Nurturing care indicators for the Brazilian Early Childhood Friendly Municipal Index (IMAPI).

The Nurturing Care Framework (NCF) calls for establishing a global monitoring and accountability systems for early childhood development (ECD). Major gaps to build low-cost and large-scale ECD monitoring systems at the local level remain. In this manuscript, we describe the process of selecting nurturing care indicators at the municipal level from existing routine information systems to develop the Brazilian Early Childhood Friendly Index (IMAPI). Three methodological steps developed through a participatory decision-making process were followed. First, a literature review identified potential indicators to translate the NCF domains. Four technical panels composed of stakeholders from federal, state and municipal levels were consulted to identify data sources, their availability at the municipal level and the strengths and weakness of each potential indicator. Second, national and international ECD experts participated in two surveys to score, following a SMART approach, the expected performance of each nurturing care indicator. This information was used to develop analytical weights for each indicator. Third, informed by strengths and weaknesses pointed out in the previous steps, the IMAPI team reached consensus on 31 nurturing care indicators across the five NCF domains (Good health [n = 14], Adequate nutrition [4], Responsive caregiving [1], Opportunities for early learning [7] and Security and safety [4]). IMAPI represents the first attempt to select nurturing care indicators at the municipal level using data from existing routine information systems.

Nurturing care indicators for the Brazilian Early Childhood Friendly Municipal Index (IMAPI)

The Nurturing Care Framework (NCF) calls for establishing a global monitoring and accountability systems for early childhood development (ECD). Major gaps to build low-cost and large-scale ECD monitoring systems at the local level remain. In this manuscript, we describe the process of selecting nurturing care indicators at the municipal level from existing routine information systems to develop the Brazilian Early Childhood Friendly Index (IMAPI). Three methodological steps developed through a participatory decision-making process were followed. First, a literature review identified potential indicators to translate the NCF domains. Four technical panels composed of stakeholders from federal, state and municipal levels were consulted to identify data sources, their availability at the municipal level and the strengths and weakness of each potential indicator. Second, national and international ECD experts participated in two surveys to score, following a SMART approach, the expected performance of each nurturing care indicator. This information was used to develop analytical weights for each indicator. Third, informed by strengths and weaknesses pointed out in the previous steps, the IMAPI team reached consensus on 31 nurturing care indicators across the five NCF domains (Good health [n = 14], Adequate nutrition [4], Responsive caregiving [1], Opportunities for early learning [7] and Security and safety [4]). IMAPI represents the first attempt to select nurturing care indicators at the municipal level using data from existing routine information systems.

Household food insecurity in black-slaves descendant communities in Brazil: has the legacy of slavery truly ended?

OBJECTIVE: To identify the factors associated with food insecurity among Quilombolas communities in Brazil. DESIGN: An analysis of secondary data assessed in the 2011 Quilombolas Census was performed. The Brazilian Food Insecurity Measurement Scale (Escala Brasileira de Insegurança Alimentar, EBIA) was used to assess household food security status. Sociodemographic conditions and access to social programmes and benefits were also evaluated. SETTING: National survey census from recognized Quilombolas Brazilian territories. SUBJECTS: Quilombolas households (n 8846). RESULTS: About half (47·8 %) of the Quilombolas lived in severely food-insecure households, with the North and Northeast regions facing the most critical situation. Households located in North Brazil, whose head of the family had less than 4 years of education, with a monthly per capita income below $US 44, without adequate sanitation and without adequate water supply had the greatest chance of experiencing moderate or severe food insecurity. Households that had access to a water supply programme for dry regions (Programa Cisternas) and an agricultural harvest subsidy programme (Programa Garantia Safra) had less chance of experiencing moderate and severe food insecurity. Households that did not have access to health care (Programa Saúde da Família) had greater chance of suffering from moderate or severe food insecurity. CONCLUSIONS: Interventions are urgently needed to strengthen and promote public policies aimed to improve living conditions and food security in Quilombolas communities.

Iron metabolism and oxidative profile of dogs naturally infected by Ehrlichia canis: Acute and subclinical disease.

The aim of this study was to evaluate the oxidant profile and iron metabolism in serum of dogs infected by Ehrlichia canis. Banked sera samples of dogs were divided into two groups: negative control (n = 17) and infected by E. canis on acute (n = 24), and subclinical (n = 18) phases of the disease. The eritrogram, leucogram, and platelet counts were evaluate as well as iron, ferritin, and transferrin levels, latent iron binding capacity (LIBC), and transferrin saturation index (TSI) concentration. In addition, the advanced oxidation protein products (AOPP) and ferric reducing ability of plasma (FRAP) in sera were also analyzed. Blood samples were examined for the presence of E. canis by PCR techniques. History and clinical signals were recorded for each dog. During the acute phase of the disease, infected animals showed thrombocytopenia and anemia when compared to healthy animals (P < 0.05) as a consequence of lower iron levels. Ferritin and transferrin levels were higher in both phases (acute and subclinical) of the disease. The AOPP and FRAP levels increased in infected animals on the acute phase; however, the opposite occurred in the subclinical phase. We concluded that dogs naturally infected by E. canis showed changes in the iron metabolism and developed an oxidant status in consequence of disease pathophysiology.

Insegurança alimentar e sua associação com consumo de alimentos regionais brasileiros / Food insecurity and its association with consumption of Brazilian regional foods

Objetivo: Verificar se existem diferenças no consumo de alimentos regionais entre adolescentes em situação de insegurança alimentar quando comparados aos seguros.Métodos: Estudo transversal realizado com adolescentes estudantes do 9º ano das 26 capitais brasileiras e Distrito Federal em 2011/2012. A amostra foi composta por 15.084 jovens. O consumo de alimentos regionais foi avaliado por meio de imagens. O participante deveria identificar o alimento, referindo seu consumo ou não. A situação de segurança alimentar foi aferida através da Escala Curta de Insegurança Alimentar, adaptada da escala americana e validada para o público adolescente brasileiro.Resultados: Foram analisados os dados de 14.690 adolescentes com média de idade de 14,4 anos, predominantemente do sexo feminino (55,7%) e alunos de escolas públicas (78,2%). Apenas 3,1% das mães eram analfabetas. A insegurança alimentar foi mais prevalente nos domicílios com jovens do sexo masculino, que estudavam em escolas púbicas, filhos de mães analfabetas e residentes na região Norte. O consumo de hortaliças e frutas foi maior entre adolescente residentes em domicílios em insegurança alimentar e insegurança alimentar grave do que entre os seguros, em todas as regiões geográficas brasileiras. As preparações regionais são mais consumidas por jovens que vivem em domicílios seguros.Conclusão: Observou-se que a insegurança alimentar está associada ao maior consumo de alimentos marcadores de dieta saudável, como frutas e hortaliças regionais. A produção e consumo de alimentos regionais deve ser estimulada e valorizada como forma de promoção da alimentação saudável e de garantia da segurança alimentar e nutricional.

Objective: The aim of this study is to investigate whether the consumption of regional food among Brazilian adolescents is associated with household food security status.Methods: This is a cross-sectional study that includes a sample of 15,084 adolescents, ninth-grade students in 26 Brazilian large cities in 2011/2012. The consumption of regional foods was evaluated using various food images; the adolescents were asked to identify the food and indicate whether they consumed that food. Household food security status was evaluated using a Short Form of the Food Insecurity Scale, adapted from the American Scale and validated for Brazilian adolescents.Results: Data of 14,690 adolescents with a mean of the age was 14.4 years were analyzed. The majority of the adolescents were female (55.7%) and public school students (78.2%). Only 3.1% of mothers were illiterate. Food insecurity was more prevalent among households with male students who were enrolled in public schools and whose mothers with were illiterate and lived in the Northern region of the country. The consumption of fruits and vegetables was higher among adolescents living in households with moderate and severe food insecurity than among those living in households that are food secure in all regions investigated. Home prepared regional foods are more commonly consumed by adolescents who live in households that are food secure.Conclusion: It was found that food insecurity is associated with greater consumption of foods that are part of a healthy diet, such as regional fruits and vegetables. The production and consumption of regional foods should be encouraged as a way to instill healthy eating habits and ensure food security.

Insegurança alimentar entre adolescentes brasileiros: um estudo de validação da Escala Curta de Insegurança Alimentar / Household food insecurity in Brazilian adolescents: a validation study

Objetivo Os objetivos do trabalho foram avaliar a validade interna e a capacidade preditiva da escala de segurança alimentar de seis itens aplicada a adolescentes. Métodos Foi um estudo transversal com amostra representativa de adolescentes brasileiros (N=14.690), realizado em escolas públicas e privadas nas 26 capitais de estados brasileiros e no Distrito Federal por meio de questionário online. Resultados A maior parte dos respondentes era do sexo feminino (53,2%), com idade média de 14,4 anos, sendo 72,7% de escolas públicas. O comportamento da escala, observado pelo modelo de Rasch, foi melhor sem o item cinco, apresentando valores ótimos de Infit e nível de severidade crescente entre os itens. O alfa de Cronbach foi 0,77, e as análises do funcionamento diferencial dos itens mostraram comportamento dos itens semelhante entre os subgrupos avaliados. A análise fatorial mostrou a unidimensionalidade do instrumento. Conclusão Foi proposta a retirada do item cinco e novos pontos de corte para a escala curta de segurança alimentar. A escala curta de segurança alimentar é válida e confiável para mensurar insegurança alimentar domiciliar entre adolescentes brasileiros. .

Objective The objective of this study was to evaluate the internal and predictive validity of a six-item household food insecurity scale to measure food insecurity in Brazilian adolescents. Methods A cross-sectional study with a representative sample of Brazilian adolescents (N=14,690) was conducted in public and private schools in 26 state capitals and in the Federal District of Brazil using an online questionnaire. Results Most respondents were female (53.2%) with mean age of 14.4 years, and 72.7% of them attended public schools. The psychometric properties of the scale, assessed using the Rasch model, showed better response rates without the item five, exhibiting optimal Infit statistics and an increasing level of severity among the items. Cronbach's á was 0.767. Differential item functioning analyses showed similar behavior between the items in the subgroups evaluated. Factor analysis confirmed the unidimensionality of the scale. Conclusion This study proposes the removal of the item five and the inclusion of new cut-off points for this short form of the scale. The Household Food Security Scale (short form) is valid and reliable to measure household food insecurity in Brazilian adolescents. .