Ecological study of the association between socioeconomic inequality and food deserts and swamps around schools in Rio de Janeiro, Brazil.

BACKGROUND: Previous research suggests that unhealthy community food environments around schools contribute to unhealthy eating habits and negative health outcomes among the youth. However, little is known about how socioeconomic inequalities in those community food environments are associated with food deserts and food swamps across schools' neighborhoods. METHODS: An ecological study was carried out in all 3,159 public and private schools in Rio de Janeiro, Brazil. Three measures of socioeconomic inequality were evaluated: per capita income, segregation index and deprivation index. The community school food environment was analyzed by metrics of food swamps and food deserts. RESULTS: Food deserts and food swamps were simultaneously more prevalent in neighborhoods of the lowest income, high deprivation, and high segregation. Spatial socioeconomic disparities at the neighborhoods of schools were associated with food deserts and food swamps in Rio de Janeiro. CONCLUSIONS: Our results point to a spatial socioeconomic inequality of establishments that sell food around schools in a Brazilian metropolis, indicating that the areas of greatest deprivation of food services are also the areas with the worst socioeconomic characteristics.

Association between perceived neighbourhood characteristics, physical activity and diet quality: results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

BACKGROUND: The study explores associations between perceived neighbourhood characteristics, physical activity and diet quality, which in Latin America and Brazil have been scarcely studied and with inconsistent results. METHODS: We conducted a cross-sectional analysis of 14,749 individuals who participated in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil) baseline. The study included current and retired civil servants, aged between 35 and 74 years, from universities and research institutes in six Brazilian states. The International Physical Activity Questionnaire (IPAQ) long form was used to characterize physical activity during leisure time and commuting; additional questions assessed how often fruit and vegetables were consumed, as a proxy for diet quality. Neighbourhood characteristics were evaluated by the "Walking Environment" and "Availability of Healthy Foods" scales originally used in the Multi-Ethnic Study of Atherosclerosis (MESA). Associations were examined using multinomial logistic regression. RESULTS: Perceiving a more walkable neighbourhood was positively associated with engaging in leisure time physical activity and doing so for longer weekly. Compared with those who saw their neighbourhood as less walkable, those who perceived it as more walkable had 1.69 (95 % CI 1.57-1.83) and 1.39 (1.28-1.52) greater odds of engaging in leisure time physical activity for more than 150 min/week or up to 150 min/week (vs. none), respectively. Perceiving a more walkable neighbourhood was also positively associated with transport-related physical activity. The same pattern was observed for diet: compared with participants who perceived healthy foods as less available in their neighbourhood, those who saw them as more available had odds 1.48 greater (1.31-1.66) of eating fruits, and 1.47 greater (1.30-1.66) of eating vegetables, more than once per day. CONCLUSIONS: Perceived walkability and neighbourhood availability of healthy food were independently associated with the practice of physical activity and diet quality, respectively, underlining the importance of neighbourhood-level public policies to changing and maintaining health-related habits.

Tributyltin degrading microbial enzymes: A promising remediation approach.

Brazil is one of the countries most impacted along the entire coastline by the presence of tributyltin (TBT), a biocide used in antifouling paints. Despite being banned since 2008, its use is still registered in the country, and it is possible to find recent inputs of this substance in places under the influence of shipyards, marinas, and fishing ports. In this study, a bacterium isolated from TBT-contaminated sediment from Santos and São Vicente Estuarine System (SESS) in Brazil, identified as Achromobacter sp., proved to be resistant to this compound. Furthermore, its crude enzymatic extract presented the ability to reduce up to 25 % of the initial TBT concentration in the liquid phase in 1 h, demonstrating to be a simple, fast, effective procedure and a potential tool for the environmental attenuation of TBT.

The Patent Landscape of Polyhydroxyalkanoates Production by Algae and Cyanobacteria.

BACKGROUND: As global awareness regarding climate change and environmental pollution outcomes arise, eco-friendly and negative emission technologies emerge. METHODS: In this scenario, polyhydroxyalkanoate (PHA)-accumulating microorganisms play an important role in the transition from the petrochemical-based non-biodegradable polymer to renewable, eco-friendly, and biocompatible materials. More specifically, CO2 can be converted to biopolymers through photosynthesis by cyanobacteria and algae, posing as a promising technology for renewable material, CO2, and petroleum-dependence mitigations. However, although many microorganisms can accumulate PHA intracellularly, limitations persist, such as the elevated cost and limited market availability. RESULTS: Herein is presented a patent-based mapping on technological trends of PHAs production, including its production by microalgae and cyanobacteria using the Questel Orbit Intelligence software (version 1.9.8) in complement with the Espacenet Patent Search database. CONCLUSION: The inquiry on PHAs retrieved 34,243 patents filed since 1912, whereas 156 are related to their specific production by photosynthetic microorganisms, evidencing a prospective market for intellectual property.

Adherence to the Planetary Health Diet Index and Obesity Indicators in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

The EAT-Lancet Commission has proposed a model diet to improve the health of human beings and that of the planet. Recently, we proposed the Planetary Health Diet Index (PHDI) to assess adherence of the population to this model diet. In this study, we aimed to evaluate adherence to the PHDI and obesity outcomes using baseline data from 14,515 participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The dietary data were assessed using a 114-item FFQ. Body mass index (BMI) and waist circumference (WC) were both used continuously and categorized. Linear and multinomial regression models adjusted for potential confounding factors were performed to assess the relationship between adherence to PHDI and outcomes. An inverse association was observed between adherence to PHDI and obesity indicators. Individuals with high adherence to the PHDI had lower BMI (ß-0.50 95% CI-0.73:-0.27) and WC (ß-1.70 95% CI-2.28:-1.12) values. They were also 24% less likely to be overweight (OR 0.76 95% CI 0.67:0.85) or obese (OR 0.76 95% CI 0.65:0.88), and they were 14% and 27% less likely to have increased WC (OR 0.86 95% CI 0.75:0.98) or substantially increased WC (OR 0.73 95% CI 0.64:0.83) than those with lower adherence. Our results showed that higher adherence to the PHDI may decrease obesity indicators.

Light excess stimulates Poly-beta-hydroxybutyrate yield in a mangrove-isolated strain of Synechocystis sp.

Poly-ß-hydroxybutyrate (PHB) is a biodegradable biopolymer that may replace fossil-based plastics reducing its negative environmental impact. One highly sustainable strategy to produce these biopolymers is the exploitation of photosynthetic microorganisms that use sunlight and CO2 to produce biomass and subsequently, PHB. Exploring environmental biological diversity is a powerful tool to find resilient microorganisms potentially exploitable to produce bioproducts. In this work, a cyanobacterium (Synechocystis sp.) isolated from a contaminated area close to an important industrial complex was shown to produce PHB under different culture conditions. Carbon, nutrients supply and light intensity impact on biomass and PHB productivity were assessed, showing that the highest yield of PHB achieved was 241 mg L-1 (31%dcw) under high light intensity. Remarkably this condition not only stimulated PHB accumulation by 70% compared to other conditions tested but also high cellular duplication rate, maximizing the potential of this strain for PHB production.

Failure to achieve proteic goals in non-critical patients increases risk for death: Old discussion, ongoing problem.

OBJECTIVES: Providing adequate nutritional support for hospitalized patients continues to be a challenge. The aim of this study was to evaluate the association of energy and protein provision with in-hospital mortality in non-critically ill patients. METHODS: A retrospective study (2014-2016) was performed with all patients >18 y of age who were admitted to medical and surgical clinic wards and given exclusive enteral therapy. The mean of energy and protein was estimated per day and per kilogram of body mass from the enteral prescription data, over the entire period of hospitalization. A prescription mean was considered hypocaloric or hypoproteic at <20 kcal · kg · d-1 or <0.8 g · kg · d-1, respectively. RESULTS: Of the 240 patients, 58.3% were >60 y of age and 60% were men. The frequencies of in-hospital mortality (19.2%) and malnutrition (78.8%) were high. The means of protein (0.75 g· kg· d-1) and energy (17.60 kcal · kg · d-1) were below the general recommendations and 37.8% did not reach a mean of 20 kcal · kg · d-1 during the entire hospitalization period. Hypocaloric (hazard ratio [HR], 5.78; 95% confidence interval [CI], 1.59-21.04) and hypoproteic nutrition (HR, 3.69; 95% CI, 1.25-10.93) were predictors of all-cause in-hospital mortality in adjusted multivariate models. However, when we adjusted the hypoprotein nutrition by energy (non-protein calories to nitrogen ratio), hypoprotein nutrition seems to maintain the increased risk for death (HR, 3.15; 95% CI, 1.04-9.53). CONCLUSIONS: Hypoproteic nutrition appears to be more significant than hypocaloric nutrition in predicting all-cause in-hospital mortality. Protocols should be implemented to ensure that target caloric and protein levels are reached as quickly as possible to optimize patient survival.

Increased P3HB Accumulation Capacity of Methylorubrum sp. in Response to Discontinuous Methanol Addition.

An alternative for non-biodegradable oil-based plastics has been the focus of many researchers throughout the years. Polyhydroxyalkanoates (PHAs) are potential substitutes due to their biodegradable characteristic and diversity of monomers that allow different biopolymer compositions and physical-chemical properties suitable for a variety of applications. The most well-known biopolymer from this class, poly(3-hydroxybutyrate) (P3HB), is already produced industrially, but its final price cannot compete with the oil-based plastics. As a low-volume high-value bioproduct, P3HB must be produced through a cheap and abundant feedstock, with high productivity and a feasible purity process in order to become an economically attractive bioproduct. In this scenario, we report a methylotrophic strain isolated from an estuarine contaminated site identified as Methylorubrum sp. highly tolerant to methanol and with great accumulation capacity of 60% (CDW) in 48 h through a simple strategy of batch fermentation with discontinuous methanol addition that could help lower P3HB's processing costs and final price.

Ostomy time and nutrition status were associated on quality of life in patients with colorectal cancer / Tempo de estomia e estado nutricional são associados com a qualidade de vida em pacientes com câncer colorretal

ABSTRACT Introduction: Colorectal cancer frequency increases each year and consequently the number of ostomies, a procedure that helps in the treatment of colorectal cancer but has an impact on quality of life. Studies evaluating the impact of ostomy time and nutritional status on the quality of life of colostomized patients with colorectal cancer are scarce in the literature. So, the aim of this study was to evaluate the association ostomy time and nutritional status on quality of life in colostomized colorectal cancer patients. Methods: A cross-sectional study was conducted with 97 colostomized patients due to colorectal cancer from a reference service. Socioeconomic, demographic, clinical data were obtained. European Organisation for Research and Treatment of Cancer questionnaires EORTC-QLQ30 and EORTC-QLQ-CR29 were used to analyse the quality of life. Statistical significance analysis was performed using the Wilcoxon's non-parametric or Chi-Square test. Results: Of the 97 individuals, 50.5% were female, 64.9% were over 60 years old, 67.4% have ostomy for less than 1 year. Half of the patients had some nutritional status inadequacy: 24.2% were malnourished, 17.9% overweight and 8.4% obese. Shorter ostomy time was associated with role function, blood or mucus in stools, stoma care problems and men's sexual interest, while malnutrition was associated with concern about weight. Conclusions: Ostomy time and nutrition status were associated with quality of life in some domains, such as role function, insomnia, appetite loss, abdominal pain, buttock pain, bloating, hair loss, taste loss have an impact together with the nutritional status on the quality of life in patients colostomized colorectal cancer.

RESUMO Introdução: A frequência do câncer colorretal aumenta a cada ano e, consequentemente, aumenta o número de estomias, procedimento que auxilia no tratamento do câncer colorretal, porém impacta na qualidade de vida. Estudos que avaliam o impacto do tempo de estomia e do estado nutricional na qualidade de vida de pacientes colostomizados com câncer colorretal são escassos na literatura. Assim, o objetivo deste estudo foi avaliar a associação entre tempo de estomia e estado nutricional e qualidade de vida em pacientes colostomizados por câncer colorretal. Métodos: Participaram deste estudo transversal 97 pacientes colostomizados por câncer colorretal de um serviço de referência. Dados socioeconômicos, demográficos e clínicos foram obtidos. Os questionários da Organização Europeia para Pesquisa e Tratamento do Câncer EORTC-QLQ30 e EORTC-QLQ-CR29 foram utilizados para analisar a qualidade de vida. A análise de significância estatística foi realizada usando o teste não paramétrico Wilcoxon ou teste Qui-Quadrado. Resultados: Dos 97 indivíduos, 50.,5% eram do sexo feminino, 64.,9% tinham mais de 60 anos, 67.,4% com estomia há menos de 1 ano. Metade dos pacientes apresentava inadequação do estado nutricional: 24.,2% estavam desnutridos, 17.,9% sobrepeso e 8,4% obesos. O menor tempo de estomia foi associado ao desempenho funcional, sangue ou muco nas fezes, problemas em cuidar da estomia e interesse sexual dos homens, enquanto a desnutrição foi associada à preocupação com o peso. Conclusão: A cirurgia de estomia esteve associada à qualidade de vida em alguns domínios, como desempenho funcional, insônia, perda de apetite, dor abdominal, dor nas nádegas, perda de cabelo, perda do paladar, e tem um impacto junto ao estado nutricional da qualidade de vida em pacientes colostomizados por câncer colorretal.

[Validity of indicators on physical activity and sedentary behavior from the Brazilian National School-Based Health Survey among adolescents in Rio de Janeiro, Brazil]. / Validade de indicadores de atividade física e comportamento sedentário da Pesquisa Nacional de Saúde do Escolar entre adolescentes do Rio de Janeiro, Brasil.

This study evaluated the relative validity of physical activity indicators from the questionnaire used in the Brazilian National School-Based Health Survey (PeNSE) in the city of Rio de Janeiro, Brazil, based on a sample of 174 students. The following indicators of weekly physical activity were evaluated: ACTIVE-300MIN (≥ 300 minutes/week); ACTIVE-150MIN (≥ 150 minutes), INACTIVE (no physical activity). Additionally, indicators of sedentary behavior were also assessed, as daily screen time (TV, videogames, and computer). The results from the questionnaire were compared with three 24-hour recalls. The results of ACTIVE-300MIN, ACTIVE-150MIN, and INACTIVE generated by PeNSE showed high accuracy. These indicators performed better than those of sedentary behavior in relation to frequency estimates as well as sensitivity, specificity, and correct classification rate. The indicators of physical activity from PeNSE showed satisfactory relative validity.

[Relative validity of dietary indicators from the Brazilian National School-Based Health Survey among adolescents in Rio de Janeiro, Brazil]. / Validade relativa de indicadores de práticas alimentares da Pesquisa Nacional de Saúde do Escolar entre adolescentes do Rio de Janeiro, Brasil.

This study evaluated the relative validity of the dietary indicators from the questionnaire used in the Brazilian National School-Based Health Survey (PeNSE) in the city of Rio de Janeiro, Brazil. The sample included 174 students. The following indicators were evaluated: regular consumption (≥ 5 times a week) of markers for healthy eating, markers for unhealthy eating, and routine eating habits (having meals with parents or guardians (MEAL), having breakfast (breakfast), and eating while studying or watching TV. The results of the questionnaire were compared with three 24-hour recalls. For all the markers of healthy eating, there was no difference in the proportion of regular consumption when comparing the two methods. The rates detected by the questionnaire were higher for packaged snacks and crackers and lower for cold cuts and MEAL. The indicators for regular consumption of markers for healthy eating and that referring to BREAKFAST were those with the highest accuracy. The dietary indicators used by the PeNSE survey showed satisfactory validity.

STROBE initiative: guidelines on reporting observational studies.

Reporting of observational studies is often inadequate, hampering the assessment of their strengths and weaknesses and, consequently, the generalization of study results. The initiative named Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) developed a checklist of 22 items, the STROBE Statement, with recommendations about what should be included in a more accurate and complete description of observational studies. Between June and December 2008, a group of Brazilian researchers was dedicated to the translation and adaptation of the STROBE Statement into Portuguese. The present study aimed to show the translation into Portuguese, introduce the discussion on the context of use, the potential and limitations of the STROBE initiative.

Validade relativa de indicadores de práticas alimentares da Pesquisa Nacional de Saúde do Escolar entre adolescentes do Rio de Janeiro, Brasil / Relative validity of dietary indicators from the Brazilian National School-Based Health Survey among adolescents in Rio de Janeiro, Brazil / Validez relativa de indicadores de prácticas alimentarias en la Investigación Nacional de Salud Escolar entre los adolescentes en Río de Janeiro, Brasil

Avaliou-se a validade relativa dos indicadores de práticas alimentares do questionário utilizado na Pesquisa Nacional de Saúde do Escolar (PeNSE) entre adolescentes da cidade do Rio de Janeiro, Brasil. Foram estudados 174 alunos. Foram avaliados os indicadores: a ingestão regular (≥ 5 vezes/semana) dos alimentos marcadores de alimentação saudável, marcadores de alimentação não saudável e as rotinas alimentares: realizar refeição com responsável (REFEIÇÃO), realizar o desjejum (DESJEJUM) e comer enquanto estuda ou assiste à TV. Foram comparados os resultados do questionário e dos três recordatórios de 24 horas. Para todos os marcadores de alimentação saudável, não houve diferença na proporção de ingestão regular de acordo com os dois métodos. As frequências geradas pelo questionário foram superiores para os indicadores salgadinhos de pacote e biscoitos salgados e mais baixas para embutidos e REFEIÇÃO. Os indicadores de consumo regular de marcadores de alimentação saudável e aquele referente a DESJEJUM foram os que apresentaram maior acurácia. Os indicadores de práticas alimentares utilizados pela PeNSE apresentaram validade satisfatória.

This study evaluated the relative validity of the dietary indicators from the questionnaire used in the Brazilian National School-Based Health Survey (PeNSE) in the city of Rio de Janeiro, Brazil. The sample included 174 students. The following indicators were evaluated: regular consumption (≥ 5 times a week) of markers for healthy eating, markers for unhealthy eating, and routine eating habits (having meals with parents or guardians (MEAL), having breakfast (breakfast), and eating while studying or watching TV. The results of the questionnaire were compared with three 24-hour recalls. For all the markers of healthy eating, there was no difference in the proportion of regular consumption when comparing the two methods. The rates detected by the questionnaire were higher for packaged snacks and crackers and lower for cold cuts and MEAL. The indicators for regular consumption of markers for healthy eating and that referring to BREAKFAST were those with the highest accuracy. The dietary indicators used by the PeNSE survey showed satisfactory validity.

Se evaluó la validez relativa de los indicadores de prácticas alimentarias del cuestionario utilizado en la Investigación Nacional de Salud Escolar (PeNSE) entre adolescentes en la ciudad de Río de Janeiro, Brasil. Se estudiaron a 174 estudiantes. Se evaluaron los indicadores: consumo regular (≥ 5 veces/semana) de los alimentos marcadores de alimentación saludable, marcadores de alimentación no saludable y las rutinas de alimentación (hacer las comidas con los responsables (COMIDA), el desayuno (DESAYUNO) y comer mientras estudian o ven la televisión. Se compararon los resultados del cuestionario y los tres recordatorios de 24 horas. Para todos los marcadores de alimentación saludable no hubo diferencia en la proporción del consumo regular, de acuerdo con ambos métodos. Las frecuencias generadas por el cuestionario fueron más altas para los indicadores snack pack y galletas saladas e inferior en COMIDA. Los indicadores de consumo regular de marcadores de alimentación saludable y que se refieren al DESAYUNO eran aquellos con mayor precisión. Los indicadores de prácticas alimentarias utilizados por la PeNSE mostraron una validación satisfactoria.

Validade de indicadores de atividade física e comportamento sedentário da Pesquisa Nacional de Saúde do Escolar entre adolescentes do Rio de Janeiro, Brasil / Validity of indicators on physical activity and sedentary behavior from the Brazilian National School-Based Health Survey among adolescents in Rio de Janeiro, Brazil / Validez de indicadores de actividad física y conducta sedentaria de la Encuesta Nacional de Salud Escolar entre adolescentes en Río de Janeiro, Brasil

Analisou-se a validade relativa dos indicadores de atividade física do questionário utilizado na Pesquisa Nacional de Saúde do Escolar (PeNSE) entre adolescentes da cidade do Rio de Janeiro, Brasil. Foram estudados 174 alunos. Avaliaram-se os seguintes indicadores referentes ao tempo semanal acumulado com a prática de atividade física: ATIVO-300MIN (acumulou 300 minutos ou mais); ATIVO-150MIN (acumulou 150 minutos ou mais); INATIVO (não praticou atividade física). Também foram estudados os indicadores de comportamento sedentário referentes ao tempo diário despendido assistindo TV, jogando videogame e usando computador. Foram comparados os resultados do questionário e dos três recordatórios de 24 horas. Os resultados de ATIVO-300MIN, ATIVO-150MIN e INATIVO gerados pela PeNSE apresentaram alta acurácia. Esses indicadores tiveram melhor desempenho que os de comportamento sedentário, tanto em relação às estimativas de frequência quanto em relação à sensibilidade, especificidade e índice de acurácia. Os indicadores de atividade física da PeNSE apresentaram validade relativa satisfatória.

This study evaluated the relative validity of physical activity indicators from the questionnaire used in the Brazilian National School-Based Health Survey (PeNSE) in the city of Rio de Janeiro, Brazil, based on a sample of 174 students. The following indicators of weekly physical activity were evaluated: ACTIVE-300MIN (≥ 300 minutes/week); ACTIVE-150MIN (≥ 150 minutes), INACTIVE (no physical activity). Additionally, indicators of sedentary behavior were also assessed, as daily screen time (TV, videogames, and computer). The results from the questionnaire were compared with three 24-hour recalls. The results of ACTIVE-300MIN, ACTIVE-150MIN, and INACTIVE generated by PeNSE showed high accuracy. These indicators performed better than those of sedentary behavior in relation to frequency estimates as well as sensitivity, specificity, and correct classification rate. The indicators of physical activity from PeNSE showed satisfactory relative validity.

Se analizó la validez relativa de los indicadores de actividad física del cuestionario utilizado en la Encuesta Nacional de Salud Escolar (PeNSE por sus siglas en portugués) entre adolescentes en la ciudad de Río de Janeiro, Brasil. Se estudiaron 174 alumnos. Fueron evaluados los siguientes indicadores, referidos al tiempo semanal acumulado con actividad física: ACTIVO-300MIN (acúmulo de 300 minutos o más); ACTIVO-150MIN (acúmulo de 150 minutos o más), INACTIVO (no practica actividad física). También se han estudiado indicadores de conducta sedentaria como: tiempo diario viendo televisión, jugando videojuegos y usando la computadora. Se compararon los resultados del cuestionario y los tres recordatorios de 24 horas. Los resultados de ACTIVO-300MIN, ACTIVO-150MIN e INACTIVO, generados por PeNSE, mostraron una alta precisión. Estos indicadores se comportaron mejor que los de comportamiento sedentario, tanto con respecto a la estimativa de frecuencia, como a la sensibilidad, la especificidad e índice de precisión. Los indicadores de actividad física de PeNSE presentaron validez relativa satisfactoria.

Time trend in breast-feeding in the city of Rio de Janeiro, Southeastern Brazil: 1996-2006.

OBJECTIVE: To analyze time trend in breast-feeding (BF) and exclusive breast-feeding (EBF). METHODS: Data from a monitoring system, based on surveys conducted during the National Immunization Campaign in the city of Rio de Janeiro, Southeastern Brazil, in 1996, 1998, 2000, 2003 and 2006, were analyzed. Study population was comprised of 19,044 children younger than one year of age, who were present in vaccination stations. A probability cluster sample (vaccination stations), self-weighted and representative of the population of children younger than 12 months of age (<12), was studied for each year. A structured questionnaire with closed questions about the child's diet at the moment of the study and maternal sociodemographic characteristics was applied. The BF and EBF indicators proposed by the World Health Organization were adopted. RESULTS: BF<12 increased from 61.3% to 73.4% between 1996 and 2006. Similar trend was observed in all age groups analyzed. EBF in children <4 and <6 months of age (EBF<6) increased from 18.8% to 42.4% and from 13.8% to 33.3%, respectively. Improvements in BF>6 and EBF<6 were found in all categories of all maternal sociodemographic variables. For EBF<6, the disadvantage observed in women with a lower level of education in 1996 and in women who worked in 1998 was not completely overcome by 2006. CONCLUSIONS: BF and EBF increased in the period studied, independently from child age group and maternal socio-demographic characteristics. The differences found among women in distinct sociodemographic situations were not completely overcome.

Effectiveness of daily and weekly iron supplementation in the prevention of anemia in infants.

OBJECTIVE: To evaluate the effectiveness of universal prophylactic targeting with iron sulfate on daily or weekly basis in the prevention of anemia in infants. METHODS: Randomized clinical field trial with children between ages six and 12 months seen at primary health care units in the municipality of Rio de Janeiro, Brazil, between 2004 and 2005. Three concurrent cohorts were compared: daily group (n=150; 12.5mg Fe/day); weekly group (n=147; 25mg Fe/week) and control group. The intervention consisted of universal supplementation with iron sulfate for 24 weeks, combined with educational adherence-promoting measures. OUTCOME: mean serum hemoglobin concentration, distribution and prevalence of anemia (Hb<110.0 g/l) at age 12 months. Effectiveness was evaluated considering both intent to treat and adherence to protocol, using multiple regression analysis (linear and Poisson). RESULTS: Groups were homogeneous in terms of descriptive variables. The intervention was implemented successfully, with high adhesion to protocol in both groups, and no statistical difference between them. After adjustment, only the daily regimen showed a protective effect. Adherence analysis demonstrated an evident dose-response effect on mean Hb and prevalence of anemia only for the daily regimen. No protective effect was detected for the weekly regimen. CONCLUSIONS: Universal supplementation with iron sulfate from six to 12 months of age was effective in increasing serum Hb and decreasing risk of anemia only when administered on a daily basis.

[Surveillance of risk factors for non-communicable diseases among adolescents: the experience in Rio de Janeiro, Brazil]. / Vigilância de fatores de risco para doenças não transmissíveis entre adolescentes: a experiência da cidade do Rio de Janeiro, Brasil.

This paper presents the methodology and results of the implementation of a Surveillance System for Non-Communicable Disease Risk Factors in Adolescents. A random sample of 8th-grade students (n = 1,684) enrolled in municipal schools in Rio de Janeiro, Brazil, was studied. Students were asked to complete a confidential questionnaire on food consumption, physical activity, sedentary leisure-time activities, and tobacco consumption. Prevalence estimates of risk factors were calculated for the entire sample and by gender. Non-response rates ranged from 1.1 to 8.9%. The findings included low consumption of fruits (45.8%) and vegetables (20.0% and 16.5% for salads and cooked vegetables, respectively), regular consumption of soft drinks (36.7%) and candies (46.7%), extensive time on TV, computer, and videogames (71.7% spend at least 4h/day at these activities), low frequency of regular physical activity (40%), and 6.4% prevalence of smoking. Girls showed less physical activity and more smoking. The system appeared to be feasible and indicated high prevalence of risk factors for non-communicable diseases.

Iniciativa STROBE: subsídios para a comunicação de estudos observacionais / Prevalencia de extremos antropométricos en niños del estado de Alagoas, Noreste de Brasil / STROBE initiative: guidelines on reporting observational studies

Freqüentemente, a descrição de pesquisas de natureza observacional é inadequada, dificultando a avaliação de seus pontos fracos e fortes e, em conseqüência, a generalização de seus resultados. A iniciativa denominada Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), formulou uma lista de verificação que contém 22 itens, denominada STROBE Statement ("Declaração STROBE"), com recomendações sobre o que deveria ser incluído em uma descrição mais precisa e completa de estudos observacionais. Entre junho e dezembro de 2008, um grupo de pesquisadores brasileiros dedicou-se à tradução e adaptação da "Declaração STROBE" para o português. O objetivo do estudo foi apresentar a tradução para o português, bem como introduzir a discussão sobre o contexto de utilização, as potencialidades e limitações da Iniciativa STROBE.

Reporting of observational studies is often inadequate, hampering the assessment of their strengths and weaknesses and, consequently, the generalization of study results. The initiative named Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) developed a checklist of 22 items, the STROBE Statement, with recommendations about what should be included in a more accurate and complete description of observational studies. Between June and December 2008, a group of Brazilian researchers was dedicated to the translation and adaptation of the STROBE Statement into Portuguese. The present study aimed to show the translation into Portuguese, introduce the discussion on the context of use, the potential and limitations of the STROBE initiative.

El objetivo del artículo fue estimar la prevalencia de extremos antropométricos indicativos del estado nutricional de niños. Se realizó estudio transversal con muestra probabilística de 1.386 niños menores de cinco años del estado de Alagoas. Las prevalencias de déficit (z< -2; patrón de la Organización Mundial de Salud - 2006) para los índices peso-para-edad (bajo peso), peso-para-altura (flacura) y altura-para-edad (déficit estatural) fueron, respectivamente, 2,9 por ciento (n=40), 1,2 por ciento (n=17) y 10,3 por ciento (n=144). El exceso de peso-para-altura (sobrepeso) acometió 135 niños (9,7 por ciento). Se concluyó que las prevalencias de bajo peso y flacura son epidemiológicamente irrelevantes y que el déficit estatural y el sobrepeso prevalecen con idéntica magnitud.

Tendência temporal da amamentação na cidade do Rio de Janeiro: 1996-2006 / Time trend in breast-feeding in the city of Rio de Janeiro, Southeastern Brazil: 1996-2006

OBJETIVO: Analisar a tendência temporal da prática de aleitamento materno (AM) e de aleitamento materno exclusivo (AME). MÉTODOS: Foram analisados dados de sistema de monitoramento baseado em inquéritos realizados nos anos de 1996, 1998, 2000, 2003 e 2006 durante a Campanha Nacional de Imunização na cidade do Rio de Janeiro, RJ. A população de estudo foi constituída de 19.044 crianças menores de um ano de idade que compareceram aos postos de vacinação. Para cada ano foi estudada uma amostra probabilística por conglomerado (postos de vacinação), auto-ponderada representativa da população de crianças menores de 12 meses (<12). Foi aplicado questionário estruturado com questões fechadas sobre alimentação da criança no momento do estudo e características sociodemográficas da mãe. Foram adotados os indicadores de AM e de AME propostos pela Organização Mundial da Saúde. RESULTADOS: O AM<12 aumentou de 61,3 por cento para 73,4 por cento entre 1996 e 2006. Tendência similar foi observada em todas as faixas etárias analisadas. O AME em crianças <4 e <6 meses (AME<6) aumentou, respectivamente, de 18,8 por cento para 42,4 por cento e de 13,8 por cento para 33,3 por cento. Melhorias em AM>6 e em AME<6 foram observadas em todas as categorias de todas as variáveis sociodemográficas maternas. Para AME<6, a desvantagem observada em 1996 entre mulheres de menor escolaridade e em 1998 entre mulheres que trabalhavam não foi completamente superada até 2006. CONCLUSÕES: O AM e o AME aumentaram no período estudado independentemente da faixa etária da criança e das características sociodemográficas maternas. Não foram totalmente superadas diferenças observadas entre mulheres em diferentes situações sociodemográficas.

OBJECTIVE: To analyze time trend in breast-feeding (BF) and exclusive breast-feeding (EBF). METHODS: Data from a monitoring system, based on surveys conducted during the National Immunization Campaign in the city of Rio de Janeiro, Southeastern Brazil, in 1996, 1998, 2000, 2003 and 2006, were analyzed. Study population was comprised of 19,044 children younger than one year of age, who were present in vaccination stations. A probability cluster sample (vaccination stations), self-weighted and representative of the population of children younger than 12 months of age (<12), was studied for each year. A structured questionnaire with closed questions about the child's diet at the moment of the study and maternal sociodemographic characteristics was applied. The BF and EBF indicators proposed by the World Health Organization were adopted. RESULTS: BF<12 increased from 61.3 percent to 73.4 percent between 1996 and 2006. Similar trend was observed in all age groups analyzed. EBF in children <4 and <6 months of age (EBF<6) increased from 18.8 percent to 42.4 percent and from 13.8 percent to 33.3 percent, respectively. Improvements in BF>6 and EBF<6 were found in all categories of all maternal sociodemographic variables. For EBF<6, the disadvantage observed in women with a lower level of education in 1996 and in women who worked in 1998 was not completely overcome by 2006. CONCLUSIONS: BF and EBF increased in the period studied, independently from child age group and maternal socio-demographic characteristics. The differences found among women in distinct sociodemographic situations were not completely overcome.

Vigilância de fatores de risco para doenças não transmissíveis entre adolescentes: a experiência da cidade do Rio de Janeiro, Brasil / Surveillance of risk factors for non-communicable diseases among adolescents: the experience in Rio de Janeiro, Brazil

Este trabalho apresenta métodos e resultados da implantação de sistema de vigilância de fatores de risco para doenças não transmissíveis entre adolescentes. Uma amostra (n = 1.699) probabilística de alunos de oitava série do ensino fundamental da rede pública municipal de ensino do Rio de Janeiro, Brasil, respondeu a questionário autopreenchido anônimo sobre consumo alimentar, atividade física, atividades sedentárias de lazer e consumo de cigarro. Estimativas de prevalência dos fatores de risco foram calculadas para o total da amostra e segundo sexo. Taxas de não resposta variaram de 0,2 por cento a 13,4 por cento. Foram observados: baixo consumo de frutas (45,8 por cento) e hortaliças (20 por cento e 16,5 por cento para saladas e legumes cozidos), consumo freqüente de refrigerantes (36,7 por cento), balas e doces (46,7 por cento), grande quantidade de horas alocadas em frente à TV, computador ou videogame (71,7 por cento alocam pelo menos 4h/dia nestas atividades), baixa freqüência de prática regular de atividade física (40 por cento) e prevalência de 6,4 por cento de fumantes. Meninas apresentaram menores índices de atividade física e maiores de consumo de cigarro. O sistema testado mostrou-se factível e indicou prevalências relevantes de fatores de risco para doenças não transmissíveis.

This paper presents the methodology and results of the implementation of a Surveillance System for Non-Communicable Disease Risk Factors in Adolescents. A random sample of 8th-grade students (n = 1,684) enrolled in municipal schools in Rio de Janeiro, Brazil, was studied. Students were asked to complete a confidential questionnaire on food consumption, physical activity, sedentary leisure-time activities, and tobacco consumption. Prevalence estimates of risk factors were calculated for the entire sample and by gender. Non-response rates ranged from 1.1 to 8.9 percent. The findings included low consumption of fruits (45.8 percent) and vegetables (20.0 percent and 16.5 percent for salads and cooked vegetables, respectively), regular consumption of soft drinks (36.7 percent) and candies (46.7 percent), extensive time on TV, computer, and videogames (71.7 percent spend at least 4h/day at these activities), low frequency of regular physical activity (40 percent), and 6.4 percent prevalence of smoking. Girls showed less physical activity and more smoking. The system appeared to be feasible and indicated high prevalence of risk factors for non-communicable diseases.