Nágela Valadão Cade

Preditores socioeconômicos da qualidade da alimentação de crianças

OBJECTIVE To develop a diet quality index and to analyze socioeconomic factors associated with low child diet quality. METHODS A cross-sectional study was performed with a representative sample of 1,282 children aged between seven and ten years, living in the city of Vitória, Southeastern Brazil, in 2007. Children were randomly selected from 26 public schools and six private schools. Data on socioeconomic characteristics and life habits of children were obtained from a structured questionnaire, sent to homes and preferably completed by mothers. A food frequency questionnaire was created from studies performed with Brazilian children and tested in a public school. An index entitled Indice de Alimentação do Escolar (ALES School Child Diet Index) was designed to assess diet quality, taking in consideration the nutritional recommendations for the Brazilian population and the habit of having breakfast. The association between diet quality and socioeconomic factors was analyzed using multinomial logistic regression. Adjusted odds ratios and 95% confidence intervals were estimated for the variables that remained in the model. RESULTS According to the ALES index, approximately 41% of the children studied had low diet quality (boys= 37.7%, girls= 42.7%, p= 0.179). There were no significant differences between sex, age, maternal employment status and living with the mother and diet quality. The variables that remained associated with low diet quality were low maternal level of education (OR= 3.93; 95% CI: 2.58;5.99), father not present in the household (OR= 2.03; 95% CI: 1.68;2.99) and not having lunch at the table (OR= 1.47; 95% CI: 1.12;1.93). CONCLUSIONS Low maternal level of education increased the probability of a child not consuming a good quality diet, whether due to lack of access to healthy foods and adequate information or poorer ability to discern what is healthy.OBJETIVO: Desarrollar indice de calidad de la alimentacion y analizar factores socioeconomicos asociados con la baja calidad de la alimentacion entre ninos. METODOS: Estudio transversal realizado con muestra representativa de 1.282 ninos de siete a diez anos de edad residentes en Vitoria, sureste de Brasil, en 2007. Los ninos fueron sorteados en 26 escuelas publicas y seis privadas. Datos socioeconomicos y de habitos de vida de los ninos fueron obtenidos a partir de cuestionario estructurado enviado al domicilio y llenado preferiblemente por sus madres. Un cuestionario de frecuencia alimentaria fue construido a partir de estudios realizados con ninos brasileras y evaluado en escuela publica. Para evaluacion de la calidad de la alimentacion fue desarrollado un indice, denominado Alimentacion del Escolar (Indice ALES), llevando en consideracion las recomendaciones nutricionales para la poblacion brasilera y el habito de realizar el desayuno. La asociacion entre la calidad de la alimentacion y factores socioeconomicos fue investigada utilizando la regresion logistica multinomial. Se estimaron odds ratio ajustados y los intervalos con 95% de confianza para las variables que permanecieron en el modelo. RESULTADOS: Segun el Indice ALES, aproximadamente 41% de los ninos estudiados poseian alimentacion de baja calidad (ninos=37,7%, ninas= 42,7%, p=0,179). No fueron encontradas diferencias significativas entre sexo, edad, condicion de empleo materno y vivir con la madre y calidad de la alimentacion. Las variables que permanecieron asociadas con la baja calidad de la alimentacion fueron baja escolaridad materna (OR=3,93; IC 95%: 2,58;5,99), ausencia del padre en el domicilio (OR= 2,03; IC 95%: 1,68;2,99) y no almorzar en la mesa (OR= 1,47; IC 95%: 1,12;1,93). CONCLUSIONES: La baja escolaridad materna aumento la probabilidad del nino no consumir una alimentacion de buena calidad, sea por la falta de acceso a alimentos saludables e informaciones adecuadas y o por la menor capacidad de discernir lo que es saludable.

Fatores de risco cardiovascular em crianças de 7 a 10 anos de área urbana, Vitória, Espírito Santo, Brasil

The study aimed to identify the simultaneous occurrence of cardiovascular risk factors in children 7 to 10 years of age in Vitória, Espírito Santo State, Brazil, and investigate associated socioeconomic variables. In a sample of 1,282 children, anthropometric data were obtained and blood pressure was measured with an automatic device. Socioeconomic, nutritional, and physical activity data were obtained with a questionnaire. To evaluate the simultaneous occurrence of cardiovascular risk factors, an index was developed including overweight, high blood pressure, poor eating, and sedentary leisure > 4 hours/day. The simultaneous presence of four cardiovascular risk factors was defined as high risk. Socioeconomic status and maternal schooling were included in the logistic regression model. Some 34% of the children presented two cardiovascular risk factors, 20% three factors, and 6.4% four cardiovascular risk factors. Maternal schooling remained associated with high cardiovascular risk (OR: 7.36, 95%CI: 2.09-25.97) and medium risk (OR: 2.57, 95%CI: 1.58-4.20). Low maternal schooling was the most important factor associated with cardiovascular risk.

A teoria do déficit de autocuidado de Orem aplicada em hipertensas

A study carried out with the objective of evaluating Orems nursing self-care theory (TDAC) in women with hypertension. Four hypertensive women in an outpatient clinic were interviewed using a form with open and multiple-choice questions on conditioning factors and self-care requirements. The data were analyzed according to the TDAC theoretical framework. Based on the self-care requirements for hypertensive people, the existence or non-existence of adjustment between self-care capacity and self-care need as well as the inhibitors and enhancers of such adjustment were identified. It was concluded that TDAC allowed to identify important aspects related to hypertensive people which must be dealt with by nurses.Estudo realizado com o objetivo de avaliar a Teoria do Deficit de Autocuidado de Orem (TDAC) em mulheres portadoras de hipertensao arterial. Foram entrevistadas quatro mulheres hipertensas em tratamento ambulatorial mediante formulario de entrevista aberta e fechada sobre os fatores condicionantes e os requisitos para o autocuidado. Os dados foram analisados segundo o referencial da TDAC. A partir dos requisitos de autocuidado que envolvem o hipertenso, foi identificada a existencia ou nao de adequacao entre a capacidade e a demanda de autocuidado, e os facilitadores e dificultadores desta adequacao. Conclui-se que a TDAC possibilitou identificar aspectos importantes do hipertenso para serem trabalhado pelo enfermeiro.

Efeitos da ansiedade sobre a pressão arterial em mulheres com hipertensão

Estudo descritivo, associativo, que objetiva conhecer a relacao da ansiedade com os niveis de pressao arterial em mulheres hipertensas e da ansiedade com o tempo de tratamento da hipertensao. Foram pesquisadas 78 mulheres em tratamento para hipertensao no InCor, mediante o Inventario de Ansiedade de Spilberger - IDATE, e a pressao arterial verificada, utilizando-se da medida indireta, obtida pelo metodo auscultatorio. Os dados foram submetidos a analise estatistica, com nivel de significância de 5%. A amostra apresentou traco e estado de ansiedade moderados e medias de pressao acima do normal, compativel com hipertensao estagio 1. Nao houve diferenca estatisticamente significante entre pressao arterial e niveis de ansiedade e entre o tempo de tratamento para hipertensao e niveis de ansiedade.This descriptive and associative study aims to examine the relation between anxiety and blood pressure levels in women with hypertension and between anxiety and hypertension treatment time. A research was carried out among 78 women under hypertension treatment at InCor Hospital, Brazil, through Spilberger Anxiety Inventory--IDATE and blood pressure was checked by means of the indirect measure, obtained by the auscultatory method. Data were submitted to statistic analysis at a 5% significance level. The sample displayed moderate traces and states of anxiety and average blood pressure above normal, compatible with hypertension stage 1. No significant statistical difference was observed between blood pressure and anxiety levels, nor between hypertension treatment time and anxiety levels.

Anxiety effects on blood pressure of women with hypertension

Estudo descritivo, associativo, que objetiva conhecer a relacao da ansiedade com os niveis de pressao arterial em mulheres hipertensas e da ansiedade com o tempo de tratamento da hipertensao. Foram pesquisadas 78 mulheres em tratamento para hipertensao no InCor, mediante o Inventario de Ansiedade de Spilberger - IDATE, e a pressao arterial verificada, utilizando-se da medida indireta, obtida pelo metodo auscultatorio. Os dados foram submetidos a analise estatistica, com nivel de significância de 5%. A amostra apresentou traco e estado de ansiedade moderados e medias de pressao acima do normal, compativel com hipertensao estagio 1. Nao houve diferenca estatisticamente significante entre pressao arterial e niveis de ansiedade e entre o tempo de tratamento para hipertensao e niveis de ansiedade.This descriptive and associative study aims to examine the relation between anxiety and blood pressure levels in women with hypertension and between anxiety and hypertension treatment time. A research was carried out among 78 women under hypertension treatment at InCor Hospital, Brazil, through Spilberger Anxiety Inventory--IDATE and blood pressure was checked by means of the indirect measure, obtained by the auscultatory method. Data were submitted to statistic analysis at a 5% significance level. The sample displayed moderate traces and states of anxiety and average blood pressure above normal, compatible with hypertension stage 1. No significant statistical difference was observed between blood pressure and anxiety levels, nor between hypertension treatment time and anxiety levels.

Recrutamento de participantes no Estudo Longitudinal de Saude do Adulto

OBJETIVO: Apresentar as estrategias de comunicacao e recrutamento no Estudo Longitudinal de Saude do Adulto (ELSA-Brasil) e discutir os resultados alcancados na constituicao da coorte. METODOS: As estrategias foram voltadas a divulgacao, a institucionalizacao e ao recrutamento propriamente dito. As acoes de comunicacao pretenderam promover o fortalecimento de imagem institucional positiva para o estudo, a gestao de conhecimentos e o dialogo eficaz com seu publico-alvo. Foi criado web site oficial visando dialogar com diferentes publicos, funcionar como difusor cientifico e contribuir para a consolidacao da imagem do estudo perante a sociedade. RESULTADOS: Foram recrutados 16.435 mulheres e homens, servidores ativos e aposentados de seis instituicoes publicas de ensino e pesquisa para constituir a coorte de 15.105 participantes. As metas de recrutamento foram plenamente alcancadas nos seis centros, com leve predominio de mulheres e daqueles mais jovens, e um pouco menos de servidores com menor escolarizacao. CONCLUSOES: As estrategias utilizadas se mostraram adequadas e essenciais para o sucesso da captacao e participacao dos servidores.

Expectativas de adolescentes em relação a mudanças do perfil nutricional

This article presents results of a research of nature quanti-qualitative on nutrition and adolescents of Centro Salesiano do Menor, located in Vitoria (ES). The aim of this study was to know the nutritional profile and expectations of the adolescents in relation the changes in the nutritional profile. Structured interview with subjective and objective questions was realized with 43 adolescents 14 to 17 years old and collected anthropometric date to valuation of the state nutritional according to the body mass index (BMI). Fragments of the speeches were selected and transcripts in the text as form of briefing of the open answers. The majority (86%) was classified as eutrofica and had disclosed to dissatisfaction with the body and a great concern with the beauty. The results had evidenced the importance given to the aesthetic one, as the main reason to desire a corporal change. Difficulties had been told in what it says respect to the alimentary control and the accomplishment of physical activity. Feeling of discrimination of the society to that they do not correspond to the beauty standard appeared in the answers of the adolescents. One concludes that the adolescents present perception of its weight not have correspondence with the found results of BMI and low self-esteem, desiring changes.

Sodium and potassium intake estimated using two methods in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

CONTEXT AND OBJECTIVE Sodium and potassium intake from different food sources is an important issue regarding cardiovascular physiology. Epidemiological assessment of the intake of these electrolytes intake is done through food frequency questionnaires or urinary excretion measurements. Our aim was to compare these methods using a sample of Brazilian civil servants. DESIGN AND SETTING Cross-sectional baseline evaluation from the Brazilian Longitudinal Study of Adult Health. METHODS Sodium and potassium intake was obtained using two methods: a semi-quantitative questionnaire including 114 food items; and overnight 12-hour urinary excretion measurement. Sodium and potassium estimates obtained through the questionnaire were adjusted for energy intake using the residual method. Urinary excretion measurements were considered valid if they met three adequacy criteria: collection time, volume and total creatinine excretion. Mean nutrients were estimated, and Spearman correlations were calculated. Sodium and potassium intake was categorized into quintiles, and weighted kappa coefficients and percentage agreement were calculated. The significance level for all tests was 0.05. RESULTS Data from 15,105 participants were analyzed, and significant differences between mean intakes of sodium (questionnaire: 4.5 ± 1.7 g; urine: 4.2 ± 2.1 g) and potassium (questionnaire: 4.7 ± 1.8 g; urine: 2.4 ± 1 g) were found. Weak agreement was found for sodium (K = 0.18) and potassium (K = 0.16). The percentage disagreement between methods ranged from 41.8 to 44.5%, while exact concordance ranged from 22.1% to 23.9%. CONCLUSIONS The agreement between the food frequency questionnaire and urinary excretion measurements for assessment of sodium and potassium intakes was modest.

Modelagem hierárquica de determinantes associados a internações por condições sensíveis à atenção primária no Espírito Santo, Brasil

The aim of this study was to investigate the relationship between health services organization and hospitalization rates for ambulatory care sensitive conditions after adjusting for socioeconomic and demographic variables in municipalities (counties) in Espírito Santo State, Brazil. In an ecological study, data were collected from the Brazilian Unified National Health System (SUS) on the following variables: hospitalization for ambulatory care sensitive conditions, city size, demographic and socioeconomic characteristics, and health services organization. Rates were analyzed by Poisson regression with robust variance. Models were adjusted for the total population and age group. The explanatory variables were ordered hierarchically. Hospitalization rates for ambulatory care sensitive conditions were associated with illiteracy rate (RR: 1.08-1.17), proportion of beds in the SUS (RR: 1.09-1.12), urbanization (RR: 1.02-1.03), proportion of blacks (RR: 0.97-0.98), and health insurance coverage (RR: 0.97-0.98). Some determinants of hospitalization for ambulatory care sensitive conditions involve patterns of health services use and lie outside the scope of primary care.O objetivo deste estudo foi investigar a associacao entre a organizacao dos servicos de saude e as taxas de internacoes hospitalares por condicoes sensiveis a atencao primaria apos ajuste para variaveis socioeconomicas e demograficas no contexto dos municipios do Espirito Santo, Brasil. Estudo ecologico das internacoes do Sistema Unico de Saude (SUS) com as variaveis: internacoes hospitalares por condicoes sensiveis a atencao primaria, porte municipal, indicadores demograficos, socioeconomicos, organizacao e indicadores de desempenho dos servicos de saude. Realizou-se analise multivariavel por regressao de Poisson com ajuste robusto da variância. Foram ajustados modelos para a populacao total e por faixas etarias. Ordenaram-se as variaveis explicativas segundo modelo hierarquizado. Houve associacao a risco de internacoes hospitalares por condicoes sensiveis a atencao primaria com o percentual de analfabetismo (RR: 1,08-1,17), proporcao de leitos SUS (RR: 1,09-1,12), urbanizacao (RR: 1,02-1,03), proporcao de negros (RR: 0,97-0,98) e cobertura de plano de saude (RR: 0,97-0,98). Ha determinantes das internacoes hospitalares por condicoes sensiveis a atencao primaria que implicam no padrao de utilizacao dos servicos e estao fora do escopo da atencao primaria.

Prevalência da abstinência ao tabaco de pacientes tratados em unidades de saúde e fatores relacionados

The scope of this study is to discover the prevalence and identify the variables related to tobacco abstinence in patients treated for quitting smoking through group therapy or support groups in primary health care units of the municipality of Vitoria, State of Espirito Santo, in the year of 2009. A cross-sectional study was performed with 160 participants of the support groups who participated in 75% of the sessions. Telephone interviews were conducted 9 to 20 months after treatment and secondary data from the text of the initial interview were used. Chi-square and Fischer tests were used in statistical analysis and the statistical significance was 5%. It was found that 28.7% were abstainers, 51.9% had relapsed and 19.4% never stopped smoking. There was a statistical difference between the groups in the variables of marital status (0.039), previous attempts to stop smoking (0.029), amount of cigarettes smoked per day (0.019), use of medication (0.001) and reported anxiety/mood disorders (0.040). The abstaining group included more married people, people who had tried to quit smoking several times, smoked fewer cigarettes/day, showed less anxiety/mood change. The incidence of abstinence was similar to other studies and the highest percentage of subjects relapsed.