RCAAP Repository

Resumo Buscou-se investigar questões relacionadas à regulação emocional, à satisfação sexual e ao comportamento sexual de risco em mulheres adultas com histórico de abuso sexual na infância. Participaram desta pesquisa oito mulheres, com média de idade 38 anos, que responderam aos instrumentos de autorrelato sobre regulação emocional e satisfação sexual e a uma entrevista em profundidade, que avaliou aspectos do contexto familiar, emocional, relacionamentos amorosos e também sexuais, abordando questões sobre comportamento sexual de risco. O delineamento utilizado foi exploratório, descritivo com abordagem mista. Os resultados demonstraram que todas as participantes avaliadas possuíam difi culdades de regulação emocional, em menores ou maiores níveis. Em relação à satisfação sexual, seis das participantes obtiveram índices positivos de satisfação, e algumas delas relataram desejo e satisfação sexual preservados. No entanto, outras participantes relataram difi culdades, como aversão sexual e comportamento hipersexualizado. Comportamentos sexuais de risco foram identifi cados em duas das participantes e vinculados a comportamentos do passado.

ABSTRACT In the last ten years, new trends in the interpretation of Vygotsky’s work have been developed, many of which have transcended the traditional interpretations that have been hegemonic in Soviet and Western psychology since the 1980s. Nonetheless, Vygotsky’s “The Psychology of Art” is among the most interesting books written by this Soviet psychologist and, paradoxically, has not received enough attention in the study of his legacy. In that book, Vygotsky developed a rich psychology, in dialogue with Philosophy, Sociology and Art. In this paper, some theoretical questions and concepts developed by Vygotsky are discussed, which were not included in the dominant interpretation of his work, neither in Soviet nor Western psychology. The discussion opened by Vygotsky throughout the book shows that philosophy, art, poetry, Sociology and Psychology are interrelated in such a way that they are a living theoretical representation whose epicenter was human motivation and the creative character of human performance.

Objective: This study aimed to determine the prevalence of food insecurity among schoolchildren living in urban and rural areas of Picos, Piauí associated with the socioeconomic profile of families and their food intake and nutritional status. Methods: Study participants were families with children aged 7-10 years enrolled in municipal schools, totaling 342 families/schoolchildren. The study was conducted at school facilities through interviews with mothers - or guardians - using a questionnaire based on the Brazilian Food Insecurity Scale and socioeconomic variables and food frequency questionnaire. The nutritional status of children was assessed using the following indexes: weight/age, height/age and body mass index/age. Results: The prevalence of food insecurity was high and similar for rural and urban areas, 84.3% and 83.3%, respectively. In general, lower income and consumption of untreated water was associated with greater frequency of food insecurity (p≤0.01). In urban areas, higher percentage of food insecurity was associated to lower educational levels (p≤0.05). Dietary intake and nutritional status of schoolchildren were not associated with food insecurity condition of families. Conclusion: The percentage of families at food insecurity, as well as the food consumption and nutritional status of schoolchildren were similar between urban and rural areas, characterized as a homogeneous population in terms of socioeconomic conditions.

Objective: To characterize the nutritional status of quilombola students and determine the food security status of their households. Methods: This is a cross-sectional study with students aged six to nineteen years from quilombola communities in twelve municipalities of Goiás categorized by age, gender, school location (urban/rural), and nutritional status based on the World Health Organization's height-for-age and body mass index for-age charts. The Brazilian Food Insecurity Scale was used for measuring food (in)security in their families. Descriptive and association analyses were conducted using the Chi-square test at a significance level of 5% (p<0.05). Results: In a sample of 226 students, overweight (17.2%) was more common than malnutrition (1.3%), especially in students attending urban schools (28.2%) (p<0.05). Most (75.2%) quilombola families experienced food insecurity, especially mild. Conclusion: The apparent contradiction of excess weight and food insecurity occurring simultaneously indicates the need of revising the study instruments and the causal network that identify poverty.

Objective: To estimate the prevalence of the fruit and vegetable intake of schoolchildren aged 7 to 14 years from Florianópolis, Santa Catarina, Brazil, and analyze the associated factors. Methods: This cross-sectional study analyzed food intake, socioeconomic, and biological data of 2,836 schoolchildren. The Chi-square test analyzed the dependent (fruit and vegetable intake) and independent variables; the latter with p-value <0.20 were selected for logistic regression analysis. The level of significance was p<0.05. Results: Only 4.8% of the sample had adequate fruit and vegetable intake. The variables associated with adequate fruit and vegetable intake were school ownership status (private versus public), mother's education level, and family income per member. After adjustment only family income per capita remained associated with fruit and vegetable intake. Conclusion: The fruit and vegetable intake of schoolchildren aged 7 to 14 years from Florianópolis, Santa Catarina, Brazil, is inadequate.

Objective: the objective of this study was to evaluate the nutritional composition and describe the acceptability of regional culinary dishes served to students from public schools of rural and urban areas. Methods: Ten Brazilian regional dishes were evaluated for acceptability and nutritional composition. the survey was conducted in schools located in rural and urban areas of two cities in the state of São Paulo. Dish acceptability was evaluated using leftover analysis and a 5-point facial hedonic scale. the adherence index was calculated and used as an indirect measure of acceptance, and the nutritional composition was calculated based on the technical files of each dish. Results: A total of 2,384 students from 20 schools participated in the study and 1,174 tasted and evaluated the dishes. the test using the 5-point facial hedonic scale demonstrated that five dishes (Caldo verde soup, persimmon jelly, chicken with okra, puréed cornmeal with spinach, and arugula pizza) had an acceptability rate above 85.0%. the mean adherence indices were 57.3% and 55.6% in urban and rural environments, respectively. Analysis of the nutritional composition of regional dishes indicates that these dishes can partially meet macronutrient recommendations. Conclusion: the tested dishes can become part of school menus as they were accepted or partly accepted by the students regardless of school location, whether rural or urban. the cultural heritage is an important resource for the food sovereignty of a country and should be constantly encouraged.

Objective: To estimate the prevalence of overweight in industry workers and its association with demographic and socioeconomic factors and soft drink intake (including type). Methods: This is a nationwide cross-sectional cohort survey of "Lifestyle and leisure habits of industry workers" conducted between 2006 and 2008 in 24 Brazilian federate units. The participants answered a previously tested questionnaire and self-reported their weight and height. Statistical analyses consisted of crude and adjusted Poisson regression. Results: Males and females had overweight prevalences of 45.7% (95%CI=45.1; 46.2) and 28.1% (95%CI=27.4; 28.9) respectively. Older and married individuals and those working in medium-sized and large factories were more likely to be overweight. Males with higher education levels and gross family incomes were also more likely to be overweight, but not females. Finally, men (PR=1.24; 95%CI=1.13; 1.36) and women (PR=1.40; 95%CI=1.22; 1.61) who consumed diet/light soft drinks were also more likely to be overweight than those who did not consume soft drinks. Conclusion: More than one-third of the workers were overweight according to their self-reported weight and height, and the prevalence of overweight was higher in males. Demographic and socioeconomic variables and diet/light soft drink intake were associated with overweight. These data may be helpful for the development of actions that reduce the risk of overweight in this population.

Objective: To analyze whether the stages of change of the Transtheoretical Model are in accordance with the fat consumption of members of the Academia da Cidade of Belo Horizonte, Minas Gerais. Methods: This cross-sectional study included a simple random sample of users aged ≥20 years frequenting an Academia da Cidade. Eating behavior toward oil and fat consumption was evaluated by the transtheoretical model and compared with fat intake adequacy, obtained through mean fat intake was investigated by three 24-hour recalls. Anthropometric and sociodemographic data were also collected. Additionally, the stages of change were verified, after reclassification the stages of change agreed with the consumption of fatty foods, fats, and fractions. Results: A total of 131 women with a mean age of 53.9±12.1 had an average fatty acid consumption of 556.0 mL. Some participants consumed high-fat foods, lipids (20.6%), saturated (31.3%) and polyunsaturated (38.2%) fatty acids, and cholesterol (16.0%) in excess. The stages of eating behavior were significantly different after reclassification. The number of women in action and maintenance decreased in a way that in the end, 4.6% were in precontemplation, 19.8% were in contemplation, 26.0% were in preparation, 28.2% were in action, and 21.4% were in maintenance. The consumption of chicken skin; fatty salad dressing; bread, doughnuts or cake with butter/margarine; and fats, saturated fatty acids, and monounsaturated fatty acids was lower in the final stages of the transtheoretical model. Conclusion: After reclassification the algorithm is in agreement with the ingestion of high-fat foods, which denotes its applicability for the evaluation of eating behavior and for providing data to food and nutrition education actions.

Objective: To evaluate the action of ascorbic acid on the healing of malnourished rats' cutaneous wounds compared with normal weight rats. Methods: We used 92 adult, male Wistar rats divided into four groups: 24 normal weight rats given only water and chow; 24 normal weight rats given vitamin C by gavage (340 mg/kg 12/12 hours); 22 malnourished rats given only water and chow; and 22 malnourished rats given vitamin C by gavage (340 mg/kg 12/12 hours). Malnutrition was induced by feeding the animals half of their daily energy requirement for 30 days. Two incisions were made, one sutured (healing by primary intention) and one left unsutured (healing by secondary intention). The rats were euthanized on the third, seventh, and fourteenth days of the experiment. Results: The following parameters differed significantly between the groups (p>0.05): granulation of the wound edge in the primary and secondary intention; extent of injuries on day 7 for primary intention and on day 3 for secondary intention; reepithelialization on day 7 for primary intention; fibrin-leukocyte scab on day 14 for primary intention; amount of neovascularization and concentration of macrophages, fibroblasts, and collagen fibers for primary and secondary intention. Conclusion: The use of vitamin C in malnourished and normal weight rats increases fibroblast proliferation and collagen deposition in the tissue, which helps to improve healing both by primary and secondary intention.

Objective: To systematize studies on the anthropometric nutritional status of Brazilian indigenous children in order to examine the ability to address the totality of biological, anthropological, and ecological aspects, as well as to characterize the main analytical results of the determinants of nutritional status of Brazilian indigenous children. Methods: MedLine and Lilacs were searched using the intersection of "South American Indians" and "nutritional status" descriptors (the search in MedLine also included the descriptor "Brazil"). Results: Overall, 65 studies were identified, and 23 were considered relevant to this study. The systematization of these studies highlights the concentration of studies in the midwestern and northern regions of Brazil, as well as the lack of cultural, biochemical, and food consumption approaches. Regarding nutritional status, we found: 1) greater vulnerability of younger children, especially in relation to stunting; 2) absence of differences in nutritional status according to sex; 3) socioeconomic determination of nutritional status; 4) differences in nutritional status between children from different villages. Conclusion: The nutritional status of Brazilian indigenous children is associated with age, socioeconomic status, and ethnic characteristics. Efforts are needed to understand the ethnic and cultural influence on nutritional status and on its causal network, as well as of various factors minimally discussed.

OBJETIVO: Este estudo tem como objetivo verificar a evolução do excesso do peso e fatores a ele associados, em mulheres de 10 a 49 anos, no Estado de Pernambuco, em pesquisas realizadas em 1997 e em 2006. MÉTODOS: Trata-se de estudo transversal, de base populacional, com amostra probabilística representativa dos meios urbano e rural de Pernambuco, abrangendo 1 . 105 mulheres em 1997, e 1 . 464 em 2006. Para mulheres entre 10 e 19 anos, foi utilizada a relação índice de massa corporal/idade, observados os seguintes parâmetros: déficit de peso: valores abaixo de -2 escores-Z; peso adequado: entre -2 e <1 escores-Z; sobrepeso: >1 e <2 escores-Z; obesidade: >2 escore-Z. Para mulheres com idade superior a 19 anos, consideraram-se os seguintes valores: déficit de peso: índice de massa corporal <18,5; normal: índice de massa corporal >18,5 e <24,9; sobrepeso: índice de massa corporal >25,0 e <29,9; obesidade: índice de massa corporal >30 kg/m2. A análise de regressão de Poisson foi utilizada para avaliar a associação entre o excesso de peso e as variáveis explanatórias. RESULTADOS: Em relação ao estado nutricional no período compreendido entre 1997 e 2006, houve um aumento significativo no sobrepeso e obesidade, com estabilização na prevalência de déficit de peso. O excesso de peso aumentou de 32,8% em 1997 para 41,7% em 2006, representando um incremento de 27,1%. As mulheres da Região Metropolitana do Recife, do Interior Urbano e Rural apresentaram um aumento de excesso de peso de 40,2%, 6,8% e 45,2%, respectivamente. Na avaliação dos fatores associados a esse agravo, em 2006, permaneceram significantes, após ajuste, baixa escolaridade (quatro ou menos anos de estudo), a posse de três ou mais bens de uso doméstico, idade e maior número de gestações, em contraste com o estudo de 1997, que apontava sobrepeso associado à idade e ao maior número de gestações. CONCLUSÃO: O excesso de peso em mulheres em idade fértil, no Estado de Pernambuco, aumentou significativamente, observando-se menor ritmo no Interior Urbano. Evidencia-se nas categorias de condições socioeconômicas e microambientais mais favoráveis uma clara desaceleração no incremento temporal do excesso ponderal.

OBJECTIVE: This study describes educational actions concerning organic foods conducted in Brazilian public schools and investigates how these actions are associated with the weekly workload and duration of employment of the dietician responsible for school meals. METHODS: In 2012 this cross-sectional, census-type study used an electronic questionnaire to collect data from dieticians or others responsible for school meals in all 5,565 Brazilian municipalities. The software Stata 11.0 was used for the statistical analyses. RESULTS: Although all Brazilian municipalities were contacted, 93.1% (n=5,184) replied. Of these, 94.2% had dieticians in charge of the school meals. Organic food-related educational actions were provided in the schools of 37.9% of the municipalities. The main actions were school gardening (67.1%) and development of educational material (50.7%). Having a dietician responsible for school meals was not associated with the existence of educational actions at school (p=0.372). However, municipalities with dieticians in charge of school meals for at least twelve months were 22.0% and 20.0%, respectively, more likely to provide educational actions at school and include the subject 'organic foods' in the municipal school curriculum (p<0.05 for both). Dieticians' weekly work hours was directly related to the performance of school gardening-related activities (p=0.016). CONCLUSION: The percentage of Brazilian municipalities that provide organic food-related educational actions at school is low. Additionally, the availability of such actions relates to the dietician's duration of employment and weekly work hours.

OBJECTIVE: To estimate the prevalence of anemia and associated factors in adolescents from the city of Recife in Pernambuco state. METHODS: This is a cross-sectional study, involving a random sample of 256 adolescents of both genders, aged 13 to 18, whose hemoglobin concentrations were evaluated, along with their nutritional status and socioeconomic and demographic characteristics. RESULTS: The prevalence of inadequate hemoglobin concentrations was 10.2% [CI95%=6.7-14.5], reaching levels considered as mild anemia (9 g/dL <hemoglobin <12 g/dL). Female students had lower mean hemoglobin concentrations in all age groups (p<0.001). No association was observed between hemoglobin concentrations and nutritional status (p>0.05), nor with socioeconomic or demographic characteristics (p>0.05). CONCLUSION: Although the prevalence of anemia was low and classified as a mild health problem, preventive nutrition education involving the dissemination of healthy eating habits in schools and encouraging the consumption of iron-rich foods are strongly recommended.

OBJECTIVE: Rats fed diets enriched with fatty fish from the Amazon region had Hematology and plasma biochemistry analyzed. METHODS: Forty Wistar rats were divided into four groups: control group fed a standard diet; mapará group fed a diet enriched with Hypophthalmus edentatus; matrinxã group fed a diet enriched with Brycon spp.; and tambaqui group fed a diet enriched with Colossoma macropomum. After thirty days the rats had an red blood count and plasma biochemistry. RESULTS: Hematocrit and hemoglobin levels were higher in rats fed tambaqui and matrinxã than in those fed the standard diet of mapará. However, mapará increased cholesterol, especially low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. All fish-enriched diets reduced triacylglycerols. CONCLUSION: Diets enriched with fatty fish from the Amazon region reduce triacylglycerol and increase high-density lipoprotein cholesterol, especially the diet enriched with tambaqui. Tambaqui and matrinxã affected hematocrit and hemoglobin levels, but not mapará. Further research is needed to determine the benefits of diets enriched with fatty fish from the Amazon region.

OBJECTIVE: To assess microbicide function and macrophage viability after in vitro cellular infection by methicillin-sensitive/resistant Staphylococcus aureus in nourished rats and rats subjected to neonatal malnutrition. METHODS: Male Wistar rats (n=40) were divided in two groups: Nourished (rats suckled by dams consuming a 17% casein diet) and Malnourished (rats suckled by dams consuming an 8% casein diet). Macrophages were recovered after tracheotomy, by bronchoalveolar lavage. After mononuclear cell isolation, four systems were established: negative control composed exclusively of phagocytes; positive control composed of macrophages plus lipopolysaccharide; and two testing systems, macrophages plus methicillin-sensitive Staphylococcus aureus and macrophages plus methicillin-resistant Staphylococcus aureus. The plates were incubated in a humid atmosphere at 37 degrees Celsius containing 5% CO2 for 24 hours. After this period tests the microbicidal response, cytokine production, and cell viability were analyzed. The statistical analysis consisted of analysis of variance (p<0.05). RESULTS: Malnutrition reduced weight gain, rate of phagocytosis, production of superoxide anion and nitric oxide, and macrophage viability. Production of nitrite and interleukin 18, and viability of macrophages infected with methicillin-resistant Staphylococcus aureus were lower. CONCLUSION: The neonatal malnutrition model compromised phagocyte function and reduced microbicidal response and cell viability. Interaction between malnutrition and the methicillin-resistant strain decreased the production of inflammatory mediators by effector cells of the immune response, which may compromise the immune system's defense ability.

Os métodos de avaliação da composição corporal em obesos têm sido amplamente discutidos, uma vez que nesses indivíduos a avaliação é dificultada devido às limitações dos equipamentos e características dos métodos utilizados. Esta sessão temática tem o objetivo de esclarecer as características, vantagens e limitações dos métodos de avaliação da composição corporal em adultos obesos. A quantificação de gordura corporal e mas-sa livre de gordura, assim como a avaliação da perda de massa muscular e de massa óssea em obesos são temas de grande interesse científico, uma vez que são utilizados para diagnosticar a obesidade osteosarcopênica. A avaliação da composição corporal de obesos pelo modelo de múltiplos compartimentos é padrão-ouro na prática científica. Por outro lado, o método de absorciometria radiológica de feixe duplo é considerado o padrão de referência em pesquisas e na prática clínica. Estudos indicam que a ressonância magnética e a tomografia computadorizada, em alguns casos, são fortemente correlacionadas com a absorciometria radiológica de feixe duplo. Os demais métodos apresentam limitações em avaliar a composição corporal, bem como suas modificações durante a redução ponderal em indivíduos obesos.

Este artigo teve como objetivo propor recomendações para a realização de estudos de custo da doença no sistema de saúde brasileiro. Realizou-se uma revisão da literatura sobre aspectos relacionados ao método de custo da doença e aplicou-se ao caso brasileiro. Os resultados estão divididos em dois blocos. O primeiro refere--se aos conceitos inerentes aos estudos de custo da doença, tais como tipos de custos, perspectiva da análise, apresentação dos valores monetários e fontes de informação. O segundo diz respeito a recomendações para aplicar o método de custo da doença ao contexto brasileiro. Foram propostas sete etapas para a elaboração de um estudo de custo da doença: 1) selecionar a doença e elaborar a pergunta a ser respondida; 2) definir a perspectiva, a abordagem e os tipos de custo a serem analisados; 3) obter os riscos de incidência das comorbidades que poderiam ser parcialmente evitadas caso a doença investigada não existisse; 4) calcular o risco atribuível à doença investigada nas suas comorbidades; 5) levantar os custos de cada patologia associada; 6) calcular o custo da doença final; e 7) analisar os resultados. É viável adotar o método de custos da doença no Brasil, pois as informações não só estão disponíveis, como também são de acesso público. Apesar de algumas limitações, os estudos sobre o custo da doença são muito úteis para o planejamento em saúde, pois permitem estimar o custo global de uma dada patologia no País.

O objetivo deste texto é fomentar a reflexão e a crítica no processo de elaboração de projetos de pesquisa em nutrição clínica. São apresentados aspectos relativos a evidências, validade e confiabilidade dos resultados dos estudos nesse campo. É imprescindível que ocorra adequado planejamento da pesquisa, desde a definição do delineamento e do tipo do experimento, passando pelos aspectos éticos, escolha da população e cálculo do tamanho amostral até a avaliação da factibilidade dos riscos envolvidos na sua condução. Após a coleta das informações, as etapas seguintes correspondem à descrição dos resultados, análise estatística, verificação da consistência desses resultados e, ao final, sua adequada interpretação.

Various indices and scores based on admittedly healthy dietary patterns or food guides for the general population, or aiming at the prevention of diet-related diseases have been developed to assess diet quality. The four indices preferred by most studies are: the Diet Quality Index; the Healthy Eating Index; the Mediterranean Diet Score; and the Overall Nutritional Quality Index. Other instruments based on these indices have been developed and the words 'adapted', 'revised', or 'new version I, II or III' added to their names. Even validated indices usually find only modest associations between diet and risk of disease or death, raising questions about their limitations and the complexity associated with measuring the causal relationship between diet and health parameters. The objective of this review is to describe the main instruments used for assessing diet quality, and the applications and limitations related to their use and interpretation.

Neste ensaio, busca-se uma primeira aproximação à pesquisa em Nutrição Clínica. Considera-se existir uma lacuna de informações e debates sobre elementos de cunho epistemológico e sobre interesses que marcam essa atividade no interior do campo científico da Alimentação e Nutrição no Brasil. O caráter multidimensional do campo alimentar-nutricional é apresentado como sua forte marca de identidade e motivo de distinção. Todavia, a pesquisa em Nutrição Clínica caracteriza-se pelo olhar biomédico, voltado enfaticamente para o metabolismo e para a doença, ficando excluídas as relações sociais e a intersubjetividade, com estudos voltados ao aspecto nutricional, sem considerar o alimentar. De outro lado, o alívio do sofrimento impõe a compreensão de relações entre seres humanos em sociedade. Tanto do ponto de vista metodológico como epistemológico, a biomedicina não é capaz de abarcar a totalidade do fenômeno da vida humana. Por essas razões, as Ciências Humanas e Sociais podem contribuir, em regime de cooperação interdisciplinar, com o campo da Alimentação e Nutrição, no sentido de instrumentalizar estudos inovadores tanto no aspecto conceitual quanto metodológico. Tais perspectivas podem trazer à luz as dimensões subjetivas do adoecimento humano, as quais constituem matéria essencial para os estudos sobre Nutrição Clínica.