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Introdução: A microcefalia é uma condição neurológica que se caracteriza por anormalidades no crescimento craniano e pode ser causada por vários fatores como a desnutrição, o uso de drogas, as infecções e mais recentemente pela contaminação pelo Zika Vírus. Apenas em 2015, o Ministério da Saúde (MS) estabeleceu pela primeira vez a possibilidade de relação entre as crianças portadoras de microcefalia e a infecção congênita pelo vírus Zika, sendo confirmada pelo Instituto Evandro Chagas (IEC), laboratório de referência nacional e internacional em ciências biológicas, meio ambiente e medicina tropical das arboviroses. Objetivo: analisar as ações realizadas pelas enfermeiras na assistência às crianças com microcefalia relacionada ao Zika Vírus na Atenção Primária à Saúde. Metodologia: Trata-se de um estudo transversal, com abordagem qualitativa, realizado com enfermeiras que assistiram crianças com microcefalia por Zika Vírus em cinco municípios do NRS SUL/Itabuna. Os dados foram coletados por entrevista semiestruturada, entre agosto e setembro de 2020. A análise do perfil biopsicossocial das enfermeiras foi realizada por estatística descritiva e as entrevistas foram processadas pela análise de conteúdo temática proposta por Bardin. Principais Resultados: Revelou-se que, as ações de acompanhamento realizadas pelas enfermeiras se restringiram à imunização e ao Programa de Crescimento e Desenvolvimento, demonstrando a importância de um olhar ampliado para as complicações/sequelas da Zika nas crianças assistidas. Conclusão: Identificou-se que, a assistência de enfermagem é restritiva, sendo necessária ações de educação permanente para estas profissionais qualificarem o cuidado às crianças com microcefalia por Zika Vírus.
Introduction: Microcephaly is a neurological condition that is characterized by abnormalities in head growth and can be caused by several factors such as malnutrition, drug use, infections and, more recently, contamination by the Zika Virus. Only in 2015, the Ministry of Health (MS) established for the first time the possibility of a relationship between children with microcephaly and congenital Zika virus infection, which was confirmed by the Evandro Chagas Institute (IEC), a national and international reference laboratory in biological sciences, environment and tropical medicine of arboviruses. Objective: to analyze the actions performed by nurses in the care of children with microcephaly related to the Zika Virus in Primary Health Care. Methodology: This is a cross-sectional study, with a qualitative approach, carried out with nurses who assisted children with microcephaly due to Zika Virus in five municipalities of NRS SUL/Itabuna. Data were collected through semi-structured interviews, between August and September 2020. The analysis of the nurses' biopsychosocial profile was performed using descriptive statistics and the interviews were processed using the thematic content analysis proposed by Bardin. Main Results: It was revealed that the follow-up actions carried out by the nurses were restricted to immunization and the Growth and Development Program, demonstrating the importance of an expanded look at the complications/sequelae of Zika in the assisted children. Conclusion: It was identified that nursing care is restrictive, requiring continuing education actions for these professionals to qualify the care of children with microcephaly due to the Zika Virus.
Introducción: La microcefalia es una condición neurológica que se caracteriza por anomalías en el crecimiento de la cabeza y puede ser causada por varios factores como la desnutrición, el consumo de drogas, infecciones y, más recientemente, la contaminación por el Virus Zika. Sólo en 2015, el Ministerio de Salud (MS) estableció por primera vez la posibilidad de relación entre niños con microcefalia e infección congénita por el virus Zika, lo que fue confirmado por el Instituto Evandro Chagas (IEC), laboratorio de referencia nacional e internacional en ciencias biológicas, medio ambiente y medicina tropical de arbovirus. Objetivo: analizar las acciones realizadas por enfermeros en la atención de niños con microcefalia relacionada al virus Zika en la Atención Primaria de Salud. Metodología: Se trata de un estudio transversal, con abordaje cualitativo, realizado con enfermeros que atendieron niños con microcefalia por Virus Zika en cinco municipios de NRS SUL/Itabuna. Los datos fueron recolectados a través de entrevistas semiestructuradas, entre agosto y septiembre de 2020. El análisis del perfil biopsicosocial de las enfermeras se realizó mediante estadística descriptiva y las entrevistas se procesaron mediante el análisis de contenido temático propuesto por Bardin. Principales resultados: Se reveló que las acciones de seguimiento realizadas por las enfermeras se restringían a la inmunización y al Programa de Crecimiento y Desarrollo, demostrando la importancia de una mirada ampliada a las complicaciones/secuelas del Zika en los niños asistidos. Conclusiones: Se identificó que los cuidados de enfermería son restrictivos, requiriendo acciones de educación continuada para que estos profesionales cualifiquen el cuidado de los niños con microcefalia debido al Virus Zika.
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The study aimed to analyze the economic impact of the adoption of optimized and nutritionally balanced diets to Brazilian families, considering the Brazilian dietary guidelines and the economic disparities of the population. Data from the Brazilian Household Budget Survey from 2008-2009 (550 strata; 55,970 households) were used. About 1,700 foods and beverages purchased by the Brazilians were classified into 4 groups according to NOVA system. Linear programming models estimated isoenergetic diets preserving the current diet as baseline and optimizing healthier diets gradually based on the "golden rule" of the Brazilian dietary guidelines, respecting nutritional restrictions for macronutrients and micronutrients (based on international recommendations) and food acceptance limits (10th and 90th percentiles of the per capita calorie distribution from the population). The diet cost was defined based on the sum of the average cost of each food group, both in the current and optimized diets (BRL per 2,000Kcal/person/day). The economic impact of the Brazilian dietary guidelines to Brazilian household budget was analyzed by comparison the cost of the optimized diets to the cost of the current diet, calculated for the total population and by income level. Three healthier diets were optimized. Current diet cost was BRL 3.37, differed among low- and high-income strata (BRL 2.62 and BRL 4.17, respectively). Regardless of income, diet cost decreased when approaching the guidelines. However, low-income strata compromised their household budget more than two times the high-income strata (20.2% and 7.96%, respectively). Thus, the adoption of healthier eating practices can be performed with the same or lower budget.
Assuntos
Dieta , Fast Foods , Brasil , Ingestão de Energia , Humanos , RendaRESUMO
Health care workers (HCWs) are at an increased risk of being exposed to COVID-19. This study aimed to characterize flu-like syndrome cases (FS) in HCWs notified in Brazil and compare them with FS cases in the general community (GC). In the Brazilian protocol, FS corresponds to a suspected case of COVID-19. The manuscript analyzed cases of FS in five Brazilian states, estimating the incidence rates of cases of FS and clinical and epidemiological characteristics. Registered cases (March to June 2020) totaled about 1,100,000 cases of FS. HCWs represented 17% of the registers, whose incidence was 20.41/100 vs. 2.15/100 in the GC. FS cases in HCWs concentrated the highest percentages in the age group of 30 to 49 years (65.15%) and among the nursing staff (46.86%). This study was the first interstate evaluation in Brazil to estimate suspected cases of FS by COVID-19 in HCWs. In order to control the spread of viral respiratory infections in HCWs, including COVID-19, it is necessary to review the management of health information to identify who they are, how many they are, and to what situations these workers are most frequently exposed, as well as in what professions they have. This information can guide specific, practical, and far-reaching actions.
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COVID-19 , Adulto , Brasil/epidemiologia , Pessoal de Saúde , Humanos , Incidência , Pessoa de Meia-Idade , SARS-CoV-2RESUMO
Objectives. To analyze trends in cigarette smoking among Brazilian adults from 2006 to 2019.Methods. We performed a time-series analysis based on data from the Surveillance of Risk and Protective Factors for Chronic Diseases Telephone Survey (n = 730 309). We calculated the annual prevalence of current cigarette smokers, heavy smokers, and passive smokers in the workplace and investigated linear trends using Prais-Winsten regression, for the entire period and for the past 5 years. We performed the analyses for the total population and according to the sociodemographic characteristics.Results. The prevalence of cigarette smoking, heavy smoking, and passive smoking in the workplace declined, respectively, an average of 3.99% per year, 5.65% per year, and 6.55% per year from 2006 to 2019. We observed this reduction regardless of gender, age, educational level, and geographic region. The magnitude of reduction in the prevalence of current cigarette smoking decreased in the past 5 years, while the magnitude of the change in heavy smoking increased.Conclusions. The prevalence of cigarette smoking decreased in the time period studied. The smaller magnitude of reduction for current cigarette smoking in the most recent years might indicate a fatigue with the current policy scenario.
Assuntos
Fumar Cigarros , Fumantes/estatística & dados numéricos , Adulto , Distribuição por Idade , Brasil/epidemiologia , Fumar Cigarros/epidemiologia , Fumar Cigarros/tendências , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Fatores Sexuais , Abandono do Hábito de FumarRESUMO
About one third of the most common cancers could be prevented by the reduction of modifiable behavioral risk factors. We aimed to identify behavioral patterns of risk and protective factors for cancer in Brazil, between 2014 and 2015. Data from Vigitel Survey (n = 95,027 adults aged ≥ 18 years) from all Brazilian capitals and Federal District were used. Thirteen risk (RBF) and protective behavioral factors (PBF) for cancer were investigated. RBF included the consumption of red meat, meat with high-fat content, soft drinks, sweets and abusive alcohol, replacement of lunch/dinner for snacks, television viewing, obesity, and smoking. PBF included the consumption of beans, fruits and vegetables, and physical activity practice. Patterns were identified by principal component analysis and linear regressions models assessed its association with sociodemographic characteristics. Four behavioral patterns for cancer were identified. The 'healthy behavior pattern' and the 'unhealthy food consumption pattern' were positively associated to females and schooling. The 'unhealthy behavior pattern' and the 'mixed behavior pattern' were both negatively associated to females, age and schooling. Our data revealed different vulnerable population groups for cancer. Actions for reduction of modifiable behavioral risk factors aiming at cancer prevention should consider distinct approaches by sex, age, and schooling.
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Neoplasias , Verduras , Adulto , Brasil/epidemiologia , Estudos Transversais , Dieta , Comportamento Alimentar , Feminino , Humanos , Neoplasias/epidemiologia , Neoplasias/etiologia , Neoplasias/prevenção & controle , Fatores de Proteção , Fatores de Risco , Fatores SocioeconômicosRESUMO
The study aimed to analyze the economic impact of the adoption of optimized and nutritionally balanced diets to Brazilian families, considering the Brazilian dietary guidelines and the economic disparities of the population. Data from the Brazilian Household Budget Survey from 2008-2009 (550 strata; 55,970 households) were used. About 1,700 foods and beverages purchased by the Brazilians were classified into 4 groups according to NOVA system. Linear programming models estimated isoenergetic diets preserving the current diet as baseline and optimizing healthier diets gradually based on the "golden rule" of the Brazilian dietary guidelines, respecting nutritional restrictions for macronutrients and micronutrients (based on international recommendations) and food acceptance limits (10th and 90th percentiles of the per capita calorie distribution from the population). The diet cost was defined based on the sum of the average cost of each food group, both in the current and optimized diets (BRL per 2,000Kcal/person/day). The economic impact of the Brazilian dietary guidelines to Brazilian household budget was analyzed by comparison the cost of the optimized diets to the cost of the current diet, calculated for the total population and by income level. Three healthier diets were optimized. Current diet cost was BRL 3.37, differed among low- and high-income strata (BRL 2.62 and BRL 4.17, respectively). Regardless of income, diet cost decreased when approaching the guidelines. However, low-income strata compromised their household budget more than two times the high-income strata (20.2% and 7.96%, respectively). Thus, the adoption of healthier eating practices can be performed with the same or lower budget.
El objetivo del estudio fue analizar el impacto económico de la adopción de dietas optimizadas y nutricionalmente equilibradas en familias brasileñas, considerando las guías alimentarias y las disparidades económicas de la población. Los datos se recopilaron de la Encuesta de Presupuestos por Hogares desde 2008-2009 (550 estratos; 55 970 hogares). Se clasificaron alrededor de 1.700 comidas y bebidas, adquiridas por brasileños en 4 grupos, según el sistema NOVA. Los modelos de programación lineal estimaron dietas isoenergéticas, preservando la dieta actual como base de referencia, y optimizando las dietas más sanas gradualmente, basadas en la "regla de oro" de las guías alimentarias, respecto a restricciones nutricionales en macronutrientes y micronutrientes (basadas en recomendaciones internacionales), y los límites de aceptación alimentarios (10o y 90o percentiles de la distribución calórica per cápita de la población). El coste de la dieta se definió basado en el total del coste medio de cada grupo de comida, ambos en las dietas actual y optimizada (BRL por 2.000Kcal/persona/día). El impacto económico de las guías alimentarias para el presupuesto por hogar se analizó mediante comparación del coste de dietas optimizadas con el coste de la dieta actual, calculado para el total de población y por nivel de ingresos. Se optimizaron las tres dietas más saludables. El coste de la dieta actual fue BRL 3,37, diferenciando los estratos entre bajo- y altos-ingresos (BRL 2,62 y BRL 4,17, respectivamente). A pesar del ingreso, el coste de la dieta decreció cuando se aproximaba a las recomendaciones de las guías. No obstante, los estratos de bajos ingresos comprometieron su presupuesto doméstico más de dos veces, respecto a los estratos de ingresos más altos (20,2% y 7,96%, respectivamente). Por ello, la adopción de prácticas alimentarias más sanas se puede conseguir con el mismo presupuesto o incluso más bajo.
O objetivo desse estudo foi analisar o impacto econômico da adoção de dietas otimizadas e nutricionalmente balanceadas para famílias brasileiras, considerando as diretrizes alimentares para a população brasileira e as disparidades econômicas da população. Foram usados dados da Pesquisa Nacional de Orçamentos Familiares de 2008-2009 (550 estratos; 55.970 domicílios). Cerca de 1,7 mil alimentos e bebidas adquiridos pelos brasileiros foram classificados em quatro grupos de acordo com o sistema NOVA. Modelos de programação linear estimaram dietas isoenergéticas preservando a dieta atual como linha de base e otimizando dietas mais saudáveis gradativamente com base na "regra de ouro" das diretrizes alimentares, respeitando restrições nutricionais para macronutrientes e micronutrientes (com base em recomendações internacionais) e limites de aceitação alimentar (10º e 90º percentis da distribuição de calorias per capita da população). O custo da dieta foi definido a partir da soma do custo médio de cada grupo de alimentos, tanto na dieta atual quanto na otimizada (R$ por 2.000Kcal/pessoa/dia). O impacto econômico das diretrizes alimentares para o orçamento familiar brasileiro foi analisado comparando-se o custo das dietas otimizadas com o custo da dieta atual, calculado para a população total e por nível de renda. Três dietas mais saudáveis foram otimizadas. O custo da dieta atual era de R$ 3,37, diferindo entre os estratos de baixa e alta renda (R$ 2,62 vs. R$ 4,17). Independentemente da renda, o custo da dieta diminuiu com a abordagem das diretrizes. No entanto, os estratos de baixa renda comprometeram seu orçamento familiar mais de duas vezes que os estratos de alta renda (20,20% vs. 7,96%). Assim, a adoção de práticas alimentares mais saudáveis pode ser realizada com orçamento igual ou inferior.
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Humanos , Dieta , Fast Foods , Brasil , Ingestão de Energia , RendaRESUMO
Resumo Objetivo: realizar comparação interpaíses e entre estados brasileiros quanto ao conteúdo dos protocolos de proteção para profissionais de saúde que atuam na assistência aos doentes da COVID-19 e desenvolver análise crítica ao modelo de prevenção que adota indicação e uso de equipamentos de proteção individual (EPI) como resposta única a um problema de caráter multidimensional. Métodos: estudo exploratório com base em revisões disponíveis na biblioteca Cochrane, articuladas com a análise dos protocolos nacionais de Argentina, Brasil, China e Estados Unidos da América e as normas previstas nos estados do Amazonas, Bahia, Minas Gerais e São Paulo, todos selecionados por critérios de conveniência. Resultados: observou-se dissensos quanto aos tipos de proteção recomendados. Somente na China eram indicados respiradores de alta eficiência de filtragem, além de modelos para o rosto inteiro nos casos de procedimentos invasivos. O reuso de equipamentos não é indicado, mas estava autorizado no protocolo brasileiro. Quanto aos dispositivos de vestuário, também não há convergência. Conclusão: os resultados reforçam a necessidade de revisão dos protocolos de proteção dos profissionais da saúde que atuam no enfrentamento da Covid-19. Ações em busca de debate institucional, interpaíses e interestaduais sobre modelos de prevenção são essenciais para alcançar consistência nas recomendações.
Abstract Objective: to make a comparison between countries and between Brazilian states regarding the contents of protection protocols for COVID-19 healthcare workers and to undertake a critical analysis of the prevention model that adopts the recommendation and use of personal protective equipment (PPE) as the only response to a multidimensional problem. Methods: exploratory study based on revisions available at the Cochrane Library, articulated with the analysis of the national protocols of Argentina, Brazil, China, and the United States of America and those of the states of Amazonas, Bahia, Minas Gerais, and São Paulo, all selected by convenience criteria. Results: there were differences between the recommended types of protection. Only China recommended high filtration efficiency respirators as well equipment covering the whole face for invasive procedures. Reusing the equipment is not recommended, but it was authorized in the Brazilian protocol. There was also no convergency about clothing devices. Conclusion: the results reinforce the need for revision of the protocols for the protection of health workers dealing with the COVID-19. Actions to promote institutional, inter-country and interstate debate on prevention models are essential for achieving consistency in the recommendations.
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OBJECTIVES: To analyze the perceived availability of public open space (POS) in the neighborhood for physical activity (PA) over the years and its association to practice of leisure-time physical activity (LTPA) among Brazilian adult population. METHODS: Data from the surveillance system of risk and protection factors for chronic diseases by telephone survey (Vigitel) from 2011 to 2015 were analyzed (n = 247,548). Prais-Winsten regression was used to investigate the trend of the perceived availability of POS, and Poisson regression to analyze its association to the LTPA. RESULTS: The perceived availability of POS in the neighborhood for PA remained fairly stable, from 73.4% in 2011 to 74.0% in 2015. The perception of this availability positively associated with the sufficient practice of LTPA (≥ 150 min/week) (RP = 1.27; p < 0.05), and with the practice of different types, weekly frequency and daily duration of the activities. CONCLUSIONS: In addition to the building and maintenance of POS, the proximity and physical accessibility of the population must be guaranteed, so that those spaces are perceived as a favorable environment for the practice of LTPA.
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Meio Ambiente , Exercício Físico/psicologia , Atividades de Lazer/psicologia , Parques Recreativos/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Saúde , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND AND AIMS: To estimate the relationship between the price of ultra-processed foods and prevalence of obesity in Brazil and examine whether the relationship differed according to socioeconomic status. METHODS AND RESULTS: Data from the national Household Budget Survey from 2008/09 (n = 55 570 households, divided in 550 strata) were used. Weight and height of all individuals were used. Weight was measured by using portable electronic scales (maximum capacity of 150 kg). Height (or length) was measured using portable stadiometers (maximum capacity: 200 cm long) or infant anthropometers (maximum capacity: 105 cm long). Multivariate regression models (log-log) were used to estimate price elasticity. An inverse association was found between the price of ultra-processed foods (per kg) and the prevalence of overweight (Body mass index (BMI) ≥25 kg/m2) and obesity (BMI ≥30 kg/m2) in Brazil. The price elasticity for ultra-processed foods was -0.33 (95% CI: -0.46; -0.20) for overweight and -0.59 (95% CI: -0.83; -0.36) for obesity. This indicated that a 1.00% increase in the price of ultra-processed foods would lead to a decrease in the prevalence of overweight and obesity of 0.33% and 0.59%, respectively. For the lower income group, the price elasticity for price of ultra-processed foods was -0.34 (95% CI: -0.50; -0.18) for overweight and -0.63 (95% CI: -0.91; -0.36) for obesity. CONCLUSION: The price of ultra-processed foods was inversely associated with the prevalence of overweight and obesity in Brazil, mainly in the lowest socioeconomic status population. Therefore, the taxation of ultra-processed foods emerges as a prominent tool in the control of obesity.
Assuntos
Orçamentos , Fast Foods/efeitos adversos , Fast Foods/economia , Abastecimento de Alimentos/economia , Renda , Obesidade/economia , Obesidade/epidemiologia , Determinantes Sociais da Saúde/economia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Obesidade/diagnóstico , Obesidade Infantil/economia , Obesidade Infantil/epidemiologia , Prevalência , Medição de Risco , Fatores de Risco , Classe Social , Adulto JovemRESUMO
OBJECTIVE: To measure change in price of food groups over time (1995-2030) in Brazil, considering the Brazilian Dietary Guidelines' recommendations. DESIGN: Data from the Household Budget Survey (2008-2009 HBS) and the National System of Consumer Price Indexes (NSCPI) were used to create a data set containing monthly prices for the foods and beverages most consumed in the country (n 102), from January 1995 to December 2017. Data on price of foods and beverages from 2008-2009 HBS (referring to January 2009) were used to calculate real price over time using the monthly variation in prices from NSCPI. All prices were deflated to December 2017. Foods and beverages were classified following the Brazilian Dietary Guidelines' recommendations. The monthly price for each food group and subgroup was used to analyse changes in prices from 1995 to 2017 and to forecast prices up to 2030 using fractional polynomial models. SETTING: Brazil. PARTICIPANTS: National estimates of foods and beverages purchased for Brazil. RESULTS: In 1995, ultra-processed foods were the most expensive group (R$ 6·51/kg), followed by processed foods (R$ 6·44/kg), then unprocessed or minimally processed foods and culinary ingredients (R$ 3·45/kg). Since the early 2000s, the price of ultra-processed foods underwent successive reductions, becoming cheaper than processed foods and reducing the distance between it and the price of the other group. Forecasts indicate that unhealthy foods will become cheaper than healthy foods in 2026. CONCLUSIONS: Food prices in Brazil have changed unfavourably considering the Brazilian Dietary Guidelines' recommendations. This may imply a decrease in the quality of the population's diet.