Estudo e caracterização dos casos sociais e o seu impacto na mortalidade nos hospitais em Portugal continental

Mestrado em Métodos Quantitativos para a Decisão Económica e EmpresarialO presente trabalho, em parceria com a empresa IASIST, tem como objetivo o estudo e a caracterização dos Casos Sociais de forma a calcular o seu impacto na mortalidade nos hospitais em Portugal Continental. Estes Casos têm sido alvo de vasta investigação, sendo um ainda conceito em discussão e sujeito a diferentes interpretações. Em Portugal existe um total de 975.439 doentes hospitalizados, sendo que 16.088 foram considerados Caso Social.The present study, in partnership with the company IASIST, aims to study and characterize Social Cases in order to calculate their impact on mortality in hospitals in Portugal Continental. Social case is a concept subject to discussions and interpretations. In Portugal there are a total of 975.439 hospitalized patients and 16.088 were considered as Social Case patients.info:eu-repo/semantics/publishedVersio

Gluten-Free Diet: a contribution to safety and informed choices

Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically susceptible individuals. Currently, medical nutrition therapy consisting of the gluten-free diet (GFD) is the only accepted treatment for CD. In the last years, the impressive growth of CD incidence, significantly provoked changes in the dietary habit of an increasingly large population, with a rise in demand of gluten-free products. GFD is a complex and challenging diet but recent advances in the food industry are making it easier to follow. Although several advances have been made in the preparation processes of gluten-free products, many of them, available on the market, exhibit a low nutritional quality. Previous studies have demonstrated that these products are poor sources of minerals, vitamins and fibre; therefore, its nutritional content is an increasing area of concern. A promising area is the use of minor or pseudo-cereals such as amaranth, buckwheat, quinoa and sorghum.In addition, patients with CD tend to compensate the restrictions of a GFD by eating foods containing high levels of fat, salt, sugars and calories, leading to the risk of developing obesity and diseases related to the metabolic syndrome. Therefore, getting nutritional therapy should be an essential part of this complex disease. The safest way for celiac patients to live healthfully is to eat naturally gluten-free whole foods, however, consumers must be educated to read labels carefully and look for sources of gluten. Currently, shopping for commercial gluten-free products is less difficult than in the past, but still risky for those particularly sensitive to gluten because many foods aren’t labelled accurately or consistently. In accordance with the European Regulation No 1169/2011, which came into force on 13 December 2014, it’s mandatory to include the substances or products that cause allergies or intolerances on the label. At European level there is a great concern with this type of food intolerance, therefore foodstuffs intended for particular nutritional use have a specific regulation (No 41/2009). This regulation, applicable since January of 2012, concerns the composition and labelling of foodstuffs suitable for people with gluten intolerance. In order to comply with this regulation, and to insert reliable information on the food labels, our laboratory works with the food industry companies and carry out analysis for detection and quantification of gluten in food and raw materials. In this study we evaluated the gluten content of 45 samples. Gluten analysis was performed using two different immunoenzimatic assays: RIDASCREEN® Gliadin and/or RIDASCREEN® Gliadin competitive.The obtained results showed that all the samples analysed can be safely labelled as “Gluten-free” as they contained levels of gluten below the 20 mg/Kg limit proposed by the Codex Alimentarius for gluten-free foods. This study underlines the importance of the laboratory in ensuring that the information “gluten-free” on the labels is reliable, so people with CD can make informed choices about the products available on the market

Diabetes: socioeconomic Inequalities in the Portuguese population in 2014

Introdução: A diabetes é considerada um dos maiores problemas de saúde pública e está associada a fatores socioeconómicos. O objetivo deste estudo foi descrever as desigualdades socioeconómicas na distribuição da diabetes na população com idade igual ou superior a 25 anos, residente em Portugal em 2014. Material e Métodos: Foram analisados dados do Inquérito Nacional de Saúde de 2014, n = 16 786. Calcularam-se estimativas da prevalência da diabetes total e estratificada por variáveis de caracterização socioeconómica designadamente o nível de escolaridade e o rendimento. O grau de desigualdade socioeconómica foi estimado através do índice de concentração e do índice relativo de desigualdade. Resultados: A diabetes concentrou-se na população com menor nível de escolaridade (índice de concentração = -0,26) e nos quintis de menor rendimento (índice de concentração = -0,14). O índice relativo de desigualdade evidenciou menor desigualdade nos grupos com um maior nível de escolaridade (0,20; IC 95% = [0,12; 0,32]) e com maior rendimento (0,59; IC 95% = [0,48; 0,74]). Discussão: A distribuição da diabetes está associada ao nível educacional e ao rendimento. Estudos anteriores mostraram que, apesar do rendimento poder refletir o padrão de vida das pessoas, a educação reflete o contexto social imediato em que o individuo se integra e que contribui para adotar estilos de vida mais saudáveis. Ainda, o Serviço Nacional de Saúde, por ser universal e tendencialmente gratuito, pode ter contribuído para reduzir desigualdades no acesso à saúde por grupos de menor rendimento. Conclusão: Integrar a ‘Saúde em Todas as Políticas’ pode reduzir as desigualdades, nomeadamente através da melhoria do nível educacional da população e do desenvolvimento de ações que promovam a literacia em saúde.Instituto Nacional de Saúde Doutor Ricardo Jorgeinfo:eu-repo/semantics/publishedVersio

A study of commercially available complementary foods for infants and young children under 36 months

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Breakfast Cereals Intended for Children: Opportunities for Reformulation and Potential Impact on Nutrient Intake

This article belongs to the Section Food NutritionReady-to-eat cereals (RTECs) have become a popular breakfast option claiming to provide important nutrients to children’s diets, despite being a source of excess sugar and, therefore, a health concern. Thus, food reformulation constitutes an important public health strategy that could benefit from inputs provided by nutrient profiling. This study aimed to assess the adequacy of the RTECs for children available in Portuguese supermarkets, applying three nutrient profile models (NPMs)—the nutrient profile model of the World Health Organization’s Regional Office for Europe (WHO-EURO), the profile of the private-sector EU Pledge (EU-Pledge), and the national model developed by the Directorate-General of Health (NPM-PT)—in order to explore the potential for reformulation of the RTECs identified as not adequate and evaluate the impact of RTECs’ reformulation on the nutritional quality of Portuguese children’s diets. In total, 78 RTECs intended for children were assessed and two scenarios—current (not considering reformulation) and alternative (considering reformulation to accomplish the nutrient profile requirements)—were considered to assess the impact of reformulation on nutritional quality. Across all RTECs, only 5.1% could be promoted to children according to the considered NPMs. The most common nutrients requiring reformulation were sugar, saturated fatty acids (SFA), salt, and dietary fiber. The scenarios of reformulation considered could reduce the RTECs average content of total sugars, SFA, and salt by 43%, 8.7%, and 1.1%, respectively, and dietary fiber intake could be increased by 34%. Thus, these results support policies to implement reformulation strategies for developing healthier food products to be promoted to children.The authors appreciate the financial support of AHFES project (EAPA_1071_2018AHFES). This project was co-funded by the European Regional Development Fund through the Atlantic Area Program. Ricardo Assunção thanks FCT/MCTES for the financial support to CESAM (UIDP/50017/2020+UIDB/50017/2020) through national funds, and the FCT Individual CEEC 2018 Assistant Researcher Grant CEECIND/01570/2018. The IAN-AF 2015–2016 was supported by funding received from the EEA Grants Program, Public Health Initiatives (PT06-000088SI3).info:eu-repo/semantics/publishedVersio

O valor nutricional de refeições escolares

Neste estudo foram analisadas 36 refeições, colhidas em 36 escolas do 1.º Ciclo do Ensino Básico da área metropolitana de Lisboa, durante o ano lectivo 2012-2013. Em cada visita foi recolhida uma refeição, tal como era fornecida aos alunos

Assessment of the nutrient profile and labelling of commercially available complementary foods for infants and young children under 36 months: an exploratory study

Uma nutrição saudável na infância é fundamental para o normal crescimento e desenvolvimento do bebé. Incentivar as crianças a consumir alimentos saudáveis, através de uma oferta repetida e positiva de novos alimentos, bem como limitar a sua exposição a alimentos considerados não saudáveis, podem evitar a preferências por alimentos e bebidas muito doces, contribuindo para o desenvolvimento de bons hábitos alimentares. Em 2016, a Assembleia Mundial da Saúde aprovou, através da resolução WHA69.9, o guia elaborado pela Organização Mundial de Saúde (OMS) Europa, com o objetivo de promover o fim da comercialização inadequada de alimentos para lactentes e crianças jovens. Este guia inclui uma proposta de Modelo de perfil nutricional, desenvolvido especificamente para identificar os alimentos complementares que reúnem as características adequadas para serem comercializados a crianças dos 6-36 meses, e garantir que estes mesmos são rotulados e promovidos de forma adequada. O presente estudo pretendeu avaliar a adequação nutricional dos alimentos à venda no mercado português, destinados à faixa etária dos 6-36 meses, e analisar os diferentes tipos de alegações presentes nas embalagens desses produtos. Dos 138 alimentos analisados, 69% não cumpriam todos os critérios nutricionais propostos pelo modelo da OMS. Aproximadamente 31% dos alimentos têm, pelo menos, uma fonte de açúcar indicada na lista de ingredientes. Este estudo também demonstrou que contrariamente às orientações da OMS e do Codex Alimentarius, os alimentos complementares estão a ser promovidos de forma inadequada, considerando que 97% apresentaram, pelo menos, um tipo de alegação nutricional ou de saúde na embalagem. A nível nacional, os resultados obtidos revelam a necessidade de implementar medidas que limitem a promoção de alimentos menos saudáveis destinados à faixa etária dos 6-36 meses, de modo a garantir que pais e cuidadores tenham acesso a informações claras e fiáveis sobre as escolhas alimentares que fazem para os seus filhos.Healthy nutritional choices in childhood are crucial to ensure optimal child growth and development. Encouraging infant and young children to consume healthy foods, through repeated and positive offerings of new foods, and limiting their exposure to unhealthy foods, which may influence their taste preferences for sweet foods and sugary drinks, helps to develop good feeding practices. In 2016, the World Health Assembly approved WHO Europe guidance on ending the inappropriate promotion of foods for infants and young children through resolution WHA69.9. This guidance provides a tool, in the form of a draft Nutrient profile model, specifically developed to identify commercially available complementary foods that are suitable to be marketed for infants and young children up to 36 months, and ensure that permitted products are properly labelled and promoted. The present study aimed to assess the nutritional suitability of complementary foods available on the Portuguese market, destined to the age group 6-36 months, and to analyse the different types of claims present on packages. Of the 138 complementary foods analysed, 69% did not meet all the nutritional criteria proposed by the WHO model. Approximately 31% of foods have at least one sugary source listed in the ingredients list. Contrary to guidelines issued by WHO and Codex, this study also demonstrated that complementary foods are being inappropriately promoted. Almost all products (97%) presented at least one type of nutrition or health claim on the label. The obtained results reveal the need to implement, at national level, effective preventive measures to limit the promotion of unhealthy foods marketed for infants and young children up to 36 months, in order to ensure that parents and caregivers receive clear and accurate information on complementary feeding.info:eu-repo/semantics/publishedVersio

Construction of control charts to help in the stability and reliability of results in an accredited water quality control laboratory

Overall, laboratory water quality analysis must have stability in their results, especially in laboratories accredited by ISO 17025. Accredited parameters should be strictly reliable. Using control charts to ascertain divergences between results is thus very useful. The present work applied a methodology of analysis of results through control charts to accurately monitor the results for a wastewater treatment plant. The parameters analyzed were pH, BOD5, COD, total suspended solids, and total phosphorus. The stability of the results was analyzed from the control charts and 30 analyses performed in the last 12 months. From the results, it was possible to observe whether the results are stable, according to the rehabilitation factor that cannot exceed WN = 1.00 and the efficiency of removal of pollutants that remained above 70% for all parameters. The method of determining the technological reliability and stability of the treatment station using control charts is an efficient tool for detecting any instability in the results. These results help to monitor the results of the analyses more clearly and thus enable a rapid response to possible disturbances and maintain the quality of the analysis control, as well as determining the accreditation entities

Nutritional quality of foods consumed by the Portuguese population according to the Nutri-Score and consistency with nutritional recommendations

In the last few years, public health authorities have shown interest in introducing front-of-pack labelling (FOPL), as one of the main policies to combat diet-related non-communicable diseases (NCDs). Nutri-Score is a FOPL that categorizes a food product into five categories according to its nutritional value. This study aimed to investigate the ability of Nutri-Score to discriminate the nutritional quality of foods consumed by the Portuguese population and the consistency with the food-based dietary guidelines. The applicability of Nutri-Score was assessed by applying it to 165 food products that were considered under the PT-Total Diet Study (PT-TDS). At least three categories (colours/letters) of the Nutri-Score were observed for most of the food groups and for sub-groups a minimum of two categories were identified. The Nutri-Score showed moderate agreement with the Portuguese Nutrient Profile Model (PT-NPM) (k = 0.416). The food classification according to the Nutri-Score was consistent with the nutritional recommendations. Food groups in which consumption is encouraged were more favourably classified than those in which consumption should be limited (i.e., Vegetables and Pastries were classified as A (93.0%) and E (57.1%), respectively). Appropriate food labelling with a system such as Nutri-Score can be relevant to health-promoting purchasing choices, improving diet quality and consequently public health.This work has been funded by the National Health Institute Doutor Ricardo Jorge, I.P., under the project ‘Incentivo aos Estudos de Dieta Total’ (Reference number 2016DAN1260). Elsa Vasco and M. Graça Dias previous work (unpublished) contributed to this study, and they were responsible for the sampling plan, collection and treatment of food products, which we thank. This manuscript was developed under the scope of WHO Collaborating Centre on Nutrition and Childhood Obesity—National Health Institute Dr. Ricardo Jorge. Ricardo Assunçao ˜ thanks FCT/MCTES for the financial support to CESAM (UIDP/50017/2020 + UIDB/50017/2020), through national funds.info:eu-repo/semantics/publishedVersio

Desenvolvimento e produção técnico-científica em tempos de pandemia: um relato da liga acadêmica de fundamentos de enfermagem

The aim of this article is to describe an experience report based on the creation and development of the Academic League in a public university in the state of Rio de Janeiro. It is believed that the leagues contribute to the training of undergraduate students, in an attempt to offer different experiences and thus promote meaningful learning. The methodology is characterized as a descriptive study of the experience report type. Observing the results, it was seen that most of the target audience were nursing students, professionals and professors, with an average interaction of 33.4 likes on Instagram© and 108 likes on Youtube©. The academic league of Fundamentals of Nursing is still under construction, intending to bring even more practical and theoretical knowledge, focusing on the fundamental bases of nursing, regarding the training of practical nursing skills, dissemination of knowledge related to care and nursing theories.Objetivou-se nesse artigo descrever um relato de experiência a partir da vivência de criação e desenvolvimento da Liga Acadêmica em uma universidade pública do Estado do Rio de Janeiro. Acredita-se que as ligas contribuam com a formação dos estudantes na graduação, na tentativa de ofertar experiências diversas e assim promover uma aprendizagem significativa. A metodologia se caracteriza como um estudo descritivo do tipo relato de experiência. Observando os resultados, viu-se que a maior parte do público atingido foram estudantes, profissionais e professores de Enfermagem, com uma interação média de 33,4 curtidas no Instagram© e 108 curtidas no Youtube©. liga acadêmica de Fundamentos de Enfermagem ainda se encontra em construção pretendendo trazer ainda mais conhecimentos práticos, teóricos, com foco nas bases fundamentais de enfermagem, no que tange ao treinamento das habilidades práticas de enfermagem, disseminação dos conhecimentos relacionados ao cuidar e teorias de enfermagem