Nursing care for maintenance and prevention of enteral probe loss

Objective: To understand the perception and practice of nursing professionals about care related to the maintenance and prevention of enteral probe loss in hospitalization units. Methods: Quanti-qualitative and descriptive study carried out in a large general hospital in Belo Horizonte, Minas Gerais, Brazil. It was attended by 40 professionals, 19 nurses and 21 nursing technicians, interviewed in September and October 2018. Secondary data were collected from the medical records of 114 patients who were using an enteral probe from 01/01/2017 to 01 /01/2018. Results: It was observed that the majority (68.4%) of patients undergoing enteral nutritional therapy were over 60 years of age. Nutritional causes were the main indication for the use of probes, occurring in 51.7% of patients. Most (90.0%) of professionals recognize that washing the probe is the main care in terms of preventing loss of this device and recognize that the biggest complication of its use is bronchoaspiration. Conclusion: It was found that nursing professionals have knowledge about care related to maintenance and prevention of probe loss, but the perception of these professionals is different from the information introduced in the medical records, which may highlight a disarticulation between knowledge and care practice

Covid-19 pandemic impacts on follow-up of child growth and development

OBJECTIVE To analyze the impact of the covid-19 pandemic on the use of primary health care services to follow-up the child growth and development in Brazil. METHOD A total of 7.9 million consultations of children (0–2 years old) across Brazil between March 2017 and May 2020 were studied. Differences between medians were analyzed using non-parametric tests, the Global Moran Index (IGM) and the Local Indicators of Spatial Association. RESULTS During the initial period of the pandemic, the median number of consultations was significantly lower than the same period in previous years, reducing more than 50%. The drop in 2020, compared to 2019, ranged from 49% to 62.2% across all regions of the country, except the South. The percentage reduction registered in 2019–2020 showed significant spatial autocorrelation (IGM = 0.20; p = 0.04), with the presence of low-low (states with reduction between 29% and 51%) and high-high (states with reduction between 55% and 69%) spatial clusters. CONCLUSION The covid-19 pandemic impacted the follow-up of child growth and development in primary health care services in Brazil, with a geographically uneven reduction

Efficacy of different strategies to treat anemia in children: a randomized clinical trial

<p>Abstract</p> <p>Background</p> <p>Anemia continues to be a major public health problem among children in many regions of the world, and it is still not clear which strategy to treat it is most effective.</p> <p>Objective</p> <p>To evaluate the efficacy and children's acceptance of several recognized strategies to treat anemia.</p> <p>Methods</p> <p>Non-breastfed children (n = 577), 6 to 43 mo of age, were screened for the trial; 267 were anemic (hemoglobin < 11.7 g/dL), and 266 of those were randomized into 1 of 5 treatments to received daily either: an iron supplement (IS), an iron+folic acid supplement (IFS), a multiple micronutrient supplement (MMS), a micronutrient-fortified complementary food as porridge powder (FCF), or zinc+iron+ascorbic acid fortified water (FW). The iron content of each daily dose was 20, 12.5, 10, 10 and 6.7 mg respectively. Hemoglobin (Hb), ferritin, total iron, weight and height were measured at baseline and after 4 months of treatment. Morbidity, treatment acceptability and adherence were recorded during the intervention.</p> <p>Results</p> <p>All treatments significantly increased Hb and total iron concentration; ferritin did not change significantly. Groups MMS, IS and IFS increased Hb (g/dL) [1.50 (95%CI: 1.17, 1.83), 1.48 [(1.18, 1.78) and 1.57 (1.26, 1.88), respectively] and total iron ((μg/dL) [0.15 (0.01, 0.29), 0.19 (0.06, 0.31) and 0.12(-0.01, 0.25), respectively] significantly more than FCF [0.92 (0.64, 1.20)] but not to FW group [0.14 (0.04, 0.24)]. The prevalence of anemia was reduced to a greater extent in the MMS and IFS groups (72% and 69%, respectively) than in the FCF group (45%) (p < 0.05). There were no significant differences in anthropometry or in the number of episodes of diarrhea and respiratory infections among treatment groups. The supplements MMS and IS were less acceptable to children, than IFS, FCF and FW.</p> <p>Conclusion</p> <p>The three supplements IS, ISF and MMS increased Hb more than the FCF; the supplements that contained micronutrients (IFS and MMS) were more effective for reducing the prevalence of anemia. In general, fortified foods were better accepted by the study participants than supplements.</p> <p>ClinicalTrial.gov Identifier</p> <p>NCT00822380</p

Adequação da ingestão de micronutrientes em crianças anêmicas em Município do Alto Vale do Jequitinhonha

O estudo objetivou avaliar a adequação do consumo de Ferro, Retinol, Zinco, Cálcio e Ácido Ascórbico em crianças anêmicas menores de três anos em distritos do município de Diamantina – MG. Trata-se de avaliação dietética a partir de informações do Registro Alimentar de três dias de 72 crianças com anemia ferropriva, selecionadas em unidades da Estratégia Saúde da Família de oito distritos de Diamantina. As crianças foram agrupadas em duas faixas de idade (faixa 1: 07 a 11 meses; faixa 2: 12 a 33 meses), estando ou não em aleitamento materno. Observou-se inadequação do consumo para todos os nutrientes, independente da faixa etária. Ao relacionar a inadequação ao fato da criança estar em aleitamento ou não, observou-se associação significativa apenas para o Cálcio (p=0,02). Os achados deste trabalho apontam para o consumo inadequado dos nutrientes, indicam falhas na prática da alimentação complementar, reforçando a necessidade de ações educativas

Estimated prevalence of hypertension and associated factors in Krenak indigenous adults in the state of Minas Gerais, Brazil

This cross-sectional study in 2016 aimed to describe the estimated prevalence of systemic arterial hypertension and associated factors in Krenak adults and elderly in an indigenous community located along the Rio Doce in eastern Minas Gerais state, Brazil. We measured weight, height, waist circumference, systolic blood pressure, diastolic blood pressure, and capillary blood glucose. Sociodemographic and lifestyle information was obtained from a face-to-face questionnaire. Pois son regression models were constructed to estimate independent associations between the target variables and hypertension. Prevalence of hypertension was 31.2% (95%CI: 24.4-37.9) in Krenak indigenous. The final model showed an independent association with increasing age, abdominal obesity, and hyperglycemia. The results highlight the need for effective measures in prevention, di agnosis, and follow-up of modifiable risk factors for hypertension, since high prevalence of this condition was observed in the Krenak indigenous community.Estudo transversal realizado em 2016, cujo objetivo foi descrever a prevalência estimada e os fatores associados à hipertensão arterial sistêmica entre adultos e idosos Krenak, em Terra Indígena localizada na beira do rio Doce, na região leste de Minas Gerais, Brasil. Foram aferidos peso, estatura, perímetro da cintura, pressão arterial sistólica, pressão arterial diastólica e glicemia capilar. Informações sociodemográficas e de estilo de vida foram obtidas via aplicação de questionário face a face. Modelos de regressão de Poisson foram construídos para estimar a associação independente entre as variáveis de interesse e a hipertensão arterial sistêmica. A prevalência da hipertensão arterial sistêmica foi de 31,2% (IC95%: 24,4-37,9) entre os indígenas Krenak. Houve associação independente no modelo final para o aumento da idade, obesidade abdominal e hiperglicemia. Destaca-se a necessidade de ações eficazes de prevenção, de diagnóstico e acompanhamento frente aos fatores modificáveis da hipertensão arterial sistêmica, uma vez que foi observada elevada prevalência dessa condição na comunidade indígena Krenak

CONHECIMENTOS, VIVÊNCIAS E CRENÇAS NO CAMPO SEXUAL: UM ESTUDO COM ALUNOS DO ENSINO MÉDIO COM PERFIS SOCIOECONÔMICOS DIFERENCIADOS

RESUMO O objetivo neste estudo foi analisar conhecimentos, vivências e crenças no campo sexual de estudantes do 1º e 2º anos do ensino médio, com perfis socioeconômicos diferenciados. Trata-se de uma investigação transversal, descritiva e analítica, com amostragem por conveniência. Aplicou-se questionário estruturado a 258 alunos de Belo Horizonte-MG, de escolas classificadas em A, B2 e C1, segundo critério de classificação econômica. Os resultados mostraram que o nível socioeconômico foi relevante na diferenciação entre os alunos das três escolas, no que se refere à iniciação sexual e a diversos conhecimentos. Essa diferença não foi, no entanto, significativa quanto à orientação sexual dada pela mãe e pai. Os alunos da escola A demonstraram mais domínio dos conteúdos, embora certos desconhecimentos essenciais a uma prática menos vulnerável tenham também se revelado independentes das condições socioeconômicas e do nível de escolaridade do responsável pela família. As limitações do conhecimento associadas aos mitos e crenças, identificadas nas três escolas, sinalizaram como uma contribuição para mais vulnerabilidade às ISTs, à gravidez na adolescência e às consequências relacionadas a sexo e violência sexual. Os resultados revelam a premência pela busca de alternativas investigativas e interventivas que deem amplitude às discussões sobre sexualidade com os adolescentes, incluindo abordagens como sexo, geração, violência nas relações de intimidade, direitos sexuais e reprodutivos e acessibilidade aos serviços de saúde, de forma que os adolescentes se vejam como protagonista em sua forma de ser e viver sua sexualidade

Plasma zinc and hair zinc levels, anthropometric status and food intake of children in a rural area of Brazil

OBJECTIVE: The objective of this study was to investigate the levels of plasma zinc, hair zinc, growth and food consumption in children aged 6 to 24 months in a rural area of Diamantina (MG), Brazil. METHODS: Plasma and hair zinc concentrations were analyzed using flame atomic absorption spectrometry and neutron activation analysis, respectively. Weight-for-age, weight-for-height and height-for-age, expressed as Z-scores, were measured according to the World Health Organization reference curves. Dietary zinc intake was determined by a 3-day dietary recall filled out by the mother or guardian. RESULTS: Zinc deficiency was found in 11.2% and 16.8% of the children according to plasma zinc e hair zinc levels, respectively. Mean plasma zinc and hair zinc for children &lt;11 (49) and &gt;11 (127) months of age were 15.4 (SD=4.2) µmol L-1 and 139.5 (SD=72.1) µg g-1 and 16.0 (SD=4.5) µmol L-1 and 134.3 (SD=110.3) µg g-1, respectively. Anthropometric measurements showed that 8.0%, 6.8% and 3.4% of the children were underweight, stunted and wasted, respectively. The mean dietary intake of zinc was 3.2 (SD=2.3) mg/day. One-third of the children did not eat enough foods that contain zinc. There were no correlations among plasma zinc level, hair zinc level, anthropometric parameters and zinc intake. CONCLUION: The results demonstrate that zinc deficiency is a problem in the studied population, not just in malnourished children. Nutritional care should be provided for this population in order to improve their consumption of high-zinc foods and monitor zinc deficiency.</jats:p

Effectiveness of communication campaign on iron deficiency anemia in Kyzyl-Orda region, Kazakhstan: a pilot study

<p>Abstract</p> <p>Background</p> <p>In 2004, wheat flour fortification (WFF) with iron was implemented in Kazakhstan as a public health strategy to increase the iron intake of all women of childbearing age and of children. In 2003, before starting the flour fortification program, a communication campaign on health education took place in a region with a high prevalence of iron deficiency anemia (IDA). The present study aimed to evaluate the prevalence of anemia, iron deficiency and IDA before and after the campaign. In addition, knowledge about IDA and its prevention, as well as awareness about fortified wheat flour, was assessed.</p> <p>Methods</p> <p>The subjects of the study were women aged 15-49 years and children aged 2-14 years. The study was carried out in urban and rural areas of Kyzyl-Orda region in 2003 before (March) and after (December) the campaign. Blood samples were collected in order to measure hemoglobin and serum ferritin. In March 80 women and 57 children in the urban area, and 41 women and 41 children in the rural area, participated in the IDA testing. The corresponding participants in December numbered 62, 52, 52, and 57, respectively. The impacts of the communications and information received by participants during the campaign was surveyed with a questionnaire for 195 women in March and 198 women in December including some who participated in the IDA testing.</p> <p>Results</p> <p>In March, the prevalence of anemia was 52.0% among 121 women and 58.1% among 98 children, and those with low iron reserve were 63.6%, 49.1% and IDA 40.5%, 11.0%, respectively. In December, the prevalence of anemia had significantly decreased among rural women (from 65.9% to 48.0%, p < 0.05) and among urban children (from 63.1% to 11.5%, p < 0.001). The prevalence of iron deficiency was significantly reduced among the children (from 51.1% to 24.8%, p < 0.001). IDA prevalence was meaningfully decreased among women in urban and combined areas (from 37.5% to 15.0% and 40.5 to 14.8%, respectively, p < 0.001) and among urban children (from 7.1% to 2.1%, p < 0.05). The surveys found that most women knew about IDA and its prevention and that the numbers were similar both in March and in December. The knowledge of the anti-anemic effect of wheat fortified flour improved significantly over the period of the campaign among women both in urban (from 48.5% to 80.9%, p < 0.001) and rural (from 69.8% to 88.6%, p < 0.001) areas.</p> <p>Conclusion</p> <p>The study demonstrated that the communication campaign before implementation of WFF program was effectively carried out, giving a biological impact on hematological indices.</p

Vitamins and minerals for women: recent programs and intervention trials

Women's nutrition has received little attention in nutrition programming, even though clinical trials and intervention trials have suggested that dietary improvement or supplementation with several nutrients may improve their health, especially in low-income settings, the main focus of this paper. Most attention so far has focused on how improvements in maternal nutrition can improve health outcomes for infants and young children. Adequate vitamin D and calcium nutrition throughout life may reduce the risk of osteoporosis, and calcium supplementation during pregnancy may reduce preeclampsia and low birth weight. To reduce neural tube defects, additional folic acid and possibly vitamin B12 need to be provided to non-deficient women before they know they are pregnant. This is best achieved by fortifying a staple food. It is unclear whether maternal vitamin A supplementation will lead to improved health outcomes for mother or child. Iron, iodine and zinc supplementation are widely needed for deficient women. Multimicronutrient supplementation (MMS) in place of the more common iron-folate supplements given in pregnancy in low-income countries may slightly increase birth weight, but its impact on neonatal mortality and other outcomes is unclear. More sustainable alternative approaches deserve greater research attention