School health promotion and fruit and vegetable consumption in secondary schools: a repeated cross-sectional multilevel study.

BACKGROUND: Worldwide, recommendations for fruit and vegetable consumption are not met, which can cause chronic diseases. Especially adolescence is an important phase for the development of health behaviours. Therefore, in the Netherlands, the Healthy School program was established to aid schools in promoting healthy lifestyles among their students. We examined to what extent the variation between secondary schools regarding students' fruit and vegetable consumption could be explained by differences between schools regarding Healthy School certification, general school characteristics, and the school population. Additionally, we examined whether Healthy School certification was related to the outcomes, and whether the association differed for subgroups. METHODS: We performed a repeated cross-sectional multilevel study. We used data from multiple school years from the national Youth Health Monitor on secondary schools (grades 2 and 4, age ranged from approximately 12 to 18 years) of seven Public Health Services, and added data with regard to Healthy School certification, general school characteristics and school population characteristics. We included two outcomes: the number of days a student consumed fruit and vegetables per week. In total, we analysed data on 168,127 students from 256 secondary schools in the Netherlands. RESULTS: Results indicated that 2.87% of the variation in fruit consumption and 5.57% of the variation in vegetable consumption could be attributed to differences at the school-level. Characteristics related to high parental educational attainment, household income, and educational track of the students explained most of the variance between schools. Additionally, we found a small favourable association between Healthy School certification and the number of days secondary school students consumed fruit and vegetables. CONCLUSIONS: School population characteristics explained more variation between schools than Healthy School certification and general school characteristics, especially indicators of parental socioeconomic status. Nevertheless, Healthy School certification seemed to be slightly related to fruit and vegetable consumption, and might contribute to healthier dietary intake. We found small differences for some subgroups, but future research should focus on the impact in different school contexts, since we were restricted in the characteristics that could be included in this study.

Does School Health Promotion Have Additional Value for Educational Performance? A Repeated Cross-Sectional Multilevel Study.

Little information is available regarding the influence of the interplay between the school context and school health promotion on educational performance. Therefore, we examined whether the variation between primary and secondary schools regarding the educational performance of students could be explained by general school characteristics, school population characteristics, and school health promotion and to what extent these factors interact. We performed multilevel analyses using existing data on 7021 primary schools and 1315 secondary schools in the Netherlands from the school years 2010-2011 till 2018-2019. Our outcomes were the final test score from primary education and the average grade of standardized final exams from secondary education. School health promotion was operationalized as having obtained Healthy School (HS) certification. For the test score, 7.17% of the total variation was accounted for by differences at the school level and 4.02% for the average grade. For both outcomes, the percentage of disadvantaged students in a school explained most variation. HS certification did not explain variation, but moderated some associations. We found small to moderate differences between schools regarding educational performance. Compositional differences of school populations, especially socioeconomic status, seemed more important in explaining variation in educational performance than general school characteristics and HS certification. Some associations were moderated by HS certification, but differences remained small in most cases.

Impact of COVID-19 pandemic on physical health amongst children: Difference-in-differences analyses of nationwide school health checkup database.

INTRODUCTION: The COVID-19 pandemic posed tremendous challenges for children. However, the long-term effects of the pandemic on various aspects of physical health at a national level remain unclear. METHODS: In this retrospective cohort study, we analysed data from nationwide health checkup records amongst children aged 7-15 years. The dataset comprised 3 544 146 records from 393 794 individuals who graduated from junior high school during fiscal years 2007 to 2022. Difference-in-differences (DID) analyses with multiple time periods were used to examine the impact of COVID-19 on physical health outcomes. RESULTS: Compared with the pre-pandemic period, the COVID-19 pandemic was associated with excess increases in obesity for boys and girls, persisting over the 3 years (+0.42%; [95% CI, 0.23-0.61]). Also, it was associated with excess increases in underweight (+0.28% [0.25-0.32]) and poor visual acuity amongst boys in the 3rd year (+1.80% [1.30-2.30]). There were excess reductions in dental caries (-1.48% [-2.01 to -0.95]), glucosuria (-0.55 [-0.88 to -0.23]) and hematuria (-0.43% [-0.73 to -0.13]) during the 3rd year of the pandemic. CONCLUSIONS: These findings underscore the multifaceted impact of the pandemic on various health indicators for school-aged children. This information could be valuable for public health policy and paediatric healthcare planning in the post-pandemic era.

Influencia de una intervención comunitaria en obesidad y estilos de vida de escolares en el ámbito rural / Influence of a community intervention of obesity and the lifestyle of schools in the rural area

INTRODUCCIÓN: La prevalencia de sobrepeso y obesidad en la población escolar se está incrementando en los últimos años, y es de vital importancia su control dada la relación que existe entre la obesidad y la morbimortalidad de causa cardiovascular y otras causas. Con este estudio se pretendía conocer la prevalencia de sobrepeso y obesidad entre los escolares de un centro rural de Castilla la Mancha y conocer sus hábitos alimentarios e intentar influir favorablemente en estos mediante actividades comunitarias en colegio. MATERIAL Y MÉTODOS: Se trata de un estudio transversal descriptivo realizado en un centro escolar del ámbito rural en Castilla la Mancha. En un primer momento se explotaron los datos de los percentiles de IMC de las historias clínicas de los escolares que se clasificaron en las categorías de sobrepeso y obesidad con las tablas de referencia de la OMS. Posteriormente se realizó una encuesta a los padres de los escolares vía online sobre el tipo de alimentación que realizaban sus hijos, nivel de actividad física y tiempo de realización de actividades de ocio sedentario. Por ultimo se realizaron 3 encuestas visuales sobre los alimentos que llevaban para almorzar al colegio, la primera antes de la intervención con los niños, la segunda después de la intervención de estos y la tercera después de la intervención con los padres. Los cálculos estadísticos se realizaron con el paquete estadístico SPSS versión 20. RESULTADOS: La mayoría de los escolares se encontraban en normopeso (84,9%), la prevalencia de sobrepeso fue del 3,8% y la de obesidad del 11,3%. Los niños consumían diariamente en un 93% pan blanco, el 24% cereales azucarados, 40%% verduras, 58% frutas, 31% de carnes blancas, 26% huevos, 41% leche entera, 48% queso y 44% yogur. En contra se aprecia un alto consumo diario de carne roja un 27% , 24 % comida rápida, y el 17 % de zumos industriales. Consumen refrescos azucarados al menos semanalmente el 44%. En lo referente al ejercicio físico la mayoría va a l colegio andando o en automóvil en igual porcentaje, el 87% hace deporte extraescolar, del ellos el 78% de 2-6 veces a la semana. El tiempo que consumen viendo televisión o con videojuegos varia de menos de 1 hora a 2 horas entre semana y los fines de semana el 52% dedican 2 horas a estas actividades. Los alimentos que con mayor frecuencia llevaban a centro para almorzar fueron embutido, queso, pan y yogur, y no vario con las intervenciones realizadas en niños y padres. CONCLUSIONES: La prevalencia de sobrepeso y obesidad en los escolares de medio rural fue menor que en otros estudios realizados en España. La alimentación se ajustaba bastante a la pirámide recomendada por la SENC pero aún queda un largo camino por mejorar los objetivos fijados. No se apreciaron modificaciones en los alimentos del almuerzo escolar tras las intervenciones realizadas en centro escolar los sanitarios tanto con escolares como con los padres

INTRODUCTION: The prevalence of overweight and obesity in the school population is increasing in recent years, and its control is vital given the relationship between obesity and the morbidity and mortality of cardiovascular causes and other causes. This study aimed to know the prevalence of overweight and obesity among schoolchildren in a rural center of Castilla la Mancha and learn their eating habits and try to influence them favorably through community activities in school. MATERIAL AND METHODS: This is a descriptive cross-sectional study carried out in a rural school in Castilla la Mancha. Initially, the BMI percentile data of the medical records of schoolchildren that were classified in the overweight and obesity categories were exploited with the WHO reference tables. Subsequently, a survey was carried out on the parents of schoolchildren via online about the type of feeding their children made, level of physical activity and time of sedentary leisure activities. Finally, 3 visual surveys were carried out on the food they took for lunch at school, the first before the intervention with the children, the second after their intervention and the third after the intervention with the parents. Statistical calculations were performed with the statistical package SPSS version 20. RESULTS: The majority of schoolchildren were in normal weight (84.9%), the prevalence of overweight was 3.8% and that of obesity was 11.3%. Children consumed 93% white bread, 24% sugary cereals, 40 %% vegetables, 58% fruits, 31% white meats, 26% eggs, 41% whole milk, 48% cheese and 44% yogurt daily. Against it, there is a high daily consumption of red meat, 27%, 24% fast food, and 17% of industrial juices. They consume sugary sodas at least 44% weekly. With regard to physical exercise, the majority go to school on foot or by car in the same percentage, 87% do extracurricular sports, 78% of them 2-6 times a week. The time they spend watching television or video games varies from less than 1 hour to 2 hours during the week and on weekends 52% spend 2 hours on these activities. The foods that were most often taken to the center for lunch were sausage, cheese, bread and yogurt, and did not vary with interventions performed on children and parents. CONCLUSIONS: The prevalence of overweight and obesity in rural schoolchildren was lower than in other studies carried out in Spain. The food was quite adjusted to the pyramid recommended by the SENC but there is still a long way to improve the objectives set. There were no changes in the school lunch foods after the interventions carried out in the school by health workers with both schoolchildren and parents

Programa de Salud Bucodental en escolares de la Comunidad del Bajo Boulogne / Oral Health Program in children from Bajo Boulogne Community

Las afecciones bucodentales constituyen un problema de salud pública por su alta prevalencia y su fuerte impacto individual y colectivo en términos de dolor, malestar y discapacidad social y funcional. El Centro de Medicina Familiar y Comunitaria San Pantaleón, ubicado en la provincia de Buenos Aires, brinda asistencia sanitaria gratuita a la comunidad. Un relevamiento documentó que el 97% de los concurrentes presentaba caries y no se lavaban los dientes por falta de cepillo y pasta dental. Se decidió llevar adelante un programa de promoción de la salud bucodental. El objetivo fue evaluar su implementación; que incluyó: a) rastreo de caries y problemas odontológicos; b) coordinación interinstitucional; c) entrega de cepillos y pasta dental; d) intervención educativa; e) extensión comunitaria. Participaron en forma irregular 120 niñas, niños y adolescentes entre 5 y 18 años del Centro de Apoyo Escolar Fundación Bajo Boulogne. Se realizaron dos encuentros educativos y entrega de cepillos y pasta dental. En la revisión odontológica inicial sobre 60 participantes se detectaron caries en 43 (71,6%), que fueron derivados para tratamiento odontológico, pero concurrieron solo 26 (60,4%). El conocimiento sobre salud bucodental mostró cambios entre los más pequeños luego de las intervenciones educativas. Se logró implementar el programa, cumplimentando las actividades propuestas. Pero surgieron barreras que dificultaron la cobertura. En cuanto a la eficacia de la intervención educativa, no se logró mostrar cambios en el conocimiento. Se consiguió la detección oportuna, la incorporación de hábitos como el cepillado dentro de la institución educativa, la articulación para mejorar el acceso a la atención y la vinculación entre los diferentes actores comunitarios. (AU)

Oral disorders are a public health problem due to their high prevalence and their strong individual and collective impact in terms of pain, discomfort, and social and functional disability. The San Pantaleón Family and Community Medicine Center, located in the province of Buenos Aires, provides free healthcare to the community. A survey documented that 97% of those present had cavities and did not brush their teeth due to a lack of brush and toothpaste. It was decided to carry out an oral health promotion program. The objective was to evaluate its implementation; which included: a) tracking of caries and dental problems; b) inter-institutional coordination; c) delivery of brushes and toothpaste; d) educational intervention; e) community extension. 120 girls and boys and adolescents between 5 and 18 years of age from the Bajo Boulogne Foundation School Support Center irregularly participated. Two educational meetings were held, handing out brushes and toothpaste. In the initial dental review of 60 participants, caries was detected in 43 (71.6%), who were referred for dental treatment, with only 26 (60.4%) concurring. Oral health knowledge showed changes among the youngest after educational interventions. It was possible to implement the program, completing the proposed activities. Barriers arose that made coverage difficult. Regarding the effectiveness of the educational intervention, it was not possible to show changes in knowledge. Timely detection was achieved, the incorporation of habits such as brushing within the educational institution, articulation to improve access to care and the link between the different community actors. (AU)

El juego de mesa como medio educativo para el conocimiento sobre la prevención del dengue en niños en edad escolar / Board game as an educational media for dengue prevention knowledge for school-aged children

Indonesia es uno de los países endémicos del dengue y los incidentes aumentan año tras año. Los niños son la población de mayor riesgo de incidentes de dengue que los demás grupos de edad. Parte de la prevención del dengue es aumentar el conocimiento y también el conocimiento de los niños. El uso del juego es una forma divertida de aprender en los niños. Objetivo: El objetivo del estudio fue conocer los conocimientos básicos de los niños sobre la prevención del dengue y desarrollar un medio educativo para los niños. Método: Este estudio utiliza un diseño cuasi experimental con pre y post prueba y el uso de un grupo de control. Los participantes son niños en edad escolar de entre 10 y 12 años de edad con un total de 92 participantes que se dividieron en grupos de intervención y control. Resultados: Los resultados mostraron que hay un puntaje significativamente creciente en el conocimiento básico de los niños en el grupo de intervención sobre el signo y el síntoma de la fiebre del dengue (valor de p = 0,001); estrategia de prevención basada en las directrices del Ministerio de Salud de Indonesia (valor de p = 0,001); agente químico (valor de p = 0,000); agente de biología (valor de p = 0,000); autoprotección (valor de p = 0,001); y sistema inmune (valor de p = 0,001). Existen diferencias de conocimiento entre los grupos de intervención y control (valor de p = 0,000). Conclusión: La conclusión del estudio es que el juego de mesa puede diseñarse para ser un medio educativo que brinde a los niños una educación sanitaria sobre la estrategia de prevención del dengue

Indonesia is one of the endemic countries for dengue fever, and for the incidents are increasing year by year. Children are the risk population to dengue incidents than the others age groups. Part of the dengue prevention is increasing the knowledge, and also the children's knowledge. The use of the game is the enjoyable way for learning in children. Aim:: The aim of the study was to know children's basic knowledge about dengue prevention and develop an educational media for children. This study uses a quasi-experimental design with pre and post-test and using a control group. Method: The participants are a school-aged children between the ages of 10-12 years old with total 92 participants who were divided into intervention group and control group. Results: The results showed that there are a significantly increasing score at children basic knowledge at intervention group about dengue fever sign and symptom (p=0,001); prevention strategy based on Indonesia Health Ministry guidelines (p=0,001); chemistry agent (p=0,000); biology agent (p=0,000); self-protection (p=0,001); and immune system (p=0,001). There are difference knowledge between intervention and control groups (p=0,000). Conclusion: The conclusion of the study is board game can be designed to be an educational media to give a health education about dengue prevention strategy to the children

Desnutrición y enteroparasitosis en escolares del departamento de Guaymallén, Mendoza / Undernutrition and enteroparasitoses among schoolchildren in the department of Guaymallén, Mendoza

Introducción: La desnutrición y las enteroparasitosis infantiles representan un problema de salud pública. Sus prevalencias varían según el área geográfica y las condiciones socio-ambientales de residencia. Objetivo: Analizar la desnutrición y las enteroparasitosis, en relación a las condiciones socio-ambientales de residencia, en niños del departamento de Guaymallén Mendoza. Métodos: Se realizó un estudio antropométrico transversal que involucró a 947 niños de 4 a 10 años de edad concurrentes a escuelas públicas del departamento de Guaymallén. A fin de determinar el estado nutricional se empleó la referencia OMS 2007. Del análisis parasitológico participaron 192 niños. Las técnicas utilizadas para el diagnóstico parasitológico fueron Ritchie modificada y escobillado anal. La caracterización socio-ambiental se realizó mediante encuesta autoadministrada y semiestructurada. Resultados: La población analizada presentó mayor desnutrición crónica (4,8%), seguida de desnutrición global (2,4%) y por último emaciación (1,2%). El análisis parasitológico indicó que el 70,8% de los niños de Guaymallén estaba parasitado por al menos una especie. Las especies más prevalentes fueron Enterobius vermicularis (33,9%) y Blastocystis sp. (28,6%). Los niños desnutridos y/o parasitados vivían en condiciones socio-ambientales y económicas desfavorables. Conclusión: Las condiciones socio-ambientales desempeñan un papel importante en el crecimiento y en la salud de los niños. La elevada desnutrición y enteroparasitosis se manifiestan mayoritariamente en niños cuyos padres tienen empleos no calificados y bajo nivel de instrucción y sus hogares carecen de servicios sanitarios adecuados. La falta de saneamiento ambiental favorece la presencia de parásitos intestinales transmitidos principalmente a través del agua, alimentos contaminados o por contacto interpersonal

Introduction: The undernutrition and childhood enteroparasitoses is a public health problem. The prevalence varies according to the geographical area and the socio-environmental conditions of residence. Objective: To analyze undernutrition and enteroparasitoses in relation to socio-environmental conditions of residence, in children of the department of Guaymallén Mendoza.Methods: A cross-sectional anthropometric study was made involving 947 children aged 4 to 10 attending public schools in the department of Guaymallén. In order to determine the nutritional status, the WHO 2007 reference was used. The parasitological analysis was made on 192 children. The techniques used for the parasitological diagnosis were Ritchie modified and anal brushing. The socio-environmental characterization was performed by semi-structured and selfadministered survey. Results: The analyzed population presented greater stunting (4.8%), followed by underweight (2.4%) and finally wasting (1.2%). The parasitological analysis indicated that 70.8% of the children of Guaymallén were parasitized by at least one species. The most prevalent species were Enterobius vermicularis (33.9%) and Blastocystis sp. (28.6%). Undernutrited and/or parasitized children lived in unfavorable socio-environmental and economic conditions. Conclusion: Socio-environmental conditions perform an important role in the growth and the health of children. High undernutrition and intestinal parasites are mainly manifested in children whose parents have low level of education and unskilled jobs and their homes have deficiencies in sanitation services. The lack of environmental sanitation favors the presence of intestinal parasites transmitted mainly through water, contaminated food or through interpersonal contact

Subjective sleep need and daytime sleepiness in adolescents / Necessidade subjetiva de sono e sonolência diurna em adolescentes

ABSTRACT Objective: To analyze the contribution of subjective sleep need for daytime sleepiness in adolescents, and to compare questions about sleep, age and body mass index between adolescents who considered to sleep enough and those who reported the need for more sleep. Methods: This is a descriptive, epidemiological and cross-sectional study. Data collection was performed in August 2016, with 773 adolescents aged 14-19 years old, from Paranaguá, Paraná, Southern Brazil. The analysis included the following variables: time in bed, half-sleep phase, sleep need, social jetlag, daytime sleepiness, body mass index and physical activity. Results: The prevalence of adolescents with subjective need for sleep was 73.0%, with an average need of 1.7 extra hours of sleep. These adolescents woke up earlier (p<0.001) and slept less on school days (p<0.001). The need for more sleep was associated with higher daytime sleepiness scores (rho=0.480; p<0.001) and with later half-sleep phase (rho=0.200; p<0.001). No correlation was identified between the sleep need and time in bed (rho=-0.044; p=0.225). The subjective sleep need was the variable with the greatest explanatory power for daytime sleepiness (24.8%; p<0.001). In addition, the less adolescents practiced physical activity, the higher their daytime sleepiness scores (rho=-0.117; p<0.001). Conclusions: The subjective sleep need has an important role in explaining daytime sleepiness among adolescents. Adolescents who needed to sleep more reported waking up early and experienced sleep deprivation during class days; they also woke up later on the weekends and experienced more daytime sleepiness, compared to those who believed they had enough sleep.

RESUMO Objetivo: Analisar a contribuição da necessidade subjetiva de sono para a sonolência diurna em adolescentes e comparar questões sobre sono, idade e índice de massa corporal entre os adolescentes que consideram dormir o suficiente e os que julgam necessitar dormir mais. Métodos: Estudo descritivo, epidemiológico e transversal, cuja coleta de dados ocorreu em agosto de 2016 em 773 adolescentes de 14 a 19 anos de Paranaguá, PR, Brasil. As variáveis de análise foram tempo de cama, meia fase do sono e necessidade de mais horas de sono, além do jetlag social, sonolência diurna, índice de massa corpórea (IMC) e atividade física. Resultados: A prevalência de adolescentes com necessidade subjetiva de sono foi 73,0%, sugerindo precisar, em média, de 1,7 hora a mais de sono. Estes acordavam mais cedo (p<0,001) e dormiam menos nos dias de aula (p<0,001). A necessidade de dormir mais associou-se a maiores pontuações de sonolência diurna (rho=0,480; p<0,001) e com meia fase do sono mais tardia (rho=0,200; p<0,001). Não foi identificada correlação entre necessidade de sono e tempo de cama (rho=-0,044; p=0,225). A necessidade subjetiva de sono foi a variável com maior poder explicativo da sonolência diurna (24,8%; p<0,001). Além disso, quanto menos os adolescentes praticavam atividade física, maiores as pontuações de sonolência diurna (rho=-0,117; p<0,001). Conclusões: A percepção subjetiva de sono teve papel importante para explicar a sonolência diurna dos adolescentes. Os jovens que precisavam dormir mais relataram acordar mais cedo e apresentavam privação de sono durante os dias de aula, acordaram mais tarde no final de semana e apresentaram maior sonolência diurna, comparando-se aos que acreditavam dormir o suficiente.

School environment and oral health promotion: the National Survey of School Health (PeNSE) / Ambiente escolar e promoção de saúde bucal: a Pesquisa Nacional de Saúde do Escolar (PeNSE)

ABSTRACT OBJECTIVE To evaluate the potential support of schools for oral health promotion and associated factors in Brazilian capitals. METHODS Data from 1,339 public and private schools of the 27 Brazilian capitals were obtained from the National Survey of School Health (PeNSE) 2015. Data from the capitals were obtained from the United Nations Development Program and the Department of Informatics of the Brazilian Unified Health System (Datasus). The indicator " ambiente escolar promotor de saúde bucal " (AEPSB - oral health promoting school environment) was designed from 21 variables of the school environment with possible influence on students' oral health employing the categorical principal components analysis (CATPCA). Associations between the AEPSB and characteristics of schools, capitals and regions were tested (bivariate analysis). RESULTS Ten variables comprised CAPTCA, after excluding those with low correlation or high multicollinearity. The analysis resulted in a model with three dimensions: D1. Within-school aspects (sales of food with added sugar in the canteen and health promotion actions), D2. Aspects of the area around the school (sales of food with added sugar in alternative points) and D3. prohibitive policies at school (prohibition of alcohol and tobacco consumption). The sum of the scores of the dimensions generated the AEPSB indicator, dichotomized by the median. From the total of schools studied, 51.2% (95%CI 48.5-53.8) presented a more favorable environment for oral health (higher AEPSB). In the capitals, this percentage ranged from 36.6% (95%CI 23.4-52.2) in Rio Branco to 80.4% (95%CI 67.2-89.1) in Florianópolis. Among the Brazilian regions, it ranged from 45.5% (95%CI 40.0-51.2) in the North to 67.6% (95%CI 59.4-74.9) in the South. Higher percentages of schools with higher AEPSB were found in public schools [58.1% (95%CI 54.9-61.2)] and in capitals and regions with higher Human Development Index [61.0% (95%IC 55.8-66.0) and 57.4% (95%CI 53.2-61.4), respectively] and lower Gini index [55.7% (95%CI 51.2-60.0) and 52.8 (95%CI 49.8-55.8), respectively]. CONCLUSIONS The potential to support oral health promotion in schools in Brazilian capitals, assessed by the AEPSB indicator, was associated with contextual factors of schools, capitals and Brazilian regions.

RESUMO OBJETIVO Avaliar o potencial de suporte do ambiente escolar para a promoção da saúde bucal e fatores associados nas capitais brasileiras. MÉTODOS Os dados de 1.339 escolas públicas e privadas das 27 capitais brasileiras foram obtidos da Pesquisa Nacional de Saúde do Escolar (PeNSE) 2015. Os dados das capitais foram obtidos do Programa das Nações Unidas para o Desenvolvimento e do Datasus. Foi elaborado o indicador "ambiente escolar promotor de saúde bucal" (AEPSB), a partir de 21 variáveis do ambiente escolar com possível influência na saúde bucal dos escolares empregando a análise de componentes principais para dados categóricos (CATPCA). Associações entre o AEPSB e características das escolas, das capitais e das regiões foram testadas (análises bivariadas). RESULTADOS Dez variáveis compuseram a CAPTCA, após exclusão daquelas com baixa correlação ou alta multicolinearidade. A análise resultou em modelo com três dimensões: D1. aspectos intraescolares (venda de alimentos com açúcar adicionado na cantina e ações de promoção de saúde), D2. aspectos do entorno escolar (venda de alimentos com açúcar adicionado em pontos alternativos) e D3. políticas proibitivas na escola (proibição do consumo de álcool e tabaco). A soma dos escores das dimensões gerou o indicador AEPSB, dicotomizado pela mediana. Do total de escolas estudadas, 51,2% (IC95% 48,5-53,8) apresentaram ambiente mais favorável à saúde bucal (maior AEPSB). Nas capitais, esse percentual variou de 36,6% (IC95% 23,4-52,2) no Rio Branco a 80,4% (IC95% 67,2-89,1) em Florianópolis. Entre as regiões brasileiras, variou de 45,5% (IC95% 40,0-51,2), no Norte a 67,6% (IC95% 59,4-74,9) no Sul. Percentuais maiores de escolas com maior AEPSB foram encontrados na rede pública [58,1% (IC95% 54,9-61,2)] e em capitais e regiões com maior índice de desenvolvimento humano [61,0% (IC95% 55,8-66,0) e 57,4% (IC95% 53,2-61,4), respectivamente] e menor índice de Gini [55,7% (IC95% 51,2-60,0) e 52,8 (IC95% 49,8-55,8), respectivamente]. CONCLUSÕES O potencial de suporte à promoção da saúde bucal de escolas das capitais brasileiras, avaliado pelo indicador AEPSB, foi associado a fatores contextuais das escolas, das capitais e das regiões brasileiras.

Revisão sistemática sobre bullying e família: uma análise a partir dos sistemas bioecológicos / Systematic review on bullying and family: an analysis based on bioecological systems / Revisión sistemática sobre acoso escolar y familia: un análisis a partir de los sistemas bioecológicos

RESUMO Objetivo Analisar as relações entre o contexto familiar e o envolvimento em situações de bullying escolar. Método Foram consultadas as bases de dados Web of Science, PsycoInfo, PubMed, Lilacs e a biblioteca virtual SciELO, utilizando nas buscas os termos bullying, família e pais. Atenderam aos critérios de seleção e elegibilidade 61 artigos. O corpus foi analisado a partir do referencial Bioecológico do Desenvolvimento. Resultados Evidenciou-se que as experiências dos estudantes em situações de bullying são multifacetadas e possuem relações com o contexto familiar. Elementos do microssistema como violências na família, práticas parentais, clima e tipo de arranjo familiar, foram mais explorados e relacionados ao bullying. Entretanto, também foram considerados o relacionamento dos pais com os amigos dos filhos, a escolaridade dos pais e as condições socioeconómicas, dos sistemas exo, meso e macro, em relação ao bullying. Conclusão A revisão contribui com a literatura ampliando a abordagem sobre o fenômeno que afeta a saúde e o desenvolvimento de crianças e adolescentes.(AU)

ABSTRACT Objective Analyze the relationships between family context and involvement in school bullying. Methods The following databases were searched: Web of Science, PsycoInfo, Pub-Med, Lilacs and SciELO virtual library, using the terms bullying, family and parents. A total of 61 papers met the eligibility criteria. The corpus was analyzed through the Bioecological Development Framework. Results The experiences of students experiencing situations of bullying are multifaceted and are related to the family context. Elements from the microsystem, such as violence in the family, parental practices, environment and type of family arrangements, were the elements more frequently explored and related to bullying, though the relationships of parents with the children's friends, the parents' education and socioeconomic conditions, along with the exo, meso and macro systems were also related to bullying. Conclusion The review contributes to the literature by broadening the approach to this phenomenon that affects the health and development of children and adolescents.(AU)

RESUMEN Objetivo Analizar las relaciones entre el contexto familiar y el envolvimiento en las situaciones de acoso escolar. Método Se han consultado las bases de datos Web of Science, PsycoInfo, PubMed, Lilacs y la biblioteca virtual SciELO, utilizando en las búsquedas los términos acoso escolar, familia y padres. Se atendieron a los criterios de selección y elegibilidad 61 artículos. El corpus fue analizado a partir del referencial bioecológico del desarrollo. Resultados Se evidenció que las experiencias de los estudiantes en situaciones de acoso escolar son de múltiples facetas y poseen relaciones con el contexto familiar. Los elementos del microsistema como violencias en la familia, prácticas parentales, clima y tipo de arreglo familiar, fueron más explorados y relacionados al acoso. Sin embargo, también fueron considerados la relación de los padres con los amigos de los hijos, la escolaridad de los padres y las condiciones socioeconómicas, de los sistemas exo, meso y macro, en relación al acoso. Conclusión La revisión contribuye con la literatura ampliando el enfoque sobre el fenómeno que afecta la salud y el desarrollo de niños y adolescentes.(AU)

Evaluation of podiatric disorders in a sample of children with intellectual disabilities: an analytical cross-sectional study

ABSTRACT BACKGROUND: Intellectual disabilities (IDs) usually derive from neurodevelopmental disabilities. They limit intellectual functioning and cause adaptive behaviors and orthopedic problems. These disabilities have harmful effects on health, everyday practical skills and social functioning, and they diminish quality of life. The goal of our research was to perform podiatric evaluations on schoolchildren with and without ID and ascertain their records of foot disorders. DESIGN AND SETTING: Analytical cross-sectional study conducted at a podiatric clinic in the city of Piedras Blancas, province of Asturias, Spain. METHODS: An analytical cross-sectional study on 82 schoolchildren affected by ID, compared with 117 healthy schoolchildren, was conducted at a podiatric clinic. Demographic data, clinical characteristics and measurements relating to podiatric examinations were recorded among the participants who completed all phases of the tool that was used in the study process. RESULTS: Almost 90% of the schoolchildren with and without ID presented foot disorders relating to smaller toes, nail disorders, flat feet or lower-limb alterations. CONCLUSIONS: The participants showed elevated prevalence of foot disorders. Podiatric evaluations are a significant means for preventing the appearance of medical conditions and/or foot problems, and they also improve general health.

Autoconfiança para o manejo inicial das intercorrências de saúde na escola: construção e validação de uma escala visual analógica / Self-confidence for the initial management of health issues in schools: construction and validation of a visual analogue scale

Objective: To describe the construction and validation of a visual analogue scale of teachers' self-confidence with regard to the initial management of health issues in schools. Method: A methodological study was developed based on theoretical (items' construction and content validation), empirical (semantic analysis and pilot test), and analytical procedures (internal consistency analysis). The project was approved by a research ethics committee. Results: The scale consisted of 12 items regarding the main health issues in schools, presented content validity index of 100% in the second round, was understood by the target audience, and presented high internal consistency among items (Cronbach's alpha of 0.89). Conclusion and implications for practice: An easy-to-use tool that proved to be relevant to meet the dimension of teachers' self-confidence in the initial management of health issues in schools. The scale may contribute to the planning of systematized and effective educational strategies among teachers.

Objetivo: Describir la construcción y validación de la escala visual analógica de autoconfianza de profesores respecto a la gestión inicial de problemas de salud en la escuela. Método: Estudio metodológico desarrollado a partir del procedimiento teórico (construcción de ítems y validación del contenido), empírico (análisis semántico y prueba piloto) y analítico (análisis de consistencia interna). Proyecto aprobado por Comité de Ética en Investigación. Resultados: Escala integrada por 12 ítems referentes a las principales complicaciones de salud en la escuela, índice de validación de contenido de 100% en segunda rueda, comprensible por público objetivo y con alta consistencia interna entre los ítems (α de Cronbach 0.89). Conclusióne implicancias para la práctica: Herramienta de fácil uso, adecuada para atender la dimensión de autoconfianza de docentes en gestión inicial de complicaciones sanitarias en la escuela. Puede contribuir al planeamiento de estrategias educativas sistematizadas y efectivas entre los docentes.

Objetivo: Descrever a construção e validação da escala visual analógica de autoconfiança dos professores com relação ao manejo inicial das intercorrências de saúde na escola. Método: Estudo metodológico desenvolvido a partir do procedimento teórico (construção dos itens e validação do conteúdo), empírico (análise semântica e teste piloto) e analítico (análise da consistência interna). Projeto aprovado pelo Comitê de Ética em Pesquisa. Resultados: Escala constituída por 12 itens referentes as principais intercorrências de saúde na escola, índice de validação de conteúdo de 100% na segunda rodada, compreensível pelo público-alvo e com alta consistência interna entre os itens (α de Cronbach 0.89). Conclusão e implicações para a prática: Ferramenta de fácil utilização que mostrou-se pertinente para atender a dimensão da autoconfiança dos professores no manejo inicial das intercorrências de saúde na escola. A escala pode contribuir no planejamento de estratégias educativas sistematizadas e efetivas entre os professores.

Innovation, development, and financing of institutions of Higher Education in health / Innovación, desarrollo y financiación de las instituciones de Enseñanza Superior en salud / Inovação, desenvolvimento e financiamento das instituições de Ensino Superior em saúde

Abstract: The article analyzes the configuration and trends in institutions of Higher Education and their relationship as components of the Health Economic-Industrial Complex (HEIC). The expansion of higher education is part of the transition from elite to mass systems, with tensions between quantitative and qualitative aspects. Such changes reflect different cultures and are related to international phenomena such as globalization, economic transformations, the development of new information and communication technologies, and the emergence of an international knowledge network. The scale and content of these changes vary according to the expansion and institutional reconfiguration of educational systems, as well as the link between state and society. Market expansion for private higher education stirs competition, shapes business clusters, modifies training processes, and raises new public policy challenges.

Resumen: Este artículo analiza la configuración y las tendencias de las instituciones de Enseñanza Superior de salud, en su relación como componentes del Complejo Económico Industrial de la Salud (CEIS). La expansión de la enseñanza superior es parte de la transición de sistemas de élite hacia sistemas de masa, con tensiones entre aspectos cuantitativos y cualitativos. Estos cambios reflejan diferentes culturas y se relacionan con fenómenos de alcance mundial como: la globalización, transformaciones económicas, desarrollo de nuevas tecnologías de comunicación e información, y emergencia de una red internacional de conocimiento. La escala y el contenido de esos cambios varían con la ampliación de los sistemas de enseñanza y en la reconfiguración institucional, así como en la articulación entre Estado y sociedad. La ampliación del mercado privado en la enseñanza estimula la competitividad, conformando conglomerados empresariales, alterando procesos de formación y forjando nuevos desafíos para las políticas públicas.

Resumo: Este artigo analisa a configuração e as tendências das instituições de Ensino Superior de saúde no seu relacionamento enquanto componentes do Complexo Econômico Industrial da Saúde (CEIS). A expansão do Ensino Superior é parte da transição de sistemas de elite para sistemas de massa, com tensionamentos entre aspectos quantitativos e qualitativos. Essas mudanças refletem diferentes culturas e se relacionam com fenômenos de escopo mundial como globalização, transformações econômicas, desenvolvimento de novas tecnologias de comunicação e informação, e emergência de uma rede internacional de conhecimento. A escala e o conteúdo dessas mudanças variam com a ampliação dos sistemas de ensino e na reconfiguração institucional, bem como na articulação entre Estado e sociedade. A ampliação do mercado privado no ensino acirra a competitividade, conformando conglomerados empresariais, alterando processos de formação e forjando novos desafios para as políticas públicas.

Physical activity and nutrition education at the school environment aimed at preventing childhood obesity: evidence from systematic reviews / A atividade física e a educação nutricional no ambiente escolar visando a prevenção da obesidade infantil: evidências de revisões sistemáticas

ABSTRACT OBJECTIVE: To organize the main findings and list the most frequent recommendations from systematic reviews of interventions developed at the school environment aimed at reducing overweight in children and adolescents. DATA SOURCE: Searches for systematic reviews available until December 31, 2014 were conducted in five electronic databases: Cochrane, PubMed, SciELO, SPORTDiscus, and Web of Science. Manual search for cross-references were also performed. SUMMARY OF THE FINDINGS: Of the initial 2139 references, 33 systematic reviews adequately met the inclusion criteria and were included in the descriptive summary. In this set, interventions with periods of time greater than six months in duration (nine reviews), and parental involvement in the content and/or planned actions (six reviews) were identified as the most frequent and effective recommendations. Additionally, it was observed that boys respond more effectively to structural interventions, whereas girls respond to behavioral interventions. None of the included reviews was able to make inferences about the theoretical basis used in interventions as, apparently, those in charge of the interventions disregarded this component in their preparation. CONCLUSIONS: Although the summary identified evidence with important applications in terms of public health, there are still gaps to be filled in this field of knowledge, such as the effectiveness of different theoretical models, the identification of the best strategies in relation to gender and age of participants and, finally, the identification of moderating variables to maximize the benefits provided by the interventions.

RESUMO OBJETIVO: Organizar os principais achados e relacionar as recomendações mais frequentes das revisões sistemáticas de intervenções desenvolvidas no ambiente escolar com fins na redução do excesso de peso em crianças e adolescentes. FONTE DOS DADOS: Buscas por revisões sistemáticas disponíveis até 31 de dezembro de 2014 foram feitas em cinco bases de dados eletrônicas: Cochrane, PubMed, SciELO, SPORTDiscus e Web of Science. Buscas manuais por referências cruzadas também foram desenvolvidas. SÍNTESE DOS DADOS: Das 2.139 referências iniciais, 33 revisões sistemáticas responderam adequadamente aos critérios de inclusão e compuseram a síntese descritiva. Nesse conjunto, identificaram-se como recomendações mais frequentes e efetivas intervenções que têm períodos de tempo superior a seis meses de duração (nove revisões) e o envolvimento dos pais nos conteúdos e/ou ações previstas (seis revisões). Além disso, observou-se que meninos respondem de forma mais efetivas às intervenções estruturais, enquanto as meninas às intervenções comportamentais. De modo consistente entre as revisões incluídas, nenhuma conseguiu fazer inferências sobre a base teórica usada nas intervenções, uma vez que, aparentemente, os responsáveis pelas intervenções desconsideraram esse componente em sua elaboração. CONCLUSÕES: Embora a síntese tenha identificado evidências com aplicações importantes em termos de saúde coletiva, ainda existem lacunas a serem preenchidas nesse campo do conhecimento, tais como a efetividade de diferentes modelos teóricos, o reconhecimento das melhores estratégias em relação ao sexo e à idade dos participantes e, por fim, a identificação de variáveis moderadoras para potencializar os benefícios proporcionados pelas intervenções.

Evaluación de menús ofertados em comedores escolares: comparación entre colegios públicos, privados y concertados / Evaluation of school menus: comparing public, private and charter schools

RESUMEN Objetivo: Evaluar los menús ofertados en los colegios públicos, privados y concertados de la ciudad de Sevilla (España) para los diferentes grupos de edad escolar. Métodos: Se consideró un total de 86 colegios, incluyendo centros públicos, privados y concertados, representando a todos los distritos de la ciudad. Cuatro colegios disponían de cocina propia, mientras el resto tenían contratado un catering. Los menús iban dirigidos a escolares de entre 3 a 16 años. Se evaluó el grado de cumplimiento de las recomendaciones respecto a la frecuencia mensual de los distintos grupos de alimentos, repetición de recetas, variabilidad de técnicas culinarias y equilibrio nutricional. Para el tratamiento estadístico se utilizó el programa Statistica 7. Resultados: En la mayoría de comedores escolares la oferta de frutas, verduras y legumbres era deficitaria a diferencia de los postres lácteos, carnes y patatas. Se observaron diferencias significativas entre los tres tipos de colegio respecto a la frecuencia mensual de alimentos, siendo los públicos los que más se ajustaban a las recomendaciones. La mayoría de los comedores evaluados no aportaban menús suficientemente detallados así como se observó falta de variedad de técnicas culinarias. La energía no se ajustaba a las necesidades de todos los grupos de edad y la distribución de macronutrientes sólo era adecuada en el 50% de los menús. Conclusión: Aunque se ha observado una evolución favorable de los menús respecto a estudios anteriores hay que seguir trabajando en aumentar la oferta de frutas y verduras, disminuir el aporte de lípidos y proteínas, así como adaptar la energía de los menús a los diferentes grupos de edad.

ABSTRACT Objective: To evaluate menus offered in public, private and charter schools in the city of Seville (Spain) for different groups of school children. Methods: A total of 86 schools were evaluated, including public, private and charter schools, which represented every district of the city. Four schools possessed their own kitchen, while the others had hired a catering service. The menus were aimed at school children aged between 3 and 16 years. The adequacy of menus regarding the monthly frequency of the different food groups, recipe repetition, variability of cooking techniques and nutritional balance were evaluated according to the recommendations. Statistica 7 software was used for statistical analysis. Results: In most school cafeterias fruits, vegetables and legumes supply was defincient compared to dairy desserts, meats and potatoes. Significant differences regarding the monthly food frequency were observed between the three types of school, being the public schools the ones the most followed the recommendations. Most school cafeterias evaluated did not provide sufficiently detailed menus and a lack of variety of culinary techniques was observed.The calories offered did not meet the needs of all age groups and macronutrient distribution was only adequate in 50% of the evaluated menus. Conclusion: Although there has been a favourable evolution of menus from previous studies, further work is needed to increase the offer of fruits and vegetables, to reduce the intake from lipids and protein, as well as to adapt the calories of the menus to the different age groups.

Lesiones no intencionadas en el centro escolar: ¿de qué estamos hablando? / Unintentional injuries at school: what are we talking about?

Introducción: se han realizado estudios sobre el impacto de las lesiones no intencionadas en el hogar y la vía pública, pero existe escasa literatura médica acerca de aquellas que se originan en los centros escolares. Objetivo: conocer las características de los accidentes escolares atendidos en nuestra área de influencia en el periodo de un año. Material y métodos: estudio descriptivo retrospectivo realizado mediante revisión de historias clínicas de los niños de 1 a 15 años que acudieron al Servicio de Urgencias de una clínica privada en el año 2014 por lesiones ocasionadas en centros escolares concertados de Vizcaya. Resultados: se atendieron un total de 20 420 casos, de los que 958 correspondieron a accidentes escolares (4,6%). Predominó el sexo masculino y la edad media fue de nueve años. El 70% de las lesiones se produjo en el exterior de las aulas, el mecanismo de lesión más frecuente fue el traumatismo directo (56,5%) y la localización predominante fueron las extremidades superiores, donde las lesiones presentaron, además, mayor gravedad. Se realizaron numerosas pruebas complementarias, fundamentalmente radiografía ósea (56%), y el 69% de los pacientes precisó tratamiento en el área de Urgencias. Conclusiones: las lesiones no intencionadas que suceden en el entorno escolar son un gran desconocido para el pediatra. En general, se trata de traumatismos de gravedad leve-moderada, que precisan pruebas complementarias y tratamiento en un alto porcentaje de casos. El conocimiento de las circunstancias que rodean a estos accidentes y sus factores de riesgo permitirían establecer estrategias preventivas adecuadas (AU)

Introduction: Studies on the impact of the unintentional injuries resulting from accidents at home and outdoors have been carried out, but there is scarce literature about those originating at schools. Objective: To know the characteristics of school accidents treated in our area of influence in the period of one year. Material and methods: Retrospective and descriptive study conducted by review of medical records of children aged 1 to 15 who came to the Emergency Department of a private clinic in the year 2014, for assessment of injuries originated at schools of Vizcaya. Results: 20,420 cases of which 958 were school accidents (4.6%) were attended. Male were more prominent and the average age was 9 years old. Seventy percent of injuries occurred outside the classroom, the most frequent injury mechanism was direct trauma (56.5%) and the predominant location were the upper extremities where the injuries were also more serious. Complementary tests were carried out, mainly bone x-ray in 56%, and 69% of patients required treatment in the Emergency Department. Conclusions: Unintentional injuries that happen in school are a great unknown for the pediatrician. In general, they are injuries of mild to moderate severity, requiring additional tests and treatment in a high percentage of cases. The knowledge of the circumstances surrounding these accidents and their risk factors would establish appropriate preventive strategies (AU)

Factors associated with obesity in Brazilian children enrolled in the School Health Program: a case-control study / Factores asociados a la obesidad en niños brasileros inscriptos en el programa de salud en la escuela: un estudio de caso control

Case-control studies evaluating the factors associated with childhood obesity are scarce in Brazil. We aimed to analyze the factors associated with obesity in Brazilian schoolchildren enrolled in the School Health Program.A case-control study was conducted on 80 schoolchildren aged 7 to 9 years, 40 of them obese and 40 of normal weight according to the cut-off points established by the World Health Organization (2007). Weight, height and waist circumference were obtained. Socioeconomic, demographic, health, eating behavior and lifestyle data were collected by applying a questionnaire to the person responsible and by determining his/her nutritional status. A binary unconditional logistic regression model (univariate and multivariate) was used for data analysis. The prevalence of obesity was 7.21%. The final model showed that duration of breast-feeding ≥6 months of age (OR 5.3; 95% CI: 1.3-22.1), excess weight of the person responsible (OR 7.1; 95% CI: 1.2-40.2), a sedentary level of physical activity (OR 4.1; 95% CI: 1.1- 15.5), and fast chewing (OR 7.4; 95% CI: 2.1-26.9) were significantly associated with childhood obesity. The factors associated with obesity in schoolchildren were duration of breast-feeding ≥6 months, persons responsible with excess weight, and sedentary children who chew fast. The present study contributes information to be used for the health actions planned by the School Health Program (AU)

La obesidad infantil es un problema creciente de salud pública mundial. Objetivamos analizar los factores asociados a la obesidad en escolares del Programa Salud en la Escuela. Se realizó un estudio caso control con 80 escolares de 7 a 9 años de edad, entre los cuales 40 obesos y 40 eutróficos de acuerdo con los puntos de corte establecidos por la World Health Organization (2007), en 2011- 2012. Se obtuvo el peso, la altura y la circunferencia de la cintura. Se colectaron datos socioeconómicos, demográficos, de salud, comportamiento alimentar y de estilo de vida con aplicación de un cuestionario al responsable, y su evaluación nutricional. Se usó un modelo de regresión logística binario incondicional para el análisis de los datos. La prevalencia de obesidad fue de 7,21%. El modelo final mostró que el período de lactancia materna ≥6 meses de edad (OR 5,3; 95% CI: 1,3 - 22,1), el exceso de peso del responsable (OR 7,1; 95% CI: 1,2- 40,2), nivel de actividad física sedentario (OR 4,1; IC 95%: 1,1-15,5) y masticación rápida (OR 7,4; IC 95%: 2,1-26,9) se asociaron significativamente con la obesidad infantil. Este fue el primer estudio a identificar los factores asociados a la obesidad en niños de 7 a 9 años de edad y el más reciente a demostrar la prevalencia de obesidad entre escolares de una ciudad brasileña. Los factores asociados con la obesidad en escolares fueron el período de lactancia materna ≥6 meses, responsables con exceso de peso, y niños sedentarios que mastican rápidamente. Este estudio contribuye con subsidios para las acciones para la salud previstas en el Programa Salud en la Escuela (AU)

Blogs escolares sobre sexualidade: estudo exploratório documental / Blogs de escuela sobre sexualidad: estudio teórico exploratorio / School blogs about sexuality: an exploratory documentary study

O objetivo foi analisar a estrutura e a utilização do blog escolar por adolescentes, ao abordarem a temática da sexualidade. Trata-se de pesquisa quantitativa exploratória documental, realizada com 11 blogs criados por estudantes que estavam disponíveis online em março de 2012. As informações foram submetidas à análise hipertextual e da estatística descritiva, observando-se os preceitos éticos em pesquisa. Os blogs grupais e educacionais desenvolvidos em escolas portuguesas e brasileiras eram na maioria assinados pelos autores e sofreram poucas atualizações. As publicações escritas mesclaram linguagem científica com informal, apresentavam vídeos e imagens. Informações sobre a quantidade de seguidores, acessos, comentários e contato para dúvidas não foram encontrados na totalidade dos blogs. Entre os assuntos discutidos, destacaram-se métodos contraceptivos e doenças sexualmente transmissíveis (DSTs). Os blogs sãorecurso de educação em saúde que necessitam assumir o seu espaço de discussão ativa e podem contar com a participação de profissionais da saúde.

El objetivo fue analizar la estructura y el uso del blog de la escuela para los adolescentes, abordando el tema sexualidad. Se trata de investigación exploratoria cuantitativa realizada con 11 blogs creados por estudiantes que estaban disponibles en línea el marzo de 2012. La información sufrió análisis de la estadística descriptiva, con observación de la ética en investigación. Los blogs y el grupo educativo desarrollado en Brasil y escuelas portuguesas fueron firmados en su mayoría por los autores y sufrió menos cambios. Las publicaciones escritas se mezclan con el lenguaje científico informal, tenían videos y fotos. La información sobre la cantidad de seguidores, visitas, comentarios y contacto para cuestiones que no se encuentran en todos los blogs. Entre los temas tratados, se puso de anticoncepción y las enfermedades de transmisión sexual. Los blogs son la educación característica de salud que necesitan para tomar su espacio y el debate activo puede incluir la participación de profesionales de la salud.

The objective was to analyze the structure of school blogs on sexuality and their utilization by adolescents. This quantitative, exploratory and documentary study was performed with 11 blogs designed by students and available online in March of 2012. The information was submitted to hypertext analysis and descriptive statistics, taking research ethics norms into consideration. Group and education blogs developed in Portuguese and Brazilian schools were most often signed by their authors and suffered few updates. The written posts mixed scientific and informal languages, besides presenting videos and images. Every blog included information regarding the number of followers, visits, comments and a contact to answer questions. The highlighted discussed topics were birth control methods and sexually transmitted diseases (STDs). Blogs are a resource for health education that should promote active discussions and rely on the participation of health care professionals.

Resultados de un programa comunitario de intervención en el estilo de vida en niños / Results of a community based life style intervention program for children

Objetivo. Describir los resultados de un programa de adopción de estilo de vida saludable, aplicado durante tres años, sobre el índice de masa corporal (IMC) y el consumo de alimentos en escolares. Material y métodos. Ensayo comunitario aleatorizado y controlado. Dos comunidades del Estado de México con características sociodemográficas similares fueron aleatorizadas para implementar la intervención (n=816) o servir como control (n=408). La intervención se llevó a cabo en escuelas primarias y consistió en educación sobre hábitos saludables, modificación de los alimentos distribuidos y actividad física. El desenlace principal fue el cambio en el IMC. Resultados. Después de tres años, la intervención resultó en un menor incremento del IMC (1.6 vs. 1.9 Kg/m², p<0.01) y menor consumo escolar de calorías totales, pan, grasa y azúcar. Conclusiones. Los programas escolares son útiles para enfrentar la obesidad infantil, pero sus beneficios no son inmediatos.

Objective. Describe the three-year results of a program designed for the adoption of a healthy life style in primary school students on the body mass index (BMI) and the consumption of food. Materials and methods. Community randomized and controlled trial. Two communities in the State of Mexico with similar socio-demographic characteristics were randomized to implement the intervention (n=816) or serve as a control (n=408). The intervention was carried out in primary schools and it consisted of education on healthy habits, modification of distributed food and physical activity. The primary outcome was the change in BMI. Results. After three years, intervention resulted in a lower increase of BMI (1.6 vs. 1.9 Kg/m², p< 0.01) and a decreased consumption of total calories, bread, fat and sugar consumption in the schools. Conclusions. School programs are useful to address childhood obesity, but its benefits are not immediate.

Health-related fitness in school children: compliance with physical activity recommendations and its relationship with body mass index and diet quality / Condición física relacionada con la salud en escolares: observancia de las recomendaciones de práctica de actividad física y su relación con el índice de masa corporal y la calidad de la dieta

This study establishes the relationship between the compliance with the governmental physical activity guidelines (at least a minimum of one hour of moderate to vigorous physical activity, MVPA, five times a week), health-related physical fitness and different health related lifestyle variables in a representative sample of Spanish children. Subjects were a representative group of scholars from five schools randomly selected in Extremadura, a mainly rural region with a very low population density. Statistical analysis comprises a t-test to calculate physical fitness differences between groups, according to the compliance with the mentioned physical activity guidelines. A multinomial logistic regression coefficient is established to determine the differences between the better physical fitness status group (= percentile 75) and the poorer physical fitness status group (= percentile 25) for each fitness test and gender, body mass index, physical activity, Mediterranean diet index and population size. Main findings show that the compliance with physical activity guidelines result in a better handgrip strength in left hand (p<0.05), leg strength (p<0.000), speed-agility run (p<0.000) and 20 m endurance shuttle run (p<0.000). Being a girl, being overweighed and living in an urban setting are associated with a lower physical fitness (= percentile 25), whereas there is no relationship between diet quality and subjects’ performance in all physical fitness test evaluated. As a conclusion, this study emphasizes the need to promote an active lifestyle in which physical activity suppose a minimum of one hour of regular MVPA, at least five times a week, to achieve a healthy fitness status.

Este estudio establece la relación entre el cumplimiento de las directrices gubernamentales de actividad física (una hora de actividad física moderada o vigorosa, MVPA, cinco veces a la semana), la condición física saludable, la calidad de la dieta y otras variables en una muestra de escolares de Extremadura (España). Se ha utilizado un t-test para calcular las diferencias de condición física entre los grupos, de acuerdo con el cumplimiento de las mencionadas directrices de actividad física. Se ha establecido un coeficiente de regresión logística multinomial para determinar las diferencias entre el grupo con mejor condición física (= percentil 75) y el grupo con peor condición física (= percentil 25), en función del sexo, índice de masa corporal, actividad física, índice mediterráneo de calidad de la dieta y tamaño de la población. El cumplimiento de las directrices de actividad física se relaciona con mejor fuerza de prensión en la mano izquierda (p <0,05), mayor potencia de las piernas (p <0,000), mejor agilidad (p <0,000) y mayor aptitud cardiorrespiratoria (p <0,000). Ser niña, tener exceso de peso y vivir en un entorno urbano se asocia con peor condición física (= percentil 25), mientras que no existe relación entre calidad de la dieta y la actuación de los sujetos en las pruebas de condición física realizadas. Este estudio enfatiza la necesidad de promover un estilo de vida activo en el que exista al menos una hora de actividad física (MVPA) durante cinco días a la semana, para alcanzar un estado físico saludable.