Epigenetic mechanisms linking early-life adversities and mental health.

Early-life adversities, whether prenatal or postnatal exposure, have been linked to adverse mental health outcomes later in life increasing the risk of several psychiatric disorders. Research on its neurobiological consequences demonstrated an association between exposure to adversities and persistent alterations in the structure, function, and connectivity of the brain. Consistent evidence supports the idea that regulation of gene expression through epigenetic mechanisms are involved in embedding the impact of early-life experiences in the genome and mediate between social environments and later behavioral phenotypes. In addition, studies from rodent models and humans suggest that these experiences and the acquired risk factors can be transmitted through epigenetic mechanisms to offspring and the following generations potentially contributing to a cycle of disease or disease risk. However, one of the important aspects of epigenetic mechanisms, unlike genetic sequences that are fixed and unchangeable, is that although the epigenetic markings are long-lasting, they are nevertheless potentially reversible. In this review, we summarize our current understanding of the epigenetic mechanisms involved in the mental health consequences derived from early-life exposure to malnutrition, maltreatment and poverty, adversities with huge and pervasive impact on mental health. We also discuss the evidence about transgenerational epigenetic inheritance in mammals and experimental data suggesting that suitable social and pharmacological interventions could reverse adverse epigenetic modifications induced by early-life negative social experiences. In this regard, these studies must be accompanied by efforts to determine the causes that promote these adversities and that result in health inequity in the population.

Differential Experiences of Intimate Partner Violence during COVID-19: A Cross-Regional Study in Mexico.

The COVID-19 pandemic brought on a marked increase in intimate partner violence (IPV) worldwide, Mexico being no exception. Factors that exacerbated gender-based violence (GBV) in the household during the pandemic include gendered loss of income, regression in access to social and legal justice resources, reversal to more traditional gender norms and roles, and increased alcoholism. While there are studies about the prevalence and determinants of IPV in rural and urban Mexico, there appears to be a lack of information regarding how these realities differed as they interacted with the compounding pressures of the COVID-19 pandemic. Stemming from 10 ethnographic interviews with women across rural and urban localities of Oaxaca, Mexico City, and Mexico State, who were recruited from NGOs providing psychological and legal services against GBV, we analyze some factors associated with the prevalence of IPV during confinement. We conclude that all women in our study experienced IPV both before and during the pandemic, with variations in IPV patterns influenced by their rural or urban residence, socio-economic status, ethnic-racial identity, and proximity to the abuser's network. We also found that not all impacts were negative, rather COVID-19 measures had a paradoxical effect for some women where restrictions on geographical mobility and decrease in access to alcohol became pivotal protective factors. We recommend that public policymakers and civil society organizations alike pay attention to these differential challenges and benefits in their crisis responses.

Socio-economic factors related to premature death from colorectal cancer in Santiago de Chile, 2014-2018: a cross-sectional study.

OBJECTIVES: In Chile, colorectal cancer (CRC) is the fourth cause of death by cancer. Few studies have evaluated the role of contextual and individual socio-economic variables associated with premature death by CRC (<70 years). We analyzed the association between socio-economic factors (at individual and contextual levels) and premature death from CRC in Santiago de Chile. STUDY DESIGN: This was a cross-sectional study. METHODS: We analyzed deaths from CRC between 2014 and 2018 using data published by the Ministry of Health. Individual predictors were sex, marital status, and educational level. Contextual variable included the Social Priority Index (SPI) of the commune where the deceased lived. The association was assessed through multilevel logistic regression models. RESULTS: During the period, 4762 deaths occurred (51.7% women); 39.3% were premature. At the individual level, male sex (odds ratio [OR] 1.36; 95% confidence interval [CI] 1.20-1.53) and single marital status (OR 1.45; 95% CI 1.24-1.68) were associated with premature death from CRC. Primary or lower education was a protective factor (OR 0.53; 95% CI 0.47-0.60). At the contextual level, communes with a higher SPI were three times more at risk than those with a lower SPI (OR 3.13; 95% CI 2.15-4.57). CONCLUSIONS: This study showed that individual and contextual socio-economic variables are related to premature death from CRC. Residing in communes with greater socio-economic vulnerability was associated with greater risk. To reduce this gap, it is urgent to design and implement structural policies to reduce social inequities and improve access to health care.

Does schooling attained by adult children affect parents' psychosocial well-being in later life? Using Mexico's 1993 compulsory schooling law as a quasi-experiment.

Higher adult child educational attainment may benefit older parents' psychosocial well-being in later life. This may be particularly important in low- and middle-income countries, where recent generations have experienced comparatively large increases in educational attainment. We used data from the 2012 Mexican Health and Aging Study, a nationally representative study of adults aged ≥50 years and leveraged the exogenous variation in adult child education induced by Mexico's compulsory schooling law passed in 1993. We employed two-stage least squares (2SLS) regression to estimate the effects of increased schooling among adult children on parents' (respondents') depressive symptoms and life satisfaction scores, controlling for demographic and socioeconomic characteristics. We considered heterogeneity by parent and child gender and other sociodemographic characteristics. Our study included 7186 participants with an average age of 60.1 years; 54.9% were female. In the 2SLS analyses, increased schooling among oldest adult children was associated with fewer depressive symptoms (ß = -0.25; 95% CI: -0.51, 0.00) but no difference in life satisfaction (ß = 0.01; 95% CI: -0.22, 0.25). Stratified models indicated differences in the magnitude of association with depressive symptoms for mothers (ß = -0.27, 95% CI: -0.56, 0.01) and fathers (ß = -0.18, 95% CI: -0.63, 0.26) and when considering increased schooling of oldest sons (ß = -0.37; 95% CI: -0.73, -0.02) and daughters (ß = -0.05, 95% CI: -0.23, 0.13). No parent and child gender differences were found for life satisfaction. Power was limited to detect heterogeneity across other sociodemographic characteristics in the second stage although first-stage estimates were larger for urban (vs. rural) dwelling and more (vs. less) highly educated respondents. Results were similar when considering the highest educated child as well as increased schooling across all children. Our findings suggest that longer schooling among current generations of adult children, particularly sons, may benefit their older parents' psychosocial well-being.

Changes in Height and Body Weight Within a Time Period of 35 Years in Males of the Same Age / Cambios en la Altura y el Peso Corporal en un Período de 35 Años en Hombres de la Misma Edad

SUMMARY: Height and body weight measurements are among the most important anthropometric variables when assessing a population's growth, development and body composition. This study aimed to evaluate the height and body weight variability of male entities aged 17-18 years within 35 years. This goal was realized by comparing the height and body weight of the population of the same gender and age in three different time studies. The descriptive statistical parameters and T-test for independent groups show systematic and significant differences in measured variables between three measurements in different timelines. Both in body height and body weight, from measurement to measurement, significant systematic and statistically significant differences (p<0.01) have been identified (1985: BH= 172.8cm, BW= 61.7kg; 2004: BH=176.8 cm, BW=66.9 kg; 2019: BH=178.5 cm, BW=72 kg). The results of this study prove that the change in the socio-economic status of a population over a period time of 35 years can significantly affect the growth and development of children/adolescents.

Las medidas de altura y peso corporal se encuentran entre las variables antropométricas más importantes a la hora de evaluar el crecimiento, el desarrollo y la composición corporal de una población. Este estudio tuvo como objetivo evaluar la variabilidad de la altura y el peso corporal de entidades masculinas de 17 a 18 años dentro de 35 años. Este objetivo se logró comparando la altura y el peso corporal de la población del mismo sexo y edad en tres estudios temporales diferentes. Los parámetros estadísticos descriptivos y la prueba T para grupos independientes muestran diferencias sistemáticas y significativas en las variables medidas entre tres mediciones en diferentes líneas de tiempo. Tanto en la altura como en el peso corporal, de medición en medición, se han identificado diferencias significativas sistemáticas y estadísticamente significativas (p<0,01) (1985: BH= 172,8 cm, BW= 61,7 kg; 2004: BH=176,8 cm, BW=66,9 kg; 2019: BH=178,5 cm, BW=72 kg). Los resultados de este estudio demuestran que el cambio en el estatus socioeconómico de una población durante un período de 35 años puede afectar significativamente el crecimiento y desarrollo de niños/ adolescentes.

Towards closing socio-economic status disparities in COVID-19 premature mortality: a nationwide and trend analysis in Chile.

BACKGROUND: Socio-economic status (SES) disparities in coronavirus disease 2019 (COVID-19) mortality have been reported but complete information and time trends are scarce. In this study, we analysed the years of life lost (YLL) due to COVID-19 premature mortality during the pandemic in Chile and its evolution according to SES and sex compared with a counterfactual scenario [cerebrovascular accidents (stroke)]. METHOD: We used Chile's national mortality databases from 2020 to 2022. YLL and age-standardized YLL and mortality rates by sex and by epidemic waves were determined. The 346 communes were stratified into SES groups according to their poverty index quintile. Negative binomial regression models were used to test trends. RESULTS: In >2 years of the pandemic, the COVID-19 YLL was 975 937, corresponding to 61 174 deaths. The YLL rate per 100 000 inhabitants was 1027 for males and 594 for females. There was a heterogeneous distribution of YLL rates and the regional level. Communes in the most advantaged SES quintile (Q5) had the highest YLL during the first wave compared with those in the lowest SES quintile (Q1) (P < 0.001) but the opposite was true during the second wave. COVID-19 YLL trends declined and differences between Q1 and Q2 vs Q5 converged from the second to the fourth waves (0.33 and 0.15, Ptrend < 0.001 and Ptrend = 0.024). YLL declined but differences persisted in stroke (-0.002, Ptrend = 0.979). CONCLUSIONS: COVID-19 deaths resulted in a higher impact on premature death in Chile, especially in men, with a heterogeneous geographic distribution along the territory. SES and sex disparities in COVID-19 premature mortality had narrowed by the end of the pandemic.

The impact of macroeconomic variables on socio-economic indicators of agricultural section based on Government development programs / O impacto das variáveis macroeconômicas nos indicadores socioeconômicos do setor agropecuário com base nos programas de desenvolvimento do Governo

In this paper, the short-term and long-term effects of macroeconomic variables on socio-economic indicators of agricultural sector, including price index, rural unemployment and gross domestic product (GDP) over the first to six government development programs were investigated. The auto-regressive distributed lag approach (ARDL) was used. The results showed that in the short run, inflation rate with a delay has a significant and negative effect on employment in the agricultural sector and increases the level of rural unemployment. The findings suggest that the effects of liquidity and inflation rate in the short run on the GDP are negative and government spending in the short run has a positive effect on the agricultural price index. In the long run, the effect of these variables on agricultural inflation is similar to the short term, but with the difference that the elasticities were larger.

Neste artigo, foram investigados os efeitos de curto e longo prazo das variáveis macroeconômicas sobre os indicadores socioeconômicos do setor agrícola, incluindo índice de preços, desemprego rural e produto interno bruto (PIB) sobre os primeiros seis programas de desenvolvimento do governo. Foi utilizada a abordagem de atraso distribuído autorregressivo (ARDL). Os resultados mostraram que no curto prazo a taxa de inflação com atraso tem um efeito significativo e negativo sobre o emprego no setor agrícola e aumenta o nível de desemprego rural. Os resultados sugerem que os efeitos da liquidez e da taxa de inflação no curto prazo sobre o PIB são negativos e os gastos do governo no curto prazo têm efeito positivo sobre o índice de preços agrícolas. No longo prazo, o efeito dessas variáveis ​​sobre a inflação agrícola é semelhante ao de curto prazo, mas com a diferença de que as elasticidades foram maiores.

Reported recommendations to address cardiovascular risk factors differ by socio-economic status in Brazil. Results from the Brazilian National Health Survey 2019.

Background: Management of cardiovascular risk factors (high cholesterol, diabetes, and hypertension) should start by implementing a healthy lifestyle. Whereas lifestyle recommendations are provided irrespective of the patient's socio-economic status has not been recently assessed in the Brazilian population. Aims: To assess the preventive measures against cardiovascular risk factors according to educational level and income in the Brazilian population. Methods: Survey data of the 2019 Brazilian National Health Survey (PNS). The PNS is a nationwide household-based survey carried out by the Brazilian Ministry of Health. The PNS included face-to-face interviews and collected information on lifestyle management of high cholesterol, diabetes, and hypertension by a healthy diet, an adequate weight, exercise, and quitting smoking. The participant's educational level and income (in multiples of the basic salary per capita) was collected. Results: Of the 88,052 participants included, 13,151 (14.9%), 6,986 (7.9%) and 22,516 (25.6%) reported being diagnosed with high cholesterol, diabetes, or hypertension, respectively. Dietary recommendations were the most frequently provided (94.5%, 94.6% and 88.1% for high cholesterol diabetes, and hypertension, respectively), while recommendations to quit smoking to current smokers were the least frequently provided (74.9%, 85.8% and 81.1% for high cholesterol, diabetes, and hypertension, respectively). After multivariable adjustment, participants with a higher educational level or a higher income had a higher likelihood of reporting receipt lifestyle recommendations for high cholesterol or hypertension, while no associations were found for most recommendations for diabetes. Conclusion: Better-educated, wealthier Brazilians report receiving more lifestyle recommendations regarding high cholesterol and hypertension management more frequently than lower-educated or with low-income.

Age and socio-economic status affect dengue and COVID-19 incidence: spatio-temporal analysis of the 2020 syndemic in Buenos Aires City.

In early 2020, Argentina experienced the worst dengue outbreak in its history, concomitant with first-to-date increasing COVID-19 cases. Dengue epidemics in temperate Argentina have already been described as spatially heterogeneous; in the previous 2016 outbreak, transmission occurred 7.3 times more frequently in slums compared to the rest of Buenos Aires City (CABA). These informal settlements have deficient sanitary conditions, precarious housing and high incidence of social vulnerabilities. The purpose of this work was to study the spatio-temporal patterns of the 2020 dengue epidemic in CABA in relation to socio-economic living conditions of its inhabitants and its interaction with the onset of COVID-19. The study considered the period between Jan 1st and May 30th 2020. Dengue and COVID-19 databases were obtained from the National Health Surveillance System; each record was anonymized and geo-localized. The city was divided according to census tracts and grouped in four socio-economic strata: slums, high, mid and low residential. An aligned-rank transform ANOVA was performed to test for differences in the incidence of dengue and COVID-19, and age at death due to COVID-19, among socio-economic strata, four age categories and their interaction. The incidence by cluster was calculated with a distance matrix up to 600 m from the centroid. Spatial joint dengue and COVID-19 risk was estimated by multiplying the nominal risk for each disease, defined from 1 (low) to 5 (high) according to their quantiles. During the study period, 7,175 dengue cases were registered in CABA (incidence rate 23.3 cases per 10,000 inh), 29.2% of which occurred in slums. During the same period, 8,809 cases of COVID-19 were registered (28.6 cases per 10,000 inh); over half (51.4%) occurred in slums, where the median age of cases (29 years old) was lower than in residential areas (42 years old). The mean age of the deceased was 58 years old in slums compared to 79 years old outside. The percentage of deaths in patients under 60 years old was 56% in slums compared to 8% in the rest of the city. The incidence of both diseases was higher in slums than in residential areas for most age categories. Spatial patterns were heterogeneous: dengue presented higher incidence values in the southern sector of the city and the west, and low values in highly urbanized quarters, whereas COVID-19 presented higher values in the east, south, high populated areas and slums. The lowest joint risk clusters were located mainly in high residential areas, whereas high joint risk was observed mainly in the south, some western clusters, the historical part of the city and center north. The social epidemiological perspective of dengue and COVID-19 differed, given that socio environmental heterogeneity influenced the burden of both viruses in a different manner. Despite the overwhelming effect of the COVID-19 pandemic, health care towards other diseases, especially in territories with pre-existing vulnerabilities, should not be unattended.

Measuring categorisation in pre-school children: new toolkit, new insights

Introduction: whilst recent years have witnessed considerable research into infant categorisation, its development during the pre-school period has garnered far less interest and innovation. Objective: this paper documents the development of a valid and reliable new toolkit for measuring categorisation in children, designed to allow fine-grained differentiation through four short tasks. Methods: the paper outlines how a pilot study with 55 children reduced confounding variables, ruled out several explanations for performance variations and enabled procedural refinements. It then documents a study conducted with 190 children aged 30-60 months. Results: this more sophisticated testing mechanism challenges previously accepted developmental norms and suggests both sex and socio-economic status (and their interaction) influence categorisational abilities in pre-schoolers. Conclusion: the results indicate that preschool children's ability to categorise varies markedly, with implications for their capacity to access formal education.

Introdução: embora nos últimos anos tenha havido pesquisas consideráveis sobre a categorização infantil, seu desenvolvimento durante o período pré-escolar atraiu muito menos interesse e inovação. Objetivo: este artigo documenta o desenvolvimento de um novo kit de ferramentas válido e confiável para medir a categorização em crianças, projetado para permitir diferenciação refinada por meio de quatro tarefas curtas. Método: o artigo descreve como um estudo piloto com 55 crianças reduziu variáveis de confusão, descartou várias explicações para variações de desempenho e permitiu refinamentos de procedimentos. Em seguida, documenta um estudo realizado com 190 crianças de 30 a 60 meses. Resultados: este mecanismo de teste mais sofisticado desafia as normas de desenvolvimento previamente aceitas e sugere que o sexo e o status socioeconômico (e sua interação) influenciam as habilidades de categorização em pré-escolares. Conclusão: os resultados indicam que a capacidade de categorização dos pré-escolares varia acentuadamente, com implicações na sua capacidade de acesso à educação forma

Parental participation and parents' support: effects on mathematics achievement, 2018 national assessment of learning, Mexico.

The relationship between family involvement in students' academic activities, their learning, and academic achievement has been widely studied. Two different types of family involvement are recognized: parental participation, which is linked to activities implemented by the school, and parental support, which occurs at home and has to do with the family's educational practice. This study analyzed the influence of parental participation in school activities, parental support at home, and family socioeconomic status on student learning in mathematics. The database of 104,973 third-year secondary education students (50.1% female and 49.9% male) from the 2018 assessment of academic achievement in mathematical thinking was considered. Path analysis was employed in structural equation modeling, where a general model of parental support was proposed to compare the learning of students from the lowest quartile and those from the highest socioeconomic level; the model presented a good fit for each group. The models used showed acceptable adjustments in some criteria; in these models, there were positive and significant associations between parental schooling and socioeconomic level and achievement in mathematics. The results obtained are consistent with the findings of other studies in which parental support, mediated by socioeconomic status, significantly influences student learning.

Risk Factors, Presentation, and Outcome in Acute Stroke according to Social Position Indicators in Patients Hospitalised in a Referral Centre in Bogotá 2011-2019.

INTRODUCTION: Treatment of stroke is time-dependent and it challenges patients' social and demographic context for timely consultation and effective access to reperfusion therapies. OBJECTIVE: The objective of this study was to relate indicators of social position to cardiovascular risk factors, time of arrival, access to reperfusion therapy, and mortality in the setting of acute stroke. METHODS: A retrospective analysis of patients with a diagnosis of ischaemic stroke in a referral hospital in Bogotá was performed. A simple random sample with a 5% margin of error and 95% confidence interval was selected. Patients were characterised according to educational level, place of origin, marital status, occupation, duration of symptoms before consultation, cardiovascular risk factors, access to reperfusion therapy, and mortality during hospitalisation. RESULTS: 558 patients were included with a slight predominance of women. Diagnosis of diabetes was more common in women and smoking in men (n = 68, 28.4% vs. n = 51, 15.9%; p = 0.0004). Rural origin was associated with higher prevalence of hypertension, diabetes, and dyslipidaemia (hypertension n = 45, 73.8% vs. n = 282, 57.4%; p = 0.007; diabetes n = 20, 33.3% vs. 109, 19.5%; p = 0.02; dyslipidaemia n = 19, 32.7% vs. n = 93, 18.9%; p = 0.02). Mortality was higher in rural patients (n = 8, 14.2% vs. n = 30, 6.1%; p = 0.03). Lower schooling was associated with higher frequency of hypertension and dyslipidaemia (hypertension n = 152, 76.0% vs. n = 94, 46.3%; p ≤ 0.0001; dyslipidaemia n = 56, 28% vs. n = 35, 17.0%; p = 0.009) as well as with late consultation (n = 30, 15% vs. n = 59, 28.7%; p = 0.0011) and lower probability of accessing reperfusion therapy (n = 12, 6% vs. n = 45, 22%; p ≤ 0.0001). Formal employment was associated with a visit to the emergency department in less than 3 h (n = 50, 25.2% vs. n = 58, 18%, p = 0.04 and a higher probability of accessing reperfusion therapy (n = 35, 17.6% vs. n = 33, 10.2%; p = 0.01). Finally, living in a household with a stratum higher than 3 was associated with a consultation before 3 h (n = 77, 25.5% vs. n = 39, 15.6%; p = 0.004) and a higher probability of reperfusion therapy (n = 57, 18.9% vs. n = 13, 5.2%; p ≤ 0.0001). CONCLUSION: Indicators of socio-economic status are related to mortality, consultation time, and access to reperfusion therapy. Mortality and reperfusion therapy are inequitably distributed and, therefore, more attention needs to be directed to the cause of these disparities in order to reduce the access gap in the context of acute stroke in Bogotá.

SARS-CoV-2 Infection in Cities from the Southern Region of Bahia State, Brazil: Analysis of Variables Associated in Both Individual and Community Level.

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), challenged public health systems worldwide. Individuals in low-income countries/regions are still at individual and community risk concerning inequality, sanitation, and economic conditions. Besides, during the pandemic, the transmission in municipalities and communities in the countryside and less developed regions kept viral spread and required structured and strengthened clinical and laboratory surveillance. Here, we present an observational, analytic, cross-sectional study conducted using secondary data from the Laboratório de Farmacogenômica e Epidemiologia Molecular (LAFEM)-Universidade Estadual de Santa Cruz (UESC), to evaluate individual and community factors associated to SARS-CoV-2 infection in outpatients from different cities from Southern Region of Bahia State, in Brazil. The data were collected between June 2021 and May 2022. The SARS-CoV-2 positivity by RT-qPCR was correlated with low socio-economic indicators, including the Human development index (HDIc) and Average worker salary (AWSc). Besides, in general, females were less likely to test positive for SARS-CoV-2 (OR = 0.752; CI 95% 0.663-0.853; p < 0.0001), while brown individuals had more positivity for infection (p < 0.0001). In addition, those who had clinical symptoms were more likely to test positive for SARS-CoV-2 (OR = 6.000; CI 95% 4.932-7.299; p < 0.0001). Although dry cough, headache, and fever were the most frequent, loss of taste (OR = 5.574; CI 95% 4.334-7.186) and loss of smell (OR = 6.327; CI 95% 4.899-8.144) presented higher odds ratio to be positive to SARS-CoV-2 by RT-qPCR. Nonetheless, the distribution of these characteristics was not homogenous among the different cities, especially for age and gender. The dynamic of SARS-CoV-2 positivity differed between cities and the total population and reinforces the hypothesis that control strategies for prevention needed to be developed based on both individual and community risk levels to mitigate harm to individuals and the health system.

Validity of self-reported oral conditions among Brazilian older women: Do socio-economic factors matter?

OBJECTIVE: To validate the level of agreement between self-report and clinical examination for oral conditions and evaluate the effect of sociodemographic conditions on the validity of self-report among women aged 60 and older. METHODS: A cross-sectional study was conducted in a social community center for seniors in Southern Brazil. Sociodemographic data (age, level of education, and income) were measured. Participants were interviewed and clinically examined for the number of teeth (DMF-T index) and the use of dental prostheses. The self-reported number of teeth in each arch and the use of dental prostheses were gathered through interviews. The level of agreement was estimated using the observed agreement, Kappa statistics, sensitivity/specificity (edentulism/prostheses) and Lin's concordance correlation coefficient, and related tests (number of teeth). The validity of the oral conditions was estimated according to sociodemographic information. RESULTS: Ninety-nine women participated in the study. High levels of agreement were observed for edentulism (97.8%; 95%CI 92.8;99.7; Kappa 0.947) and the use of dental prostheses (97.0%; 95%CI 91.3;99.4; Kappa 0.922). In both conditions, despite achieving similar concordance correlation coefficients (ranging from weak to moderate), the mean number of upper teeth was lower in clinical examination (7.1 ± 5.2) compared with self-reported (8.6 ± 3.6), while the opposite was observed for lower teeth (clinical examination: 9.1 ± 3.4; self-reported: 6.6 ± 5.3). Larger differences were found among women of low income and educational levels. CONCLUSIONS: Our findings suggest that the participants' socio-economic position might influence their self-reported number of teeth.

Sociodemographic determinants of eating patterns in two Latin American populations.

BACKGROUND: The present study aimed to describe the dietary patterns of a population from Brazil and another from Colombia with respect to understanding their determinants, similarities and differences. METHODS: An analytical cross-sectional study was conducted based on secondary data. The dietary patterns of the adult population of Pernambuco, Brazil, as well as those of the adult population of Antioquia, Colombia, were analysed using principal component analysis method with orthogonal varimax rotation, and a Poisson regression with robust variance was used to verify the association between eating patterns and socio-economic variables. RESULTS: In each population, three eating patterns were identified. One of them related to healthy eating, named "Prudent", was identified in the two populations analysed. In Pernambuco, a food pattern consisting exclusively of foods with some degree of processing was verified, entitled "Processed". The food culture was reflected in the pattern called "Traditional-Regional" in Pernambuco and the "Traditional" and "Regional" patterns in Antioquia. CONCLUSIONS: Income, education, age, family size, food security status and area of residence were presented as determinants of dietary patterns in both populations. Elements of the food transition were found, which seems to have happened more rapidly in Pernambuco. The food groups that make up the dietary patterns of each population are similar, but the foods that constitute them present differences due to their availability depending on aspects such as climate, soil quality, access to water, local culture and food tradition.

Socio-economic status, psychosocial factors, health behaviours and incidence of dental caries in 12-year-old children living in deprived communities in Manaus, Brazil.

OBJECTIVES: This study examines the relationships between socio-economic status, psychosocial factors, health-related behaviours and the incidence of dental caries amongst 12-year-old schoolchildren living in deprived communities in Manaus, Brazil. METHODS: A longitudinal study involving 312 children aged 12 years was conducted in the city of Manaus, Brazil. Baseline data including socio-economic status (number of goods, household overcrowding, parents' schooling, family income), psychosocial factors (sense of coherence [SOC-13], social support [Social Support Appraisals questionnaire]) and health-related behaviours (frequency of toothbrushing, sugar consumption, sedentary behaviour) were collected through structured questionnaires. The number of decayed teeth was clinically assessed at baseline and one-year follow-up. A hypothesised model evaluating the direct and indirect pathways between the variables was tested using confirmatory factor analysis and structural equation modelling. RESULTS: The incidence of dental caries at the one-year follow-up was 25.6%. Sugar consumption (ß = 0.103) and sedentary behaviour (ß = 0.102) directly predicted the incidence of dental caries. A higher socio-economic status was directly linked with lower sugar consumption (ß = -0.243) and higher sedentary behaviour (ß = 0.227). Higher social support directly predicted lower sugar consumption (ß = -0.114). Lower socio-economic status (ß = -0.046) and lower social support (ß = -0.026) indirectly predicted the incidence of dental caries via sugar consumption and sedentary behaviour. CONCLUSIONS: In the population studied, sugar consumption and sedentary behaviour are meaningful predictors of the incidence of dental caries amongst schoolchildren living in deprived communities. Indirect pathways of lower socio-economic status and low social support with dental caries incidence via sugar consumption and sedentary behaviour were detected. These findings should be considered in oral interventions and oral health care policies to prevent dental caries amongst children living in deprivation. CLINICAL SIGNIFICANCE: Social conditions, social support, sedentary behaviour and sugar consumption directly influence dental caries in children.

Is There Any Relationship between Physical Activity Levels and Academic Achievement? A Cross-Cultural Study among Spanish and Chilean Adolescents.

The current scientific literature has shown significant disparity in results when physical activity is linked to academic achievement among adolescents. Thus, the main objectives of this study were (1) to analyze the relationship among students' academic achievement, intention to be physically active, and physical activity levels depending on the country (Spain or Chile), as well as to analyze these relationships based on students' socio-economic status, type of school, school year, gender, and body mass index; and (2) to analyze the differences between all these variables depending on the students' country and gender. In total, 3052 adolescents participated in the research (14.58 ± 1.39 years): 734 Chilean students (336 males and 398 females) and 2318 Spanish students (1180 males and 1138 females). Various questionnaires were used to measure the study variables. The results revealed significant relationships between academic achievement and the rest of the variables in Spanish adolescents, but in the Chilean population, academic achievement was significantly related only to socio-economic status and the type of school. Moreover, Spanish students obtained higher scores, especially the males, except for academic achievement, which was higher in females. There were also significant differences in academic achievement, intention to be physically active, physical activity levels, and socio-economic status depending on the country, with all scores being higher in Spain. Given the results, the country seems to be an important factor when comparing academic achievement and physical activity levels, besides other demographic variables.

Socio-economic inequalities in the effect of public policies and the COVID-19 pandemic on exclusive breastfeeding in Chile.

OBJECTIVE: To assess the impact of the addition of 12 maternity leave (ML) weeks (2011), a pay for performance (P4P) exclusive breastfeeding (EBF) promotion strategy (2015), and the COVID-19 pandemic in EBF inequalities in Chile. STUDY DESIGN: Interrupted time-series analyses (ITSAs). METHODS: Aggregated national EBF data by municipality and month were collected from 2009 to 2020. We assess the impact of the three events in EBF inequalities using two procedures: 1. ITSA stratified by municipal SES quintiles (Q1-Q5); 2. Calculating the EBF slope index of inequality (SII). RESULTS: The EBF prevalence was higher in lower SES municipalities before and after the three time-events. No impact in EBF inequalities was observed after the extended ML. The P4P strategy increased EBF at six months in all SES quintiles (effect size between 4% and 5%), but in a higher level in poorer municipalities (SII: -0.36% and -1.05%). During COVID-19, wealthier municipalities showed a slightly higher EBF at six months prevalence (SII: 1.44%). CONCLUSION: The null impact of the extended ML in EBF inequalities could be explained by a low access to ML among affiliated to the public health system (20%). The P4P strategy includes multiple interventions that seemed effective in increasing EBF across all SES quintiles, but further in lower quintiles. The restrictions in healthcare access in poorer municipalities could explain EBF inequalities during COVID-19.

Neuroanatomical correlates of macrostructural receptive abilities in narrative discourse in unilateral left hemisphere stroke: A behavioural and voxel-based morphometry study.

BACKGROUND: Little is known about story retelling and comprehension abilities in groups with lower levels of education and socio-economic status (SES). A growing body of evidence suggests the role of an extended network supporting narrative comprehension, but few studies have been conducted in clinical populations, even less in developing countries. AIMS: To extend our knowledge of the impact of a stroke on macrostructural aspects of discourse processes, namely main and complementary information, in individuals with middle-low to low SES and low levels of education. Relationships were tested between the performance in story retell and comprehension and reading and writing habits (RWH). Also, the associations between retelling and comprehension measures and their structural grey matter (GM) correlates were explored. METHODS & PROCEDURES: A total of 17 adults with unilateral left hemisphere (LH) chronic ischaemic stroke without the presence of significant aphasia and 10 matched (age, education and SES) healthy controls (HC) participated in the study. Retell and comprehension tasks were performed after listening or reading narrative stories. Voxel-based morphometry (VBM) analysis was conducted on a subgroup of nine individuals with LH stroke and the 10 matched controls using structural magnetic resonance imaging (MRI). OUTCOMES & RESULTS: Retelling and comprehension abilities were not significantly different between LH and HC, nonetheless quantitively lower in LH. Exploratory correlations showed that retelling and comprehension abilities in both written and auditory modalities were correlated with naming abilities. At the neural level, written comprehension positively correlated with GM density of the LH, including areas in the temporal pole, superior and middle temporal gyrus as well as the orbitofrontal cortex, precentral and postcentral gyri. Auditory narrative comprehension was associated with GM density of the lingual gyrus in the right hemisphere. CONCLUSIONS & IMPLICATIONS: The present results suggest that retelling and comprehension of auditory and written narratives are relatively well-preserved in individuals with a LH stroke without significant aphasia, but poorer than in HC. The findings replicate previous studies conducted in groups with higher levels of education and SES both at the behavioural and neural levels. Considering that naming seems to be associated with narrative retell and comprehension in individuals with lower SES and education, this research provides evidence on the importance of pursuing further studies including larger samples with and without aphasia as well as with various SES and education levels. WHAT THIS PAPER ADDS: What is already known on this subject Story retell and comprehension of auditory and written discourse have been shown to be affected after stroke, but most studies have been conducted on individuals with middle to high SES and high educational levels. What this paper adds to existing knowledge The study reports on narrative retell and comprehension in both auditory and written modalities in groups of HC and individuals with LH brain damage, with low-to-middle SES and lower levels of education. What are the potential or actual clinical implications of this work? This study highlights the importance of taking into consideration the sociodemographic and RWH of patients when assessing discourse retell and comprehension in both auditory and written modalities. It also underlines the importance of including patients without significant aphasia following LH stroke to look at the effect of both stroke and aphasia on narrative comprehension and story retelling.

Socio-economic determinants of healthy behaviours among primary schoolchildren and adolescents in Lokossa district of southern Benin.

BACKGROUND: There is little information regarding fruit and vegetable (FV) intake and physical activity (PA) among schoolchildren in Benin. In this study we evaluated the differences in breakfast eating, FV consumption and PA according to socio-economic (SE) determinants in primary schoolchildren. METHODS: A cross-sectional study using a probabilistic sample of 612 students (8-17 y of age) from 26 primary schools was done between December 2018 and January 2019. The association was estimated by logistic regression analyses. RESULTS: Of all students, 53% were physically inactive, 60% took breakfast <5 d/week, 84% irregularly ate fruits and 68% irregularly ate vegetables. Younger students (8-10 y) take breakfast regularly and older ones (>15 y) were physically more active. The probability of regular breakfast and fruit consumption were significantly higher in children of educated parents (p<0.01 and p<0.001, respectively) compared with children of non-educated parents. Medium SE status was associated with regular breakfast intake, whereas high SE status was associated with higher fruit intake and lower physical activity compared with low SE status (p<0.001). There was no association between breakfast eating, FV intake, PA and the body mass index. CONCLUSIONS: Findings emphasize the need for interventions to promote healthy eating behaviours in primary schoolchildren and their family environments.