RESUMO

OBJECTIVE: This study aimed to verify the association between socio-economic and demographic characteristics and dietary patterns (DP) of children assisted by the Conditional Cash Transfer Program, Bolsa Família Program (BFP). DESIGN: This is a cross-sectional study. DP were defined using a principal component analysis. The association of the predictive variables and DP was modelled using multilevel linear regression analysis. SETTING: This study was conducted in six municipalities from the State of Alagoas, Brazil. PARTICIPANTS: The participants were children aged 6-24 months who were assisted by the BFP. RESULTS: A total of 1604 children were evaluated. Four DP were identified (DP1, DP2, DP3 and DP4). DP1 is composed of traditional Brazilian food. DP2 is formed mostly from ultra-processed foods (UPF). DP3 consists of milk (non-breast) with added sugar, while DP4 consists of fresh and minimally processed foods. Caregivers with higher age and education (ß = -0·008; (95 % CI -0·017, -0·000); ß = -0·037; (95 % CI -0·056, -0·018), respectively) were negatively associated with DP2. We observed a negative association between households with food insecurity (ß = -0·204; (95 % CI -0·331, -0·078)) and DP4 and a positive association between caregivers with higher age and education (ß = 0·011; (95 % CI (0·003; 0·019); ß = 0·043; (95 % CI 0·025, 0·061), respectively) and DP4. CONCLUSION: This study identified the association between socio-economic inequities and DP early in life, with an early introduction of UPF, in children assisted by BFP in the State of Alagoas.

RESUMO

OBJECTIVE: To evaluate the association between the consumption of ultra-processed foods (UPF) and the practice of breast-feeding in children under 2 years of age assisted by the conditional cash transfer programme, Bolsa Família Programme (PBF). DESIGN: A cross-sectional study. The consumption of UPF and the practice of breast-feeding were assessed using a structured 24-h recall. Associations were calculated using hierarchical Poisson regression, adjusted at the last level by socio-economic, demographic and environmental variables from previous hierarchical levels. SETTING: Six counties from the state of Alagoas, Brazil. PARTICIPANTS: Children aged 6-24 months, assisted by PBF. RESULTS: A total of 1604 children were evaluated, 11·7% of whom were overweight, and most had consumed UPF (90·6%) in the last 24 h. The most consumed UPF were biscuits, chocolate milk and baby food with 74·8, 66·8 and 24·9%, respectively. Through multivariable analysis, an association was found between lower consumption of UPF in the continuation of breast-feeding until the second year of life (prevalence ratio (PR) 0·91, 95 % CI 0·86, 0·96) and in the first year of life (PR 0·93, 95 % CI 0·88, 0·99). CONCLUSIONS: It was found that the studied population had a high consumption of UPF, which harmed continued breast-feeding. We highlight the importance of strengthening public policies aimed at the promotion, protection and support of breast-feeding and healthy complementary feeding aimed at populations that have difficulties in physical and economic access to a healthy and adequate diet.

Assuntos

RESUMO

OBJECTIVE: To evaluate the association between Fe deficiency anaemia (IDA) and complementary feeding in children under 2 years old assisted by the Conditional Cash Transfer programme, Bolsa Família (BFP). DESIGN: Cross-sectional study. Data were obtained through a standardised form, questionnaire to assess the eating habits of children under 2 years of age, capillary Hb (HemoCue®) and the Brazilian Household Food Insecurity Measurement Scale. Associations were calculated using hierarchical Poisson regression, adjusted at the last level by socio-economic, demographic and environmental variables from previous hierarchical levels. SETTING: Six municipalities from the State of Alagoas, Brazil. PARTICIPANTS: Children aged 6-24 months assisted by BFP. RESULTS: A total of 1604 children were evaluated, among whom 58·1 % had anaemia. A higher number of food groups consumed (prevalence ratio (PR) = 0·97; 95 % CI 0·95, 0·99; P = 0·009), the consumption of dairy (PR = 0·86; 95 % CI 0·79, 0·84; P = 0·001) and meat (PR = 0·90; 95 % CI 0·83, 0·99; P = 0·030) in addition to bottle feeding (PR = 0·88; 95 % CI 0·82, 0·96; P = 0·004) were associated with a lower prevalence of IDA. CONCLUSIONS: IDA is still a serious public health problem in children under 2 years old assisted by BFP in Alagoas. We highlight the importance of promoting complementary feeding based on a diversified dietary intake, as well strengthening prophylactic supplementation programmes to increase children's adherence in conjunction with the implementation of food and nutrition education to help reduce the prevalence of this condition.

Assuntos

RESUMO

O consumo de substâncias psicoativas por pessoas com idades entre 15 e 64 anos atingiu o número de 271 milhões no mundo, e a fragilidade da Rede de Atenção Psicossocial faz com que essas pessoas careçam de acompanhamento e cuidado. Objetivo: Descrever o perfil dos atendimentos prestados a crianças e adolescentes com transtornos mentais e comportamentais por uso de substâncias psicoativas (SPA) realizados pelos Centros de Atenção Psicossocial (CAPS) da I Macrorregião de Saúde de Pernambuco, no período de 2014 à 2018. Materiais e Métodos: Estudo descritivo, quantitativo, com dados secundários. Resultados e discussão: Foram observados 1.761 atendimentos, 73,88% do sexo masculino, na faixa etária entre 14 e 18 anos; As principais causas de atendimento foram o uso de múltiplas substâncias psicoativas (62,01%), seguida por uso de canabinoides (25,56%) e uso de álcool (9,48%). Os CAPS Álcool e outras Drogas foram responsáveis por 67,18% dos atendimentos, seguido pelo CAPSi com 16,52%. Apesar dos atendimentos terem sido prestados dentro do território de residência do paciente, observou-se uma centralização nos atendimentos nos CAPSad, de forma que reitera-se a necessidade de qualificar a atenção prestada nos demais tipos de CAPS, propiciando o fortalecimento dos serviços nos municípios de pequeno porte populacional.(AU)

The consumption of psychoactive substances by people between the ages of 15 and 64 reached 271 million in the world, and the fragility of the Psychosocial Care Network makes these people need monitoring and care. Objective: To describe the profile of care provided to children and adolescents with mental and behavioral disorders due to the use of psychoactive substances (SPA) carried out by the Psychosocial Care Centers (CAPS) of the I Macroregion of Pernambuco, from 2014 to 2018. Materials and Methods: Descriptive and quantitative study, with secondary data. Results and discussion: 1,761 visits were observed, 73.88% male, aged between 14 and 18 years; The main causes of care were the use of multiple psychoactive substances (62.01%), followed by the use of cannabinoids (25.56%) and use of 3 alcohol (9.48%). CAPS Alcohol and other Drugs were responsible for 67.18% of the visits, followed by CAPSi with 16.52%. Although the services were provided within the patient's home territory, there was a centralization of care in the CAPSad, so the need to qualify the care provided in other types of CAPS is reiterated, enabling the strengthening of services in the municipalities with a small population. (AU)

Assuntos

RESUMO

RESUMO O ensino da acupuntura vem sendo progressivamente introduzido em cursos médicos no Brasil e no mundo. Na Universidade Federal Fluminense (UFF), em Niterói (RJ), a reforma curricular da Faculdade de Medicina, implementada em 1994, possibilitou a oferta da disciplina optativa Medicina Tradicional Chinesa/Acupuntura a partir de 1995, além da criação, em 1997, de um curso de especialização em acupuntura destinado ao público médico. Este artigo apresenta um estudo que buscou identificar os principais desafios e perspectivas relacionados a esse ensino na graduação e pós-graduação médicas da UFF, resgatando o debate sobre a polarização paradigmática entre a acupuntura da MTC e a acupuntura neurofisiológica. Foi realizada uma pesquisa qualitativa de caráter etnográfico com análise documental, observação dos cenários de sala de aula e entrevistas semiestruturadas com o professor e alunos da disciplina e curso selecionados. De forma complementar, para garantir a triangulação de informações, utilizou-se a técnica do grupo focal com ex-alunos da graduação médica. O tratamento e a interpretação dos dados deste estudo se ancoraram na discussão epistemológica de Thomas Kuhn - o conceito de paradigmas e a questão da incomensurabilidade de ideias. Os resultados desta pesquisa mostraram que, apesar das diferenças paradigmáticas significativas, há interesse e receptividade de estudantes de Medicina e médicos na abordagem integrativa do processo saúde-doença oferecida pela medicina tradicional chinesa/acupuntura. Entre os aspectos positivos levantados, destacam-se a valorização da abordagem de dimensões do adoecimento humano negligenciadas pela biomedicina, o favorecimento da construção de um olhar integral sobre o sujeito e os bons resultados obtidos nos tratamentos com acupuntura. Os principais desafios apontados foram a necessidade de promover maior integração teórico-prática nas aulas, sugerida pelos alunos da graduação, e a crítica ao reducionismo no ensino da MTC/acupuntura, com simplificação exagerada de conteúdos complexos, feita pelos alunos da pós-graduação. Duas conclusões se destacaram neste estudo. Constatou-se um duplo padrão de aprendizado: abertura dos estudantes de graduação e pós-graduação médicas para o paradigma da medicina chinesa devido às suas especificidades e múltiplas abordagens terapêuticas, ao mesmo tempo em que se buscavam aproximações com o modelo biomédico. A complementaridade entre o paradigma da medicina chinesa e o das neurociências foi a principal característica do processo de incorporação da acupuntura ao ensino médico da UFF.

ABSTRACT The teaching of acupuncture has gradually been introduced into medical courses in Brazil and worldwide. At Universidade Federal Fluminense (UFF), in Niterói, Rio de Janeiro, the newly reformulated medical course curriculum, introduced in 1994, included the offer of an optative discipline in Traditional Chinese Medicine/Acupuncture to start the following year, and also the creation, in 1997, of a specialization course in Acupuncture for qualified medical doctors. In this article, we present a study that aims to identify major challenges and perspectives in Chinese Medicine teaching for undergraduate and graduate students at the UFF medical school, emphasizing the paradigmatic polarization between Traditional Chinese Medicine (TCM) and Neurophysiological Acupuncture. We performed a qualitative, ethnographic study involving document analysis, observation of classroom scenarios, and semi-structured interviews with the teacher and students of the selected discipline and course. In order to ensure triangulation of information, we also used the focus group technique, with former undergraduate students. The data treatment and interpretation of this study were anchored in the epistemological discussion of Thomas Kuhn - the concept of paradigms and the incommensurability of scientific theories. The results of this study show that despite the significant paradigmatic differences, medical students and doctors demonstrate interest in and receptivity towards the integrative approach of health-disease processes offered by traditional TCM. The following positive aspects were highlighted: the valorization of dimensions of human sickness hitherto neglected by biomedicine, the building of an integral perspective on the subject, and the good results obtained with acupuncture. The graduate students noted the need to increase integration between theory and practice, and criticized the reductionism in TCM teaching, with the excessive simplification of complex subjects. Two conclusions can be drawn from this study. A double learning pattern was observed: the interest among undergraduate and graduate students in Traditional Chinese Medicine paradigm, due to its specificities and multiple therapeutic approaches and, at the same time, a search for comparisons with the biomedical model. The complementarity between the paradigms of Traditional Chinese Medicine and neurosciences was the most important characteristic of the introduction of teaching on acupuncture at UFF.

RESUMO

INTRODUÇÃO: Atualmente as altas taxas de morbidade e mortalidade em ambientes hospitalares estão relacionadas às infecções da corrente sanguínea o que tem causado grande preocupação, sendo assim, a hemocultura é considerada de grande importância em suspeitas clínicas de bacteremia, e a sinalização de positividade rápida é essencial. OBJETIVO: Identificar os microrganismos isolados no Hospital das Clínicas da Faculdade de Medicina Unidade de Emergência de Ribeirão Preto - SP, no período de janeiro de 2009 á dezembro de 2013 utilizando o Tempo de Positividade entre 0 a 10:30h e acima de 120 horas para discriminar os patógenos. Obtivemos um total de 9.105 hemoculturas positivas, nos quais 1.607 hemoculturas foram estudadas. RESULTADOS: Dentre as 320 amostras positivas de microrganismos, não houve diferença significativa na porcentagem de isolamento nos anos estudados entre Klebsiella pneumoniae , Pseudomonas aeruginosa, Acinetobacter baumannii, no entanto observou-se uma queda em Staphylococcus aureus. Klebsiella pneumoniae positivou na 1ª hora de incubação nos 4 anos estudados. Streptococcus pneumoniae apresentou positividade a partir da 3ª hora de incubação e Neisseria meningitis a partir da 4ª hora. CONCLUSÃO: Dentre os microrganismos isolados, os bacilos Gram negativos apresentaram maior rapidez no índice de positividade dentre os demais, no entanto, nem todos os hospitais apresentam os equipamentos automatizados em suas rotinas, podendo acarretar um atraso na identificação dos microrganismos e posteriormente no tratamento do paciente.

Assuntos

RESUMO

RATIONALE: Although 5-HT2 receptors seem to play an important role in anxiety, results from numerous studies are still highly variable. Moreover, little is known about the behavioral effects of centrally administered 5-HT2 compounds in animal models of anxiety. OBJECTIVE: The current study was performed to: (1) further investigate the effects of 5-HT2 receptor activation in rats exposed to the elevated plus-maze (EPM) and the open-field arena, two widely used animal models for studying anxiety and locomotor activity; and (2) evaluate the involvement of the 5-HT2 receptors within the basolateral nucleus of the amygdala (BLA) in the modulation of such effects. METHODS: In the first experiment, male Wistar rats were exposed for 5 min to the EPM 27 min following intraperitoneal (i.p.) (1.0 ml/kg) injections of the preferential 5-HT2C receptor agonist 6-chloro-2[1-piperazinyl]pyrazine (MK-212) at doses of 1.0, 2.0, or 4.0 mg/kg. Control animals were injected with saline. The percentage of open-arm entries and the percentage of time spent in these arms were employed as anxiety indexes, whereas the number of closed-arm entries was calculated as indicative of locomotor activity. In the second experiment, rats were exposed for 10 min in an open-field arena to further assess the interference of the same MK-212 doses upon locomotor activity. In Experiment 3, rats were microinjected (0.2 microl) either with the mixed 5-HT 2A/2C receptor antagonist ritanserin (0.5, 1.25, 2.5, and 5.0 microg) or its vehicle into the BLA 12 min following i.p. injections of saline or the intermediate dose of MK-212 (2.0 mg/kg). Fifteen minutes later, each animal was exposed to the EPM as before. RESULTS: Whereas the highest dose of MK-212 (4.0 mg/kg) induced motor-suppressant effects in both EPM and open-field arena, the intermediate dose of the drug (2.0 mg/kg) reduced open-arm exploration without significantly affecting the number of closed-arm entries. This behavioral profile, consistent with selective anxiogenic effect in the EPM, was dose-dependently prevented by ritanserin microinfusion into the BLA. In saline-pretreated animals, however, ritanserin (all doses) was ineffective. CONCLUSIONS: MK-212 increases anxiety and decreases locomotor activity. The anxiogenic-like profile of 5-HT2 receptor activation is prevented by the blockade of 5-HT2 receptors within the BLA, which does not have an effect by itself upon basal anxiety levels triggered by the EPM.

Assuntos