MARIA FERNANDA TOURINHO PERES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
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- Food environments in schools and in the immediate vicinity are associated with unhealthy food consumption among Brazilian adolescents(2016) AZEREDO, Catarina Machado; REZENDE, Leandro Fornias Machado de; CANELLA, Daniela Silva; CLARO, Rafael Moreira; PERES, Maria Fernanda Tourinho; LUIZ, Olinda do Carmo; FRANCA-JUNIOR, Ivan; KINRA, Sanjay; HAWKESWORTH, Sophie; LEVY, Renata BertazziBackground. Evidence of the influence of the school food environment on adolescent diet is still little explored in low-and middle-income countries. We aimed to evaluate the association between food environment in schools and the immediate vicinity and the regular consumption of unhealthy food among adolescents. Methods. We used cross-sectional data collected by the Brazilian National Survey of School Health (PeNSE) from a representative sample of adolescents attending 9th grade public and private schools in Brazil, in 2012. We estimated students' regular consumption (>5 days/week) of unhealthy food (soft drinks, bagged salty snacks, deep fried salty snacks and sweets) and school availability, in the cafeteria or an alternative outlet, of the same food plus some healthy options (fruit and natural fruit juice). We performed multilevel logistic regression models. Results. Having a cafeteria inside school selling soft drinks (private schools OR = 1.23; 95% CI = 1.14-1.33; public schools OR = 1.13; 95% CI = 1.06-1.20) and deep fried salty snacks (private schools OR = 1.41 95% CI = 1.26-1.57; public schools OR = 1.16 95% CI = 1.08-1.24) was associated with a higher consumption of these unhealthy foods of among students. In private schools, cafeteria selling fruit and natural fruit juice was associated with lower student consumption of bagged salty snacks (OR = 0.86; 95% CI 0.77-0.96) and soft drinks (OR = 0.85; 95% CI = 0.76-0.94). In addition, eating meals from the Brazilian School Food Program in public schools was associated with a lower consumption of unhealthy foods. Conclusions. Foods available in the school food environment are associated with the consumption of unhealthy food among adolescents in Brazil.
- Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of Sao Paulo city, Brazil(2022) MASSAZZA, Alessandro; ALMEIDA, Juliana Feliciano de; QUINLAN-DAVIDSON, Meaghen; SILVA, Renata Teixeira da; DEVAKUMAR, Delanjathan; PERES, Maria Fernanda Tourinho; LEWIS, Glyn; KISS, LigiaBackground Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high prevalence of trauma. Additionally, little is known about the perceived applicability among clinicians of the new ICD-11 diagnosis of complex PTSD (CPTSD), despite its potential relevance for contexts of chronic trauma. The current study investigated local understandings of PTSD and CPTSD among health professionals working with adolescents in violent neighbourhoods of Sao Paulo city. Methods Semi-structured interviews were conducted with 58 health professionals working at both the primary care and specialized mental health levels in two areas of Sao Paulo city with high levels of community violence. Results Most participants knew about PTSD, but most did not know about CPTSD. There were mixed views concerning the commonality of PTSD among adolescents exposed to community violence. Many participants reported having no experience working with patients with the PTSD diagnosis. According to some, community violence was normalized by adolescents and health professionals, and did not result in PTSD. Others highlighted how they did not use psychiatric diagnoses in their practice, had critical perspectives towards psychiatric diagnoses and/or PTSD, or simply knew little about PTSD. Furthermore, many highlighted how the chronic nature of multiple traumas experienced by adolescents often resulted in complex clinical presentations characterised by many symptoms beyond PTSD. The diagnosis of CPTSD was considered appropriate to the context by many participants as it captured the complex traumatic histories and symptom presentations of adolescents exposed to community violence in Brazil. Conclusions These findings have important implications for the assessment and treatment of mental health among adolescents exposed to community violence in Brazil.
- Patterns of health-related behaviours among adolescents: a cross-sectional study based on the National Survey of School Health Brazil 2012(2016) AZEREDO, Catarina Machado; LEVY, Renata Bertazzi; PERES, Maria Fernanda Tourinho; MENEZES, Paulo Rossi; ARAYA, RicardoObjectives: The aim of this study was to analyse the clustering of multiple health-related behaviours among adolescents and describe which socio-demographic characteristics are associated with these patterns. Design: Cross-sectional study. Setting: Brazilian schools assessed by the National Survey of School Health (PeNSE, 2012). Participants: 104 109 Brazilian ninth-grade students from public and private schools (response rate= 82.7%). Methods: Exploratory and confirmatory factor analyses were performed to identify behaviour clustering and linear regression models were used to identify socio-demographic characteristics associated with each one of these behaviour patterns. Results: We identified a good fit model with three behaviour patterns. The first was labelled 'problem-behaviour' and included aggressive behaviour, alcohol consumption, smoking, drug use and unsafe sex; the second was labelled 'health-compromising diet and sedentary behaviours' and included unhealthy food indicators and sedentary behaviour; and the third was labelled 'health-promoting diet and physical activity' and included healthy food indicators and physical activity. No differences in behaviour patterns were found between genders. The problem-behaviour pattern was associated with male gender, older age, more developed region (socially and economically) and public schools (compared with private). The 'health-compromising diet and sedentary behaviours' pattern was associated with female gender, older age, mothers with higher education level and more developed region. The 'health-promoting diet and physical activity' pattern was associated with male gender and mothers with higher education level. Conclusions: Three health-related behaviour patterns were found among Brazilian adolescents. Interventions to decrease those negative patterns should take into account how these behaviours cluster together and the individuals most at risk.
- A global analysis of the impact of COVID-19 stay-at-home restrictions on crime(2021) NIVETTE, Amy E.; ZAHNOW, Renee; AGUILAR, Raul; AHVEN, Andri; AMRAM, Shai; ARIEL, Barak; BURBANO, Maria Jose Arosemena; ASTOLFI, Roberta; BAIER, Dirk; BARK, Hyung-Min; BEIJERS, Joris E. H.; BERGMAN, Marcelo; BREETZKE, Gregory; CONCHA-EASTMAN, I. Alberto; CURTIS-HAM, Sophie; DAVENPORT, Ryan; DIAZ, Carlos; FLEITAS, Diego; GERELL, Manne; JANG, Kwang-Ho; KAARIAINEN, Juha; LAPPI-SEPPALA, Tapio; LIM, Woon-Sik; REVILLA, Rosa Loureiro; MAZEROLLE, Lorraine; MESKO, Gorazd; PEREDA, Noemi; PERES, Maria F. T.; POBLETE-CAZENAVE, Ruben; ROSE, Simon; SVENSSON, Robert; TRAJTENBERG, Nico; LIPPE, Tanja van der; VELDKAMP, Joran; PERDOMO, Carlos J. Vilalta; EISNER, Manuel P.The implementation of COVID-19 stay-at-home policies was associated with a considerable drop in urban crime in 27 cities across 23 countries. More stringent restrictions over movement in public space were predictive of larger declines in crime. The stay-at-home restrictions to control the spread of COVID-19 led to unparalleled sudden change in daily life, but it is unclear how they affected urban crime globally. We collected data on daily counts of crime in 27 cities across 23 countries in the Americas, Europe, the Middle East and Asia. We conducted interrupted time series analyses to assess the impact of stay-at-home restrictions on different types of crime in each city. Our findings show that the stay-at-home policies were associated with a considerable drop in urban crime, but with substantial variation across cities and types of crime. Meta-regression results showed that more stringent restrictions over movement in public space were predictive of larger declines in crime.
- Intersectional insights into racism and health: not just a question of identity(2022) SHANNON, Geordan; MORGAN, Rosemary; ZEINALI, Zahra; BRADY, Leanne; COUTO, Marcia Thereza; DEVAKUMAR, Delon; EDER, Ben; KARADAG, Ozge; MUKHERJEE, Maki; PERES, Maria Fernando Tourinho; RYNGELBLUM, Marcelo; SABHARWAL, Nidhi; SCHONFIELD, Amos; SILWANE, Pamela; SINGH, David; RYNEVELD, Manya Van; VILAKATI, Siyasanga; WATEGO, Chelsea; WHYLE, Eleanor; MURAYA, KuiIntersectionality is a useful tool to address health inequalities, by helping us understand and respond to the individual and group effects of converging systems of power. Intersectionality rejects the notion of inequalities being the result of single, distinct factors, and instead focuses on the relationships between overlapping processes that create inequities. In this Series paper, we use an intersectional approach to highlight the intersections of racism, xenophobia, and discrimination with other systems of oppression, how this affects health, and what can be done about it. We present five case studies from different global locations that outline different dimensions of discrimination based on caste, ethnicity and migration status, Indigeneity, religion, and skin colour. Although experiences are diverse, the case studies show commonalities in how discrimination operates to affect health and wellbeing: how historical factors and coloniality shape contemporary experiences of race and racism; how racism leads to separation and hierarchies across shifting lines of identity and privilege; how racism and discrimination are institutionalised at a systems level and are embedded in laws, regulations, practices, and health systems; how discrimination, minoritisation, and exclusion are racialised processes, influenced by visible factors and tacit knowledge; and how racism is a form of structural violence. These insights allow us to begin to articulate starting points for justice-based action that addresses root causes, engages beyond the health sector, and encourages transnational solidarity.
- The role of social support in reducing the impact of violence on adolescents' mental health in Sao Paulo, Brazil(2021) QUINLAN-DAVIDSON, Meaghen; KISS, Ligia; DEVAKUMAR, Delan; CORTINA-BORJA, Mario; EISNER, Manuel; PERES, Maria Fernanda TourinhoObjectives We investigated whether perceived social support among adolescent students moderated the association between violence exposure and internalising symptoms in Sao Paulo city, Brazil. Methods We tested the stress-buffering model using data from the cross-sectional school-based, survey Sao Paulo Project on the Social Development of Children and Adolescents. Internalising symptoms were measured using an adapted version of the Social Behaviour Questionnaire; serious victimisation, being bullied once/week, school violence and community violence, friend and teacher support were scales adapted by the research team; the Alabama Parenting Questionnaire measured parenting style. Linear mixed-effects models were used to quantify moderation effects of (i) social support between violence exposure and internalising symptoms and (ii) gender between violence exposure and internalising symptoms across schools. Results Across schools, being bullied once/week, school violence, and community violence were associated with a significant (p<0.001) increase in internalising symptoms (e.g., bullied b = 5.76, 95% CI 2.26, 9.26; school violence b = 0.48, 95% CI 0.30, 0.67; community violence b = 0.36; 95% CI 0.22, 0.50). Males exposed to all types of violence had significantly lower (p<0.01) internalising symptoms compared to females (e.g., serious victimisation: b = -1.45; 95% CI -2.60, -0.29; school violence b = -0.27; 95% CI -0.30, -0.24; community violence b = -0.23; 95% CI -0.25, -0.20). As a main effect, social support was associated with a significant (p<0.01) decrease in internalising symptoms across schools (e.g., positive parenting b = -2.42; 95% CI -3.12, -1.72; parent involvement b = -2.75; 95% CI -3.32, -2.17; friend support b = -1.05; 95% CI -1.74, -0.34; teacher support b = -0.90; 95% CI -1.58, -0.22). Social support did not moderate the association between violence exposure and internalising symptoms. Conclusions Adolescent students in Sao Paulo exposed to violence have a higher likelihood of internalising symptoms, compared to those who are not. Support from parents, friends, and teachers, independent of violence, appear to be protective against internalising symptoms, pointing to potential programmes that could improve adolescent mental health.
- Relationship between polyvictimization and overweight among adolescents from Sao Paulo city, Brazil(2023) MARQUES, Emanuele Souza; FAUS, Daniela Porto; LEVY, Renata Bertazzi; LEITE, Maria Alvim; EISNER, Manuel P.; PERES, Maria Fernanda TourinhoThis study is to identify victimization patterns and analyze the association between the experience of poly -victimization and overweight or obesity among adolescent girls and boys. The sample consisted of 2680 Brazilian ninth-graders enrolled in public and private schools, taken from the Sa similar to o Paulo Project for the social development of children and adolescents (SP-PROSO). Victimization was explored in two ways: (i) as per Finkelhor and (ii) by latent class analysis (LCA). The interest outcomes were overweight and obesity. Multinomial logistic regression models were used to study the relationship between victimization and overweight or obesity, controlling for confounders. LCA grouped boys and girls adolescents into three classes. These classes received the same labels, but the patterns differed between sexes. Class 1 was characterized by fewer types of victimization suffered and lower endorsement values in the analyzed items and was named bullying and indirect victimization (9: 42.7%, n = 546; male: 21.6%, n = 293). Class 2 included more victimization types than Class 1 and less than Class 3. This class was labeled family violence and peer victimization (9: 29.1%, n = 356; male: 47.9%, n = 652). Class 3 was named high polyvictimization (9: 28.2%, n = 345; male: 30.5%, n = 418). According to Finkelhor, polyvictimization was not associated with overweight or obesity in both sexes. Only the class of high polyvictimization was associated with being overweight (ORadj: 1.60, 95%CI: 1.01-2.54) in girls. In this study, polyvictimization was associated with being overweight only among adolescent girls. Longitudinal studies in different contexts and populations are needed to understand this relationship.