Efficacy of Cinnamon as an Adjuvant in Reducing the Glycemic Biomarkers of Type 2 Diabetes Mellitus: A Three-Month, Randomized, Triple-Blind, Placebo-Controlled Clinical Trial.

The major aim of this randomized, placebo-controlled, triple-blind clinical trial was to evaluate the efficacy of cinnamon as an adjuvant treatment in reducing glycemic levels in people with type 2 diabetes, compared to a placebo. The study was conducted between August and December 2019, with 160 people with type 2 diabetes, in five Primary Health Units, in Parnaíba, Brazil. Inclusion criteria were: persons of both genders using oral antidiabetic agents, with glycated hemoglobin ≥ 6.0%, and between 18 and 80 years of age. The primary outcome was change in glycated hemoglobin levels after 90 days of intervention. Other biomarkers evaluated were fasting blood glucose, insulin level, and HOMA-IR index. Participants were divided equally into two groups of 80 individuals each, and were given 3 g capsules of either cinnamon or placebo to be taken in combination with their usual oral antidiabetic agents. After 90 days, participants in the cinnamon group had statistically significant reductions of 0.2% of glycated hemoglobin and 0.55 mmol/L of fasting venous glucose, when compared with the placebo group. Cinnamon reduced the glycemic measures of persons with type 2 diabetes, albeit with modest reductions. TRIAL: RBR-2KKB6D.

Association between sleep disorders on children, sociodemographic factors and the sleep of caregivers / Asociación entre los trastornos del sueño de niños y niñas, los factores sociodemográficos y el sueño de sus cuidadores

Abstract Aim: To analyze the association between children's sleep disorders, sociodemographic factors, and caregivers' sleep. Method: An Epidemiological, cross-sectional, analytical study, with a quantitative approach, was carried out in two public schools in the Northeast of Brazil. The participants were 222 students, aged between 6 and 11 years old, and 123 caregivers. The Sleep Disturbance Scale in Children was used for the children's evaluations. The caregivers' sleep was analyzed using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Results: Regarding the sleep disorders in children, 60.8% had good sleep quality. Most of them had an adequate number of sleep hours, studied in the afternoon, spent less than two hours in front of screens, and had no reports of illnesses. There was a significant relationship between those caregivers outside the home and the children with an adequate number of hours of sleep. Children with poor sleep quality had a predominance of enuresis. There was an association between good quality of sleep and physical activity during free time and the acceptance of school meals. Children with good sleep quality predominated seemed to be the ones in the care of caregivers who did not present excessive daytime sleepiness and reports of illnesses. Conclusion: The data found suggest the need to conduct new strategies that can promote more quality to children's sleep, with caregivers and the pre-school educational community.

RESUMEN Objetivo: Analizar la asociación entre los trastornos del sueño de niños y niñas, los factores sociodemográficos y el sueño de sus cuidadores. Método: Estudio epidemiológico, transversal, analítico y con enfoque cuantitativo. Fue desarrollado en dos escuelas públicas del nordeste de Brasil. Los participantes fueron 222 estudiantes de 6 a 11 años y 123 cuidadores. Se utilizó la escala de alteración del sueño para niñas y niños. El sueño de las personas cuidadoras se analizó mediante el índice de calidad del sueño de Pittsburgh y la escala de somnolencia de Epworth. Resultados: En la escala de trastornos del sueño para niñas y niños, el 60,8 % tenía buena calidad de sueño. La mayoría de los niños y niñas con horas de sueño adecuadas estudiaban por la tarde, pasaban menos de dos horas frente a las pantallas y no tenían informes de enfermedad. Hubo una relación significativa entre cuidadores sin empleo extrafamiliar y las horas de sueño adecuadas para la niña o el niño. Los niños y las niñas con mala calidad del sueño tenían predominio de enuresis. Hubo una asociación entre la buena calidad del sueño, la actividad física durante el tiempo libre y la aceptación de las comidas escolares. Entre las personas cuidadoras que no presentaron excesiva somnolencia diurna y relatos de enfermedad, predominaron niñas y niños con buena calidad de sueño. Conclusión: Los datos encontrados sugieren la necesidad de ejecutar nuevas estrategias con los cuidadores y la comunidad educativa preescolar, que promuevan una mejor calidad del sueño de las personas infantes.

RESUMO Objetivo: Analisar a associação entre distúrbios do sono infantil, fatores sociodemográficos e sono dos cuidadores. Método: Estudo epidemiológico, transversal, analítico, com abordagem quantitativa, desenvolvido em duas escolas públicas do Nordeste do Brasil. Os participantes foram 222 estudantes, com idades entre 6 e 11 anos, e 123 cuidadores. Foi utilizada a escala de distúrbios do sono em crianças. O sono dos cuidadores foi analisado por meio do índice de qualidade do sono de Pittsburgh e Escala de Sonolência de Epworth. Resultados: Na escala de distúrbios do sono em crianças,60,8% tinham boa qualidade do sono. A maioria das crianças com horas de sono adequadas estudavam no período vespertino, passavam menos de duas horas em frente das telas e não tinham relato de doença. Houve relação significante entre cuidadores sem vínculo empregatício extradomiciliar e horas adequadas de sono da criança. Crianças com má qualidade do sono apresentaram predomínio de enurese. Houve associação entre boa qualidade do sono e prática de atividade física em horário livre e aceitação da refeição escolar.Entre os cuidadores que não apresentaram sonolência diurna excessiva e relato de doença, predominou as crianças com boa qualidade do sono. Conclusão: Os dados encontrados sugerem a necessidade de conduzir novas estratégias que possam promover mais qualidade ao sono de crianças, junto dos cuidadores e da comunidade educativa pré-escolar.

Atendimento ao adulto em parada cardiorrespiratória: intervenção educativa para estudantes leigos / Care of adults at cardiorrespiratory stop: educational intervention for lay students

Objetivo: Avaliar o efeito de uma intervenção educativa, no contexto do ensino médio, sobre o tema parada cardiorrespiratória em adultos. Método: Trata-se de um estudo quase-experimental, do tipo antes e depois, com abordagem quantitativa desenvolvido entre fevereiro a novembro de 2019 em uma escola da rede pública do município de Fortaleza, Ceará. Resultados: Inicialmente foram recrutados 30 estudantes, porém 10 estudantes se encaixavam dentro dos critérios de inclusão, sendo esta a amostra final. Para a realização do estudo foi utilizado um questionário estruturado, de autoria dos pesquisadores, composto por 10 perguntas objetivas. Após a intervenção educativa e análise dos dados, foi obtida uma média de acertos de 7,225 no pós-teste comprovando através dos números a eficiência da educação em saúde realizada, pois inicialmente a média apresentada foi 4,375. Conclusão: Constatou-se que os estudantes possuíam conhecimento referente ao suporte básico de vida insuficiente, porém com grande capacidade para aprendizagem, sendo a escola um ambiente favorável para práticas educativas sobre a temática. (AU)

Objective: To evaluate the effect of an educational intervention, in the context of high school, on the theme cardiorespiratory arrest in adults. Methods: Quasi-experimental study, before and after, with quantitative approach developed between February and November 2019 in a public school in the city of Fortaleza, Ceará. Results: Initially, 30 students were recruited, but 10 met the inclusion criteria, which was the final sample. To carry out the study, a structured questionnaire was used, authored by the researchers, composed of 10 objective questions. After the educational intervention and data analysis, an average of 7,225 correct answers were obtained in the post-test, proving through the numbers the efficiency of health education performed, since initially the average presented was 4,375. Conclusion: It was found that the students had knowledge related to insufficient basic life support, but with great learning capacity, and the school was a favorable environment for educational practices on the subject. (AU)

Objetivo: Evaluar el efecto de una intervención educativa, en el contexto de la escuela secundaria, sobre el tema del paro cardiorrespiratorio en adultos. Métodos: Estudio cuasiexperimental, antes y después, con un enfoque cuantitativo desarrollado entre febrero y noviembre de 2019 en una escuela pública de la ciudad de Fortaleza, Ceará. Resultados: Inicialmente, se reclutaron 30 estudiantes, pero 10 cumplieron con los criterios de inclusión, que fue la muestra final. Para llevar a cabo el estudio, se utilizó un cuestionario estructurado, escrito por los investigadores, compuesto por 10 preguntas objetivas. Luego de la intervención educativa y el análisis de datos, se obtuvo un promedio de 7,225 respuestas correctas en la prueba posterior, demostrando a través de los números la eficiencia de la educación en salud realizada, ya que inicialmente el promedio presentado fue de 4,375. Conclusión: Se encontró que los estudiantes tenían conocimientos relacionados con un apoyo básico insuficiente para la vida, pero con una gran capacidad de aprendizaje, y la escuela era un ambiente favorable para las prácticas educativas sobre el tema. (AU)

Port and industrial compound of Pecém: an epidemiological survey. / Complexo industrial e portuário do Pecém: um inquérito epidemiológico.

This research aimed to analyze the dwellers' knowledge of the territories, Pecém Port and Industrial Compound (CIPP), the quality of life of the communities living in the vicinity of the enterprises, and the prevalence of hypertension and overweight. This is a home-based, epidemiological survey of four areas of the Family Health Strategy (ESF) in São Gonçalo do Amarante and one area of the ESF in Caucaia, Ceará, Brazil. The study was carried out between 10/2017 and 03/2018. Anthropometric and blood pressure measurements were performed, and sociodemographic data and knowledge about community, the CIPP, and quality of life were collected. A total of 69.8% of the 503 adults interviewed were female, and the mean age was 44 years. Parada was the area reporting the highest percentage of problems related to air particles (51.1%), the worst concept regarding the CIPP (40.1% bad), the highest percentage of worse quality of life (29, 1%), and greater desire to move to another place (31.5%). Pecém had the highest percentage of community problems related to violence, consumption of illicit drugs, and prostitution. We concluded that there are signs of impact on local populations' health and quality of life without more significant direct work/income benefits.

Esta pesquisa busca analisar o conhecimento dos moradores sobre o território, Complexo Industrial e Portuário do Pecém (CIPP), qualidade de vida das comunidades que vivem no entorno dos empreendimentos, além da prevalência de hipertensão e excesso de peso. Trata-se de um inquérito epidemiológico, de base domiciliar, envolvendo quatro áreas da Estratégia de Saúde da Família (ESF) do Município de São Gonçalo do Amarante e uma de Caucaia, Ceará, Brasil. O estudo foi realizado entre 10/2017 e 03/2018, em que foram realizadas aferições antropométricas e pressão arterial e coletados dados sociodemográficos e o conhecimento sobre comunidade, CIPP e qualidade de vida. Dos 503 adultos entrevistados, 69,8% eram do sexo feminino e a média de idade foi 44 anos. Parada foi a área que relatou o maior percentual de problemas relacionados às partículas aéreas (51,1%), pior conceito em relação ao CIPP (40,1% ruim), maior percentual de piora da qualidade de vida (29,1%) e maior desejo de mudar (31,5%). Pecém apresentou maior percentual de problemas na comunidade relacionados à violência, consumo de drogas ilícitas e prostituição. Conclui-se que se apresenta indícios de impacto na saúde e qualidade de vida das populações locais sem maiores benefícios diretos no trabalho/renda.

Development and validation of a MHEALTH technology for the promotion of self-care for adolescents with diabetes. / Desenvolvimento e validação de uma tecnologia MHEALTH para a promoção do autocuidado de adolescentes com diabetes.

Self-care is encouraged in the type 1 Diabetes Mellitus (DM1) setting. Thus, this research aimed to develop and validate a mobile application (APP) to promote self-care for adolescents with DM1. The method was divided into two stages: development and validation, ranging from literature review, benchmarking, prototype construction to validation by specialists. The APP construction was subsidized by the seven steps proposed by the American Association of Diabetes Educators. The screens were designed and possible functions were selected. After the design, the APP prototype was developed and named "DM Agendinha". The content validation process was mediated by the Suitability Assessment of Materials tool, where the percentage obtained was 85.3%, characterizing the APP as "Superior Material". The Smartphone Usability questionnaire was employed for technical validation, and the APP reached a global Content Validity Index of 0.96. We concluded, therefore, that the use of this material by adolescents will favor the acquisition of new knowledge and adherence to healthy practices, considering that it is a highly intelligible electronic technology.

No cenário do Diabetes Mellitus tipo 1 (DM1), uma prática incentivada é o autocuidado. Dessa forma, objetivou-se elaborar e validar um aplicativo móvel (APP) para a promoção do autocuidado em adolescentes com DM1. O método foi divido em duas etapas: elaboração e validação, que vão desde a revisão de literatura, benchmarking, construção do protótipo e validação por especialistas. A construção do APP foi subsidiada pelos sete passos propostos pela American Association of Diabetes Educators. Foram desenhadas as telas e selecionaram-se as possíveis funções; após o desenho, o protótipo do APP foi desenvolvido e nomeado como "DM Agendinha". O processo de validação de conteúdo foi mediado pelo instrumento Suitability Assessment of Materials, por meio do qual o percentual obtido foi de 85,3%, caracterizando o APP como "Material Superior". Para a validação técnica, empregou-se o questionário Smartphone Usability questionnaire, que obteve um Índice de Validade de Conteúdo global de 0,96. Conclui-se, portanto, que o uso desse material por parte dos adolescentes favorecerá a aquisição de novos conhecimentos e a adesão de práticas saudáveis, tendo em vista que se trata de uma tecnologia de caráter eletrônico e de fácil compreensão.

Family Health Postgraduate Program in the Brazilian northeast: repercussions in the professional exercise of postgraduates. / Programa de Pós-Graduação em Saúde da Família no nordeste brasileiro: repercussões no exercício profissional dos egressos.

Brazilian postgraduate education has grown in recent years, but there is a knowledge gap regarding whether the course's planned educational objective is being achieved. We aimed to evaluate the contribution of the Postgraduate Program in Family Health for the postgraduates' professional practice. This is a cross-sectional study conducted with 225 postgraduates from October 2019 to July 2020. Data were collected by an online questionnaire containing different sociodemographic and educational variables and competencies developed in the master's degree program and identifying the domains of Health Promotion Competencies. Most of the participants were female (78.2%), nurses (58.2%), public servants (64%), and SUS workers (93.3%). Two hundred and twenty-two (98.7%) postgraduates' final paper theme built on a practice-related issue. A high mean score was observed for all competencies analyzed. The mean scores for domains in Health Promotion competencies were high. We can conclude that the postgraduate program has contributed satisfactorily to the formation of critical, active masters, with competencies developed and being realized in professional practice.

A pós-graduação no Brasil tem crescido nos últimos anos, porém há uma lacuna do conhecimento em saber se o objetivo formativo planejado do curso está sendo alcançado. Com isso, objetivou-se avaliar a contribuição do Programa de Pós-graduação em Saúde da Família, no exercício profissional de seus egressos. Trata-se de estudo transversal, realizado nos meses de outubro de 2019 a julho de 2020, com 225 egressos. A coleta de dados se deu por meio de questionário on-line contendo distintas variáveis sociodemográficas e de formação, além de competências desenvolvidas no mestrado e identificação dos domínios das Competências de Promoção da Saúde. A maioria dos participantes era do sexo feminino (78,2%), enfermeiros (58,2), concursados (64%) e trabalhadores do SUS (93,3). Notou-se que 222 (98,7%) egressos tiveram a temática do trabalho de conclusão oriunda de uma questão relacionada à prática. Observou-se média elevada nos escores para todas as competências avaliadas. Foram elevados os escores médios dos domínios de Competências de Promoção da Saúde. Conclui-se que o programa de pós-graduação tem contribuído de forma satisfatória na formação de mestres críticos, atuantes, com competências desenvolvidas e sendo realizadas na prática profissional.

Complexo industrial e portuário do Pecém: um inquérito epidemiológico / Port and industrial compound of Pecém: an epidemiological survey

Resumo Esta pesquisa busca analisar o conhecimento dos moradores sobre o território, Complexo Industrial e Portuário do Pecém (CIPP), qualidade de vida das comunidades que vivem no entorno dos empreendimentos, além da prevalência de hipertensão e excesso de peso. Trata-se de um inquérito epidemiológico, de base domiciliar, envolvendo quatro áreas da Estratégia de Saúde da Família (ESF) do Município de São Gonçalo do Amarante e uma de Caucaia, Ceará, Brasil. O estudo foi realizado entre 10/2017 e 03/2018, em que foram realizadas aferições antropométricas e pressão arterial e coletados dados sociodemográficos e o conhecimento sobre comunidade, CIPP e qualidade de vida. Dos 503 adultos entrevistados, 69,8% eram do sexo feminino e a média de idade foi 44 anos. Parada foi a área que relatou o maior percentual de problemas relacionados às partículas aéreas (51,1%), pior conceito em relação ao CIPP (40,1% ruim), maior percentual de piora da qualidade de vida (29,1%) e maior desejo de mudar (31,5%). Pecém apresentou maior percentual de problemas na comunidade relacionados à violência, consumo de drogas ilícitas e prostituição. Conclui-se que se apresenta indícios de impacto na saúde e qualidade de vida das populações locais sem maiores benefícios diretos no trabalho/renda.

Abstract This research aimed to analyze the dwellers' knowledge of the territories, Pecém Port and Industrial Compound (CIPP), the quality of life of the communities living in the vicinity of the enterprises, and the prevalence of hypertension and overweight. This is a home-based, epidemiological survey of four areas of the Family Health Strategy (ESF) in São Gonçalo do Amarante and one area of the ESF in Caucaia, Ceará, Brazil. The study was carried out between 10/2017 and 03/2018. Anthropometric and blood pressure measurements were performed, and sociodemographic data and knowledge about community, the CIPP, and quality of life were collected. A total of 69.8% of the 503 adults interviewed were female, and the mean age was 44 years. Parada was the area reporting the highest percentage of problems related to air particles (51.1%), the worst concept regarding the CIPP (40.1% bad), the highest percentage of worse quality of life (29, 1%), and greater desire to move to another place (31.5%). Pecém had the highest percentage of community problems related to violence, consumption of illicit drugs, and prostitution. We concluded that there are signs of impact on local populations' health and quality of life without more significant direct work/income benefits.

Programa de Pós-Graduação em Saúde da Família no nordeste brasileiro: repercussões no exercício profissional dos egressos / Family Health Postgraduate Program in the Brazilian northeast: repercussions in the professional exercise of postgraduates

Resumo A pós-graduação no Brasil tem crescido nos últimos anos, porém há uma lacuna do conhecimento em saber se o objetivo formativo planejado do curso está sendo alcançado. Com isso, objetivou-se avaliar a contribuição do Programa de Pós-graduação em Saúde da Família, no exercício profissional de seus egressos. Trata-se de estudo transversal, realizado nos meses de outubro de 2019 a julho de 2020, com 225 egressos. A coleta de dados se deu por meio de questionário on-line contendo distintas variáveis sociodemográficas e de formação, além de competências desenvolvidas no mestrado e identificação dos domínios das Competências de Promoção da Saúde. A maioria dos participantes era do sexo feminino (78,2%), enfermeiros (58,2), concursados (64%) e trabalhadores do SUS (93,3). Notou-se que 222 (98,7%) egressos tiveram a temática do trabalho de conclusão oriunda de uma questão relacionada à prática. Observou-se média elevada nos escores para todas as competências avaliadas. Foram elevados os escores médios dos domínios de Competências de Promoção da Saúde. Conclui-se que o programa de pós-graduação tem contribuído de forma satisfatória na formação de mestres críticos, atuantes, com competências desenvolvidas e sendo realizadas na prática profissional.

Abstract Brazilian postgraduate education has grown in recent years, but there is a knowledge gap regarding whether the course's planned educational objective is being achieved. We aimed to evaluate the contribution of the Postgraduate Program in Family Health for the postgraduates' professional practice. This is a cross-sectional study conducted with 225 postgraduates from October 2019 to July 2020. Data were collected by an online questionnaire containing different sociodemographic and educational variables and competencies developed in the master's degree program and identifying the domains of Health Promotion Competencies. Most of the participants were female (78.2%), nurses (58.2%), public servants (64%), and SUS workers (93.3%). Two hundred and twenty-two (98.7%) postgraduates' final paper theme built on a practice-related issue. A high mean score was observed for all competencies analyzed. The mean scores for domains in Health Promotion competencies were high. We can conclude that the postgraduate program has contributed satisfactorily to the formation of critical, active masters, with competencies developed and being realized in professional practice.

Desenvolvimento e validação de uma tecnologia MHEALTH para a promoção do autocuidado de adolescentes com diabetes / Development and validation of a MHEALTH technology for the promotion of self-care for adolescents with diabetes

Resumo No cenário do Diabetes Mellitus tipo 1 (DM1), uma prática incentivada é o autocuidado. Dessa forma, objetivou-se elaborar e validar um aplicativo móvel (APP) para a promoção do autocuidado em adolescentes com DM1. O método foi divido em duas etapas: elaboração e validação, que vão desde a revisão de literatura, benchmarking, construção do protótipo e validação por especialistas. A construção do APP foi subsidiada pelos sete passos propostos pela American Association of Diabetes Educators. Foram desenhadas as telas e selecionaram-se as possíveis funções; após o desenho, o protótipo do APP foi desenvolvido e nomeado como "DM Agendinha". O processo de validação de conteúdo foi mediado pelo instrumento Suitability Assessment of Materials, por meio do qual o percentual obtido foi de 85,3%, caracterizando o APP como "Material Superior". Para a validação técnica, empregou-se o questionário Smartphone Usability questionnaire, que obteve um Índice de Validade de Conteúdo global de 0,96. Conclui-se, portanto, que o uso desse material por parte dos adolescentes favorecerá a aquisição de novos conhecimentos e a adesão de práticas saudáveis, tendo em vista que se trata de uma tecnologia de caráter eletrônico e de fácil compreensão.

Abstract Self-care is encouraged in the type 1 Diabetes Mellitus (DM1) setting. Thus, this research aimed to develop and validate a mobile application (APP) to promote self-care for adolescents with DM1. The method was divided into two stages: development and validation, ranging from literature review, benchmarking, prototype construction to validation by specialists. The APP construction was subsidized by the seven steps proposed by the American Association of Diabetes Educators. The screens were designed and possible functions were selected. After the design, the APP prototype was developed and named "DM Agendinha". The content validation process was mediated by the Suitability Assessment of Materials tool, where the percentage obtained was 85.3%, characterizing the APP as "Superior Material". The Smartphone Usability questionnaire was employed for technical validation, and the APP reached a global Content Validity Index of 0.96. We concluded, therefore, that the use of this material by adolescents will favor the acquisition of new knowledge and adherence to healthy practices, considering that it is a highly intelligible electronic technology.

Health promotion actions in the School Health Program in Ceará: nursing contributions.

OBJECTIVES: to compare health promotion actions carried out by Family Health teams in Ceará, linked to the School Health Program. METHODS: a cross-sectional study involving the first and second cycles of an external assessment of 910 and 1,626 teams from 184 municipalities, which joined the Brazilian National Program for Improvement of Access and Quality of Primary Care. Eight clinical assessment and seven health promotion indicators were assessed, together with health professionals working in schools. RESULTS: the interviewees were nurses (95.6% and 98.3%). Between the cycles, there was an increase in clinical assessment (78.7% and 91.3%), health promotion and disease prevention (82.5% and 89.3%) and survey of students for follow-up (41.4% and 66.4%) in schools. CONCLUSIONS: health actions at school advanced between cycles, with nurses as protagonists in school health, which can reduce vulnerabilities in children and adolescents and qualify Primary Care.

Effectiveness of the piperine-supplemented Curcuma longa L. in metabolic control of patients with type 2 diabetes: a randomised double-blind placebo-controlled clinical trial.

There is robust evidence of using Curcuma longa L. in reducing metabolic levels in people with diabetes. This study analysed the effectiveness of Curcuma longa L. in the metabolic control of patients with type 2 diabetes in Brazil. A randomised double-blind placebo-controlled clinical trial was conducted with 71 participants divided into a Curcuma longa L. group (500 mg/day with piperine 5 mg) and a placebo group, for 120 days. Anthropometric, clinical and biochemical variables were evaluated at baseline, 60 and 120 days after the beginning of the intervention. Paired and independent Student's t-test and chi-square test were used for statistical analysis. The curcuma group presented a significantly decreased glycaemia (p=.013), glycated haemoglobin (p=.015), HOMA index (p=.037) and triglycerides (TGs) (p=.002). The use of piperine-added Curcuma longa L. was effective in the glycaemic and TG control of patients with type 2 diabetes.

Cost-Effectiveness of Passion Fruit Albedo versus Turmeric in the Glycemic and Lipaemic Control of People with Type 2 Diabetes: Randomized Clinical Trial.

BACKGROUND: Robust evidence has related yellow passion fruit albedo and long turmeric to the metabolic and glycemic control of diabetes. AIM: To analyze the incremental cost-effectiveness of the flour made from yellow passion fruit albedo versus long turmeric merged with piperine in the glycemic and lipid control of individuals with type 2 diabetes. METHOD: Eighty-nine patients were enrolled in this randomized, placebo-controlled, clinical trial for 120 days. The first group was prescribed 500 mg capsules, three times a day, of yellow passion fruit albedo flour (FAMA). The second group was prescribed long turmeric capsules (500 mg), merged with piperine (5 mg) (CURPI), at fasting. The third group followed the standard advice recommendations, and ingested a placebo of carboxymethyl cellulose (500 mg) at fasting. RESULTS: The group using FAMA showed a higher reduction (-5.9%) of glycemia after fasting, compared to placebo (+9%), and CURPI (-3.2%) (p < 0.05). Regarding HbA1c, the study observed a significant and similar statistical reduction (-0.8%) in the intervention groups, in contrast with the placebo group (p < 0.05). The reduction in HOMA-IR in the CURPI group (-9.4%) was higher than the other groups (p < 0.05). The CURPI group also showed a higher reduction of serum triglyceride levels (-20.8%) compared to the placebo (-0.09%) and FAMA (+1.8%) (p < 0.05) groups. CONCLUSION: It was concluded that turmeric is the most cost-effective in comparison with yellow passion fruit albedo, because of its decrease in the levels of triglycerides and HOMA-IR, even when adjusted for confounding variables. On the other hand, HbA1c cost-effectiveness relation was similar.

Fatores presentes na satisfação dos usuários na Atenção Básica / Factors influencing user satisfaction with Primary Health Care / Factores presentes en la satisfacción de los usuarios en la Atención Básica

Trata-se de uma revisão integrativa de 11 artigos científicos selecionados sobre satisfação dos usuários, por meio dos dados do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), publicados no período de 2012 a 2018. O material textual foi processado pelo software IRaMuTeQ®. A análise textual produziu sete classes que geraram três categorias: Organização e coordenação do cuidado - equipe de apoio matricial, procedente das classes 5, 6 e 1; Satisfação do usuário - marcação de consulta e atendimento das classes 2 e 7; Indicadores socioeconômicos e diferenças regionais das classes 3 e 4. Os fatores presentes na satisfação dos usuários foram acessibilidade, continuidade do cuidado, longitudinalidade, integralidade e resolubilidade, considerados atributos importantes na reorientação da organização dos serviços e das práticas dos profissionais. (AU)

Integrative literature review of user satisfaction based on data from the National Program for Improving Primary Care Access and Quality (PMAQ-AB) involving 11 articles published between 2012 and 2018. A text analysis was performed using the software IRaMuTeQ®, resulting in seven classes and three categories: care organization and coordination - matrix support team from classes 5, 6 and 1; user satisfaction - appointment scheduling and treatment from classes 2 and 7; socioeconomic indicators and regional differences from 3 and 4. The factors influencing user satisfaction were accessibility, continuity of care, longitudinality, comprehensiveness, and resolvability. These are important attributes in the reorientation of the organization of care services and professional practices. (AU)

Estudio de revisión integradora de 11 artículos científicos seleccionados sobre satisfacción de los usuarios, a partir de los datos del Programa Nacional de Mejora del Acceso y de la Calidad de la Atención Básica (PMAQ-AB, por sus siglas en portugués), publicados en el período de 2012 y 2018. El material textual se procesó por medio del software IRAMUTEQ®. El análisis textual produjo siete clases que generó tres categorías: Organización y coordinación del cuidado - equipo de apoyo matricial procedente de las clases 5, 6 y 1; Satisfacción del usuario - programación de consulta y atención, de las clases 2 y 7; Indicadores socioeconómicos y diferencias regionales de las clases 3 y 4. Los factores presentes en la satisfacción de los usuarios fueron accesibilidad, continuidad del cuidado, longitudinalidad, integralidad y capacidad de resolución. Estos son atributos importantes en la reorientación de la organización de los servicios y de las prácticas de los profesionales. (AU)

Health promotion actions in the School Health Program in Ceará: nursing contributions / Acciones de promoción de la salud en el Programa de Salud en la Escuela de Ceará: aportes de enfermería / Ações de promoção da saúde no Programa Saúde na Escola no Ceará: contribuições da enfermagem

ABSTRACT Objectives: to compare health promotion actions carried out by Family Health teams in Ceará, linked to the School Health Program. Methods: a cross-sectional study involving the first and second cycles of an external assessment of 910 and 1,626 teams from 184 municipalities, which joined the Brazilian National Program for Improvement of Access and Quality of Primary Care. Eight clinical assessment and seven health promotion indicators were assessed, together with health professionals working in schools. Results: the interviewees were nurses (95.6% and 98.3%). Between the cycles, there was an increase in clinical assessment (78.7% and 91.3%), health promotion and disease prevention (82.5% and 89.3%) and survey of students for follow-up (41.4% and 66.4%) in schools. Conclusions: health actions at school advanced between cycles, with nurses as protagonists in school health, which can reduce vulnerabilities in children and adolescents and qualify Primary Care.

RESUMEN Objetivos comparar las acciones de promoción de la salud realizadas por los equipos de Salud de la Familia de Ceará vinculados al Programa Salud en la Escuela. Métodos: estudio transversal, que involucró el primer y segundo ciclo de evaluación externa de 910 y 1.626 equipos, respectivamente, de 184 municipios adheridos al Programa Nacional de Mejoramiento del Acceso y Calidad de la Atención Primaria. Se evaluaron ocho indicadores de evaluación clínica y siete indicadores de promoción de la salud con profesionales de la salud que trabajan en las escuelas. Resultados: los entrevistados fueron enfermeros (95,6% y 98,3%). Entre ciclos, hubo un aumento en la evaluación clínica (78,7% y 91,3%), promoción de la salud y prevención de enfermedades (82,5% y 89,3%), y encuesta a los estudiantes para el seguimiento (41,4% y 66,4%) en las escuelas. Conclusiones: las acciones de salud en la escuela avanzaron entre ciclos, con la enfermera como protagonista en la salud escolar, que pueden reducir las vulnerabilidades en niños y adolescentes y calificar la Atención Primaria.

RESUMO Objetivos: comparar as ações de promoção da saúde realizadas pelas equipes de Saúde da Família do Ceará vinculadas ao Programa Saúde na Escola. Métodos: estudo transversal, envolvendo os primeiros e segundos ciclos da avaliação externa de 910 e 1.626 equipes, respectivamente, de 184 municípios, que aderiram ao Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica. Avaliaram-se oito indicadores de avaliação clínica e sete de promoção da saúde, junto aos profissionais de saúde atuantes nas escolas. Resultados: os entrevistados eram enfermeiros (95,6% e 98,3%). Entre os ciclos, houve aumento da avaliação clínica (78,7% e 91,3%), promoção da saúde e prevenção de doenças (82,5% e 89,3%), e levantamento de escolares para acompanhamento (41,4% e 66,4%) nas escolas. Conclusões: ações de saúde na escola avançaram entre os ciclos, tendo o enfermeiro como protagonista na saúde escolar, o que pode reduzir vulnerabilidades em crianças e adolescentes e qualificar a Atenção Básica.

Effectiveness of ginger in reducing metabolic levels in people with diabetes: a randomized clinical trial.

OBJECTIVE: to evaluate the effectiveness of ginge (Zingiber officinale) in reducing blood sugar and lipid levels in people with type 2 diabetes. METHOD: a randomized and double-blind clinical trial conducted with people with type 2 diabetes in primary care facilities. The study included individuals aged between 20 and 80 years old, using oral antidiabetic drugs and with HbA1c levels between 6.0% and 10%. The participants were paired 1:1, allocated in two distinct groups, and randomized in blocks, based on their HbA1c levels. In the experimental group, the participants used 1.2g of ginger and, in the control group, 1.2g of placebo, daily for 90 days. The primary outcome was a reduction in fasting blood sugar and HbA1c, and the secondary outcome was a reduction in lipids and HOMA-IR. 103 individuals completed the study, 47 in the experimental group and 56 in the control group. RESULTS: the participants in the experimental group showed a greater reduction in the blood glucose and total cholesterol values compared to the control group. CONCLUSION: the use of ginger can help in the treatment of people with diabetes, and data support the inclusion of this herbal drug in the clinical practice of nurses. RBR-2rt2wy.

Infrastructure and work process in primary health care: PMAQ in Ceará.

OBJECTIVE To analyze the quality of the infrastructure and work process of the Family Health Strategy in the municipalities of Ceará between 2012 and 2014. METHODS Cross-sectional study, using secondary data from the external evaluation of the 1st (2012) and 2nd (2014) cycle of the National Program for Improvement of Access and Quality of Primary Care in Ceará. A total of 20 composite indicators were used to verify the quality of infrastructure and work process. RESULTS Data from 183 (99.4%) of the 184 municipalities of Ceará were collected in both cycles. A total of 1,441 teams were evaluated for the infrastructure and 800 for the work process. Among the 20 composite indicators evaluated, 18 presented an improvement, but in a non-homogeneous way, ranging between 0.0 and 413.5%. We observed that the lower the initial value of the indicator, the greater the variation in quality between 2012 and 2014. The indicators of infrastructure and work process were influenced by the regional health system and population size of the municipality, being more evident the influence on the variables of the work process. CONCLUSIONS We identified that quality improvements related to infrastructure and work process occurred in the period of implementation of the program in the state of Ceará in an equitable manner, being influenced by population size and regional health system, showing the influence of the context in the implementation of public policies of this nature.

Assessment of access to first contact in the perspective of professionals.

OBJECTIVES: to evaluate the "access to first contact" attribute, from the perspective of Primary Care Health professionals. METHODS: an evaluative and cross-sectional study, carried out from February to March 2017. The sample consisted of 163 health professionals, of both genders, who worked in the basic care of the Municipality of Juazeiro do Norte, Ceará. Access to first contact was evaluated by the Primary Care Assessment Tool (PCATool). The 6.60 mark was used as the cut-off point for the evaluated attribute. RESULTS: access to first contact reached a score of 3.3, denoting a low degree of orientation for Primary Health Care. Nurses were the ones who evaluated the attribute more negatively (p=3.2). CONCLUSIONS: access to first contact obtained a low score, pointing to the fragility of the Family Health Strategy as a gateway to the Brazilian Unified Health System (Sistema Único de Saúde).

Analysis of the effectiveness of cinnamon (Cinnamomum verum) in the reduction of glycemic and lipidic levels of adults with type 2 diabetes: A study protocol.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) is a chronic disease that is increasing the number of cases worldwide. The treatments currently used have not worked as expected. Alternative and complementary medicines were inserted in health services, especially in primary care, as an attempt to minimize risks and help control diseases such as diabetes. Among the herbal medicines used stands out cinnamon, which can serve as an adjuvant in the control of diabetes. OBJECTIVE: To analyze the effectiveness of 3 grams of cinnamon (Cinnamomum verum) per day for 90 days in reducing glycemic and lipid levels in adults with T2DM compared with placebo METHODS:: A randomized, double-blind, placebo-controlled, phase II trial, which will be conducted at basic health units in the city of Parnaíba, state of Piauí, Brazil. In total, 130 people diagnosed with T2DM, followed at health units, with hemoglobin A1c > 6.5%, and using oral antidiabetic medicines, are expected to participate in the study. The intervention will last for 3 months, and each participant will receive a total of 3 bottles containing 120 capsules in each bottle of cinnamon or placebo. Each person should take 4 capsules daily, for 90 days. The patients will be distributed into the 2 groups by performing block randomization (n = 6) at a ratio of 1:1 according to a code generated by a software. Assessments of socioeconomic, clinical, lifestyle, anthropometric, and laboratory variables will be performed in 2 separate visits. DISCUSSION: This study will be the first to investigate cinnamon to reduce glycemic, lipid, and anthropometric levels in Brazil. In case of favorable results, this therapy may be used as an alternative or additional medicine in cases where only oral antidiabetic agents are used and can promote the use of the product to minimize future complications of patients with diabetes and people who do not have the disease. TRIAL REGISTRATION: RBR-2KKB6D, registered on December 11th, 2018.