Cursos de vida y destinos tempranos de inclusión, vulnerabilidad y exclusión educativo-laboral de los jóvenes evaluados en PISA 2009

La tesis responde a dos objetivos generales. El primero, comprender en qué medida los determinantes sociales, las competencias académicas, los procesos de transición a la adultez, las trayectorias educativas y la realización de tareas de cuidados no remunerados, inciden en los destinos tempranos de integración, vulnerabilidad y exclusión sobre los 20 años. Dada la centralidad de la culminación de la educación obligatoria para la integración en las estructuras sociales y productivas, en segundo lugar, analizo cómo la experiencia, calendarios y secuencias de eventos escolares y eventos de transición a la adultez inciden en la desafiliación de la educación media, con sus consecuencias sobre procesos de exclusión y vulnerabilidad. El abordaje es cuantitativo, con un diseño longitudinal, e integra técnicas descriptivas y explicativas. Se aplicaron modelos de regresión logística de tipo multinomial y modelos de regresión logística de tiempo discreto, para responder al primer y segundo objetivo respectivamente, con base en el panel de jóvenes evaluados por PISA en 2009 (PISA-L 2009, DS-FCS-Udelar). Los resultados muestran cómo los destinos de integración, vulnerabilidad y exclusión, así como la desafiliación de la educación media, son expresión de procesos acumulativos de ventajas y privaciones que involucran distintos factores escolares, transformaciones familiares, distribución de cargas de cuidado no remunerado, y factores estructurales. A su vez, los tiempos y secuencias de los eventos en los cursos de vida muestran tipos de transición y hacen la diferencia en estos resultados. En segundo lugar, la tesis discute con estudios previos que señalan ventajas para las mujeres en términos de mayor acreditación y menor desafiliación de la educación media, mostrando que estas diferencias sólo se sostienen parcialmente. La tenencia de hijos, la conyugalidad y una desigual división sexual del trabajo no remunerado en cuidados, activa fuertemente entre las mujeres, pero no entre los varones, procesos de privaciones que derivan en desafiliación de la educación media, y en exclusión temprana de las esferas educativa y laboral. Por último, la tesis contrasta la mirada meritocrática sobre la integración/exclusión asociada a las competencias académicas previas, y la incidencia de lo que PISA define como el nivel de alfabetización o suficiencia de competencias para una integración social y ciudadana. Los resultados ilustran hasta qué punto se sostiene esta determinación de las competencias académicas sobre los destinos tempranos y la desafiliación de la educación obligatoria, y en qué medida es expresión indirecta de desigualdades sociales antecedentes.This study draws both on the fields of sociology of education and sociology of youth. The thesis integrates R. Castel’s theory of social cohesion, the transition to adulthood and the inequality of opportunities approaches, to analyze educational trajectories and early educational and labor destinations of social integration, vulnerability or exclusion within the life course until age 20. My approach articulates, conceptually, a life-course, an institutional and a structural level, each of which is believed to condition the opportunities and participation of individuals in a given socio-historic setting. The thesis seeks to respond two main purposes. First, to understand how social factors, academic skills, transition to adulthood events, educational trajectories and unpaid care work, affect early destinations, conceived of as states of social integration, vulnerability or exclusion, at around age 20. On the other hand, I examine how and to what extent a set of educational and life course events during the observation window of the study -ages 15 to 20-, impact on high school graduation odds, and thus condition individual trajectories leading to exclusion or vulnerability early destinations. In this last analysis, I take into account whether these events were experienced or not, as well as their calendar, that is to say, when they happened, and their sequence. The thesis follows a quantitative and longitudinal approach, articulating descriptive and explicative techniques. I use multinomial logistic regressions and discrete time to event logistic models to address objectives one and two, respectively, drawing on panel data from the 2009 Uruguayan Pisa Longitudinal Study (PISA-L 2009, DS-FCS-UdelaR). My results show early destinations of social integration, vulnerability or exclusion, as well as secondary school trajectories that end up in disaffiliation are, to a great extent, a consequence of cumulative advantages and deprivations, which depend on structural conditions, school factors, family events and an uneven sexual distribution of unpaid care work. At the same time, the study reveals how the timing and sequence of life course events substantially affect these outcomes, specifying different life experiences or types of transitions at these ages. The thesis also addresses previous studies’ results that show females outperform males both in terms of high school graduation rates and of high school disaffiliation risks, and argues that this assertion is only partially accurate. In particular, my analysis reveal that, for women, motherhood, conjugality and unpaid care work activate processes of deprivation that lead to substantially higher risks of both school dropout and early exclusion and vulnerability social destinations, while, for men, none similar effects are found. Lastly, the study deals with a meritocratic hypothesis which explains integration/exclusion destinations as the result of previous academic competencies, in particular, focusing on the incidence of what PISA defines as the minimal literacy threshold for social and citizen integration. My approach on this issue helps clarify to what extent such outcomes as early social destinations or school disaffiliation are determined by early academic skills, and to what extent such association actually reflects the indirect effects of previous social inequalities

La París, Curridabat

Proyecto de graduación (Licenciatura en Arquitectura y Urbanismo) Instituto Tecnológico de Costa Rica, Escuela de Arquitectura y Urbanismo, 2019This research focuses on the preschool sector, which requires specific spaces for children, since it is a very active and changing stage. However, in general, the architectural and educational fields have not been adequately articulated, due to the functionalist approach that has been given to schools without considering the spatial quality that can be experienced in them. For this reason, an architectural project is proposed to be conceptualized from the foundations of pedagogy and facilitates the learning process. The Pedagogical Children’s Center is focused on serving the population of the preschool stage and is located in the La Paris neighborhood, in Curridabat. This project aims to serve as a demonstrative model of the concepts studied and the guidelines generated from the study developed; therefore, these bases can be used for future educational and children’s projects.Esta investigación se enfoca en el sector de preescolar, el cual requiere de espacios característicos para los niños y niñas, ya que es una etapa muy activa y cambiante. Sin embargo, por lo general, el ámbito arquitectónico y el educativo no se han visto articulados adecuadamente, debido al enfoque funcionalista que se le ha dado a los centros de enseñanza, sin considerar la calidad espacial que se pueda experimentar en estos. Por esta razón, se propone un proyecto arquitectónico que esté conceptualizado desde los fundamentos de la pedagogía y facilite el proceso de aprendizaje. El Centro Infantil Pedagógico está enfocado en atender a la población de la etapa preescolar y se sitúa en el barrio La París, ubicado en Curridabat. Esta propuesta pretende servir como un modelo demostrativo de los conceptos que se estudian y los lineamientos que se generan a partir del estudio desarrollado; por lo tanto, se pueden utilizar estas bases para proyectos educativos e infantiles futuros.Instituto Tecnológico de Costa Rica. Escuela de Arquitectura y Urbanismo

Influenza vaccination hesitancy in large urban centers in South America : qualitative analysis of confidence, complacency and convenience across risk groups

Influenza vaccination coverage in countries of Latin America is low among priority risk groups, ranging from 5 to 75% among older people. This paper aims to describe and analyze the determinants of influenza vaccination hesitancy through the lens of the 3C model of confidence, complacency and convenience among middle-class, urban risk group populations in Brazil, Chile, Paraguay, Peru, Uruguay, countries in South America with contrasting vaccination coverage. Focus groups were conducted among four risk groups: pregnant women, mothers of children aged =60 years in samples of urban residents. Adults with risk factors expressed the most detailed perceptions about confidence in the vaccine. A wide range of perceptions regarding complacency were expressed across risk groups and countries, with pregnant women and mothers showing greater concerns while convenience had a narrower and generally more positive range of perceptions. Participants from Chile and Paraguay expressed the most contrasts regarding confidence and complacency. Information and communication strategies need to be tailored for risk groups while confidence and complacency should be addressed in synergy

Barreiras e facilitadores da vacinação contra influenza observados por funcionários dos programas nacionais de imunização em países Sul-Americanos com diferentes níveis de cobertura

Influenza is a severe, vaccine-preventable disease. Vaccination programs across Latin American countries show contrasting coverage rates, from 29% in Paraguay to 89% in Brazil. This study explores how national influenza vaccination programs in the chosen South American countries address vaccine confidence and convenience, as well as complacency toward the disease. Barriers and facilitators to influenza vaccination programs in their relation to vaccine hesitancy were observed by documentary analysis and interviews with 38 national immunization program officers in high- (Brazil and Chile) and lowperforming (Paraguay, Peru, and Uruguay) countries. Influenza vaccination policies, financing, purchasing, coordination, and accessibility are considered good or acceptable. National communication strategies focus on vaccine availability during campaigns. In Chile, Paraguay, and Uruguay, anti-vaccine propaganda was mentioned as a problem. Programming and implementation face human resource shortages across most countries. Statistical information, health information systems, and nominal risk-group records are available, with limitations in Peru and Paraguay. Health promotion, supervision, monitoring, and evaluation are perceived as opportunities to address confidence and complacency. Influenza vaccination programs identify and act on most barriers and facilitators affecting influenza vaccine hesitancy via supply-side strategies which mostly address vaccine convenience. Confidence and complacency are insufficiently addressed, except for Uruguay. Programs have the opportunity to develop integral supply and demand-side approaches.La gripe es una enfermedad grave, prevenible mediante vacunas con sus correspondientes programas en países latinoamericanos, informando sobre tasas contrastadas de cobertura, desde el 29% en Paraguay al 89% en Brasil. Este artículo investiga cómo los programas nacionales contra la gripe en países seleccionados de Suramérica abordan la confianza en la vacuna y su conveniencia, así como también la complacencia hacia la enfermedad. Las barreras y facilitadores del programa de vacunación de la gripe, en su relación con la vacilación hacia la vacuna, se observaron mediante análisis documental y entrevistas a 38 a cargo de los programas nacionales de inmunización en países con alto (Brasil y Chile) y bajo desempeño (Paraguay, Perú y Uruguay). Políticas de vacunación contra la gripe, financiamiento, compras coordinación y accesibilidad fueron consideradas como buenas o aceptables. Las estrategias nacionales de comunicación se centran en la disponibilidad de la vacuna durante las campañas. En Chile, Paraguay y Uruguay la propaganda antivacunas fue mencionada como un problema. La planificación e implementación enfrentan escasez de recursos humanos en la mayoría de países a través de la mayoría de países. Los sistemas de información en salud, estadísticas y registros nominales por grupos de riesgo se encuentran disponibles con limitaciones en Perú y Paraguay. La promoción de la salud, supervisión, monitoreo y evaluación son percibidos como oportunidades para abordar la confianza y complacencia. Los programas de vacunación contra la gripe actúan principalmente sobre las barreras y facilitadores que afectan la vacilación a vacunarse mediante estrategias del lado de la demanda, las cuales en su mayor parte van dirigidas a contrarestar la conveniencia. La confianza y complacencia son insuficientemente abordadas en todos los países, excepto en Uruguay. Los programas tienen la oportunidad de desarrollar estrategias que aborden tanto el lado de la oferta como de la demanda.A influenza é uma doença grave, imunoprevenível, para a qual os programas de vacinação nos países latino-americanos apresentam taxas de cobertura contrastantes, desde 29% no Paraguai até 89% no Brasil. O artigo explora de que maneira os programas nacionais de influenza em países selecionados da América do Sul lidam com a confiança e a conveniência da vacina, assim como, a acomodação em relação à doença. As barreiras e facilitadores dos programas de vacinação contra influenza foram observados em relação à hesitação vacinal, através de análise documental e entrevistas com 38 autoridades de programas nacionais de imunização em países com desempenho alto (Brasil e Chile) e baixo (Paraguai, Peru e Uruguai). As políticas de vacinação contra influenza, financiamento da compra de vacinas, coordenação e acessibilidade são consideradas boas ou aceitáveis. As estratégias nacionais de comunicação estão concentradas na disponibilidade durante campanhas. No Chile, Paraguai e Uruguay, a propaganda antivacina foi mencionada enquanto problema. A programação e a implementação enfrentam escassez de recursos humanos na maioria dos países. Dados estatísticos, sistemas de informação em saúde e registros nominais de grupos de risco estão disponíveis, com limitações no Peru e no Paraguai. A promoção da saúde, supervisão, monitoramento e avaliação foram percebidas como oportunidades para tratar da confiança e da acomodação. Os programas de vacinação contra influenza identificam e agem sobre a maioria das barreiras e facilitadores que afetam a hesitação vacinal através de estratégias do lado da oferta, tratando principalmente da conveniência da vacina. A confiança e a acomodação não são tratadas de maneira suficiente, com exceção notável do Uruguai. Os programas têm a oportunidade de desenvolver abordagens que integram os lados da oferta e da procura

Influenza vaccination hesitancy in five countries of South America : confidence, complacency and convenience as determinants of immunization rates

Introduction: Influenza morbidity and mortality are significant in the countries of South America, yet influenza vaccination is as low as 56.7% among pregnant women, reaching 76.7% of adults with chronic diseases. This article measures the relative values for the vaccination hesitancy indicators of confidence, complacency and convenience by risk-groups in urban areas of five countries of South America with contrasting vaccination rates, analyzing their association with sociodemographic variables and self-reported immunization status. Methods: An exit survey was applied to 640 individuals per country in Brazil, Chile, Paraguay, Peru and Uruguay, distributed equally across risk groups of older adults, adults with risk factors, children <=6 and pregnant women. Indicators were constructed for vaccine confidence, complacency and convenience. Analysis of variance and multiple logistic analysis was undertaken. Results: Adults with risk factors are somewhat more confident of the influenza vaccine yet also more complacent. Convenience is higher for mothers of minors. Children and older adults report higher levels of vaccination. The 3Cs are more different across countries than across risk groups, with values for Chile higher for confidence and those for Uruguay the lowest. Complacency is lower in Brazil and higher in Uruguay. Results suggest that confidence and complacency affect vaccination rates across risk groups and countries. Conclusions: Influenza vaccine confidence, complacency and convenience have to be bolstered to improve effective coverage across all risk groups in the urban areas of the countries studied. The role played by country contextual and national vaccination programs has to be further researched in relation to effective coverage of influenza vaccine

Revista de Ciencias Sociales (Vol. 22 no. 25 jul 2009)

Juventud como objeto, jóvenes como sujetos. Presentación/ Verónica Filardo Notas sobre a invençâo social de um singular sujeito de dereitos. Juventude, juventudes/ Regina Novaes La construcción social de las juventudes/ Carlos Basilio Muñoz De los herederos a los desheredados. Juventud, capital escolar y trayectorias de vida/ Oscar Dávila León, Felipe Ghiardo Soto Las marcas de clase de la inseguridad ciudadana. Juventud y pobreza/ Gabriel Chouhy, Sebastián Aguiar, Laura Noboa Adiós juventud: tendencias en las transiciones a la vida adulta en Uruguay/ Santiago Cardozo, Alejandra Iervolino Reflexiones sobre equidad entre clases de edad/ Verónica Filardo De jóvenes ni, ni que habitan Casavalle. Representaciones sociales desde espacios de exclusión/ Fabiana Espíndola Fragmentación socioeconómica y segregación urbana en Montevideo/ Danilo Veiga, Ana Laura Rivoir Diagnóstico y repertorio de políticas para el rediseño institucional de la enseñanza media en Uruguay/ Nicolás Bentancur, Tabaré Fernández Reseñas de libros El Uruguay del siglo XX. La sociedad/ Sylvia González La movilidad social en el Uruguay contemporáneo/ Enrique Mazzei La implementación de normas de calidad en la industria uruguaya. Entre la innovación y el ritualismo/ Graciela Lescano Las bases invisibles del bienestar social. El trabajo no remunerado en Uruguay/ Alejandra Iervolino Las batallas por la subjetividad: luchas sociales y construcción de derechos en Uruguay/ Pedro Robert

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks