Socioeconomic Status, Urbanization and Executive Functions Development: Differences Between Urban and Rural Children / Status Socioeconômico, Urbanização e Desenvolvimento de Funções Executivas: Diferenças entre Crianças Urbanas e Rurais

Abstract Socioeconomic Status (SES) has been linked to the development of Executive Functions (EF) usually by means of parental education and family income. Living conditions related to urbanization characteristics are rarely considered. This cross-sectional study investigated the performance in EF tasks of 99 Brazilian children aged 6 to 8 years residing in rural and urban regions. Results showed that children who lived in the rural area performed better than those who lived in the industrial city in the working memory and inhibitory tasks. Social interactions and urbanization conditions, such as parent occupations and social stratification, may explain these differences. Therefore, urbanization conditions of locations where families live should be considered in future studies concerning the influences of SES in EF development.

Resumo O Status Socioeconômico (SES) tem sido vinculado ao desenvolvimento das Funções Executivas (FE), geralmente por meio da educação dos pais e da renda familiar. As condições de vida e a urbanização raramente são consideradas. Este estudo transversal investigou o desempenho em tarefas de FE de 99 crianças brasileiras de 6 a 8 anos residentes em regiões rurais e urbanas. Os resultados demonstram crianças residentes na zona rural obtendo desempenho superior às em cidade industrial em memória operacional e tarefas inibitórias. As interações sociais e as condições de urbanização, como ocupações dos pais e estratificação social, podem explicar essas diferenças. Portanto, as condições de urbanização devem ser consideradas em estudos futuros sobre as influências do SES no desenvolvimento do EF.

Abordagem cognitivo-comportamental na escola: possibilidades de intervenção / Cognitive behavioral approach at school: possibilities for intervention

RESUMO O objetivo deste artigo é descrever técnicas grupais desenvolvidas nas turmas do 3º e 6º ano do ensino fundamental de uma escola municipal situada em uma cidade do interior do estado do Rio Grande do Sul. As técnicas tiveram o intuito de intervir em demandas escolares associadas a relações interpessoais e comportamentos desafiadores e opositores tendo como base os pressupostos teóricos e práticos da abordagem cognitivo-comportamental. Os grupos foram homogêneos, com média de 10 estudantes, com objetivo de psicoeducação e de orientação/ treinamento, visando a promoção de saúde na escola. A experiência relatada colabora com a práxis metodológica da área a qual pertence, oferecendo relatos de práticas singulares que podem ser adaptadas a outros contextos e demandas escolares similares.

ABSTRACT The objective of this article is to describe group techniques that have developed in the 3rd and 6th grade classes of a municipal school located in a city in the state of Rio Grande do Sul. These techniques, based on the theoretical and practical assumptions of cognitive behavioral theory, have intended to intervene in school demands related to interpersonal relationships and challenging behavior and opposing behaviors. The groups have been homogeneous, with an average of 10 students, aiming at psychoeducation and orientation / training, with the objective at to promote health at school. The reported experience collaborates with the methodological praxis of the area to which it belongs, offering reports of singular practices that can be adapted to other similar contexts and school demands.

Identificação de grupos prioritários para a vacinação contra COVID-19 no Brasil / Identificación de grupos prioritarios para la vacunación contra la COVID-19 en Brasil / Identification of priority groups for COVID-19 vaccination in Brazil

Em um contexto de transmissão comunitária e escassez de vacinas, a vacinação contra a COVID-19 deve focar na redução direta da morbidade e da mortalidade causadas pela doença. Portanto, é fundamental a definição de grupos prioritários para a vacinação pelo Programa Nacional de Imunizações (PNI), baseada no risco de hospitalização e óbito pela doença. Para tal, calculamos o sobrerrisco por sexo, faixa etária e comorbidades por meio dos registros de hospitalização e óbito por síndrome respiratória aguda grave com confirmação de COVID-19 (SRAG-COVID) em todo o Brasil nos primeiros seis meses de epidemia. Apresentaram maior sobrerrisco pessoas do sexo masculino (hospitalização = 1,1 e óbito = 1,2), pessoas acima de 45 anos para hospitalização (SRfe variando de 1,1 a 8,5) e pessoas acima de 55 anos para óbitos (SRfe variando de 1,5 a 18,3). Nos grupos de comorbidades, doença renal crônica, diabetes mellitus, doença cardiovascular e pneumopatia crônica conferiram sobrerrisco, enquanto para asma não houve evidência. Ter doença renal crônica ou diabetes mellitus e 60 anos ou mais mostrou-se um fator ainda mais forte, alcançando sobrerrisco de óbito 14 e 10 vezes maior do que na população geral, respectivamente. Para todas as comorbidades, houve um sobrerrisco mais alto em idades maiores, com um gradiente de diminuição em faixas mais altas. Esse padrão se inverteu quando consideramos o sobrerrisco em relação à população geral, tanto para hospitalização quanto para óbito. O presente estudo forneceu evidências a respeito do sobrerrisco de hospitalização e óbito por SRAG-COVID, auxiliando na definição de grupos prioritários para a vacinação contra a COVID-19.

En un contexto de transmisión comunitaria y escasez de vacunas, la vacunación contra la COVID-19 debe enfocarse en la reducción directa de la morbilidad y de la mortalidad causadas por la enfermedad. Por lo tanto, es fundamental la definición de grupos prioritarios para la vacunación por el Programa Nacional de Inmunizaciones (PNI), basada en el riesgo de hospitalización y óbito por la enfermedad. Para tal fin, calculamos el sobrerriesgo por sexo, franja de edad y comorbilidades mediante los registros de hospitalización y óbito por síndrome respiratorio agudo grave con confirmación de COVID-19 (SRAG-COVID) en todo Brasil, durante los primeros seis meses de epidemia. Presentaron mayor sobrerriesgo personas del sexo masculino (hospitalización = 1,1 y óbito = 1,2), personas por encima de 45 años para hospitalización (SRfe variando de 1,1 a 8,5) y personas por encima de 55 años para óbitos (SRfe variando de 1,5 a 18,3). En los grupos de comorbilidades, enfermedad renal crónica, diabetes mellitus, enfermedad cardiovascular y neumopatía crónica ofrecieron sobrerriesgo, mientras que para el asma no hubo evidencia. Sufrir una enfermedad renal crónica o diabetes mellitus y tener 60 años o más mostró un factor todavía más fuerte, alcanzando sobrerriesgo de enfermedad 14 y 10 veces mayor que en la población general, respectivamente. Para todas las comorbilidades, hubo un sobrerriesgo más alto en edades mayores, con un gradiente de disminución en franjas más altas. Este patrón se invirtió cuando consideramos el sobrerriesgo en relación con la población general, tanto para hospitalización como para óbito. El presente estudio proporcionó evidencias respecto al sobrerriesgo de hospitalización y óbito por SRAG-COVID, ayudando en la definición de grupos prioritarios para la vacunación contra la COVID-19.

In a context of community transmission and shortage of vaccines, COVID-19 vaccination should focus on directly reducing the morbidity and mortality caused by the disease. It was thus essential to define priority groups for vaccination by the Brazilian National Immunization Program (PNI in Portuguese), based on the risk of hospitalization and death from the disease. We calculated overrisk according to sex, age group, and comorbidities using hospitalization and death records from severe acute respiratory illness with confirmation of COVID-19 (SARI-COVID) in all of Brazil in the first 6 months of the epidemic. Higher overrisk was associated with male sex (hospitalization = 1.1 and death = 1.2), age over 45 years for hospitalization (OvRag ranging from 1.1 to 8.5), and age over 55 year for death (OvRag ranging from 1.5 to 18.3). In the groups with comorbidities, chronic kidney disease, diabetes mellitus, cardiovascular disease, and chronic lung disease were associated with overrisk, while there was no such evidence for asthma. Chronic kidney disease or diabetes and age over 60 showed an even stronger association, reaching overrisk of death 14 and 10 times greater than in the general population, respectively. For all the comorbidities, there was higher overrisk at older ages, with a downward gradient in the oldest age groups. This pattern was reversed when examining overrisk in the general population, for both hospitalization and death. The current study provided evidence of overrisk of hospitalization and death from SARI-COVID, assisting the definition of priority groups for COVID-19 vaccination.

Patterns of influenza B circulation in Brazil and its relevance to seasonal vaccine composition

Abstract Data on the burden of disease and circulation patterns of influenza B lineages for Brazil are limited. This review aims to describe the pattern of influenza B occurrence in Brazil to have a better understanding of its epidemiology and its relevance when considering seasonal influenza vaccine composition. A review of the data including analysis of international and local surveillance data as well as information from online search of databases using Medical Subject Headings terms in conjunction with screening of abstracts from scientific events was performed. Based on international epidemiologic surveillance data, moderate levels of influenza B disease (19%; 2006–2014) were observed. Of these nine years, it was possible to compare data from three years (2007, 2008 and 2013) which have information on the circulating influenza B lineage. Co-circulation of influenza B lineages was observed in all these three influenza seasons, of which, during one season, a high degree of mismatch between the vaccine lineage and the predominant circulating lineage (91.4% [2013]) was observed. Local surveillance data reveal a distinct and dynamic distribution of respiratory viruses over the years. Data from published literature and abstracts show that influenza B is a significant cause of disease with an unpredictable circulation pattern and showing trends indicating reemergence of the B/Victoria lineage. The abstracts report notable levels of co-circulation of both influenza B lineages (2000–2013). Mismatch between the Southern hemisphere vaccine and the most prevalent circulating viruses in Brazil were observed in five influenza seasons. The evidence on co-circulation of two influenza B lineages and mismatched seasons in Brazil indicates the benefit of quadrivalent influenza vaccines in conferring broader seasonal influenza protection. Additionally, improving influenza surveillance platforms in Brazil is important for monitoring disease trends and the impact of introducing seasonal influenza vaccination.

Profile of circulating levels of IL-1Ra, CXCL10/IP-10, CCL4/MIP-1β and CCL2/MCP-1 in dengue fever and parvovirosis

Dengue virus (DENV) and parvovirus B19 (B19V) infections are acute exanthematic febrile illnesses that are not easily differentiated on clinical grounds and affect the paediatric population. Patients with these acute exanthematic diseases were studied. Fever was more frequent in DENV than in B19V-infected patients. Arthritis/arthralgias with DENV infection were shown to be significantly more frequent in adults than in children. The circulating levels of interleukin (IL)-1 receptor antagonist (Ra), CXCL10/inducible protein-10 (IP-10), CCL4/macrophage inflammatory protein-1 beta and CCL2/monocyte chemotactic protein-1 (MCP-1) were determined by multiplex immunoassay in serum samples obtained from B19V (37) and DENV-infected (36) patients and from healthy individuals (7). Forward stepwise logistic regression analysis revealed that circulating CXCL10/IP-10 tends to be associated with DENV infection and that IL-1Ra was significantly associated with DENV infection. Similar analysis showed that circulating CCL2/MCP-1 tends to be associated with B19V infection. In dengue fever, increased circulating IL-1Ra may exert antipyretic actions in an effort to counteract the already increased concentrations of IL-1β, while CXCL10/IP-10 was confirmed as a strong pro-inflammatory marker. Recruitment of monocytes/macrophages and upregulation of the humoral immune response by CCL2/MCP-1 by B19V may be involved in the persistence of the infection. Children with B19V or DENV infections had levels of these cytokines similar to those of adult patients.