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Background: Physical education (PE) plays a critical role in the healthy development of youth; however, the influence of PE classes in helping to provide students with health-related behavior patterns is not clear. This study aims to analyze whether participation in PE classes is associated with health-related behavior among high school students. Methods: A total of 4210 students attending public high schools in Pernambuco (northeast of Brazil) were selected using random 2-stage cluster sampling. Data were collected by using the Global School-based Student Health Survey. The independent variable was the frequency of participation in PE classes, whereas physical activity, television viewing, smoking, and alcohol, fruit, vegetables and soda consumption were dependent variables. Logistic regressions were carried out to perform crude and adjusted analysis of the association between enrollment in PE classes and health-related behaviors. Results: Sixty-five percent of students do not take part in PE classes, with a significantly higher proportion among females (67.8%). It was observed that enrollment in PE classes was positively associated with physical activity, TV viewing, and fruit consumption, but was negatively associated with soda drinking. The likelihood of reporting being active and eating fruit on a daily basis was 27% and 45% higher, respectively, among those who participate in at least 2 classes per week in comparison with those who do not. Students who participate in PE classes had 28-30% higher likelihood of reporting lower TV viewing during week days. Conclusions: Findings suggest that higher levels of enrollment in PE classes could play a role in the promotion of health-related behaviors among high school students. (Contains 4 tables.)

OBJETIVO: Identificar a prevalência e analisar a associação entre comportamentos de risco à saúde, percepção de estresse e auto-avaliação do nível de saúde, em trabalhadores da indústria. MÉTODOS: Estudo epidemiológico transversal, utilizando questionário previamente testado em estudo-piloto realizado em Santa Catarina, Brasil. Foram coletados dados sobre fumo, abuso de álcool, consumo de frutas e verduras, atividades físicas, percepção de estresse e auto-avaliação do nível de saúde de 4.225 trabalhadores (67,5% homens e 32,5% mulheres). Os sujeitos foram recrutados por meio de amostragem por conglomerados em três estágios (erro de 5%). A análise estatística incluiu o teste de qui-quadrado e a análise de regressão logística, para um nível de significância de p

Baecke questionnaire have been widely used to assess physical activity. However, the role of educational level on validity and reliability of Baecke questionnaire is still not stablished, being a factor that can potentially influence the accuracy of self-reported measures. The present study aimed to verify the validity and reliability of Baecke questionnaire for the measurement of physical activity in community dwelling adults according to education level. The sample included 251 adults (42.4±17.0 years, 55% of women). Physical activity was self-reported by Baecke questionnaire and objectively measured by accelerometer. The education level (EL) was classified by years of study into low (<8 years), medium (8–11 years) and high (>11 years). A 7-day test-retest reliability was analyzed by intraclass correlation coefficient. The relationship, agreement and validity of the Baecke questionnaire against accelerometry were analyzed by Spearman's correlation, Kappa index, and ROC curve, respectively. The reliability of Baecke questionnaire were r = 0.97 (high EL), r = 0.78 (medium EL), and r = 0.68 (low EL). Sensitivity and specificity were 77% and 71% in high EL, 54% and 80% in medium EL and 33% and 89% in the low EL. Baecke questionnaire proved to be reliable and a valid measurement of habitual physical activity in adults with medium and high EL. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity in each domain (leisure, work, commuting, and household) is not completely independent. This study aimed to describe the clustering of physical inactivity in different domains and its association with sociodemographic factors among Brazilian industrial workers. Methods: This was a cross-sectional, population-based study using data from 23 Brazilian states and the Federal District collected via questionnaires between 2006 and 2008. Physical inactivity in each domain was defined as nonparticipation in specific physical activities. Clustering of physical inactivity was identified using the ratio of the observed (O) and expected (E) percentages of each combination. Multinomial logistic regression was used to identify sociodemographic factors with the outcome. Results: Among the 44,477 interviewees, most combinations exceeded expectations, particularly the clustering of physical inactivity in all domains among men (O/E = 1.37; 95% CI: 1.30; 1.44) and women (O/E = 1.47; 95% CI: 1.36; 1.60). Physical inactivity in 2 or more domains was observed more frequently in women, older age groups, individuals living without a partner, and those with higher education and income levels. Conclusions: Physical inactivity tends to be observed in clusters regardless of gender. Women and workers with higher income levels were the main factors associated with to be physically inactive in 2 or more domains. [ABSTRACT FROM AUTHOR]

Background: It is unclear how different exercise intensities affect cardiovascular disease (CVD) risk factors in obese adolescents. The aim of this study was to compare the effects of high-intensity (HIT) vs. low-intensity (LIT) aerobic training on CVD risk factors in obese adolescents. Methods: Forty-three obese adolescents (age: 15.7 ± 1.3 years, BMI: 34.3 ± 4.1kg/m²) participated this study either HIT (corresponding to ventilatory threshold I; N = 20) or LIT (20% below ventilatory threshold I; N = 23) for 12 weeks. All sessions were isocaloric (350 kcal). All participants received the same nutritional, psychological, and clinical counseling. Subjects were assessed in fatness, fitness, lipid profile, and glucose at baseline and after 12 weeks. The CVD risk factors assessed were waist circumference (WC), total cholesterol (TC), high-density lipoprotein (HDL), glucose, and fitness, which were single and clustered analyzed (z scores sum). Results: Body mass, Body Mass Index, fatness, and WC were improved (P < .001) in both groups. The sum of z scores (WC + TC + glucose-fitness-HDL) improved in both HIT (12 weeks = -2.16 SD; Cohen's d = .45) and LIT (12 weeks = -2.13 SD; Cohen's d = .60) without groups differences. Changes in fitness were associated with changes in WC (r = -.48; P = .003). Conclusion: HIT does not promote any additional improvements in CVD risk factors than LIT in obese adolescents. [ABSTRACT FROM AUTHOR]

We evaluated the association between weight status and motor competence from preschool age (3‐5 years of age) until middle childhood (7‐9 years of age). Longitudinal study with three to five‐year‐old preschool children (n = 1155) enrolled in public and private preschools in Recife, Brazil. Children were followed twice (2010, 2012, and 2014) for four years. Köperkoordinationstest für kinder (KTK) assessed the children's motor competence (KTK Motor Quotient). Weight status (underweight, normal weight, overweight, and obesity) was classified according to the children's sex and age. Preschool children with normal weight exhibited higher motor competence at 5‐7 years of age compared to preschool children with overweight (+3.73 MQ, P =.03) and obesity (+5.09 MQ, P <.01). Preschool children with normal weight presented higher motor competence at 7‐9 years of age compared to their peers with overweight (+6.00 MQ, P =.03) and obesity (+5.88 MQ, P =.01). Children with normal weight at 5‐7 years of age presented higher motor competence at 7‐9 years of age compared to their peers with overweight (+3.33 MQ, P =.02) and obesity (+4.00 MQ, P =.02). Independent of the childhood phase and extension of the period evaluated (2‐ or 4‐year period), children who had excessive weight (overweight or obesity) and changed their weight status to underweight or normal weight presented similar motor competence compared to children who continued underweight or normal weight. Weight status already at preschool age is an important predictor of the children's motor competence until middle childhood. Interventions improving the children's weight status, already at preschool age, might impact their motor competence development positively. [ABSTRACT FROM AUTHOR]

Background: A cross-cultural, randomized study was proposed to observe the effects of a school-based intervention designed to promote physical activity and healthy eating among high school students in 2 cities from different regions in Brazil: Recife and Florianopolis. The objective of this article is to describe the methodology and subjects enrolled in the project. Methods: Ten schools from each region were matched and randomized into intervention and control conditions. A questionnaire and anthropometry were used to collect data in the first and last month of the 2006 school year. The sample (n = 2155 at baseline; 55.7% females; 49.1% in the experimental group) included students 15 to 24 years, attending nighttime classes. The intervention focused on simple environmental/organizational changes, diet and physical activity education, and personnel training. Results: The central aspects of the intervention have been implemented in all 10 intervention schools. Problems during the intervention included teachers' strikes in both sites and lack of involvement of the canteen owners in schools. Conclusions: The Saude na Boa study provides evidence that public high schools in Brazil represent an important environment for health promotion. Its design and simple measurements increase the chances of it being sustained and disseminated to similar schools in Brazil. [ABSTRACT FROM AUTHOR]

Aim To assess the development of high dental anxiety and the factors that are associated with it over a 2-year period. Design This longitudinal study focused on 416 Brazilian children aged 5-7 years over 2 years. Interviews were conducted with the children's parents to investigate the children's health-related behaviours. Additionally, the children's dental caries experience was clinically evaluated to obtain information about DMFT/dmft (decayed, filled and missing teeth) indices. Using the Dental Anxiety Question, children whose parents responded 'yes' to the prompt 'Is he/she very afraid of going to the dentist?' were classified as having high dental anxiety. Multilevel mixed-effects logistic regression was used to analyse factors to determine the extent to which they were associated with high dental anxiety longitudinally. Results The prevalence of high dental anxiety in children at baseline was 16.2%, whereas it was 19.8% at follow-up. Additionally, 38% of the children with high dental anxiety at baseline still had the condition after two years, although 62% of them no longer had high dental anxiety. The incidence of high dental anxiety at 2-year follow-up was 15.0%. Children who used medication chronically had a 2.1 times greater likelihood of having high dental anxiety. Furthermore, children whose parents reported high dental anxiety had a 2.6 times greater likelihood of having high dental anxiety themselves. A one-unit increase in a child's dmft score increased the risk of high dental anxiety by 1.1 times at follow-up. Conclusion After two years, the incidence of high dental anxiety was 15.0%. Poor oral health, unstable general health and parents with high dental anxiety were factors that were associated with this type of anxiety in schoolchildren. It is important that dentists are aware of children's high dental anxiety and the associated factors so that they can appropriately intervene. Dentists fulfil an important role and should stimulate and promote good general hygiene habits that may prevent future problems. [ABSTRACT FROM AUTHOR]

The aim of the study was to test the performance of a new definition of metabolic syndrome (MetS), which better describes metabolic dysfunction in children. Methods. 15,794 youths aged 6–18 years participated. Mean z-score for CVD risk factors was calculated. Sensitivity analyses were performed to evaluate which parameters best described the metabolic dysfunction by analysing the score against independent variables not included in the score. Results. More youth had clustering of CVD risk factors (>6.2%) compared to the number selected by existing MetS definitions (International Diabetes Federation (IDF) < 1%). Waist circumference and BMI were interchangeable, but using insulin resistance homeostasis model assessment (HOMA) instead of fasting glucose increased the score. The continuous MetS score was increased when cardiorespiratory fitness (CRF) and leptin were included. A mean z-score of 0.40–0.85 indicated borderline and above 0.85 indicated clustering of risk factors. A noninvasive risk score based on adiposity and CRF showed sensitivity and specificity of 0.85 and an area under the curve of 0.92 against IDF definition of MetS. Conclusions. Diagnosis for MetS in youth can be improved by using continuous variables for risk factors and by including CRF and leptin. [ABSTRACT FROM AUTHOR]

Objective To establish reference values of heart rate variability (HRV) measures in a cohort of adolescent boys and to determine the relationship between HRV and the clustering of risk factors (RFs) for cardiovascular disease. Study design This cross-sectional study included 1152 adolescent boys (age: 16.6 ± 1.2 years old). Demographic data, health-related habits, obesity indicators, and blood pressure were evaluated. HRV measures of time (SD of all RR intervals, root mean square of the squared differences between adjacent normal RR intervals, and the percentage of adjacent intervals over 50 ms) and frequency domains were assessed (low [LF] and high [HF] frequency). Results The components of HRV were RR interval (827 ± 128 ms), SD of all RR intervals (61.9 ± 23.5 ms), root mean square of the squared differences between adjacent normal RR intervals (54.5 ± 29.4 ms), percentage of adjacent intervals over 50 ms (29.4 ± 20.4%), LF (53 ± 16 nu), HF (47 ± 16), and LF/HF (1.44 ± 1.08). Greater sympathetic and lower parasympathetic modulation at rest were associated with higher adiposity, higher blood pressure and physical inactivity. Adolescents with 2 or more RFs also presented lower HRV than subjects with no RFs (P < .001). Conclusions The study has provided descriptive indicators that help the interpretation of HRV results in adolescents. Lower HRV measures are associated with the clustering of cardiovascular RFs. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the direct and indirect associations between perceived environmental characteristics and psychosocial factors and physical activity levels in adolescents from Northeast Brazil. The sample was composed of 2,361 adolescents aged 14–19 years (56.6% female). Physical activity was measured using a questionnaire and environmental (perceived environmental characteristics) and psychosocial (self-efficacy, social support from parents and friends for physical activity) factors with previously validated scales. Perceived environmental characteristics were not directly associated with the levels of physical activity, but exhibited significant indirect associations, mediated by self-efficacy in males. Self-efficacy and social support were positively and directly associated with physical activity levels, and part of the associations between social support and physical activity was mediated by self-efficacy. Perception of self-efficacy and social support, important factors associated with physical activity levels in adolescents, should be the target of interventions aimed at increasing physical activity. Favorable environments for physical activity also need to be considered, since they have a positive influence on the self-efficacy of adolescents. [ABSTRACT FROM AUTHOR]

Objective: This is an analytic, interventional, cross sectional study to evaluate the risk factors of post-dural (post-lumbar) puncture headache (PDPH) and the validity of the diagnostic criteria for PDPH from the ICHD II.Methods: Six-hundred-and-forty patients (332 non-pregnant women and 308 men) aged 8–65 years underwent spinal anesthesia with Quincke 25G or 27G needles in elective surgery.Results: Forty-eight (7.5%) of the patients developed PDPH. The binary logistic regression analysis identified as risk factors: gender [11.1% female vs. 3.6% male, OR 2.25 (1.07–4.73); p = 0.03], age [11.0% 31–50 years of age vs. 4.2% others, OR 2.21 (1.12–4.36); p = 0.02], previous history of PDPH [26.4% positive vs. 6.2% negative, OR 4.30 (1.99–9.31); p < 0.01] and bevel orientation [16.1% perpendicular vs. 5.7% parallel, OR 2.16 (1.07–4.35); p = 0.03]. The period of latency between lumbar puncture and headache onset range from 6 to 72 hours and the duration from 3 to 15 days. In 34/48 (71%) patients with PDPH, at least one of the following was present: neck stiffness, tinnitus, hypoacusia, photophobia, or nausea.Conclusion: In conclusion, 14/48 patients (29%) suffered none of the above-mentioned symptoms, indicating that a significant number of patients may suffer from PDPH in the absence of any symptoms apart from the headache itself. This suggests that a further analyses of existing studies should be made to determine if a criteria change may need consideration. [ABSTRACT FROM PUBLISHER]

Objectives: Suicide is one of the leading causes of death in adolescence, and the second most common cause of death among young people. The objective of this study was to identify trends in suicidal ideation by sex and ascertain factors associated with this outcome. Methods: Secular trend study with statewide coverage conducted at 5-year intervals, with 4,207 adolescents (2006), 6,264 adolescents (2011) and 6,026 adolescents (2016). Logistic regression was used to evaluate the secular trend of suicidal ideation. Multilevel logistic regressions evaluated the factors associated with suicidal ideation in the survey conducted in 2016. Results: There was a positive trend in suicidal ideation prevalence in 2016 compared to the prevalence in 2006 and 2011, in both boys and girls. Low social support, poor sleep quality, and low parental supervision were associated with suicidal ideation in boys and girls. Exposure to violence and bullying was associated with suicidal ideation only in girls. TV time and computer and videogame time were not associated with suicidal ideation in boys or girls. Conclusion: There is an alarming trend of increased suicidal ideation in adolescents. Several dimensions were associated with suicidal ideation in adolescents, especially social support, sleep quality, and parental supervision. [ABSTRACT FROM AUTHOR]