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Predição de risco de atraso no desenvolvimento neuropsicomotor nos primeiros mil dias de vida utilizando aprendizado de máquina: coorte brisa

Fri, 27 Feb 2026 00:00:00 GMT

Título: Predição de risco de atraso no desenvolvimento neuropsicomotor nos primeiros mil dias de vida utilizando aprendizado de máquina: coorte brisa Autor: SILVA, Katia Susana Azevedo Primeiro orientador: SOUZA, Bruno Feres de Abstract: Introduction: The first thousand days of life represent a critical window of brain plasticity, in which neuropsychomotor development (NPMD) is sensitive to biological and psychosocial influences. Early prediction of risks during this period is fundamental for timely interventions, although it constitutes a complex challenge in community-based populations. Objective: To develop and evaluate Machine Learning (ML) models to predict the risk of NPMD delay in children during the first thousand days of life. Methods: Prospective study with data from 972 mother-child pairs from the BRISA cohort (São Luís – MA). The outcome was the risk of delay assessed in the cognitive, communication and motor domains evaluated by the Bayley III scale. The algorithms Penalized Logistic Regression (PLR), Random Forest (RF), Support Vector Machines (SVM) with radial kernel and Artificial Neural Networks (ANN), and the null classifier were tested. Preprocessing included imputation of missing data, encoding of categorical variables by one-shot encoding and standardization of numerical variables. For the evaluation of the generated ML models, K-fold cross-validation (k = 5) with 10 repetitions was used. As performances metrics, the area under the AUC-ROC curve (AUC), sensitivity, specificity, accuracy, precision and F1-score were used. The interpretability of the models was analyzed using the SHapley Additive Explanations (SHAP) technique. Results: The highest prevalence of risk of delay occurred in expressive communication (44.1%). The models showed moderate performance with AUC ranging between 0.533 and 0.603, with PLR being the most stable algorithm, reaching an AUC of 0.603 in the fine motor domain. SHAP analysis identified as main predictors: family history of epilepsy, child's sex, maternal depressive symptoms, psychological violence and social support, maternal education and family income. Conclusion: ML models demonstrated moderate discrimination ability in heterogeneous population samples, showing that increased algorithmic complexity did not surpass logistic regression. The findings reinforce the multifactorial nature of development, highlighting the impact of psychosocial and biological determinants, contributing to the development of screening tools applicable to Primary Health Care. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

PERCEPÇÕES DE PROFISSIONAIS DA ATENÇÃO PRIMÁRIA SOBRE A SAÚDE DE PESSOAS LGBTQIA+

Fri, 27 Feb 2026 00:00:00 GMT

Título: PERCEPÇÕES DE PROFISSIONAIS DA ATENÇÃO PRIMÁRIA SOBRE A SAÚDE DE PESSOAS LGBTQIA+ Autor: ABREU, Carla Michelle Rodrigues Primeiro orientador: LIMA, Sara Fiterman Abstract: Introduction: Despite advances in the creation of the National Policy for Comprehensive Health of Lesbians, Gays, Bisexuals, Transvestites, and Transsexuals, the health needs of the LGBTQIA+ population are still unknown to a large part of health professionals. Without adequate care, lesbians, gays, bisexuals, and transgender people tend to resist seeking qualified support. In this context, it becomes fundamental that professionals develop skills and competencies to understand and value the real needs of this population. Objective: To analyze the perceptions and attitudes of Primary Care professionals regarding the health of the LGBTQIA+ community. Method: This is a qualitative, descriptive, and analytical study, carried out between October 2025 and January 2026 at the Bezerra de Menezes Primary Health Care Unit, São Francisco Primary Health Care Unit, Centro Primary Health Care Unit, and Liberdade Primary Health Care Unit, located in São Luís – MA, with professionals from the Family Health Strategy. Data collection was carried out through a focus group, using a structured questionnaire for sociodemographic information and professional trajectory, and a semi-structured interview guide. The interviews were transcribed and analyzed according to Thematic Analysis, following the perspective of Braun and Clarke. Results: From the analysis of the statements, three main categories emerged: the first, Conceptual understanding of gender identity and sexual orientation, is composed of three core meanings: Lack of knowledge of the acronym LGBTQIA+ and its meanings, generating misunderstanding about sexual and gender diversity; The first part, "Attitudes and Positions of Professionals Towards the LGBTQIA+ Population," is composed of three core meanings: Perception and Recognition of Prejudice in the Care of the LGBTQIA+ Population; Influence of Personal, Religious, Moral, or Cultural Beliefs; Recognition of Ethical-Professional Duty in Care. The second part, "Experiences in the Care of the LGBTQIA+ Population in Primary Health Care," is composed of four core meanings: Programmed Invisibility: Accounts of Little or No Experience; Clinical Reductionism: Care Centered on Complaint and Pathologization; Conducts Marked by Insecurity, Hesitation, and Exclusionary Attitudes; Primary Health Care as an Entry Point: Potentialities and Limitations in Reception. Final Considerations: The participants' statements reveal conceptual confusion, embarrassment when addressing the topic, and resistance in the correct use of pronouns and social names, revealing weaknesses both in the technical field and in the fulfillment of human rights. legal. The influence of personal moral and religious values proves to be a limiting element for professional practice guided by ethical principles and the universality of the SUS (Brazilian Unified Health System). Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

Associação entre consumo de alimentos segundo o grau de processamento e dificuldades comportamentais em adolescentes de 10 a 13 anos da coorte brisa

Wed, 25 Feb 2026 00:00:00 GMT

Título: Associação entre consumo de alimentos segundo o grau de processamento e dificuldades comportamentais em adolescentes de 10 a 13 anos da coorte brisa Autor: OLIVEIRA, Lucia Regina Moreira de Primeiro orientador: VIOLA, Poliana Cristina de Almeida Fonseca Abstract: Introduction: Adolescence is a critical period for the consolidation of dietary habits and mental health development. Growing evidence suggests that diet quality, particularly the high consumption of Ultra-Processed Foods (UPF), can negatively influence behavior and mental health, given their low nutrient density and pro-inflammatory potential. Studying this relationship, while controlling for socioeconomic and behavioral factors, is essential for formulating specific interventions. Objective: To investigate the association between the degree of food processing and behavioral difficulties in adolescents (10 to 13 years old) participating in the BRISA cohort. Methods: This was a cross-sectional cohort study conducted with adolescents aged 10-12 years from the BRISA Cohort, São Luís, Maranhão (N=2293). The exposure variable was food consumption, categorized according to the NOVA classification and measured in energy percentage (%Kcal) using a 24-Hour Dietary Recall (24hDR). The primary outcome was the Total Difficulties Score, assessed by the Strengths and Difficulties Questionnaire (SDQ). Sociodemographic, socioeconomic, and behavioral variables (Sex, Age, Brazilian Economic Class, Physical Activity, Screen Time, Sleep Duration) were used as confounding factors, as directed by a Directed Acyclic Graph (DAG). The association was tested through bivariate analyses and adjusted Multiple Linear Regression. A significance level of 5% was adopted. Results: The average consumption of UPF corresponded to 30.3% of the Total Energy Value of the diet. The SDQ analysis revealed that 26% of adolescents were classified as at risk (borderline + clinical) in the total score. Bivariate analysis indicated a significant association between UPF consumption and sex, with female adolescents being more prevalent in the higher consumption tertiles (p=0.002). Multiple Linear Regression demonstrated that, even after adjustment for all confounders, a higher consumption of UPF was independently associated with higher behavioral difficulties scores (β=0.300; 95% CI: 0.05; 0.55). Complementarily, an increase in the consumption of Unprocessed or Minimally Processed Foods (UMPF) was associated with a reduction in the Total Difficulties Score (β = - 0.410; 95% CI: -0.70; -0.12). Other risk factors included sedentary behavior/inactivity and high screen time. Conclusion: The consumption of ultra-processed foods acts as a fundamental determinant of increased behavioral difficulties in adolescence. The findings reinforce the urgent need for comprehensive public policies that promote the substitution of ultra-processed foods with diets based on unprocessed and minimally processed foods, aiming to protect the mental health of Brazilian adolescents. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

Relações da atividade física e do comportamento sedentário com um fenótipo da saúde musculoesquelética em adolescentes: consórcio RPS, São Luís

Tue, 10 Mar 2026 00:00:00 GMT

Título: Relações da atividade física e do comportamento sedentário com um fenótipo da saúde musculoesquelética em adolescentes: consórcio RPS, São Luís Autor: TOCANTINS, Patrícia Viana Primeiro orientador: ALMEIDA, Cecília Cláudia Costa Ribeiro de Abstract: Adolescence is an essential stage for musculoskeletal development, characterized by the consolidation of bone mass, muscle mass, and muscle strength, which are fundamental components for functional capacity and the prevention of musculoskeletal diseases in adulthood. These processes are strongly influenced by human movement–related behaviors, such as physical activity at different levels, as well as sedentary behavior. Insufficient levels of physical activity and excessive sedentary time during adolescence may compromise the development of the musculoskeletal system, resulting in less favorable health profiles, with an increased risk of chronic non-communicable diseases (NCDS) and functional frailty throughout life. In this context, this dissertation aims to analyze the association between physical activity, sedentary behavior, and the Musculoskeletal Health Phenotype in adolescents at the end of the second decade of life. This is a cross-sectional analytical study nested within a birth cohort, using data from the 18–19-year follow-up of the 1997/98 birth cohort from São Luís, Brazil, with a sample of 2,515 participants. Physical activity was assessed using a validated questionnaire, the Self-Administered Physical Activity Checklist (SAPAC), and actigraphy. Sedentary behavior was measured by the daily time spent in low-energy-expenditure activities. The outcome corresponded to the Musculoskeletal Health Phenotype, a latent variable constructed from the shared variance among bone mineral density, handgrip strength (HGS), and muscle mass. Associations were estimated using Structural Equation Modeling, adjusted for socioeconomic status, sex, and nutritional status. The results indicated that physical activity showed a direct positive association, increasing the values of the Musculoskeletal Health Phenotype (standardized coefficient = 0.143; p < 0.001), whereas sedentary behavior exerted a direct negative effect (standardized coefficient = −0.040; p < 0.001). Lower socioeconomic status increased the values of the Musculoskeletal Health Phenotype (standardized coefficient = 0.291; p < 0.001) and reduced sedentary behavior (standardized coefficient = −0.041; p < 0.001). Female sex was associated with lower levels of physical activity and greater sedentary behavior, while overweight increased the values of the Musculoskeletal Health Phenotype (standardized coefficient = 0.263; p < 0.001). The findings highlight the importance of interventions to promote physical activity among adolescents, preventing future risks to musculoskeletal health and associated chronic non-communicable diseases. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação