126 research outputs found
Boletim and Arquivos: scientific communication until the creation of the Revista de SaĂșde PĂșblica
Pathways to health: a framework for health-focused research and practice
Public health research and practice is faced with three problems: 1) a focus on disease instead of health, 2) consideration of risk factor/disease relationships one at a time, and 3) attention to individuals with limited regard for the communities in which they live. We propose a framework for health-focused research and practice. This framework encompasses individual and community pathways to health while incorporating the dynamics of context and overall population vulnerability and resilience. Individual pathways to health may differ, but commonalities will exist. By understanding these commonalities, communities can work to support health-promoting pathways in addition to removing barriers. The perspective afforded by viewing health as a dynamic process instead of as a collection of risk factors and diseases expands the number of approaches to improving health globally. Using this approach, multidisciplinary research teams working with active community participants have the potential to reshape health and intervention sciences
Circumstances and factors associated with accidental deaths among children, adolescents and young adults in Cuiaba, Brazil
Concentração de fluoreto em arroz, feijão e alimentos infantis industrializados
OBJETIVO: Determinar a concentração de fluoreto na refeição brasileira tĂpica (arroz e feijĂŁo) e em alimentos infantis industrializados e estimar suas contribuiçÔes para fluorose dental. MĂTODOS: Os alimentos foram adquiridos de supermercados das cidades de Piracicaba e Campinas, SP, Brasil. Os alimentos infantis industrializados foram comprados em 2001 e o arroz e feijĂŁo em 2003, e imediatamente analisados. Foram analisadas trĂȘs marcas de arroz, trĂȘs de feijĂŁo e 36 amostras de alimentos infantis divididos em cinco grupos: prontos para o consumo; mingaus; alimentos formulados; leites em pĂł e outros alimentos. No arroz e feijĂŁo, foram determinadas as concentraçÔes de fluoreto nas sementes "in natura" e apĂłs cozimento com ĂĄgua destilada ou fluoretada (0,7 ppm). Todas as anĂĄlises de fluoreto foram feitas com eletrodo especĂfico. Considerou-se 0,07 mg/kg/dia como a dose limite de exposição a fluoreto para risco de fluorose. RESULTADOS: A concentração de fluoreto encontrada nos grĂŁos de arroz e feijĂŁo foi baixa. PorĂ©m, a concentração aumentou 100-200 vezes apĂłs cozimento em ĂĄgua fluoretada e mesmo assim, foi menor que a encontrada em alguns alimentos industrializados. Uma refeição com arroz e feijĂŁo preparada com ĂĄgua fluoretada seria responsĂĄvel por 29% da dose limite de ingestĂŁo de fluoreto em termos de fluorose aceitĂĄvel; a contribuição de alguns alimentos industrializados atingiria 45%. CONCLUSĂES: A alimentação tĂpica brasileira, mesmo preparada com ĂĄgua fluoretada, Ă© mais segura em termos de risco de fluorose dental que alguns alimentos infantis industrializados
The International Caries Classification and Management System (ICCMSâą) An Example of a Caries Management Pathway.
The effects of long-term total parenteral nutrition on gut mucosal immunity in children with short bowel syndrome: a systematic review
BACKGROUND: Short bowel syndrome (SBS) is defined as the malabsorptive state that often follows massive resection of the small intestine. Most cases originate in the newborn period and result from congenital anomalies. It is associated with a high morbidity, is potentially lethal and often requires months, sometimes years, in the hospital and home on total parenteral nutrition (TPN). Long-term survival without parenteral nutrition depends upon establishing enteral nutrition and the process of intestinal adaptation through which the remaining small bowel gradually increases its absorptive capacity. The purpose of this article is to perform a descriptive systematic review of the published articles on the effects of TPN on the intestinal immune system investigating whether long-term TPN induces bacterial translocation, decreases secretory immunoglobulin A (S-IgA), impairs intestinal immunity, and changes mucosal architecture in children with SBS. METHODS: The databases of OVID, such as MEDLINE and CINAHL, Cochran Library, and Evidence-Based Medicine were searched for articles published from 1990 to 2001. Search terms were total parenteral nutrition, children, bacterial translocation, small bowel syndrome, short gut syndrome, intestinal immunity, gut permeability, sepsis, hyperglycemia, immunonutrition, glutamine, enteral tube feeding, and systematic reviews. The goal was to include all clinical studies conducted in children directly addressing the effects of TPN on gut immunity. RESULTS: A total of 13 studies were identified. These 13 studies included a total of 414 infants and children between the ages approximately 4 months to 17 years old, and 16 healthy adults as controls; and they varied in design and were conducted in several disciplines. The results were integrated into common themes. Five themes were identified: 1) sepsis, 2) impaired immune functions: In vitro studies, 3) mortality, 4) villous atrophy, 5) duration of dependency on TPN after bowel resection. CONCLUSION: Based on this exhaustive literature review, there is no direct evidence suggesting that TPN promotes bacterial overgrowth, impairs neutrophil functions, inhibits blood's bactericidal effect, causes villous atrophy, or causes to death in human model. The hypothesis relating negative effects of TPN on gut immunity remains attractive, but unproven. Enteral nutrition is cheaper, but no safer than TPN. Based on the current evidence, TPN seems to be safe and a life saving solution
Assisted Reproductive Technologies in Europe. Usage and Regulation in the Context of Cross-Boarder Reproductive Care
This chapter reviews assisted reproductive technologies (ART) usage and policies across European countries, and scrutinizes emerging issues related to cross-border reproductive care (or âreproductive tourismâ). Although Europe is currently the largest market for ART, the extent of usage varies widely across countries, largely because of differences in the laws, the affordability, the types of reimbursement, and the norms surrounding childbearing and conception. Since 2009, the regulation of ART has been expanding in Europe, and all countries now have some form of ART legislation. Countries where the treatments are completely covered by national health plans have the highest level of ART utilization. Being in a legal marriage or a stable union is often a prerequisite for access to ART. Currently, only half of European countries allow single women to use ART, and even fewer grant access to lesbian women. Surrogate motherhood is strictly prohibited in many countries in Europe, and where it is allowed, strong restrictions against commercial surrogacy are in place. While restrictive national legislation can be easily circumvented by crossing national boundaries for ART treatments, questions of equity of access have been raised, as not all prospective parents can afford to travel for treatment
- âŠ