Características do processo de aquisição de alimentos da agricultura familiar pelo Programa Nacional de Alimentação Escolar: um estudo transversal exploratório do universo de municípios brasileiros

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-graduação em Nutrição, Florianópolis, 2013.O Programa Nacional de Alimentação Escolar (PNAE) foi criado oficialmente em 1954 originalmente com o nome de Campanha Nacional de Merenda Escolar (CNME), sendo incorporado à realidade dos estados e municípios em todo o país. O processo de compra de alimentos foi realizado de forma centralizada pelo nível federal até 1993, o que necessitava de uma logística de compra e distribuição que muitas vezes não era atendida devido às proporções continentais do Brasil. Em 1994 ocorreu a descentralização administrativa e financeira do programa em direção aos estados e municípios, o que impulsionou a compra de alimentos de origem local. Atualmente o programa é gerenciado pelo Fundo Nacional de Desenvolvimento da Educação (FNDE). Na articulação entre PNAE e desenvolvimento da agricultura familiar, no que concerne ao programa Fome Zero (PFZ), em 2003 instituiu-se a compra de alimentos da agricultura familiar pela alimentação escolar no Brasil, obrigatoriedade aplicada a partir de 2009. Todavia, antes da publicação da lei já existiam estratégias de incentivo à aproximação da agricultura familiar com a alimentação escolar, tanto no Brasil quanto em outros países. O objetivo desta pesquisa foi caracterizar a compra de alimentos provenientes da agricultura familiar pelo Programa Nacional de Alimentação Escolar (PNAE) no ano de 2011. Trata-se de um estudo transversal, exploratório e descritivo. Foram enviados questionários on-line aos nutricionistas ou secretários de educação dos 5564 municípios do país. Foi realizada análise descritiva com testes de qui-quadrado com nível de significância pAbstract : The School Feeding National Program (SFNP) was officially created in 1954 with School Meals National Campaign (SMNC) as the original name, being incorporated to the states and municipalities? realities all over the country. The food purchase process was developedin a central way by federal level until 1993, which needed a buying and distribution logistic that, many times, was not answered due to the continental proportions of Brazil. In 1994 occurred the administrative and financial decentralization of the program in direction to the states and municipalities, which boosted the food purchase?s local origin. Currently the program is managed by the Educational Development National Fund (EDNF). In the articulation between SFNP and family agriculture development, regarding the Zero Hunger program (ZHP), in 2003 it was instituted the family agriculture school food purchase in Brazil, mandatory applied since 2009. Nevertheless, before the law publication it already existed incentive strategies to family agriculture approximation with school feeding, both in Brazil as in other countries. This research?s aim was to characterize the food purchase provided from family agriculture by the School Feeding National Program (SFNP) in the year of 2011. It is a cross-sectional, exploratory and descriptive study. On-line questionnaires were sent to educational nutritionists or secretaries from 5564 municipalities all over the country. Descriptive analyzes were developed with Chi-square tests with high leval of significance p<0,05. 93,2% of brazilian municipalities participated (n=5184), from those, 78,5% (p<0,001) acquired family agriculture foods. The buying realization prevalence varied between 67,9% (IC95% 63,6; 72,3) in the Midwest region (p=0,02) and 98,7% (IC95% 94,3; 96,6) in the Southern region (p=0,284). Regarding the stated, Amapá and Roraima stands out with lower percentages of purchase realization, with 38,5% and 50,0% respectively. In association analyses between family agricultural purchase fulfillment and the municipalities size, the bigger prevalences are among the median municipalities with 81,0%(IC95% 68,6; 79,2), and the smaller prevalences in the bigger ones (73,9% 68,6; 79,2). Among the small municipalities, the north region stands out with the higher variety amid the purchase perceptuals, going from 22,2% in Amapá to 76,5% in Tocantins (p<0,001). When the family agriculture food purchase realization was analyzed in association to the SFNP?s management type in the municipality, and the nutritionist presence as program technical responsible, the major realization prevalences were encountered among municipalities with a centralized feeding school management (80,3% IC95% 79,1; 81,4) and among those who possessed a nutritionist (80,7% IC95% 79,5; 81,8). Both analyzes presented p<0,001. It was also noticed that 56.3% of municipalities purchase less than 30% of total resources passed by the EDNF. This research had extensive municipalities? participation, of all the country regions, and proposed a characterization innovation in the public policies and in its effectiveness analyses. With the public support and the greater commitment of municipal, state and federal managers, the legislation execution can be amplified relative to family agricultural purchase on the program. The research continuity is suggested to guide the technical assistance in school feeding from EDNF in encouraging the brazilian family agricultural development, due to the SFNP potential as an economic development instrument and guarantee of good feeding habits trend to the Feeding properly human right and Nutritional and Feeding Security effectives in Brazil

Análise eletroforética para detectar e quantificar soro de leite adicional em leite e bebidas lácteas

Polyacrylamide gel electrophoresis, SDS-PAGE system, was adjusted to detect the presence of additional whey in dairy beverages distributed in a Brazilian Government School Meals Program. Aqueous solutions of samples in 8 M urea were submitted to a polyacrylamide gel gradient (10% to 18%). Gel scans from electrophoresis patterns of previously adulterated milk samples showed that caseins peak areas decreased while peak areas of b -lactoglobulin plus a -lactalbumin increased as the percentage of raw milk powder replaced by whey powder increased. The relative densitometer areas of caseins or b -lactoglobulin plus a -lactalbumin plotted against the percentage of whey added to the raw milk showed a linear correlation coefficient square higher than 0.97. The caseins plot was used to determine the percentage of additional whey in 116 dairy beverages, chocolate or coffee flavor. Considering that the lowest relative caseins concentration found in commercial milk powder samples by the present method was 72%, the dairy beverages containing caseins percentages equal to or higher than this value were considered free of additional whey. Based on this criterion, about 49% of the coffee-flavor dairy beverages and 29% of the chocolate-flavor beverages, among all the samples analyzed were adulterated with whey protein to reach the total protein contents specified on their labels. The present method showed a sensitivity of 5% to additional whey.A adulteração de bebidas lácteas, distribuídas no Programa Nacional da Merenda Escolar, pela adição de soro, foi investigada através da análise eletroforética em sistema de SDS-PAGE. Soluções aquosas de amostras em uréia 8M, foram submetidas a um gradiente de 10% a 18% de gel de poliacrilamida. Após a eletroforese, o gel corado com "Comassie Blue" foi submetido à densitometria para identificação e quantificação das proteínas lácteas. A partir de amostras de leite em pó, previamente adulteradas com diferentes proporções de soro em pó (0 a 100%) foi observada alta correlação linear entre a concentração relativa de soro adicionado ao leite e as concentrações de proteínas lácteas. Esta correlação foi inversamente proporcional ao percentual de caseínas (r2 = 0,987) e diretamente proporcional à soma dos percentuais de b -lactoglobulina e a -lactalbumina (r2 = 0,979) apresentados nos densitogramas. A partir da curva padrão de caseínas versus soro adicionado foi estimada a magnitude das adulterações encontradas nas bebidas lácteas sabor chocolate e café do programa da merenda escolar. Tendo em vista que, amostras de leite em pó comerciais analisadas através deste método apresentaram uma concentração mínima de 72% de caseínas, as bebidas lácteas, contendo percentual igual ou superior a este valor, foram consideradas livres de soro adicional. Baseado neste critério, cerca de 49 % das bebidas lácteas, sabor café, e 29 % sabor chocolate, de um total de 58 amostras analisadas por sabor, apresentaram adulteração. O método proposto apresenta uma sensibilidade de 5% de soro adicionado

Preliminary studies for the aplication of Thymbra capitata essential oil as potential antimicrobial agent in Bacterial Vaginosis

Bacterial vaginosis (BV) is the most common gynecological clinical condition in women in reproductive age, and has been associated with an increased risk of development of preterm labor, spontaneous abortion, and several sexually transmitted diseases such as HIV [1]. BV is not only a condition that involves excessive growth of anaerobic microorganisms, but also involves the presence of an adherent biofilm [2]. Despite its high prevalence, the aetiology of BV remains unknown, but frequently Gardnerella vaginalis is the main microorganism associated with this disorder [3], that is often the main species in biofilms presented in BV [4]. These results led to the theory that the microorganisms that form biofilms may be relevant for the aetiology of BV [5]. Traditionally, the treatment of BV involves the antibiotics metronidazole, clindamicin or tinidazole [6]. However, the recurrence rate remains high and this can be related to the biofilm-forming ability of G. vaginalis [5]. In this context, recently it was reported that natural compounds, such as Thymbra capitata essential oil, can reduce the activity of biofilms [7]. To test if T. capitata could be used in the treatment of BV, we determined the biofilm-forming ability and the effect of essential oil in seven strains of G. vaginalis isolated from women with BV. Thus, the biofilm-forming ability was assessed under anaerobic conditions for 48 hours, allowing each strain to form biofilm. These assays revealed that in fact, G. vaginalis strains produced moderate to tenacious biofilm. We then determined the sensibility of the tested bacteria to the common antibiotics used to treat BV. Not surprisingly, most of strains were resistant of metronidazole and tinidazole which are more commonly administered. However half of strains were sensitive to clindamicin. We then evaluated the antibacterial activity of essential oil upon G. vaginalis strains, determining minimum inhibitory concentration (MIC) and minimum lethal concentration (MLC). The T. capitata essential oil exhibited a potent anti-G. vaginalis effect, which was confirmed by the low values of MIC (0.16 µL.mL-1) and MLC (0.16 - 0.31 µL.mL-1). To conclude, these results showed that T. capitata essential oil presents a strong antibacterial activity upon antibiotic resistant and biofilm forming of G. vaginalis strains, reinforcing the potential interest of this essential oil as antimicrobial agent in the treatment of BV

Estrutura e processo de trabalho para as ações de alimentação e nutrição na Atenção Primária à Saúde no Brasil, 2014

Objective: To evaluate the conditions of structure and work process for food and nutrition actions in primary health care in Brazil. Methods: Cross-sectional study with secondary data from the Program for Improving Access and Quality in Primary Care. The proportions of adequacy of the Basic Health Units (UBS) and health teams were described according to organizational variables for the reason of the prevalence and Poisson Regression. Results: 19,793 UBS and 24,549 teams were analyzed; 35.0% (n=6.928) of the UBS were considered adequate for the structure and 7.9% (n=1,934) of the appropriate teams in the work process. In the association analyzes, the UBS in the South region (44.7%) and the teams in the Southeast region (10.9%) stand out, in addition to municipalities with more than 300 thousand inhabitants. Conclusion: The UBS and teams analyzed presented a low proportion of adquacy for structure and work process for the actions of food and nutrition.Objetivo:&nbsp; Avaliar as condições de estrutura e de processo de trabalho para as ações de alimentação e nutrição na Atenção Primária à Saúde, no Brasil. Métodos: Estudo transversal, sobre dados secundários do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. Foram descritas as proporções de adequação das unidades básicas de saúde (UBS) e equipes de saúde segundo variáveis organizacionais, pela razão da prevalência e regressão de Poisson. Resultados: Foram analisadas 19.793 UBS e 24.549 equipes; 35,0% (n=6.928) das UBS mostraram-se adequadas na estrutura e 7,9% (n=1.934) das equipes adequadas ao processo de trabalho. Nas análises de associação, destacaram-se as UBS da região Sul (44,7%) e as equipes da região Sudeste (10,9%), além de municípios com mais de 300 mil habitantes. Conclusão: As UBS e equipes analisadas apresentaram baixas proporções de adequação de estrutura e de processo de trabalho para as ações de alimentação e nutrição

Clinical Approach to Pulp Canal Obliteration: A Case Series

This article describes four cases with safe and feasible clinical treatment strategies for anterior teeth with pulp canal obliteration (PCO) using cone-beam computed tomography (CBCT), digital radiography (DR), dental operating microscopy (DOM) and ultrasonic tips (US). Four anterior teeth with PCO were chosen. DR was taken with different angulations and analyzed with different filters. Subsequently, the access cavity was performed with the aid of DOM. If the canal was not identified, CBCT was requested. Sagittal and axial slices guided the direction of the ultrasonic tips. After identification of the canal, it was then negotiated and instrumented with the rotary instruments. All four canals were successfully identified, with no complications. In case 1, the canal was identified using DR, DOM and US tips. In cases 2, 3 and 4, the canals were identified with DR,DOM,UStips and CBCT. Complete root canal obliteration identified in radiography did not necessarily mean that pulp tissue was not visible clinically, either. The clinical evaluation of the access cavity with the aid of MO was crucial. If the canal was not identified, CBCT was mandatory in order to show more detailed view of the precise position of the canals, their directions, degrees of obstruction and dimensions. It served as a guide for the direction of the ultrasonic tips to keep them within the pulp chamber safely, with a low risk of iatrogenic injury.Keywords: Cone-beam Computed Tomography; Dental Operating Microscope; Digital Radiography; Guided Endodontics; Pulp Canal Obliteration; Ultrasoun

MPV17 Mutations Are Associated With a Quiescent Energetic Metabolic Profile

Funding: SJ was funded by Fundação Calouste Gulbenkian. TO was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany’s Excellence Strategy - EXC 2067/1- 390729940). AR and TC-O were funded by Fundação para a Ciência e a Tecnologia and European Regional Development Fund (CENTRO-01-0145-FEDER000012- HealthyAging2020), (POCI-010145-FEDER-007440), and (POCI-01-145-FEDER-29297). MS and MG were funded by UID/NEU/04539/2019 (Strategic Plan CNC.IBILI).Mutations in the MPV17 gene are associated with hepatocerebral form of mitochondrial depletion syndrome. The mechanisms through which MPV17 mutations cause respiratory chain dysfunction and mtDNA depletion is still unclear. The MPV17 gene encodes an inner membrane mitochondrial protein that was recently described to function as a non-selective channel. Although its exact function is unknown, it is thought to be important in the maintenance of mitochondrial membrane potential (ΔΨm). To obtain more information about the role of MPV17 in human disease, we investigated the effect of MPV17 knockdown and of selected known MPV17 mutations associated with MPV17 disease in vitro. We used different approaches in order to evaluate the cellular consequences of MPV17 deficiency. We found that lower levels of MPV17 were associated with impaired mitochondrial respiration and with a quiescent energetic metabolic profile. All the mutations studied destabilized the protein, resulting in reduced protein levels. We also demonstrated that different mutations caused different cellular abnormalities, including increased ROS production, decreased oxygen consumption, loss of ΔΨm, and mislocalization of MPV17 protein. Our study provides novel insight into the molecular effects of MPV17 mutations and opens novel possibilities for testing therapeutic strategies for a devastating group of disorders.publishersversionpublishe

Presence of Gardnerella vaginalis in healthy portuguese women: a pilot study

Bacterial vaginosis (BV) has an important position worldwide, as the leading vaginal disorder in women, and affects 30-50% of African women and 10-20% of White women of reproductive age. This condition although not mortal causes great discomfort and may lead to other complications such as pre-term labour or increase susceptibility for HIV infection. During BV occur a decrease of Lactobacillus spp. present in the vaginal epithelium and an increase in the number of anaerobic microorganisms like Gardnerella vaginalis, Pretovella spp., Mobilincus spp.; Mycoplasma hominis and Atopobium vaginae. Gardnerella vaginalis is also responsible for the formation of a biofilm in the vaginal epithelium in sick women’s. However, the direct correlation between the pathology and the causing agent (or agents) has not been clearly established. Currently there is only one article in PubMed (Guerreiro et. al, 1998) referring to the prevalence of bacterial vaginosis in Portugal and we aim to extend the research in this field specifically to the portuguese population. As part of this effort one of our aims it to characterise the bacterial population of portuguese women both healthy and diagnosed with BV. As such we collected swab samples of vaginal fluids from protuguese women with the help of health professionals and using self collection. The swabs were collected and treated within 24 hours at the University of Minho for the characterization of the bacterial population present, by using conventional microbiological growth techniques, PNA-FISH microscopy and 16S PCR. It was found that about 20% of the samples tested possessed G. vaginalis and all possessed Lactobacillus spp. using all 3 identification techniques described. This result is consistent with previous reports of G. vaginalis prevalence althought slightly lower, and shows that traditional microbiological techniques, microscopy and molecular methods were consistent in terms of results

Análise da estrutura fatorial do Audit em adolescentes entre 18 e 19 anos

OBJETIVO: Determinar a estrutura fatorial do instrumento Alcohol Use Disorders Identification Test (Audit) em uma amostra representativa de adolescentes de 18 a 19 anos. MÉTODOS: Estudo transversal realizado com adolescentes nascidos em São Luís (MA). A consistência interna do instrumento foi determinada pelo coeficiente alfa de Cronbach e a validade do construto foi avaliada por meio da Análise Fatorial Confirmatória (AFC). O índice de Kaiser-Meyer-Olkin (KMO) foi calculado para analisar a adequação da amostra. A qualidade de ajuste do modelo fatorial foi analisada de acordo com os índices dos testes qui-quadrado de ajustamento, comparative fit index (CFI), Tucker-Lewis index (TLI) e root mean square error of approximation (RMSEA). RESULTADOS: A amostra do estudo foi composta por 1.002 adolescentes entre 18 e 19 anos, sendo 56,8% meninas, 68,5% com 18 anos, 63,3% pardos ou mulatos, 48,6% pertencentes à classe C, 15,4% não trabalhavam e não estudavam e 52,1% tinham pais separados. A amostra foi adequada para a análise fatorial confirmatória (KMO = 0,79) e o coeficiente do alfa de Cronbach foi de 0,70, demostrando consistência interna satisfatória com cargas fatoriais acima de 0,5, com exceção do item 9 “Ficou ferido ou ficou alguém ferido por ter bebido”. A análise fatorial confirmatória revelou a validade do modelo de três fatores para a amostra em estudo com base nos índices de ajustes psicométricos. CONCLUSÃO: A estrutura fatorial do Audit com três fatores foi confirmada para a população de adolescentes entre 18 e 19 anos residentes em São Luís, ratificando os domínios conceituais originais propostos pela Organização Mundial da Saúde. O Audit apresentou-se como um instrumento confiável para a identificação do consumo de álcool.OBJECTIVE: To determine the factor structure of the instrument Alcohol Use Disorders Identification Test (AUDIT) in a representative sample of adolescents aged 18 to 19 years. METHODS: Cross-sectional study performed with adolescents born in São Luís (MA). The internal consistency of the instrument was determined by the Cronbach's alpha coefficient, and the validity of the construct was assessed by Confirmatory Factor Analysis (CFA). The Kaiser-Meyer-Olkin (KMO) was estimated to analyze the adequacy of the sample. The fit quality of the factor model was analyzed according to the indexes of the Chi-square adjustment test, comparative fit index (CFI), Tucker-Lewis index (TLI) and root mean square error of approximation (RMSEA). RESULTS: The sample of the study was composed of 1,002 adolescents aged from 18 to 19 years, being 56.8% girls, 68.5% with 18 years, 63.3% brown, 48.6% belonging to class C, 15.4% did not work or did not study, and 52.1% had divorced parents. The sample was suitable for confirmatory factor analysis (KMO = 0.79); Cronbach's alpha coefficient was 0.70, demonstrating satisfactory internal consistency with factor loads above 0.5, except for item 9, “was injured or someone else was injured due to drinking.” Confirmatory factor analysis revealed the validity of the three-factor model for the studied sample based on the indices of psychometric adjustments. CONCLUSION: The three-factor AUDIT factor structure was confirmed for the population of adolescents between 18 and 19 years old living in São Luís, ratifying the original conceptual domains proposed by the World Health Organization. AUDIT proved to be a reliable instrument to identify the consumption of alcohol

Abordagem do conteúdo de estomaterapia nos cursos de graduação em enfermagem: reflexões a partir de um projeto de extensão

This research aimed to reflect on the approach to the contents of Stomatherapy in undergraduate nursing courses. This is a reflection study that emerged from discussions held with the team of an Extension Project, linked to the Nursing course at a university in the State of Rio de Janeiro. With the growing number of people undergoing stomatherapy, as well as the emergence of equipment and technologies to treat these health problems, it is essential to include disciplines in undergraduate nursing curricula that allow students to expand their skills, preparing them for the care of these patients. Although graduation aims at training generalist nurses, it is of fundamental importance to have the minimum relevant content related to the area of stomatherapy, in order to enable future professionals to identify certain health problems, thus offering holistic care. and safe, because the need to acquire knowledge and develop specific skills that are required in professional practice is notorious.A presente pesquisa objetivou refletir sobre a abordagem dos conteúdos de Estomaterapia nos cursos de graduação em enfermagem. Trata-se de um estudo de reflexão que emergiu a partir de discussões feitas junto à equipe de um Projeto de Extensão, vinculado ao curso de Enfermagem de uma universidade no Estado do Rio de Janeiro. Com o crescente número de pessoas em situação de estomaterapia bem como com o surgimento de equipamentos e tecnologias no tratamento desses problemas de saúde, faz-se imprescindível a inclusão nos currículos de graduação em enfermagem de disciplinas que possibilitem aos acadêmicos expandirem suas competências, preparando-os para a assistência desses pacientes. Apesar da graduação objetivar a formação de enfermeiros generalistas, é de fundamental importância que se tenha o mínimo relevante do conteúdo ligado à área da estomaterapia, a fim de possibilitar ao futuro profissional a identificação de determinados problemas de saúde, ofertando, assim, um cuidado holístico e seguro, isto porque é notória a necessidade da apreensão de conhecimentos e o desenvolvimento de habilidades específicas que são requeridas na prática profissional

Abordagem do conteúdo de estomaterapia nos cursos de graduação em enfermagem: reflexões a partir de um projeto de extensão

This research aimed to reflect on the approach to the contents of Stomatherapy in undergraduate nursing courses. This is a reflection study that emerged from discussions held with the team of an Extension Project, linked to the Nursing course at a university in the State of Rio de Janeiro. With the growing number of people undergoing stomatherapy, as well as the emergence of equipment and technologies to treat these health problems, it is essential to include disciplines in undergraduate nursing curricula that allow students to expand their skills, preparing them for the care of these patients. Although graduation aims at training generalist nurses, it is of fundamental importance to have the minimum relevant content related to the area of stomatherapy, in order to enable future professionals to identify certain health problems, thus offering holistic care. and safe, because the need to acquire knowledge and develop specific skills that are required in professional practice is notorious.A presente pesquisa objetivou refletir sobre a abordagem dos conteúdos de Estomaterapia nos cursos de graduação em enfermagem. Trata-se de um estudo de reflexão que emergiu a partir de discussões feitas junto à equipe de um Projeto de Extensão, vinculado ao curso de Enfermagem de uma universidade no Estado do Rio de Janeiro. Com o crescente número de pessoas em situação de estomaterapia bem como com o surgimento de equipamentos e tecnologias no tratamento desses problemas de saúde, faz-se imprescindível a inclusão nos currículos de graduação em enfermagem de disciplinas que possibilitem aos acadêmicos expandirem suas competências, preparando-os para a assistência desses pacientes. Apesar da graduação objetivar a formação de enfermeiros generalistas, é de fundamental importância que se tenha o mínimo relevante do conteúdo ligado à área da estomaterapia, a fim de possibilitar ao futuro profissional a identificação de determinados problemas de saúde, ofertando, assim, um cuidado holístico e seguro, isto porque é notória a necessidade da apreensão de conhecimentos e o desenvolvimento de habilidades específicas que são requeridas na prática profissional