Environmental sustainability, the forgotten aspect that makes nursing invisible

Scientific publications in research journals have adeptly investigated into topics of considerable interest, rendering nursing care more intricate in the face of increasingly thorough investigations into numerous phenomena. This ongoing exploration contributes significantly to the body of knowledge disseminated within the scientific community. Nevertheless, the advent of the global era has presented nursing with novel challenges that persist from the dawn of history parallel to a lingering shadow obscuring the true essence of the profession. An example is environmental nursing, often overlooked from the lens of social sustainability­a neglect that researchers, as minority groups in a relentless struggle, have sidelined. These challenges align with the dynamic demands imposed by society and the mandates of state and/or governmental parliaments.

Individual and contextual factors associated with the survival of patients with severe acute respiratory syndrome by COVID-19 in Brazil / Fatores individuais e contextuais associados à sobrevida de pacientes com síndrome respiratória aguda grave por COVID-19 no Brasil

ABSTRACT Objective: To analyze the influence of individual and contextual factors of the hospital and the municipality of care on the survival of patients with Severe Acute Respiratory Syndrome due to COVID-19. Methods: Hospital cohort study with data from 159,948 adults and elderly with Severe Acute Respiratory Syndrome due to COVID-19 hospitalized from January 1 to December 31, 2022 and reported in the Influenza Epidemiological Surveillance Information System. The contextual variables were related to the structure, professionals and equipment of the hospital establishments and socioeconomic and health indicators of the municipalities. The outcome was hospital survival up to 90 days. Survival tree and Kaplan-Meier curves were used for survival analysis. Results: Hospital lethality was 30.4%. Elderly patients who underwent invasive mechanical ventilation and were hospitalized in cities with low tax collection rates had lower survival rates compared to other groups identified in the survival tree (p<0.001). Conclusion: The study indicated the interaction of contextual factors with the individual ones, and it shows that hospital and municipal characteristics increase the risk of death, highlighting the attention to the organization, operation, and performance of the hospital network.

RESUMO Objetivo: Analisar a influência dos fatores individuais e contextuais do hospital e do município de assistência sobre a sobrevida de pacientes com Síndrome Respiratória Aguda Grave por COVID-19. Métodos: Estudo de coorte hospitalar com dados de 159.948 adultos e idosos com Síndrome Respiratória Aguda Grave por COVID-19 internados de 01 de janeiro a 31 de dezembro de 2022 e notificados no Sistema de Informação de Vigilância Epidemiológica da Influenza. As variáveis contextuais foram relacionadas à estrutura, aos profissionais e equipamentos dos estabelecimentos hospitalares e indicadores socioeconômicos e de saúde dos municípios. O desfecho foi a sobrevida hospitalar em até 90 dias. Árvore de sobrevida e curvas de Kaplan-Meier foram utilizados para analisar a sobrevida. Resultados: A letalidade hospitalar foi de 30,4%. Idosos submetidos à ventilação mecânica invasiva e internados em cidades com baixo percentual de arrecadação de impostos apresentaram menor sobrevida quando comparados aos demais grupos identificados na árvore de sobrevida (p<0,001). Conclusão: O estudo indicou a interação de fatores contextuais com os individuais, e evidencia que características hospitalares e dos municípios aumentam o risco de óbito, destacando a atenção à organização, ao funcionamento e desempenho da rede hospitalar.

Which physical and social characteristics of Brazilian cities contribute to physical activity of adolescents? / Quais características físicas e sociais das cidades brasileiras contribuem para atividade física de adolescentes?

Abstract This study aimed to analyze the association between adolescents' physical activity and the Brazilian capitals' built and social environment. The units of analysis of this ecological study were the 26 capitals and the Federal District, with data from the National Adolescent Health Survey (2012). The outcome variable was the reported regular physical activity (PA) of ninth graders in Brazilian schools. Exposure variables included characteristics of the natural environment, socioeconomic and educational indicators, urban infrastructure, urban violence, and sociocultural factors retrieved from several secondary sources of Brazilian databases. We adopted multiple linear regression to verify the association between PA and exposure variables. The percentage of active adolescents was 33.0% (95%CI: 32.1; 33.9). In the final model, higher PA was associated with lower temperature, higher Primary Education Development Index, the higher percentage of ramps for wheelchair users, and a higher percentage of leisure-time active adults. The data show that climatic and educational factors, the infrastructure, and the social environment of the capitals can contribute to Brazilian adolescents complying with the recommended weekly PA levels.

Resumo Este estudo teve como objetivo analisar a associação entre atividade física em adolescentes e ambientes construído e social das capitais brasileiras. Trata-se de um estudo ecológico cujas unidades de análise foram as 26 capitais e o Distrito Federal, com dados da Pesquisa Nacional de Saúde do Adolescentes (2012). A variável de desfecho foi a prática regular de atividade física (AF) relatada pelos escolares do 9º ano de escolas brasileiras. As variáveis de exposição incluíram características do ambiente natural, indicadores socioeconômicos e educacionais, de infraestrutura, violência urbana e fatores socioculturais, obtidas de diferentes bases de dados de fontes secundárias brasileiras. Adotou-se a regressão linear múltipla para verificar a associação entre AF e variáveis de exposição. O percentual de adolescentes ativos foi de 33,0% (IC95%: 32,1; 33,9). No modelo final, foram associados à maior prática de AF: menor temperatura, maior Índice de Desenvolvimento da Educação Básica, maior percentual de rampa para cadeirante e maior percentual de adultos ativos no lazer. Os dados mostram que fatores climáticos e educacionais, a infraestrutura e o ambiente social das capitais podem contribuir para que os adolescentes brasileiros cumpram os níveis semanais recomendados de AF.

Association between contextual factors and coverage of the Acwy meningococcal vaccine, after three years of its overdue, in the vaccination calendar of adolescents in the state of Minas Gerais, Brazil: global space regressions.

The objective of the study was to analyze the spatial distribution of vaccination coverage of bacterial meningitis vaccine: A, C, W and Y (menacwy) and identify the association between socioeconomic and social environment factors with menacwy vaccine coverage among adolescents in the state of Minas Gerais (MG), Brazil. This is an ecological, mixed study, conducted with secondary data from the 853 municipalities of the State of MG, Brazil, from 2020 to 2022, provided by the information system of the National Immunization Program. For spatial statistical analysis, spatial dependence and the presence of spatial clusters formed by municipalities with high and low vaccination coverage of Menacwy were evaluated. In the year 2021, MG presented the largest vaccination coverage (60.58%) since the introduction of the Menacwy vaccine by the PNI. Regarding the analysis of global regressions, it is observed that for the year 2020, as the MG Index of Social Responsibility-Health increased and MG Index of Social Responsibility-Public Security increased, increased the vaccination coverage of the municipalities of the Menacwy vaccine. Finally, compared to 2021, similar association was observed in relation to the proportion of the population served by the Family Health Strategy of the municipalities of the state of MG and per capita spending on education activities: as this indicator increased, with increased coverage of the Vaccine of the Menacwy vaccine of the state municipalities. They reinforce the importance of assessing the quality-of-care management and health surveillance system, professional training, and damage reduction to populations, especially adolescents.

Ecological determinants of obesity risk in Mexican infants: a scoping review.

BACKGROUND: Childhood obesity is a multifactorial disease. Most of these factors start to develop before birth and worsen throughout life. Therefore, prevention efforts should begin in the first 1000 days of life. This study aimed to quantify published studies on risk factors according to the Six-Cs model of childhood obesity (cell, child, clan, culture, community, and country) and determine which of them have been related to anthropometric indicators of overweight or obesity in children under 2 years of age in Mexico. METHODS: A systematic scoping review (PRISMA-ScR) was performed. PubMed, Scopus, and EBSCOhost databases were reviewed. RESULTS: We found that 88% of the studies were observational. The child and family spheres were the most studied, individually and as a whole. The least studied were community, culture, and country. The main risk factors related to obesity indicators were high birth weight, birth by cesarean section, and inadequate feeding practices, in addition to mothers with obesity and those who underestimate their child's weight, stressful parenting style, and food insecurity in the home, together with living in urban areas, family income, and beliefs about preference for ultra-processed products. CONCLUSION: In Mexico, the study of obesity in early childhood is emerging at the research level. However, further efforts are required to close the knowledge gap at the socioecological level to design evidence-based interventions and reduce early obesity.

INTRODUCCIÓN: La obesidad infantil es una enfermedad multifactorial en la que varios factores comienzan a desarrollarse antes del nacimiento y se agravan a lo largo de la vida. Por ello, los esfuerzos de prevención para evitar su desarrollo deben comenzar durante los primeros 1000 días de vida. Los objetivos de este estudio fueron cuantificar los estudios publicados sobre factores de riesgo según el modelo de obesidad infantil de las 6-Cs (célula, niño, familia, cultura, comunidad y país) y determinar cuáles de ellos se han relacionado con indicadores de sobrepeso u obesidad en niños menores de 2 años en México. MÉTODOS: Se realizó una revisión sistemática de alcance (PRISMA-ScR). Se revisaron las bases de datos de PubMed, Scopus y EBSCOhost. RESULTADOS: Se encontró que el 88% de los estudios fueron de tipo observacional. La esfera niño y familia fueron las más abordadas, tanto individual como en conjunto. Las menos estudiadas fueron comunidad, cultura y país. Los principales factores de riesgo relacionados con indicadores de obesidad fueron alto peso al nacer, nacer por vía cesárea y prácticas inadecuadas de alimentación; además, madres con obesidad y que subestiman el peso del hijo, estilo de crianza presionante e inseguridad alimentaria en el hogar, aunado el vivir en zonas urbanas, ingreso económico-familiar y creencias sobre la preferencia por productos ultraprocesados. CONCLUSIONES: En México, el estudio de obesidad durante los primeros 1000 días es emergente a nivel de investigación, pero se requiere continuar con el esfuerzo para cerrar la brecha de conocimiento a nivel socio-ecológico, diseñar intervenciones basadas en la evidencia y disminuir la obesidad temprana.

Evidencias de validez de una escala para evaluar el ajuste a la vida universitaria / Evidence of Validity of a Scale to Assess College Adjustment / Evidências de validade de uma escala para avaliar a adaptação à vida universitária

El propósito de la investigación fue desarrollar una escala para medir el proceso de ajuste a la vida universitaria. Este constructo multifactorial se basa en un modelo teórico de tres dimensiones: académica, social e institucional. La muestra principal estuvo conformada por 673 estudiantes: 42.1 % mujeres, 57.7 % hombres y 0.3 % otro, con un promedio de 18.29 años. En el primer análisis se encontraron evidencias asociadas al contenido de las dimensiones de la escala denominada AjusteU. En el análisis de validez convergente se halló una correlación de 0.582 a un nivel de significancia del 0.01 (bilateral) con el instrumento CAVU, otra medida del ajuste a la vida universitaria. En el tercer análisis se validó el planteamiento teórico con los datos empíricos mediante un modelo de ecuaciones estructurales. Finalmente, en el análisis predictivo se comprobó que la puntuación de la escala AjusteU se asoció significativamente con el rendimiento del primer período universitario. Se concluye que estas evidencias empíricas permiten un uso adecuado de los resultados, especialmente en la toma de decisiones oportunas para favorecer el proceso de transición de secundaria a la educación superior. La principal limitación fue la aplicación de la escala en modalidad remota en el contexto de pandemia, por lo que las experiencias del estudiantado podrían ser diferentes en un entorno presencial

The purpose of the research was to develop a scale to measure college adjustment. The theorical model was based on three dimensions: academical, social and institutional. The principal sample was conformed for 673 students: 42.1 % women, 57.7 % men and 0.3 % other, with an average of 18.29 years old. In the first analysis were found evidence associated to the content of the dimensions of the scale denominated AjusteU. In the validity convergent analysis was found a correlation of 0.582 to a significance level of 0.01 (bilateral) with the instrument CAVU, other measure that is related to the adjustment process. In the third analysis, the theoretical approach was validated with empirical data using a structural equation model. Finally, in the predictive analysis was proved that the scoring of the scale AjusteU was associated significantly with the performance of the first period of college. The conclusion is that this empirical evidence allows an appropriate use of their results, specifically in the opportune decision making to favor the transition process from high school to higher education. The main limitation was the application of the scale in the remote modality in the pandemic context, therefore the experiences of the students might be different in an on-site experience.

O objetivo da pesquisa foi desenvolver uma escala para medir o processo de adaptação à vida universitária. Este construto multifatorial é baseado em um modelo teórico de três dimensões: acadêmica, social e institucional. A amostra principal foi composta por 673 estudantes, sendo: 42.1 % mulheres, 57.7 % homens e 0.3 % outros, com idade média de 18.29 anos. Na primeira análise, foram encontradas evidências associadas ao conteúdo das dimensões da escala denominada AjusteU. Na análise de validade convergente, uma correlação de 0.582 foi encontrada em um nível de significância de 0.01 (bilateral) com o instrumento CAVU, outra medida de adaptação à vida universitária. Na terceira análise, a abordagem teórica foi validada com dados empíricos usando um modelo de equações estruturais. Por fim, na análise preditiva verificouse que a pontuação da escala AjusteU esteve significativamente associada ao desempenho do primeiro período universitário. Concluise que estas evidências empíricas permitem uma utilização adequada dos resultados, sobretudo na tomada de decisões oportunas que favoreçam o processo de transição do ensino médio para o superior. A principal limitação do estudo foi a aplicação da escala de forma remota no contexto de pandemia, de modo que as experiências do corpo discente poderiam ser diferentes em um ambiente presencial.

Ecological determinants of obesity risk in Mexican infants: a scoping review / Determinantes ecológicos de riesgo de obesidad en lactantes mexicanos: una revisión de alcance

Abstract Background: Childhood obesity is a multifactorial disease. Most of these factors start to develop before birth and worsen throughout life. Therefore, prevention efforts should begin in the first 1000 days of life. This study aimed to quantify published studies on risk factors according to the Six-Cs model of childhood obesity (cell, child, clan, culture, community, and country) and determine which of them have been related to anthropometric indicators of overweight or obesity in children under 2 years of age in Mexico. Methods: A systematic scoping review (PRISMA-ScR) was performed. PubMed, Scopus, and EBSCOhost databases were reviewed. Results: We found that 88% of the studies were observational. The child and family spheres were the most studied, individually and as a whole. The least studied were community, culture, and country. The main risk factors related to obesity indicators were high birth weight, birth by cesarean section, and inadequate feeding practices, in addition to mothers with obesity and those who underestimate their child's weight, stressful parenting style, and food insecurity in the home, together with living in urban areas, family income, and beliefs about preference for ultra-processed products. Conclusion: In Mexico, the study of obesity in early childhood is emerging at the research level. However, further efforts are required to close the knowledge gap at the socioecological level to design evidence-based interventions and reduce early obesity.

Resumen Introducción: La obesidad infantil es una enfermedad multifactorial en la que varios factores comienzan a desarrollarse antes del nacimiento y se agravan a lo largo de la vida. Por ello, los esfuerzos de prevención para evitar su desarrollo deben comenzar durante los primeros 1000 días de vida. Los objetivos de este estudio fueron cuantificar los estudios publicados sobre factores de riesgo según el modelo de obesidad infantil de las 6-Cs (célula, niño, familia, cultura, comunidad y país) y determinar cuáles de ellos se han relacionado con indicadores de sobrepeso u obesidad en niños menores de 2 años en México. Métodos: Se realizó una revisión sistemática de alcance (PRISMA-ScR). Se revisaron las bases de datos de PubMed, Scopus y EBSCOhost. Resultados: Se encontró que el 88% de los estudios fueron de tipo observacional. La esfera niño y familia fueron las más abordadas, tanto individual como en conjunto. Las menos estudiadas fueron comunidad, cultura y país. Los principales factores de riesgo relacionados con indicadores de obesidad fueron alto peso al nacer, nacer por vía cesárea y prácticas inadecuadas de alimentación; además, madres con obesidad y que subestiman el peso del hijo, estilo de crianza presionante e inseguridad alimentaria en el hogar, aunado el vivir en zonas urbanas, ingreso económico-familiar y creencias sobre la preferencia por productos ultraprocesados. Conclusiones: En México, el estudio de obesidad durante los primeros 1000 días es emergente a nivel de investigación, pero se requiere continuar con el esfuerzo para cerrar la brecha de conocimiento a nivel socio-ecológico, diseñar intervenciones basadas en la evidencia y disminuir la obesidad temprana.

Neighborhood Availability and Use of Food, Physical Activity, and Social Services Facilities in Relation to Overweight and Obesity in Children and Adolescents.

OBJECTIVE: To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments. METHODS: Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics. RESULTS: Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome. CONCLUSIONS: Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents.

Environmental factors associated with excessive gestational weight gain: a meta-analysis and systematic review / Fatores ambientais associados ao ganho de peso gestacional excessivo: uma meta-análise e revisão sistemática

Abstract The aim is, systematically examine the scientific evidences that associated environmental factors (environment, social environment, environmental planning and spatial population distribution) with the excessive gestational weight gain. A meta-analysis and systematic review carried out as per the Cochrane Handbook recommendations and following the steps recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The inclusion studies were done with the following PECO criteria: P-pregnant women, E-environmental factors, O-weight gain. The search procedure was conducted on the databases EMBASE, Web of Science, Cinahl, LILACS and MEDLINE (PubMed). The relationship between the socioeconomic factors of the micro-region of residence and gestational weight gain was evidenced by the linkage between residing in high-poverty neighborhoods and inadequate gestational weight gain. This study revealed the higher prevalence of excessive gestational weight gain in pregnant women those lives in urban areas. Environmental factors of the pregnant women's residence area implicated in the excessive gestational weight gain. Our findings can therefore contribute to the development of public policies to prevent inadequate gestational weight gain.

Resumo O objetivo é examinar sistematicamente as evidências científicas que associam fatores ambientais (meio ambiente, meio ambiente social, planejamento ambiental e distribuição espacial da população) com o excessivo ganho de peso gestacional. Trata-se de uma revisão sistemática e meta-análise realizada seguindo os passos recomendados pelo Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. Os estudos de incluídos basearam-se nos seguintes critérios PECO: P-gestantes, E-fatores ambientais, O-ganho de peso gestacional. O procedimento de pesquisa foi conduzido nas bases de dados EMBASE, Web of Science, Cinahl, LILACS e MEDLINE (PubMed). A relação entre os fatores socioeconômicos da microrregião de residência e o ganho de peso gestacional foi evidenciada pela ligação entre a residência em bairros de alta pobreza e o ganho de peso gestacional inadequado. Este estudo revelou a maior prevalência de ganho de peso gestacional excessivo em gestantes que vivem em áreas urbanas. Fatores ambientais da área de residência das gestantes implicados no ganho de peso gestacional excessivo. As descobertas desse estudo podem, portanto, contribuir para o desenvolvimento de políticas públicas para evitar o ganho de peso gestacional inadequado.

Contexto social e Inseguridad Alimentaria y Nutricional Moderada- Grave en familias con niños de 0 a 59 meses, Paraíba, Brasil, 2017- 2018 / Social context and moderate-severe food and nutritional insecurity in families with children 0 to 59 months, Paraíba, Brazil, 2017-2018

Objetivo. Analizar la asociación entre el contexto social (factores demográficos, socioeconómicos y soporte social) y la inseguridad alimentaria y nutricional moderada-grave de familias con niños de 0 a 59 meses matriculados en jardines infantiles municipales del estado de Paraíba, Brasil. Materiales y métodos. Estudio transversal desarrollado en municipios brasileños prioritarios para la prevención de la obesidad infantil. Se utilizó un cuestionario que recogió información sobre el contexto social de la familia (perfil demográfico del niño, situación socioeconómica y soporte social) y la escala brasileña de inseguridad alimentaria. La asociación entre las variables independientes y la inseguridad alimentaria y nutricional moderada-grave se determinó a través de una regresión de Poisson para estimar razones de prevalencia crudas y ajustadas, y sus respectivos intervalos de confianza al 95%. Resultados. De un total de 382 familias, el 27,2% presentaba inseguridad alimentaria y nutricional moderada-grave. Además, se encontró que aquellas familias con niños menores de 24 meses, de clases menos prósperas, beneficiadas del Programa Bolsa Família, sin apoyo social (material, emocional/informacional y de interacción) y disfuncionales tenían una mayor probabilidad de presentar el desenlace de estudio. Conclusiones. Los resultados del presente estudio indicaron que el 27,2% de las familias tenía inseguridad alimentaria y nutricional moderada-grave, siendo mayores en núcleos beneficiarios del Programa Bolsa Família, disfuncionales y sin apoyo social. En este sentido, la identificación de estos factores sería de utilidad para optimizar la seguridad alimentaria y nutricional familiar.

Objective. To analyze the association between the social context (demographic, socioeconomic and social support factors) and moderate-severe food and nutritional insecurity in families with children aged 0-59 months enrolled in municipal kindergartens in the state of Paraíba, Brazil. Materials and methods. We conducted a cross-sectional study in Brazilian municipalities prioritized for the prevention of childhood obesity. A questionnaire was used to collect information on the social context of the family (demographic profile of the child, socioeconomic situation and social support) as well as the Brazilian food insecurity scale. The association between the independent variables and moderate-severe food and nutrition insecurity was determined by applying Poisson regression to estimate crude and adjusted prevalence ratios and their respective 95% confidence intervals. Results. We included 382 families; 27.2% had moderate-severe food and nutrition insecurity. In addition, dysfunctional families with children under 24 months, from less affluent classes, beneficiaries of the Bolsa Família Program and without social support (material, emotional/informational and interaction) were more likely to present the outcome. Conclusions. Our results show that 27.2% of the families had moderate-severe food and nutritional insecurity, were beneficiaries of the Bolsa Família Program, dysfunctional and did not have social support. Therefore, the identification of these factors would be useful to improve family food and nutritional security.

Terapia ocupacional desde una perspectiva ecosocial de la salud mental / Occupational therapy from an ecosocial perspective of mental health

Resumen Se describe la experiencia de un proyecto de huerta terapéutica ubicada en las inmediaciones del Servicio de psiquiatría del Hospital Guillermo Grant Benavente (HGGB) de Concepción, Chile, liderada por la Organización No Gubernamental Rebrota (ONG Rebrota) en base a la perspectiva eco-social aplicada en personas con necesidades de salud mental. Se objetiva analizar la experiencia de Terapia Ocupacional Ecosocial como herramienta práctica para la transformación de los territorios, permitiendo a los terapeutas ocupacionales comprender la interacción entre la sociedad y la naturaleza como un proceso socioecológico que impacta en diferentes esferas de los seres humanos, especialmente en la participación social y la salud mental. Utilizando la metodología descriptiva del Modelo Procesal de Emprendimiento Eco-social realizamos una orientación práctica de acciones para que las comunidades, insertas en sus entornos naturales y culturales, logren descubrirse reflexivamente generando procesos de salud colectiva. La Terapia Ocupacional Ecosocial desarrolla praxis que mejoran la salud y promueven el bienestar de las personas, grupos y/o comunidades, generando un impacto positivo en los socio-ecosistemas y construyen comunidades más saludables, inclusivas, sostenibles. La Terapia Ocupacional Ecosocial es una invitación a generar proyectos de investigación-acción para mitigar el impacto social sobre la naturaleza en un contexto de crisis climática, donde encontramos comunidades en la génesis de saberes transculturales que nos permitan desarrollar una praxis transformadora para el buen vivir en sintonía con nuestro entorno; mientras mejoran su bienestar y participación, desde una perspectiva de derechos humanos y justicia ocupacional.

Abstract It is described the experience of a therapeutic garden project located in the vicinity of the Psychiatry Service of the Guillermo Grant Benavente Hospital (HGGB) in Concepción, Chile, led by the Non-Governmental Organization Rebrota (ONG Rebrota) based on the ecosocial perspective applied in people with mental health needs. It aims to analyze this Eco-social Occupational Therapy experience as a practical tool for the transformation of territories, allowing occupational therapists to understand the interaction between society and nature as a socio-ecological process that impacts different spheres of human beings, especially in social participation and mental health. Using the descriptive methodology of the Eco-social Entrepreneurship Process Model, we carry out a practical orientation of actions so that communities, inserted in their natural and cultural environments, can discover themselves reflexively, generating collective health processes. Eco-social Occupational Therapy develops practices that improve health and promotes the well-being of individuals, groups and/or communities, generating a positive impact on socio-ecosystems and building healthier, more inclusive, and sustainable communities. Eco-social Occupational Therapy is an invitation to generate research-action projects to mitigate the social impact on nature in a context of the climate crisis, where we find communities in the genesis of transcultural knowledge that allows us to develop a transformative praxis for good living in tune with our environment; while improving their well-being and participation, from a human rights and occupational justice perspectives.

Relationship between Malocclusion, Bullying, and Quality of Life in Students from Low Social Development Area: A Cross-Sectional Study

ABSTRACT Objective: To analyze the relationship between malocclusion and bullying and its impact on the well-being and quality of life of students from low social development areas. Material and Methods: This cross-sectional study included 243 schoolchildren between 10 and 17 years. Malocclusion was analyzed using Dental Aesthetic Index. Bullying and self-perception of the impact of one's oral condition on quality of life and interpersonal relationships were assessed by questions from National Survey of Schoolchildren's Health and Child Perceptions Questionnaire 11-14 (CPQ11-14). Data were analyzed using the Spearman correlation coefficient and Mann-Whitney tests, considering groups: 10-11, 12-14 and 15-17 years. Results: No correlation was observed between malocclusion and bullying. However, in the 12-14 group, poor correlations were found between malocclusion and the CPQ11-14 (0.226) and between malocclusion and being shy/embarrassed due to oral aspects (0.298). Positive correlations were observed between bullying and the impact on the quality of life in the 10-11 (0.420) and 12-14 (0.425) groups. In the older group, a positive correlation (0.724) was observed between the concern about what others think of their oral health and the impact on their quality of life. Conclusion: There was no evidence of a relationship between malocclusion and bullying. However, the oral conditions negatively affected the interpersonal relationships and the student's quality of life.

Neighborhood factors associated with leisure-time physical activity in a Brazilian city.

The purpose of this study was to estimate the association between environmental variables and leisure-time physical activity levels in an adult population of a medium-sized city in Brazil. This is a cross-sectional study with a sample of 965 adults (20-59 years). Individual, socioeconomic, demographic and behavioral data were obtained through a population-based survey. Environmental data were collected through direct observation and subsequently georeferenced. The outcome variable was leisure-time physical activity level, dichotomized as insufficiently active (<150 min/week) and active (≥150 min/week). Physical activity-related facilities were categorized as public or private, and food outlets as healthy, unhealthy or mixed. Monthly per capita income and crime rate by census tract were used to categorize the social environment. Statistical analysis was performed using binary logistic regression (generalized estimating equation models). A direct association was found between the availability of public (adjusted OR = 2.16; 95% CI = 1.44-3.25) and private (adjusted OR = 1.21; 95% CI = 1.02-1.44) physical activity facilities in the census tract and leisure-time physical activity. A greater availability of mixed food establishments was associated with higher leisure-time physical activity levels (adjusted OR = 1.10; 95% CI = 1.004-1.22). Environmental characteristics can contribute together to leisure-time physical activity and could be the focus of policies aimed at promoting physical activity in middle-income countries.

This research estimated how leisure-time physical activity relates to environmental aspects in an adult population of a medium-sized city in Brazil. Nine hundred sixty-five adults (20­59 years) participated in a survey to give individual, socioeconomic, demographic and behavioral information. Researchers also directly observed the environment to collect data and subsequently georeferenced it, to further apply regression models (statistical analysis). Being active during leisure, (i.e. practicing 150 min/week or more), was related to having more public (city squares and outdoor gyms, walking areas and university campus) and private physical activity facilities (clubs, courts, sports halls, soccer fields and gyms), as well as having greater availability of mixed food establishments (restaurants, bakeries, supermarkets and hypermarkets). Therefore, environmental characteristics can contribute together to leisure-time physical activity and could be the focus of policies aimed at promoting physical activity in middle-income countries.

Premature Primary Tooth Loss and Oral Health-Related Quality of Life in Preschool Children.

The present study aimed to evaluate the association between premature primary tooth loss and oral health-related quality of life (OHRQoL) in preschool children. A cross-sectional study was conducted in 769 5-year-old preschool children. The children and their parents or guardians answered the Brazilian version of the Scale of Oral Health Outcomes for 5-Year-Old Children for the assessment of OHRQoL. Meanwhile, clinical examinations were performed for the assessment of premature primary tooth loss. Unadjusted and adjusted multilevel Poisson regression models were utilized to investigate the associations between the variables. In the parental version of the scale, premature posterior primary tooth loss (rate ratio [RR] = 2.65; 95% confidence interval [CI] = 1.51-4.68), weak sense of coherence (RR = 2.25; 95% CI = 1.62-3.11), and visit to a dentist (RR = 1.61; 95% CI = 1.04-2.52) were associated with OHRQoL. Based on the children's perceptions, only the preschool type was associated with OHRQoL (RR = 1.92; 95% CI = 1.21-3.05). Premature posterior primary tooth loss had a greater impact on OHRQoL based on the parents' perception, whereas only the preschool type was associated with OHRQoL based on the children's perception.

Yolk corticosterone and progesterone levels in Greater Rhea (Rhea americana) eggs vary in a changing social environment.

Maternal hormones in avian egg yolks may signal and prepare offspring for the prevailing conditions. However, this adjustment requires some degree of flexibility in regulating yolk hormone deposition. The Greater Rhea (Rhea americana) has a particular mating system that combines mixed polygyny and polyandry, communal nesting, and exclusive paternal care of chicks. In this species, we previously found that yolk hormone deposition varies among eggs of different captive populations and could influence chicks' physiology and behavior. However, it is still unknown whether females can modify yolk hormone deposition in a changing social environment. Using a captive population of Greater Rheas, in this study, we quantified yolk hormone levels before and after a reduction in the number of females present in the population. We found that females deposited on average higher yolk corticosterone and lower yolk progesterone after the change in their social environment. Since corticosterone deposited into the yolk comes exclusively from the female's plasma, our results suggest that females had, on average, higher plasma corticosterone levels. The change in the number of females may increase the events of male-male competitions, courtships, and matings, leading to an increase of corticosterone in the females' plasma and then into their eggs. Since we previously found that higher yolk corticosterone and lower yolk progesterone were associated with the production of chicks that have an attenuated stress response, the present study results suggest that yolk hormone deposition is mediated by flexible mechanisms that could adjust development to the prevailing conditions.

Social environment perception and associations with overweight in the city of Porto Alegre, Brazil.

The prevalence of overweight in Brazilian adults has grown in recent years. There is evidence indicating that environmental factors, especially social characteristics, may be involved in the aetiology of overweight, but few studies have investigated this association adequately. The main objective of this study was to identify residents' perception of their social environment (social cohesion, security and violence) and assess its relationship with overweight in a central area of Porto Alegre, Brazil. The associations between socioeconomic characteristics and social environment perception were also explored. This cross-sectional study conducted in 2018-19 had 400 participants aged from 20 to 70 years living in low- and high-income areas of the city of Porto Alegre. Participants' perception of social cohesion, security and violence were evaluated using a validated questionnaire. Participants' body mass index (BMI) was measured, and those with a BMI ≥25 kg/m2 were considered to be overweight. Unadjusted and adjusted prevalence ratios (PRs) and 95% confidence intervals (95% CIs) were estimated through Poisson regression analysis; level of significance was 5%. The prevalence of overweight in the sample was 68.8% (95% CI 64.0-73.2). Individuals with a more positive social cohesion perception had a higher prevalence of overweight (PR 1.06; 95% CI: 1.00-1.12; p=0.02) than those with a less positive perception. Brown individuals also had a higher prevalence of overweight (PR: 1.08; 95% CI: 1.02-1.15; p=0.03) than those of other skin colour/race. No association was found between overweight and perception of security or violence. Therefore, social cohesion may be an important factor in overweight and the findings highlight the importance of considering social factors, and their perceptions, when planning actions for the prevention and control of overweight in a population.

Built and social environments and overweight among Brazilian adults from medium-sized city: CUME Project / Ambientes construído e social e excesso de peso em adultos brasileiros de uma cidade de médio porte: Projeto CUME

Abstract A cross-sectional study enrolled participants from the CUME project (n = 289) who lived in Viçosa, Brazil. The neighborhood unit adopted was the buffer (200 meters), considering the participant's residence as central point. We measure the number of public and private facilities inside the buffer as well as violent criminal occurrences. Food establishments were categorized into establishments with predominant sale of natural or minimally processed foods, mixed establishments, and establishments with predominant sale of ultra-processed foods. Those who attended the face-to-face interview filled two scales of perception of the environment. Overall, 33.6% of participants reported overweight. We observed a higher concentration of individuals close to the central region of the city. Access to different establishments, food environments, and criminal occurrences differed between normal-weight and overweight individuals. The groups deferred in the perception of the location of squares, open public spaces, clubs, and soccer fields. The results indicate the association between environmental characteristics and overweight in Brazilian adults.

Resumo Realizou-se um estudo transversal com participantes do projeto CUME (n = 289) que moravam em Viçosa, Brasil. A unidade de vizinhança adotada foi o buffer (200 metros), considerando a residência do participante como ponto central. Foi contabilizado o número de instalações públicas e privadas dentro do buffer, bem como as ocorrências criminais. Os estabelecimentos alimentares foram categorizados em estabelecimentos com venda predominante de alimentos naturais ou minimamente processados, estabelecimentos mistos e estabelecimentos com venda predominante de alimentos ultraprocessados. Os participantes que compareceram à entrevista presencial, preencheram duas escalas de percepção do ambiente. No total, 33,6% dos participantes apresentaram excesso de peso. Foi observada uma maior concentração de indivíduos próximos à região central da cidade. O acesso a diferentes estabelecimentos, ambientes alimentares e ocorrências criminais diferiram entre indivíduos com eutrofia e com excesso de peso. Os grupos diferiram na percepção da localização de praças, espaços públicos abertos, clubes e campos de futebol. Os resultados indicam a associação entre as características ambientais e o excesso de peso em adultos brasileiros.

Food environment of the economic capital of the Northeast: social and territorial disparities in the availability of food stores / Ambiente alimentar da capital econômica do Nordeste: disparidades sociais e territoriais da disponibilidade dos comércios de alimentos

ABSTRACT Objective Characterize the community food environment through the different types of food outlets in the city of Fortaleza and associate their distribution according to sociodemographic indicators. Methods This is an ecological study carried out in the city of Fortaleza in which data from the Health Surveillance Service were used with the location of all licensed food stores in the city in the years 2018 and 2019. Georeferenced maps were set up to illustrate the spatial distribution of the establishments. Correlation analyses were performed to verify the association between food outlets and socioeconomic data. Values of p≤0.005 were considered significant. Results We identified a greater concentration of food stores in the neighborhoods with better socioeconomic levels. Snack bars (n=2051; 27.7%) and restaurants (n=1945; 26.3%), were in greater quantity and exhibited a positive correlation with the Human Development Index and average income. Supermarkets and hypermarkets (n=288; 3.9%) and street markets (n=81; 1.1%) were in a smaller number and had the worst spatial distribution. Conclusion We observed socioeconomic inequalities in the distribution of different types of food outlets. The little diversity and the limited number of establishments in peripheral neighborhoods, besides the centralization of outlets that sell food that is harmful to health, constitute obstacles for the population to make healthy food choices.

RESUMO Objetivo Caracterizar o ambiente alimentar comunitário por meio dos diferentes tipos de estabelecimentos de venda de alimentos existentes na cidade de Fortaleza e relacionar sua distribuição de acordo com indicadores sociodemográficos. Métodos Trata-se de um estudo ecológico realizado na cidade de Fortaleza em que foram utilizados dados da Vigilância Sanitária com a localização de todos os comércios de alimentos licenciados para funcionamento no município nos anos de 2018 e 2019. Foram construídos mapas georreferenciados para ilustrar a distribuição espacial dos estabelecimentos. Análises de correlação foram realizadas para verificar associação entre os estabelecimentos de venda de alimentos e dados socioeconômicos. Consideraram-se significativos valores de p≤0,005. Resultados Foi possível identificar maior concentração de comércios de alimentos nos bairros com melhores níveis socioeconômicos. Lanchonetes (n=2051; 27,7%) e restaurantes (n=1945; 26,3%) apresentaram-se em maior quantidade e obtiveram correlação positiva com o Índice de Desenvolvimento Humano e a renda média. Supermercados e hipermercados (n = 288; 3,9%) e feiras livres (n=81; 1,1%) existiam em menor proporção e apresentaram a pior distribuição espacial. Conclusão Desigualdades socioeconômicas foram observadas na distribuição dos diferentes tipos de pontos de venda de alimentos. A pouca diversidade e a limitada quantidade de estabelecimentos em bairros periféricos, além da centralização da oferta de comércios que vendem alimentos prejudiciais à saúde, constituem-se obstáculos para que a população faça escolhas alimentares saudáveis.

HIV in women over 50 years: An analysis of administrative data in the departments of the Colombian Pacific region (2014-2018) / [HIV en mujeres mayores de 50 años. Análisis de datos administrativos en departamentos del Pacífico colombiano (2014-2018)].

Introduction: HIV is a public health problem that is relevant in the Colombian Pacific due to major social problems in the region where women are exposed to more risk factors. Objective: To describe the differences by gender and age of the most frequent ICD-10 code related to HIV in four departments of the Colombian Pacific region during the period 2014 to 2018. Materials and methods: We conducted a descriptive, retrospective observational study with ecological units of analysis (departments and municipalities) obtained by aggregation. The data source was SISPRO, a platform for the mandatory registration of health services in the country. For each age group and territorial entity, we estimated the proportions of each code for women and men, as well as the absolute differences (the female proportion minus the male proportion). Results: At the regional level, there was a predominance of women in 9 of 22 groups evaluated. The largest absolute difference was in the 25-29 age group. Five of the nine age groups with a predominance of women represented ages over 50 years. The greatest difference was found in the 50-54 age group in Chocó, and the smallest difference was found in the 90-94 age group in Nariño. The analysis identified the following two patterns: before the age of 50 with a predominance of men and over the age of 50 with a predominance of women. Conclusions: The secondary analysis of databases for routine information collection is useful. Given that the data showed a prevalence of older adults, especially women, it is important to consider including this population in the promotion and prevention strategies of the HIV program.

Introducción. El HIV es un problema de salud pública relevante en el Pacífico colombiano debido a la gran problemática social de la región y la exposición de las mujeres a más factores de riesgo. Objetivo. Describir las diferencias por sexo y grupos de edad con respecto al código CIE-10 de HIV más frecuente en los cuatro departamentos de la Región Pacífica colombiana durante el periodo de 2014 a 2018. Materiales y métodos. Se hizo un estudio observacional descriptivo, retrospectivo y con unidades de análisis ecológicas (departamentos y municipios) obtenidas por agregación. La fuente de datos fue el SISPRO, una plataforma para el registro obligatorio de las prestaciones de servicios de salud en el país. Para cada grupo de edad y ente territorial, se estimaron las proporciones del código para mujeres y para hombres, y se calcularon las diferencias absolutas (la proporción femenina menos la proporción masculina). Resultados. A nivel regional, en 9 de 22 grupos se observó el predominio de mujeres, con la mayor diferencia en el grupo de 25 a 29 años. Cinco de los nueve grupos de edad con mayor reporte en mujeres correspondían a mayores de 50 años. La mayor diferencia se encontró en el grupo de 50 a 54 años en Chocó y, la menor, en el grupo de 90 a 94 años en Nariño. En el análisis se identificaron dos patrones: antes de los 50 años, con predominio de los hombres, y después de los 50 años, con predominio de las mujeres. Conclusiones. El análisis secundario de una base de datos de recolección rutinaria es útil. Dado que los datos evidenciaron una prevalencia de los adultos mayores, especialmente mujeres, es importante que se considere incluir esta población en las estrategias de promoción y prevención del programa de HIV.

HIV en mujeres mayores de 50 años. Análisis de datos administrativos en departamentos del Pacífico colombiano (2014-2018) / HIV in women over 50 years: An analysis of administrative data in the departments of the Colombian Pacific region (2014-2018)

Resumen | Introducción. El HIV es un problema de salud pública relevante en el Pacífico colombiano debido a la gran problemática social de la región y la exposición de las mujeres a más factores de riesgo. Objetivo. Describir las diferencias por sexo y grupos de edad con respecto al código CIE-10 de HIV más frecuente en los cuatro departamentos de la Región Pacífica colombiana durante el periodo de 2014 a 2018. Materiales y métodos. Se hizo un estudio observacional descriptivo, retrospectivo y con unidades de análisis ecológicas (departamentos y municipios) obtenidas por agregación. La fuente de datos fue el SISPRO, una plataforma para el registro obligatorio de las prestaciones de servicios de salud en el país. Para cada grupo de edad y ente territorial, se estimaron las proporciones del código para mujeres y para hombres, y se calcularon las diferencias absolutas (la proporción femenina menos la proporción masculina). Resultados. A nivel regional, en 9 de 22 grupos se observó el predominio de mujeres, con la mayor diferencia en el grupo de 25 a 29 años. Cinco de los nueve grupos de edad con mayor reporte en mujeres correspondían a mayores de 50 años. La mayor diferencia se encontró en el grupo de 50 a 54 años en Chocó y, la menor, en el grupo de 90 a 94 años en Nariño. En el análisis se identificaron dos patrones: antes de los 50 años, con predominio de los hombres, y después de los 50 años, con predominio de las mujeres. Conclusiones. El análisis secundario de una base de datos de recolección rutinaria es útil. Dado que los datos evidenciaron una prevalencia de los adultos mayores, especialmente mujeres, es importante que se considere incluir esta población en las estrategias de promoción y prevención del programa de HIV.

Abstract | Introduction: HIV is a public health problem that is relevant in the Colombian Pacific due to major social problems in the region where women are exposed to more risk factors. Objective: To describe the differences by gender and age of the most frequent ICD-10 code related to HIV in four departments of the Colombian Pacific region during the period 2014 to 2018. Materials and methods: We conducted a descriptive, retrospective observational study with ecological units of analysis (departments and municipalities) obtained by aggregation. The data source was SISPRO, a platform for the mandatory registration of health services in the country. For each age group and territorial entity, we estimated the proportions of each code for women and men, as well as the absolute differences (the female proportion minus the male proportion). Results: At the regional level, there was a predominance of women in 9 of 22 groups evaluated. The largest absolute difference was in the 25-29 age group. Five of the nine age groups with a predominance of women represented ages over 50 years. The greatest difference was found in the 50-54 age group in Chocó, and the smallest difference was found in the 90-94 age group in Nariño. The analysis identified the following two patterns: before the age of 50 with a predominance of men and over the age of 50 with a predominance of women. Conclusions: The secondary analysis of databases for routine information collection is useful. Given that the data showed a prevalence of older adults, especially women, it is important to consider including this population in the promotion and prevention strategies of the HIV program.