Digital Educational Game "O Jardim do Ferro": A Tool for the Prevention of Iron Deficiency Anemia in Childhood.

Objective: To create and evaluate a digital educational game (DEG) for preschool children for the prevention of iron deficiency and iron deficiency anemia. Methodology: The DEG software was developed by a multidisciplinary team, according to Chandler's methodology, in Engine Unity. The game is a 2D platformer, for Android, with three different phases. A quiz was developed for parents/caregivers about iron absorption and anemia. The quiz content was evaluated by experts. The evaluation of the game was carried out through a questionnaire applied in the school for children from 4 to 6 years of age. Results: For the construction of the game, programming, team planning, art, and soundtrack were necessary. The game was registered at the National Institute of Industrial Property. The quiz was evaluated by 14 experts and all questions had more than 80% agreement. The questionnaire was answered by 32 children with a mean age of 5.0 ± 0.7 years, and ∼70% evaluated the game positively. Thus, the acceptability of the software was favored by most players. Conclusion: The "O Jardim do Ferro" software, from its conception to evaluation, proved to be a promising tool to contribute to food and nutrition education actions, providing opportunities for the construction of knowledge about iron-rich foods for the prevention of iron deficiency and iron deficiency anemia in childhood.

Shift handover qualification in obstetric unit during the pandemic period: reinventions and learning.

OBJECTIVE: Qualify the shift handover in an Obstetric Unit during the COVID-19 pandemic period, through Permanent Health Education. METHOD: Action research conducted in southern Brazil. The research was conducted from interviews with healthcare professionals and students and the data were analyzed using the Reflexive technique. Interventions took place in different work shifts, with the support of a serial album as a didactic and educational resource. RESULTS: The data analysis made it possible to record experiences and the delineation of two thematic categories: From traditional approaches to the reinvention of learning in healthcare work; and From conformism to professional growth. CONCLUSION: The shift handover in the Obstetric Unit, through Permanent Health Education, enabled autonomous, interactive, and cooperative learning; awakened the desire to transcend the work routine; and highlighted the need to continuously (re)signify the healthcare work process.

Análise sobre o conhecimento do pediatra brasileiro sobre a alergia à proteína do leite de vaca / Analysis of brazilian pediatricians' knowledge of cow's milk protein allergy

Analisar o conhecimento de pediatras brasileiros sobre alergia à proteína do leite de vaca (APLV) por meio de um questionário validado. Estudo quantitativo com delineamento transversal no qual foi aplicado um questionário online sobre conhecimentos de APLV. O cálculo amostral foi de 294. O formulário online foi dividido em dois blocos, sendo o primeiro composto por questões de identificação dos pediatras e o segundo composto pelo questionário validado, construído a partir do Consenso Brasileiro de Alergia Alimentar (2018). A avaliação geral do questionário mostrou um percentual de concordância de 91% e Índice de Validade de Conteúdo de 0,95. Os resultados dos questionários aplicados foram apresentados em frequências absolutas e relativas, média, mediana, desvio padrão e percentis. O nível de significância foi estabelecido em 5% (p < 0,05). O questionário validado foi respondido por 1.316 médicos brasileiros, dos quais 1.017 (77,3%) eram do sexo feminino. A média de idade observada foi de 45,50 ± 13,20 anos. Ao analisar o número total de acertos, notou-se que a média de acertos foi de 80,66 ± 10,42%. Os pediatras responderam principalmente a perguntas sobre o conceito e o tratamento da APLV. A questão com menor índice de acertos foi relacionada à investigação clínica e laboratorial. A maioria dos médicos que respondeu ao questionário demonstrou compreender o conceito e as principais recomendações terapêuticas da APLV.

To analyze the knowledge of Brazilian pediatricians about cow's milk protein allergy (CMPA) using a validated questionnaire. Quantitative study with a cross-sectional design in which an online questionnaire on CMPA knowledge was applied. The sample calculation indicated 1024 participants. The online form was divided into two blocks, the first comprising questions on the identification of pediatricians, and the second comprising the validated questionnaire, built from the Brazilian Consensus on Food Allergy (2018). The general evaluation of the questionnaire showed a percentage of agreement of 91% and a Content Validity Index of 0.95. The results of the applied questionnaires were presented in absolute and relative frequencies, mean, median, standard deviation, and percentiles. The level of significance was set at 5% (p <0.05). The validated questionnaire was answered by 1316 Brazilian doctors, of whom 1017 (77.3%) were females, and their mean age was 45.50 ± 13.20 years. The mean total number of correct answers was 80.66 ± 10.42%. Pediatricians mostly answered questions about the concept and treatment of CMPA. The question with the lowest rate of correct answers was related to clinical and laboratory investigation. Most physicians who answered the questionnaire demonstrated they understood the concept and the main CMPA therapeutic recommendations.

Fidelização e impacto de tecnologias sociais em saúde centradas no usuário: nova proposta de desenvolvimento / Reliability and impact of user-centered social technologies in health: a new development proposal / Reliability and impact of user-centered social technologies in health: a new development proposal / Fidelización e impacto de tecnologías sociales en salud centradas en el usuario: nueva propuesta de desarrollo

Resumo Objetivo Descrever metodologia para o desenvolvimento de tecnologias sociais em enfermagem/saúde centradas no usuário Métodos Estudo de desenvolvimento tecnológico que apresenta proposição metodológica para a expansão de tecnologias sociais, com foco na solução de problemas oriundos de demandas dos usuários de saúde. Resultados A metodologia de aplicação tecnológica foi concebida e sistematizada em cinco fases sequenciais, quais sejam: Diagnóstico situacional, Idealização e prototipagem, Validação, Implementação, Fidelização e impacto social da aplicação. Conclusão Pretende-se, com essa nova proposta de desenvolvimento tecnológico, contribuir para a fidelização e o impacto das tecnologias sociais centradas nas necessidades dos usuários de saúde, a partir de abordagens como o Design Thinking e o Design Centrado no Usuário.

Resumen Objetivo Describir metodología para el desarrollo de tecnologías sociales en enfermería/salud centradas en el usuario Métodos Estudio de desarrollo tecnológico que presenta una proposición metodológica para la expansión de tecnologías sociales, con enfoque en la solución de problemas originarios de demandas de los usuarios de salud. Resultados La metodología de aplicación tecnológica fue formulada y sistematizada en cinco etapas secuenciales, a saber: Diagnóstico situacional, Idealización y creación de prototipo, Validación, Implementación, Fidelización e impacto social de la aplicación. Conclusión Con esta nueva propuesta de desarrollo tecnológico se pretende contribuir para la fidelización y para el impacto de las tecnologías sociales centradas en las necesidades de los usuarios de salud, a partir de intervenciones como el Design Thinking y el Design Centrado en el Usuario.

Abstract Objective To describe the methodology for developing user-centered social technologies in nursing/health Methods A technological development study that presents a methodological proposal for the expansion of social technologies, with a focus on solving problems arising from the demands of healthcare users. Results The technological application methodology was conceived and systematized in five sequential steps, namely: Situational diagnosis, Ideation and prototyping, Validation, Implementation, Reliability, and social impact of the application. Conclusion With this new technological development proposal, we intend to contribute to the reliability and impact of social technologies centered on health users' needs, based on approaches such as Design Thinking and User-Centered Design.

Shift handover qualification in obstetric unit during the pandemic period: reinventions and learning / Calificación de cambio de turno en unidad obstétrica en período de pandemia: reinvenciones y aprendizajes / Qualificação da passagem de plantão em unidade obstétrica durante período pandêmico: reinvenções e aprendizados

ABSTRACT Objective: Qualify the shift handover in an Obstetric Unit during the COVID-19 pandemic period, through Permanent Health Education. Method: Action research conducted in southern Brazil. The research was conducted from interviews with healthcare professionals and students and the data were analyzed using the Reflexive technique. Interventions took place in different work shifts, with the support of a serial album as a didactic and educational resource. Results: The data analysis made it possible to record experiences and the delineation of two thematic categories: From traditional approaches to the reinvention of learning in healthcare work; and From conformism to professional growth. Conclusion: The shift handover in the Obstetric Unit, through Permanent Health Education, enabled autonomous, interactive, and cooperative learning; awakened the desire to transcend the work routine; and highlighted the need to continuously (re)signify the healthcare work process.

RESUMEN Objetivo: Calificar el cambio de turno en la Unidad Obstétrica durante el período de pandemia de COVID-19, a través de la Educación Permanente en Salud. Método: Investigación acción realizada en la región sur de Brasil. La parte investigativa se realizó a partir de entrevistas a profesionales de la salud y estudiantes y se analizó mediante la técnica Reflexive. Ya las intervenciones se realizaron en diferentes turnos de trabajo, con el apoyo de un álbum seriado como recurso didáctico y educativo. Resultados: El análisis de datos permitió registrar experiencias y la significación de las intervenciones resultó en dos categorías temáticas: De los enfoques tradicionales a la reinvención del aprendizaje en el trabajo en salud y Del conformismo al crecimiento profesional. Conclusión: El cambio de turno en la Unidad de Obstetricia, a través de la Educación Permanente en Salud, posibilitó el aprendizaje autónomo, interactivo, colegiado; despertó el deseo de trascender la rutina laboral; y destacó la necesidad de (re)significar continuamente el proceso de trabajo en salud.

RESUMO Objetivo: Qualificar a passagem de plantão em Unidade Obstétrica durante período pandêmico da COVID-19, por meio da Educação Permanente em Saúde. Método: Pesquisa-ação realizada na região sul do Brasil. A investigação foi conduzida a partir de entrevistas com profissionais e alunos da saúde e os dados foram analisados pela técnica Reflexive. Já as intervenções ocorreram nos diferentes turnos de trabalho, com o apoio de um álbum seriado como recurso didático e educativo. Resultados: A análise dos dados possibilitou o registro de vivências e a delimitação de duas categorias temáticas: De abordagens tradicionais à reinvenção da aprendizagem no trabalho em saúde; e Do conformismo ao crescimento profissional. Conclusão: A passagem de plantão em Unidade Obstétrica, por meio da Educação Permanente em Saúde, possibilitou o aprendizado autônomo, interativo e cooperativo; despertou o desejo de transcender a rotina de trabalho; e intuiu à necessidade de (re)significar continuamente o processo de trabalho em saúde.

Acolhimento e desafios no retorno ao trabalho, após a licença-maternidade em uma instituição de ensino / Acogimiento y desafíos en el retorno al trabajo, luego de la licencia maternidad en una institución de enseñanza / Reception and challenges in returning to work, after maternity leave in an educational institution

Objetivo: analisar os sentimentos e dificuldades de mães no retorno da licença-maternidade e a percepção do acolhimento institucional. Método: estudo quali-quantitativo com 40 mães trabalhadoras de uma instituição de ensino pública de ensino médio, técnico e superior que retornaram ao trabalho após o período de licença. Foi aplicado um questionário on-line, com análise quantitativa descritiva e qualitativa de conteúdo. Resultados: das participantes, 42,5% relataram sentimentos difíceis (tristeza, depressão e desamparo), 50% dificuldade nas rotinas, 17,5% problemas para amamentar pela distância e 35% pontos positivos quanto à amamentação exclusiva no trabalho remoto. Cinco categorias foram encontradas: sentimentos no retorno ao trabalho; dificuldades do retorno e amamentação; pandemia e trabalho remoto; fragilidades percebidas e sugestões de melhorias; reflexões quanto à sua saúde mental. Conclusão: os sentimentos negativos e as dificuldades prevaleceram na percepção das mães, demandando atenção institucional para acolhimento no retorno da licença-maternidade.

Objective: To analyze the feelings and difficulties of mothers in returning from maternity leave and the perception of institutional care. Method: A qualitative-quantitative study with 40 working mothers from a public high school, technical and higher education institution who returned to work after the period of leave. An online questionnaire, with descriptive quantitative and qualitative content analysis, was applied. Results: From the participants, 42.5% reported difficult feelings (sadness, depression and helplessness), 50% difficulty in routines, 17.5% problems with breastfeeding at a distance and 35% positive points regarding exclusive breastfeeding in remote work. Five categories were found: feelings on returning to work; difficulties in returning and breastfeeding; pandemic and remote work; perceived weaknesses and suggestions for improvement; reflections on your mental health. Conclusion: Negative feelings and difficulties prevailed in the mothers' perception, demanding institutional attention for reception when returning from maternity leave.

Objetivo: analizar los sentimientos y dificultades de las madres en el retorno de la licencia maternidad y la percepción de la acogida institucional. Método: estudio cuali-cuantitativo con 40 mujeres trabajadoras de una institución de enseñanza pública de nivel medio, técnico y superior que volvieron al trabajo después del período de licencia. Se aplicó un cuestionario en línea, con un análisis de contenido descriptivo cuantitativo y cualitativo. Resultados: de los participantes, el 42,5% relatan sentimientos difíciles (tristeza, depresión y desamparo), el 50% dificultad en las rutinas, el 17,5% problemas para amamantar por la distancia y el 35% puntos positivos en cuanto al amamantamiento exclusivo en el trabajo remoto. Se encontraron cinco categorías: sentimientos en el retorno al trabajo; dificultades del retorno y amamantamiento; pandemia y trabajo remoto; fragilidades percibidas y sugerencias de mejora; reflexiones sobre su salud mental. Conclusión: los sentimientos negativos y las dificultades prevalecieron en la percepción de las madres, exigiendo la atención institucional para el acogimiento en el retorno de la licencia maternidad.

Cerebral palsy: association between nutritional status and occurrence of oropharyngeal dysphagia / Paralisia cerebral: associação entre estado nutricional e ocorrência de disfagia orofaríngea

ABSTRACT Objective: to verify the association between nutritional status and the occurrence of oropharyngeal dysphagia in individuals with cerebral palsy. Methods: a cross-sectional, quantitative study with people aged between two and 20 years. Neuromotor impairment, occurrence and degree of dysphagia, anthropometry, food consumption, feeding route, diet fractionation and consistency were evaluated. Swallowing evaluation was performed by a skilled speech-language-hearing therapist, through the Clinical Evaluation Protocol of Pediatric Dysphagia (PAD-PED, Portuguese acronym).The statistical analysis was performed adopting p<0.05%. Results: 40 subjects with a median of 8.7 (5.45-14.5) years, 65% of whom were males. Concerning neuromotor impairment, 72.5% were classified at levels IV and V. The prevalence of dysphagia was 70%, the feeding route being predominantly oral (77.5%) with a normal diet consistency (55%). In the growth curves, all of them were classified within an adequate height for their age. As for weight, body mass index and skinfolds, 82.5%, 85% and 62.5% were eutrophic, respectively. Statistically significant association was found between dysphagia and body mass index (p=0.018). The mean daily caloric and proteic intake was 1427.29±338.62 kcal and 56.86±17.57 grams, respectively. Statistically significant association was found between the feeding route and the amount of protein ingested daily (p=0.041). Conclusion: most subjects presented oropharyngeal dysphagia and more severe motor impairment; they were fed orally with a normal diet consistency. It was observed that the greater the difficulty in swallowing, the greater the impairment of nutritional status.

RESUMO Objetivo: verificar a associação entre estado nutricional e ocorrência de disfagia orofaríngea em indivíduos com paralisia cerebral. Métodos: estudo transversal, quantitativo, realizado com indivíduos entre dois e 20 anos. Foi avaliado comprometimento neuromotor, ocorrência e grau de disfagia, antropometria, consumo alimentar, via alimentar, fracionamento e consistência da dieta. A avaliação da deglutição foi realizada por fonoaudióloga capacitada, por meio do Protocolo para Avaliação Clínica da Disfagia Pediátrica. Foi realizada análise estatística pertinente, adotando p<0,05%. Resultados: participaram 40 indivíduos com mediana de 8,7 (5,45-14,5) anos, sendo 65% do sexo masculino. Quanto ao comprometimento neuromotor, 72,5% foram classificados no nível IV e V. A prevalência de disfagia foi de 70%, via alimentar predominantemente oral (77,5%) e consistência da dieta normal (55%). Nas curvas de crescimento, todos foram classificados com estatura adequada para idade. Para peso, índice de massa corporal e dobras cutâneas houve, respectivamente, 82,5%, 85% e 62,5% em eutrofia. Foi encontrada associação estatisticamente significante entre disfagia e índice de massa corporal (p=0,018). A média diária de ingestão calórica e proteica foi de 1427,29±338,62 kcal e 56,86±17,57 gramas, respectivamente. Foi encontrada associação estatisticamente significante entre via alimentar e quantidade de proteína ingerida diariamente (p=0,041). Conclusão: a maioria dos indivíduos apresentou disfagia orofaríngea e comprometimento motor mais grave, alimentavam-se por via oral com consistência de dieta normal. Observou-se que quanto maior a dificuldade de deglutição, maior o comprometimento do estado nutricional.

Evidence on nutritional assessment techniques and parameters used to determine the nutritional status of children and adolescents: systematic review.

This article aims to review systematically the evidence on nutritional assessment techniques and parameters used to determine the nutritional status of children and adolescents. The literature review and the selection of publications were performed using the Medline, Lilacs, SciELO, Embase, personal files. 17 studies were identified, 7 addressed the anthropometric indices as the main outcome, 7 analyzed the growth and development of children and adolescents through growth curves, and the remainder surveyed body composition. In general, all met the quality criteria, unless 6 of the articles who did not discuss the limitations. The literature review suggests several techniques and parameters that can be applied to determine the nutritional status of children and adolescents from different countries. Growth graphs are essential to assess the health of children, but depend greatly of the growth tables used. Although BMI can be practical, it does not distinguish body fat from lean mass. The best interpretation of anthropometry will depend of valid reference values for age range of the study population. BIA is a quick feasible method, but the measurement has some various nationalities.

Evidence on nutritional assessment techniques and parameters used to determine the nutritional status of children and adolescents: systematic review / Evidência sobre técnicas e parâmetros de avaliação nutricional para crianças e adolescentes: revisão sistemática

Abstract This article aims to review systematically the evidence on nutritional assessment techniques and parameters used to determine the nutritional status of children and adolescents. The literature review and the selection of publications were performed using the Medline, Lilacs, SciELO, Embase, personal files. 17 studies were identified, 7 addressed the anthropometric indices as the main outcome, 7 analyzed the growth and development of children and adolescents through growth curves, and the remainder surveyed body composition. In general, all met the quality criteria, unless 6 of the articles who did not discuss the limitations. The literature review suggests several techniques and parameters that can be applied to determine the nutritional status of children and adolescents from different countries. Growth graphs are essential to assess the health of children, but depend greatly of the growth tables used. Although BMI can be practical, it does not distinguish body fat from lean mass. The best interpretation of anthropometry will depend of valid reference values for age range of the study population. BIA is a quick feasible method, but the measurement has some various nationalities.

Resumo O objetivo deste artigo é revisar sistematicamente as evidências sobre as técnicas de avaliação nutricional e parâmetros utilizados para determinar o estado nutricional em crianças e adolescentes. Revisão da literatura com busca nas bases de dados, Medline, Lilacs, SciELO e Embase, além de arquivos pessoais. Identificamos 17 artigos que relatavam dados de diferentes populações, sete estudos abordaram os índices antropométricos, quatro o crescimento e o desenvolvimento de crianças e adolescentes por meio de curvas de crescimento, e o restante a composição corporal. Todos preencheram os critérios de qualidade, com exceção das limitações. A revisão da literatura sugere diversas técnicas e parâmetros que podem ser aplicados para determinar o estado nutricional de crianças e adolescentes de diferentes países. Gráficos de crescimento são essenciais para avaliar a saúde de crianças, mas depende muito das tabelas de crescimento utilizadas. Embora o IMC seja prático, não distingue a gordura corporal de massa magra. Existem várias técnicas para avaliar proporções, tamanho e composição corporal. A melhor interpretação da antropometria dependerá de valores de referência válidos para a faixa etária da população estudada. BIA é um método factível, mas tem algumas limitações para a realização do exame.

Anthropometric indicators of general and central obesity in the prediction of asthma in adolescents; central obesity in asthma / Indicadores antropométricos de la obesidad general y central en la predicción de asma en adolescentes; obesidad central en asma

Objective: to determine the prevalence of asthma risk associated with anthropometric indicators of excess weight and body fat distribution. Methodology: cross-sectional study including adolescents between 10 and 19 years of age. The anthropometric indicator used to classify excess weight was the body mass index (BMI-Z); those used for abdominal adiposity were waist circumference (WC), waist-to-height ratio (WHtR) and the conicity index (CI). Asthma characteristics were evaluated using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The significance level was 5%, and the analyses were performed using Statistical Package for the Social Sciences (SPSS) Version 18.0. Results: adolescent students (n=1362; 788 [57.9%] female) with a mean age of 15.65±1.24 years were evaluated. A high prevalence of asthma, excess weight (BMI-Z) and excess abdominal adiposity (WC and WHtR) was observed in the females. Only CI values for excess abdominal adiposity were higher for males than for females. Adolescents with excess abdominal adiposity, as shown by the WHtR, had a 1.24 times higher risk of having asthma compared with non-obese adolescents. Boys with excess abdominal adiposity, as classified by CI, presented a 1.8 times greater risk of asthma. The risk of severe asthma was 3 times higher among adolescents who were classified as severely obese via the BMI-Z. Conclusion: this study showed that excess body weight and abdominal obesity are associated with an increased risk of asthma and asthma severity in adolescents. Thus, additional BMI measurements are suggested for asthmatics (AU)

Objetivo: determinar la prevalencia de riesgo de asma asociado con indicadores antropométricos de exceso de peso y la distribución de la grasa corporal. Metodología: estudio transversal que incluye adolescentes entre 10 y 19 años de edad. El indicador antropométrico utilizado para clasificar el exceso de peso fue el índice de masa corporal (IMC-Z); los utilizados para la adiposidad abdominal fueron la circunferencia de la cintura (CC), la relación cintura-estatura (RCE) y el índice de conicidad (IC). Las características del asma se evaluaron utilizando el cuestionario International Study of Asthma and Allergies in Childhood (ISAAC). El nivel de significación fue del 5%, y los análisis se realizaron con el Statistical Package for the Social Sciences (SPSS) versión 18.0. Resultados: fueron evaluados estudiantes adolescentes (n=1362; 788 [57,9%] mujeres) con una edad media de 15,65±1,24 años. Se observó en las mujeres una alta prevalencia de asma, exceso de peso (IMC-Z) y exceso de adiposidad abdominal (WC y RCE). Solo los valores de IC para el exceso de adiposidad abdominal fueron mayores para los hombres que para las mujeres. Los adolescentes con exceso de adiposidad abdominal, como lo demuestra la RCE, tenían 1,24 veces más riesgo de tener asma en comparación con los adolescentes no obesos. Los niños con exceso de adiposidad abdominal, según la clasificación de IC, presentaron 1,8 veces mayor riesgo de asma. El riesgo de asma grave era 3 veces mayor entre las adolescentes que fueron clasificados como severamente obesos a través del IMC-Z. Conclusión: este estudio mostró que el exceso de peso y la obesidad abdominal se asocian con un mayor riesgo de asma y asma severa en adolescentes. Por lo tanto, se sugieren mediciones de IMC adicionales para los asmáticos(AU)

Consumo de bebidas alcoólicas durante a gestação por mulheres atendidas em uma maternidade de Santa Maria-RS e seus efeitos nos recém-nascidos / Drinking profile of postpartum women admitted to a maternity hospital of Santa Maria-RS and its effetcs on newborns

Introdução: Devido à embriotoxidade e à teratogenicidade fetal que a ele estão relacionadas, o álcool é considerado uma das principais causas evitáveis de defeitos congênitos; desta forma, o objetivo da pesquisa foi investigar o consumo de bebida alcoólica na gestação, em puérperas de um Hospital Público de Santa Maria- RS, e associar os fatores socioeconômicos e culturais, o estado nutricional da puérpera e do recém-nascido. Métodos: Estudo transversal com puérperas e recém-nascidos atendidos no alojamento conjunto da maternidade. Foram aplicados dois questionários para as puérperas, o questionário validado TWEAK, para investigar o consumo de bebida alcoólica, e outro com questões socioeconômicas, culturais, histórico e saúde, seguidos de análise do prontuário do recém-nascido. Para análise dos dados, utilizou-se o programa SPSS. Resultados: Participaram do estudo 66 puérperas, com idade média de 24,09 ± 6,79 anos; destas, 15 (22,7%) consumiram bebida alcoólica na gravidez. O consumo de bebidas alcoólicas esteve associado a recém-nascidos pré-termo, com peso ao nascer e perímetro torácico menor, quando comparados aos recém-nascidos de mães não consumidoras de bebidas alcoólicas. Conclusões: Uma importante parcela de puérperas consumiu bebidas alcoólicas durante a gestação, e este consumo esteve associado a baixo peso e menor perímetro torácico do recém-nascido (AU)

Introduction: Due to fetal teratogenicity and embryo toxicity associated with alcohol, drinking behavior is considered one of the leading preventable causes of birth defects. The aim of this study was to investigate postpartum women's drinking behavior during pregnancy in a public hospital of Santa Maria, RS, and its association with economic and cultural factors, as well as with the nutritional status of mother and newborn. Methods: Cross-sectional study with postpartum women and newborns cared for at the joint quarters of the maternity ward. Two questionnaires were administered to the mothers: the validated TWEAK questionnaire, to investigate alcohol consumption, and another one with socioeconomic, cultural, historical and health questions, followed by analysis of the newborn medical records. The SPSS program was used for data analysis. Results: The study included 66 postpartum women with a mean age of 24.09 ± 6.79 years; of these, 15 (22.7 %) consumed alcohol in pregnancy. The consumption of alcohol was associated with preterm infants with lower birth weight and chest girth than children born to mothers who did not drink alcoholic beverages. Conclusions: A significant proportion of pregnant women reported drinking during pregnancy and this consumption was associated with lower birth weight and smaller thoracic girth of the newborn (AU)

Balanço energético em crianças e adolescentes com bronquiolite obliterante pós-infecciosa / Energy balance in children and adolescents with post-infectious bronchiolitis obliterans

OBJETIVOS: Quantificar o gasto e estimar a ingestão energética de crianças e adolescentes com bronquiolite obliterante pós-infecciosa e comparar com crianças e adolescentes hígidos. MÉTODOS: Estudo transversal com 72 crianças e adolescentes de 8 a 18 anos. Compararam-se dois grupos de 36 indivíduos - um com diagnóstico de bronquiolite obliterante e outro hígido -, os quais foram pareados pelo sexo, idade e classificação do índice de massa corporal. Para avaliação nutricional, utilizaram-se a antropometria e a composição corporal. O gasto energético foi medido pela calorimetria indireta; o fator atividade, pelo recordatório 24h de atividades físicas, e a ingestão energética, pelos inquéritos alimentares. RESULTADOS: O grupo com bronquiolite obliterante e o grupo-controle apresentaram respectivamente: índice de massa corporal de M=18,9, DP=4,0kg/m² e M=18,8, DP=3,4kg/m²; gasto energético de repouso de M=1717,6, DP=781,5 e M=2019,9, DP=819; gasto energético total de M=2677,5, DP=1514,0kcal/dia e M=3396,1, DP=1557,9kcal/dia; estimativa da ingestão energética de M=2294,1, DP=746,7kcal/dia e M=2116,5, DP=612,1kcal/dia. O gasto energético de repouso (p=0,102) e o gasto energético total (p=0,051) não foram diferentes entre os grupos, mesmo quando ajustados pela massa magra. Não houve diferenças estatisticamente significativas entre o o gasto energético total e o consumo energético no grupo com bronquiolite obliterante (p=0,202). O grupo-controle consumiu menos calorias do que o previsto pelo gasto energético total (p<0,001). CONCLUSÃO: O gasto energético de repouso e o gasto energético total foram semelhantes entre os grupos. A estimativa da ingestão energética dos hígidos foi menor que o gasto energético total. O grupo com bronquiolite obliterante apresentava um balanço energético adequado.

OBJECTIVE: The aim of the study was to determine the energy expenditure and estimate the energy intake of children and adolescents with post-infectious bronchiolitis obliterans and compare them with those of healthy children and adolescents. METHODS: This cross-sectional study included 36 children and adolescents with bronchiolitis obliterans aged 8 to 18 years, and a control group with 36 healthy individuals matched for sex, age and body mass index. Anthropometric data were collected from all individuals. Energy expenditure was determined by indirect calorimetry, activity factor was estimated by a 24-hour record of physical activities, and energy intake was estimated by the 24-hour food recall. RESULTS: Data for the bronchiolitis obliterans and control groups are, respectively: body mass index of M=18.9, SD=4.0kg/m² and M=18.8, SD=3.4kg/m²; resting energy expenditure of M=1717.6, SD=781.5kcal/day and M=2019.9, SD=819kcal/day; total energy expenditure of M=2677.5, SD=1514.0kcal/day and M=3396.1, SD=1557.9kcal/day; estimated energy intake of M=2294.1, SD=746.7kcal/day and M=2116.5, SD=612.1kcal/day. Resting energy expenditure (p=0.102) and total energy expenditure (p=0.051) did not differ between the groups, even when adjusted for lean mass. Total energy expenditure and intake of the bronchiolitis obliterans group did not differ significantly (p=0.202). Energy intake by the control group was lower than expected according to their total energy expenditure (p<0.001). CONCLUSION: The resting energy expenditure and total energy expenditure of the two groups were similar. The estimated energy intake of the control group was lower than their total energy expenditure. The bronchiolitis obliterans group had an appropriate energy balance.

Consumo de alimentos industrializados em pré-escolares / Consumption of processed foods in preschool children

Na criança, a nutrição adequada é fundamental para o crescimento e desenvolvimento normais. Este estudo objetivou avaliar a oferta de alimentos industrializados em pré-escolares pelos pais e pela escola, assim como o estado nutricional. Métodos: Estudo transversal com amostra de 54 pré-escolares. Realizou-se avaliação do estado nutricional, por meio das variáveis: índice de massa corpórea, sexo, idade, peso, estatura. Avaliou-se consumo de alimentos industrializados na escola, por meio de observação do cardápio escolar e, no domicílio, através de questionário de frequência alimentar. A análise dos dados foi realizada pelo SPSS 15.0. Resultados: Dos pré-escolares avaliados 59,3% eram do sexo masculino. A média de idade foi 42,87 (±13,29) meses. Alto índice de risco de sobrepeso, 27,8% para IMC, 25,9% para P/A. Índices de sobrepeso e obesidade apresentaram, ambos, 11,1% no indicador IMC. Nos domicílios há elevada oferta de alimentos industrializados (21 qualidades diferentes), e destes, todos são consumidos com frequência maior que uma vez por semana. Já os cardápios escolares oferecem (13 diferentes), e destes, sete são consumidos mais de uma vez na semana. Conclusão: Observou-se consumo significativo de alimentos industrializados tanto nas escolas infantis quanto nos domicílios, por crianças com e sem excesso de peso. Foi relevante o número de pré-escolares de ambos os sexos, com excesso de peso.

In children, adequate nutrition is essential for normal growth and development. This study aimed to evaluate the availability of processed foods to preschool children by their parents and school as well as their nutritional status. Methods: Cross-sectional study of a sample of 54 preschoolers. We carried out an assessment of nutritional status through the following variables: body mass index, sex, age, weight, and height. We evaluated the consumption of foods at school, through observation of the school menu, and at home using a food frequency questionnaire. Data analysis was performed using SPSS 15.0. Results: 59.3% of the young children evaluated were males. The mean age was 42.87 (± 13.29) months. There was a high degree of risk of overweight: 27.8% for BMI and 25.9% for W/H. Rates of overweight and obesity were both 11.1% according to BMI. In the households there was a high supply of processed foods (21 different qualities), and of these, all are consumed more frequently than once a week. On the other hand the school menus offer 13 different items, and of these, seven are consumed more than once a week. Conclusion: There was a significant consumption of processed foods at school and at home by children with and without overweight. The number of preschool children of both sexes who were overweight was significant.

Gasto energético em adolescentes asmáticos com excesso de peso: calorimetria indireta e equações de predição / Energy expenditure in overweight, asthmatic adolescents: indirect calorimetry and prediction equations

OBJETIVO: Comparar o gasto energético medido por calorimetria indireta com o estimado por equações de predição entre adolescentes asmáticos e não asmáticos. MÉTODOS: Trata-se de estudo transversal com 69 adolescentes de 10 a 18 anos. Foram comparados três grupos pareados (asmáticos com excesso de peso, asmáticos eutróficos e não asmáticos com excesso de peso). Para avaliação nutricional utilizaram-se medidas antropométricas e de composição corporal. O gasto energético foi medido por calorimetria indireta e estimado por fórmulas de predição. RESULTADOS: Cada grupo foi composto por 23 adolescentes, dos quais 10 do sexo feminino, com média de idade de M=12,4, DP=2,4 anos. O gasto energético de repouso, pela calorimetria indireta nos asmáticos com excesso de peso, foi de M=1550,2, DP=547,2kcal/dia; nos asmáticos eutróficos, M=1540,8, DP=544,2kcal/dia; e nos não asmáticos com excesso de peso, M=1697,2, DP=379,8kcal/dia, com resultado semelhante entre os grupos, mesmo quando ajustado pela massa magra e massa gorda (f=0,186; p=0,831). Obtiveram-se achados semelhantes entre o gasto energético medido pela calorimetria indireta e o estimado pelas fórmulas de predição, com exceção da fórmula de Harris-Benedict, que subestimou o gasto energético nos asmáticos eutróficos e nos não asmáticos com excesso de peso. CONCLUSÃO: O gasto energético de repouso não foi estatisticamente diferente entre os grupos asmáticos e não asmáticos, mesmo quando ajustado pela massa magra e massa gorda. Para os três grupos, as equações de predição são úteis para estimar o gasto energético de repouso e o gasto energético total.

OBJECTIVE: This study compared the energy expenditure measured by indirect calorimetry with that estimated by prediction equations in asthmatic and non-asthmatic adolescents. METHODS: This was a cross-sectional study with 69 adolescents aged 10 to 18 years. Three paired groups were compared (overweight, asthmatic adolescents, normal weight, asthmatic adolescents and overweight, non-asthmatic adolescents). Energy expenditure was estimated by indirect calorimetry and prediction equations. RESULTS: Each group consisted of 23 adolescents (10 females), with an average age of M=12.4, SD=2.4 years. In the group of overweight, asthmatic adolescents, the resting energy expenditure was M=1550.2, SD=547.2kcal/day; in the group of normal weight asthmatic adolescents, the resting energy expenditure was M=1540.8, SD=544.2kcal/day; and in the group of overweight, non-asthmatic adolescents, the resting energy expenditure was M=1697.2 SD=379.8kcal/day. The results were similar among groups even when adjusted for lean and fat mass (f=0.186; p=0.831). The total energy expenditure was also similar among groups, except that the Harris-Benedict formula underestimated the energy expenditure in normal weight asthmatic adolescents and overweight, non-asthmatic adolescents. CONCLUSION: The resting energy expenditure was not statistically different among groups of asthmatic and non-asthmatic adolescents, even when adjusted for lean mass and fat mass. For all three groups, the predictive equations were useful for estimating the resting energy expenditure and total energy expenditure.

Energy expenditure and estimated caloric intake in asthmatic adolescents with excess body weight.

OBJECTIVE: To measure resting energy expenditure (REE) and to estimate caloric intake of asthmatic adolescents with excess body weight and compare results with those groups of eutrophic asthmatic adolescents and non-asthmatic adolescents with excess body weight. METHODS: This cross-sectional study categorized 69 adolescents aged 10 to 18 y into three matched groups. Nutritional status was assessed using anthropometric and body composition measurements. Indirect calorimetry was used to measure energy expenditure, and caloric intake was estimated from dietary recalls. RESULTS: In each group, there were 23 adolescents (10 girls) aged 12.39 ± 2.40 y. Results for each group were as follows. For asthmatic adolescents with excess body weight, body mass index (BMI) was 24.83 ± 2.73 kg/m(2), REEs were 1550.24 ± 547.23 kcal/d and 27.69 ± 11.33 kcal · kg(-1) · d(-1), and estimated caloric intake was 2068.75 ± 516.66 kcal/d; for eutrophic asthmatic adolescents, BMI was 19.01 ± 2.10 kg/m(2), REEs were 1540.82 ± 544.22 kcal/d and 36.65 ± 15.04 kcal · kg(-1) · d(-1), and estimated caloric intake was 2174.05 ± 500.55 kcal/d; and for non-asthmatic adolescents with excess body weight, BMI was 25.35 ± 3.66 kg/m(2), REEs were 1697.24 ± 379.84 kcal/d and 28.18 ± 6.70 kcal · kg(-1) · d(-1), and estimated caloric intake was 1673.17 ± 530.68 kcal/d. Absolute REE values between groups were not statistically different, even after correction for lean mass and fat mass (F = 0.186, P = 0.831). REE (kilocalories per kilogram per day) was significantly higher in the group of eutrophic asthmatic adolescents (P = 0.016). Estimated caloric intake was greater than REE only in the group of adolescents with asthma. CONCLUSION: The REE was not significantly different among groups, and REE (kilocalories per kilogram per day) was higher in the group of eutrophic asthmatic adolescents. Estimated caloric intake was greater than REE in the group of adolescents with asthma.

Assessment of nutritional status in children and adolescents with post-infectious bronchiolitis obliterans.

OBJECTIVE: To assess the nutritional status of children and adolescents with bronchiolitis obliterans and to analyze associations with clinical and nutritional factors. METHODS: The study included 57 patients. Nutritional status was assessed using z scores for weight/age, stature/age, weight/stature in children, and stature/age and body mass index percentiles in adolescents. Body composition was assessed via tricipital skin folds, subscapular skin folds, and the sum of both plus the muscular circumference of the arm; pulmonary function was also investigated in subjects over 8 years old. RESULTS: The high percentages of malnutrition and risk for malnutrition are noteworthy: 21.7 and 17.5%, respectively. Among children, weight/age and stature/age detected higher percentages of malnutrition (21.6 and 16.2%), while weight/stature underestimated this diagnosis. Among adolescents, body mass index detected a high percentage of malnutrition (25%) and of risk for malnutrition (20%). Body composition analysis detected 51% of patients with low muscle reserves, and the majority of patients had normal fat reserves. Compromised pulmonary function was associated with poor performance at exercise (r = 0.434; p = 0.024). Malnutrition and/or nutritional risk and low muscle reserves were significantly associated with the 6-minute walk test (p = 0.032; p = 0.030). There was no association between spirometry and the nutritional variables (p > 0.05). CONCLUSION: These results emphasize the need for nutritional intervention, and suggest that, in addition to using weight and height indices for nutritional assessment, it is necessary to combine these with an analysis of body composition, so that a larger number of patients with malnutrition and/or at an increased risk for developing malnutrition may be identified and correctly managed.

Avaliação do estado nutricional de crianças e adolescentes com bronquiolite obliterante pós-infecciosa / Assessment of nutritional status in children and adolescents with post-infectious bronchiolitis obliterans

OBJETIVOS: Avaliar o estado nutricional de crianças e adolescentes portadores de bronquiolite obliterante e analisar a associação com aspectos clínicos e nutricionais. MÉTODOS: Estudo com 57 crianças e adolescentes. Realizou-se avaliação do estado nutricional (nas crianças, pelos escores z de peso/idade, estatura/idade e peso/estatura; nos adolescentes, por estatura/idade e percentis do índice de massa corporal), da composição corporal (avaliaram-se dobras cutâneas tricipital, subescapular e soma das duas e circunferência muscular do braço) e avaliação da função pulmonar nos maiores de 8 anos. RESULTADOS: Destaca-se o alto percentual de desnutrição (21,7 por cento) e risco de desnutrição (17,5 por cento). Nas crianças, o peso/idade e estatura/idade apresentaram maior percentual de desnutrição, 21,6 e 16,2 por cento, respectivamente, ao passo que o peso/estatura subestimou este diagnóstico. Nos adolescentes, o índice de massa corporal demonstrou alto percentual de desnutrição (25 por cento) e riscode desnutrição (20 por cento). Na composição corporal, 51 por cento apresentaram baixa reserva muscular, e a maioria dos pacientes apresentou reserva de gordura dentro da normalidade. O prejuízo da função pulmonar associou-se com menor desempenho ao exercício (r = 0,434; p = 0,024). A desnutrição e/ou risco nutricional e baixa reserva muscular associaram-se significativamente com teste de caminhada de 6 minutos (p = 0,032; p = 0,030). Não houve associação entre a espirometria e variáveis nutricionais (p > 0,05). CONCLUSÃO: Estes resultados salientam a necessidade de intervenção nutricional. Na avaliação nutricional, além da utilização dos indicadores de peso e estatura, faz-se necessária a associação da análise da composição corporal, para que um número maior de pacientes com desnutrição e/ou com risco aumentado de desenvolvê-la sejam identificados e adequadamente manejados.

OBJECTIVE: To assess the nutritional status of children and adolescents with bronchiolitis obliterans and to analyze associations with clinical and nutritional factors. METHODS: The study included 57 patients. Nutritional status was assessed using z scores for weight/age, stature/age, weight/stature in children, and stature/age and body mass index percentiles in adolescents. Body composition was assessed via tricipital skin folds, subscapular skin folds, and the sum of both plus the muscular circumference of the arm; pulmonary function was also investigated in subjects over 8 years old. RESULTS: The high percentages of malnutrition and risk for malnutrition are noteworthy: 21.7 and 17.5 percent, respectively. Among children, weight/age and stature/age detected higher percentages of malnutrition (21.6 and 16.2 percent), while weight/stature underestimated this diagnosis. Among adolescents, body mass index detected a high percentage of malnutrition (25 percent) and of risk for malnutrition (20 percent). Body composition analysis detected 51 percent of patients with low muscle reserves, and the majority of patients had normal fat reserves. Compromised pulmonary function was associated with poor performance at exercise (r = 0.434; p = 0.024). Malnutrition and/or nutritional risk and low muscle reserves were significantly associated with the 6-minute walk test (p = 0.032; p = 0.030). There was no association between spirometry and the nutritional variables (p > 0.05). CONCLUSIONS: These results emphasize the need for nutritional intervention, and suggest that, in addition to using weight and height indices for nutritional assessment, it is necessary to combine these with an analysis of body composition, so that a larger number of patients with malnutrition and/or at an increased risk of developing malnutrition may be identified and correctly managed.