Tobacco Retail Environment and Smoking: A Systematic Review of Geographic Exposure Measures and Implications for Future Studies.

INTRODUCTION: To review the geographic exposure measures used to characterize the tobacco environment in terms of density of tobacco outlets and proximity to tobacco outlets, and its association with smoking-related outcomes. METHODS: We used PubMed and Google Scholar to find articles published until December 2019. The search was restricted to studies that (1) measured the density of and/or proximity to tobacco outlets and (2) included associations with smoking outcomes. The extraction was coordinated by several observers. We gathered data on the place of exposure, methodological approaches, and smoking outcomes. RESULTS: Forty articles were eligible out of 3002 screened papers. Different density and proximity measures were described. 47.4% density calculations were based on simple counts (number of outlets within an area). Kernel density estimations and other measures weighted by the size of the area (outlets per square kilometer), population, and road length were identified. 81.3% of the articles which assessed proximity to tobacco outlets used length distances estimated through the street network. Higher density values were mostly associated with higher smoking prevalence (76.2%), greater tobacco use and smoking initiation (64.3%), and lower cessation outcomes (84.6%). Proximity measures were not associated with any smoking outcome except with cessation (62.5%). CONCLUSION: Associations between the density of tobacco outlets and smoking outcomes were found regardless of the exposure measure applied. Further research is warranted to better understand how proximity to tobacco outlets may influence the smoking outcomes. This systematic review discusses methodological gaps in the literature and provides insights for future studies exploring the tobacco environment. IMPLICATIONS: Our findings pose some methodological lessons to improve the exposure measures on the tobacco outlet environment. Solving these methodological gaps is crucial to understand the influence of the tobacco environment on the smoking outcomes. Activity spaces should be considered in further analyses because individuals are exposed to tobacco beyond their residence or school neighborhood. Further studies in this research area demand density estimations weighted by the size of the area, population, or road length, or measured using Kernel density estimations. Proximity calculations should be measured through the street network and should consider travel times apart from the length distance.

Validation and calibration of the patient health questionnaire (PHQ-9) in Argentina.

BACKGROUND: The Patient Health Questionnaire-9 (PHQ-9) is a brief tool to assess the presence and severity of depressive symptoms. This study aimed to validate and calibrate the PHQ-9 to determine appropriate cut-off points for different degrees of severity of depression in Argentina. METHODS: We conducted a cross-sectional study on an intentional sample of adult ambulatory care patients with different degrees of severity of depression. All patients who completed the PHQ-9 were further interviewed by a trained clinician with the Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory-II (BDI-II). Reliability and validity tests, including receiver operating curve analysis, were performed. RESULTS: One hundred sixty-nine patients were recruited with a mean age of 47.4 years (SD = 14.8), of whom 102 were females (60.4%). The local PHQ-9 had high internal consistency (Cronbach's alpha = 0.87) and satisfactory convergent validity with the BDI-II scale [Pearson's correlation = 0.88 (p < 0.01)]. For the diagnosis of Major Depressive Episode (MDE) according to the MINI, a PHQ-9 ≥ 8 was the optimal cut-off point found (sensitivity 88.2%, specificity 86.6%, PPV 90.91%). The local version of PHQ-9 showed good ability to discriminate among depression severity categories according to the BDI-II scale. The best cut off points were 6-8 for mild cases, 9-14 for moderate and 15 or more for severe depressive symptoms respectively. CONCLUSIONS: The Argentine version of the PHQ-9 questionnaire has shown acceptable validity and reliability for both screening and severity assessment of depressive symptoms.

A Community-Driven Approach to Generate Urban Policy Recommendations for Obesity Prevention.

There is an increasing research interest in targeting interventions at the neighborhood level to prevent obesity. Healthy urban environments require including residents' perspectives to help understanding how urban environments relate to residents' food choices and physical activity levels. We describe an innovative community-driven process aimed to develop environmental recommendations for obesity prevention. We conducted this study in a low-income area in Madrid (Spain), using a collaborative citizen science approach. First, 36 participants of two previous Photovoice projects translated their findings into policy recommendations, using an adapted logical framework approach. Second, the research team grouped these recommendations into strategies for obesity prevention, using the deductive analytical strategy of successive approximation. Third, through a nominal group session including participants, researchers, public health practitioners and local policy-makers, we discussed and prioritized the obesity prevention recommendations. Participants identified 12 policy recommendations related to their food choices and 18 related to their physical activity. The research team grouped these into 11 concrete recommendations for obesity prevention. The 'top-three' ranked recommendations were: (1) to adequate and increase the number of public open spaces; (2) to improve the access and cost of existing sports facilities and (3) to reduce the cost of gluten-free and diabetic products.

Understanding the local food environment: A participatory photovoice project in a low-income area in Madrid, Spain.

There is a need to partner between researchers, practitioners and residents to increase our understanding of environmental influences on dietary behaviors. We used the participatory method of Photovoice to understand key determinants of the local food environment influencing residents' diets. This project was conducted in Villaverde, a low-income area located in Madrid, Spain. From February to May 2015, 24 residents working in four Photovoice groups, took photographs related to their local food environment. Each group analyzed and critically discussed their photographs in small group sessions. Through a consensus-building process, participants identified 30 emerging categories, which followed five conceptual themes related to their food environment: 1) eating in moderation, 2) cultural diversity, 3) food stores, 4) social relationships and 5) economic crisis and poverty. Participants, researchers and practitioners successfully collaborated in analyzing, writing, disseminating the project results, and directly informing local policy-makers, media, and other residents. The project results may guide community-generated interventions for promoting a healthier food environment.

Will global change modify the distribution of the Anadenanthera colubrina (Fabales: Fabaceae) plant, a key species in dry tropical forest? / ¿El cambio global modificará la distribución de la planta Anadenanthera colubrina (Fabales: Fabaceae), especie clave de los bosques tropicales secos?

Introduction: Seasonally dry tropical forests (SDTF) are one of the most threatened terrestrial ecosystems on the planet as a consequence of global change. They harbor high biodiversity and provide a wide range of ecosystem services; therefore, their conservation is a priority worldwide. Climate warming, as well as land use patterns, are leading to species distribution range shifts. Objective: The objective of this work was to study the current and future potential distribution of a SDTF representative tree species (Anadenanthera colubrina) in the Argentinian Sub Andean Piedmont nucleus and to assess the effects of land use and climate changes. Methods: Current and future potential distribution was modeled with Maxent, using 49 presence points and 20 variables. Climate change effects were estimated in four different temperature and carbon dioxide concentration scenarios. Land use changes were determined subtracting the deforested area until 2017 to the current and future potential distribution of the species. Results: A. colubrina current distribution represents 18 % of Northwestern Argentina. Land use changes decreased almost 25 % of it and climate change will probably cause a retraction in the East and a slight expansion towards the West and South of the current distribution. The synergistic effect of land use and climate change projected to the worst scenario would reduce 63 % of its current distribution. Conclusions: Our data demonstrate the central role of distribution range studies to assess the effects of anthropic activities. Climate change and land use change would have a negative and synergistic effect on the distribution of A. colubrina. Although a possible expansion of the Sub Andean Piedmont nucleus of SDTF would occur, this expansion may be limited by the Sub Andean mountain range that could act as an orographic barrier.

Introducción: Los Bosques Tropicales Estacionalmente Secos (BTES) son unos de los ecosistemas terrestres más amenazados del planeta como consecuencia del cambio global. Estos bosques albergan una alta biodiversidad y proporcionan una amplia gama de servicios ecosistémicos, por lo que su conservación es una prioridad a nivel mundial. El cambio climático y el cambio en los usos del suelo están afectando la distribución de las especies. Objetivo: El objetivo de este trabajo fue estudiar la distribución potencial de una especie representativa de BTES (Anadenanthera colubrina) en el núcleo del Piedemonte subandino argentino y evaluar los efectos del cambio en los usos del suelo y del cambio climático sobre su distribución. Métodos: La distribución actual y futura de A. colubrina fue modelada con Maxent, utilizando 49 puntos de presencia y 20 variables. Los efectos del cambio climático se estimaron en cuatro escenarios que difieren en los niveles de temperatura y concentración de dióxido de carbono. Los efectos del cambio en el uso del suelo se estimaron descontando el área deforestada hasta el 2017 a la distribución actual y futura de la especie. Resultados: La distribución actual de A. colubrina representa un 18 % del Noroeste Argentino. Los cambios en el uso del suelo produjeron una disminución del 25 % del área de distribución actual y el cambio climático probablemente causará una retracción al Este y una expansión hacia el oeste y sur de su distribución. El efecto sinérgico del cambio en el uso del suelo y el cambio climático podría producir una pérdida del 63 % considerando el peor escenario de cambio climático. Conclusiones: Nuestros datos demuestran el rol fundamental de los estudios de distribución para evaluar los efectos de las actividades antrópicas. Los cambios en los usos del suelo y el cambio climático podrían tener un efecto negativo y sinérgico sobre la distribución de A. colubrina. La posible expansión del núcleo Piedemonte de SDTF hacia el oeste y el sur de la región no estaría limitada por cambios en el uso del suelo, aunque las cadenas montañosas podrían actuar como barreras orográficas y limitar la expansión.