PRÁTICA CLÍNICA DO ENFERMEIRO NA ESTRATÉGIA DE SAÚDE DA FAMÍLIA

Objective: to list and analyze the possible enhancers and hindering factors of clinical nursing practice in the context of the Family Health Strategy. Method: integrative literature review conducted in LILACS and MEDLINE databases. Results: It is found in the reviewed articles the following potential factors: social care practice involving expanded from strategies as the host and the systematization of nursing care clinic. And while hindering factors: influence of the biomedical model; incipient qualification of nurses, for example, to implement the nursing process; and inadequate organizational and structural conditions. Final considerations: there is the importance of research-intervention to take effect so that they can perform certain practices and recommend them, especially with regard to the application of the nursing process in Primary Health Care, in its full aspects organizational, structural and assistance.  Descriptors: Nursing; Nursing Process; Primary Health Care.Objetivo: elencar e analisar os possíveis fatores potencializadores e dificultadores da prática clínica do enfermeiro no contexto da Estratégia de Saúde da Família. Método: revisão integrativa da literatura realizada nas bases de dados LILACS e MEDLINE. Resultados: encontraram-se nos artigos revisados os seguintes fatores potencializadores: prática social do cuidado envolvendo a clínica ampliada a partir de estratégias como o acolhimento e a sistematização da assistência de enfermagem. E enquanto fatores dificultadores: influência do modelo biomédico; incipiente qualificação dos enfermeiros, como por exemplo, para a implementação do processo de enfermagem; e, condições organizacionais e estruturais inadequadas. Considerações finais: verifica-se a importância de que pesquisas-intervenção sejam efetivadas para que se possam realizar determinadas práticas e recomendá-las, principalmente, no que se refere, à aplicação do processo de enfermagem na Atenção Primária à Saúde, em seus plenos aspectos organizacionais, estruturais e assistenciais. Descritores: Enfermagem; Processos de Enfermagem; Atenção Primária à Saúde.

Resistência à insulina em adolescentes com e sem excesso de peso de município da Grande Florianópolis-SC

O aumento na prevalência de excesso de peso está relacionado a mais casos de Diabetes Mellitus tipo 2 e resistência à insulina (RI) entre jovens. Este estudo objetivou comparar a prevalência de RI entre adolescentes com peso corporal normal e com excesso de peso. A amostra foi composta por 96 indivíduos (35,4% rapazes, 50% excesso de peso) com idade entre 14 e 19 anos (16,6±0,98). Os valores de IMC e perímetro de cintura (PC) foram dicotomizados de acordo com a literatura. Para RI utilizou-se o índice HOMA-IR com o ponto de corte de 4,39. O teste Qui quadrado avaliou a diferença de prevalências entre categorias de peso ou de PC (p<0,05). Não houve diferenças significativas entre categorias e a prevalência de RI encontrada foi de 2,1%. No entanto, os adolescentes com excesso de peso tenderam a apresentar valores mais altos de HOMA-IR. Segundo critérios de glicemia, não foi encontrada RI na amostra

Relationship of time spent in front of the TV with energy expenditure in adolescents with different percents of body fat

http://dx.doi.org/10.5007/1980-0037.2008v10n1p81 Physical inactivity is considered an independent risk factor for chronic diseases, and time spent in front of the TV is one of the most widespread sedentary activities. The purpose of this study was to investigate the association between time spent in front of the TV and energy expenditure among adolescents with different percents of body fat (%BF). The study included 40 White male adolescents aged 14 to 16 years, of high socioeconomic status (classes A and B). Anthropometric (body mass, stature, skin folds) and level of physical activity (Tritac accelerometer TR3) data were obtained. The adolescents were divided by %BF: below of 11% or above of 20%.The results demonstrated that adolescents with %BF above the ideal range spent more time in front of the TV and had lower energy expenditure than adolescents with %BF below the ideal range (p < 0.05). A negative association was observed between time in front of the TV and energy expenditure (on weekdays: r = - 0.426; on weekends: r = - 0.579) and there was a positive correlation with body fat (on weekdays: r = 0.518; on weekends: r = 0.514) (p < 0.05). According to the evidence, it was concluded that the greater the amount of time spent in front of the TV, the greater the prevalence of inactivity and the greater the amount of body fat

Gasto energético e consumo calórico em adolescentes do sexo masculino com diferentes níveis de adiposidade corporal Energy expenditure and caloric intake among male adolescents with different levels of body adiposy

Foram comparados o gasto energético e consumo calórico de adolescentes com diferentes níveis de gordura corporal. Estudo transversal com 40 adolescentes de 14 a 16 anos do sexo masculino. Os adolescentes foram divididos em dois grupos, cada um com 20 sujeitos, de acordo com o %G: baixo (%G 20%). O gasto energético foi mensurado por acelerômetros triaxiais e recordatório de atividades diárias. O consumo calórico foi avaliado pelo registro de 24 horas. Os jovens com baixo %G tiveram menor consumo calórico ( = 2408,1 ± 557,9 kcal.dia-1) em comparação aos jovens com alto %G ( = 2931,7 ± 679,2 kcal.dia-1, pEnergy expenditure and caloric intake were compared among adolescents with different levels of adiposity. A cross-sectional study was carried with 40 adolescent boys aged 14 to 16 years. The adolescents were divided into two groups of 20 subjects each, according to % body fat (%BF): low ( 20%). Energy expenditure was measured using accelerometer and daily activity diary. The dietary pattern was evaluated based on 24-h recall. Caloric intake was lower in adolescents with low %F ( = 2408.1 ± 557.9 kcal.day-1) compared to those with high %F ( = 2931.7 ± 679.2 kcal.day-1, p<0.05). In addition, they presented greater relative energy expenditure than adolescents with high %F (p<0.05). High %F adolescents showed larger caloric intake than expenditure, while the opposite was observed among low %F males

Validity of tritrac tri-axial accelerometer: a review of literature

Physical activity is one of the main components of a healthy lifestyle due to reduction of risk for several diseases and the many health benefits. However, the need for a measurement is a challenge to researchers. There are several methods mentioned in the literature such as doubly labeled water, indirect calorimetry, the accelerometers, pedometers and questionnaires. Nevertheless all show limitations in either reliability, usage or elevated costs. This review presents an overview of the Tri-axial accelerometer TriTrac (models R3D and RT3), focusing on their characteristics and functions, as well as the main validation studies. The Brazilian studies using accelerometers as a physical activity measurement were also analyzed. The available data seem to confirm that both models of TriTrac accelerometer provide an easy-to-use and valid method for measuring physical activity levels among several age groups, however, it is recommended a report of the physical activities along with accelerometer data for a complete and reliable information. <p> <b> RESUMO </b> A atividade física é um dos principais componentes de um estilo de vida saudável, por reduzir o risco de várias doenças e proporcionar muitos benefícios à saúde, porém a medida precisa é um desafio aos pesquisadores. Diversos métodos são citados na literatura, entre eles estão a água duplamente marcada, a calorimetria indireta, os acelerômetros, pedômetros e questionários, porém todos apresentam limitações quanto a fidedignidade, utilização ou custo elevado. Esta revisão buscou abordar uma visão geral do acelerômetro Tri-axial TriTrac (modelos R3D e RT3), destacando suas características e funções, bem como os principais estudos de validação deste instrumento. Também foram analisados, os estudos brasileiros que utilizaram este acelerômetro como método de mensuração da atividade física. Os dados disponíveis parecem confirmar que ambos os modelos do acelerômetro TriTrac proporcionam um método fácil de usar e válido para mensuração da atividade física em diversas idades, contudo, recomenda-se utilizar juntamente um registro de atividade física para obter dados mais confiáveis e precisos

Predictive capacity of anthropometric indicators for dyslipidemia screening in children and adolescents

Objective: To analyze the predictive capacity of anthropometric indicators and their cut‐off values for dyslipidemia screening in children and adolescents. Methods: This was a cross‐sectional study involving 1,139 children and adolescents, of both sexes, aged 6 to 18 years. Body weight, height, waist circumference (WC), and subscapular (SSF) and triceps skinfold thickness (TSF) were measured. The body mass index (BMI) and waist‐to‐height ratio (WHtR) were calculated. Children and adolescents exhibiting at least one of the following lipid alterations were defined as having dyslipidemia: elevated total cholesterol, low HDL‐C, elevated LDL‐C, and high triglyceride concentration. A receiver operating characteristic curve was constructed and the area under the curve, sensitivity, and specificity were calculated for the parameters analyzed. Results: The prevalence of dyslipidemia was 62.1%. WHtR, WC, SSF, BMI, and TSF, in this order, presented the largest number of significant accuracies, ranging from 0.59 to 0.78. The associations of the anthropometric indicators with dyslipidemia were stronger among adolescents than among children. Significant differences between accuracies of the anthropometric indicators were only observed by the end of adolescence; the accuracy of WHtR was higher than that of SSF (p = 0.048) for females, and the accuracy of WC was higher than that of SSF (p = 0.029) and BMI (p = 0.012) for males. In general, the cut‐off values of the anthropometric predictors of dyslipidemia increased with age, except for WHtR. Sensitivity and specificity varied substantially between anthropometric indicators, ranging from 75.6‐53.5 and from 75.0‐50.0, respectively Conclusions: The anthropometric indicators studied had little utility as screening tools for dyslipidemia, especially in childre

Time spent by Brazilian students in different modes of transport going to school: changes over a decade (2001-2011)

To examine changes in the time spent in each mode of transportation used for going to school by gender and age among adolescents from Santa Catarina State, Brazil. Two school-based surveys were performed in 2001 (N = 5,028) and 2011 (N = 6,529) in high school students (15-19 years old). The mode of transportation (on foot; by bicycle; by bus; car/motorcycle) and the time spent for commuting to school were assessed. Active commuting increased for short trips in both genders (male: 25.1% to 36.7%; female: 18.8% to 29.2%) and in all ages (15-16 years: 21% to 32.7%; 17-19 years: 21.9% to 32.4%), and declined for longer trips in males (30.5% to 21.9%) and in 15-16 years old students (25.7% to 34.7%). Car/motorcycle use has doubled for short trips in males (38.1% to 65.9%) and in 17-19 years old students (37.7% to 62.7%), while the use of buses remained stable in both genders. Our findings contribute to discussions on public policy focusing on the design of safe environments to promote active commuting to schools, particularly to decrease the use of motorized transport for short trips