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Diagnósticos de enfermagem do domínio nutrição em pacientes submetidos à hemodiálise

The study aimed to analyze the nursing diagnoses of the nutrition domain from NANDA International in patients undergoing hemodialysis. This is a transversal study conducted in a university hospital in northeastern Brazil, with 50 hemodialysis patients. The data collection instrument was an interview form and a physical examination, in digital format, applied between the months of December 2013 to May 2014. Data analysis was divided into two stages. In the first, defining characteristics, related factors and risk factors were judged as to their presence by the researcher, according to the data collected. In the second stage, based on data from the first, diagnostic inference by experts was held. The results were organized in tables and analyzed using descriptive and inferential statistics for the diagnoses that showed higher frequencies than 50%. The project was approved by the Ethics Committee responsible for the research institution (protocol number 392 535), with Certificate Presentation to Ethics Assessment 18710613.4.00005537 number. The results indicate a median of 7 (± 1.51) nursing diagnoses of the nutrition domain per patient. Six diagnoses with greater frequency than 50% were identified, namely: Risk for electrolyte imbalance, Risk for unstable blood glucose level, Excess fluid volume, Readiness for enhanced fluid balance, Readiness for enhanced nutrition and Risk for deficient fluid volume. The defining characteristics, related and risk factors presented an average of 34.78 (± 6.86), 15.50 (± 3.40) and a median of 4 (± 1.93), respectively, and 11 of these components had statistically significant association with the respective diagnoses. Were identified associations between adventitious breath sounds, edema and pulmonary congestion with the diagnosis Excess fluid volume; Expressed desire to increase fluid balance with the nursing diagnosis Readiness for enhanced fluid balance; It feeds regularly, Attitude to food consistent with the health goals, Consume adequate food, expresses knowledge about healthy food choices, expresses desire to improve nutrition, expresses knowledge about liquid healthier choices and following appropriate standard supply with diagnosis Readiness for enhanced nutrition. It is concluded that the diagnosis of the nutrition domain related to electrolyte problems are prevalent in customer submitted to hemodialysis. The identification of these diagnoses contributes to the development of a plan of care targeted to the needs of these clients, providing better quality of life and advance in the practice of care

Riscos à saúde dos trabalhadores em unidade de alimentação e nutrição de um Hospital Universitário

The Food and Nutrition Units (FNU) are designed to produce food for healthy and/or sick communities and need to be done in a way to ensure the quality of foodstuffs that were produced. In these units, in the working environment, in general, there is excessive noise, heat and physical condition with many adaptations, presence of obstacles, inadequate flows, as well as the ways of the working organization may represent risks for workers health and lead to errors during production and/or distribution of food. The main goal of this study was to analyse the working processes in the Food Production Unit of the university’s hospital and identify the workers' health risk factors, using for this the knowledge of ergonomics, specifically the method of Ergonomic Work Analysis (EWA). After this analysis it was possible to develop proposals that will bring improvements to the working conditions, minimizing health risk factors during the process of meals production. It’s crucial to reassert this method considers the work activity performed in real time and highlights the importance of listening and the engagement of the workers in the changing process. It is a descriptive research with a qualitative approach. In the field research were collected demographics data, employment characteristics of the individuals (age, education, stocking sector, the total length of service and length of service in the industry) and data related to their usual work (task analysis, activity analysis and Analysis of the working environment) in the FNU. The instruments that were used in this study were document analysis, global and systematic observations and semi structured interviews in order to identify the main complaints related to those activities developed by them. The study was based on data for the analysis of Bardin, 2011, so the documents have been selected and including those that treat issues related to risks to workers' health were selected. The result of semi-structured interviews, global and systematic observations took place a confrontation of this material to the theoretical framework, held the inference and the interpretation of results the light of the knowledge of ergonomics and legislation. Issues related to the risks and the perception of workers has crafted a table showing the frequency of responses to the physical, chemical and biological and even the risk of accidents and was made a descriptive analysis. The results of this analysis indicated that the unit in question presents several problems ambience of jobs, both in terms of physical structure, but also in the organization of work. Non-conformities that leads to a favourable environment to the development of disease and injury hazards and compromising the quality of food produced. It is necessary to comply with legislation and that short, medium and long-term measures are taken to ensure the physical integrity of workers and improve the working environment.

Serum copper evolution in patients that underwent endoscopic gastrostomy for long term enteral feeding

Background and aims: Copper (Cu) is a well studied trace element but little is known about Cu evolution in long term endoscopic gastrostomy (PEG) feeding. We aimed to evaluate the evolution serum Cu since the gastrostomy until 12 weeks after the procedure in PEG patients fed with homemade meals. Methods: A prospective observational study was performed evaluating serum copper, albumin, transferrin and body mass index (BMI) at the time of the gastrostomy, 4 weeks and 12 weeks after. Data also included age, gender, NRS 2002 and nature of the underlying disease causing dysphagia: head and neck cancer (HNC) or neurological dysphagia (ND). After gastrostomy, patients were fed with homemade PEG meals. Results: One hundred and forty-six patients enrolled, 89 men, aged 21-95 years, 90 with neurologic dysphagia (ND), and 56 with head and neck cancer (HNC). 78 (53%) showed low BMI. Initially, Cu ranged 42-160 μg/dl (normal: 70-140 μg/dl); 130 patients (89%) presented normal Cu, 16 (11%) presented hypocupremia, 53% low albumin (n = 77), and 94 (65%) low transferrin. After 4 weeks, 93% presented normal Cu, 7% presented hypocupremia, low albumin was present in 34%, and low transferrin in 52%. After 12 weeks, 95% presented normal Cu, 5% presented hypocupremia, low albumin was present in 25%, and low transferrin in 32%. Comparing age, gender, underlying disease, BMI, albumin and transferrin, there were no significant differences on serum Cu. Conclusions: Most patients present normal serum Cu when gastrostomy is performed. For patients presenting hypocupremia before gastrostomy, homemade meals are effective for normalizing serum Cu.

Caraterização in vitro dos efeitos tóxicos da patulina na integridade do epitélio intestinal e potenciais efeitos protetores da cisteína

A mucosa intestinal é a primeira barreira biológica encontrada pelas micotoxinas presentes nos alimentos, sendo a patulina, uma micotoxina produzida por fungos do género Penicillium spp., uma preocupação particular atendendo a que a exposição humana a esta micotoxina pode conduzir a efeitos imunológicos, neurológicos e gastrointestinais. Considerando estes efeitos para a saúde, o presente estudo tem como objetivos a avaliação do efeito tóxico da exposição intestinal a patulina, bem como a determinação do potencial efeito protetor da coadministração de patulina e cisteína na membrana intestinal, utilizando para o efeito células Caco-2. A integridade da membrana intestinal foi determinada pela medição da resistência elétrica transepitelial (TEER). Os resultados evidenciaram um decréscimo acentuado nos valores de TEER após 24 horas de exposição celular a 95 μM de patulina. Para as concentrações mais reduzidas verificou-se uma redução máxima inferior a 25% após 24 horas de exposição. A coadministração de patulina (95 μM) e cisteína (40 μM) revelou um decréscimo nos valores de TEER. O tratamento com cisteína em concentrações superiores ( 400 μM) revelou efeito protetor da membrana intestinal, tendo em conta os valores de TEER. Estes resultados contribuem para uma avaliação do risco mais precisa associada à exposição a contaminantes alimentares.

A altura de dossel e a adubação nitrogenada da pastagem podem afetar a nutrição nitrogenada do milho, num sistema de integração lavoura pecuária?

We conducted a field experiment near Abelardo Luz, Santa Catarina, from October 2012 to April 2014, to evaluate the effect interaction of nitrogen fertilization and height of canopy over the N nutrition of corn subsequently grown to pasture. The data belonging to this thesis are related to the first two production cycles obtained in sorghum pasture (2012/2013), oat (2013) and corn crop (2013/2014). In the evaluation of forage sorghum and oat it was used the same experimental design, consisting of randomized complete block in a factorial arrangement (2 x 2) with three replications. The first factor was considered canopy height (Low and High) and the second factor was the fertilization of cover crop pasture (0 and 200 kg N.ha-1). In phase I and II, the combination of factors evaluators were prepared in the same experimental unit. For corn crop the design was a randomized complete block in a factorial design (2X2X4X6) with three replications. Factors considered in corn were: canopy height of pasture (Low and High), nitrogen application times (NG - nitrogen in the grains and NP - nitrogen in pasture), nitrogen fertilization in corn (0, 100, 200 and 300 kg N.ha-1) and time (46, 53, 60, 67, 76 and 103 days after sowing the maize). In phases I and II, in general the use of N in the pasture increased the productive potential of the pasture and animal management and canopy height has changed the dynamics of structural components and botanical pasture. In cold conditions for long periods and not acclimatized plants the adoption of high nitrogen fertilization and height high grazing pasture leave vulnerable to damage caused by the freezing of plants. The anticipation of nitrogen fertilization on pasture positively affects the corn crop by increasing the accumulated dry matter and N content in the plant. Nitrogen nutritional content of corn with the anticipation of fertilization in pasture is suitable for obtaining high crop production in integrated crop-livestock system. When used nitrogen only coverage in corn sufficiency level in the nitrogen nutrition is achieved with the use of 100 kg N.ha-1. With the use of 200 kg N ha -1 NG and NP no difference in nitrogen content and nitrogen nutrition index.

Desenvolvimento de metodologias alternativas para quantificação de micronutrientes em produtos de nutrição infantil

As farinhas infantis, alimentos que se destinam a recém-nascidos e crianças até à idade pré-escolar, devem satisfazer todas as necessidades nutricionais que se verificam durante o período de crescimento e desenvolvimentos físico e mental desta faixa etária. Desta forma, são frequentemente adicionadas prémisturas de vitaminas e minerais durante a sua produção (fortificação), de maneira a que a quantidade adicionada e a composição do produto final sejam concordantes com a legislação comunitária em vigor. A implementação, na linha de produção, de métodos alternativos de análise “amigos do ambiente” e passíveis de obter resultados rápidos acerca da composição nutricional dos produtos alimentares, mesmo antes destes serem embalados, permite reduções de tempo, custos e um melhor controlo do processo de produção. A espectroscopia FT-NIR e a espectroscopia de XRF são técnicas que permitem a quantificação de micronutrientes e possuem características fundamentais ao controlo rápido de processos. Neste trabalho foram desenvolvidos modelos de calibração para quantificação de zinco, por espectroscopia de XRF, em três receitas de pré-misturas de vitaminas e minerais. Construíram-se dois modelos de calibração, um com um R2 de 0,990 e um SEC de 26,624 mg/100g e outro com um R2 de 0,927 e um SEC de 18,838 mg/100g. Estes resultados indicam que os modelos de calibração construídos são adequados e podem ser usados na determinação rápida do teor de zinco em pré-misturas de vitaminas e minerais. Foram também verificadas as rectas de calibração existentes para quantificação de cálcio e ferro por espectroscopia de XRF e quantificação de vitamina C por espectroscopia FT-NIR para aplicação nas novas receitas de pré-misturas de vitaminas e minerais.

Atividade física dos adolescentes diabéticos tipo I inscritos na consulta de nutrição do Hospital Santa Maria Maior de Barcelos

A actividade física é entendida como qualquer movimento corporal, que resulta em dispêndio energético acima dos níveis considerados de repouso. Os seus benefícios para a saúde são amplamente comprovados na literatura, sobretudo no que se refere à prevenção do aparecimento e desenvolvimento de disfunções crónico-degenerativas. Objectivos/ Metodologia-Avaliar a prática de actividade física de jovens diabéticos. Desenvolveu-se uma investigação quantitativa de metodologia transversal e observacional. Aplicou-se um questionário auto administrado adaptado do Self Administered Physical Activity Checklist. Resultados/ Conclusões- Cerca de 71% dos adolescentes pratica actividade física extra curricular, sendo o futebol, o futsal e a musculação os preferidos.É imperioso desenvolver acções de sensibilização, alertando para o facto de que os jovens diabéticos com um controlo adequado de insulina e um plano alimentar individualizado podem usufruir dos benefícios físicos e psicossociais promovidos pela prática de exercício físico.

PULMONARY REHABILITATION PROGRAMS IN LUNG TRANSPLANT: A LITERATURE REVIEW

Objective: To analyze, using a literature review, Pulmonary Rehabilitation (RP) Programs in lung transplant. Methods: A literature review in July 2014 in Ebsco Host, Periódicos Capes, BVS and Science Direct data bases using descriptors in English (“lung transplantation”, “lung transplant” AND/OR “rehabilitation”) and Portuguese (“reabilitação” AND/OR “transplante pulmonar”). The eligibility criterions were interventional studies of PR before and/or after lung transplant; participants who were candidates to lung transplant or lung transplant recipients; studies that applied any kind of PR program (hospital-based, homebased or outpatient) and articles published in English, Spanish or Portuguese. Literature reviews, guidelines and case reports were excluded. The search process yielded 46 articles of which two were duplicated. After title and abstract screening 13 articles remained for full text reading. Six studies met the inclusion eligibility and were included in the review. Results: The studies involved patients with Chronic Obstructive Pulmonary Disease, Cystic Fibrosis, Pulmonary Hypertension, Interstitial Lung Disease and Pulmonary Fibrosis. Pulmonary function, exercise capacity, quality of life (QoL) and quadriceps force were evaluated. Most interventions were outpatient programs with three months duration, three times a week and session with at least one hour. Protocols included physical training, educational approach and just one included nutritional, psychiatric and social assistant follow-up. The studies presented significant change in the six-minute walking distance, QoL and quadriceps force after PR programs. Conclusion: This review showed the benefits of the PR in the QoL and exercise capacity contributing to the Health Promotion of the patients.

Nutrição e fertilidade em bovinos de leite

Neste relatório são descritas as atividades desenvolvidas durante o estágio curricular em nutrição e fertilidade de bovinos de leite. Engloba também, uma revisão bibliográfica sobre a influência da nutrição na fertilidade e na produção de leite, e um estudo em que se procurou avaliar a influência do controlo da ingestão de água numa vacaria de leite. Para isso, foram utilizados 2 sistemas de produção (sistemas semi-extensivo e intensivo) e maneio alimentar. Independentemente do sistema, observou-se uma estreita relação da ingestão de água com ingestão de matéria seca, e produção de leite (ingerindo 5kg de água por cada kg de matéria seca ingerida por dia e apresentando uma produção de leite cerca de 29% da quantidade de água ingerida). Em ambos os sistemas, o controlo da ingestão de água é um potencial indicador de estro, pois existe uma diminuição significativa da ingestão de água nesse período; Abstract: This report describes the activities carried out during the internship in nutrition and fertility in dairy cattle. It also includes a literature review about the influence of nutrition on the fertility and milk production. It provides a case study that sought to assess the influence of the water intake control in a dairy farm. For this, we used 2 different production systems (semi-extensive and intensive systems) and ration. Regardless of the production or feeding system, there was a close relationship of water intake, dry matter intake and milk production (ingesting 5 kg of water per kg of dry matter, and producing nearly 29% of the total water intake). Both groups showed a decrease in water intake related to oestrus, so it means that it could be a potential indicator of oestrus behaviour and be helpful for the detection of the metabolic disorders.

O efeito do peso vivo às 17 semanas de idade de galinhas poedeiras nos parâmetros produtivos e de qualidade do ovo durante a fase de postura

Dissertação de Mestrado em Engenharia Zootécnica/Produção Animal

Inequities in energy-balance related behaviours and family environmental determinants in European children: baseline results of the prospective EPHE evaluation study

BACKGROUND:Tackling inequalities in overweight, obesity and related determinants has become a top priority for the European research and policy agendas. Although it has been established that such inequalities accumulate from early childhood onward, they have not been studied extensively in children. The current article discusses the results of an explorative analysis for the identification of inequalities in behaviours and their determinants between groups with high and low socio-economic status. METHODS: This study is part of the Epode for the Promotion of Health Equity (EPHE) evaluation study, the overall aim of which is to assess the impact and sustainability of EPODE methodology to diminish inequalities in childhood obesity and overweight. Seven community-based programmes from different European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands) participate in the EPHE study. In each of the communities, children aged 6-8 years participated, resulting in a total sample of 1266 children and their families. A parental self-administrated questionnaire was disseminated in order to assess the socio-economic status of the household, selected energy balance-related behaviours (1. fruit and vegetable consumption; 2. soft drink/ fruit juices and water consumption; 3. screen time and 4. sleep duration) of the children and associated family environmental determinants. The Mann-Whitney U test and Pearson's chi-square test were used to test differences between the low and high education groups. The country-specific median was chosen as the cut-off point to determine the educational level, given the different average educational level in every country. RESULTS: Children with mothers of relatively high educational level consumed fruits and vegetables more frequently than their peers of low socio-economic status. The latter group of children had a higher intake of fruit juices and/or soft drinks and had higher screen time. Parental rules and home availability were consistently different between the two socio-economic groups in our study in all countries. However we did not find a common pattern for all behaviours and the variability across the countries was large. CONCLUSIONS: Our findings are indicative of socio-economic inequalities in our samples, although the variability across the countries was large. The effectiveness of interventions aimed at chancing parental rules and behaviour on health inequalities should be studied.

Nutrição de precisão e manejo alimentar como formas de reduzir a poluição ambiental dos resíduos gerados na produção de suínos e aves.

2016

Folhas de Sacha-inchi na nutrição de juvenis de tambaqui.

O objetivo desta pesquisa foi avaliar níveis de inclusão das folhas de sacha-inchi na nutrição de juvenis de tambaqui.

Sementes de Sacha-inchi na nutrição de juvenis de tambaqui.

O presente trabalho avaliou a influência do uso da semente de sacha-inchi sobre o desempenho zootécnico e as relações corporais de juvenis de tambaqui.