Results from Portugal's 2022 report card on physical activity for children and youth.

Background: The purpose of this study is to update results of Portuguese's Report Card on Physical activity (PA) for Children and Adolescents. Methods: The grades were assigned by results derived from the PA and Fitness in Portugal 2021 Portuguese Report Card and corresponds to the third report for the Portuguese children and adolescents. It includes indicators of PA and sedentary behavior (SB) that are common to the GLOBAL matrix 4.0: Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behaviors, Family and Peers, School, Community and the Environment, Government and Physical Fitness. The search focused on published national evidence/data sources (academia, NGO, governmental) from end 2018 onwards excluding data obtained during the covid-19 pandemic. Results: The grades were assigned as follows: Overall PA (D-), Organized Sport Participation (C-), Active Play (D+), Active Transportation (D-), Sedentary behaviors (C+), Physical Fitness (C), Family and Peers (B), School (A), Community and Environment (B), and Government (B). Conclusion: In line with previous Portuguese Report Cards, a large proportion of Portuguese children and adolescents are not sufficiently active nor fit enough setting urgency for effective strategies. Particular attention should be given to Active play, Active transport and Organized Sports Participation has their grades have decreased. Some actions in selected indicators as Governmental and policy seems promising however results weren't seen yet. Despite the strong support of schools with mandatory curricula in PE no correspondent change is observed in fitness or PA, so more research is needed to find why.

Associations of accelerometer measured school- and non-school based physical activity and sedentary time with body mass index: IPEN Adolescent study.

BACKGROUND: This study examined the strength, shape and direction of associations of accelerometer-assessed overall, school- and non-school-based moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) with BMI among adolescents across the world. Second, we examined whether these associations differed by study site and sex. METHODS: Cross-sectional data from the IPEN Adolescent study, an observational multi-country study, were used. Participants wore an accelerometer for seven days, reported height and weight, and completed a socio-demographic survey. In total, 4852 adolescents (46.6% boys), aged 11-19 years (mean age = 14.6, SD = 1.7 years) were included in the analyses, using generalized additive mixed models. RESULTS: Adolescents accumulated on average 41.3 (SD = 22.6) min/day of MVPA and 531.8 (SD = 81.1) min/day of ST, and the prevalence of overweight and obesity was 17.2% (IOTF), but these mean values differed by country. Linear negative associations of accelerometer-based MVPA and ST with standardized BMI scores and the likelihood of being overweight/obese were found. School-based ST and non-school-based MVPA were more strongly negatively associated to the outcomes than non-school based ST and school-based MVPA. Study site moderated the associations; adolescent sex did not. No curvilinear associations were found. CONCLUSIONS: This multi-country study confirmed the importance of MVPA as a potential protective factor against overweight/obesity in adolescents. Non-school-based MVPA seemed to be the main driver of these associations. Unexpected results were found for ST, calling for further examination in methodologically sound international studies but using inclinometers or pressure sensors to provide more precise ST measures.

Relationship between green space near schools with physical activity and body mass index in portuguese adolescents / Relação entre o espaço verde próximo a escola com a atividade física e índice de massa corporal em adolescentes portugueses

Our aim was to determine the relationship between urban green spaces (UGS) number and green-ness amount close to school with physical activity (PA) and body mass index (BMI) of adoles-cents. Participants (n = 194, aged 13­18 years) were recruited in 75 public secondary schools in the Porto Metropolitan Area. We used a self-administered questionnaire to obtain information on height, weight, age and sex. PA levels were assessed using accelerometers. UGS number and green-ness amount were measured using network buffers by 300, 500, 1000 and 1500 meters around each school, through geographic information system and normalized difference vegetation index (NDVI), respectively. Multilevel regressions were fitted to each green indicator individually. Multilevel models without adjustment showed a direct relationship between PA and NDVI [B = 118.14; 95%CI: 20.71, 215.57] and inverse relationship between PA and UGS number [B = -5.95; 95%CI: -10.06, -1.83] at 300 meters. Multilevel models with adjustment for socioeconomic deprivation showed a direct relationship between BMI and NDVI [B = 83.41; 95%CI: 30.84, 135.98] at 500 meters and a direct relationship between BMI and NDVI [B = 61.68; 95%CI: 3.07, 120.29] at 1000 meters. The present investigation does not support the idea that UGS number and the NDVI close to school promote PA and metabolic health in adolescents, as the results proved to be inconsistent and dependent on the distance threshold used to define geographic proximity

O objetivo foi determinar a relação entre quantidade de espaços verdes (EV ) e quantidade de vegetação na proximidade da escola com a atividade física (AF) e índice de massa corporal (IMC) em adolescentes. Os participantes (n = 194, com idades de 13 a 18 anos) foram recrutados em 75 escolas públicas secundárias da Área Metropolitana do Porto. Altura, peso, idade e sexo foram reportadas por questionário e a AF avaliada por acelerómetros. A quantidade de EV e de vegetação foram medidas em buffers de 300, 500, 1000 e 1500 metros ao redor da escola, através de Sistema de Informação Geográfica e índice de vegetação por diferença normalizada (IVDN), respetivamente. Regressões multinível foram realizadas individualmente com cada indicador de verde. A regressões sem ajuste demonstraram relação direta entre a AF e IVDN [B = 118,14; IC95%: 20,71; 215,57] e relação inversa entre a AF e quantidade de EV [B = -5,95; IC95%: -10,06; -1,83] a 300 metros. Modelos ajustados para a privação socioeconómica, apontaram relação direta entre a AF e IVDN [B = 130,18; IC95%: 7,30; 253,07], relação inversa entre a AF e quantidade de EV [B = -5,67; IC95%: -9,87; -1,47] a 300 metros, relação direta entre o IMC e IVDN a 500 [B = 61,68 ;IC95%: 3,07; 120,29] e a 1000 metros [B = 67,68; IC95%: 3,07; 120,29]. A presente investigação não suporta a ideia de que os EV e o IVDN próximos da escola promovem a AF e a saúde metabólica dos adolescentes, pois os resul-tados foram inconsistentes e dependentes do limiar de distância usado para definir proximidade geográfica

The effect of impact exercise on bone mineral density: A longitudinal study on non-athlete adolescents.

PURPOSE: High impact exercise is known to induce osteogenic effects in the skeleton. However, less is known about the systemic effect of exercise practice in a potential adaptive mechanism of the skeletal accrual. This research aimed to assess the effect of impact exercise on bone mineral density (BMD) in the radius throughout adolescence. METHODS: This study evaluated 1137 adolescents, at 13 and 17 years old, as part of the population-based cohort EPITeen. BMD (g/cm2) was measured at the ultradistal and proximal radius of the non-dominant forearm by dual-energy X-ray absorptiometry (DXA) using a Lunar® Peripheral Instantaneous X-ray Image device. The practice of (extra-curricular) exercise was categorized as: no exercise, exercise with high impact and exercise with low impact. Regression coefficients (ß) and respective 95% confidence intervals (CI95%) were used to estimate the association between exercise practice categories at 13 years old and BMD at 13 and 17 years old and BMD gain between evaluations. RESULTS: In boys, at 13 years, BMD was similar between the ones not practicing exercise and those practicing exercise with low impact, and the gain of BMD was also similar in both groups. Still in boys, at 13 years, those who practiced exercise with high impact presented higher mean (standard-deviation) of BMD, comparing to the other two groups (no exercise and low impact exercise), and also significantly increased the BMD gain between 13 and 17 years (ß = 0.013; CI95%0.003;0.023). In girls, no statistically significant differences on BMD were found between the categories of exercise at 13 years and BMD at 17 years of age. CONCLUSION: This research shows that the practice of high impact exercise could help to increase BMD more than low impact exercise even in a nonweight-bearing bone during adolescence.

Urban Green Spaces, Greenness Exposure and Species Richness in Residential Environments and Relations with Physical Activity and BMI in Portuguese Adolescents.

Environmental factors play an important role in obesity-related behaviors. Evidence indicates significant associations between weight and urban green spaces in adults, but it is not clear whether this relationship applies to adolescents. Therefore, our aim was to determine the associations between urban green spaces, greenness exposure and species richness in residential environments with physical activity and body mass index. Sixty-two adolescents between 12 and 18 years of age answered a self-administered questionnaire, providing information on height, weight, age, sex and home address. Data on socioeconomic deprivation were obtained from the European Index of Deprivation for Small Portuguese Areas. Physical activity levels were assessed using accelerometers. Urban green space counts and the normalized difference vegetation index values were measured using buffers along the roads with distances of 300, 500, 1000 and 1500 m from each participant's residence. To quantify the species richness, the species richness index was used. Linear regression models were fitted to analyze whether urban green spaces, exposure to green spaces and species richness counts for each distance were associated with physical activity and self-reported body mass index. We did not find significant associations between the independent variables and the probability of overweight or obesity. The relationship between environmental variables, adolescents' physical activity and body weight seems to be complex and further studies may contribute to better understanding of the topic.

International Physical Activity and Built Environment Study of adolescents: IPEN Adolescent design, protocol and measures.

INTRODUCTION: Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese). METHODS AND ANALYSIS: The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11-19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status. ETHICS AND DISSEMINATION: Ethical approval was received from each study site's Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.

Alternativas de cuidado a usuários de drogas na América Latina: desafios e possibilidades de ação pública

Este livro visa complementar debates já desenvolvidos sobre a regulação da produção, da distribuição e da comercialização de substâncias psicoativas (SPAs), como é o caso de CEDD (2014), por meio do foco exclusivo nas políticas públicas de atenção e cuidado aos usuários, objeto ainda carente de análises mais sistemáticas na região.

Desafios do multiprofissionalismo para a redução de danos em Centros de Atenção Psicossocial Álcool e outras Drogas / Multi-professionalism related challenges in the implementation of harm reduction strategies at the Center for Psychosocial Attention to Users of Alcohol and Other Drugs

Resumo O artigo aborda a implementação da estratégia de Redução de Danos (RD) por equipes multiprofissionais nos Centros de Atenção Psicossocial Álcool e outras Drogas (Caps AD) do Distrito Federal. A partir dos aportes teóricos dos estudos sobre implementação de políticas públicas e da sociologia das profissões, buscou-se refletir sobre as implicações do multiprofissionalismo para a tradução da RD em ações práticas junto aos usuários dos serviços. Realizou-se pesquisa de campo nas sete unidades de Caps AD do Distrito Federal, onde as atividades cotidianas foram observadas e profissionais foram entrevistados. A análise revelou que: (1) há variação substantiva na forma como os profissionais atuantes nos Caps AD interpretam e praticam a RD; (2) suas diferentes formas de entendimento e ação associam-se à formação profissional em distintos campos de conhecimento (psicossocial versus biomédico); e (3) estas divergências podem resultar em conflitos entre profissionais e implicar consequências negativas para os usuários dos serviços. Discute-se, também, os meios encontrados pelas gerências para a gestão e mitigação destas implicações. Os achados contribuem para reflexões mais amplas sobre os desafios que se impõem à sustentabilidade do modelo de atenção proposto para os Caps AD.

Abstract The article focuses on the implementation of the Harm Reduction strategy by multiprofessional teams in the Centers for Psychosocial Attention to Users of Alcohol and other Drugs (CAPS AD) at the Brazilian Federal District. Based on theoretical propositions from the fields of policy implementation and sociology of professions, it sought to reflect upon the implications of different professional perspectives about the concept of Harm Reduction, and its translation into practice, for the aims of the Ministry of Health Care Policy for Alcohol and Other Drugs Users and its beneficiaries. Our study is supported by empirical research involving qualitative fieldwork on the seven units of CAPS AD in the Federal District. Our findings suggest that: (1) there is substantive variation in the way CAPS AD professionals interpret and practice harm reduction principles; (2) this variation is associated with professional education in distinct fields of knowledge (psychosocial versus biomedical); and (3) divergences among professionals may result in conflicts and produce negative consequences for service users. We also discuss the means by which service managers seek to mitigate those negative implications. These findings contribute to broader reflections on the challenges for sustainability of the Caps AD model.

Políticas públicas locais para promoção da atividade física das crianças nos parques públicos / Local public policies to promote children's physical activity in public parks

Resumo Evidências revelam o potencial dos parques públicos para a promoção da atividade física e da saúde. A valorização desses ambientes para a promoção da atividade física das crianças pode ser uma mais-valia nas políticas públicas de promoção da saúde e prevenção do sedentarismo das crianças. O objetivo deste estudo foi a análise das políticas públicas de promoção da atividade física das crianças em parques públicos do Município de Guimarães, Portugal. Foram realizadas entrevistas semiestruturadas individuais a gestores políticos públicos locais. O tratamento dos dados foi realizado segundo a metodologia qualitativa de análise do conteúdo, donde emergiram os seguintes temas relacionados com a promoção da atividade física das crianças: parceria política (pública e intersetorial), as estratégias e os constrangimentos locais. Os resultados revelaram a necessidade de maiores esforços públicos para a valorização dos parques públicos para a promoção da atividade física das crianças. Promover políticas públicas locais que favoreçam a parceria intersetorial local poderá ser uma estratégia eficaz para a promoção da atividade física das crianças nos parques públicos.

Abstract Evidence reveals the potential of public parks to promote physical activity and health. The valorization of these environments for the promotion of children's physical activity can be an asset in public policies for health promotion and prevention of children's sedentary lifestyle. This study aimed to analyze public policies to promote children's physical activity in public parks in the municipality of Guimarães, Portugal. Individual semi-structured interviews were conducted with local public political managers. Data processing was carried out according to the qualitative methodology of content analysis, from which emerged the following themes related to the promotion of children's physical activity: political partnership (public and intersectoral), strategies and local constraints. The results revealed the need for greater public efforts to enhance public parks to promote children's physical activity. Promoting local public policies that favor local intersectoral partnership may be an effective strategy for promoting physical activity for children in public parks.

[Interaction of sociodemographic factors in the association between psychosocial factors and active commuting to school]. / Interação dos fatores sociodemográficos na associação entre fatores psicossociais e transporte ativo para a escola.

The study aimed to analyze the interaction of sociodemographic factors in the association between psychosocial factors and active commuting to school. This was a cross-sectional study in 2018 with a sample of 1,984 students. The target sociodemographic factors were sex, age, parents' schooling, and socioeconomic status. Social support and self-efficacy were measured with questionnaires. Active commuting to school was defined as walking, bicycling, or skateboarding to and from school. Binary logistic regression was used to verify the association between psychosocial factors and active commuting to school. Then, interaction terms with the sociodemographic variables (age, father's schooling, mother's schooling, socioeconomic status) were included in the relationship between psychosocial factors and active commuting to school. The sample consisted of 1,984 adolescents (55.9% females). Of these, 748 (37.7% of the sample) reported active commuting to school during a normal week. Analyses of interaction showed that high levels of schooling and high socioeconomic status were negatively associated with active commuting to school. Low socioeconomic status and low schooling were positively associated with such commuting. The peer social support scale showed more significant variables than the other scales. The results indicate that sociodemographic factors (parents' schooling and socioeconomic status) moderate the association between psychosocial factors and active commuting to school.

Neighborhood environmental factors associated with leisure walking in adolescents.

OBJECTIVE To verify the associations of leisure walking with perceived and objective measures of neighborhood environmental factors stratified by gender and socioeconomic status (SES) in Brazilian adolescents. METHODS Cross-sectional study with a random sample of 1,130 high school students (47.3% girls; aged 14 to 20 years old) from Porto Alegre, Brazil. Leisure walking and SES were self-reported by the adolescents. Perceived environmental factors were assessed through Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Objective measures were evaluated using Geographic Information Systems, with road network calculated around the adolescent's residential address, using 0.5km and 1.0km buffers. Data collection was carried out in 2017 and generalized linear regression models were used. RESULTS Leisure walking was positively associated with access to services (0.5 km buffers [Odds ratio (OR) = 2.22] 1.0 km buffers [OR = 2.17]) and lower distance to parks and squares (0.5 km [OR=2.80] 1.0 km [OR = 2.73]) in girls from low SES. Residential density (0.5 km [OR = 1.57] 1.0 km [OR = 1.54]) and walkability index (0.5 km [OR = 1.17] 1.0 km [OR = 1.20]) were associated with leisure walking in girls from middle SES. Boys from low SES showed an inverse association between crime safety and leisure walking (0.5 km [OR = 0.59] 1.0 km [OR = 0.63]). Neighborhood recreation facilities was positively associated with leisure walking in middle SES (0.5 km [OR = 1.55] 1.0 km [OR = 1.60]). Land use mix (0.5 km [OR = 1.81] 1.0 km [OR = 1.81]), neighborhood recreation facilities (0.5 km [OR = 2.32] 1.0 km [OR = 2.28]) and places for walking (0.5 km [OR=2.07] 1.0 km [OR=2.22]) were positively associated with leisure walking in high SES. CONCLUSION Environmental factors (objectively and subjectively measured) and leisure walking show association in boys and girls of different SES.

Physical activity level among older adultsover 70 years old and very old adults / Nível de atividade física entre idosos acima de 70 anos e idosos longevos / Nivel de actividad física entre ancianos mayores de 70 años y ancianos longevos

Abstract Introduction: Physical activity (PA) is an effective strategy to ensure good health in older adults and mitigate the harmful effects of aging. Objective: To compare PA levels in people aged between 70 and 79 years and very old adults. Method: Quantitative, observational, descriptive cross-sectional study, with 343 individuals aged 70 years or older from a medium-sized municipality in western Santa Catarina state (SC). Data were collected using the MMSE, the Morais' Questionnaire, and the IPAQ-SF. Data were analyzed using the Mann-Whitney U test, X² and Spearman's correlation. Significance was set at p < 0.05. Results: The average physical activity level among 70 to 79-year-olds was 168.55 (± 146.81) minutes a week and 93.91 (± 122.66) in very old adults. IPAQ classification indicated that a higher percentage of very old adults were sedentary (79.5%), while 67.8% of 70 to 79-year-olds were categorized as active/very active. There was a statistically significant correlation between physical activity level, number of self-reported chronic diseases and number of medications. Conclusion: Older adults between 70 and 79 years old are more active than very old adults; older women are more active than their male counterparts; the increase in the number of chronic diseases and medications taken lowers physical activity level.

Resumo Introdução: Atividade física (AF) constitui-se numa estratégia eficaz para garantir bons níveis de saúde para os idosos, bem como para reduzir os efeitos deletérios do processo de envelhecimento. Objetivo: Comparar o nível de AF de idosos entre 70 e 79 anos e idosos longevos. Método: Pesquisa quantitativa, observacional, descritiva e transversal com 343 idosos de 70 anos ou mais, de um município de médio porte do extremo oeste de Santa Catarina (SC). Utilizaram-se como instrumentos de coleta de dados o MEEM, o Questionário de Morais e o IPAQ versão curta. A análise de dados foi realizada por meio do teste U de Mann-Whitney, X² e correlação de Spearman. O nível de significância adotado foi de p < 0,05. Resultados: A média de atividade física de idosos entre 70 e 79 anos foi de 168,55 (± 146,81) minutos semanais; nos idosos longevos, foi de 93,91 (± 122,66). Em relação à classificação do IPAQ, constatou-se que há um percentual maior de sedentários na população longeva (79,5%); na classificação ativo/muito ativo, evidenciou-se maior frequência na população com idade entre 70 e 79 anos (67,8%). Houve correlação estatisticamente significativa entre o volume de atividade física e o número de doenças crônicas autorrelatadas e o número de medicamentos. Conclusão: Idosos entre 70 e 79 anos são mais ativos do que os longevos; as mulheres idosas são fisicamente mais ativas do que os homens; o volume de atividade física diminui com o aumento do número de doenças crônicas, bem como de medicamentos.

Resumen Introducción: La actividad física (AF) se constituye en una estrategia eficaz para garantizar buenos niveles de salud a los ancianos, así como para reducir los efectos dañinos del proceso de envejecimiento. Objetivo: Comparar el nivel de AF de ancianos entre 70 y 79 años y ancianos longevos. Método: Investigación cuantitativa, observacional, descriptiva y transversal, con 343 ancianos de 70 años o más, de un municipio de mediano porte del extremo oeste del estado de Santa Catarina (SC). Se utilizaron como instrumentos de recolección de datos el MEEM, el Cuestionario de Morales y el IPAQ versión corta. El análisis de datos fue realizado por medio de la prueba U de Mann-Whitney, X² y correlación de Spearman. El nivel de significación fue de p <0,05. Resultados: El promedio de actividad física de ancianos entre 70 y 79 años fue de 168,55 (± 146,81) minutos semanales; en los ancianos longevos, fue de 93,91 (± 122,66). Con relación a la clasificación del IPAQ, se constató que hay un porcentaje mayor de sedentarios en la población longeva (79,5%); la clasificación como activo/muy activo se evidenció con mayor frecuencia en la población con edad entre 70 y 79 años (67,8%). Se observó una correlación estadísticamente significativa entre el volumen de actividad física y el número de enfermedades crónicas autorrelatadas y la cantidad de medicamentos. Conclusión: Los ancianos entre 70 y 79 años son los más activos que los longevos; las mujeres mayores son físicamente más activas que los hombres; el volumen de actividad física disminuye con el aumento del número de enfermedades crónicas, así como de medicamentos.

Interação dos fatores sociodemográficos na associação entre fatores psicossociais e transporte ativo para a escola / Interaction of sociodemographic factors in the association between psychosocial factors and active commuting to school / Interacción de los factores sociodemográficos en la asociación entre factores psicosociales y el transporte activo para la escuela

Resumo: O objetivo foi investigar a interação dos fatores sociodemográficos na associação dos fatores psicossociais com o transporte ativo para a escola. Foi realizado estudo transversal, conduzido em 2018 com uma amostra de 1.984 estudantes. Os fatores sociodemográficos incluídos foram: sexo, idade, escolaridade dos pais e nível socioeconômico. O apoio social e a autoeficácia foram mensurados por questionários. Caminhar, pedalar ou usar skate foram considerados meios de transporte ativo para a escola. A regressão logística binária foi utilizada para verificar a associação dos fatores psicossociais com o transporte ativo para a escola. Em seguida, termos de interação com as variáveis sociodemográficas (idade, escolaridade pai, escolaridade mãe, nível socioeconômico) foram incluídos na relação dos fatores psicossociais com o transporte ativo para a escola. A amostra foi composta de 1984 adolescentes (55,9% feminino). Desses, 748 (37,7% da amostra) relataram utilizar transporte ativo para a escola em uma semana habitual. As análises de interação demonstraram que escolaridade e nível socioeconômico alto estão associados negativamente com transporte ativo para escola. Nível socioeconômico baixo e escolaridade baixa estão associados positivamente. A escala de apoio social dos amigos apresentou um número maior de variáveis significativas quando comparada às demais escalas. Os resultados indicam que os fatores sociodemográficos (escolaridade dos pais e nível socioeconômico) moderam a associação dos fatores psicossociais com o transporte ativo para a escola.

Abstract: The study aimed to analyze the interaction of sociodemographic factors in the association between psychosocial factors and active commuting to school. This was a cross-sectional study in 2018 with a sample of 1,984 students. The target sociodemographic factors were sex, age, parents' schooling, and socioeconomic status. Social support and self-efficacy were measured with questionnaires. Active commuting to school was defined as walking, bicycling, or skateboarding to and from school. Binary logistic regression was used to verify the association between psychosocial factors and active commuting to school. Then, interaction terms with the sociodemographic variables (age, father's schooling, mother's schooling, socioeconomic status) were included in the relationship between psychosocial factors and active commuting to school. The sample consisted of 1,984 adolescents (55.9% females). Of these, 748 (37.7% of the sample) reported active commuting to school during a normal week. Analyses of interaction showed that high levels of schooling and high socioeconomic status were negatively associated with active commuting to school. Low socioeconomic status and low schooling were positively associated with such commuting. The peer social support scale showed more significant variables than the other scales. The results indicate that sociodemographic factors (parents' schooling and socioeconomic status) moderate the association between psychosocial factors and active commuting to school.

Resumen: El objetivo fue investigar la interacción de los factores sociodemográficos en la asociación de los factores psicosociales con el transporte activo hacia la escuela. Estudio transversal, llevado a cabo en 2018, con una muestra de 1.984 estudiantes. Los factores sociodemográficos incluidos fueron: sexo, edad, escolaridad de los padres y nivel socioeconómico. El apoyo social y la autoeficacia fueron medidos por medio de cuestionarios. Se consideró transporte activo hacia la escuela: caminar, pedalear o usar monopatín. La regresión logística binaria se utilizó para verificar la asociación de los factores psicosociales con el transporte activo a la escuela. Después, los términos de interacción con las variables sociodemográficas (edad, escolaridad del padre, escolaridad de la madre, nivel socioeconómico) se incluyeron en la relación de los factores psicosociales con el transporte activo hacia la escuela. La muestra estaba compuesta por 1.984 adolescentes (55,9% de sexo femenino). De ellos, 748 (37,7% de la muestra) informaron utilizar transporte activo hacia la escuela durante una semana normal. Los análisis de interacción demostraron que escolaridad y nivel socioeconómico alto están asociados negativamente con el transporte activo hacia la escuela. El nivel socioeconómico bajo y la escolaridad baja están asociados positivamente. La escala de apoyo social de los amigos presentó un número mayor de variables significativas, cuando se compara con las demás escalas. Los resultados indican que los factores sociodemográficos (escolaridad de los padres y nivel socioeconómico) moderan la asociación de los factores psicosociales con el transporte activo hacia la escuela.

Neighborhood environmental factors associated with leisure walking in adolescents

ABSTRACT OBJECTIVE To verify the associations of leisure walking with perceived and objective measures of neighborhood environmental factors stratified by gender and socioeconomic status (SES) in Brazilian adolescents. METHODS Cross-sectional study with a random sample of 1,130 high school students (47.3% girls; aged 14 to 20 years old) from Porto Alegre, Brazil. Leisure walking and SES were self-reported by the adolescents. Perceived environmental factors were assessed through Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Objective measures were evaluated using Geographic Information Systems, with road network calculated around the adolescent's residential address, using 0.5km and 1.0km buffers. Data collection was carried out in 2017 and generalized linear regression models were used. RESULTS Leisure walking was positively associated with access to services (0.5 km buffers [Odds ratio (OR) = 2.22] 1.0 km buffers [OR = 2.17]) and lower distance to parks and squares (0.5 km [OR=2.80] 1.0 km [OR = 2.73]) in girls from low SES. Residential density (0.5 km [OR = 1.57] 1.0 km [OR = 1.54]) and walkability index (0.5 km [OR = 1.17] 1.0 km [OR = 1.20]) were associated with leisure walking in girls from middle SES. Boys from low SES showed an inverse association between crime safety and leisure walking (0.5 km [OR = 0.59] 1.0 km [OR = 0.63]). Neighborhood recreation facilities was positively associated with leisure walking in middle SES (0.5 km [OR = 1.55] 1.0 km [OR = 1.60]). Land use mix (0.5 km [OR = 1.81] 1.0 km [OR = 1.81]), neighborhood recreation facilities (0.5 km [OR = 2.32] 1.0 km [OR = 2.28]) and places for walking (0.5 km [OR=2.07] 1.0 km [OR=2.22]) were positively associated with leisure walking in high SES. CONCLUSION Environmental factors (objectively and subjectively measured) and leisure walking show association in boys and girls of different SES.

Dietary inflammatory index and academic performance in children.

OBJECTIVE: The main aim of the present study was to examine the association between the Dietary Inflammatory Index (DII®) and academic performance in children. DESIGN: School-based cross-sectional study. The DII was calculated based on dietary information obtained from a single 24h dietary recall. Academic performance was assessed by school records provided by the administrative services (i.e. Maths and Language). SETTING: Porto area (Portugal). SUBJECTS: A total of 524 children (277 girls) aged 11·56 (sd 0·86) years. RESULTS: The DII was associated with academic indicators (standardized ß values ranging from -0·121 to -0·087; all P<0·05). Significant differences were found between quartiles of the DII (P<0·05); children in the fourth quartile had significantly lower scores in all academic indicators compared with children in the first quartile (score differences ranging from -0·377 to -0·292) after adjustment for potential confounders. CONCLUSIONS: The inflammatory potential of diet may negatively influence academic performance. Children should avoid the consumption of a pro-inflammatory diet and adhere to a more anti-inflammatory diet to achieve academic benefits.

"Crianças, vamos ao parque?" ­ Percepções sobre a utilização de parques públicos por crianças / Children, let's go to the park? ­ Perceptions from children's about public parks use

Parques públicos localizados em áreas urbanas podem contribuir para maiores oportunidades de ati-vidade física das crianças. Conhecer a utilização dessas áreas verdes urbanas pelas crianças, bem como a percepção destas acerca da atividade física nos parques pode facilitar a elaboração de estratégias de promoção da saúde das crianças através da atividade física nos parques. O objetivo deste estudo foi descrever a utilização de parques por criança para a prática da atividade física, bem como suas percepções sobre a atividade física nos parques. Para tal recorreu-se a uma metodologia de caráter quali-quantitativo. Os dados quantitativos sobre a utilização de dois parques foram obtidos através do instrumento SOPARC. Os dados qualitativos sobre a percepção das crianças (10 a 12 anos) foram obtidos através de quatro grupos focais. Para análise dos dados quantitativos recorreu-se ao teste do qui-quadrado e de Mann-Whitney; o tratamento dos dados qualitativos foi realizado por análise temática de conteúdo. Os resultados não evidenciaram diferença na utilização dos parques pelas crianças, contudo indicam uma reduzida utilização destas áreas pelas crianças (Parque 1 = 20,9% versus Parque 2 = 11,0%), especialmente no inverno (Parque 1 = 15,4% versus Parque 2 = 4,5%). O discurso das crianças revelou que estas utilizam o parque para a prática da atividade física recreativa, bem como o prazer em praticarem atividade física nestes locais. A promoção de estratégias que favoreçam uma maior utilização dos parques pelas crianças poderá contribuir para o aumento da atividade física das crianças

Public parks located in urban reas may contribute to greater opportunities for children's physically active be-havior. Knowing the use of these urban green reas by children, as well as the perception of these about physical activity in the park can facilitate the elaboration of strategies to promote children's health through physical activity in parks. The aim of this study is to describe the use of parks by child to practice physical activity, as well as their perceptions about physical activity in parks. The data were collected through a quali-quanti-tative methodology. Quantitative data of two parks were obtained through the SOPARC instrument and qualitative data on the perception of children (10 to 12 years) were obtained through four focus groups. The chi-square test and the Mann-Whitney test were used to analyze the quantitative data; the treatment of qualitative data was performed by thematic reaste analysis. The results didn ́t show a difference in the use of the parks by the children, however they indicate a reduced use of these reas by children (park 1 = 20,9% versus park 2 = 11,0%), especially in winter (park 1 = 15,4% versus park 2 = 4,5%). The children's speech revealed that they use the park to practice recreational physical activity, as well as the pleasure of practicing physical activity in these places. The promotion of strategies that favor the greater use of the parks by children can contribute to na increase in the physical activity of children

Comunidades terapêuticas e a disputa entre modelos de atenção e cuidado a usuários de drogas

O artigo trata do modelo de cuidado adotado pelas comunidades terapêuticas a partir do que se pode depreender da pesquisa realizada pelo Ipea e da literatura disponível sobre o tema. Reflete sobre o debate que se trava em torno dos modelos de cuidado a usuários de drogas implementados no Brasil, apontando algumas questões que demandam a consideração dos gestores das políticas públicas nesta área.

Crianças nos parques: segurança acima de tudo / Children in the parks: safety above all

Resumo Os parques públicos são espaços ao ar livre, que podem contribuir para o aumento da atividade física das crianças. O objetivo deste estudo, partindo da avaliação das características ambientais físicas dos parques, é identificar fatores relatados por crianças usuárias de parques que podem influenciar a sua frequência de utilização dos parques. Estudo descritivo e exploratório de abordagem qualitativa com a aplicação do instrumento EAPRS para avaliação da oferta estrutural dos parques e realização de grupos focais com crianças usuárias dos parques. Os resultados deste estudo indicam que a segurança percebida pelas crianças e a manutenção geral dos parques podem contribuir para a maior frequência desse público nos parques. Estratégias transdisciplinares visando a melhorias na segurança e na manutenção geral dos parques públicos são necessárias para promover a maior frequência infantil nesses locais.

Abstract Parks are outdoor environment that can contribute to increase the children´s physical activity. This study aimed to identify factors that may influence children parks use frequency of use of parks by evaluating the environmental characteristics of park and identifying factors reported by children. Descriptive and exploratory study with qualitative approach using the EAPRS tool and focal groups with children. Our results suggest that children's perceptions about park safety and maintenance can influence their park use. Transdisciplinary strategies aimed at improving safety and park maintenance are necessary to promote greater children ´s park use.