Food Insecurity and the Behavioral and Intellectual Development of Children: A Review of the Evidence

Background: Given that an alarming 1 in 5 children in the USA are at risk of hunger (1 in 3 among black and Latino children), and that 3.9 million households with children are food insecure, it is crucial to understand how household food insecurity (HFI) affects the present and future well-being of our children. Purpose: The objectives of this review article are to: (i) examine the association between HFI and child intellectual, behavioral and psycho-emotional development, controlling for socio-economic indicators; (ii) review the hypothesis that HFI is indeed a mediator of the relationship between poverty and poor child development outcomes; (iii) examine if the potential impact of HFI on caregivers’ mental health well-being mediates the relationship between HFI and child development outcomes. Methods: Pubmed search using the key words “food insecurity children.” For articles to be included they had to: (i) be based on studies measuring HFI using an experience-based scale, (ii) be peer reviewed, and (iii) include child intellectual, behavioral and/or socio-emotional development outcomes. Studies were also selected based on backward and forward Pubmed searches, and from the authors’ files. After reviewing the abstracts based on inclusion criteria a total of 26 studies were selected. Results: HFI represents not only a biological but also a psycho-emotional and developmental challenge to children exposed to it. Children exposed to HFI are more likely to internalize or externalize problems, as compared to children not exposed to HFI. This in turn is likely to translate into poor academic/cognitive performance and intellectual achievement later on in life. A pathway through which HFI may affect child development is possibly mediated by caregivers’ mental health status, especially parental stress and depression. Thus, HFI is likely to foster dysfunctional family environments. Conclusion: Findings indicate that food insecure households may require continued food assistance and psycho-emotional support until they transition to a “stable” food secure situation. This approach will require a much better integration of social policies and access to programs offering food assistance and mental health services to those in need. Findings also fully justify increased access of vulnerable children to programs that promote early in life improved nutrition as well as early psycho-social and cognitive stimulation opportunities

Oral Health: Work Process and Interdisciplinarity

Objective: To contribute to the debate about tools that favor the organization of the health work process and its interface with interdisciplinary practices. Material and Methods: We opted for a textual construction based on more specific publications on the field of oral health care. Results: The matrix support is configured as a method of inter-professional activity in co-management that aims to favor the qualification of the health care network. From this perspective, it is an interdisciplinary practice capable of integrating two or more areas of knowledge for a better performance of the actors involved in a given organizational and decision-making process, whether in the clinical or health management scope. Conclusion: Matrix support is an essential tool for the practice of managing health services and amplifying interdisciplinary actions

RELAÇÃO DAS PRÁTICAS PARENTAIS COM SOBREPESO E OBESIDADE EM ADOLESCENTES ESCOLARES: ESTUDO DE CASO-CONTROLE

Objetivo: avaliar as práticas parentais educativas relativas à alimentação e sua relação com sobrepeso/obesidade em adolescentes escolares. Método: estudo de caso-controle com adolescentes de escolas públicas, mediante investigação das dimensões restritivas em relação ao consumo de doces e alimentos calóricos, pressão para comer, comer de acordo com a determinação e monitoramento-controle sobre consumo de doces e alimentos calóricos. Aplicou-se teste qui-quadrado com intervalo de confiança de 95%. Resultados: participaram 148 adolescentes (80 casos-sobrepeso/obesidade e 68 controles-eutróficos). Houve associação entre estado nutricional do cuidador e do adolescente (OR=5,688; p<0,01), maior percentual de sobrepeso/obesidade entre adolescentes submetidos a práticas restritivas de consumo de doces; em pressão para comer, proporção maior de adolescentes com sobrepeso/obesidade entre os cuidadores que discordaram; maior percentual de adolescentes com sobrepeso/ obesidade entre as mães/cuidadores que relataram monitorar o consumo de alimentos calóricos na maior parte do tempo. Conclusão: as práticas parentais educativas relacionaram-se com o sobrepeso/obesidade em adolescentes escolares.Descritores: Poder Familiar. Comportamento Alimentar. Obesidade. Sobrepeso. Adolescente

Household food insecurity in Brazilian adolescents : a validation study

Objetivo: os objetivos do trabalho foram avaliar a validade interna e a capacidade preditiva da escala de segurança alimentar de seis itens aplicada a adolescentes. Métodos: foi um estudo transversal com amostra representativa de adolescentes brasileiros (N=14.690), realizado em escolas públicas e privadas nas 26 capitais de estados brasileiros e no Distrito Federal por meio de questionário online. Resultados: a maior parte dos respondentes era do sexo feminino (53,2%), com idade média de 14,4 anos, sendo 72,7% de escolas públicas. O comportamento da escala, observado pelo modelo de Rasch, foi melhor sem o item cinco, apresentando valores ótimos de Infit e nível de severidade crescente entre os itens. O alfa de Cronbach foi 0,77, e as análises do funcionamento diferencial dos itens mostraram comportamento dos itens semelhante entre os subgrupos avaliados. A análise fatorial mostrou a unidimensionalidade do instrumento. Conclusão: foi proposta a retirada do item cinco e novos pontos de corte para a escala curta de segurança alimentar. A escala curta de segurança alimentar é válida e confiável para mensurar insegurança alimentar domiciliar entre adolescentes brasileiros.Objective: the objective of this study was to evaluate the internal and predictive validity of a six-item household food insecurity scale to measure food insecurity in Brazilian adolescents. Methods: a cross-sectional study with a representative sample of Brazilian adolescents (N=14,690) was conducted in public and private schools in 26 state capitals and in the Federal District of Brazil using an online questionnaire. Results: most respondents were female (53.2%) with mean age of 14.4 years, and 72.7% of them attended public schools. The psychometric properties of the scale, assessed using the Rasch model, showed better response rates without the item five, exhibiting optimal Infit statistics and an increasing level of severity among the items. Cronbach's á was 0.767. Differential item functioning analyses showed similar behavior between the items in the subgroups evaluated. Factor analysis confirmed the unidimensionality of the scale. Conclusion: this study proposes the removal of the item five and the inclusion of new cut-off points for this short form of the scale. The Household Food Security Scale (short form) is valid and reliable to measure household food insecurity in Brazilian adolescents

Análise espacial e espaço-temporal das anomalias congênitas do sistema nervoso no Estado da Paraíba entre os anos de 2010 a 2016

Introduction: In Brazil, congenital malformation anomaly of the nervous system has been the most frequent among the anomalies. Knowledge of your geographical distribution both in space as throughout the time, can assist public managers in the decision-making process about the areas that must be prioritized for the monitoring of this disease. Objective: Detecting spatial and spatio-temporal clusters of congenital malformations of nervous system. Methods: An ecological study based on secondary data from the National Information System on Live Births in the period from 2010 to 2016 in the state of Paraíba. We estimated the spatial incidence ratios and applied circular and spatio-temporal Scan statistics to detect clusters with of abovementioned malformations. Results: The spatial pattern was different throughout the years of the occurrence of these malformations, since the spatial clusters were detected on different regions of the state, except in the years 2013 and 2015, which revealed a higher concentration in the central-west and northwest regions of the state. The retrospective spatio-temporal analysis revealed three clusters that persisted during the years of 2015 and 2016. Conclusion: The findings indicated the regions that must be prioritized for the monitoring of congenital malformations of nervous system in the state of Paraíba in time and space.Introdução: No Brasil, a anomalia congênita do sistema nervoso tem sido a mais frequente dentre as anomalias. O conhecimento da sua distribuição geográfica, tanto no espaço quanto ao longo do tempo, pode auxiliar os gestores públicos no processo de tomada decisão sobre as áreas que devem ser priorizadas no monitoramento dessa doença. Objetivo: Detectar aglomerados espaciais e espaço-temporais das anomalias congênitas do sistema nervoso. Método: Estudo ecológico a partir de dados secundários do Sistema de Informações sobre Nascidos Vivos no período de 2010 a 2016 no estado da Paraíba. Foram estimadas as Razões de Incidências Espacial e aplicada a estatística Scan circular e Scan espaço-temporal para a detecção dos aglomerados das anomalias citadas anteriormente. Resultados: O padrão espacial foi diferente ao longo dos anos da ocorrência destas anomalias, uma vez que os aglomerados espaciais foram detectados em diferentes regiões do estado, exceto nos anos 2013 e 2015 que foi verificada uma maior concentração nas regiões do centro-oeste e noroeste do estado. Conslusão: Os achados indicaram as áreas que devem serpriorizadas para o monitoramento de anomalias congênitas do sistema nervoso no estado da Paraíba, tanto no tempo quanto no espaço

[breastfeeding Patterns And Energy Adequacy].

To analyze caloric adequacy in infant feeding six months of age or under, the volume of breast milk consumed was estimated through a regression equation as proposed by Drewett. Energy adequacy was estimated according to World Health Organization guidelines for developing countries and the recommended daily allowance of the Food and Nutrition Board. A cross-sectional analysis was conducted on data from a cohort of 118 infants in a neighborhood around a health center in Campinas, São Paulo, Brazil, with home interviews by trained students. Data were gathered on social and demographic characteristics, infant feeding patterns, duration of breastfeeding, frequency of feedings, and age when breast milk substitutes were introduced. On average, weaning began early, with a 2.7-month median duration of exclusive breastfeeding. Mean breast milk volume was estimated (from frequency of feeding) as 561.0 ml, 558.9 ml and 565.5 ml for children in exclusive, predominant, and supplemented breastfeeding, respectively. Mean energy consumption was adequate for all exclusively breastfed children regardless of age and above the recommended level for infants with supplemented breastfeeding and those already weaned.2064-7

ANALYSIS OF DOMESTIC VIOLENCE ON WOMEN’S HEALTH

Introduction: Violence against women is characterized by damage to physical and mental health of the victim, and is not linked solely to the use of physical force, but also the idea of submission, culturally ingrained in gender relations, in which man behaves itself as being dominant and women an inferior being. As result of violence, women are hindered in their social life, repressed and psychologically shaken. It is a public health problem of great magnitude in the world. It is known that women are more vulnerable to health problems and has unique needs, differentiated from other groups in society, such as prevention, control and combat to physical and mental illnesses. According to the National Policy for Integral Attention to Women’s Health, these injuries are more linked with gender issues such as the situation of discrimination in society than to biological factors. Gender inequalities, historically produced and legitimated by culture and society, put women in inferiority and depreciation position. In this context, violence is used as a mechanism of maintenance and confirmation of male power over women. Objective: Investigating the health problems resulting from domestic violence against women. Methods: An exploratory study with a qualitative approach, in the city of João Pessoa, involving 406 women who met the inclusion criteria. The speeches made by the interviewees were coded as analysis technique of speech. Results: The main diseases cited were headache, nausea, feeling of insecurity, stress, depression, difficulty with new relationships. Conclusion: The grievances caused from domestic violence in women who suffer permeate the physical damage, interfere with quality of life and surpass. It is important to give visibility to the phenomenon and insert gender concepts in the training of health professionals, providing tools for them to meet in a humane way and emancipatory approach to this population segment