Microbiological contamination present in enteral tube feeding prepared in hospitals and/or at home: a systematic review.

CONTEXT: The safety of enteral formulas is important to restore and maintain the health of patients. OBJECTIVE: A systematic review of the literature was conducted to assess the microbiological contamination present in enteral tube feeding prepared in hospitals and/or at home. DATA SOURCES: A systematic search was conducted of the Medline, Scopus, BVS, CAPES/MEC, Embase, Science Direct, and SciELO databases and gray literature. DATA EXTRACTION: Eligible studies that analyzed the contamination of enteral formulas manipulated in hospitals and/or at home were selected; a quality assessment tool was used. DATA ANALYSIS: Twenty-three studies evaluated 1099 enteral formulations. Of these, 44.67% of enteral formulas (n = 491) exceeded the acceptable bacterial count. Samples of homemade enteral formulation preparations (86.03%; n = 191) had the highest bacterial counts, followed by mixed preparations (79.72%; n = 59), and commercial formulas (30.01%; n = 241). The number of samples of enteral formulations that exceeded the bacterial count at home was 70.79% (n = 160 at the hospital was 37.91% (n = 331). Total coliforms (82.68%; n = 406) and mesophilic aerobes (79.22%; n = 389) were the most common microorganisms. Samples with bacterial pathogens were also identified, with Bacillus cereus (4.07%; n = 20) and Listeria monocytogenes (3.66%; n = 18) being the most prevalent. CONCLUSIONS: A high number of samples of enteral formulations exceeded the bacterial count, but the risk to patient's health when consuming enteral tube feeding prepared in hospitals or at home may be low. This is because the bacteria present in the samples are not considered potential causes of disease but rather indicators of hygiene conditions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022367573.

Irregularidades registradas durante inspeções sanitárias em restaurantes e similares / Irregularities recorded during sanitary inspections in restaurants and similar

Identificar irregularidades em restaurantes pode auxiliar a minimizar riscos de contaminação. O objetivo desse estudo foi analisar as irregularidades registradas em inspeções sanitárias de restaurantes e similares em Curitiba, Brasil, entre 2005 a 2017. A descrição das irregularidades foi organizada seguindo as categorias e os itens da legislação de Boas Práticas (BP) para serviços de alimentação do Brasil e as cinco chaves para uma alimentação mais segura, definidas pela Organização Mundial da Saúde. Do total de 4.098 registros, houve a descrição de 8.327 irregularidades. Em relação às BP, houve a prevalência da descrição de irregularidades nos anos de 2005, 2006 e 2013, e das categorias: edificações, instalações, equipamentos, móveis e utensílios (42,80%); preparação do alimento (11,54%); documentação e registro (9,92%) e matéria-prima, ingredientes e embalagens (9,06%). Em relação às cinco chaves para uma alimentação mais segura, apenas 3.209 (38,53%) descrições correspondiam a esse tema, com destaque a: manter a limpeza (40,70%) e usar água e matérias-primas seguras (34,71%). Houve uma tendência decrescente na descrição das irregularidades no período estudado, porém ainda é um desafio implementar as BP em restaurantes e similares no Brasil, o que pode favorecer a ocorrência de doenças e aumentar o risco à saúde da população.

Identifying irregularities in restaurants can help minimize contamination risks. The objective of this study was to analyze the irregularities recorded in sanitary inspections of restaurants and similar establishments in Curitiba, Brazil, between 2005 and 2017. The description of the irregularities was categorized following the items and criteria outlined in the Good Practices (GP) legislation for food services of Brazil and the Five Keys to Safer Food, defined by the World Health Organization. Out of the total of 4,098 records, 8,327 irregularities were documented. Concerning GP, there was a prevalence of irregularities described in the years 2005, 2006 and 2013, mainly in the following categories: buildings, installations, equipment, furniture and utensils (42.80%); food preparation (11.54%); documentation and registration (9.92%) and raw materials, ingredients and packaging (9.06%). Regarding the Five Keys to Safer Food, only 3,209 (38.53%) corresponded to this theme, with particular emphasis on maintaining cleanliness (40.70%) and using safe water and raw materials (34.71 %). The study observed a declining trend in the description of irregularities over the study period. However, the successful implementation of GP in restaurants and similar establishments in Brazil remains a challenge, potentially favoring the occurrence of foodborne diseases and increasing the risk to public health.

Checklist to assess food safety when handling home enteral nutrition.

BACKGROUND: Identifying food safety risks when handling enteral formulations at home is important to restore and maintain the health of patients. Therefore, this study developed and validated a food safety assessment checklist for handling home enteral nutrition (HEN). METHODS: This methodological study developed a checklist based on a literature review and interviews with food safety professionals. The content validation, which was conducted by food safety and enteral feeding experts, assessed the relevance, clarity, and simplicity of the checklist using the content validity index of items (CVI-I), categories (CVI-C), and the entire instrument (CVI-EI). Each item was rated as either essential, necessary, or recommended according to the risk in relation to foodborne diseases. RESULTS: The Food Safety for Handling Home Enteral Nutrition checklist (FSHEN checklist) that was developed includes 40 items and the following eight categories: physical structure; cleaning of facilities, equipment, furniture, and utensils; pests and waste; water supply; food handlers; ingredients and packaging; handling of enteral formulations; and the bottling and storage of enteral formulations. The CVI-EI was above the recommendation (≥0.93) for the three assessed criteria, as was the CVI-C in terms of clarity (≥0.95), relevance (≥0.98), and simplicity (≥0.84). A total of 52.5% of the items were rated as essential, 32.5% as necessary, and 15% as recommended. CONCLUSION: The FSHEN checklist is relevant, clear, and easy to use. It can help health professionals and individuals working in the field to assess and prioritize items to improve food safety in the management of HEN.

The use of food delivery apps during the COVID-19 pandemic in Brazil: The role of solidarity, perceived risk, and regional aspects.

This study aimed to evaluate the use of food delivery apps (FDA) during the COVID-19 pandemic in Brazil. A total of 950 questionnaires were collected, covering four Brazilian regions: Southeast, Central-West, Northeast, and South. The data was collected during the peak of the second wave of the pandemic. A questionnaire with 39 measurement items was applied using an online survey. These items were evaluated using a five-point Likert scale covering the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). The data was analyzed using covariance-based structural equation modeling. About 47% of consumers use FDA weekly. The continuance intention of FDA during the pandemic in Brazil was affected by performance expectancy (ß = 0.496; p < 0.001), social influence (ß = 0.094; p < 0.001), hedonic motivation (ß = 0.068; p = 0.026), price value (ß = 0.103; p < 0.001), habit (ß = 0.305; p < 0.001), frequency of using FDA (ß = 0.051; p = 0.039), and solidarity with the foodservice sector (ß = 0.090; p < 0.001). It was also observed that the continuance intention reduces risk perception (ß = -0.403; p < 0.001), and risk perception reduces the frequency of using FDA (ß = -0.178; p < 0.001). The results indicate that the UTAUT2 strongly explains consumers' continuance intention. Differences in path estimates among Brazilian regions were observed, indicating some regional differences. It was possible to observe a tendency of using FDA during and after the pandemic, motivated by several factors. The FDA developers and foodservice managers could use this data to improve their services. Policies must be established to increase consumer and employee safety during the delivery service.

Home-Prepared Enteral Tube Feeding: Evaluation of Microbiological Contamination, Hygiene, and the Profile of the Food Handler.

BACKGROUND: Little is known about the risk to patients' health when using home-prepared enteral tube feeding. The objective of this study was to explore the differences in hygiene conditions and microbial load of different types of home-prepared enteral tube feeding and explore associations between those differences and food handlers' characteristics. METHODS: We evaluated 96 enteral formulations, considering 3 types used by adult patients: homemade enteral preparations (HEPs), blended enteral preparations (BEPs), and commercial enteral formulas (CEFs). Enteral formulations were collected from homes and microbiologically analyzed. Hygiene criteria were assessed using a checklist, applied during the handling stages. The profile of the food handler was reviewed using a questionnaire. RESULTS: 82.3% (79/96) exceeded acceptable bacterial counts, which was 10³ colony-forming units per gram for aerobic mesophilic microorganisms and for total coliforms (35 °C), Escherichia coli, Staphylococcus sp, and Staphylococcus coagulase-positive, if present in the enteral formulations. The number of inadequate samples was higher in HEPs and BEPs than in CEFs. Considering the hygiene criteria, the home-prepared enteral tube feedings did not differ significantly. There was a significant difference among hygiene conditions considering the variables "monthly family income" and "food training." CONCLUSION: Regardless of the type of enteral formulations used by patients, when handled at home, there was a risk of contamination. However, contaminants present in enteral formulations can be easily controlled with improvements in hygiene measures as well as with greater guidance and control during the handling stages.

Informação nutricional em restaurantes: um estudo de compreensão de pictogramas / Nutritional information in restaurants: a study of pictogram comprehension

A informação nutricional em serviços de alimentação se mostra relevante para as escolhas alimentares, além de ser uma forma de respeitar o direito a escolha do consumidor. Contudo, é necessário que essa seja facilmente compreendida pelos comensais. Assim, o objetivo deste estudo é propor um modelo pictórico de informação nutricional, que alerte para presença de glúten, leite, ovo e carne em Restaurantes Universitários de uma instituição pública a partir da percepção dos consumidores e do conhecimento da nutrição e do design de informação. A pesquisa quali-quantitativa, com delineamento transversal e caráter exploratório, foi realizada em Curitiba, Paraná, com graduandos adultos de uma instituição pública. Por meio de um questionário autorrespondido, foram avaliadas a compreensão de pictogramas com e sem rótulo que representassem a presença de glúten, leite, carne e ovo, a relevância das informações apresentadas e a preferência do local da disponibilização da informação nutricional. Participaram 131 consumidores com idade média de 21,3 ± 2,6 anos, sendo 73,3% do sexo feminino. Observou-se boa percepção dos pictogramas propostos, sendo melhor compreendidos aqueles com rótulos, que representavam "contém ovo" e "contém carne". Em relação a presença de leite, o pictograma da garrafa foi o mais aceito. O local de preferência para a visualização da informação foi no buffet, havendo interesse, principalmente, no nome da preparação e na lista de ingredientes. Os modelos de pictogramas propostos se mostraram adequados conforme os consumidores, atingindo o objetivo do estudo, contribuindo para que as informações sejam facilmente compreendidas, e favorecendo o direito de escolha dos consumidores.

Nutritional information in food services is relevant to food choices, in addition to being a way of respecting the consumer's right to choose. However, it is necessary that this information to be easily understood by the diners. Thus, the aim of this study is to propose a pictorial model of nutritional information, which warns of the presence of gluten, milk, eggs, and meat in a public university restaurant based on the perception of consumers and the knowledge of nutrition and the information design. The quali-quantitative study, with a cross-sectional design and exploratory character, was carried out in Curitiba, Paraná, with adult students from a public institution. Through a self-answered questionnaire, the comprehension of pictograms with and without a label that represented the presence of gluten, milk, meat, and egg, the relevance of the information presented, and the preference of the place where the nutritional information was made available were evaluated. 131 consumers participated with an average age of 21.3 ± 2.6 years, 73.3% of whom were female. A good perception of the proposed pictograms was observed, and was better understood with labels, which represented "contains egg" and "contains meat". Regarding the presence of milk, the bottle pictogram was the most accepted. The preferred location for viewing the information was at the buffet, with interest mainly in the name of the meal and the list of ingredients. The proposed pictograms models were shown to be adequate according to consumers, reaching the objective of the study, making the information easily understood, and favoring the consumers' right to choose.

Conhecimento e uso de rótulos nutricionais por consumidores / Consumers' knowledge and use of nutritional information on food labels

A rotulagem de alimentos é importante para a comunicação entre produtores e consumidores. No entanto, para ajudar os consumidores a ter maior autonomia em suas escolhas alimentares, é importante interpretar corretamente a rotulagem dos alimentos. Assim, esta pesquisa avaliou o conhecimento e o uso das informações nutricionais apresentadas nos rótulos dos alimentos. Pesquisa quantitativa, exploratória e transversal, realizada em 2018 em uma universidade pública no Brasil, com 415 consumidores com 18 anos ou mais. Para avaliar o conhecimento, aplicouse questionário estruturado com pontuação de 0 a 24. Os dados foram analisados por meio de análise descritiva, correlação de Spearman e teste de Kruskal-Wallis e Mann Whitney. Participaram indivíduos com idade de 21,02 ± 2,89 anos, dos quais 58,31% eram do sexo feminino. Muitos consumidores liam frequentemente os rótulos dos alimentos (56,39%). A pontuação média de conhecimento foi de 14,99 ± 4,12. A média do escore de conhecimento foi afetada pela idade (p = 0,039) e renda (p = 0,020). Os participantes que utilizaram alegações nutricionais como critério de compra (p = 0,004) obtiveram maiores pontuações. Os maiores problemas na interpretação dos rótulos nutricionais estavam relacionados às reivindicações obrigatórias de nutrientes e aos termos "zero gordura trans (0%)", "alimento funcional", "diet" e "light". Considerando que a regulamentação dos rótulos de alimentos está em processo de revisão no Brasil, torna-se importante pesquisar seu uso e conhecimento por consumidores adultos jovens. Isso contribuirá para a discussão da revisão da legislação, além de ajudar os profissionais a orientarem os consumidores na interpretação dos rótulos. (AU)

Food labelling is important to communication between food producers and consumers. For consumers to have greater autonomy in terms of their food choices, it is important to facilitate a correct interpretation about what is on a food label. This paper assessed consumers' knowledge and use of nutritional information on food labels. Cross-sectional exploratory quantitative, "blind" research carried out in 2018 in a public university in Brazil, with 415 consumers aged 18 years or older. A structured questionnaire with a score ranging from 0 to 24 was applied. Descriptive analysis, Spearman correlation coefficient, the Kruskal-Wallis test and the Mann Whitney test were employed. Participants were individuals aged 21.02 ± 2.89 years, of which 58.31% were female. Many consumers reported they read food labels frequently (56.39%). The mean score was 14.99 ± 4.12. The knowledge score mean was affected by age (p =0.039) and income (p = 0.020). Participants who used nutritional claims as a criterion for purchase (p = 0.004) had higher scores. The biggest issues in interpreting nutritional labels were related to mandatory nutrient claims and the terms "trans-fat free (0%)", "functional food", "diet" and "light". Food label regulation is a process currently under review in Brazil, so research on the use and knowledge of nutritional information on food labels by young adult consumers becomes important. It will contribute to the discussion of the revision of legislation, as well as helping professionals guide consumers in the interpretation of labels. (AU)

Use of nutritional food labels and consumers confidence in label information / Uso da rotulagem nutricional e percepção sobre a confiabilidade das informações por consumidores

ABSTRACT Objective This investigation evaluated the use of food labels and consumers' perception of the reliability of food labels nutritional information. Methods This is a transversal exploratory quantitative investigation, carried out in Curitiba, Brazil. A total of 536 students from a public institution participated in the survey answering a structured questionnaire. Descriptive analyses, Chi-Square test and Fisher's exact test were performed considering a significance level of 5%. Results The participants' mean age was 21.11±2.83 years, and 59.3% were female. It was noticed that 41.6% of consumers used the nutritional information sometimes and 14.7% always, mainly because they liked to know what they were buying and consuming (35.8%). Lack of patience (29.5%) and concern about the composition of the food purchased (34.2%) were the main reasons for not using the information provided. The most commonly used nutrition claim was "trans fat-free" (42.5%) and the type of food in which nutrition labeling was used most was milk and dairy products (42.0%). Frequent use of nutritional information was higher among women (p<0.01) and among those who practice physical activity (p=0.04). Many individuals relied on food labels nutritional information (61.9%), but out of these, 43.6% did not use that information at the time of purchase. There was no difference between respondents' confidence in the information, sociodemographic and health data. Conclusion Many people still do not use the label nutrition information. Efforts should be made to change this scenario. Changes in nutrition labeling can help modify this situation, with the use of clearer label information, more easily understood, that does not raise any doubts in the consumers' mind.

RESUMO Objetivo Este estudo avaliou o uso da rotulagem nutricional e a percepção sobre a confiabilidade das informações por consumidores. Métodos Pesquisa transversal, exploratória e de abordagem quantitativa, realizada no município de Curitiba, Brasil. Participaram 536 estudantes, de uma instituição pública, respondendo um questionário estruturado. Foram realizadas análises descritivas, teste Qui-Quadrado e teste exato de Fisher, considerando nível de significância de 5%. Resultados A idade média dos participantes foi 21,11±2,83 anos, sendo 59,3% do sexo feminino. Quanto ao uso das informações nutricionais, 41,6% utilizavam às vezes e 14,7% sempre, principalmente porque gostavam de saber o que estavam comprando e consumindo (35,8%). A falta de paciência (29,5%) e de preocupação com a composição do alimento comprado (34,2%) foram os principais motivos pelos quais não utilizarem as informações. A alegação nutricional mais utilizada foi "sem gordura trans" (42,5%) e o tipo de alimento em que mais se utilizou a rotulagem nutricional foi leite e derivados (42,0%). O uso frequente das informações nutricionais foi maior entre as mulheres (p<0,01) e os praticantes de atividade física (p=0,04). Muitos indivíduos confiavam nas informações presentes nos rótulos dos alimentos (61,9%), porém, destes, 43,6% não as utilizavam no momento da compra. Não foram observadas diferenças entre a confiança das informações, os dados sociodemográficos ou de saúde dos entrevistados. Conclusão Muitas pessoas ainda não usam as informações nutricionais, sendo necessário esforços para mudar este panorama. Alterações na rotulagem nutricional podem mudar este processo, com o uso de informações mais claras, de fácil entendimento, que não gerem dúvida ao consumidor.

Nutrition students beliefs on the nutritional information and nutritional claims in the pre-packaged food products: an application of the Theory of Planned Behavior / Crenças de estudantes de nutrição sobre informação e alegação nutricional em produtos alimentícios: uma aplicação da Teoria do Comportamento Planejado

This study identified the modal salient behavior, the normative and the control modal beliefs on the nutritional label use for the prepackaged food products among the college students. In November 2015, the exploratory qualitative research was conducted with 19 nutrition students, applying the concepts of Theory of Planned Behavior. Contents analysis of two organized focus groups and the statistical descriptive analysis of quantitative variables were performed. Both focus groups mentioned the advantages of the use of nutritional information, as the assistance for choosing the healthy food. A specific disadvantage associated with the mentioned nutritional claims was this influence on the purchase decisions (behavioral beliefs). The students mentioned their parents and siblings as the peoples who approve the use of this information, when they purchase a product (normative beliefs). Small lettering and difficulty to interpret the portions size indicated in the nutritional information on the labels were the factors, which could difficult their use. Making easy to read the nutritional claims tend to stimulate the purchasing decisions (control beliefs). Eleven salient modal beliefs were identified, which may explain participants' behavior when using information and nutrition claims. (AU)

O trabalho teve como objetivo identificar as crenças modais salientes comportamentais, normativas e de controle sobre o uso do rótulo nutricional de produtos alimentícios entre estudantes universitários. Em novembro de 2015, 19 estudantes de nutrição participaram de pesquisa qualitativa exploratória, que abordou conceitos da Teoria do Comportamento Planejado. Foram realizadas a análise de conteúdo de dois grupos focais e a análise estatística descritiva das variáveis quantitativas. Ambos os grupos focais mencionaram vantagens do uso de informações nutricionais, como auxílio na realização de escolhas de alimentos saudáveis. Uma desvantagem específica associada às alegações nutricionais mencionada, foi a influência desta na decisão de compra (crenças comportamentais). Os alunos mencionaram seus pais e irmãos como pessoas que aprovam o uso dessa informação, quando compram um produto (crenças normativas). Quanto às letras pequenas e à dificuldade de interpretar o tamanho das porções, na informação nutricional nos rótulos, foram fatores que poderiam dificultar o uso. Em relação às alegações nutricionais, por serem fáceis de ler, tenderam a estimular as decisões de compra (crenças de controle). Foram identificadas 11 crenças modais salientes, que podem explicar o comportamento dos participantes ao usar a informação e as alegações nutricionais. (AU)

Nutrition students beliefs on the nutritional information and nutritional claims in the pre-packaged food products: an application of the Theory of Planned Behavior / Crenças de estudantes de nutrição sobre informação e alegação nutricional em produtos alimentícios: uma aplicação da Teoria do Comportamento Planejado

This study identified the modal salient behavior, the normative and the control modal beliefs on the nutritional label use for the prepackaged food products among the college students. In November 2015, the exploratory qualitative research was conducted with 19 nutrition students, applying the concepts of Theory of Planned Behavior. Contents analysis of two organized focus groups and the statistical descriptive analysis of quantitative variables were performed. Both focus groups mentioned the advantages of the use of nutritional information, as the assistance for choosing the healthy food. A specific disadvantage associated with the mentioned nutritional claims was this influence on the purchase decisions (behavioral beliefs). The students mentioned their parents and siblings as the peoples who approve the use of this information, when they purchase a product (normative beliefs). Small lettering and difficulty to interpret the portions size indicated in the nutritional information on the labels were the factors, which could difficult their use. Making easy to read the nutritional claims tend to stimulate the purchasing decisions (control beliefs). Eleven salient modal beliefs were identified, which may explain participants’ behavior when using information and nutrition claims.

O trabalho teve como objetivo identificar as crenças modais salientes comportamentais, normativas e de controle sobre o uso do rótulo nutricional de produtos alimentícios entre estudantes universitários. Em novembro de 2015, 19 estudantes de nutrição participaram de pesquisa qualitativa exploratória, que abordou conceitos da Teoria do Comportamento Planejado. Foram realizadas a análise de conteúdo de dois grupos focais e a análise estatística descritiva das variáveis quantitativas. Ambos os grupos focais mencionaram vantagens do uso de informações nutricionais, como auxílio na realização de escolhas de alimentos saudáveis. Uma desvantagem específica associada às alegações nutricionais mencionada, foi a influência desta na decisão de compra (crenças comportamentais). Os alunos mencionaram seus pais e irmãos como pessoas que aprovam o uso dessa informação, quando compram um produto (crenças normativas). Quanto às letras pequenas e à dificuldade de interpretar o tamanho das porções, na informação nutricional nos rótulos, foram fatores que poderiam dificultar o uso. Em relação às alegações nutricionais, por serem fáceis de ler, tenderam a estimular as decisões de compra (crenças de controle). Foram identificadas 11 crenças modais salientes, que podem explicar o comportamento dos participantes ao usar a informação e as alegações nutricionais.

Satisfaction of nutritionists who work in food service / Satisfação dos nutricionistas que atuam na alimentação coletiva

ABSTRACT Objective To evaluate the job satisfaction of nutritionists who work in food service in the state of Paraná (Brazil). Methods A survey was carried out with 249 nutritionists through a semi-structured online questionnaire, which assessed their profile, professional activities, and job satisfaction. The Mann-Whitney and Kruskal-Wallis tests and the ordinal logistic regression at a 5% significance level were applied to evaluate the differences and relationship between job satisfaction and the independent variables. Results The average age of the survey participants was 31.9±6.4 years, the majority was female (95.58%), and graduated between 2000 and 2016 (90.36%). The survey revealed that 55.41% of the nutritionists were satisfied at work, 33.68% were indifferent, 6.86% were highly satisfied, and 4.04% were dissatisfied. The variables that influenced job satisfaction the most were age, years of training, income, and workdays in the week. Income explained satisfaction positively. There was statistical difference in relation to the satisfaction of participants regarding their knowledge on food service (p=0.0350), completion of postgraduate courses (p=0.0082), and interest in working in an area of nutrition other than food service (p<0.0001). Conclusion Although most professionals are satisfied, many were indifferent to job satisfaction, which may reflect a low perspective on their current job or poor experience in the food service. These results suggest the need for further actions aiming at raising nutritionists' perceived professional importance.

RESUMO Objetivo Avaliar a satisfação no trabalho dos nutricionistas que atuam na área de alimentação coletiva no estado do Paraná. Métodos Pesquisa realizada com 249 nutricionistas, por meio de um questionário semiestruturado online, que avaliou o perfil, o exercício profissional e a satisfação do nutricionista. O teste Mann-Whitney, Kruskal-Wallis e a regressão logística ordinal com nível de significância de 5% foram utilizados para avaliar a diferença e relação entre a satisfação e as variáveis. Resultados A idade média dos respondentes foi de 31,9±6,4 anos, sendo a maioria do sexo feminino (95,58%) e graduado entre 2000 e 2016 (90,36%). Constatou-se que 55,41% dos nutricionistas estavam satisfeitos no trabalho, 33,68% indiferentes, 6,86% altamente satisfeitos e 4,04% insatisfeitos. As variáveis que mais influenciaram a satisfação foram a idade, os anos de formação, o salário e os dias da semana de trabalho, sendo que a renda explicou positivamente a satisfação. Houve diferença estatística com relação à satisfação dos participantes com a avaliação do conhecimento sobre alimentação coletiva (p=0,0350), a realização de pós-graduação (p=0,0082) e o interesse em atuar em outra área da nutrição que não a alimentação coletiva (p<0,0001). Conclusão Apesar de a maioria dos profissionais estarem satisfeitos, muitos foram indiferentes à satisfação no trabalho, podendo refletir ausência de perspectiva sobre seu trabalho atual ou indicar a falta de familiaridade com a alimentação coletiva. Os dados indicam a necessidade de mais ações de valorização junto a esses profissionais.

Good hygiene practices in hospital nutrition services: the view of internal and external auditors

The objective of this study was to evaluate the hygienic-sanitary conditions of hospital nutrition services according to internal and external auditors, before and after intervention, based on the requirements of Good Hygiene Practices. Fifteen hospital nutrition services were evaluated based on a checklist applied by internal auditors and by an external auditor. The intervention program was prepared and implemented in all the locations over one year, and was composed of four points: 1) training; 2) preparation of the action plan; 3) preparation of the documentation; 4) monthly visits to motivate the food handlers and responsible technicians, accompaniment and assistance in the implementation of Good Hygiene Practices. An improvment in the application of Good Hygiene Practices was observed in the hospital nutrition services after the systematic intervention, in the view of both the internal and external auditors, except the requirement related to operational aspects, which had a low percentage of adequacy, both before and after the intervention Before the intervention, there was a significant difference between the evaluation of the internal auditors and the external auditor, which was not found later. These results suggest that the systematic intervention assisted in the adoption of Good Hygiene Practices by hospital nutrition services, according to both the internal and external auditors, and contributed to increasing the knowledge of the internal auditors.(AU)

Benefits and risks of fish consumption for the human health / Benefícios e riscos do consumo de peixes para a saúde humana

The article aimed at identifying and discussing scientific evidences on the benefits and risks of fish consumption the human health. There was a systematic survey for articles published from 2003 and May 2011, at the MedLine, Scopus, SciELO, Lilacs and Google Scholar databases. The key words used were: fish, food intake, omega-3 fatty acids, fatty fish, benefits, risk, and consumption. The search produced 12,632 articles, 25 eligible cohort studies on possible benefits, 61 on risks and 10 studies that assessed the "risk/benefit" relation. Of the 25 works, 14 suggested a preventive effect of fish consumption related to cardiovascular diseases, depression, cataract and some types of cancer. Evidences of a relation between exposure to mercury and an increase in the risk of neurological disorders, but not of cardiovascular diseases, were also found. Given the importance of fish consumption, its possible risks and the lack of Brazilian studies on the topic, it is important to conduct more longitudinal studies that assess both the benefits and risks of fish consumption for the human health. We also emphasize the need for policies to reduce exposure of fish and seafood to mercury and other contaminants.

O artigo objetivou identificar e discutir evidências científicas sobre benefícios e riscos do consumo de peixes para a saúde humana. Realizou-se uma busca de artigos publicados entre 2003 e maio de 2011, nas bases de dados MedLine, Scopus, SciELO, Lilacs e Google acadêmico. Utilizaram-se as palavras chaves: fish, food intake, omega-3 fatty acids, fatty fish, benefits, risk, consumption. Encontraram-se 12.632 artigos, sendo elegíveis 25 estudos de coorte que investigaram possíveis benefícios, 61 sobre riscos e 10 estudos que avaliam a relação "risco/benefício". Dentre os 25 trabalhos, 14 sugeriram efeito protetor do consumo de peixes, relacionado a doenças cardiovasculares, depressão, catarata e alguns tipos de câncer. Foram encontradas evidências de relação entre exposição ao mercúrio e aumento do risco de distúrbios neurológicos, mas não do risco de doenças cardiovasculares. Tendo em vista a importância do consumo de peixes e seus possíveis riscos, bem como a escassez de pesquisas nacionais sobre o tema, observa-se a relevância de se realizarem mais estudos longitudinais que aliem a avaliação dos benefícios e riscos do seu consumo para a saúde humana. Ressalta-se também a necessidade de políticas para redução da exposição de peixes e frutos do mar ao mercúrio e outros contaminantes.