Evaluación de ingesta dietética según el nivel socioeconómico en un grupo de personas vegetarianas en Colombia

Diferentes estudios han relacionado el nivel socioeconómico con la calidad de la dieta y la prevalencia de riesgo de deficiencia de nutrientes. En personas vegetarianas, cuando no se sigue una dieta adecuada, existe la posibilidad de tener una baja ingesta de ciertos nutrientes, principalmente de vitamina B12, vitamina D, calcio, hierro, zinc, ácidos grasos omega-3 y proteínas. Este estudio tiene como objetivo evaluar la ingesta dietética en personas vegetarianas según su nivel socioeconómico en una región de Colombia. Los participantes completaron un cuestionario en el cual se les preguntó por variables socioeconómicas, antropométricas y la frecuencia de consumo de 48 alimentos y suplementos. Posteriormente, a un subgrupo de la muestra se le realizaron dos recordatorios de 24 horas en diferentes días de la semana. Se encontró que, a menor nivel socioeconómico, hay un menor consumo de lácteos, cereales integrales, frutas y verduras. Así mismo, se observó que según el tipo de vegetarianismo hay diferencias en el consumo de cobalamina, fibra y calcio. Se concluye que, de manera similar a los omnívoros, se requiere de educación nutricional para mejorar la elección de los alimentos y lograr suplir los requerimientos nutricionales, independientemente del nivel económico.

Different studies have related socioeconomic status to diet quality and the prevalence of nutrient deficiency risk. Among vegetarians, when an adequate diet is not followed, there is a possibility of having a low intake of certain nutrients, mainly vitamin B12, vitamin D, calcium, iron, zinc, omega-3 fatty acids and proteins. This study aims to evaluate the dietary intake of vegetarians according to their socioeconomic level in a region of Colombia. Participants completed a questionnaire in which they were asked about socioeconomic and anthropometric variables and the frequency of consumption of 48 foods and supplements. Subsequently, a subgroup of the sample was given two 24-hour reminders on different days of the week. We found that the lower the socioeconomic level, the lower the consumption of dairy products, whole grains, fruits and vegetables. Likewise, it was observed that depending on the type of vegetarianism, there are differences in the consumption of cobalamin, fiber and calcium. We conclude that, similar to omnivores, nutritional education is required to improve the choice of foods and to meet nutritional requirements, regardless of economic level.

Mesotelioma maligno en Colombia: carga de enfermedad, panorama general e índice sociodemográfico subnacional, 2015-2020 / Malignant mesothelioma in Colombia: burden of disease, overview, and subnational sociodemographic index, 2015-2020 / Mesotelioma maligno na Colômbia: carga de morbidade, visão geral e índice sociodemográfico subnacional, entre 2015 e 2020

RESUMEN Objetivo. Establecer la carga de enfermedad por mesotelioma maligno (MM) en Colombia entre 2015 y 2020 y su asociación con el índice sociodemográfico (SDI) subnacional y las localizaciones de asbesto. Métodos. Estudio ecológico mixto en la población colombiana con diagnóstico de MM según la CIE-10 durante 2015 a 2020. La carga global de enfermedad (GBD, por su sigla en inglés) se estimó por medio de la metodología propuesta de Murray y López a partir de la prevalencia y mortalidad obtenida de fuentes oficiales. Se estimó el SDI (por su sigla en inglés) subnacional (nivel departamental) como medida de desarrollo socioeconómico y se establecieron regresiones lineales con la GBD, el SDI y las localizaciones documentadas de asbesto. Resultados. La GBD estimada por MM en Colombia durante 2015-2020 fue de 51,71 años de vida ajustados por discapacidad (AVAD) por cada 1 000 000 de habitantes (15 375,79 AVAD totales), con predominio en personas mayores de 50 años (91,1%) y de sexo masculino (66,4%). A nivel departamental, Bogotá y Valle del Cauca presentaron la mayor cantidad de AVAD ajustados; mientras que Bogotá tuvo el SDI más alto, y Guainía y Cesar el más bajo. Se evidenció una asociación entre los AVAD y el SDI, donde este último explicó 22,8% de los casos de AVAD. Conclusión. El MM es causa de una gran cantidad de AVAD, con predominio en los departamentos con mayor desarrollo socioeconómico, y con presencia de empresas que solían utilizar asbesto; no obstante, el posible subdiagnóstico de MM limita el análisis de la información.

ABSTRACT Objective. Establish the disease burden of malignant mesothelioma (MM) in Colombia between 2015 and 2020, and its association with the subnational sociodemographic development index (SDI) and with asbestos sites. Methods. Mixed ecological study of the Colombian population diagnosed with MM (according to ICD-10) from 2015 to 2020. The global burden of disease (GBD) was estimated using the methodology proposed by Murray and Lopez, based on prevalence and mortality data obtained from official sources. The subnational (departmental level) SDI was estimated as a measure of socioeconomic development. Linear regressions were established with the GBD, SDI, and documented asbestos sites. Results. The estimated GBD of MM in Colombia during 2015-2020 was 51.71 disability-adjusted life years (DALYs) per 1 000 000 inhabitants (15 375.79 total DALYs), with predominance in people over 50 years of age (91.1%) and males (66.4%). Bogotá and Valle del Cauca were the departments with the highest number of adjusted DALYs. Bogotá had the highest SDI and Guainía and Cesar had the lowest. There was evidence of an association between DALYs and SDI, explaining 22.8% of DALYs. Conclusion. Malignant mesothelioma is the cause of a large number of DALYs, predominantly in the departments with greater socioeconomic development and with companies that used to use asbestos. However, possible underdiagnosis of MM limits analysis of the information.

RESUMO Objetivo. Estabelecer o ônus da doença por mesotelioma maligno (MM) na Colômbia entre 2015 e 2020 e sua associação ao índice sociodemográfico subnacional (ISS) e locais de amianto. Métodos. Estudo ecológico misto na população colombiana diagnosticada com MM, de acordo com a CID-10 durante 2015 a 2020. A carga global da doença (CGD) foi estimada usando a metodologia proposta por Murray e López com base na prevalência e na mortalidade obtidas de fontes oficiais. O SDI subnacional (nível departamental) foi estimado como uma medida de desenvolvimento socioeconômico e foram estabelecidas regressões lineares com CGD, SDI e localizações documentadas de amianto. Resultados. A estimativa de CGD por MM na Colômbia entre 2015-2020 foi de 51,71 anos de vida ajustados por incapacidade (AVAI) por 1 000 000 de habitantes (15 375,79 AVAI totais), com predominância em pessoas com mais de 50 anos (91,1%) e do sexo masculino (66,4%). Com relação aos departamentos, Bogotá e Valle del Cauca tiveram o maior número de AVAI ajustados, enquanto Bogotá teve o maior SDI, e Guainía e Cesar, o menor. Houve uma associação entre os AVAI e o SDI, sendo que o SDI foi responsável por 22,8% dos AVAI. Conclusões. O MM é a causa de um grande número de AVAI, predominantemente em departamentos com maior desenvolvimento socioeconômico e com a presença de empresas que usavam amianto; no entanto, o possível subdiagnóstico do MM limita a análise das informações.

The National Wealth Score in the Brazilian National Survey on Child Nutrition (ENANI-2019) / O Indicador Econômico Nacional no Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019) / El Indicador Económico Nacional en el Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019)

The National Wealth Score (IEN) is a synthetic household index that assesses socioeconomic conditions. This study aims to present the methods used to update the IEN using data from the Brazilian National Survey on Child Nutrition (ENANI-2019). The following items were included: the education level of the mother or caregiver of the child; the number of bedrooms and bathrooms, TV sets, and cars in the household; and the presence of a radio, refrigerator or freezer, washing machine, microwave oven, telephone line, computers, air conditioner, media player devices, cable or satellite TV, cell phone ownership and type of service, cell phone internet, and internet at the household. Principal component analysis (PCA) was used to estimate the IEN with and without incorporating the complex sampling design (CSD). Thus, the IEN validation considered proxy indicators of socioeconomic status and living conditions. The first component of the PCA explained 31% and 71% of the variation with and without incorporating the CSD, respectively. The coefficients of variation of the IEN were 53.4% and 2.6% with and without incorporating the CSD, respectively. The mean IEN score was lower in households without access to a sewage system, those that received benefits from Brazilian Income Transfer Program, those with some degree of food insecurity, and those with stunted children. Adding ENANI-2019 items to the calculation of IEN to capture technological advances resulted in a better fit of the model. Incorporating the CSD increased PCA performance and the IEN precision. The new IEN has an adequate performance in determining the socioeconomic status of households with children aged under five years.

O Indicador Econômico Nacional (IEN) é um índice domiciliar sintético que avalia condições socioeconômicas. Este estudo tem como objetivo apresentar os métodos utilizados para atualização do IEN a partir de dados do Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019). Foram incluídos os seguintes itens: escolaridade da mãe/cuidador da criança; o número de quartos e banheiros, aparelhos de TV e carros no domicílio; a presença de rádio, geladeira ou freezer, máquina de lavar, forno micro-ondas, linha telefônica, computadores, ar-condicionado, aparelhos multimídia, TV a cabo ou via satélite, propriedade e tipo de serviço de telefone celular, rede de dados de telefone celular e internet no domicílio. A análise de componentes principais (ACP) foi utilizada para estimar o IEN com e sem a incorporação da amostragem complexa. Assim, a validação do IEN considerou indicadores proxy de nível socioeconômico e condições de vida. O primeiro componente da ACP explicou 31% e 71% da variação com e sem a incorporação da amostragem complexa, respectivamente. Os coeficientes de variação do IEN foram de 53,4% e 2,6% com e sem a incorporação da amostragem complexa, respectivamente. O escore médio do IEN foi menor em domicílios sem acesso a esgoto, naqueles que receberam benefícios do Programa Bolsa Família, naqueles com algum grau de insegurança alimentar e naqueles com crianças com déficit de crescimento. A adição de itens do ENANI-2019 ao cálculo do IEN, a fim de capturar os avanços tecnológicos, resultou em um melhor ajuste do modelo. A incorporação da amostragem complexa aumentou o desempenho da ACP e a precisão do IEN. O novo IEN tem um desempenho adequado na determinação do nível socioeconômico de domicílios com crianças menores de cinco anos.

El Indicador Económico Nacional (IEN) es un índice domiciliar que evalúa las condiciones socioeconómicas. Este estudio tiene como objetivo presentar los métodos utilizados en la actualización del IEN con base en datos del Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019). Se incluyeron los siguientes ítems: nivel educativo de la madre/cuidador del niño; la cantidad de dormitorios y baños, televisores y autos en el hogar; la tenencia de radio, heladera o freezer, lavadora, horno de microondas, línea telefónica, computadoras, aire acondicionado, equipo multimedia, televisión por cable o satélite, titularidad y tipo de servicio de telefonía celular, red de datos celular e internet en el hogar. Se utilizó el análisis de componentes principales (ACP) para estimar el IEN con y sin la incorporación de muestreo complejo. Así, la validación del IEN consideró indicadores proxy de nivel socioeconómico y condiciones de vida. El primer componente ACP explicó el 31% y el 71% de la variación con y sin la incorporación de muestreo complejo, respectivamente. Los coeficientes de variación del IEN fueron el 53,4% y el 2,6% con y sin incorporación de muestreo complejo, respectivamente. El puntaje medio del IEN fue menor en los hogares sin acceso a alcantarillado, en aquellos que recibieron beneficios del Programa Bolsa Família, en aquellos con algún grado de inseguridad alimentaria y en aquellos con niños con retraso en el crecimiento. La incorporación de los ítems del ENANI-2019 en el cálculo del IEN, con el fin de capturar los avances tecnológicos, dio como resultado un mejor ajuste del modelo. La incorporación de muestreo complejo incrementó el desempeño de la ACP y la precisión del IEN. El nuevo IEN tiene un desempeño adecuado para estimar el nivel socioeconómico de los hogares con niños menores de cinco años.

Estilo de vida del adulto mayor de acuerdo con el nivel socioeconómico, ocupación y vecindario / Elder adult´s lifestyle according to socioeconomic status, occupation and neighborhood

Resumen Objetivo: Conocer si el estilo de vida es determinado por el nivel socioeconómico, ocupación y vecindario de adultos mayores. Materiales y métodos: El estudio fue transversal, correlacional, con muestreo no probabilístico por conveniencia usando medios digitales de grupos conocidos. Se contactaron 101 adultos mayores por correo electrónico, WhatsApp o a través de conocidos. Los datos fueron recolectados mediante la herramienta digital QuestionPro. Se usaron las subescalas del instrumento FANTASTIC: actividad física, nutrición, toxicidad (tabaco), alcohol, sueño, estrés y control de la salud; Neighborhood Environment Walkability Survey; el AMAI para valorar estilos de vida, caminabilidad del vecindario y nivel socioeconómico, respectivamente. así como preguntas abiertas sobre ocupación. Las medidas de tendencia central, dispersión, frecuencias y porcentajes describen las variables continuas y nominales, el Alpha de Cronbach la consistencia interna de los instrumentos y prueba de Kolmogorov Smirnov con corrección de Lilliefors para la distribución de variables. Se usaron coeficientes de correlación de Spearman y modelos de regresión lineal múltiple para responder los objetivos. Resultados: A medida que el nivel socioeconómico mejora las medias de caminabilidad del vecindario aumentan (p < 0.001). El modelo de regresión lineal múltiple fue significativo (p < 0.001), el nivel socioeconómico (p = 0.006) y vecindario (p = 0.005), explican el 28% de la variación de estilos de vida. Conclusiones. El estudio permitió confirmar las teorizaciones en el sentido de que el estatus social y las oportunidades de vida, entendidas como el entorno inmediato juegan un papel importante en la elección del estilo de vida, en este caso representado por nivel socioeconómico y la caminabilidad del vecindario de los adultos mayores. Sin embargo, ello evidencia la desigualdad de oportunidades para mantener un estilo de vida saludable por parte de los adultos mayores, y es a la vez un reto para los profesionales de la salud.

Abstract Objective: To learn if elder adults lifestyle is determined by socioeconomic status, occupation, and neighborhood. Materials and methods: The design was cross sectional, correlational and a convenience non probabilistic sampling through digital social networks of known groups was used. One hundred and one older adults were contacted through e-mail, WhatsApp or by known groups (friends, classmates, professors). Data were collected through the QuestionPro digital tool. Lifestyle was measure using the following subscales: physical activity, nutrition, toxicity (tobacco), alcohol, sleep, stress and health control of the FANTASTIC instrument. Neighborhood's walkability was measured by short version of the Neighborhood Environment Walkability Survey, the AMAI index was used to determine the socioeconomic status, and the type of past or present occupation, activities performed and number of people under their command. Descriptive statistics, Cronbach's Alpha, Kolmogorov Smirnov test with Lilliefors correction, and nonparametric statistics were used. Results: As socioeconomic status went up medians of neighborhood walkability increased (p < 0.001). The linear multiple regression model was significant (p < 0.001); socioeconomic status (p = 0.006), and neighborhood (p = 0.005), explained 28% of the lifestyle variance. Conclusions. The study allowed some theoretical confirmation, in that social status, and life opportunities like environment, play an important role on lifestyle choices, in this study represented by socioeconomic status and neighborhood's walkability of elder adults. But results evidence social inequalities of opportunities to keep a healthy lifestyle by elder adults and at the same time it is a challenge for health professionals.

Habilidades de comprensión y producción narrativa en niños montevideanos de 5 años. Una comparación por nivel socioeconómico / Narrative abilities in a group of Uruguayan preschoolers from different socioeconomic backgrounds

Resumen Este estudio caracteriza y compara las habilidades narrativas y el vocabulario receptivo de 54 preescolares montevideanos de nivel socioeconómico medio (NSM) y bajo (NSB). Los niños realizaron tareas de vocabulario receptivo, producción narrativa (en dos condiciones: manipulando títeres al contar la historia y sin manipularlos), y comprensión narrativa (recuento oral y preguntas posteriores a la reconstrucción). Las narrativas fueron transcritas, codificadas y analizadas en términos de super y macroestructura siguiendo la gramática de historias de Stein y Glenn (1979) (coherencia) y de microestructura (productividad y complejidad). Los niños de ambos grupos tuvieron un desempeño acorde a su edad en comprensión y producción narrativa, a pesar de que el grupo de NSM tuvo un mejor desempeño en vocabulario receptivo. Hubo diferencias en comprensión (cantidad de episodios recuperados y en la respuesta a preguntas) que favorecieron al NSM, pero no en la cantidad de categorías recuperadas ni en la extensión y complejidad del recuento. Para producción narrativa no hubo diferencias en secuencia narrativa, ni en la cantidad de episodios completos en ninguna de las condiciones, pero sí en cuanto a la complejidad sintáctica en la condición sin títeres. Los resultados muestran una relación compleja entre vocabulario y habilidades narrativas, dado que diferencias importantes en vocabulario no se reflejaron de manera homogénea en el desempeño narrativo. Estos resultados aportan a los debates actuales sobre el papel del vocabulario en el desarrollo de habilidades narrativas, así como a pensar la validez ecológica de las evaluaciones en el desarrollo cognitivo y lingüístico.

Abstract Narrative abilities are an important part of communication, academic success, and healthy relationships. These abilities involve complex language and cognitive skills, such as precise vocabulary, control of the coherence markers, relations of cause-effect, and planning. They are also relevant during the elementary school years and interact with the socio-emotional skills necessary to understand different points of view. Oral narrative production develops dramatically from 3 to 5 years of age and is a key factor in a child's ability to communicate about the world. During this period narratives are a product of increasing linguistic sophistication over the preschool period and there is a complex relationship between early narratives and language proficiency. So far, most research about this topic has been pursued in populations other than Latin American preschoolers. At the same time, a considerably lesser number of studies about narrative abilities development have been carried out comparing typically developing children from different socioeconomic backgrounds. To our knowledge, there are no studies in Uruguay that assess the narrative abilities development in typically developing preschool children who grow up in vulnerable contexts. It is therefore of the utmost relevance to produce empirical evidence for this population. For these reasons, this study aimed at characterizing and comparing narrative abilities and receptive vocabulary in a group of a total of 54 Uruguayan preschoolers from different socioeconomic backgrounds (middle and low socioeconomic status, SES). Children were assessed in receptive vocabulary and narrative abilities across two task conditions: (1) narrative comprehension through a story retelling task which included some final questions about the story; (2) narrative production elicited from a set of thematically related puppets. The examiner gives a child a puppet set and asks him/her to elaborate a narrative using them. After that, puppets are removed and the child is asked to retell the story without puppets. Children's oral productions were video-taped and then transcribed and categorized using the ELAN software (Max Planck Institute for Psycholinguistics, 2019). The verbal information was categorized according to Stein and Glenn's (1979) story grammar and considering the microstructural aspects (productivity and complexity). Analyses showed that both groups performed according to their stage of development in both narrative task conditions. With regards to the narrative comprehension task, no differences in the number of recovered categories, extension, or narrative complexity were observed. Concerning the narrative production task, there were no differences between the groups in narrative sequences, nor in the number of completed episodes in conditions neither with puppets nor without puppets. Results showed that children who grow up in poverty perform more poorly than their peers from middle-income families in receptive vocabulary, in the number of recovered episodes, ask-answer items of narrative comprehension tasks. Moreover, concerning the microstructural parameters analyses showed that children from middle socioeconomic backgrounds scored better in syntactic complexity in the without puppets condition. No differences between the groups were observed in syntactic complexity in the puppets condition. Taken together these results indicate a complex link between vocabulary and narrative abilities. It is worth noting that important differences in vocabulary did not reflect in the children's narrative performance. These findings are also relevant as a contribution to an ongoing debate about the role of vocabulary in the development of narrative abilities. Furthermore, these results could inform the discussion about the ecological validity of the test of cognitive and linguistic development. Finally, to provide some additional evidence to Uruguayan Spanish language about the relationships between oral language and cognitive development allows to carry out early interventions before formal schooling sets children for success in school and life.

Estudiantes con alta capacidad: explorando su distribución según tipo de establecimiento educativo / Gifted Students: Exploring their Distribution According to the Type of Educational Institution

Resumen Antecedentes: estudiantes con alta capacidad o potencial de talento académico, necesitan un entorno enriquecedor para alcanzar un desempeño sobresaliente, y fenómenos como la segregación escolar impactan negativamente la transformación del potencial intelectual en talento académico. Objetivo: comparar la distribución de estudiantes con alta capacidad de quinto básico a cuarto medio de la provincia de Concepción, Chile, provenientes de familias de nivel socioeconómico bajo, medio y alto, según el tipo de establecimiento educativo en que estudian. Método: participaron 650 estudiantes entre 11 y 17 años de edad, quienes respondieron el test de matrices progresivas de Raven, el cual permitió identificar el potencial intelectual según el puntaje de corte. Resultados: hay diferencias estadísticamente significativas en el potencial intelectual entre estudiantes de establecimientos públicos, particulares subvencionados y particulares pagados, así como diferencias en la distribución del potencial intelectual según el nivel educativo de los estudiantes y el nivel socioeconómico de sus familias. Conclusiones: al explorar la distribución de estudiantes con alta capacidad según el tipo de establecimiento educativo, hay una mayor concentración de estudiantes con alta capacidad en establecimientos educativos con familias de nivel socioeconómico alto y una menor concentración de estos en establecimientos educativos con familias de nivel socioeconómico bajo.

Abstract Background: Gifted students or students with academic potential need an enriching environment to achieve an outstanding performance. However, phenomena such as school segregation negatively affect the transformation of intellectual potential into academic talent. Objective: To compare the distribution of gifted students from the fifth grade of elementary school to the fourth year of high school in the Province of Concepción, Chile, coming from families of low, medium and high socioeconomic status, determined by the type of educational institution in which they study. Method: Six hundred fifty (650) students aged between 11 and 17 participated in the study and answered the Raven's Progressive Matrices Test, which allowed the identification of the intellectual potential based on the cut-off score. Results: Statistically significant differences were found in the intellectual potential among students from public, subsidized private and fee-paying private educational institutions, as well as differences in the distribution of the intellectual potential relative to the students' education level and their families' socioeconomic status. Conclusions: When exploring the distribution of gifted students according to the type of educational institution, there was a higher concentration of those students in educational institutions with families of high socioeconomic status, and a lower concentration in educational institutions with families of low socioeconomic status.

Inequality, abuse of women and duration of breastfeeding, Colombia, 2010: Ecological study / Desigualdad, maltrato de la mujer y duración de la lactancia materna, Colombia, 2010: Estudio ecológico

Abstract Introduction: Breastfeeding decreases morbidity, mortality and promotes health in the mother and child. The lower morbidity in relative terms in breastfed versus non-breastfed infants reduces healthcare costs. In Colombia, the duration of breastfeeding is far from desirable times and continues to decline. Objectives: The objectives were (a) to determine economic inequality based on poverty at the ecological level during exclusive breastfeeding (EBF) and total breastfeeding (BF) and (b) to establish the social determinants of EBF and BF using the territory as a unit of analysis. Method: An ecological study was conducted based on data collected in the National Survey of the Nutritional Situation of 2010 in Colombia regarding the median duration of exclusive breastfeeding and total breastfeeding. The data was summarized in 24 departments or geodemographic units that represent the Colombian territory (n=24). Fourteen variables representing the economic, social, human and structural development levels in the territory were related by linear regression to explain the duration of EBF and BF. Results: EBF lasted 1.18 months (95% CI: 1.00 to 1.36), and BF lasted 14.79 months (95% CI: 13.50 to 16.08). Economic inequality was low, and the Gini coefficient was 0.35 for EBF and 0.10 for BF. The EBF duration is affected by the gender empowerment measure (GEM) (β =-1.94, p=0.006) and medical coverage (%) (β =-0.02, p=0.060). The BF duration is explained by the monetary poverty (β =0.12, p=0.007) GEM (β =-9.94, p=0.033) and female abuse rate x 100,000 (β =0.01, p=0.005). Conclusions: The impact of social and human development is greater than the economic aspect as a determinant of EBF and BF duration in Colombia. Exclusive and total breastfeeding are phenomena explained differently.

Resumen Introducción: La lactancia materna disminuye la morbilidad, la mortalidad y promueve la salud de la madre y del niño. La menor morbilidad en términos relativos en los niños amamantados frente a los no amamantados reduce los costes sanitarios. En Colombia, la duración de la lactancia materna está lejos de los tiempos deseables y sigue disminuyendo. Objetivos: Los objetivos fueron (a) determinar la desigualdad económica basada en la pobreza a nivel ecológico durante la lactancia materna exclusiva (LME) y la lactancia materna total (LMT) y (b) establecer los determinantes sociales de la LME y la LMT utilizando el territorio como unidad de análisis. Método: Se realizó un estudio ecológico a partir de los datos recogidos en la Encuesta Nacional de Situación Nutricional de 2010 en Colombia sobre la mediana de duración de la lactancia materna exclusiva y la lactancia materna total. Los datos se resumieron en 24 departamentos o unidades geo demográficas que representan el territorio colombiano (n=24). Catorce variables que representan los niveles de desarrollo económico, social, humano y estructural del territorio se relacionaron mediante regresión lineal para explicar la duración de la LME y la LMT. Resultados: La LME tuvo una duración de 1,18 meses (IC 95 %: 1,00 a 1,36), y la LMT tuvo una duración de 14,79 meses (IC 95 %: 13,50 a 16,08). La desigualdad económica fue baja, y el coeficiente de Gini fue de 0,35 para la LME y de 0,10 para la LMT. La duración de la LME se ve afectada por la medida de empoderamiento de género (GEM) (β =-1,94, p=0,006) y la cobertura médica (%) (β=-0,02, p=0,060). La duración de la LMT se explica por la pobreza monetaria (β =0,12, p=0,007) GEM (β =-9,94, p=0,033) y la tasa de maltrato femenino x 100 000 (β =0,01, p=0,005). Conclusiones: En Colombia el impacto del desarrollo social y humano es mayor que el aspecto económico como determinante de la LME y de la duración de la LMT. La lactancia materna exclusiva y total son fenómenos que se explican de manera diferente.

Socioeconomic Status, Urbanization and Executive Functions Development: Differences Between Urban and Rural Children / Status Socioeconômico, Urbanização e Desenvolvimento de Funções Executivas: Diferenças entre Crianças Urbanas e Rurais

Abstract Socioeconomic Status (SES) has been linked to the development of Executive Functions (EF) usually by means of parental education and family income. Living conditions related to urbanization characteristics are rarely considered. This cross-sectional study investigated the performance in EF tasks of 99 Brazilian children aged 6 to 8 years residing in rural and urban regions. Results showed that children who lived in the rural area performed better than those who lived in the industrial city in the working memory and inhibitory tasks. Social interactions and urbanization conditions, such as parent occupations and social stratification, may explain these differences. Therefore, urbanization conditions of locations where families live should be considered in future studies concerning the influences of SES in EF development.

Resumo O Status Socioeconômico (SES) tem sido vinculado ao desenvolvimento das Funções Executivas (FE), geralmente por meio da educação dos pais e da renda familiar. As condições de vida e a urbanização raramente são consideradas. Este estudo transversal investigou o desempenho em tarefas de FE de 99 crianças brasileiras de 6 a 8 anos residentes em regiões rurais e urbanas. Os resultados demonstram crianças residentes na zona rural obtendo desempenho superior às em cidade industrial em memória operacional e tarefas inibitórias. As interações sociais e as condições de urbanização, como ocupações dos pais e estratificação social, podem explicar essas diferenças. Portanto, as condições de urbanização devem ser consideradas em estudos futuros sobre as influências do SES no desenvolvimento do EF.

Teste de dígitos no ruído no Português Brasileiro: influência das variáveis demográficas e socioeconômicas em normo-ouvintes / Digits-in-noise test in Brazilian Portuguese: how demographic and socioeconomic variables influence normal-hearing subjects

RESUMO Objetivo Verificar a influência das variáveis demográficas e socioeconômicas no limiar de reconhecimento de fala no ruído (LRF) obtidos no teste de dígitos no ruído (TDR) no Português Brasileiro em normo-ouvintes. Método Estudo transversal e prospectivo. A amostra de conveniência foi composta por 151 sujeitos normo-ouvintes com idade entre 12 e 79 anos (média =34,66) que realizaram audiometria tonal liminar e teste de dígitos no ruído branco com sequência de trios numéricos em estímulo diótico (inphase) no mesmo dia. O TDR foi realizado com um smartphone Motorola Z3 play com acesso à internet com fones de ouvido intra-auriculares. Os limiares de reconhecimento dos dígitos no ruído (LRF) foram analisados em função do sexo, idade, escolaridade e nível socioeconômico. Foi utilizado para comparar as amostras independentes, o teste não-paramétrico Kruskal-Wallis e Mann-Whitney, adotando-se o nível de significância de 5%. Resultados A média do LRF foi de -8,47 dBNA (dp -3,89), com mediana de -9,6 dBNA. O LRF foi proporcionalmente inverso à escolaridade e nível socioeconômico e mais negativo (isto é, melhor) com menor faixa-etária. Não houve evidência de influência do sexo no LRF do TDR. Conclusão Idade, escolaridade e nível socioeconômico mostraram influenciar o limiar no TDR; essas variáveis devem ser consideradas na análise de desempenho do TDR no Português Brasileiro em sujeitos normo-ouvintes.

ABSTRACT Purpose Verify how demographic and socioeconomic variables on the in-noise speech recognition threshold (SRT) from the digits-in-noise test (DIN) in Brazilian Portuguese influence normal-hearing subjects. Methods Cross-sectional, prospective study. The convenience sample had 151 normal-hearing subjects between 12 and 79 years (mean=34.66) who underwent pure tone audiometry and digits-in-noise test with white noise using a sequence of three numbers in diotic stimulus (in-phase) on the same day. The DIN was performed using a Motorola Z3 Play smartphone with internet access and in-ear headphones. In-noise digit speech recognition threshold (SRT) was analyzed for gender, age, educational levels, and socioeconomic status. We used the non-parametric version of the Kruskal-Wallis and Mann-Whitney U tests to compare independent samples adopting a significance level of 5%. Results The mean SRT was -8.47 dBNA (SD -3.89) with a median of -9.6 dBNA. The SRT was proportionally inverse to educational levels and socioeconomic status and more negative (better) with lower age groups. Gender did not influence the DIN SRT. Conclusion Age, educational levels, and socioeconomic status influenced the DIN threshold. These variables must be considered when analyzing DIN performance in Brazilian Portuguese in normal-hearing subjects.

Incidência, mortalidade e tendências do câncer de estômago no Brasil: um estudo de base populacional / Incidence, mortality and trends of stomach cancer in Brazil: a population-based study

INTRODUÇÃO: O câncer de estômago (CaE) ocupou o 5º lugar de todos os cânceres que ocorreram no mundo em 2020 e foi a 4ª principal causa de morte por câncer no Brasil, e a 4ª mais frequente entre os homens e o 6º nas mulheres. A incidência e mortalidade de CaE variam de acordo com o IDH (Índice de Desenvolvimento Humano). Essas variações são atribuídas a diferentes fatores de riscos associados ao estilo de vida, a prevalência de H. Pylori e detecção precoce do CaE. OBJETIVO: analisar o perfil epidemiológico de incidência, mortalidade e tendências do CaE no Brasil e verificar as suas associações com IDH. MÉTODOS: Os dados para a incidência foram extraídos dos Registros de Câncer de Base Populacional (RCBP), de 1988 à 2017, sob o código C-16 (neoplasias maligna do estômago) e os dados da mortalidade extraídos do Sistema de Informação de Mortalidade do Sistema Único de Saúde (DATASUS). Foram calculadas as taxas de incidência e mortalidade brutas e padronizadas. Para as análises de tendência foi utilizado a análise de regressão no programa Joinpoint Regression Program (SEER). Os dados do IDH foram extraídos do banco do Programa das Nações Unidas para o Desenvolvimento (PNUD). Para as análises de correlação de Pearson foi utilizada o programa Stata 15. Os efeitos de idade-período-coorte de nascimento foram estimados para a mortalidade pelo modelo de APC calculados pelo pacote Epi do software R. RESULTADOS: A incidência do CaE foi o dobro no sexo masculino. As maiores taxas incidência foram observadas na região Norte com tendência de estabilidade na maioria das capitais brasileiras. Foi observado correlação negativa do IDH e IDH-longevidade com as taxas padronizadas de incidência para homens e mulheres e IDH-educação para mulheres. A mortalidade foi maior para homens e as maiores taxas foram observadas no Amapá. A região Sul apresentou as maiores taxas de 2000-2009 e em 2010-2019 foi a região Norte para homens e mulheres. As regiões Sul, Sudeste e Centro-oeste apresentaram tendências de redução da mortalidade de CaE, enquanto as regiões Nordeste e Norte aumento nos últimos 20 anos. As taxas de mortalidade de CaE aumentam com a idade (> 60anos), com risco maior de óbito em homens e mulheres nascidos após a década de 1960 nas regiões Nordeste e Norte, o risco diminui nas regiões Sudeste, Sul e Centro-Oeste para ambos os sexos. Houve correlação positiva da taxa de CaE (2000-2010) com IDH (2000) para ambos os sexos e correlação negativa para a tendência. CONCLUSÃO: A incidência de CaE apresentou estabilidade para a maioria das capitais do Brasil e a mortalidade aumento para as regiões Norte e Nordeste. O risco de CaE é maior em pessoas acima de 60 anos e o IDH correlaciona-se inversamente com as taxas de incidência e tendências da mortalidade na primeira década e positivamente na taxa de mortalidade no mesmo período. A análise permite verificar que as melhorias no desenvolvimento socioeconômico ao longo do tempo podem contribuir para a redução na tendência da mortalidade do CaE.

INTRODUCTION: Stomach cancer (SC) ranked 5th among all cancers that occurred in the world in 2020 and was the 4th leading cause of cancer death in Brazil, and the 4th most frequent among men and the 6th among women. The incidence and mortality of SC varies according to the HDI (Human Development Index). These variations are attributed to different risk factors associated with lifestyle, H. pylori prevalence, and early detection of SC. OBJECTIVE: to analyze the epidemiological profile of incidence, mortality and trends of SC in Brazil and to verify its associations with HDI. METHODS: Data for incidence were extracted from the Population Based Cancer Registry (PBCR), 1993 to 2017, under code C-16 (malignant neoplasms of the stomach) and mortality data from the Information System of Mortality of the Unified Health System (DATASUS). Crude and standardized incidence and mortality rates were calculated. For trend analysis, linear regression analysis was used in the Joinpoint Regression Program (SEER). HDI data were extracted from the United Nations Development Program (UNDP) database. For Pearson's correlation analysis, the Stata 11.2 program was used. The age-period-birth cohort effects from 2000-2019 were estimated by the APC model calculated by Epi of the R software. RESULTS: The incidence of SC in Brazil were twice as high in males. The highest incidence rates were observed in the North region, with a trend towards stability in most Brazilian capitals. A negative correlation of IDH and HDI-longevity with the standardized incidence rates for men and women and HDI-education for women was observed. Mortality was higher for men and the highest rates were observed in Amapá. The South region had the highest rates from 2000-2000 and in 2010-2019 it was the North region for men and women. The South, Southeast and Central-West regions showed a tendency to reduce SC, while the Northeast and North regions increased in the last 20 years. SC mortality rates increase with age (> 60 years), with a higher risk of death in men and women born after the 1960s in the Northeast and North regions and the risk decreases in the Southeast, South and Midwest regions for both the sexes. There was a positive correlation between the SC rate (2000-2010) and the HDI (2000) for both sexes and a negative correlation for the trend. CONCLUSION: The incidence of SC remained stable for most capitals in Brazil and mortality increased in the North and Northeast regions. The risk of SC is higher in people over 60 years of age and the HDI is inversely correlated with incidence rates and mortality trends in the first decade and positively with the mortality rate in the same period. The analysis makes it possible to verify that improvements in socioeconomic development over time can contribute to a reduction in the mortality trend of SC

Niveles de actividad física y su relación con el nivel socioeconómico en adultos de la comuna La Florida

RESUMEN Fundamento: las medidas de aislamiento inducidas por la pandemia de la COVID-19 provocaron una disminución de los niveles de actividad física y un aumento del sedentarismo. Estas condiciones generaron un aumento de la prevalencia de trastornos derivados de estas conductas sedentarias. Aún se desconoce qué factores se ven involucrados en esta disminución de los niveles de actividad física. Objetivo: verificar si existe relación entre el nivel socioeconómico y los niveles de actividad física en adultos pertenecientes a la Región Metropolitana de Chile. Método: participaron 130 personas que respondieron el cuestionario que mide los niveles de actividad física a través de los equivalentes metabólicos y que contestaron sobre la escala personal que mide el bienestar subjetivo, finalmente se consultó sobre cuál era su nivel socioeconómico durante este periodo. Resultados: se determinó que existieron diferencias significativas (p<0,05) en relación a la cantidad de actividad física realizada por las personas que viven en casas versus departamentos y diferencias según el nivel socioeconómico. Se obtuvo una diferencia entre los grupos media-baja y baja; media-baja y media-alta; media y baja; media y alta; baja y media-alta; baja y alta; media-alta y alta. Respecto a la relación existente entre el nivel de bienestar y la realización de actividad física, esta no tuvo un índice relevante (0,09). Conclusiones: las diferencias estadísticamente significativas en el tipo de vivienda y el nivel de actividad física entre los sujetos indica que podría incidir en que el espacio intradomiciliario, es un factor influyente a la hora de poder realizar algún tipo de actividad física. Se debe considerar una variable relevante al momento de planificar acciones preventivas.

ABSTRACT Background: the isolation measures induced by the COVID-19 pandemic caused an increase in sedentary lifestyle and a decrease in physical activity levels. These conditions generated an increase in the prevalence of disorders derived from these sedentary behaviors. It is still unknown what factors are involved in this decrease in physical activity levels. Objective: to verify if there is a relationship between the socioeconomic level and the levels of physical activity in adults belonging to the Chile Metropolitan Region. Method: 130 people participated who answered the questionnaire that measures the levels of physical activity through the metabolic equivalents and who answered on the personal scale that measures subjective well-being and finally, they were asked about their socioeconomic level during this period. Results: it was determined that there were significant differences (p<0.05) in relation to the amount of physical activity in people living in houses versus apartments and differences according to socioeconomic level. It was obtained a difference between the medium-low and low groups; medium-low and medium-high; medium and low; medium and high; low and medium-high; low and high; medium-high and high. Regarding the relationship between the level of well-being and the performance of physical activity, this did not have a relevant index (0.09). Conclusions: the statistically significant differences in the type of housing and the level of physical activity between the subjects indicate that it could influence that the intradomiciliary space is an influential factor when it comes to being able to carry out some type of physical activity. A relevant variable should be considered when planning preventive actions.

Diferencias en el estado nutricional y potencia aeróbica máxima en adolescentes de acuerdo al nivel de vulnerabilidad

RESUMEN Introducción: Chile, en los últimos 40 años, ha presentado cambios sociales que han influido en el nivel de vulnerabilidad de niños, niñas y adolescentes. Este nivel es determinado a través del índice de vulnerabilidad (IVE). El objetivo de este estudio es analizar diferencias en el estado nutricional y potencia aeróbica máxima de acuerdo al IVE, en estudiantes de 14 años de establecimientos educacionales de comunas de la Región Metropolitana de Chile. Método: fueron evaluados 186 escolares de 14,1 ± 0,7 años (88 hombres y 98 mujeres), pertenecientes a 8 establecimientos educacionales, caracterizados por IVE (IVE-0 e IVE-89). Las variables antropométricas medidas fueron peso, talla, perímetro de cintura, IMC, Z-score-IMC y relación cintura estatura. La potencia aeróbica máxima fue medida por el consumo máximo de oxígeno (VO2máx) relativo al peso corporal (mlO2·kg−1·min−1) obtenido de la prueba de 20 m ida y vuelta. Resultados: Fueron observadas diferencias por IVE en Zscore-IMC [IVE-0: 0,761 (0,352 −1,19) IVE-89: 1,29 (0,341-2,45) (p<0,0001)] y potencia aeróbica máxima [IVE-0: 46 (42,1-50,2) IVE-89: 43,7 (33,2-46,3) (p<0,0001)] en los escolares. Además, se demostró que adolescentes obesos presentan 5,34 mayor probabilidad de presentar menores valores VO2máx, de igual forma, este modelo demuestra que, pertenecer al grupo con mayor vulnerabilidad (IVE 89), expone a los adolescentes a 5,09 veces la probabilidad de presentar valores bajos de VO2máx. Conclusiones: Adolescentes, pertenecientes a establecimientos educacionales con mayor índice de vulnerabilidad presentan mayor prevalencia de sobrepeso u obesidad y menor capacidad cardiorrespiratoria.

ABSTRACT Introduction: In the last 40 years, Chile has presented social changes, which influence the level of vulnerability of children and adolescents, as measured by a vulnerability index (EVI). Objective: To analyze the differences by EVI in nutritional status and cardiorespiratory fitness, as well as, the relationship between these variables in 14-year-old students. Method: Adolescents (n= 186, 88 males and 98 females) were 14.08±0.72 years of age from 8 educational establishments were characterized according to the EVI (EVI-0 and EVI-89) of their educational establishment. Weight and height were measured to determine BMI and BMI z-score, waist circumference, waist height ratio and cardiorespiratory fitness was measured by the maximum oxygen consumption (VO2max) relative to body weight (mlO2·kg−1·min−1) using the 20 m shuttle run test. Results: Differences were observed by EVI in BMI z-score [EVI-0: 0.761 (0.352 −1.19) EVI-89: 1.29 (0.341 −2.45) (p<0.0001)] and cardiorespiratory capacity of adolescents [EVI-0: 46 (42.1-50.2) EVI-89: 43.7 (33.2 - 46.3) (p<0.0001)]. In addition, it was shown that obese adolescents had 5.34 greater probability of presenting lower VO2max values, in the same way, this model shows that, belonging to the group with greater vulnerability (IVE 89), exposed adolescents to 5.09 times the probability of presenting low VO2max values. Conclusions: Adolescents belonging to educational establishments with greater vulnerability due to EVI present a higher prevalence of overweight or obesity and lower cardiorespiratory fitness than those more economically favored.

Asociación del nivel socioeconómico y educacional en los egresos por cáncer de mama en Chile durante los años 2001 al 2016 / Association of the socioeconomic and educational level in the breast cancer hospital outbreaks in Chile during the years 2001 to 2016

Introducción: El cáncer de mama constituye la primera causa de muerte en los cánceres en Chile según Globocan 2018. Dentro de los factores que explican esta alta mortalidad encontramos una baja tasa de detección y de realización de mamografías en los niveles socioeconómicos altos. Es por esto que comprender las causas de defunción y los factores que afectan en la mortalidad y letalidad por cáncer de mama en los últimos 17 años nos permitirá enfocar las políticas públicas de los próximos 50 años. Los objetivos generales de este trabajo fueron caracterizar los egresos hospitalarios en los pacientes por cáncer de mama según la edad, el sexo, la previsión, el nivel socioeconómico y educacional en Chile durante los años 2001 al 2016 y calcular la mortalidad y letalidad específica en estas mismas variables durante los años 2001 a 2016. El objetivo específico es asociar las variables socioeconómicas y educacionales, estimando los Odd's ratios de las variables en los egresos hospitalarios por cáncer de mama en Chile durante los años 2001 al 2016. Materiales y Métodos: Estudio de cohorte longitudinal retrospectivo en 81,072 egresos hospitalarios y 20,220 defunciones obtenidas de la página DEIS MINSAL, años 2001-2016. Para el análisis univariado se efectuó una regresión de ajuste de tasas Prais-weinstein según edad y sexo según modelo OMS de ajuste de tasas. Para las variables de tipo discreta se describieron mediante porcentajes y tasas y para las variables de tipo continua se utilizó mediana y desviación estándar. Se efectuó un test de smirnov-kolmolgorov para determinar el tipo de distribución y de normalidad de las muestras. Para las variables de tipo dicotómica se utilizó un modelo de regresión logística binaria para describir estas variables y determinar la posible asociación entre el nivel socioeconómico y educacional de las pacientes diagnosticadas por cáncer de mama. Resultados: Murieron 1,88 veces más personas de nivel socioeconómico alto con un IC entre 1,83- 1,94 con respecto a la población de nivel socioeconómico bajo. En cambio, las personas con un mayor nivel educacional murieron 0,5 veces menos según la regresión realizada respecto al bajo nivel educacional con un IC entre 0,47- 0,52, pero a menor nivel educacional aumentó 20 veces la mortalidad, constituyendo una causa inversa. Respecto al sexo las mujeres murieron 2,08 veces más que los hombres. Para el nivel socioeconómico alto en relación al bajo un OR [1.88 (1.83 a 1,94)], p<0,0001], para el nivel educacional alto en relación al bajo fue a favor del mayor nivel educacional con OR [0,5 (0,47 - 0,52)] y en cuanto a la comparación de sexos un OR [1,04 (1,03-2,17), p=0,039]. Es decir, la diferencia entre mortalidad que hubo fue significativa para todos los intervalos tanto para sexo, nivel educacional como para nivel socioeconómico. Se encontró una constante de 0,013 de mortalidad basal, es decir, todos tienen 1,3% de riesgo de morir por cáncer de mama independiente del nivel socioeconómico, educacional y del sexo. Conclusión: Existen diferencias estadísticamente significativas respecto a la mortalidad entre los niveles socioeconómicos altos y bajos y también en nivel educacional, sin embargo, al realizar los métodos de regresión se obtuvo una mayor mortalidad y mayor riesgo de morir por cáncer de mama en los niveles socioeconómicos más altos asociados a, probablemente, la menor cantidad de tamizajes y realización de mamografías en este estrato. A partir del año 2008 se observó un incremento a los niveles originales observados al inicio del segundo milenio incrementando las diferencias existentes en los índices de desigualdad tanto por nivel educacional como por nivel socioeconómico incrementando en 20 veces respecto al nivel educacional, y 1.88 respecto al nivel socioeconómico.

Introduction: Breast cancer is the leading cause of death in cancers in Chile according to Globocan 2018. Among the factors that explain this high mortality, we find a low rate of detection and performance of mammograms in high socioeconomic levels. This is why understanding the causes of death and the factors that affect mortality and fatality from breast cancer in the last 17 years will allow us to focus on public policies for the next 50 years Materials and Methods: Retrospective longitudinal cohort study in 79,996 hospital discharges and 20,220 deaths obtained from the DEIS MINSAL page, years 2001 -2016. For the univariate analysis, a Prais-Weinstein rate adjustment regression was performed according to age and sex according to the WHO rate adjustment model. For discrete type variables, they were described by percentages and rates, and median and standard deviation were used for continuous type variables. A smirnov-kolmolgorov test was performed to determine the type of distribution and normality of the samples. For dichotomous variables, a binary logistic regression model was used to describe these variables and determine the possible association between the socioeconomic and educational level of the patients diagnosed with breast cancer. Abstract: In this observational, longitudinal and retrospective study with 101.292 patients that includes men and women of all ages with diagnosis of breast cancer all along Chile, we´ll analyze the impact of socioeconomic level, evaluated through educational level and money income, into the prevalence, mortality and lethality of breast cancer in the years 2001 to 2016. Results: People with a high socioeconomic level died 1.88 times more, with a CI between 1.83 and 1.94, than those with a low socioeconomic level. On the other hand, people with a higher educational level died 0.5 times less according to the regression carried out with respect to the low educational level with a CI between 0.47 and 0.52, but the lower the educational level the mortality increased 20 times, constituting an inverse cause. Regarding sex, women died 2.08 times more than men. For the high socioeconomic level in relation to the low one an OR [1.88 (1.83 to 1.94)], p<0.0001], for the high educational level in relation to the low one it was in favor of the higher educational level with OR [0.5 (0.47 - 0.52)] and as for the comparison of sexes an OR [1.04 (1.03-2.17), p=0.039]. In other words, the difference between mortality was significant for all the intervals for sex, educational level and socioeconomic level. A constant baseline mortality of 0.013 was found, i.e., everyone has a 1.3% risk of dying from breast cancer regardless of socioeconomic level, educational level and sex. Conclusions: There are statistically significant differences in mortality between high and low socioeconomic levels and also in educational level; however, when regression methods were used, a higher mortality and higher risk of dying from breast cancer was obtained in the higher socioeconomic levels, probably associated with the lower number of screenings and mammograms performed in this stratum. As of 2008, an increase to the original levels observed at the beginning of the second millennium was observed, increasing the existing differences in the inequality indexes both by educational level and socioeconomic level, increasing by 20 times with respect to educational level, and 1.88 times with respect to socioeconomic level.

Resiliencia académica: la influencia del esfuerzo, las expectativas y el autoconcepto académico / Academic resilience: The influence of academic effort, expectations, and self-concept

Resumen Introducción: La resiliencia académica consiste en obtener altas calificaciones a pesar de hallarse en una desventaja socioeconómica. En el presente estudio se observó si el esfuerzo, las expectativas y el autoconcepto académicos forman parte de la resiliencia académica o estarían explicando un buen rendimiento académico en general. Método: Los participantes, una población de 7479 adolescentes españoles (M = 13.87; DT = 0.82), fueron divididos en cuatro grupos según el rendimiento académico (Bueno-Malo) y el nivel socioeconómico (Clase alta-Clase baja). Se realizaron análisis de diferencias y regresiones logísticas binarias para detectar cuál de las variables empleadas explicaba el rendimiento académico en los grupos de igual nivel socioeconómico. También se estudió si el sexo influía en la pertenencia a los grupos de buen rendimiento. Resultados: Se observaron diferencias en el esfuerzo, las expectativas y el autoconcepto académicos en función de los cuatro grupos creados; los grupos de buen rendimiento académico obtuvieron puntuaciones más altas independientemente del nivel socioeconómico. Se observó que las expectativas y el autoconcepto académicos explicaban gran parte del rendimiento académico. Se detectó una tasa de mujeres significativamente más alta con relación a la de hombres en los grupos de mayor rendimiento. Conclusiones: Muchas variables, que se han considerado propias de los alumnos académicamente resilientes, explican un buen rendimiento académico, en general, independientemente del nivel socioeconómico.

Abstract Introduction: Academic resilience is defined as getting high marks despite being at a socioeconomic disadvantage. In the present study, it was observed whether Academic Effort, Expectations and Self-Concept are part of academic resilience or would be explaining a good academic performance in general. Method: The participants, a population of 7479 Spanish adolescents (M = 13.87; SD = 0.82), were divided into four groups according to academic performance (Good-Bad) and socioeconomic level (Upper class-Lower class). Analysis of differences and binary logistic regressions were performed to detect which of the variables used explained the academic performance in the groups of the same socioeconomic level. It was also studied whether sex influenced membership in the good performance groups. Results: Differences in Academic Effort, Expectations and Self-concept were found according to the four groups created; the groups with good academic performance obtained higher scores regardless of socioeconomic level. Expectations and academic self-concept were found to explain much of academic performance. A significantly higher rate of women than men was found in higher performance groups. Conclusions: Many variables that have been considered typical of academically resilient students explain good academic performance in general, regardless of socioeconomic status.

Caracterización de una población pediátrica de escasos recursos que habita por encima de 2500 m. s. n. m., positiva para SARS-COV-2 / Characterization of a Low-Income Pediatric Population Living Above 2500 m. a. s. l. Positive for SARS-COV-2 / Caracterizaçáo de urna populaçáo pediátrica de baixa renda vivendo acima de 2.500 m. s. n. m. positiva para SARS-COV-2

Resumen: La infección por el nuevo SARS-COV-2 ha impactado de diversas maneras a toda la sociedad, incluidos los niños. Se describe el comportamiento de esta enfermedad en una población pediátrica de escasos recursos localizada por encima de 2500 m. s. n. m. Este es un trabajo retrospectivo transversal entre marzo y octubre de 2020 en Bogotá involucró niños entre 1 mes y 14 años con RT-PCR positiva para SARS-COV-2. Se estudiaron antecedentes, características sociodemográficas, clínicas, de laboratorio, radiológicas y evolutivas, agrupando los pacientes según la gravedad y analizando su significancia (p < 0.05). Como resultado, se obtuvieron 416 casos, de los cuales 43.3 % eran asintomáticos, 46.6 % sintomáticos leves, 8.9 % graves y 1.2 % críticos. De los consultantes a urgencias, los menores de 1 año fueron los más frecuentes (56.79 %) y los que más se hospitalizaron (35.8 %). El tiempo entre el inicio de los síntomas y la consulta fue en promedio de 2 días, El diagnóstico más frecuente en los pacientes no hospitalizados fue rinofaringitis (58.97 %), y en los que se hospitalizaron fue bronquiolitis (50 %). La mediana del tiempo de hospitalización de todo el grupo fue de 4 días la cual ser prolongó a 7 días para los que requirieron UCI. Con la hospitalización se asocia, entre otras causas, los índices nutricionales < 2 de, taquipnea, dificultad respiratoria, hipoxemia, linfopenia (en mayores de 2 años) (p < 0.05), no influyendo el hacinamiento ni el nivel socioeconómico. Después del estudio, se pudo concluir que la enfermedad es, generalmente, mucho más leve en niños que en adultos, diferenciándose de estos tanto en los factores predisponentes, los paraclínicos y en la evolución. Sin embargo, algunas variables demográficas, clínicas y de laboratorio podrían asociarse con una mayor gravedad en este grupo poblacional.

Abstract: Infection with the new SARS-COV-2 has impacted the entire society, including children, in various ways. The behavior of this disease in a low-income pediatric population located above 2500 m. a. s. I. is described. This is a cross-sectional retrospective study carried out between March and October 2020 in Bogotá involving children between 1 month and 14years old with positive RT-PCR for SARS-COV-2. History, sociodemographic, clinical, laboratory, radiological and evolutionary characteristics were studied, grouping the patients according to severity and analyzing their significance (p < 0.05). As a result, 416 cases were obtained, of which 43.3 % were asymptomatic, 46.6 % mildly symptomatic, 8.9 % severe, and 1.2 % critical. Of the consultants to the emergency room, those under 1 year of age were the most frequent (56.79 %) and those who were hospitalized the most (35.8 %). The time between the onset of symptoms and consultation was an average of 2 days. The most frequent diagnosis in non-hospitalized patients was rhinopharyngitis (58.97 %), and in those who were hospitalized it was bronchiolitis (50 %). The median hospitalization time for the entire group was 4 days, which was extended to 7 days for those who required ICU. Hospitalization is associated with, among other causes, nutritional indices < 2 SD, tachypnea, respiratory distress, hypoxemia, lymphopenia (in those older than 2 years) (p < 0.05), with neither overcrowding nor socioeconomic status as influencing factors. After the study, it was possible to conclude that the disease is generally much milder among children than in adults, differing from these in predisposing factors, paraclinical factors, and evolution. However, some demographic, clinical and laboratory variables could be associated with greater severity in this population group.

Resumo: A infecção com o novo SARS-COV-2 impactou toda a sociedade de várias maneiras, incluindo crianças. O comportamento desta doença em urna população pediátrica de baixa renda localizada acima de 2.500 m. s. n. m. é descrito. Este é um estudo transversal retrospectivo entre margo e outubro de 2020 em Bogotá, envolvendo crianças entre 1 mês e 14 anos com RT-PCR positiva para SARS- COV-2. Foram estudados antecedentes, características sociodemográficas, clínicas, laboratoriais, radiológicas e evolutivas, agrupando os pacientes de acordo com a gravidade e analisando sua significância (p < 0.05). Como resultado, foram obtidos 416 casos, sendo 43.3 % assintomáticos, 46.6 % sintomáticos leves, 8.9 % graves e 1.2 % críticos. Dos pacientes em pronto-socorro, os menores de 1 ano foram os mais frequentes (56.79 %) e os que mais internaram (35.8 %). O tempo entre o inicio dos sintomas e a consulta foi em média de 2 dias, sendo o diagnóstico mais frequente nos pacientes não internados a rinofaringite (58.97 %), e nos internados foi a bronquiolite (50 %). A mediana do tempo de internação para todo o grupo foi de 4 dias, que foi estendida para 7 dias para aqueles que necessitaram de UTI. A hospitalização está associada, entre outras causas, a índices nutricionais < 2 DP, taquipneia, desconforto respiratório, hipoxemia, linfopenia (nos maiores de 2 anos) (p < 0.05), não influenciando a superlotação ou o nível socioeconómico. Após o estudo, foi possível concluir que a doença geralmente é muito mais branda em crianças do que em adultos, diferindo destes em fatores predisponentes, fatores para clínicos e evolução. No entanto, algumas variáveis demográficas, clínicas e laboratoriais podem estar associadas á maior gravidade nesse grupo populacional.

Características socioeconómicas y sociodemográficas de las familias de pacientes hospitalizados en el Instituto Nacional de Salud San Borja, 2018 / Socioeconomic and sociodemographic characteristics of the family members of patients hospitalized in the Instituto Nacional de Salud del Niño San Borja, 2018

RESUMEN Objetivo: Describir las características familiares y sociales de los pacientes hospitalizados en el Instituto Nacional de Salud del Niño San Borja durante los meses de abril a diciembre de 2018. Materiales y métodos: Investigación descriptiva, observacional y analítica. La selección de la muestra fue probabilística de un universo de 4383 pacientes. La muestra fue de 573 pacientes, con un nivel de confianza de 96 %, y un margen de error de 4,00 %. El instrumento empleado fue la ficha de recolección de datos de la historia clínica. La información se procesó con el paquete estadístico SPSS. Resultados: El 47,12 % de los pacientes proceden de Lima Metropolitana; el 2,97 %, de la Provincia Constitucional del Callao, y el 49,91 % del interior del país, lo que incluye Lima Provincia. El 73,65 % de pacientes vive en condición de pobreza; el 24,26 % tiene condición de pobreza extrema; y solo el 2,09 % son considerados no pobres. El 40,49 % de pacientes habita en viviendas en condiciones inadecuadas. La mayoría de los participantes son beneficiarios del Seguro Integral de Salud (SIS) (94,24 %). Respecto al nivel educativo de las madres, el 1,92 % no tiene instrucción y el 7,68 % no concluyeron los estudios primarios. El 0,52 % de los padres no tienen instrucción, y el 4,19 % tienen estudios primarios incompletos. En cuanto a la educación básica regular (EBR), 43,11 % de las madres y 39,3 % de los padres la concluyeron; mientras que solo 9,77 % del grupo masculino y 6,63 % del femenino cuentan con educación superior técnica. Conclusiones: El estudio permitió un acercamiento a las condiciones socioeconómicas de los pacientes, en tanto determinantes de la salud. Se evidencia que la mayoría de pacientes viven en condición de pobreza y pobreza extrema. Un porcentaje significativo procede de los diferentes departamentos del país, lo que refleja el centralismo nacional en cuanto a los centros pediátricos especializados y, a la vez, evidencia la importancia del enfoque de interculturalidad en salud. El tipo de seguro de salud está relacionado con la condición económica: se corrobora que la mayoría es beneficiaria del Seguro Integral de Salud (SIS) y vive en condición de pobreza y pobreza extrema. La condición económica del paciente guarda relación con la proporción de viviendas que no cumplen con los requerimientos mínimos de habitabilidad, lo cual es un factor de riesgo para pacientes con enfermedades crónicas o postrasplantados (médula ósea y órganos sólidos). Finalmente, los padres de familia muestran un mayor nivel de instrucción que las madres, lo cual podría sugerir una brecha de género.

ABSTRACT Objective: To describe the family and social characteristics of patients hospitalized in the Instituto Nacional de Salud del Niño San Borja from April to December 2018. Materials and methods: A descriptive, observational and analytical research. Probability sampling was used in a study population of 4,383 patients. The sample consisted of 573 patients, with a 96 % confidence level and a 4 % margin of error. A data collection sheet included in the medical record was used as instrument. The data was processed using the IBM SPSS Statistics statistical software. Results: Forty-seven point one two percent (47.12 %) of the patients came from Lima Metropolitan Area, 2.97 % from the Constitutional Province of Callao, and 49.91 % from inland, including Lima Province. Seventy-three point six five percent (73.65 %) of the patients lived in poverty, 24.26 % lived in extreme poverty, and only 2.09 % were not considered poor. Forty point four nine percent (40.49 %) of the patients lived in unsuitable housing conditions. Most study subjects were holders of the Comprehensive Health Insurance (SIS) (94.24 %). Regarding the mothers' and fathers' educational level, 1.92 % and 0.52 % received no education, and 7.68 % and 4.19 % did not finish primary school, respectively. Forty-three point one one percent (43.11 %) of the mothers and 39.3 % of the fathers finished the regular basic education (EBR). Nine point seven seven percent (9.77 %) of the fathers and only 6.63 % of the mothers had higher technical education. Conclusions: The study enabled us to take a close look to the patients' socioeconomic conditions, which definitely affect their health. It showed that most patients live in poverty and extreme poverty. A significant percentage of the patients come from the different departments of Peru. This situation reflects the centralism prevailing in the specialized pediatric centers and demonstrates the importance of the intercultural approach in health. The type of insurance is related to the patients' economic status. It was confirmed that most of them hold the SIS and live in poverty or extreme poverty. The patients' low economic status is related to dwellings which do not comply with minimum housing standards. This fact is a risk factor for patients with chronic diseases or who got a transplant (bone marrow and solid organs). Finally, fathers evidenced a higher education level than mothers, which could suggest a gender gap.

Prevalencia de sobrepeso, obesidad con actividad física y nivel socioeconómico en escolares de educación básica / Prevalence of overweight, obesity with physical activity and socioeconomic status in elementary school students

INTRODUCCIÓN: el sobrepeso y obesidad infantil son problemas de salud pública en México, por lo que es necesario crear entornos que capaciten y motiven conductas positivas en relación a un estilo de vida saludable. OBJETIVOS: determinar la prevalencia de sobrepeso y obesidad. Describir la actividad física y sedentarismo con relación al nivel socioeconómico. MATERIAL Y MÉTODOS: se llevó a cabo un estudio descriptivo, observacional, transversal y prospectivo en 278 alumnos entre seis y 12 años de edad. Se calculó el IMC, se aplicaron cuatro cuestionarios: CVAFA, CCSNP, CNSE, AMAI 2018. RESULTADOS: la prevalencia de sobrepeso y obesidad fue de 42.7%. La actividad física vigorosa 49.6%. El 95% pasa dos horas diarias frente al televisor, 87% ocupa la computadora una hora diaria para tareas. El 32% toma siesta de 30 minutos. El nivel socioeconómico estuvo correlacionado a los primeros tres niveles. CONCLUSIONES: la prevalencia de sobrepeso y obesidad representa casi la mitad de la población estudiantil. La alimentación de tipo obesogénico da como resultado el IMC elevado, aunque el nivel socieconómico permitía obtener alimentos de buena calidad. La actividad física significativa sólo fue realizada por un bajo porcentaje de estudiantes. Las horas de descanso se encontraron adecuadas a su edad.

INTRODUCTION: Childhood overweight and obesity are public health problems in Mexico, so it is necessary to create environments that train and motivate positive behaviors in relation to a healthy lifestyle. OBJECTIVES: To determinate the prevalence of overweight and obesity. Describe physical activity and sedentary behaviors with socioeconomic status. MATERIAL AND METHODS: A descriptive, observational, cross-sectional and prospective study was carried out in 278 students between six and 12 years old. The BMI was calculated, four questionnaires were applied: CVAFA, CCSNP, CNSE, AMAI 2018. RESULTS: the prevalence of overweight and obesity was 42.7%. Vigorous physical activity 49.6%. A 95% spend two hours a day in front of the television, 87% use the computer an hour a day for homework. 32% nap for 30 minutes. The economic level is correlated to the first three levels. CONCLUSIONS: the prevalence of overweight and obesity represents almost half of the student population. The obesogenic type diet results in a high BMI, although the economic level allowed obtaining quality food. Significant physical activity was also performed by a low percentage of students. The hours of rest were found to be appropriate for their age.

Sedentary Behavior and Physical Activity of Schoolchildren from a Low-income Region in Brazil: Associations with Maternal Variables / Comportamento Sedentário e Atividade Física de Escolares de uma Região de Baixa Renda no Brasil: Associações com Variáveis Maternas

INTRODUCTION: In the last decade, an increasing number of studies investigated markers of Sedentary Behavior (SB) and Physical Activity (PA) in school-age children since they lead to nutritional status changes in this groupOBJECTIVE: To analyze associations between maternal factors and SB and PA of schoolchildrenMETHODS: This is a cross-sectional study involving 410 mothers of children enrolled between the first and the fifth year in municipal schools of Santa Cruz, RN, Brazil. By applying questionnaires, socioeconomic variables of the family, maternal data, and habits related to SB and PA on weekdays and weekends were investigated. Pearson's chi-square test and Fisher's exact test were used to test associationsRESULTS: It was observed that income below one minimum wage and less maternal education were associated with greater active transportation among children (69.3%, p = 0.012 and 68.4%, p = 0.022, respectively). Children from low-income families (65.4%, p = 0.016) and who had six and seven siblings (8.2%, p = 0.023 and 7.6%, p = 0.037, respectively) presented lower SB at the weekend. Low level of maternal education was associated with reduced PA during the week (70.8%, p = 0.024CONCLUSION: Socioeconomic (i.e., family income and number of siblings) and maternal factors (i.e., level of education) are important indicators for time spent on sedentary behavior and physical activity of schoolchildren

INTRODUÇÃO: Na última década, um número crescente de estudos tem se preocupado em investigar marcadores de Comportamento Sedentário (CS) e Atividade Física (AF) em crianças na idade escolar, por serem reconhecidos como causadores de alterações do estado nutricional nesta faixa etáriaOBJETIVO: Analisar os fatores associados maternos sobre o CS e AF de escolaresMÉTODO: Trata-se de uma pesquisa com delineamento transversal, envolvendo 410 mães de crianças matriculadas entre o primeiro e quinto ano nas escolas municipais de Santa Cruz, RN, Brasil. Por meio da aplicação de questionários, foram investigadas variáveis socioeconômicas da família, dados maternos e hábitos relacionados ao CS e AF dos escolares, nos dias da semana e no final de semana. Para testar associações foi utilizado o teste Qui-quadrado de Pearson e Teste Exato de FisherRESULTADOS: Foi observado que uma renda inferior a um salário mínimo e menor escolaridade materna foram associados com maior deslocamento ativo das crianças (69,3%, p = 0,012 e 68,4% p = 0,022, respectivamente). As crianças de famílias com baixa renda (65,4%, p = 0,016) e que tinham seis e sete irmãos (8,2%, p = 0,023 e 7,6%, p = 0,037, respectivamente) apresentam menor CS no final de semana. Um menor grau de escolaridade materna foi associado com uma menor prática de AF durante a semana (70,8%, p = 0,024CONCLUSÃO: Conclui-se que os fatores socioeconômicos (i.e., renda familiar e número de irmãos) e maternos (i.e., nível de escolaridade) são importantes indicadores para o tempo dispendido em comportamento sedentário e atividade física de escolares

O impacto do ensino público e privado na memória de crianças / The impact of public and private education on children's memory / El impacto de la educación pública y privada en la memoria de los niños

Esse estudo teve como objetivo comparar o desempenho de memória operacional e memória episódica em estudantes do ensino público e privado. A amostra foi composta por 79 crianças, com idades entre 9 e 12 anos, divididos por gênero, idade e tipo de escola. A avaliação foi realizada individualmente por meio da CMS e Raven. Para a análise dos dados, foi utilizado o teste t de Student, com nível de significância adotado de 5%. Os resultados evidenciam melhor desempenho das crianças de escola pública nas tarefas de inteligência e memória visual, enquanto os estudantes de escola particular apresentaram melhor desempenho em memória verbal e visual, corroborando com estudos que apontam diferenças em tarefas cognitivas para crianças de níveis socioeconômicos diferentes. Esses resultados fomentam a importância de mais pesquisas na área, para compreensão e melhorias no desenvolvimento cognitivo das crianças e adolescentes brasileiros. (AU)

This study aimed to compare the performance of working memory and episodic memory in students from public and private schools. A sample consisted of 79 children, aged between 9 and 12 years; divided by gender, age and type of school. The assessment was carried out individually using the CMS and Raven's test. For the data analysis student's t-test was used, the level of significance adopted was 5%. The results showed better performance by the public school children in tasks of intelligence and visual memory, while the students from private schools showed better performance in verbal and visual memory, corroborating studies that highlight differences in cognitive tasks for children with different socioeconomic levels. These results demonstrate the importance of more research in the area, aiming to better understand and improve the cognitive development of Brazilian children and adolescents. (AU)

Este estudio tuvo como objetivo comparar el rendimiento de la memoria de trabajo y la memoria episódica en estudiantes de escuelas públicas y privadas. La muestra se compuso por 79 niños, con edades comprendidas entre 9 y 12 años; divididos por género, edad y tipo de escuela. La evaluación se realizó individualmente a través de la CMS y Raven. Se utilizó la prueba t de student para el análisis de datos, el nivel de significación adoptado fue del 5%. Los resultados evidenciaron un mejor rendimiento de los niños de las escuelas públicas en tareas de inteligencia y memoria visual, mientras que los estudiantes de la escuela privada mostraron un mejor rendimiento en la memoria verbal y visual, corroborando con estudios que señalan diferencias en las tareas cognitivas para niños de diferentes niveles socioeconómicos. Estos resultados alientan la importancia de una mayor investigación en el área, para comprender y mejorar el desarrollo cognitivo de los niños y adolescentes brasileños. (AU)

Socioeconomic status and physical activity during elementary school student recess / Nível socioeconômico e atividade física durante o recreio de crianças do ensino fundamental / Nivel socioeconómico y actividad física durante el recreo de niños de la enseñanza fundamental

ABSTRACT Introduction The association between socioeconomic status (SES) and the level of physical activity (PA) at school has not been studied at length. Objective To describe the association between SES and the intensity of physical activity during recess in elementary school children as well as the space dedicated to physical activity. Methods A total of 212 children (110 boys and 102 girls) who were enrolled in the fourth, fifth and sixth grade of elementary school at the time participated in this study. The subjects were divided into 4 levels according to the marginalization index (MI). The geographical location of the schools and the available area were calculated using Google Maps Pro (GMP) software.1 Physical activity level was measured using accelerometry.2 Comparisons of different levels of PA with respect to marginalization indices and sex were investigated using one-way analysis of variance. The association between health variables and PA was determined through the Pearson correlation coefficient. Results Results indicated that the level and intensity of PA during recess are associated with socioeconomic status and the social marginalization index, as well as sex, age, and infrastructure. Conclusion The higher the level of social marginalization, the lower the level of PA and the smaller the space dedicated to PA. Level of Evidence III; Comparative retrospective study.

RESUMO Introdução A associação entre o nível socioeconômico (NSE) e o nível de atividade física (AF) no âmbito escolar tem sido pouco estudada. Objetivo Descrever a associação entre o NSE e a intensidade da AF durante o recreio em crianças de ensino fundamental e também o espaço dedicado à atividade física. Métodos Participaram 212 crianças (110 meninos e 102 meninas) que, na ocasião do estudo, estavam no quarto, quinto e sexto ano do ensino fundamental. O número de sujeitos foi dividido em quatro níveis de acordo com o índice de marginalização (IM). A localização geográfica das escolas e a área disponível foram calculadas com o software Google Maps Pro (GMP).1 O nível de atividade física foi medido por acelerometria.2 As comparações dos diferentes níveis de AF com relação aos índices de marginalização e sexo foram analisadas por variância unidirecional. A associação entre as variáveis de saúde e a AF foi determinada pela correlação de Pearson. Resultados Os resultados indicaram que o nível e a intensidade de AF durante o recreio estão associados ao nível socioeconômico e ao índice de marginalização social, bem como a sexo, idade e infraestrutura. Conclusões Quanto maior foi o nível de marginalização social, menor o espaço para praticar e o nível de AF. Nível de Evidência III; Estudo retrospectivo comparativo.

RESUMEN Introducción La asociación entre el nivel socioeconómico (NSE) y el nivel de actividad física (AF) en el ámbito escolar ha sido poco estudiada. Objetivo Describir la asociación entre el NSE y la intensidad de la AF durante el recreo en niños de enseñanza fundamental y también el espacio dedicado a la actividad física. Métodos Participaron 212 niños (110 niños y 102 niñas) que, en la ocasión del estudio, estaban en cuarto, quinto y sexto año de la enseñanza fundamental. El número de sujetos fue dividido en cuatro niveles de acuerdo con el índice de marginalización (IM). La localización geográfica de las escuelas y el área disponible fueron calculadas con el software Google Maps Pro (GMP).1 El nivel de actividad física fue medido por acelerometría.2 Las comparaciones de los diferentes niveles de AF con relación a los índices de marginalización y sexo fueron analizadas por variancia unidireccional. La asociación entre las variables de salud y la AF fue determinada por la correlación de Pearson. Resultados Los resultados indicaron que el nivel y la intensidad de AF durante el recreo están asociados al nivel socioeconómico y al índice de marginalización social, bien como a sexo, edad e infraestructura. Conclusiones Cuanto mayor sea el nivel de marginalización social, menor será el espacio para practicar y el nivel de AF. Nivel de Evidencia III; Estudio retrospectivo comparativo.