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.

Pattern of Sedentary Behavior in Different Periods of School Time of Brazilian Adolescents.

BACKGROUND: Sedentary behavior (SB) is related to unhealthy outcomes and is performed in many contexts, including school. The aim of this study was to identify sociodemographic, biological, and psychosocial correlates of SB performed at school in a sample of adolescents. METHODS: Adolescents provided information regarding sex, age, socioeconomic status, and psychosocial variables related to physical activity (self-efficacy, attitudes, perception of school environment, peer and parental support). Body fat was estimated using skinfolds, and maximum aerobic capacity with a 20 m shuttle run. Adolescents wore accelerometers and SB performed during class time, physical education (PE) classes, and recesses was estimated. RESULTS: Adolescents (N = 567, 53% female, 12.9 ± 5.3 years old) spent 67% of class time, 41% of PE classes, and 41% of recesses in SB. Girls spent more time in SB, and age was negatively associated with SB. Body fat was positively associated with SB in class time and PE classes. Peer support for physical activity was negatively associated with SB in class time, whereas attitudes related to physical activity were negatively associated with SB during PE classes and recesses. CONCLUSION: Adolescents spend long periods in SB at school, even during opportunities to be active like PE classes and recesses.

School Food Environment, Food Consumption, and Indicators of Adiposity Among Students 7-14 Years in Bogotá, Colombia.

BACKGROUND: In Colombia, the prevalence of overweight/obesity in children has increased by 26% in the past 5 years. School food environment may be an important contributor and offers opportunities for effective intervention. METHODS: We conducted a cross-sectional study among 7- to 14-year-old schoolchildren from 10 schools in Bogotá, Colombia. We examined the school food environment and the relationship of individual-level consumption, and physical activity with overweight/obesity, measured by body mass index and percentage body fat. RESULTS: Schools with a restaurant/store were characterized as having excessive unhealthy foods. In the sample of 714 schoolchildren, 17.5% were overweight and 10.5% were obese. In multivariate models, boys had significantly increased odds of being overweight/obese (odds ratio [OR]: 1.53; p = .01) as compared to girls. Schoolchildren who consumed a greater number of energy drinks (OR = 1.82; p = .04), and those who spent more than 3 hours per schoolday watching TV (OR = 1.53; p < .01) had increased odds of being overweight/obese. CONCLUSIONS: Approximately 1 in 4 schoolchildren were overweight/obese, with boys, energy drink consumers, and those with low physical activity having increased risk. School-based interventions focused on improving food options and providing health behavior education may be effective to reduce overweight among children in Bogotá and similar settings.

Drug policy: what impact does it have on children and youth? / Políticas sobre drogas: qual o impacto para crianças e adolescentes?

This article reviews the national and international literature on drug policy, focusing on harm reduction strategies and their impact on the development of children and youth in Brazil. Without using statistical criteria, this paper develops an overview of the current context and discusses the trends in the literature through an exploratory analysis of production and a non-exhaustive bibliography. The results showed that state investment in public policies for the treatment and prevention of drug abuse is recent. In addition, harm reduction is still a little known and controversial strategy, especially among children and adolescents.(AU)

O artigo traz uma revisão da literatura nacional e internacional referente às políticas sobre drogas, notadamente a propósito da estratégia de redução de danos, com o objetivo de situar, nesse contexto, as ações voltadas para o público infanto-juvenil em desenvolvimento no Brasil. Através de análise exploratória e não exaustiva da produção bibliográfica sobre o tema, e sem o emprego de critérios estatísticos, apresentamos um panorama da situação atual da discussão e principais tendências. Como resultados, identificamos que é muito recente o investimento do Estado em políticas públicas visando ao tratamento e prevenção do uso abusivo de drogas, especialmente quando se trata de crianças e adolescentes, e que a estratégia de redução de danos é ainda pouco conhecida e cercada por muita polêmica.(AU)

Drug policy: what impact does it have on children and youth? / Políticas sobre drogas: qual o impacto para crianças e adolescentes?

This article reviews the national and international literature on drug policy, focusing on harm reduction strategies and their impact on the development of children and youth in Brazil. Without using statistical criteria, this paper develops an overview of the current context and discusses the trends in the literature through an exploratory analysis of production and a non-exhaustive bibliography. The results showed that state investment in public policies for the treatment and prevention of drug abuse is recent. In addition, harm reduction is still a little known and controversial strategy, especially among children and adolescents...

O artigo traz uma revisão da literatura nacional e internacional referente às políticas sobre drogas, notadamente a propósito da estratégia de redução de danos, com o objetivo de situar, nesse contexto, as ações voltadas para o público infanto-juvenil em desenvolvimento no Brasil. Através de análise exploratória e não exaustiva da produção bibliográfica sobre o tema, e sem o emprego de critérios estatísticos, apresentamos um panorama da situação atual da discussão e principais tendências. Como resultados, identificamos que é muito recente o investimento do Estado em políticas públicas visando ao tratamento e prevenção do uso abusivo de drogas, especialmente quando se trata de crianças e adolescentes, e que a estratégia de redução de danos é ainda pouco conhecida e cercada por muita polêmica...

O papel do pediatra no PSF-Paidéia de Campinas (SP) / The pediatrician's role in the Paidéia-Family Health Program in Campinas, São Paulo State, Brazil

O Brasil vem implantando o Programa de Saúde da Família, em sua atenção básica à saúde. A composição das equipes do programa tem sido questionada como insuficiente, sendo uma das críticas a ausência do pediatra. Este trabalho analisou parte da experiência do município de Campinas (SP), que implantou o programa com adaptações, entre as quais a existência de pediatra em suas 140 equipes. Utilizando metodologia qualitativa e entrevistas semi-estruturadas, foram entrevistados pediatras e médicos de família de dez equipes, indicadas pelos gestores como as de melhores resultados. O objetivo foi conhecer a visão dos mesmos sobre a atenção à saúde da criança por eles praticada, o papel de cada um e a existência do pediatra no programa. Há uma quase unanimidade de defesa da importância do pediatra na atenção básica por aumentar a resolubilidade da equipe. Porém, são apontadas críticas à sua atuação, muito focada no referencial biomédico e no consultório médico, havendo necessidade de maior envolvimento com o trabalho em equipe, os aspectos psicossociais, a família e o território. É essencial uma melhor capacitação do médico de família e do pediatra frente à complexidade da missão da atenção básica atual.

Brazil is developing a Family Health Program in the Primary Health Care. The Family Health Program's team composition has been criticized as insufficient. One of the criticisms has been about the absence of the pediatrician. This study analyzed the experience of the city of Campinas, São Paulo State, which implemented this program with adaptations specifically with the presence of the pediatrician in its 140 teams. Using qualitative methodology and semi-structured interviews, pediatricians and ten family physicians teams were interviewed. The objective was to know their visions about their practice with children's primary health care, the role of each one and about the pediatrician's presence in the team. It was almost an unanimity about the importance of the pediatrician's participation in Primary Health Care, not as a specialty, but because of the improvement of the team's resolubility. Though, the pediatrician's work was considered too focused in the biomedical paradigm and in the office. There is a need for the pediatrician to have more engagement with the psychosocial aspects, the family and territory. It is essential the improvement of the training of pediatricians and family physicians to deal with the complex mission of the primary health care of nowadays.