Development and validation of a scale to measure social isolation in adolescents.

There is a lack of questionnaires specifically designed to assess social isolation in adolescents. We developed and validated a self-report measure of social isolation in adolescents, the Social Isolation Questionnaire (QIS). A literature review on social isolation and mental health in adolescents indicated 20 questions to form QIS. Two cross-sectional surveys with 48 and 1135 adolescents, respectively, evaluated the reproducibility and validity of QIS. The Bland-Altman plot did not indicate a systematic difference between measurements 15 days apart. Bartlett's sphericity test verified a correlation between the questions and the Kaiser-Meyer-Olkin test showed good adequacy (.896) to the factor analysis. Exploratory factor analysis suggested the exclusion of three questions (loading factors <0.3), and eigenvalues (4.9-0.8) indicated that the questionnaire should be composed of three factors (dimensions). The Cronbach's alpha indicated high internal consistency of the 17 questions (0.850 overall; Dimensions: 0.815 'feeling of loneliness'; 0.760 'friendship'; and, 0.680 'Family support'). The QIS score ranged from 0 to 131 (maximum social isolation score). The correlation between QIS and depressive symptoms (r = .543) indicated the construct validity of QIS. We evaluated QIS in the Portuguese version, thus translation and cultural adaptation are necessary to evaluate the questionnaire in other settings. We constructed and validated the QIS questionnaire, a self-administered questionnaire to assess social isolation in adolescents, composed of three dimensions; feelings of loneliness, friendship and family support. The QIS questionnaire seems a very promising tool to support practitioners and researchers in assessing social isolation among adolescents.

The Longitudinal Association of Cardiorespiratory Fitness and Adiposity With Clustered Cardiometabolic Risk: A Mediation Analysis.

PURPOSE: Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk. METHOD: Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05] y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS. RESULTS: BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (-0.036; 95% confidence interval, -0.070 to -0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI. CONCLUSIONS: BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI.

Clustering of cardiometabolic risk factors and the continuous cardiometabolic risk score in children from Southern Brazil: a cross-sectional study.

PURPOSE: The present study aimed to verify the clustering of cardiometabolic risk factors for cardiovascular diseases (CVD) and its relationship with the continuous cardiometabolic risk score (cMetS). METHODS: Cross-sectional study with 631 children aged 6 to 9 years. Cardiorespiratory fitness, glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference were assessed. The number of children in whom the risk factors were not independently distributed was analyzed. Z-scores were computed for each risk factor to calculate the cMetS. RESULTS: There was a high proportion of children with clustering of risk factors for CVD. The clustering of risk factors was apparent in 11.3% of the children for four or more risk factors, and 21.9% had three or more risk factors. The cMetS showed a linear relationship with the increase in the number of risk factors. A cMetS value higher than 0.91 indicated clustering of cardiometabolic risk factors amongst children. CONCLUSION: The use of clustering of cardiometabolic risk factors identified a high proportion of children with the presence of relevant cardiometabolic alterations. A cMetS value higher than 0.91 (relative to an international standard) indicated higher clustering of cardiometabolic risk factors amongst children. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00845-9.

Constructs of poor sleep quality in adolescents: associated factors.

This study aims to evaluate factors associated with sleep quality (overall and by domains) in adolescents. A cross-sectional study. This study was conducted with 1,296 first-year high school students from public schools in the Northern Region of the State of Pernambuco, Brazil. Demographic, socioeconomic, and behavioral data were obtained with a questionnaire. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) Body mass index (BMI) was calculated based on the ratio of weight and height squared. Multilevel linear and logistic regressions evaluated factors associated with sleep quality. We observed 53% of adolescents reported poor sleep quality. Adolescents at higher risk of clinical depression were 3.45 times more likely to have poor sleep quality (95%CI: 2.04; 5.81), and each additional unit in the social anxiety score presented 1.03 (95%CI: 1.01; 1.05) higher odds of adolescents having poor sleep quality. Adolescents with depressive symptoms had higher sleep latency, greater sleep disturbance, and greater daytime sleep dysfunction. Social anxiety was associated with sleep latency, sleep disturbance, and daytime sleep dysfunction. Higher risk of clinical depression was associated with all domains related to sleep quality. Negative health perception was associated with sleep disturbance, and physical inactivity was associated with daytime sleep dysfunction. Social anxiety and especially higher risk of clinical depression were determinants of poor sleep quality. Changes in sleep latency, sleep disturbance and daytime sleep dysfunction seems to be relevant to poor sleep quality.

Depressive symptoms in older adults: the role of physical activity and social support

Abstract Objective To evaluate the role of social support in the association between physical activity (PA) in its various domains and depressive symptoms in older adults. Methods This was a cross-sectional study involving 399 older adults seen at basic health units in the municipality of Recife, state of Pernambuco, northeastern Brazil. Linear regression was implemented using the forward method to assess the association between PA and its domains and depressive symptoms, as well as to test the possible moderating component of social support in this association. Results Of the total sample, 17.6% reported not practicing PA; 6.7% presented depressive symptoms, with a mean score of 1.59 points. A total of 18.6% of the older adults assessed reported not having social support. Older adults who did not practice total, transportation or domestic PA showed increased scores of depressive symptoms when compared to older adults who practiced PA in these domains. Older adults with social support also had fewer depressive symptoms. Practicing domestic, leisure and total PA, and/or having social support, decreased depressive symptoms in older adults. Having social support or practicing PA decreased depressive symptoms in older adults in a similar way. Conclusions Older adults with social support and who practiced PA, especially domestic and total PA, presented the lowest scores of depressive symptoms. The data showed the importance of providing elements to strengthen social support and PA practice in older adults living in poor communities as a strategy to prevent and reduce depressive symptoms.

Violence and psychosocial stress: A 10-year time trend analysis.

AIM: The aim of this study was to analyze the temporal trend of psychosocial stress and its association between exposure to violence in adolescents. METHODS: This is a cross-sectional study of temporal trends based on three school-based and statewide surveys with regular intervals of five years. The target population consisted of high school students from public schools. A total of 4,207 adolescents were evaluated in 2006, 6,264 in 2011, and 6,002 in 2016. The psychosocial stress indicator was the dependent study variable and was analyzed according to questions: a) Feeling of loneliness; b) Feeling of sadness; c) Difficulty sleeping due to worry; d) Number of close friends; e) Suicide ideation. Exposure variables were exposure to physical violence, involvement in fights and bullying. Logistic and linear regressions were used to verify the temporal trend of psychosocial stress, and to analyze the association between exposure of violence and psychosocial stress. RESULTS: Regardless of gender, the psychosocial stress score increasing trend between 2006 and 2016. The girls showed a variation in the feeling of loneliness from 18.7% to 22.8%, and suicide ideation increased from 10.4% to 14.2% between 2006 and 2016. All types of violence were associated with greater psychosocial stress for both boys and girls. CONCLUSION: Adolescents had a higher prevalence of feelings of loneliness, difficulty sleeping due to worry and suicide ideation during the period from 2006 to 2016, regardless of gender. Exposure to violence is associated with psychosocial stress in both genders, however, the strongest associations occurred in girls.

Cardiometabolic risk factors in children and adolescents from southern Brazil: comparison to international reference values.

OBJECTIVES: To compare cardiometabolic risk factors of Brazilian children and adolescents with international reference values. Cardiometabolic risk factors constitute the Metabolic Syndrome, whose evaluation is important to assess pediatric populations' health and potential to experience metabolic disorders. METHODS: Cross-sectional study that included 2,250 randomly selected children and adolescents (55.6% girls), aged 6 to 17. Cardiometabolic parameters (body mass index [BMI], waist circumference [WC], systolic and diastolic blood pressures [SBP and DBP], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], TC:HDL-C ratio, triglycerides [TG], glucose and peak oxygen uptake [VO2peak]), and clustered risk scores were compared to international age- and sex-specific reference values. A clustered risk score was calculated by summing the WC, glucose, SBP, TG, and the TC:HDL-C ratio Z-scores divided by five. A second clustered was calculated including VO2peak (inverted) Z-score, but divided by six. RESULTS: The clustered risk score, considering the all ages sample, was better in the Brazilian boys (-0.20 [-0.41;0.01] and -0.18 [-0.37;0.01], including or not VO2peak, respectively) but not significantly, and worse in girls (0.24 [0.05;0.43] and 0.28 [0.11;0.44], including or not VO2peak, respectively) than the international reference. Additionally, Brazilian youth had a statistically better profile in TC, LDL-C, HDL-C, TC:HDL-C ratio, and VO2peak (only girls) as well as a worse profile in BMI, WC, SBP, DBP, TG (only girls), and VO2peak (only boys). CONCLUSIONS: The clustered cardiometabolic risk score (including or not VO2peak), considering the all ages sample, was better in the Brazilian boys, but not significantly, and worse in girls compared to the international reference.

Depressive symptoms in older adults: the role of physical activity and social support.

OBJECTIVE: To evaluate the role of social support in the association between physical activity (PA) in its various domains and depressive symptoms in older adults. METHODS: This was a cross-sectional study involving 399 older adults seen at basic health units in the municipality of Recife, state of Pernambuco, northeastern Brazil. Linear regression was implemented using the forward method to assess the association between PA and its domains and depressive symptoms, as well as to test the possible moderating component of social support in this association. RESULTS: Of the total sample, 17.6% reported not practicing PA; 6.7% presented depressive symptoms, with a mean score of 1.59 points. A total of 18.6% of the older adults assessed reported not having social support. Older adults who did not practice total, transportation or domestic PA showed increased scores of depressive symptoms when compared to older adults who practiced PA in these domains. Older adults with social support also had fewer depressive symptoms. Practicing domestic, leisure and total PA, and/or having social support, decreased depressive symptoms in older adults. Having social support or practicing PA decreased depressive symptoms in older adults in a similar way. CONCLUSIONS: Older adults with social support and who practiced PA, especially domestic and total PA, presented the lowest scores of depressive symptoms. The data showed the importance of providing elements to strengthen social support and PA practice in older adults living in poor communities as a strategy to prevent and reduce depressive symptoms.

Prevalence of alcohol consumption and factors associated with binge drinking behavior among adolescents in the state of Pernambuco, Brazil, 2016

To investigate the prevalence of alcohol consumption and the factors associated with binge drinking behavior amongadolescents in the state of Pernambuco, Brazil. A cross-sectional study with a probabilistic sample of 6,002 adolescents composed of students from public high schools in Pernambuco, Brazil, aged 14 to 19 years. Binge drinking behavior was used as a dependent variable. The following were evaluated as possible risk factors: sociodemographic variables (gender, maternal education, marital status, work, religion); indicators of psychosocial stress (feelings of sadness; suicidal thoughts; feelings of loneliness;friends) and health risk behaviors (physical inactivity; number of sexual partners; drug use; and involvement in fights in the last year). Logistic regression was used to estimate odds ratios (OR). A total of 6,002 adolescents participated, with 75% reporting having consumed alcoholic beverages at least once in their lives. The prevalence of binge drinking in the last month was 17%. Adolescents without a religion had 81% (95%CI: 1.51; 2.16) more chance of consuming alcohol in excess. Adolescents who felt sad were 29% more likely to binge drink (95%CI: 1.08; 1.54), and adolescents who had already thought about suicide had 41% (95%CI: 1.13; 1.76) more chance to drink excessively. Adolescents who used illicit drugs had 4.6 times the chance (95%CI: 3.51; 6.17)of excessive drinking. Adolescents who engaged in four or more fights during the year were twice as likely to binge drink as those who did not fight (95%CI: 1.36; 2.88). The prevalence of alcohol consumption and binge drinking behavior was high. Sociodemographic factors, psychosocial stress and health risk behaviors were associated with binge drinking.

Constructs of poor sleep quality in adolescents: associated factors / Os construtos de baixa qualidade de sono em adolescentes: fatores associados / Constructos de calidad deficiente del sueño en adolescentes: factores asociados

This study aims to evaluate factors associated with sleep quality (overall and by domains) in adolescents. A cross-sectional study. This study was conducted with 1,296 first-year high school students from public schools in the Northern Region of the State of Pernambuco, Brazil. Demographic, socioeconomic, and behavioral data were obtained with a questionnaire. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) Body mass index (BMI) was calculated based on the ratio of weight and height squared. Multilevel linear and logistic regressions evaluated factors associated with sleep quality. We observed 53% of adolescents reported poor sleep quality. Adolescents at higher risk of clinical depression were 3.45 times more likely to have poor sleep quality (95%CI: 2.04; 5.81), and each additional unit in the social anxiety score presented 1.03 (95%CI: 1.01; 1.05) higher odds of adolescents having poor sleep quality. Adolescents with depressive symptoms had higher sleep latency, greater sleep disturbance, and greater daytime sleep dysfunction. Social anxiety was associated with sleep latency, sleep disturbance, and daytime sleep dysfunction. Higher risk of clinical depression was associated with all domains related to sleep quality. Negative health perception was associated with sleep disturbance, and physical inactivity was associated with daytime sleep dysfunction. Social anxiety and especially higher risk of clinical depression were determinants of poor sleep quality. Changes in sleep latency, sleep disturbance and daytime sleep dysfunction seems to be relevant to poor sleep quality.

O estudo buscou avaliar os fatores associados à qualidade do sono (global e por domínios) entre adolescentes. Foi realizado um estudo transversal com 1.296 estudantes de primeiro ano do ensino médio em escolas públicas na Região Norte do Estado de Pernambuco, Brasil. Foram obtidos dados demográficos, socioeconômicos e comportamentais através de um questionário. A qualidade do sono foi medida com o Pittsburgh Sleep Quality Index (PSQI). O índice de massa corporal (IMC) foi calculado como peso dividido por altura ao quadrado. Os fatores associados à qualidade do sono foram avaliados através da regressão linear multinível e logística. Observamos que 53% dos adolescentes relatavam baixa qualidade de sono. Os adolescentes com risco maior de depressão clínica apresentaram 3,45 vezes maior probabilidade de apresentar baixa qualidade de sono (IC95%: 2,04; 5,81), e cada unidade adicional na escala de ansiedade social apresentou 1,03 vezes maiores chances (IC95%: 1,01; 1,05) de baixa qualidade de sono. Os adolescentes com sintomas depressivos mostraram maior latência do sono, maior transtorno do sono e maior disfunção diurna do sono. A ansiedade social mostrou associação com latência do sono, transtorno do sono e disfunção diurna do sono. O risco maior de depressão esteve associado a todos os domínios relacionados à qualidade. Autoavaliação de saúde negativa esteve associada ao transtorno do sono, e inatividade física esteve associada à disfunção diurna do sono. Ansiedade social, e principalmente risco maior de depressão clínica, foram determinantes na baixa qualidade do sono. Mudanças na latência do sono, transtorno do sono e disfunção diurna do sono parecem ser relevantes para a baixa qualidade do sono.

El objetivo de este estudio fue evaluar factores asociados con la calidad del sueño (general y por ámbitos) en adolescentes. Se realizó un estudio transversal con 1.296 estudiantes del primer año de escuela secundaria, procedentes de escuelas públicas en la Región Norte del Estado de Pernambuco, Brasil. Se obtuvieron datos demográficos, socioeconómicos y comportamentales, a través de un cuestionario. La calidad del sueño se midió usando el Pittsburgh Sleep Quality Index (PSQI). El índice de masa corporal (IMC) se calculó de la ratio de peso y altura al cuadrado. Las regresiones logísticas y lineales multinivel evaluaron factores asociados con calidad del sueño deficiente. Observamos que un 53% de los adolescentes informaron de una calidad de sueño deficiente. Los adolescentes con mayor riesgo de depresión clínica fueron 3,45 veces más propensos a tener una calidad de sueño deficiente (95%CI: 2,04; 5,81), y cada unidad adicional en la puntuación de ansiedad social presentaba 1,03 (95%CI: 1,01; 1,05) mayores posibilidades de adolescentes sufriendo por calidad de sueño deficiente. Los adolescentes con síntomas depresivos presentaban mayor latencia de sueño, mayores perturbaciones en el sueño, y mayor disfunción durante el día de sueño. La ansiedad social estuvo asociada con la latencia de sueño, perturbaciones de sueño y disfunción del sueño durante el día. Un mayor riesgo de depresión clínica estuvo asociado con todos los ámbitos relacionados con calidad del sueño. Una percepción negativa de salud respecto a la perturbación de sueño e inactividad física estuvo asociada con un sueño deficiente durante el día. La ansiedad social y, especialmente, un mayor riesgo de depresión clínica fueron determinantes en una escasa calidad de sueño. Los cambios en la latencia del sueño, trastornos del sueño y disfunción del sueño durante el día parecieron relevantes para la deficiente calidad del sueño.

Association between body mass index, physical activity and motor competence in children: moderation analysis by different environmental contexts.

BACKGROUND: Although the association between body mass index (BMI), physical activity (PA) and motor competence (MC) has been widely investigated, the influence of different environmental contexts is not well defined. AIM: To analyse the relationship between BMI, PA and MC and the moderating role of the environmental context. SUBJECTS AND METHODS: A cross-sectional study was performed with 668 children (318 boys) aged 5-7 years (north-eastern district - Brazil). MC (Körper koordination test fur Kinder; KTK), BMI and PA (parent reporting) were assessed. To classify three contexts of the environment a variable was created based on the presence of a sports court in school and/or environment for play or sports practice out of school. Multilevel mixed-effects linear regressions, interaction test and estimation of coefficients in moderation analysis were used. RESULTS: BMI (ß = -2.93; p < .01) and age (ß = 19.02; p < .01) were associated, and PA was not associated (ß = 0.07; p = .05) with MC. The strength of the association between BMI and MC changed based on the environmental contexts. The better the environment context the weaker the association between BMI and MC (ß = -2.93, p < .01 to ß = -2.38, p = .33 to ß = 0.26, p = .94). CONCLUSIONS: The association between BMI and MC is moderated by environmental contexts.

Reciprocal longitudinal relationship between dental fear and oral health in schoolchildren.

BACKGROUND: No longitudinal study has evaluated the mutual relationship between dental fear and oral health in the same investigation. AIM: To evaluate the reciprocal longitudinal relationship between dental fear and oral health in schoolchildren. DESIGN: This longitudinal study monitored 416 Brazilian children aged 5-7 years of age at baseline for 2 years. The decayed, filled and missing teeth were clinically assessed for each child. Dental fear was evaluated by Dental Anxiety Question. Multilevel mixed-effects linear and logistic regressions analysed the reciprocal relationship between dental fear and oral health. RESULTS: Children with caries experience had 1.8 times higher odds of dental fear compared to children who were caries free. The presence of a carious tooth increased the odds of dental fear by 1.2 times. Children with dental fear had 0.46 additional carious tooth; an additional 0.22 tooth indicated for extraction; and a 0.67 higher caries experience score compared to children without dental fear. CONCLUSIONS: We observed a reciprocal relationship between dental fear and poor oral health. Both parents and dentists should provide realistic information for the children, discouraging biased negative expectations regarding dental treatment. Ultimately, the child would acquire positive perceptions of the dental environment, reducing their phobia and consequently improving oral health.

The synergic relationship between social anxiety, depressive symptoms, poor sleep quality and body fatness in adolescents.

BACKGROUND: The aim of the current study was to evaluate the cross-sectional synergic relationship among social anxiety, poor sleep quality, depressive symptoms and body fatness. METHODS: A cross-sectional study was performed with 1,242 adolescents from a north-eastern district in Brazil. It was used the Social Anxiety Scale for Adolescents for symptoms of social anxiety, the Pittsburgh Sleep Quality Index for sleep quality and the Depression Scale of the Center for Epidemiologic Studies for depressive symptoms. Body fatness was the sum of triceps and subscapular skinfolds. Structural equation modelling was used to evaluate associations among these comorbidities. RESULTS: Social anxiety was directly and positively associated with depressive symptoms, poor sleep quality and body fatness (ß = 0.316 standard deviations [SD]; ß = 0.299 SD; ß = 0.072 SD, respectively). Moreover, social anxiety was indirectly associated with depressive symptoms via poor sleep quality (ß = 0.113 SD). Poor sleep quality was directly associated with depressive symptoms (ß = 0.377 SD). We did not observe a significant relationship of poor sleep quality and depressive symptoms with body fatness. LIMITATIONS: This is a cross-sectional study; therefore, we cannot infer causality in the interpretation of the findings. CONCLUSIONS: Social anxiety seemed to play pivotal role in adolescents' health, since it was associated with poor sleep quality, depressive symptoms and body fatness. Interventions targeting sleep quality, depressive symptoms and body fatness in adolescents should designate relevant effort addressing social anxiety.

The longitudinal relationship between motor competence and measures of fatness and fitness from childhood into adolescence / Relação longitudinal entre a coordenação motora e as medidas de gordura e aptidão física da infância à adolescência

Abstract Objectives: To examine longitudinal (seven years) relationships among cardiorespiratory fitness (VO2peak), body fatness, and motor competence. Method: Data were collected as part of the Copenhagen School Child Intervention Study (CoSCIS). Body fatness was assessed by the sum of four skinfolds. VO2peak was measured directly in a continuous running protocol. Motor competence was assessed using the Körperkoordinationtest für Kinder. This study used multilevel linear mixed models to evaluate the reciprocal longitudinal association between body fatness, VO2peak, and motor competence. All regressions were stratified by sex and adjusted by intervention and pubertal status. All variable coefficients were standardized. Results: A reciprocal relationship was observed between children's motor competence with body fatness and VO2peak at the seven-year follow-up (6 -13 years of age). Children with higher motor competence at baseline had a lower risk of having higher body fatness (βboys = −0.45, 95% CI: −0.52 to −0.38; βgirls = −0.35, 95% CI: −0.42 to −0.28) and higher VO2peak (βboys = 0.34, 95% CI: 0.27 -0.40; βgirls = 0.27, 95% CI: 0.20 -0.33) during childhood. Alternatively, higher body fatness or lower levels of VO2peak at baseline were associated with lower motor competence during childhood. Conclusions: These data suggest motor competence, body fatness, and VO2peak demonstrate reciprocal relationships across childhood (6 -13 years of age). Interventions addressing motor competence, cardiorespiratory fitness, and body fatness in early childhood are recommended, as intervention effects are likely to be enhanced because of the mutual reciprocal associations between these three variables.

Resumo Objetivos: Examinar as relações longitudinais (sete anos) entre a aptidão cardiorrespiratória (VO2 pico), gordura corporal e coordenação motora. Método: Os dados foram coletados como parte do Copenhagen School Child Intervention Study (CoSCIS). A gordura corporal foi avaliada pela soma de quatro dobras cutâneas. O VO2 pico foi medido diretamente em um protocolo de corrida contínua. A coordenação motora foi avaliada com o teste de coordenação corporal para crianças (Körperkoordination für Kinder - KTK). Usamos modelos lineares mistos multiníveis para avaliar a associação longitudinal recíproca entre a gordura corporal, o VO2 pico e a coordenação motora. Todas as regressões foram estratificadas por sexo e ajustadas para intervenção e estado puberal. Todos os coeficientes das variáveis foram padronizados. Resultados: Observamos uma relação recíproca entre a coordenação motora e a gordura corporal. As crianças com maior coordenação motora no início do estudo apresentaram menor risco de ter maior nível de gordura corporal (βmeninos = -0,45, IC de 95%: -0,52: -0,38; βmeninas = -0,35, IC de 95%: -0,42: -0,28) e maior VO2 pico (βmeninos = 0,34, IC de 95%: 0,27: 0,40; βmeninas = 0,27, IC de 95%: 0,20: 0,33). Por outro lado, maior nível de gordura corporal ou menores níveis de VO2 pico no início do estudo foram associados a menor coordenação motora durante a infância. Conclusões: Esses dados sugerem que a coordenação motora, gordura corporal e VO2 pico demonstram relações recíprocas durante a infância (6-13 anos). São recomendadas intervenções que abordem a coordenação motora, a aptidão cardiorrespiratória e a gordura corporal na primeira infância, pois os efeitos da intervenção são provavelmente maiores devido às associações recíprocas mútuas entre essas três variáveis.

The longitudinal relationship between motor competence and measures of fatness and fitness from childhood into adolescence.

OBJECTIVES: To examine longitudinal (seven years) relationships among cardiorespiratory fitness (VO2peak), body fatness, and motor competence. METHOD: Data were collected as part of the Copenhagen School Child Intervention Study (CoSCIS). Body fatness was assessed by the sum of four skinfolds. VO2peak was measured directly in a continuous running protocol. Motor competence was assessed using the Körperkoordinationtest für Kinder. This study used multilevel linear mixed models to evaluate the reciprocal longitudinal association between body fatness, VO2peak, and motor competence. All regressions were stratified by sex and adjusted by intervention and pubertal status. All variable coefficients were standardized. RESULTS: A reciprocal relationship was observed between children's motor competence with body fatness and VO2peak at the seven-year follow-up (6-13 years of age). Children with higher motor competence at baseline had a lower risk of having higher body fatness (ßboys=-0.45, 95% CI: -0.52 to -0.38; ßgirls=-0.35, 95% CI: -0.42 to -0.28) and higher VO2peak (ßboys=0.34, 95% CI: 0.27-0.40; ßgirls=0.27, 95% CI: 0.20-0.33) during childhood. Alternatively, higher body fatness or lower levels of VO2peak at baseline were associated with lower motor competence during childhood. CONCLUSIONS: These data suggest motor competence, body fatness, and VO2peak demonstrate reciprocal relationships across childhood (6-13 years of age). Interventions addressing motor competence, cardiorespiratory fitness, and body fatness in early childhood are recommended, as intervention effects are likely to be enhanced because of the mutual reciprocal associations between these three variables.

Predictors of dental anxiety in Brazilian 5-7years old children.

OBJECTIVES: The aim of this study was to analyze the predictors of dental anxiety in 5 to 7-year-old children in a two years follow-up. MATERIALS AND METHODS: This is a longitudinal study conducted with 784 children with 5 to 7years old. A face-to-face interview was conducted with the parents. The Dental Anxiety Question (DAQ) answers were categorized as presence or absence of dental anxiety. The possible predictor factors analyzed were: related to the children (age, sex, parentage, childbirth, physical activity, body satisfaction, psychological well-being, physical well-being, dentist visit); and related to the parents or guardians (excessive alcohol consumption, smoke, family income, number of children). Forward stepwise logistic binary regression was performed for the multivariate analysis. The analysis was controlled by gender. RESULTS: The prevalence of dental anxiety was 17.4%. Children in lower family income had 2.3 (95% CI: 1.3-4.0) greater chance to report high dental anxiety in comparison to children in higher family income. Similarly, children's parents who reported lower psychological well-being had 1.5 (95% CI: 1.0-3.0) greater chance to report high dental anxiety in comparison to children's parents with higher psychological well-being. CONCLUSIONS: The prevalence of dental anxiety was high, and the family income and psychological well-being were inversely associated to dental anxiety in children. CLINICAL RELEVANCE: Knowing the dental anxiety predictors could help the pediatric dentist to analyze and understand who is more susceptible to develop dental anxiety. An adequate approach, a trust relationship could be built, improving the oral health conditions and reducing the need of treatment in children.

Effectiveness of a school-based intervention regarding screen time in high school students / Efetividade de uma intervenção de base escolar sobre o tempo de tela em estudantes do ensino médio

Few interventions to reduce sedentary behavior in youth have been successful and have had only subtle effects. The aim of the study was to assess the effectiveness of a school-based intervention to promote physical activity and healthy eating habits on screen time indicators in students. This was a randomized controlled intervention study of high school students (15-24 years of age) who attended evening classes in the public schools of 2 Brazilian capital cities, Florianópolis and Recife. Data collection was performed via a questionnaire at the beginning (March) and end (December) of the 2006 school year. Students who reported spending 2 or more hours per day watching television or playing videogames/using the computer on weekdays or weekend days were considered exposed to screen time. Logistic regression analyses were performed. Among the 2,155 students included in the baseline sample, 989 were evaluated during the post-intervention period. The intervention group showed significantly reduced exposure to videogame/computer time on weekend days compared with the control group (29.8% vs. 35.6%; p=0.004). After adjusting for potential confounding factors, the results showed that the intervention had no significant effect on reducing the exposure to screen time in the surveyed students. The intervention model adopted in the Saúde na Boa project was not effective in reducing the screen time exposure of high school students.

Embora os efeitos sejam pequenos, algumas intervenções para a redução do comportamento sedentário em jovens têm sido bem sucedidas. O objetivo do estudo foi verificar a efetividade de uma intervenção de base escolar para promoção da atividade física e hábitos alimentares saudáveis sobre indicadores de tempo de tela em escolares. Trata-se de um estudo de intervenção randomizado e controlado com estudantes (15 a 24 anos) do ensino médio do período noturno de escolas públicas de duas capitais brasileiras: Florianópolis e Recife. A coleta de dados foi realizada no início (março) e ao final (dezembro) do ano letivo de 2006, mediante aplicação de um questionário. Os estudantes que relataram despender duas ou mais horas por dia assistindo televisão ou jogando videogame/usando o computador em dias de semana ou em dias do fim de semana foram considerados expostos ao tempo de tela. Estas análises foram conduzidas mediante utilização de regressão logística. Dos 2.155 escolares incluídos na linha de base, 989 foram avaliados no período pós-intervenção. Observou-se que o grupo intervenção reduziu significativamente a exposição ao tempo de videogame/computador nos dias de fim de semana quando comparado ao grupo controle (29,8% vs 35,6%, respectivamente; p=0,004). Após ajustamento para potenciais fatores de confusão, verificou-se que a intervenção não teve efeito significativo na redução da exposição ao tempo de tela nos escolares investigados. O modelo de intervenção adotado no projeto Saúde na Boa não foi efetivo em reduzir o tempo de tela de estudantes do ensino médio.

Factors associated with dental anxiety in brazilian children of 5 to 8 years

Objective:To test the agreement between the evaluators index oral health, to conduct a preliminary analysis possible associated factors to dental in children, and show the prevalence of dental anxiety in children and their parents. Material and Methods:It is a pilot study composed for sample with 100 children (5-8 years) from Recife, Pernambucostate. The dates were collected by a questionnaire administered in a face to face interview with the parents. The anxiety were available through the Dental Anxiety Question and with the oral health measured by index CPOD , and others 26 variables associate were available. Results: The prevalence of dental anxiety in children was 46% and 28% in parents. Association was observed between dental anxiety with their satisfaction with friends (p <0.005). We identified 10 possible associated factors to child dental anxiety (p <0.25). Conclusion:The satisfaction with friends are inversely associated with dental anxiety in children and those new studies analyzing dental anxiety in children should include the investigation of other variables to test for associations

Influence of number of days and valid hours using accelerometry on the estimates of physical activity level in preschool children from Recife, Pernambuco, Brazil / Influencia do numero de dias e de horas validas de uso do acelerometro na estimativa do nivel de atividade fisica em pre-escolares de Recife, Pernambuco, Brasil

A few studies have proposed the number of hours/day and the number of days of monitoring that should be completed to obtain good quality accelerometry data for preschool children. The aim of this study was to analyze how the estimates of physical activity levels and sample profiles (demographic and anthropometric data) vary according the use of different criteria to define valid monitoring periods. Children (n=180) aged three to five years were randomly selected among participants from a longitudinal study performed in Recife, Brazil. Children wore a GT1M Actigraph accelerometer on the right waist during a period of seven days, including the weekend days, using 15 s epochs. A total of 176 children were included in the study (52.8% boys; mean age of 4.3 years [s=0.8]). Using the criterion of 10+ hours/day of wearing time to define a valid monitoring day, 67.0% (n=118) and 36.9% (n=65) of the children showed 3+ and 5+ valid days, respectively. When the criterion of 5+ hours/day was used, the time spent in moderate activity was approximately 10 minutes shorter than when the criterion of 10+ hours/day was used. The criterion of 10+ hours/day for defining a valid monitoring day leads to a sample size reduction and the criterion of 5+ hours/day underestimates the moderate activity level.

Poucos estudos têm pesquisado acerca do número de horas/dia e o número de dias de monitoramento que devem ser completados para se obter boa qualidade de dados por meio do uso de acelerômetros para crianças pré-escolares. O objetivo deste estudo foi analisar a influencia em se usar diferentes critérios para definir períodos de monitoramento válido na estimativa nos níveis de atividade física e no perfil da amostra. Crianças (n=180) com idade de três a cinco anos foram randomicamente selecionadas entre as participantes de um estudo longitudinal realizado em Recife, Brasil. As crianças usaram um acelerômetro GT1M (Actigraph) à direita da cintura por um período de sete dias consecutivos, incluindo o final de semana, empregando-se epochs de 15 segundos. Um total de 176 crianças foram incluídas no estudo (52,8% meninos; idade média de 4,3 anos [s=0,8]). Usando o critério de 10+ horas/dia de tempo de uso para definir um dia de monitoramento válido, 67,0% (n=118) e 36,9% (n=65) das crianças apresentaram 3+ e 5+ dias válidos, respectivamente. Quando o critério de 5+ horas/dia foi empregado o tempo despendido em atividades moderadas foi aproximadamente 10 minutos menor quando comparado ao critério de 10+ horas/dia. O critério de 10+ horas/dia para definir um dia de monitoramento válido induz uma redução no tamanho da amostra e o critério de 5+ horas/dia subestima o nível de atividade física moderada.

Associação entre prática de atividade física e indicadores de comportamento sexual de risco em adolescentes / Association between physical activity and indicators of risk sexual behavior in adolescents

O objetivo deste estudo foi analisar a associação entre prática de atividades físicas no lazer (PAFL) e participação nas aulas de Educação Física (PAEF) com indicadores de comportamento sexual de risco (CSR) em estudantes adolescentes. Para tanto, adotou-se estudo transversal mediante análise secundária de dados de uma amostra representativa de estudantes do ensino médio da rede pública estadual de Pernambuco. Dados de 4.207 estudantes (14-19 anos) foram coletados mediante aplicação de questionário. Os adolescentes que relataram não ter usado preservativo na última relação sexual ou ter três ou mais parceiros ao longo da vida foram considerados expostos aos CSR. Nas análises de regressão logística o CSR foi definido como desfecho enquanto a PAFL e PAEF foram consideradas variáveis independentes. Sexo, faixa etária, afiliação religiosa, morar com os pais, consumo de álcool e tabagismo foram fatores incluídos nas análises como covariáveis. Observou-se que os adolescentes que relataram participar de pelo menos uma aula de Educação Física tinham chance 25% inferior de intercurso sexual sem uso de preservativo quando comparados àqueles que não participavam das aulas. Aqueles que referiram praticar AFL tinham chance 67% superior de relatarem experiência de intercurso sexual com três ou mais parceiros. A PAEF e a PAFL foram identificados como fatores associados a indicadores de CSR, mas o inesperado sentido da ligação entre PAFL e números de parceiros na vida exige aprofundamento da investigação nesta área.

The aim of this study was to analyze the association between physical activity during leisure time (PAL) and participation in physical education classes (PEC) with indicators of sexual risk behavior (SRB) in adolescents. It was a cross-sectional study using secondary analysis of data from a representative sample of high school students attended at the state public education system in Pernambuco. Data from 4,207 students (14-19 years) were collected by applying a previously validated questionnaire. Students who reported not have used a condom in the last intercourse and had three or more partners during their life were considered exposed to SRB. Logistic regression was performed with SRB set as dependent variable, PAL and PEC defined as independent variables, and sex, age group, religious affiliation, living with parents, alcohol consumption and smoking as potential confounders. It was observed that adolescents who reported have participated of PEC at least one time per week were 25% less likely to refer have not used condom in the last sexual intercourse in comparison with those who never participated in physical education classes. In relation to sexual intercourse, those who reported practice of PAL have a 67% higher likelihood to have had three or more partners in their lifetime sexual experience. It was concluded that PEC and PAL were associated with sexual risk behaviors, but the surprising direct association between PAL practice and number of sexual partners needs to be further investigated to elucidate causal pathways.