The Labor Market Integration of Women Having Suffered Gender Violence: Some Critical Questions.

The integration of women victims of gender-based violence (WVGBV) in the labor market is key to women's autonomy and empowerment. After pursuing some personal stability in different domains (emotional, physical, relational, etc.), these women require a further step toward recovery, which is often related to financial independence and, therefore, to their integration in the labor market. In this article, we describe the results of a study that focused on the actions aimed at integrating WVGBV into the labor market in the region of Andalusia (Spain). Based on a qualitative methodology, we collected the narratives and perspectives of the different actors involved in these processes (public administrations, nongovernmental organizations, the business world, and the WVGBV). The results revealed a series of deficiencies in social intervention methodologies that can sometimes lead to greater social exclusion. In conclusion, we believe that more participatory methodologies in their design, incorporating the views of woman themselves, are necessary.

Public Telemedicine Policy in Brazilian Unified Health System: An Impact Analysis.

There are several difficulties in evaluating interventions seeking to promote public health policies. In this article, we analyzed the promotion of the use of telemedicine during COVID-19 in Brazil. Using the random promotion method with instrumental variables, we showed that the policy of promoting telemedicine was adequate, with intense use of this type of care. Our results showed that telemedicine works if it is encouraged in the population. We contributed to the discussion of public health policies and their impact on the population's health in times of health crisis, such as during the COVID-19 pandemic.

Sustainable Development versus Extractivist Deforestation in Tropical, Subtropical, and Boreal Forest Ecosystems: Repercussions and Controversies about the Mother Tree and the Mycorrhizal Network Hypothesis.

This research reviews the phenomenon of extractive deforestation as a possible trigger for cascade reactions that could affect part of the forest ecosystem and its biodiversity (surface, aerial, and underground) in tropical, subtropical, and boreal forests. The controversy and disparities in criteria generated in the international scientific community around the hypothesis of a possible link between "mother trees" and mycorrhizal networks in coopetition for nutrients, nitrogen, and carbon are analyzed. The objective is to promote awareness to generate more scientific knowledge about the eventual impacts of forest extraction. Public policies are emphasized as crucial mediators for balanced sustainable development. Currently, the effects of extractive deforestation on forest ecosystems are poorly understood, which requires caution and forest protection. Continued research to increase our knowledge in molecular biology is advocated to understand the adaptation of biological organisms to the new conditions of the ecosystem both in the face of extractive deforestation and reforestation. The environmental impacts of extractive deforestation, such as the loss of biodiversity, soil degradation, altered water cycles, and the contribution of climate change, remain largely unknown. Long-term and high-quality research is essential to ensure forest sustainability and the preservation of biodiversity for future generations.

Coping strategies of food insecure households with children and adolescents in Uruguay, a high-income Latin American country: A qualitative study through the lens of Bourdieu's theories of capitals and practice.

Food insecurity has been associated with negative short, medium, and long-term health consequences, which are more detrimental for children and adolescents. These effects may depend on the coping strategies developed to deal with food shortages. The present research aimed at exploring coping strategies in food insecure households with children and adolescents in Uruguay, incorporating sociological theoretical insights from Bourdieu. A qualitative approach based on individual semi-structured interviews was used. A total of 40 interviews were conducted with adults who had parental responsibilities of children and adolescents and who received different types of food assistance, between July and December 2022, in four cities. Results showed that adults tend to develop a wide range of coping strategies aimed at: reducing food expenditure, increasing the availability of money for purchasing food, increasing food availability and/or rationing the food available in the household. Some of the strategies were implemented regardless of the severity of food insecurity, whereas others were characteristic of the moderate and severe levels of the construct. Evidence to support the mediation effect of coping strategies on health outcomes was found. Discourses suggested that lower accumulation of economic and cultural capital may be aligned with the adoption of less socially accepted mechanisms to access to food. Expressions of a specific habitus aimed at securing food were identified among participants with more deprivations. Taken together, the findings suggest that coping strategies may not be a universal or invariant sequence according to the severity of food insecurity and stress the importance of considering households' resources and local context for the development of strategies to improve access to food.

A comprehensive analysis of children's blood lead levels in Latin America and the Caribbean over the last eight years: Progress and recommendations.

In 2017 we published a review on blood lead levels (BLL) in children from Latin America and the Caribbean (LAC) for data available up to 14th of March 2014 and recommended the identification and control of "lead hot spots". In the present study, an evaluation of progress toward reducing BLL in the region was carried out. A systematic review of the latest literature on lead exposure in the LAC region held on the PubMed, Web of Science and LILACS databases (January 2014 to March 2022) was conducted using the PRISMA methodology. Only original papers published in peer-reviewed English, Spanish, or Portuguese journals were eligible. A total of 558 papers were retrieved, 77 of which met the selection criteria and 31 (40.25 %) were carried out in Mexico. The prevalence of children with BLL above 10 µg. dL-1 was 22.08 % in the previous review versus 6.78 % in the current study. In the present review, the prevalence of children with BLL above 5 µg. dL-1 was 29.62 %, and only one study reported a BLL prevalence rate between 3.3 and 5 µg. dL-1. The highest BLLs were associated with well-known sources or occupational exposures. The number of countries (n = 13) that published data on BLL in children was lower compared to the previous review (n = 16). Most studies were conducted in areas with known lead exposure sources, similar to the earlier review. The percentage of children at risk of lead poisoning in the region remains unknown because few studies have published data on environmental exposure levels and most samples were relatively small. The recommendation to identify and control sources of lead exposure was maintained, while further suggestions for establishing a systematic public health surveillance system for lead were proposed to help reduce the knowledge gap and inform public health policy-making in LAC.

Perspectivas de Profissionais de Educação sobre ações do Programa Saúde na Escola em Pelotas em 2022 / Perspectives of Education Professionals on actions of the School Health Program in Pelotas in 2022

Esta pesquisa teve como objetivo descrever as ações do Programa Saúde na Escola em 2022 no município de Pelotas, Rio Grande do Sul, segundo a perspectiva de profissionais da educação. Trata-se de um estudo transversal, contemplando 51 das 60 escolas de Ensino Fundamental de nível municipal. Foram utilizados dois questionários estruturados administrados aos responsáveis pelo Programa ou membros da equipe gestora das instituições por meio telefônico, ou presencial. Os temas abordados com diretores, vice-diretores, orientadores educacionais e coordenadores pedagógicos incluíram a existência do Programa, as temáticas desenvolvidas, sua frequência, capacitação, envolvimento de profissionais de saúde e educação, articulação entre setores, apoio, autonomia de estudantes e barreiras para implementação do programa. Entre as 51 escolas analisadas, 41 (80,5%) delas possuíam o programa, com frequência das ações prevalentes a cada 3 meses (39,0%) e sendo a ação de Promoção da saúde bucal (90,2%) a mais apontada. Em 70,7% das escolas foram realizadas ações de promoção de atividade física. Além disso, observou-se o setor saúde como principal responsável pelas ações (87,8%), limitada participação dos alunos na escolha das temáticas (34,0%) e escassez de capacitações aos educadores (36,6%). Embora uma instituição universitária tenha se apresentado como fonte de apoio (53,7%) e todas as escolas com o programa registraram ao menos uma ação realizada, a sobrecarga (36,6%) e a necessidade de articulação (34,1%) foram as barreiras mais relatadas. Apesar dos desafios e dificuldades em diversos indicadores, foram identificadas iniciativas que configuram o Programa como importante ferramenta para promoção da saúde de escolares no município.

This research aimed to describe the actions of the School Health Program in 2022 in the municipality of Pe-lotas, Rio Grande do Sul, Brazil, from the perspective of education professionals. This is a cross-sectional, as-sessing 51 of the 60 municipal elementary schools. Two structured questionnaires were administered to those responsible for the Program or members of the management team of the institutions by telephone or face-to-face. Topics addressed with principals, vice-principals, educational advisors and pedagogical coordinators included the description of the existence of the Program, the themes developed, as well as its frequency, train-ing, involvement of health and education professionals, articulation between sectors, support, autonomy of students and barriers to the implementation of the program. Among the 51 schools analyzed, 41 (80.5%) of them had the program, with the frequency of prevalent actions every 3 months (39.0%) and the Oral Health Promotion action (90.2%) being the most pointed out. In 70.7% of the schools, actions to promote physical activity were carried out. In addition, the health sector was the main responsible for the actions (87.8%), limited participation in the choice of themes (34.0%) and scarcity in the provision of training for educa-tors (36.6%). Although a local university was a strong support (53.7%) and all schools with the program recorded at least one action taken, overload (36.6%) and the need for articulation (34.1%) were the most reported barriers. Despite the challenges and difficulties in several indicators, initiatives were identified that configure the Program as an important tool for promoting the health of schoolchildren in the municipality.

An assessment of the owned canine and feline demographics in Chile: registration, sterilization, and unsupervised roaming indicators.

The global rise in companion animal populations, particularly dogs and cats, is driven by emotional and social benefits for owners, and their population management is becoming critically important to avoid a plethora of adverse effects on themselves, humans, and wildlife. We estimated the size and density of the owned canine and feline population in Chile and evaluated the status of microchipping, registration, sterilization rates, and the proportion of owned animals that roam unsupervised. A cross-sectional household survey in 36 districts was conducted and standard inferential statistics was employed to analyze differences between cats and dogs, sexes within each species, and between rural and urban areas. Additionally, two negative binomial models with mixed effects were developed to predict the number of dogs and cats per households. Two methods were used to compare population size estimates at the country level, multiplying: (1) the estimated mean number of companion animals per household by the estimated number of households at the country level, and (2) the estimated human:dog and human:cat ratios by the total human population. The study involved 6333 respondents, of which 76% (74% urban; 83% rural) owned companion animals (dogs and/or cats). Individuals in rural multi-person households increase the probability of owning dogs and/or cats. Additionally, women exhibit a greater inclination towards cat and dog ownership compared to men, while those over 30 years old demonstrate lower rates of companion animal ownership in contrast to the 18-30 age group for both species. The overall human:dog and human:cat ratios estimated were 2.7:1, and 6.2:1, respectively. The estimated total number of owned dogs and cats in Chile ranged from 9.6 to 10.7 million, depending on the methodological approach, while national median density of companion animals was 12 dogs per km2 (ranging from 0.02 to 7232) and 5 cats per km2 (ranging from 0.01 to 3242). This nationwide study showed one of the highest percentages of households with companion animals in Latin America and relatively low registration and sterilization rates, highlighting the need to strength long-term public policies to control populations of companion animals and promote responsibility in pet ownership.

Air, land, and water pollutants and public health expenditures: Empirical data from selected EU countries in the transport sector.

The increase in economic activity, particularly in transport, leads to a significant increase in emissions of pollutants, such as ammonia, arsenic and cadmium, at the European Union (EU) level. This can seriously impact human health and, consequently, public health spending. Based on data from 15 European Union countries from 1992 to 2020, a panel co-integration approach is used to study these pollutants' short- and long-term co-movements and per capita health expenditure. The results show a long-term relationship between ammonia, arsenic and cadmium emissions and per capita health spending, as they are panel-cointegrated. Ammonia and cadmium emissions exert a statistically significant positive effect on health expenditure in the short run, and arsenic emissions have a statistically significant positive impact in the long run. The forecast assessment of reductions in health spending resulting from policies to reduce emissions of air, land and water pollutants, such as ammonia, arsenic and cadmium, from the transport sector supports investments in its policies that reduce pressure on health spending. The reduction in annual healthcare expenditure is greater when these reductions are made sooner and more severely. Indeed, varying the reduction in emissions for each pollutant by 10% and 100%, respectively, from the first year for all countries over a 3-year period results in an average annual reduction in health spending of 2.05% and 51.02%, respectively. However, if we wait until the third year, the annual reduction is only 0.77% and 17.63% respectively.

Simple economics of vaccination: public policies and incentives.

This paper focuses on the economics of vaccination and, more specifically, analyzes the vaccination decision of individuals using a game-theoretic model combined with an epidemiological SIR model that reproduces the infection dynamics of a generic disease. We characterize the equilibrium individual vaccination rate, and we show that it is below the rate compatible with herd immunity due to the existence of externalities that individuals do not internalize when they decide on vaccination. In addition, we analyze three public policies consisting of informational campaigns to reduce the disutility of vaccination, monetary payments to vaccinated individuals and measures to increase the disutility of non-vaccination. If the public authority uses only one type of policy, herd immunity is not necessarily achieved unless monetary incentives are used. When the public authority is not limited to use only one policy, we find that the optimal public policy should consist only of informational campaigns if they are sufficiently effective, or a combination of informational campaigns and monetary incentives otherwise. Surprisingly, the requirement of vaccine passports or other restrictions on the non-vaccinated are not desirable.

Preparing schools for future pandemics: Insights on water, sanitation and hygiene solutions from the Brazilian school reopening policies.

Post-COVID-19, schools urgently need to enhance infection control and prevention (IPC) measures, including water, sanitation, and hygiene (WASH), to prepare for future outbreaks and pandemics. Particularly in Brazil, that is of particular concern, as students are still recovering from the 20th longest school closure in the world. Hence, the current study had two goals: (i) to describe WASH solutions outlined in policies released at the federal, state, and capital city levels in Brazil during the COVID-19 pandemic for the safe reopening of schools and (ii) to discuss their potential to enhance school's capacity to remain operational during a new pandemic or outbreak. With a qualitative exploratory approach, we performed content analysis to discuss the direction (what, where, how and for whom?) of 66 public policies by integrating four frameworks. Solutions were discussed in the light of the principles of human rights and the human rights to water and sanitation, international guidelines for WASH and IPC in schools and the Sphere minimum standards for humanitarian aid. One hundred and fifty-nine solutions, spanning five thematic areas and five population groups, including software and hardware interventions, were compiled for potential use in Brazil and beyond. While suggested solutions have the potential to provide a cleaner and safer learning environment, it is essential to exercise caution when implementing these measures and adapt them to the specific circumstances of each school.

Food and nutritional insecurity in the rural community Laguinha near the wind energy complex in Caetés in Pernambuco / Insegurança alimentar e nutricional na comunidade rural Laguinha nas proximidades do complexo eólico do município de Caetés em Pernambuco

Food and Nutrition Security (SAN) is the realization of everyone's right to access food in sufficient quantities, quality and regularly, without compromising access to other needs. In view of the increase in food and nutrition insecurity, observed in recent years in Brazil and in the world, concomitant with the disruption of programs and public policies combined with the incentive to promote the right to Food and Nutritional Security (SAN) in Brazil (2019-2022) , and the pandemic context that aggravated this problem, we are currently experiencing alarming levels of Food and Nutrition Insecurity (INSAN), including the serious one that is characterized by hunger, which preferentially affects a certain social class and region in Brazil, North and Northeast. The present study analyzed the food and nutritional security profile of families residing in the rural community of Sítio Laguinha, around a wind farm in the municipality of Caetés, in Pernambuco. This study can be characterized as a mixed descriptive study with a quantitative and qualitative approach, in order to identify the prevalence of food (in)security and the associated factors. A semi-structured questionnaire was used to obtain information on socioeconomic conditions and food consumption in the rural community of Laguinha, as well as the Brazilian Food Insecurity Scale (EBIA) to assess the situation of Food and Nutritional Security. Among the factors associated with the community, the vulnerabilities to which this community is exposed stand out, such as the location in a rural area that is difficult to move around, around a wind farm that brings with it impacts and the pandemic context. The results obtained showed a high prevalence of food and nutritional insecurity (88.4%) at all levels, mild, moderate and severe. Among the factors that may be associated with and aggravate the INSAN situation, we can mention the impact of the wind farm and the pandemic, with all associated socioeconomic impacts. The results obtained in this work bring relevant data about the situation of an invisible community that needs assistance to achieve food and nutritional security, a right established in our constitution. In addition, these data can serve as a basis for the implementation of public policies aimed at the community

A Segurança Alimentar e Nutricional (SAN) é a realização do direito de todos ao acesso a alimentos em quantidade suficiente, qualidade e regularmente, sem comprometer o acesso a outras necessidades. Diante do aumento da insegurança alimentar e nutricional, observada nos últimos anos no Brasil e no mundo, concomitante com a desestruturação de programas e políticas públicas aliadas ao incentivo à promoção do direito à Segurança Alimentar e Nutricional (SAN) no Brasil (2019-2022), e o contexto pandêmico que agravou esse problema, atualmente vivenciamos índices alarmantes de Insegurança Alimentar e Nutricional (INSAN), incluindo a insegurança grave que se caracteriza pela fome, que afeta preferencialmente uma determinada classe social e região no Brasil, Norte e Nordeste. O presente estudo analisou o perfil da segurança alimentar e nutricional de famílias residentes na comunidade rural do Sítio Laguinha, em torno de um parque eólico no município de Caetés, em Pernambuco. Esse estudo pode ser caracterizado como descritivo misto com abordagem quantitativa e qualitativa, a fim de identificar a prevalência da (in)segurança alimentar e os fatores que a ela se associam. Foram utilizados um questionário semiestruturado para obtenção de informações sobre condições socioeconômicas e de consumo alimentar da comunidade rural de Laguinha bem como a Escala Brasileira de Insegurança Alimentar (EBIA) para avaliar a situação de Segurança Alimentar e Nutricional. Dentre os fatores associados à comunidade destaca-se as vulnerabilidades às quais essa comunidade está exposta, como a localização em uma área rural de difícil deslocamento, em torno de um parque eólico que traz consigo impactos e o contexto pandêmico. Os resultados obtidos mostraram alta prevalência de insegurança alimentar e nutricional (88,4%) em todos os níveis, leve, moderada e grave. Dentre os fatores que podem estar associados e agravar a situação de INSAN podemos citar o impacto do parque eólico e a pandemia, com todos impactos socioeconômicos associados. Os resultados obtidos neste trabalho trazem dados relevantes sobre a situação de uma comunidade invisibilizada e que necessita de assistência para alcançar a segurança alimentar e nutricional, um direito estabelecido na nossa constituição. Além disso, esses dados podem servir de base para implementação de políticas públicas voltadas à comunidade.

Obesogenic environments as major determinants of a disease: It is time to re-shape our cities.

Obesity rates are increasing in almost all high- and low-income countries, and population-based approaches are necessary to reverse this trend. The current global efforts are focused on identifying the root causes of obesity and developing effective methods for early diagnosis, screening, treatment, and long-term management, both at an individual and health system level. However, there is a relative lack of effective options for early diagnosis, treatment, and long-term management, which means that population-based strategies are also needed. These strategies involve conceptual shifts towards community- and environment-focused approaches. This review aimed to provide evidence on how environmental factors contribute to the risk of obesity and how reshaping cities can help slow down obesity prevalence rates and improve long-term management.

Long-term care needs and the risk of household poverty across Europe: a comparative secondary data study.

PURPOSE: Population ageing and rising poverty are two of the most pressing issues today, even in Western European nations, growing as a result of the recent global economic crisis and the COVID-19 containment measures. This study explores the relationship between long-term care (LTC) needs and risk of poverty at household level in eight European countries, representing the different European care regimes. METHODS: The main international databases were scoured for study variables, categorized according to the following conceptual areas: home care, residential care, health expenditure, service coverage, cash benefits, private services, population, family, education, employment, poverty, disability and care recipients, and life expectancy. We initially identified 104 variables regarding 8 different countries (Austria, Finland, Germany, the Netherlands, Italy, Spain, Poland, Romania). Statistical analyses were conducted as described hereafter: analysis of the Pearson's Bivariate Correlation between the dependent variable and all other variables; a Multivariable Linear Regression Model between the Poverty Index (dependent variable) and the covariates identified in the preceding step; a check for geographical clustering effects and a reduced Multivariable Linear Regression Model for each identified European cluster. RESULTS: The variables that addressed the risk of poverty pertained to the area of policy intervention and service provision. Rising private out-of-pocket health expenditures and proportion of "poor" couples with at least one child are two factors that contributed significantly to poverty increasing. Moreover, rising private out-of-pocket health expenditures for covering LTC needs (even in presence of public financial contribution to the family) is the main contributor to household poverty increasing in presence of ADL disability. CONCLUSION: The results reveal the existence of a clear correlation between the need for LTC and the risk of poverty in households across Europe. These results highlight the central relevance of LTC policies, which are often still treated as marginal and sectoral, for the future sustainability of integrated care strategies.

Intersectorality in a conditional cash transfer programme: Actors, convergences and conflicts.

This study aimed to analyse intersectoral arrangements among the health, education and social assistance sectors in the operationalization of the Bolsa Família Program (BFP). A qualitative approach was carried out, in a peripheral region of a large urban centre of Southeast Brazil. Data content analysis was performed on the basis of reference in the Actor-Network Theory (ANT) using statements by the actors and considering ideas in dispute and work processes in the geopolitical territorial context. Seventeen managers of Municipal Secretariats of Health, Education and Social Assistance were interviewed, as were basic education, primary health care and social assistance professionals. One-off, episodic and discontinuous intersectoral actions were identified, with limited integration among sectors. Convergences and conflicts were found with respect to the institutional processes of BFP. The convergences referred to the conceptions shared among the actors about the role of intersectoral collaboration, as they recognize themselves as providing care to the same vulnerable population. Considering the multiple vulnerabilities of these families, the convergence of actions from different sectors can impact factors that condition inequalities. The conflicts were related to institutional conditions, to sectorized work processes and to a lack of understanding by professionals about the duties of their respective sectors.

Pollution and endometriosis: A deep dive into the environmental impacts on women's health.

BACKGROUND: The interaction between pollution and endometriosis is a pressing issue that demands immediate attention. The impact of pollution, particularly air and water pollution, or occupational hazards, on hormonal disruption and the initiation of endometriosis remains a major issue. OBJECTIVES: This narrative review aims to delve into the intricate connection between pollution and endometriosis, shedding light on how environmental factors contribute to the onset and severity of this disease and, thus, the possible public health policy implications. DISCUSSION: Endocrine-disrupting chemicals (EDCs) in pollutants dysregulate the hormonal balance, contributing to the progression of this major gynaecological disorder. Air pollution, specifically PM2.5 and PAHs, has been associated with an increased risk of endometriosis by enhancing chronic inflammation, oxidative stress, and hormonal imbalances. Chemical contaminants in water and work exposures, including heavy metals, dioxins, and PCBs, disrupt the hormonal regulation and potentially contribute to endometriosis. Mitigating the environmental impact of pollution is required to safeguard women's reproductive health. This requires a comprehensive approach involving stringent environmental regulations, sustainable practices, responsible waste management, research and innovation, public awareness, and collaboration among stakeholders. CONCLUSION: Public health policies have a major role in addressing the interaction between pollution and endometriosis in a long-term commitment.

The INFORMAS healthy food environment policy index in Brazil: Benchmarking, current policies, and determining priorities for the future.

INTRODUCTION: Obesity and non-communicable diseases are the most important cause of death and inability in Brazil and worldwide. Public policies are an important strategy to prevent obesity. This study analysed the scope of Brazilian public policies for preventing and controlling obesity using the INFORMAS/Food-EPI protocol. METHODS: The public policies evaluation was conducted based on the INFORMAS/Food-EPI protocol. Experts from academia, civil society, and government assessed the level of implementation of food policies compared with international best practices and proposed new actions to be developed nationally. The protocol consisted of five phases: (1) A comprehensive review of the implementation of food environment-related public policies; (2) validation with experts; (3) comparison of the national actions with the international best practice and due to the level of implementation; (4) list a set of actions to improve the current policies; and (5) evaluation of the actions due to their importance and achievability. RESULTS: Brazilian actions were focused on monitoring, leadership, governance, and resources and financing domains. CONCLUSION: The results will provide elements to support and improve the national policies that aim at the promotion of a healthy food environment and obesity prevention.

Panorama dos esportes ginásticos olímpicos nos municípios paranaenses / Panorama of olympic gymnastics in municipalities of paraná state

RESUMO Este artigo objetivou analisar o panorama dos esportes ginásticos olímpicos nos municípios paranaenses. Metodologicamente, seguiu-se os critérios da análise descritiva com coleta de dados realizada em três etapas distintas: 1) coleta de registros sobre a oferta das modalidades gímnicas no instrumento de pesquisa GEEM, do Instituto de Pesquisa Inteligência Esportiva; 2) consulta a documentos e notícias nos portais oficiais da Secretaria de Esporte do Paraná e Federação Paranaense de Ginástica; e 3) cruzamento dos dados levantados. Conclui-se que há ênfase na oferta de Ginástica Artística Feminina e Ginástica Rítmica, sem fomento à Ginástica de Trampolim - especialmente nos Jogos oficiais do Estado -, sendo que 16% dos municípios paranaenses incentivam ao menos uma das práticas gímnicas competitivas, seja na Formação Esportiva, Excelência Esportiva ou Esporte para a Vida Toda.

ABSTRACT This article aimed to analyze the panorama of Olympic gymnastics in municipalities of Paraná. Methodologically, the study followed the criteria of descriptive analysis with data collection conducted in three distinct stages: 1) gathering records on the provision of gymnastic modalities using the GEEM research tool from the Instituto de Pesquisa Inteligência Esportiva; 2) consulting documents and news on the official portals of the Sports Department of Paraná and the Paraná Gymnastics Federation; and 3) cross-referencing the collected data. It is concluded that there is an emphasis on the provision of Women's Artistic Gymnastics and Rhythmic Gymnastics, with little support for Trampoline Gymnastics - especially in official state games - as only 16% of municipalities in Paraná encourage at least one of the competitive gymnastic practices, whether in Sports Training, Sports Excellence, or Lifelong Sports.

A implementação de ações intersetoriais na assistência a crianças com síndrome congênita do vírus Zika no estado do Rio de Janeiro / The implementation of intersectoral actions to assist children with congenital Zika virus syndrome in the state of Rio de Janeiro

Resumo Este trabalho analisa as ações e parcerias estabelecidas entre os integrantes das Secretarias Estaduais de Saúde e da Assistência Social do Rio de Janeiro e outras organizações da área da saúde e assistência para atender à emergência sanitária desencadeada pela síndrome congênita do vírus Zika entre os anos de 2015 e 2018. O contexto caracterizava-se por acentuada crise econômica, erosão da capacidade de governança das autoridades políticas no estado, e reduzido conhecimento técnico-científico sobre a epidemia. Além de análise de documentos relativos ao tema, foram feitas 17 entrevistas com gestores e profissionais das duas secretarias. Roteiros semiestruturados focalizaram ações intersetoriais e processos de cooperação e coordenação inter e intraorganizacional. A grade analítica contemplou aspectos dos papéis interpessoais, informacionais e de tomada de decisão dos gestores e técnicos. Os resultados mostram que, apesar da crise política e econômica, os atores das secretarias conseguiram criar um fluxo de atenção aos pacientes. Observou-se que mecanismos informais de cooperação e coordenação foram fundamentais para a criação de estratégias intersetoriais de longo prazo.

Abstract This paper focuses on the actions and partnerships established between members of the State Secretariats of Health and Social Assistance in Rio de Janeiro and other organizations in the health and assistance areas to respond to the health emergency triggered by the congenital Zika virus syndrome between 2015 and 2018. Some characteristics of the context were: a severe economic crisis, the erosion of the governance capacities of the state political authorities as well and scarce technical-scientific knowledge about the epidemic. The study was grounded on an analysis of documents related to the topic, 17 semi-structured interviews with managers and professionals from the two secretariats. Interview scripts focused on intersectoral actions and processes of cooperation and coordination within and between organizations. The analytical grid included aspects of the interpersonal, informational, and decision-making roles of managers and technicians. The results show that, despite the political and economic crisis, the Secretariat actors managed to create a flow of care for patients. Informal cooperation and coordination mechanisms were crucial for the creation of long-term intersectoral strategies.

Percepções de escolares e merendeiras sobre alimentação escolar: uma análise por grupos focais / Perceptions of schoolchildren and lunch ladies about school meals: a focus groups analysis

Resumo Introdução: O Programa Nacional de Alimentação Escolar (PNAE) destaca-se por ser um dos maiores programas do mundo de alimentação escolar, contemplando o Direito Humano à Alimentação Adequada a estudantes brasileiros. Entretanto, alguns estudos têm observado baixa aceitabilidade e adesão à alimentação escolar. Objetivo: Analisar a percepção de merendeiras e escolares acerca da aceitabilidade e adesão à alimentação escolar. Metodologia: Pesquisa qualitativa realizada através de grupos focais com merendeiras de três escolas e escolares do sexto ao nono ano de escola pública de Sumidouro, Rio de Janeiro, Brasil. Os grupos focais foram realizados utilizando-se roteiros semiestruturados e gravados em áudio e vídeo, posteriormente transcritos e analisados por Análise de Conteúdo. Resultados: Foram identificados seis temas: autoconhecimento, adesão, aceitabilidade, preparo e distribuição da alimentação escolar, cardápio e ambiente. Conclusão: O emprego de esforços na melhoria da infraestrutura e aspecto do ambiente alimentar, com a aquisição de utensílios adequados, alteração no modelo de serviço de distribuição e no modo de preparo das refeições, resultando em cardápios variados, são estratégias que podem contribuir para melhorar a adesão e aceitabilidade à alimentação escolar. Essas mudanças favorecem a promoção de saúde no espaço escolar, com foco em políticas públicas saudáveis.

Abstract Introduction: National School Feeding Program (PNAE) stands out for being one of the largest school feeding programs in the world, contemplating the Human Right to Adequate Food for Brazilian students. However, some research works have observed low acceptability and adherence to school meals. Objective: To analyze the perception of school lunch ladies and students about acceptability and adherence to school meals. Methodology: Qualitative research carried out through focus groups with lunch ladies from three schools and students from the sixth to the ninth grade of a public school in Sumidouro, Rio de Janeiro state, Brazil. The focus groups were carried out using semi-structured scripts and recorded in audio and video, later transcribed and analyzed by Content Analysis. Results: Six themes were identified: self-knowledge, adherence, acceptability, preparation and distribution of school meals, menu and environment. Conclusion: The use of efforts to improve the infrastructure and aspect of the food environment, with the acquisition of adequate utensils, change in the distribution service model and in the way of preparing meals, resulting in varied menus, are strategies that can contribute to improve adherence and acceptability to school meals. These changes favor the promotion of health in the school environment, focusing on healthy public policies.