FCS (DCN) - Artigos em Revistas Científicas Internacionais com Arbitragem Científica
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- Children mental health after the 2008 global economic crisis: assessing the impact of austerity in PortugalPublication . Costa, Diogo; Cunha, Marina; Ferreira, Cláudia; Gama, Augusta; Machado-Rodrigues, Aristides M.; Rosado-Marques, Vítor; Nogueira, Helena; Silva, Maria Raquel; Padez, CristinaBackground: The austerity measures implemented in Europe after the 2008 global economic crisis, had a negative impact on the population health. The mental health of adults from southern Europe was particularly affected during this period, however, much less is known about the impact of austerity on the mental health of children. This study measured the impact on Portuguese children’s mental health of specific changes in family life during the 2008 economic crisis. Methods: In this study, a cross-sectional analysis of school-aged children (aged 7.5–11 years old, n = 1157) was conducted in 118 public and private schools of three Portuguese districts during 2016/2017. Parent reports of child’s psychosocial functioning (Strengths and Difficulties Questionnaire – SDQ) and children self-reports of depression, anxiety and stress symptoms (Depression, Anxiety and Stress Scales, Children version – DASS-C) and health-related quality of life (HRQoL - KIDSCREEN-27), were compared according to eight yes/no questions specifically developed about changes to normal life during the economic crisis (e.g. During the economic crisis did you: “Started buying cheaper food?” “Had to change to more economic housing?”). General linear regression models were fitted to estimate mean scores of the selected mental health outcomes according to the positive or negative answers to each question about the changes to life during the economic crisis. The models were adjusted for age, sex, socioeconomic status and district of residence. Results: Following the crisis 48.6% of the parents reported that they had to use their savings, and 6.8% reported that they had to change to a more economic housing. The questions about the changes to life that occurred during the crisis were associated with more frequent psychosocial problems, depression, anxiety and stress symptoms and with poorer HRQoL among children, after adjustment for potential confounders in the regression models. The effect sizes in mean differences for all mental health outcomes assessed according to the changes were small to moderate (Cohen’s d from 0.01 to 0.68). Conclusion: Specific changes to normal life attributed to the economic crisis seem to have an independent negative impact on the mental health outcomes of primary school-aged children. These results highlight the need to tackle early-life determinants of inequalities in children mental health, particularly among those that were exposed to the economic crisis.
- Socioeconomic inequalities in children's health‐related quality of life according to weight statusPublication . Costa, Diogo; Cunha, Marina; Ferreira, Cláudia; Gama, Augusta; Machado‐Rodrigues, Aristides M.; Rosado‐Marques, Vítor; Mendes, Larissa L.; Nogueira, Helena; Pessoa, Milene; Silva, Maria Raquel; Velasquez‐Melendez, Gustavo; Padez, CristinaObjectives: This study explores the association between socioeconomic position (SEP) and health-related quality of life (HRQoL) among Portuguese children according to their weight status. Methods: A total of 1215 primary school-aged children (mean age 8.78 years) from three Portuguese districts (Lisbon, Porto, Coimbra) were assessed during 2016/2017. Father and mother's education (low, medium, high) and work status (employed, unemployed/retired) were used as SEP indicators. Self-reported HRQoL was assessed with the KIDSCREEN-27. Height and weight were objectively measured and body mass index categorized in normal, overweight or obese. Age, sex, and district-adjusted linear regression models were fitted to estimate associations between SEP indicators and HRQoL dimensions, according to weight status. Results: We found that 24.9% of children were categorized as having overweight/obesity. The mean scores of the Physical Well-Being, and School Environment dimensions of HRQoL were lower among children classified with overweight/obesity compared to children with normal weight (57.21 vs 54.11, P < .001 and 57.85 vs 56.04, P = .010, respectively). Father's education was significantly associated with all HRQoL dimensions in children with a normal weight, but the same was not observed among children presenting overweight/ obesity. An increase in the level of maternal education was also significantly associated with all HRQoL dimensions among children classified with a normal weight, and only for the School Environment dimension among children classified with overweight/obesity. Conclusions: These results suggest the presence of socioeconomic inequalities in self-reported HRQoL from early age, particularly among children with normal weight.
- Socioeconomic inequalities in the prevalence of overweight and obesity among portuguese preschool‐aged children: changes from 2009 to 2016Publication . Rodrigues, Daniela; Costa, Diogo; Gama, Augusta; Machado‐Rodrigues, Aristides M.; Nogueira, Helena; Silva, Maria Raquel; Rosado‐Marques, Vítor; Padez, CristinaObjectives: We evaluated, for the first time in Portugal, the prevalence of overweight and obesity according to parental education in a population of preschool-aged Portuguese children in 2009/2010 and 2016/2017. Methods: Anthropometric data were collected in public and private preschools (n = 1996 in 2009/2010; n = 2077 in 2016/2017). Body mass index was calculated and weight status categories were based on the International Obesity Task Force cutoff points. Parental education level was self-reported. Results: Prevalence of overweight (17.1%–14.1%; p < 0.001) and obesity (6.6%–3.9%, p < 0.001) was lower in 2016/2017 than in 2009/2010, with higher rates being found in the north of the country. Parental education was significantly associated with childhood overweight and obesity and inequalities between low- and high-education increased between the two periods. Conclusions: While a decrease in childhood overweight and obesity were positive findings, the prevalence is still high and shows pronounced socioeconomic differences. Policies for obesity prevention need to be inclusive and tackle inequalities, with interventions tailored to suit local contexts.
- The environment contribution to gender differences in childhood obesity and organized sports engagementPublication . Nogueira, Helena; Costeira e Pereira, Margarida M.; Costa, Diogo; Gama, Augusta; Machado‐Rodrigues, Aristides; Silva, Maria Raquel; Marques, Vítor R.; Padez, Cristina M.Objective: This study aims to analyze gender-specific associations between sports activity outside of school and obesity, observing to what extent the local built environment contributes to the patterns found. Methods: A total of 2253 children aged 6.0-11.0 years were assessed: 49.3% girls and 50.7% boys. Children's weight and height were measured, age and sex-specific BMI cut-off points were used to define normal vs overweight/obesity. Children's organized sports (OS) activity was assessed by questionnaire, and local facilities for children's engagement in OS were analyzed. Logistic regression models were computed, adjusted for confounding variables. Results: Results showed greater overweight and obesity (25.1% vs 20.1%) and lower OS engagement (66.5% vs 73.8%) in girls as well as greater impact of OS engagement on weight status in girls (OR for having a normal weight = 1.434 in girls vs 1.043 in boys). Additionally, opportunities to engage in OS were scarce for girls. Conclusions: The gender gap in children's weight status and OS engagement might be enhanced by an environmental mismatch that undermines girls' opportunities to play sports. There should be more opportunities for girls to engage in their favorite sports as a means to tackle the obesity epidemic and to promote gender equality.