004, where all hospital births were assessed by daily visits to all maternity hospitals and 4558 deliveries were included in the study.
Abstract: OBJECTIVE: To assess the effect of hospital of birth on neonatal mortality. METHODS: A birth cohort study was carried out in Pelotas, Southern Brazil, in 2004. All hospital births were assessed by daily visits to all maternity hospitals and 4558 deliveries were included in the study. Mothers were interviewed regarding potential risk factors. Deaths were monitored through regular visits to hospitals, cemeteries and register offices. Two independent pediatricians established the underlying cause of death based on information obtained from medical records and home visits to parents. Logistic regression was used to estimate the effect of hospital of birth, controlling for confounders related to maternal and newborn characteristics, according to a conceptual model. RESULTS: Neonatal mortality rate was 12.7 and it was highly influenced by birthweight, gestational age, and socioeconomic variables. Immaturity was responsible for 65% of neonatal deaths, followed by congenital anomalies, infections and intrapartum asphyxia. Adjusting for maternal characteristics, a three-fold increase in neonatal mortality was seen between similar complexity hospitals. The effect of hospital remained, though lower, after controlling for newborn characteristics. CONCLUSIONS: Neonatal mortality was high, mainly related to immaturity, and varied significantly across maternity hospitals. Further investigations comparing delivery care practices across hospitals are needed to better understand NMR variation and to develop strategies for neonatal mortality reduction.
TL;DR: Exclusive breastfeeding throughout the first 3 months of life is an uncommon practice among the population of Pelotas, RS, in particular when the mother works away from home, the father has little education and the child is given a pacifier, which reinforces the need to continue stimulating exclusive breastfeeding during the first months oflife.
Abstract: OBJETIVO: Determinar a prevalencia do aleitamento materno exclusivo nos 3 primeiros meses de vida e os fatores determinantes em uma cidade da Regiao Sul do Brasil. METODOS: Estudo de coorte prospectivo, envolvendo bebes nascidos entre setembro de 2002 e maio de 2003 na cidade de Pelotas (RS). Os dados foram obtidos atraves de entrevistas, nas maternidades e no domicilio, com maes de bebes entre 1 e 3 meses de idade. Para analise dos fatores relacionados a interrupcao do aleitamento materno, foram realizadas analises univariada, bivariada e multivariada. RESULTADOS: Foram entrevistadas 940 maes de bebes com ate 3 meses de idade, sendo que 39% destes recebiam aleitamento exclusivo e cerca de 1/3 ja nao mamava mais. Apos analise multivariada por regressao logistica, trabalho materno, uso de chupeta, renda familiar entre um e tres salarios minimos e escolaridade paterna menor que 5 anos mostraram associacao significativa com interrupcao do aleitamento exclusivo antes dos 3 meses de vida. CONCLUSOES: O aleitamento materno exclusivo nos primeiros 3 meses e pouco praticado na populacao de Pelotas (RS), em especial quando a mae trabalha fora do lar, o pai tem pouca escolaridade e a crianca faz uso de chupeta, o que reforca a necessidade de se continuar estimulando a amamentacao exclusiva nos primeiros meses de vida.
TL;DR: Average values for the subjects studied were similar to those for the white North American population and the Mexican-American population of the third National Health and Nutrition Examination Survey, but exceeded those of the black populations of the same survey by 20%.
Abstract: Objective In clinical practice, spirometry is an extremely useful test that requires strict quality control, an appropriate strategy for interpretation, and reliable reference values. The aim of this study was to report spirometric reference values for 5 cities in Latin America. Patients and methods From data for 5315 subjects who had undergone spirometry in the PLATINO study in Caracas, Mexico City, Santiago, Sao Paulo, and Montevideo, we selected information for 906 (17%) individuals aged between 40 years and 90 years to provide reference values. The chosen subjects had never smoked, were asymptomatic, had not been diagnosed with lung disease, and were not obese. Multiple regression models were constructed with the following spirometric parameters: forced expiratory volume in 1 second (FEV1) and in 6 seconds (FEV6), peak expiratory flow, forced vital capacity (FVC), FEV1/FEV6, FEV1/FVC, and forced midexpiratory flow rate. Height, sex, and age were also included in the model. Results Average values for the subjects studied were similar to those for the white North American population and the Mexican-American population of the third National Health and Nutrition Examination Survey, but exceeded those of the black population of the same survey by 20%. Conclusions The proposed reference values are an improvement on those currently available for Latin America because the participants were chosen by population sampling methods and standardized up-to-date methodology was used.
TL;DR: Los valores de referencia propuestos representan una ventaja sobre los disponibles en the actualidad en Latinoamerica, ya que se eligio a los participantes por metodos de muestreo poblacional y el metodo empleado es estandarizado y actualizado.
Abstract: Objetivo La espirometria es una prueba de gran utilidad clinica, que requiere un estricto control de calidad, una estrategia de interpretacion y valores de referencia adecuados. El proposito del presente trabajo es comunicar los valores de referencia para la espirometria en 5 ciudades de Latinoamerica. Pacientes y metodos El estudio PLATINO se llevo a cabo en Caracas, Mexico, Santiago, Sao Paulo y Montevideo e incluyo a un total de 5.315 sujetos con espirometria realizada. De ellos, se estudio a 906 (17%) que tenian entre 40 y 90 anos de edad para crear valores de referencia, porque nunca habian fumado, estaban asintomaticos y no tenian enfermedad pulmonar diagnosticada ni obesidad. Se efectuaron modelos de regresion multiple con los valores espirometricos –volumen espiratorio forzado en el primer segundo (FEV 1 ) y en 6 s (FEV 6 ), flujo espiratorio maximo, capacidad vital forzada (FVC), FEV 1 /FEV 6 , FEV 1 /FVC y flujo mesoespiratorio forzado–, la talla, el sexo y la edad. Resultados Los sujetos estudiados presentaron en promedio valores similares a los de la poblacion norteamericana blanca y americana de origen mexicano del estudio NHANES III, pero superiores a los de la poblacion negra en un 20%. Conclusiones Los valores de referencia propuestos representan una ventaja sobre los disponibles en la actualidad en Latinoamerica, ya que se eligio a los participantes por metodos de muestreo poblacional y el metodo empleado es estandarizado y actualizado.
TL;DR: A brief historic account of how ethylene became the focus of fruit ripening research as well as the development and the state-of- art of these studies at both biochemical and genetic levels is presented.
Abstract: The effects of ethylene on plants have been recognized since the Nineteenth Century and it is widely known as the phytohormone responsible for fruit ripening and for its involvement in a number of plant growth and development processes. Elucidating the mechanisms involved in the ripening of climacteric fruit and the role that ethylene plays in this process have been central to fruit production and the improvement of fruit quality. The biochemistry, genetics and physiology of ripening has been extensively studied in economically important fruit crops and a considerable amount of information is available which ranges from the ethylene biosynthesis pathway to the mechanisms of perception, signaling and control of gene expression. However, there is still much to be discovered about these processes and the objective of this review is to present a brief historic account of how ethylene became the focus of fruit ripening research as well as the development and the state-of- art of these studies at both biochemical and genetic levels.
TL;DR: Geographic patterns of implementation of the Integrated Management of Childhood Illness (IMCI) strategy in three countries were described and whether the strategy was implemented in areas with the most pressing child health needs was assessed.
Abstract: OBJECTIVE: To describe geographical patterns of implementation of the Integrated Management of Childhood Illness (IMCI) strategy in three countries and to assess whether the strategy was implemented in areas with the most pressing child health needs. METHODS: We conducted interviews with key informants at the national and district levels in Brazil, Peru and the United Republic of Tanzania, and an ecological study of factors associated with health worker training in IMCI. Explanatory factors included district population, distance from the capital, human development index, other socioeconomic indicators and baseline mortality rates in children younger than five years. FINDINGS: In line with recommendations by WHO, early implementation districts were characterized by proximity to the capital and suitable training sites, presence of motivated health managers and a functioning health system. In the expansion phase, IMCI tended to be adopted by other districts with similar characteristics. In Brazil, uptake by poor and small municipalities and those further away from the state capital was significantly lower. In Peru, there was no association with distance from Lima, and a non-significant trend for IMCI adoption by small and poor departments. In the United Republic of Tanzania, the only statistically significant finding was a lower uptake by remote districts. Implementation was not associated with baseline mortality levels in any country studied. CONCLUSION: Whereas clear and reasonable guidelines are provided for selection of early use districts, no criteria for promoting IMCI expansion had been issued, and areas of greatest need were not prioritized. Equity analyses based on the geographical deployment of new programmes and strategies can contribute to assessing whether they are reaching those who need them most.