O controlo social e a experiência dos Conselhos de Saúde: inovações institucionais na governação em saúde

Os Conselhos de Saúde, criados no Brasil no âmbito do processo de reforma sanitária e de construção do Sistema Único de Saúde (SUS) constituem uma das inovações mais interessantes no campo da saúde e do envolvimento dos cidadãos na definição das políticas de saúde. Estes surgem como instituições híbridas que associam mecanismos de democracia directa com os da democracia representativa. A sua compreensão enquanto espaços institucionais de participação cidadã será tanto mais abrangente e eficaz se forem tomados em consideração 3 pilares distintos que enformam a sua existência: um pilar político, que tomou forma com o movimento sanitarista brasileiro; um pilar de conhecimento e de produção de saberes, que corresponde à emergência de um novo paradigma no domínio da saúde pública e que dá pelo nome de Saúde Colectiva; e, finalmente, um pilar institucional, ligado à própria criação do Sistema Único de Saúde (SUS) brasileiro. É, aliás, ao SUS que os conselhos de saúde se encontram vinculados

Factors associated with active commuting to school in adolescents

Active commuting contribute to the realization ofphysical activity by adolescents, being able to exertbeneficial effects on health. The aim of the study wasto analyze active trips to the school, evaluating theirrelationship with various lifestyle habits and indicators ofphysical and psychosocial health, as well as the influenceof different sociodemographic variables. The study wasconducted on a sample of 761 students (14.51 ± 1.63years) from 25 educational centers in northern Spain. activecommuting to school, hours of nightly sleep, adherenceto the Mediterranean diet, physical activity engagement,maximum oxygen uptake, body mass index, health-relatedquality of life, self-esteem and various sociodemographicfactors were analysed for all participants. Being older,studying in urban or publicly owned centers, residing infavorable environments for physical activity, having a low /medium socioeconomic level and having higher levels ofphysical activity, were found to be predictive factors ofactive trips to the school. Likewise,active transportreportedpositive associations with MD. Interventions aimed atpromoting active displacement should take these predictivefactors into account, trying to apply them especially to themost vulnerable groups.Los desplazamientos activos contribuyen a la realizaciónde actividad física por parte de los adolescentes, pudiendoejercer efectos beneficiosos para la salud. El objetivo delestudio fue analizar la realización de desplazamientosactivos al centro escolar, evaluando su relación condiversos hábitos de vida e indicadores de salud física ypsicosocial, así como la influencia de diferentes variablessociodemográficas. El estudio se llevó a cabo sobre unamuestra de 761estudiantes (14,51±1,63años) de 25 centroseducativos del norte de España. Se valoró la realizacióndel desplazamiento activo al centro escolar, horas desueño nocturno, adherencia a la dieta mediterránea, nivelde actividad física, consumo máximo de oxígeno, índicede masa corporal, calidad de vida relacionada con lasalud, autoestima y diversos factores sociodemográficos.Tener mayor edad, estudiar en centros urbanos o detitularidad pública, residir en entornos favorables pararealizar actividad física, poseer un nivel socioeconómicobajo/medio y tener niveles de actividad física más altos,resultaron ser factores predictores de los desplazamientosactivos al centro escolar. Asimismo, el trasporte activoreportó asociaciones positivas con la dieta mediterránea.Las intervenciones dirigidas a la promoción de losdesplazamientos activos deberían tener en cuenta estosfactores predictores, tratando de aplicarlas especialmenteen los grupos más vulnerables

Mediterranean diet adherence is associated with lifestyle, physical fitness, and mental wellness among 10-y-olds in Chile

Objective: The aim of this study was to assess adherence to the Mediterranean diet (MD) within a population of children from Santiago, Chile. A secondary aim was to examine the relationship between MD adherence, body composition, physical fitness, self-esteem, and other lifestyle factors. Methodology: A cross-sectional study of a sample of children (N = 515; 10.6 +/- 0.5 y) was conducted. Weight, body mass index, skinfolds, and waist circumference were measured. Physical fitness was determined using aspects of the Assessing Levels of Physical Activity health fitness test battery for children. Adherence to the MD was assessed using the Mediterranean Diet Quality Index for children and adolescents questionnaire. Self-esteem was evaluated using the Rosenberg scale and the Five-Factor Self-Concept Questionnaire measured self-concept. Participants completed the Physical Activity Questionnaire for Older Children and also were asked to report the number of hours per day they spent watching various screen-based devices. Results: All findings were significant at the level P < 0.001. Adherence to an MD was consistently and negatively associated with percentage body fat (r = -0.302) and subscapular skinfold thickness (r = -0.329). Positive associations were found with PAQ-C (r = 0.277), self-esteem (r = 0.301) and self-concept (r = 0.234), and for physical fitness, especially for explosive power of the legs (r = 0.355). Positive correlations with handgrip strength were found in boys (r = 0323), whereas negative correlations with screen time were found in girls (r = -0.511). Conclusion: Given its relation to a healthier body composition, physical fitness, healthier lifestyle behaviors, and mental wellness, the MD should be promoted amongst youngsters. (C) 2016 Elsevier Inc. All rights reserved

Different healthy habits between northern and southern Spanish school children

Aim: Healthy habits are influenced by several factors such as, geographical location. The aims of this study were to describe and compare healthy habits within two populations of sixth-grade primary school children (aged 11-12 years) from Northern and Southern Spain. Subject and Methods: A cross-sectional study using two representative samples of school children was conducted. Participants came from Logroño (n=329), in the North and Granada (n=284), in the South of Spain. Socio-demographic and anthropometric variables, adherence to the Mediterranean diet, aerobic fitness, and healthy lifestyles were recorded. Results: Boys reported higher level of physical activity and aerobic fitness than girls (p=0.000). Southern school children reported significantly higher adherence to the Mediterranean diet (♀: p=0.041; ♂: p=0.008), and lower aerobic fitness (♀: p=0.000; ♂: p=0.042) and hours of nightly sleep (♀: p=0.008, ♂: p=0.007) than Northern school children. Southern boys also reported lower levels of physical activity (p=0.013). There were slight or moderate correlations among all habits measured (physical activity, diet, screen and sleep time). Additionally, physical activity level was inversely related to body mass index in Northern boys (p=0.020) and Southern girls (p=0.024). Conclusions: Results showed differences in physical activity, eating and sleep habits, and aerobic fitness, according to geographical location. The relationships found among lifestyle habits indicate the need of health promotion interventions nationally and considering the differences discussed here

Relationship between physical fitness and body composition in primary school children in northern Spain (Logroño)

Introducción: La obesidad infantil es una epidemia que afecta especialmente a los países desarrollados, pero cuyos efectos negativos sobre la salud podrían verse disminuidos por una buena condición física. Objetivos: El objetivo de este estudio fue determinar el nivel de condición física de una población de escolares de una ciudad del norte de España (Logroño, La Rioja), así como analizar las relaciones del mismo con la composición corporal, la tensión arterial y diversos factores sociodemográficos. Métodos: El estudio se llevó a cabo sobre una muestra representativa compuesta por 329 escolares de 11-12 años de las 31 escuelas de la ciudad. Se obtuvieron datos sociodemográficos, antropométricos, tensión arterial, desarrollo madurativo y de condición física. Resultados: Los escolares de género masculino y los normopesos obtuvieron rendimientos superiores en las pruebas de condición física que las chicas y que quienes padecían sobrepeso u obesidad. El 88% de los niños y el 80% de las niñas presentaron valores saludables de capacidad aeróbica, mientras que sólo el 73% de los inmigran- tes lo hicieron. Un mayor riesgo de padecer sobrepeso u obesidad se asoció con un menor rendimiento en las pruebas de condición física, encontrándose relaciones inversas entre el porcentaje graso y el volumen máximo de oxígeno (r = -0,524), la fuerza explosiva del tren inferior (r = -0,400) y el rendimiento en velocidad (r = 0,385). Conclusiones: Las relaciones encontradas entre la condición física y la composición corporal ponen de manifiesto la importancia de realizar intervenciones destinadas a mejorar la condición física, especialmente la capacidad aeróbica, haciendo hincapié en los alumnos inmigrantes y de género femenino.Introduction: Childhood obesity is an epidemic that is more prevalent in developed countries, but the negative effects it has on children’s health could be decreased by good physical fitness. Objectives: The aim of this study was to determine the level of physical fitness of a group of school children in a city in the North of Spain (Logroño, La Rioja), and to analyze the relationship with the body composition, blood pressure and various socio-demographic factors. Methods: Research was conducted with a representative sample of 329 students aged 11-12 from all 31 schools of the city. Data included their socio-demographic back-ground, anthropometric measurements, blood pressure, biological maturity and physical fitness. Results: Male students and students with normal body weight fared better in physical fitness tests than females and than those who suffered from overweight or obesity. 88% of boys and 80% of girls were found to have healthy aerobic capacity, while only 73% of immigrant children demonstrated this. A major risk of suffering from over-weight or obesity was associated with inferior results in physical fitness tests, finding inverse relationships between the percentage of body fat and maximal oxygen uptake (r = -0.524), lower-body explosive strength (r = -0.400) and speed performance (r = 0.385). Conclusions: The relationship between physical fitness and body composition demonstrates the importance of intervening in order to improve physical fitness, especially with respect to aerobic capacity, with special emphasis needed for immigrant and female students.El estudio fue parcialmente financiado por el Instituto de Estudios Riojanos del Gobierno de La Rioja

Factors associated with adolescent participation in out-of-school physical activity

La participaciónen actividades físico-deportivas extraescolares contribuye al cumplimento de las recomendaciones de actividad física en los adolescentes, pudiendo tener una influencia directa en la salud.El objetivo del estudio fue analizar la realización de actividadesfísico-deportivas extraescolares, evaluando su relación con diversos hábitos de vida e indicadores de salud física y psicosocial, así como la influencia de diferentes variables sociodemográficas. El estudio se llevó a cabo sobre una muestra de 761 estudiantes (14,51±1,63 años) de 25 centros educativos. Se valoró la realización de actividades físico-deportivas extraescolares, nivel de actividad física, horas de sueño nocturno, adherencia a la dieta mediterránea, consumo máximo de oxígeno, índice de masa corporal, calidad de vida relacionada con la salud, autoestima, satisfacción con la imagen corporal y diversos factores sociodemográficos. Tener menor edad, ser chico, poseeParticipation in out-of-school physical activities contributes to the fulfilment of physical activity recommendations in adolescents and may have a direct influence on health. The aim of the study was to analyse the performance of extracurricular physical sports activities, assessing their relationship with various lifestyle habits and physical and psychosocial health indicators, as well as the influence of different socio-demographic variables. The study was carried out on a sample of 761 students (14.51 ± 1.63 years) from 25 educational centers. Performance of extracurricular physical sports activities, Physical activity engagement, hours of nightly sleep, adherence to the Mediterranean diet, maximum oxygen uptake, body mass index, health-related quality of life, self-esteem, satisfaction with body image were assessed and various sociodemographic factors. Being younger, being a boy, having a high socioeconomic level, having bee

Intermediate Repeat Expansion in the ATXN2 Gene as a Risk Factor in the ALS and FTD Spanish Population

Intermediate CAG expansions in the gene ataxin-2 (ATXN2) are a known risk factor for ALS, but little is known about their role in FTD risk. Moreover, their contribution to the risk and phenotype of patients might vary in populations with different genetic backgrounds. The aim of this study was to assess the relationship of intermediate CAG expansions in ATXN2 with the risk and phenotype of ALS and FTD in the Spanish population. Repeat-primed PCR was performed in 620 ALS and 137 FTD patients in three referral centers in Spain to determine the exact number of CAG repeats. In our cohort, >= 27 CAG repeats in ATXN2 were associated with a higher risk of developing ALS (odds ratio [OR] = 2.666 [1.471-4.882]; p = 0.0013) but not FTD (odds ratio [OR] = 1.446 [0.558-3.574]; p = 0.44). Moreover, ALS patients with >= 27 CAG repeats in ATXN2 showed a shorter survival rate compared to those with = 27 repeats in ATXN2 are associated with ALS risk but not with FTD in the Spanish population. ALS patients carrying an intermediate expansion in ATXN2 show more frequent limb onset but a worse prognosis than those without expansions. In patients carrying C9orf72 expansions, the intermediate ATXN2 expansion might increase the penetrance and modify the phenotype

Factores asociados con la participación de los adolescentes en actividades físicas fuera de la escuela

Participation in out-of-school physical activities contributes to the fulfilment of physical activity recommendations in adolescents and may have a direct influence on health. The aim of the study was to analyse the performance of extracurricular physical sports activities, assessing their relationship with various lifestyle habits and physical and psychosocial health indicators, as well as the influence of different socio-demographic variables. The study was carried out on a sample of 761 students (14.51 ± 1.63 years) from 25 educational centers. Performance of extracurricular physical sports activities, Physical activity engagement, hours of nightly sleep, adherence to the Mediterranean diet, maximum oxygen uptake, body mass index, health-related quality of life, self-esteem, satisfaction with body image were assessed and various sociodemographic factors. Being younger, being a boy, having a high socioeconomic level, having been born in Spain, residing in urban environments and being satisfied with body image were predictors of performing extracurricular physical sports activities. These factors accounted for 19.2% of physical sports participation. Likewise, adolescents who practiced these activities had lower rates of overweight / obesity and higher values of adherence to the Mediterranean diet, physical activity, health-related quality of life, self-esteem and maximum oxygen uptake.The practice of out-of-school physical activity is influenced by multiple factors that should be taken into account for its promotion.La participaciónen actividades físico-deportivas extraescolares contribuye al cumplimento de las recomendaciones de actividad física en los adolescentes, pudiendo tener una influencia directa en la salud.El objetivo del estudio fue analizar la realización de actividadesfísico-deportivas extraescolares, evaluando su relación con diversos hábitos de vida e indicadores de salud física y psicosocial, así como la influencia de diferentes variables sociodemográficas. El estudio se llevó a cabo sobre una muestra de 761 estudiantes (14,51±1,63 años) de 25 centros educativos. Se valoró la realización de actividades físico-deportivas extraescolares, nivel de actividad física, horas de sueño nocturno, adherencia a la dieta mediterránea, consumo máximo de oxígeno, índice de masa corporal, calidad de vida relacionada con la salud, autoestima, satisfacción con la imagen corporal y diversos factores sociodemográficos. Tener menor edad, ser chico, poseer un nivel socioeconómico alto, haber nacido en España, residir en entornos urbanos y estar satisfecho con la imagen corporal fueron predictores de la realización de actividades físico-deportivas extraescolares. Estos factores explicaron en un 19,2% la participación físico-deportiva. Asimismo, los adolescentes que practicaban estas actividades presentaron menores tasas de sobrepeso/obesidad y valores más altos de adherencia a la dieta mediterránea, actividad física, calidad de vida relacionada con la salud, autoestima y consumo máximo de oxígeno.La práctica de actividad físico-deportiva extraescolar está influenciada por múltiples factores que deberían ser tenidos en cuenta para su promoción