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Resumo O Programa Criança Feliz (PCF) atinge 1,4 milhão de crianças brasileiras menores de três anos com visitas domiciliares visando o desenvolvimento neuropsicomotor. Com base em modelo conceitual, avaliou-se implementação e impacto do PCF em estudo randomizado, em 30 municípios. Ao todo 3.242 crianças foram alocadas para o grupo intervenção (GI) ou controle (GC), sendo 80,0% acompanhadas prospectivamente durante três anos. O desenvolvimento foi avaliado pelo Ages and Stages Questionnaire (ASQ3). Análises por intenção de tratar mostraram escores médios de 203,3 no GI e 201,3 no GC. Análises adicionais com variáveis instrumentais e emparelhamento por escores de propensão tampouco mostraram efeito, uma vez que o número de contatos recebidos não esteve associado aos escores ASQ3. Tampouco foi observado impacto sobre estimulação, interações responsivas ou atributos psicológicos das crianças. As visitas foram interrompidas durante 12 meses devido à COVID-19, sendo substituídas por contatos virtuais. O estudo de implementação revelou baixa cobertura no GI, contaminação do GC, deficiências na gestão e baixa qualidade das visitas em muitos municípios. O estudo não demonstrou impacto do PCF implementado sob condições de rotina e fornece elementos para seu aprimoramento. Abstract The Happy Child Program (Programa Criança Feliz - PCF, in Portuguese) reaches 1.4 million Brazilian children under three years of age with home visits aimed at promoting neuropsychomotor development. Based on a conceptual model, PCF implementation and impact were evaluated in a randomized study in 30 municipalities. A total of 3,242 children were allocated to the intervention (IG) or control (CG) group, 80.0% of whom were prospectively followed up from late 2018 to late 2021. Development was assessed by the Ages and Stages Questionnaire (ASQ3). During the three-year study period, visits were replaced by virtual contacts for an average of 12 months due to COVID-19. At the endline survey, intent-to-treat analyses showed mean scores of 203.3 in the IG and 201.3 in the CG. Additional analyses using instrumental variables and propensity scores matching also showed no effect, since the number of contacts with the program was not associated with ASQ3 scores. No impact was observed on stimulation, responsive interactions or psychological attributes of children. The implementation study revealed low coverage in the IG, contamination of the CG, deficiencies in management and low quality of visits in many municipalities. The study did not demonstrate an impact of PCF implemented under routine conditions, but provides elements for its improvement.

Resumo O Programa Criança Feliz (PCF) atinge 1,4 milhão de crianças brasileiras menores de três anos com visitas domiciliares visando o desenvolvimento neuropsicomotor. Com base em modelo conceitual, avaliou-se implementação e impacto do PCF em estudo randomizado, em 30 municípios. Ao todo 3.242 crianças foram alocadas para o grupo intervenção (GI) ou controle (GC), sendo 80,0% acompanhadas prospectivamente durante três anos. O desenvolvimento foi avaliado pelo Ages and Stages Questionnaire (ASQ3). Análises por intenção de tratar mostraram escores médios de 203,3 no GI e 201,3 no GC. Análises adicionais com variáveis instrumentais e emparelhamento por escores de propensão tampouco mostraram efeito, uma vez que o número de contatos recebidos não esteve associado aos escores ASQ3. Tampouco foi observado impacto sobre estimulação, interações responsivas ou atributos psicológicos das crianças. As visitas foram interrompidas durante 12 meses devido à COVID-19, sendo substituídas por contatos virtuais. O estudo de implementação revelou baixa cobertura no GI, contaminação do GC, deficiências na gestão e baixa qualidade das visitas em muitos municípios. O estudo não demonstrou impacto do PCF implementado sob condições de rotina e fornece elementos para seu aprimoramento.

Investigate factors associated with symptoms of postpartum depression in mothers from families in social vulnerability.Information was used from the baseline of a randomized trial to assess a child development program that enrolled 3,242 children12 months of age from beneficiary families of the Bolsa Família Program residing in 30 municipalities (counties) in six states of Brazil. The Edinburgh Postnatal Depression Scale (EPDS) was applied to the mothers, and depression was defined as score ≥10. Information on the mother (schooling, age, parity, marital status, skin color, smoking, number of prenatal appointments, and planning of the pregnancy), family (paternal schooling, household crowding, support from the child's father and the family during the pregnancy, and number of children under 7 years living in the household), and infant (sex, gestational age, birthweight, Apgar score, and child's age at the time of the interview) was collected. Prevalence rates for depressive symptoms were calculated with crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI), using hierarchical logistic regression, in a multilevel model.The analysis included 3,174 mothers with information on EPDS. The interviews were conducted on average 7.9 months (standard deviation= 2.9) after childbirth. Overall prevalence of depressive symptoms was 26.5% (25.0-28.1%). In the adjusted analysis, higher parity was associated with higher odds of postpartum depression (p0.001). Women with ≥3 previous deliveries showed an odds 84% higher of presenting depressive symptoms (OR= 1.84; 1.43-2.35) than primiparae. Higher maternal and paternal schooling, presence of husband or partner, and having received support from the child's father and the family during the pregnancy were protective factors against postpartum depression.The study showed high prevalence of postpartum depressive symptoms. Promotion of parental education, alongside with the promotion of support to the woman during pregnancy by the child's father and by the family, as well as family planning leading to birth spacing are measures that may help to prevent postpartum depressive symptoms.

Resumo Objetivo Identificar os fatores associados à qualidade da dieta de estudantes do 9º ano da rede municipal de ensino de Pelotas, Rio Grande do Sul, Brasil. Métodos Estudo transversal, realizado em 2019. As informações alimentares foram coletadas por formulário de frequência alimentar, e a qualidade da dieta foi avaliada mediante índice desenvolvido pelos autores. A dieta foi classificada como de baixa, intermediária ou alta qualidade. A associação foi avaliada por regressão logística multinomial. Resultados Os 808 adolescentes avaliados obtiveram média de 16,0 pontos (desvio-padrão=4,1) no índice desenvolvido. A alta qualidade da dieta mostrou-se associada a experimentação de tabaco [razão de chances, ou odds ratio (OR) 2,92; intervalo de confiança de 95% (IC95%) 1,74;4,92] e prática de atividade física no lazer (OR=1,65; IC95% 1,15;2,38). Conclusão Destaca-se a importância do incentivo à prática de atividade física, monitoramento de comportamentos de riscos nos adolescentes e promoção do consumo de alimentos considerados saudáveis. Resumen Objetivo Identificar factores asociados a calidad de la dieta de estudiantes de 9º ano de escuelas municipales de Pelotas, Rio Grande do Sul. Métodos Estudio transversal, realizado en 2019. La información dietética se recopiló mediante Formulario de Frecuencia de Alimentos y la calidad de la dieta se evaluó mediante índice desarrollado por los autores. La dieta fue clasificada como de baja, intermedia o de alta calidad. La asociación se investigó mediante regresión logística multinomial. Resultados Los 808 adolescentes evaluados tuvieron en media 16,0 puntos (desvío-estándar=4,1) en el índice desarrollado. La alta calidad de la dieta se asoció con experimentación de tabaco [OR=2,92; intervalo de confianza del 95% (IC95%) 1,74;4,92] y práctica de actividad física en el tiempo libre (OR=1,65; IC95% 1,15;2,38). Conclusión Se destaca la importancia de fomentar la práctica de actividad física, el seguimiento de conductas de riesgo en adolescentes y promover el consumo de alimentos saludables. Abstract Objective To identify the factors associated with the diet quality among 9th grade students in the municipal education system of Pelotas, state of Rio Grande do Sul, Brazil. Methods This was a cross-sectional study, conducted in 2019. Food information was collected using a food frequency questionnaire, and diet quality was assessed through an index developed by the authors. Diet was classified as low, intermediate or high quality. The association was assessed using multinomial logistic regression. Results The 808 adolescents evaluated obtained a mean score of 16.0 points (deviation-standard=4.1) according to the developed index. The high diet quality was associated with tobacco experimentation [odds ratio (OR) 2.92; 95% confidence interval (95%CI) 1.74;4.92] and leisure-time physical activity (OR=1.65; 95%CI 1.15;2.38). Conclusion We highlighted the importance of encouraging physical activity practice, monitoring risk behaviors among adolescents and promoting the consumption of healthy food.

OBJETIVO: Avaliar a associação da idade gestacional (IG) e crescimento intrauterino com a composição corporal aos 11 anos de idade. MÉTODO: Análise de dados da coorte de nascimentos de Pelotas de 2004, cujos desfechos foram massa gorda (MG, kg), índice de massa gorda (IMG, kg/m2), massa livre de gordura (MLG, kg), índice de massa livre de gordura (IMLG, kg/m2) – medidos por pletismografia por deslocamento de ar –, e índice de massa corporal para idade (IMC/Idade, escore-Z). Sendo as exposições de interesse o índice gestacional (IG) de nascidos com menos de 33 semanas, de 34 a 36 e de 37 a 41, e crescimento intrauterino categorizado em pequeno para a idade gestacional (PIG), adequado (AIG) e grande (GIG). Para comparar médias, utilizou-se análise de variância e, para avaliar a força de associação, regressão linear. As análises foram ajustadas de acordo com variáveis coletadas ao nascer, como renda familiar mensal, características maternas – escolaridade, idade, índice de massa corporal (IMC) pré-gestacional, ganho de peso na gestação, tabagismo na gestação, tipo de parto e paridade – e características dos adolescentes – cor da pele e peso ao nascer. Para análise, o MG e o IMG sofreram transformação logarítmica devido a assimetria dos dados. RESULTADOS: Foram analisados 3.401 adolescentes, entre meninos e meninas nascidos com menos de 33 semanas, com médias de MG e MLG menores que as dos nascidos(as) a termo. Porém, nas análises ajustadas, não houve associação entre IG e qualquer um dos desfechos em ambos os sexos. Meninos GIG apresentaram IMG 10,5% maior (p = 0,026) e +0,3 escore-Z de IMC/Idade (p = 0,019) em relação aos AIG, e meninas GIG apresentaram +0,3 kg/m2 de IMLG (p = 0,039) do que as AIG. CONCLUSÃO: A IG não se associou à composição corporal aos 11 anos. Entretanto, meninos GIG apresentaram maiores IMG e escore-Z de IMC/Idade e meninas GIG, maior IMLG, quando comparados aos AIG.

To identify the factors associated with the diet quality among 9th grade students in the municipal education system of Pelotas, state of Rio Grande do Sul, Brazil.This was a cross-sectional study, conducted in 2019. Food information was collected using a food frequency questionnaire, and diet quality was assessed through an index developed by the authors. Diet was classified as low, intermediate or high quality. The association was assessed using multinomial logistic regression.The 808 adolescents evaluated obtained a mean score of 16.0 points (deviation-standard=4.1) according to the developed index. The high diet quality was associated with tobacco experimentation [odds ratio (OR) 2.92; 95% confidence interval (95%CI) 1.74;4.92] and leisure-time physical activity (OR=1.65; 95%CI 1.15;2.38).We highlighted the importance of encouraging physical activity practice, monitoring risk behaviors among adolescents and promoting the consumption of healthy food.Identificar os fatores associados à qualidade da dieta de estudantes do 9º ano da rede municipal de ensino de Pelotas, Rio Grande do Sul, Brasil.Estudo transversal, realizado em 2019. As informações alimentares foram coletadas por formulário de frequência alimentar, e a qualidade da dieta foi avaliada mediante índice desenvolvido pelos autores. A dieta foi classificada como de baixa, intermediária ou alta qualidade. A associação foi avaliada por regressão logística multinomial.Os 808 adolescentes avaliados obtiveram média de 16,0 pontos (desvio-padrão=4,1) no índice desenvolvido. A alta qualidade da dieta mostrou-se associada a experimentação de tabaco [razão de chances, ou odds ratio (OR) 2,92; intervalo de confiança de 95% (IC95%) 1,74;4,92] e prática de atividade física no lazer (OR=1,65; IC95% 1,15;2,38).Destaca-se a importância do incentivo à prática de atividade física, monitoramento de comportamentos de riscos nos adolescentes e promoção do consumo de alimentos considerados saudáveis.Identificar factores asociados a calidad de la dieta de estudiantes de 9º ano de escuelas municipales de Pelotas, Rio Grande do Sul.Estudio transversal, realizado en 2019. La información dietética se recopiló mediante Formulario de Frecuencia de Alimentos y la calidad de la dieta se evaluó mediante índice desarrollado por los autores. La dieta fue clasificada como de baja, intermedia o de alta calidad. La asociación se investigó mediante regresión logística multinomial.Los 808 adolescentes evaluados tuvieron en media 16,0 puntos (desvío-estándar=4,1) en el índice desarrollado. La alta calidad de la dieta se asoció con experimentación de tabaco [OR=2,92; intervalo de confianza del 95% (IC95%) 1,74;4,92] y práctica de actividad física en el tiempo libre (OR=1,65; IC95% 1,15;2,38).Se destaca la importancia de fomentar la práctica de actividad física, el seguimiento de conductas de riesgo en adolescentes y promover el consumo de alimentos saludables.

Background: Our aim was to investigate the association between preterm birth and body fat at 6, 18, and 30 years of age using data from three population-based birth cohort studies. Methods: Information on gestational age (GA) gathered in the hospital of birth in the first 24-hours after the delivery was obtained for all live births occurring in the city of Pelotas, Brazil, in the years 2004, 1993 and 1982. GA was defined by the date of last menstrual period and was later categorized in ≤33, 34-36 and ≥37 weeks. Body fat was assessed by air-displacement plethysmography. Outcomes included fat mass (FM, kg), percent fat mass (%FM), fat mass index (FMI, kg/m2), and body mass index (BMI, kg/m2 at 18 years in the 1993 cohort and at 30 years in the 1982 cohort; and BMI Z-score, at 6 years in the 2004 cohort). Crude and adjusted linear regression provided beta coefficients with 95% confidence intervals (95%CI).Results: A total of 3036, 3027, and 2417 participants, respectively, from the 2004, 1993, and 1982 cohorts were analyzed. At 6 years, boys born at 34-36 weeks GA presented lower adjusted mean %FM (β: -2.91%; -4.45--1.36), FMI (β: -0.70 kg/m2 ; -1.13--0.28) and BMI Z-score (β: -0.48 kg/m2; -0.79--0.16), when compared to boys born at term (≥37). At 30 years, FM (15.6kg; 0.40-30.90), %FM (13.65%; 1.38-25.92) and FMI (5.3kg/m2; 0.30-10.37) were higher among males born at ≤33 weeks, with no statistical difference as compared to those born at term. No association was found between GA and body fat at the 1993 cohort (18 years) for both sexes. Conclusions: Given the large number of preterm infants born each year, prevention of prematurity is essential as there are possible links between body composition and diseases later in life.

RESUMO: Objetivos: Descrever a ocorrência simultânea de fatores de risco para doenças crônicas não transmissíveis e os fatores associados à simultaneidade dessas prevalências em adultos residentes na zona rural de um município no sul do Brasil. Métodos: Trata-se de estudo transversal com 1.445 adultos da zona rural de Pelotas, RS. Foram considerados quatro fatores de risco: tabagismo, consumo de álcool, inatividade física e consumo inadequado de legumes/verduras. Para verificar a ocorrência simultânea, utilizou-se análise de clusters. A associação foi avaliada por regressão ordinal, obtendo-se estimativas em razões de odds. Resultados: Dos quatro fatores de risco avaliados, três foram mais prevalentes entre os homens, sendo apenas inatividade física maior entre as mulheres. Na análise de clusters, consumo de álcool + tabagismo + consumo inadequado de vegetais foi a única combinação que apresentou prevalência observada significativamente maior que a esperada (O/E = 2,67; IC95% 1,30; 5,48), sendo superior a encontrada em outro estudo no sul do país, dado que pode ser justificado pois tal estudo incluiu o consumo de frutas além de ter avaliado população urbana, enquanto para este estudo avaliou-se apenas a população rural. Após ajuste, os homens, indivíduos solteiros, de cor da pele preta, parda ou outra, com baixa escolaridade, pior condição socioeconômica, pior percepção de saúde e que não desenvolviam atividades rurais apresentaram maior odds ratio de acúmulo de fatores de risco. Conclusão: Os achados evidenciam a importância do desenvolvimento de ações prioritárias em relação à saúde da população rural com atenção específica aos subgrupos de maior risco identificados. ABSTRACT: Objectives: To describe the occurrence of simultaneous risk factors for chronic noncommunicable diseases, and factors associated with these prevalences in rural adults of a Southern Brazilian city. Methods: The design of this study was cross-sectional with a sample of 1,445 adults from the rural area of Pelotas, RS. Four risk factors were considered: smoking, alcohol consumption, physical inactivity and inadequate consumption of vegetables. To verify the simultaneous occurrence of the outcomes, a cluster analysis was used. The association was tested by ordinal regression resulting in odds ratios. Results: Among the four risk factors evaluated, three were the most prevalent among men, and only physical inactivity was greater among women. In the cluster analysis, only the combination of alcohol consumption + smoking + inadequate vegetable consumption presented an observed prevalence that was significantly higher than the expected (O/E = 2.67, 95%CI 1.30, 5.48), and higher than another study in the south of the country. This can be justified because that study included an evaluation of urban dwellers and the consumption of fruits. After adjustment, men, single individuals, non-white people, those with less schooling, those with a worse socioeconomic status, those who reported poor perception of health, and those who do not work in specifically rural activities had a greater probability of having the simultaneity of risk factors. Conclusion: The results show the importance of developing priority actions regarding the health of rural populations with special attention to the subgroups with an identified higher risk.

Objective: To evaluate all-cause mortality in approximately three years of follow-up and related sociodemographic, behavioral and health factors in community-dwelling older adults in Pelotas, RS. Methods: This was a longitudinal observational study that included 1,451 older adults (≥ 60 years) who were interviewed in 2014. Information on mortality was collected from their households in 2016–2017 and confirmed with the Epidemiological Surveillance department of the city and by documents from family members. Associations between mortality and independent variables were assessed by crude and multiple Cox regression, with hazard ratio with respective 95% confidence intervals (95%CI). Results: Almost 10% (n = 145) of the participants died during an average of 2.5 years of follow-up, with a higher frequency of deaths among males (12.9%), ?80 years (25.2%), widowhood (15.0%), no education (13.8%) and who did not work (10.5%). Factors associated with higher mortality were: being a male (HR = 2.8; 95%CI 1.9 – 4.2), age ?80 years (HR = 3.9; 95%CI 2.4 – 6.2), widowhood (HR = 2.2; 95%CI 1.4 – 3.7), physical inactivity (HR = 2.3; 95%CI 1.1 – 4..6), current smoking (HR = 2.1; 95%CI 1.2 – 3.6), hospitalizations in the previous year (HR = 2.0; 95%CI 1.2 – 3.2), depressive symptoms (HR = 2.0; 95%CI 1.2 – 3,4) and dependence for two or more daily life activities (HR = 3.1; 95%CI 1,7 – 5.7). Conclusion: The identification of factors that increased the risk of early death makes it possible to improve public policies aimed at controlling the modifiable risk factors that can lead to aging with a better quality of life.

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

Resumo Objetivo analisar a associação entre qualidade da dieta e multimorbidade entre idosos. Métodos estudo transversal com idosos (≥60 anos) de Pelotas, RS, Brasil, 2014; consumo alimentar avaliado por Questionário de Frequência Alimentar reduzido, qualidade da dieta calculada pelo índice de qualidade da dieta (IQD-I) e pela pontuação atribuída aos alimentos; multimorbidade (≥5 doenças) autorrelatada; utilizou-se regressão de Poisson para obter razões de prevalência e intervalos de confiança (IC 95% ) brutos e ajustados. Resultados foram incluídos 1.426 idosos; homens que consumiram alimentos integrais (1 a 6 dias) tiveram maior probabilidade (RP=1,64 IC 95% 1,21;2,23) de multimorbidade; idosos que consumiram carne ao menos semanalmente apresentaram menor probabilidade de multimorbidade (RP homens =0,68 IC 95% 0,51;0,92; RP mulheres =0,70 IC 95% 0,61;0,81); não houve associação entre IQD-I e multimorbidade. Conclusão embora o consumo da maioria dos alimentos não se tenha associado à multimorbidade, os resultados geram reflexões sobre atuais hábitos alimentares e multimorbidade em idosos, pertinentes de discussão pelos gestores de saúde. Resumen Objetivo analizar la asociación entre la calidad de la dieta (ICD-I) y la multimorbilidad entre adultos mayores. Métodos estudio transversal en ancianos (≥60 años) de Pelotas, RS, Brasil, 2014; consumo de alimentos evaluado por Cuestionario de Frecuencia Alimentaria reducida; calidad de la dieta calculada por el índice de calidad de la dieta (IQD-I) y por la puntuación atribuida a los alimentos; multimorbilidad (≥5 enfermedades) autoinformada; se usó la regresión de Poisson para obtener relaciones de prevalencia e intervalos de confianza (IC95%), brutos y ajustados. Resultados se incluyeron 1.426 ancianos; los hombres que consumieron alimentos integrales (1 a 6 días) tuvieron mayor probabilidad de multimorbilidad (RP=1,64 IC95%1,21;2,23]); los ancianos, que consumieron carne por lo menos semanalmente presentaron menor probabilidad de multimorbilidad (RPhombres=0,68 IC95%0,51;0,92; RPmujeres=0,70 IC95%0,61;0,81); no hubo asociación entre ICD-I y multimorbilidad. Conclusión aunque el consumo de la mayoría de los alimentos no se ha asociado con la multimorbilidad, los resultados generan reflexiones sobre los hábitos alimenticios actuales y la multimorbilidad en los adultos mayores, pertinentes de ser discutidos por los administradores de salud. Abstract Objective to analyze association between diet quality and multimorbidity among elderly individuals. Methods this was a cross-sectional study of elderly people aged 60 years or older in Pelotas, RS, Brazil, 2014; food consumption was assessed using an abridged Food Frequency Questionnaire; diet quality according to the diet quality index (DQI-E) and scores given to food items; multimorbidity (≥5 diseases) was self-reported; Poisson Regression was used to obtain crude and adjusted prevalence ratios and 95% confidence intervals. Results 1,426 elderly people were included; men who consumed wholefoods (1 to 6 days) were more likely to have multimorbity (PR=1.64 95%CI 1.21;2.23]); those who ate meat at least weekly were less likely to have multimorbity (PRmen=0.68 95%C I0.51;0.92]; PRwomen=0.70 95%CI 0.61;0.81); no association was found between DQI-E and multimorbidity. Conclusion although consumption of most foods was not associated with multimorbidity, the results have produced reflections about dietary habits that are pertinent for discussion by health service managers

To estimate the prevalence of pesticide exposure and associated factors among rural residents.A population-based, cross-sectional study conducted with 1,518 individuals in 2016. We randomly selected 24 census tracts from the eight rural districts of the city of Pelotas, RS. All individuals aged 18 years or older, living in the randomly selected households were eligible. A descriptive analysis was performed and the prevalence of contact with pesticides was presented. The association between outcome and independent variables was analyzed using Poisson regression according to the hierarchical model. The variables were all adjusted to the same level, including those at the previous level and those with p0.20 were kept in the model.The prevalence of contact with pesticides in the past year was 23.7% and among the participants, 5.9% reported having pesticide poisoning at some time in their lives. The probability of contact with pesticides in the past year was higher among men (PR=2,00; 95%CI 1.56 - 2.56), among those aged 40-49 years (PR = 2.00; 95%CI 1.12 - 1.80), among individuals with lower levels of education (PR = 2.06; 95%CI 1.39 - 3.10), in those who performed rural work (PR = 2.87; 95%CI 1.39 - 3.10) and in those who had lived in rural areas all their lives (PR = 1.28 95%CI 1.00 - 1.66).Approximately one in four adults in rural Pelotas had come into contact with pesticides in the year before the study. The findings show the existence of social inequalities related to exposure to pesticides and provide information for action aimed at reducing exposure and poisoning from these products.

To describe the occurrence of simultaneous risk factors for chronic noncommunicable diseases, and factors associated with these prevalences in rural adults of a Southern Brazilian city.The design of this study was cross-sectional with a sample of 1,445 adults from the rural area of Pelotas, RS. Four risk factors were considered: smoking, alcohol consumption, physical inactivity and inadequate consumption of vegetables. To verify the simultaneous occurrence of the outcomes, a cluster analysis was used. The association was tested by ordinal regression resulting in odds ratios.Among the four risk factors evaluated, three were the most prevalent among men, and only physical inactivity was greater among women. In the cluster analysis, only the combination of alcohol consumption + smoking + inadequate vegetable consumption presented an observed prevalence that was significantly higher than the expected (O/E = 2.67, 95%CI 1.30, 5.48), and higher than another study in the south of the country. This can be justified because that study included an evaluation of urban dwellers and the consumption of fruits. After adjustment, men, single individuals, non-white people, those with less schooling, those with a worse socioeconomic status, those who reported poor perception of health, and those who do not work in specifically rural activities had a greater probability of having the simultaneity of risk factors.The results show the importance of developing priority actions regarding the health of rural populations with special attention to the subgroups with an identified higher risk.

Purpose Urban violence is a major problem in Brazil and may contribute to mental disorders among victims. The aim of this study was to assess the association between robbery victimisation and mental health disorders in late adolescence. Methods At age 18 years, 4106 participants in the 1993 Pelotas Birth Cohort Study were assessed. A questionnaire about history of robbery victimisation was administered, the Self-Report Questionnaire was used to screen for common mental disorders, and the Mini International Neuropsychiatric Interview was used to assess major depressive disorder and generalised anxiety disorder. Cross-sectional prevalence ratios between lifetime robbery victimisation and mental disorders were estimated using Poisson regression with robust standard errors, adjusting for socioeconomic variables measured at birth and violence in the home and maltreatment measured at age 15. Results There was a dose–response relationship between frequency of lifetime robberies and risk of mental disorders. Adolescents who had been robbed three or more times had twice the risk (PR 2.04; 95% CI 1.64–2.56) for common mental disorders, over four times the risk for depression (PR 4.59; 95% CI 2.60–8.12), and twice the risk for anxiety (PR 1.93; 95% CI 1.06–3.50), compared with non-victims, adjusting for covariates. Experiencing frequent robberies had greater impact on common mental disorders than experiencing an armed robbery. Population attributable fractions with regard to robbery were 9% for common mental disorders, 13% for depression, and 8% for anxiety. Conclusions Robberies are associated with common mental disorders in late adolescence, independently of violence between family members. Reducing urban violence could significantly help in preventing common mental illnesses. Electronic supplementary material The online version of this article (10.1007/s00127-018-1488-z) contains supplementary material, which is available to authorized users.

Objective The number of chronic diseases is associated with the reduction in muscle mass and strength in older people (≥60 y of age). The purpose of this study was to asses the association between multimorbidities and handgrip strength in older community-dwelling individuals from a city in southern Brazil, identifying potential differences according to sex and loss of muscle mass. Methods This was a cross-sectional population-based study among older individuals living in the urban area of Pelotas, Rio Grande do Sul, Brazil. Grip strength was assessed with digital dynamometers according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) to define dynapenia. Multimorbidity was defined by self-report as the presence of at least 5 diseases diagnosed by a physician. Covariates of the study were age, sex, socioeconomic status, schooling, marital status, nutritional status, alcohol consumption, and smoking habits. Statistical analyses were stratified according to the presence of myopenia (low muscle mass). Results We received completed information from 1336 individuals ≥60 y of age. Multimorbidity was 50% and 16% more prevalent, respectively, among men and women classified in the lower quartile of manual grip strength (prevalence ratio [PR], 1.50; 95% confidence interval [CI], 1.15–1.95 for men and PR, 1.16; 95% CI, 1.03–1.32 for women) compared with those from the upper quartile. Among men without myopenia, the presence of dynapenia increased the odds of having multimorbidity (PR, 1.42; 95% CI, 1.18–1.71). Among those with myopenia, there was a 10% increase in the prevalence of multimorbidity only for women with dynapenia (PR, 1.10; 95% CI, 1.00–1.21). Conclusion Results from the present study indicated an association between manual grip strength and multimorbidity among this population, and the effect measures were greater in men. Manual grip strength proved to be a good marker of health in this population, especially in those who did not present with myopenia.

Objetivo: Avaliar o consumo de alimentos não saudáveis e fatores associados em adolescentes estudantes do ensino médio integrado da rede pública federal de quatro cidades do sul do país. Métodos: Estudo transversal de base escolar realizado com adolescentes. O consumo alimentar foi avaliado pelo Formulário de Marcadores de Consumo, autoaplicado, referente à semana anterior à entrevista. Foi realizada análise descritiva das variáveis estudadas, além da associação entre o consumo alimentar e as variáveis independentes (sexo, idade, ano escolar, índice de bens e prática de atividade física). Foi utilizado teste Qui-quadrado para heterogeneidade ou tendência linear (p