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Objectives: The impact of climate change on mental health is well established, but few studies have examined the perspectives of young people, especially in low- and middle-income countries (LMICs). In this qualitative study, we explored how Brazilian children and adolescents experience climate change. This approach can help inform environmental education, communication, and self-care strategies for this age group. Methods: We conducted focus groups with 50 children and adolescents aged 5 to 18 years in three locations in Brazil. We analyzed the data using an interpretative phenomenological analysis framework. Results: We identified three profiles of involvement with climate change: unaware, disengaged, and engaged. Profiles were largely related to different socioeconomic contexts. We analyzed each profile across the dimensions of space, time, emotions, and actions. Adults were portrayed by participants as stubborn deniers, as neutral influences, or as role models of knowledge and engagement. Due to their age and developmental level, young children had distinctive perceptions of climate change. Conclusion: Spatial and temporal perceptions of climate change are a key element for experiencing and engaging with environmental concerns and vary according to age and socioeconomic differences. Effective communication to foster climate action at individual and collective levels requires narratives that reach different ages. Replication of these findings in other LMICs is warranted. [ABSTRACT FROM AUTHOR]

The following article addresses the exploitation of child labor in sports, analyzing the legal regulations applicable to soccer teams in Brazil. In this sense, and considering the need to investigate further the consequences for children and adolescents, the following problem emerges: how does Brazilian legislation seek to impose limits that guarantee the protection of children and adolescents in the sporting sphere in Brazil? The approach applied in this article is the deductive method. The source of the research is the bibliography on the subject and the legal framework. The article has three specific objectives: to contextualize the exploitation of child labor and its historical aspects; to address the exploitation of children and adolescents in soccer; and finally, to analyze the legal protection for children and adolescents in terms of child labor in Brazilian soccer. We identify the existence of a limitation in Brazilian legislation, which imposes restrictions against the exploitation of child labor by children and adolescents in sports, seeking to guarantee their right to a healthy childhood and adolescence, as well as to guarantee the full protection of their rights. Such legal provisions converge with international provisions, especially those laid out by FIFA (Federation International Football Association). [ABSTRACT FROM AUTHOR]

Introduction: Since the onset of the pandemic, COVID-19 has affected the entire world population, however, data on child morbidity and mortality are scarce. This study aimed to analyze the profile of hospitalizations and factors associated with the deaths of Brazilian children and adolescents with Severe Acute Respiratory Syndrome caused by COVID-19. Methodology: This cross-sectional study uses public domain data from the Influenza Epidemiological Surveillance System in 2021. The prevalence rates, lethality, and duration of hospitalization of children and adolescents with Severe Acute Respiratory Syndrome caused by COVID-19 were analyzed. Logistic regression and adjusted Odds Ratio were used. A p < 0.05 was considered significant. Results: The prevalence of hospitalization among children and adolescents was 3.6%, and the case lethality rate was 4.0%. Higher lethality rates occurred among adolescents, natives, rural residents, those living in Brazil's northern and northeastern regions, and those who became critically ill and had comorbidities. Hospitalization time was longer for adolescents who became critically ill or had comorbidities. The highest chance of death was associated with: children under one year of age and adolescents, natives, and residents from the North, Northeast, and Southeast regions, who became critically ill and had comorbidities. Conclusions: Despite lower hospitalization and death rates than adults, the prevalence, complications, and mortality from COVID-19 in the pediatric population are relevant. Knowledge of the profile of children and adolescents hospitalized due to COVID-19 and the factors associated with these deaths allows the guidance of response efforts directed to assist this vulnerable population. [ABSTRACT FROM AUTHOR]

The study sought to discuss the situation of child labor in the country, especially domestic child labor, since it is one of the most common forms of child labor in Brazil, where it is probably the most vulnerable and exploited type of work for children and adolescents, as well as it is more difficult to protect, because in the environment of Brazilian families' homes they are considered as invisible workers, as they are away from street work that may in fact be noticed by competent authorities who can verify this situation. The topic addressed is justified because, according to research data, there are numerous cases of children and adolescents who perform this type of work. With this in mind, the general objective of this study was to analyze the context of child labor in Brazil with an emphasis on domestic child labor. Therefore, the methodology used was compilation, for this, the largest number of published works on the topic were gathered in order to clearly expose the content addressed. Among the findings of the research, it can be noted that this still happens due to social inequality and lack of opportunities that still haunts and divides Brazil, becoming even more evident, as well as domestic child labor causes serious occupational risks to children preventing access. school, games, and opening space for psychological and sexual violations. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the literature on the instruments used to assess excessive daytime sleepiness (EDS) in Brazilian children and adolescents. Data source: A systematic review of the literature was performed in the databases MEDLINE PubMed, Scopus, Web of Science, LILACS, Scielo and SPORTDiscus, with no time limit for searches. The eligibility criteria were studies published in English and Portuguese, original articles that used questionnaires to assess EDS and whose sample consisted of Brazilian children and/or adolescents. As search strategy, the following terms were combined with Boolean operators "OR" and/or "AND": drowsiness, disorders of excessive somnolence, excessive daytime sleepiness, day sleepiness, midday sleepiness, daytime sleepiness, adolescents, Brazil, Brazilian adolescents, and children. Data synthesis: Sixteen articles were selected, in which nine different instruments were applied to 8.240 children and adolescents from the South, Southeast, Midwest and Northeast regions of Brazil. The mean of methodological quality of studies was 16.1±1.9 points. The instruments most frequently used were the Pediatric Daytime Sleepiness Scale (PDSS) and Karolinska Sleepiness Scale (KSS), but only PDSS was shown reliable to assess EDS in Brazilian children and adolescents. Conclusions: The PDSS was the only instrument considered reliable to assess EDS in Brazilian children and adolescents. Further research on EDS in children and adolescents are suggested to perform the validation of other instruments for Brazil and present internal consistency values. [ABSTRACT FROM AUTHOR]

Objective: To describe COVID-19 deaths among children and adolescents in Sergipe, Brazil.Methods: Ecological study of all COVID-19 reported cases and deaths occurring in children and adolescents < 19 years of age in Sergipe reported by the health surveillance and mortality information systems of Sergipe's Health Secretary and hospital records.Results: Of 37 deaths of children < 19 years old were reported up to 30 September 2020, corresponding to 4.87 deaths for 100 000 population < 19 years old. Most deaths occurred among infants (44.1/100 000), and this age group had the highest case fatality rate (15.3 %). Most children had comorbidities such as chronic neurological diseases (n = 7; 19%) and prematurity (n = 4; 11%). Most children who died (n = 18; 49%) were not admitted to intensive care units (ICUs).Conclusion: COVID-19 mortality in children and adolescents in Sergipe was higher than in other Brazilian states and in high-income countries. A large proportion of the deaths occurred among children with comorbidities and a minority of children were admitted to ICU, reflecting the limited provision of such beds in the State. Newborns and infants are a high-risk group that must have priority in health public policy. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between social deprivation and the food environment. Furthermore, to evaluate if the food environment is associated with the prevalence of obesity among students in Brazilian public schools.Design: Cross-sectional. For the classification of obesity, weight and height were measured, and the cut-off point of BMI-for-age Z-score >+2 was adopted. Social deprivation level was determined from the Health Vulnerability Index (HVI). To assess the food environment, the density of food establishments in urban residential areas was calculated. Associations between the food environment and the presence of obesity were estimated by binary logistic regression through a generalized estimating equations model.Setting: Juiz de Fora, Minas Gerais, Brazil.Subjects: Children and adolescents (n 661) aged 7-14 years.Results: The lowest social deprivation level showed a higher density of all types of establishments that sold predominantly unhealthy foods. An inverse association was found between the density of supermarkets and hypermarkets and the presence of obesity (OR=0·58; 95 % CI 0·36, 0·93). For the other categories of food retailers, no significant differences were found.Conclusions: The findings reinforce the need for public policies that promote equality in the food environments of the city. Also, further investigations into the influence of the presence of supermarkets on the nutritional status of children and adolescents are required. [ABSTRACT FROM AUTHOR]

Background: The major non-communicable chronic diseases (NCD) are associated with a small group of modifiable lifestyle-related risk factors, including smoking, insufficient physical activity, unhealthy eating, and alcohol abuse. In this study, we evaluated the co-occurrence and clustering of the major NCD risk factors among Brazilian adolescents. Methods: This cross-sectional study analyzed data of 101,607 adolescents from the Brazilian National Survey of School Health (PeNSE) 2015. The risk factors included were: regular consumption of ultra-processed foods, irregular consumption of fruits and vegetables, insufficient physical activity, smoking, and alcohol consumption. Clustering was defined through the ratio between observed and expected prevalences of combination of risk factors greater than 1. Expected prevalence of the co-occurrence of risk factors was calculated from the joint probability of the behaviors. Additionally, we examined the presence of at least four risk factors according to socioeconomic characteristics. Results: Of the 32 combinations of risk factors, 13 corresponded to clustering. We observed a strong correlation between alcohol consumption and smoking, which were found together in 8 of the 13 clusters identified. The most frequent combinations of risk factors involved unhealthy eating and insufficient physical activity. Only 2.9% of the adolescents did not present any risk behaviors, while 38.0%, 32.9%, 9.4% and 1.8% accumulated two, three, four and five risk factors, respectively. The accumulation of risk factors was higher in girls, older adolescents, those who did not live with both parents, children of less-educated mothers, students attending public school, and residents of cities in more developed urban areas of the country. Conclusions: The main risk factors for NCD are frequent and not randomly distributed among Brazilian adolescents. Our results provide information for policymakers to target specific groups and joint behavioral risk factors for health improvement in adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Inpatient psychiatry is a therapeutic resource for symptom stabilization, risk management, diagnostic clarification and/or treatment planning. Psychological assessment provides information on emotional and cognitive functioning. This study aims to provide an overview of psychological assessment in a child and adolescent inpatient psychiatric unit at a general hospital in southern Brazil in 2015, 2016 and 2017. Methods: This cross-sectional retrospective study obtained information from electronic medical records of patients admitted to the hospital psychiatric unit. Data for analysis were sex, age, place of birth, psychological assessment, reason and length of stay. Results: In those three years, psychological assessments were requested in 65.1% of all unit admissions. However, there was a statistically significant decrease (p = 0.006) in the number of psychological assessments in relation to the number of admissions: 82% in 2015; 63% in 2016; and 53% in 2017. Conclusion: The decrease in the number of psychological assessments performed in the inpatient unit indicates that there was some changes in the process, as first most children and adolescents (82%) underwent the assessment and then the rate reduced to half of all patients (53%). This can be explained by the implementation of strategies to educate the health care team about psychological assessment, with the purpose of improving costeffectiveness and quality of care. This led to greater reflection on relevance, risks and benefits of psychological assessment in a child and adolescent inpatient psychiatric unit. [ABSTRACT FROM AUTHOR]

Objective: To assess the sociodemographic factors associated with the double burden of malnutrition (DBM) among Brazilian adolescents. Methods: This was a descriptive study based on data from 59,637 and 10,770 students who participated in the National Adolescent School-Based Health Survey (PeNSE), 2009 and 2015 editions, respectively. Weight and height measurements were obtained to evaluate nutritional status. DBM was classified as follows: adolescents with high BMI-for-age and low height-for-age (BMI/A: Z-score > +1 and H/A: Z-score < -2). Sociodemographic data on the participants were also collected. A multinomial logistic regression analysis was used to detect associations of interest. Results: The prevalence of DBM in the 2009 and 2015 editions of the PeNSE was 0.4% and 0.3%, respectively. In the 2009 edition, the chance of DBM was lower among boys (OR = 0.60; 95% CI = 0.45–0.81) and higher among those over 14 years old (OR = 2.40; 95% CI = 1.80–3.20), living in the country’s north and northeast regions (OR = 2.01; 95% CI = 1.49–2.84), and from families with a low maternal education level (OR = 1.48; 95% CI = 1.07–2.04). In the 2015 edition, no significant associations were found regarding the DBM outcome. Conclusion: The results indicate the presence of socioeconomic inequalities in the occurrence of DBM in the 2009 edition of the PeNSE. Simultaneous interventions in the area of equity are necessary to prevent the advancement of nutrition-related problems. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effect of a nutritional intervention involving a problem-raising approach and the use of pictorial representations on the promotion of knowledge and practices of healthy eating among adolescents. This randomized study included 461 adolescents from public schools in Brasilia, Federal District, Brazil (intervention group: 273 students from four schools; control group: 188 students from three schools). Mean age was 14.8±1.0, and 52.9% were boys. The intervention consisted of three meetings with interactive activities about principles of healthy eating, food classification, importance of reading labels and analyzing food advertising critically, and representations of healthy and unhealthy meals and their sugar, salt, and fat content. Pictorial materials consisted of food drawings, food models, and a food packaging model. Controls were not exposed to any activity. Dietary knowledge, consumption, and behaviors were the variables of interest. The intervention group showed a higher mean score of correct answers to questions about dietary knowledge than the control group (p = 0.0006), with higher odds of correctly answering questions about in natura (OR: 3.7; 95% CI: 1.9–6.6), minimally processed (OR: 3.6; 95% CI: 1.9–6.4), processed (OR: 2.2; 95% CI: 1.1–4.3), and ultra-processed foods (OR: 3.5; 95% CI: 1.8–6.6) and composition of ultra-processed foods (OR: 2.4; 95% CI: 1.3–4.4). Participants in the intervention group were also 2.5 times more likely to correctly answer questions about the importance of the dietary environment (95% CI: 1.1–5.5) and caution with food advertising (95% CI: 1.2–5.3) than controls. Increased weekly consumption of vegetables (p = 0.0077; OR: 2.4; 95% CI: 1.26–4.51) and reduced consumption of soft drinks (p = 0.0212; OR: 0.36; 95% CI: 0.15–0.86) were observed in the intervention group compared to the control group. The proposed intervention increased adolescents’ knowledge and improved some of their dietary habits. Educational activities using a problem-raising approach and pictorial representations of food appear to be effective in promoting healthy eating practices among adolescents. [ABSTRACT FROM AUTHOR]

Aims: To determine the prevalence of temporomandibular disorders and associated factors in an adolescent sample from Recife, Brazil. Materials and methods: A cross-sectional study was conducted with 1342 adolescents aged 10–17 years. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used by calibrated examiners to evaluate the presence and levels of chronic pain. To evaluate the socioeconomic conditions, the subjects answered the Brazilian Economic Classification Criteria (CCEB) questionnaire. Data were analyzed by means of binary logistic regression in SPSS. Results: The results showed that 33.2% of the subjects had TMD irrespective of age (p = 0.153) or economic class (p = 0.653). Statistically significant associations were found between TMD and female gender (p = 0.017), headache/migraine in the past six months (p<0.001), chronic pain (p<0.001) and chronic pain level (p<0.001). In the final model, logistic regression showed that the level of chronic pain and the headache/migraine in the past six months were related to the presence of TMD. Conclusions: The prevalence of TMD was considered high (33.2%) and adolescents with chronic pain and headache in the past six months were more likely to have TMD. Clinical relevance: The data contribute to the understanding of TMD among adolescents and to the development of preventive measures and polices to identify the dysfunction promptly. [ABSTRACT FROM AUTHOR]

The aims of this study were to identify dietary patterns (DPs) of children and adolescents participating in three cross-sectional surveys (2013–2015) and to test their associations with sociodemographic variables, physical activity (PAS), screen-based sedentary activity (SA), and weight status. One-day data were obtained from 5,364 schoolchildren (7–12 years) from public schools of Florianopolis (South of Brazil), using the validated questionnaire Web-CAAFE (Food Intake and Physical Activity of Schoolchildren). DPs were derived from the frequency of daily consumption of 32 foods/beverages by latent profile analysis. Multinomial logistic regression analysis was used to estimate the association of the DPs with sociodemographic variables, physical activity, screen activity and weight status. ‘Traditional’, ‘Monotonous’, and ‘Mixed’ DPs were identified. The percentages of children and adolescents within these profiles were 41.3, 36.3, and 22.4%, respectively. Children and adolescents in the highest tertiles of both PAS and daily frequency of SA had a higher probability to present a ‘Mixed’ DP compared to peers with less PAS and SA. Children and adolescents who reported having a school meal were significantly more likely to present the ‘Traditional’DP, while boys who did not report having a school meal had a higher probability to present the ‘Monotonous’ DP. The DPs were not associated with the year of survey, age, family income, or weight status. [ABSTRACT FROM AUTHOR]

Highlights • Boys develop more pronounced isometric muscular strength starting at 10 years of age and it peaks at 14 and 15 years. • The Handheld dynamometer has excellent inter-rater reliability and an intra-rater agreement for all muscle groups tested. • The development of muscle strength for the Brazilian population is similar to that observed in the northern hemisphere. Abstract Objective Isometric muscle strength measured by Handheld dynamometer indicates physical ability. There is no normative data for the Brazilian population. This study aims (a) to describe the development of isometric muscle strength in healthy children and adolescents 5–15 years of age; (b) to evaluate Handheld dynamometer inter and intra-rater reliability. Methods Isometric muscle strength was obtained for shoulder abduction, elbow and knee flexion and extension, dorsiflexion and plantar flexion in 55 boys and 55 girls, aged between 5 and 15 years. Inter-rater reliability was determined based on the evaluation of 2 raters, with a 20-min interval between them. Intra-rater reliability was based on 2 evaluations from the same rater, one week apart. Interclass correlation coefficient (ICC 2,1; 3,1), Bland Altman plots and linear regression models with mixed effects were used to quantify inter and intra-rater reliability, agreement and associations with physical activity level and maturational factors. Results A linear development of isometric muscular strength was observed for ages between 5 and 10. After age 10, boys showed a larger isometric muscular strength, when compared to girls. Both inter and intra-rater measurements of the Handheld dynamometer are reliable (ICC > 0.63). Conclusions This study shows increase in isometric muscle strength starting at 10 years of age for boys, when compared to girls and inter and intra-rater reliability for the assessment of isometric strength, using the Handheld dynamometer for the muscle groups tested on the dominant and non-dominant side, for children between 5 and 15 years of age. [ABSTRACT FROM AUTHOR]

Objectives: To estimate changes over time of breakfast frequency and foods/food groups consumed at breakfast. Methods: Cohort of 809 students aged 10–16 years old from Rio de Janeiro, Brazil, enrolled in 2010, and followed for three years. Breakfast skippers were those not eating breakfast. Those with breakfast frequency of 4 or less times per week were considered irregular breakfast eaters. Changes over time of breakfast frequency and breakfast foods/food groups were analyzed by generalized estimating equations. Results: At baseline, overweight/obese girls had higher prevalence of irregular breakfast than those non-overweight/obese (40% vs. 26%; p = 0.005); among boys, there was no significant difference in the prevalence of irregular breakfast according to weight status. After three years, among girls there was an increase in the risk of irregular breakfast consumption (RR = 1.29; 95% CI: 1.08; 1.54) and breakfast skipping (RR = 1.63; 95% CI: 1.12; 2.38). Also, overweight/obese boys (RR = 1.40, 95% CI: 1.03, 1.89) and non-overweight/obese girls (RR = 1.54, 95% CI: 1.17, 2.04) had higher risk of irregular breakfast in three years, compared to baseline. After three years, boys changed the consumption of foods/food groups at breakfast and presented higher risk of decreased intake of fruits (RR = 1.60, 95% CI: 1.20, 2.13), sandwiches and snacks (RR = 1.58, 95% CI: 1.12, 2.22), chips (RR = 1.43, 95% CI: 1.01, 2.13), and ham (RR = 1.52, 95% CI: 1.12, 2.07), and lower risk of cheese intake (RR = 0.73, 95% CI: 0.53, 1.00). Girls had higher risk of decreased intake of fruits (RR = 2.08, 95% CI: 1.47, 2.95), milk (RR = 1.49, 95% CI: 1.07, 2.08), chocolate powder (RR = 1.54, 95% CI: 1.11, 2.14) and ham (RR = 1.65, 95% CI: 1.16, 2.36). Conclusions: Changes in breakfast patterns are different according to sex. Also, different changes in breakfast frequency according to BMI category were found. Consumption patterns of some foods/food groups have a tendency to become changed from initial to middle adolescence. [ABSTRACT FROM AUTHOR]

Objective: to investigate health professionals' knowledge about the concept, assessment and intervention in fatigue in children and adolescents with cancer. Method: exploratory study with qualitative approach, with 53 health professionals (10 nurses, 33 assistant nurses, 3 physicians, 3 nutritionists, 2 psychologists and 2 physical therapists). Semi structured interviews were held, which were recorded and analyzed by means of inductive thematic content analysis. Results: the data were organized around three themes: knowledge of health professionals about fatigue; identification of fatigue and interventions to relieve fatigue. Conclusion: the results indicate the health professionals' limited knowledge about fatigue, as well as the lack of investment in their training and continuing education. Most of all, the lack of research on the theme in the Brazilian context remains a barrier to support improvements in care for this symptom in children and adolescents with cancer. [ABSTRACT FROM AUTHOR]

Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74-91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth. [ABSTRACT FROM AUTHOR]

Background: The main modifiable risk factors for obesity are related to lifestyle and significantly influenced by the family, environment and culture. We aimed to estimate the prevalence of overweight/obesity and associated lifestyle factors in children from Bento Gonçalves, a southern Brazil city with strong Italian immigration influence. Italian traditional foods were locally adapted since the immigrants' arrival in the XIX century, to include more fat and fewer vegetables, and physical activity levels have decreased. Methods: Cross-sectional study of a population-based cluster sample with students aged 9-18 years. We assessed time spent in sedentary behaviors, hours of physical activity, food frequency and family history. All children underwent physical examination with anthropometric and blood pressure measurements. Overweight and obesity were classified according to WHO percentile curves. Results: A total of 590 students were evaluated. Mean age was 12.45 ± 1.49 years. The prevalence of overweight and obesity was 16.3% and 8.3%, respectively. Boys were more frequently overweight and obese than girls (16.3% and 12.2% versus 16.2% and 5.5%, respectively). Vegetables and fruits were consumed less than 4 times per week in 49% and 36.8%, while soft drinks, fast food and sweets were consumed more than 4 times a week by 71%, 70.3% and 42.7%, respectively. The habit of omitting breakfast was associated with overweight (p = 0.007). The average screen time was 5.38 ± 2.88 hours/day. Overweight/obesity was present in 12.2% (n = 5), 24.8% (n = 122) and 36.8% (n = 14) children with low birth weight, normal birth weight and high birth weight respectively (p = 0.04). The prevalence of high blood pressure was higher in obese (30.6%) and overweight (21.2%) children, comparing to eutrophic children (6.8%; p < 0.001). Excess weight was more frequent among fathers (62.8%) than in mothers (46.3%), but excess weight in mothers was positively associated with excess weight in children (p 0.048). Conclusion: The city showed high prevalence of overweight and obesity. These findings reinforce the importance of implementing prevention strategies aimed at children and their families, considering that health habits are shared and transmitted along generations. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the influence of dietary patterns on the occurrence of dental caries. Using a population-based, cross-sectional study design, we assessed a sample of 1.439 children aged 6-13 years who were enrolled in public schools in the municipality of São Francisco do Conde, Bahia state, Brazil. Oral examinations for dental caries were performed by two dental surgeons (Kappa = 0.72) in the school environment under natural light with the aid of a wooden spatula and gauze. Dietary intake was assessed using the qualitative-quantitative food frequency questionnaire. A questionnaire on the demographic and socioeconomic conditions was applied to the families. The Poisson multivariate analysis was performed for statistical purposes. Considering both dentitions, the prevalence of caries was 82.14% and 37.3% in the permanent and deciduous dentitions, respectively. The identified dietary patterns were classified into "standard obesogenic" and "prudent." The results showed statistically significant association between the obesogenic dietary pattern and dental caries; the proportion of students with dental caries was 1.4 times higher among those who most frequently consumed foods that constitute a standard obesogenic diet (PR = 1.40, 95% CI: 1.04-1.96) compared to those who less frequently consumed these types of foods. A positive association between the obesogenic dietary pattern and dental caries was found in the students investigated. Therefore, the promotion of healthy eating habits and nutritional habits should be encouraged to prevent dental caries in children and adolescents. [ABSTRACT FROM AUTHOR]

Background Tuberculosis is a major disease worldwide and most research focus on risk factors for adults, although there is a marked adolescent peak in incidence. The objective of this study was to identify risk factors for tuberculosis in children aged 7 to 19. Methods A case control study matched by age with 169 cases and 477 controls. The study population consisted of adolescents and older children from Recife, Brazil. Cases were individuals diagnosed with tuberculosis in the control programme and controls were selected in the neighborhood of cases. Conditional logistic regression was used to identify risk factors. Results Cigarette smoking increased by 50% the risk of tuberculosis but that this was not statistically significant (OR = 1.6). Other risk factors were sleeping in the same house as a case of tuberculosis (OR = 31.6), living in a house with no piped water (OR = 7.7) (probably as a proxy for bad living conditions), illiteracy (OR = 3.7) and male sex (OR = 1.8). The increase in risk with living in houses with no piped water was much more marked in males. The proportion of cases of tuberculosis attributed to contact with someone with TB was 38% and to illiteracy, lack of piped water and smoking, 20%. Conclusion Household contact with tuberculosis, social factors and male sex play the biggest role in determining risk of TB disease among children and adolescents in the study. We recommend further research on the relationship of cigarette smoking on tuberculosis in adolescents, and on whether the sex differentials are more marked in bad living conditions. Separate studies should be conducted in older children and in adolescents. [ABSTRACT FROM AUTHOR]

This study aimed to generate equations for the indirect determination of lactate minimum (LM) intensity from short-distance maximal performances in 10- to 17-year-old swimmers. Seventy-one male (n = 41) and female (n = 30) competitive swimmers were divided into subgroups: one to generate predictive equations for LM (~70% of the sample), and the second to cross-validate the proposed equations (~30% of the sample). All participants swam maximally short-distance using front crawl stroke, and mean speed of the 100 (S100), 200 (S200), and 400 m (S400) performances were calculated in m·s-1. The LM protocol was measured after an 8 min of passive recovery from the S200, consisting of five progressive 200 m performances (~80%, 84%, 88%, 92%, and 96% of S200). Multiple linear regressions generated predictive equations for LM from single performances (S100, S200, and S400), also considering as independent variables age, pubic hair index, body mass, height, and body fat. The relationships between variables were examined using standard error of estimate (SEE). Nevertheless, age, biological maturation and anthropometric variables did not contribute to explain LM. Further, for both genders, S200 was the best predictor for LM, contributing to 95% of LM variation in males and 81% in females. The generated equations were: "LM = 0.24 + 0.67 × S200" (adjusted R2 = 0.95; SEE = 0.03 m·s-1) for boys and "LM = 0.13 + 0.79 × S200" (adjusted R2 = 0.81; SEE = 0.03 m·s-1) for girls. The predicted LM did not differ from the measured LM during cross-validation analysis. A single performance was found to be a valid LM predictor in 10- to 17-year-old swimmers regardless of gender, age and biological maturation. Thus, this is a practical, non-invasive, and economical alternative to estimate the aerobic capacity in young swimmers. [ABSTRACT FROM AUTHOR]

Objectives: to analyze the patient characteristics and evaluate overall survival, survival according to demographic variables, the most common tumor groups and subgroups, the stages of disease, and risk factors after at least 5 years among children and adolescents with cancer who were admitted to a state referral hospital between 2000 and 2005. Methods: the Kaplan-Meier method was employed to estimate survival. The survival curves were compared using the log-rank test. The Cox regression model was used to estimate the effect of independent variables. Results: a total of 571 new cases were registered. The most frequent cancer groups were leukemia (34%), lymphoma (18%), and central nervous system (CNS) tumors (15%). The overall survival rate was 59%. The risk factors associated with lower survival were an age of more than 4 years or less than 1 year, the presence of CNS tumors, and non-localized disease. Conclusion: although this was not a population-based study, it provides important epidemiological information about a state where population data on childhood and adolescent cancer are scarce and where hospital-based data do not exist. The survival rate found here should serve as a framework for future improvements, helping to guide policymakers focused on pediatric oncology in the state. [ABSTRACT FROM AUTHOR]

This study was carried out with eight psychologists and social workers who work in institutional shelters in a city in the interior of Rio Grande do Sul, with the purpose of understanding their views regarding the shelter, since the implementation of the New Adoption Law. The method applied was the semi directed interview with open questions and the results were analyzed by content analysis. Results evidence that institutional shelter is understood by the professionals as a midst of failure and overcoming, highlighting the movement of transformation of past practices referred to the orphanages, encouraged by the new National Adoption Law. Final considerations emphasize important changes in the scenery of institutionalization of children and adolescents in such context, and at the same time evidence the presence of practices and models historically built. Recognizing the presence of such practices is a path to overcome them. [ABSTRACT FROM AUTHOR]

This study aimed to understand the reasons for sexual exploitation of children and adolescents from the perception of Brazilian construction workers and compare groups of perpetrators and non-perpetrators. Two hundred eighty-eight construction workers were interviewed in different Brazilian regions. 67% of respondents indicated the involvement of co-workers with the issue and 25.4% reported their own involvement with it. Main variables correlated to the issue were the involvement with prostitutes, drug use and time out-of-home. Being involved with prostitutes was pointed as the most important variable explaining the involvement with the issue. Interventions in this area require more knowledge about the perpetrators, which may contribute to the development of more effective strategies of confrontation. [ABSTRACT FROM AUTHOR]

Introduction: Atherosclerosis represents a disease that begins in childhood, and alterations in lipid concentration play a fundamental role in the development of this condition. Objective: To evaluate which of the currently applied obesity parameters (the body index mass, the percentage of body fat, the waist circumference and the upper arm fat area) can predict the risk for dyslipidemia in Brazilian children and adolescents. Methods: Cross-sectional study, standardized anthropometric data and lipid profile were collected from 874 subjects between the ages of 6 and 19 years. Logistic regression models were used to evaluate the degree of association between the anthropometric measurements and the lipid profile, controlling for potentially confounding variables, such as age and gender. Results: Individuals with excess body weight, elevated percentage of body fat, waist circumference and upper arm fat above the 90lh percentile showed a positive correlation with alterations in the lipid profile. After adjusting for age and income, a body mass index above the 85th percentile and an elevated percentage of body fat were the variables most strongly associated with dyslipidemia in the youngest subjects (odds ratio (OR) = 2.00, p < 0.001 and OR = 1.47, p = 0.014, respectively). Children (64.5%) and adolescents aged 10-12 years (51.0%) had the highest rates of dyslipidemia. Conclusion: Compared with other variables, such as the percentage of body fat, the body mass index was the best predictor of dyslipidemia in children and adolescents. [ABSTRACT FROM AUTHOR]

This study analyzed the analyzed the relationship among motor performance, age and gender in a representative sample of schoolchildren from Montes Claros, Minas Gerais, Brazil. The sample consisted of 2849 subjects (1457 girls and 1392 boys), ranging in age from 6 to 18 years, selected randomly. The motor performance components were determined using a test battery consisting of five items: a) sit-and-reach, b) curl-ups, c) trunk-lift, d) push-ups, and e) PACER. The results show that, in almost all motor tests occurred differences intersexes from 6 years and up which increased abruptly after 12-13 years. In relation to chronological age, boys presented gradually better results from 6 to 18 years in the majority of the motor tests. Girls' best performance occurred around 11-12 years of age followed by a steady performance or a tendency to decline. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of metabolic syndrome (MetS) in schoolchildren from 6 to 16 years old, while considering their socio-economic status and other potential risk factors. Design: A cross-sectional study was conducted between April and November of 2005 in a semi-rural city with a total population of 13 000 inhabitants. Setting: The study was conducted in Maracai city, located in the Brazilian state of Sao Paulo. Subjects: Schoolchildren (n 2170) of both genders, corresponding to approximately 82% of all Maracai schoolchildren, were evaluated for components of MetS, as defined by the National Cholesterol Education Program; reference values for children and adolescents were adjusted for age and sex. Results: Overall, MetS prevalence was 3·6% (95% CI 2·9, 4·5) and did not differ statistically between genders, skin colour, between children and adolescents. However, when we analysed groups of subjects by weight, MetS prevalence progressively increased from 0·3% (95% CI 0·1, 0·8) in normal-weight subjects to 10·7% (95% CI 7·4, 14·8) and 34·5% (95% CI 25·9, 43·9) in overweight and obese subjects, respectively (both P,0·001 compared to normal-weight controls). When socio-economic classes were considered, 4·7% high-income students (95% CI 3·5, 6·2) had MetS, which was significantly greater than low-income students (2?7%; 95% CI 1?9, 3·9; P50·023). Conclusions: MetS prevalence was high in overweight and obese schoolchildren and these risk factors were present during childhood and adolescence. Changes in lifestyle and alimentary safety should be encouraged to avoid future cardiovascular morbidity and type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]