RESUMO
Adherence to secondary prevention measures after acute coronary syndrome (ACS) is essential to prevent disease recurrence. In Brazil, the Brazilian Unified Health System (SUS, in Portuguese), and the private healthcare system (PHCS) coexist. We aimed to evaluate the adherence to secondary prevention in patients with ACS who were assisted by either SUS or PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, three of which assisted PHCS users, and one, SUS users. We analyzed the two patient care models with multiple logistic regression models for adherence to physical activity, pharmacotherapy, and smoking cessation. We enrolled 581 volunteers in this study: 44.1 % from SUS and 55.9 % from PHCS. PHCS users showed greater adherence to pharmacotherapy at both 30 and 180 (p = 0.001) days after ACS with better results in all classes of medications (p < 0.05) than SUS users did. They also showed better adherence to physical activity (p = 0.047). There was no distinction between the groups regarding smoking cessation. The secondary prevention measures after ACS were more effective in PHCS users than in SUS users due to better adherence, especially to pharmacotherapy and regular physical activity.
RESUMO
(1) Background: Quality of life (QOL) is used as a health indicator to assess the effectiveness and impact of therapies in certain groups of patients. This study aimed to analyze the QOL of patients with acute coronary syndrome (ACS) who received medical treatment by a public or private health care system. (2) Methods: This observational, prospective, longitudinal study was carried out in four referral hospitals providing cardiology services in Sergipe, Brazil. QoL was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey. The volunteers were divided into two groups (public or private health care group) according to the type of health care provided. Multiple linear regression models were used to evaluate QoL at 180 days after ACS. (3) Results: A total of 581 patients were eligible, including 44.1% and 55.9% for public and private health care, respectively. At 180 days after ACS, the public health care group had lower QoL scores for all domains (functional capacity, physical aspects, pain, general health status, vitality, social condition, emotional profile, and health) (p < 0.05) than the private group. The highest QoL level was associated with male sex (p < 0.05) and adherence to physical activity (p ≤ 0.003) for all assessed domains. (4) Conclusions: This shows that social factors and health status disparities influence QoL after ACS in Sergipe.
RESUMO
INTRODUCTION: Boardwalk Cisterns is a government program that aims to attend a population with precarious access to water in Brazil. Developed as part of the Zero Hunger strategy, it intends to increase food security and contribute to the realization of the human right to food. The objective of this study was to assess farmers' perceptions of the Boardwalk Cisterns program and its impact on the food security situation of beneficiary households. METHODS: Data were collected through a descriptive cross-sectional quali-quantitative survey. Questionnaires were applied to farming families selected from two municipalities in the state of Alagoas (Northeast Brazil), containing questions on sociodemographic characteristics, production methods, and food security status. The Free Evocation Technique for social representation, analyzed through the software Ensemble of Programs Permettant L'analyze des Évocations, was used to ascertain farmers' perceptions of the program. RESULTS: The study showed a positive perception of the interviewees in relation to the boardwalk cisterns. The program brought some improvement in the agricultural production conditions and, consequently, in the food security situation of the households. Corn, beans and cassava were the most common crops, with almost half of this production (48.3%) destined for consumption by the families themselves. Farmers also reported having more water, allowing them to plant more fruit trees, as well as medicinal and ornamental plants. Nevertheless, 79.1% of the households interviewed were still in a situation of food insecurity, of which 28.1% were classified as mild food insecurity, 26% as moderate food insecurity, and 25% as severe food insecurity. CONCLUSION: Farmers were correct in their perception that the Boardwalk Cisterns program improved their food security situation. The program resulted in greater access to water, and greater production and consumption of food. However, by itself, the Boardwalk Cisterns program was not enough to raise beneficiary families above their food-insecure status. The program alleviated the problem of food insecurity, but other complementary government interventions are needed to guarantee the food security of families living in extreme poverty.
Assuntos
Fazendeiros , Segurança Alimentar , Brasil , Estudos Transversais , Abastecimento de Alimentos , Humanos , PercepçãoRESUMO
OBJECTIVE: To associate dietary patterns and food neophobia in low-income preschoolers. DESIGN: This was a cross-sectional study using a semi-structured questionnaire for socio-demographic data, birth conditions and breast-feeding history. Food neophobia was assessed using an adapted version of the Child Food Neophobia Scale. Children's nutritional status was assessed using BMI-for-age and height-for-age Z-scores. Dietary patterns were estimated using a semi-quantitative FFQ through exploratory factor analysis. Multiple linear regression was used to test for an association between food neophobia and dietary pattern adherence. SETTING: Philanthropic childhood education schools in Aracaju, an urban community in northeastern Brazil, between July and December 2017. PARTICIPANTS: Two hundred fourteen children aged 3-6 years and their parents. RESULTS: The percentages of low/medium and high food neophobia among preschoolers were 85·9 % and 11·2 %, respectively. Children with high food neophobia more frequently consumed ultra-processed foods rich in sugars (snacks, filled and unfilled cookies and sweets), as well as protein-rich foods (white meat, cheese and yogurt). Three dietary patterns were identified (traditional, snacks and school snacks). Children with a high level of neophobia had lower adherence to traditional dietary patterns. CONCLUSIONS: A high level of food neophobia among socially vulnerable preschoolers is an eating behaviour related to unhealthy eating and is associated with the poorest diet in typical foods.
Assuntos
Transtorno Alimentar Restritivo Evitativo , Preferências Alimentares , Criança , Pré-Escolar , Estudos Transversais , Dieta , Comportamento Alimentar , HumanosRESUMO
The objective of this study was to identify and describe the experience of family farmers and their respective families after using the Boardwalk Cistern rainwater collection system and consequent impacts on nutrition profile and food security. This is a qualitative-quantitative study conducted in two municipalities in the semi-arid region of the state of Alagoas, northeastern Brazil. A structured questionnaire was applied to collect information on demographic and socioeconomic status and household access to food, based on the Brazilian Food Insecurity Scale of 29 family farmers' households. Food intake was assessed by food intake markers of the Ministry of Health, while nutritional status was determined by measuring the weight and height of all family members and waist circumference of adults. Nutrition diagnosis was performed using the cutoff points of body mass index for age. Three focus groups were conducted, and the information collected was analyzed through Content Analysis with the aim of knowing the participants' perception of the effects of the received water equipment. The study showed a high prevalence of excess weight (52.7%) and high risk for cardiovascular diseases (35.9%) marked by a high salt and sugar in the food intake. Food Insecurity Scale showed that food insecurity is a problem occurring in 75% of these families. However, focus groups showed that families have a positive perception of Boardwalk Cisterns for their food security. They believe that agricultural production has improved, thereby offering a wider range of foods and, consequently, improving food security. In conclusion, this study highlights the importance of water access programs for food production within public policies to guarantee FNS.
Assuntos
Equipamentos e Provisões , Características da Família , Fazendas , Abastecimento de Alimentos/instrumentação , Estado Nutricional , Abastecimento de Água/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Agricultura , Brasil , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Chuva , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Cerebral Palsy (CP) is commonly associated with low socioeconomic status. Use of spatial statistics and a Geographic Information Systems (GIS) are scarce and may contribute to the understanding of CP in a social context. To that end a spatial analysis of CP in children and adolescents was performed to analyze the association of CP with levels of vulnerability in a city (Aracaju, Sergipe) in north-eastern Brazil. In addition, an ecological study was conducted with data obtained from a populationbased survey and secondary data. Exploratory spatial data analysis and linear regression were used. A total of 288 CP cases were identified, with a prevalence of 1.65/1,000 and differences among city neighbourhoods ranging from 0-4/1,000. The mean age of cases studied was 9 years 1 month, with a standard deviation of 5 years 2 months. Most study subjects with cerebral palsy (163) were male (56.4%). The distribution of CP in the study population was not homogeneous throughout the territory. Some areas had clusters, with more cases associated with areas of high vulnerability. Spatial data analysis using GIS was useful to gain an epidemiological understanding of CP distribution that can guide decisionmaking with respect to production, distribution, and regulation of health goods as well as services at the local level.
Assuntos
Paralisia Cerebral , Análise Espacial , Brasil/epidemiologia , Paralisia Cerebral/epidemiologia , Criança , Pré-Escolar , Sistemas de Informação Geográfica , Humanos , Prevalência , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To evaluate the internal consistency and predictive validity of the Brazilian Food Insecurity Scale applied by two unconventional methods, as well as its external validity expressed in relation to the per capita family income. METHODS: The Scale was sent to the household of 488 adolescents enrolled in fifth grade of public schools of Piracicaba, Sao Paulo, Brazil, composing the initial sample of the main study. However, since some scholars' responsible did not send the filled questionnaire back, it was necessary to conduct the interview over the phone. After applying the exclusion criteria, the final sample consisted in 350 scholars, where 310 questionnaires were self-administered and 40 were responded by phone. Cronbach's alpha was used toverify internal consistency and Pearson's Chi-squared was applied to verify predictivevalidity. RESULTS: Cronbach's alpha coefficients was 0.91 and 0.92 to self administered Scale and to the Scale conduct by phone, respectively. Education level and per capita household income were higher among households in which Scale was completed by phone. The proportion of scholars whose families were beneficiaries of Cash transfer programs, was higher among the group which the Scale was self-administered. CONCLUSION: The prevalence of food insecurity did not differ between both groups, but it is possible to assume that the self-administered group is more vulnerable, since lower income and higher participation in Cash transfer programs were observed. Both application methods showed good internal consistency and predictive validity. Therefore, both can be used in further studies
OBJETIVO: Avaliar a consistência interna da Escala Brasileira de Insegurança Alimentar aplicada por dois métodos não convencionais, assim como sua validade externa expressa na relação com rendimento familiar per capita. MÉTODOS: A escala foi enviada para os domicílios dos 488 adolescentes da amostra inicial, matriculados na 5ª série de escolas públicas de Piracicaba, São Paulo, Brasil. Como parte de seus responsáveis não devolveu o questionário preenchido, realizou-se contato telefônico para a execução da entrevista. Após a aplicação dos critérios de exclusão, a amostra final do estudo foi constituída por 350 escolares, sendo 310 com questionários autopreenchidos e 40 respondidos por telefone. Aplicou-se o teste de alpha de Cronbach e Chi-quadrado de Pearson. RESULTADOS: O coeficiente alpha de Cronbach para a escala autopreenchida foi de 0,91, enquanto que para a escala aplicada por entrevista telefônica foi de 0,92. Puderam ser observados maiores níveis de escolaridade e renda familiar dentre domicílios em que a escala foi preenchida por telefone. Já nos domicílios em que os próprios responsáveis a preencheram, foi observada maior proporção de escolares cuja família recebia benefícios de programas de transferência de renda. CONCLUSÃO: A prevalência de insegurança alimentar não foi diferente entre os dois grupos, embora o grupo que a autopreencheu apresente maior vulnerabilidade, já que revelam menor rendimento. e maior participação em programas sociais. Ambos os métodos de preenchimento mostraram boa consistência interna e boa validade preditiva, podendo ser utilizados em futuros estudos
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Saúde do Adolescente , Comportamento Alimentar , Programas e Políticas de Nutrição e AlimentaçãoRESUMO
Objetivo: Avaliar a prevalência da inadequação no consumo de nutrientes entre gestantes atendidas em Unidades Básicas de Saúde de Picos-PI, Brasil. Métodos: Estudo transversal envolvendo 72 gestantes. Coletaram-se dados sociodemográficos e de estilo de vida, além de informações sobre ingestão dietética, a partir de 3 recordatórios alimentares de 24 horas. Calcularam-se prevalências de inadequação para carboidrato, cálcio, ferro, vitaminas A, C, E e ácido fólico, baseando-se em suas respectivas médias estimadas (EAR); avaliouse a adequação da ingestão energética habitual em relação ao gasto energético usual indiretamente pelo índice de massa corporal (IMC). Resultados: Verificou-se que 86,1% (n=62) das gestantes apresentavam renda per capita inferior a 1 salário mínimo, 4,2% (n=3) fumavam e 11,1% (n=8) faziam uso de bebida alcoólica durante a gestação. No que se refere ao consumo, os carboidratos e a vitamina C tiveram prevalência de inadequação menor que 2%, enquanto a vitamina A ficou entre 30% e 50%. Cálcio, ferro, ácido fólico e vitamina E tiveram prevalência de inadequação maior que 98%. Ao considerar que 38,9% (n=28) das gestantes estavam com excesso de peso e 4,2% (n=3), com baixo peso, presume-se elevada prevalência de consumo inadequado de energia. Conclusão: Houve elevada prevalência de inadequação no consumo dos micronutrientes cálcio, ferro, ácido fólico e vitamina E nas gestantes, além de inadequação de consumo energético ? situação preocupante, visto que pode desencadear consequências adversas para o binômio mãe-filho.
Objective: To assess the dietary intake of pregnant women attended in Basic Health Units of Picos-Piauí. Methods: Cross-sectional study involving 72 pregnant women. Sociodemographic and lifestyle data was collected, plus information on dietary intake from three 24-hour food recalls. The prevalence of inadequacy for carbohydrate, calcium, iron, A, C, E vitamins, and folate were calculated based on their respective estimated average requirements (EAR), while the adequacy of habitual energy intake relative to usual energy expenditure was estimated indirectly by body mass index (BMI). Results: It was found that 86.1% of the pregnant women had a per capita income lower than one minimum wage, 4.2% were smokers and 11.1% used alcohol during pregnancy. As regards consumption, carbohydrates and vitamin C had inadequacy prevalence lower than 2%, while vitamin A ranged from 30 to 50%. Calcium, iron, folate, and vitamin E had inadequacy prevalence higher than 98%. Considering that 38.9% of the pregnant women were overweight and 4.2%, underweight, it is assumed that the prevalence of energy intake inadequacy is high. Conclusion: There was a high inadequacy prevalence in the micronutrients calcium, iron, folate, and vitamin E intake in pregnant women, as well as high inadequacy of energy consumption ? a disturbing situation, since it can trigger adverse consequences for the mother-baby binomial.
Objetivo: Evaluar la prevalencia de la inadecuación del consumo de nutrientes por embarazadas asistidas en Unidades Básicas de Salud de Picos-PI, Brasil. Métodos: Estudio transversal com 72 embarazadas. Se recogieron datos sociodemográficos, Del estilo de vida e informaciones sobre ingesta dietética a partir de 3 recordatorios de 24 horas. Se calculó las prevalencias de inadecuación para carbohidrato, calcio, hierro, vitaminas A, C, E y ácido fólico basándose en sus respectivas medias estimadas (EAR); se evaluó la adecuación de ingesta energética habitual respecto al gasto energético usual de modo indirecto a través Del índice de masa corporal (IMC). Resultados: Se verificó que El 86,1% (n=62) de las embarazadas presentaban renta per capita menor que 1 sueldo mínimo, el 4,2% (n=3) fumaban y el 11,1% (n=8) tomaban bebida alcohólica en el embarazo. Respecto al consumo, los carbohidratos y la vitamina C tuvieron prevalência de inadecuación menor que el 2% mientras que la vitamina A se quedó entre el 30% y el 50%. Calcio, hierro, ácido fólico y vitamina E tuvieron prevalencia de inadecuación mayor que el 98%. Considerando que el 38,9% (n=28) de las embarazadas tenían exceso de peso y el 4,2% (n=3) bajo peso, presúmase de elevada prevalencia del consumo inadecuado de energía. Conclusión: Hubo elevada prevalencia de inadecuación del consumo de los micronutrientes calcio, hierro, ácido fólico y vitamina E en las embarazadas además de la inadecuación del consumo energético ? situación preocupante ya que puede desencadenar consecuencias adversas para el binomio madre-hijo.
Assuntos
Ingestão de Alimentos , Nutrientes , Estado Nutricional , Gestantes , Necessidades NutricionaisRESUMO
INTRODUCTION: Epidemiological research has been adhering to new technologies, such as computer systems, and using the Internet as a tool. Usability is a characteristic of a specific product concerning the facility to use it, its speed and the facility to learn how to use it. It should also not present errors, or these must be easy to solve, in case they occur, thus providing high satisfaction to users. OBJECTIVE: To evaluate the usability of the "System of health and nutrition monitoring - nutrition of school children" (NUTRISIM). METHODS: A sample of 17 Information Technology professionals evaluated the system and answered the "Questionnaire for System Usability", which determines the level of usability of systems by the Fuzzy Logic. The questionnaire contains 30 questions, which are divided into six metrics. The usability of the system determines six usability criteria in a large Fuzzy scale. RESULTS: With the exception of the metric "error control", all metrics were analyzed as "very good". The metrics "error control", "efficiency" and "satisfaction" presented medium amplitude, which is a better result in relation to the metrics "easy to learn", "easy to remember" and "effectiveness", which was assessed as "high". CONCLUSION: The study showed that the system is easy to be learned and used, but the answers are scattered. The instrument proved to be a useful tool to monitor and evaluate health and dietary intake in epidemiologic studies. .
INTRODUÇÃO: As pesquisas epidemiológicas vêm aderindo a novas tecnologias, tais como sistemas computadorizados, e utilizando a Internet como ferramenta. A usabilidade é uma característica de um determinado produto relativo à facilidade de uso, à rapidez para aprender a usá-lo, ao fato de não gerar erros ou à facilidade de resolução dos mesmos, caso ocorram, oferecendo um alto grau de satisfação para seus usuários. OBJETIVO: Avaliar a usabilidade do "Sistema de monitoramento da saúde e alimentação - nutrição do escolar" (NUTRISIM). METÓDOS: A avaliação do sistema foi realizada pela Lógica Fuzzy, através do "Questionário para Usabilidade de Sistemas", composto por 30 questões que se dividiam em seis métricas, respondido por 17 profissionais de Tecnologia da Informação. A avaliação da usabilidade do sistema consiste em determinar, para cada um dos seis critérios de usabilidade, um conceito na escala Fuzzy. RESULTADOS: Todas as métricas obtiveram avaliação "muito boa" com exceção da relacionada com o "controle de erros". As amplitudes referentes às métricas "controle de erros", "eficiência" e "satisfação" foram consideradas com designação "média", melhor resultado do que para as métricas "facilidade de aprender", "facilidade de relembrar" e "eficácia", que apresentaram classificação "alta". CONCLUSÃO: Pode-se perceber que o sistema é fácil de aprender e de usar, porém apresenta dispersão entre as respostas. O instrumento mostrou ser uma ferramenta útil para a avaliação e monitoramento da saúde e do consumo alimentar em pesquisas epidemiológicas de pequeno a grande porte. .
Assuntos
Adulto , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Software , Inquéritos e Questionários , Estudos EpidemiológicosRESUMO
INTRODUCTION: Epidemiological research has been adhering to new technologies, such as computer systems, and using the Internet as a tool. Usability is a characteristic of a specific product concerning the facility to use it, its speed and the facility to learn how to use it. It should also not present errors, or these must be easy to solve, in case they occur, thus providing high satisfaction to users. OBJECTIVE: To evaluate the usability of the "System of health and nutrition monitoring - nutrition of school children" (NUTRISIM). METHODS: A sample of 17 Information Technology professionals evaluated the system and answered the "Questionnaire for System Usability", which determines the level of usability of systems by the Fuzzy Logic. The questionnaire contains 30 questions, which are divided into six metrics. The usability of the system determines six usability criteria in a large Fuzzy scale. RESULTS: With the exception of the metric "error control", all metrics were analyzed as "very good". The metrics "error control", "efficiency" and "satisfaction" presented medium amplitude, which is a better result in relation to the metrics "easy to learn", "easy to remember" and "effectiveness", which was assessed as "high". CONCLUSION: The study showed that the system is easy to be learned and used, but the answers are scattered. The instrument proved to be a useful tool to monitor and evaluate health and dietary intake in epidemiologic studies.