Maria do Carmo Soares de Freitas

O Programa Saúde da Família: contribuições para uma reflexão sobre a inserção do nutricionista na equipe multidisciplinar

Brazil is presently experiencing the implementation of a differentiated model to provide health basic care, conduced by a multidisciplinary action directed towards an intervention aiming at then population health promotion, consolidated on the Brazilian Family Health Program. The objective of promotion, consolidated on the specially in Brazil, will not be achieved unless effective action in the area of food health monitoring system. Thus, this paper reflects on the epidemiologic transition being experienced in Brazil and discusses the food and nutritional problems in this process. Some basic proposals of Family Health Program and Food and Nutrition National Policy area also emphasized. This article still argues that the nutritionist can contribute yo the necessary transformation, acting on the practices and results of this new model of intervention. Finally, the authors focus on the impossibility of effective transformation of health basic care without the support of professionals who have been studding and practicing the food and nutrition surveillance and the dietary assistance to the populations.

Segurança alimentar e nutricional: a produção do conhecimento com ênfase nos aspectos da cultura

This essay on food safety stresses the importance of cultural aspects in assessing food and nutrition policies. It thus intends to contribute to topic discussions in educational centers interested in research on this issue. Such an objective involves various disciplines, including those concerned with law and culture. A bibliographical review was carried out in order to contextualize food and nutritional safety problems within the macro and micro-social spheres. Anthropological studies, the analysis of official documents and sample situations related to the subject were considered in an attempt to strengthen concepts comprising cultural aspects in order to improve the evaluation of social policies on nutritional and food safety. The anthropological approach is emphasized for an understanding of the diverse meanings of chronic hunger, one of the most perverse effects of food and nutritional insecurity. It was concluded that a better understanding of cultural factors brings forth a new analytical perspective for the study and evaluation of the efficacy of food and nutritional safety, beyond the explanatory and normative scope of the biomedical model.

Prática do aleitamento materno em comunidades rurais do semi-árido baiano

A Research project in the establishment and duration of total and exclusive breast-feeding in rural communities of Cansação, BA, Brazil, is presented. It included 226 children, from zero to two years old, of families of peasants living on small-holdings in one of the driest and poorest regions of the Brazilian Northeast. The data were collected through questionnaires answered by mothers or any adult responsible for the child during 1988 and 1989. It relates to all children from these families who were two years of age at the time of the study. The survival time was the statistical method used to calculate the median duration of breast-feeding; 91.6% of the 226 children started to be breast-fed. This finding shows that the establishment of the breast-feeding was high. The median duration of total breast-feeding was of 90.28 days and exclusive breast-feeding presented a median duration of 0.1 day. Through the establishment of breast-feeding can be considered high, the median duration of total breast-feeding is extremely short and that of exclusive breast-feeding insignificant.Com o objetivo de conhecer p estabelecimento e duracao do aleitamento materno total e exclusivo em comunidades rurais do Semi-Arido Baiano, Brasil, foram estudadas 226 criancas de O a 2 anos de idade, filhas de pequenos produtores rurais que vivem numa das regioes mais secas do nordeste brasileiro, de pobreza absoluta. Os dados referem-se a todas as criancas da familia que a data do estudo tinham ate 2 anos de idade. Os dados foram coletados por meio de formularios aplicados as maes ou responsaveis pelo menor, no periodo de 1988 a 1989. A tabua de vida foi o recurso estatistico utilizado para o calculo da duracao mediana do evento. Das 226 criancas que integraram o estudo, 91,6 iniciaram a amamentacao ao peito. A duracao mediana do aleitamento total foi de 90,28 dias e o aleitamento exclusivo apresentou duracao mediana de 0,1 dia. Ainda que o estabelecimento da amamentacao ao peito possa ser considerado alto, a duracao mediana do aleitamento total foi extrememente curta, e o aleitamento exclusivo foi desprezivel.

Perfil do nutricionista do programa nacional de alimentação escolar na região Nordeste do Brasil

OBJECTIVE: This study analyzed the profile of dieticians who work for the National School Food Program and participated in training courses offered by the Schoolchildrens Food and Nutrition Collaborator Center of the Northeastern states in 2007. METHODS: This descriptive, exploratory study used nonprobability sampling to recruit 434 dieticians. Education, work experience, work, activities performed at National School Food Program and sociodemographic variables were analyzed. Pearsons chi square test was used to investigate possible associations between time working for National School Food Program and performed activities. RESULTS: Most participants were females (97.2%) aged 20 to 30 years (42.7%) and graduated more than ten years ago (40.2%). Most were also working only part time in the program (53.3%). The income of most dieticians ranged from 2-5 minimum salaries (64.1%). Most dieticians who frequently performed the analyzed activities had been in National School Food Program for 2-5 years (p<0.05). CONCLUSION: National School Food Program dieticians take on responsibilities that overlap with other areas of knowledge, especially education and administration. In parallel, despite the professional satisfaction, the participants were not very satisfied with their work conditions.

Uma abordagem fenomenológica da fome

This study collects some elements to deepen the understanding of health and nutrition. Its epistemological dimension refers to the hermeneutics of Paul Ricoeur and the phenomenology, and seeks to interpret the phenomenon of hunger, which is felt and expressed by different individuals in their specific social contexts. The approach is based on an ethnographical study of hunger carried out in a poor district in Salvador, state of Bahia; objectively, this work emphasizes an approach to the understanding of the phenomenon of hunger, from the point of view of social actors who live under conditions of extreme poverty.

Escola: lugar de estudar e de comer

This study seeks to discuss the significance of school nutrition expressed by students in public schools from the state of Bahia, Brazil. The objective is to understand the symbolic aspects associated with school nutrition. The results of a survey into the significance of nutrition offered by the Brazilian School Nutrition Program (PNAE) expressed by students from six public schools in municipalities in the state of Bahia, Brazil, are presented. A qualitative approach to understand nutrition at school and notions about healthy food by analyzing oral and written narratives of adolescents is used. The reports point to opposing stances between food in the home and food outside the home. What is customary can appear strange depending on the time and place. In this sense, they do not make an association between healthy food and PNAE. The food culture requires students to eat food on two occasions: breakfast and lunch (or dinner). These are aspects that are distinct, however they must be combined in school, because for these social actors, studying and eating are necessities that complement each other.

Trabalho artesanal, cadências infernais e lesões por esforços repetitivos: estudo de caso em uma comunidade de mariscadeiras na Ilha de Maré, Bahia

Non-industrial labor is still widespread in Brazil. An appropriate approach ought to consider different social specificities from those of salaried-work relations. The scope was to examine non-industrial work practices, specifically those of extractive shellfishing, and their relation to health conditions in a small-scale fishing community. It focused on the cadences and time contingencies, as well as other working conditions, related to the development of ailments such as repetitive strain injury -RSI. A qualitative-ethnographic study was conducted between 2005 and 2007 in a community of 800 inhabitants, located on Mare Island in the state of Bahia. In a population consisting of fishing households, thirty families were interviewed, observed at work and - in cases of suspected RSI -referred to a specialized health service. The seriousness of the working conditions became evident, especially with respect to RSI. By way of illustration, an average frequency of 10,200 repetitive movements per hour were verified in extractive shellfishing, while the official Brazilian norm (NR17) for a keyboarder establishes a maximum of 8,000 movements per hour. This suggests that women shellfishers ought to be included in repetitive strain injury risk groups.

A nutrição clínica ampliada e a humanização da relação nutricionista-paciente: contribuições para reflexão

The extended clinical nutrition conception is a new theme for the field of nutrition, especially clinical nutrition. Given the process of reformulation of the health practice scenarios within the Unified Healthcare System, this theme instigates a substantial interest in scientific production, in the formation and clinical practice of the dietician with the use of communication competencies and the magnification of the technical and nutritional look on the process health-disease-care, which may contribute to the reconfiguration of the relationship dietician-patient with the purpose of amplifying its humanization. This trial shows how the conception of an extended clinical nutrition can contribute for the reflection on broadening the humanization of the relationship dietician-patient in health services. The trial is designed in two parts: the starting point and the continuation point. At the starting point, official publications on the social, historical and political conformations of the biomedical model and its repercussion on the clinical practice are analyzed. At the continuation point, nutritional clinic is observed as a social practice and the extended clinical conception is used for discussing the possibilities of restructuring clinical nutrition and broadening its knowledge and techniques beyond a restricted and restrictive biomedical model. Finally, extended clinical nutrition is discussed, with the possibility of rethinking the relationship dietician-patient and proposing, in this sense, its humanization, the incorporation of non-biomedical contents, valuing practical knowledge and listening skills, the organization of knowledge and exploration of dialogue in the current practice of clinical nutrition.

Bró, caxixe e ouricuri estratégias de sobrevivência no semi-árido baiano

This study was developed within the context of the project Cansancao - PROCAN- developed by the Federal University of Bahia, Brazil. The study analyzed information concerning cultural patterns which surround the eating habits of the social groups which live in the semi-arid region of Bahia. It is an ethnographic study carried out over the period of 1987 to 1990. The subject of the investigation was the cultural aspect of eating habits of female rural workers, observing the strategies of eating survival as concrete actions to ensure the reproduction of the family unit. The fear of imminent illness and death proves to be fundamental references as ways of conceiving life and of defining food habits, supported by their own understanding of their worlds. The food habits in Cansancao reveal a relationship between the body survival and the reproduction of the family unit, permeated by the daily life in a drought-stricken region. The main activity, the work in the fields, subordinated to precarious living conditions, allows the production and reproduction of ways of interpreting life and, in particular, defines various concepts and classifications about the need to provide sustenance to the body. In some areas of Cansancao food is considered linked to its commercial value; however, the phenomenon of drought still remains the determining factor in the food culture of the population and in its concrete actions to solve the lack of food within the family group.

O nutricionista no programa de alimentação escolar: avaliação de uma experiência de formação a partir de grupos focais

OBJECTIVE: This study assessed a training program for dieticians, actors of the Brazilian School Food Program, in Northeast Brazil. This program was developed by a partnership between the Schoolchildrens Food and Nutrition Collaborator Center from the Federal University of Bahia and National Education Development Fund, from 2007 and 2008. METHODS: The focus group method was administered to dieticians who participated in the training program. Four focus groups were done and the data were organized into two categories: one about learning during the training program and one about the ability to make changes. RESULTS: Most participants were females aged 20 to 35 years. Their participation in the training program had been at least three months before the study. Assessment of the training program showed that the program improved their technical and scientific knowledge about themes related to professional practice and about the ethical and political dimension of their work. The program encouraged mobilization for possibly strengthening the category, incentivized partnerships among different agents and sectors and promoted the planning of new law-enforcement actions. CONCLUSION: The dialogical perspective was striking for the participants, enabling them to confront their realities and collectively reflect on the dieticians role in the field of school food.