ObjetivoTrata-se de um estudo prospectivo com o objetivo de determinar a incidência, em um hospital universitário, de úlceras de pressão e verificar fatores nutricionais envolvidos em seu desenvolvimento. MétodosForam registrados dados clínicos, sociodemográficos, antropométricos e dietéticos de 50 pacientes, posteriormente analisados com auxílio do programa Epi Info 3.2. ResultadosVerificou-se a predominância de indivíduos do sexo feminino, com média de idade de 66,6, DP=18,0 anos. A incidência das injúrias foi de 28,0%, resultando em uma média de 1,7 feridas por paciente, mais frequentes na região sacral (57,1%) e em calcanhares (35,7%). Encontrou-se significância estatística (p<0,05) para as variáveis: mudança de decúbito, nível de atividade e uso de fralda, assim como para a presença de doenças mentais, neurológicas, anemia, uso de antibióticos, anti-inflamatórios e imunossupressores. Com relação aos fatores nutricionais, foi encontrada associação positiva entre pacientes com úlcera e baixos valores da área muscular do braço, circunferência de panturrilha, pregas cutâneas tricipital e subescapular, hemoglobina, hematócrito e valores elevados de leucócitos. As feridas também estiveram associadas a maiores índices de mortalidade e ao aumento do tempo de internação. ConclusãoObservou-se que um estado nutricional deficiente está estreitamente relacionado com o desenvolvimento de úlceras de pressão. Neste estudo, foram identificados alguns parâmetros nutricionais relacionados com esse evento que poderão ser ferramentas importantes na identificação e no tratamento de pacientes em risco. Termos de indexação:Estado nutricional. Hospitalização. Úlcera de pressão.
Background Obesity is an increasingly prevalent chronic condition. Its multiple causes and the complexity of its treatment pose challenges for health professionals. Objective To explore and describe the challenges for obesity management in the Brazilian Unified Health System according to health professionals. Methods An exploratory quantitative web-based study, carried out in 2018 with health professionals, developed from the first stage of a national project that aims to examine the management of obesity in Brazil. The questionnaire was self-applied. Invitations to participate in the research were sent by the Ministry of Health, Health Department of Minas Gerais and members of the research group. We collected data on sex, age, professional category, region and level of care. The challenges were investigated using a Likert scale and categorized into structure and work process. Results We evaluated 1323 professionals, of which about 45% were dietitians, 90.2% were women, and 83.1% self-reported working in primary health care. The main barriers cited included a high demand for curative and individual assistance, the presence of comorbidities, and the absence or insufficient access to instructional materials, professional qualification and lack of support. Conclusion Obesity management is a critical challenge for all professionals. Barriers were related to the work process and structural aspects and reinforce the need to empower health teams. We propose that permanent education activities should be established, as well as the development of instructional materials that are applicable to routine work. Finally, the results may be used to develop policies and strategies to improve obesity management.
OBJECTIVE: To analyze the quantity and diversity in the consumption fruits and vegetables, as well as its relationship with the consumer’s purchase characteristics and food environment. METHODS: Baseline study stemming from a controlled and randomized community trial investigating a sample representative of Primary Health Care services (Health Academy Program) of Belo Horizonte, state of Minas Gerais. The intake of fruits and vegetables was analyzed in servings/day, whereas diversity was assessed by the Food Frequency Questionnaire. Users were also questioned on the frequency, purchase location and availability of these foods at their households. To assess the consumer’s food environment, commercial establishments within a 1.6 km radius around the program unit sampled were audited. RESULTS: 3,414 adults and older adults (88.1% women) were investigated, as well as 336 commercial establishments, in 18 units of the Health Academy Program. The average consumption of fruits and vegetables was adequate [5.4 (SD = 2.1) servings/day] but monotonous, with average daily intake of two different types. In the establishments audited, a good diversity (77.7% and 85.0%) and variety (74.5% and 81.4%) of fruits and vegetables was observed, although with lower quality of vegetables (60.4%). After adjusting for sociodemographic variables, we identified that knowledge on food crops (p = 0.006), increased monthly availability of fruits at households (p < 0.001), and greater variety of fruits (p = 0.03) and quality of vegetables (p = 0.05) in commercial establishments could improve the quantitative intake of fruits and vegetables, whereas a greater variety of fruits (p = 0.008) would increase consumption diversity. CONCLUSIONS: The intake of fruits and vegetables was quantitatively adequate but monotonous, being influences by the consumer environment. Such results highlight the need for improving educational actions in health services and programs, in addition to acting on the consumer environment, aiming to promote and maintain the adequate and diversified consumption, as recommended by Brazilian guidelines for proper and healthy eating.
Objective: To evaluate the validity and reproducibility markers of food and beverage intake obtained by means of a telephone-based surveillance system. Methods: Reproducibility was assessed by means of repeated interviews with a 7-15 day interval after the first interview of the system (n=258). Validity was analyzed based on three interviews corresponding to the 24 hour recall method, used as gold standard, 3 days a week, 7 to 15 days after the original telephone interview (n=217). In the study of reproducibility, kappa statistics was used to measure the similarity between the results of the proportions obtained in the first and second interviews. For validation, the proportion of positive reports regarding foods and beverages at the original telephone interview was compared to that obtained by the 24 hour recall method, and the results was analyzed by calculating sensitivity, specificity and positive predictive value. Results: In the reproducibility study, the agreement was almost perfect for the marker milk consumption (0.86), substantial for fruit consumption (0.67), intake of fruits and vegetables, intake of meat with fat and alcohol abuse. The agreement was moderate for the intake of soft drink, and fair for the consumption of vegetables. Regarding the validity, there was an underestimation of fruit, vegetable and milk consumption, except for meat and alcohol when compared with the consumption frequency estimated from the three 24-hours recalls, differences related to soft drink consumption was inexpressive. Conclusion: The instruments enabled the surveillance of factors which were potentially associated with chronic diseases, however, it is a priority to continue with validation studies in other populations to provide greater system reliability, always considering possible limiting factors.
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