Actividad física, maduración biológica y salud ósea en función de la condición socioeconómica en escolares colombianos / Physical Activity, Biological Maturation and Bone Health as a Function of the Socio-Economic Status in Colombian Schools / Atividade física, maturação biológica e saúde óssea como função do status socioeconômico em escolas colombianas

Resumen Introducción: diversos estudios describen los diferentes beneficios de la práctica de actividad física en niños y adolescentes; su déficit en estos grupos etarios, provoca un aumento concomitante de alteraciones cardiovasculares y metabólicas. Objetivo: analizar los patrones de actividad física, la maduración biológica y el contenido mineral óseo en escolares colombianos entre 8 y 16 años de edad en función del estrato socioeconómico al que pertenecen. Materiales y métodos: estudio de enfoque cuantitativo, descriptivo, transversal con alcance correlacional el cual incluyó una muestra representativa para escolares colombianos entre 8-16 años de edad a los cuales se les valoró el nivel de actividad física a través del PAQ-C, igualmente, se evaluaron diferentes medidas antropométricas y de manera indirecta se determinó la velocidad pico de crecimiento (VPC) y la densidad mineral ósea (DMO). Resultados: se evaluaron un total de 2147 escolares de los cuales el 56,7 % pertenecían a instituciones educativas del sistema público, se encontraron asociaciones estadísticamente significativas entre el sexo y el estrato socioeconómico con el nivel de actividad física (p<0,005) y las demás variables de estudio. Conclusión: se puede concluir que la actividad física, la maduración biológica y la salud ósea guardan estrecha relación con la condición socioeconómica en escolares colombianos lo que permite establecer diagnósticos tempranos y toma de decisiones frente a programas y estrategias educativas y de salud pública.

Abstract Introduction: Several studies describe the different benefits of physical activity in children and adolescents. Indeed, when a deficit of physical activity is evident in these age groups, there is a concomitant increase in metabolic and metabolic disorders. Objective: to analyze the patterns of physical activity, biological maturation and bone mineral content in Colombian schoolchildren between 8 and 16 years of age according to the socioeconomic status to which they belong. Materials and methods: A quantitative, descriptive, cross-sectional study with a correlational scope, which included a representative sample of Colombian schoolchildren between 8 and 16 years of age, who were assessed for their level of physical activity through the PAQ-C, also, different anthropometric measurements are evaluated and indirectly the peak growth velocity (PSV) and bone mineral density (BMD) are prolonged. Results: a total of 2147 schoolchildren were evaluated, of which 56.7% belonged to educational institutions of the public system, statistically significant associations were found between sex and socioeconomic status with the level of physical activity and the other study variables. Conclusion: It can be concluded that physical activity, biological maturation and bone health are closely related to socioeconomic status in Colombian schoolchildren, which allows early diagnoses and decision-making regarding educational and public health programs and strategies.

Resumo Introdução: Vários estudos descrevem os diferentes benefícios da prática de atividade física em crianças e adolescentes. De fato, quando um déficit de atividade física é evidenciado nessas faixas etárias, ocorre um aumento concomitante de distúrbios cardiovasculares e metabólicos. Objetivo: analisar os padrões de atividade física, maturação biológica e conteúdo mineral ósseo em escolares colombianos entre 8 e 16 anos de idade de acordo com o status socioeconômico ao qual pertencem. Materiais e métodos: Um estudo quantitativo, descritivo, transversal com escopo correlacional, que incluiu uma amostra representativa de escolares colombianos entre 8 e 16 anos de idade, que foram avaliados quanto ao seu nível de atividade física por meio do PAQ-C, além disso, diferentes medidas antropométricas são avaliadas e, indiretamente, a velocidade máxima de crescimento (PSV) e a densidade mineral óssea (DMO) são prolongadas. Resultados: Um total de 2147 escolares foram avaliados, dos quais 56,7% pertenciam a instituições educacionais do sistema público, foram encontradas associações estatisticamente significativas entre sexo e status socioeconômico com o nível de atividade física e as outras variáveis do estudo. Conclusão: Pode-se concluir que a atividade física, a maturação biológica e a saúde óssea estão intimamente relacionadas ao status socioeconômico em escolares colombianos, o que permite diagnósticos precoces e tomada de decisões em relação a programas e estratégias educacionais e de saúde pública.

Occurrence of hepatitis B and C virus infection in socioeconomic population strata from Recife, Pernambuco, Northeast Brazil / Ocorrência da infecção pelo vírus das hepatites B e C em estratos socioeconômicos populacionais do município de Recife, Pernambuco, Nordeste do Brasil

ABSTRACT Objective: To estimate the probability of infection with hepatitis B (HBV) and C (HCV) viruses in different socioeconomic strata of the population of Recife, Northeast Brazil. Methods: Study carried out from samples obtained in a survey of residents of a large urban center that had a population base and stratified sampling with random selection of households using the "Brazil Sample" package in the R software. HBV (HBsAg) and anti-HCV was performed using immunochromatographic tests. In cases positive for HBsAg, anti-HBc and HBeAg were tested using chemiluminescence, as well as HBV-DNA using real-time PCR. For cases positive for anti-HCV, the search for this antibody was repeated by chemiluminescence and for HCV-RNA by real-time PCR. The occurrence of HBsAg and anti-HCV cases in the general population was estimated based on a theoretical negative binomial distribution. Results: Among 2,070 samples examined, 5 (0.24%) were HBsAg and 2 (0.1%) anti-HCV positive. The majority of cases had self-reported skin color as black/brown (6/7), education level up to high school (6/7), a steady partner (5/7) and lived in an area of low socioeconomic status (5/7). Conclusion : The occurrence of HBsAg and anti-HCV was lower than those previously found in population-based studies and slightly lower than the most recent estimates. Individuals with lower socioeconomic status should be a priority target of public health policies.

RESUMO Objetivo: Estimar a probabilidade da ocorrência de infecção pelos vírus das hepatites B (HBV) e C (HCV) em diferentes estratos socioeconômicos da população de Recife, Nordeste do Brasil. Métodos: Estudo realizado com base em amostras obtidas em um inquérito de residentes de um grande centro urbano que teve base populacional e amostragem estratificada com seleção aleatória dos domicílios por meio do pacote "Amostra Brasil" no software R. A pesquisa do antígeno de superfície do HBV (HBsAg) e do anti-HCV foi realizada por testes imunocromatográficos. Nos casos positivos para HBsAg, foram realizadas pesquisas do anti-HBc e do HBeAg por quimioluminescência, bem como do HBV-DNA, por meio de PCR em tempo real. Para os casos positivos para anti-HCV, foi repetida a pesquisa desse anticorpo por quimioluminescência e do HCV-RNA por PCR em tempo real. A ocorrência de casos HBsAg e anti-HCV na população geral foi estimada com base em uma distribuição teórica binomial negativa. Resultados: Dentre 2.070 amostras examinadas, cinco (0,24%) foram HBsAg e duas (0,1%) anti-HCV positivas. A maioria dos casos tinha cor de pele autorreferida como preta/parda (6/7), nível de escolaridade até o ensino médio (6/7), companheiro fixo (5/7) e morava em área de baixo estrato socioeconômico (5/7). Conclusão: A ocorrência de HBsAg e anti-HCV foi inferior às anteriormente encontradas em estudos de base populacional e pouco menor do que as estimativas mais recentes. Indivíduos que apresentam menor condição socioeconômica devem ser alvo prioritário das políticas públicas de saúde.

Social inequities in the food retail patterns around schools in Recife, Brazil / Desigualdades sociais no padrão do varejo de alimentos no entorno de escolas em Recife, Brasil

Abstract This study aimed to describe the community food environment surrounding schools and its association with territorial socio-environmental vulnerability in the city with the highest intraurban social inequity index in Brazil. Methods: this ecological observational study includes data on the presence and type of food retail in a 400 m buffer surrounding public and private schools in Recife. We have also described the Health Vulnerability Index (HVI) of census tracts and conducted multivariate analyses. Results: through factor analysis, we observed two grouping patterns of food retail. The "diverse food outlets" pattern was positively associated with middle HVI (β 0.14, 95% confidence interval [CI] - 0.11; 0.16) and higher HVI areas (β 0.15, 95%CI - 0.11; 0.17), while "the large food retail chains" pattern was inversely associated with middle HVI (β -0.42, 95% CI - 0.53; -0.30) and high HVI areas (β -0.32, 95%CI - 0.45; -0.18) and positively associated with private schools (β 0.15, 95%CI - 0.030; 0.27). Conclusion: the greatest variety in food retail is in high HVI areas, and large food retail chains prevail around private schools, especially in low HVI areas.

Resumo Este trabalho objetivou descrever o ambiente alimentar comunitário no entorno das escolas e sua associação com a vulnerabilidade socioambiental territorial na cidade com maior índice de desigualdade social intraurbana do Brasil. Métodos: estudo ecológico observacional, inclui dados sobre a presença e o tipo de varejo de alimentos em uma área de 400 m no entorno de escolas públicas e privadas de Recife. Descrevemos o Índice de Vulnerabilidade à Saúde (IVS) dos setores censitários e realizamos análises multivariadas. Resultados: por meio da análise fatorial, observamos dois padrões de agrupamento de estabelecimentos. O padrão "Diversos pontos de venda de alimentos" foi associado positivamente com IVS médio (β 0,14; intervalo de confiança [IC] 95% - 0,11; 0,16) e áreas de IVS mais alto (β 0,15; IC95% - 0,11; 0,17), enquanto o padrão "Grandes redes varejistas de alimentos" foi inversamente associado às áreas de IVS médio (β -0,42; IC95% - 0,53; -0,30) e alto IVS (β -0,32; IC95% - 0,45; -0,18) e positivamente associado com escolas particulares (β 0,15; IC95% - 0,030; 0,27). Conclusão: a maior variedade de estabelecimentos está em áreas de alto IVS, e grandes redes varejistas de alimentos predominam no entorno de escolas particulares, especialmente em áreas de baixo IVS.

Disparities in regional obesity rates in argentina by socioeconomic status / Disparidades en prevalencia de obesidad por región y estatus socioeconómico en Argentina

Abstract Background : Obesity rates in Latin America are increasing overall and among people with low socio economic status (SES). Obesity and SES disparities can vary by region-a valuable indicator of local drivers. The objective of this study was to examine regional and SES differences in obesity in Argentina. Methods : We used data from Argentina's 4th Na tional Risk Factors Survey (n = 29226) 2018 and defined obesity as BMI ≥ 30. Low SES was defined as not fin ished high school or having a household income in the lowest two quintiles. Descriptive analysis stratified by sex compared obesity rates by SES, province, and re gion. Age-adjusted logistic regression models explored the association between obesity, socioeconomic status, and region. Results : Obesity rates varied more by SES among women (39% for low SES vs. 26% for middle/high SES; p < 0.001) than among men (33% low SES vs. 29% middle/ high SES; p = 0.027). The Patagonian region had the high est obesity prevalence for both men (36%) and women (37%). A gender-stratified age-adjusted analysis with region and SES showed that low SES (OR 1.72, 95% CI 1.45, 2.03) and the Patagonian region (OR 1.29, 95% CI 1.02, 1.62) were the only significant predictors for women. Conclusions : SES associated disparities in obesity in Argentina were pronounced for women but not men. Disparities were particularly high in Patagonia. Further research is needed to understand the drivers behind these SES, regional, and gender disparities.

Resumen Introducción : Las tasas de obesidad en América La tina están aumentando, tanto en la población general como entre las personas con bajo nivel socioeconómi co (NSE). Las disparidades en obesidad y NSE pueden variar ampliamente según la región, un indicador po tencialmente valioso de fenómenos causales locales. El objetivo de este estudio fue examinar las diferencias en la prevalencia de obesidad a nivel regional y según el NSE en Argentina. Métodos : Utilizamos datos de la 4ª Encuesta Nacio nal de Factores de Riesgo realizada en Argentina en 2018 (n = 29226). Definimos obesidad como índice de masa corporal ≥ 30, y bajo NSE como no haber termi nado la escuela secundaria o tener un ingreso familiar en los dos quintiles más bajos. El análisis descriptivo estratificado por sexo comparó la prevalencia de obe sidad por NSE, provincia y región. Además, utilizamos modelos de regresión logística ajustados por edad para explorar la asociación entre obesidad, nivel socioeconó mico y región, tanto globalmente como estratificando por sexo.367 Resultados : Las tasas de obesidad variaron más por NSE entre las mujeres (39% NSE bajo vs. 26% NSE medio/ alto; p < 0.001) que entre los hombres (33% NSE bajo vs. 29% NSE medio/alto; p = 0.027). La región patagónica tuvo la mayor prevalencia de obesidad tanto para hom bres (36%) como para mujeres (37%). Un análisis estra tificado por género, con región y NSE como covariables, mostró que el bajo NSE (OR 1.72, IC 95% 1.45, 2.03) y la región patagónica (OR 1.29, IC 95% 1.02, 1.62) fueron los únicos predictores significativos para las mujeres; nin guno se asoció significativamente con un mayor riesgo de obesidad para los hombres. Conclusiones : Las disparidades asociadas al NSE en la obesidad en Argentina fueron pronunciadas entre mujeres, pero no entre hombres. Las disparidades fueron particularmente altas en la Patagonia. Se necesita más estudios para comprender los factores detrás de estas disparidades de NSE, regionales y de género.

Incidence and Risk Factor of Unintentional Fall Related Injuries Among Children in Tamil Nadu, India

Introduction: Injuries are a major global public health problem. There are very few community-based studies on childhood injury from India in this study, we identified the distribution and risk factors for fall-related child injuries in the Chengalpattu district, Tamil Nādu community. Methodology: A descriptive analysis was done among 710 children of age up to 14 years residing in the Kat-tankulathur region in Tamil Nādu. The appropriate number of samples were recruited using the cluster sam-pling method by dividing the subjects into separate clusters and from each cluster 40 samples were obtained. The information on fall-related injury was collected according to mechanism of ‘injury’ Results: The annual incidence of fall-related injuries was 9.1 %. About 72.3% of children had injuries at home and 36% of the persons had fractures in the upper limb. 42% of children had disability in their hands. The age, gender, education and type of family was significant to injury. Conclusion:Our study reported a higher incidence of Fall injuries in Tamil Nādu when compared other stud-ies done in India. Male children are the most common victims of injury and also identified homes, roads/streets as the most common places for the occurrences of fall injury in children.

Parallelism between hypovitaminosis D3 and recently detected myopia in children with amplified screen use in the COVID-19 era—A preliminary study

Purpose: This introductory study aims to analyze the association of serum vitamin D3 levels with recently detected myopia in Indian children following home confinement post?COVID?19 pandemic. Methods: Children aged 5–15 years who had not attended physical school in the past 1 year and visited the ophthalmology department with various ocular symptoms were divided into two groups: the myopic group with recently detected myopia and the non?myopic group with ocular ailments other than myopia. All children underwent basic ophthalmic evaluation and a general physical examination. Blood samples were collected for serum vitamin D3 levels. A pretested questionnaire inquiring about the duration of exposure to a digital screen, outdoor activities, and socioeconomic status was filled out for all children. Results: The mean serum vitamin D3 level in the myopic group was 28.17 ± 15.02 ng/dl in comparison to 45.36 ± 17.56 ng/dl in the non?myopic group (P value < 0.05). Linear regression of the data establishes that myopia is associated with hypovitaminosis D3 (OR? 13.12, 95% CI 2.90–50.32, a P value of 0.001). The correlation between spherical equivalent and vitamin D3 levels was significant (Pearson correlation value: 0.661). In the myopic group, 63.3% of children had screen use >6 hours against 43.3% of children in the non?myopic group. In the myopic group, 33.3% of the children had an outdoor activity duration of <2 hours against 6.6% of children in the non?myopic group. Conclusion: This study proposes hypovitaminosis D3 as a strong factor associated with the development of myopia in children. Although it is a preliminary study, it suggests that the trial for vitamin D3 supplementation in young children to delay or cease the development of myopia is warranted.

Socioeconomic Status Impacts the Prognosis of Chronic Rhinosinusitis Treated by Endoscopic Sinus Surgery: An Observational Cohort Study in Northeast China / 生物医学与环境科学（英文）

OBJECTIVE@#To explore the association between socioeconomic status (SES) and postoperative outcomes in patients with chronic sinusitis (CRS) after functional endoscopic sinus surgery (ESS).@*METHODS@#We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS. Discharged patients were followed up to 72 weeks for all-cause recurrence events. Baseline SES was established based on occupation, education level, and family income of the patients 1 year before the operation. Kaplan-Meier method was used to calculate the recovery rate after ESS, and Cox proportional hazards regression analysis was used to evaluate the relationship between SES and prognosis.@*RESULTS@#Patients of middle SES had lower unadjusted all-cause recurrence than those of low or high SES; 24-week overall recovery rate was 90.4% [95 % confidence interval ( CI): 89.6%-91.2%] in patients of middle SES, 13.5% (95 % CI: 12.8%-14.2%) in patients of low SES, and 31.7% (95 % CI: 30.7%-32.7%) in patients of high SES (both log-rank P < 0.001). After adjustment for covariates, hazard ratios ( HRs) were 7.69 (95 % CI: 6.17-9.71, P trend < 0.001) for all-cause recurrence for low SES versus middle SES, and 6.19 (95 % CI: 4.78-7.93, P trend < 0.001) for middle SES versus high SES.@*CONCLUSION@#Low SES and high SES were more associated with the worse prognosis of CRS patients after ESS than middle SES.

Association and potential mediators between socioeconomic status and childhood obesity in China:findings from a national cohort study / 《全球健康杂志（英文）》

Objective:Socioeconomic status(SES)is associated with childhood obesity,but the underlying factors remain unknown.This study aimed to identify mediators that may explain SES disparities in childhood obesity in China.Methods:Nationally representative longitudinal data from the China Education Panel Survey of 11 019 chil-dren(13.03±0.79)collected from 2013-2014 to 2016-2017 academic years.Overweight/obesity was de-fined using Chinese national body mass index cut-points.Principal component analysis was used to con-vert the four SES indicators(maternal and paternal education,and occupation)into one comprehensive vari-able.Mediation analysis for SES disparities in childhood obesity was conducted using structure equation models.Results:The prevalence of overweight/obesity was 12.8％,and was higher in boys than in girls(17.8％vs.7.6％,P＜0.001)at baseline.Among boys,relative risk(RR)of obesity was 1.23(95％CI:1.09 to 1.40,P＜0.001)for per unit change in SES.There was no significant association between obesity and SES among girls.Mediation analyses showed that among boys,birth weight,being the only child in the family and children's self-perceived weight status mediated 70.0％of the effects of SES on obesity.No mediation effect was detected in girls.Conclusions:Chinese boys are more likely to be overweight or obese than girls.SES may impact childhood obesity through birth weight,being the only child in the family and children's self-perceived body weight status in boys,but not in girls.More attention should be made to address childhood obesity in high SES families among boys.Interventions targeting at these mediators are needed.

Determinants of Unintentional Home Injury Prevention Practice Among B40 Parents of Under-Five Children in Selangor: A Study Protocol

@#Introduction: Unintentional injuries among children are considered a major public health concern since they are one of the leading causes of child death and disability. Inadequate study has been done on whether and how parental influences are linked to childhood injury at home especially among the community with low-socioeconomic status. The study aims to determine the factors affecting unintentional home injury prevention practice among low socioeconomic status (B40) parents of under-five children in Selangor, Malaysia. Methods: This is a cross-sectional and quantitative study. A sample size of 453 parents will be sampled among B40 parents with under-five children in Selangor using a stratified random sampling method. For analysis, only complete questionnaires will be used. Data entry and statistical analysis will be carried out using IBM SPSS version 28.0. Chi-square/Fisher Exact test and simple logistic regression will be used for data analysis. Multiple logistic regression will be used to examine the predictors of poor home injury prevention practice. Discussion: Findings from the study will provide insight on challenges experienced by B40 parents of children under five in implementing preventive injury measures at home.

The National Wealth Score in the Brazilian National Survey on Child Nutrition (ENANI-2019) / O Indicador Econômico Nacional no Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019) / El Indicador Económico Nacional en el Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019)

The National Wealth Score (IEN) is a synthetic household index that assesses socioeconomic conditions. This study aims to present the methods used to update the IEN using data from the Brazilian National Survey on Child Nutrition (ENANI-2019). The following items were included: the education level of the mother or caregiver of the child; the number of bedrooms and bathrooms, TV sets, and cars in the household; and the presence of a radio, refrigerator or freezer, washing machine, microwave oven, telephone line, computers, air conditioner, media player devices, cable or satellite TV, cell phone ownership and type of service, cell phone internet, and internet at the household. Principal component analysis (PCA) was used to estimate the IEN with and without incorporating the complex sampling design (CSD). Thus, the IEN validation considered proxy indicators of socioeconomic status and living conditions. The first component of the PCA explained 31% and 71% of the variation with and without incorporating the CSD, respectively. The coefficients of variation of the IEN were 53.4% and 2.6% with and without incorporating the CSD, respectively. The mean IEN score was lower in households without access to a sewage system, those that received benefits from Brazilian Income Transfer Program, those with some degree of food insecurity, and those with stunted children. Adding ENANI-2019 items to the calculation of IEN to capture technological advances resulted in a better fit of the model. Incorporating the CSD increased PCA performance and the IEN precision. The new IEN has an adequate performance in determining the socioeconomic status of households with children aged under five years.

O Indicador Econômico Nacional (IEN) é um índice domiciliar sintético que avalia condições socioeconômicas. Este estudo tem como objetivo apresentar os métodos utilizados para atualização do IEN a partir de dados do Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019). Foram incluídos os seguintes itens: escolaridade da mãe/cuidador da criança; o número de quartos e banheiros, aparelhos de TV e carros no domicílio; a presença de rádio, geladeira ou freezer, máquina de lavar, forno micro-ondas, linha telefônica, computadores, ar-condicionado, aparelhos multimídia, TV a cabo ou via satélite, propriedade e tipo de serviço de telefone celular, rede de dados de telefone celular e internet no domicílio. A análise de componentes principais (ACP) foi utilizada para estimar o IEN com e sem a incorporação da amostragem complexa. Assim, a validação do IEN considerou indicadores proxy de nível socioeconômico e condições de vida. O primeiro componente da ACP explicou 31% e 71% da variação com e sem a incorporação da amostragem complexa, respectivamente. Os coeficientes de variação do IEN foram de 53,4% e 2,6% com e sem a incorporação da amostragem complexa, respectivamente. O escore médio do IEN foi menor em domicílios sem acesso a esgoto, naqueles que receberam benefícios do Programa Bolsa Família, naqueles com algum grau de insegurança alimentar e naqueles com crianças com déficit de crescimento. A adição de itens do ENANI-2019 ao cálculo do IEN, a fim de capturar os avanços tecnológicos, resultou em um melhor ajuste do modelo. A incorporação da amostragem complexa aumentou o desempenho da ACP e a precisão do IEN. O novo IEN tem um desempenho adequado na determinação do nível socioeconômico de domicílios com crianças menores de cinco anos.

El Indicador Económico Nacional (IEN) es un índice domiciliar que evalúa las condiciones socioeconómicas. Este estudio tiene como objetivo presentar los métodos utilizados en la actualización del IEN con base en datos del Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019). Se incluyeron los siguientes ítems: nivel educativo de la madre/cuidador del niño; la cantidad de dormitorios y baños, televisores y autos en el hogar; la tenencia de radio, heladera o freezer, lavadora, horno de microondas, línea telefónica, computadoras, aire acondicionado, equipo multimedia, televisión por cable o satélite, titularidad y tipo de servicio de telefonía celular, red de datos celular e internet en el hogar. Se utilizó el análisis de componentes principales (ACP) para estimar el IEN con y sin la incorporación de muestreo complejo. Así, la validación del IEN consideró indicadores proxy de nivel socioeconómico y condiciones de vida. El primer componente ACP explicó el 31% y el 71% de la variación con y sin la incorporación de muestreo complejo, respectivamente. Los coeficientes de variación del IEN fueron el 53,4% y el 2,6% con y sin incorporación de muestreo complejo, respectivamente. El puntaje medio del IEN fue menor en los hogares sin acceso a alcantarillado, en aquellos que recibieron beneficios del Programa Bolsa Família, en aquellos con algún grado de inseguridad alimentaria y en aquellos con niños con retraso en el crecimiento. La incorporación de los ítems del ENANI-2019 en el cálculo del IEN, con el fin de capturar los avances tecnológicos, dio como resultado un mejor ajuste del modelo. La incorporación de muestreo complejo incrementó el desempeño de la ACP y la precisión del IEN. El nuevo IEN tiene un desempeño adecuado para estimar el nivel socioeconómico de los hogares con niños menores de cinco años.

Focusing on "what matters": the Occupation, Capability and Wellbeing Framework for Occupational Therapy / Focando no "que importa": a Estrutura de Ocupação, Capacidade e Bem-estar para terapia ocupacional

Abstract Introduction Critical occupational therapists have challenged models from the Global North that have dominated occupational therapy and informed ableist practices focused on appraising dysfunctions, classifying deviations from bodily "norms", and remedying individuals' "deficits" in performing three occupations (self-care, productive, leisure). This indicated the need for a new conceptual framework; one grounded in research evidence derived from a diversity of people and contexts. Objectives To outline the imperative for, and genesis and features of an evidence-informed conceptual framework for occupational therapy, centred on occupations, capabilities and wellbeing. Methods This paper draws from the work of critical occupational therapists; outlining the conception and process of building a flexible framework by linking concepts identified through extensive review of multidisciplinary research from both the Global South and North. Results Building on evidence that occupation is a determinant of wellbeing, the Occupation, Capability and Wellbeing Framework for Occupational Therapy (OCWFOT, Hammell, 2020a) encourages a strengths-based approach to occupational therapy: assessing and building on individual, collective and community assets, abilities and resources; focusing on occupations that "matter most"; and fostering a relational view of people as interdependent and embedded within families and communities. Conclusion Focused unequivocally on the wellbeing needs and aspirations of individuals, families, groups, communities and populations that are met or unmet by current patterns of occupational engagement; on both abilities and opportunities; and on occupation as a human right, the OCWFOT is theoretically defensible, provides conceptual clarity, and has utility as an evidence-informed structure around which future research and practices may be oriented.

Resumo Introdução Terapeutas ocupacionais críticos têm desafiado modelos do Norte Global que dominaram a terapia ocupacional e informaram práticas capacitistas focadas em avaliar disfunções, classificar desvios das "normas" corporais e remediar os "déficits" dos indivíduos no desempenho de três ocupações (autocuidado, produtividade e lazer). Isso indicou a necessidade de uma nova estrutura conceitual, fundamentada em evidências de pesquisa derivadas de uma diversidade de pessoas e contextos. Objetivos: Descrever o imperativo, a gênese e as características de uma estrutura conceitual baseada em evidências para a terapia ocupacional, centrada nas ocupações, capacidades e bem-estar. Métodos: Baseado no trabalho de terapeutas ocupacionais críticos, delinea-se a concepção e o processo de construção de uma estrutura flexível, vinculando conceitos identificados por meio de extensa revisão de pesquisas multidisciplinares do Sul e do Norte globais. Resultados Com base nas evidências de que a ocupação é um determinante do bem-estar, a Ocupação, Capacidade e Bem-Estar para Terapia Ocupacional (OCWFOT, Hammell, 2020a) incentiva uma abordagem baseada em pontos fortes para a terapia ocupacional: avaliar e construir ativos individuais, coletivos e comunitários, habilidades e recursos; focar nas ocupações que "mais importam"; e promover uma visão relacional das pessoas como interdependentes e inseridas em famílias e comunidades. Conclusão Focado inequivocamente nas necessidades e aspirações de bem-estar de indivíduos, famílias, grupos, comunidades e populações que são atendidas ou não pelos padrões atuais de engajamento ocupacional; em habilidades e oportunidades; e sobre a ocupação como um direito humano, o OCWFOT é teoricamente defensável, fornece clareza conceitual e é útil como estrutura baseada em evidências em torno da qual futuras pesquisas e práticas podem ser orientadas.

Estilo de vida del adulto mayor de acuerdo con el nivel socioeconómico, ocupación y vecindario / Elder adult´s lifestyle according to socioeconomic status, occupation and neighborhood

Resumen Objetivo: Conocer si el estilo de vida es determinado por el nivel socioeconómico, ocupación y vecindario de adultos mayores. Materiales y métodos: El estudio fue transversal, correlacional, con muestreo no probabilístico por conveniencia usando medios digitales de grupos conocidos. Se contactaron 101 adultos mayores por correo electrónico, WhatsApp o a través de conocidos. Los datos fueron recolectados mediante la herramienta digital QuestionPro. Se usaron las subescalas del instrumento FANTASTIC: actividad física, nutrición, toxicidad (tabaco), alcohol, sueño, estrés y control de la salud; Neighborhood Environment Walkability Survey; el AMAI para valorar estilos de vida, caminabilidad del vecindario y nivel socioeconómico, respectivamente. así como preguntas abiertas sobre ocupación. Las medidas de tendencia central, dispersión, frecuencias y porcentajes describen las variables continuas y nominales, el Alpha de Cronbach la consistencia interna de los instrumentos y prueba de Kolmogorov Smirnov con corrección de Lilliefors para la distribución de variables. Se usaron coeficientes de correlación de Spearman y modelos de regresión lineal múltiple para responder los objetivos. Resultados: A medida que el nivel socioeconómico mejora las medias de caminabilidad del vecindario aumentan (p < 0.001). El modelo de regresión lineal múltiple fue significativo (p < 0.001), el nivel socioeconómico (p = 0.006) y vecindario (p = 0.005), explican el 28% de la variación de estilos de vida. Conclusiones. El estudio permitió confirmar las teorizaciones en el sentido de que el estatus social y las oportunidades de vida, entendidas como el entorno inmediato juegan un papel importante en la elección del estilo de vida, en este caso representado por nivel socioeconómico y la caminabilidad del vecindario de los adultos mayores. Sin embargo, ello evidencia la desigualdad de oportunidades para mantener un estilo de vida saludable por parte de los adultos mayores, y es a la vez un reto para los profesionales de la salud.

Abstract Objective: To learn if elder adults lifestyle is determined by socioeconomic status, occupation, and neighborhood. Materials and methods: The design was cross sectional, correlational and a convenience non probabilistic sampling through digital social networks of known groups was used. One hundred and one older adults were contacted through e-mail, WhatsApp or by known groups (friends, classmates, professors). Data were collected through the QuestionPro digital tool. Lifestyle was measure using the following subscales: physical activity, nutrition, toxicity (tobacco), alcohol, sleep, stress and health control of the FANTASTIC instrument. Neighborhood's walkability was measured by short version of the Neighborhood Environment Walkability Survey, the AMAI index was used to determine the socioeconomic status, and the type of past or present occupation, activities performed and number of people under their command. Descriptive statistics, Cronbach's Alpha, Kolmogorov Smirnov test with Lilliefors correction, and nonparametric statistics were used. Results: As socioeconomic status went up medians of neighborhood walkability increased (p < 0.001). The linear multiple regression model was significant (p < 0.001); socioeconomic status (p = 0.006), and neighborhood (p = 0.005), explained 28% of the lifestyle variance. Conclusions. The study allowed some theoretical confirmation, in that social status, and life opportunities like environment, play an important role on lifestyle choices, in this study represented by socioeconomic status and neighborhood's walkability of elder adults. But results evidence social inequalities of opportunities to keep a healthy lifestyle by elder adults and at the same time it is a challenge for health professionals.

Conocimientos y factores de riesgo socioambientales en relación con arbovirosis urbanas en Barranquilla (Colombia)

Objetivo: Comparar el nivel de conocimiento sobre las arbovirosis urbanas y los factores socioambientales de riesgo para su presencia en barrios de diferentes estratos socioeconómicos de la ciudad de Barranquilla. Metodología: Estudio descriptivo-transversal, con muestreo simple por conveniencia. Se aplicaron 100 encuestas en cuatro barrios, dos de estrato socioeconómico dos y dos de estrato socioeconómico tres (25 viviendas/barrio), para evaluar el conocimiento de la comunidad sobre las arbovirosis urbanas y las condiciones socioambientales de riesgo, para la presencia de larvas y adultos del vector Aedes aegypti. Los datos cuantitativos resultantes fueron analizados mediante una prueba Chi cuadrado-X2 con 95 % de confianza y un análisis de componentes principales-ACP para estudio de diferencias significativas e inferencia de variables determinantes en cuanto a conocimientos y factores socioambientales de riesgo en el área de estudio. La información fue analizada con el programa SPSS versión 25. Resultados: Los encuestados de todos los barrios reconocieron a los mosquitos como transmisores de agentes causantes de dengue, Zika o chikungunya. Se identificaron larvas y adultos de Ae. aegypti en nichos del intra- y peridomicilio como factores de riesgo. Conclusión: No se encontraron diferencias significativas entre el nivel de conocimiento sobre arbovirosis y el estrato socioeconómico de los entrevistados. En cuanto a los factores de riesgo socioambientales, los barrios de estrato socioeconómico dos presentaron mayores factores de riesgo para la instalación de arbovirosis, siendo la presencia de Ae. aegypti el componente principal. La presencia de mascotas en el domicilio, atrayentes del mosquito, también tienen alta ponderación entre las variables de riesgo en los barrios estudiados.

Objective: To compare the level of knowledge about urban arboviruses and the socio-environmental risk factors for their presence in neighborhoods of different socioeconomic status of the City of Barranquilla. Methodology: Descriptive-cross-sectional study, with simple convenience sampling. 100 surveys were applied in four neighborhoods, two from socioeconomic status two, and two from socioeconomic status three (25 dwellings/neighborhood), to evaluate the community's knowledge about urban arboviruses and socioenvironmental risk conditions, for the presence of larvae and adults of the vector Aedes aegypti. The resulting quantitative data were analyzed using a Chi square-X2 test with 95 % confidence and a principal component analysis-PCA to study significant differences and inference of determining variables in terms of knowledge and socio-environmental risk factors in the study area. The information was analyzed with the SPSS version 25 program. Results: Respondents from all neighborhoods recognized mosquitoes as transmitters of agents causing dengue, Zika or Chikungunya. Larvae and adults of Ae. aegypti, in intra and peridomicile niches as risk factors. Conclusion: No significant differences were found between the level of knowledge about arboviruses and the socioeconomic status of the interviewees. Regarding the socio-envi-ronmental risk factors, the neighborhoods of socioeconomic status two presented higher risk factors for the installation of arboviruses, being the presence of Ae. aegypti the main component. The presence of pets in the home, mosquito attractants, also have a high weighting among the risk variables in the neighborhoods studied.

Sociodemographic profile of patients with snakebite in Jharkhand

Background:Snakebites are a very serious issue that affects people all around the world. The world health organization (WHO) has recently classified snake bites as one of the neglected tropical diseases.Methods:It was an observational, prospective and cross-sectional study conducted at the department of general medicine, (Rajendra institute of medical sciences, Ranchi). A total of 60 patients suffering with first time snakebite were selected for this study by using a purposive sampling technique. Demographic data of the 60 selected cases were recorded in pre-designed standard study forms by means of structured personal interview of patients and attendants after taking informed consent.Results:The mean age � standard deviation of participants� age was 37.35�.123.There were 61.7% tribal people and 38.3% non-tribal people. Out of 60 cases included in this study, 93 % were from rural area and only 7% belonged to urban areas. The sociodemographic analysis showed that 93% patients were belonging to lower socioeconomicstatus and 7% were belonging to middle socioeconomic statusConclusions:The present study concluded that majority of the snakebite fresh cases in Jharkhand belonged to male gender. Majority of cases fell in the age range of 16-48 years, majority of casesbelonged to tribal community and rural areas.

Habilidades prelectoras en niños uruguayos de diferente nivel socioeconómico / Differential pre-literacy skills development in Uruguayan children from different socioeconomic backgrounds

Resumen El objetivo del presente estudio fue comparar las habilidades prelectoras en 50 preescolares uruguayos de 5 años de edad de diferente nivel socioeconómico (NSE) y analizar el impacto de estas habilidades en el aprendizaje de la lectura. Para ello, se evaluó a los niños mediante pruebas de vocabulario receptivo, conciencia fonológica, conocimiento sobre el nombre y el sonido de las letras, y denominación rápida de objetos a fin del nivel preescolar Tiempo 1 (T1). Un año más tarde, se evaluó a un subgrupo de la muestra inicial mediante una prueba de lectura de palabras Tiempo 2 (T2). Los resultados señalaron la existencia de correlaciones significativas entre los predictores (T1) y la lectura de palabras (T2) y entre todas las variables evaluadas y el nivel socioeconómico de los niños. La comparación del desempeño intergrupal señaló la existencia de diferencias significativas en todas las habilidades evaluadas a favor del nivel socioeconómico medio. Sin embargo, el desempeño en la lectura de palabras de ambos grupos fue bajo. Por otra parte, un análisis de regresión mostró que, para los niños de nivel socioeconómico bajo, el nivel de conciencia fonológica fue el que explicó la mayor parte de la varianza en la eficiencia lectora. El nivel de lectura de los niños de nivel socioeconómico medio fue mayormente explicado por el conocimiento del nombre de las letras. Los resultados ponen en evidencia la importancia de atender a las diferencias que se generan temprano en el desarrollo de habilidades lingüísticas fundamentales para aprender a leer.

Abstract Learning to read transforms lives. Reading contributes to knowledge acquisition, cultural engagement, and success in the school. The unequal distribution of literacy skills in a society is associated with economic and social inequalities as a result, children with a poor foundation in literacy before entering formal schooling are more likely to struggle academically and to drop out of school. For these reasons, there has been an intense scientific interest for decades in understanding how children learn to read. It is well established that in the early stages of reading development, phonological awareness, letter name-sounds knowledge, and the naming speed are three independent longitudinal predictors of children's later word-reading skills in alphabetic-writing systems. Phonological awareness constitutes the ability to recognize and manipulate the sounds of their own language, meanwhile letter knowledge promotes the discovery of systematic relationships between writing and oral language. As early readers develop some level of phonological awareness and some level of letter knowledge, they can recognize written words through phonological recoding processes, in which graphemes are recoded as phonemes and assembled to pronounce words. In addition, rapid naming expresses the speed at which phonological information is accessed from a graphic label. Phonological processing and letter knowledge are powerfully affected by the experience, stimulation, and support that children receive before beginning formal education. Most children acquire these abilities relatively effortlessly during early childhood. However, there is a significant number of children in Latin America who experience difficulties in their pre-literacy skills development. This study examined the cognitive profiles of a total of 50 Uruguayan preschoolers from different socioeconomic backgrounds from two public schools in Montevideo, Uruguay. Twenty-six children from low-income households were compared to peers from middle-income. At the end of the pre-schooling period (time 1) receptive vocabulary, phonological awareness, letter name-sounds knowledge, and object naming speed tests were administered to children. One year later (time 2), word -reading of a subgroup of children was measured. Significant correlations were observed between all predictors at time 1; between predictors at time 1 and word reading at time 2; and between all measured abilities and socioeconomic status. Comparative analysis between children of different socioeconomic status showed that children growing up in poverty contexts performed more poorly than their peers from middle-income families in all the tests. Nonetheless, both groups performed poorly in word reading. Descriptive statistics indicated that, out of a total of 26 words, low SES children correctly read a total of 7 words per minute, and medium SES children a total of 14 words. Finally, regression analyses indicated that phonological awareness contributed 30 % variance in predicting the total score achieved in a reading-word test in children of low-income families, meanwhile letter name knowledge contributed 74 % variance in predicting the total score achieved in a reading-word test in their peers from middle-income families. In general terms, results of pre-reading skills and reading performance seem to indicate that children of different socioeconomic status use different word recognition strategies according to their level of letter-knowledge of and phonological processing. Discussion considers international literature pointing out that children who enter elementary school with limited reading-related skills are unlikely to be able to keep pace with their peers. These findings warn about the importance to elaborate systematic and high-quality educational proposals to try to reduce the gap in reading development for children from low-income families. Developing literacy and language skills before formal schooling sets a child up for success in school and life. Results also suggest the importance of analyzing the variables that affect reading development in populations that are not the majority described.

North India Childhood Cataract Study - The real scenario and causes of surgical delay of pediatric cataract

Purpose: The study sought to describe the clinical presentation pattern of pediatric cataracts and factors leading to delay in surgery at a tertiary care center in North India. Methods: A cross?sectional, interview?based study was conducted from January 2020 to October 2020, that included pediatric patients <12 years, with unilateral or bilateral congenital or developmental cataract. A pre?validated questionnaire was used to record data. The parameters recorded were age at first symptoms, age at diagnosis of cataract, age at surgery, laterality of cataract, first symptom, first family member noticing the abnormality, the morphology of cataract, association of perinatal complications, family history, systemic diseases, and cause (s) of delay in surgery. Results: A total of 89 patients were included. The mean age of subjects was 4.75(±3.51) years. A white pupil was the most common symptom (64.04%) and appeared in infancy in 30.3% of cases. Parents first detected the problem in 60.67%, and the pediatrician was the first medical contact in 11.23% of cases. The median (IQR) delay period between diagnosis of cataract and cataract surgery was 4 (3–6) months, the major causes were long GA waiting (30.33%), and delay due to systemic ill health (14.61%). Conclusion: Parental education on cataract detection is recommended to help in the timely detection and hence, improved outcomes of pediatric cataract surgery. Pediatricians, consulted for any systemic illness, have the role of the second most important contact in the detection of pediatric cataract.

Kasurdi Health and Demographic Surveillance System: A Profile and Way Forward

Kasurdi Health and Demographic Surveillance System (Kasurdi HDSS) was established at Rural Health Training Center Kasurdi on February 16, 2018. Kasurdi HDSS has been established to increase the research potential of medical colleges and develop real?time data for research purposes to study the changes in population demography, health, and health?care utilization. Kasurdi HDSS currently follows 2755 individuals living in 549 households. The system collects the data from the population through annual rounds conducted by postgraduate residents of the department of community medicine. The data are collected in the digital format with the help of android-based tablets. HDSS has collected demographic data, reproductive data, data on diseases such as tuberculosis and noncommunicable diseases, and socioeconomic data. The HDSS is in the process to upgrade its data management system to a more integrated platform, coordinated and guided by national/international standards, and data sharing policy.

Posición social y obesidad en población chilena: mediadores y moderadores psicológicos / Social position and obesity in Chilean population: Psychological mediators and moderators

Resumen Introducción: la obesidad es un problema de salud mundial que ha sido vinculada con la posición social de las personas. Si bien la evidencia que relaciona estas variables es clara, se ha puesto menos atención a los mecanismos por medio de los cuales estas variables pueden asociarse. El objetivo de este estudio fue determinar si la posición social se relacionaba directamente con obesidad abdominal e indirectamente vía percepción de discriminación, afectividad negativa y calidad de la dieta, y el rol moderador del apoyo social. Método: 420 funcionarios de una universidad chilena. Se midió el perímetro de cintura como proxy de obesidad, se utilizaron instrumentos de autorreporte para variables psicológicas y conductuales. Resultados: análisis de ecuaciones estructurales revelaron que la posición social no se asoció directamente con obesidad abdominal, pero sí a través de una secuencia de mediación que incluyó la percepción de discriminación, afectividad negativa y calidad de la dieta. El apoyo social no moderó estas relaciones. Conclusión: se identifican mecanismos que median el nexo entre posición social y obesidad abdominal. Se destaca la relevancia de considerar variables psicológicas y conductuales subyacentes en esta relación.

Abstract Introduction: Obesity is a health problem worldwide that has been linked to social position. Although the evidence linking these variables is sound, little attention has been paid to the mechanisms by which these variables can be associated. We sought to determine whether social position is directly related to abdominal obesity and indirectly via perceived discrimination, negative affectivity and diet quality, and the moderating role of social support. Method: Four hundred and twenty participants from a Chilean University were selected. Obesity was measured through waist circumference and self-reported measures were used to asses psychological and behavioral variables. Results: Structural equation modeling allowed us to estimate that social position was not directly related to abdominal obesity, but indirectly via a sequenced mechanism that included perceived discrimination, negative affectivity and diet quality. Social support did not moderate these associations. Conclusion: We identified underlying mechanisms that mediate the association between social position and abdominal obesity. We highlight the relevance that psychological and behavioral variables has in obesity.

Estudiantes con alta capacidad: explorando su distribución según tipo de establecimiento educativo / Gifted Students: Exploring their Distribution According to the Type of Educational Institution

Resumen Antecedentes: estudiantes con alta capacidad o potencial de talento académico, necesitan un entorno enriquecedor para alcanzar un desempeño sobresaliente, y fenómenos como la segregación escolar impactan negativamente la transformación del potencial intelectual en talento académico. Objetivo: comparar la distribución de estudiantes con alta capacidad de quinto básico a cuarto medio de la provincia de Concepción, Chile, provenientes de familias de nivel socioeconómico bajo, medio y alto, según el tipo de establecimiento educativo en que estudian. Método: participaron 650 estudiantes entre 11 y 17 años de edad, quienes respondieron el test de matrices progresivas de Raven, el cual permitió identificar el potencial intelectual según el puntaje de corte. Resultados: hay diferencias estadísticamente significativas en el potencial intelectual entre estudiantes de establecimientos públicos, particulares subvencionados y particulares pagados, así como diferencias en la distribución del potencial intelectual según el nivel educativo de los estudiantes y el nivel socioeconómico de sus familias. Conclusiones: al explorar la distribución de estudiantes con alta capacidad según el tipo de establecimiento educativo, hay una mayor concentración de estudiantes con alta capacidad en establecimientos educativos con familias de nivel socioeconómico alto y una menor concentración de estos en establecimientos educativos con familias de nivel socioeconómico bajo.

Abstract Background: Gifted students or students with academic potential need an enriching environment to achieve an outstanding performance. However, phenomena such as school segregation negatively affect the transformation of intellectual potential into academic talent. Objective: To compare the distribution of gifted students from the fifth grade of elementary school to the fourth year of high school in the Province of Concepción, Chile, coming from families of low, medium and high socioeconomic status, determined by the type of educational institution in which they study. Method: Six hundred fifty (650) students aged between 11 and 17 participated in the study and answered the Raven's Progressive Matrices Test, which allowed the identification of the intellectual potential based on the cut-off score. Results: Statistically significant differences were found in the intellectual potential among students from public, subsidized private and fee-paying private educational institutions, as well as differences in the distribution of the intellectual potential relative to the students' education level and their families' socioeconomic status. Conclusions: When exploring the distribution of gifted students according to the type of educational institution, there was a higher concentration of those students in educational institutions with families of high socioeconomic status, and a lower concentration in educational institutions with families of low socioeconomic status.

A Cross Sectional Study on Assessment of Depression among Patients of Diabetes Mellitus

Objective:An assessment of Depression among patients of diabetes mellituspresenting at THQ Hospital Samanabad, FaisalabadMaterials & Methods: A total of 196 patientswith diabetes mellitus of age 18-65 years of either genderwere included. Patients with history of mood disorders, psychotic disorders, anxiety disorders prior to onset of DM, other chronic disease and any drug addiction were excluded. The demographic information like name, age, sex, socioeconomic status and duration of disease was noted in each patient. All patients were assessed by single psychiatrist, using DSM-IV criteria for Depression (yes / no) Results: Mean age was 53.35 ± 6.71 years in our studywith majority of the patients 97 (49.49%) were between 51 to 65 years of age.Out of the 196 patients, 89 (45.41%) were male and 107 (54.59%) were females with male to female ratio of 1:1.2. Majority of patients 54.41% belonged to upper socioeconomic status. Depression was found in 47 (23.98%) patients, whereas there were 149 (76.02%) patients having no depression. Conclusion:Our study concluded that prevalence of depression in type 2 diabetes mellitus patients was much higher and hasshown positive association with extremes of ages and duration of disease.