Association between physical activity level and consumption of fruit and vegetables among adolescents in northeast Brazil

AbstractObjectiveTo determine the association between low levels of physical activity and consumption of fruits and vegetables among adolescents.MethodsThis cross-sectional study included 2,057 adolescents aged 13 to 18 years from the city of Aracaju, Northeastern Brazil. We analyzed the level of physical activity, consumption of fruits and vegetables by standardized and validated questionnaires. The control variables were sex, age, socioeconomic status, maternal education, alcohol consumption and smoking. For data analysis, univariate and multivariate logistic regression were used, with a significance level of 5%.ResultsThe prevalence of low levels of physical activity was 81.9%; the inadequate consumption of fruits ocurred in 79.1% and the inadequate consumption of vegetables in 90.6%. Adolescents who consumed few fruits daily had an increase in 40% of chance of being insufficiently active and, for those who consumed few vegetable's the likelihood of being insufficiently active was 50% higher, compared to those who had adequate intake of these foods.ConclusionsLow levels of physical activity were associated with inadequate fruit and vegetable intake among adolescents in a city in northeastern Brazil. These findings suggest that insufficiently active adolescents have other unhealthy behaviors that may increase the risk of chronic diseases in adulthood

PERFIL SOCIODEMOGRÁFICO E ANTROPOMÉTRICO DE IDOSOS DE GRUPOS DE CONVIVÊNCIA

Objetivou-se neste estudo descrever e analisar o perfil sociodemográfico e antropométrico de idosos de grupos de convivência. O estudo transversal foi formado por 181 idosos (98 mulheres e 83 homens) de 18 diferentes grupos de Aracaju-SE. As variáveis sociodemográficas foram: idade, escolaridade, estado civil e renda. As antropométricas foram: massa corporal (MC), estatura, circunferência da cintura (CC) e do quadril (CQ). Calculou-se o IMC e o RCQ. Empregou-se a estatística descritiva, teste “t” para amostras independentes e análise de variância, com comparações post-hoc de Tukey, adotando um p<0,05. A maioria dos idosos tinha mais de 70 anos (64%), eram do sexo feminino (54%), com no máximo ensino fundamental (73%), casados (68%) e com renda própria (60%). A MC e a estatura diminuíram com o passar da idade. Em média, o IMC foi superior aos recomendados em todas as faixas etárias. Mais mulheres do que homens apresentaram inadequação na CC e RCQ. SOCIODEMOGRAPHIC AND ANTHROPOMETRIC PROFILE OF ELDERLY PEOPLE FROM COEXISTENCE GROUPS. abstract The aim of this study was to describe and analyze sociodemographic and anthropometric profile of elderly from coexistence groups. The cross-sectional study was formed by 181 elderly people (98 women and 83 men) of 18 different groups of Aracaju-SE. The sociodemographic variables were: age, education, marital status and income. The anthropometric were: body mass (BM), height, waist circumference (WC) and hip (WH). The BMI and the WHR were calculates. It was applied the descriptive statistics, “t” test for independent samples and analysis of variance, with post-hoc of Tukey, adopting p <0.05. Most elderly people had more than 70 years (64%), were female (54%), with at most elementary school (73%), married (68%), and with own income (60%). The BM and stature declined with the age passage. On average, BMI was higher than those recommended for all ages. More women than men showed inadequacy in the WC and WHR

Indicadores antropométricos de obesidade e fatores sociodemográficos e de saúde associados à pressão arterial elevada em adultos de Florianópolis, Santa Catarina, Brasil: estudo de base populacional

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Desportos. Programa de Pós-Graduação em Educação FísicaEste estudo teve como objetivo analisar a associação de indicadores antropométricos de obesidade generalizada e central e fatores individuais sociodemográficos e de saúde com níveis pressóricos elevados em adultos de Florianópolis, Santa Catarina, Brasil. Esta pesquisa faz parte do projeto EpiFloripa Adultos 2009, caracteriza-se como transversal, de base populacional com amostra de 1.720 adultos (20 a 59 anos de idade), de ambos os sexos, residentes na cidade de Florianópolis. A coleta de dados foi domiciliar e ocorreu entre setembro de 2009 e janeiro de 2010. As pressões arteriais, sistólica e diastólica, foram avaliadas por meio de um aparelho digital de pulso, devidamente calibrado. Os indicadores antropométricos de obesidade analisados foram o índice de massa corporal (IMC), circunferência da cintura, razão circunferência da cintura-estatura (RCest), índice de conicidade (índice-C), percentual de gordura corporal (%G) estimado por meio de equações que consideram o IMC e a circunferência da cintura. Todos os indicadores antropométricos apresentaram boa capacidade preditiva para hipertensão, sendo que o IMC, a circunferência da cintura e a RCest foram os melhores indicadores. Valores elevados de %G e dos demais indicadores foram associados com a hipertensão. Os homens, sujeitos com cor de pele preta, faixa etária acima de 40 anos, tercil intermediário de renda per capita, escolaridade menor que 12 anos, inativos fisicamente, IMC > 25 kg/m², circunferência da cintura elevada e com percepção negativa do estado de saúde foram os grupos mais vulneráveis a apresentar hipertensão. O presente estudo sugere que indicadores antropométricos de obesidade generalizada e central apresentam poder discriminatório e magnitude de associação semelhante para hipertensão em adultos, e que fatores individuais passíveis de modificação microestruturais e macroestruturais estão fortemente associados à hipertensão arterial.This study aimed to analyze the association between anthropometric indicators of general and central obesity and individual sociodemographic and health factors with high blood pressure among adults from Florianopolis, Santa Catarina, Brazil. This research is part of a project entitled EpiFloripa Adultos 2009, which is a cross-sectional population-based study with a sample composed of 1,720 adults (20-59 years) from both sexes living in the city of Florianopolis, SC, Brazil. Data were collected at home and occurred between September 2009 and January 2010. Systolic and diastolic blood pressure was evaluated by means of a digital pulse device, properly calibrated. Anthropometric indicators of obesity were analyzed using body mass index (BMI), waist circumference, waist-to-height ratio (WHtR), conicity index (C-index), body fat percentage (% BF) estimated by equations that consider BMI and waist circumference. All anthropometric indicators showed good predictive capacity for hypertension, and BMI, waist circumference and WHtR were the best indicators. High %BF values and other indicators were associated with hypertension. Men, subjects with black skin color, aged over 40 years, intermediate tertile of per capita income, educational level lower than 12 years, physical inactivity, BMI > 25 kg / m², high waist circumference and negative health state perception were the groups most vulnerable to show hypertension. The present study suggests that anthropometric indicators of general and central obesity have similar discriminatory power and magnitude of association for hypertension in adults, and that individual factors that can be micro structurally and macro structurally changed are strongly associated with hypertension

Efeito de um programa de exercício físico aeróbio na composição corporal, perfil lipídico e capacidade aeróbia em adolescentes com excesso de peso

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Desportos, Programa de Pós-Graduação em Educação Física, Florianópolis, 2010O excesso de peso corporal entre os adolescentes, nas formas de sobrepeso e obesidade, vem aumentando nos países em desenvolvimento, o que acarreta preocupações aos órgãos de saúde, devido aos agravos e riscos provocados por essas condições. Associado ao excesso de peso, as alterações no perfil lipídico aumenta o risco de mortalidade na vida adulta. Uma das recomendações para diminuição do excesso de peso e dos fatores de risco associados é a prática de exercícios físicos aeróbios regulares, pois o aprimoramento da capacidade aeróbia resulta em alterações na composição corporal e no perfil lipídico. Assim, este estudo desenvolvido com adolescentes que apresentam excesso de peso teve como objetivos verificar o efeito de um programa de exercício físico nas seguintes variáveis: a) composição corporal; b) perfil lipídico; c) capacidade aeróbia. Este estudo experimental de delineamento de grupos randomizados com testes pré e pós-tratamento foi formado por adolescentes com excesso de peso, divididos aleatoriamente em grupos experimental - GE (n=9) e controle - GC (n=5). A intervenção teve duração de 12 semanas, na qual o GE realizou exercício aeróbio três vezes semanais, em cicloergômetro, com intensidades individuais referentes ao limiar de lactato (LL) e ao Onset of Blood Lactate Accumulation (OBLA), tendo a cada duas semanas um incremento de 10% na carga do ergômetro. Após o período de intervenção, diferentemente do GC, o GE teve uma melhora nas seguintes variáveis: a) composição corporal, diminuição da dobra cutânea tricipital (14,0%), percentual de gordura corporal (4,2%), massa de gordura (4,2%) e aumento da massa livre de gordura (1,7%); b) perfil lipídico, aumentando o HDL - colesterol (10,6%); c) capacidade aeróbia, aumento nas cargas do ergômetro referentes ao LL (33,3%) e OBLA (14,2%), além de se atingir o LL com uma freqüência cardíaca superior ao período inicial. O programa de exercício físico aeróbio em cicloergômetro, destinado aos adolescentes com excesso de peso, tendo uma intensidade elevada, prescrita com indicadores da resposta de lactato sanguíneo, provocou alterações positivas na composição corporal, perfil lipídico e capacidade aeróbia nos adolescentes que participaram do treinamento. Estes achados indicam, supostamente, que adolescentes com excesso de peso, inseridos em programas de exercício físico de intensidade elevada, podem diminuir o risco de desenvolvimento de doenças cardiovasculares na idade adulta

Prevalence and factors associated with low lumbar strength in adolescents

Introduction: Low back pain is a multifactorial disorder and is one of the most common musculoskeletal discomfort in adolescents and adults. Objective: To determine the prevalence and factors associated with low levels of lumbar force in adolescents.  Methods: This is a cross-sectional study involving 909 adolescents aged 14 to 16 years enrolled in public schools in São José, of Santa Catarina State – Southern Brazil. Lumbar force was analyzed by the lumbar extension test developed by a Canadian research group, which proposes different cutoffs according sex. Independent variables were sex, age, socioeconomic status, alcohol consumption, screen time, physical activity, aerobic fitness and mass body index. For data analysis, binary logistic regression was used, with significance level of 5%.  Results: The prevalence of low levels of lumbar force was 45.2%, being 36.2% for boys and 53.1% for girls. The population subgroups most likely to present low levels of lumbar force were females (OR: 1,99; CI95%: 1,52 to 2,60) and those adolescents with overweight (OR: 1,48; CI95%: 1,12 to 1,96). Conclusion: Almost half of the students had low levels of lumbar force. The girls, the adolescents with overweight and with excessive time in front of the screen most likely present low levels of lumbar force. The innovation of this study is  modifiable factors such as  the excessive time screen and overweight may be used to promote health  interventions to improve  levels of  lumbar strength of youth.Objetivo: Verificar a prevalência e fatores associados a baixos níveis de força lombar em adolescentes de 14 a 19 anos de idade.Método: Trata-se de um estudo transversal, com 909 adolescentes de 14 a 19 anos, estudantes de escolas públicas da cidade de São José, Santa Catarina – Brasil. Analisou-se a força lombar por meio do teste de extensão lombar proposto pela Canadian Physical Activity, Fitness and Lifestyle Approach (CPAFLA) que propõe pontos de corte distintos para os sexos. As variáveis independentes analisadas foram: sexo, idade, nível econômico, tempo de tela, atividade física, aptidão aeróbia e Indíce de Massa corporal. Para a análise dos dados utilizou-se a regressão logística binária com nível de significância de 5%.Resultados: A prevalência de baixos níveis de força lombar foi de 45,2%, sendo 36,2% para os meninos e 53,1% para as meninas. Os subgrupos populacionais com maiores chances de baixos níveis de força lombar foram o sexo feminino (OR: 1,99; IC95%: 1,52-2,60) e adolescentes com excesso de peso (OR: 1,48; IC95%: 1,12-1,96). Conclusão: Quase metade dos estudantes apresentaram baixos níveis de força lombar. As meninas e os adolescentes com excesso de peso estiveram mais propícios a ter baixos níveis de força lombar

Prevalence of excessive screen time and associated factors in a school from a city in the northeast of brazil

Introduction: Studies about screen time and its correlates are generally determined by the sum of the duration of several behaviours. Studies that analysed behaviours separately highlighted different correlates. Objective: Estimate the prevalence of excessive screen time, through watching television and using computers or video games, and its correlates, in students in a city in North-eastern Brazil. Methods: An investigation in a high school located in the city of Jequie, Bahia state, Brazil, with a sample of 1163 students between 14 and 20 years. The dependent variables were excessive time watching television and using computers or video games, and the independent ones were socio-demographic and lifestyle variables. The magnitude of the association was determined by the Odds Ratio (OR) and by 95% of con fi dence intervals (CI). Results: The prevalence of excessive time watching television was estimated at 32.8% (95% CI: 29.9% - 35.5%) and using computer/videogames was 27.3% (95%CI: 24.5% - 29.5%). Those who did not work (OR = 1.940; 95%CI: 1.365 - 2.758); those students whose mothers had less than eight years of schooling (OR = 1.324; 95%CI: 1.023 - 1.714); and who did not regularly eat vegetables (OR = 1.423; 95%CI: 1.082-1.871) were more likely to be exposed to excessive television. On the other hand, those who had not reached the minimum consumption of fruits (OR = 0.712; 95% CI: 0.245 - 0.929) showed lower odds. Female students (OR = 0.694; 95%CI: 0.528 - 0.912) and students with family income lower than two minimum wages (OR = 0.630; 95%CI: 0.474 - 0.838) had lower chances of exposure to excessive time using computer/video games, while the insufficiently active (OR = 0.631; 95% CI: 0.438 - 0.911) showed higher chances. Conclusions: About 1/3 of the students spent too much time in front of the television and computer/video games, with a different correlation relative to each of these behaviours

Effects of the herbal remedy Tribulus terrestris on the prostate of the Mongolian gerbil (Meriones unguiculatus)

Orientadores: Sebastião Roberto Taboga, Fernanda Cristina Alcântara dos SantosTese (doutorado) - Universidade Estadual de Campinas, Instituto de BiologiaResumo: A planta Tribulus terrestris (TT) é utilizada para o tratamento de inúmeros problemas de saúde em diversas medicinas tradicionais. Uma das principais indicações é no tratamento de disfunções sexuais, supostamente por sua capacidade de interferir no metabolismo androgênico. Por conta disso, o fitoterápico se popularizou entre indivíduos de várias idades, tendo sido utilizado como alternativa natural e legal para anabolizantes. Entretanto, o uso de substâncias que interferem no equilíbrio hormonal pode trazer consequências negativas para a histofisiologia prostática, já que a próstata é um órgão alvo da ação dos andrógenos, sensível às alterações hormonais. Por outro lado, dados da literatura apontam uma possível ação quimioprotetora de alguns dos principais componentes do TT, as saponinas, as quais seriam capazes de atenuar efeitos deletérios da idade e da exposição a agentes tóxicos. Assim, este trabalho se propôs a apresentar uma extensa revisão da literatura a respeito do papel do fitoterápico sobre os aspectos da biologia reprodutiva (Capítulo I) e avaliar os efeitos do uso do extrato de TT sobre os níveis de testosterona e suas consequências sobre a histofisiologia prostática no gerbilo da Mongólia intacto ou exposto ao carcinógeno N-metil-N-nitrosoureia (MNU). Para avaliar os efeitos da exposição em curto prazo (Capítulo II), 24 machos foram divididos em quatro grupos: controle experimental, controle da indução carcinogênica (50 mg/kg de MNU em dose única aos 180 dias), controle dos efeitos do TT (11 mg/kg em doses diárias do 180º ao 270° dia) e tratamento pós-indução (11 mg/kg em doses diárias do extrato de TT do 180º ao 270° dia, após dose única de 50 mg/kg de MNU aos 180 dias). Para avaliar os efeitos da exposição em longo prazo (Capítulo III), 24 machos foram divididos em quatro grupos: controle experimental, controle da indução carcinogênica (50 mg/kg de MNU em dose única aos 180 dias), controle do uso prolongado do TT (11 mg/kg em doses diárias do 90º ao 270° dia) e tratamento prolongado associado à indução (11 mg/kg em doses diárias do extrato de TT do 90º ao 270° dia, com dose única de 50 mg/kg de MNU aos 180 dias). O TT não foi capaz de elevar os níveis séricos de testosterona e não causou alterações biométricas em órgãos sensíveis a andrógenos, o que indica baixo potencial anabolizante na dose e nos períodos administrados. Além disso, o fitoterápico pode ter contribuído para a quimioproteção da próstata uma vez que retardou o surgimento de lesões malignas na glândula. Houve uma ação específica do TT em reduzir a atividade da via androgênica canônica (diminuição de receptores de andrógenos e de proliferação de células epiteliais), reproduzindo, in vivo, a proteção contra a atividade tumoral já observada in vitro. No entanto, apesar de frear o surgimento de lesões malignas, o TT não foi capaz de evitar o surgimento de lesões pré-malignas, especialmente quando a utilização teve início em indivíduos ainda jovens. Dessa forma, os efeitos do TT para a próstata precisam ser melhor compreendidos e o uso do fitoterápico ainda requer cautelaAbstract: The plant Tribulus terrestris (TT) is used to treat numerous health problems in many traditional medicines. One of the most frequent indication of use is for the treatment of sexual dysfunction, because of its supposed ability to interfere with androgenic metabolism. Because of this, TT became popular among individuals of various ages, having been used as a natural and legal alternative for anabolics. However, the use of substances that interfere with hormonal balance can have negative consequences for prostate histophysiology, since the prostate is an organ that is the target of androgen action and sensitive to hormonal changes. On the other hand, data from the literature indicate a possible chemoprotective action of some of the major components of TT, the saponins, which would be able to attenuate deleterious effects of age and exposure to toxic agents. Thus, this work has proposed to present an extensive review of the literature on the role of this herbal medicine in aspects of reproductive biology (Chapter I) and to evaluate the effects of the use of TT extract on testosterone levels and its consequences on the histophysiology of the prostate in intact Mongolian gerbil, or those exposed to the carcinogen N-methyl-N-nitrosourea (MNU). To evaluate the effects of short-term exposure (Chapter II), 24 males were divided into four groups: experimental control, control of carcinogenic induction (50 mg/kg of MNU in a single dose on the 180º day), control of TT effects (11 mg/kg, in daily doses from 180º to 270º day) and treatment after induction (11 mg/kg of TT, in daily doses from 180º to 270º day, after a single dose of 50 mg/kg of MNU on the 180º day). To evaluate the effects of long-term exposure (Chapter III), 24 males were divided into four groups: experimental control, carcinogenic induction control (50 mg/kg MNU, in a single dose on the 180º day), control of prolonged use of TT (11 mg/kg in daily doses from 90º to 270º day) and prolonged treatment associated with induction (11 mg/kg of TT, in daily doses from 90º to 270º day, with a single dose of 50 mg/kg of MNU on the 180º day). TT was not able to raise serum testosterone levels and did not cause biometric changes in androgen-sensitive organs, which indicates low anabolic potential at the dose and periods administered. In addition, the herbal medicine may have contributed to the chemoprotection of the prostate as it has delayed the onset of malignant lesions in the gland. There was a specific action of TT in reducing the activity of the canonical androgenic pathway (decrease of androgen receptors and proliferation of epithelial cells), reproducing, in vivo, the protection against the tumor activity already observed in vitro. However, in spite of repressing the onset of malignant lesions, TT was not able to prevent the onset of premalignant lesions, especially when the use started in young individuals. Thus, the effects of TT on the prostate need to be better understood and phytotherapeutic use still requires cautionDoutoradoBiologia CelularDoutor em Biologia Celular e Estrutural2014/26660-0305840/2015-0FAPESPCNP

Gut microbial metabolite increases skeletal muscle regeneration through epigenetic mechanisms

Introduction: Reduction in skeletal muscle regeneration capacity, such as in inflammatory muscle diseases and aging, leads&nbsp;to progressive muscle strength decrement, which impairs mobility and increases risk of falls and mortality, with a negative&nbsp;impact of quality of life. This reduction in skeletal muscle regeneration has been associated with an impaired function of&nbsp;the skeletal muscle stem cells, namely, the satellite cells. These cells are localized beneath basal lamina in a quiescence&nbsp;state and can be activated and differentiated into new myofibers after muscle damage. Indeed, satellite cells need to exit&nbsp;the cell cycle for differentiation. Therefore, the search for biological tools that can improve activation/differentiation of&nbsp;satellite cells is of great interest to regenerative medicine. In this regard, butyrate, a gut microbial metabolite, which can&nbsp;induce cell cycle arrest through histone deacetylase inhibition, has emerged as a therapeutic tool in some diseases, such&nbsp;as cancer. Then, we hypothesize that butyrate could improve skeletal muscle regeneration by accelerating satellite cellsdifferentiation into myofibers through epigenetics mechanisms related to cell cycle exit.&nbsp;Objectives: To assess whether butyrate could improve skeletal muscle regeneration after barium chloride damage and its&nbsp;epigenetics mechanisms.&nbsp;Methods: Twenty C57Bl/6 male mice (CEUA: 133/2014), with 8 weeks of age, were grouped as follows: (1) control&nbsp;group with no injury + saline (C-Sal); (2) control group with no injury + butyrate (CBut); (3) injury with saline (I-Sal);and (4) injury + butyrate (I-But). The muscle injury was performed with the injection of 50 μL of barium chloride (1.2%)&nbsp;in both tibialis anterior and the muscles were harvested six and twelve days after injury for histological and molecular&nbsp;analyses. Butyrate were injected intraperitoneally (400 mg/kg) for 6 days. For in vitro assays, primary satellite cells were&nbsp;isolated and cultured as myoblasts. Myoblasts were treated with 300 μM of butyrate during proliferation and differentiation&nbsp;conditions in order to assess cell cycle molecules, differentiation index, and epigenetics mechanisms. The significance&nbsp;was assumed when P &lt; 0.05.&nbsp;Results: Skeletal muscle regeneration, assessed by cross-sectional area of tibialis anterior muscle, was higher in I-But&nbsp;than I-Sal group (P &lt; 0.05). Histogram analysis also showed higher frequency of smaller fibers in I-Sal than I-But group&nbsp;(P &lt; 0.05). In vitro analyses showed a reduction in the myoblasts proliferation when treated with butyrate (P &lt; 0.05). Also,&nbsp;butyrate treatment downregulated genes related to cell cycle activation (cdk1, cdk2, cdk4), and up-regulated genes related&nbsp;to cell cycle repression (p57) (P &lt; 0.05). The myotubes differentiation, assessed by fusion index, were higher in myoblasts treated with butyrate (P &lt; 0.05), which was followed by an upregulation of the myogenic marker of differentiation, myogenin&nbsp;(P &lt; 0.05). Moreover, butyrate was able to decrease histone deacetylase (P &lt; 0.05) and increase histone acetyltransferase&nbsp;enzymatic activities (P &lt; 0.05).&nbsp;Conclusion and discussion: Butyrate increased skeletal muscle regeneration in mice by accelerating the myotubes&nbsp;differentiation through induction of cell cycle arrest in myoblasts. Preliminary data suggested that this improvement was&nbsp;epigenetically mediated

Comparison of three criteria for overweight and obesity classification in brazilian adolescents

OBJECTIVE: To describe and compare the nutritional status of adolescents using three criteria for nutritional status classification (Conde & Monteiro, International Obesity Task Force - IOTF and Word Health Organization - WHO), to analyze the correlation between these three criteria as for the overweight proportion, and to investigate whether factors associated with overweight and obesity differ among the three criteria. METHODS: Demographic (gender, age, geographic area) and anthropometric (body weight, height) variables were measured in 33.728 adolescents aged 11 to 17 years. The following criteria were investigated: IOTF (2000); Conde & Monteiro (2006); and WHO (2007). RESULTS: The overall overweight prevalence was 20.6% for the Conde & Monteiro criteria; 15.3% for the IOTF criteria and 20.1% for the WHO criteria. Both for boys and girls, the estimated overweight prevalence using the Conde & Monteiro and WHO criteria were higher than that using the IOTF criteria. Higher concordance was found between the Conde & Monteiro (2006) and WHO (2007) criteria for all age groups. Regarding associated factors, similar associations were found for the three criteria for higher BMI classification: being male, 11–12 and 13–14 years of age and living in the Midwestern, Southeastern and Southern regions of Brazil. CONCLUSION: The criteria for BMI classification estimate overweight prevalence in a different way, and the criteria proposed by Conde & Monteiro resulted in higher prevalence in both sexes. Higher concordance between the Conde & Monteiro and WHO criteria was found for all age groups. The groups most vulnerable to showing overweight and obesity for the three criteria for BMI classification were males, age 11–12 and 13–14 years, and living in the Midwestern, Southeastern and Southern regions of Brazil. Overweight and obesity are considered a public health problem prevalent among adolescents in Brazil, regardless of the criteria adopted

É tempo de cuidar das crianças e dos adolescentes brasileiros

Editorial - sem resumo