Terapia ocupacional em ação interdisciplinar: jogos educativo-nutricionais na prevenção da obesidade infantil

The inter-subjectivity is the answer in the search for the solution of complex problems, which concerns interfaces of knowledge, respecting their borders. This paradigm is essential in the author's work. So, the search on screen is based on this perspective, by using inter-subject groups of work conduced by professionals of Computer Science, Social Communication, Architecture and Urbanism, Pedagogy, Psicopegagogy, Nutritional Science, Endocrinology, Occupational Therapy and Nursing, it was also part of this group an 8 year old child, daughter of one of the professional who took part of the group. This thesis aims to present the course of investigation developed, analyzing the action of inter-subject Occupational Therapy and Nutrition on the promotion of learning nutritional concepts through educative-nutritional games in order to prevent child's obesity in an educative context. The research was analytic, interventionist and almost experimental. It took place in a public school in Fortaleza, Ceará, Brazil, between August and December 2004. It was selected a sample non-probabilistic, by convenience, of 200 children, born from 1994 to 1996. It was selected almost nonprobabilistically, by convenience, 200 children born between 1994 and 1996. To analyze the results it was used a triangulation, associated by quantitative and qualitative approaches. The basis collect happened through games specially manufactured to these research- video-games, board games, memory games, puzzles, scramble, searching words and iterative basics. There were semi-structured interviews, direct and structured observations and focus in-groups. It was noticed the efficiency of educativenutritional games in the learning process, which lead to a changing of attitude towards the eating choices. These games gave similar results in relation to the compared variations preferences, experience and attitudes, theses attitudes were observed through the game; and the categories to compare the possibility of learning by playing, the fantasy in the learning process, learning concepts of nutritional education and the need of help in the learning process (mediation). It was proved that educativenutritional games could be used to teach nutritional concepts, in an inter-subjective action of Occupational Therapy and Nutrition in schools. The simultaneous application of these games lead to the optimization of child s learning process. It should be emphasized the need of studies about the adaptation of tools used in a child s Nutritional Education, with the help of inter-subjective action. Because just one subject, in a fractionated way can give an answer to complex problems and help to a change of the reality with effectiveness and resolution

Níveis de homocisteína e desempenho cognitivo em uma amostra populacional de idosos da cidade do Natal-RN

The imprecision of the frontier that separates those cognitive deficits inherent to the human physiological aging process from those which represent the early signs of nervous system degenerative pathologies ,very prevalent among the elderly, has brought attention to the need of studies aiming to establish clinical and/or laboratorial criteria to allow this differentiation. Elderly people living in poor and developing countries are frequently exposed to precarious socioeconomic conditions which facilitate the development of an array of pathologies which have metabolic and nutritional dysfunctions as the established or proposed etiological agents. The levels of certain micronutrients, such as the vitamins B12 and B9 (folic acid), and of some intermediary metabolites, such as homocysteine are being thought of as etiological factors and/or as biological markers of a group of alterations which affect the normal functioning of the nervous system with important reflexes upon cognitive performance. This study aims to investigate the influence of homocysteine, B12 vitamin and folic acid levels on the cognitive performance of the low income elderly population. This transversal study took place in Natal, Rio Grande do Norte State, Brazil, and involved 205 dwelling elderly people, users of the Programa de Saúde da Família, a public healthcare program, maintained by the city s health authorities. A multidimensional questionnaire was used to assess the socio-demographic aspects and the overall health and nutrition conditions. The cognitive performance was measured by the use of the Portuguese version of the Mini Mental State Exam (MMSE). The serum levels of homocysteine, B12 vitamin and folic acid were determined by chemiluminescence. The association between the socio-demographic and serum levels of Hcy, B12 vitamin and folic acid was determined by multiple linear regression. Serum levels higher than 13.5 μmol/l, indicative of hyperhomocysteinemia (HHcy), were found on 25.4% of the sample, being more prevalent in men (p<0.05). Deficitary levels of folic acid (<5ng/mol) and of B12 vitamin (<193 pg/ml) were found on 3.9% and 10.2% of the sample respectively. A negative correlation was found between cognitive performance with both age and HHcy and a positive correlation was found between cognitive performance and schooling. The isolated HHcy R2 values were an explanation to only 4% of the variance of the MMSE scores. However, when associated with schooling and age, this model explains about 25% of this association

Associação entre fatores nutricionais e a resposta frente à infecção por Leishmania chagasi

Leishmania chagasi infection presents a wide spectrum of clinical outcomes, ranging from asymptomatic self resolving infection to disease, visceral leishmaniasis (VL). The exact mechanisms that lead the evolution of infection to disease are not understood. It is believed that malnutrition is a risk factor associated with VL development, although there are few human studies in the area. We aimed to assess the nutritional factors associated with the response to L. chagasi infection in Rio Grande do Norte. The study was conducted from December 2006 to January 2008. 149 children were assessed: 20 active VL cases, 33 children with VL history, 40 DTH+ asymptomatic children and 56 DTH-. Nutritional status was assessed using z scores for Weight/Age, Weight/Height, Height/Age, Body Mass Index (BMI), and mid-upper arm circumference/height (MUAC/height). Vitamin A status was determined by serum retinol concentrations and the modified-relative-dose-esponse test (MRDR). Breastfeeding time and birth weight were also evaluated. VL children presented compromised nutritional status when compared to the other groups using BMI and MUAC/age, with means -1,53 ± 1,10 and -1,48 ± 1,28 z scores, respectively (ANOVA, p < 0,05). VL children also showed lower vitamin A levels: 43% presented serum retinol < 20 µg/dL and 15% MRDR > 0,060. Birth weight was inverserly associated with the risk to belong the VL group (β = -0,00; OR = 0,84; 95% CI 0,73 - 0,99; p = 0,047), whereas more breastfeeding time was directly associated with the risk to belong to the DTH+ group (β = 0,02; OD = 1,16; 95% CI 1,01 - 1,33; p = 0,036). The nutritional variables evaluated were associated with the response to the L. chagasi infection, with malnutrition and compromised vitamin A status as markers of children who present with VL. Higher birth weight was associated with protection to disease, and higher breastfeeding time was associated with increased likelihood of an asymptomatic infection. The results show that modifiable nutritional aspects in the study population are associated with the response to the L. chagasi infection

Marcadores nutricionais e inflamatórios e sua associação com a morbimortalidade em hemodiálise

Background: Malnutrition, inflammation and comorbidities are frequent in patients with chronic renal failure in hemodialysis (HD), contributing for morbidity and mortality. Aims: To evaluate the correlation between anthropometric, laboratory parameters, bioelectrical impedance (BIA) and inflammatory markers with the morbidity and mortality of patients in HD, as well as the impact of its alterations throughout 12 months. Methods: 143 patients of a dialysis facility in Northeast Brazil were evaluated throughout 18 months. Patients with more than 3 months on dialysis, older than 18 years, without amputation of hands and feet, were included in the study. We performed a clinical (subjective global assessment - SGA), anthropometric (BMI, percent of ideal weight, MAC, MAMC, MAMA, percent of fat mass and TSF), laboratory (albumin, creatinine, lymphocyte count as nutritional markers and CRP, IL-6 and TNF- as inflammatory markers) evaluation and BIA (reactance, phase angle and percent of body cell mass) at the beginning of study and after 3, 6 and 12 months of follow-up. The association between study variables and deaths and hospitalizations in 6 and 12 months was investigated. The variable with significance < 10% in the univariate analysis had been enclosed in a multivariate logistic regression analysis. We also investigated the risk of mortality and hospitalization associated with differences in measurements of the variables at baseline and six months later. Results: Patients were aged 52.2 ± 16.6 years on the average, 58% were male, and mean dialysis vintage was 5.27 ± 5.12 years. The prevalence of malnutrition varied from 7.7-63.6%, according to the nutritional marker. The variables associated with morbidity and mortality in 6 and 12 months had been creatinine ≤ 9.45 mg/dl, phase angle ≤ 4.57 degrees, BMI ≤ 23 kg/m2, age ≤ 64.9 years, reactance ≤ 51.7 ohms; Charlson´s index ≥ 4 and socioeconomic status ≤ 7. During six months of follow up, decrease in albumin was associated with significantly higher mortality risk. Conclusions: This study detected that the best predictors of morbidity and mortality between nutritional and inflammatory markers are phase angle, reactance, creatinine and BMI and that changes in albumin values over six 107 months provide additional prognostic information. The authors believe that parameters of BIA may detect early changes in nutritional status and emphasize that longitudinal studies with larger number of patients are necessary to confirm these data and to recommend BIA as a routine nutritional evaluation in HD patients

Crescimento e esporulação de Bipolaris euphorbiae cultivado sob diferentes condições nutricionais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Níveis nutricionais de cálcio para aves de corte ISA Label criadas sob semiconfinamento

Determinaram-se os níveis nutricionais de cálcio (Ca) para aves, machos e fêmeas, da linhagem ISA Label, nas fases inicial (um a 28 dias), crescimento (28 a 56 dias) e final (56 a 84 dias). Foram realizados três ensaios, um para cada fase, e, em cada ensaio, 480 aves com idade correspondente à fase de criação foram alojadas em 24 unidades experimentais com áreas de abrigo e de pastejo. Foi utilizado delineamento inteiramente ao acaso, em esquema fatorial 4x2 (Ca e sexo), totalizando oito tratamentos com três repetiç ões de 20 aves. Avaliaram-se: ganho de peso (GP); consumo de dieta (CD); conversão alimentar (CA); teores de fósforo (PT), de cálcio (CaT) e de cinzas na tíbia (CT) e resistência à quebra óssea (RQO). Na fase inicial, recomenda-se 1,16% de Ca na dieta, para aves de ambos os sexos, na fase de crescimento, 0,78 e 0,88% de Ca para machos e fêmeas, respectivamente, e, na fase final, 0,69% de Ca na dieta para ambos os sexos.

Crescimento e esporulação de isolados de Verticillium lecanii sob diferentes condições nutricionais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dermatose responsiva à biotina em cão

Os transtornos da pele e dos pelos são parte importante na prática clínica de pequenos animais. Numerosos fatores nutricionais afetam a homeostase, a qualidade e o aspecto da pelagem. As vitaminas do complexo B incluem compostos hidrossolúveis necessários como coenzimas em diversas funções celulares envolvidas no metabolismo energético e na síntese tecidual. A biotina, em especial, é necessária nas reações de carboxilação, participando da síntese de ácidos graxos, aminoácidos e purinas pelo tecido epitelial. Uma cadela com quadro de cistite recorrente e tumor venéreo transmissível foi tratada com antibioticoterapia prolongada e quimioterapia. Após alguns meses de tratamento, foram observadas lesões no plano nasal e nos coxins plantar e palmar, caracterizadas por hiperceratose, espessamento, fissuras, sangramento e inflamação. O paciente recebeu suplementação de 15mg de biotina por via oral (equivalente a 1,4mg kg-1 de peso corporal), uma vez por dia, durante 60 dias, havendo importante regressão das lesões. Sugere-se que, sob antibioticoterapia e doença, a síntese intestinal de biotina possa não ter sido suficiente, sendo necessária sua suplementação.

Produtividade, eficiência agronômica, características nutricionais e tecnológicas do feijão adubado com nitrogênio em plantio direto e convencional

Altas produtividades do feijoeiro são obtidas sob condições tecnológicas adequadas, destacando-se o uso de sistemas de manejos de solo e a adubação nitrogenada, porém, há pouco conhecimento sobre tais técnicas culturais interferindo nas características nutricionais e tecnológicas de grãos. Desse modo, o trabalho teve como objetivo verificar a interferência da adubação nitrogenada em cobertura (0, 40, 80, 120 e 160 kg ha-1 de N) no feijoeiro, cultivar Pérola, cultivado no preparo convencional do solo e no plantio direto e suas relações com a produtividade, eficiência agronômica, características nutricionais e tecnológicas do grão. O delineamento experimental empregado foi o de blocos ao acaso em esquema de parcelas subdivididas, com quatro repetições, onde as parcelas foram constituídas pelos sistemas de manejo de solo e as subparcelas pelas doses de N em cobertura. A produtividade do feijoeiro é influenciada positivamente pela adubação nitrogenada em cobertura, com maior necessidade de fertilizante no plantio direto. A eficiência agronômica é superior no sistema de preparo convencional do solo. O aumento do teor de proteína bruta é em função das doses crescentes de N em cobertura nos sistemas de plantio direto e de preparo convencional do solo. O tempo para cozimento dos grãos é diminuido em função das doses de N empregadas no sistema de plantio direto em relação ao preparo convencional. Há aumento no tempo para a máxima hidratação dos grãos até a aplicação de 120 kg ha-1 de N no sistema de plantio direto e no preparo convencional do solo.

Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

Padrões nutricionais para lavouras arrozeiras irrigadas por inundação pelos métodos da CDN chance matemática

Para o arroz irrigado, poucos trabalhos utilizam métodos de diagnose foliar desenvolvidos para as condições locais de clima, solo ou cultivares. O objetivo deste trabalho foi avaliar os métodos da Diagnose da Composição Nutricional e da Chance Matemática na definição dos padrões nutricionais de lavouras arrozeiras do Estado do Rio Grande do Sul. Resultados de produtividade de grãos e teores foliares de N, P, K, Ca, Mg, S, B, Cu, Fe, Mn, Zn e Mo de 356 lavouras arrozeiras cultivadas sob sistema de irrigação por inundação foram utilizados para a determinação das faixas de suficiência calculadas pelo método da Chance Matemática. As faixas de suficiência foram comparadas com valores críticos propostos pela literatura e com o intervalo de confiança do teor médio dos nutrientes em lavouras consideradas nutricionalmente equilibradas, identificadas pelo método Diagnose da Composição Nutricional. Observou-se pouca concordância entre os valores das faixas de suficiência indicados pelos métodos da Chance Matemática e da Diagnose da Composição Nutricional e os respectivos valores indicados na literatura. A faixa de teores foliares adequados, consistentes com maior produtividade média das lavouras arrozeiras, foi indicada ser de 23 a 28 g kg-1 para N; 11 a 14 g kg-1 para K; 1,4 a 2,0 g kg-1 para S; 6 a 12 mg kg-1 para B; e 70 a 200 mg kg-1 para Fe. Para os teores foliares de P, Ca, Mg, B, Cu, Mn e Zn e Mo nenhuma das faixas adequadas testadas indicou capacidade para distinguir as lavouras arrozeiras quanto à produtividade média.

Exigências nutricionais de caprinos da raça alpina em crescimento. 2. composição corporal e do ganho em peso em proteína, extrato etéreo, energia, cálcio e fósforo

This experiment was conducted to estimate the body composition and the composition of the weight gain of energy, protein, calcium and phosphorus of kid goals in the growing phase. Fifteen four-month-old male kid goats, average live weight of 20 kg and fed an isocaloric and isoproteic diet with an increased level of calcium, were used. The experimental period was 27 days. The animals were slaughtered to determine the body composition and estimate the body content of energy, protein, ether extract, calcium, and phosphorus. The average values for the body composition were, respectively: water, 64.88%; protein, 15.22%; ether extract 14.17%; energy, 2.40 Mcal/kg as fed; calcium, .79%; and phosphorus, .54%. The values for the composition of live weight gain for 18 and 26 kg of live weight were: protein, 168.15 and 183.12 g; ether extract 83.47 and 67.71 g; energy, 1.80 and 1.63 Mcal/kg as fed; calcium, 6995.36 and 6579.02 mg; and phosphorus, 5860.95 and 6427.16 mg, respectively.

Exigências nutricionais de caprinos da raça alpina em crescimento. 3. exigências nutricionais de energia, proteína, cálcio e fósforo1

This experiment was conducted to estimate the energy, protein, calcium, and phosphorus requirements for kid goats in the growing phase. Fifteen four-month-old male kid goats, average live weight of 20 kg and fed an isocaloric and isoprotein diet with increased levels of calcium, were used. The experimental period was 27 days. The animals were slaughtered to determine body composition and to estimate the body contents of energy, protein, ether extract, calcium, and phosphorus. The estimates per kg of gain were: net energy, 1,802 to 1,632 kcal; net protein, 0.168 to 0.183 g; calcium, 6.993 to 6.758 mg; and phosphorus, 5.865 to 6.430 mg for animals from 18 to 26 kg of live weight.

Composição corporal e exigências nutricionais de macrominerais para cordeiros morada nova

Este trabalho foi desenvolvido para se determinar a composição corporal e as exigências nutricionais de cálcio (Ca), fósforo (P), magnésio (Mg), sódio (Na) e potássio de ovinos da raça Morada Nova. Foram utilizados 30 cordeiros com peso vivo (PV) médio inicial de 15 kg e 70 dias de idade. Seis cordeiros foram abatidos aos 15 kg, para determinação da composição corporal inicial (animais-referência) pela metodologia do abate comparativo; seis foram abatidos aos 20 kg (abate intermediário) e os demais distribuídos em seis grupos de três animais (um para cada dieta), de acordo com as relações volumoso(V):concentrado(C): 1) 40V:60C; 2) 55V:45C; e 3) 70V:30C. Os animais, em cada grupo, foram abatidos quando o cordeiro que recebia a dieta com maior teor de concentrado atingiu 25 kg de PV. A composição corporal variou de 14,33 a 12,42 g de Ca; 8,12 a 7,15 g de P; 0,47 a 0,46 g de Mg; 1,60 a 1,40 g de Na e de 2,30 a 2,23 g de K por kg de peso de corpo vazio. As exigências líquidas de ganho variaram de 13,54 a 11,74 mg de Ca; 7,96 a 7,02 mg de P; 0,57 a 0,55 mg de Mg; 1,54 a 1,35 mg de Na e de 2,75 a 2,68 mg de K por g de ganho de PV. As exigências dietéticas diárias de macrominerais para cordeiros dos 15 aos 25 kg de PV, ganhando 100 g/dia, variaram de 2,76 a 3,12 g de Ca; 1,91 a 2,95 de g de P; 0,60 a 0,77 g de Mg; 0,60 a 0,86 g de Na e de 1,51 a 2,63 g de K.