Association between calf circumference and mortality in people receiving home enteral nutrition: A retrospective cohort study.

BACKGROUND: Among the anthropometric measurements, calf circumference has been widely used as a simple and practical method to diagnose low muscle mass and sarcopenia. However, the association between this measurement and clinical outcomes in people receiving home enteral nutrition is still unknown. Therefore, this study aimed to investigate the association of calf circumference with mortality, discharge from home enteral nutrition, continuity in home enteral nutrition, and new hospitalizations in adult and older adult people. METHODS: This retrospective cohort study used secondary data, including people aged ≥18 years receiving home enteral nutrition. The association between calf circumference and the outcomes of mortality, discharge from home enteral nutrition, and continuity in home enteral nutrition was analyzed using multinomial logistic regression. The association between calf circumference and the occurrence of new hospitalizations was investigated using binary logistic regression. RESULTS: Among the 899 people included in the study, 470 were men (52.3%), the median age was 72 years (interquartile range, 56.5-82), and 850 had inadequate calf circumference (94.5%). As calf circumference increased, the odds of mortality decreased and the probability of discharge from home enteral nutrition and continuity in home enteral nutrition increased. Furthermore, in people with oncologic diagnoses, the odds of new hospitalizations were reduced by 71.9% for each additional centimeter in calf circumference. CONCLUSION: These findings underline the importance of using calf circumference as part of the nutrition assessment because it is a simple, easy, and cost-effective method that can also be used as a tool to predict clinical outcomes.

Pre-Slaughter Stunning of Farmed Atlantic Halibut in CO2-Saturated Seawater: Assessment of Unconsciousness by Electroencephalography (EEG).

As fish welfare becomes a growing concern, it is important to ensure humane treatment during slaughter. This study aimed to assess the onset of unconsciousness in Atlantic halibut immersed in CO2-saturated seawater through electroencephalography (EEG). Of the 29 fish studied, 10 exhibited escape attempts, indicating aversion to CO2-saturated water despite its oxygenation. EEG signals showed four distinct phases: transitional, excitation (high amplitude-high frequency), suppressed, and iso-electric phases. The onset of the suppressed phase, indicative of unconsciousness, occurred on average 258.8 ± 46.2 s after immersion. The spectral analysis of the EEG signals showed a progressive decrease in median frequency, spectral edge frequency, and high frequency contribution, which corresponded to the gradual loss of consciousness. The study concludes that CO2-saturated water is not recommended for pre-slaughter handling of halibut due to the extended time required for the onset of unconsciousness and the observed aversive behaviour. Ensuring humane treatment during slaughter is important for addressing public concern and safeguarding fish welfare in all stages of production.

Animal Welfare Science: Why and for Whom?

There are, in the literature, distinct ways to approach animal welfare. The objective of this work was to study the value attributed to farm animals in the scientific papers published in animal welfare and animal production journals at three different points in time, separated by a decade each. The first ten papers mentioning "animal welfare" or "animal well-being" in their objectives or hypotheses from each journal and each focus year were selected. The 180 papers were blindly scored by five assessors between 1 and 10, according to the degree of intrinsic value attributed to animals. The overall mean score and standard deviation were 5.60 ± 2.49, with 6.46 ± 2.29 and 4.74 ± 2.40 for AW and AP journals, respectively, and 5.37 ± 2.44, 5.68 ± 2.52 and 5.75 ± 2.41 for the focus years of 2000, 2010 and 2020, respectively. There was an interaction between focus year and publication area: papers from AW journals scored better over time, in contrast with papers from AP journals, for which scores remained similar over decades. The inter-assessor agreement is moderate, which may reflect the subject complexity, as the language used in the papers studied was ambiguous in relation to why and for whom it is performed. The low overall mean score evidenced that the animal welfare scientific publications are, on average, not prioritizing the interests of the animals. Thus, our results evidenced the presence of animal welfarism in animal welfare science, a problem that seems not to be intrinsic to animal welfare science itself, but rather to the way research is frequently conceived, conducted, interpreted, summarized and applied. Therefore, it seems urgent to further study the motivation for animal welfare research. The statement of the main justification for animal welfare papers, with an explicit declaration of the motivational priorities that constitute each scientific animal welfare study, may be an interesting recommendation for the improvement of animal welfare science.

Consumption of food groups and associated factors among children aged 6 to 23 months.

OBJECTIVE: To assess the consumption of food groups among children aged 6 to 23 months in day care centers and at home and its associated factors. METHODS: This is a population-based cross-sectional study conducted with children from nursery schools in Guaratuba, Paraná. Parents answered a socioeconomic and demographic questionnaire. Food consumption was assessed by directly weighing the meals offered at the day care center. At home, parents filled an estimated food record. The reported foods were classified into seven food groups. Minimum dietary diversity was calculated by the proportion of children who consumed foods from four or more groups. Data were analyzed by simple and multiple logistic regression, presented as odds ratios. RESULTS: A total of 213 children participated in this study. The average number of food groups consumed was 4.2±1.0 at home and 4.2±1.2 in day care centers. At the day care center, all children consumed grains, roots, and tubers, while at home, this rate was 99.1%. The egg group was the least consumed both at day care (6.6%) and at home (2.8%). At home, more than 60% of children consumed sweets and sugar-sweetened beverages. Children aged 12 to 23 months were more likely to consume milk and dairy products, as well as flesh foods. Higher income was associated with the consumption of legumes, and older maternal age with the consumption of fruits and vegetables. CONCLUSIONS: At home, children had a predominantly dairy-based diet and a high intake of ultra-processed foods. In day care centers, the consumption of healthy foods was higher, indicating the need for families to participate in the formation of healthy eating habits.

Dietary patterns and associated factors of children under two years of age born prematurely.

OBJECTIVE: To identify the dietary patterns and associated factors of children aged between 6 and 23 months, born prematurely and assisted at a University Hospital in Curitiba, state of Paraná, Brazil. METHODS: The parents or guardians of the 135 children were asked about their children's eating habits and the family's socioeconomic and demographic conditions. Information regarding birth and health history were obtained from medical records. Data on food consumption were subjected to exploratory factor analysis and the principal component analysis method was used to estimate the factor loads. Multiple linear regression was performed to verify possible associations. RESULTS: Two dietary patterns were observed: "unhealthy" and "healthy." The "unhealthy" pattern was significantly associated with maternal age, the child's corrected age, and gestational age at birth. The "healthy pattern" was associated with the child's corrected age. Maternal age and child's corrected age remained significant after multiple regression analyses. For the "unhealthy" pattern, a positive effect was observed, suggesting that the consumption of this pattern is higher as the child's age increases and less intense for children with mothers aged 30 years or older. For the "healthy" dietary pattern, the same two variables showed statistical significance. The authors observed a direct proportion between the age and consumption of food groups in both patterns. CONCLUSIONS: These results indicate the importance of nutritional education for younger mothers regarding their children's eating practices, especially as the child grows.

DEVELOPMENT AND VALIDATION OF A PSYCHOLOGICAL SCALE FOR BARIATRIC SURGERY: THE BARITEST.

BACKGROUND: It is recommended that bariatric surgery candidates undergo psychological assessment. However, no specific instrument exists to assess the psychological well-being of bariatric patients, before and after surgery, and for which all constructs are valid for both genders. AIMS: This study aimed to develop and validate a new psychometric instrument to be used before and after bariatric surgery in order to assess psychological outcomes of patients. METHODS: This is a cross-sectional study that composed of 660 individuals from the community and bariatric patients. BariTest was developed on a Likert scale consisting of 59 items, distributed in 6 constructs, which assess the psychological well-being that influences bariatric surgery: emotional state, eating behavior, quality of life, relationship with body weight, alcohol consumption, and social support. Validation of BariTest was developed by the confirmatory factor analysis to check the content, criteria, and construct. The R statistical software version 3.5.0 was used in all analyses, and a significance level of 5% was used. RESULTS: Adjusted indices of the confirmatory factor analysis model indicate adequate adjustment. Cronbach's alpha of BariTest was 0.93, which indicates good internal consistency. The scores of the emotional state, eating behavior, and quality of life constructs were similar between the results obtained in the community and in the postoperative group, being higher than in the preoperative group. Alcohol consumption was similar in the preoperative and postoperative groups and was lower than the community group. CONCLUSIONS: BariTest is a reliable scale measuring the psychological well-being of patients either before or after bariatric surgery.

Mind the Gap: Animal Protection Law and Opinion of Sheep Farmers and Lay Citizens Regarding Animal Maltreatment in Sheep Farming in Southern Brazil.

We aimed to study the gaps between the law and sheep farmer and citizen opinions regarding animal maltreatment by discussing the risk of sheep maltreatment in regular farming practices in Southern Brazil. We surveyed the perception of 56 farmers and 209 citizens regarding general animal and specific on-farm sheep maltreatment issues. The main themes from these two groups about the key components of animal maltreatment were similar: failing to provide for the basic animal needs (27.0%; 96 of 355 total quotes) and aggression or physical abuse (23.9%; 85/355). However, citizens (19.8%; 60/303) were more sensitive than farmers (9.6%; 5/52) to animal stress, suffering, fear, pain or painful procedures (p < 0.05). The perspective of citizens was closer than that of farmers to expert definitions for three situations: emaciation, movement restriction and tail docking without anesthetic use (p < 0.05). More citizens (71.6%; 116/162) than sheep farmers (49.0%; 24/49) believed that animal maltreatment occurs in sheep farming (p < 0.05), but nearly half of the farmers recognized sheep maltreatment within regular production practices. Most citizens (86.4%; 140/162) and all farmers (100.0%; 0/51) were unaware of any Brazilian animal protection law. Most citizens (79%; 131/167) stated that they would not purchase products from animals exposed to maltreatment. We suggest painful procedures as a major risk of animal maltreatment in sheep farming and a priority issue. With the many decades of animal protection laws and scientific recognition of animal sentience and welfare requirements, the level of cognitive dissonance and practical contradictions observed in our results indicate that mitigation policies are urgently needed.

A Cross-Cultural Adaptation of the Collective Efficacy Questionnaire for Sports (CEQS): Validity Evidence for a Brazilian Version.

This three-part study aimed to translate, cross-culturally adapt, and validate the Collective Efficacy Questionnaire for Sports (CEQS) for Brazilian athletes. In Study 1, six translators and six specialists developed a Portuguese version of the CEQS (the CEQS-B), and 10 experts and 10 sports participants provided content validity evidence based on test content. In Study 2, 553 athletes completed the CEQS-B, and we provided evidence of construct and convergent validity for the test's internal structure through factor analysis and of reliability evidence based on the instrument's internal consistency and temporal stability. In Study 3, 79 athletes completed both the new CEQS-B and the Group Cohesion Questionnaire, and we provided evidence of concurrent validity for the CEQS-B, based on its relationship to other variables, with specific strong correlations between team task cohesion and collective efficacy among these participants. Overall, the results of this study support the use of the CEQS-B by researchers and professionals wishing to assess various sport athletes' self-perceived collective efficacy.

From the Point of View of the Chickens: What Difference Does a Window Make?

We aimed to investigate what broiler chickens prefer when given free choice between a barn side with artificial lighting only as opposed to the other barn side with natural light through glass windows and artificial light. Eighty-five 1 day-old male Cobb 500 broiler chickens were divided into 10 pens; half of each pen area was provided with only artificial light (OAL) and the other half with natural and artificial light (NAL), and birds were free to move across sides. Environmental indicators and external conditions such as temperature, relative humidity, air velocity, ammonia and illuminance were monitored inside and outside the barn. Chickens' preference was registered each three days, divided in categories: I (at 9, 12, and 15 days), II (at 18, 21, 24, and 27 days), and III (at 30, 33 and 36 days). The effect of the interaction between environmental indicators and week was statistically different only for illuminance. Chickens preferred NAL to OAL from 18 days onwards (II p < 0.001; III p = 0.016). Drinking (p = 0.034) and exploration or locomotion (p = 0.042) behaviours were more frequent, and "not visible" behaviours (p < 0.001) were less frequent, in NAL. Foraging was the only behaviour with an interaction effect between age category and light treatment, as birds during period II expressed this behaviour more frequently in NAL than OAL (p = 0.003). For our experimental conditions, the chickens preferred NAL from 18 days of age onwards, when the confounding effect of the heating light was removed, and their behavioural repertoire was also different according to each side of the barn and to their ages.

Effects of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 Supplementation on Nutritional and Metabolic Parameters in the Early Postoperative Period after Roux-en-Y Gastric Bypass: a Randomized, Double-Blind, Placebo-Controlled Trial.

Studies have suggested that Roux-en-Y gastric bypass (RYGB) causes changes in the intestinal microbiota composition and function due to anatomical and physiological modifications. The role of probiotic supplementation after bariatric procedures remains to be determined. PURPOSE: The aim of this study was to investigate the effects of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 supplementation on nutritional and metabolic parameters after RYGB. MATERIALS AND METHODS: This is a randomized, double-blind, placebo-controlled clinical trial. Patients were assigned to receive either a probiotic supplement (FloraVantage®) or placebo for three consecutive months, beginning 7 days after surgery. Anthropometric and biochemical indexes were evaluated in the preoperative period and at the end of the study. RESULTS: Following RYGB, serum 25-OH vitamin D increased in both groups compared to baseline; however, this increase was significant only in the probiotic group (p = 0.004). Vitamin B12 levels tended to be higher in the probiotic group compared to the placebo group (p = 0.063), and triglyceride levels showed a significant reduction in the probiotic group only (p < 0.001). In addition, a significant reduction was observed in the anthropometric parameters and glycemic profile (p < 0.05) in both groups. CONCLUSION: Probiotic supplementation after RYGB improves the vitamin and lipid profile.

Individual and contextual predictors of children's hemoglobin levels from Southern Brazilian municipalities in social vulnerability.

Few studies have investigated the simultaneous effect of individual and contextual factors on the occurrences of anemia. This study aims to evaluate the variability of children's hemoglobin levels from municipalities in social vulnerability and its association with factors of individual and municipal nature. This is a cross-sectional, multi-center study, with children data (12-59 months) collected from 48 municipalities of the Southern region of Brazil, that were included in the Brazil Without Poverty Plan. Individuals' data were collected using a structured questionnaire, and secondary and ecological data of children's municipalities were collected via national surveys and institutional websites. The outcome was defined as the hemoglobin level obtained by HemoCue. A multilevel analysis was performed using Generalized Linear Models for Location Scale and Shape using R, with a 5% significance level. A total of 1,501 children were evaluated. The mean hemoglobin level was 12.8g/dL (95%CI: 12.7-12.8), with significant variability between municipalities. Lower values of hemoglobin were observed in children who lived in municipalities with a higher urbanization rate and a lower number of Community Health Agents, in relation to the reference categories. At the individual level, lower hemoglobin values were identified for children under 24 months, not enrolled at daycares, who were beneficiaries of the conditional cash transfer program and diagnosed with underweight. The results shed light on important factors at the municipal and the individual levels that were associated to the hemoglobin levels of children living in municipalities in social vulnerability.

Effects of Probiotics Supplementation on Gastrointestinal Symptoms and SIBO after Roux-en-Y Gastric Bypass: a Prospective, Randomized, Double-Blind, Placebo-Controlled Trial.

Bariatric surgery may cause undesirable gastrointestinal symptoms due to anatomical, functional and intestinal microbiota changes. PURPOSE: The aim of this study was to evaluate the effect of probiotic supplementation on gastrointestinal symptoms and small intestine bacterial overgrowth (SIBO) in patients after Roux-en-Y gastric bypass (RYGB). MATERIALS AND METHODS: This is a prospective, randomized, double-blind, placebo-controlled trial. The patients were randomized into Control Group (CG) (n = 39) and Probiotic Group (PG) (n = 34). The PG received tablets containing Lactobacillus acidophilus and Bifidobaterium lactis (5 billion CFU/strain) for 90 days, and the CG received tablets with starch. Both the Gastric Symptom Rating Scale (GSRS) questionnaire and 3-day food record were answered before surgery (T0) and after 45 days (T1) and 90 days of surgery (T2). At T0 and T2, hydrogen breath test was used to verify the presence of SIBO. RESULTS: The prevalence of SIBO was similar among times, and the mean score of GSRS responses did not differ between groups at any time. However, PG patients reported less bloating compared to CG, more abdominal pain at T1 (which reduced at T2), more episodes of soft stools and nausea and less hunger pain after surgery, with no reports of urgent episodes to evacuate, even though they consumed more fat than the CG. CONCLUSIONS: The supplementation of L. acidophilus and B. lactis is effective in reducing bloating, but without influencing the development of SIBO in the early postoperative period.

[Adherence to school food and associated factors among adolescents in public schools in the Southern region of Brazil]. / Adesão à alimentação escolar e fatores associados em adolescentes de escolas públicas na região Sul do Brasil.

The scope of this study was to analyze adherence to school food and associated factors among adolescents from public state schools in the municipality of Lapa, Paraná, in the Southern region of Brazil. The study uses a cross-sectional and analytical design and includes 492 male and female adolescents aged 10 to 19 years from five urban and five rural schools in the municipality. The students underwent anthropometric assessment and answered a questionnaire about school food and alternative food intakes (purchased or home-cooked). Their parents/guardians answered a questionnaire about their demographic and socioeconomic characteristics. An adjusted proportional odds regression model investigated the associations. The effective adherence to school food was 30.1% in rural schools and 23.7% in urban schools. Dislike of the food preparation was the main reason for non-adherence. The results showed lesser adherence among adolescents with higher per capita family income who consumed alternative food products four to five times per week. Adolescents who considered school food healthy showed higher adherence. Low adherence to school food indicates the inadequate universality of the program. The factors revealed may help to improve program planning and execution.

Objetivou-se analisar o índice de adesão à alimentação escolar e os fatores associados entre adolescentes matriculados em escolas públicas estaduais do município da Lapa, Paraná, sul do Brasil. De caráter transversal e analítico, incluiu 492 adolescentes de 10 a 19 anos de cinco escolas urbanas e cinco rurais do município. Foi aplicado um questionário sobre o consumo da alimentação escolar e de alimentos competitivos (aqueles comprados ou trazidos de casa) e realizada a avaliação antropométrica nos adolescentes. Os seus pais/responsáveis responderam um questionário demográfico e socioeconômico. Foi utilizado modelo de regressão de "odds" proporcionais ajustado para verificar as associações. O índice de adesão efetiva à alimentação escolar foi de 30,1% nas escolas rurais e de 23,7% nas urbanas. Não gostar das preparações servidas foi o principal motivo apontado para a não adesão. Observou-se menor adesão entre os adolescentes que possuíam maior renda familiar per capita e entre os que consumiam alimentos competitivos de 4 a 5x/semana. A adesão foi maior entre aqueles que consideravam a alimentação escolar saudável. Diante do baixo índice de adesão à alimentação escolar, a universalidade do atendimento não está sendo atingida. Os fatores apontados podem auxiliar em melhoras na execução do programa.

Ultra-processed food consumption during pregnancy and newborn weight / Consumo de alimentos ultraprocessados durante a gestação e peso ao nascer do recém-nascido

Abstract Objectives: to assess the association between pregnant women's consumption of ultra-processed foods and newborn body weight. Methods: prospective study with pregnant women (n=214) selected from all Basic Health Units in the city of Pinhais, Paraná. Socioeconomic, demographic, and health data were collected. Food consumption data were assessed using a 24-hour dietary recall and tabulated with GloboDiet software. Daily relative energy intake of ultra-processed food was estimated and logistic regression analysis was utilized. The infuence of covariates on the association analysis was also explored (e.g., income and education). Results: ultra-processed foods contributed to 26.9% of pregnant women's total energy intake. About 5.7% of newborns were classifed as small-for-gestational-age and 10.7% as large-for-gestational-age. A borderline statistically signifcant association was observed between large-for-gestational-age newborn weight and maternal consumption of ultra-processed foods (OR= 1.027; p=0.048). Additionally, family income was associated with the consumption of ultra-processed foods (OR= 0.144; p=0.008). With each additional 1% consumption of ultra-processed foods, mothers' likelihood of having large-for-gestational-age babies increased by about 2.7%. Conclusions: the study reveals a trend of positive association between the weight of large-for-gestational-age newborns and the consumption of ultra-processed foods by pregnant women, but not for small-for-gestational-age children.

Resumo Objetivos: avaliar a associação entre o consumo de alimentos ultraprocessados por gestantes e o peso de recém-nascidos. Métodos: estudo prospectivo com gestantes (n=214) selecionadas em Unidades Básicas de Saúde em Pinhais, Paraná. Dados socioeconômicos, demográfcos e de saúde foram coletados. Dados de consumo alimentar foram coletados por recordatório de 24-horas físico e entrados no software GloboDiet. O consumo diário relativo de energia proveniente de alimentos ultraprocessados foi estimado e a análise de regressão logística foi utilizada, considerando covariáveis como renda familiar e escolaridade. Resultados: o consumo de alimentos ultraprocessados pelas gestantes representou 26,9% da energia total. Cerca de 5,7% de recém-nascidos foram classifcados como pequenos para idade gestacional (PIG) e 10,7% como grandes para idade gestacional (GIG). Foi observada uma associação estatisticamente signifcativa limítrofe entre o peso dos recém-nascidos GIG e o consumo materno de alimentos ultraprocessados (OR= 1,027; p=0,048). Além disso, a renda familiar esteve associada com o consumo de alimentos ultraprocessados (OR=0,144; p=0,008). A cada 1% adicional de consumo de alimentos ultraprocessados, a probabilidade de as mães terem recém-nascidos GIG aumentou cerca de 2,7%. Conclusões: o estudo revela uma tendência de associação positiva entre o peso de recém-nascidos GIG e o consumo de alimentos ultraprocessados por mulheres grávidas, mas não para crianças PIG.

FOOD INTAKE EVALUATION DURING THE FIRST YEAR OF POSTOPERATIVE OF PATIENTS WITH TYPE 2 DIABETES MELLITUS OR GLYCEMIC ALTERATION SUBMITTED TO ROUX-EN-Y GASTRIC BYPASS.

BACKGROUND: : Obesity is one of the main causes of glycemic change. Failure of clinical obesity treatment may lead to an increase in bariatric surgery. Dietary guidance, in conjunction with disabsorptive and hormonal factors resulting from the anatomical and physiological changes provoked by the surgery, is associated with changes in food intake. AIM: To analyze food intake evolution during the first postoperative year of Roux-en-y gastric bypass in patients with type 2 diabetes mellitus or glycemic alteration. METHODS: : This was a longitudinal and retrospective observational study. For food intake evolution analysis, linear regression models with normal errors were adjusted for each of the nutrients. RESULTS: At 12 months, all patients presented improvement in glycemic levels (p<0.05). During the first postoperative year, there was a reduction in energy intake, macronutrients, consumption of alcoholic beverages and soft drinks. Conversely, there was an increase in fiber intake and diet fractionation. It was observed that, despite gastric restrictions, the micronutrient intake specifically recommended for glycemic control was greater up to six months postoperatively. CONCLUSION: There was change in the quantity and quality of food intake. It was the most prevalent glycemic control contributor up to six months postoperatively. At the end of one year, the diet underwent a change, showing a similar tendency to the preoperative food intake pattern.

Predictors of Success in Bariatric Surgery: the Role of BMI and Pre-operative Comorbidities.

BACKGROUND: This is a retrospective review of 204 patients who underwent bariatric surgery. The impact of weight regain (WR), pre-operative comorbidities and BMI values on the recurrence of comorbidities was evaluated, and an equation was elaborated to estimate BMI at 5 years of bariatric surgery. METHODS: Pre-operative data, after 1 year and after 5 years, was collected from the medical records. Descriptive analyses and bivariate hypothesis tests were performed first, and then, a generalised linear regression model with Tweedie distribution was adjusted. The hit rate and the Kendall coefficient of concordance (Kendall's W) of the equation were calculated. At the end, the Mann-Whitney test was performed between the BMI, WR and the presence of comorbidities, after a post-operative period of 5 years. RESULTS: The adjustment of the model resulted in an equation that estimates the mean value of BMI 5 years after surgery. The hit rate was 82.35% and the value of Kendall's W was 0.85 for the equation. It was found that patients with comorbidities presented a higher median WR (10.13%) and a higher mean BMI (30.09 kg/m2) 5 years after the surgery. CONCLUSIONS: It is concluded that the equation is useful for estimating the mean BMI at 5 years of surgery and that patients with low pre-operative HDL and folic acid levels, with depression and/or anxiety and a higher BMI, have a higher BMI at 5 years of surgery and higher incidence of comorbid return and dissatisfaction with post-operative results.

Translation of social and occupational functioning scale for epilepsy into Portuguese - Brazil.

Epilepsy has important consequences on functionality and social activities. There are few evaluation tools for this purpose. This study aimed to translate the Social and Occupational Functioning Scale for Epilepsy. It is a translation study, for which Beaton et al's. guidelines were used. Sixty patients over 18 years of age, with a confirmed diagnosis of epilepsy, were evaluated. The analysis of internal consistency (Cronbach's alpha) showed values between 0.55 and 0.72 associated with the original dimensions of the instrument, while the five dimensions identified by the results of an exploratory factor analysis showed values between 0.60 and 0.68, with different grouping of the structures of the original scale. Respondents had no difficulty answering the translated version of the Social and Occupational Functioning Scale for Epilepsy, but the statistics show the need for cultural adaptation to the Brazilian population.

[Factors associated with adherence to school meals by adolescents in State public schools in Colombo, Paraná State, Brazil]. / Fatores associados à adesão à alimentação escolar por adolescentes de escolas públicas estaduais de Colombo, Paraná, Brasil.

This study aimed to estimate the prevalence of adherence to school meals and associated factors among adolescent schoolchildren (N = 1,569). The adolescents completed an on-line questionnaire on adherence to school meals, and their parents answered another questionnaire on socioeconomic data. The chi-square test was used to assess the association between adherence to school meals and gender, nutritional status, per capita family income, maternal schooling, adolescents' opinions on the dining hall layout, whether they considered school meals healthy, and consumption of other foods. Variables with statistical significance for adherence to school meals were included in the multilevel proportional odds logistic regression model. The covariates for comprising the final model were defined by backward selection methods. The results of the adjusted model were presented as odds ratios with respective 95% confidence intervals (95%CI). Prevalence of adherence to school meals was low, especially effective adherence (19.8%). Adherence was associated with per capita family income less than one minimum wage, lower consumption of foods outside of school meals, the fact that adolescents considered the dining hall space adequate, and believing that school meals are healthy. Adherence to school meals in this study falls short of universal coverage for the program. Different factors contribute to incomplete program implementation, which may hinder achieving the food and nutritional security policy under the Brazilian National School Feeding Program (PNAE).

O objetivo deste estudo é identificar a prevalência e os fatores associados à adesão à alimentação escolar de adolescentes, sendo avaliados 1.569 indivíduos. Foi aplicado um formulário on-line sobre adesão à alimentação escolar aos adolescentes, e outro com dados socioeconômicos, aos pais. O teste de χ² foi utilizado para avaliar a associação entre a adesão à alimentação escolar e sexo, estado nutricional, renda familiar per capita, escolaridade materna, opinião dos adolescentes sobre a estrutura do refeitório, se consideram a alimentação escolar saudável ou não e consumo de outros alimentos. As variáveis com significância estatística em relação à adesão à alimentação escolar foram incluídas no modelo de regressão logística de chances proporcionais pelo modelo multinível. O conjunto de covariáveis a compor o modelo final foi definido por métodos de seleção Backward. O resultado do modelo ajustado foi apresentado na forma de razão de chances, acompanhado dos respectivos intervalos de 95% de confiança (IC95%). A prevalência de adesão à alimentação escolar foi baixa, especialmente a adesão efetiva (19,8%). A adesão mostrou-se associada à renda familiar per capita inferior a um salário mínimo, ao menor consumo de alimentos que não os da alimentação escolar, ao fato de os adolescentes considerarem o espaço do refeitório adequado e acreditarem que a alimentação escolar era saudável. A adesão à alimentação escolar neste estudo está distante de atender a universalidade do programa. Diferentes fatores apontados contribuem para a sua não efetivação, o que pode dificultar a concretização da política de segurança alimentar e nutricional, uma perspectiva do Programa Nacional de Alimentação Escolar (PNAE).

El objetivo de este estudio es identificar la prevalencia y los factores asociados con la adhesión a la alimentación escolar por parte de adolescentes, siendo evaluados 1.569 individuos. Se aplicó un formulario on-line sobre adhesión a la alimentación escolar por parte de los adolescentes, y otro con datos socioeconómicos a los padres. El test de χ² se utilizó para evaluar la asociación entre la adhesión a la alimentación escolar y sexo, estado nutricional, renta familiar per cápita, escolaridad materna, opinión de los adolescentes sobre la estructura del comedor, si consideraban la alimentación escolar sana o no y el consumo de otros alimentos. Las variables con significancia estadística, en relación con la adhesión a la alimentación escolar, se incluyeron en el modelo de regresión logística de oportunidades proporcionales por el modelo multinivel. El conjunto de covariables para componer el modelo final fue definido por métodos de selección Backward. El resultado del modelo ajustado fue presentado en forma de razón de oportunidad, acompañado de sus respectivos intervalos de 95% de confianza (IC95%). La prevalencia de adhesión a la alimentación escolar fue baja, especialmente la adhesión efectiva (19,8%). La adhesión se mostró asociada a la renta familiar per cápita inferior a un salario mínimo, a un menor consumo de alimentos que no son los de la alimentación escolar, al hecho de que los adolescentes considerasen el espacio del comedor adecuado y creyeran que la alimentación escolar era sana. La adhesión a la alimentación escolar en este estudio está distante de atender la universalidad del programa. Diferentes factores apuntados contribuyen a su no efectivación, lo que puede dificultar la concretización de la política de seguridad alimentaria y nutricional, una perspectiva del Programa Nacional de Alimentación Escolar (PNAE).

Development and validation of a psychological scale for bariatric surgery: the baritest / Desenvolvimento e validação de escala psicométrica para os pacientes de cirurgia bariátrica: o baritest

ABSTRACT BACKGROUND: It is recommended that bariatric surgery candidates undergo psychological assessment. However, no specific instrument exists to assess the psychological well-being of bariatric patients, before and after surgery, and for which all constructs are valid for both genders. AIMS: This study aimed to develop and validate a new psychometric instrument to be used before and after bariatric surgery in order to assess psychological outcomes of patients. METHODS: This is a cross-sectional study that composed of 660 individuals from the community and bariatric patients. BariTest was developed on a Likert scale consisting of 59 items, distributed in 6 constructs, which assess the psychological well-being that influences bariatric surgery: emotional state, eating behavior, quality of life, relationship with body weight, alcohol consumption, and social support. Validation of BariTest was developed by the confirmatory factor analysis to check the content, criteria, and construct. The R statistical software version 3.5.0 was used in all analyses, and a significance level of 5% was used. RESULTS: Adjusted indices of the confirmatory factor analysis model indicate adequate adjustment. Cronbach's alpha of BariTest was 0.93, which indicates good internal consistency. The scores of the emotional state, eating behavior, and quality of life constructs were similar between the results obtained in the community and in the postoperative group, being higher than in the preoperative group. Alcohol consumption was similar in the preoperative and postoperative groups and was lower than the community group. CONCLUSIONS: BariTest is a reliable scale measuring the psychological well-being of patients either before or after bariatric surgery.

RESUMO RACIONAL: Recomenda-se que os candidatos à cirurgia bariátrica sejam submetidos a uma avaliação psicológica. Contudo, não existe nenhum instrumento específico para avaliar os pacientes bariátricos, e que todos os construtos sejam válidos para ambos os sexos. OBJETIVOS: Desenvolver e validar um novo instrumento psicométrico para avaliar o bem-estar psicológico dos pacientes antes e após a cirurgia bariátrica. MÉTODOS: O estudo foi transversal e composto por 660 indivíduos da comunidade e pacientes bariátricos. O BariTest foi desenvolvido numa escala Likert composta por 59 itens, distribuídos em seis construtos, que avaliam o bem-estar psicológico que influenciam a cirurgia bariátrica: estado emocional, comportamento alimentar, qualidade de vida, relação com o peso corporal, consumo de álcool, e suporte social. A validação do BariTest foi feita pela validação de conteúdo, critério e construto e utilizou-se análise fatorial confirmatória. O software estatístico R versão 3.5.0, foi utilizado em todas as análises, com um nível de significância de 5%. RESULTADOS: Os índices ajustados do modelo análise fatorial confirmatória indicam um ajustamento adequado. O alfa de Cronbach do BariTest foi 0,93, o que indica uma boa consistência interna. As pontuações de estado emocional, comportamento alimentar e qualidade de vida foram semelhantes na comunidade e no grupo pós-operatório, sendo mais elevados do que no grupo pré-operatório. O consumo de álcool foi semelhante nos grupos pré e pós-operatórios e foi inferior ao do grupo comunitário. CONCLUSÕES: O BariTest é uma escala confiável que mede o bem-estar psicológico dos pacientes antes e após a cirurgia bariátrica.

Dietary patterns and associated factors of children under two years of age born prematurely / Padrões alimentares e fatores associados de crianças menores de dois anos nascidas prematuramente

ABSTRACT Objective: To identify the dietary patterns and associated factors of children aged between 6 and 23 months, born prematurely and assisted at a University Hospital in Curitiba, state of Paraná, Brazil. Methods: The parents or guardians of the 135 children were asked about their children's eating habits and the family's socioeconomic and demographic conditions. Information regarding birth and health history were obtained from medical records. Data on food consumption were subjected to exploratory factor analysis and the principal component analysis method was used to estimate the factor loads. Multiple linear regression was performed to verify possible associations. Results: Two dietary patterns were observed: "unhealthy" and "healthy." The "unhealthy" pattern was significantly associated with maternal age, the child's corrected age, and gestational age at birth. The "healthy pattern" was associated with the child's corrected age. Maternal age and child's corrected age remained significant after multiple regression analyses. For the "unhealthy" pattern, a positive effect was observed, suggesting that the consumption of this pattern is higher as the child's age increases and less intense for children with mothers aged 30 years or older. For the "healthy" dietary pattern, the same two variables showed statistical significance. The authors observed a direct proportion between the age and consumption of food groups in both patterns. Conclusions: These results indicate the importance of nutritional education for younger mothers regarding their children's eating practices, especially as the child grows.

RESUMO Objetivo: Identificar os padrões alimentares e fatores associados de crianças entre seis e 23 meses de idade, nascidas prematuramente e assistidas em um Hospital Universitário de Curitiba, Paraná. Métodos: Os pais ou responsáveis pelas 135 crianças foram questionados quanto aos hábitos alimentares dos filhos e as condições socioeconômicas e demográficas da família. Informações relativas ao nascimento e ao histórico de saúde foram obtidas dos prontuários. Os dados de consumo alimentar foram submetidos a análise fatorial exploratória e o método dos componentes principais foi utilizado para estimar as cargas fatoriais. Regressão linear múltipla foi realizada para verificar possíveis associações. Resultados: Foram observados dois padrões alimentares distintos. Aquele denominado de "não saudável" apresentou associação significativa com a idade materna, a idade corrigida da criança e a idade gestacional ao nascer. Por sua vez, o padrão denominado de "saudável" esteve associado à idade corrigida da criança. As variáveis idade materna e idade corrigida da criança permaneceram significativas após as análises de regressão múltipla. Para o padrão "não saudável", observou-se um efeito positivo, o que sugere que seu consumo é maior conforme a idade da criança aumenta e menos intenso para crianças com mães de 30 anos de idade ou mais. Para o padrão "saudável", as mesmas duas variáveis mostraram significância estatística. Observamos uma proporção direta entre idade e consumo dos grupos alimentares em ambos os padrões. Conclusões: Esses resultados apontam para a importância da educação nutricional de mães mais jovens quanto às práticas alimentares de seus filhos, especialmente à medida que a criança cresce.