Declaración de la Sociedad Argentina de Pediatría sobre la prevención de enfermedades no transmisibles: la necesidad de fortalecer conocimientos y reforzar estrategias / Statement of the Sociedad Argentina de Pediatría on the prevention of noncommunicable diseases: the need to strengthen knowledge and reinforce strategies

Investigaciones de las últimas décadas revelaron que un ambiente adverso en la etapa de desarrollo puede producir una mayor susceptibilidad hacia fenotipos relacionados con enfermedad cardiovascular, diabetes, hipertensión, trastornos neuroconductuales y otras enfermedades crónicas no transmisibles. Estas enfermedades, cuyo aumento ocurre especialmente en países con alta vulnerabilidad social, provocan muertes prematuras y constituyen la primera causa de muerte en la vida adulta, además de un elevado costo para la salud pública. Consciente de la necesidad de prevenir estas enfermedades desde los primeros mil días de vida, la Sociedad Argentina de Pediatría creó la Subcomisión DOHaD y formuló una declaración para la prevención de enfermedades no transmisibles a la que adhirieron otros países de Latinoamérica. La aplicación de las estrategias declaradas con acciones interdisciplinarias e intersectoriales sostenidas en el tiempo contribuirá a construir salud, a disminuir la carga de enfermedades crónicas no transmisibles y al mayor bienestar y productividad para los pueblos.

Research in recent decades has revealed that an adverse environment in the developmental stage can produce a greater susceptibility to phenotypes related to cardiovascular disease, diabetes, hypertension, or neurobehavioral disorders, among other chronic noncommunicable diseases. These diseases, whose tendency is increasing especially in countries with high social vulnerability, cause premature deaths and constitute the first cause of death in adult life as well as a great cost to public health. Aware of the need to prevent these diseases from the first thousand days of life, the Sociedad Argentina de Pediatría created the DOHaD Committee and formulated a statement for the prevention of NCDs, to which Latin American countries also adhered. We believe that the application of the declared strategies with interdisciplinary and intersectoral actions sustained over time will contribute to building health, reducing the burden of NCDs, and to greater wellbeing and productivity for the people

Trayectorias de fragilidad y factores relacionados en la población de adultos mayores en México / Trajectories of frailty and related factors of elderly people in Mexico

Resumen Introducción: la fragilidad es un indicador del estado de salud en la vejez y un síndrome clínico común en adultos mayores; conlleva un elevado riesgo de resultados deficientes de salud que incluyen caídas, incidentes de discapacidad, hospitalización y mortalidad. Este estudio tuvo como objetivo identificar las diferentes trayectorias de la fragilidad y los factores relacionados con esta entre adultos mayores mexicanos a lo largo del tiempo. Metodología: los datos provienen de un panel de cuatro rondas compuesto por adultos mayores mexicanos y desarrollado de 2001 a 2015 por el Estudio Nacional de Salud y Envejecimiento en México (ENASEM). La fragilidad es la acumulación de déficits a partir de un índice de fragilidad. Se aplicó un análisis multinivel, utilizando modelos jerárquicos para conocer los cambios de trayectorias de fragilidad y qué factores se relacionan con ella. Resultados: ser mujer mayor, viuda y tener un bajo nivel educativo fueron factores de riesgo para un índice de fragilidad alto y una menor satisfacción financiera o realizar actividades en el hogar tienen efectos adversos. Conclusiones: se halló una prevalencia de la fragilidad según la proporción de déficits que poseen los individuos y sus primordiales componentes asociados. Se requiere mejorar las condiciones socioeconómicas de salud en fases previas a la vejez con miras a evitar la presencia de fragilidad en el futuro.

Abstract Introduction: Frailty is an indicator of health status in old age and a common clinical syndrome in older adults that carries an increased risk of poor health outcomes, including falls, incidents of disability, hospitalization, and mortality. This study aimed to identify the different trajectories of frailty and the factors related to frailty among Mexican older adults over time. Methods: Data are from a four-wave panel composed of older Mexican adults from 2001 to 2015 of the Mexican Health and Aging Study (MHAS). Frailty is the accumulation of deficits using a frailty index. A multilevel analysis, using hierarchical models, was applied to know the changes of frailty trajectories and what factors are related to it. Results: Being female, older, being widowhood, and having a lower level of education were risk factors for having a high frailty index and lower financial satisfaction doing activities at home have adverse effects. Conclusion: The findings of this work present information about the prevalence of frailty considering the proportion of deficits that individuals possess and their main associated components in older Mexican adults. It is necessary to improve socioeconomic health conditions in phases before old age to avoid developing frailty in the future.

Prácticas alimentarias, un fenómeno multinivel

RESUMEN El presente ensayo tiene como propósito posicionar el entender las prácticas alimentarias de las personas y de las poblaciones desde la perspectiva de curso de vida como tema relevante para generar conocimientos desde perspectivas interdisciplinarias. Así, se expondrán a las prácticas alimentarias desde una perspectiva sociohistórica, posicionándonos desde una visión que integre los diferentes niveles, dominios y temporalidades, con el fin de ampliar la perspectiva de un fenómeno esencialmente interdisciplinario. De esta manera, se abren las preguntas sobre qué niveles y dominios de la vida de las personas y las poblaciones se encuentran involucrados y cuáles son las formas temporales que se manejan en la interconexión de los diferentes elementos. Se busca posicionar a las prácticas alimentarias desde una perspectiva holística que pueda orientar la planificación e interpretación de investigaciones aplicadas para afrontar los desafíos de salud pública en el presente.

ABSTRACT The purpose of this essay is to position the understanding of food practices of individuals and populations from a life course perspective as relevant to focus in producing knowledge from an interdisciplinary perspective. So, here I discuss food practices as a sociohistorical phenomenon, acquiring a point of view that integrates different levels, domains and temporalities, with the purpose of broaden the perspective of a essentially multidisciplinary phenomenon. This opens questions about what levels and domains of the life of individuals and societies are involved, as well as what temporal forms are handled in the interconnection of the different elements. Thus, this essay seeks to position food practices from a wide perspective that can guide interpretation in empirical research necessary to face public health challenges that appear in the present.

Soledad, envejecimiento y viudez en el curso de la vida. Un estudio de casos en personas viudas de Argentina / Loneliness, aging and widowhood throughout the life course. A case study in widowed people in Argentina 172

Resumen El presente trabajo indaga sobre formas de afrontar la viudez en el curso de vida. Se analizan diferencias de cohorte y género sobre el sentimiento subjetivo de soledad. Se estudian las actividades que se abandonaron, transformaron e iniciaron pos viudez y los tipos de apoyo social percibido. A partir de una estrategia metodológica cualitativa se realizaron entrevistas en profundidad a personas viudas del Área Metropolitana de Buenos Aires, Argentina. El análisis permitió reconstruir diferencias según cohorte, posición y género frente a la viudez, así como dimensiones espaciales y temporales referidas al sentimiento de soledad. Se evidencia que las mujeres cuentan con variados recursos y mayor apoyo emocional para afrontar la soledad, a diferencia de los viudos. La división sexual de tareas es notable en los viudos(as) nacidos entre 1930 y 1959 mientras que las cohortes posteriores a 1960 registran menor rigidez en este punto.

Abstract This article explores ways of coping with widowhood throughout life course. Cohort and gender differences on the subjective feeling of loneliness are analyzed. The activities abandoned, changed and initiated after widowhood and the types of perceived social support are studied. Based on a qualitative methodological strategy, in-depth interviews were conducted with widowed people in the Buenos Aires Metropolitan Area (Área Metropolitana de Buenos Aires), Argentina. The analysis allowed us to reconstruct differences according to cohort, position and gender in relation to widowhood, as well as spatial and temporal dimensions related to the feeling of loneliness. It is evident that women have a variety of resources and greater emotional support to cope with loneliness, unlike widowers. Sexual division of labor is significant among widowed people born between 1930 and 1959, while the cohorts born after 1960 show more flexibility in this regard.

Reto de los primeros 1000 días de vida / Challenge of the first 1000 days of life

Los primeros mil días de vida son parte del Curso de Vida, al tomar en consideración la Epigenética, término postulado por Waddington en 1942: modifica la expresión genética SIN cambiar la secuencia de las bases de ADN. El proyecto internacional llamado DOHaD (Developmental Origins of Health and Disease) u ODSE (Orígenes del Desarrollo de la Salud y Enfermedad), está inserto dentro de la Transición Alimentaria y Nutricional (TAN), que, en países en desarrollo­ocurre en forma muy rápida ­produce tanto la malnutrición por déficit como por exceso; es decir la doble carga nutricional. La TAN es producto en nuestro país, de una urbanización acelerada y anárquica, y de cambios socioculturales, como la incorporación de la mujer al mercado de trabajo con menos tiempo para cocinar; está acompañada de una transición epidemiológica con la emergencia y prevalencia de la obesidad y de las enfermedades crónicas como morbiletalidad. Esta doble carga nutricional se modificó, por la situación país, y prevalece más el déficit que el exceso. Se presenta el PROYECTO FUNDACIÓN BENGOA ­ SVPP ­ SOGV ­ CANIA, cuya meta es: Elaborar una agenda preventiva común contra la malnutrición tanto por déficit como por exceso y sus comorbilidades, bajo el enfoque de los primeros mil días de vida y su efecto sobre todo el curso de vida. Se realizó el diseño y aplicación de tres cuestionarios digitales, que se utilizaran para la elaboración de esta meta. Se consolidó un CONSENSO NACIONAL formado por profesionales de la salud involucrados en los primeros mil días de vida(AU)

The first 1000 days of life is the new paradigm that determines health and nutrition during the life course, based on epidemiological models that incorporate the concept of Epigenetics, term introduced by Waddington, that refers to changes that affect the genetic expression without changing the DNA sequence, within the international program DOHaD/ODSE as well as the Food and Nutrition Transition(FNT). This FNT, product of an accelerated and anarchic urbanization that led to sedentary activities, plus the incorporation of women to the work media, with less time for cooking, with the substitution of the traditional diet for one much more practical and efficient in time and effort. It is accompanied by demographic and epidemiologic changes and transitions. The Double Burden of Nutrition in VENEZUELA has changed due to the effect of the recent crisis with a rise in malnutrition and a fall in obesity/overweight. The current project: Fundación Bengoa- Pediatric Society Venezuela (SVPP) ­ CANIA - Obstetric Society of Venezuela (SOGV) is called Developmental Origins of Health and Disease in Venezuela (DOHaD Venezuela): and by means of a national consensus of medical societies and institutions, its goal is "To elaborate a Preventive Agenda both for Malnutrition and for Overweight and Obesity and its comorbidities, considering the First 1000 Days of life and its effect over the life course"

Enfoque intersectorial y responsabilidad social universitaria en la gestión del conocimiento sobre actividad física y salud / Intersector approach and university social responsibly in managing knowledge about physical activity and health

Introducción: La inactividad física constituye uno de los principales factores de riesgo de morbimortalidad a nivel mundial y son causa fundamental de las enfermedades no transmisibles. En cambio, la actividad física regular durante el curso de la vida proporciona beneficios para la salud física y mental. No obstante, aun resultan insuficientes las acciones intersectoriales que potencien alianzas estratégicas, en aras de evidenciar el rol de la actividad física como componente del estilo de vida saludable. Objetivo: Identificar la responsabilidad social del Centro de Estudio para la Actividad Física, el Deporte y la Promoción de la Salud, en la formación de capacidades para la producción, la transferencia, la diseminación y la aplicación de conocimientos en el contexto de la actividad física para la salud. Desarrollo: La inactividad física, por su estrecha relación comórbida con la obesidad y el sobrepeso, la diabetes, la hipertensión, la hipercolesterolemia, entre otras, da al traste con los principales problemas de salud durante el curso de la vida, lo cual reclama de un enfoque sistémico, integrador e intersectorial, así como de la formación de recursos humanos competentes para ello. Conclusiones: El Centro de Estudios para la Actividad Física, el Deporte y la Promoción de Salud evidencia su pertinencia académica e investigativa, al devenir en un actor clave en la producción, la distribución y el uso del conocimiento sobre la actividad física para la salud, y articular las necesidades del contexto social y el proyecto universitario, alineados con las prioridades nacionalmente establecidas(AU)

Introduction: Physical inactivity is one of the main risk factors for morbidity and mortality worldwide and its fundamental cause is non-communicable diseases. In contrast, regular physical activity during the span of life provides physical and mental health benefits. However, there are still insufficient intersector actions for strengthening strategic alliances, in view of demonstrating the role of physical activity as a component of the healthy lifestyle. Objective: To identify the social responsibility of the University of Physical Culture and Sports Sciences, particularly its Center for Studies on Physical Activity, Sports and Health Promotion, in the formation of capacities for knowledge production, transfer, dissemination and application in the context of physical activity for health. Development: Physical inactivity, due to its close comorbid relationship with obesity and overweight, diabetes, hypertension, hypercholesterolemia, among others, disrupts into the main health problems during the lifespan, which demands a systemic, integrative and intersector approach, as well as the training of competent human resources for it. Conclusions: The Center for Studies on Physical Activity, Sports and Health Promotion proves its academic and research relevance, insofar as it becomes a key stakeholder in the production, distribution and use of knowledge about physical activity for health, and articulates the needs of the social context and the university project, aligned with nationally established priorities(AU)

Trayectorias y dinámicas alimentarias de adultos/as mayores: la alimentación como relato de vida / Trajectories and food dynamics of Elderly People: food as life story

Argentina atraviesa un proceso de transición demográfica avanzada, ya que los/as adultos mayores (AM) alcanzan el 15,1% de la población. Ello pone en tensión el lugar de las/os AM en la sociedad, sus condiciones de acceso y resolución de necesidades, entre ellas la alimentación. En este trabajo se postula que hablar de la alimentación, de los alimentos, es hablar de los/as AM, de la historia de vida de estas personas que se va escribiendo entre sustancias y circunstancias que hacen a actividades tan cotidianas como el cocinar y el comer. Así, se planteó como objetivo, indagar acerca de la categoría trayectorias y dinámicas alimentarias (TyDA) de los/as AM de la Ciudad de Córdoba-Argentina, para establecer diálogo(s) posible(s) entre alimentación y curso de vida. Se realizó una investigación con posicionamiento epistemológico mixto entre paradigma interpretativista y crítico; con triangulación metodológica cuali-cuantitativa. Etapa cuantitativa: muestra no probabilística por cuotas según nivel de instrucción (n=384); incluyendo a AM de Córdoba y gran Córdoba que integran espacios participativos. Se implementó un cuestionario semiestructurado. Etapa cualitativa: muestra intencional (n=10) a partir del muestro anterior. Se realizaron observaciones participantes, bitácora de campo y entrevistas. Participaron 384 AM, edad promedio de 72 años (DE=7), 79% mujeres y 21% varones. Las "TyDA", siguiendo una idea de proceso que se construye y reconstruye constantemente, fueron abordadas desde: a) Etapa de la vida b) Sistema Alimentario y c) Alimentos identificadores. Reconstruir la historia de la comida de los/as AM propicia el reencuentro con la propia historia (infancia, juventud, adultez, vejez). Esta matriz de sentido es una invitación a repensar los abordajes en materia de políticas públicas destinados a este grupo poblacional; que genera cambios demográficos tanto a nivel macrosocial (cultura, economía, mercado de trabajo, sistemas políticos) pero especialmente en la experiencia de vida de los y las AM.

Una introducción al enfoque del curso de vida y su uso en la investigación pediátrica: principales conceptos y principios metodológicos / An introduction to the life course approach and its use in pediatric research: main concepts and methodological principles

Resumen Desde su concepción, el enfoque del curso de vida se ha utilizado ampliamente en la investigación sociodemográfica y en los estudios sociológicos. El empleo de esta perspectiva se ha difundido desde hace algunos años en la investigación en salud. Sin embargo, su uso ha sido muy limitado en pediatría. Este trabajo presenta una exposición de los principales conceptos del enfoque del curso de vida y algunos principios metodológicos para el desarrollo de investigaciones desde esta perspectiva. Además, se incluyen una serie de proyectos de investigación que se han valido de este enfoque como fundamentación conceptual en su diseño e implementación y algunas fuentes de información que pueden ser utilizadas para el desarrollo de investigaciones desde esta conceptualización en México.

Abstract Since its inception, the life course approach has been widely used in the socio-demographic research and sociological studies. The use of this perspective in health research has spread for some years, although its use in pediatrics has been limited. This work presents the main concepts of the life course approach and some methodological principles for the development of research from this perspective. In addition, a series of research projects that have used this approach as a conceptual basis in their design and implementation are included, as well as some sources of information that can be used for the development of research since this conceptualization in Mexico.

Escala de Macarthur de status social subjetivo: validade e associação com indicadores de posição socioeconômica no curso de vida - estudo longitudinal de saúde do adulto (ELSA-BRASIL) / Escala de Macarthur de status social subjetivo: validade e associação com indicadores de posição socioeconômica no curso de vida - estudo longitudinal de saúde do adulto (ELSA-BRASIL)

INTRODUCTION: The MacArthur scale of subjective social status (SSS), which combines verbal instruction and an image of a 10-steps ladder, aims to capture the common sense perception that an individual has about his/her own position in social hierarchies, in three different contexts: society, community and work. OBJECTIVE: To conduct a concurrent and face validity analysis of the MacArthur scale (Paper 1) and to investigate whether individuals who perceive themselves as having a low SSS in adult life, in the society context, were more exposed to low objective socioeconomic positions (SEP) in childhood and youth, after adjusting for current SEP. METHODS: The article 1 included 159 participants from the Longitudinal Study of Adult Health (ELSA-Brasil), from Minas Gerais Investigating Center, selected by convenience during the 2nd wave of interviews and examinations between 11/2012 and 02/2014. The MacArthur scale was compared with a Status scale, created for this study based on the cognitive metaphor theory, which used the same image of a ladder as an indicator of the status and a very similar but more direct instruction. The concurrent validity was examined by comparing the answers to both scales (MacArthur and Status) using weighted kappa statistics. The face validity was assessed by qualitative methods from corpus linguistics. Ordinal logistic regression was used to investigate whether sociodemographic factors were associated with differences of 1, or 2 or more steps in the choices made using the MacArthur and the Status ladders. In the paper 2, 15.105 participants from the base line of ELSA-Brasil (2008-2010) were included. Low SSS was in the society was defined by the choice of a step lower than 5 out of 10. Multivariate logistic regression analysis was used to investigate whether exposures to low objective indicators of SEP in the childhood (maternal education), youth (occupational social class of the household head; occupational social class of the first job; nature of occupation of household head; nature of occupation in the first job) and adult life (current occupational social class; current nature of occupation; current education) increased the chances of being at low SSS. RESULTS: Agreement between the answers to the MacArthur and Status scales moderated in the society context (kw=0,55) and good in the community (kw=0,60) and work (kw=0,67). Face validity analysis showed that MacArthur scale captures beyond the classic socioeconomic indicators, encompassing elements from collective health, as home, transport, health, leisure, merit etc. Although individuals without college education (in the society context) and women (in the community ambience) had greater chances of differing by 1, or 2 or more steps from those with college education or who were women, qualitative differences were not identified by the corpus linguistics, suggesting that the MacArthur scale has good face validity. In paper 2, after adjustments, low SSS in adult life remained statistically associated with low SEP in all stages of the life course, being the magnitude of the associations strong in adult life, moderate in youth and weak in childhood, showing dose response gradients in all associations. CONCLUSION: The MacArthur scale seems to be a valid instrument to measure the SSS in the Brazilian sociocultural context, thus they can be used in studies of social inequality in health. In addition, results suggest that the scale may capture a summary of exposures and experiences of present and past SEP, both intra and intergenerational, allowing to expand the interpretations of findings of health inequalities based on the MacArthur scale.

INTRODUCTION: The MacArthur scale of subjective social status (SSS), which combines verbal instruction and an image of a 10-steps ladder, aims to capture the common sense perception that an individual has about his/her own position in social hierarchies, in three different contexts: society, community and work. OBJECTIVE: To conduct a concurrent and face validity analysis of the MacArthur scale (Paper 1) and to investigate whether individuals who perceive themselves as having a low SSS in adult life, in the society context, were more exposed to low objective socioeconomic positions (SEP) in childhood and youth, after adjusting for current SEP. METHODS: The article 1 included 159 participants from the Longitudinal Study of Adult Health (ELSA-Brasil), from Minas Gerais Investigating Center, selected by convenience during the 2nd wave of interviews and examinations between 11/2012 and 02/2014. The MacArthur scale was compared with a Status scale, created for this study based on the cognitive metaphor theory, which used the same image of a ladder as an indicator of the status and a very similar but more direct instruction. The concurrent validity was examined by comparing the answers to both scales (MacArthur and Status) using weighted kappa statistics. The face validity was assessed by qualitative methods from corpus linguistics. Ordinal logistic regression was used to investigate whether sociodemographic factors were associated with differences of 1, or 2 or more steps in the choices made using the MacArthur and the Status ladders. In the paper 2, 15.105 participants from the base line of ELSA-Brasil (2008-2010) were included. Low SSS was in the society was defined by the choice of a step lower than 5 out of 10. Multivariate logistic regression analysis was used to investigate whether exposures to low objective indicators of SEP in the childhood (maternal education), youth (occupational social class of the household head; occupational social class of the first job; nature of occupation of household head; nature of occupation in the first job) and adult life (current occupational social class; current nature of occupation; current education) increased the chances of being at low SSS. RESULTS: Agreement between the answers to the MacArthur and Status scales moderated in the society context (kw=0,55) and good in the community (kw=0,60) and work (kw=0,67). Face validity analysis showed that MacArthur scale captures beyond the classic socioeconomic indicators, encompassing elements from collective health, as home, transport, health, leisure, merit etc. Although individuals without college education (in the society context) and women (in the community ambience) had greater chances of differing by 1, or 2 or more steps from those with college education or who were women, qualitative differences were not identified by the corpus linguistics, suggesting that the MacArthur scale has good face validity. In paper 2, after adjustments, low SSS in adult life remained statistically associated with low SEP in all stages of the life course, being the magnitude of the associations strong in adult life, moderate in youth and weak in childhood, showing dose response gradients in all associations. CONCLUSION: The MacArthur scale seems to be a valid instrument to measure the SSS in the Brazilian sociocultural context, thus they can be used in studies of social inequality in health. In addition, results suggest that the scale may capture a summary of exposures and experiences of present and past SEP, both intra and intergenerational, allowing to expand the interpretations of findings of health inequalities based on the MacArthur scale.

O casamento como "armário": histórias de um homem com conduta homossexual no Pantanal de Mato Grosso do Sul / El matrimonio como "armario": historias de un hombre con conducta homosexual en el Pantanal de Mato Grosso do Sul / Marriage as a "closet": stories of a man with homosexual practices in Mato Grosso do Sul's Pantanal in Brazil

Resumo Neste artigo analiso a trajetória de um homem com conduta homossexual na região do Pantanal de Mato Grosso do Sul. Proponho pensar as convenções de gênero e sexualidade construídas a partir da relação com os diferentes regimes de visibilidade a que esteve submetido ao longo do curso da vida. De um lado, recorro à noção de "armário homossexual" (homossexual closet) para analisar as estratégias adotadas por ele para a vivência de uma conduta homossexual. De outro, incorporo a noção de "mapas de segurança" para refletir sobre o modo com que os sujeitos controlam e administram estrategicamente os graus de visibilidade mais ou menos possíveis de suas condutas homossexuais de acordo com os territórios sociais nos quais circulam e interagem.

Resumen En este artículo analizo la trayectoria de un hombre con conducta homosexual de la región del pantanal del estado de Mato Grosso do Sul. Propongo pensar las convenciones de género y sexualidad construidas a partir de la relación con los diferentes regímenes de visibilidad a los cuales estuvo sujeto en su curso de vida. Por un lado, recurro a la noción de "armario homosexual" (homossexual closet) para analizar las estrategias adoptadas por él para la vivencia de una conducta homosexual. Por otro lado, incorporo la noción de "mapas de seguridad" para reflexionar sobre el modo como los sujetos controlan y administran estratégicamente los grados de visibilidad mas o menos posibles de sus conductas homosexuales de acuerdo con los territorios sociales en los cuales circulan e interactúan.

Abstract This article analyzes the trajectory of a man with homosexual practices in the Pantanal region of Mato Grosso do Sul, Brazil. I look at gender and sexuality conventions constructed in relation with the regimes of visibility this man has been subjected to in his lifetime. On the one hand, I use the notion of "homosexual closet" to analyze the strategies adopted on his homosexual practices. On the other hand, I use the concept of "security maps" to think about how subjects control and strategically manage possible degrees of visibility for their homosexual practices, according to the social territories in which they move and interact.

Tarefas de desenvolvimento e história de vida de idosos: análise da perspectiva de Havighurst / Developmental tasks and life history of the elderly: analysis of Havighurst's theory

Para analisar as tarefas de desenvolvimento propostas por Havighurst, 12 idosos foram submetidos ao método de História de Vida. Eles relataram suas histórias em entrevistas grupais e em textos digitalizados. Desconsiderou-se a primeira infância, pois as memórias autobiográficas dessa fase são limitadas. Uma análise de conteúdo temática das verbalizações e dos textos revelou que somente quatro das 40 tarefas das demais fases do curso de vida - meia infância, adolescência, adultez inicial, adultez intermediária e maturidade tardia - não foram mencionadas. As alterações recomendadas para algumas tarefas e a inclusão de uma nova demanda para a maturidade denotam o caráter contextual e histórico delas. Todavia, considera-se que as tarefas de desenvolvimento de Havighurst apresentam evidências de validade ecológica para o contexto brasileiro...

In order to analyze the developmental tasks proposed by Havighurst, 12 elderly people were submitted to the life history method. They told their stories in group interviews and reported them in written texts. Early childhood was disregarded because autobiographical memories of that phase are limited. A thematic content analysis of the verbalizations and texts revealed that only four out of the 40 tasks of the remaining life course phases - middle childhood, adolescence, early adulthood, middle age and later maturity - were not mentioned. The results suggest the need of altering five of the six tasks originally proposed by the author. It is also necessary to include new demands for later maturity which denote the contextual and historical character of the process. Havighurst's developmental tasks showed ecological validity evidence for the Brazilian context, though...

A ressignificação da feminilidade na terceira idade / The re-significance of the femininity during the aging process

Este trabalho propõe investigar a ressignificação da feminilidade em mulheres da terceira idade. Participaram da pesquisa sete mulheres da terceira idade, moradoras da cidade de Araçatuba, que frequentaram um grupo de vivências denominado "Encontros para o bem viver", grupo esse que faz parte da programação do projeto Universidade da Terceira Idade, da Unesp - Campus de Araçatuba. A coleta de dados foi feita através da utilização de entrevista semidirigida, realizada nas próprias residências das participantes e o material coletado foi sistematizado, transcrito e interpretado para análise qualitativa de seu conteúdo. As análises dos dados foram realizadas através da metodologia de análise do conteúdo proposta por Bardin, que tiveram como eixo a questão do feminino no processo de envelhecimento, ou seja, o entendimento e a compreensão da mulher frente à sua condição nesta fase da vida. Tais leituras foram embasadas também na teoria do curso de vida e em autores que trabalham com a temática da velhice. Os resultados obtidos sugerem que a feminilidade é vivenciada de formas variadas. Algumas participantes relatam mudanças importantes, muitas vezes acompanhada de eventos como a viuvez, doenças inesperadas, separações e aposentadoria. Outras, no entanto, não perceberam quaisquer alterações significativas em suas vidas. No tocante às ressignificações da feminilidade, foi possível verificar que as principais mudanças de sentido situam-se no plano da sociabilidade, com o aumento de amizades; no plano da autonomia pessoal, com a sensação de conquista de maior liberdade e no plano das realizações, com a concretização de aspirações, sonhos e desejos até então cerceados.

This study aims to investigate the resignificance of femininity for oldwomen. The research was conducted through analyses of seven participant's interviews. The participants' profile matched as old women; who lived in Araçatuba city, and were engaged in a weekly group named "Meetings for Well-being", which was sponsored by the Open University for Elderly - UNESP- Campus of Araçatuba. The data were collected through semidirective interviews, which were performed in the participants' own residences. This material was systematized, transcribed and interpreted for qualitative analyses. The interpretation of the data were accomplished through the methodology proposed by Bardin focusing on feminine's pers pective for the aging process, in other words, the women's cognition about their condition facing that phase of life. The analyses were also based on the life course theory and other authors who studied the aging process. The results suggest that femininity is expressed in varied forms. Some individuals refer important changes, frequently linked with events, for example, widowhood, unexpected diseases, separations and retirement. By the other hand, others didn't notice any significant changes in their lives. Concerning the resignificance of femininity, it was possible to observe the most important shifts were related to the level of sociability with the increased number of friendships, in the level of personal autonomy, with the sensation of conquering expanded freedom, and in the level of accom plishments, with the materialization of goals, dreams and desires, which were formerly precluded.

A Juventude como Fase de Vida: dos ritos de passagem aos ritos de impasse / Youth as a Stage of Life: from rites of passage to rites of impasse

O curso de vida apresenta-se segmentado em diferentes fases. Porém, nas três últimas décadas - pelo menos em nível europeu - diversos estudos têm acentuado uma crescente variabilidade na determinação das fronteiras que as separam. No que respeita à juventude é certo que continuam a ser valorizados determinados marcadores de passagem para a chamada idade adulta, como é o caso da obtenção de um emprego, do casamento ou do nascimento do primeiro filho (European Social Survey de 2006/2007). Entretanto, as trajectórias de vida bloqueiam frequentemente encruzilhadas de impasse, determinadas por variáveis societais, apesar de os arranjos de transição cada vez mais se alinharem com estratégias de autonomização, na esteira das teses da individualização. Em sociedades de outrora, existiam ritos de passagem que demarcavam, de modo preciso, a transição dos jovens para a idade adulta. Hoje em dia, muitos desses ritos desapareceram embora alguns ainda sobrevivam. É o que acontece com a chamada festa dos rapazes, rito de iniciação à idade adulta que ocorre em muitas aldeias do nordeste de Portugal, onde a identidade masculina é celebrada de forma festiva, transgressora, orgiástica. Pesquisas etnográficas sobre a festa dos rapazes sugerem-nos que a complexidade do moderno não é redutível a manifestações do passado despidas de suas novas valências significativas. O objectivo deste artigo é, justamente, o de discutir como um antigo rito de expressão localizada se enfrenta a aragens da modernidade. A conclusão entreabre portas para a possibilidade de, entre os jovens, os ritos de passagem estarem a ceder lugar a ritos de impasse.

Does leisure-time physical activity in early adulthood predict later physical activity? Pro-Saude Study / Atividade física de lazer no início da vida adulta prediz a atividade física posterior? Estudo Pró-Saúde

INTRODUCTION: Leisure-Time Physical Activity (LTPA) is a health behavior that is considered relatively stable over the course of life; this life-long habit seems to be shaped during youth and early adulthood. LTPA is one of the few healthy behaviors more prevalent among men than among women. METHODS:Data from 3,199 participants of the Pro-Saude Study were analyzed - a cohort of employees of a university in Rio de Janeiro, collected with a self-reported multidimensional questionnaire. The association between LTPA in early adulthood and later was investigated using multinomial logistic regression, with estimated odds ratios (OR), considering three outcome categories: inactive, insufficiently active, and active. Past LTPA was grouped into three categories: never/rarely (reference category), sometimes and frequently/always. Estimates were adjusted for: age; participants' schooling, their father's and mother's schooling, and color/race. RESULTS:Analysis shows men who engaged in LTPA sometimes and almost always/always in early adulthood had an OR= 1.42 (95 percent CI: 0.70-2.89) and OR= 3.33 (95 percent CI: 1.82-6.10), respectively, of being physically active in later adulthood than those who did not engage in LTPA. Among women, the corresponding odds ratios were lower: OR = 1.19 (95 percent CI: 0.79-1.79) and OR =1.42 (95 percent CI: 1.00-2.04). CONCLUSION:LTPA during early adulthood is associated with physical activity later in adulthood, and this association is stronger in men than in women. Public policies that encourage LTPA among youth, with specific efforts directed at women, could increase the proportion of physically active adults.

INTRODUÇÃO: Atividade física é um comportamento de saúde relativamente estável, em geral determinado no início da vida adulta. Atividade física de lazer (AFL) é um dos poucos comportamentos benéficos à saúde mais prevalente entre homens que entre mulheres. MÉTODOS: Foram analisados dados de 3.199 participantes do Estudo Pró-Saúde - coorte de funcionários de universidade no Rio de Janeiro, coletados por meio de questionário multidimensional e autopreenchível. A associação entre AFL no início da vida adulta e posteriormente foi analisada com uso de regressão logística multinomial, com estimativas de razões de chance (odds ratio) e seus respectivos intervalos de 95 por cento de confiança considerando três categorias de desfecho: sedentários, insuficientemente ativos e ativos. AFL pregressa foi agrupada em 3 categorias: nunca/raramente (categoria de referência), às vezes, quase sempre/sempre. Estimativas foram ajustadas por idade, escolaridade, escolaridade dos pais e cor/raça. RESULTADOS:Homens que se engajavam em AFL às vezes e quase sempre/sempre no início da vida adulta tiveram, respectivamente, OR = 1,42 (IC 95 por cento: 0,70-2,89) e OR = 3,33 (IC 95 por cento: 1,82-6,10) de ser fisicamente ativos em idade posterior do que os sedentários. Entre as mulheres, os odds ratios foram menores: OR = 1,19 (IC 95 por cento: 0,79-1,79) e OR =1,42 (IC 95 por cento: 1,00-2,04). CONCLUSÃO:A prática de AFL durante o início da vida adulta apresentou associação com atividade física posterior, e essa associação foi mais expressiva em homens do que em mulheres. Políticas públicas que encorajem a AFL entre os jovens, com esforços específicos direcionados às mulheres, poderiam aumentar a proporção de adultos fisicamente ativos.

Processos de auto-regulação no curso de vida: controle primário e controle secundário / Self-regulation processes in the life-course: primary and secondary control

Este artigo discute conceitos relevantes à perspectiva do curso de vida, porém pouco difundidos no Brasil: controle primário e controle secundário. O primeiro se refere aos esforços que o indivíduo empreende para adaptar o ambiente às suas necessidades; o segundo, para se adaptar ao ambiente. Apresenta-se a formulação original dos conceitos como modelo de dois processos de controle, em oposição a modelos de processo único, como o do desamparo aprendido. Em seguida, discute-se revisão conceitual que trouxe modificação e ampliação para estes construtos, concebendo-os em um modelo bidimensional que articula controle primário e secundário com os conceitos de seleção e compensação. Nesse processo, apresentam-se contribuições no intuito de estimular a reflexão e expandir a discussão teórico-conceitual que envolve estes construtos.

This article discusses relevant concepts of life course perspective which are not very much diffused in Brazil: primary and secondary control. The former refers to efforts to change the environment so that it fits individual's needs. The latter involves efforts to fit in with the environment. The original definitions are presented as a two-process model of control in contrast to one-process models such as learned helplessness. Furthermore, it discusses a conceptual revision, which modified and expanded these constructs as a bi-dimensional model that relates primary and secondary control to the concepts of selection and compensation. In process of arguing about those, suggestions are presented for thinking and expanding the theoretical and conceptual discussion of these constructs.

O ingresso na universidade após os 45 anos: um evento não-normativo / El ingreso a la universidad después de los 45 años: un evento no-normativo / Admittance to the university after age 45: a non-normative event

Examinam-se neste estudo as razões que levam à decisão de ingressar na universidade na idade adulta, um evento não dependente de gradação por idade, denominado pela perspectiva do curso de vida de evento não-normativo (non-normative event). Os 40 participantes (27 F e 13 M), alunos de uma universidade particular do Centro-Oeste, com idades entre 45 e 60 anos, responderam a seis questões de uma entrevista estruturada, cujas respostas foram preenchidas pela primeira autora. Os resultados indicaram que os respondentes vivenciaram na vida adulta um período de estabilidade e que, embora conscientes das expectativas do seu ambiente quanto ao tempo e à seqüência das transições do ciclo de vida, avaliaram seus recursos pessoais, selecionaram seus objetivos e otimizaram suas capacidades de reserva antes de ingressar no ensino superior. Os resultados são discutidos à luz da perspectiva do curso de vida.

The reasons for admittance to the university after age 45, a non-normative event according to the life-span perspective, are analyzed. Forty students (27 females and 13 males), between 45 and 60 years old, from a private university in the central-western region of Brazil responded to a structured interview administered and recorded by the first author. Results indicate that the respondents perceived their adult life as a period of stability. While conscious of the expectations of their environment as to the time and transitions in their life cycle, the respondents evaluated their personal resources, selected their objectives and optimized their capacities before entering university. These results are discussed according to the life-span perspective frame of reference.

Se examinan en este estudio las razones que llevan a la decisión de ingresar a la universidad en la edad adulta, un acontecimiento no dependiente de gradación por edad, denominado por la perspectiva del curso de vida de evento no-normativo (non-normative event). Los 40 participantes (27 M y 13 H), alumnos de una universidad particular de la región centro-oeste brasileño, con edades entre 45 y 60 años, contestaron a seis preguntas de una encuesta estructurada cuyas respuestas fueron rellenadas por la primera autora. Los resultados indicaron que los respondientes vivenciaron en la vida adulta un periodo de estabilidad y que, aunque conscientes de las expectativas de su ambiente cuanto al tiempo y a la secuencia de las transiciones del ciclo de vida, evaluaron sus recursos personales, seleccionaron sus objetivos y optimizaron sus capacidades de reserva antes de ingresar en la enseñanza superior. Los resultados son discutidos a la luz de la perspectiva del curso de vida.