Proposta de versão curta da Escala Brasileira de Insegurança Alimentar

OBJECTIVE To propose a short version of the Brazilian Food Insecurity Scale. METHODS Two samples were used to test the results obtained in the analyses in two distinct scenarios. One of the studies was composed of 230 low income families from Pelotas, RS, Southern Brazil, and the other was composed of 15,575 women, whose data were obtained from the 2006 National Survey on Demography and Health. Two models were tested, the first containing seven questions, and the second, the five questions that were considered the most relevant ones in the concordance analysis. The models were compared to the Brazilian Food Insecurity Scale, and the sensitivity, specificity and accuracy parameters were calculated, as well as the kappa agreement test. RESULTS Comparing the prevalence of food insecurity between the Brazilian Food Insecurity Scale and the two models, the differences were around 2 percentage points. In the sensitivity analysis, the short version of seven questions obtained 97.8% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively, while specificity was 100% in both studies. The five-question model showed similar results (sensitivity of 95.7% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively). In the Pelotas sample, the kappa test of the seven-question version totaled 97.0% and that of the five-question version, 95.0%. In the National Survey on Demography and Health sample, the two models presented a 99.0% kappa. CONCLUSIONS We suggest that the model with five questions should be used as the short version of the Brazilian Food Insecurity Scale, as its results were similar to the original scale with a lower number of questions. This version needs to be administered to other populations in Brazil in order to allow for the adequate assessment of the validity parameters.OBJETIVO : Propor versão curta da Escala Brasileira de Insegurança Alimentar. Foram analisados dois estudos constituídos por amostra de 230 famílias de baixa renda, de Pelotas, RS, e de 15.575 mulheres com base nos dados da Pesquisa Nacional de Demografia e Saúde, de 2006. MÉTODOS : Foram utilizadas duas amostras para testar os resultados obtidos nas análises em dois cenários distintos. Um dos estudos foi composto por 230 famílias de baixa renda, de Pelotas, RS, e o outro, por 15.575 mulheres, cujos dados foram obtidos na Pesquisa Nacional de Demografia e Saúde de 2006. Foram testados dois modelos, o primeiro contendo sete questões e o segundo as cinco consideradas mais relevantes na análise de concordância. Os modelos foram comparados à Escala Brasileira de Insegurança Alimentar, calculando-se os parâmetros de sensibilidade, especificidade e acurácia e o teste de concordância de kappa. RESULTADOS : Comparando as prevalências de insegurança alimentar entre a Escala Brasileira de Insegurança Alimentar e os dois modelos, as diferenças ficaram em torno de dois pontos percentuais. Na análise de sensibilidade, a versão curta de sete questões obteve 97,8% e 99,5% na amostra de Pelotas e da Pesquisa Nacional de Demografia e Saúde, respectivamente, enquanto a especificidade foi de 100% em ambos os estudos. O modelo de cinco questões mostrou resultados semelhantes (sensibilidade de 95,7% e 99,5% na amostra de Pelotas e da Pesquisa Nacional de Demografia e Saúde, respectivamente). A versão de sete questões apresentou teste de kappa de 97,0% e a versão de cinco questões, de 95,0%, na amostra de Pelotas. Já na amostra da Pesquisa Nacional de Demografia e Saúde, os dois modelos apresentaram kappa de 99,0%. CONCLUSÕES : Sugere-se o modelo com cinco questões para ser utilizado como versão curta da Escala Brasileira de Insegurança Alimentar, visto que apresentou resultados semelhantes à escala original com menor número de questões. É necessário que essa versão seja aplicada em outras populações do Brasil, de forma a permitir adequada avaliação dos parâmetros de validade

Environmental impact monitoring of a minero-chemical complex in Catalão urban area of PTS, PM10 and PM2.5 by EDX characterization

Depending on its nature, particulate matter has very different size, composition and morphology. By the combination of these criteria it is possible to distinguish the emitting sources (primary or secondary). The shape and the dimension of the particles have also a direct interaction with the risk assessment for human health. The minero-chemical complex consists of phosphate fertilizer manufacturing, rock phosphate and niobium mining open pits and it is located northeast of the urban area of the city. Environmental issues associated with it include the following: fugitive emissions which are primarily associated with operational leaks from tubing, valves, connections, flanges, packings, open ended lines, floating roof storage tank and pump seals, gas conveyance systems, compressor seals, pressure relief valves, tanks or open its/containments, and loading and unloading operations of products. Furthermore the area of study is characterized by a predominantly northeast winds direction. The monitoring was performed weekly particulates samples were collected in two seasonal episodes at one representative places in the urban area of Catalao (a Brazilian city located in Goias state) in the period from August to November of 2014. Suspended particles were sampled on pure fiberglass filters by using a High Volume air sampler and were analyzed via an energy dispersive X-ray microanalysis system (EDX). The airborne particulate matter was characterized from a physico-chemical point of view to supply information on the particle composition and the compounds carried on their surfaces. The microanalysis enables identification of several groups of particles such as: soot, Si-rich, metal-rich and biological particules. These results may help in controlling and preventing fugitive emissions in atmospheric air.Depending on its nature, particulate matter has very different size, composition and morphology. By the combination of these criteria it is possible to distinguish the emitting sources (primary or secondary). The shape and the dimension of the particles h4319091914CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPEG - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE GOIÁSsem informaçãosem informaçãoFinancial support and scholarships from the Brazilian funding agencies CNPq, FAPEG and Environment Office City of Catalão, City Council Environmental Protection of Catalão and Public Ministry of Goiás State are gratefully acknowledged

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Body shape at age six: components and determinants

Central body shape is usually assessed by traditional anthropometry (e.g. BMI and waist and hip circumferences) and is associated with adverse outcomes. However, these measures may underestimate the total variability of body shape, not detecting other possible dimensions. Between 2010 and 2011, 3350 children from 2004 Pelotas Birth Cohort Study (6.8 years average age) were followed and examined by Three-Dimensional Photonic Scanner, and more than 30 different measures among circumnferences, body lengths and body volume were calculated. The first paper of our thesis aimed to describe the variation of body shape and size in 6 year-old children and assess how these dimensions are captured by traditional anthropometric and body composition measurements. Using Principal Component Analysis, we found four different body shape’s components (corpulence, central:peripheral ratio, height & arm lengths e shoulder diameter), and only one (corpulence) was well correlated with traditional anthropometry and body composition measures. Moreover, these components presented differences according to some children’s characteristics, such as sex, socioeconomic position and birth weight. We concluded that some dimensions of children’s body shape and size are not well captured by traditional anthropometry or body composition measures. In addition, differences in these novel components by sex, birth weight, socio-economic position and skin colour may indicate their potential relevance to disease risks. After, we carried out a systematic review where we aimed to identify the determinants of body shape in pre-pubertal children. In this study, we identified that body shape is defined in different ways (waist and/or hip circumferences, skinfold thickness measurements, or regional body composition by DXA scanning). Birth weight and infancy weight gain were the most evident determinants of children’s body shape. Sex differences in body shape were dependent on the type of measurement. In our systematic review, there was limited evidence reported for effects of ethnicity, maternal characteristics, and breastfeeding and dietary practices in infancy on body shape. Finally, in the last10 paper we investigated the effect of dietary intake patterns at 1, 2 and 4 years on BMI z-score and body shape. Despite we have found a relative tracking of dietary intake pattern from 1 to 4 years of age, these patterns were not consistently associated with BMI z-score and body shape after adjustment for sociodemographic characteristics. We concluded that there are different dimensions of children’s body shape and size which may not being well captured by anthropometry and body composition measures. Birth weight and infancy weight gain are the most determinants of children’s body shape, and sex differences are dependent of the way body shape is defined. Finally, dietary intake patterns from 1 to 4 years are more associated with sociodemographic characteristics than with body shape at 6 years.Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqO acúmulo de tecido adiposo, principalmente na região central (forma corporal androide), é usualmente avaliado por medidas tradicionais, como o índice de massa corporal e circunferência da cintura, e tem sido associado a risco de doenças crônicas. No entanto, essas medidas tradicionais podem não avaliar a variabilidade total da forma corporal, subestimando outras possíveis dimensões presentes. Entre 2010 e 2011, 3350 crianças com idade média de 6,8 anos participaram do acompanhamento da coorte de nascimentos de 2004 e foram examinadas pelo Three-Dimensional Photonic Scanner, que calculou mais de 30 medidas, entre circunferências, medidas de comprimento e volume corporal, entre outras. O primeiro artigo desta tese objetivou descrever a variabilidade total da forma corporal aos seis anos, a partir das diferentes medidas calculadas pelo scanner, e sua correlação com medidas tradicionais de antropometria e composição corporal. Usando análise de componentes principais, identificamos quatro componentes da forma corporal (corpulência, razão centro-periférica, altura e comprimento dos braços e diâmetro dos ombros), sendo que apenas um deles (corpulência) apresentou forte correlação com medidas tradicionais de antropometria e composição corporal. Além disso, tais componentes apresentaram diferenças de acordo com algumas características das crianças, tais como sexo, nível socioeconômico e peso ao nascer. Neste artigo, concluímos que existem dimensões da forma corporal que podem não estar sendo bem capturadas por medidas tradicionais de antropometria e composição corporal. Ademais, diferenças nesses componentes de acordo com características sociodemográficas podem indicar potenciais riscos futuros. Após, realizou-se uma revisão sistemática no intuito de identificar os determinantes da forma corporal no período pré-pubertal. Nessa revisão identificamos que a forma corporal é avaliada de diferentes formas (circunferência da cintura e quadril, pregas cutâneas ou medidas regionais calculadas pelo DXA) e que o peso ao nascer e o ganho de peso na infância8 precoce foram os determinantes mais evidentes da forma corporal antes da puberdade. Diferenças por sexo foram observadas desde idades precoces, mas foram dependentes da maneira como a forma corporal foi avaliada. Em nossa revisão, encontramos evidência limitada a respeito dos efeitos da cor da pele, características maternas e aleitamento materno e alimentação na infância sobre a forma corporal. Por fim, no último artigo da tese investigamos o efeito da alimentação na infância precoce (1, 2 e 4 anos) na determinação da forma corporal aos 6 anos. Apesar de haver uma relativa estabilidade nos padrões alimentares indentificados de 1 a 4 anos de idade, tais padrões não apresentaram associação consistente com o IMC e com a forma corporal aos 6 anos após ajuste para fatores sociodemográficos. Sendo assim, nossa tese permite concluir que há dimensões da forma corporal que podem estar sendo marginalizadas pelas medidas típicas que avaliam a forma corporal. Peso ao nascer e rápido ganho de peso são determinantes evidentes da forma aos 6 anos e diferenças por sexo já são evidentes desde cedo. Por fim, os padrões alimentares na infância precoce estão mais relacionados a fatores sociais e não determinam a forma corporal aos 6 anos

Relationship between food insecurity and nutritional status of Brazilian children under the age of five

OBJECTIVE: The aim of this study was to investigate the relationship between food insecurity and nutritional status of Brazilian children. METHODS: The National Demographic and Health Survey 2006 database is available on the worldwide web. Thus, the analyzed variables were obtained in this study, including nutritional indices, food insecurity and other socioeconomic and demographic variables. The height-for-age, weight-for-age and weight-for-height indices were evaluated as the Z-score of the World Health Organization reference curves. Food insecurity was defined by using the Brazilian Food Insecurity Scale. Averages of three indices according to the presence of food insecurity were analyzed, including other variables. Linear regression evaluated the effect of food insecurity on the Z-score of the three nutritional indices. RESULTS: The sample included 4,817 children, out of whom 7% had deficit in height, 7% were overweight and 47% had food insecurity. It was found that the average of height-for-age, weight-for-age and weight-for-height were -0.31, 0.12 and 0.40, respectively, being lower among children with food insecurity. CONCLUSION: The regression analysis showed that children living with some level of food insecurity have worse rates of height-for-age, even controlling for demographic and socioeconomic factors

Effects of dietary intake patterns from 1 to 4 years on BMI z-score and body shape at age of 6 years: a prospective birth cohort study from Brazil.

PURPOSE: To assess the association between dietary intake patterns from 1 to 4 years and BMI and body shape at age of 6 years. METHODS: This longitudinal study was based on 3374 Brazilian children from the 2004 Pelotas Birth Cohort Study. We used previously described dietary patterns from 1 to 4 years as the main exposure. We defined body shape using scores for corpulence (a recently described body shape component measured by Photonic Scanner), and trunk and gynoid fat mass percentage from DXA. We run linear regression models to evaluate the associations between dietary patterns from 1 to 4 years and BMI and body shape at 6 years. RESULTS: Several apparent associations between dietary patterns and BMI or body shape were explained by sociodemographic factors. High adherence to snacks (positive loadings to coffee, bread and cookies) at 4 years predicted lower BMI, but higher gynoid fat mass percentage at 6 years, while higher adherence to staple at 2 years (positive loadings to rice and beans) predicted higher trunk fat mass and lower gynoid fat mass. Finally, higher scores on milks at 1 year (positive loading to breast milk) predicted higher gynoid fat mass at 6 years. CONCLUSION: There were inconsistent associations between dietary patterns in infancy and early childhood and BMI and body shape at 6 years. In adjusted analyses, higher adherence to breast milk at 1 year and to snacks at 4 years appeared to be beneficial for body shape, associated with lower BMI, but higher peripheral fat

Maternal determinants of dietary patterns in infancy and early childhood in the Growing up in New Zealand cohort

Abstract Given the importance of diet in early life, assessing children’s diet is crucial to guide interventions. Using data from a nationally generalizable New Zealand (NZ) birth cohort we examined children’s dietary patterns at 9- (n = 6259), 24- (n = 6292), and 54-months (n = 6131), and their association with maternal sociodemographic and health behaviours. At each time-point, children's dietary patterns were identified using principal components analysis. We then used multivariate linear regression to examine associations between each pattern and maternal variables. At 9-, 24- and 54-months, two dietary patterns were identified, explaining 36.4%, 35.3% and 33.6% of children's intake variability, respectively. Refined high in sugar, salt and fat dietary pattern, at all time-points, was characterized by high positive loadings in white/refined breads and cereals, and items with high sugar, sodium, and fat content. At 24-months, Refined high in sugar, salt and fat also included a high positive loading with protein food groups. Fruit and vegetables dietary pattern, at all time-points, had high positive loadings for fruits and vegetables (with type varying across time-points). Fruit and vegetables also included high loading in whole grain options of breads and cereals at 24-months and the protein food group was part of this dietary pattern at 9- and 54-months. Children’s scores on the Refined high in sugar, salt and fat pattern had strong associations with maternal smoking habits, education level, ethnicity, and maternal scores in the “Junk” and “Traditional/White bread” dietary patterns (constructed from an antenatal interview). Children’s scores on the Fruit and vegetables pattern had strong associations with the maternal scores in the dietary pattern “Health Conscious”. Interventions to improve diet in early life in NZ need to be responsive to ethnicity and suitable for people of all education levels. Interventions that improve maternal health behaviours may also improve children’s diet