A qualidade dos alimentos: análise de algumas categorias da dietética popular Quality of foods: analysis of some folk dietary categories

O artigo aborda os conhecimentos dietéticos tradicionais expressos nas seguintes categorias: "quente/frio"; "forte/fraco" e "reimoso", que definem a qualidade e a propriedade dos alimentos e da comida e os seus efeitos sobre o corpo. Vale-se da literatura antropológica nacional e dos estudos qualitativos produzidos desde 1975 a 2005. Os estudos antigos são mais abundantes do que os atuais e, apesar dessa limitação, o artigo contribui para discutir as diferentes abordagens conceituais usadas pelos autores e demonstra a persistência do saber dietético tradicional, que convive com o saber científico da nutrição, sendo importante não desprezá-lo nas intervenções nutricionais.<br>The article analyses the traditional dietary knowledge expressed in the following categories: "hot/cold"; "strong/ weak" and "reimoso" (watery) which define food quality and properties and its effects on the body. The discussion originates from Brazilian anthropological and qualitative studies published from 1975 to 2005. Old studies are more abundant than current ones and, in spite of this limitation, the article contributes to discuss conceptual approaches utilized by authors and demonstrates that traditional dietary knowledge survives with the scientific knowledge on nutrition. Therefore, it is important not to reject them in nutritional interventions

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)