Socio-environmental Approach Research Articles

A Socio environmental approach on Coastal Federal Patrimony Management in Brazil

This paper aims to systematize data from legal, governmental and non-governmental actions due to Coastal Management and its interface with Federal Commonwealth heritage Territories managed by the Federal Union Patrimony Secretariat of Brazil called SPU. SPU´s mission is to obtain information about public areas, manage federal heritage, ensure and guarantee that each asset and property of the Brazilian population fulfills its social and environmental functions. Some guiding questions led the data organization that facilitates the comprehension of the information related to Coastal Management of public federal domain land and water in Brazil. It also correlates National and international strategic programs, actions and plans regarding these issues, bringing a brief discussion on Marine and Coastal Management.

An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy

Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

The Use of Biosimulation in the Design of a Novel Multilevel Weight Loss Maintenance Program for Overweight Children

Weight loss outcomes achieved through conventional behavior change interventions are prone to deterioration over time. Basic learning laboratory studies in the area of behavioral extinction and renewal and multilevel models of weight control offer clues as to why newly acquired weight loss skills are prone to relapse. According to these models, current clinic-based interventions may not be of sufficient duration or scope to allow for the practice of new skills across the multiple community contexts necessary to promote sustainable weight loss. Although longer, more intensive interventions with greater reach may hold the key to improving weight loss outcomes, it is difficult to test these assumptions in a time efficient and cost-effective manner. A research design tool that has been increasingly utilized in other fields (e.g., pharmaceuticals) is the use of biosimulation analyses. The present study describes our research team's use of computer simulation models to assist in designing a study to test a novel, comprehensive socio-environmental treatment approach to weight loss maintenance in children ages 7-12 years. Weight outcome data from the weight loss, weight maintenance, and follow-up phases of a recently completed randomized controlled trial (RCT) were used to describe the time course of a proposed, extended multilevel treatment program. Simulations were then conducted to project the expected changes in child percent overweight (POW) trajectories in the proposed study. A 12.9% decrease in POW at 30 months was estimated based upon the midway point between models of "best-case" and "worst-case" weight maintenance scenarios. Preliminary data and further analyses, including biosimulation projections, suggest that our socio-environmental approach to weight loss maintenance treatment is promising and warrants evaluation in a large-scale RCT. Biosimulation techniques may have utility in the design of future community-level interventions for the treatment and prevention of childhood overweight.

Mapeamento de tendências na produção acadêmica sobre Educação Ambiental

Este trabalho procurou configurar o cenário das pesquisas apresentadas na área de Educação Ambiental - EA nas reuniões anuais da Associação Nacional de Pós-Graduação e Pesquisa em Educação - Anped, no período de 2003 a 2007, a partir da solicitação do grupo de EA da Anped (GT-22). Buscou-se, com isso, elucidar as tendências temáticas, teóricas e metodológicas na produção acadêmica sobre EA e compreender a diversidade que constitui esse campo de investigação e de ação pedagógica. Foram considerados 66 trabalhos apresentados nas cinco reuniões analisadas. Os resultados foram articulados considerando-se: evolução da temática; linha temporal associada à diversificação temática, teórica e metodológica; localização espacial; e articulação entre as áreas ambiental, de educação e de EA. Observa-se concentração da produção no eixo sul-sudeste do Brasil, predominância da abordagem socioambiental e de uma visão crítica da EA ao longo dos anos e ênfase na educação formal e no método qualitativo.

Estudo com enfermeiros e médicos da atenção básica à saúde: uma abordagem socioambiental

Trata-se de estudo quantitativo sobre o processo organizativo do trabalho na Atenção Básica de Saúde, a partir de uma abordagem socioambiental. Os objetivos foram analisar como enfermeiras e médicos identificam as estratégias para trabalharem a relação entre saúde e ambiente; que problemas ambientais influenciam a saúde das comunidades e como eles atuam com as comunidades frente aos mesmos. Foram realizadas entrevistas estruturadas com 36 enfermeiros e 19 médicos, seguindo-se uma análise quantitativa e contextual. O quesito referente ao conhecimento das situações ambientais que implicam em riscos à saúde recebeu média significativamente maior dos enfermeiros (p=0,000) e dos médicos (p=0,042). A falta de saneamento básico, presença de vetores, manejo inadequado de resíduos sólidos e ruas sem pavimentação foram os problemas ambientais da comunidade que os entrevistados atribuíram as melhores médias (p=0,000). Conclui-se que a estrutura organizativa do trabalho na atenção básica à saúde, ainda não é influenciada significativamente pela relação saúde e ambiente.

Local health policy development processes in the Netherlands: an expanded toolbox for health promotion

Although much research has been done on the existence and formation of risk and issue based health policies, there is only little insight in health policy development processes in a broader context. This hampers intervention in these policy processes to adequately develop integrated and effective health policies. Legislation in the Netherlands requires municipalities to develop and implement local health policies. These policies are supposed to aim at the promotion of health across sectors and with a strong community involvement. Health policy development processes have been studied in four Dutch municipalities. For each case, we identified a range of stakeholders and monitored the change or stability of their characteristics over 3 years. In addition, for each case, three overlaying maps of networks were made addressing communication and collaboration actions within the defined set of stakeholders. We point out a number of barriers which impede integrated policy development at the local level: the importance given to local health policy, the medical approach to health development, the organizational self-interest rather than public health concern, the absence of policy entrepreneurial activity. Furthermore, this article advocates the use of complementary theoretical frameworks and the expansion of the methodological toolbox for health promotion. The value of stakeholder and network analysis in the health promotion domain, at this stage, is two-fold. First, mapping relevant actors, their positions and connections in networks provides us with insight into their capacity to participate and contribute to health policy development. Second, these new tools contribute to a further understanding of policy entrepreneurial roles to be taken up by health promotion professionals and health authorities in favour of the socio-environmental approach to health. Notwithstanding the value of this first step, more research is required into both the practical application as well as in the theoretical connections with, for example, Multiple Streams theory.

A Model to Describe the Role of Health Promotion in Creating Healthy Communities

Health promotion theory and practice is grounded in the belief that health is far more than the absence of disease. In order to influence most effectively the health of communities, Community Health Centres must balance their attention and resources amongst medical, lifestyle/behavioural, and socioenvironmental approaches to health promotion. This discussion will include an overview of these approaches to health promotion based on current literature. Community Health Centres need to incorporate a variety of complementary health promotion approaches into their core services and activities. An analysis of one model, which integrates health promotion and population health, is provided with a discussion of its application in creating healthy communities.

Borderline Clients: Practice Implications of Recent Research

Current research on treatment of borderline clients with medication, individual counseling, and family interventions is reviewed. Recent studies indicate that the borderline personality is a heterogeneous condition in which different underlying disorders (affective, schizotypal, and neurological) may be present. Research on biological treatments has shown that a range of medications may be helpful depending on the biological substrate of the borderline disorder. Research on psychotherapeutic and socioenvironmental approaches indicates that providing a structured, supportive, consistent "holding" environment is helpful for most borderline clients, whereas intensive psychodynamic therapy is effective [corrected] for only a small subset. Behavioral interventions have been effective in reducing parasuicidal (self-destructive) behaviors that are characteristic of the borderline client.

Toward a socio-environmental theory of aging.

Explanatory problems of activity and disengagement theories of aging necessitate a re-examination of their theoretical assumptions about the social behavior of old people together with propositions and hypotheses. As an outcome of intensive interviews with 210 persons, age 60 to 94, in various types of residential settings, a new socio-environmental theory of aging is proposed. The theory is built around the inter-relationship of two conceptual components: (1) environmental effects such as social homogeneity, residential proximity, and local protectiveness; and (2) personal resources influencing behavior flexibility such as health, solvency, and education. Specific attention is given to a socio-environmental approach to criminal victimization in old age, with suggested hypotheses.