Portfólio coletivo reflexivo: ferramenta potencializadora do trabalho em equipe, raciocínio crítico e tomada de decisões Portafolio colectivo reflexivo: herramienta motivadora del trabajo en equipo, pensamiento crítico y toma de decisiones Collective re

Objetivo: analisar a experiência de construção de portfólios coletivos reflexivos como ferramenta de ensino, aprendizagem e avaliação, potencializadora do trabalho em equipe, raciocínio crítico e tomada de decisões, no ensino das Políticas de Saúde. Métodos: pesquisa qualitativa utilizando a análise documental de portfólios coletivos (119) e grupos focais (48) construídos na disciplina de Políticas de Saúde. Participou do estudo um total de 1.043 estudantes universitários dos cursos de saúde nos anos de 2008 a 2015 (16 semestres letivos). Resultados: os portfólios estimularam a autonomia, responsabilidade e empoderamento dos estudantes na construção de seus projetos de vida pessoal, social e profissional, com ênfase no trabalho em equipe interdisciplinar, a partir da superação das adversidades com criatividade, crítica e reflexão. Os estudantes desenvolveram, gradativamente, os pensamentos cognitivos e metacognitivos, buscando novas fontes de reflexão, assumindo atitudes mais responsáveis, comprometidas e questionadoras, próprias da juventude

Efect of vitamin A suplementation: a systematic review

To evaluate the effect of vitamin A supplementation in postpartum infants and women on serum retinol levels and breast milk. The databases Medline, PubMed, Lilacs and SciELO were consulted. The descriptors used were vitamin A, dietary supplement, child, postpartum period, infant and nutrition programs policies. Search found 7432 articles. After elimination of duplicity and application of eligibility criteria, 8 studies remained. All evaluated the effect of vitamin A supplementation on immediate postpartum, five studies used retinyl palmitate supplementation, one with retinyl palmitate and two did not specify the form of supplementation. Six studies evaluated colostrum and two included supplementation of children. It was found that supplementation in the puerperium increases the concentrations of serum retinol and breast milk, however, this result was in the short term and was relevant when the previous concentrations of the mother were low. When maternal serum concentrations are adequate, the retinol content in milk does not change, with little relevance for children. Further studies should be performed to evaluate the effect of megadoses supplementation on serum concentrations of children.Avaliar o efeito da suplementação de vitamina A, em lactentes e mulheres no pós-parto, nos níveis de retinol sérico e no leite materno. Foram consultadas as bases de dados Medline, PubMed, Lilacs e SciELO. Os descritores utilizados foram: vitamin A, dietary supplement, child, postpartum period, infant e nutrition programs policies. A busca identificou 7432 artigos. Após eliminação da duplicidade e aplicação dos critérios de elegibilidade permaneceram 8 estudos. Todos avaliaram o efeito da suplementação de vitamina A no pós parto imediato, cinco estudos utilizaram a suplementação com retinil palmitato, um com palmitato de retinila e dois não especificaram a forma de suplementação. Seis estudos avaliaram o colostro e dois incluíram a suplementação de crianças. Encontrou-se que a suplementação no puerpério aumenta as concentrações de retinol sérico e do leite materno, no entanto, este resultado foi a curto prazo e foi relevante quando as concentrações prévias da mãe eram baixas. Quando as concentrações séricas maternas encontram-se adequadas, pouco se altera o teor de retinol no leite, tendo pouco relevância para as crianças. Mais estudos devem ser realizados para avaliar o efeito da suplementação com megadoses nas concentrações séricas de crianças

Adherence to non-pharmacological treatment for hypertension: impact of two educational strategies on health and nutrition / Adesão ao tratamento não medicamentoso da hipertensão arterial: impacto de duas estratégias de educação em saúde e nutrição

Objective: To compare the effect of two strategies of education in health and nutrition about adherence to non-pharmacological treatment of hypertension. Methods: a longitudinal intervention study, comparative test type community. The sample was composed of 84 individuals with hypertension, divided into two groups (group 1: educational workshops; Group 2: educational workshops and visits), accompanied by 5 consecutive months in 2016 in Viçosa, Brazil. Were evaluated anthropometric, biochemical, clinical and dietary requirements. For the analyzes were performed the Kolmogorov-Smirnov test, the Chi-square test, Wilcoxon test, paired t-test, Mann Whitney test. Results: group 2 presented more satisfactory results when compared to group 1. To analyze the results before and after the activities carried out independent of the types of intervention, of the 17 variables analyzed, 12 were statistically significant. Conclusion: The educational workshops and visits were essential for the improvement of the quality of life of patients with arterial hypertension. However, it reinforces that visits is a privileged locus for the practice of nutritional counseling, because it contributed to the change of behavior patterns and increase the quality of life of patients with arterial hypertension. 

Saúde da família: desafios no processo de reorientação do modelo assistencial

O Programa Saúde da Família (PSF) constitui-se em uma estratégia de reformulação do modelo assistencial de saúde no Brasil. Este estudo tem como objetivo refletir sobre os desafios desta estratégia quanto às práticas de saúde no contexto da atenção primária. Foi realizado um estudo bibliográfico, 90 artigos foram selecionados, sendo 50 considerados de maior interesse. Após quatorze anos de existência, surgem questionamentos quanto ao papel do PSF, suas estruturas continuam permeáveis ao modelo hegemônico que corrompe o processo de trabalho cotidiano. Mudanças nas práticas de saúde, especialmente, no que tange a produção de cuidados, são necessárias e este processo de reconstrução implica muito labor. No entanto, possibilita a construção de práticas de saúde mais solidárias, acolhedoras e conseqüentemente mais resolutivas.The Family Health Program (PSF) constitutes a strategy for reformulating the health assistance model in Brazil. This study was carried out to ponder over the challenges of this strategy concerning to health practices in the primary care context. After existing for more than twelve years, there appear questionings related to the paper of PSF in the reformulation of the way to think and promote health, and their structures remain permeable to the traditional hegemonic model that corrupts the daily work process. Some changes and reconstruction are necessary in the health practices concerning to care production based on light, relational and integrate technologies that are centered on users’ needs. Although the deconstruction/reconstruction process implicates much labor, the advantage in overcoming the challenges faced by PSF rather leads to the transformation of reality and to construction of health practices that are solidary, welcoming, and resolvent

Análise do programa nacional de alimentação escolar no município de Viçosa, MG, Brasil

OBJECTIVE: To analyze the implementation of the Brazilian National School Feeding Program as a food and nutritional security policy in public schools. METHODS: This a cross-sectional study, with a quantitative and qualitative approach, carried out with 268 schoolchildren aged eight to nine years from the public school system of Viçosa, state of Minas Gerais, Brazil, in 2015. Interviews were carried out using semi-structured questionnaires with the children, parents, cooks, nutritionists, trainer of the Technical Assistance and Rural Extension Company, and president of the School Feeding Council. In order to analyze the implementation of the National School Feeding Program in Viçosa, we evaluated the direct weighing of the food served in the schools using mechanical balances with a capacity of up to 10 kg and the perception of the social players involved in the implementation of the National School Feeding Program. The children were questioned about the acceptance of and adherence to the food offered, in addition to the habit of bringing food from home. Parents reported knowledge about the School Feeding Program and Council. The qualitative analysis consisted of content analysis and quantitative analysis using the chi-square test, Fisher’s exact test, and Mann-Whitney test. We adopted the statistical significance of 5% for quantitative analysis. RESULTS: Children reported low adherence to the school feeding program and most of them used to bring food from home. Irregularities were identified in the implementation of the National School Feeding Program, such as: inadequate number of nutritionists, suspension of Council meetings, inadequate infrastructure in the areas of preparation and distribution of meals, lack of training of cooks, lack of nutritional adequacy of the food offered, and lack of actions on food and nutritional education. The Program complied with the recommendations for purchasing food from family farms. CONCLUSIONS: The National School Feeding Program presented many irregularities in Viçosa. It is important to monitor the problems identified for better reformulation and planning of the Program, in order to guarantee the food and nutritional security of the children served.OBJETIVO: Analisar a execução do Programa Nacional de Alimentação Escolar como política de segurança alimentar e nutricional em escolas públicas. MÉTODOS: Estudo transversal, com abordagem quantitativa e qualitativa, realizado com 268 escolares de oito a nove anos da rede pública de ensino em Viçosa, MG, em 2015. Foram realizadas entrevistas por meio de questionários semiestruturados com as crianças, os pais, merendeiras, nutricionistas, extensionista da Empresa de Assistência Técnica e Extensão Rural e presidente do Conselho de Alimentação Escolar. Para analisar a execução do Programa Nacional de Alimentação Escolar em Viçosa, foi avaliada a pesagem direta dos alimentos servidos nas escolas, utilizandose balanças mecânicas com capacidade de até 10 kg, e a percepção dos atores sociais envolvidos na execução do Programa Nacional de Alimentação Escolar. As crianças foram questionadas sobre a aceitação e adesão da alimentação ofertada, além do hábito de levar lanches de casa. Os pais relataram o conhecimento sobre o Programa e o Conselho de Alimentação Escolar. A análise qualitativa foi constituída pela análise de conteúdo e a quantitativa pelo Teste do Quiquadrado, Exato de Fisher e Mann-Whitney. Adotou-se significância estatística de 5% para a análise quantitativa. RESULTADOS: As crianças relataram baixa adesão à alimentação escolar e a maior parte costumava levar lanche de casa. Foram identificadas irregularidades na execução do Programa Nacional de Alimentação Escolar, como: inadequação do número de nutricionistas, suspensão das reuniões do Conselho, inadequação da infraestrutura nas áreas de preparo e de distribuição das refeições, falta de capacitação das merendeiras, não adequação nutricional da alimentação ofertada e ausência de ações de educação alimentar e nutricional. O Programa atendeu as recomendações de compra dos alimentos provenientes da agricultura familiar. CONCLUSÕES: O Programa Nacional de Alimentação Escolar apresentou muitas irregularidades em Viçosa. É importante o monitoramento dos problemas identificados para melhor reformulação e planejamento do Programa, visando à garantia da segurança alimentar e nutricional das crianças atendidas

Cognitive competence: comparing learning between traditional classroom and active classroom

INTRODUCTION: The new student profile has required new formats of teaching and learning, with interconnected knowledge based on a pedagogical practice founded on reflection OBJECTIVE: The aim of this study was to analyze how students evaluate what they learned using the of the Concept Map associated with the Inverted Classroom in the teaching, learning and assessment process compared to the Traditional Classroom. METHODS AND MATERIALS: A cross-sectional study carried out with 90 students at a public university in Brazil in the years of 2016 to 2018. For data collection the authors used a high reliability tool based on the Likert scale of 4 points containing questions regarding the competences to be developed by the students. The Kolmogorov-Smirnov normality test was performed and the Wilcoxon test was used to identify the differences between the two methods. The level of significance was 5%. RESULTS: The mean attributed to each of the two investigated methods was significantly higher (p <0.001) in the Concept Map with Flipped Classroom (3.38) than in the Traditional Classroom (2.75). CONCLUSIONS: While the Concept Map favors the process of meaningful learning with comprehension, integration and assimilation of content in an autonomous and co-responsible form by the students, the Traditional Classroom is based on the passive memorization of the content given by the teachers. Because of this, it is suggested that, the Concept Map with a Flipped Classroom according to the perception of the students was more effective when compared to the Traditional Classroom, by providing the assimilation, interpretation and integration of the contents

Prevalence of Diabetes Mellitus among individuals with chronic kidney disease: systematic review and meta-analysis

BACKGROUND: Diabetes Mellitus (DM) is currently considered a global epidemic, with alarming estimates for the coming years on all continents, with Chronic Kidney Disease (CKD) as one of its main consequences when a timely diagnosis is not made. OBJECTIVE: The objective of this study is to estimate the prevalence of DM among individuals diagnosed with CKD by means of a systematic review and meta-analysis. METHODS: A systematic review was carried out in the main free-access databases such as Pubmed (Medlaine), Lilacs, Scopus and Scielo. Two researchers selected the articles, extracted the data and evaluated the quality. The collected data were evaluated using a random effects model. RESULTS: Of 994 articles, 17 studies were included that looked at three continents. The group prevalence of DM among individuals with CKD (95% CI) was 29% (23-35%), with heterogeneity I2 = 99,86% and p = 0.00, which was not explained by meta-regression and subgroups. CONCLUSIONS: The present study confirmed the high prevalence of DM among individuals with CKD, especially among those with end-stage renal disease, demonstrating the need for early diagnosis and timely treatment of DM and new studies in this area, considering the social and economic impact of these diseases worldwide