Analysis of Food Security of Older Rural Indigenous People in Latin America and the Caribbean.

Food insecurity is a critical issue in the Americas, with severe impacts in the Caribbean, Mesoamerica, and South America, particularly affecting older adults in Indigenous and rural contexts where it intersects with poverty, gender, and ethnicity. This study aims to provide an in-depth understanding of the current research about food insecurity among older Indigenous adults in Latin America and the Caribbean. A comprehensive literature review was conducted, utilizing specific search queries and the population, intervention, comparison, and outcome (PICO) strategy across multiple databases to identify the pertinent studies. The findings indicate an increase in academic output on this topic since 2018, with significant emphasis on the interplay between climate change and food insecurity. The review highlights the importance of developing targeted food programs, reforming policies, and fostering collaboration between academia and local communities to implement practical interventions. Despite the growing body of literature, a notable research gap persists in rural areas of Latin America and the Caribbean. This study underscores the necessity of balancing the geographic distribution of research and emphasizes the preservation of cultural practices and the adaptation of public policies to support traditional food practices. It advocates for culturally sensitive interventions and interdisciplinary collaboration to formulate comprehensive strategies. The originality and value of this study lie in its focused analysis of older Indigenous adults, contributing crucial insights to the international literature on food security.

A multicriteria decision analysis for selecting rainwater harvesting systems in rural areas: a tool for developing countries.

Global water provision challenges have promoted decentralized water supply alternatives such as rainwater harvesting systems (RWHS). RWHS sustainability demands involve social, technical, and economic criteria in planning. Generally, in rural areas, water provision is more complex due to multiple uses of water, scattering of households, and low economies of scale. This research proposes a multicriteria tool for selecting RWHS in rural areas, considering social, technical, and economic criteria. The tool was developed by systematically identifying subcriteria and their hierarchization through the analytical hierarchy process (AHP), the technique for order of preference by similarity to ideal solution (TOPSIS), and a case study validation. Seven subcriteria were identified. The hierarchy of criteria was social (49.7%), technical (26.4%), and economic (23.9%). The tool involved: (i) users' consultation about the perceived ease of use and availability of water sources other than rainwater; (ii) system dimensioning to establish supply size, maintenance requirements, and required water quality; and (iii) costs and benefits estimation. Tool validation in a rural area included the evaluation of the alternatives proposed: (a) alternative 1: potable domestic uses (PD) and non-potable (NPD); (b) alternative 2: PD and NPD, irrigation of crops and chicken farming for self-consumption; and alternative 3: PD and NPD and chicken farming for profit sale. The sensitivity analysis showed the tool's consistency and robustness. Tool validation highlights the importance of integrating the three dimensions in selecting RWHS. The study provides a systematic methodology to assess and prioritize RWHS, appealing to policymakers, engineers, and practitioners facilitating water management and supply processes in rural areas.

Prevalência e fatores associados à violência contra as mulheres rurais: um estudo transversal, Pesquisa Nacional de Saúde, 2019 / Prevalence of violence against women living in rural areas and associated factors: a cross-sectional study based on the 2019 National Health Survey

Resumo Este estudo transversal objetivou estimar a prevalência e os fatores associados à violência contra as mulheres rurais e descrever os casos positivos segundo autoria, local e frequência, com dados da Pesquisa Nacional de Saúde (2019). Calcularam-se as prevalências brutas e ajustadas de violência contra as mulheres rurais de todo o Brasil nos últimos 12 meses, segundo perfil demográfico, apoio e saúde por meio da regressão de Poisson. A violência psicológica foi de 18%, a física, de 4,4% e a sexual, de 1,5%. Os principais autores eram pessoas conhecidas, a maior parte dos casos ocorreu na residência e as agressões eram recorrentes. As maiores prevalências: mulheres adultas jovens (24,2%), solteiras e divorciadas (20% cada), com ensino fundamental completo ao superior incompleto (22%),, percepções de saúde muito ruim (34%), ruim (30%) e aquelas com problema de saúde mental (30%). Após o ajuste, permaneceram no modelo as de 30-39 anos e de 40 a 49 anos, casadas, com estado de saúde muito ruim, ruim e regular e com problema de saúde mental. Aponta-se para a alta prevalência de violência contra as mulheres rurais.

Abstract The aim of this cross-sectional study was to estimate the prevalence of violence against women living in rural areas, explore associated factors, and characterize cases of violence according to perpetrator, place of occurrence, and frequency. Based on data from the 2019 National Health Survey, using Poisson's regression we calculated crude and adjusted prevalence ratios for violence committed during the last 12 months against women living in rural areas across Brazil, focusing on the following variables: sociodemographic characteristics, income, social support, and self-reported health status. The prevalence of psychological, physical, and sexual violence was 18%, 4.4%, and 1.5%, respectively. Perpetrators were mainly people known to the victim and violence was mainly committed at home and repeated over time. Prevalence was highest among young women (24.2%), single and divorced women (20% each), women who had complete elementary school till not complete higher education (22% each), women with very poor (34%) and poor (30%) self-perceived health status; and women with a mental health problem (30%). After adjustment, the following variables were retained in the model: women aged 30-39 years and 40-49 years; married women; women with very poor, poor, and fair perceived health; and women diagnosed with a mental health problem.

Avaliação de indicadores sociais e de saúde em municípios de Minas Gerais conforme tipologia rural-urbano / Assessment of social and health indicators in municipalities of Minas Gerais according to the rural-urban typology

RESUMO O presente artigo tem o objetivo de avaliar indicadores sociais e de saúde de municípios conforme a tipologia rural-urbano. Trata-se de estudo ecológico que utilizou dados oficiais de acesso público dos 853 municípios do estado de Minas Gerais, Brasil. Foram conduzidas análises descritivas e bivariadas através da Regressão de Poisson e Teste de Kruskal-Wallis. Do total de municípios, 547 (64,12%) são rurais. A maior média do Índice de Desenvolvimento Humano Municipal (IDH-M) foi observada entre os municípios urbanos. A maior média de cobertura da Estratégia Saúde da Família (ESF) foi verificada entre os municípios rurais, nos quais também foram demonstrados os melhores resultados para os indicadores de mortalidades infantil, prematura e por causas evitáveis, homogeneidade vacinal e prevalência de desnutrição. Os achados deste estudo evidenciam que uma maior cobertura da ESF está associada à ocorrência de melhores condições gerais de vida e de saúde das populações atendidas em municípios de tipologia rural. Recomenda-se aos gestores de saúde o fomento à consolidação da ESF em comunidades com contextos socioeconômicos e culturais desfavoráveis, como localidades rurais remotas e aglomerados urbanos, e o estabelecimento de ações intersetoriais com impacto positivo na saúde.

ABSTRACT This article aims to evaluate social and health indicators of municipalities according to the rural-urban typology. This is an ecological study that used official publicly accessible data from the 853 municipalities in the state of Minas Gerais, Brazil. Descriptive and bivariate analysis were carried out using Poisson Regression and Kruskal-Wallis Test. 547 (64.12%) are rural municipalities. The highest average of the Municipal Human Development Index (MHDI) was observed among urban municipalities. The highest average coverage of the Family Health Strategy (FHS) was found among rural municipalities. In these municipalities, the best results were shown for the indicators of infant mortality, premature mortality and mortality from preventable causes, vaccine homogeneity and prevalence of malnutrition. The findings of this study show that greater FHS coverage is associated with the occurrence of better general living and health conditions in the populations served in rural municipalities. It is recommended that health managers encourage the consolidation of the FHS in communities with unfavorable socioeconomic and cultural contexts, such as remote rural locations and urban agglomerations, and the establishment of intersectoral actions with a positive impact on health.

Political events upon the Romania rural population using VAR model / A influência de eventos políticos sobre a população rural usando o modelo VAR: Eventos da Romênia

Maintaining a rural-urban balance is absolutely necessary in the context of the challenges related to food security and environmental protection as well as the perspectives of urban agglomeration. This paper highlighted the impact of the main events from the last 30 years on the rural population. This study used the vector autoregressive model (VAR) to investigate the estimates and analyse the dynamic impact of innovations on the system of variables. Key issues that influenced certain periods in the analyzed interval were highlighted, which clearly show the impact on the analyzed variables using variance decomposition. The cost of living in rural areas is increasing, so more and more inhabitants give up growing certain crops or raising certain animals, thus having to search for food to survive, leading to additional wage income to cover these costs.

A manutenção do equilíbrio rural-urbano é absolutamente necessária no contexto dos desafios relacionados com a segurança alimentar e proteção ambiental, bem como as perspetivas de aglomeração urbana. O objetivo do trabalho é destacar o impacto dos principais acontecimentos dos últimos 30 anos sobre a população rural. Este estudo utilizou o modelo autoregressivo vetorial (VAR) para investigar as estimativas e analisar o impacto dinâmico das inovações no sistema de variáveis. Foram destacadas as principais questões que influenciaram determinados períodos no intervalo analisado, o que mostra claramente o impacto nas variáveis ​​analisadas usando a decomposição de variância. O custo de vida nas zonas rurais está a aumentar, tanto mais que cada vez mais habitantes desistem de cultivar determinadas culturas ou de criar determinados animais, tendo assim de obter os alimentos necessários à sua sobrevivência, o que obriga a um rendimento salarial adicional para cobrir estas despesas custos.

Strategies used by nurses regarding underreporting of rural work accidents due to pesticide use / Estrategias utilizadas por los enfermeros en relación con el subregistro de accidentes laborales rurales causados por el uso de plaguicidas / Estratégias utilizadas por enfermeiros sobre subnotificações de acidentes de trabalho rural por uso de agrotóxicos

ABSTRACT Objective: To learn the strategies used regarding underreporting of pesticide use in rural areas. Methods: A qualitative study was carried out in eight primary healthcare units in rural areas and two emergency care units in a municipality in southern Brazil. Data collection took place in 2023 through interviews. Twenty professional nurses participated. The data was submitted to content analysis. Results: The strategies identified were lifelong and continuing education for the professionals who carry out the notification, active search and training of workers who deal directly with this type of substance, computerizing the notification by filling in the forms online, and carrying out research on the subject. Final considerations: Nurses play an important role in reporting occupational accidents caused by the use of pesticides, improving occupational safety in rural areas.

RESUMEN Objetivo: Conocer las estrategias utilizadas para el subregistro del uso de plaguicidas en áreas rurales. Métodos: Estudio cualitativo realizado en ocho unidades de atención primaria en áreas rurales y dos unidades de atención de emergencia en un municipio del sur de Brasil. La recopilación de datos se realizó en 2023 mediante entrevistas. Participaron 20 profesionales de enfermería. Los datos fueron sometidos a análisis de contenido. Resultados: Las estrategias identificadas fueron la educación continua y permanente de los profesionales que realizan la notificación, la búsqueda activa y la capacitación de los trabajadores que tratan directamente con este tipo de sustancia, la informatización de la notificación mediante el llenado de los formularios en línea y la realización de investigaciones sobre el tema. Consideraciones finales: Los enfermeros desempeñan un papel importante en la notificación de accidentes laborales causados por el uso de plaguicidas, mejorando la seguridad laboral en las zonas rurales.

RESUMO Objetivo: Conhecer as estratégias utilizadas acerca das subnotificações por uso de agrotóxicos no meio rural. Método: Estudo qualitativo realizado em oito unidades básicas de regiões rurais e duas unidades de pronto atendimento de um município do sul do Brasil. A coleta de dados deu-se em 2023, por entrevistas. Participaram 20 profissionais enfermeiros. Os dados foram submetidos à análise de conteúdo. Resultados: Apontaram como estratégias a realização da educação permanente e continuada dos profissionais que realizam a notificação, a busca ativa e a capacitação dos trabalhadores que lidam diretamente com esse tipo de substância, a informatização da notificação por meio do preenchimento das fichas online e a realização de pesquisas acerca da temática. Considerações Finais: Os enfermeiros desempenham um papel importante na notificação de acidentes de trabalho pelo uso de agrotóxicos, melhorando a segurança ocupacional no meio rural.

"Eu sofria calada e certamente toda mulher é assim" - Silenciamentos: reproduções e rupturas da violência contra as mulheres que vivem em contextos rurais / "I suffered in silence and certainly all women are like that" - Silenced: reproduction of, and breaking with, violence against women living in rural areas

Resumo Este estudo se dedica, através de histórias de vida, a analisar a violência contra as mulheres que vivem em contextos rurais, seu silenciamento e os desafios de rompê-lo. Trata-se de uma pesquisa qualitativa a partir de 20 entrevistas com mulheres rurais em dois municípios do Rio Grande do Sul. Através da Análise de Narrativas chegamos a duas categorias: "Eu sofria calada e certamente toda mulher é assim" - A violência e o silenciamento; e "A gente cuida dela" - Rompendo o silêncio. A primeira, faz referência a opressão do silenciamento e como as mulheres foram afetadas através da violência e do isolamento. A segunda, apresenta os desafios enfrentados pelas mulheres ao romper o silenciamento e sair da relação abusiva, e como, através de suas narrativas, acessamos a histórias de outras mulheres que sofrem violência. As narrativas reforçam que o silenciamento, advindo dos papeis de gênero e do cerceamento de liberdade, contribuiu para a permanência na relação abusiva. A violência teve sustentáculo no contexto rural, no qual as mulheres ficavam ainda mais isoladas, sozinhas e sem apoio, acentuando seus medos, culpa, vergonha, dependência financeira. É fundamental haver um trabalho intersetorial para o enfrentamento a essa problemática com mais informação e assistência às mulheres rurais.

Abstract By way of life stories drawn from 20 interviews of women in two municipalities of Rio Grande do Sul, this qualitative study examined how violence against women living in rural areas is silenced and the challenges involved in breaking that silence. Narrative Analysis arrived at two categories: "I suffered in silence and certainly all women are like that" (Violence silenced) and "We take care of her" (Breaking the silence). The first relates to the oppression of imposed silence and how women were affected by violence and isolation. The second shows the challenges facing women who break the silence and leave abusive relationships and how, through their narratives, to access the stories of other women who suffer violence. The narratives stress that the imposition of silence, which arose from gender roles and constraints on freedom, contributed to their continuing in the abusive relationship. The violence was sustained by the rural setting, where women were even more isolated, alone and unsupported, which heightened their fears, guilt, shame and financial dependence. An inter-sector approach, with more information and care for rural women, is fundamental to addressing this problem.

Prevalence and Risk Factors of Leptospira spp. Infection in Backyard Pigs in the State of Paraná, Brazil.

Leptospirosis is a zoonotic disease that poses a significant threat to human and animal health worldwide. Among different animal species, pigs are known to play a crucial role in the transmission of the pathogenic Leptospira spp. This study aimed to investigate the prevalence of Leptospira spp. infection and associated risk factors in backyard pigs in the state of Paraná, Brazil. A set of 1393 blood samples were collected from pigs on 188 subsistence properties from 136 different municipalities of the Paraná state and tested using the microscopic agglutination test (MAT) to detect antibodies against 24 different Leptospira spp. serovars. The results revealed an overall seroprevalence of 15.87% (221/1393; 95% CI: 13.95-17.78%) for Leptospira spp. antibodies, with Icterohaemorrhagiae, Butembo, and Pomona being the most commonly detected in serovar levels. The lack of rodent control (OR 1.12, 95% CI: 0.63-1.98, p = 0.02) was the only variable associated with disease incidence and was identified as a significant risk factor for Leptospira spp. infection in this context. These findings highlight the urgent need to implement effective control measures, such as improved housing conditions, rodent control, and veterinary assistance, to prevent the spread of this zoonotic disease in backyard pigs in Paraná, Brazil.

Epidemiological profile, temporal analysis, and future projections of suicide cases in rural cities in the extreme south of Brazil.

The present study aimed to verify the time series (2000-2017) of death rates by suicide and its associated factors in 4 municipalities in the extreme south of Brazil. Data were obtained through the analysis of medical reports and police report bulletins at the Instituto Médico Legal, in the city of Rio Grande. The suicide rate in the Rio Grande region varied from 4 to 11 suicides per 100,000 inhabitants and it is estimated that by 2030 this rate could reach 16.5 suicides per 100,000 inhabitants. The rural cities of Santa Vitória do Palmar and Chuí present even higher suicide averages when compared to Rio Grande, the most populous city of the four. The death rate from suicide increased gradually in the period analyzed, with the prevalence rising among the youngest and the elderly population. A more comprehensive understanding of the influences of environmental issues on suicidal decisions constitutes an important action that needs to be taken, both because of regional vulnerabilities and the target population identified. Evidence indicates that knowledge of factors affecting individuals residing in this Brazilian region where increased suicide rates are recorded needs to be recognized as a priority.

Prevalencia de la soledad en las personas mayores que viven en zonas rurales. Diferencias por grupos étnicos y variables predictivas / Prevalence of loneliness among older people living in rural areas. Differences by ethnic group and predictor variables

ANTECEDENTES: La soledad es uno de los problemas de salud pública más recurrentes en las personas mayores, sin embargo, en Chile se disponen de escasos datos sobre su prevalencia en personas mayores a 60 años que viven en zonas rurales y que pertenecen a pueblos originarios o al tribal afrodescendiente. OBJETIVO: Examinar la prevalencia de la soledad entre personas mayores que viven en zonas rurales por grupo étnico; y analizar las variables sociodemográficas, familiares y de salud que se relaciona con soledad. MATERIAL Y MÉTODOS: Se aplicó la escala de soledad DJGLS-6, APGAR-familiar, cuestionario de 13 problemas de salud más frecuentes en personas mayores chilenas, e índice de Barthel a 1.692 personas mayores que residen en zonas rurales de las regiones de Arica y Parinacota, Tarapacá, Antofagasta, Atacama, Coquimbo, Valparaíso, Los Lagos, Aisén y Magallanes. RESULTADOS: Se observa una alta prevalencia de la soledad (sobre el 55%) en personas de los pueblos: Afrodescendiente, Quechua, Atacameño, Colla, Chango, Huilliche, Kawesqar y no indígenas. Siendo la soledad emocional la más prevalente entre personas mayores indígenas y no indígenas que viven en zonas rurales (≥ 71%). Las variables que se asocian con soledad son: ser mujer, edad, no tener pareja, vivir solo(a), disfuncionalidad familiar y tener problemas de salud. CONCLUSIONES: La soledad en zonas rurales es más alta en las personas mayores y esta situación se complejiza en el cruce de diversidad étnico cultural, es necesario seguir abordando este problema que afecta el bienestar biopsicosocial en la vejez.

BACKGROUND: Loneliness is one of the most recurrent public health problems in older people. However, there is little data available in Chile on its prevalence in people over 60 years of age living in rural areas and belonging to native or Afro-descendant groups. AIM: To examine the prevalence of loneliness among older people living in rural areas by ethnic group and to analyze the socio-demographic, family, and health variables related to loneliness. METHODS: We interviewed 1,692 elderly people living in Chilean rural areas of the regions of Arica and Parinacota, Tarapacá, Antofagasta, Atacama, Coquimbo, Valparaíso, Los Lagos, Aisén and Magallanes. The instruments applied were the DJGLS-6 loneliness scale, Family-APGAR, questionnaire of 13 most frequent health problems in Chilean older people, and Barthel index. RESULTS: We found a high prevalence of loneliness (over 55%) among Afro-descendants, Quechua, Atacameño, Colla, Chango, Huilliche, Kawesqar and non-indigenous people. Emotional loneliness is the most prevalent among indigenous and non-indigenous older people living in rural areas (≥ 71%). Variables associated with loneliness were being female, age, not having a partner, living alone, family dysfunctionality, and having health problems. CONCLUSIONS: Loneliness in rural areas is higher in older people, and this situation becomes more complex at the crossroads of ethnic-cultural diversity; it is necessary to continue to address this problem that affects biopsychosocial well-being in old age.

Prevention and Mitigation of Rural Higher Education Dropout in Colombia: A Dynamic Performance Management Approach.

Background: Dropout in higher education is a socio-educational phenomenon that has the scope to limit the benefits of education as well as to widen social disparities. For this reason, governments have implemented various public policies for its prevention and mitigation. However, in rural populations, such policies have proven to be ineffective. The aim of this paper is to simulate public policy scenarios for the treatment of school dropout in rural higher education in Colombia from a Dynamic Performance Management approach. Methodology: To achieve the aim, a parameterised simulation model was designed with data from Colombian state entities in rural higher education. Five simulations were carried out. The analysis of the results was carried out using descriptive statistics and comparison of means using the Wilcoxon Sign Rank statistic. Results: The adoption of such an approach based on simulations suggests that policies to expand the coverage of educational credits and financial support, as well as the addition of a family income subsidy, allow for a reduction in the number of dropouts. Conclusions: A dynamic, data-driven approach can be effective in preventing and mitigating dropout in these areas. It also highlights the importance of identifying the key factors contributing to dropout. The results also suggest that government policies can have a significant impact on school retention in rural areas.

Predictors of COVID-19 Related Health Literacy among Older People Living in Rural Areas of Indonesia / Predictores de la alfabetización en salud relacionados con el COVID-19 en las personas mayores que viven en zonas rurales de Indonesia / Preditores relacionados à COVID-19 de alfabetização em saúde em idosos que vivem na zona rural da Indonésia

Objective. This study aims to identify predictive factors of COVID-19-related health literacy (HL) among older adults living in rural areas. Method. This study used a cross-sectional design. A total of 106 respondents participated in this study. HL was measured by using a questionnaire modified from the HLS-COVID-Q22, in addition, the scales 'Health Information Seeking', 'Family's Social Support Scale', 'Health Service Utilization'; and information on some socio-demographic variables was also obtained. A multiple linear regression model was used to identify the predictors of HL. Results. About two-thirds of the respondents had a moderate level of HL (63.2%). Multiple linear regression analysis showed that education level, family support, information source, and gender were significant predictors for HL (p<0.01). Conclusion. HL literacy was better among males, highly educated older people, media users, and those with adequate family support. This study provided insight for nurses and healthcare professionals to pay greater attention to vulnerable groups of older people (ie. female gender and those with less formal education) as well as involve family members in education or health promotion activities and use easily accessed media, such as television and radio.

Objetivo. Este estudio tiene como objetivo identificar los factores predictivos de alfabetización en salud (AS) relacionados con el COVID-19 en los adultos mayores indonesios que viven en zonas rurales. Métodos. Este estudio utilizó un diseño de corte transversal. Un total de 106 encuestados participaron en este estudio. La AS relacionada con el COVID-19 se midió con el cuestionario HLS-COVID-Q22, además se utilizaron las escalas 'Búsqueda de información sanitaria', 'Escala de apoyo social de la familia' y 'Utilización de servicios sanitarios'; también se obtuvo información de algunas variables sociodemográficas. Se utilizó un modelo de regresión lineal múltiple para identificar los predictores de la AS. Resultados. Alrededor de dos tercios de los encuestados tenían un nivel moderado de AS (63.2%). El análisis de regresión lineal múltiple mostró que el menor nivel educativo, el apoyo familiar, la fuente de información y el sexo eran predictores significativos de la AS (p<0.01). Conclusión. La AS fue mejor entre los varones, las personas mayores con alto nivel educativo, los usuarios de los medios de comunicación y aquellos con un apoyo familiar adecuado. Este estudio sugirió que las enfermeras y los profesionales de la salud deben prestar más atención a los grupos vulnerables de personas mayores (especialmente las mujeres y las personas con poca educación formal). También mostró la importancia de involucrar a los familiares en las actividades de educación y promoción de la salud, y de usar medios de comunicación accesibles, como la televisión y la radio.

Objetivo. Este estudo tem como objetivo identificar preditores de alfabetização em saúde (AS) relacionados ao COVID-19 em idosos indonésios que vivem em áreas rurais. Métodos. Este estudo utilizou um desenho transversal. Um total de 106 entrevistados participaram deste estudo. A AS relacionada à COVID-19 foi medida com o questionário HLS-COVID-Q22, além das escalas 'Pesquisa de informações em saúde', 'Escala de apoio social familiar' e 'Uso de serviços de saúde'; também foram obtidas informações sobre algumas variáveis sociodemográficas. Um modelo de regressão linear múltipla foi usado para identificar os preditores de HL. Resultados. Cerca de dois terços dos entrevistados apresentaram nível moderado de LH (63.2%). A análise de regressão linear múltipla mostrou que menor escolaridade, apoio familiar, fonte de informação e gênero foram preditores significativos de HL (p<0.01). Conclusão. A alfabetização em LH foi melhor entre os homens, idosos altamente educados, usuários de mídia e aqueles com suporte familiar adequado. Este estudo forneceu ideias para enfermeiros e profissionais de saúde prestarem mais atenção a grupos vulneráveis de idosos (ou seja, mulheres e pessoas com menos educação formal), bem como envolver os familiares em atividades de educação ou promoção de saúde e usar mídias de fácil acesso, como televisão e rádio.

Analysis of the tick communities associated to domestic mammals in rural areas of the Yungas montane forest from Argentina.

The aim of this work was to describe the tick community associated to domestic mammals in rural areas from the Yungas lower montane forest of Argentina. The circulation of tick-borne pathogens was also analyzed. Samples of ticks parasitizing cattle, horses, sheep and dogs were carried out in different seasons, and questing ticks were collected from vegetation and analyzed to detect the presence of Rickettsia, Ehrlichia, Borrelia and Babesia by a battery of different PCRs. The structure of the tick communities was analyzed through the Chao1 species richness estimator, the Shannon-Wiener index and the Horn index of community similarity. Eight tick species were collected in the study area: Amblyomma sculptum, Rhipicephalus microplus, Amblyomma hadanii, Dermacentor nitens, Amblyomma ovale, Haemaphysalis juxtakochi, Ixodes pararicinus and Rhipicephalus sanguineus sensu stricto. However, A. sculptum was by far the dominant species in the tick assemblages analyzed, and this was reflected in the low diversity values obtained. Dermacentor nitens, A. sculptum and R. microplus were the three species associated to horses. The predominance of A. sculptum was also observed in the tick samples obtained from dogs, even on two tick species, namely A. ovale and R. sanguineus s.s., which have dogs as the principal domestic host. Rhipicephalus microplus and A. sculptum were the most abundant ticks on cattle, while few specimens of I. pararicinus, A. hadanii and D. nitens were found on bovines. Dermacentor nitens ticks were found to be infected with B. caballi, which indicate the circulation of this pathogen of horses in the Yungas area. The detection of a strain of Borrelia sp. belonging to the B. burgdorferi s.l. complex in I. pararicinus is consistent with previous findings made in Argentina, but the public health relevance of this vector-microorganism association is far from being similar to that occurs in the northern hemisphere because there are practically no records of these tick species parasitizing humans in South America. The tick community of rural areas of the Yungas lower montane forest is composed by species which are potential vectors of pathogenic microorganism with veterinary and public health importance, circulating in a human-wildlife-livestock interface.

A systematic review of the epidemiology of epilepsy in Mexico during 1970 to 2020 / Revision sistematica de la epidemiologia en Mexico de la epilepsia de 1970 a 2020

Abstract Background Epilepsy is the most common major neurological disorder that affects people of all ages. The prevalence varies from one country to another and even between different areas, due to a lack of access to medical care for reasons related to limited resources. Objective Epilepsy is a worldwide public health problem that affects more deeply populations living in developing countries such as Mexico, where more aggressive health policies based on epidemiological data are needed; however, this information is scarce and the evolution of this data over time remains unclear. The aim of the present study is to provide an overview of the epidemiology of epilepsy in Mexico from 1970 to 2020. Methods We searched descriptive epidemiological studies on epilepsy in rural and urban regions of Mexico from 1970 to 2020. Available data on the sociodemographic characteristics, prevalence, and incidence data were extracted. Finally, the abstract, full-text review, and data abstraction were conducted in duplicate and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Descriptive statistics was also used. Results Overall, 11 underrepresented and heterogeneous epidemiological studies were included. In total, the prevalence of epilepsy in Mexico is 3.9 to 41:1,000 inhabitants; 3.9 to 41 per 1,000 persons in rural regions, and 3.49 to 44.3 per 1,000 persons in urban regions. None of these studies addressed the incidence of epilepsy. The prevalence of epilepsy in Mexico has remained unchanged during the last 5 decades. Conclusions Our results confirm a high prevalence of epilepsy in both urban and rural settings in Mexico that remain unchanged during the last 5 decades. All studies included in the present review showed multiple methodological limitations. New and robust epidemiological studies are needed to delineate the epidemiological profile of epilepsy in Mexico.

Resumen Antecedentes La epilepsia es el trastorno neurológico más común que afecta a individuos de todas las edades. La prevalencia varía entre paises e incluso entre diferentes áreas del mismo pais debido a la falta de acceso a la atención médica. Objectivo La epilpesía es un problema de salud pública mundial que afecta de manera más importante a los países en desarrollo como México, donde hacen falta políticas en salud y datos epidemiológicos, para conocer el impacto real de esta enfermedad. El objetivo de este estudio es brindar una visión general de la epidemiología de la epilepsia en México (1970-2020). Métodos Se realizo unas búsquedas bibliografica de estudios epidemiológicos descriptivos sobre epilepsia en regiones rurales y urbanas de México desde 1970 a 2020. Se extrajeron los datos disponibles sobre las características sociodemográficas, prevalencia e incidencia. Finalmente, el resumen, la revisión completa del texto y la extracción de datos se realizaron por duplicado y se informaron utilizando PRISMA. Se utilizo estadística descriptiva. Resultados Se incluyeron 11 estudios epidemiológicos heterogeéneos. En total la prevalencia de epilepsia en México es 3.9-41: 1000 habitantes; 3,9 a 41 por 1000 personas en las regiones rurales y 3,49 a 44,3 por 1000 personas en las regiones urbanas. Ninguno de estos estudios abordó la incidencia de epilepsia. La prevalencia de la epilepsia en México se ha mantenido sin cambios durante las últimas cinco décadas. Conclusiones Nuestros resultados confirman una alta prevalencia de epilepsia en las areas urbanas y rurales de México que se mantiene sin cambios durante las últimas cinco décadas. Todos los estudios incluidos en esta revisión mostraron múltiples limitaciones metodológicas. Se necesitan estudios epidemiológicos nuevos y sólidos para delinear el perfil epidemiológico de la epilepsia en México.

Terapia ocupacional e meio rural: uma revisão de escopo / Occupational therapy and rural environment: a scoping review

Resumo O mundo rural é um território de extrema importância para a sociedade como um todo; não obstante, tende ainda a ser visto como algo separado desta e, muitas vezes marginalizado em relação ao meio urbano. Além disso, é tido como um espaço atrasado, desatualizado e rústico em alguns contextos, como no brasileiro. A falta de acesso a bens sociais acaba por limitar as perspectivas da pessoa que vive nesse território, diminuindo sua autonomia e oportunidade de escolhas com relação à sua própria vida. Tanto no âmbito mundial quanto nacional, a terapia ocupacional, em suas diferentes subáreas, tem buscado contribuir para a resolução de problemáticas que envolvem contextos e sujeitos diversos que ocupam e vivem no meio rural. Assim, o objetivo primário deste estudo foi realizar uma revisão de escopo que abrangesse publicações nacionais e estrangeiras, procurando apreender, sistematizar e divulgar a produção científica na interface da terapia ocupacional com o mundo rural, analisando-a criticamente, de modo a perceber suas potencialidades e fragilidades, considerando as diversas ruralidades e contextos mundo afora. Foram encontrados resultados dos cinco continentes com dados necessários para essa sistematização e para uma síntese dessa produção. Tais resultados foram estudados, analisados e distribuídos em seis categorias configuradas a partir dos assuntos específicos abordados. Conclui-se que estudos relevantes foram realizados na interface terapia ocupacional-mundo rural, voltando-se a fatores que influenciam a atuação profissional nesses territórios, ao mesmo tempo em que propõem métodos, estratégias e programas de prática e formação para superar importantes desafios.

Abstract The rural world is a territory of extreme importance for society as a whole; nevertheless, it still tends to be seen as something separate from it and often marginalized in relation to the urban environment. In addition, it is seen as a backward, outdated and rustic space in some contexts, such as the Brazilian one. The lack of access to social goods ends up limiting the perspectives of people living in this territory, reducing their autonomy and opportunity to make choices about their own lives. Both worldwide and nationally, occupational therapy, in its different subareas, has sought to contribute to the resolution of problems involving different contexts and subjects who occupy and live in rural areas. Thus, the primary objective of this study was to carry out a scope review that covered national and foreign publications, seeking to apprehend, systematize and disseminate scientific production in the interface of occupational therapy with the rural world, critically analyzing it, in order to perceive its potential and weaknesses, considering the different ruralities and contexts around the world. Results from five continents were found with data necessary for this systematization and for a synthesis of this production. Such results were studied, analyzed and distributed in six categories configured from the specific subjects addressed. It is concluded that relevant studies were carried out in the occupational therapy-rural world interface, focusing on factors that influence professional performance in these territories, while proposing methods, strategies and practice, and training programs to overcome important challenges.

Diferenças urbano-rurais relativas ao consumo e ambiente alimentar e aos parâmetros antropométricos de adultos mais velhos: resultados do ELSI-Brasil / Diferencias urbano-rurales relativas al consumo y entorno alimentario y a los parámetros antropométricos de adultos mayores: resultados de ELSI-Brasil / Urban-rural differences in food consumption and environment and anthropometric parameters of older adults: results from ELSI-Brazil

Objetivou-se identificar diferenças alimentares e antropométricas entre adultos mais velhos brasileiros (≥ 50 anos) residentes em áreas urbano-rurais. Trata-se de um estudo transversal com dados da segunda onda (9.949 participantes) do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil), de 2019-2021. Foram avaliados: consumo alimentar semanal de fruta/hortaliça, feijão e peixe; autopercepção do consumo de sal; ambiente alimentar (disponibilidade de fruta/hortaliça na vizinhança e produção própria de alimentos); e parâmetros antropométricos objetivos (índice de massa corporal [IMC] e circunferência da cintura [CC]). As análises foram ajustadas por escolaridade. Em comparação com as áreas urbanas, observaram-se nas rurais: menor consumo de fruta/hortaliça em cinco dias da semana ou mais (74,6% vs. 86,4%) e maior consumo adequado de sal (96,8% vs. 92,1%) - diferenças observadas para homens e mulheres. A CC elevada foi menor nas áreas rurais (61,9% vs. 68%), sendo significativa somente para homens. Houve menor disponibilidade de fruta/hortaliça na vizinhança (41,2% vs. 88,3%) e maior produção própria de alimentos (38,2% vs. 13,2%) nas áreas rurais. O consumo de fruta/hortaliça em cinco dias da semana ou mais foi menor nas áreas rurais quando houve disponibilidade de fruta/hortaliça na vizinhança e ausência de produção própria de alimentos. Há diversidade alimentar e nutricional entre áreas urbano-rurais. O incentivo ao consumo de fruta/hortaliça nas áreas urbanas deve considerar a disponibilidade de fruta/hortaliça na vizinhança, enquanto nas áreas rurais deve ser em conjunto com a produção do próprio alimento. O consumo adequado de sal e a manutenção da CC nos valores ideais devem ser reforçados nas áreas urbanas.

El objetivo fue identificar diferencias alimentarias y antropométricas entre adultos mayores brasileños (≥ 50 años) que viven en áreas urbano-rurales. Se trata de un estudio transversal con datos de la segunda ola (9.949 participantes) del Estudio Longitudinal Brasileño sobre el Envejecimiento (2019-2021). Se evaluaron el consumo semanal de alimentos, como frutas/verduras, frijoles y pescado; autopercepción del consumo de sal; entorno alimentario (disponibilidad de frutas/verduras en el barrio y la producción propia de alimentos); y parámetros antropométricos objetivos (índice de masa corporal [IMC] y circunferencia de la cintura [CC]). Los análisis se ajustaron por escolaridad. Se observó un menor consumo de frutas/verduras en las zonas rurales respecto a las urbanas en ≥ 5 días/semana (74,6% vs. 86,4%), mayor consumo adecuado de sal (96,8% vs. 92,1%), y estas diferencias se observaron para hombres y mujeres. La CC elevada fue menor en las zonas rurales (61,9% vs. 68%), y fue significativa solo para los hombres. Hubo una menor disponibilidad de frutas/verduras en el barrio (41,2% vs. 88,3%) y mayor producción propia de alimentos (38,2% vs. 13,2%) en las zonas rurales. El consumo de frutas/verduras en ≥ 5 días/semana fue menor en las zonas rurales cuando hubo frutas/verduras disponibles en el barrio y ausencia de producción del propio alimento. Existe una diversidad alimentaria y nutricional entre las zonas urbanas y rurales. Fomentar el consumo de frutas/verduras en las zonas urbanas debe tener en cuenta la disponibilidad de frutas/verduras en el barrio, mientras que en las zonas rurales debe tener en cuenta también la producción del propio alimento. Se debe reforzar el consumo adecuado de sal y el mantenimiento de la CC en valores ideales en las zonas urbanas.

This study aimed to identify dietary and anthropometric differences in older Brazilian adults (≥ 50 years old) living in urban-rural areas. This is a cross-sectional study with data from the second wave (9,949 participants) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) from 2019-2021. Weekly dietary intake of fruit/vegetables, beans, and fish; self-perception of salt consumption; food environment (availability of fruit/vegetables in the neighborhood and self-production of food); and objective anthropometric parameters (body mass index [BMI] and waist circumference [WC]) were evaluated. Analyses were adjusted for schooling level. Compared to urban areas, rural areas show lower consumption of fruit/vegetables five days or more per week (74.6% vs. 86.4%) and greater adequate salt intake (96.8% vs. 92.1%) - differences we observed for men and women. Rural areas showed lower high WC (61.9% vs. 68%), significant only for men. Considering food environment, rural areas had lower fruit and vegetable availability in the neighborhood (41.2% vs. 88.3%) and higher self-production of food (38.2% vs. 13.2%). We observed a lower consumption of fruit/vegetables five days or more per week in rural areas with fruit/vegetable availability in the neighborhood and no self-production of food. Urban and rural areas show food and nutritional diversity. Incentives for fruit or vegetable consumption among residents in urban areas should consider the greater availability of these foods in their neighborhood, whereas, in rural areas, self-production of food should be encouraged. Adequate salt intake and ideal WC maintenance should be reinforced in urban areas.

Avaliação das estratégias de promoção da saúde e prevenção ao uso de drogas na rede psicossocial / Evaluación de estrategias de promoción de la salud y prevención del consumo de drogas en la red psicosocial / Assessment of health promotion and drug use prevention strategies in the psychosocial network

Resumo Objetivo avaliar as estratégias de promoção da saúde e prevenção ao uso de drogas na Rede de Atenção Psicossocial. Método estudo qualitativo, fundamentado na avaliação de empoderamento, desenvolvido em 2017 na Rede de Atenção Psicossocial (RAPS) de um município do Rio Grande do Sul, Brasil. Os grupos de interesse foram 42 trabalhadores e gestores representativos dos componentes da RAPS municipal. Foram utilizadas técnicas de observação participante, entrevistas e Fórum Aberto. Resultado avaliou-se que as ações de promoção da saúde e prevenção ao uso de drogas são precárias e necessitam de investimentos, constituindo-se a missão dos trabalhadores e gestores. Identificou-se como dificuldade a atuação da atenção primária, devido às fragilidades nas políticas públicas e à falta de apoio dos serviços especializados. Como potencialidade, elencou-se o matriciamento em saúde mental. Sugere-se investimento na Atenção Primária por meio de treinamento e suporte a essas equipes. Conclusão e implicações para a prática a pauta da promoção da saúde e prevenção ao uso abusivo de drogas é urgente e deve ser incluída na estruturação de políticas públicas e práticas no âmbito das redes.

Resumen Objetivo evaluar las estrategias de promoción de la salud y prevención de drogas en la Red de Atención Psicosocial. Método estudio cualitativo, basado en la evaluación de empoderamiento, desarrollado en 2017 en la Red de Atención Psicosocial (RAPS) de un municipio de Rio Grande do Sul, Brasil. Los grupos de interés fueron 42 trabajadores y directivos representantes de los componentes de la RAPS municipal. Se utilizaron técnicas de observación participante, entrevistas y Foro Abierto. Resultado se evaluó que las acciones de promoción de la salud y prevención del uso de drogas son precarias y requieren inversiones, constituyendo la misión de trabajadores y gestores. La actuación de la atención primaria fue identificada como una dificultad, debido a las debilidades de las políticas públicas y la falta de apoyo de los servicios especializados. Como potencialidad, se enumeró el apoyo matricial en salud mental. Se sugiere invertir en Atención Primaria a través de la formación y el apoyo a estos equipos. Conclusión e implicaciones para la práctica la agenda de promoción de la salud y prevención del abuso de drogas es urgente y debe ser incluida en la estructuración de políticas públicas y prácticas en redes.

Abstract Objective to assess health promotion and drug use prevention strategies in the Psychosocial Care Network. Method this is a qualitative study based on empowerment evaluation, developed in 2017 in the Psychosocial Care Network of a municipality in Rio Grande do Sul, Brazil. The interest groups were 42 workers and managers representing the municipal RAPS components. Participant observation techniques, interviews and Open Forum were used. Results it was assessed that health promotion and drug use prevention actions are precarious and require investments, constituting the mission of workers and managers. Primary care was identified as a difficulty due to weaknesses in public policies and lack of support from specialized services. As a potentiality, matrix support in mental health was listed. Investment in Primary Care is suggested through training and support for these teams. Conclusion and implications for practice health promotion and drug abuse prevention agenda are urgent and must be included in the structuring of public policies and practices within the networks.

Prevalência e fatores associados à multimorbidade em pessoas idosas residentes na zona rural de um município do Nordeste brasileiro / Prevalence of multimorbidity and associated factors among older people in rural Northeast Brazil

Resumo Objetivo identificar a prevalência de multimorbidade em pessoas idosas residentes na zona rural e os fatores sociodemográficos, comportamentais e clínico-terapêuticos associados. Método estudo transversal, realizado com idosos residentes na zona rural de Araçagi, Paraíba, Brasil, vinculados à Estratégia Saúde da Família e selecionados aleatoriamente. A variável dependente do estudo foi a multimorbidade, entendida como a presença de duas ou mais condições crônicas em um só indivíduo. Os dados foram coletados através de um questionário sociodemográfico e um formulário sobre problemas de saúde autorreferidos, abordando 32 condições. Na análise dos dados, utilizou-se a estatística univariada, bivariada e regressão de Poisson. Resultados participaram do estudo 360 idosos com prevalência de multimorbidade de 54,2% (IC95%: 49,0-59,3). Após regressão, identificou-se que sexo feminino (RP=1,16; IC95%: 1,09-1,25), idade ≥ 70 anos (RP=1,08; IC95%: 1,01-1,15), sobrepeso (RP=1,19; IC95%: 1,10-1,29), acesso a água tratada e encanada (RP=1,09; IC95%: 1,00-1,18), histórico de tabagismo (RP=1,10; IC95%: 1,03-1,17), não fazer uso de álcool (RP=1,13; IC95%: 1,05-1,22), dor crônica (RP=1,18; IC95%: 1,10-1,26), hospital como primeira opção de serviço de saúde (RP=1,12; IC95%: 1,03-1,21) e consulta médica no último ano (RP=1,19; IC95%: 1,11-1,27) eram fatores associados à multimorbidade. Conclusão o estudo revelou alta prevalência de multimorbidade e seus fatores associados. Por fim, torna-se viável o planejamento de medidas que melhorem a condição de saúde desses indivíduos e pensar em possibilidades de promover um envelhecimento saudável.

Abstract Objective to identify the prevalence of multimorbidity in elderly people living in rural areas and associated sociodemographic, behavioral and clinical-therapeutic factors. Method cross-sectional study, conducted with randomly selected elderly residents in the rural area of Araçagi, Paraíba, Brazil, linked to the Family Health Strategy. The dependent variable of the study was multimorbidity, understood as the presence of two or more chronic conditions in a single individual. Data were collected through a sociodemographic questionnaire and a form about self-reported health problems, addressing 32 conditions. Univariate and bivariate statistics and Poisson regression were used in the data analysis, considering significant when p-value <0.05. Results 360 elderly subjects participated in the study, with a 54.2% (95%CI: 49,0-59,3) prevalence of multimorbidity. After regression, it was identified that female gender (PR=1,16; 95%CI: 1,09-1,25), age ≥70 years (PR=1,08; 95%CI: 1,01-1,15), overweight (PR=1,19; 95%CI: 1,10-1,29), access to treated and piped water (PR=1,09; 95%CI: 1,00-1,18), smoking history (PR=1,10; 95%CI: 1,03-1,17), not using alcohol (PR=1,13; 95%CI: 1,05-1,22), chronic pain (PR=1,18; 95%CI: 1,10-1,26), hospital as first choice of health service (PR=1,12; 95%CI: 1,03-1,21) and medical consultation in the last year (PR=1,19; 95%CI: 1,11-1,27) were factors associated with multimorbidity. Conclusion the study revealed a high prevalence of multimorbidity and its associated factors. Finally, it becomes feasible to plan measures that improve the health condition of these individuals and think of possibilities to promote healthy aging.

Predictors of COVID-19 Related Health Literacy among Older People Living in Rural Areas of Indonesia.

Objective: . This study aims to identify predictive factors of COVID-19-related health literacy (HL) among older adults living in rural areas. Methods: This study used a cross-sectional design. A total of 106 respondents participated in this study. HL was measured by using a questionnaire modified from the HLS-COVID-Q22, in addition, the scales 'Health Information Seeking','Family's Social Support Scale', 'Health Service Utilization'; and information on some socio-demographic variables was also obtained. A multiple linear regression model was used to identify the predictors of HL. Results: About two-thirds of the respondents had a moderate level of HL (63.2%). Multiple linear regression analysis showed that education level, family support, information source, and gender were significant predictors for HL (p<0.01). Conclusion: HL literacy was better among males, highly educated older people, media users, and those with adequate family support. This study provided insight for nurses and healthcare professionals to pay greater attention to vulnerable groups of older people (ie. female gender and those with less formal education) as well as involve family members in education or health promotion activities and use easily accessed media, such as television and radio.

Violência contra as mulheres que vivem em contextos rurais: uma revisão integrativa / Violence against women living in rural contexts: an integrative review

Resumo O objetivo deste artigo foi analisar quais violências acometem as mulheres que vivem em contextos rurais. Foi realizada uma revisão integrativa nas bases BVS, SciELO, Medline, Web of Science, Scopus, Embase, Redalyc e Redib, sem restrição de idioma e período, de artigos brasileiros, com os termos: violência contra a mulher, violência entre parceiros íntimos, violência doméstica, violência de gênero e rural. Os 23 artigos incluídos foram analisados de forma qualitativa e organizados em duas categorias: as múltiplas violências contra as mulheres em contextos rurais (18 artigos) e a violência invisibilizada e silenciada contra as mulheres em contextos rurais (cinco artigos). Observou-se uma multiplicidade de violências, como doméstica, de gênero, entre parceiros íntimos e institucional. Destacam-se as violências física, psicológica, sexual, moral, patrimonial, além de feminicídio, desvalorização do trabalho, dependência financeira, privação e controle de liberdade, jornadas de trabalho intensas e falta de acesso a financiamentos públicos, potencializadas próprio contexto rural. As mulheres rurais, portanto, são sistematicamente silenciadas diante da opressão de gênero e violência que vivem. Além disso, o silenciamento também ocorre pela falta de pesquisas na área e até mesmo a não diferenciação entre rural e urbano nos registros e dados coletados.

Abstract The objective of this article was to analyze which violence affect women living in rural contexts. An integrative review was carried out in the databases VHL, SciELO, MEDLINE, Web of Science, Scopus, EMBASE, Redalyc, and REDIB, without restriction of language and period, of Brazilian articles, with the terms: violence against women, intimate partner violence, domestic violence, gender-based and rural violence. The 23 articles included were analyzed qualitatively and organized into two categories: the multiple violence against women in rural contexts (18 articles) and the invisible and silenced violence against women in rural contexts (five articles). A multiplicity of violence was observed, such as domestic, gender, intimate partner, and institutional. Physical, psychological, sexual, moral, patrimonial violence, as well as femicide, devaluation of work, financial dependence, deprivation, and control of freedom, intense working hours, and lack of access to public funding, potentiated by the rural context itself, stand out. Rural women are, therefore, systematically silenced in the face of the gender oppression and violence they experience. In addition, the silencing also occurs due to the lack of research in the area and even the non-differentiation between rural and urban in the records and collected data.