Health literacy and quality of life among people in semi-urban and urban areas / Letramento em saúde e qualidade de vida entre pessoas em áreas semiurbanas e urbanas / Alfabetización en salud y calidad de vida entre personas en áreas semiurbanas y urbanas

Abstract Objective: to investigate health literacy level, quality of life and related factors in semi-urban and urban areas. Method: this cross-sectional study was carried out between December 2018 and February 2019 with 595 participants. The variables found significant in the bivariate regression analysis were included in the multivariate regression analysis. Results: according to the scores obtained from the Health Literacy Scale, participants' health literacy 76.5% levels were adequate. The factors affecting the Health Literacy Scale score in semi-urban areas were educational status, income status, presence of a chronic disease, perceived health, and understanding the health information provided. The factors affecting the Health Literacy Scale score in urban areas were age, marital status, reading habits, presence of a chronic disease, and understanding the health information provided (p < .05). There was a statistically significant difference between participants living in semi-urban and urban areas in terms of their health literacy and quality of life levels (p < .001). Conclusion: the health literacy level was inadequate in three out of ten participants, and it was even lower in semi-urban areas.

RESUMO Objetivo: investigar o nível de letramento em saúde, qualidade de vida e fatores relacionados em áreas semiurbanas e urbanas. Método: este estudo transversal foi realizado entre dezembro de 2018 e fevereiro de 2019 com 595 participantes. As variáveis encontradas significativas na análise de regressão bivariada foram incluídas na análise de regressão multivariada. Resultados: de acordo com os escores obtidos na Health Literacy Scale, os níveis de letramento em saúde dos participantes de 76,5% estavam adequados. Os fatores que afetaram a pontuação da Health Literacy Scale em áreas semiurbanas foram escolaridade, renda, presença de doença crônica, percepção de saúde e compreender as informações de saúde fornecidas. Os fatores que afetaram a pontuação da Health Literacy Scale em áreas urbanas foram idade, estado civil, hábitos de leitura, presença de doença crônica e compreender as informações de saúde fornecidas (p < 0,05). Houve uma diferença estatisticamente significativa entre os participantes que vivem em áreas semiurbanas e urbanas em termos de letramento em saúde e níveis de qualidade de vida (p < 0,001). Conclusão: o nível de letramento em saúde foi inadequado em três dos dez participantes, sendo ainda menor nas áreas semiurbanas.

RESUMEN Objetivo: investigar el nivel de alfabetización en salud, calidad de vida y factores relacionados en áreas semiurbanas y urbanas. Método: este estudio transversal se realizó entre diciembre de 2018 y febrero de 2019 con 595 participantes. Las variables que se encontraron significativas en el análisis de regresión bivariante se incluyeron en el análisis de regresión multivariante. Resultados: según los puntajes obtenidos en la Health Literacy Scale, los niveles de alfabetización en salud de los participantes del 76,5% fueron adecuados. Los factores que afectaron los puntajes de la Health Literacy Scale en áreas semiurbanas fueron la educación, los ingresos, la presencia de enfermedades crónicas, la salud percibida y comprender la información de salud proporcionada. Los factores que afectaron el puntaje de la Health Literacy Scale en áreas urbanas fueron la edad, el estado civil, los hábitos de lectura, la presencia de una enfermedad crónica y comprender la información de salud proporcionada (p < 0,05). Hubo una diferencia estadísticamente significativa entre los participantes que vivían en áreas urbanas y semiurbanas en términos de alfabetización en salud y niveles de calidad de vida (p < 0,001). Conclusión: el nivel de alfabetización en salud fue inadecuado en tres de cada diez participantes, y fue aún más bajo en las áreas semiurbanas.

Comparison of Dental Caries and Oral Hygiene Status of Children in Suburban with those in Rural Population of Southwestern Nigeria

ABSTRACT Objective: To compare prevalence of dental caries, oral hygiene status and associated risk factors of children in suburban and rural communities in the Southwest region of Nigeria. Material and Methods: Secondary data was extracted from cross-sectional researches conducted in two study locations involving 8 to 12 year olds. Data retrieved included age, gender, family structure, socioeconomic status, oral hygiene and dental caries. Caries assessment was done using WHO Oral Health Survey methods. Oral hygiene data was collected using Simplified Oral Hygiene Index (OHI-S) by Greene and Vermillion. Statistical significance was established at p<0.05. Results: The prevalence of dental caries in Group A and Group B study participants were 13.4% and 22.2% respectively. Children from rural community had significant higher caries prevalence (p=0.00) and poorer oral hygiene (P=0.00) compare with their counterparts in the suburban community. There was a significant association between oral hygiene, age and dental caries in suburban participants (p=0.02) while among the rural participants there was significant association between gender and dental caries (p=0.04). Children with poor oral hygiene have increased odds of having dental caries compared to children with good oral hygiene in the two study communities. Conclusion: Dental caries was more prevalent among the rural dwellers than the sub-urban dwellers. There is a need to make oral health care services/products available, accessible and affordable for the rural community.

Dental caries in three-year-old preschool children in Lima, Peru assessed according to the CAST instrument / Caries dental en niños prescolares de 3 años en Lima-Perú evaluados con el instrumento CAST

ABSTRACT The aim of this study was to determine the caries situation of three-year-old preschool children residing in low socioeconomic status districts in Lima, Peru. The study is a crosssectional analysis of the caries situation of suburban areas of Lima. A stratified sampling procedure by geographical distribution, considering healthcare centers with a motherand- child health clinic and surrounding preschools as factors, identified 45 randomly selected preschools, of which 17 accepted to participate. Children from 3-year-old classrooms were examined by two independent calibrated dentists using the Caries Assessment Spectrum and Treatment (CAST) instrument at their premises using artificial light, sterile examination mirrors and gauze for drying each tooth before evaluation. ANOVA and the Tamhane method were used to analyze the data. 308 children, mean age 3.4 years (min: 3 years; max: 3 years, 7 months), were examined. The sample prevalence of enamel and dentine carious lesions (CAST code 3-7) was 91.2% while the prevalence of dentine carious lesions (CAST code 4-7) was 58.8%. The mean number of teeth with cavities that had reached the pulp and those that had an abscess or fistula were 2.0% and 0.5% respectively. The majority of enamel and dentine carious lesions were observed in molars. The CAST severity score was 7.0. Mean examination time was 57 seconds. The burden of dental caries of the children at this young age was high.

RESUMEN El objetivo del presente estudio fue determinar la prevalencia de caries dental en niños en edad preescolar de 3 años residentes en áreas suburbanas de Lima, Perú. Se trata de un análisis transversal de la situación de caries de áreas periféricas de Lima. Un procedimiento de muestreo estratificado por distribución geográfica consideraba a los centros de salud materno-infantiles y centros educativos preescolares de la jurisdicción como factores, identificando 45 centros prescolares aleatoriamente, de los cuales 17 aceptaron la invitación para participar del presente estudio. Dos odontólogas independientes, calibradas examinaron a los niños de las aulas de 3 años utilizando el instrumento Caries Assessment Spectrum and Treatment (CAST) en las instalaciones de cada jardín de infancia, utilizando luz artificial, instrumental estéril y gasas para el secado de las superficies a evaluar. Los datos fueron analizados utilizando ANOVA y el método Tamhane. Se evaluaron 308 niños, quienes tenían una edad media de 3.4 años (min: 3 años; max: 3 años, 7 meses). La prevalencia de lesiones de caries de esmalte y dentina (código CAST 3-7) fue del 91,2%, mientras que la prevalencia de lesiones de caries en dentina (código CAST 4-7) fue de 58,8%. El número promedio de dientes afectados por caries dental con compromiso pulpar y que tenían un absceso o fístula fue de 2.0% y 0.5% respectivamente. La mayoría de las lesiones de caries en esmalte y dentina se observaron en los molares. La valoración de severidad CAST fue 7.0. El tiempo promedio de examinación fue de 57 segundos. La carga de la enfermedad caries dental a estas edades tan tempranas ya es alta en la infancia suburbana de Lima.

Percepción etnobotánica de los campesinos sobre la flora arvense en fincas de la agricultura suburbana en Santiago de Cuba, Cuba / Ethnobotanical perception of the farmers about the weed flora in farms of suburban agriculture in Santiago de Cuba, Cuba

Currently the weed species are a resource to conserve. The objective was to evaluate the ethnobotanical perception of the peasants about the weed flora in farms of suburban agriculture in Santiago de Cuba, Cuba. An ethnobotanical study was developed and the percentage of known species, percentage of species per management action and the percentage of weed species with potential utility was determined. The spectrum of use, the categories of use and the species richness by category were also taken into account. The weed species found in each of the farms were identified by at least 60% of the producers conferring more than 70% of this flora potential utilities such as medicinal, animal feed and agricultural. Although different forms of management for these species were identified, more than 40% are eliminated regardless of the potential benefits that productive systems can bring to this.

Actualmente las especies arvenses son un recurso a conservar. El objetivo fue evaluar la percepción etnobotánica de los campesinos sobre la flora arvense en fincas de la agricultura suburbana en Santiago de Cuba, Cuba. Se desarrolló un estudio etnobotánico y se determinó el porcentaje de especies conocidas, porcentaje de especies por acción de manejo y el porcentaje de especies arvenses con utilidad potencial. También se tuvo en cuenta el espectro de uso, las categorías de uso y la riqueza de especies por categoría. Las especies arvenses que se encuentran en cada una de las fincas fueron identificadas por al menos el 60% de los productores confiriéndoles a más del 70% de esta flora utilidades potenciales como medicinal, alimento animal y agrícola. Aunque se identificaron diferentes formas de manejo para estas especies, más del 40% resultan eliminadas independientemente de los beneficios potenciales que puedan aportar a estos sistemas productivos.

Autocorrelación espacial de mortalidad por cáncer de mama en la Región Metropolitana, Chile: estudio ecológico / Spatial autocorrelation of breast cancer mortality in the Metropolitan Region, Chile: an ecological study

INTRODUCCIÓN El cáncer de mama es la neoplasia maligna más común en las mujeres en todo el mundo y en Chile, siendo la primera causa de muerte oncológica femenina. Se ha reportado amplia variación en la mortalidad, con focos geográficos de mayor riesgo. OBJETIVO Analizar espacialmente la mortalidad por cáncer de mama en mujeres de la Región Metropolitana en 2015. MÉTODOS Estudio ecológico. Se utilizaron los datos de los registros de defunciones del año 2015 (C50 según CIE10), y las proyecciones poblacionales del Instituto Nacional de Estadísticas. Se calcularon tasas de mortalidad por cáncer de mama brutas y razones de mortalidad estandarizadas. Se realizó un análisis epidemiológico espacial estimando el índice I de Moran Global y Local para evaluar autocorrelación espacial. Los resultados se presentan en mapas (cartografía precenso 2016). RESULTADOS Se registraron 622 defunciones por cáncer de mama en la Región Metropolitana en 2015. La edad promedio de las mujeres fallecidas fue de 66 años (desviación estándar: 15,5). El 92,4% de las muertes se registró en zonas centrales o urbanas. Sin embargo, las mayores tasas de mortalidad se observaron en comunas periféricas. No se observó autocorrelación espacial global en la región (I de Moran de 0,007; p = 0,134). A nivel local, cuatro comunas se diferencian de forma significativa de sus vecinas. CONCLUSIONES El riesgo de morir por cáncer de mama en la Región Metropolitana de Chile se concentra en comunas periféricas. Cuatro comunas de la región presentan riesgos diferentes de sus comunas vecinas, por lo que es necesario explorar factores que explican la desigual distribución de las muertes.

INTRODUCTION Breast cancer is the most common malignancy in women worldwide and Chile, being the leading cause of female cancer death. A wide variation in mortality has been reported, with geographic clusters of higher risk. OBJECTIVE To spatially analyze mortality from breast cancer in women in the Metropolitan Region in 2015. METHODS Ecological study of location. We used death records in 2015 (C50 according to ICD10) and population projections of the Statistics Institute to estimate mortality rates. We calculated crude breast cancer mortality rates and standardized mortality ratios and performed a spatial epidemiological analysis of breast cancer mortality in women, estimating the global and local Moran I index to assess spatial autocorrelation. We present the results in maps according to the 2016 pre-census cartography. RESULTS There were 622 deaths from breast cancer in the Metropolitan Region in 2015. The mean age was 66 years (SD: 15.5). 92.4% of deaths were registered in urban or central areas. However, the highest mortality rates were observed in peripherical districts. No global spatial autocorrelation was observed in the region (Moran's I 0.007 p = 0.134). However, at the local level, four districts differ significantly from their neighbors. CONCLUSIONS The risk of dying from breast cancer in the Metropolitan Region of Chile is concentrated in women from peripherical communes. Four districts in the region present different risks from their neighboring districts. It is necessary to investigate local realities to prevent deaths from this pathology.

Practice of exclusive breastfeeding and its associated factors in a suburban area in Angola: a cross-sectional study

ABSTRACT BACKGROUND: Exclusive breastfeeding for six months is one of the measures with highest impact on prevention of child deaths. The determinants of breastfeeding practices are complex and differ between populations. This study aimed to identify factors associated with the prevalence of exclusive breastfeeding in a suburban area in Angola. DESIGN AND SETTING: Population-based cross-sectional study in the municipality of Cacuaco, Luanda. METHODS: A random sample of children under two years of age and their mothers was included. ­Prevalence ratios (PR) were estimated using Poisson regression based on a hierarchical model. RESULTS: 749 children and their mothers were surveyed, including 274 children under six months. Theprevalence of exclusive breastfeeding among children under six months was 51.5% (95% confidence interval, CI, 46.3-56.6%). Four variables were positively associated with exclusive breastfeeding at ages of under six months: number of prenatal visits (PR 1.11 for each visit after the first one; 95% CI 1.04-1.18), maternal occupation (other occupations versus self-employed) (PR 1.54; 95% CI 1.05-2.26), younger child age (PR 0.77 for each month; 95% CI 0.71-0.84) and female child (PR 1.34; 95% CI 1.02-1.76). CONCLUSIONS: Our findings showed that the prevalence of exclusive breastfeeding at six months was satisfactory, according to international recommendations. Factors associated with exclusive breastfeeding practices that had never been surveyed before in Angola were identified through this study. These data are particularly relevant in the context of high infant mortality and may be useful in planning actions aimed at improving child health through promotion of exclusive breastfeeding, in Angola and other countries.

Risk factors associated with abdominal obesity in suburban adolescents from a Malaysian district

INTRODUCTION@#We aimed to determine the risk factors associated with abdominal obesity (AO) in suburban adolescents.@*METHODS@#This cross-sectional study included adolescents aged 15-17 years from five randomly selected secondary schools in the Hulu Langat district of Selangor state, Malaysia. Waist circumference (WC) was measured at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest. Information on sociodemographic data, dietary habits, physical activity levels and duration of sleep was obtained via interviewer-administered questionnaires. Participants' habitual food intake was determined using a 73-item Food Frequency Questionnaire.@*RESULTS@#Among 832 participants, 56.0% were girls; 48.4% were Malay, 40.5% Chinese, 10.2% Indian and 0.8% of other ethnic groups. Median age and WC were 16 (interquartile range [IQR] 15-16) years and 67.9 (IQR 63.0-74.6) cm, respectively. Overall prevalence of AO (> 90th percentile on the WC chart) was 11.3%. A higher proportion (22.4%) of Indian adolescents were found to have AO compared with Malay and Chinese adolescents. Logistic regression analysis showed that female gender (adjusted odds ratio [OR] 7.064, 95% confidence interval [CI] 2.087-23.913; p = 0.002), Indian ethnicity (adjusted OR 10.164, 95% CI 2.182-47.346; p = 0.003), irregular meals (adjusted OR 3.193, 95% CI 1.043-9.774; p = 0.042) and increasing body mass index (BMI) (adjusted OR 2.867, 95% CI 2.216-3.710; p < 0.001) were significantly associated with AO.@*CONCLUSION@#AO was common among Malaysian adolescents. Female gender, Indian ethnicity, irregular meals and increasing BMI were significant risk factors.

The effects of water-pipe smoking on birth weight: a population-based prospective cohort study in southern Iran / 한국역학회지

OBJECTIVES: Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight.METHODS: Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016–2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI).RESULTS: Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05).CONCLUSIONS: Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women's knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.

The effects of water-pipe smoking on birth weight: a population-based prospective cohort study in southern Iran / 한국역학회지

OBJECTIVES: Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight. METHODS: Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016–2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI). RESULTS: Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05). CONCLUSIONS: Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women's knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.

Prevalence of tobacco use in selected Johannesburg suburbs

Background. Tobacco smoking is estimated to kill more than 44 000 South Africans every year. Studies have shown that since the introduction of tobacco control measures, national smoking prevalence has declined in South Africa (SA). Objective. To determine the prevalence of tobacco smoking over a 7-year period in five impoverished neighbourhoods in Johannesburg, SA.Methods. Data were collected through the annual administration of a prestructured questionnaire to one adult respondent in preselected dwellings from 2006 to 2012. Information was collected on socioeconomic status, smoking practices and health status.Results. Over the 7-year period of the analysis, smoking levels remained unchanged. The proportion of households with one or more smokers varied significantly across the five study neighbourhoods. Approximately 20% of households in Hillbrow and as many as 77% in Riverlea had a member who smoked.Conclusions. Despite a national downward trend in smoking levels, tobacco use remains high and persistent in certain vulnerable communities, requiring scaled-up action to reduce the risk of a range of tobacco-related diseases

Situación de salud en asentamientos precarios / The health situation of precarious settlements

OBJETIVO: Conocer la situación de salud de los miembros del Campamento Manuel Bustos, en la región de Valparaíso, considerando sus características socioeconómicas y ambientales y la autopercepción del estado de salud. Material y MÉTODO: Se realizó una investigación cuantitativa, descriptiva y no experimental. Se aplicó un cuestionario a través de una entrevista semiestructurada a una muestra de 89 familias del campamento. RESULTADOS: Las familias del campamento se caracterizan principalmente por ser jóvenes, asistir a controles (principalmente el Niño Sano y EMPA), estar casi en su totalidad inscritos en un CESFAM. Las viviendas poseen irregular eliminación de excretas y un 40% de los hogares tiene algún miembro con hipertensión arterial. En promedio, los residentes valoran su estado de salud con nota 5 en una escala de 1 a 7.CONCLUSIÓN: Se observó que la situación de salud de los habitantes del campamento presenta aspectos positivos vinculados a la inscripción en CES-FAM y la asistencia a controles. No obstante, la alta presencia de hipertensión arterial, las precarias condiciones de eliminación de excretas y la presencia de basurales cercanos son factores de riesgo para la salud, que deberán ser atendidas por los organismos gubernamentales y no gubernamentales que trabajan en este territorio.

OBJECTIVE: To explore the health status of members of the Manuel Bustos Settlement, in the region of Valparaiso, in terms of socioeconomic and environmental characteristics and their self-perceived health status. MATERIAL AND METHODS: A descriptive and non-experimental quantitative study was conducted. A questionnaire was applied through semistructured interviews to 89 families in the settlement. RESULTS: Families of the settlement are characterized principally by their young age, for attending regular health appointments (mainly the Well Child check ups and preventative annual physical exam for adults), and, in the case of the majority, for being enrolled in a local community health center. Their houses have irregular human waste disposal and 40% of households have a member with hypertension. On average, the residents valued their health status with a grade of 5, on a scale from 1 to 7. CONCLUSIONS: The health situation of the inhabitants of the settlement presents positive as-pects related to health center enrollment and regular attendance of controls. However, the high prevalence of hypertension, the precarious conditions of eliminating human waste, and the pre-sence of nearby landfills are risk factors for health that must be addressed by government and nongovernmental organizations, which work in this territory.

Reurbanização da favela do Real Parque em São Paulo: um olhar sobre impactos e possibilidades do processo de reestruturação urbana / Reurbanization of the favela Real Parque, São Paulo a look at impacts and possibilities of urban restructuring process

No Brasil a expansão urbana, como um componente fundamental das mudanças estruturais na sociedade brasileira, ocorreu de forma mais intensa na segunda metade do século XX, entre os anos de 1950 e 1970. O processo de urbanização, baseado na terra como mercadoria e acompanhado por uma ocupação desordenada, trouxe diversos problemas para boa parte das cidades brasileiras, com ocupações em áreas de rios e encostas, lançamentos de resíduos em cursos dágua e terrenos vazios, saneamento básico insuficiente, habitações insalubres, trânsito, ruído e poluição. São Paulo, a cidade mais populosa do país e o principal centro financeiro, corporativo e mercantil da América do Sul, é representativa desse processo. Estudos focados na urbanização da cidade revelam que a dinâmica de expansão da metrópole tem provocado um processo de concentração de população de baixa renda em áreas periféricas, mas também em localidades que concentram bolsões de pobreza e abrigam populações de baixa renda, com processos de ocupação por atividades irregulares, como invasões, favelas e loteamentos clandestinos. Exemplo de uma dessas áreas é a antiga favela do Real Parque, situada no bairro do Real Parque, um dos cinco bairros que compõem o distrito do Morumbi, na subprefeitura do Butantã, e considerada uma área de risco e que passou recentemente por um processo de reurbanização. Pelas suas especificidades, esse território é um estudo de caso ilustrativo para pensar os contrastes da megacidade, os impactos da urbanidade (ou da sua falta), a conformação de áreas de ocupação irregular e as relações estabelecidas pelos seus moradores e os possíveis delineamentos de processos de reurbanização. Neste sentido, a presente dissertação apresenta e discute resultados de uma pesquisa que teve como objetivo geral compreender, na perspectiva dos moradores, as potencialidades e limitações do processo de reurbanização nesta localidade, que teve início em 2008 e seguiu até 2016, com a entrega dos últimos condomínios. Como objetivos específicos, buscou-se investigar as características dessa localidade, particularmente antes do início da reurbanização; identificar percepções dos moradores sobre o local onde vivem e condições de vulnerabilidades; e compreender, a partir das suas narrativas, como as mudanças relacionadas ao novo empreendimento têm impactado o cotidiano da comunidade. Por meio de pesquisa documental e pesquisa de campo, o estudo partiu da hipótese de que enquanto os riscos geológicos foram minimizados e/ou se tornaram inexistentes, outros problemas e condições de vulnerabilidade passaram a ganhar maior visibilidade e projeção para os moradores

In Brazil, urban expansion, as a fundamental component of structural changes in Brazilian society, occurred more strongly in the second half of the twentieth century, between the 1950s and 1970s. The urbanization process, based on land as a commodity, and accompanied by a disorderly occupation brought diverse problems for most Brazilian cities, with occupations in rivers and slopes, waste streams in empty water and land, insufficient basic sanitation, unhealthy housing, traffic, noise and pollution. São Paulo, the most populous city in the country and the main financial, corporate and mercantile center of South America, is representative of this process. Studies focused on the urbanization of the city reveal that the dynamics of metropolis expansion has provoked a process of concentration of low income population in peripheral areas, but also in localities that concentrate pockets of poverty and shelter low income populations, with processes of occupation by irregular activities such as invasions, favelas and clandestine settlements. An example of one of these areas is the former Real Parque favela, located in the neighborhood of Real Parque - one of the five neighborhoods that compose the Morumbi district, in the region of Butantã -, and considered a risk area , which has recently undergone a process of reurbanization. For its specificities, this territory is an illustrative case study to think about the contrasts of the megacity, the impacts of urbanity (or its lack), the conformation of areas of irregular occupation and the relations established by its residents, and possible delineations of processes of reurbanization. This dissertation presents and discusses results of a study that seeks to understand, from the perspective of the residents, the potentialities and limitations of the reurbanization process in this locality, which initiated in 2008 and continued until 2016, with the delivery of recent condominiums. This study also seeks: (i) to investigate the characteristics of this locality, particularly before the beginning of the reurbanization; (ii) to identify residents perceptions of this place and conditions of vulnerability; (iii) to understand, from their narratives, how the changes related to the new enterprise have affected the daily life of the community. Through documentary research and field research, the study is based on the hypothesis that while geological risks were minimized and/or became non-existent, other problems and conditions of vulnerability started to gain greater visibility and projection for the residents

Sazón y formación: prácticas alimenticias e identidad cultural en lasfamilias afrodescendientes de la comuna ocho de Medellín / Seasoning and training: nutritional practices and cultural identity in people of african descent families of the commune eight of Medellin

Con el presente artículo se pretende construir una ruta hermenéutica que genere un acercamiento teórico frente a los cambios en las prácticas alimenticias de algunas familias ubicadas en la comuna ocho de Medellín, para comprender sus condiciones de posibilidad en la comunidad afrodescendiente que por factores personales, grupales, culturales, políticos o económicos, se han visto obligados a migrar a un contexto diferente al suyo, donde sus prácticas y estilos de vida han sufrido algunas modificaciones. En ese orden de ideas,se abordaron conceptos tales como prácticas alimenticias, familias afrodescendientes, migración y acción social que permitieron dar claridad y comprensión al tema de interés.

This article is intended to build a hermeneutic path that generates a theoretical approach to changes in the nutritional practices of some families located in the Commune Eight ofMedellin, in order to understand its conditions of possibility in the community of African descent, who for personal, group, cultural, political, or economic factors have been forced tomigrate to a context different from theirs where its practices and lifestyles have undergone some changes. Along these lines, concepts such as nutritional practices, families, people of African descent, migration, and social action, that allowed you to give clarity andunderstanding to the topic of interest, were addressed.

Calidad de vida relacionada a la salud bucal en escolares de ámbito urbano-marginal / Oral Health Related Quality of Life in schoolchildren of urban-marginal area

Medir el impacto de las condiciones orales sobre la Calidad de Vida Relacionada a la Salud Bucal (CVRSB) en escolares de 11 y 12 años de edad, de ámbito urbano-marginal, Pachacútec-Ventanilla, Callao, Lima, durante el año 2013. Materiales y Métodos: Estudio transversal, en 132 escolares de la escuela ôMártir José Olayaõ. Se utilizó la versión en español (Perú) del Índice Child-OIDP para evaluar impactos de 17 Condiciones orales sobre 8 Desempeños diarios. Resultados: El 100% de los escolares entrevistados informaron al menos un desempeño diario afectado. El promedio de condiciones bucales auto-percibidas como problema fue de 4,52±1,96 condiciones. La principal causa de impacto fue Dolor de muela (72,7%).Comer tuvo la mayor prevalencia de impactos (81,1%). La mayoría de impactos fue de ômuy pocaõ o ôpocaõ Intensidad. El mayor promedio de Severidad del impacto fue en el desempeño Comer: 1,34 +- 0,94. La Extensión del impacto alcanzó el promedio de 3,92+-1,75 Desempeños impactados. El Índice Child-OIDP global fue 9,71 +- 7,63. Conclusiones: El estudio mostró que los impactos de las Condiciones orales afectan la calidad de vida de los todos escolares estudiados de Pachacútec-Ventanilla, mayormente en el desempeño Comer, principalmente por causa de Dolor dentario...

To measure the impact of oral conditions on Quality of Life Related to Health (OHRQoL) in schoolchildren aged 11-12 years, at the urban-marginal area, Pachacutec - Ventanilla, Callao, Lima, in 2013. Materials and Methods: A cross sectional study of 132 students of the school ôMártir José Olayaõ. The Spanish (Peru) Child-OIDP was used to assess the impacts of Oral conditions on daily Performances. Results: 100% of the students interviewed reported at least one affected daily performance. The average self-perceived oral conditions as the cause of the problem was 4.52 ± 1.96 conditions. The main cause of impact was ôToothacheõ (72.7%). ôEatingõ had the highest prevalence of impact (81.1%). Most impacts were ôlow intensityõ. The highest average severity of the impact was on performance Eating (1.34 +- 0.94). The Extent of the impact reached an average of 3.92 +- 1.75 impacted performances. The Child-OIDP overall index was 9.71 +- 7.63. Conclusions: The study showed that oral conditions are affecting the quality of life for all schoolchildren studied in Pachacutec - Ventanilla, mostly in ôEatingõ, mainly because of ôToothacheõ...

Los servicios ecosistémicos en el ordenamiento ambiental del suelo suburbano del municipio de Pereira, estudio de caso / Ecosystemservicees in the environmental mnagement of suburban land in thhe municipality of pereira, case study

El presente artículo presenta una síntesis de trabajo de investigación sobre la problemática relacionada con el actual modelo de ocupación del suelo suburbano² del municipio de Pereira (Risaralda), dicha investigación parte de la premisa de que dicho modelo genera impactos ambientales negativos y un deterioro progresivo de los Servicios Ecosistémicos (SE), lo que conlleva a una pérdida de las capacidades territoriales para el mantenimiento del bienestar de la población. El estudio de caso metodológicamente se desarrolla bajo un enfoque mixto, vinculando herramientas de análisis cualitativas y cuantitativas, lo que permitió identificar los impactos más representativos sobre los SE y los aspectos comunes a dichos impactos; posteriormente se realizó la identificación de las causas estructurales que originan el actual modelo de suburbanización. Los análisis realizados permitieron conducir a la definición de una propuesta de planificación ambiental territorial, con el objeto de procurar una ocupación sustentable del suelo suburbano, por medio de la identificación de unos principios de sustentabilidad y unas determinantes ambientales para este tipo de suelos, entendidas como el conjunto de directrices, lineamientos y propuestas normativas que direccionan la forma de usar y ocupar el suelo suburbano en busca de una sustentabilidad del mismo, y donde los instrumentos de planificación, gestión y financiación identificados permiten hacerlos operativos.

This article presents a research project synthesis about the problems associated with the current suburban land use model of the municipality of Pereira (Risaralda). The research was conducted under the hypothesis that this model generates a negative environmental impact and progressive deterioration of the Ecosystem Services (ES) which implies the loss of territorial capabilities for the maintenance of the population welfare. Methodologically the study is developed under a mixed approach, linking qualitative and quantitative analysis tools which allowed identifying the most representative impacts about ES and the common aspects to these impacts. Subsequently the identification of structural causes behind the current model of suburbanization was carried out. The analyses performed allowed reaching the definition of a territorial environmental planning proposal in order to ensure sustainable suburban ground occupation by means of the identification of some sustainability principles and environmental determinants for this type of ground, understood as a set of directives, guidelines and policy proposals to address the way to use and occupy the suburban land searching for its sustainability and where the identified planning, management and financing instruments allow them to be operational.

Suburban Breastfed Infants In Klang Valley Are At Higher Risk Of Dioxins Toxicity

Dioxins are a most toxic compound ever studied by human until today. Their significant health effects involved all ranges of age, including infants due to exposure to contaminated breast milk. The objective of the study was to appraise the status of dioxin contamination in breast milk among postnatal mothers live in urban and suburban areas in Klang Valley. It was conducted as a cross sectional study involving 101 postnatal mothers who came for their infant second hepatitis B vaccination. The samples were analysed using High Resolution Gas Chromatography (HRGC) following the USEPA Method 8290. About 70.3% of the samples were found detected with dioxin congeners. More suburban mothers have positive breast milk dioxins compared to urban mothers, 100.0% and 67.0% respectively. Significant associated factors include high fat daily intake (p=0.013), high milk daily intake (p= 0.044), high meat daily intake (p=0.001), body mass index more than 30 kg/m2 (p=0.005), and body fat % of more than 26% (p=0.046). In conclusion, amount daily intake of fat diet, meat, milk, body mass index and body fat are significant associated factors for the present of dioxins in breast milk among postnatal mothers in Klang Valley. More suburban mothers contain dioxins in their breast milk, which poses higher risk of health problems among their infants. A comprehensive study need to be conducted and regular followup need to be established in monitoring the future severity of maternal breast milk contamination to ensure the health of the next generations.

The peri-urban interface and house infestation with Triatoma infestans in the Argentine Chaco: an underreported process?

Peri-urban infestations with triatomine bugs, their sources and their dynamics have rarely been investigated. Here, we corroborated the reported occurrence of Triatoma infestans in a peri-urban area and in neighbouring rural houses in Pampa del Indio, in the Argentine Chaco, and identified its putative sources using spatial analysis and demographic questionnaires. Peri-urban householders reported that 10% of their premises had triatomines, whereas T. infestans was collected by timed manual searches or community-based surveillance in only nine (3%) houses. Trypanosoma cruzi-infected T. infestans and Triatoma sordida were collected indoors only in peri-urban houses and were infected with TcV and TcI, respectively. The triatomines fed on chickens, cats and humans. Peri-urban infestations were most frequent in a squatter settlement and particularly within the recently built mud houses of rural immigrants, with large-sized households, more dogs and cats and more crowding. Several of the observed infestations were most likely associated with passive bug transport from other sources and with active bug dispersal from neighbouring foci. Thus, the households in the squatter settlement were at a greater risk of bug invasion and colonisation. In sum, the incipient process of domestic colonisation and transmission, along with persistent rural-to-urban migratory flows and unplanned urbanisation, indicate the need for active vector surveillance and control actions at the peri-urban interface of the Gran Chaco.

Analysis of mortality rate and causes of death among children under 5 years old in Beijing from 2003 to 2012 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the age-specific and cause-specific mortality rate among children under 5 years old in Beijing from 2003 to 2012.</p><p><b>METHODS</b>Death surveillance data of children under the age of 5 were obtained from Beijing children mortality surveillance network from 2003 to 2012. Neonatal mortality rate (NMR), infant mortality rate (IMR), under 5-year old children mortality rate (U5MR) and the leading cause of death for under 5-year old children in urban, suburbs, and outer suburbs in Beijing were analyzed.</p><p><b>RESULTS</b>The NMR, IMR and U5MR in Beijing were 2.08 (253/121 747), 3.11 (379/121 747) and 3.57 (435/121 747) per 1000 live births in 2012, respectively, which declined 54.88%, 50.24% and 54.75% compared with the level in 2003 respectively. The children mortality rates showed a decreasing trend in urban, suburb, and outer suburbs during 2003 and 2012 (NMR was decreased from 0.53%, 0.42%, and 0.48% in 2003 to 0.20%, 0.19%, and 0.23% in 2012; IMR was decreased from 0.73%, 0.58%, and 0.63% in 2003 to 0.30%, 0.29%, and 0.35% in 2012; U5MR was decreased from 0.90%, 0.72%, and 0.82% to 0.33%, 0.34%, and 0.39% in 2012, P < 0.01). There was a steady decline in the U5MR due to congenital heart disease, birth asphyxia, premature birth or low birth weight and traffic accident in Beijing from 2003 to 2012. The mortality rate of congenital heart disease declined from 140.63 to 41.89 per 100 000 live births, birth asphyxia declined from 109.38 to 59.96 per 100 000 live births, premature birth or low birth weight declined from 85.94 to 52.57 per 100 000 live births, traffic accident declined from 26.04 to 6.57 per 100 000 live births (P < 0.01). The mortality rate of congenital heart disease declined remarkably from 216.56 to 52.47, from 119.75 to 23.50, and from 134.58 to 63.11 per 100 000 live births in urban, suburb, and outer suburbs(P < 0.01). Six of the top 8 leading causes of death among children under 5 years old declined remarkably in rural areas. They were congenital heart disease, birth asphyxia, premature birth or low birth weight, traffic accident, drowning, and septicemia, and the mortality rate of them declined from 134.58 to 63.11, from 127.85 to 65.54, from 100.94 to 60.69, from 33.65 to 12.14, from 33.65 to 0.00, and from 26.92 to 4.85 per 100 000 live births, respectively (P < 0.05). There was no drowning death case in rural areas in recent 4 years. The top 5 leading causes of death among children under 5 years old in Beijing in 2012 were birth asphyxia, premature birth or low birth weight, congenital heart disease, pneumonia, and accidental suffocation. The mortality rate of these top 5 leading causes were 59.96, 52.57, 41.89, 24.64, and 15.61 per 100 000 live births in 2012.</p><p><b>CONCLUSION</b>From 2003 to 2012, the NMR, IMR, U5MR and mortality rate of congenital heart disease declined remarkably in urban, suburb, and outer suburb areas in Beijing. There was a decrease trend for the six of the top 8 leading causes of death among children under 5 years old. The mortality rate of drowning dropped markedly in outer suburbs.</p>

A study on risk factors and perceptions of diabetes among urban and suburban residents from six provinces in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the epidemiological status of diabetes' risk factors among urban and suburban residents and their perceptions of their own health status and risk of diabetes.</p><p><b>METHODS</b>Stratified multi-stage sampling method was used to conduct the survey among 18-60 years old residents from Zhejiang, Jiangsu, Shanxi, Henan, Yunnan, and Qinghai provinces in China from March to May in 2013. The Questionnaire of Health Literacy of Diabetes Mellitus of the Public in China was used to conduct the survey, and then the data were analyzed. The main contents of the questionnaire included diabetes mellitus knowledge, diabetes mellitus risk factors and diabetes mellitus risk self-assessment. The results of the survey were standardized by the 6(th) national census data.</p><p><b>RESULTS</b>A total of 4 416 respondents were surveyed, and 4 282 valid questionnaires were successfully collected during the survey and the response rate was 97.0%. After weighted adjustment, the overweight and obesity rate of the residents in 6 provinces was 35.3%, abdominal obesity rate was 54.7%. 77.8% of the residents without diabetes had more than one risk factor, but only 8.5% thought they might got diabetes. The residents with high risk behavior possessing rates of diabetes were in eastern areas (79.7%), urban areas (80.7%), men (84.1%), aged from 45 to 60(100.0%), below primary school education level (83.4%) and enterprise personnel (79.7%). The residents with high risk consciousness of getting diabetes were in eastern areas (11.0%), urban areas (9.7%), men (9.7%), aged from 45 to 60 (12.3%), over college education level (12.7%) and the offices (14.7%). The results of logistic regression showed that residents in the middle areas (OR = 2.148, 95% CI: 1.633-2.920), urban residents (OR = 2.100, 95% CI: 1.611-2.738), male (OR = 2.488, 95% CI: 1.962-3.154), the older (OR = 1.102, 95% CI: 1.090-1.115) had a higher risk behavior rate of diabetes mellitus. Urban residents (OR = 2.784, 95% CI: 1.497-5.175), male (OR = 1.522, 95% CI: 1.152-2.011), the older (OR = 1.022, 95% CI: 1.009-1.035), college educational level (OR = 1.685, 95% CI: 1.033-2.749), with a higher score of health awareness(OR = 1.090, 95% CI: 1.061-1.120)had a higher risk consciousness to being diabetes mellitus.</p><p><b>CONCLUSION</b>The urban and suburban residents in China had a high risk behavior possessing rates of diabetes, and a low risk consciousness of being diabetes.</p>

Prevalence of obesity and its associated risk factors among Chinese adults in a Malaysian suburban village

<p><b>INTRODUCTION</b>Obesity is a major modifiable risk factor associated with most chronic diseases. The aim of this study was to determine the prevalence of obesity, and its associated risk factors, among apparently healthy Chinese adults in a Malaysian suburban village.</p><p><b>METHODS</b>This was a cross-sectional study conducted among the Chinese residents in Seri Kembangan New Village, Klang Valley, Selangor, Malaysia. Convenience sampling was used for the selection of participants. Body weight, height, waist and hip circumferences, and blood pressure were measured. Fasting venous plasma was drawn for the measurement of fasting glucose level and lipid profile. Data on sociodemographic factors, dietary habits, physical activity, perceived stress level and sleep duration were collected using interviewer-administered, pretested and validated questionnaires.</p><p><b>RESULTS</b>Among the 258 Chinese residents (mean age 41.4 ± 10.0 years) recruited, the prevalence of obesity was 40%. The obese participants had significantly higher mean blood pressure, and triglyceride and fasting plasma glucose levels than the non-obese participants (p < 0.05). The obese participants also had a significantly lower high-density lipoprotein cholesterol level than the non-obese participants. Logistic regression analysis showed that drinking soy milk (adjusted odds ratio [OR] 0.447; 95% confidence interval [CI] 0.253-0.787; p < 0.05) and the perception that a balanced diet consists mainly of vegetables (adjusted OR 0.440; 95% CI 0.215-0.900; p < 0.05) were associated with a reduced risk of obesity. The risk of obesity was higher in younger participants (adjusted OR 2.714; 95% CI 1.225-6.011; p < 0.05).</p><p><b>CONCLUSION</b>The prevalence of obesity was high among the apparently healthy suburban Chinese. Our findings suggest that soy milk consumption and the perception that a balanced diet consists mainly of vegetables are associated with a lower risk of developing obesity in this population.</p>