Physical Activity Policies at National and Subnational Levels: A Study in Colombia, Costa Rica, Ecuador, and Mexico.

BACKGROUND: National physical activity (PA) policy processes are only beginning to be studied in Latin America, and little attention has focused at the subnational level. This study examined national-subnational relations in the policy process (agenda setting, policy formulation, adoption, implementation, and evaluation) in selected Latin American countries. METHODS: The Global Observatory for Physical Activity's (GoPA!) INTEGRATE-PA-Pol tool was applied in Colombia, Costa Rica, Ecuador, and Mexico. Data were collected in matched pairs of the capital plus one noncapital city among national and subnational policymakers (n = 27), previously identified by the GoPA! Country Contacts. PA policy development and implementation were assessed using descriptive statistics. RESULTS: Twenty-three (response rate = 85.2%) informants provided data, mainly from the health sector (52.2%), followed by the sport (26.1%), transport (13.0%), and education (8.7%) sectors. Most informants reported that their countries had a current PA policy embedded within noncommunicable diseases prevention plans (46.2%), other plans (46.2%), or obesity prevention/management/control plans (7.7%). Respondents at the subnational level rated PA promotion as central (64.3%), while the national-level role was important but not central (75.0%). National and subnational policymakers indicated low-to-little involvement in the other level's PA policy processes across the 5 policy stages. CONCLUSIONS: This study demonstrated that collecting national and subnational PA policy data across countries with the active collaboration of the GoPA! network was feasible. We also successfully identified governmental interactions throughout the PA policy process, suggesting suboptimal engagement between national and subnational levels.

The role of gender inequality and health expenditure on the coverage of demand for family planning satisfied by modern contraceptives: a multilevel analysis of cross-sectional studies in 14 LAC countries.

Background: Despite international efforts to improve reproductive health indicators, little attention is paid to the contributions of contextual factors to modern contraceptive coverage, especially in the Latin America and the Caribbean (LAC) region. This study aimed to identify the association between country-level Gender Inequality and Health Expenditure with demand for family planning satisfied by modern contraceptive methods (DFPSm) in Latin American sexually active women. Methods: Our analyses included data from the most recent (post-2010) Demographic and Health Survey or Multiple Indicator Cluster Survey from 14 LAC countries. Descriptive analyses and multilevel logistic regressions were performed. Six individual-level factors were included. The effect of the country-level factors Gender Inequality Index (GII) and Current Health Expenditure on DFPSm was investigated. Findings: DFPSm ranged from 41.8% (95% CI: 40.2-43.5) in Haiti to 85.6% (95% CI: 84.9-86.3) in Colombia, with an overall median coverage of 77.8%. A direct association between the odds of DFPSm and woman's education, wealth index, and the number of children was identified. Women from countries in the highest GII tertile were less likely (OR: 0.32, 95% CI: 0.13-0.76) to have DFPSm than those living in countries in the lowest tertile. Interpretation: Understanding the contribution of country-level factors to modern contraception may allow macro-level actions focused on the population's reproductive needs. In this sense, country-level gender inequalities play an important role, as well as individual factors such as wealth and education. Funding: Bill and Melinda Gates Foundation and Associação Brasileira de Saúde Coletiva (ABRASCO).

High prevalence of risk factors for non-communicable diseases in university students of a nursing course / Elevada prevalência de fatores de risco para doenças crônicas não transmissíveis em universitários de enfermagem

Abstract Background The inadequate lifestyle of university students can contribute to the occurrence of chronic noncommunicable diseases (NCD). Objective To evaluate the prevalence of NCD risk and prevention factors and verify gender differences for healthy habits among nursing students. Method A cross-sectional study with 974 nursing students. A self-administered questionnaire on health-related life habits was used in the study. Results Of the 974 students, 78.7% were women, 62.6% were between 20-29 years of age, 65.1% consumed alcohol, 57.4% did not do physical activity, and 34.7% were overweight. The women (41.9%) drank more full-fat milk, while the men drank more soft drinks and routinely consumed more meat with fat. The students who did not engage in physical activity smoked more (p<0.01), consumed less fruit (p<0.01), less salad (p<0.01), and less vegetables (p<0.01), and consumed more soft drinks (p=0.03), and meat with fat (p=0.04). In the physically inactive students, a high prevalence of diabetes mellitus (p=0.03) and high cholesterol (p<0.01) was observed. Conclusion The results show a clear profile of NCD risk factors among university students, highlighting the need to implement educational programs to reduce these factors.

Resumo Introdução O estilo de vida inadequado dos universitários pode contribuir para o aparecimento de doenças crônicas não transmissíveis (DCNT). Objetivo Avaliar a prevalência de fatores de risco e proteção para DCNT e verificar as diferenças de gêneros em hábitos saudáveis de estudantes de enfermagem. Método Estudo transversal com 974 estudantes. Foi utilizado um questionário sobre os hábitos de vida relacionados à saúde. Resultados Dos 974 alunos, 78,7% eram mulheres, 62,6% com idade entre 20-29 anos, 65,1% consumiam álcool, 57,4% não realizavam atividade física (AF), e 34,7% tinham sobrepeso. As mulheres (41,9%) apresentavam maior prevalência no consumo de leite com gordura, e os homens consumiam mais refrigerante e tinham o hábito de comer mais carne com gordura. Os universitários que não realizavam AF fumavam mais (p<0,01), apresentavam consumo baixo de frutas (p<0,01), saladas (p<0,01) e verduras (p<0,01), e consumiam mais refrigerante (p=0,03) e carne com gordura (p=0,04). Observamos que os estudantes fisicamente inativos tinham elevada prevalência para desenvolverem diabetes mellitus (p=0,03) e colesterol elevado (p<0,01). Conclusão Os resultados mostram um perfil elevado de fatores de risco para DCNT entre os universitários, mostrando assim a necessidade de implementar programas educacionais, a fim de reduzir esses fatores.

Effectiveness and adherence to closed face shields in the prevention of COVID-19 transmission: a non-inferiority randomized controlled trial in a middle-income setting (COVPROSHIELD).

BACKGROUND: The use of respiratory devices can mitigate the spread of diseases such as COVID-19 in community settings. We aimed to determine the effectiveness of closed face shields with surgical face masks to prevent SARS-CoV-2 transmission in working adults during the COVID-19 pandemic in Bogotá, Colombia. METHODS: An open-label non-inferiority randomized controlled trial that randomly assigned participants to one of two groups: the intervention group was instructed to wear closed face shields with surgical face masks, and the active control group was instructed to wear only surgical face masks. The primary outcome was a positive reverse transcription polymerase chain reaction test, IgG/IgM antibody test for SARS-CoV-2 detection, or both during and at the end of the follow-up period of 21 days. The non-inferiority limit was established at - 5%. RESULTS: A total of 316 participants were randomized, 160 participants were assigned to the intervention group and 156 to the active control group. In total, 141 (88.1%) participants in the intervention group and 142 (91.0%) in the active control group completed the follow-up. PRIMARY OUTCOME: a positive SARS-CoV-2 test result was identified in one (0.71%) participant in the intervention group and three (2.1%) in the active control group. In the intention-to-treat analysis, the absolute risk difference was - 1.40% (95% CI [- 4.14%, 1.33%]), and in the per-protocol analysis, the risk difference was - 1.40% (95% CI [- 4.20, 1.40]), indicating non-inferiority of the closed face shield plus face mask (did not cross the non-inferiority limit). CONCLUSIONS: The use of closed face shields and surgical face masks was non-inferior to the surgical face mask alone in the prevention of SARS-CoV-2 infection in highly exposed groups. Settings with highly active viral transmission and conditions such as poor ventilation, crowding, and high mobility due to occupation may benefit from the combined use of masks and closed face shields to mitigate SARS-CoV-2 transmission. TRIAL REGISTRATION: ClinicalTrials.gov NCT04647305 . Registered on November 30, 2020.

Association between social capital indicators and depressive symptoms among Brazilian university students.

The study aimed to investigate the association between social capital indicators and depressive symptoms among university students from Brazil. The study drew on a sample of 579 randomly selected university students, from a greater crossnational study conducted in 2018. Students completed a self-administered questionnaire assessing depressive symptoms, indicators of social capital and lifestyle behaviors. Data were analyzed using multivariate logistic regression models. Indicators of social capital included trust, group membership and frequency of meeting friends. Four social capital indicators were significantly associated with clinically relevant depressive symptoms. Students who agreed that people are likely to take advantage of one another were more likely to report depressive clinically relevant symptoms (OR: 1.80, 95%CI: 1.00 - 3.23) as well as students who agreed that people are not willing to help in case needed (OR: 2.11, 95%CI: 1.02 - 4.36). Perceived stress, smoking and hazardous alcohol consumption were not associated with clinically relevant depressive symptoms. Social capital plays an important role in explaining depressive symptoms among Brazilian university students. The study suggests that creating trust and enhancing participation in social networks can be an important strategy for promoting mental health among university students investigated in this study.

Association between social capital indicators and depressive symptoms among Brazilian university students / Associação entre indicadores de capital social e sintomas depressivos entre estudantes universitários brasileiros

Abstract The study aimed to investigate the association between social capital indicators and depressive symptoms among university students from Brazil. The study drew on a sample of 579 randomly selected university students, from a greater crossnational study conducted in 2018. Students completed a self-administered questionnaire assessing depressive symptoms, indicators of social capital and lifestyle behaviors. Data were analyzed using multivariate logistic regression models. Indicators of social capital included trust, group membership and frequency of meeting friends. Four social capital indicators were significantly associated with clinically relevant depressive symptoms. Students who agreed that people are likely to take advantage of one another were more likely to report depressive clinically relevant symptoms (OR: 1.80, 95%CI: 1.00 - 3.23) as well as students who agreed that people are not willing to help in case needed (OR: 2.11, 95%CI: 1.02 - 4.36). Perceived stress, smoking and hazardous alcohol consumption were not associated with clinically relevant depressive symptoms. Social capital plays an important role in explaining depressive symptoms among Brazilian university students. The study suggests that creating trust and enhancing participation in social networks can be an important strategy for promoting mental health among university students investigated in this study.

Resumo O estudo investigou a associação entre indicadores de capital social e sintomas depressivos entre estudantes universitários do Brasil. Um estudo transversal foi conduzido com uma amostra de 579 estudantes universitários selecionados randomicamente em 2018. Os estudantes completaram questionários auto-administrados para avaliar sintomas depressivos, indicadores de capital social e comportamentos de estilos de vida. Os dados foram analisados usando modelos de regressão logística multivariada. Indicadores de capital social incluíam confiança, associações em grupos, frequência de encontrar com os amigos, entre outros. Quatro indicadores de capital social se associaram significativamente com relevantes sintomas clínicos de depressão. Estudantes que disseram que as pessoas tendem a tirar mais vantagens umas das outras eram mais propensas a relatar sintomas clínicos relevantes de depressão (OR: 1.80, 95%CI: 1.00 - 3.23), assim como estudantes que relataram que as pessoas não estão dispostas a ajudar caso precise de ajuda (OR: 2.11, 95%CI: 1.02 - 4.36). A autopercepção de estresse, o consumo de álcool e o fumo não se associaram aos sintomas clínicos de depressão. O capital social desempenha um papel importante na explicação dos sintomas depressivos entre os universitários brasileiros. O estudo sugere que promover confiança e aumentar a participação nas redes sociais pode ser uma estratégia importante para a promoção da saúde mental entre os universitários investigados neste estudo.

Patient-important outcomes reported in randomized controlled trials of pharmacologic treatments for COVID-19: a protocol of a META-epidemiological study.

BACKGROUND: The coronavirus disease 19 (covid-19) pandemic has underscored the need to expedite clinical research, which may lead investigators to shift away from measuring patient-important outcomes (PIO), limiting research applicability. We aim to investigate if randomized controlled trials (RCTs) of covid-19 pharmacological therapies include PIOs. METHODS: We will perform a meta-epidemiological study of RCTs that included people at risk for, or with suspected, probable, or confirmed covid-19, examining any pharmacological treatment or blood product aimed at prophylaxis or treatment. We will obtain data from all RCTs identified in a living network metanalysis (NMA). The main data sources are the living WHO covid-19 database up to 1 March 2021 and six additional Chinese databases up to 20 February 2021. Two reviewers independently will review each citation, full-text article, and abstract data. To categorize the outcomes according to their importance to patients, we will adapt a previously defined hierarchy: a) mortality, b) quality of life/ functional status/symptoms, c) morbidity, and d) surrogate outcomes. Outcomes within the category a) and b) will be considered critically important to patients, and outcomes within the category c) will be regarded as important. We will use descriptive statistics to assess the proportion of studies that report each category of outcomes. We will perform univariable and multivariable analysis to explore associations between trial characteristics and the likelihood of reporting PIOs. DISCUSSION: The findings from this meta-epidemiological study will help health care professionals and researchers understand if the current covid-19 trials are effectively assessing and reporting the outcomes that are important to patients. If a deficiency in capturing PIOs is identified, this information may help inform the development of future RCTs in covid-19. SYSTEMATIC REVIEW REGISTRATIONS: Open Science Framework registration: osf.io/6xgjz .

Quality of antenatal care and its sociodemographic determinants: results of the 2015 Pelotas birth cohort, Brazil.

BACKGROUND: Inadequate antenatal care (ANC) has been associated with adverse pregnancy outcomes. ANC quality is considered a key component of the right to health and a route to equity and dignity for women and their children. Although ANC coverage is relatively high in Brazil, there are revealed some health disparities when coverage is examined by socio-demographic determinants. In this study we evaluated ANC quality and its socio-demographic determinants using data from the 2015 Pelotas birth cohort, Rio Grande do Sul, Brazil. METHODS: This study is part of the 2015 Pelotas population-based birth cohort (n = 3923 pregnant women) conducted in southern Brazil. ANC quality was assessed through 19 content and service utilization indicators recommended by the Brazilian Ministry of Health. Descriptive analyses and associations of each of the ANC indicators and independent variables were performed using the chi-square and linear trend test. ANC indicators were analyzed individually and aggregated as a score. Associations between ANC score quality and socio-demographic variables were assessed with ordinal regressions. Mediation analysis with G-computation was performed to estimate direct and indirect effect of mother's level of education on ANC quality mediated by the number of consultations and timing of ANC initiation. Base and post confounders were included. RESULTS: The results showed that except for breast examination, height measurement, tetanus toxoid vaccination and ANC starting at the first trimester, all ANC indicators showed more than 80% coverage during ANC visits. In the adjusted analysis, inadequate quality ANC was associated with lower maternal education level, not having a partner, being multiparous, being attended by a private provider and by the same professional in all consultations. In the mediation analyses, 6.8% of the association between ANC quality and mother's education was mediated by the trimester in which ANC started, while 12.8% was mediated by the number of ANC visits. CONCLUSIONS: ANC quality is associated with pregnant women's socio-demographic characteristics. Significant efforts are needed to improve the quality of facility-based maternity care.

COVID-19 spread, detection, and dynamics in Bogota, Colombia.

Latin America has been severely affected by the COVID-19 pandemic but estimations of rates of infections are very limited and lack the level of detail required to guide policy decisions. We implemented a COVID-19 sentinel surveillance study with 59,770 RT-PCR tests on mostly asymptomatic individuals and combine this data with administrative records on all detected cases to capture the spread and dynamics of the COVID-19 pandemic in Bogota from June 2020 to early March 2021. We describe various features of the pandemic that appear to be specific to a middle income countries. We find that, by March 2021, slightly more than half of the population in Bogota has been infected, despite only a small fraction of this population being detected. The initial buildup of immunity contributed to the containment of the pandemic in the first and second waves. We also show that the share of the population infected by March 2021 varies widely by occupation, socio-economic stratum, and location. This, in turn, has affected the dynamics of the spread with different groups being infected in the two waves.

Factors Associated With SARS-CoV-2 Infection in Bogotá, Colombia: Results From a Large Epidemiological Surveillance Study.

BACKGROUND: Epidemiologic surveillance of COVID-19 is essential to collect and analyse data to improve public health decision making during the pandemic. There are few initiatives led by public-private alliances in Colombia and Latin America. The CoVIDA project contributed with RT-PCR tests for SARS-CoV-2 in mild or asymptomatic populations in Bogotá. The present study aimed to determine the factors associated with SARS-CoV-2 infection in working adults. METHODS: COVID-19 intensified sentinel epidemiological surveillance study, from April 18, 2020, to March 29, 2021. The study included people aged 18 years or older without a history of COVID-19. Two main occupational groups were included: healthcare and essential services workers with high mobility in the city. Social, demographic, and health-related factors were collected via phone survey. Afterwards, the molecular test was conducted to detect SARS-CoV-2 infection. FINDINGS: From the 58,638 participants included in the study, 3,310 (5·6%) had a positive result. A positive result was associated with the age group (18-29 years) compared with participants aged 60 or older, participants living with more than three cohabitants, living with a confirmed case, having no affiliation to the health system compared to those with social health security, reporting a very low socioeconomic status compared to those with higher socioeconomic status, and having essential occupations compared to healthcare workers. INTERPRETATION: The CoVIDA study showed the importance of intensified epidemiological surveillance to identify groups with increased risk of infection. These groups should be prioritised in the screening, contact tracing, and vaccination strategies to mitigate the pandemic. FUNDING: The CoVIDA study was funded through donors managed by the philanthropy department of Universidad de los Andes.

Lifestyle and risk behaviors for chronic noncommunicable diseases among healthcare undergraduates in Midwest, Brazil.

This study aimed to assess the lifestyle of undergraduate university students, and to investigate the prevalence of risk behaviors for chronic noncommunicable diseases. This cross-sectional study took place in Brasilia, with 2.163 healthcare undergraduates. We used a self-administered questionnaire for demographic variables, social class, behavioral data, self-perception of health and self-reported diseases. Given a total of 2.163 students, 69.3% were female, 65.4% were 20-29 years, men smoked more cigarettes (p < 0.01) and used more alcohol than women. We found significant differences in the consumption of beans (p < 0.04) and full-fat milk (p < 0.01) between females and males. Women also had more sedentary lifestyles (p < 0.01) and showed higher prevalences of overweight (33.8%) and obesity (5.0%). Students who did not engage in physical activity were more morbidities, overweight (p = 0.03), consumed more soft drinks (p < 0.01) and meat with excess fat (p = 0.01). University students were found to have unhealthy lifestyles. There is an urgent need for both a formulation and implementation of public health policies to promote health and improve student quality of life (QoL).

Lifestyle and risk behaviors for chronic noncommunicable diseases among healthcare undergraduates in Midwest, Brazil / Estilo de vida e comportamentos de risco para doenças crônicas não transmissíveis entre universitários da saúde na região Centro-Oeste, Brasil

Abstract This study aimed to assess the lifestyle of undergraduate university students, and to investigate the prevalence of risk behaviors for chronic noncommunicable diseases. This cross-sectional study took place in Brasilia, with 2.163 healthcare undergraduates. We used a self-administered questionnaire for demographic variables, social class, behavioral data, self-perception of health and self-reported diseases. Given a total of 2.163 students, 69.3% were female, 65.4% were 20-29 years, men smoked more cigarettes (p < 0.01) and used more alcohol than women. We found significant differences in the consumption of beans (p < 0.04) and full-fat milk (p < 0.01) between females and males. Women also had more sedentary lifestyles (p < 0.01) and showed higher prevalences of overweight (33.8%) and obesity (5.0%). Students who did not engage in physical activity were more morbidities, overweight (p = 0.03), consumed more soft drinks (p < 0.01) and meat with excess fat (p = 0.01). University students were found to have unhealthy lifestyles. There is an urgent need for both a formulation and implementation of public health policies to promote health and improve student quality of life (QoL).

Resumo Este estudo teve como objetivo avaliar o estilo de vida dos universitários e investigar a prevalência de comportamentos de risco para doenças crônicas não transmissíveis. Estudo transversal com 2.163 universitários da área de saúde da cidade de Brasília. Foi aplicado um questionário sobre as variáveis demográficas, classe social, comportamentos e autopercepção de saúde e doenças autorreferidas. Dos 2.163, 69,3% eram mulheres, 65,4% idade entre 20 a 29 anos, 66,8% consumiam álcool e 44,2% não realizavam atividade física. Os homens fumavam (p <0,01) e consumiam mais álcool do que as mulheres. Encontramos diferenças no consumo de feijão (p <0,04) e leite integral (p <0,01) entre homens e mulheres. Elas também apresentaram estilos de vida mais sedentários (p <0,01) e elevada prevalência de sobrepeso (33,8%) e obesidade (5,0%). Os estudantes que não praticavam atividade física tinham mais morbidades, estavam acima do peso (p = 0,03), consumiam mais refrigerantes (p <0,01) e carne com excesso de gordura (p = 0,01). Os estudantes têm adotado um estilo de vida pouco saudável. Observa-se a necessidade da elaboração e implantação de políticas públicas de promoção da saúde dentro da Universidade, com vistas à melhoria da saúde e da qualidade de vida dos universitários.

Perfil alimentar e inatividade física em mulheres universitárias na cidade de Brasília / Perfil alimentario y la inactividad física en mujeres universitarias de la ciudad de Brasilia / Food profile and physical inactivity in university women in the city of Brasília

Resumo Objetivo Analisar a associação entre perfil alimentar, atividade física e estado nutricional entre mulheres universitárias. Método Estudo transversal com 1500 mulheres. O questionário abordava questões sobre a vigilância de fatores de risco e proteção para doenças crônicas. As associações foram analisadas pelo teste qui-quadrado e análise de correspondência múltipla. Resultados Das 1500 mulheres, 64,3% tinham entre 20 e 29 anos. Aquelas fisicamente ativas consumiram mais frutas (p<0,01), salada (p<0,01) e vegetais/verduras (p<0,01), enquanto as fisicamente inativas consumiram mais refrigerantes (p<0,01), carne com gordura visível (p=0,03) e leite com gordura (p=0,04). As mulheres fisicamente inativas também apresentaram maior prevalência de diabetes mellitus (p<0,01), colesterol elevado (p<0,01) e dislipidemia (p=0,04). Conclusão e implicação para a prática As universitárias apresentaram comportamentos de risco a sua saúde, onde o consumo de álcool, baixo consumo de alimentos saudáveis ​​e a alta prevalência de inatividade física contribuíram para o aumento dos fatores de risco para doenças crônicas. Ações preventivas com a participação de uma equipe multidisciplinar ajudará na melhora da saúde no ambiente acadêmico.

Resumen Objetivo Analisar la asociación entre el perfil alimentario, la actividad física y el estado nutricional en mujeres universitarias. Método Estudio transversal con 1500 mujeres. El cuestionario abordó preguntas sobre la vigilancia de factores de riesgo y protección para las enfermedades crónicas. Las asociaciones se analizaron mediante la prueba de chi-cuadrado y análisis de correspondencia múltiple. Resultados De las 1500 mujeres, el 64,3% tenía entre 20 y 29 años. Las físicamente activas consumieron más frutas (p<0,01), ensalada (p<0,01) y verduras (p<0,01), mientras que las físicamente inactivas consumieron más refrescos (p<0,01), carne con grasa visible (p=0,03) y leche con grasa (p=0,04). Las mujeres físicamente inactivas también tenían una mayor prevalencia de diabetes mellitus (p<0,01), colesterol alto (p<0,01) y dislipidemia (p=0,04). Conclusión e implicación para la práctica Las estudiantes universitarias mostraron conductas de riesgo para su salud, donde el consumo de alcohol, el bajo consumo de alimentos saludables y la alta prevalencia de inactividad física contribuyeron al aumento de los factores de riesgo para las enfermedades crónicas. Las acciones preventivas con la participación de un equipo multidisciplinario ayudarán a mejorar la salud en el entorno académico.

Abstract Objective To analyze the association between the food profile, physical activity and weight status among university women. Method This cross-sectional study, included 1.500 Brazilian women. We used a self-administered questionnaire. All questions were obtained from the surveillance of risk and protection factors for chronic diseases survey through telephone interviews. The association was analyzed using chi-square tests and multiple correspondence analysis. Results The sample included 1.500 college women, 64.3% aged 20-29 years. Physically active participants consumed more fruit (p<0.01), salad (p<0.01) and vegetables/greens (p<0.01), whereas physically inactive participants consumed more soft drinks (p<0.01), meat with visible fat (p=0.03) and full fat milk (p=0.04). Physically inactive women also had a higher prevalence of diabetes mellitus (p<0.01), high cholesterol (p<0.01) and dyslipidemia (p=0.04). Conclusion and implication for practice The students showed behaviors that put their health at risk, where alcohol consumption, low consumption of healthy foods and high prevalence of physical inactivity contributed to an increase in risk factors for chronic diseases. Preventive actions with the participation of a multidisciplinary team will help to improve health in the academic environment.

Eating habits, physical activity and sedentary behavior among Brazilian schoolchildren: National Student Health Survey, 2015. / Hábitos alimentares, atividade física e comportamento sedentário entre escolares brasileiros: Pesquisa Nacional de Saúde do Escolar, 2015.

INTRODUCTION: Urbanization and industrialization have contributed to changes in eating patterns, as well as the emergence of sedentary behaviors and reduced physical activity. OBJECTIVES: To identify and describe the prevalence of eating habits, physical activity and sedentary behavior in Brazilian schoolchildren, and to analyze their association with sociodemographic characteristics. METHODS: Data from the National Student Health Survey (PeNSE) of 2015 were used. Prevalence rates, prevalence ratios, and 95% confidence intervals (95%CI) were calculated. The analyses were adjusted for age and maternal schooling. RESULTS: The majority of adolescents: consumed beans (65.1%) and snacks (52.3%); had more than three days of physical education at school (50.7%); practiced physical activity out of school for more than three days (55.4%); had a sedentary behavior (73.3%); and, had physical activity during 60min/day for less than four days a week (72.7%). In general, girls were more exposed to unhealthy eating habits and sedentary behavior, and a higher socioeconomic level was associated with higher prevalence of the indicators studied. High consumption of unhealthy foods, increased sedentary behavior and reduction in the practice of physical activity. CONCLUSION: An association of unhealthy attitudes with sociodemographic characteristics was observed among schoolchildren. Strategies that focus on reducing these behaviors will contribute to health promotion actions in the school and family environments.

Hábitos alimentares, atividade física e comportamento sedentário entre escolares brasileiros: Pesquisa Nacional de Saúde do Escolar, 2015 / Eating habits, physical activity and sedentary behavior among Brazilian schoolchildren: National Student Health Survey, 2015

RESUMO: Introdução: A urbanização e a industrialização colaboraram para a alteração nos padrões de alimentação, bem como para o surgimento de comportamentos sedentários e a redução da atividade física. Objetivos: Identificar e descrever a prevalência de hábitos alimentares, prática de atividade física e comportamento sedentário em escolares brasileiros e analisar sua associação com as características sociodemográficas. Métodos: Foram utilizados dados da Pesquisa Nacional de Saúde do Escolar de 2015. Foram calculadas prevalências, razões de prevalências e intervalos de 95% de confiança (IC95%). As análises foram ajustadas para idade escolaridade materna. Resultados: A maioria consumia feijão (65,1%) e guloseimas (52,3%), teve mais de três dias de aula de Educação Física escolar (50,7%), realizava atividade física fora da escola por mais de três dias (55,4%), tinha comportamento sedentário (73,3%) e realizava atividade física durante 60 min/dia por menos de quatro dias na semana (72,7%). Em geral, as meninas estavam mais expostas a práticas alimentares não desejáveis e ao comportamento sedentário, e o melhor nível socioeconômico associou-se a maiores prevalências dos indicadores estudados. Elevado consumo de alimentos não saudáveis, aumento do comportamento sedentário e redução na prática de atividade física. Conclusão: Observou-se associação de atitudes não saudáveis com características sociodemográficas entre os escolares. Estratégias que foquem na redução desses comportamentos irão contribuir para ações de promoção da saúde nos ambientes escolar e familiar.

ABSTRACT: Introduction: Urbanization and industrialization have contributed to changes in eating patterns, as well as the emergence of sedentary behaviors and reduced physical activity. Objectives: To identify and describe the prevalence of eating habits, physical activity and sedentary behavior in Brazilian schoolchildren, and to analyze their association with sociodemographic characteristics. Methods: Data from the National Student Health Survey (PeNSE) of 2015 were used. Prevalence rates, prevalence ratios, and 95% confidence intervals (95%CI) were calculated. The analyses were adjusted for age and maternal schooling. Results: The majority of adolescents: consumed beans (65.1%) and snacks (52.3%); had more than three days of physical education at school (50.7%); practiced physical activity out of school for more than three days (55.4%); had a sedentary behavior (73.3%); and, had physical activity during 60min/day for less than four days a week (72.7%). In general, girls were more exposed to unhealthy eating habits and sedentary behavior, and a higher socioeconomic level was associated with higher prevalence of the indicators studied. High consumption of unhealthy foods, increased sedentary behavior and reduction in the practice of physical activity. Conclusion: An association of unhealthy attitudes with sociodemographic characteristics was observed among schoolchildren. Strategies that focus on reducing these behaviors will contribute to health promotion actions in the school and family environments.

Fetal, neonatal, and post-neonatal mortality in the 2015 Pelotas (Brazil) birth cohort and associated factors.

This study aimed to describe fetal, neonatal, and post-neonatal mortality and associated factors in participants of the 2015 Pelotas (Brazil) birth cohort. The child mortality sub-study followed up all deaths in the first year of life. Data were collected on intrauterine fetal deaths (weight ≥ 500g and/or gestational age ≥ 20 weeks), neonatal deaths (< 28 days of life), and post-neonatal deaths (from 28 days to the end of the first year of life). Descriptive analyses using the Pearson chi-square test and a multinomial logistic regression to estimate the risk of fetal, neonatal, and post-neonatal deaths compared to live infants in the cohort (reference group) were performed. Data from 4,329 eligible births were collected, of which 54 died during the fetal period. Of the 4,275 eligible live births, 59 died in the first year of life. An association between fetal, neonatal, and post-neonatal deaths (OR = 15.60, 7.63, and 5.51 respectively) was found, as well as less than six prenatal consultations. Compared to live infants, fetal deaths were more likely to occur in non-white mothers, and neonatal deaths were 14.09 times more likely to occur in a preterm gestational age (< 37 weeks). Compared to live infants, infants that were born in a C-section delivery had 3.71 increased odds of post-neonatal death. Additionally, neonatal deaths were 102.37 times more likely to have a low Apgar score on the fifth minute after birth. These findings show the need for early interventions during pregnancy, ensuring access to adequate prenatal care.

Weight status, physical activity and eating habits of young adults in Midwest Brazil.

OBJECTIVE: To assess weight status and eating habits of undergraduate university students in relation to gender and examine the relationships between weight status, physical activity and eating habits. DESIGN: Cross-sectional study conducted between October 2016 and May 2017. SETTING: Young adults in Midwest Brazil. PARTICIPANTS: Undergraduate university students (n 2163) majoring in health care. RESULTS: Among 2163 students, 69·3 % were female, 65·4 % were aged 20-29 years, 66·8% consumed alcohol and 44·2% did not achieve more than 150 min of physical activity per week. We found significant differences in the consumption of beans (P < 0·04) and full-fat milk (P < 0·01) between women and men. Women also had more sedentary lifestyles (P < 0·01) and showed higher prevalence of overweight (33·8 %) and obesity (5·0 %) than men. Students who did not engage in physical activity were more overweight (P = 0·03), consumed more soft drinks (P < 0·01) and meat with excess fat (P = 0·01). There was a positive association between weight status and fruit (P = 0·02), salad (P < 0·01), greens/vegetables (P < 0·01) and beans (P < 0·01) intake. CONCLUSIONS: The low level of physical activity and unhealthy eating patterns reported by the study participants were inconsistent with the national recommendations for a healthy active lifestyle for adults and may contribute to the increasing rate of overweight and obesity in this population. A joint effort between universities and all relevant government agencies is needed to develop and promote school- and community-based interventions.