787 resultados para Longitudinal study
Resumo:
Human selenium (Se) requirements are currently based on biochemical markers of Se status. In rats, tissue glutathione peroxidase-1 (Gpx1) mRNA levels can be used effectively to determine Se requirements; blood Gpx1 mRNA levels decrease in Se-deficient rats, so molecular biology-based markers have potential for human nutrition assessment. To study the efficacy of molecular biology markers for assessing Se status in humans, we conducted a longitudinal study on 39 subjects (age 45 +/- 11) in Reading, UK. Diet diaries (5 day) and blood were obtained from each subject at 2, 8, 17 and 23 weeks, and plasma Se, glutathione peroxidase (Gpx3) enzyme activity, and selenoprotein mRNA levels were determined. There were no significant longitudinal effects on Se biomarkers. Se intake averaged 48 +/- 14 mu g/d. Plasma Se concentrations averaged 1.13 +/- 0.16 mu mol/l. Plasma Se v. energy-corrected Se intake (ng Se/kJ/d) was significantly correlated, but neither Gpx3 activity v. Se intake (ng Se/kJ/d) nor Gpx3 activity v. plasma Se was significantly correlated. Collectively, this indicates that subjects were on the plateaus of the response curves. Selenoprotein mRNAs were quantitated in total RNA isolated from whole blood, but mRNA levels for Gpx1, selenoprotein H, and selenoprotein W (all highly regulated by Se in rodents), as well selenoprotein P, Gpx3, and phospholipid hydroperoxide glutathione peroxidase were also not significantly correlated with plasma Se. Thus selenoprotein molecular biomarkers, as well as traditional biochemical markers, are unable to further distinguish differences in Se status in these Se replete subjects. The efficacy of molecular biomarkers to detect Se deficiency needs to be tested in Se-deficient populations.
Depression in men in the postnatal period and later child psychopathology: a population cohort study
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Objective: Postnatal depression in women is associated with adverse effects on both maternal health and children's development. It is unclear whether depression in men at this time poses comparable risks. The present study set out to assess the association between depression in men in the postnatal period and later psychiatric disorders in their children and to investigate predisposing factors for depression in men following childbirth. Method: A population-based cohort of 10,975 fathers and their children from the Avon Longitudinal Study of Parents and Children (ALSPAC) was recruited in the prenatal period and followed for 7 years. Paternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale and later child psychiatric disorder (DSM-IV) with the Development and Well-Being Assessment. Results: Depression in fathers in the postnatal period was significantly associated with psychiatric disorder in their children 7 years later (adjusted OR 1.72, 95% CI 1.07-2.77), most notably oppositional defiant/conduct disorders (adjusted OR 1.94, 95% CI 1.04-3.61), after adjusting for maternal depression and paternal educational level. A history of severe depression and high prenatal symptom scores for depression and anxiety were the strongest predictors of paternal depression in the postnatal period. Conclusions: Depression in fathers in the postnatal period is associated with later psychiatric disorders in their children, independently of maternal postnatal depression. Further research into the risks associated with paternal psychopathology is required because this could represent an important opportunity for public health intervention.
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The development of emotional regulation capacities in children at high versus low risk for externalizing disorder was examined in a longitudinal study investigating: a) whether disturbances in emotion regulation precede and predict the emergence of externalizing symptoms; and b) whether sensitive maternal behavior is a significant influence on the development of child emotion regulation. Families experiencing high (n=58) and low (n=63) levels of psychosocial adversity were recruited to the study during pregnancy. Direct observational assessments of child emotion regulation capacities and maternal sensitivity were completed in early infancy, at 12 and 18-months, and at 5-years. Key findings were as follows. First, high risk children showed poorer emotion regulation capacities than their low risk counterparts at every stage of assessment. Second, from 12-months onwards, emotion regulation capacities showed a degree of stability, and were associated with behavioral problems, both concurrently and prospectively. Third, maternal sensitivity was related to child emotion regulation capacities throughout development, with poorer emotion regulation in the high risk group being associated with lower maternal sensitivity. The results are consistent with a causal role for problems in the regulation of negative emotions in the etiology of externalizing psychopathology, and highlight insensitive parenting as a potentially key developmental influence.
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Aggression in children is associated with an enhanced tendency to attribute hostile intentions to others. However, limited information is available regarding the factors that contribute to the development of such hostile attribution tendencies. We examined factors that contribute to individual differences in child hostile attributions and aggression, focusing on potential pathways from maternal hostile attributions via negative parenting behavior. We conducted a longitudinal study of 98 mothers and children (47 male, 51 female), recruited from groups experiencing high and low levels of psychosocial adversity. Maternal hostile attributions, observed parenting, and child behaviour were assessed at 18 months and 5 years child age, and child hostile attributions were also examined at 5 years. Independent assessments of maternal and child processes were utilized where possible. Analyses provided support for a direct influence of maternal hostile attributions on the development of child hostile attributions and aggressive behaviour. Maternal hostile attributions were also associated with negative parenting behaviour, which in turn influenced child adjustment. Even taking account of possible parenting influences and preexisting child difficulties, hostile attributions in the mother showed a direct link with child aggression at 5 years. Maternal hostile attributions were themselves related to psychosocial adversity. We conclude that maternal hostile attributions are prevalent in high-risk samples and are related to less optimal parenting behaviour, child hostile attributions, and child aggression. Targeting hostile maternal cognitions may be a useful adjunct to parenting programs
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The present longitudinal study examines the interaction of learner variables (gender, motivation, self-efficacy and first language literacy) and their influence on second language learning outcomes. The study follows English learners of French from Year 5 in primary school (aged 9-10) to the first year in secondary school (Year 7 aged 11-12). Language outcomes were measured by two oral production tasks; a sentence repetition task and a photo description task both of which were administered at three time points. Longitudinal data on learner attitudes and motivation were collected via questionnaires. Teacher assessment data for general first language literacy attainment were also provided. The results show a great deal of variation in learner attitudes and outcomes and that there is a complex relationship between first language literacy, self-efficacy, gender and attainment. For example, in general, girls held more positive attitudes to boys and were more successful. However, the inclusion of first language ability, which explained 30-40% of variation, shows that gender differences in attitudes and outcomes are likely mediated by first language literacy and prior learning experience.
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Objective: Turnover of the extracellular matrix in all solid organs is governed mainly by a balance between the degrading matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). An altered extracellular matrix metabolism has been implicated in a variety of diseases. We investigated relations of serum levels of MMP-9 and TIMP-1 to mortality risk from an etiological perspective. Design: The prospective Uppsala Longitudinal Study of Adult Men (ULSAM) cohort, followed from 1991–1995 for up to 18.1 years. A random population-based sample of 1,082 71-year-old men, no loss to follow-up. Endpoints were all-cause (n = 628), cardiovascular (n = 230), non-cardiovascular (n = 398) and cancer mortality (n = 178), and fatal or non-fatal myocardial infarction (n = 138) or stroke (n = 163). Results: Serum MMP-9 and TIMP-1 levels were associated with risk of all-cause mortality (Cox proportional hazard ratio [HR] per standard deviation 1.10, 95% confidence interval [CI] 1.03–1.19; and 1.11, 1.02–1.20; respectively). TIMP-1 levels were mainly related to risks of cardiovascular mortality and stroke (HR per standard deviation 1.22, 95% CI 1.09–1.37; and 1.18, 1.04–1.35; respectively). All relations except those of TIMP-1 to stroke risk were attenuated by adjustment for cardiovascular disease risk factors. Relations in a subsample without cardiovascular disease or cancer were similar to those in the total sample. Conclusion: In this community-based cohort of elderly men, serum MMP-9 and TIMP-1 levels were related to mortality risk. An altered extracellular matrix metabolism may be involved in several detrimental pathways, and circulating MMP-9 or TIMP-1 levels may be relevant markers thereof.
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BACKGROUND: The role of inflammation and oxidative stress in mild renal impairment in the elderly is not well studied. Accordingly, we aimed at investigating the associations between estimated glomerular filtration rate (eGFR), albumin/creatinine ratio (ACR), and markers of different inflammatory pathways and oxidative stress in a community based cohort of elderly men. FINDINGS: Cystatin C-based GFR, ACR, and biomarkers of cytokine-mediated inflammation (interleukin-6, high-sensitivity C-reactive protein[CRP], serum amyloid A[SAA]), cyclooxygenase-mediated inflammation (urinary prostaglandin F2alpha [PGF2alpha]), and oxidative stress (urinary F2 isoprostanes) were assessed in the Uppsala Longitudinal Study of Adult Men(n = 647, mean age 77 years). RESULTS: In linear regression models adjusting for age, BMI, smoking, blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides, and treatment with statins, ACE-inhibitors, ASA, and anti-inflammatory agents, eGFR was inversely associated with CRP, interleukin-6, and SAA (beta-coefficient -0.13 to -0.19, p < 0.001 for all), and positively associated with urinary F2-isoprostanes (beta-coefficient 0.09, p = 0.02). In line with this, ACR was positively associated with CRP, interleukin-6, and SAA (beta- coefficient 0.09-0.12, p < 0.02 for all), and negatively associated with urinary F2-isoprostanes (beta-coefficient -0.12, p = 0.002). The associations were similar but with lower regression coefficients in a sub-sample with normal eGFR (>60 ml/min/1.73 m2, n = 514), with the exception that F2-isoprostane and SAA were no longer associated with eGFR. CONCLUSION: Our data indicate that cytokine-mediated inflammation is involved in the early stages of impaired kidney function in the elderly, but that cyclooxygenase-mediated inflammation does not play a role at this stage. The unexpected association between higher eGFR/lower albuminuria and increased F2-isoprostanes in urine merits further studies.
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AZEVEDO, George Dantas de et al. Raloxifene therapy does not affect uterine blood flow in postmenopausal women: a transvaginal Doppler study. Maturitas, Amsterdam, v.47, n.3, p.195-200, 2004
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Objetivos: A proporção de ocorrência de alcoolismo em homens e mulheres tem uma variação de 14:1 até 2:1, mostrando a necessidade de estudos específicos para a população feminina. O objetivo deste estudo foi analisar o perfil e a evolução de alcoolistas, segundo gênero e gravidade da dependência. Métodos: Realizou-se um estudo longitudinal retrospectivo de 114 homens e 57 mulheres alcoolistas (CID-10), inscritos no ambulatório da Faculdade de Medicina de Botucatu, no período de 1990-1994 e avaliados até julho de 1997. Utilizou-se um questionário semi-estruturado, e, para avaliação da gravidade do alcoolismo, o Short Alcohol Dependence Data. Resultados/Conclusões: Os principais resultados mostraram que a estrutura familiar estava comprometida com: relacionamento difícil para 55,6% das mulheres e 65,7% dos homens; violência familiar em 74,1% das mulheres e 61,1% dos homens. As mulheres iniciaram a ingestão mais tarde que os homens (p=0,01), em geral com seus cônjuges (p=0,00). Não houve diferença de evolução no tratamento entre os gêneros. Os principais fatores associados à melhor resposta ao tratamento, independentemente do sexo, foram: nível de gravidade de dependência do álcool (dependentes leves e moderados apresentaram 5,59 vezes mais chances de melhorar do que os dependentes graves); ser praticante de alguma religião (2,3 vezes mais chances de melhora do que os pacientes que não eram praticantes); e tempo de seguimento no programa, negativamente correlacionado a chances de melhora (0,68 vezes menos chances de melhora que aqueles que permaneceram por tempo menor em tratamento).
Resumo:
Background. Predicting risk of posteruptive enamel breakdown (PEB) of molar-incisor hypomineralization (MIH) opacity is a difficult but important clinical task. Therefore, there is a need to evaluate these aspects through longitudinal studies.Objective. The aim of this longitudinal study was to analyse the relationship between colours of MIH opacity of children aged 6-12 (baseline) and other clinical and demographic variables involved in the increase in severity of MIH.Materials and methods. A blinded prospective 18-month follow-up was conducted with 147 individuals presenting mild MIH. Tooth-based incidence of increase in severity of MIH (PEB or atypical restorations) was used as dependent measurement. Enamel opacities were recorded according to colour shades of white, yellow and brown, allowing assessment of susceptibility to structural loss over time, according to colour of MIH opacity. Poisson regression models were used to adjust the results for demographic and clinical variables.Results. Brown and yellow MIH opacities were at higher risk for PEB and atypical restorations than those of white ones, even after adjustment for clinical and demographic variables.Conclusion. Teeth presenting mild MIH severity associated with yellow and brown enamel opacities were at high risk for increase in severity of MIH than lighter ones. This result could help clinicians determine a risk-based treatment for children with MIH.
Resumo:
O objetivo deste trabalho foi descrever o processo de intervenção fonoaudiológica de dois irmãos com transtornos invasivos do desenvolvimento, por meio de um estudo longitudinal de caso clínico. Participaram dois irmãos, um de nove e outro de 11 anos de idade, ambos do gênero masculino, com autismo (Caso 1) e transtorno invasivo do desenvolvimento sem outra especificação (Caso 2). Como procedimento de coleta e análise de dados foi realizado um estudo longitudinal, por meio de acompanhamento dos casos ao longo de quatro anos de intervenção fonoaudiológica. Foram realizadas filmagens durante as sessões de terapia, análise documental de informações dos prontuários referentes à anamnese, avaliação e relatórios terapêuticos fonoaudiológicos, exames e avaliações multidisciplinares. em ambos os casos houve melhora no contato visual, na interação social, no vocabulário e na brincadeira simbólica. No Caso 1 ocorreu aumento de 2,0 para 6,2 atos comunicativos por minuto, no Caso 2 de 3,5 para 8,0 atos e ambos demonstraram predominância do meio verbal e maior variedade de funções comunicativas. Outros fatores influenciaram estes resultados, como a deficiência intelectual, a dinâmica familiar, os conflitos no relacionamento entre os irmãos e o ambiente escolar em que estavam inseridos. Confirmou-se a relevância do fonoaudiólogo em intervenções nos transtornos invasivos do desenvolvimento, junto a equipes multidisciplinares, para a discussão diagnóstica e de condutas mais adequadas. Estudos longitudinais podem contribuir para uma análise mais detalhada e fidedigna de intervenções terapêuticas nesses casos, para esclarecer lacunas existentes na literatura e subsidiar a atuação do fonoaudiólogo clínico.
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Linear mixed effects models are frequently used to analyse longitudinal data, due to their flexibility in modelling the covariance structure between and within observations. Further, it is easy to deal with unbalanced data, either with respect to the number of observations per subject or per time period, and with varying time intervals between observations. In most applications of mixed models to biological sciences, a normal distribution is assumed both for the random effects and for the residuals. This, however, makes inferences vulnerable to the presence of outliers. Here, linear mixed models employing thick-tailed distributions for robust inferences in longitudinal data analysis are described. Specific distributions discussed include the Student-t, the slash and the contaminated normal. A Bayesian framework is adopted, and the Gibbs sampler and the Metropolis-Hastings algorithms are used to carry out the posterior analyses. An example with data on orthodontic distance growth in children is discussed to illustrate the methodology. Analyses based on either the Student-t distribution or on the usual Gaussian assumption are contrasted. The thick-tailed distributions provide an appealing robust alternative to the Gaussian process for modelling distributions of the random effects and of residuals in linear mixed models, and the MCMC implementation allows the computations to be performed in a flexible manner.
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The purpose of this study was to employ photographic evaluation to observe the presence or absence of bubbles in pit and fissure sealants Concise and Prisma Shield, at 7 days, 18 months, 36 months and 11 years after accomplishment of treatment. Methods: A hematoxylin-based staining solution was applied to the occlusal surface at the study periods, which allowed assessment of the sealing material on the surface. All occlusal surfaces were photographed and the photographs corresponding to each period were subjected to photographic evaluation. Results: There was statistically significant difference only at 18 months, with a significantly higher number of specimens with bubbles for the Prisma Shield sealant compared to the Concise, whereas the groups were similar at all other study periods. On the other hand, separate analysis of subsequent periods of the sealants did not reveal any significant difference. Conclusions: According to the results of the present longitudinal investigation, it may be concluded that the sealing materials showed that bubbles came into and went out with time. However, this fact did not interfere with its clinical purpose, provided the remaining material covers the expected region of pits and fissures.
Resumo:
Child temperament has been studied in various researches and may be useful to predict how a child responds to dental treatment, especially very young children. The purpose of the present longitudinal study was to evaluate the behavioral manifestation of children aged 0 to 3 years, considering different types of dental situation. A total of 169 children were selected and the following data were collected: the age of the child, gender, age of the mother, number of dental visits and their respective dates, stimuli offered to the child, and behavioral response to these stimuli. The children and their respective behaviors were divided into five groups according to the dental situation offered: control, missed visits, fluoride varnish, restoration, and dental trauma. The data were submitted to descriptive and inferential analysis using the chi-square test, with the level of significance set at 5%. Analysis of the different situation offered to infants during routine dental care revealed a predominance of collaborating and partially collaborating behavior, and age at the time of dental care influenced the behavior of the infants, irrespective of the stimulus group. The different types of dental situation provoked changes in the behavioral response of the children of certain age groups, especially in the dental trauma group.
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Abstract: When and how the dentist intervenes have repercussions on children's physical and emotional patterns. The objective of the present study was to conduct a longitudinal behavioral analysis during dental care of babies aged 0 to 3 years. A total of 216 patients seen at the Baby Clinic of the School of Dentistry at Araçatuba, São Paulo State University (UNESP), were selected. The selection criterion was attendance at ten dental care sessions at bimonthly intervals for routine procedures such as clinical examination and oral hygiene. There was a predominance of cooperative behavior compared to uncooperative behavior when each visit was analyzed separately. The behavior of the patients must have been directly influenced by their psychomotor development. Constant attendance and exposure of the baby to non-stressful dental stimuli are factors that favor a cooperative behavior.