Vitamina D y embarazo: una experiencia piloto / Vitamin D and pregnancy: a pilot experience

La insuficiencia de vitamina D (VD) en el embarazo se relaciona con una mayor incidencia de cesáreas, preeclampsia y partos prematuros. Objetivo: evaluar si el grado de insuficiencia de VD se asocia a mayor número de cesáreas y evaluar la correlación entre la 25 hidroxivitamina D (25OHD) materna y en sangre del cordón del recién nacido. Las mujeres (n=127) se dividieron según sus niveles de 25OHD (ng/mL):G1:<20 (deficiencia), G2:20-30 (insuficiencia), G3:>30 (suficiencia). Se registraron edad; edad gestacional (EG); índice de masa corporal (IMC); tensión arterial sistólica y diastólica; tipo de parto y la estación del año en que se tomó la muestra. Se determinaron calcemia (ng/mL); 25OHD; parathormona intacta (pg/mL); fosfatasa alcalina ósea (UI/L) y crosslaps (pg/mL). La edad media fue de 26±6 años y la EG de 35,8±2,7 semanas, sin diferencias entre grupos. El porcentaje de cesáreas fue mayor en G1 que en G2 y G3 (31,3%, 21,4% y 25%, respectivamente; p<0,05). El mayor porcentaje de muestras se tomó en primavera (p<0,05). No se observaron diferencias en las demás variables maternas estudiadas. La 25OHD materna correlacionó positivamente con los valores de la sangre de cordón de sus respectivos recién nacidos (r= 0,67; p<0,0001). Independientemente de la época del año y del IMC, se observó que un porcentaje significativo de las mujeres embarazadas estudiadas tenía niveles de 25OHD inferiores a 30 ng/mL. Conclusión: evidenciamos que la deficiencia de VD materna se asoció al número de cesáreas. Asimismo, los niveles séricos de 25OHD en sangre de cordón umbilical correlacionaron significativamente con los maternos. (AU)

Vitamin D (VD) insufficiency in pregnancy is associated with a higher incidence of cesarean section, preeclampsia, and preterm delivery. Objective: to evaluate if the degree of VD insufficiency is associated with the incidence of cesarean section and to determine the correlation between maternal and newborn cord blood 25-hydroxy VS (25OHD). Women (n=127) were divided according to their 25OHD levels (ng/mL): G1:<20 (deficiency), G2:20-30 (insufficiency), G3:>30 (sufficiency). Age; gestational age (GA); body mass index (BMI); systolic and diastolic blood pressure (mmHg); type of delivery and the season of the year in which the sample was taken were recorded. Calcemia (ng/mL); 25OHD; intact parathormone (pg/mL); bone alkaline phosphatase (IU/L) and Crosslaps (pg/mL) levels were determined. Mean age was 26±6 years and GA was 35.8±2.7 weeks with no differences among groups. The % of cesarean sections was higher in G1 than in G2 and G3 (31.3%, 21.4% and 25%; p<0.05). The highest % of samples were taken in spring (p<0.05). No differences were observed in the other maternal variables studied. Maternal serum 25OHD levels correlated positively with those of cord blood from their respective newborns (r=0.67; p<0.0001). Regardless the season of the year and BMI, a high % of the studied pregnant women presented 25OHD levels lower than 30 ng/ml. Conclusion: we found that maternal VD deficiency is associated with the number of cesarean sections. In addition, 25OHD levels in the newborn significantly correlate with maternal serum levels. (AU)

Observation of the curative effect of scleral suture fixation technique with four-loop foldable intraocular lens

The objective of the study was to evaluate the curative effect of a modified technique of scleral suture fixation with a four-loop foldable intraocular lens (IOL) for eye with inadequate capsule support. This was a retrospective study of 22 eyes with inadequate capsule support of 20 patients who underwent the scleral suture fixation technique with 9-0 polypropylene suture and foldable four-loop IOL implant. Preoperative and follow-up data were collected for all patients. The mean follow-up was 5.08 ± 0.48 months (range: 3–12 months). The mean pre- and postoperative log of minimum angle of resolution (logMAR) uncorrected distance visual acuity was 1.11 ± 0.32 versus 0.09 ± 0.09 (P < 0.001). The mean pre- and postoperative logMAR best corrected visual acuity was 0.37 ± 0.19 versus 0.08 ± 0.07 (P < 0.001). The intraocular pressure (IOP) increased briefly (range: 21–30 mmHg) in eight eyes on the first day postoperatively and returned to normal within 1 week. No IOP drops were used postoperatively. The IOP was 12–19.3 (13.72 ± 1.28) in this follow-up, which had no significant difference compared to the preoperative IOP (t = 0.34, P = 0.74). At this follow-up, there was no hyperemia, local hyperplasia, obvious scar, suture knots, or segment ends observed under the conjunctiva, as well as no pupil deformation or vitreous hemorrhage. The mean postoperative IOL decentration degree was 0.22 ± 0.08 mm. At the 7-day follow-up postoperatively, one side of the IOL was dislocated to the vitreous cavity in one case, which was resolved by reimplantation of a new IOL in time with the same technique. Scleral suture fixation technique of a four-loop foldable IOL was a feasible operation method for an eye with inadequate capsular support.

Popular Restaurants as strategies to fight hunger and to promote Food and Nutrition Security: an integrative review of scientific publications in the period 2011-2021 / Restaurantes Populares como estratégias de combate à fome e de promoção da Segurança Alimentar e Nutricional: uma revisão integrativa de publicações científicas no período de 2011-2021

ABSTRACT Objective Evaluate the contribution of Popular Restaurants in promoting Food and Nutrition Security and fighting hunger. Methods This is an integrative review with searches performed in Scopus, Virtual Health Library, Directory of Open Access Journals, Scientific Electronic Library Online, Web of Science, PubMed and Google Scholar databases. The capture of studies was limited to the period from 2011 to 2021. The articles were categorized according to the focus of the evaluation carried out, conceptualization and thematic analysis procedures, and aggregated into five categories of analysis: 1) users' profile; 2) food handlers; 3) leftovers, food loss and waste; 4) physical-functional structure; and 5) promotion of the human right to adequate food. Results 35 articles were included. There was a predominance of a quantitative approach and, among the focus of the studies, the most recurrent was related to the "users' profile" (54%), followed by the categories: "food handlers" (14%), "Leftovers, food loss and waste" (14%), "promotion of the Human Right to Adequate Food" (12%), and "physical-functional structure (6%). 88.5% of the studies discuss the equipment in a sectored way, evaluating specific items of the equipment and/or the population served. Only four studies discussed Popular Restaurants as promoters of the Human Right to Adequate Food. Conclusion There was a scarcity of the analyzed literature, attesting to the existing gap in the role of Popular Restaurants in the promotion of Food and Nutrition Security. It is recommended to carry out evaluative studies that can contribute to the qualification and expansion of Popular Restaurants as instruments to promote the Human Right to Adequate Food and fight hunger.

RESUMO Objetivo Avaliar a contribuição dos Restaurantes Populares na promoção da Segurança Alimentar e Nutricional e combate à fome. Métodos Trata-se de revisão integrativa com buscas nas bases de dados Scopus, Biblioteca Virtual em Saúde, Directory of Open Access Journals, Scientific Electronic Library Online, Web of Science, PubMed e Google Acadêmico. A captura de estudos limitou-se ao período entre 2011 e 2021. Os artigos foram categorizados segundo o enfoque da avaliação realizada, conceituação e procedimentos de análise temática e agregados em cinco categorias de análise: 1) perfil dos usuários; 2) manipuladores de alimentos; 3) resíduos, perdas e desperdício; 4) estrutura físico-funcional; e 5) promoção do direito humano à alimentação adequada. Resultados Foram incluídos 35 artigos. Observou-se predominância de abordagem quantitativa e, dentre os focos dos estudos, o mais recorrente foi relacionado ao "perfil dos usuários" (54%), seguido pelas categorias: "manipuladores de alimentos" (14%), "resíduos, perdas e desperdício" (14%), "promoção do Direito Humano à Alimentação Adequada" (12%), e "estrutura físico-funcional (6%). 88,5% dos estudos discute o equipamento de forma setorizada, avaliando itens pontuais do mesmo e/ou da população atendida. Apenas quatro estudos discutiram os Restaurantes Populares como promotores do Direito Humano à Alimentação Adequada. Conclusão Verificou-se escassez da literatura analisada, atestando a lacuna existente sobre o papel dos Restaurantes Populares na promoção da Segurança Alimentar e Nutricional. Recomenda-se a realização de estudos avaliativos que possam contribuir com a qualificação e a ampliação dos Restaurantes Populares como instrumentos de promoção do Direito Humano à Alimentação Adequada e combate à fome.

Atuação do MESA São Paulo durante a pandemia do Coronavírus / MESA São Paulo's performance during the Coronavirus pandemic

Introdução: O Mesa Brasil é um programa social desenvolvido pelo Serviço Social do Comércio que busca reduzir o desperdício de alimentos e auxiliar no enfrentamento da fome. Objetivo: O estudo teve como objetivo compreender a sua atuação frente à pandemia de COVID-19, um período de crise humanitária, sanitária, ambiental e socioeconômica mundial. Métodos: Trata-se de um estudo transversal qualitativo que envolveu a realização de entrevistas semi-estruturadas com as Coordenadoras estadual, municipal (metrópole, litoral e interior) e do Centro de Captação e Armazenagem Mesa Brasil de São Paulo. A análise de todo o conteúdo foi do tipo temática. Resultados: Dentre as principais alterações e adaptações, estão a redução das doações, para a qual houve flexibilidade no cadastro das instituições, atendimento às famílias, desenvolvimento de campanha e cestas básicas com produtos de higiene e limpeza; aumento de doações de ultraprocessados, para o qual houve a respectiva adesão a alguns produtos não usuais. Conclusão: O programa demonstrou enorme capacidade em desenvolver medidas criativas para o novo cenário a um tempo relativamente curto, muitas das quais podem servir de inspiração para outras iniciativas. Apresentou-se ainda mais imprescindível para esse cenário de emergência, especialmente no que tange a alimentação da população vulnerabilizada dentro de um país com políticas públicas ausentes para tal. (AU)

Introduction: Mesa Brazil is a social program developed by the Social Service of Commerce that seeks to reduce food waste and help fight hunger. Objective: The objective of the study was to understand its performance in a period of humanitarian, sanitary, environmental and world socioeconomic crisis. Methods: This is a qualitative cross-sectional study that carried out semi-structured interviews with the state and municipal coordinators (metropolis, coast and countryside) and the Mesa Brazil Collection and Storage Center in São Paulo. The analysis of all the material was of a thematic type. Results: Among the main changes and adaptations are the reduction of donations, for which there was flexibility in the registration of institutions, assistance to families, development of campaigns and basic baskets with hygiene and cleaning products; increase in donations of ultra-processed products, for which there was the respective adherence to certain unusual products. Conclusion: The program has shown enormous capacity to develop creative measures for the new scenario in a relatively short time, many of which can serve as inspiration for other initiatives. It was even more essential for this emergency scenario, especially with regard to feeding the vulnerable population within a country with absent public policies for this. (AU)

AMR Sign - An Arthroscopic S-shaped Fold Signifying Adequate Medial Meniscus Repair

@#Introduction: The preferred management of medial meniscus tears has notably moved from meniscectomies towards repair. With a higher volume of meniscal repairs being done all across the world with every passing day, the lack of an objective and definitive sign suggesting the adequacy of its repair is daunting. The purpose of our study was to introduce a unique and novel arthroscopic sign formed after adequate repair of the medial meniscus, the AMR (Adequacy of Medial meniscus Repair) sign. We hypothesised that it is not only the objective end point for repair, but can also form the indicator for excellent clinical, functional, and radiological outcome even in the long term. Materials and methods: This was a multicentric, prospective study initiated by the corresponding author, and the findings validated subsequently by the other authors. Overall, it included 804 patients of isolated medial meniscus tear operated with arthroscopic all-inside technique between January 2014 and December 2017. Patients were segregated into three groups based on whether an S-shaped curve in the free, inner edge of the medial meniscus sign was formed post-repair, lost after further tightening, or not formed upon subjective completion of repair. All the patients were followed-up and evaluated based of medial joint line tenderness, McMurray’s test for medial meniscus, IKDC score, WOMET score, and radiologically using an MRI at the terminal follow-up. Results: The mean terminal follow-up was 42.34±4.54 months. There was significant (p<0.01) improvement in all patients at the terminal follow-up post-surgery, irrespective of the group. The group in which AMR sign was formed and maintained showed a significantly better functional outcome on terminal follow-up as well as lower failure rates compared to the other two groups. Conclusion: AMR sign is an S-shaped fold at the inner, free edge of medial meniscus, formed after an adequate repair of isolated medial meniscus tear, as viewed on arthroscopy. It is an objective sign denoting regained integrity of the collagen architecture of the medial meniscus following repair. It is also a reliable indicator of excellent long term functional, clinical, and radiological outcome and also lower failure rates in patients after arthroscopic medial meniscus repair.

Derecho a la alimentación: ¿Qué dicen las constituciones de América y el Caribe?

RESUMEN Introducción: Numerosos países de América y el Caribe cuentan con el derecho constitucional a la Alimentación. Chile no cuenta con este derecho constitucionalizado. Objetivo: Describir comparativamente cómo se encuentra explícito el derecho a la alimentación (DA) en la Constitución de los países de América y el Caribe, generando insumos para aquellos países que no cuentan con este derecho explícito, como en Chile. Fuentes de datos: Esta búsqueda se realizó en las plataformas: Seguridad Alimentaria y Nutricional (SAN-CELAC), Derecho a la Alimentación en el Mundo (FAO) y Constitute Project que presenta las constituciones del mundo. Método de revisión: Se realizó una revisión todas las constituciones disponibles de los países independientes de América y el Caribe y de países con territorios dependientes y departamentos de ultramar en la Región. Posteriormente, en aquellos países que presentan el DA de forma explícita en su texto constitucional, se realizó una revisión sobre las características generales del texto constitucional y de los conceptos asociados a la definición del DA, sugeridos por la FAO. La revisión se llevó a cabo entre los meses de junio y septiembre de 2020. Resultados: Del total de los países revisados (n= 42), solo el 40,5% presentó el DA explícito en su texto constitucional. La seguridad alimentaria es el concepto que aparece con mayor frecuencia. Conclusión: La mayor parte de las constituciones acompañan el DA con características de seguridad alimentaria, disponibilidad y accesibilidad, e incluyen alguna forma de judicialización, conceptos que deberían ser incorporadas la nueva Carta Magna de Chile.

ABSTRACT Introduction: Many American and Caribbean countries consider the right to food as constitutional right. Chile does not have this explicit right in the Constitution. Objective: To describe comparatively how the right to food is explicit in the constitutions of American and Caribbean countries, generating inputs for those countries that do not have this constitutional right, such as the case of Chile. Data sources: This research was carried out on platforms: Food and Nutritional Security (SAN-CELAC), Right to Food in the World (FAO) and Constitute Project which presents constitutions of the world. Revision method: A revision was made of all available constitutions of American and independent Caribbean countries, dependent territories and overseas departments in the Region. Subsequently, in those countries which explicitly consider the right to food in constitutional texts, a review of general characteristics and right to food-associated concepts, suggested by FAO, was carried out. The review was carried out between June and September 2020. Results: Of the total of countries reviewed (n= 42), 40.5% presented the right to food in constitutional text. The most frequently associated concept was food security. Conclusion: Most of the revised constitutions accompany the right to food with food safety, availability and accessibility characteristics, and include kinds of judicialization, concepts that should be incorporated into the new Magna Carta of Chile.

Desafíos para la garantía del derecho a una alimentación adecuada en mujeres afrodescendientes en condición de desplazamiento, mujeres cisgénero e individuos del colectivo LGBTI, en Colombia / Challenges in Guaranteeing the Right to Adequate Nutrition for Displaced Afro-descendant Women, Cisgender Women and LGBTI Individuals in Colombia

Resumen Antecedentes: aunque las problemáticas alimentarias afectan indistintamente a la población, ameritan reflexiones académicas que presten especial atención a los colectivos poblacionales vulnerables. El objetivo del presente artículo fue identificar los desafíos que supone la garantía del derecho a una alimentación adecuada en mujeres afrodescendientes víctimas de desplazamiento, mujeres cisgénero y población LGBTI. Reflexión: la discriminación basada en género, pertenencia étnica u otra condición tiene incidencia directa en la seguridad alimentaria y desfavorece el goce efectivo de la alimentación adecuada como un derecho fundamental. Esto pone de manifiesto la necesidad de que el Estado implemente acciones afirmativas que promuevan la igualdad real de los grupos poblacionales minoritarios. Conclusión: los principales desafíos identificados se relacionan con la necesidad de robustecer la jurisprudencia sobre el derecho a una alimentación adecuada, de modo que se logre entender como un derecho propiamente dicho; promover la movilización social como mecanismo para demandar reconocimiento, respeto y protección por parte del Estado y, por último, modificar progresivamente las circunstancias socioeconómicas de los individuos, ante un escenario en el que la capacidad de acumulación de capital los lleva a materializar su bienestar en forma diferencial, según la clase social, el género o la etnia.

Abstract Background: Although food issues affect all populations, they deserve to be the subject of academic reflections that give special attention to vulnerable social groups. This article aimed to identify the challenges involved in guaranteeing the right to adequate nutrition in Afro-descendant women victims of internal displacement, cisgender women, and LGBTI people. Reflection: Discrimination based on gender, ethnicity, or some other condition has a direct impact on food security, and it puts the effective fulfillment of adequate nutrition as a fundamental right at a disadvantage. This exposes the need of demanding from the State affirmative actions that promote effective equality among minority population groups. Conclusion: The main challenges identified are related to the need to strengthen the legal framework to the right to adequate nutrition, and to understand it as a right in itself. Besides, to promote social mobilization as a mechanism to demand recognition, respect, and protection from the State, and to progressively modify the socio-economic conditions of people, in a scenario where the capacity of capital accumulation leads them to materialize their well-being in a differentiated way, according to social class, gender or ethnicity.

Percepções sobre a implementação do programa nacional de alimentação escolar (PNAE) na perspectiva do direito humano à alimentação adequada / Perceptions about the implementation the national school feeding program (PNAE) from the perspective of the human right to adequate food / Percepciones sobre la implementación del programa nacional de alimentación escolar (PNAE) en la perspectiva del derecho humano a la alimentación adecuada

O artigo tem por objetivo analisar, diante das condições de implementação do PNAE em escolas públicas de educação básica do Oeste catarinense, percepções quanto à efetivação do acesso de forma igualitária e ao respeito às diferenças biológicas e condições de saúde dos estudantes, na perspectiva do direito humano à alimentação adequada. Toma por base resultados de pesquisa com nutricionistas e diretores de escola da região, realizada por meio de questionários, com enfoque na leitura que fazem acerca da ação do Estado na perspectiva do direito humano à alimentação adequada e, nesse contexto, da efetividade do Programa Nacional de Alimentação Escolar (PNAE). Conclui que, quanto ao respeito às diferenças biológicas e condições de saúde dos estudantes, são parciais as condições de implementação do PNAE em escolas públicas de educação básica da mesorregião, embora afirmada a efetivação do acesso de forma igualitária à alimentação viabilizada pelo Programa.(AU)

The article aims to analyze, according to the conditions for implementation of the PNAE in public schools of basic education in the West of Santa Catarina, perceptions regarding the effectiveness of equal access and to the respect for biological differences and health conditions of the students, from the perspective of the human right to adequate food. It is based on the results of research with nutritionists and school principals from the region, carried out through questionnaires, focusing on the reading they make about the State's action in the perspective of the human right to adequate food and, in this context, the effectiveness of the National School Feeding Program (PNAE). It concludes that, regarding the biological differences and health conditions of the students, the conditions for implementation of the PNAE in public schools of basic education on the microregion are partial, although the effectiveness of equal access to food enabled by the program is affirmed.(AU)

El artículo tiene por objetivo analizar, en vista de las condiciones de implementación del Programa Nacional de Alimentación Escolar (PNAE) en escuelas públicas de educación básica del Oeste de Santa Catarina, percepciones cuanto a la efectividad del acceso de manera igualitaria y al respeto a las distinciones biológicas y condiciones de salud de los estudiantes, en la perspectiva del derecho humano a la alimentación adecuada. Tiene como base resultados de investigación con nutricionistas y directores de escuela de la región, realizada por medio de cuestionarios, con enfoque en la lectura que hacen sobre la acción del Estado en la perspectiva del derecho humano a la alimentación adecuada y, en ese contexto, de la efectividad del PNAE. Se concluye que, en relación al respeto a las distinciones biológicas y condiciones de salud de los estudiantes, son parciales las condiciones de implementación del PNAE en escuelas públicas de educación básica de la mesorregión, sin embargo, afirmada la efectividad del acceso de manera igualitaria a la alimentación viabilizada por el Programa.(AU)

A new method for calculating copper content and determining appropriate copper levels in foods

ABSTRACT Since the amount of food can affect the copper content, the copper content of different amounts of food (except foods without copper) is different. The copper content of some foods is inappropriately calculated per 100 kcal, 100 g or 100 mL, or the reference amount customarily consumed (RACC). Thus, making some food choices based on these calculations to achieve adequate copper intake may increase the risk of some chronic diseases. Calculating the copper content and determining appropriate copper levels (to achieve adequate copper intake) based on U.S. Food and Drug Administration (FDA), Codex Alimentarius Commission (CAC), and the proposed method were performed in 7,379 food items. Making some food choices based on the FDA and CAC per serving (the serving is derived from the RACC) or CAC per 100 g or 100 mL to achieve adequate copper intake exceeded energy needs, which could lead to overweight or obesity. Making some food choices based on the CAC per 100 kcal or CAC per 100 g or 100 mL to achieve adequate copper intake did not meet copper requirements, which could lead to copper deficiency. Some foods that met copper requirements were not appropriate food choices based on the CAC per 100 g or 100 mL or CAC per serving to achieve adequate copper intake. On the basis of the proposed method, calculating the copper content and determining appropriate copper levels in foods are performed by considering RACCs and the energy content of foods. Thus, making food choices based on the proposed method met copper requirements and did not exceed energy needs.

RESUMEN Dado que la cantidad de alimento puede afectar el contenido de cobre, el contenido de cobre de diferentes cantidades de alimentos (excepto los alimentos sin cobre) puede ser diferente. El contenido de cobre de algunos alimentos se calcula incorrectamente por 100 kcal, 100 g o 100 mL, o la cantidad de referencia habitualmente consumida (RACC). Por lo tanto, elegir algunos alimentos en función de ellos para lograr una ingesta adecuada de cobre puede aumentar los riesgos de algunas enfermedades crónicas. El cálculo del contenido de cobre y la determinación de los niveles apropiados de cobre (para lograr una ingesta adecuada de cobre) en 7.379 alimentos según métodos de la Administración de Drogas y Alimentos de los Estados Unidos (FDA), la Comisión del Codex Alimentarius (CAC) y por el método propuesto en este trabajo. La elección de alimentos basadas en la FDA y el CAC por porción (la porción se deriva del RACC) o CAC por 100 g o 100 ml, para lograr una ingesta adecuada de cobre, excedió las necesidades energéticas, lo que podría provocar sobrepeso u obesidad. La elección de alimentos basadas en el CAC por 100 kcal o CAC por 100 g o 100 ml para lograr una ingesta adecuada de cobre no cumplió con los requisitos de cobre, lo que podría conducir a una deficiencia de cobre. Algunos alimentos que cumplían con los requisitos de cobre no eran opciones de alimentos adecuadas según el CAC por 100 g o 100 ml o el CAC por porción, para lograr una ingesta adecuada de cobre. Sobre la base del método propuesto, el cálculo del contenido de cobre y la determinación de los niveles apropiados de cobre en los alimentos se realizaron considerando las RACC y el contenido energético de los alimentos. Por lo tanto, la elección de alimentos basada en el método propuesto cumplió con los requisitos de cobre y no excedió las necesidades energéticas.

Evolución de la regulación jurídica sobre seguridad alimentaria de las personas celíacas en Argentina / Evolution of Food Safety regulation for celiac people in Argentina / Evolução da regulamentação legal sobre segurança alimentar de pessoas com doença celíaca na Argentina

Este trabalho explora o sistema jurídico argentino para reconstruir sistematicamente o quadro de proteção da segurança alimentar para pessoas com doença celíaca. Trata-se, de maneira central, de analisar a Lei Nacional do Celíaco n. 26.588, que constitui a base normativa para sua proteção. Outras normas importantes do marco protetor da saúde também são divulgadas em termos amplos, como as normas do direito do consumidor. O objetivo é determinar quais são os elementos normativos que afetam efetivamente a segurança alimentar da população celíaca. Da mesma forma, trata-se de estabelecer qual é o grau de proteção de seu direito à alimentação adequada, constitucionalmente reconhecido. Em termos metodológicos, o trabalho assenta centralmente numa clássica análise documental do conjunto de normas jurídicas indicadas. As chaves de análise normativa foram construídas a partir de outras fontes documentais complementares, como manuais de boas práticas ou publicações de acesso aberto editadas por associações de pessoas com doença celíaca. Primeiramente, é feita uma breve descrição da doença celíaca e dos principais problemas que afetam a população celíaca em relação ao conceito de segurança alimentar. Em seguida, a construção do recente marco regulatório nacional que protege a população celíaca é ordenada cronologicamente. Terceiro, a legislação atual é analisada a fim de identificar os direitos reconhecidos pelo Estado nacional e os instrumentos que ele projeta para torná-los efetivos. Finalmente, algumas linhas são esboçadas como uma conclusão.

Este trabalho explora o sistema jurídico argentino para reconstruir sistematicamente o quadro de proteção da segurança alimentar para pessoas com doença celíaca. Trata-se, de maneira central, de analisar a Lei Nacional do Celíaco n. 26.588, que constitui a base normativa para sua proteção. Outras normas importantes do marco protetor da saúde também são divulgadas em termos amplos, como as normas do direito do consumidor. O objetivo é determinar quais são os elementos normativos que afetam efetivamente a segurança alimentar da população celíaca. Da mesma forma, trata-se de estabelecer qual é o grau de proteção de seu direito à alimentação adequada, constitucionalmente reconhecido. Em termos metodológicos, o trabalho assenta centralmente numa clássica análise documental do conjunto de normas jurídicas indicadas. As chaves de análise normativa foram construídas a partir de outras fontes documentais complementares, como manuais de boas práticas ou publicações de acesso aberto editadas por associações de pessoas com doença celíaca. Primeiramente, é feita uma breve descrição da doença celíaca e dos principais problemas que afetam a população celíaca em relação ao conceito de segurança alimentar. Em seguida, a construção do recente marco regulatório nacional que protege a população celíaca é ordenada cronologicamente. Terceiro, a legislação atual é analisada a fim de identificar os direitos reconhecidos pelo Estado nacional e os instrumentos que ele projeta para torná-los efetivos. Finalmente, algumas linhas são esboçadas como uma conclusão.

This paper explores the Argentine legal system to systematically reconstruct the protective framework of food safety for people with celiac disease. The main focus is to analyze the National Law for Celiac Disease no. 26588, which constitutes the normative basis for its protection. Other important norms of protective framework of health are also revealed in broad terms, such as consumer law norms. The objective is to identify the normative elements that effectively affect the food safety of the celiac population. Likewise, is it a matter of establishing the level of protection of their constitutionally recognized right to adequate food. In methodological terms, the work is based on a classic documentary analysis of the set of legal norms indicated. The normative analysis keys were constructed from other complementary documentary sources such as manuals of good practice or open access publications edited by associations of people with celiac disease. First, a brief description of celiac disease and the main problems affecting the celiac population in relation to the concept of food safety is described. Then, the construction of the recent national regulatory framework that protects the celiac population is chronologically ordered. Third, current legislation is analyzed in order to identify both the rights recognized by the national State and the instruments designed to make them effective. Finally, some concluding remarks are outlined.

"Hunger and rage (and the virus) are human things": reflections on solidarity in times of Covid-19 / "A fome e a raiva (e o vírus) é coisas dos home": reflexões sobre participação social em tempos de Covid-19

ABSTRACT Objective To identify and reflect about civil society's initiatives to curb hunger in connection with the Covid-19 pandemic in Brazil. Methods In order to identify society's initiatives to fight hunger, two independent systematic searches were conducted in the Google® search engine using the following keywords: "covid civil society initiatives" and "hunger pandemic solidarity campaign". Results Fourteen nationwide civil society-promoted initiatives were identified, that among their objectives aimed at fostering collective funding to purchase and distribute foods. Conclusion Brazilian society has been historically sensitive to the hunger problem and shows solidarity as a social value. Nevertheless, the State is legally bound to provide food, as a social right.

RESUMO Objetivo Mapear e refletir sobre as iniciativas da sociedade civil para o combate à fome no contexto da pandemia de Covid-19 no Brasil. Métodos Para identificar as iniciativas da sociedade para o combate à fome foram conduzidas duas buscas sistemáticas independentes na plataforma Google®, utilizando as palavras-chave: "iniciativas sociedade civil covid" e "fome pandemia campanha solidariedade". Resultados Foram localizadas quatorze iniciativas da sociedade civil de abrangência nacional que têm entre seus objetivos promover campanhas de financiamento coletivo para aquisição e distribuição de alimentos. Conclusão Historicamente, a sociedade brasileira é sensível ao tema do combate à fome e presta solidariedade como um valor social. Contudo, cabe ao Estado a obrigação legal do cumprimento da alimentação enquanto um direito de cidadania.

Escolhas alimentares no contexto de um município com relevante produção agrícola: a perspectiva dos ambientes alimentares em Palmeira das Missões-RS / Food choices in the context of a relevant agricultural production municipality: the food environment perspective in Palmeira das Missões-RS

Introdução: Os ambientes alimentares podem ser entendidos como o contexto em que os indivíduos acessam e realizam suas escolhas alimentares, podendo favorecer ou não a alimentação saudável e adequada. Objetivo: Analisar as escolhas alimentares de consumidores urbanos na perspectiva de ambientes alimentares em Palmeira das Missões, no Rio Grande do Sul. Métodos: Estudo de abordagem qualitativa, que utilizou como técnica de pesquisa entrevista semiestruturada com consumidores residentes na área urbana no município. Os dados foram analisados por meio da análise de conteúdo por categorias temáticas, a partir das dimensões física, econômica, política e sociocultural, as quais compõem os ambientes alimentares. Resultados e Discussões: As escolhas alimentares estão interseccionadas com a ampla disponibilidade e facilidade para encontrar mais alimentos ultraprocessados do que in natura, bem como com as condições econômicas, que se tornam limitadoras das escolhas alimentares pautadas na variedade e inclusão de alimentos in natura e minimamente processados. Constatou-se a importância do Programa Bolsa Família para a aquisição de alimentos, sobretudo para famílias de menores estratos socioeconômicos. Considerações finais: Os dados da pesquisa indicam que escolhas alimentares que incluem maior variedade e disponibilidade de alimentos in natura estão associadas principalmente às condições econômicas e à disponibilidade desses alimentos. Por isso, destaca-se a importância do fortalecimento de políticas públicas para a promoção da alimentação adequada e saudável, bem como a relevância da articulação de ações locais, tendo em vista o potencial agrícola do município. (AU)

Introduction: Food environments can be understood as the context in which individuals access and make their food choices, which may or may not favor healthy and adequate food. Objective: To analyze the food choices of urban consumers from the perspective of food environments in Palmeira das Missões, in Rio Grande do Sul. Methods: Qualitative approach research, based on semi-structured interviews with consumers living in the urban area of Palmeira das Missões. Data were analyzed through content analysis by thematic categories, from the physical, economic, political and sociocultural dimensions, both related to food environments. Results and Discussions: Food choices are intersected with the wide availability and ease of finding more ultra-processed foods than in natura, as well as with the economic conditions, which become limiting of food choices based on the variety and inclusion of fresh and minimal processed foods. The importance of the Bolsa Família Program for the purchase of food was verified, especially for families from lower socioeconomic strata. Final considerations: The research findings indicate that food choices based on greater variety and availability of fresh foods are mainly associated with economic conditions and availability of these foods. Therefore, the importance of strengthening public policies for the promotion of adequate and healthy food is highlighted, as well as the relevance of articulating local actions, considering the municipality's agricultural potential. (AU)

O direito à moradia: reflexões sobre habitabilidade e dignidade / The right to adequate housing: considerations about habitability and dignity / El derecho a la vivienda: reflexiones sobre habitabilidad y dignidad

Resumo Com base no pressuposto de que o direito à moradia é um princípio básico estabelecido em tratados internacionais e na própria Constituição brasileira, este ensaio tem três objetivos: situar historicamente a introdução deste princípio no contexto internacional e nacional; sua reelaboração a partir do conceito de adequação habitacional e a translação, no contexto brasileiro, da discussão sobre moradia adequada para moradia digna. Com este intuito, foram analisados documentos considerados centrais nesse debate, tendo como ponto de partida a Declaração de Direitos Humanos de 1948. Como método, a discussão está assentada na análise de documentos de domínio público e pautada na perspectiva da psicologia social discursiva. Como conclusão, consideramos que a translação de moradia adequada para moradia digna tem por base situar o direito à moradia como exercício de cidadania, com o uso de moradia digna para indicar que o que está em pauta é a possibilidade de ter uma vida digna.

Abstract Starting from the premise that the right to adequate housing is a basic principle established in international treaties as well as in the Brazilian Constitution, the aim of this essay is threefold: to trace the introduction of this principle in the international and national contexts; to follow its further elaboration in debates on adequate housing and to examine the translation of the term "adequate housing" into "dignified housing" in Brazilian Portuguese. National and international documents that are considered central to this debate were analyzed, taking as a starting point the United Nation's 1948 Declaration of Human Rights. Methodologically, the analysis is based on discursive social psychology discussion of the characteristics of public domain documents. We conclude that the translation of adequate housing to dignified housing, in Brazil, is the result of placing the right to a house as an exercise in citizenship, with the use of the expression dignified housing serving to indicate that what is at stake is the dignity of life itself.

Resumen Con base en el supuesto de que el derecho a la vivienda es un principio básico establecido por tratados internacionales y por la propia Constitución brasileña, este ensayo tiene tres objetivos: situar históricamente la introducción de este principio en el contexto internacional y nacional; su reelaboración a partir del concepto de adecuación habitacional y la traslación, en el contexto brasileño, de la discusión sobre vivienda adecuada para vivienda digna. Con este propósito, se analizaron documentos considerados centrales en ese debate, teniendo como punto de partida la Declaración de Derechos Humanos de 1948. La discusión está asentada en el análisis de documentos de dominio público y pautada en la perspectiva de la psicología social discursiva. Concluimos que la traslación de vivienda adecuada para vivienda digna tiene por base situar el derecho a la vivienda como ejercicio de la ciudadanía, con el uso de vivienda digna para indicar que lo que está en pauta es la posibilidad de tener una vida digna.

Device associated infections among neonates in neonatal intensive care units: a single unit survey study in Cairo, Egypt

Background: Device Associated Infection (DAI) namely Ventilator Associated Pneumonia (VAP) and Central Line Associated Blood Stream Infection (CLABSI) is one of the challenges for both neonatal nurses and doctors. Aims of the study were 1) Assess the rate of DAI occurrence among neonates, 2) explore the relationship between DAI rates and certain risk factors such as nurse patient ratio, hand hygiene practice, gestational age (GA), weight, and length of hospital stay among neonates.Methods: Descriptive correlational survey research design. Sample: All neonates admitted in twelve months-duration were included (total number 1090 neonates). Nurses and doctors were observed for compliance to adequate hand hygiene technique. Tools: 1) Center for Disease Control (CDC) criteria to calculate DAI rates, 2) Hand hygiene five points checklist 3) Review of neonates charts to collect data as weight, GA 4) Ballard score and 5) nurse/patient ratio.Results: 24 neonates developed DAI, high significant negative correlations between DAI and infants' weight, GA, nurse/patient ratio and overall compliance to hand hygiene techniques were reported (p-value ?0.05). Length of hospital stay, inadequate hand hygiene technique had strong positive correlations with DAI rate (p-value ?0.05).Conclusions: Factors that could affect DAI were infant's weight, GA, length of hospital stay, inadequate hand hygiene technique and nurse/patient ratio. Recommendations: implementation of infection control programs to raise nurses as well as physicians' compliance to adequate hand hygiene technique and increase number of nurses in the Neonatal Intensive Care Unit (NICU) per shift.

Educação popular e Extensão Universitária em Segurança Alimentar e Nutricional e Direito Humano à Alimentação Adequada e Saudável: um caminho metodológico possível / Popular Education and University Outreach in Food and Nutition Security and the Human Right to Adequate and Healty Food: a possible methodological path

Introdução: A temática da segurança alimentar e nutricional e do direito humano à alimentação adequada e saudável tornou-se uma questão política no Brasil, no período de 2003 a 2016. No entanto, a tarefa de manutenção de direitos sociais não estava concluída e hoje encontra-se politicamente ameaçada, demandando a conscientização e mobilização de segmentos da sociedade civil para a compreensão crítica da realidade e a retomada da construção de caminhos possíveis para a exigibilidade do direito e garantia da segurança alimentar e nutricional. Objetivo: Este trabalho buscou relatar a experiência e evidenciar as expressões pedagógicas dos princípios da educação popular ao longo do processo de ensino-aprendizagem da edição de 2018 do curso, realizado no município de Colinas do Sul, Goiás. Métodos: Na Universidade de Brasília, em 2018, instituiu-se um Programa de Extensão e Ação Continuada, o MultiplicaSAN. Dentre suas atividades, estava a realização de um curso de formação e promoção da cultura de direitos visando à formação da sociedade civil nas temáticas de segurança alimentar e nutricional e direito humano à alimentação adequada e saudável, utilizando como referência a pedagogia freireana e os princípios da Política de Educação Popular. Resultados: A experiência do projeto de extensão proporcionou aprofundamento sobre a educação popular, mostrando a riqueza da construção do conhecimento junto com uma comunidade de trabalhadoras. Conclusão: Revelou, ainda, o potencial transformador de um processo educativo pautado nos princípios da educação popular: amorosidade, dialogicidade, conscientização, construção do conhecimento, a partir da realidade concreta, transformação do mundo e sistematização do conhecimento na formação de educadoras e educandas. (AU)

Introduction: The theme of food and nutrition security and the human right to adequate and healthy food became a political issue in Brazil, from 2003 to 2016. However, the task of maintaining social rights was not completed and today it is politically threatened, demanding the awareness and mobilization of segments of civil society for an understanding of reality and the resumption of the construction of possible paths for the enforceability of the law and guarantee of food and nutritional security. Objective: This work sought to report the experience and highlight the pedagogical expressions of the principles of popular education throughout the teaching-learning process of the 2018 edition of the course, held in the municipality of Colinas do Sul, Goiás. Methods: At the University of Brasília, in 2018, an Outreach Program, MultiplicaSAN, was instituted. Among its activities, there was a course to promote the culture of rights aiming at the formation of civil society in the themes of food and nutritional security and the human right to adequate and healthy food, using Freire's pedagogy and the principles of Popular Education Policy. Results: The experience of the outreach program provided an in-depth look at popular education, showing the wealth of knowledge construction together with a community of female workers. Conclusion: It also revealed the transformative potential of an educational process based on the principles of popular education: lovingness, dialogicity, awareness, construction of knowledge, based on concrete reality, transformation of the world and systematization of knowledge in the teaching-learning process of educators and students. (AU)

Strategic Policies in Expanding Frontiers of Food Security among Cassava-based Farmers in Cross River State, Nigeria

The research was carried out to identify the possible constraints and development of strategic policies in expanding and improving cassava production and processing amongst cassava value chain actors in Cross River State, Nigeria. Data generated from the research the 150 cassava producers and processors (cassava value chain actors) through the use of well- define structured interview schedule was collated. The Multistage sampling procedure was adopted in selection of farmer respondents. The multivariate analytical technique was used in analyzing generated data employing the statistical application software of Genstat version 12. The eigen value, percentage variations and loading values contributing to low cassava output were used in achieving the objectives. The results showed that the major constraints to cassava production and processing were agronomic, technical/institutional and financial constraints. The major policy strategies should include a global, national, regional and community strategies all geared towards the evolution of industry analysis for improving cassava productivity in the study area through the development of the traditional farming systems, making good planting material accessible to farmers and on time and at lowest possible prices; the provision of credit facilities to the resource poor cassava –based farmers in the area with no collateral; the establishment of cassava product based cottage industries in the area for cassava value chain development; provision of adequate cassava processing equipment and the formation of cassava farmers’ multipurpose cooperative societies to enhance farmers’ access to benefit from world bank assisted programmes; have free access to basic information and production facilities. The study, therefore, recommended that cassava product based cottage industries be established in the study area in order to encourage both producers and processors in the value addition chain. This will also provide employment and likewise encourage the restive youths in the region to venture into agriculture as a business for economic returns, growth and development of the area. The identified constraints with the higher loading values for each of the principal multivariate should be strengthened using appropriate development strategies/policies to ensure food security and increased farm income for cassava – based farmers in the region.

Insegurança Alimentar em famílias em que o idoso é o principal provedor / Food Insecurity in families where the elderly is the main provider / Inseguridad Alimentaria en familias en las que el anciano es el principal proveedor

O presente estudo aborda a questão da segurança alimentar, em famílias mantidas economicamente por idosos usuários do Programa Bolsa Família, tendo sido realizado na Unidade do Programa Bolsa Família, do Jardim Ingá, na cidade de Luziânia, estado de Goiás, Brasil. Trata-se de um estudo descritivo, qualitativo. Participaram da pesquisa 25 indivíduos com idade de 60 ou mais anos. Foi identificada a prevalência de segurança alimentar em 8% das famílias; 24% com insegurança leve; 40% com insegurança moderada; e, por fim, 28% com insegurança alimentar grave. A insegurança alimentar observada evidencia a necessidade contínua de estudos para monitorarem a condição alimentar e nutricional das famílias brasileiras, especialmente a de seus idosos.

The present study addresses the issue of food security in families maintained economically by elderly users of the Bolsa Familia Program, and was conducted at the Bolsa Familia Program Unit, Jardim Ingá, in the city of Luziânia, state of Goiás, Brazil. It is a descriptive, qualitative study. Twenty-five individuals aged over 60 years participated in the research. The prevalence of food security was identified in 8% of households; 24% with mild insecurity; 40% with moderate insecurity; and finally 28% with severe food insecurity. The observed food insecurity highlights the continuing need for studies to monitor the food and nutritional status of Brazilian families, especially that of their elderly.

l presente estudio aborda el tema de la seguridad alimentaria en familias mantenidas económicamente por usuarios mayores del Programa Bolsa Familia, y se realizó en la Unidad del Programa Bolsa Familia, Jardim Ingá, en la ciudad de Luziânia, estado de Goiás, Brasil. Es un estudio descriptivo, cualitativo. Veinticinco personas mayores de 60 años participaron en la investigación. La prevalencia de la seguridad alimentaria se identificó en el 8% de los hogares; 24% con inseguridad leve; 40% con inseguridad moderada; y finalmente 28% con inseguridad alimentaria severa. La inseguridad alimentaria observada resalta la necesidad continua de estudios para monitorear el estado alimentario y nutricional de las familias brasileñas, especialmente la de sus ancianos.

Fluoride concentration of bottled water and public water in Lebanon

Background and Aims: People in Lebanon turned to bottle water consumption because of its poor public water quality. In general, fluoride is known as dental caries preventive. A study in 1986 and two other national surveys in 1994 and 2004 showed that the concentration of fluoride in public Lebanese water was insignificant for the prevention of dental caries (less than 0.3 mg/L). The aim of the study was to measure the fluoride concentration in the highest selling and known commercial brands for bottled water in Lebanon, as well as to assess their effectiveness regarding prevention of dental caries. Result: Fluoride has a notable therapeutic effect but in small doses that fluoride can be found in drinking water. Analysis using an absorptiometry of 625nm and another technique using an Orion electrode of 9609 BN have shown the low content of fluoride in the Lebanese waters (less than 0.3 mg/l). Strategies have recently been evolved based on fluroide supplementation (if the results turn negative) to reduce the index of caries in LEBANON.

Knowledge, Attitude and Practice (KAP) of Women about Breast Cancer in a Tertiary Care Teaching Hospital in Rohtas, Bihar

Breast cancer (BC) is an important cause of morbidity and mortality. The early detection of BC and its early and adequate treatment increases the chance of survival of patients. Breast Health Global Initiative guidelines for low and middle income countries suggests that diagnosing BC early by promoting self awareness and clinical breast examination (CBE) will reduce BC mortality. There is a paucity of data related to knowledge and awareness of BC in Bihar. We designed this hospital based cross sectional descriptive study to evaluate the current status of knowledge; attitude and practices (KAP) related to BC in the female rural population attending a tertiary care teaching hospital in Rohtas, Bihar. Methods: A random sampling was done to identify and enrol 400 women and their female relatives. Women who had already undergone a screening mammography or had a BC were excluded from the study sample. The data was collected by a self-administered questionnaire in local vernacular language. Results: The mean age of study population was 45.21 (±10.2) years. Only 5 (1.25%) females had a family history of BC. A whopping 82.75% of women did not have any knowledge about BC. Almost all of the women had firm belief that CBE by doctors was the only way for detecting BC. Conclusion: It is imperative to increase awareness about BC and its early detection methods in the community through health education campaigns. The government should have major policy changes to increase future screening programmes which could have an overall positive impact on reducing the BC burden in community.

Free gingival graft: An effective technique to create healthy keratinised gingiva

The high labial frenal attachment in mandibular anterior segment is most commonly associated with inadequate width of attached gingiva. Insufficient attached gingiva contributed to the difficulty in oral hygiene maintenance and ultimately poor gingival health. Frenectomy, vestibular extension and gingival augmentation procedures either alone or in combination are often required to maintain adequate health of the gingiva. Clinical relevance Inadequate width of keratinised gingiva contributed to the difficulty in oral hygiene maintenance and ultimately poor gingival health. Frenotomy with free gingival graft (FGG) technique is most predictable in these situations. Objective To highlight the importance of keratinised gingiva and overview of the FGG technique.