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1.
Infant Ment Health J ; 44(5): 663-678, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37608475

RESUMO

Early detection of behavioral disorders in children is necessary for intervention. Available data show a high prevalence of child and adolescent psychiatric disorders in Chile (22.5%), but behavioral problems in younger children have not been evaluated. This work assesses behavioral disorders in preschoolers and their association with sociodemographic variables of the family and the child. The data was collected during the impact assessment of the Biopsychosocial Development Support Program "Chile Crece Contigo", using a multistage and representative random sample of 1377 preschoolers, aged between 30 and 48 months, who attended public health services. Homes were visited to apply a questionnaire and the Child Behavior Checklist (CBCL, 1.5-5 years). Results: Multivariable regression model for total raw scores shows that child's age, the number of chronic diseases in the child, and history of exposure to mother's alcohol consumption in pregnancy, remain significant when adjusted for all variables included (R2 of 17.8% and η2 of .19 (95% CI: .14-.22)). In externalizing and internalizing explanatory models, child's chronic diseases and a higher score of authoritarian beliefs about parenting show the two largest effect sizes. These results add to the evidence of urgent problems in preschool mental health.


La temprana detección de trastornos de comportamiento en los niños es necesaria para la intervención. La información disponible muestra una alta prevalencia de trastornos siquiátricos de niños y adolescentes en Chile (22.5%), pero no se han evaluado los problemas de comportamiento en niños más pequeños. Este trabajo evalúa trastornos de comportamiento en niños de edad prescolar y su asociación con variables sociodemográficas de la familia y del niño. La información se recogió durante la evaluación del impacto del Programa de Apoyo al Desarrollo Biosicosocial "Chile Crece Contigo," usando un grupo muestra de multiniveles representativo de 1,377 niños prescolares, de entre 30 y 48 meses de edad, quienes recibían servicios de salud pública. Se visitaron las casas para dar un cuestionario y la Lista de Comprobación del Comportamiento del Niño (CGCL, 1.5-5 años). Resultados: El modelo de regresión de variables múltiples para el total de la puntuación en bruto muestra que la edad del niño, el número de enfermedades crónicas en el niño, así como el historial de exposición al consumo de alcohol por parte de la madre durante el embarazo permanecen siendo significativos cuando se les ajusta para todas las variables incluidas (R2 de 17.8% y η2 de 0.19 (95% CI 0.14 a 0.22)). En los modelos explicativos de externalización e internalización, las enfermedades crónicas del niño y un más alto puntaje de creencias autoritarias acerca de la crianza demuestran ser las dos con la magnitud de efectos más extensa. Estos resultados contribuyen aun más a la evidencia sobre los problemas urgentes en la salud mental prescolar.


La détection précoce de troubles du comportement chez les enfants est nécessaire afin d'intervenir. Les données disponibles font état d'une forte prévalence de troubles psychiatrique de l'enfant et de l'adolescent au Chili (22,5%) mais les problèmes de comportement chez les plus jeunes enfants ne sont pas évalués. Ce travail évalue les troubles du comportement chez des enfants d'âge préscolaire et leur lien aux variables sociodémographiques de la famille et de l'enfant. Les données ont été recueillies durant l'évaluation de l'impact du programme de Soutien au Développement Biopsychosocial « Chile Crece Contigo ¼, en utilisant un échantillon aléatoire à plusieurs degrés et représentatif de 1 377 enfants d'âge préscolaire, âgés de 30 à 48 mois, qui participaient à des services de santé publique. Les domiciles ont été visités pour appliquer un questionnaire et la Checklist de Comportement de l'Enfant (CBCL, 1,5-5 ans). Résultats: Le modèle de régression multivariable pour les scores bruts totaux montre que l'âge de l'enfant, le nombre de maladies chroniques chez l'enfant et le passé d'exposition à la consommation d'alcool de la mère durant la grossesse restent importants après l'ajustement pour toutes le variables inclues (R2 de 17,8% and η2 de 0,19 (95% CI 0.14 à 0.22)). Dans les modèles explicatifs externalisant et internalisant les maladies chroniques de l'enfant et un score élevé de croyances autoritaire sur le parentage font preuves des plus grands effets de taille. Ces résultats s'ajoutent aux preuves sur les problèmes urgents de santé mentale préscolaire.


Assuntos
Transtornos Mentais , Adolescente , Criança , Feminino , Gravidez , Humanos , Pré-Escolar , Chile/epidemiologia , Fatores de Risco , Escolaridade , Saúde Mental
2.
Fam Process ; 59(4): 1672-1689, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-31802491

RESUMO

Family-level conflict and cohesion are well-established predictors of adolescent mental health. However, traditional approaches focusing on between-family differences in cohesion and conflict may overlook daily intrafamily variability that might provide important new information. We used data from a 21-day daily diary protocol in a sample of 151 caregivers (95.3% female) and their adolescent child (61.5% female) in two-caregiver families to test whether daily changes in family functioning are associated with daily changes in adolescent well-being and whether adolescent well-being depends on average levels of family functioning. We examined family cohesion and conflict in relation to adolescent angry, depressed, and anxious mood, as well as happiness, life satisfaction, and meaning and purpose in life in multilevel models. Both cohesion and conflict exhibited meaningful daily variation. Adolescent-reported cohesion and conflict had unique within-family associations with all six adolescent outcomes. Models using parent reports of family functioning yielded fewer associations than models with adolescent reports; however, several findings remained. Cross-level interactions indicated that within-family variations in cohesion were only associated with adolescent depression in families with lower average levels of cohesion across days. In sum, this study provides compelling evidence that families exhibit meaningful variability from day to day and that daily variation has important implications for adolescent well-being.


El conflicto y la cohesión a nivel familiar son predictores bien establecidos de la salud mental adolescente. Sin embargo, los enfoques tradicionales que se centran en diferencias interfamiliares en la cohesión y el conflicto pueden pasar por alto la variabilidad intrafamiliar diaria que podría proporcionar información importante y nueva. Utilizamos datos de un protocolo de registro diario de 21 días en una muestra de 151 cuidadores (el 95.3 % de sexo femenino) y su hijo adolescente (el 61.5% de sexo femenino) en familias de dos cuidadores para evaluar si los cambios diarios en el funcionamiento familiar están asociados con los cambios diarios en el bienestar de los adolescentes, y si el bienestar de los adolescentes depende de los niveles promedio de funcionamiento familiar. Analizamos la cohesión y el conflicto familiar en relación con los estados de ánimo de enojo, depresión y ansiedad así como de felicidad, satisfacción con la vida, y significado y propósito en la vida en modelos multinivel. Tanto la cohesión como el conflicto demostraron una variación diaria significativa. La cohesión y el conflicto informados por los adolescentes tuvieron asociaciones únicas dentro de las familias con los seis resultados de los adolescentes. Los modelos que utilizaron informes de los padres del funcionamiento familiar indicaron menos asociaciones que los modelos con informes de los adolescentes, sin embargo, quedaron varios hallazgos. Las interacciones a nivel transversal indicaron que las variaciones en la cohesión intrafamiliar estuvieron solamente asociadas con la depresión de los adolescentes en las familias con niveles promedio más bajos de cohesión a lo largo de los días. En resumen, este estudio ofrece pruebas convincentes de que las familias demuestran una variabilidad significativa día a día y de que la variación diaria tiene importantes implicancias para el bienestar de los adolescentes.


Assuntos
Comportamento do Adolescente/psicologia , Afeto , Conflito Familiar/psicologia , Relações Familiares/psicologia , Saúde Mental , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multinível
3.
J Diabetes ; 10(4): 328-337, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29031002

RESUMO

BACKGROUND: This study analyzed the effects of a 12-week resistance training (RT) program without dietary interventions on metabolic syndrome (MetS) components and inflammatory biomarkers in older women. METHODS: Fifty-three older women (mean [±SD] age 70.4 ± 5.7 years; mean body mass index 26.7 ± 4.0 kg/m2 ) were randomly assigned to a training group (TG; n = 26) that performed 12 weeks of an RT program or a control group (CG; n = 27) that did not perform any type of physical exercise over the same period. Body composition (dual energy X-ray absorptiometry), muscular strength (one-repetition maximum tests), blood pressure (BP), and blood sample measurements were performed before and after intervention. RESULTS: After the 12-week period, there were significantly reductions (P < 0.05) in glucose levels (-20.4% vs -0.3%), waist circumference (-1.5% vs +2.0%), and systolic BP (-6.2% vs +0.9%), and complete normalization of MetS prevalence (18% at baseline vs. 0% after 12-weeks RT) in the TG. Moreover, C-reactive protein and tumor necrosis factor-α concentrations decreased in the TG (-28.6% and -21.6%, respectively), but increased in the CG (+34.5% and +13.3%, respectively). In addition there were positive improvements in the MetS Z-score in the TG but not CG (-21.6% vs +13.3%, respectively). CONCLUSION: The results suggest that a 12-week RT program seems to effectively reduce MetS components and inflammatory biomarkers in older women, regardless of dietary intervention. The RT-induced adaptations in body composition and inflammatory biomarkers appear to be related to healthy adaptations in risk factors for MetS.


Assuntos
Proteína C-Reativa/análise , Síndrome Metabólica/sangue , Treinamento Resistido , Fator de Necrose Tumoral alfa/sangue , Idoso , Biomarcadores/sangue , Glicemia/análise , Pressão Sanguínea , Composição Corporal , Índice de Massa Corporal , Feminino , Humanos , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Força Muscular , Avaliação de Resultados em Cuidados de Saúde
4.
J Diabetes ; 6(6): 586-94, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24460859

RESUMO

BACKGROUND: This study was conducted among individuals with diabetes and hypertension in order to assess the prevalence of erectile dysfunction (ED) and the association between ED and cardiovascular risk variables such as echocardiographic changes. METHODS: We evaluated 114 men with type 2 diabetes mellitus and hypertension. ED was assessed by International Index of Erectile Function (IIEF-5) score. Clinical and laboratory variables were evaluated, including C-reactive protein (CRP), ambulatory blood pressure monitoring (ABPM), ankle brachial index (ABI) and transthoracic echocardiography. Comparisons between patients with ED (IIEF-5 < 22) and without ED (IIEF-5 ≥ 22) were performed. RESULTS: Patients were 56.8 ± 5.7 years-old, systolic and diastolic blood pressure were 150.7 ± 19.5 mmHg and 85.4 ± 11.4 mmHg, respectively, and HbA1c was 8.0 ± 1.7%. The majority (74.6%) of patients had ED. Levels of CRP, ABPM values and ABI were similar between men with and without ED. Echocardiography variables related to cardiac chamber diameters, left ventricular hypertrophy and diastolic function were similar between groups, except there was a slight lower left ventricular ejection fraction in men with ED (64.9 ± 7.3 vs 68.1 ± 3.9%, P = 0.004). CONCLUSIONS: In high cardiovascular risk hypertensive individuals with type 2 diabetes, ED is highly prevalent as expected, but its presence is associated with neither echocardiographic variables, nor other cardiovascular risk factors.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Disfunção Erétil/epidemiologia , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/complicações , Pressão Sanguínea , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Disfunção Erétil/complicações , Disfunção Erétil/diagnóstico por imagem , Humanos , Hipertensão/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Ultrassonografia
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