NUTRITIONAL COUNSELING OFFERED TO CHILDREN AND ADOLESCENTS WITH DISABILITIES

Objective: To evaluate the nutritional counseling offered to children and adolescents with disabilities in the municipality of Santa Cruz, RN, Brazil. Methods: Observational, crosssectional, population-based study, developed from May to December 2013, with 102 children and adolescents attending a Children’s Rehabilitation Center. We conducted socioeconomic, demographic, health and lifestyle assessments, and evaluated the received nutritional assistance (whether they had received nutritional counseling from any health professional in relation to food and nutrition, how often it occurred and which professional conducted such counseling). Results: Only 37% (n=37) of parents had received some nutritional guidance. Regarding the frequency of counseling, only 11.8% (n=4) of the youngsters received it 7 or more times/year; 23.5% (n=8) received it 2 to 6 times/year; and most (64.7 %, n=22) received it 1 time/year or less. The length of the nutritional counseling was short: the majority (64.7%, n=22) received only one guidance session throughout the whole period attending the institution, and less than 15% (n=5) received counseling for more than six consecutive months. For the majority (73.5%, n=25), the amount of time receiving nutritional guidance has not reached half of the monitoring period. Nutritional counseling was carried out mainly by nutritionists (89.2%, n=33). Conclusion: There was a low frequency of nutritional counseling directed specifically to the disabilities presented by the participants. When such activity was conducted, it occurred irregularly during the participant´s follow-up, only during a short period of time, and lacking connection with the monitoring by the multidisciplinary team.

Factors Affecting the Body Mass Index in Adolescents in Portuguese Schools

The prevalence of overweight and obesity among children is increasing; hence, it was aimed to assess the Body Mass Index (BMI) in school children aged from 10 to 18 years for girls and to 17 for boys, as well as to identify the factors influencing BMI. This study included 742 students who answered a questionnaire previously approved for application in schools. The results showed some sociodemographic factors associated with BMI classes: age, school year, practicing high competition sport, being federate in a sport or having a vegetarian diet. The educational factors associated with BMI classes included only seminars given at school by a nutritionist. Behavioural factors significantly associated with BMI included: learning in classes, playing in the open air, reading books or use of internet. As conclusion, the results demonstrated that several factors affect BMI, and hence some actions could be taken in order to change them so as to reduce the prevalence of overweight, namely reinforcing the role of school and a more active participation of nutritionists in the education of the adolescents.

Avaliação da política de segurança alimentar implementada através dos restaurantes populares do Rio Grande do Norte

This survey has to general objective to evaluate the Food Safety Policy implemented by Restaurantes Populares do Rio Grande do Norte. The survey is qualitative of type exploratory and descriptive. The universe of survey is all Units of Food and Nutrition (UAN) of the Restaurantes Populares do Rio Grande do Norte. To collects of data were used two instruments: interview and form. The interviews were intended to analyze the four axes of the Food Safety: access, food quality, production and marketing of food and organizational arrangement. The form was used to check the quality of nutrition and sanitary-hygienic food served. We used two types of forms: a spreadsheet with the weekly menu and the portions served to verify that the meals serve the nutritional needs proposed by the program; and the check-list of ANVISA to verify the sanitary-hygienic conditions in each unit. Through the survey data and analyses made observe that the access category have some problems such as lack of registration, lack of advertising of Restaurants and wastage of public resources, making policy that should be of included in a policy of exclusion. In the nutritional aspect there is neglect on the daily nutritional goal, because it is not accomplished nutritional analysis of menu offered, the nutritionists do not know what should be the nutritional value of meals served; in the hygienic-health aspect trough the problems identified is concludes that there is no guarantee of food quality hygienic-sanitary, committing the program as a Food Safety Program. About the production and marketing of food is observed some problems as: the goal of sale of meals is not achieved in full, the purchase of genres does not stimulate the local economy, nor generates jobs and income, and inefficient performance of the MEIOS's supervision. In the analysis of organizational arrangement is concluded that the partnerships are beneficial, despite some negative points, therefore, are these partnerships the problems of non-compliance, as both the MEIOS and Nutriti of important criteria established in the partnership. Therefore, it is understood that the Programa Restaurantes Populares in its original formulation is proposed to be a food safety policy, but has some problems that impossible to meet its goal, making it unprofitable like Food Safety Policy

Experiences of health professionals with nutritional support of critically ill patients in tertiary hospitals in Malawi

Background Nutritional support is a recognized determinant of outcome in critically ill patients. Development of critical care services in low-income countries has not been accompanied by certain appropriate ancillary services and interventions, such as adequate nutritional support. This study was designed to investigate the experiences of health professionals who have provided nutritional supportive care to critically ill patients admitted to two major central hospitals in Malawi, with the aim of identifying the common practices in nutritional support in these settings. Materials and Methods A cross-sectional study in which 50 health professionals working in intensive care and high dependency units, admitting both adult and pediatric patients, were interviewed using a semi-structured questionnaire. Data were coded and then analyzed using SPSS version 16.0. Responses between the two hospitals were compared using Fisher’s exact test. Results There was no difference in the composition of respondents from the two hospitals. About 60% of respondents had had experience with nutritional supplementation in their patients—mainly enteral. The most commonly used formulations were the “ready-to-use therapeutic feeds,” followed by modified milk. A high percentage of respondents (40%) reported having used dextrose solution as the sole nutritional supplement. Lack of in-service training, nonexistent nutrition protocols pertaining to acutely and critically ill patients, and a lack of clinical nutritionists were the major challenges identified. Conclusion Knowledge of nutrient supplementation was poor among the respondents. The use of ready-to-use therapeutic feeds was quite common, although there is no evidence of its effectiveness in care of acutely critically ill patients. There is a need to establish nutritional support teams in these tertiary hospitals. Clinical nutritionists would ideally help train and play leadership roles in such teams, who would be responsible for assessing patients for their nutritional needs, and ensuring that the feeds provided to patients are appropriate and adequate for their needs.

Nurses knowledge of health effects of dietary fibre

Introduction: Nurses accompany patients throughout their health care to prevent and treat disease, so their knowledge about diet and dietary fibre is key to successful diet therapy, which is an essential part of a patient's non-pharmacological treatment. It is known from the literature that a high proportion of nurses have limited knowledge about diet therapy and about sources of soluble fibre and other foods that can prevent or treat certain diseases. Given the position of nurses as key providers of dietary guidance, and given the health benefits of dietary fibre, we wanted to assess the level of fibre-related knowledge among nurses in Croatia. Material and Methods: Cross-sectional study based on data collected between October 2014 and March 2015 using a survey developed by the CI&DETS Polytechnic Institute in Viseu, Portugal. The survey contains questions about demographic characteristics as well as about knowledge of sources of dietary fibre, recommended daily intake and effects of fibre intake on particular diseases. The study included a total of 369 nurses from two health institutions and one nursing school from Croatia older than 18 years. Differences in knowledge were assessed for significance using the non-parametric Mann-Whitney U test. Possible associations among variables were explored using Spearman's rank correlation. For all statistical analyses, the threshold of significance was defined as P<0.05. Results: The level of knowledge among nurses in Croatia about dietary fibre varied from «undecided» to «partial knowledge». The median for level of knowledge ranged from 3 to 4 with low variability ranging from 0.11 to 0.33. Average levels of knowledge in percentages varied from 57.6% to 82.1%. Nurses with higher education levels showed significantly higher knowledge levels about the influence of dietary fiber intake on the risk of certain diseases (p = 0.007), constipation (p = 0.016), bowel cancer (p = 0.005) and breast cancer (p = 0.039). Conclusion: The level of nurses’ knowledge about dietary fiber is suboptimal. This indicates the need to strengthen nurse education in the areas of diet and diet therapy. Increase the level of knowledge of nurses about nutrition can positively influence the quality of care.