Nesta pesquisa, analisei o padrão temporal de sono e as atividades cotidianas realizadas por duas crianças cegas e quatro crianças com baixa visão, na faixa etária entre 3-4 a 7-8 anos, por meio de diário de sono e de atividades preenchido ao longo de três semanas, com o objetivo de investigar se crianças cegas ou com baixa visão, sendo algumas com múltipla deficiência, apresentam padrão de ciclo vigília/sono alterado em função da dificuldade de percepção da mudança do ambiente pelo comprometimento do sentido da visão. Parti da hipótese de que a percepção dos ciclos e a organização temporal na espécie humana, principalmente nos centros urbanos das sociedades atuais, estão cada vez mais vinculadas aos compromissos sociais, em geral relacionados ao trabalho e à escola, e cada vez menos à observação da mudança do ambiente causada por eventos geofísicos, como é o caso do ciclo claro/escuro. Ao analisar os resultados, percebemos evidências indiretas de privação de sono nos dias da semana compatíveis com os dados existentes em pesquisas sobre ritmicidade biológica na espécie humana de modo geral, o que confirma a nossa hipótese inicial de organização temporal baseada no ritmo social cada vez mais independente do ciclo claro/escuro geofísico. Porém, evidencio a nossa sugestão em relação a uma identidade temporal singular para cada indivíduo, construída com base em aspectos sociais e biológicos. Assim, a partir de uma análise dialética, concluímos que a questão sobre sincronização de ritmos supera a dicotomia social-biológico e se desloca para as possibilidades diversas de interações entre os sinais temporais do ambiente e a forma como eles atingem singularmente cada sujeito em uma estrutura histórico-cultural / In this research, I analyzed the temporal pattern of sleep and daily activities performed by two blind children and four children with low vision, aged 3-4 to 7-8 years, through sleep and activity diaries filled in along three consecutive weeks, aiming to investigate whether blind or low vision children, some with multiple disabilities, present altered wake/sleep cycle pattern due to the difficulty of perceiving the change of environment due to the impairment of vision. I assumed that the perception of cycles and the temporal organization in the human species, especially in the urban centers of present-day societies, are increasingly linked to social commitments, generally related to work and school, and less and less to the observation of the environmental change caused by geophysical events, such as the light/dark cycle. Analyzing the results, we found indirect evidence of weekday sleep deprivation consistent with data from research on biological rhythmicity in humans, which confirms our initial hypothesis of temporal organization based on increasingly social rhythm independent of the light/dark geophysical cycle. However, I highlight our suggestion regarding a unique temporal identity for each individual, built on social and biological aspects. Thus, from a dialectical analysis, we conclude that the question of rhythm synchronization overcomes the social-biological dichotomy and shifts to the diverse possibilities of interactions between the temporal signals of the environment and the way they uniquely affect each subject in a historical-cultural structure

L'étude présente une recherche portant sur les rythmes scolaires par une évaluation chronopsychologique des modalités organisationnelles du temps scolaire à l'école algérienne, elle compare entre la double et la simple vacation chez les enfants âgés de 11 à 12 ans. Les résultats obtenus dans cette recherche dégagent l'influence du type de modalité proposée-imposée sur les facteurs physiologiques et psychologiques des élèves algériens. Les résultats indiquent que sur le plan journalier et hebdomadaire les performances attentionnelles des enfants scolarisés en double vacation présentent une rythmicité classique qui témoigne d'une relative adaptation de cet emploi du temps aux rythmes de vie de l'enfant. En ce qui concerne l'étude des comportements, on conclue que les deux élèves scolarisés en double vacation s'adaptent mieux à la situation scolaire au cours de la journée scolaire. Par contre au cours de la semaine scolaire, c'est les deux élèves scolarisés en simple vacation qui semblent mieux s'adapter à la situation scolaire. Quelle que soit la modalité du temps scolaire simple vacation ou double vacation et quelle que soit l'heure d'entrée des enfants des deux sites, cela ne génère pas de perturbations du rythme veille sommeil ; les enfants des deux sites dorment plus que la moyenne établie par les recherches chronopsychologiques. Par contre, l'effet de la coupure de la demi-journée au cours de la semaine scolaire n'est pas bénéfique pour les élèves de la double vacation contrairement aux élèves de la simple vacation. La coupure du week-end permet de compenser la fatigue liée à la fin de la semaine chez les enfants des deux sites. En ce qui concerne les activités extra-scolaires, on ne peut que constater la similitude des deux modalités proposée-imposée aux enfants algériens simple vacation ou double vacation en matière d'organisation des temps extra-scolaires. / The purpose of this study is to make a chrono-psychological assessment of the type of time organization applied in Algerian schools. Comparison was made between the single and double vacation types of school timing organization based on a sample of pupils aged between 11 and 12 years. The results of the study highlight the physiological and psychological impact of the two types of school vacation on Algerian pupils. Furthermore the daily and weekly attention levels of pupils in the double vacation type of organization indicate that this type of time organization is well suited for Algerian pupils who seem well adapted to their school timing. With regard to the behavior of the two children observed during the study it was found that those in the double vacation type were better adapted to daily school life compared to their peers in the single type of vacation. However during the week it is the pupils in the single vacation type who showed a better level of adaptation. The results also indicate that regardless of the type of time organization and the time of school entrance the subjects showed no troubles with regard to time of sleeping or awaking: Pupils from the two types of time organization slept more than the average time indicated by chrono-psychological research. However it was also shown that the brake taken tuesday afternoon by pupils from the double vacation type - unlike their peers in the single vacation type- had no positive effects, but the brake taken in the weekend by all pupils regardless of the type of vacation was useful for since it enabled them to take a rest and overcome their fatigue. With regard to extra- curricular school activities they clearly appear to be the same for all pupils.

Introdução: o ciclo de sono-vigília é o comportamento rítmico circadiano mais onipresente nos humanos. Ele é estabelecido por um sistema temporizador circadiano endógeno que é regulado pela presença ou ausência de luz no ambiente. O comportamento em relação a dormir e acordar varia entre os indivíduos e essa característica nomeia-se cronotipo. Efeitos negativos à saúde têm sido associados ao cronotipo que apresenta horários para iniciar e terminar o sono mais tarde. A hipótese considerada para explicar esses achados é de que demandas sociais, que não levam em conta essa variabilidade individual, sejam mediadoras dessa relação. Objetivos: avaliar a associação entre cronotipo e saúde mental (bem-estar psicológico e sintomas depressivos) levando-se em conta fatores demográficos (sexo e idade) e as rotinas de escola ou trabalho. Materiais e métodos: estudos transversais aninhados a um estudo epidemiológico em uma amostra de indivíduos do Vale do Taquari, no sul do Brasil. Na primeira avaliação, 6.506 participantes foram avaliados quanto a variáveis demográficas, dados de saúde, sintomas depressivos (Inventário de Depressão de Beck – BDI) e cronotipo (Questionário de Cronotipo de Munique – MCTQ). Na segunda etapa, 1.127 indivíduos entre 18 e 65 anos, selecionados a partir de seu cronotipo foram avaliados através do Índice de bem-estar de 5-itens da Organização Mundial da Saúde (OMS). O ponto médio do sono nos dias de rotinas de trabalho ou escolares foi utilizado como indicador do cronotipo, sendo “atrasado” aquele que tem o ponto médio mais tarde em relação ao início da noite e “avançado”, mais cedo. Resultados: no primeiro artigo, estudou-se a relação entre cronotipo e depressão em uma amostra de estudantes adolescentes. O modelo de regressão que melhor explicou a diferença entre os grupos com diferentes níveis de sintomas de depressão (BDI<10 X BDI!10) incluiu o sexo feminino e o cronotipo atrasado. O segundo artigo demonstrou que a escala de Bem-estar de 5-itens da OMS tem uma estrutura unidimensional, boa validade interna e externa e utilidade como instrumento de triagem para depressão quando comparada ao BDI. Assim, no terceiro artigo, foi avaliada a relação entre cronotipo e bem-estar, em indivíduos entre 18 e 65 anos. O modelo de regressão que incluiu o cronotipo atrasado, maior carga de trabalho, rotinas de trabalho mais cedo no dia e menor exposição à luz do sol, como variáveis preditoras, e piores escores na Escala de Bem-estar, como desfecho, foi significativo para o sexo feminino. Discussão: a presente tese explicitou a importância de considerar os fatores idade e sexo na expressão do cronotipo e na relação deste com saúde mental. Corroborou com a hipótese de que as demandas sociais mediam a relação entre cronotipo e os desfechos estudados. A expressão do cronotipo nos dias de rotinas escolares ou de trabalho foi identificada como a variável que estabeleceu a mais forte relação com piores escores de bemestar e com mais sintomas de depressão. Por fim, reforçou a necessidade de revermos as rotinas de trabalho e escolares que, ao não considerarem as diferenças fisiológicas individuais, têm-se associado, de forma consistente, a conseqüências negativas à saúde. / Introduction: the sleep-wake cycle is the most ubiquitous human circadian rhythmic behavior. It is established by an endogenous circadian timing system that is regulated by the presence or absence of light in the environment. Sleep and wake behavior varies among individuals and this feature has been termed chronotype. Negative health effects have been associated with the chronotype that presents later start and end sleep times. A hypothesis to explain these findings is that social demands, which do not take into account individual variability, are mediators of this relationship. Objectives: to evaluate the association between chronotype and mental health (psychological well-being and depressive symptoms) taking into account demographic factors (age and sex) and the routines of school or work. Materials and methods: the studies included here are cross-sectional nested to an epidemiological study in a sample of individuals from “Vale do Taquari”, in southern Brazil. In the first evaluation, 6,506 participants were assessed for demographic variables, health data, depressive symptoms (Beck Depression Inventory - BDI) and chronotype (Munich Chronotype Questionnaire - MCTQ). In the second stage, 1,127 individuals between 18 and 65 years, selected based on their chronotype, were evaluated through the Well-being 5 items Index from the World Health Organization (WHO). The midpoint of sleep on working or school days was used as an indicator of chronotype, and considered "delayed" or “late” those who have later midpoints in relation to environmental night and "advanced" or “early”, earlier. Results: in the first article, we studied the relationship between chronotype and depression in a sample of adolescent students. The regression model that best explained the difference between groups with different levels of depression symptoms (BDI<10 X BDI!10) included female sex and late chronotype. The second article demonstrated that the Well-being index has a unidimensional structure, good internal and external validities and might be usefulness as a screening tool for depression when compared to the BDI. Thus, in the third article, we evaluated the relationship between chronotype and well-being in individuals between 18 and 65 years. The regression model that included late chronotype, increased workload, earlier working routines in the day and less exposure to sunlight, as predictor variables, and worse scores on the well-being index, as the outcome was significant for females. Discussion: the present thesis content highlighted the importance of considering age and sex as factors influencing the expression of chronotype and the relationship with mental health outcomes. It corroborated the hypothesis that social demands mediate the relationship between chronotype and the studied outcomes. The expression of chronotype during the days of work or school routines was identified as the variable that established the strongest relationship with worse well-being scores and more depression symptoms. Finally, it reinforced the need to reconsider work and school routines that, by not taking into acount individual physiological differences, have been associated consistently with negative health consequences.

Tesis por compendio de publicaciones / La luz y los patrones de alimentación influyeron sobre el comportamiento, fisiología y reloj molecular de dos peces teleósteos. Se clonaron dos criptocromos de lubina (cry1 y cry2), expresándose en todos los tejidos estudiados y mostrando ritmos diarios de expresión en cerebro, hígado y corazón (excepto cry2). La fase (día/noche) de alimentación a demanda en lubina afecta a los patrones diarios de actividad amilasa intestinal y expresión de period1 en tejidos periféricos (i.e. hígado), pero no en cerebro. Durante las inversiones estacionales de alimentación de la lubina, mostraron mayores valores de glucosa sanguínea durante la fase de alimentación, revelando también los mayores valores medios en lubinas nocturnas invierno. El pez cebra utilizó un nuevo comedero a demanda, mostrando independencia de fase entre ritmos circadianos de alimentación (nocturno) y locomoción (diurno), con diferentes periodicidades. Además la actividad y posición del pez cebra resultó espectro-dependiente, provocando mayores efectos las longitudes de onda cortas. / Thesis summary in English Light and feeding patterns influence on the behaviour, physiology and molecular clock of two teleost fish. Two cryptochromes (cry1 and cry2) were cloned, being expressed in all studied tissues and showing daily rhythm of expression in brain, liver and heart (except cry2). The self-seabass feeding phase (day/night) affected on daily patterns of intestinal amylase activity and on the period1 expression in peripheral tissues (i.e. liver), but not in brain. During the seasonal feeding inversions in seabass, the highest blood glucose levels were shown during their feeding phase, revealing also the highest values in nocturnal seabass in winter. Zebrafish used a new self-feeding system, displaying phase-independence between feeding (nocturnal) and locomotor (diurnal) circadian rhythms, with different periodicities. Moreover, the zebrafish activity and vertical position were spectrum-dependent, being the main effects provoked by short-wavelengths.

Background: ST-elevation acute myocardial infarction (STEMI) represents one of the leading causes of death. The time of STEMI onset has a circadian rhythm with a peak during diurnal hours, and the occurrence of STEMI follows a seasonal pattern with a salient peak of cases in the winter months and a marked reduction of cases in the summer months. Scholars investigated the reason behind the winter peak, suggesting that environmental and climatic factors concur in STEMI pathogenesis, but no studies have investigated whether the circadian rhythm is modified with the seasonal pattern, in particular during the summer reduction in STEMI occurrence. Methods and Results: Here, we provide a multiethnic and multination epidemiological study (from both hemispheres at different latitudes, n=2270 cases) that investigates whether the circadian variation of STEMI onset is altered in the summer season. The main finding is that the difference between numbers of diurnal (6:00 to 18:00) and nocturnal (18:00 to 6:00) STEMI is markedly decreased in the summer season, and this is a prodrome of a complex mechanism according to which the circadian rhythm of STEMI time onset seems season dependent. Conclusions: The “summer shift” of STEMI to the nocturnal interval is consistent across different populations, and the sunshine duration (a measure related to cloudiness and solar irradiance) underpins this season-dependent circadian perturbation. Vitamin D, which in our results seems correlated with this summer shift, is also primarily regulated by the sunshine duration, and future studies should investigate their joint role in the mechanisms of STEMI etiogenesis.

Introdução: o ciclo de sono-vigília é o comportamento rítmico circadiano mais onipresente nos humanos. Ele é estabelecido por um sistema temporizador circadiano endógeno que é regulado pela presença ou ausência de luz no ambiente. O comportamento em relação a dormir e acordar varia entre os indivíduos e essa característica nomeia-se cronotipo. Efeitos negativos à saúde têm sido associados ao cronotipo que apresenta horários para iniciar e terminar o sono mais tarde. A hipótese considerada para explicar esses achados é de que demandas sociais, que não levam em conta essa variabilidade individual, sejam mediadoras dessa relação. Objetivos: avaliar a associação entre cronotipo e saúde mental (bem-estar psicológico e sintomas depressivos) levando-se em conta fatores demográficos (sexo e idade) e as rotinas de escola ou trabalho. Materiais e métodos: estudos transversais aninhados a um estudo epidemiológico em uma amostra de indivíduos do Vale do Taquari, no sul do Brasil. Na primeira avaliação, 6.506 participantes foram avaliados quanto a variáveis demográficas, dados de saúde, sintomas depressivos (Inventário de Depressão de Beck – BDI) e cronotipo (Questionário de Cronotipo de Munique – MCTQ). Na segunda etapa, 1.127 indivíduos entre 18 e 65 anos, selecionados a partir de seu cronotipo foram avaliados através do Índice de bem-estar de 5-itens da Organização Mundial da Saúde (OMS). O ponto médio do sono nos dias de rotinas de trabalho ou escolares foi utilizado como indicador do cronotipo, sendo “atrasado” aquele que tem o ponto médio mais tarde em relação ao início da noite e “avançado”, mais cedo. Resultados: no primeiro artigo, estudou-se a relação entre cronotipo e depressão em uma amostra de estudantes adolescentes. O modelo de regressão que melhor explicou a diferença entre os grupos com diferentes níveis de sintomas de depressão (BDI<10 X BDI!10) incluiu o sexo feminino e o cronotipo atrasado. O segundo artigo demonstrou que a escala de Bem-estar de 5-itens da OMS tem uma estrutura unidimensional, boa validade interna e externa e utilidade como instrumento de triagem para depressão quando comparada ao BDI. Assim, no terceiro artigo, foi avaliada a relação entre cronotipo e bem-estar, em indivíduos entre 18 e 65 anos. O modelo de regressão que incluiu o cronotipo atrasado, maior carga de trabalho, rotinas de trabalho mais cedo no dia e menor exposição à luz do sol, como variáveis preditoras, e piores escores na Escala de Bem-estar, como desfecho, foi significativo para o sexo feminino. Discussão: a presente tese explicitou a importância de considerar os fatores idade e sexo na expressão do cronotipo e na relação deste com saúde mental. Corroborou com a hipótese de que as demandas sociais mediam a relação entre cronotipo e os desfechos estudados. A expressão do cronotipo nos dias de rotinas escolares ou de trabalho foi identificada como a variável que estabeleceu a mais forte relação com piores escores de bemestar e com mais sintomas de depressão. Por fim, reforçou a necessidade de revermos as rotinas de trabalho e escolares que, ao não considerarem as diferenças fisiológicas individuais, têm-se associado, de forma consistente, a conseqüências negativas à saúde. / Introduction: the sleep-wake cycle is the most ubiquitous human circadian rhythmic behavior. It is established by an endogenous circadian timing system that is regulated by the presence or absence of light in the environment. Sleep and wake behavior varies among individuals and this feature has been termed chronotype. Negative health effects have been associated with the chronotype that presents later start and end sleep times. A hypothesis to explain these findings is that social demands, which do not take into account individual variability, are mediators of this relationship. Objectives: to evaluate the association between chronotype and mental health (psychological well-being and depressive symptoms) taking into account demographic factors (age and sex) and the routines of school or work. Materials and methods: the studies included here are cross-sectional nested to an epidemiological study in a sample of individuals from “Vale do Taquari”, in southern Brazil. In the first evaluation, 6,506 participants were assessed for demographic variables, health data, depressive symptoms (Beck Depression Inventory - BDI) and chronotype (Munich Chronotype Questionnaire - MCTQ). In the second stage, 1,127 individuals between 18 and 65 years, selected based on their chronotype, were evaluated through the Well-being 5 items Index from the World Health Organization (WHO). The midpoint of sleep on working or school days was used as an indicator of chronotype, and considered "delayed" or “late” those who have later midpoints in relation to environmental night and "advanced" or “early”, earlier. Results: in the first article, we studied the relationship between chronotype and depression in a sample of adolescent students. The regression model that best explained the difference between groups with different levels of depression symptoms (BDI<10 X BDI!10) included female sex and late chronotype. The second article demonstrated that the Well-being index has a unidimensional structure, good internal and external validities and might be usefulness as a screening tool for depression when compared to the BDI. Thus, in the third article, we evaluated the relationship between chronotype and well-being in individuals between 18 and 65 years. The regression model that included late chronotype, increased workload, earlier working routines in the day and less exposure to sunlight, as predictor variables, and worse scores on the well-being index, as the outcome was significant for females. Discussion: the present thesis content highlighted the importance of considering age and sex as factors influencing the expression of chronotype and the relationship with mental health outcomes. It corroborated the hypothesis that social demands mediate the relationship between chronotype and the studied outcomes. The expression of chronotype during the days of work or school routines was identified as the variable that established the strongest relationship with worse well-being scores and more depression symptoms. Finally, it reinforced the need to reconsider work and school routines that, by not taking into acount individual physiological differences, have been associated consistently with negative health consequences.

RESUME GENERAL<p><p>Contexte :une association entre exposition prolongée aux champs magnétiques (CM) d’extrêmement basses fréquences (ELF) et risque sanitaire a été établie pour la leucémie infantile (CM 50/60 Hz de l’électricité, RR = 2,0 pour ≥ 0,4 µT d‘intensité moyennée dans le temps) et est suggérée pour le décès par maladie d’Alzheimer (CM 50/60 Hz, CM 16,7 Hz des voies ferrées pour 21 µT d’intensité moyennée dans le temps) et pour certaines hémopathies chez l’adulte (CM 16,7 Hz). Ces associations restent inexpliquées à ce jour. Sur base d’observations animales (effets des CM ELF sur la sécrétion de mélatonine) d’une part, et de la sensibilité magnétique confirmée des cryptochromes (régulateurs des biorythmes) d’autre part, il a été suggéré que ces associations puissent être dues à une perturbation des biorythmes par les CM ELF. Selon les instances internationales, une intensité > 1 mT est requise pour l’existence d’effets biologiques. <p>Objectifs et méthode :sur base d’une revue exhaustive de la littérature et de modèles théoriques reconnus, le présent travail développe certains mécanismes possibles pour un effet perturbateur des biorythmes par les CM ELF. L’impact en santé publique de cette hypothèse est ensuite évalué. Enfin, des protocoles sont proposés pour sa mise à l’épreuve, tenant compte des mécanismes envisagés. <p>Résultats :la possibilité existe d’une interaction des oscillations ELF de l’intensité et/ou de l’orientation du CM (somme vectorielle du CM ELF et du CM terrestre ou CMT) avec les cryptochromes rétiniens. Chez l’animal magnétosensible (dont le rongeur), une perturbation des biorythmes pourrait être consécutive à un mécanisme non spécifique de perturbation sensorielle. Toute observation animale pourrait donc ne pas être extrapolable à l’Homme. Chez ce dernier, une perturbation des biorythmes pourrait être causée par les oscillations de l’intensité du CM (peut- être dès < 100 µT d’intensité de CM ELF). Une telle perturbation pourrait aussi être causée par les variations spatiales de l’intensité du CMT qui existent dans l’environnement résidentiel (proximité de structures métalliques). Par ailleurs, dans l’éventualité de l’existence, chez l’Homme également, d’une sensibilité directionnelle basée sur les cryptochromes rétiniens, les oscillations de l’orientation du CM pourraient alors aussi interférer avec ces cryptochromes (peut-être dès ≤ 10 µT). Dans l’hypothèse où une telle interférence affecte les biorythmes, seules pourraient alors être concernées les oscillations dont l’amplitude atteint plusieurs degrés d’angle. Un tel mécanisme ne pourrait donc s’appliquer à la relation entre CM ELF et leucémie infantile que dans l’éventualité où les intensités les plus élevées (+ 1 à 2 SD) de CM ELF y jouent un rôle. Au cas où l’hypothèse de la perturbation des biorythmes par les CM ELF se voyait confirmée, d’autres troubles de santé seraient alors concernés et d’autres sources de CM seraient en cause, tels les CM statiques d’intensité variable émis par les lignes de transport électrifié. Les paramètres d’exposition considérés devraient inclure l’orientation relative CM ELF/CMT, mais aussi l’intensité locale du CMT (facteur à la fois déterminant et confondant dans la présente hypothèse). L’expérimentation animale devrait investiguer l’expression des clock genes. L’expérimentation humaine devrait investiguer les biorythmes chez l’enfant. Et l’épidémiologie devrait investiguer l’incidence de troubles liés à une perturbation des biorythmes en relation avec l’exposition aux CM ELF ainsi qu’aux variations locales de l’intensité du CMT. <p>Conclusions :malgré les incertitudes persistantes quant aux fonctions précises des cryptochromes de la rétine humaine et quant à l’exactitude des modèles théoriques qui décrivent les interactions entre CM et cryptochromes, certains mécanismes paraissent possibles pour une interaction entre CM ELF et biorythmes. En l’absence persistante d’alternative valide pour l’explication de l’association entre CM ELF et leucémie infantile, l’hypothèse de la perturbation des biorythmes par ces CM paraît devoir être investiguée plus avant, mais en tenant compte des variations locales d’intensité du CMT. <p>Background: An association between prolonged exposure to extremely low frequency (ELF) magnetic fields (MF) and health risk has been established for childhood leukemia (50/60 Hz MF of electricity, RR = 2.0 for ≥ 0.4 µT of time-averaged intensity) and is suggested for death by Alzheimer's disease (50/60 Hz MF, 16.7 Hz MF of railways at 21 µT of time-averaged intensity) and for some hematologic malignancies in adults (16.7 Hz MF). These associations remain unexplained so far. Based on animal studies (effects of ELF MF on melatonin secretion) on the one hand, and on the confirmed magnetic sensitivity of cryptochromes (regulators of biorhythms) on the other hand, it has been suggested that these associations may be due to a disruption of biorhythms by ELF MF. From current data, however, biological effects seem only possible at > 1 mT of intensity.<p>Objectives and methods: on the basis of an exhaustive literature review and with use of recognized theoretical models, this paper develops some possible mechanisms for disruption of biorhythms by ELF MF. The public health impact of this hypothesis is then evaluated. Finally, protocols are proposed for the testing of it, with taking into account the proposed mechanisms.<p>Results: an interaction seems possible between ELF oscillations of the intensity and/or the orientation of the ambient MF (the vector sum of both the ELF MF and the geomagnetic field or GMF) with retinal cryptochromes. In magnetosensitive animals (including rodents), disruption of biorhythms may then be secondary to a non-specific mechanism of sensory disturbance. All animal observation could therefore not be extrapolated to humans. In the latter, on his turn, a disruption of biorhythms may be caused by the oscillations of the MF intensity (perhaps from <100 µT of ELF MF intensity). Such disruption could also be caused by spatial variations of the intensity of the GMF that exist in residential environment (near steel structures). Moreover, in case of the existence in humans (like in animals) of a directional sensitivity based on retinal cryptochromes, then the oscillations of the MF orientation also could interfere with these cryptochromes (perhaps from ≤ 10 µT). In the event that such interference affects biorhythms, only oscillations of several degrees of amplitude would then be concerned. As a consequence, such a mechanism could apply to the relation between ELF MF and childhood leukemia only in the event that the highest MF intensities (Mean + 1-2 SD) also play a role in that relation. In the event the hypothesis of disruption of biorhythms by ELF MF is confirmed, other health problems would be concerned and other kind of MF would be involved, such as the static MF of variable intensity that are emitted by the lines of electrified transport. The considered exposure parameters should include the relative orientation of ELF MF and GMF, but also the local intensity of GMF (both determining factor and confounder in this case). Animal experiments should investigate the expression of clock genes. Human experimentation should investigate biorhythms in children. And epidemiology should investigate the incidence of disorders related to disruption of biorhythms in relation to exposure to ELF MF as well as to local variations in the intensity of the GMF.<p>Conclusions: Despite the persisting uncertainties about the precise functions of retinal cryptochrome as well as about the accuracy of the theoretical models that describe the interactions between MF and cryptochromes, some mechanisms seem possible for an interaction between ELF MF and biorhythms. In the persisting absence of valid alternative explanation for the association between childhood leukemia and ELF MF, the hypothesis of biorhythm disturbance by ELF MF deserves further investigation, however with taking into account local intensity variations of the GMF.<p> / Doctorat en Sciences de la santé publique / info:eu-repo/semantics/nonPublished

Introdução: o ciclo de sono-vigília é o comportamento rítmico circadiano mais onipresente nos humanos. Ele é estabelecido por um sistema temporizador circadiano endógeno que é regulado pela presença ou ausência de luz no ambiente. O comportamento em relação a dormir e acordar varia entre os indivíduos e essa característica nomeia-se cronotipo. Efeitos negativos à saúde têm sido associados ao cronotipo que apresenta horários para iniciar e terminar o sono mais tarde. A hipótese considerada para explicar esses achados é de que demandas sociais, que não levam em conta essa variabilidade individual, sejam mediadoras dessa relação. Objetivos: avaliar a associação entre cronotipo e saúde mental (bem-estar psicológico e sintomas depressivos) levando-se em conta fatores demográficos (sexo e idade) e as rotinas de escola ou trabalho. Materiais e métodos: estudos transversais aninhados a um estudo epidemiológico em uma amostra de indivíduos do Vale do Taquari, no sul do Brasil. Na primeira avaliação, 6.506 participantes foram avaliados quanto a variáveis demográficas, dados de saúde, sintomas depressivos (Inventário de Depressão de Beck – BDI) e cronotipo (Questionário de Cronotipo de Munique – MCTQ). Na segunda etapa, 1.127 indivíduos entre 18 e 65 anos, selecionados a partir de seu cronotipo foram avaliados através do Índice de bem-estar de 5-itens da Organização Mundial da Saúde (OMS). O ponto médio do sono nos dias de rotinas de trabalho ou escolares foi utilizado como indicador do cronotipo, sendo “atrasado” aquele que tem o ponto médio mais tarde em relação ao início da noite e “avançado”, mais cedo. Resultados: no primeiro artigo, estudou-se a relação entre cronotipo e depressão em uma amostra de estudantes adolescentes. O modelo de regressão que melhor explicou a diferença entre os grupos com diferentes níveis de sintomas de depressão (BDI<10 X BDI!10) incluiu o sexo feminino e o cronotipo atrasado. O segundo artigo demonstrou que a escala de Bem-estar de 5-itens da OMS tem uma estrutura unidimensional, boa validade interna e externa e utilidade como instrumento de triagem para depressão quando comparada ao BDI. Assim, no terceiro artigo, foi avaliada a relação entre cronotipo e bem-estar, em indivíduos entre 18 e 65 anos. O modelo de regressão que incluiu o cronotipo atrasado, maior carga de trabalho, rotinas de trabalho mais cedo no dia e menor exposição à luz do sol, como variáveis preditoras, e piores escores na Escala de Bem-estar, como desfecho, foi significativo para o sexo feminino. Discussão: a presente tese explicitou a importância de considerar os fatores idade e sexo na expressão do cronotipo e na relação deste com saúde mental. Corroborou com a hipótese de que as demandas sociais mediam a relação entre cronotipo e os desfechos estudados. A expressão do cronotipo nos dias de rotinas escolares ou de trabalho foi identificada como a variável que estabeleceu a mais forte relação com piores escores de bemestar e com mais sintomas de depressão. Por fim, reforçou a necessidade de revermos as rotinas de trabalho e escolares que, ao não considerarem as diferenças fisiológicas individuais, têm-se associado, de forma consistente, a conseqüências negativas à saúde. / Introduction: the sleep-wake cycle is the most ubiquitous human circadian rhythmic behavior. It is established by an endogenous circadian timing system that is regulated by the presence or absence of light in the environment. Sleep and wake behavior varies among individuals and this feature has been termed chronotype. Negative health effects have been associated with the chronotype that presents later start and end sleep times. A hypothesis to explain these findings is that social demands, which do not take into account individual variability, are mediators of this relationship. Objectives: to evaluate the association between chronotype and mental health (psychological well-being and depressive symptoms) taking into account demographic factors (age and sex) and the routines of school or work. Materials and methods: the studies included here are cross-sectional nested to an epidemiological study in a sample of individuals from “Vale do Taquari”, in southern Brazil. In the first evaluation, 6,506 participants were assessed for demographic variables, health data, depressive symptoms (Beck Depression Inventory - BDI) and chronotype (Munich Chronotype Questionnaire - MCTQ). In the second stage, 1,127 individuals between 18 and 65 years, selected based on their chronotype, were evaluated through the Well-being 5 items Index from the World Health Organization (WHO). The midpoint of sleep on working or school days was used as an indicator of chronotype, and considered "delayed" or “late” those who have later midpoints in relation to environmental night and "advanced" or “early”, earlier. Results: in the first article, we studied the relationship between chronotype and depression in a sample of adolescent students. The regression model that best explained the difference between groups with different levels of depression symptoms (BDI<10 X BDI!10) included female sex and late chronotype. The second article demonstrated that the Well-being index has a unidimensional structure, good internal and external validities and might be usefulness as a screening tool for depression when compared to the BDI. Thus, in the third article, we evaluated the relationship between chronotype and well-being in individuals between 18 and 65 years. The regression model that included late chronotype, increased workload, earlier working routines in the day and less exposure to sunlight, as predictor variables, and worse scores on the well-being index, as the outcome was significant for females. Discussion: the present thesis content highlighted the importance of considering age and sex as factors influencing the expression of chronotype and the relationship with mental health outcomes. It corroborated the hypothesis that social demands mediate the relationship between chronotype and the studied outcomes. The expression of chronotype during the days of work or school routines was identified as the variable that established the strongest relationship with worse well-being scores and more depression symptoms. Finally, it reinforced the need to reconsider work and school routines that, by not taking into acount individual physiological differences, have been associated consistently with negative health consequences.

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Background: ST-elevation acute myocardial infarction (STEMI) represents one of the leading causes of death. The time of STEMI onset has a circadian rhythm with a peak during diurnal hours, and the occurrence of STEMI follows a seasonal pattern with a salient peak of cases in the winter months and a marked reduction of cases in the summer months. Scholars investigated the reason behind the winter peak, suggesting that environmental and climatic factors concur in STEMI pathogenesis, but no studies have investigated whether the circadian rhythm is modified with the seasonal pattern, in particular during the summer reduction in STEMI occurrence. Methods and Results: Here, we provide a multiethnic and multination epidemiological study (from both hemispheres at different latitudes, n=2270 cases) that investigates whether the circadian variation of STEMI onset is altered in the summer season. The main finding is that the difference between numbers of diurnal (6:00 to 18:00) and nocturnal (18:00 to 6:00) STEMI is markedly decreased in the summer season, and this is a prodrome of a complex mechanism according to which the circadian rhythm of STEMI time onset seems season dependent. Conclusions: The “summer shift” of STEMI to the nocturnal interval is consistent across different populations, and the sunshine duration (a measure related to cloudiness and solar irradiance) underpins this season-dependent circadian perturbation. Vitamin D, which in our results seems correlated with this summer shift, is also primarily regulated by the sunshine duration, and future studies should investigate their joint role in the mechanisms of STEMI etiogenesis.