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BACKGROUND: Obesity is a chronic complex disease with an increasing prevalence around the world. Prospective studies in adult cohorts are needed to provide information about predictors of new-onset overweight/obesity on population-based levels. The aim of this study was to identify factors associated with the risk of an adult individual become overweight/obese after 13 years of follow-up. METHODS: Second phase of an observational population-based prospective cohort study in a small town in the Midwest region of Brazil. A representative sample of the adult population (≥18 years) was assessed in 2002 (phase 1). Anthropometric, sociodemographic, dietary intake and lifestyle data were collected. After 13 years of follow-up (2015), the same variables were re-evaluated (phase 2). New-onset overweight/obesity was the outcome variable. RESULTS: A total of 685 subjects were included with a mean age in phase 1 of 42.7 ± 13.8 years and 56.1 ± 13.8 years in phase 2, the mean follow-up time was 13.2 years and female sex counted for 66.3% of the sample. Total weight gain was 5.9 ± 10.2 Kg, body mass index increased 2.6 ± 3.8 Kg/m2 and waist circumference (WC) values increased 8.0 ± 10.5 cm. The prevalence of overweight/obesity went from 49.1% in phase 1 to 69.8% in phase 2 (p < 0.001). The factors associated with a decreased risk of new-onset overweight/obesity were ages between 50 and 64 (RR 0.40; CI 0.24-0.67 - p = 0.001) and ≥65 years (RR 0.15; CI 0.06-0.35 - p < 0.001), being part of the second quartile of fat consumption (RR 0.59; CI 0.35-0.97 - p = 0.041), no alcohol consumption (RR 0.59; CI 0.37-0.93 - p = 0.024) and smoking (RR 0.58; CI 0.39-0.86 - p = 0,007) in phase 1. CONCLUSIONS: We identified in thirteen years of follow-up that older ages, a moderate fat consumption compared to low consumption, no alcohol consumption and smoking habit were related to a decreased risk of new-onset overweight/obesity. Obesity prevention actions must focus on subjects at younger ages and include policies to reduce alcohol consumption.
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Antropometria/métodos , Dieta/métodos , Estilo de Vida , Sobrepeso/epidemiologia , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Fatores Socioeconômicos , Circunferência da Cintura , Adulto JovemRESUMO
BACKGROUND: The best anthropometric indicator to verify the association between obesity and hypertension (HTN) has not been established. We conducted this study to evaluate and compare the discriminatory power of waist-to-height ratio (WHtR) in relation to body mass index (BMI) and waist circumference (WC) in predicting HTN after 13 years of follow-up. METHODS: This study was an observational prospective cohort study performed in the city of Firminópolis, in Brazilian's midwest. The cohort baseline (phase 1) was initiated in 2002 with the evaluation of a representative sample of the normotensive population (≥ 18 years of age). The incidence of HTN was evaluated as the outcome (phase 2). Sociodemographic, dietary and lifestyle variables were used to adjust proportional hazards models and evaluate risk of HTN according to anthropometric indices. The areas under the receiver operating characteristic (ROC) curves were used to compare the predictive capacity of these indices. The best HTN predictor cut-offs were obtained based on sensitivity and specificity. RESULTS: A total of 471 patients with a mean age of 38.9 ± 12.3 years were included in phase 1. The mean follow-up was 13.2 years, and 207 subjects developed HTN. BMI, WC and WHtR were associated with risk of HTN incidence and had similar power in predicting the disease. However, the associations were only significant for women. The cut-off points with a better HTN predictive capacity were in agreement with current recommendations, except for the WC in men. CONCLUSIONS: The results suggest that both overall obesity (BMI) and central obesity (WC and WHtR) anthropometric indicators can be used in this population to evaluate the risk of developing hypertension.
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Hipertensão/epidemiologia , Razão Cintura-Estatura , Adulto , Brasil/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos TestesRESUMO
The aim of this study was to perform a meta-analysis of the effects of sanitizing treatments of fresh produce on Salmonella spp., Escherichia coli O157:H7, and Listeria monocytogenes. From 55 primary studies found to report on such effects, 40 were selected based on specific criteria, leading to more than 1,000 data on mean log reductions of these three bacterial pathogens impairing the safety of fresh produce. Data were partitioned to build three meta-analytical models that could allow the assessment of differences in mean log reductions among pathogens, fresh produce, and sanitizers. Moderating variables assessed in the meta-analytical models included type of fresh produce, type of sanitizer, concentration, and treatment time and temperature. Further, a proposal was done to classify the sanitizers according to bactericidal efficacy by means of a meta-analytical dendrogram. The results indicated that both time and temperature significantly affected the mean log reductions of the sanitizing treatment (P < 0.0001). In general, sanitizer treatments led to lower mean log reductions when applied to leafy greens (for example, 0.68 log reductions [0.00 to 1.37] achieved in lettuce) compared to other, nonleafy vegetables (for example, 3.04 mean log reductions [2.32 to 3.76] obtained for carrots). Among the pathogens, E. coli O157:H7 was more resistant to ozone (1.6 mean log reductions), while L. monocytogenes and Salmonella presented high resistance to organic acids, such as citric acid, acetic acid, and lactic acid (â¼3.0 mean log reductions). With regard to the sanitizers, it has been found that slightly acidic electrolyzed water, acidified sodium chlorite, and the gaseous chlorine dioxide clustered together, indicating that they possessed the strongest bactericidal effect. The results reported seem to be an important achievement for advancing the global understanding of the effectiveness of sanitizers for microbial safety of fresh produce.
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Desinfetantes/farmacologia , Escherichia coli O157/efeitos dos fármacos , Microbiologia de Alimentos , Frutas/microbiologia , Listeria monocytogenes/efeitos dos fármacos , Salmonella/efeitos dos fármacos , Verduras/microbiologiaRESUMO
OBJECTIVE: The COVID-19 pandemic affected individuals in different contexts (e.g. long-term care facilities, schools, communities), including psychiatric hospitals. Thus, the objective of this systematic review, duly registered and approved on PROSPERO (CRD42023427835), is to assess the frequency of positive COVID-19 cases among patients hospitalized in psychiatric hospitals. METHODS: A total of 4,922 articles were identified in the database searches, and 17 studies conducted in psychiatric hospitals from different regions of the world were selected. RESULTS: The frequency of positive COVID-19 cases among patients hospitalized in psychiatric hospitals ranged from 1.8% to 98.8%. Out of a total of 19,573 patients hospitalized in psychiatric hospitals, the pooled mean frequency of positive COVID-19 cases was 11.9%. The majority of patients presented COVID-19 symptoms (e.g. cough, fever and others). The COVID-19 diagnosis was primarily conducted through RT-PCR testing in 88.9% of the studies. CONCLUSION: In conclusion, there is discrepancy in the methodology of the studies assessing the frequency of positive COVID-19 cases in psychiatric hospitals. However, this review allowed us to understand how the COVID-19 pandemic has impacted the population hospitalized in psychiatric hospitals.
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Total body irradiation (TBI) has been an essential component of the conditioning regimen in hematopoietic cell transplantation for many years. However, higher doses of TBI reduce disease relapse at the expense of more significant toxicities. Therefore, total marrow irradiation and total marrow and lymphoid irradiation have been developed to deliver organ-sparing targeted radiotherapy. Data from different studies show that TMI and TMLI can be safely administered in escalating doses in association with different chemotherapy conditioning regimen protocols, in situations with unmet needs, such as multiple myeloma, high-risk hematologic malignancies, relapsed or refractory leukemias, and elderly or frail patients, with low rates of transplant-related mortality. We reviewed the literature on applying TMI and TMLI techniques in autologous and allogeneic hematopoietic stem cell transplantation in different clinical situations.
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Reduced-intensity conditioning (RIC) regimens frequently provide insufficient disease control in patients with high-risk hematologic malignancies undergoing allogeneic hematopoietic stem cell transplantation (HSCT). We evaluated intensification of fludarabine/busulfan (Flu/Bu) RIC with targeted marrow irradiation (TMI) in a dose escalation with expansion phase I clinical trial. TMI doses were delivered at 1.5 Gy in twice daily fractions on days -10 through -7 (dose levels: 3 Gy, 4.5 Gy, and 6 Gy), Flu (30 mg/m2 for 5 days) and Bu (area under the curve, 4800 µM*minute for 2 days). Eligible patients were age ≥18 years with high-risk hematologic malignancy and compromised organ function ineligible for myeloablative transplantation (n = 26). The median patient age was 64 years (range, 25 to 76 years). Nineteen patients (73%) had active or measurable residual disease at transplantation. One-year disease-free survival and overall survival were 55% (95% confidence interval [CI], 34% to 76%) and 65% (95% CI, 46% to 85%), respectively. Day +100 and 1 year transplantation-related mortality were 4% (95% CI, 0.6% to 27%) and 8.5% (95% CI, 2% to 32%), respectively. The 1-year cumulative incidence of relapse was 43% (95% CI, 27% to 69%). Rates of grade II-IV and III-IV acute GVHD rates were 57% (95% CI, 39% to 84%) and 22% (95% CI, 9% to 53%), respectively. Whole blood immune profiling demonstrated enrichment of central/transitional memory-like T cells with higher TMI doses, which correlated with improved survival compared with control samples from patients undergoing allogeneic HSCT. Intensification of a Flu/Bu RIC regimen with TMI is feasible with a low incidence of transplantation-related mortality in medically frail patients with advanced malignancies. The recommended phase 2 TMI dose is 6 Gy.
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Neoplasias Hematológicas , Transplante de Células-Tronco Hematopoéticas , Adolescente , Adulto , Idoso , Medula Óssea , Bussulfano/uso terapêutico , Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/etiologia , Transplante Homólogo , Vidarabina/análogos & derivadosRESUMO
BACKGROUND AND PURPOSE: The roles of surgery, chemotherapy, and parameters of radiation therapy for treating very rare central nervous system germ cell tumors (CNS-GCT) are still under discussion. We aimed to evaluate the survival and recurrence patterns of patients with CNS-GCT treated with chemotherapy followed by whole ventricle irradiation with intensity-modulated radiation therapy. MATERIALS AND METHODS: We reviewed the clinical outcomes of 20 consecutive patients with CNS-GCT treated with chemotherapy and intensity-modulated radiation therapy from 2004 to 2014 in two partner institutions. RESULTS: Twenty children with a median age of 12 years were included (16 males). Sixteen tumors were pure germinomas, and 4 were non-germinomatous germ cell tumors (NGGCT). All patients were treated with intensity-modulated radiation therapy guided by daily images, and 70% with volumetric intensity-modulated arc radiotherapy additionally. The median dose for the whole-ventricle was 25.2 Gy (range: 18-30.6 Gy) and 36 Gy (range: 30-54 Gy) for the tumor bed boost. The median post-radiation therapy follow-up was 57.5 months. There were 3 recurrences (2 NGGCT and 1 germinoma that recurred as a NGGCT), with 1 death from the disease and the other 2 cases each successfully rescued with chemotherapy and craniospinal irradiation. The overall survival at 5 years was 95% and disease-free survival was 85%. CONCLUSIONS: The results of this study suggest that the combined use of chemotherapy followed by whole ventricle irradiation with intensity-modulated radiation therapy is effective for CNS-GCTs, especially pure germinomas. Even being rescued with craniospinal irradiation, the NGGCT cases have markedly worse prognoses and should be more rigorously selected for localized treatment.
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Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Neoplasias Embrionárias de Células Germinativas/tratamento farmacológico , Neoplasias Embrionárias de Células Germinativas/radioterapia , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/mortalidade , Carboplatina/administração & dosagem , Carboplatina/uso terapêutico , Quimiorradioterapia , Criança , Irradiação Craniana , Ciclofosfamida/administração & dosagem , Ciclofosfamida/uso terapêutico , Fracionamento da Dose de Radiação , Etoposídeo/administração & dosagem , Etoposídeo/uso terapêutico , Feminino , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/mortalidade , Radioterapia de Intensidade Modulada , Estudos Retrospectivos , Terapia de Salvação , Análise de Sobrevida , Resultado do TratamentoRESUMO
Cohort studies assessing predictive values of self-rated health (SRH) and illiteracy on mortality in low-to-middle income countries are missing in the literature. Aiming to determine if these two variables were death predictors, an observational prospective population-based cohort study was conducted in a Brazilian small city. The cohort was established in 2002 with a representative sample of adults living in the city, and re-assessed in 2015. Sociodemographic (including illiteracy), anthropometric, lifestyle, previous CVD, and SRH data were collected. Cox proportional hazard models were designed to assess SRH and illiteracy in 2002 as death (all causes, CVD and non-CVD) predictors in 2015. From a total of 1066 individuals included in this study, 95(9%) died of non-CVD causes and 53(5%) from CVD causes. Mortality rates were higher among those with worse SRH in comparison to better health status categories for all causes of death, CVD and non-CVD deaths (p<0.001 for all outcomes). Similarly, illiterate individuals had higher mortality rates in comparison to non-illiterate for all causes of death (p<0.001), CVD (p = 0.004) and non-CVD death (p<0.001). Higher SRH negatively predicted CVD death (HR 0.44; 95%CI 0.44-0.95; p = 0.027) and all causes of death (OR 0.40; 95%CI 0.20-0.78; p = 0.008) while illiteracy positively predicted Non-CVD death (OR 1.59; 95%CI 1.03-2.54; p = 0.046). In conclusion, we found in this large Brazilian cohort followed for 13 years that better health perception was a negative predictor of death from all causes and CVD deaths, while illiteracy was a positive predictor of non-CVD deaths.
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Doenças Cardiovasculares/mortalidade , Autoavaliação Diagnóstica , Nível de Saúde , Alfabetização , Adulto , Idoso , Brasil/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores SocioeconômicosRESUMO
Introdução: O conhecimento das percepções de familiares acerca da participação e comunicação de seus filhos com PC (Paralisia Cerebral) não oralizados contribui com processos educacionais e terapêuticos centrados na pessoa e na família. Objetivo: Conhecer aspectos da participação e comunicação de crianças e adolescentes com PC não oralizados, bem como fatores que favorecem ou dificultam o uso da CSA (Comunicação Suplementar e/ou Alternativa) no ambiente familiar e na escola. Método: Estudo descritivo e transversal de abordagem qualitativa, com amostra de cinco mães de alunos com PC não oralizados. Resultados: As mães relatam barreiras à participação de seus filhos e reconhecem a importância da comunicação nas interações e nas atividades familiares. Mencionam, também, não terem alcançado uso funcional da CSA, em casa, mas expressam satisfação com o nível de comunicação que têm com seus filhos. Por outro lado, abordam dificuldades de comunicação quando não identificam os desejos de seus filhos ou quando eles estão com outros interlocutores. Conclusão: Os achados evidenciam participação reduzida das crianças e do adolescente do estudo, e pouco, ou nenhum uso da CSA. Diante das dificuldades relatadas pelas participantes, os achados reforçam a necessidade de equipar os familiares, no sentido de promoverem a participação e a comunicação de seus filhos. Reforça-se a importância de profissionais de CSA e professores de educação especial trabalhar em parceria com os familiares, a fim de expandir as maneiras como interagem e se comunicam com seus filhos, e vice-versa, visando uma maior participação dos mesmos.
Introduction: Knowing family members' perceptions about the participation and communication of their children with non-speaking CP (Cerebral Palsy), contributes to educational and therapeutic processes centered on the person and family. Aim: Become acquainted with participation and communication aspects of children and adolescents with non-speaking CP, as well as factors that favor or hinder AAC (Augmentative Alternative Communication) use in the family environment and school. Method: Descriptive and cross-sectional study with a qualitative approach, with a sample of five mothers of students with non-speaking CP. Results: Mothers report barriers to their children's participation and recognize the importance of communication in family interactions and activities. They mention not having achieved functional use of AAC at home, but express satisfaction with the level of communication they have with their children. On the other hand, they address communication difficulties when they are unable to identify their children's wishes or when their children are with other interlocutors. Conclusion: The findings show reduced participation of the children and the adolescent in the study, as well as little or no AAC use. In view of the difficulties reported by the participants, the findings reinforce the need to equip family members, in order to promote these children's communication and participation. The importance of AAC professionals and special education teachers working in partnerships with families is reinforced. These professionals can help expand the ways in which mothers interact and communicate with their children, and vice versa, aiming at greater participation among them.
Introducción: Conocer las percepciones de los familiares sobre la participación y comunicación de sus hijos con PC (Parálisis Cerebral) no hablantes, contribuye a procesos educativos y terapéuticos centrados en la persona y la familia. Objetivo: Conocer aspectos de la participación y comunicación de niños y adolescentes con PC no hablantes, así como factores que favorecen o dificultan el uso de la CAA (Comunicación Aumentativa y Alternativa) en el ámbito familiar y en la escuela. Método: Estudio descriptivo y transversal con enfoque cualitativo, con una muestra de cinco madres de alumnos con PC no hablantes. Resultados: Las madres relatan barreras para la participación de sus hijos y reconocen la importancia de la comunicación en las interacciones y en las actividades familiares. Mencionan no haber logrado uso funcional de la CAA en casa, pero expresan satisfacción por el nivel de comunicación que tienen con sus hijos. Por otro lado, abordan las dificultades de comunicación cuando no identifican los deseos de sus hijos o cuando ellos están con otros interlocutores. Conclusión: Los hallazgos muestran una participación reducida de los niños y adolescente en el estudio y poco o ningún uso de CAA. Los hallazgos refuerzan la necesidad de equipar a las familias para promover la participación y comunicación de sus hijos. Se refuerza la importancia de que profesionales de CAA y maestros de educación especial trabajen en colaboración con las familias para ampliar las formas en que interactúan y se comunican con sus hijos, y viceversa, buscando una mayor participación de estos.
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Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Percepção , Mães , Comunicação não Verbal , Paralisia Cerebral , Estudos Transversais , Auxiliares de Comunicação para Pessoas com Deficiência , Barreiras de Comunicação , Pesquisa Qualitativa , Habilidades SociaisRESUMO
The aim of this study was to assess the incidence and to estimate the growth kinetic parameters (maximum growth rate, µ; lag time, λ; and maximum population, κ) of Salmonella on the peel and pulp of avocado (Perseaamericana var. americana) and custard apple (Annona squamosa L.) as affected by temperature (10-30°C). The incidence of Salmonella was assessed on the peel and pulp of the fruits (n=200 of each fruit), separately, totalizing 800 analyses. Only three samples of custard apple pulp were positive for Salmonella enterica and the three isolates recovered belonged to serotype S. Typhimurium. Salmonella was not recovered from avocado and custard apple peels and from avocado pulp. Generally, the substrate (pulp or peel) of growth did not affect µ values of S. enterica (p>0.05). Very similar µ values were found for S. enterica inoculated in custard apple and avocado. S. enterica presented the highest λ in the peel of the fruits. The growth of S. enterica resulted in larger λ in custard apple in comparison to avocado. For example, the λ of S. enterica in the pulp of custard apple and avocado were 47.0±0.78h and 10.0±3.78h, respectively. The lowest values of κ were obtained at the lower storage temperature conditions (10°C). For instance, κ values of 3.7±0.06log CFU/g and 2.9±0.03log CFU/g were obtained from the growth of S. enterica in avocado and custard apple pulps at 10°C (p<0.05), respectively. On the other hand, at 30°C, κ values were 6.5±0.25log CFU/g and 6.5±0.05log CFU/g, respectively. Significantly higher κ were obtained from the growth of S. enterica in the pulp than in the peel of the fruits (p<0.05). For instance, the growth of S. enterica in the pulp of avocado led to a κ value of 6.5±0.25log CFU/g, while in the peel led to a κ value of 4.6±0.23log CFU/g (p<0.05). In general, growth kinetic parameters indicated that avocado comprises a better substrate than custard apple for the growth of S. enterica. The square root model fitted to the data obtained in this study and to the growth data available in the literature for other tropical low acid fruits indicated high variability in µ and λ of Salmonella. The results obtained in this study show that whole low acid tropical fruits can harbor Salmonella, and that this foodborne pathogen can not only survive but also grow both on the peel and pulp of low acid tropical fruits, such as avocado and custard apple.
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Annona/microbiologia , Frutas/microbiologia , Persea/microbiologia , Salmonella enterica/crescimento & desenvolvimento , Salmonella enterica/isolamento & purificação , Doenças Transmitidas por Alimentos/microbiologia , Incidência , Cinética , PrevalênciaRESUMO
ABSTRACT Purpose: to discuss the implementation and use of the International Classification of Functioning, Disability and Health (ICF) and International Classification of Functioning, Disability and Health, Children and Youth Version (ICF-CY) among children and adolescents, within the Augmentative and Alternative Communication (AAC) field. Methods: an integrative literature review. PubMed, Web of Science and VHL databases were searched for papers published between 2006 and 2017 that reported on the use of ICF and ICF-CY within the AAC context. Eighteen papers were reviewed and sorted into: Category i) papers which reported on the use of the ICF or ICF-CY with people who rely on AAC; and Category ii) theoretical papers or papers that used the ICF and ICF-CY to organize the results. Results: papers used the frameworks with different purposes, including the characterization of the children and their environment, goal setting and measurement of the results of therapeutic intervention. The papers drew on all elements, however, Activities and Participation were the components most used. Parents or caregivers were most commonly consulted in classifying the children's and young people's profiles of functioning, followed by the Educators and speech and language pathologists. Conclusion: classifications have shown advantages when used in the AAC field. Therefore, it is necessary to provide training in order for professionals to implement them in services.
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This study evaluated the effects of irradiation on the reduction of Shiga toxin-producing Escherichia coli (STEC), Salmonella strains, and Listeria monocytogenes, as well as on the sensory characteristics of minimally processed spinach. Spinach samples were inoculated with a cocktail of three strains each of STEC, Salmonella strains, and L. monocytogenes, separately, and were exposed to gamma radiation doses of 0, 0.2, 0.4, 0.6, 0.8, and 1.0 kGy. Samples that were exposed to 0.0, 1.0, and 1.5 kGy and kept under refrigeration (4°C) for 12 days were submitted to sensory analysis. D10 -values ranged from 0.19 to 0.20 kGy for Salmonella and from 0.20 to 0.21 for L. monocytogenes; for STEC, the value was 0.17 kGy. Spinach showed good acceptability, even after exposure to 1.5 kGy. Because gamma radiation reduced the selected pathogens without causing significant changes in the quality of spinach leaves, it may be a useful method to improve safety in the fresh produce industry.
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Aizoaceae/microbiologia , Irradiação de Alimentos/métodos , Raios gama , Listeria monocytogenes/efeitos da radiação , Salmonella/efeitos da radiação , Escherichia coli Shiga Toxigênica/efeitos da radiação , Contagem de Colônia Microbiana , Relação Dose-Resposta à Radiação , Microbiologia de Alimentos , Conservação de Alimentos/métodos , Refrigeração , TemperaturaRESUMO
O Programa Vida Saudável visa oportunizar a prática de atividades físicas, culturais e de lazer para o cidadão idoso para melhorar a sua qualidade de vida, isto considerando, que na atualidade passou-se a viver mais tempo devido aos avanços tecnológicos que têm contribuído para o desenvolvimento humano. Dessa forma, este trabalho objetivou descrever o processo de implantação deste Programa na cidade de Contagem, Minas Gerais, para identificar as suas potencialidades e dificuldades. A metodologia utilizada foi a partir de um enfoque epistemológico fenomenológico que adota a interpretação como fundamento da compreensão dos fenômenos como eixo da explicação científica, sendo assim um estudo qualitativo transversal, do tipo descritivo-exploratório por meio do qual se realizou uma pesquisa bibliográfica, documental e de campo. O resultado da pesquisa permitiu reconhecer algumas potencialidades do programa assim como dificuldades para sua implantação em Contagem, que levam a refletir, sobretudo, na importância da adoção de políticas internas que permitam oferecer um serviço social de qualidade para o cidadão idoso.
The aim of the Healthy Living Program is to create opportunities for physical activity, cultural and leisure facilities for the elderly in order to improve the quality of their life, considering that today has gone to live longer because technological advances that have contributed to human development. Thus, the following paper aims to describe the process of implementing this program in the city of Contagem, Minas Gerais, to identify their potential and difficulties. The methodology used was from a phenomenological epistemological approach that adopts the interpretation as the basis for understanding the phenomena as axis of scientific explanation, so the following is a cross-sectional qualitative study of descriptive exploratory whereby an investigation was carried from the literature and official documents available and field. The result of research helped to identify some potential of the program and the difficulties in its implementation in Contagem, leading to reflect on the importance of domestic policies exist to provide quality service to the older people.
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Humanos , Idoso , Idoso de 80 Anos ou mais , Política Pública , Qualidade de Vida , Serviço Social , Idoso , Participação da Comunidade , Atividades de LazerAssuntos
Doenças Cardiovasculares/terapia , Telemedicina/normas , Síndrome Coronariana Aguda/economia , Síndrome Coronariana Aguda/epidemiologia , Síndrome Coronariana Aguda/terapia , Brasil , Doenças Cardiovasculares/economia , Doenças Cardiovasculares/epidemiologia , Humanos , Telemedicina/métodos , Telemedicina/organização & administração , Resultado do TratamentoRESUMO
Nos últimos anos, vegetais têm sido responsáveis por surtos de enfermidades transmitidas por alimentos (ETA) em diversas regiões do mundo por serem veículos dos mais diferentes micro-organismos patogênicos, entre eles Salmonella spp, Listeria monocytogenes e Escherichia coli produtora de toxina de Shiga (STEC). O uso de sanitizantes nem sempre reduz de maneira significativa a população de micro-organismos presentes nos vegetais, sendo necessária a aplicação de técnicas mais eficientes, entre elas, a radiação gama. Assim, os objetivos do presente estudo foram avaliar o efeito da irradiação na redução de STEC, Salmonella spp. e L. monocytogenes inoculadas em espinafre minimamente processado, bem como sobre os atributos físico-químicos e sensoriais do vegetal. Amostras de espinafre (Tetragonia expansa) foram inoculadas com um "pool" de cepas de Salmonella spp, um "pool" de cepas de L. monocytogenes e um "pool" de cepas de STEC, separadamente, e expostas às doses de 0; 0,2; 0,4; 0,6; 0,8 e 1,0 kGy. Os valores de D10 para Salmonella spp, L. monocytogenes e STEC foram, respectivamente, 0,19 a 0,20 kGy, 0,20 a 0,21 kGy e 0,17 kGy. Foram avaliados os comportamentos de Salmonella spp, L. monocytogenes e STEC em amostras de espinafre expostas à doses cinco vezes maiores do que o valor D10 obtido para cada micro-organismo: 1,0; 1,05 e 0,85 kGy, respectivamente, e em amostras não irradiadas armazenadas por 12 dias a (4±1) °C e a (10±1) °C. Os resultados mostram que as doses empregadas reduziram a população de Salmonella e de STEC em aproximadamente 6 ciclos log no dia zero tendo permanecido abaixo do limite de detecção (<10 UFC/g), mesmo após 12 dias de armazenamento em ambas as temperaturas. A dose de 1,05 kGy reduziu a população de L. monocytogenes em, aproximadamente, 5 log imediatamente após a irradiação, porém com recuperação de 2,62 log nas amostras armazenadas a (10±1) °C ao final do período de armazenamento. Amostras de espinafre expostas às doses de 1 e 1,5 kGy e a amostra-controle, mantidas sob refrigeração (4±1) ºC, foram utilizadas para a avaliação da vida de prateleira (VP), análise sensorial, análise de cor, determinação de ácido ascórbico, flavonoides, compostos fenólicos e capacidade antioxidante. A VP da amostra exposta à dose de 1 kGy foi de 15 dias, dois dias a mais que a da amostra-controle, enquanto a exposta a 1,5 kGy apresentou VP de 12 dias. Todas as amostras expostas à radiação foram aceitas pelos provadores. A irradiação não provocou alterações significativas na concentração de compostos fenólicos e atividade antioxidante, porém houve alteração na cor e na concentração de flavonoides. As estações do ano, por sua vez, tiveram influência sobre a coloração, concentração de compostos fenólicos e atividade antioxidante. Apesar da alteração na coloração ter sido observada na análise instrumental, esta não foi percebida pelos provadores durante a análise sensorial. O processo de irradiação mostrou ser uma boa alternativa para aumentar a segurança microbiológica de espinafre sem alterar as características sensoriais. No entanto, o uso das Boas Práticas de Fabricação nunca deve ser negligenciado
In recent years, fresh produce have been responsible for foodborne disease outbreaks worldwide, due to their contamination by different pathogenic microorganisms such as Salmonella spp., Listeria monocytogenes and Shiga toxin-producing Escherichia coli (STEC). The use of sanitizers does not always significantly reduce the microbial populations present in vegetables, and thus, the application of more efficient techniques such as gamma radiation, is required. The objectives of this study were to evaluate the effect of irradiation on the reduction of the populations of STEC, Salmonella spp. and L. monocytogenes, inoculated on minimally processed spinach, as well as to assess its effect on the sensory and physicochemical characteristics of the vegetable. Spinach (Tetragonia expansa) samples were individually inoculated, with a cocktail of three strains of Salmonella spp, three strains of L. monocytogenes and three strains of STEC and exposed to doses of 0, 0.2; 0.4; 0.6; 0.8 and 1.0 kGy. The D10 values determined in this study ranged from 0.19 to 0.20 kGy for Salmonella spp, 0.20 to 0.21 kGy for L. monocytogenes, and 0.17 kGy for STEC. The behavior of Salmonella spp., L. monocytogenes and STEC were evaluated in spinach samples exposed to doses of 1.0, 1.05 and 0.85 kGy, respectively, and in non-irradiated samples, stored for 12 days at (4±1) °C and (10±1) °C. The results showed that the populations of Salmonella and STEC were reduced at about 6 log, on day zero, and remained below the detection limit (<10 CFU/g) even after 12 days of storage at both temperatures tested. The 1.05 kGy dose reduced the population of L. monocytogenes in approximately 5 log, but in the samples stored at (10±1) °C, the growth of the microorganism (2,62 log) was observed at the end of the storage time. Spinach samples exposed to 1 and 1.5 kGy, as well as the control sample, all kept under refrigeration (4±1) °C were used for the evaluation of the product shelf life, sensory analysis, color analysis, determination of ascorbic acid, flavonoids, phenolic compounds and the antioxidant capacity. The samples exposed to 1 kGy displayed a shelf life of 15 days, two days longer than that observed for the control sample, while those exposed to 1.5 kGy showed a shelf life of 12 days. All samples exposed to radiation were accepted by the sensorial panel. The irradiation had no significant effect either on the concentration of phenolic compounds or on the antioxidant activity. Nevertheless, there was a reduction in the concentration of flavonoids and change on the color. The color, phenolic compounds concentration and antioxidant activity were influenced by the seasons of the year. Although the change in color was observed by instrumental analysis, this was not perceived by the panelists during sensory analysis. The irradiation process is a great alternative for microbiological safety purpose together with Good Manufacturing Practices
Assuntos
Spinacia oleracea/efeitos da radiação , Irradiação de Alimentos/métodos , Salmonella/química , Colimetria , Toxina Shiga , Escherichia coli/classificação , Listeria monocytogenes/crescimento & desenvolvimentoRESUMO
A carne de frango é a segunda mais consumida no mercado brasileiro, perdendo apenas para a carne bovina. O aumento do seu consumo está relacionado ao seu preço acessível. Como conseqüência do seu baixo custo, sabor agradável e alto valor nutricional resultante da alta concentração de proteínas e da baixa concentração de gordura, ela vem sendo consumida por diferentes classes sociais. Devido ao seu grande consumo, cuidados específicos devem ser tomados durante o abate para evitar contaminações. Assim, a água utilizada não pode ter substâncias dissolvidas em níveis tóxicos e nem microrganismos patogênicos que possam provocar doenças colocando em risco saúde e a vida do consumidor. Os patógenos mais freqüentes transmitidos pela água são aqueles que causam infecção no trato gastrintestinal causando desde diarréia leve até febre entérica e cólera. Portanto, o objetivo deste trabalho foi avaliar a qualidade microbiológica da água coletada em diferentes pontos da linha de abate após ter sido tratada pelo sistema de tratamento de água em um abatedouro avícola localizado no município de Itatiba/SP. Amostras de água foram coletadas antes e após o sistema de tratamento do abatedouro assim como nos tanques de escaldagem, lavagem e resfriamento. (...) Os resultados mostraram que as amostras de água do afluente, de água tratada e da água da lavagem da carcaça apresentaram contaminação por coliformes totais, sendo que as amostras do afluente e da lavagem também apresentaram contaminação por Escherichia coli. (...) Os Coliformes não foram encontrados na água do tanque de resfriamento no final do processo, o que demonstrou a eficiência do sistema de tratamento de água do abatedouro. Portanto, é necessário destacar a importância de um rigoroso monitoramento nos pontos críticos da cadeia do frango, desde a fazenda até o processo de abate para garantir um produto seguro ao consumidor.