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In comparison to research on assets and their impact on school performance, less research has been devoted to household assets. This article studies the relationship among durable goods, academic achievement, and school attendance in Colombia. Durable goods are approximated through three different methodological approaches: inventory, attributional, and index approaches. Data come from the 2017 SABER test, a nationwide examination that assesses reading and math skills, for fifth- and ninth-grade students, (N = 621,218). Students with complete durable goods information (N = 364,436) were included. Multilevel modeling was used to test the effects of durable goods on academic achievement and school attendance. The results suggest that while the index approach provides a broad understanding of how durable goods relate to school performance, the inventory and the attributional approaches show that different types of durable goods have differential effects on educational outcomes. The index approach illustrates that the possession of durable goods is positively associated with academic achievement and school attendance. The inventory and the attributional approaches show that washing machines, computers, and internet access are positively related to academic achievement and school attendance. In contrast, TVs, video games, and cars are negatively related to school performance. This research added to the literature by using different methodological approaches to operationalize durable goods, and by expanding the geographic scope to Latin America. Findings from this study may contribute to reassessing current measures of multidimensional poverty in Colombia to include durable goods.

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Background: Applied research using the phase angle (PhA) in children and adolescents has increased notably. Using multilevel modeling in a fully Bayesian framework, we examined the relationships between PhA, age, sex, biological maturity status, and body size in 10-16-year-old adolescents. Methods: The sample comprised 519 adolescents (women, n = 241; men, n = 278) from Campinas, São Paulo, Brazil. Biological maturity status was assessed with self-examination of pubertal development for sexual maturity and maturity offset protocol to estimate age at peak height velocity (PHV) for somatic maturity status. Stature and body mass were measured by anthropometry. Phase angle was calculated based on raw resistance and reactance values (50 kHz frequency) obtained by bioelectrical impedance with the foot-to-hand technology. Results: The multilevel regression analysis revealed that boys had significantly higher values of phase angle than girls, adjusting for age group and sexual maturity status. Overall, older and more mature adolescents had higher values of phase angle. When considering aligning variation in the phase angle by distance to estimated PHV (maturity offset), there was a higher association between the phase angle and time before and after predicted age at PHV for boys (r = 0.31, 90% CI: 0.23 to 0.39) than girls (r = 0.2, 90% CI: 0.11 to 0.28). When including body mass in the multilevel models, corresponding changes in the overall body mass mediate most of the influence of the maturity status and age group on the phase angle. Conclusion: The present study demonstrated that the variability in phase angle is related to inter-individual variation in sex, age, and maturity status, as well as differences in body size. Research with adolescents considering phase angle should use multilevel modeling with standardized parameters as default to adjust for the concurrent influence of sex, age, maturity status, and body size.

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Although system-justifying beliefs often mitigate perceptions of discrimination, status-based asymmetries in the ideological motivators of perceived discrimination are unknown. Because the content and societal implications of discrimination claims are status-dependant, social dominance orientation (SDO) should motivate perceptions of (reverse) discrimination among members of high-status groups, whereas system justification should motivate the minimization of perceived discrimination among the disadvantaged. We tested these hypotheses using multilevel regressions among a nationwide random sample of New Zealand Europeans (n = 29,169) and ethnic minorities (n = 5,118). As hypothesized, group-based dominance correlated positively with perceived (reverse) discrimination among ethnic-majority group members, whereas system justification correlated negatively with perceived discrimination among the disadvantaged. Furthermore, the proportion of minorities within the region strengthened the victimizing effects of SDO-Dominance, but not SDO-Egalitarianism, among the advantaged. Together, these results reveal status-based asymmetries in the motives underlying perceptions of discrimination and identify a key contextual moderator of this association.

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Aims: there is increasing awareness that for effective patient care we need more than only randomized controlled trials with groups of participants and that carefully collected single case (N = 1) data have several important advantages over traditional group-level studies. With the advance of technology, collecting relevant data from a single case is becoming easier by the day, and this offers tremendous opportunities for understanding how behaviors displayed by an individual can be influenced by one or several key variables. For example, how pain experienced influences the amount of time spent on physical exercise. Method: using publicly available observational single case data, five models are compared: a classical ordinary least squares (OLS) linear regression model; a dynamic regression model (DRM); a two-level random-intercepts model (2LRI); a continuous covariate first-order autoregressive correlation model (CAR1); and an ordinary least squares model with time trend (OLST). These models are compared in terms of overall model fit statistics, estimates of the relation between physical activity (response variable of interest) and pain (covariate of interest), and residual statistics. Results: 2LRI outperforms all other models on both overall model fit and residual statistics, and provides covariate estimates that are in between the relative extremes provided by other models. CAR1 and OLST demonstrate an almost identical performance and one that is substantially better than OLS ­ which performs worst ­ and DRM. Conclusion: for observational single case data, DRM, CAR1, OLST, and 2LRI account for the serial correlation that is typically present in single case data in somewhat different ways under somewhat different assumptions, and all perform better than OLS. Implications of these findings for observational, quasi-experimental, and experimental single case studies are discussed.

Objetivos: há uma crescente conscientização de que, para um atendimento eficaz ao paciente, precisamos de mais do que apenas ensaios clínicos randomizados com grupos de participantes e que os dados de caso único cuidadosamente coletados (N = 1) têm várias vantagens importantes sobre os estudos tradicionais em nível de grupo. Com o avanço da tecnologia, coletar dados relevantes de um único caso está se tornando mais fácil a cada dia, e isso oferece enormes oportunidades para entender como os comportamentos exibidos por um indivíduo podem ser influenciados por uma ou várias variáveis-chave. Por exemplo, como a dor experimentada influencia a quantidade de tempo gasto no exercício físico. Método: usando dados de caso único observacionais disponíveis publicamente, cinco modelos são comparados: um modelo clássico de regressão linear de mínimos quadrados ordinários (OLS); um modelo de regressão dinâmica (DRM); um modelo de interceptações aleatórias de dois níveis (2LRI); um modelo de correlação autorregressiva de primeira ordem covariável contínua (CAR1); e um modelo ordinário de mínimos quadrados com tendência temporal (OLST). Esses modelos são comparados em termos de estatísticas gerais de ajuste do modelo, estimativas da relação entre atividade física (variável de resposta de interesse) e dor (covariável de interesse) e estatísticas residuais. Resultados: o 2LRI supera todos os outros modelos tanto no ajuste geral do modelo quanto nas estatísticas residuais e fornece estimativas de covariáveis que estão entre os extremos relativos fornecidos por outros modelos. CAR1 e OLST demonstram um desempenho quase idêntico e substancialmente melhor que o OLS, que apresenta o pior desempenho, e o DRM. Conclusão: para dados observacionais de caso único, DRM, CAR1, OLST e 2LRI são responsáveis pela correlação seriada que normalmente está presente em dados de caso único de maneira um pouco diferentes sob suposições um pouco diversas, e todos têm um desempenho melhor que o OLS. Implicações dessas descobertas para estudos de caso único observacionais, quase-experimentais e experimentais são discutidas.

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BACKGROUND: Neighborhood disadvantage (ND) is a risk factor for child behavior problems (CBPs), but is understudied outside the United States and Europe. Our mixed methods study aims to (1) create a culturally meaningful measure of ND, (2) test cross-sectional associations between ND and CBPs and (3) qualitatively explore life in the neighborhoods of families participating in the Salud Ambiental Montevideo (SAM) study. METHODS: The quantitative study (Study 1) comprised 272, ~7-year-old children with geolocation and complete data on twelve behavioral outcomes (Conner's Teachers Rating Scale - Revised Short Form: CTRS-R:S and Behavioral Rating Inventory of Executive Functioning: BRIEF). A ND factor was created at the census segment level (1,055 segments) with 19 potential indicators of ND downloaded from the Municipality of Montevideo Geographic Services. Children were assigned ND scores based on the location of their household within a census segment. Multilevel models tested associations between ND and all CBP scales, controlling for confounders at the individual level. The qualitative study (Study 2) comprised 10 SAM caregivers. Photovoice alongside semi-structured interviews in Spanish were used to foster conversations about neighborhood quality, activities, and raising children. Thematic analysis with inductive coding was used to summarize qualitative study findings. RESULTS: The ND factor consisted of 12 census-based indicators related to education, employment, ethnicity, housing quality, and age characteristics, but unrelated to home ownership and some ethnicity variables. In multivariable models, ND was associated with greater conduct problems (ß = 1.37, p < .05), poor shifting (ß = 1.56, p < .01) and emotional control problems (ß = 2.36, p < .001). Photovoice and semi-structured interviews yielded four themes: physical disorder, recreation, safety and crime, and community resources. Residents discussed improving waste management and transportation, updating playgrounds, and ensuring neighborhood safety. CONCLUSIONS: ND in Montevideo comprised a unique set of census indicators. ND was primarily related to behavioral regulation problems. Hypothesized pathways whereby ND affects CBPs are discussed.

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The ecological model theory highlights that human development (or a given behavior) is the result of the interaction of variables derived from different levels, comprising those directly related to the subjects and those related to the environment. Given that, the purpose of this study is to establish whether runners' performance may vary among different Brazilian states, as the factors associated with this difference. The sample comprised 1151 Brazilian runners (61.8% men) that completed an online questionnaire, providing information about biological (sex, age, height, and weight), training (running pace, frequency and volume/week, and motivation), sociodemographic (place of residence and wage) aspects, and perceptions about the environmental influences on the practice. Information about state variables was obtained from official institutes, and comprised the human development index (HDI), athletics events, and violence index. Multilevel analysis was conducted in HLM software. State-level characteristics explained ≈3% of the total variance in running performance. Of the total variance explained for the individual level, 56.4% was associated with male sex (ß = -54.98; p < 0.001), age (ß = 1.09; p < 0.001), body mass index (ß = 6.86; p < 0.001), economic status (ß = 6.23; p = 0.003), the perception of the natural environment (ß = 7.58; p = 0.02), training frequency (ß = -16.64; p < 0.001), and weekly volume (ß = -0.30; p < 0.001). At the state level, only athletics events presented a positive and significant influence on performance. There is a significant role of the environment on the explanation of running performance variability, and given the diversity across states, environmental variables should not be neglected, as they are relevant to the exploration of other variables possibly related to running performance.

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We use a multivariate multilevel model to study the links between physical fitness (PF) and gross motor coordination (GMC) and investigate the influence of predictors affecting their levels across age. We sampled 7918 Peruvians, aged 6-15 years, from sea-level, Amazon region and high-altitude. Composite markers of GMC and PF were derived (GMCz and PFz , respectively). BMI, biological maturation, and stunting were assessed. School characteristics were obtained via an objective audit. School contexts explained 35% of the associations between PFz and GMCz , whereas children's characteristics explained 65% of the total variation. On average, with increasing age, there was a greater increase in GMCz (ß = 0.79 ± 0.04, P < .001) than in PFz (ß = 0.15 ± 0.03, P < .001); boys outperformed girls (PFz , ß = 3.25 ± 0.08, P < .001; GMCz , ß = 1.58 ± 0.09, P < .001); those with lower BMI and ahead in their maturation had higher PFz (ß = -0.13 ± 0.01, P < .001; ß = 1.09 ± 0.05, P < .001, respectively) and GMCz (ß = -0.18 ± 0.01, P < .001; ß = 0.39 ± 0.06, P < .001, respectively) levels. Stunting was negatively related to PFz (ß = -0.30 ± 0.07; P < .001) and GMCz (ß = -0.30 ± 0.08, P < .001) and high-altitude Peruvians had significantly lower GMCz (ß = -0.93 ± 0.33, P < .001), and those living in the Amazon region had significantly higher PFz (ß = 1.21 ± 0.58, P < .001) compared to those living at sea level. A higher number of students was negatively related to PFz (ß = -0.016 ± 0.006, P < .001) and positively with GMCz (ß = 0.005 ± 0.003, P < .001); the duration of physical education classes was positively associated with PFz (ß = 0.70 ± 0.32, P < .001) and GMCz (ß = 0.46 ± 0.15, P < .001); and the existence of policies for physical activity was only negatively associated with GMCz (ß = -1.17 ± 0.34, P < .001). In conclusion, PFz and GMCz were positively correlated and child- and school-level traits predicted their levels.

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Abstract Objective: Children's differences in moderate-to-vigorous physical activity levels are not at random. This study investigates the relevance of individual- and school-level characteristics in explaining these differences. Methods: In total, 307 children (154 girls) aged 5-10 years, from 19 Portuguese schools, were sampled. Height and weight were measured, and body mass index was calculated. Time spent in moderate-to-vigorous physical activity was measured by accelerometry. Gross motor coordination was assessed with the KörperkoordinationsTest für Kinder battery and socio-economic status was obtained via the school social support system. School characteristics were obtained with an objective school audit. A multilevel analysis was used as implemented in Stata 15. Results: Schools explained 18.2% of the total variance in moderate-to-vigorous physical activity, with the remainder being ascribed to children's distinct characteristics. Boys were more active (β = 29.59 ± 11.52, p < 0.05), and having higher gross motor coordination levels (β = 0.11 ± 0.04, p < 0.05) was positively associated with daily moderate-to-vigorous physical activity, whereas being older (β = −5.00 ± 1.57, p < 0.05) and having higher socio-economic status (β = −7.89 ± 3.12, p < 0.05) were negatively related with moderate-to-vigorous physical activity. From the school-level correlates, only playground dimension was significantly associated with moderate-to-vigorous physical activity levels. Children from schools with medium (40 m2 to 69 m2) and large playground dimensions (≥70 m2) were less active than children with smaller playground dimensions (10 m2 to 39 m2). Conclusions: Variation in school children's moderate-to-vigorous physical activity is mostly explained by their individual characteristics; school characteristics also play a role but to a smaller degree. Future intervention programs to change this behavior should be more personalized, emphasizing mostly individual-level characteristics.

Resumo Objetivo As diferenças entre crianças na atividade física moderada a vigorosa não são aleatórias. Este estudo investiga a relevância das características em níveis individuais e escolares para explicar essas diferenças. Métodos Foram amostradas 307 crianças (154 meninas) entre 5 e 10 anos, de 19 escolas portuguesas. A estatura e o peso foram medidos e o índice de massa corporal foi calculado. O tempo gasto em atividade física moderada a vigorosa foi medido por acelerometria. A coordenação motora grossa foi avaliada com a bateria do Körperkoordinationstest für Kinder e o status socioeconômico foi obtido através do sistema de apoio social da escola. As características da escola foram obtidas através de uma auditoria escolar objetiva. Uma análise multinível foi utilizada como implantada no Stata 15. Resultados As escolas explicaram 18,2% da variância total da atividade física moderada a vigorosa, com o restante atribuído às diferentes características das crianças. Os meninos foram mais ativos (β = 29,59 ± 11,52, p < 0,05) e o fato de ter níveis mais altos de coordenação motora grossa (β = 0,11 ± 0,04, p < 0,05) foi positivamente associado com a atividade física moderada a vigorosa diária. Os mais velhos (β = -5,00 ± 1,57, p < 0,05) e com maior status socioeconômico (β = -7,89 ± 3,12, p < 0,05) foram negativamente relacionados com a atividade física moderada a vigorosa. Com base nos correlatos a nível escolar, apenas a dimensão da área recreativa foi significativamente associada aos níveis de atividade física moderada a vigorosa. As crianças das escolas com área recreativa média (40 m2 a 69 m2) e grande (≥ 70 m2) foram menos ativas do que as crianças com áreas recreativas com menores dimensões (10 m2 a 39 m2). Conclusões A variação na atividade física moderada a vigorosa de escolares é explicada principalmente por suas características individuais; as características da escola também desempenham um papel, mas em menor grau. Futuros programas de intervenção para mudar esse comportamento devem ser mais personalizados, enfatizar principalmente as características em nível individual.

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OBJECTIVE: Children's differences in moderate-to-vigorous physical activity levels are not at random. This study investigates the relevance of individual- and school-level characteristics in explaining these differences. METHODS: In total, 307 children (154 girls) aged 5-10 years, from 19 Portuguese schools, were sampled. Height and weight were measured, and body mass index was calculated. Time spent in moderate-to-vigorous physical activity was measured by accelerometry. Gross motor coordination was assessed with the KörperkoordinationsTest für Kinder battery and socio-economic status was obtained via the school social support system. School characteristics were obtained with an objective school audit. A multilevel analysis was used as implemented in Stata 15. RESULTS: Schools explained 18.2% of the total variance in moderate-to-vigorous physical activity, with the remainder being ascribed to children's distinct characteristics. Boys were more active (ß=29.59±11.52, p<0.05), and having higher gross motor coordination levels (ß=0.11±0.04, p<0.05) was positively associated with daily moderate-to-vigorous physical activity, whereas being older (ß=-5.00±1.57, p<0.05) and having higher socio-economic status (ß=-7.89±3.12, p<0.05) were negatively related with moderate-to-vigorous physical activity. From the school-level correlates, only playground dimension was significantly associated with moderate-to-vigorous physical activity levels. Children from schools with medium (40m2 to 69m2) and large playground dimensions (≥70m2) were less active than children with smaller playground dimensions (10m2 to 39m2). CONCLUSIONS: Variation in school children's moderate-to-vigorous physical activity is mostly explained by their individual characteristics; school characteristics also play a role but to a smaller degree. Future intervention programs to change this behavior should be more personalized, emphasizing mostly individual-level characteristics.

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Background: Diabetes is a major health burden in Mexican American populations, especially among those in the Lower Rio Grande Valley (LRGV) in the border region of Texas. Understanding the roles that social determinants of health (SDOH) play in diabetes management programs, both at the individual and community level, may inform future intervention strategies. Methods: This study performed a secondary data analysis on 1,568 individuals who participated in Salud y Vida (SyV), a local diabetes and chronic disease management program, between October 2013 and September 2018 recruited from a local clinic. The primary outcome was the reduction of hemoglobin A1C (HbA1C) at the last follow-up visit compared to the baseline. In addition to age, gender, insurance status, education level and marital status, we also investigated 15 community (census tract) SDOH using the American Community Survey. Because of the high correlation in the community SDOH, we developed the community-level indices representing different domains. Using Bayesian multilevel spatial models that account for the geographic dependency, we were able to simultaneously investigate the individual- and community-level SDOH that may impact HbA1C reduction. Results: After accounting for the diabetes self-management education classes taken by the participants and their length of stay in the program, we found that older age at baseline, being married (compared to being widowed or divorced) and English speaking (compared to Spanish) were significantly associated with greater HbA1C reduction. Moreover, we found that the community level SDOH were also highly associated with HbA1C reduction. With every percentile rank decrease in the socioeconomic advantage index, we estimated an additional 0.018% reduction in HbA1C [95% CI (-0.028, -0.007)]. Besides the socioeconomic advantage index, urban core opportunity and immigrant's cohesion and accessibility indices were also statistically associated with HbA1C reduction. Conclusion: To our knowledge, our study is the first to utilize Bayesian multilevel spatial models and simultaneously investigate both individual- and community-level SDOH in the context of diabetes management. Our findings suggest that community SDOH play an important role in diabetes control and management, and the need to consider community and neighborhood context in future interventions programs to maximize their overall effectiveness.

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ABSTRACT Objective: This study examined the growth status and physical development of Brazilian children with autism spectrum disorders from 4 to 15 years of age. Furthermore, it was examined whether variation in growth patterns and weight status was influenced by the use of psychotropic medications. Methods: One-hundred and twenty children aged 3.6-12.1 years at baseline (average = 7.2 years, SD = 2.3 years) diagnosed with autism spectrum disorders were measured on three repeated occasions across a 4-year period. Stature, body mass, and body mass index were considered. Bayesian multilevel modeling was used to describe the individual growth patterns. Results: Growth in stature was comparable to the age-specific 50th percentile for Centers for Disease Control and Prevention reference data until approximately 8 years, but a substantial decrease in growth rate was observed thereafter, reaching the age-specific 5th percentile at 15 years of age. Both body mass and body mass index values were, on average, higher than both the Brazilian and Centers for Disease Control and Prevention age-specific 95th percentile reference until 8 years, but below the 50th specific-age percentile at the age of 15 years. Conclusions: Brazilian boys with autism spectrum disorders between 4 and 15 years appear to have impaired growth in stature after 8-9 years of age, likely impacting pubertal growth. A high prevalence of overweight and obesity was observed in early childhood, although a trend of substantial decrease in body mass and body mass index was apparent when children with autism spectrum disorders entered the years of pubertal development.

RESUMO Objetivo: Este estudo examinou o estado de crescimento e o desenvolvimento físico de crianças brasileiras com transtornos do espectro autista entre 4 e 15 anos. Adicionalmente, examinamos se a variação nos padrões de crescimento e na massa corporal foi influenciada pelo uso de medicamentos psicotrópicos. Métodos: 120 crianças com idades entre 3,6 e 12,1 anos no início do estudo (média = 7,2 anos, DP = 2,3 anos) diagnosticadas com transtornos do espectro autista foram avaliadas em três ocasiões repetidas em um período de 4 anos. Foram considerados estatura, massa corporal e índice de massa corporal. O modelo multinível bayesiano foi utilizado para descrever os padrões de crescimento individual. Resultados: O crescimento em estatura foi comparável ao percentil 50 específico para a idade para os dados de referência do Centro de Controle e Prevenção de Doenças dos Estados Unidos até cerca de 8 anos. Porém, foi observada uma redução substancial na taxa de crescimento depois dos 8 anos, atingindo o percentil 5 específico para a idade aos 15 anos de idade. Tanto os valores de massa corporal quanto de índice de massa corporal foram, em média, maiores comparativamente ao percentil 95 específico para a idade até aos 8 anos da referência brasileira e do Centro de Controle e Prevenção de Doenças dos Estados Unidos, porém abaixo do percentil 50 específico para a idade aos 15 anos de idade. Conclusões: Os meninos brasileiros com transtornos do espectro autista entre 4 e 15 anos parecem ter retardo do crescimento na estatura após os 8-9 anos, provavelmente afeta o crescimento púbere. Foi observada uma alta prevalência de sobrepeso e obesidade na primeira infância, apesar de uma tendência de redução substancial na massa corporal e no índice de massa corporal ter sido aparente quando as crianças com transtornos do espectro autista entraram nos anos de desenvolvimento púbere.

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Background: The interpretation of young athletes' performance during pubertal years is important to support coaches' decisions, as performance may be erroneously interpreted due to the misalignment between chronological age (CA), biological age (BA) and sport age (SA). Aim: Using a Bayesian multilevel approach, the variation in longitudinal changes in performance was examined considering the influence of CA, BA (age at menarche), SA, body size, and exposure to training among female basketball players. Method: The study had a mixed-longitudinal design. Thirty eight female basketball players (aged 13.38 ± 1.25 years at baseline) were measured three times per season. CA, BA and SA were obtained. Anthropometric and functional measures: countermovement jump, Line drill (LD), Yo-Yo (Yo-Yo IR1). Based on the sum of the z-scores, an index of overall performance was estimated. The effects of training on longitudinal changes in performance were modeled. Results: A decrease in the rate of improvements was apparent at about 14 years of age. When aligned for BA, the slowing of the rate of improvements is apparent about 2 years after menarche for LD. For countermovement jump longitudinal changes, when performance was aligned for BA improvements became linear. For Yo-Yo IR1 and performance index, both indicators showed a linear trend of improvement when aligned for CA and BA, separately. Older players showed higher rates of improvement for Yo-Yo IR1 and performance index from pre-season to end-season. When considering performance changes aligned for BA it was apparent an improvement of performance as players became biologically mature. Conclusions and Implications: The alignment of CA with BA and SA provides important information for coaches. Human growth follows a genetically determined pattern, despite variation in both tempo and timing. When the effects of maturation reach their end, all the girls went through the same process. Hence, there is no need to artificially manipulate youth competitions in order to accelerate gains that sooner or later reach their peak and tend to flat their improvement curve.

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BACKGROUND: Irritable bowel syndrome (IBS) is a stress-related disease linked to psychosocial factors, though knowledge about its occupational psychosocial aspects is scarce. OBJECTIVE: A cross-sectional study of the prevalence of IBS and its association with occupational psychosocial factors in Chilean workers was conducted. METHODS: IBS prevalence, using the IBS-Rome IV criteria, in the working population was estimated using data from the National Health Survey of 2009. Data on occupational psychosocial aspects were drawn from the Chilean Survey of Employment, Health, and Work of 2009, and allocated to individual survey participants at the occupation-region level. Data on family and community stressors were available at the individual level. Prevalence ratios (PR) for IBS were computed using generalized linear mixed models to account for variability at the group level. RESULTS: The IBS prevalence in the overall working population (weighted n = 5 435 253) was 18.4%, but varied substantially by industry sector. Compared with 'professionals' (IBS prevalence = 7.3%), jobs with high prevalence of IBS included 'health and social work activities' [PR = 4.9; 95% confidence interval (CI) = 1.4-16.7], 'household employment' (PR = 4.8; 95% CI = 1.5-15.9), and 'manufacturing' (PR = 3.5; 95% CI = 1.0-11.8). With Karasek Job Demand Control scores assigned to occupations within regions, high job demand doubled the prevalence of IBS (PR = 2.0; 95% CI = 1.4-2.9), whereas high-skill discretion was associated with lower prevalence of IBS (PR = 0.6; 95% CI = 0.4-0.8). There was also evidence that these two factors were not independent; high-skill discretion appeared to buffer the effect of high job demand on IBS prevalence (P < 0.001). CONCLUSIONS: Occupational factors were associated with IBS prevalence, showing effects as important as those for non-occupational stresses such as civic insecurity or having health problems. High job skill discretion appeared to reduce the prevalence of IBS in the presence of high job demands. Given its high overall prevalence and poorly understood risk factors, further research on occupational psychosocial factors of IBS is warranted.

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OBJECTIVE: This study examined the growth status and physical development of Brazilian children with autism spectrum disorders from 4 to 15 years of age. Furthermore, it was examined whether variation in growth patterns and weight status was influenced by the use of psychotropic medications. METHODS: One-hundred and twenty children aged 3.6-12.1 years at baseline (average=7.2 years, SD=2.3 years) diagnosed with autism spectrum disorders were measured on three repeated occasions across a 4-year period. Stature, body mass, and body mass index were considered. Bayesian multilevel modeling was used to describe the individual growth patterns. RESULTS: Growth in stature was comparable to the age-specific 50th percentile for Centers for Disease Control and Prevention reference data until approximately 8 years, but a substantial decrease in growth rate was observed thereafter, reaching the age-specific 5th percentile at 15 years of age. Both body mass and body mass index values were, on average, higher than both the Brazilian and Centers for Disease Control and Prevention age-specific 95th percentile reference until 8 years, but below the 50th specific-age percentile at the age of 15 years. CONCLUSIONS: Brazilian boys with autism spectrum disorders between 4 and 15 years appear to have impaired growth in stature after 8-9 years of age, likely impacting pubertal growth. A high prevalence of overweight and obesity was observed in early childhood, although a trend of substantial decrease in body mass and body mass index was apparent when children with autism spectrum disorders entered the years of pubertal development.

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Sociologists recognize that immigration enforcement policies are forms of institutionalized racism that can produce adverse health effects in both undocumented and documented Latinos and Mexican-origin persons in the United States. Despite this important advancement, little research examines the relationship between fear of immigration enforcement and biobehavioral health in mixed-status Mexican-origin families. This study applies an embodiment of racism approach to examine how household fear of deportation (FOD) is related to differences in salivary proinflammatory cytokines (IL-1 ß , IL-6, IL-8, and TNF α ) in healthy Mexican-origin families with at least one immigrant, living in Phoenix, AZ. Participants were 111 individuals (n=46 adults, 72% female; n=65 children, 49% female) from 30 low-income, mixed-status families. During a home visit, anthropometric measures and saliva were collected from each family member and a household survey was administered. Saliva was assayed for salivary IL-1 ß , IL-6, IL-8, and TNF α . Random effects multilevel structural equation models estimated the relationship between household FOD and a salivary proinflammatory cytokine latent variable between families, while controlling for other chronic stressors (economic/occupational, immigration, parental, and family conflict). Household FOD ( ß =0.68, p=0.04) and family conflict chronic stress ( ß =1.96, p=0.03) were strongly related to elevated levels of proinflammatory cytokines between families. These results were consistent in non-mixed and mixed-status families. Future research is needed to characterize what aspects of living with an undocumented family member shape the physical health outcomes of persons with authorized status or US-citizenship.

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Youth sporting activities have been explored as a way to impact positive personal transformation and development, glaringly demonstrated by world-wide investments in public policies, programs, and projects. We studied positive effects of participation in sports on the developmental assets of 614 adolescents (13.1 ± 1.7 years) actively engaged in extracurricular sport programs targeted at socially disadvantaged youths, from five municipalities across five states of the southern, south-eastern and north-eastern regions of Brazil. Participants responded to a developmental assets questionnaire designed to capture sociodemographic and human development data. Multilevel logistic regression was used to explore associations between years of participation in sport and human development indicators, controlling for age and sex. Our results showed that the quality of the young people's support network and duration of program participation positively influenced sport participation, which, in turn, was associated with willingness to learn. A strong association was also observed between sport participation and developmental assets. Thus, we offer new evidence of a relationship between positive development and environmental factors in which individual and contextual forces can be aligned, and we provide new reference data for developing countries.

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The present study examined extracurricular sport participation variables and developmental context in relationship to perceived self-efficacy among underserved adolescents. Participants ( n = 821, 13.6 ± 1.5 years) completed the Youth Experience in Sport questionnaire and General Self-Efficacy Scale. We used the Human Development Index (HDI) to characterize developmental contexts. Multilevel regression models were used to explore the relative contributions of age, sex, years of participation in extracurricular sport, HDI, and perceived positive experience in sport. Our results highlight that positive experience alone and in interaction with length of participation in the program fostered perceived self-efficacy. Participants from higher HDI contexts remained longer in the program. An implication of our research is that variables linked to positive sport experiences and perceived self-efficacy can be used as markers to evaluate the outcomes and impact of sport participation programs aimed at promoting positive youth development.

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Touch between mother and infant plays an important role in development starting from birth. Cross-cultural differences surrounding rearing practices have an influence on parent-infant interaction, including types of touch used and the development of emotional regulation. This study was designed to investigate maternal touch and infant emotional regulation in infant-mother dyads from Ecuador (n=25) and Hispanic dyads from the United States (US) (n=26). Mothers and their 4-month-old full-term infants participated in the Still Face Paradigm. Second-by-second coding of maternal touch and infant affect was completed. Overall the analyses showed that Ecuadorian mothers used more nurturing and accompaniment touch and less attention seeking touch than US Hispanic mothers during the pre-stressor (baseline) episode. Lagged multilevel models were used to investigate the effect of the different types of touch on infant emotional regulation in the groups for the episodes. The data suggest that playful touch had a significant increase in infant affect, whereas accompaniment and attention-seeking touch had a significant decrease in infant affect. Overall, this study provides support for the role of touch in mother-infant synchronicity in relation to infant's emotional regulation. Identifying touch that is more calming is important to foster emotional regulation in infancy, which can have important implications for development.

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OBJECTIVE: We aimed to estimate the attributable fraction of systolic (SBP) and diastolic blood pressure (DBP) that can be explained by family socioeconomic factors (FSFs) in adolescents using two observational studies. METHODS: Participants were recruited by multistage random cluster in two cross-sectional studies performed in Europe [Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, n = 3308] and Brazil [Brazilian Cardiovascular Adolescent Health (BRACAH) study, n = 991]. SBP and DBP were measured, and FSFs (socioeconomic status and parental education) were self-reported in both studies. The correlations of SBP and DBP with FSFs were examined by multilevel linear regression through two different models (hierarchical and fully adjusted). The generalized attributable fractions of the FSFs were estimated by comparing the models. RESULTS: Our results showed a significant inverse relationship between parental education (father and mother) and SBP in European boys. The higher generalized attributable fraction to SBP was observed in boys (13.2-22.4%). In girls, we found lower generalized attributable fractions to DBP (10.8-12.1% in Brazilian girls and 3.1-3.8% in European girls). CONCLUSIONS: Our findings revealed a significant inverse relationship between parental education and SBP in European boys. FSF also significantly influenced blood pressure in adolescents, mainly in Brazilian adolescents.

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