Childbearing in adolescence: intergenerational dejà-vu? Evidence from a Brazilian birth cohort

Abstract Background Pregnancy in adolescence tends to repeat over generations. This event has been little studied in middle and low-income societies undergoing a rapid epidemiological transition. To assess this association it is important to adjust for socioeconomic conditions at different points in lifetime. Therefore, the aim of this study is to analyze the independent effect of adolescent childbearing in a generation on its recurrence in the subsequent generation, after adjusting for socioeconomic status at different points in life. Methods The study was conducted on a prospective cohort of singleton liveborn females from the city of Ribeirão Preto, Brazil, evaluated in 1978/79, and their daughters assessed in 2002/04. A total of 1059 mother-daughter pairs were evaluated. The women who had their first childbirth before 20 years of age were considered to be adolescent mothers. The risk of childbearing in adolescence for the daughter was modeled as a function of the occurrence of teenage childbearing in her mother, after adjustment for socio-demographic variables in a Poisson regression model. Results The rate of childbearing during adolescence was 31.4% in 1978/79 and 17.1% in 2002/04. Among the daughters of the 1st generation adolescent mothers, this rate was 26.7%, as opposed to 12.7% among the daughters of non adolescent mothers. After adjustments the risk of adolescent childbearing for the 2nd generation was 35% higher for women whose mothers had been pregnant during adolescence – RR = 1.35 (95% CI 1.04-1.74). Conclusion Adolescent childbearing in the 1st generation was a predictor of adolescent childbearing in the 2nd, regardless of socioeconomic factors determined at different points in lifetime.

ADOLESCENCE AND DRUG USE THROUGH THE LENS OF PSYCHOANALYSIS: SUFFERING AND ECSTASY IN THE PASSAGE

ADOLESCENCE AND DRUG USE THROUGH THE LENS OF PSYCHOANALYSIS: SUFFERING AND ECSTASY IN THE PASSAGE The purpose of this study is to reflect upon the psychological factors of adolescent drug addiction according to a psychoanalytic perspective. First we consider adolescence as a social-historical category and then we discuss the psychoanalytic understanding of the adolescent transition. This theoretical path builds the approach that considers drug use as a phenomenon that serves as a passage ritual to contemporary adolescence. This phenomenon is modulated by the drive organization, which determines how the individual will take ownership of the use of psychoactive substances. We conclude that the substance use may function as a buffer-object, activated to deal with the structural fragility of the contemporary affective bonds.

Acute exercise adjustments of cardiovascular autonomic control in diabetic rats

Introduction: We evaluated the role of cardiovascular autonomic changes in hemodynamics at rest and in response to exercise in streptozotocin-induced diabetic rats. Methods: Male Wistar rats were divided into nondiabetic (ND, n = 8) and diabetic (D, n = 8) groups. Arterial pressure signals were recorded in the basal state and after atropine or propranolol injections at rest, during exercise and during recovery. Results: At rest, vagal tonus was reduced in D (37 +/- 3 bpm) in comparison with the ND group (61 +/- 9 bpm). Heart rate during exercise was lower in D in relation to ND rats associated with reduced vagal withdrawal in the D group. The D rats had an increase in vagal tonus in the recovery period (49 +/- 6 bpm). Conclusions: Exercise-induced hemodynamic adjustment impairment in diabetic rats was associated with reduced cardiac vagal control. The vagal dysfunction was attenuated after aerobic exercise, reinforcing the positive role of this approach in the management of cardiovascular risk in diabetics. Muscle Nerve 46: 96101, 2012

Brief Cognitive Behavioral Intervention in Groups in a Brazilian Assisted Reproduction Program

The study's objective was to assess the effect of a cognitive behavioral group intervention on the pregnancy rates of patients submitted to in vitro fertilization (IVF) techniques or to intracytoplasmic sperm injection (ICSI). The study was conducted on 188 patients, 93 who participated in a group of psychological intervention before the IVF and ICSI procedures and 95 patients submitted to IVF and ICSI during the same period of time, who did not participate in the intervention (control group). Clinical pregnancy was the outcome measure. Demographic and clinical variables were compared between groups in order to assess the group's homogeneity. Participants in the psychological intervention obtained a pregnancy rate of 39.8%, significantly higher than the 23.2% rate of nonparticipants (chi(2) = 6.03, p =.01, odds ratio of 22 (CI: 1.16-4.13). The data suggest that group psychological intervention before IVF and ICSI in order to control stress seems to increase the rate of success of these procedures.

Cesarean section and increased body mass index in school children: two cohort studies from distinct socioeconomic background areas in Brazil

Abstract Background Recent studies have raised controversy regarding the association between cesarean section and later obesity in the offspring. The purpose of this study was to assess the association of cesarean section with increased body mass index (BMI) and obesity in school children from two Brazilian cities with distinct socioeconomic backgrounds. Methods Two birth cohorts respectively born in 1994 in Ribeirao Preto, a wealthy city in Southeast, and in 1997/98 in Sao Luis, a less wealthy city in Northeast of Brasil, were evaluated. After birth, 2,846 pairs of mothers-newborns were evaluated in Ribeirao Preto and 2,542 in Sao Luis. In 2004/05, 790 children aged 10/11 years were randomly reassessed in Ribeirao Preto and 673 at 7/9 years in Sao Luis. Information on type of delivery, maternal and child characteristics, socioeconomic position and anthropometric measurements were collected after birth and at school age. Obesity was defined as BMI ≥ 95th percentile at school age. Results Obesity rate was 13.0% in Ribeirao Preto and 2.1% in Sao Luis. Cesarean section was associated with obesity and remained significant after adjustment only in Ribeirao Preto [OR = 1.74 (95% CI: 1.04; 2.92)]. The association between cesarean section and BMI remained significant after adjustment for maternal schooling, maternal smoking during pregnancy, duration of breastfeeding, gender, birth weight and gestational age, type of school and, only in Sao Luis, pre-pregnancy maternal weight. In Ribeirao Preto children born by cesarean section had BMI 0.31 kg/m2 (95%CI: 0.11; 0.51) higher than those born by vaginal delivery. In Sao Luis BMI of children born by cesarean section was 0.28 kg/m2 higher (95%CI: 0.08; 0.49) than those born by vaginal delivery. Conclusion A positive association between cesarean section and increased BMI z-score was demonstrated in areas with different socioeconomic status in a middle-income country.

Influence of obesity and cardiometabolic makers on lipoprotein-associated phospholipase A2 (Lp-PLA2) activity in adolescents: the healthy young cross-sectional study

Abstract Background Lipoprotein-associated phospholipase A2 activity (Lp-PLA2) is a good marker of cardiovascular risk in adults. It is strongly associated with stroke and many others cardiovascular events. Despite this, the impact of obesity on this enzyme activity and its relation to biomarkers of cardiovascular disease in adolescents is not very well investigated. The purpose of this article is to evaluate the influence of obesity and cardiometabolic markers on Lp-PLA2 activity in adolescents. Results This cross-sectional study included 242 adolescents (10–19 years) of both gender. These subjects were classified in Healthy Weight (n = 77), Overweight (n = 82) and Obese (n = 83) groups. Lipid profile, glucose, insulin, HDL size, LDL(−) and anti-LDL(−) antibodies were analyzed. The Lp-PLA2 activity was determined by a colorimetric commercial kit. Body mass index (BMI), waist circumference and body composition were monitored. Food intake was evaluated using three 24-hour diet recalls. The Lp-PLA2 activity changed in function to high BMI, waist circumference and fat mass percentage. It was also positively associated with HOMA-IR, glucose, insulin and almost all variables of lipid profile. Furthermore, it was negatively related to Apo AI (β = −0.137; P = 0.038) and strongly positively associated with Apo B (β = 0.293; P < 0.001) and with Apo B/Apo AI ratio (β = 0.343; P < 0.001). The better predictor model for enzyme activity, on multivariate analysis, included Apo B/Apo AI (β = 0.327; P < 0.001), HDL size (β = −0.326; P < 0.001), WC (β = 0.171; P = 0.006) and glucose (β = 0.119; P = 0.038). Logistic regression analysis demonstrated that changes in Apo B/Apo AI ratio were associated with a 73.5 times higher risk to elevated Lp-PLA2 activity. Conclusions Lp-PLA2 changes in function of obesity, and that it shows important associations with markers of cardiovascular risk, in particular with waist circumference, glucose, HDL size and Apo B/Apo AI ratio. These results suggest that Lp-PLA2 activity can be a cardiovascular biomarker in adolescence.

Spatial analysis of the social vulnerability of adolescent pregnancy

The purpose of this study was to present a spatial analysis of the social vulnerability of teenage pregnancy by geoprocessing data on births and deaths present on the Brazilian Ministry of Health databases in order to support intersectoral management actions and strategies based on spatial analysis in neighborhood areas. The thematic maps of the educational, occupational, birth and marital status of mothers, from all births and deaths in the city, presented a spatial correlation with teenage pregnancy. These maps were superimposed to produce social vulnerability map of adolescent pregnancy and women in general. This process presents itself as a powerful tool for the study of social vulnerability.

The Young Mother and the Labor Market

Introduction - The Centro de Orientacao ao Adolescente of Campinas (Southeastern Brazil) maintains a program to qualify economically disadvantaged adolescent students aged 15 to 18 years to enter the labor market. Objective - To understand life projects of teenagers who became mothers while participating in the program, in the period from 2003 to 2008, aiming to find the place of professional life in their life trajectory before and after motherhood. Method - Eight young mothers were interviewed, and a qualitative methodology was applied to the analysis of the interviews. Results - The trajectories of study and work were discontinued or adapted due to motherhood. Four young mothers completed high school and none had entered university. Three did not return to work and the rest had diverse work experiences. The reported difficulties to enter the labor market were: inadequate instruments to support the children's care, low income, lack of work experience, presence of small children and little educational background. Final Considerations - Teenage motherhood did not indicate the exclusion of educational or work projects but indicated adjustments and the need for a family and social support network. It was noted the need for public policies targeted at the inclusion of youths in the labor market and at support services such as nurseries. Also, the need for a change in gender relations was demonstrated, with greater equality of rights as a precondition for the inclusion of women, especially those who are mothers, in the labor market.

Pre Vertical Jump Performance to Regulate the Training Volume

The purpose of this study was to assess the effect of training load regulation, using the CMJ at the beginning of the session, on the total plyometric training load and the vertical jump performance. 44 males were divided into 4 groups: No Regulation Group (nRG), Regulation Group (RG), Yoked Group (YG) and Control Group (CG). The nRG received 6 weeks of plyometric training, with no adjustment in training load. The RG underwent the same training; however, the training load was adjusted according to the CMJ performance at the beginning of each session. The adjustment made in RG was replicated for the volunteers from the corresponding quartile in the YG, with no consideration given to the YG participant's condition at the beginning of its session. At the end of the training, the CMJ and SJ performance of all of the participants was reassessed. The total training load was significantly lower (p=0.036; ES=0.82) in the RG and the YG (1905 +/- 37 jumps) compared to the nRG (1926 +/- 0 jumps). The enhancement in vertical jump performance was significant for the groups that underwent the training (p<0.001). Vertical jump performance, performed at the beginning of the session, as a tool to regulate the training load resulted in a decrease of the total training load, without decreasing the long-term effects on vertical jump performance.

Gravidez na adolescência: percepções das mães de gestantes jovens

OBJETIVO: Conhecer as experiências e percepções de mães cujas filhas engravidaram durante a adolescência. MÉTODOS: Pesquisa de abordagem qualitativa, realizada em hospital de ensino na cidade de São Paulo, com coleta de dados realizada por meio de roteiro de entrevista semiestruturada e com participação de dez mães de adolescentes. RESULTADOS: Antes da gravidez, as mães orientaram as filhas a respeito da sexualidade, o que originou sentimentos de surpresa quando souberam da gravidez. Apesar disso, as mães fizeram-se presentes em todo o processo gravídicopuerperal. Não foram identificadas mudanças significativas no relacionamento familiar em função da gravidez precoce. CONCLUSÃO: A figura materna surge como representativa, tanto durante como após a gestação da adolescente, fato que propicia o suporte, a fim de que a adolescente tenha gestação mais segura e para que possa retomar seus projetos de vida.

Being the mother of a pregnant adolescent: experiences and expectations

OBJECTIVE: To understand the typical actions of the mother during the pregnancy of her teenage daughter. METHODS: Qualitative study, based on the theoretical-methodological framework of social phenomenology of Alfred Schütz. The data were collected in 2009, and the subjects were nine mothers of adolescent primigravidae. RESULTS: The mother of the pregnant adolescent is typified as one that reacts with surprise and disappointment to being notified of the pregnancy and who, subsequently, conforms to the new reality. In reflecting on her own experience of an adolescent mother, she has expectations to support her daughter during the pregnancy and to offer support, so that the course of her life is not impaired as a result of pregnancy. CONCLUSION: Considering the experience and expectations of the mother of the pregnant adolescent, this study could give subsidies to the planning and execution of the care for this binomial, decreasing the distance between the demands made by it and the practice of health professionals.

A jovem mãe e o mercado de trabalho

INTRODUÇÃO: O Centro de Orientação ao Adolescente de Campinas mantém um programa para capacitar adolescentes de 15 a 18 anos, desfavorecidos economicamente, estudantes, para a entrada no mercado de trabalho. OBJETIVO: Compreender projetos de vida de adolescentes, que se tornaram mães, enquanto participavam do programa, no período de 2003 a 2008, buscando desvelar o lugar da vida profissional na trajetória de vida, antes e depois da maternidade. MÉTODO: Oito jovens mães foram entrevistadas, sendo aplicada metodologia qualitativa para a análise das entrevistas. RESULTADOS: As trajetórias de estudo e trabalho foram descontinuadas, ou sofreram adaptações, com a maternidade. Quatro jovens finalizaram o segundo grau e nenhuma havia ingressado na faculdade. Três não voltaram a trabalhar e as demais tiveram experiências diversificadas de trabalho. As dificuldades relatadas para a inserção no mercado de trabalho foram: insuficiência de instrumentos de apoio no cuidado das crianças, baixo ganho salarial, falta de experiência de trabalho, filhos pequenos e pouca formação educacional. CONSIDERAÇÕES FINAIS: A maternidade na adolescência não indicou a exclusão dos projetos de formação educacional ou de trabalho, mas adaptações e necessidade de uma rede de apoio familiar e social. Constatou-se a necessidade de políticas públicas para a inserção do jovem no mercado de trabalho e para serviços de apoio, como creches. Demonstra-se a necessidade de uma mudança nas relações de gênero, com maior igualdade de direitos, como pré-condição à inserção da mulher no mercado de trabalho, em especial, daquelas que são mães.

Psicologia na atenção primária: ações e reflexões em programa de aprimoramento profissional

A inserção da Psicologia na Atenção Primária exigiu dos profissionais um repensar de suas práticas, ações e condutas, considerando a realidade da população com que se pretende atuar e os objetivos desse nível de atenção. O objetivo deste estudo é retratar a experiência de psicólogos do Programa de Aprimoramento Profissional em Promoção de Saúde na Comunidade em Núcleos de Saúde da Família em Ribeirão Preto, SP. Para o desenvolvimento das intervenções, inicialmente foram realizadas análises das necessidades, a fim de se verificar os padrões de morbimortalidade da população. A atuação dos psicólogos foi dividida em duas frentes de trabalho: uma voltada para o suporte à equipe e outra para realizar ações com a comunidade. Com os usuários, o psicólogo realizou visitas domiciliares, atendimentos individuais, familiares e coordenação de grupos. Os grupos eram abertos ou fechados, podendo ser classificados em educativos/reflexivos e de socialização. Para auxiliar no desenvolvimento das atividades, foram utilizados recursos audiovisuais, técnicas de dinâmica de grupo, discussões em grupos e trocas de experiências. Notase a importância de as ações do psicólogo na Atenção Básica estarem focadas na interferência nos fatores de risco à saúde da população, visando a alcançar mudanças comportamentais que proporcionem melhor qualidade de vida.

Possibilidades de atuação para o licenciado em Psicologia nas Etecs

Este artigo apresenta um levantamento do campo de atuação possível para o licenciado em Psicologia nas escolas técnicas estaduais de São Paulo (Etecs), buscando evidenciar a existência desse campo e provocar o debate sobre ele. Iniciamos o texto historicizando e contextualizando o ensino de Psicologia na educação profissional de nível médio. Posteriormente, apresentamos o processo de construção dos dados, que consistiu em levantamento e organização de informações disponíveis em sítios oficiais do Centro Paula Souza, identificando em quais disciplinas e cursos o licenciado em Psicologia pode ministrar aulas nas Etecs, bem como quão representativos são esses cursos na rede de ensino técnica pública estadual. Os resultados apontam um amplo campo possível de atuação para o licenciado em Psicologia, como em cursos técnicos de Administração, Marketing e Segurança do Trabalho, e sua ausência nos cursos técnicos de Enfermagem, e incitam ainda questões sobre os objetivos e as contribuições dos conhecimentos psicológicos abordados nas Etecs e sobre os fatores que determinam sua presença nesse contexto. Os resultados destacam também a necessidade de os profissionais da Psicologia fomentarem discussões quanto à licenciatura em Psicologia no sentido de avaliar as contribuições que o ensino da área pode trazer ao ensino médio profissional.

Contribuições para a construção da historiografia da Psicologia educacional e escolar no Brasil

Este artigo apresenta alguns dados sobre a história do campo de conhecimento e prática da Psicologia em sua relação com a educação no Brasil. Este estudo foi conduzido baseado no fundamento epistêmico-filosófico do materialismo histórico dialético e na nova história, utilizando fontes bibliográficas históricas e cinco relatos orais de personagens da Psicologia educacional e escolar. Os depoimentos e o material das fontes escritas constituíram o corpus documental, cuja organização seguiu a metodologia da história oral e da historiografia plural. Foi realizada análise descritivo-analítica compreendida em duas etapas: a) análise documental (fontes não orais) e b) construção de indicadores e núcleos de significação dos registros orais. A partir das análises, compôs-se uma periodização da história da Psicologia educacional e escolar brasileira por meio de marcos históricos que compreendeu as fases: 1) colonização, saberes psicológicos e educação (1500-1906), 2) a Psicologia em outros campos de conhecimento (1906-1930), 3) desenvolvimentismo - a Escola Nova e os psicologistas na educação (1930-1962), 4) A Psicologia educacional e a Psicologia do escolar (1962-1981), 5) o período da crítica (1981-1990), 6) a Psicologia educacional e escolar e a reconstrução (1990-2000) e 7) A virada do século: novos rumos? (2000-).