An integrated theory based-educational intervention to change intention to have a child: study protocol of a cluster randomized controlled trial.

BACKGROUND: In high- and low-income countries, declining birth rates have become a global concern. Couples do not have enough information about the complications of delaying and reducing childbearing and this leads them to make inappropriate decisions. Therefore, this study aims to evaluate whether an educational program based on integrating the Theory of Planned Behavior (TPB) and the Trans-Theoretical Model (TTM) affects child-free couples' intention to have children and minimizes the consequences of this decline. METHODS: Thirty couples (intervention, n = 15; control, n = 15) will be enrolled in this cluster randomized controlled trial. After collecting baseline data and separating participants in the pre-contemplation and contemplation stages based on the TTM, the samples were randomly assigned to the intervention and control groups. The intervention group will receive 60-min training based on TPB components for 4 weeks. The first follow-up assessment was performed immediately after the intervention and the final assessment 6 months later. For all 3 time assessments, three questionnaires will be used: The knowledge questionnaire, the TTM, and the TPB questionnaire. The most important consequences are changes in knowledge, attitudes, subjective norms, perceived behavioral control, and stages of intentions to have children. DISCUSSION: Decision-makers will use the results of this study as a basis to design appropriate, transparent, and useful policies and interventions to improve or stop the decline of the fertility rate at the national level. Also, this study will help young couples who wish to have a child in their lifetime by providing relevant information so that they do not miss this opportunity and face the consequences of delaying having a child. Trial registration This study was approved by the Iranian Registry of Clinical Trials (IRCT), Number: IRCT20220618055210N2, Date of registration: 2023-10-03.

Exploration of the effects of incarceration on the health of Latina women and their children using the life course theory.

OBJECTIVE: Use the Life Course Theory (LCT) to explore the effects of involvement with the justice system on the health of Latina women and their children. DESIGN: A supplementary analysis was conducted using data collected from the original study to answer a new research question. SETTING: South Central Texas. PARTICIPANTS: A primary qualitative data set from 12 Latina women involved with the justice system. METHODS: We applied LCT principles and used thematic content analysis as such we employed categoric distinction: lifespan development, time and place in individuals' lives, the timing of lives, human agency, and linked lives to analyze participants' narratives. RESULTS: Five themes emerged that aligned with LCT principles: (1) It feels like I'm living in my own prison; (2) What do I have to live for now; (3) It is like double punishment; (4) They made my choices; and (5) People didn't really understand. Participants felt helpless with few options to overcome their prior adversities, which affected their ability to make positive future choices. CONCLUSIONS: Findings highlight the potential, long-term, negative health consequences that may result from incarceration. Considering that justice system involvement can lead to more profound maternal and child health disparities, our findings suggest that greater advocacy from the nursing profession would increase accessibility to equitable and respectful maternity and women's health care services. Key points Involvement with the justice system can result in negative health consequences for women and their children. Maternal and child health disparities are often more profound after involvement with the justice system. Greater advocacy is needed from the nursing profession to ensure access to equitable and respectful maternity and women's health care services.

"Unlinked lives": Elaboration of a concept and its significance for the life course.

This article introduces the concept of "unlinked lives" and illustrates its significance for scholarship on the life course. There are many lessons to be learned about human interdependence by focusing not on relationships that are formed and then maintained, but instead on relationships that are lost or ended by choice or circumstance, such as through changes in institutional affiliations, social status and positions or places. Unlinked lives carry important social meanings, are embedded in complex social processes, and bring consequences for the wellbeing of individuals, families, and societies. To develop this concept, we put forward nine key propositions related to when and how unlinkings happen as processes, as well as some of the consequences of being unlinked as a status or outcome. The coupling of "unlinked lives" with "linked lives" offers a crucial avenue for advancing life course theories and research, integrating scholarship across multiple life periods and transitions, and bridging the two now-distinct traditions of intellectual inquiry on the life course and on social networks.

Cohort Differences in PTSD Symptoms and Military Experiences: A Life Course Perspective.

BACKGROUND AND OBJECTIVES: There have been major changes in military service over the past 50 years. Most research on posttraumatic stress disorder (PTSD) among combat Veterans comes from help-seeking Vietnam and WWII cohorts; results from more recent cohort comparisons are mixed. The present study addressed these gaps by exploring cohort differences among Vietnam, Persian Gulf, and Post-9/11 combat Veterans from a life course perspective. RESEARCH DESIGN AND METHODS: We recruited community-dwelling combat and war zone Veterans (N = 167), primarily from Veterans' associations in Oregon from three cohorts: Vietnam, Persian Gulf, and Post-911. Online surveys assessed current PTSD symptoms, life course (demographics and cohort membership), and experiential variables (combat severity, appraisals of military service, homecoming, and social support). RESULTS: Cohorts were comparable in demographics and war experiences. Step one of a hierarchical regression found that PTSD symptoms were higher among Veterans of color and those with lower incomes, R2 = 0.37, p < .001. When cohort was added, Vietnam Veterans had higher symptoms than Post-9/11; income and race/ethnicity remained significant, ΔR2 = 0.01, p = .13. The final model added experiential variables, ΔR2 = 0.38, p < .001; cohort and income were no longer significant, although Veterans of color still reported higher symptoms. Those with more undesirable service appraisals and who sought social support had higher symptoms, while desirable appraisals were protective. DISCUSSION AND IMPLICATIONS: From a life course perspective, the particular war zone that Veterans served in was less important than demographics and both service and postservice experiences, suggesting generalizability of risk and protective factors, as well as treatment modalities, across cohorts.

The Contribution of the Underlying Factors to Socioeconomic Inequalities in Obesity: A Life Course Perspective.

Objectives: Socioeconomic disparities in obesity have been observed in both childhood and adulthood. However, it remains unclear how the role of risk factors influencing these inequalities has evolved over time. Methods: Longitudinal data on 2,866 children and adolescents (6-17 years old) from the China Health and Nutrition Survey were used to track their BMI during childhood, adolescence, and adulthood. Concentration Index was utilized to measure socioeconomic inequalities in obesity, while Oaxaca decomposition was employed to determine the share of different determinants of inequality. Results: The concentration index for obesity during childhood and adulthood were 0.107 (95% CI: 0.023, 0.211) and 0.279 (95% CI: 0.203, 0.355), respectively. Changes in baseline BMI (24.6%), parental BMI (10.4%) and socioeconomic factors (6.7%) were found to be largely responsible for the increasing inequality in obesity between childhood and adulthood. Additionally, mother's education (-7.4%) was found to contribute the most to reducing these inequalities. Conclusion: Inequalities in obesity during childhood and adulthood are significant and growing. Interventions targeting individuals with higher BMI, especially those who are wealthy, can significantly reduce the gap.

Os sentidos do aposentar-se na visão de sujeitos aposentados / The senses of retirement in the perspective of retired subjects

O artigo tem o objetivo de investigar como se dá o processo de interrupção do trabalhar no momento da aposentadoria e como os sujeitos passam por essa experiência em um cenário em que o trabalho é considerado fundamental na vida das pessoas. Foi utilizada metodologia qualitativa, composta por análise de narrativa de entrevistas realizadas com 20 sujeitos aposentados. Os resultados da pesquisa evidenciam que o fator financeiro é bastante relevante, no entanto existem aspectos subjetivos que não são ponderados no momento de parar de trabalhar. De maneira complementar, percebeu-se que ficar sem trabalho em uma sociedade produtivista faz com que os sujeitos se sintam desconfortáveis, mesmo tendo o direito legitimado para o descanso. Eles dizem se sentir julgados como inúteis e improdutivos pela sociedade, o que torna o ócio penoso em muitos momentos. Por fim, as narrativas demonstraram que se aposentar é percebido como ficar velho e sem perspectiva de futuro

The article aims to investigate how retirement occurs and is perceived by subjects in a society in which work is seen as fundamental in people's lives. A qualitative approach was used and data were collected and analysed through interviews with 20 subjects and narrative analysis. Results show that finances is quite a relevant factor when choosing to retire, while subjective aspects to this process are disregarded. Complementarily, not working in a productivity-bound society makes subjects uncomfortable, despite their legitimized right to rest. The participants reported feeling judged as useless and unproductive by society, which makes idleness painful in many moments. Finally, the narrative analysis showed that retiring is perceived as getting old and having no perspective for the future

Estrategias de aprendizaje y estudio, perspectiva temporal y rendimiento académicoen estudiantes universitarios de Buenos Aires / Learning and study strategies, temporal perspective and academic performance in university students of Buenos Aires

La investigación tuvo como objetivo analizar la relación entre estrategias de aprendizaje y estudio, perspectiva temporal y rendimiento académico en estudiantes universitarios de Buenos Aires. Se trató de un estudio correlacional ­de diferencias entre grupos, con un diseño no experimental, de corte transversal. Participaron 334 sujetos (68.6% mujeres, 31.4% hombres; Medad=25.90, DEedad= 8.23). Los instrumentos de recolección de datos fueron: una encuesta sociodemográfica y de datos académicos, el Inventario de Perspectiva Temporal de Zimbardo, y el Inventario de Estrategias de Aprendizaje. En los análisis de diferencias de medias se hallaron diferencias según rendimiento académico. Se encontró que los alumnos con mejor rendimiento académico presentaron mayores puntajes en Motivación, Competencias para el Manejo de la Información, Futuro Neutro y menores en Pasado Negativo, Presente Fatalista AU

The aim of the research was to analyze the relationship between learning and study strategies, time perspective and academic performance in university students from Buenos Aires. A correlational study ­of differences between groups, with a non-experimental, cross-sectional design was conducted. Participants were 334 subjects (68.6% women, 31.4% men; Mage=25.90, SDage= 8.23). The data collection instruments were: a sociodemographic and academic data survey, the Zimbardo Time Perspective Inventory, and the Learning Strategies Inventory. In the analysis of differences in means, differences were found according to academic performance. It was found that the students with the best academic performance presented higher scores in Motivation, Information ManagementCompetences, Neutral Future and lower scores in Negative Past, Fatalistic Present AU

Notas para decolonizar os estudos transpessoais no brasil: contribuições do pluriperspectivismo participativo / Notes for decolonizing transpersonal studies in brazil: contributions of participatory pluriperspectivism / Apuntes para la decolonización de los estudios transpersonales en brasil: aportes del pluriperspectivismo participativo

O campo dos estudos transpessoais tem avançado em diversas áreas no Brasil. Comemorou seus 40 anos com uma inserção ativa nas Instituições de Ensino Superior (IES) e uma ampliação de núcleos formativos e apoiadores de ensino, pesquisa e ações sociais, além de diálogos com o Sistema de Conselhos de Psicologia. Desafios são apresentados a partir do levantamento de uma série de questões importantes e ignoradas dentro da Psicologia Transpessoal no Brasil. Apresentamos o pluriperspectivismo participativo como possibilidade de decolonizar as matrizes eurocêntricas e estadunidenses, que dão suporte ao pensamento transpessoal brasileiro, buscando honrar nossas raízes históricas e incluir outras epistemologias e ontologias, que dão continuidade à crítica à lógica cartesiana moderna. Indicamos uma breve agenda de notas temáticas que carecem de um processo decolonizador no campo transpessoal: a) crítica às perspectivas de um pensamento hegemônico, em termos globais por meio da dominação Norte-Sul ou no campo das relações sociais; b) revisão das formas de "centrocentrismo"; c) questionamento da noção de universalismo das ciências e da ética; d) aprofundamento da análise crítica da supremacia restritiva da racionalidade formal técnico-científica em relação às formas de subjetividade, de vivências holísticas e integradoras e de valorização do corpo; e) revisão da noção de sujeito moderno desprovida da cocriação do humano com a comunidade, a história, a natureza e o cosmos.(AU)

The field of transpersonal studies has advanced in several areas in Brazil. It celebrated its 40th anniversary with an active insertion in Higher Education Institutions (HEI) and an expansion of training centers and supporters of teaching, research, and social actions, in addition to dialogues with the System of Councils of Psychology. Challenges are presented based on a survey of a series of important and ignored issues within Transpersonal Psychology in Brazil. We present participatory pluriperspectivism as a possibility to decolonize the Eurocentric and North American matrices that support Brazilian transpersonal thought, seeking to honor our historical roots and include other epistemologies and ontologies, which continue the critique of modern Cartesian logic. We indicate a brief agenda of thematic notes that lack a decolonizing process in the transpersonal field: a) criticism of the perspectives of a hegemonic thought, whether in global terms via North-South domination or in the field of social relations; b) review of the forms of "centrocentrism"; c) questioning of the notion of universalism of science and ethics; d) deepening of the critical analysis of the restrictive supremacy of the technical-scientific formal rationality in relation to the forms of subjectivity, of holistic and integrative experiences, and of valuing the body; e) review of the notion of the modern subject devoid of the co-creation of the human with the community, the history, the nature, and the cosmos.(AU)

El campo de los estudios transpersonales ha avanzado en varias áreas de Brasil. Se celebró su 40.º aniversario con una inserción activa en Instituciones de Educación Superior (IES) y una ampliación de los centros de formación y promotores de la docencia, la investigación y la acción social, además de diálogos con el Sistema de Consejos de Psicología. Los desafíos se presentan a partir de una encuesta de una serie de temas importantes e ignorados dentro de la Psicología Transpersonal en Brasil. Presentamos el pluriperspectivismo participativo como una posibilidad para decolonizar las matrices eurocéntrica y americana, que sustentan el pensamiento transpersonal brasileño, buscando honrar nuestras raíces históricas e incluir otras epistemologías y ontologías que continúan la crítica de la lógica cartesiana moderna. Indicamos una breve agenda de apuntes temáticos que carecen de un proceso decolonizador en el campo transpersonal: a) crítica de las perspectivas de un pensamiento hegemónico, ya sea en términos globales a través del dominio Norte-Sur o en el campo de las relaciones sociales; b) revisión de las formas de "centrocentrismo"; c) cuestionamiento de la noción de universalismo de la ciencia y la ética; d) profundización del análisis crítico de la supremacía restrictiva de la racionalidad formal técnico-científica en relación a las formas de subjetividad, de experiencias holísticas e integradoras y de valoración del cuerpo; e) revisión de la noción de sujeto moderno desprovisto de la cocreación de lo humano con la comunidad, la historia, la naturaleza y el cosmos.(AU)

Vivências de trabalho precoce de adolescentes em medida socioeducativa / Experience of child labor of adolescents complying with a social-educational measure / Vivencias de trabajo infantil de adolescentes en medidas socioeducativas

Este artigo tem como objetivo analisar a vivência de trabalho precoce de adolescentes e jovens em cumprimento de medida socioeducativa, no estado da Paraíba. Os instrumentos utilizados foram um Questionário Mosquito Diagnóstico e uma Entrevista Semiestruturada. A análise foi realizada com o software Iramuteq, (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires), através da Análise Hierárquica Descendente, que gerou seis classes: significado do trabalho; infância e escola; condições objetivas de vida; trabalho, drogas e ato infracional; consequências do trabalho infantil; e trabalho infantojuvenil. A perspectiva teórica utilizada foi a psicologia histórico-cultural e os dados discutidos a partir do conceito de vivência. Conclui-se que as vivências e situações sociais de desenvolvimento foram caracterizadas pelo trabalho precoce que oportunizou o envolvimento com atos infracionais e as instituições responsáveis pela garantia de direitos em vez de garantir a proteção social, criminalizaram por meio de medidas socioeducativas.(AU)

This article aims to analyze the experience of child labor of adolescents and youngsters that are complying a social-educational measure, in the State of Paraíba. The instruments utilized were a Questionnaire Mosquito Diagnóstico and a Semi-Structured Interview. The analysis was performed by using the Iramuteq software (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires), by using Descending Hierarchical Analysis, which generated six classes: meaning of labor; childhood and school; objective conditions of life; labor, drugs, and act of infraction; consequences of child labor; and child labor. The theoretical perspective used was historical-cultural psychology and the data were discussed from the concept of experience. It was concluded that the experiences and social situations of development were characterized by child labor, which enabled the involvement with acts of infraction; and the institutions responsible for guaranteeing rights, instead of guaranteeing social protection, criminalized by using social-educational measures.(AU)

Este artículo tiene como objetivo analizar la vivencia precoz de adolescentes y jóvenes que cumplen medidas socioeducativas en el estado de Paraíba (Brasil). Los instrumentos utilizados fueron un Cuestionario Mosquito Diagnóstico y una entrevista semiestructurada. El análisis se realizó con el software Iramuteq (Interface de R pour les Multidimensionnelles Analyzes de Textes et de Questionnaires), mediante análisis jerárquico descendente, que generó seis clases: Significado del trabajo; Infancia y escuela; Condiciones objetivas de vida; Trabajo, drogas y acto de infracción; Consecuencias del trabajo infantil; y Trabajo infantojuvenil. La perspectiva teórica que se utilizó fue la psicología histórico-cultural, y los datos se discutieron desde el concepto de vivencia. Se concluye que las vivencias y situaciones sociales de desarrollo se caracterizaron por trabajo infantil que permitió la participación en infracciones y que las instituciones responsables de garantizar los derechos en lugar de la protección social los criminalizaron mediante medidas socioeducativas.(AU)

(Sobre)viver na rua: narrativas das pessoas em situação de rua sobre a rede de apoio / (About) living on the street: narratives of homeless people about the support network / (Sobre)vivir en la calle: narrativas de personas en situación de calle sobre la red de apoyo

A população em situação de rua (PSR), em seu cotidiano, se relaciona com diferentes pessoas, grupos e/ou coletivos ligados à execução das políticas públicas, às organizações não governamentais, familiares ou a membros da sociedade civil. Pensar nessas dinâmicas de trabalho, cooperação e auxílio remete a pensar sobre uma rede de apoio que constrói estratégias com essa população. Tendo presente essas problematizações, este estudo teve como objetivo analisar as narrativas das pessoas em situação de rua sobre como é produzida sua rede de apoio. Para tanto, foi realizado um estudo qualitativo, de orientação etnográfica, sendo utilizada a observação participante, registros em diário de campo e entrevistas narrativas. Participaram seis pessoas em situação de rua que recebem alimentação ofertada por projetos sociais em uma cidade do interior do Rio Grande do Sul. Os dados produzidos foram analisados a partir da Análise Temática. As análises expressam as especificidades das narrativas das trajetórias de vida associadas à chegada às ruas e à composição de uma rede de apoio na rua. Ao conhecer como se produz e opera essa rede de apoio, a partir das narrativas das pessoas em situação de rua, problematiza-se a complexidade dessa engrenagem e o desafio de produzir ações integradas entre as diferentes instâncias da rede. Nisso, destaca-se a potencialidade de práticas que levem conta à escuta, ao diálogo e à articulação na operacionalização de políticas públicas atentas às necessidades dessa população.(AU)

The street population, in their daily lives, relates to different people, groups and/or collectives linked to the execution of public policies, to non-governmental organizations, family members, or to members of civil society. Thinking about these dynamics of work, cooperation, and assistance leads to thinking about a support network that builds strategies with this population. Having these problematizations in mind, this study aims to analyze the narratives of homeless people about how their support network is produced. To this end, a qualitative study was carried out, with ethnographic orientation, using participant observation, records in a field diary, and narrative interviews. Participated in the research six homeless people who receive food offered by social projects in a municipality in the interior of Rio Grande do Sul. The data produced were analyzed using the Thematic Analysis. The analyzes express the specifities of the narratives of life trajectories associated with the arrival on the streets and the composition of a support network on the street. By knowing how the support network is produced and operated, the complexity of this gear and the challenge of producing integrated actions between the different instances of the network are problematized. Thus, it highlights the potential of practices that consider listening, dialogue, and articulation in the operationalization of public policies that are attentive to the needs of this population.(AU)

Las personas en situación de calle en su cotidiano se relacionan con distintas personas, grupos y/o colectivos, que están vinculados a la ejecución de políticas públicas, organizaciones no gubernamentales, familiares o miembros de la sociedad civil. Pensar en estas dinámicas de trabajo, cooperación y ayuda nos lleva a una red de apoyo que construye estrategias con estas personas. Teniendo en cuenta esta problemática, este estudio tiene como objetivo analizar las narrativas de las personas en situación de calle acerca de cómo se produce su red de apoyo. Con este fin, se realizó un estudio cualitativo, etnográfico, utilizando observación participante, registros de diario de campo y entrevistas narrativas. Este estudio incluyó a seis personas en situación de calle que reciben alimentos ofrecidos por proyectos sociales en una ciudad del interior de Rio Grande do Sul (Brasil). Se utilizó el Análisis Temático. Los análisis expresan las especificidades de las narrativas de las trayectorias de vida asociadas con la llegada a las calles y la composición de una red de apoyo en la calle. Al saber cómo se produce y opera la red de apoyo, a partir de las narrativas de las personas en la calle, se problematizan la complejidad de este equipo y el desafío de producir acciones integradas entre las diferentes instancias de la red. Destaca el potencial de las prácticas que tienen en cuenta la escucha, el diálogo y la articulación en la implementación de políticas públicas que estén atentas a las necesidades de esta población.(AU)

Melancolia e juventude num mundo sem perspectivas no ambiente onírico do filme "O professor substituto" / Melancolía y juventud en un mundo sin perspectivas en la atmósfera onírica de la película La última lección / Melancholy and youth in a world without prospects in the dreamlike environmentof the movie School's Out / Mélancolie et jeunesse dans un monde sans perspectives dans l'environnement onirique du film L'heure de la sortie

Dada a sobreposição de acontecimentos traumáticos a catástrofes anunciadas ­ tais como o colapso climático vindouro e os desmandos das autoridades que compõem a política e economia neoliberais ­ e a forma como esses acontecimentos reverberam no psiquismo dos jovens, o objetivo deste artigo é apresentar o filme O professor substituto de modo a tomá-lo como alegoria para a função traumatolítica dos sonhos e do cinema. Foi possível discutir uma das características da contemporaneidade, que favorece certa melancolização do laço social entre os jovens inseridos em uma sociedade distópica. Diante de tais acontecimentos, uma das evidências encontradas foi que a confiança dos sujeitos foi a mais penalizada, e por conta disso coube alargar a noção de esperança

Dadas la superposición de eventos traumáticos a catástrofes anunciadas (como el colapso climático que se avecina y los abusos de las autoridades que componen la política y la economía neoliberales) y la forma en que esos eventos repercuten en el psiquismo de los jóvenes, el objeto de este artículo es presentar la película La última lección para tomarla como alegoría de la función traumatolítica de los sueños y del cine. Se pudo discutir una de las características de la contemporaneidad, que favorece cierta melancolización del vínculo social entre los jóvenes insertados en una sociedad distópica. Ante tales hechos, una de las evidencias que vimos fue que la confianza de los sujetos fue la más penalizada, y por eso hubo que ensanchar el concepto de esperanza

There is an overlap of traumatic events and announced catastrophes (such as the coming climate collapse and the abuses of the authorities that make up neoliberal politics and economics) and a way those events reverberate in the psyche of young people. In that context, the purpose of this article is to present the movie School's Outin order to take it as an allegory for the traumatolytic function of dreams and cinema. We discussed one of the characteristics of contemporaneity that favors a certain melancholyzation of the social bond among young people inserted in a dystopian society. Considering such events, one of the evidences found was that the subjects'trust was the most penalized, and because of that, it was necessary to broaden the notion of hope

Compte tenu de la superposition d'événements traumatiques aux catastrophes annoncées ­ tels que le collapse climatique à venir et les dérives des autorités qui composent la politique et l'économie néolibérale ­ et la façon dont ces événements se répercutent dans le psychisme des jeunes, le but de cet article est de présenter le film L'heure de la sortie afin de le prendre comme une allégorie de la fonction traumatolytique des rêves et du cinéma. Il a été possible de discuter d'une des caractéristiques de la contemporanéité, qui favorise une certaine mélancolisation du lien social chez les jeunes insérés dans une société dystopique. Face à de tels événements, une des preuves trouvées était que la confiance des sujets était la plus pénalisée et, pour cette raison, il était nécessaire d'élargir la notion d'espoir

Trajetórias e determinantes do alto risco cardiovascular de 30 anos entre participantes de uma coorte brasileira (Estudo CUME) / Trajectories and determinants of 30-year high cardiovascular risk among participants in a Brazilian cohort (CUME Study)

Introdução: As doenças cardiovasculares são o principal problema de saúde pública em todo o mundo. Portanto, a avaliação do risco cardiovascular, com a identificação de seus fatores de risco e de proteção e de suas trajetórias ao longo do tempo são importantes para a proposição, a consolidação e a implementação de medidas de prevenção da ocorrência de doenças cardiovasculares. Objetivo geral: Analisar a trajetória e os determinantes do alto risco cardiovascular de 30 anos em participantes da Coorte de Universidades Mineiras (Estudo CUME). Métodos: Inicialmente, foi realizada uma revisão integrativa da literatura e, em seguida, dois estudos de coorte prospectiva. A) Artigo 1 ­ revisão integrativa da literatura sobre a estimação do alto risco cardiovascular e seus fatores associados, realizada nas bases Medical Literature Analysis and Retrievel System Online, Web of Science, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature e no portal Biblioteca Virtual de Saúde; B) Artigo 2 ­ Coorte aberta prospectiva desenvolvida com 2.854 participantes do Estudo CUME, que é uma pesquisa multicêntrica conduzida com egressos de sete instituições públicas federais de ensino superior do Estado de Minas Gerais desde 2016. A incidência do alto risco cardiovascular de 30 anos foi calculada usando o escore de Framingham e seus determinantes foram estimados usando análise multivariada hierárquica pela técnica de regressão de Cox; C) Artigo 3 ­ Estudo prospectivo fechado desenvolvido com 1.286 participantes da CUME, que responderam ao questionário da linha de base em 2016, aos questionários de seguimento de dois anos (2018) e de quatro anos (2020). O risco cardiovascular foi avaliado com o escore de Framingham de 30 anos. A identificação das trajetórias do risco cardiovascular foi realizada com a técnica de modelagem de crescimento de classe latente com o uso do modelo normal censurado. A análise dos fatores independentemente associados a cada uma das trajetórias foi conduzida com a técnica de regressão logística multinominal. Resultados: Artigo 1 ­ foram selecionados 13 artigos com um ou mais fatores associados ao alto risco cardiovascular, segundo o escore de Framingham de 10 anos. Nenhum artigo investigou os fatores associados ao alto risco cardiovascular de 30 anos. Artigo 2 ­ após média de 2,62 anos de seguimento, a incidência do alto risco cardiovascular de 30 anos foi 8,1 casos/1.000 pessoas-ano no sexo feminino e 20,2 casos/1.000 pessoas-ano no sexo masculino. Sexo masculino (Hazard Ratio ­ HR: 2,34; IC 95%: 1,58 - 3,46), trabalhar (HR: 2,13; IC 95%: 1,13 - 3,99), alto consumo de alimentos processados (HR: 2,44; 95% CI: 1,21 - 4,90) e ser ativo fisicamente (HR: 0,63; IC 95%: 0,41 - 0,98) se associaram independentemente ao alto risco cardiovascular de 30 anos; Artigo 3 - Três trajetórias de risco cardiovascular de 30 anos foram identificadas: Baixo-Baixo (68,3%), Médio-Médio (26,2%) e Alto-Alto (5,5%). Ao longo do tempo, o risco cardiovascular apresentou discreto aumento para a trajetória Baixo-Baixo (2,9%), moderado aumento para a trajetória Médio-Médio (7,6%) e elevado aumento para a trajetória Alto-Alto (13%). O sexo masculino, viver em união estável, ter consumos moderado e alto de alimentos ultraprocessados se associaram positivamente às trajetórias de risco cardiovascular Médio-Médio e Alto-Alto. Ainda, ter formação profissional fora da área da saúde e estar trabalhando se associaram positivamente à trajetória de risco cardiovascular Médio-Médio, enquanto ser ativo fisicamente se associou negativamente à trajetória de risco cardiovascular Alto-Alto. Conclusão: Poucos estudos foram conduzidos para avaliar o alto risco cardiovascular de 30 anos, sendo que em nenhum deles foram estimados fatores associados ao desfecho. Nossos achados científicos indicaram que praticar atividade física reduz a incidência do alto risco cardiovascular de 30 anos. Homens, pessoas que trabalham e com consumo elevado de alimentos processados devem ser monitorados com maior cautela, pois apresentaram maior susceptibilidade de ocorrência do alto risco cardiovascular de 30 anos. Adultos jovens e com melhor situação socioeconômica possuem uma trajetória de baixo risco cardiovascular de 30 anos, entretanto, há uma tendência de piora desta trajetória ao longo do tempo devido aos maus hábitos de vida. Dessa forma, é essencial a implementação de estratégias de prevenção para evitar o adoecimento cardiovascular.

Introduction: Cardiovascular diseases are the main public health problem worldwide. Therefore, the assessment of cardiovascular risk, with the identification of its risk and protection factors and their trajectories over time, are important for proposing, consolidating and implementing measures to prevent the occurrence of cardiovascular diseases. General objective: To analyze the 30-year trajectory and determinants of high cardiovascular risk in participants of the Cohort of Universities of Minas Gerais (CUME Study). Methods: Initially, an integrative literature review was performed, followed by two prospective cohort studies. A) Article 1 ­ integrative review of the literature on the estimation of high cardiovascular risk and its associated factors, carried out in the databases Medical Literature Analysis and Retrievel System Online, Web of Science, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature and the Virtual Health Library portal; B) Article 2 ­ Prospective open cohort developed with 2,854 participants of the CUME Study, which is a multicenter research conducted with graduates from seven federal public institutions of higher education in the State of Minas Gerais since 2016. The incidence of high cardiovascular risk at 30 years was calculated using the Framingham score and its determinants were estimated using hierarchical multivariate analysis by the Cox regression technique; C) Article 3 ­ Prospective closed study developed with 1,286 participants from CUME, who answered the baseline questionnaire in 2016, the two-year follow-up questionnaire in 2018 and the four-year follow-up questionnaire in 2020. The risk Cardiovascular was assessed using the 30-year Framingham score. The identification of cardiovascular risk trajectories was performed using the latent class growth modeling technique using the normal censored model. The analysis of the factors independently associated with each of the trajectories was conducted using the multinomial logistic regression technique. Results: Article 1 ­ 13 articles were selected with one or more factors associated with high cardiovascular risk, according to the Framingham score over 10 years. No article investigated the factors associated with 30-year high cardiovascular risk. Article 2 ­ After an average of 2.62 years of follow-up, the incidence of high cardiovascular risk at 30 years was 8.1 cases/1,000 person-years in females and 20.2 cases/1,000 person-years in males. Male sex (Hazard Ratio ­ HR: 2.34; 95% CI: 1.58 - 3.46), work (HR: 2.13; 95% CI: 1.13 - 3.99), high food intake processed foods (HR: 2.44; 95% CI: 1.21 - 4.90) and being physically active (HR: 0.63; 95% CI: 0.41 - 0.98) were independently associated with high cardiovascular risk 30 years old; Article 3 - Three 30-year cardiovascular risk trajectories were identified: Low-Low (68.3%), Medium-Medium (26.2%) and High-High (5.5%). Over time, cardiovascular risk showed a slight increase for the Low-Low trajectory (2.9%), a moderate increase for the Medium-Medium trajectory (7.6%) and a high increase for the High-High trajectory (13%). Being male, living in a stable relationship, having moderate and high consumption of ultra-processed foods were positively associated with Medium-Medium and High-High cardiovascular risk trajectories. Also, having professional training outside the health area and being working were positively associated with the Medium-Medium cardiovascular risk trajectory, while being physically active was negatively associated with the High-High cardiovascular risk trajectory. Conclusion: Few studies were conducted to assess the 30-year high cardiovascular risk, and none of them estimated factors associated with the outcome. Our scientific findings indicated that practicing physical activity reduces the incidence of 30-year high cardiovascular risk. Men, people who work and with a high consumption of processed foods should be monitored with greater caution, as they were more susceptible to the occurrence of the high cardiovascular risk of 30 years. Young adults with better socioeconomic status have a 30-year trajectory of low cardiovascular risk, however, there is a tendency for this trajectory to worsen over time due to bad lifestyle habits. Thus, it is essential to implement prevention strategies to avoid cardiovascular disease.

Meeting of WHO collaborating centres for child and adolescent health and sexual and reproductive health in the WHO European Region: Cologne, Germany, 16–17 May 2023

A joint meeting of WHO collaborating centres (CCs) for child and adolescent health and sexual and reproductive health in the European Region was held in Cologne, Germany, on 16–17 May 2023, hosted by the Federal Centre for Health Education. This was the first opportunity for representatives of WHO CCs to meet across areas of work since February 2018. Recent developments in WHO were discussed, and the CCs presented updates on their areas of collaborative work with WHO. The main theme of the meeting was the priorities for each programme’s strategies in the light of the most recent progress reports and the impact of the coronavirus disease (COVID-19) pandemic. This report presents a summary of the main points from the meeting.