IMC e perímetros de cinturas e quadril em escolares do município de São José da Lagoa Tapada

INTRODUÇÃO: Os aspectos alimentar e nutricional envolvem transformação e melhoria no hábito alimentar, pois abrange uma variedade de fatores que influenciam a qualidade de vida do indivíduo. Os benefícios da atividade física para uma boa expectativa de vida são muitos, principalmente, quando se pensa na grande importância que tem os indicadores antropométricos como o índice de massa corporal (IMC) e o índice de cintura e quadril (ICQ) que são parâmetros considerados adequados para a saúde dos adolescentes. OBJETIVO: Mediante isso, o presente estudo teve como objetivo comparar o IMC e medidas de cinturas e quadril de escolares do município de São José da Lagoa Tapada e classificar os escolares de acordo com o IMC. MÉTODOS: Trata-se de uma pesquisa descritiva, dedutiva de caráter exploratório e foi realizada com 58 escolares da Escola Estadual de Ensino Fundamental e Médio. Utilizou-se a análise quantitativa dos dados coletados, no qual foram analisados tabelas e gráficos que serviram de suporte para a pesquisa. RESULTADOS: O estudo mostrou que o IMC apresentado pelos estudantes do sexo feminino foi satisfatório, classificando-se dentro dos padrões de normalidade de acordo com a OMS, enquanto que os do sexo masculino foi inferior ao das meninas, porém continuaram de acordo com os parâmetros de normalidade, diminuindo assim os riscos à saúde. Em relação ao ICQ, os índices medidos foram considerados normais, existindo pequenas variações entre meninos e meninas, o que não indica o risco de doenças cardiovasculares e outros tipos de doenças. CONCLUSÃO: De acordo com a análise e discussão, a melhor forma de minimizar estes riscos, é por meio de exercícios físicos constantes e moderados e de uma alimentação balanceada, o que possibilitam impactos positivos no bem-estar dos adolescentes

APRENDENDO A CUIDAR: uma experiência de curso preparatório para mães principiantes

Este artigo tem por objetivo o relato da experiência do curso de extensão de curta duração intitulado Aprendendo a Cuidar: curso preparatório para mães principiantes, cuja finalidade compartilhar os conhecimentos a respeito dos cuidados com a gravidez, o parto e o recém-nascido para primigestas. A proposta nasceu da percepção da ausência desse tipo de curso preparatório em Imperatriz, Maranhão. Considerando a importância dos cuidados com a criança nos primeiros meses de vida e os impactos que este período tem sobre sua qualidade de vida, o Grupo de Estudos Educação, Cultura e Infância/GECI-CNPq em parceria com o curso de Enfermagem, ofereceu um curso preparatório para mulheres primigestas, tomando como protagonistas o próprio público alvo, suas angústias, inquietações e anseios. Promoveu-se trocas de experiências a partir de rodas de discussão com estudantes de enfermagem, além de profissionais diversos com o fim de promover educação em saúde. Os procedimentos adotados no cursoe os temas que o orientaram são apresentados neste artigo à luz de referencial teórico apropriado.Palavras-chave: Educação em Saúde. Gravidez. Recém-nascido

Políticas Públicas de Saúde em Fortaleza: do movimento pela reforma sanitária à reforma administrativa

The purpose of this artille is to describe the conformation of public health policies in Fortaleza, Ceará, from the pro-Sanitary Reform movement to the Administrative Reform, in order to know how the organization of basic health services evolved. All data were systematized according to the periodís correspondent to municipal administrations from 1986 to 2004. Some information about the Administrative Reform was obtained from the Diário Oficial do Município - DOM (Official Gazette of Fortaleza) through consultation of laws and decrees. The results revealed processual changes in the administrative structure of Fortaleza and in conformation of health policies. There was also a transformation in the work processes of the administration of Fortaleza County as well as adoption of some basic principles established by Sistema  Único de Saúde - SUS (National Health System) such as decentralization, interaction of different sectors and hierarchical structure. Additionally the study points out distortions between what it is regulated on the laws, decrees and what it was established, that is, basic attention to health is organized on verticalized, excluding, modelar programmes, despite its legal support and organizational structure to consolidate an assistance model which promotes health and prevention of diseases and risks to the population.Este artigo tem como objetivo descrever a conformação das políticas públicas de saúde em Fortaleza, Ceará, desde o movimento pela Reforma Sanitária à Reforma Administrativa, para conhecer a evolução da organização do sistema de serviços básicos de saúde. Optou-se por sistematizar as informações levantadas, obedecendo aos períodos correspondentes `às administrações municipais instaladas de 1986 a 2004. Parte das informaÁıes sobre a Reforma Administrativa foram obtidas junto ao Di´ário Oficial do Município de Fortaleza (DOM), através de consulta a leis e decretos. Os resultados deste estudo revelam que houve mudanças processuais na estrutura administrativa de Fortaleza e na conformação das políticas de saúde. Houve ainda, transformação dos processos de trabalho da Prefeitura Municipal de Fortaleza (PMF) e adoção de alguns princípios básicos do Sistema Único de Saúde (SUS) como a descentralização, a intersetorialidade e a hierarquização. O estudo aponta ainda, distorções entre o indicado nas Leis, decretos e portarias e o de fato implementado. A Atenção Básica à Saúde está organizada a partir de programas verticalizados, modelares e excludentes, apesar de ter suporte legal e estrutura organizacional para consolidar um modelo assistencial que privilegie a promoção da saúde e a prevenção de doenças ou de riscos na população

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Food intake in women two years or more after bariatric surgery meets adequate intake requirements

Restricted food intake after bariatric surgery can be an important factor both in the long-term control of body weight and in the onset of nutritional deficiencies. The objective of this study was to assess the adequacy of food intake in women two or more years after bariatric surgery according to the excess weight lost. A group of 141 women who underwent banded Roux-en-Y gastric bypass (RYGB) was divided according to the percentage of excess weight they lost (%EWL)<50; 50-175; = 75. The habitual energy and nutrient intakes were determined by a 24-hour recall over two days and the probability of adequate intake was based on the Dietary Reference Intake. The mean total estimated energy requirement (EER) as well as energy, macronutrient and cholesterol intakes did not differ among the groups. Only the %EWL < 50 group had an intake equal to their EER, but they presented a higher number of inadequacies, such as low levels of magnesium, folic acid and vitamins C and E. Calcium and dietary fiber intakes were extremely low in all three groups. In conclusion, weight loss after surgery is associated with food habits that favor energy intake over micronutrient intake. (C) 2012 Elsevier B.V. All rights reserved

Training of adolescent multipliers from the perspective of health promotion core competencies

ABSTRACT Objective: Recognize the domains of health promotion core competencies in the training process of adolescents carried out by nursing students. Method: Qualitative and descriptive study, which used the theoretical methodological contribution Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP), carried out with 14 nursing students. Results: There were four domains: Enable Change; Mediate through Partnership; Communication; and Leadership. These domains came from the interest and commitment of adolescents in intersectoral partnership, the use of communication techniques, and the role of facilitator to catalyze learning and empowerment. Conclusion: There were some domains of core competency in the training of adolescents, suggesting that nursing students act as health promoters. Challenges for Nursing are the implementation of a theoretical contribution of CompHP in undergraduate and ongoing training to carry out health promotion action

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)