Distribución de nutricionistas en el sistema de salud peruano: un panorama por niveles de atención

La prestación de servicios para la atención integral de la salud requiere la participación de diversos profesionales con competencias específicas para brindar la mejor atención posible a la población. La inclusión del nutricionista en los diferentes niveles del sistema de salud es crucial para garantizar una atención integral en las diversas etapas de la vida. Una distribución inequitativa de nutricionistas en los niveles de atención puede conducir a una fragmentación de la atención y la pérdida de oportunidades para abordar los problemas relacionados con la alimentación y nutrición. Por ello, se desarrolló un estudio con el objetivo de describir la distribución de nutricionistas en los establecimientos de salud según el nivel de atención, y evaluar el cumplimiento de las recomendaciones de recursos humanos establecidas por la norma técnica de las UPSS de Nutrición y Dietética. Se desarrolló un estudio descriptivo y transversal, mediante el análisis de fuentes secundarias. Se utilizaron los datos de recursos humanos por IPRESS de SUSALUD, del año 2022. Se consideró la Norma técnica de UPSS de Nutrición y Dietética para evaluar el cumplimiento de las recomendaciones de recursos humanos. Entre los principales resultados, se identificó que el 7.93% de los establecimientos de salud del primer nivel de atención tienen al menos un nutricionista. En el segundo nivel de atención, el 96.35% de los establecimientos de salud no cumplen con las recomendaciones de recursos humanos de la norma técnica, y ningún establecimiento del tercer nivel de atención cumplió esta recomendación. La distribución de nutricionistas en los diversos niveles de atención del sistema de salud peruano es desigual. Es necesario mejorar la planificación de recursos humanos en el sistema de salud peruano para garantizar una atención integral de la salud a la población.

The provision of services for comprehensive healthcare requires the involvement of various professionals with specific competencies to provide the best possible care to the population. The inclusion of nutritionists at different levels of the healthcare system is crucial to ensure comprehensive care at various stages of life. An unequal distribution of nutritionists across healthcare levels can lead to fragmented care and missed opportunities to address nutrition-related issues. Therefore, a study was conducted with the aim of describing the distribution of nutritionists in healthcare facilities according to the level of care and evaluating compliance with the human resources recommendations established by the technical standard of Nutrition and Dietetics UPSS. A descriptive and cross-sectional study was conducted using the analysis of secondary sources. Human resources data from SUSALUD for the year 2022 were used. The Technical Standard of UPSS of Nutrition and Dietetics was considered to assess compliance with human resources recommendations. Among the main findings, it was identified that 7.93% of first-level healthcare facilities have at least one nutritionist. In the second level of care, 96.35% of healthcare facilities do not comply with the human resources recommendations of the technical standard, and no third-level healthcare facility met this recommendation. The distribution of nutritionists across various levels of care in the Peruvian healthcare system is unequal. It is necessary to improve human resources planning in the Peruvian healthcare system to ensure comprehensive healthcare for the population..

Análisis cualitativo de los perfiles de egreso en procesos de aseguramiento de la calidad de carreras de Nutrición y Dietética en Chile

Antecedentes: La evaluación de los perfiles de egreso es uno de los aspectos centrales en la acreditación de carreras en Chile, por cuanto su formulación y aplicación en los procesos formativos influyen en sus niveles de pertinencia y calidad. Objetivo: Evidenciar las fortalezas y debilidades del diseño y aplicación de los perfiles de egreso de las carreras de Nutrición y Dietética en Chile, a partir de los resultados de sus procesos de acreditación. Materiales y métodos: Estudio transversal, descriptivo, cualitativo. Se identificaron, en las resoluciones de acreditación entre los años 2004 y 2016, las fortalezas y debilidades de los perfiles de egreso y las contradicciones entre lo declarado y lo ejecutado por los programas. Las carreras se ordenaron en dos grupos según el tiempo de acreditación: i) de dos a cuatro años y ii) de 5 o más años. Usando el software Atlas.ti 7.0 se determinaron los patrones y diferencias conceptuales en los juicios evaluativos de los perfiles de egreso. Resultados: Existe una alta variabilidad entre carreras en los contenidos y aplicación de los perfiles de egreso. Ella se asocia a las capacidades instaladas en las instituciones y a los tiempos de acreditación de la carrera. Existen carreras con déficit en el cumplimiento de competencias, conocimientos y habilidades. Conclusiones: Los contenidos y aplicación de perfiles de egreso son muy heterogéneos y su aplicación se asocia al tiempo de acreditación de la carrera. Es necesario limitar la alta dependencia a la demanda y estimular mayores compromisos institucionales.

Background: Assessment of the graduate profiles is one of the key aspects of program accreditation in Chile, therefore, their development and application in training processes have an impact on their relevance and quality. Objective: To demonstrate the strengths and weaknesses of the design and application of graduate profiles of Nutrition and Dietetics degree programs in Chile, on the basis of the outcomes of their accreditation processes. Materials and methods: Cross-sectional, descriptive, qualitative study. Strengths and weaknesses of graduate profiles, and inconsistencies between what was stated and what was actually implemented in the programs were identified in the accreditation resolutions issued between 2004 and 2016. Degree programs were classified in two groups, according to accreditation years: i) two to four years, and ii) five or more years The Atlas.ti 7.0 software was used to determine patterns and conceptual differences in the evaluative judgement of graduate profiles. Results: There was a high variability in the content and application of graduate profiles between degree programs. This was associated with the institutions' installed capacities and with accreditation years awarded to the program. Some programs were not compliant with the required competencies, knowledge and skills. Conclusions: The content and application of graduate profiles are highly heterogeneous, and its application is associated to accreditation years of the program. It is necessary to limit high dependency on demand to encourage stronger institutional commitments.

Five Common Rights on Ayurvedic Dietetics - A Review

Ahara is as old as the history of humanity as the body is originated and subsequently maintained by food. Historically, by the fundamental methods as looking and accumulating and agriculture humans secured their food from nature. As agricultural technologies elevated, humans settled into agriculture existence with diets fashioned through the agriculture possibilities of their geographical environment. Geographic and cultural variations have caused creation of numerous cuisines and culinary arts, which includes a big selection of components, herbs, spices, techniques, and dishes. With engorgement of rapid transferring lifestyles, fashions of assimilation of various subculture and way of life the food become very venerable for life expectancy. In Ayurveda, proper style of partaking food or Ahara has been mentioned by different treatise in a holistic approach. In the present study the holistic measure regarding Ahara is stipulated in five common rights as the Right Quantity, Right Time, Right Quality, Right Method, and Right Place

Relación entre el consumo materno de carne vacuna durante el embarazo y los niveles de ferritina en el cordón umbilical / Relationship between maternal beef consumption during pregnancy and umbilical cord ferritin concentration / Relação entre o consumo materno de carne bovina durante a gravidez e os níveis de ferritina no cordão umbilical

Antecedentes: la nutrición durante el embarazo impacta en la salud del recién nacido, con efectos a nivel epigenético determinando consecuencias neurológicas a largo plazo. Las necesidades de hierro durante el embarazo se estiman en 27 mg/día. El hierro hemo que se absorbe mejor se encuentra en la carne. La determinación de ferritina en sangre de cordón umbilical permite evaluar los depósitos de hierro alcanzados durante la etapa fetal. Sus niveles se asociaron con efectos a largo plazo sobre el desarrollo infantil. Objetivos: el objetivo de este estudio de carácter exploratorio es determinar la relación entre el consumo de carnes rojas durante el tercer trimestre de gestación y el nivel de ferritina en el cordón umbilical. Métodos: se realizó un estudio observacional descriptivo con datos recolectados prospectivamente durante un año en el Departamento de Neonatología del Centro Hospitalario Pereira Rossell (CHPR) en Montevideo, Uruguay. Un total de 188 pacientes cumplieron los criterios de inclusión. Se extrajo sangre del cordón umbilical después de un pinzamiento estricto del cordón pasado un minuto de vida. La ferritina se midió utilizando el método de quimioinmunofluorescencia. Se aplicó una encuesta nutricional materna (cualitativo-cuantitativa) que midió la frecuencia de consumo de alimentos con fuente de hierro y las cantidades aproximadas consumidas durante el último trimestre del embarazo. Esta encuesta se centró en el consumo materno de carne vacuna como principal fuente de hierro hemínico en Uruguay. Se analizó la relación entre estas variables. Resultados: el déficit latente de hierro (ferritina en el cordón umbilical <100 ng/ml) se asoció con un menor consumo de carne vacuna durante el embarazo. Valor p de Fisher: 0,0133, OR: 3,71, IC del 95% (1,25-11,05). Conclusiones: este estudio considera adecuada la evidencia que relaciona que los niveles bajos de consumo total de hierro y de carne vacuna durante el tercer trimestre de gestación determinarán un mayor riesgo de déficit latente de hierro y de ferritina medido en el cordón umbilical. Los niveles descendidos de ferritina en cordón umbilical se asocian con un mayor riesgo de efectos adversos a largo plazo sobre la mielinización y el desarrollo neurocognitivo.

Background: nutrition during pregnancy impacts the foetus and the newborn health, it has consequences at the epigenetic level and determines long-term neurological consequences. Iron requirements during pregnancy are estimated at 27 mg/day. Iron is blood absorption from is most efficient from beef. Umbilical cord blood ferritin levels can be used to assess iron deposits reached during the foetal stage. Ferritin levels are linked to the child's long-term development. Objective: this exploratory study's objective is to determine the relationship between beef consumption during the first quarter of pregnancy and ferritin levels in the umbilical cord. Methods: we carried out a descriptive, observational study with prospectively collected data for one-year at the Neonatology Department of the Pereira Rossell Hospital Center (CHPR) in Montevideo, Uruguay. A total of 188 patients met the inclusion criteria. We extracted umbilical cord blood after a strict cord clamping after one minute of life. Ferritin was measured using the chemoimmunofluorescence method. We carried out a maternal nutritional survey using a qualitative-quantitative method and measured the frequency and approximate quantity of iron source food consumption during the last quarter of pregnancy. This survey was focused on maternal beef consumption as the major heme iron source in Uruguay. We analyzed the relationship between these variables. Results: latent iron deficiency (ferritin in the umbilical cord <100 ng / ml) was associated with lower beef consumption during pregnancy. Fisher p-value: 0.0133, OR: 3.71, 95% CI (1.25 - 11.05). Conclusions: this study agrees with the evidence that shows that low levels of total iron and beef consumption during pregnancy determine an increased risk of latent iron deficiency and lower levels of ferritin in newborns, and therefore, greater risk of long-term adverse effects on myelination and neurocognitive development.

Contexto: a nutrição durante a gravidez tem impacto sobre a saúde do recém-nascido, com efeitos no nível epigenético, determinando consequências neurológicas a longo prazo. As necessidades de ferro durante a gravidez são estimadas em 27 mg / dia. O ferro heme de melhor absorção e aquele encontrado na carne vacuna. A determinação da ferritina no sangue do cordão umbilical permite avaliar os depósitos de ferro atingidos na fase fetal. Seus níveis foram associados a efeitos de longo prazo no desenvolvimento das crianças. Objetivos: o objetivo deste estudo exploratório é determinar a relação entre o consumo de carne vermelha durante o terceiro trimestre de gestação e o nível de ferritina no cordão umbilical. Métodos: foi realizado um estudo observacional descritivo com dados coletados prospectivamente durante um ano no Departamento de Neonatologia do Centro Hospitalar Pereira Rossell (CHPR) em Montevidéu, Uruguai. Um total de 188 pacientes cumpriram os critérios de inclusão. O sangue do cordão umbilical foi coletado após clampeamento estrito do cordão após um minuto de vida da criança. A ferritina foi medida pelo método de quimioimunofluorescência. Aplicamos um inquérito nutricional materno (qualitativo-quantitativo) que mediu a frequência de consumo de alimentos com fonte de ferro e as quantidades aproximadas consumidas durante o último trimestre da gravidez. Esta pesquisa enfocou o consumo materno de carne bovina como principal fonte de ferro heme no Uruguai. A relação entre essas variáveis foi analisada. Resultados: a deficiência latente de ferro (ferritina no cordão umbilical <100 mg / ml) foi associada ao menor consumo de carne bovina durante a gestação. Valor de p de Fisher: 0,0133, OR: 3,71, IC 95% (1,25-11,05). Conclusões: este estudo concorda com as evidências que relacionam que os baixos níveis de ferro total e consumo de carne bovina durante o terceiro trimestre de gestação determinam um maior risco de déficit de ferro latente e ferritina mensurado no cordão umbilical. A redução dos níveis de ferritina no cordão umbilical está associada a um risco aumentado de efeitos adversos de longo prazo na mielinização e no desenvolvimento neurocognitivo.

Análisis cualitativo de los procesos regulatorios de la calidad en los programas de Nutrición y Dietética en Chile

RESUMEN Introducción. El objetivo de este estudio es establecer patrones positivos y negativos de los resultados de los procesos de acreditación de las carreras. Asimismo, identificar desde una perspectiva cualitativa, variables relevantes y relaciones entre los criterios usados en su evaluación. Materiales y métodos. El estudio es transversal, descriptivo y cualitativo. Se analizaron veinte resoluciones de acreditación de las carreras de Nutrición y Dietética en Chile, emitidas entre los años 2004 y 2016 por la Comisión Nacional de Acreditación mediante el software ATLAS ti. Se consideraron las tres dimensiones; Propósitos e Institucionalidad; Condiciones de Operación y Resultados; y Capacidad de Autorregulación para establecer una matriz de relaciones con la identificación de patrones positivos y negativos entre criterios. Resultados. Se evidencian fuertes diferencias entre las carreras. Las relaciones positivas y negativas entre los códigos de los criterios perfil de egreso y plan de estudio indican que solo algunas de ellas proveen una formación adecuada. Del mismo modo, las relaciones entre la calificación del cuerpo docente y la investigación revelan casos de docentes sin niveles suficientes. Otros aspectos deficitarios son el nivel con que ingresan los estudiantes y el uso efectivo de diagnósticos y autoevaluaciones. Conclusiones. El estudio provee información relevante para la toma de decisiones y procesos de retroalimentación orientados al urgente mejoramiento y aseguramiento de la calidad de carreras, en particular de sus planes de estudio, calificación de docentes y efectividad de los procesos de aseguramiento de la calidad, dada la creciente importancia de estos profesionales en la salud pública.

ABSTRACT Introduction. The objective of this study is to establish positive and negative patterns based on the results of accreditation processes of degree programs. Similarly, its aim is to identify, from a qualitative perspective, relevant variables and relationships among the criteria used in their evaluation. Materials and methods. This is a cross-sectional, descriptive and qualitative study. Twenty accreditation resolutions of Chilean Nutrition and Dietetics degree programs were analyzed using the software ATLAS ti. Resolutions were issued between 2004 and 2016 by the National Accreditation Commission. Three dimensions were considered in order to establish a matrix of relationships associated with the identification of positive and negative patterns among criteria: Purpose and Institutionalism; Operating Conditions and Results; and Self-Regulatory Ability. Results. Major differences were found among the degree programs. Positive and negative relationships between criteria codes, graduate profile and curriculum, indicate that only some degree programs provide an appropriate training. In the same way, the relationship between the teaching staff qualification and research work revealed cases of teachers who were not sufficiently qualified. Other weak aspects were the level of knowledge that students have when they enter university and the effective use of diagnostics and self-assessment tests. Conclusions. This study provides relevant information for decision making and feedback processes oriented at the urgent improvement and quality assurance of degree programs, particularly of curricula, teaching staff qualifications, and effectiveness of the quality assurance processes, given the increasing importance of nutrition professionals in the public health area.

¿Qué pasa con la formación de nutricionistas en Chile? / What happening with nutritionist training in Chile?

RESUMEN El propósito de este artículo es analizar la evolución de las carreras y programas de Nutrición y Dietética en Chile. Se verifica un incremento sostenido de la oferta formativa, particularmente en los últimos veinte años, asociado a procesos de mercantilización de la Educación Superior. El aseguramiento de la calidad ha operado a través de la acreditación voluntaria y sus resultados son congruentes con el contexto nacional. La creciente importancia de la alimentación y nutrición en la salud pública del país exige formular cambios en la formación en Nutrición y Dietética, para lo cual se plantean diversas recomendaciones para lograr mayores niveles de pertinencia y el mejoramiento continuo de la calidad.

ABSTRACT The purpose of this article is to analyze the evolution of Nutrition and Dietetics degree programs and majors in Chile. This research demonstrated a sustained increase in the number of training programs, particularly during the last twenty years, due to the process of commodification of higher education. Quality assurance has been implemented by voluntary accreditation, which has shown results consistent with the national context. The growing importance given to food and nutrition in the national public health scenario requires changes in Nutrition and Dietetics academic programs. To this end, different recommendations are made in order to achieve improved relevance standards and continuous quality improvement.

Guía práctica de aplicación del método dietético para el diagnóstico nutricional integrado / Practical guide for applying the dietary method for integrated nutritional diagnosis

RESUMEN El método dietario, como parte de la evaluación nutricional, presenta como meta final el reunir información que faculta la interpretación del consumo de alimentos en una persona, independiente del grupo etario o condición de salud en que se encuentre. Considera aspectos cronológicos, sexo, actividad física o religión, entre otros factores. El objetivo de esta revisión es la entrega de una guía práctica para aplicar el método dietético del diagnóstico nutricional integrado a través de la administración e interpretación de las encuestas alimentarias, profundizando en aquellas más reconocidas como el Diario Dietético o la Encuesta del Recordatorio de 24 hrs. El artículo sugiere, además, datos prácticos que facilitan su aplicación y estudio, información necesaria para los nutricionistas o los futuros expertos en el área y también para todo el equipo de salud, fomentando la comprensión de la importancia que presenta su adecuada aplicación. Como conclusión, un apropiado uso de herramientas de obtención de información dietaria, permiten la profundización en la alimentación y otorga directrices para el estudio de algunos comportamientos alimentarios.

ABSTRACT The dietary method, as part of a nutritional evaluation, aims to gather information that allows the interpretation of food consumption in a person, independent of age or health condition. The method considers chronological aspects, sex, physical activity or religion, among others. The objective of this review is to provide practical guidance to apply the dietary method of integrated nutritional diagnosis through the administration and interpretation of food surveys, such as a daily diet survey or a 24-hour dietary recall. The article also provides practical information that allows its application and research, information that is necessary for nutritionists, other health staff, and future experts to enhance the comprehension of the importance of correct application. In conclusion, an appropriate use of dietary information tools allows for a deepening of the diet and provides guidelines for the study of certain eating behaviors.

Aceitabilidade e fatores associados ao consumo dietético em pacientes diabéticos de um hospital público universitário / Acceptability and factors associated with dietary consumption in diabetic patients of a public university

A dietoterapia é essencial para pacientes hospitalizados. O objetivo deste estudo foi avaliar a aceitabilidade das refeições do almoço de pacientes que receberam a dietética para Diabetes Mellitus (DM) e verificar aspectos que podem interferir nesse consumo, como as estações do ano. Estudo quantitativo descritivo que avaliou o consumo da refeição almoço dos pacientes que receberam dietética DM em um período de verão e outro de inverno no ano de 2019. Os dados foram verificados em frequências absolutas, porcentagens, médias, e o teste estatístico foi o de regressão logística com a correlação de dados a um nível de significância de 95% (p <0,05) usando o software SPSS® 18.0. Foram selecionadas duas unidades de internação, com amostra de 49 indivíduos (63,3% do sexo masculino). Das 115 refeições servidas, 55,7% foram parcialmente consumidas ou não consumidas. O desperdício de pratos nas refeições do almoço apresentou média per capita de 64,15 g (consumo de 310,89g) no verão e de 135,99g (consumo de 248,12g) no inverno. O padrão do cardápio foi semelhante nas duas estações. Encontrou-se p <0,05 em relação à temporada na associação do odds ratio univariável. Pesquisas dessa natureza são importantes para auxiliar no prognóstico do paciente. (AU)

Diet therapy is essential for hospitalized patients. This study aimed to evaluate the acceptability of lunch meals in patients who received diet for diabetes mellitus (DM) and to verify aspects that may interfere with this consumption, such as seasons. This is a quantitative, descriptive study. The consumption of lunch meal in patients who received dietary DM in summer and a winter period in 2019 was evaluated. The data were verified in absolute frequencies, percentages, means, and the statistical test was the logistic regression with the association data at a 95% significance level (p <0.05) using the SPSS® 18.0 software. Two inpatient units were selected, with a sample of 49 individuals (63.3% males). Out of the 115 lunch meals served, 55.7% were partially consumed or not consumed. The plate waste for the lunch meals showed a mean per capita of 64.15 g (intake of 310.89g) in the summer and of 135.99g (intake of 248.12g) in winter. The menu pattern was similar for both seasons. It was found p <0.05 in relation to the season in the association of univariable odds ratio. This typo of research is important to assist in the patient's prognosis. (AU)

Involvement of the food industry in nutrition conferences in Latin America and the Caribbean

Objective: Identify and characterise the food industry's involvement in nutrition and dietetics national and regional events in Latin America and the Caribbean. Design: Between February and April 2020, we conducted desk-based searches for nutrition and dietetics events held in the region between January 2018 and December 2019. Online freely accessible, publicly available information was collected on the involvement of the food industry through: sponsorship of events; sponsorship of sessions; speakers from the food industry; scholarships, fellowship, grants, awards and other prizes and; exhibition space/booths. Setting: Nutrition and dietetics events in Latin America and the Caribbean. Results: Thirty-one events held in twenty countries of the region had information publicly available online at the period of data collection. There was a lack of transparency on the involvement of industry actors in these events. When information was publicly available, we found that a total of ninety-two food industry actors sponsored 88 % of these events. Conclusions: There is a mostly unreported, but likely extensive, involvement of food industry actors in nutrition and dietetics events in Latin America and the Caribbean.(AU)

Hábitos alimentarios, obesidad y sobrepeso en adolescentes de un centro escolar mixto / Eating habits, obesity and overweight in adolescents ofmixed school

RESUMEN Introducción: los hábitos alimentarios se adquieren de forma paulatina desde la infancia hasta la adolescencia con la influencia de factores culturales y el entorno social traducidos en errores en su alimentación. Objetivo: caracterizar el estado nutricional, consumo y hábitos alimentarios en adolescentes de un centro escolar multigrado de Pinar del Río durante los meses octubre y noviembre de 2017. Métodos: se utilizaron métodos descriptivo y transversal para analizar el estado nutricional, consumo y hábitos alimentarios en adolescentes de ambos sexos entre 12 y 17 años de un centro escolar de Pinar de Río, en una muestra aleatoria de 400 sujetos. Se aplicó una encuesta para la caracterización de los hábitos alimentarios, se realizaron mediciones antropométricas de peso y talla, y se midió la circunferencia abdominal en todos los escolares de la muestra. Se utilizó la estadística descriptiva mediante frecuencias absolutas y relativas porcentuales. Resultados: según el índice de masa corporal se detectó un 13 % de los adolescentes obesos y el 25 % sobrepesos; con una circunferencia abdominal en valores atípicos un 23 % de adolescentes, y 16 % con cifras consideradas como valores de riesgo para padecer obesidad. Omiten el desayuno, comen pocas frutas y vegetales, recurren a la comida chatarra adquiridas en cafeterías y preferencias por comidas ricas en grasas. Conclusiones: corroborada la existencia de malos hábitos alimentarios y se elaboró una guía dietética con orientaciones a profesores y padres para promover cambios en el estilo de vida de niños y adolescentes.

ABSTRACT Introduction: dietary habits are gradually acquired from childhood to adolescence with the influence of cultural factors and social environment resulting in errors on their diet. Objective: to characterize the nutritional status, consumption and eating habits of adolescents at a multi-grade school in Pinar del Río during October and November 2017. Method: a descriptive and cross-sectional research concerning the nutritional status, consumption and eating habits in adolescents of both sexes between 12 and 17 years old at a school in Pinar de Río, a random sample included 400 subjects. A survey was applied to characterize the dietary habits, anthropometric measurements of weight and height were made, and the abdominal circumference was measured in all schoolchildren who were included in the sample. Descriptive statistics was used by absolute and relative percentage frequencies. Results: according to the body mass index, 13 % of obese and 25 % overweight adolescents were detected; with an abdominal circumference in atypical values ​​23 % of adolescents, and 16 % with figures considered as risk values ​​for obesity. They skip breakfast, eat few quantities of fruits and vegetables, buy fast-food in cafeterias and confirmed their preferences for high-fat meals. Conclusions: the existence of poor eating habits was corroborated and a dietary guide was prepared including guidelines for teachers and parents to promote changes in the lifestyle of children and adolescents.

A Systematic Review on Factors Associated with Health-Related Quality of Life among Chronic Obstructive Pulmonary Disease Patients

@#Health-Related Quality of Life (HRQOL) is an important data in managing Chronic Obstructive Pulmonary Disease (COPD). Therefore, it is essential to determine factors that associated with HRQOL and identify the gaps for future research. A systematic search using PubMed, Science Direct and Scopus was performed to discover factors that could impact HRQOL among COPD patients. Socio-demographic factors like age, gender, educational level, smoking status, income were found associated with HRQOL. Other factors included Body Mass Index (BMI), comorbidities, sleep quality and exercise capability also could influence HRQOL of COPD patients. Other than that, lung function, dyspnea and exacerbation also found closely related with HRQOL. However, future study is needed to explore more factors such as nutritional status. Besides that, the finding only focused on general population and very little information on elderly population.

The concept of cooking skills: A review with contributions to the scientific debate / O conceito de habilidades culinárias. uma revisão com contribuições ao debate científico

ABSTRACT This paper aimed to conduct a literature review about the concept of cooking skills to contribute to the scientific debate about the subject. A systematic search was performed in the Scopus, PubMed/MedLine and Web of Science databases as well as the periodicals of the Federal Agency for Support and Evaluation of Graduate Education in Brazil Coordenação de Aperfeiçoamento de Pessoal de Nível Superior website, using the following Portuguese and English keywords: cooking skills, cooking and food/meal preparation. We also consulted references cited by these papers, electronic dictionaries (in Portuguese, English and French), technical documents found on public and private institutional websites, as well as books. Basic, etymological/vernacular and systematic definitions for cooking were identified, including historical global and national contexts. To conceptualize cooking skills, categories related to food and individuals were established, purposing a conceptual model. The category related to food referred to the use of unprocessed/minimal processed foods (which require procedures prior to their preparation), and/or processed/ultra-processed foods (which need a little or no preparation, such as re-heating). The category related to individuals involved dimensions such as confidence, attitudes, behavior, and individual knowledge used to prepare foods. The historical definitions of cooking allowed us to clarify the concept of cooking skills. Considering the global context of valuing and recovering cooking for the promotion of healthy eating, this review can contribute to the scientific discussion about the concept of cooking skills. The purposed conceptual model enables parameters to be established for further investigations, allowing cooking interventions to be directed toward promoting healthy eating.

RESUMO O objetivo do artigo foi realizar uma revisão de literatura sobre o conceito de habilidades culinárias, a fim de contribuir para o debate científico sobre o tema. Foi realizada busca sistemática de artigos nas bases de dados Scopus, PubMed/MedLine, Web of Science e portal de periódicos da Coordenação de Aperfeiçoamento de Pessoal do Ensino Superior, utilizando os seguintes descritores em português e inglês: habilidades culinárias, culinária, preparo dos alimentos/das refeições. Consultaram-se ainda referências citadas por esses artigos, dicionários eletrônicos (nos idiomas português, inglês e francês), documentos técnicos capturados em sites institucionais públicos ou privados, bem como livros. Identificaram-se definições para culinária denominadas como básicas, etimológicas/vernáculas e sistemáticas, incluindo um resgate histórico da culinária no contexto mundial e no Brasil. Para conceituar habilidades culinárias, foram estabelecidas categorias relacionadas aos alimentos e aos indivíduos, propondo-se um modelo conceitual. A categoria relacionada aos alimentos refere-se ao uso de alimentos in natura/minimamente processados (que requerem procedimentos prévios ao seu preparo), e/ou processados/ultraprocessados (que requerem pouco ou nenhum preparo, como reaquecimento). A categoria relacionada aos indivíduos envolveu dimensões como confiança, atitude, comportamento e conhecimentos individuais empregados para preparar os alimentos. As definições históricas de culinária permitiram elucidar o conceito de habilidades culinárias. Considerando o contexto mundial de valorização e resgate da culinária na promoção da alimentação saudável, essa revisão pode contribuir para o debate científico em torno do conceito de habilidades culinárias. O modelo conceitual proposto possibilita estabelecer parâmetros para avaliação em futuras investigações, permitindo direcionar intervenções culinárias para promoção da alimentação saudável.

Clinical, dietary and demographic characteristics interfering on quality of life of cancer patients / Características clínicas, dietéticas e demográficas que interferem na qualidade de vida de pacientes com câncer

ABSTRACT Objective To estimate the dietary intake of cancer patients and its relation with clinical and demographic characteristics, and to assess the contribution of dietary intake, appetite/symptoms and clinical and demographic characteristics to their quality of life. Methods The consumption of energy and macronutrients of patients was estimated. The relation between dietary intake and clinical and demographic characteristics was evaluated by analysis of variance. The intake of energy and macronutrient of the patients was compared to the nutritional recommendations using 95% confidence interval. The Cancer Appetite and Symptom Questionnaire (CASQ) and the European Organization for Research and Treatment of Cancer (EORTC QLQ C-30) were used to assess appetite/symptoms and quality of life, respectively. The psychometric properties of the instruments were estimated. A structural equation model was prepared. Results In this study, 772 cancer patients (63.1% women) participated. There was a significant relation between dietary intake and work activity, economic class, specialty field of cancer, type of treatment and nutritional status. Patients' energy and macronutrients intake was below recommended values. Both CASQ and EORTC QLQ C-30 were refined to fit the data. In the structural model, impaired appetite, more symptoms, presence of metastasis, being female and of higher economic classes were characteristics that significantly contributed to interfering in patients' quality of life. Conclusion The dietary intake of oncology patients did not reach the recommended values. Different characteristics impacted on quality of life of patients and should be considered in clinical and epidemiological protocols.

RESUMO Objetivo Estimar a ingestão dietética de pacientes com câncer e sua relação com características clínicas e demográficas, além de verificar a contribuição da ingestão dietética, apetite/sintomas e características clínicas e demográficas para a qualidade de vida deles. Métodos Foi estimado o consumo de energia e de macronutrientes. A relação entre ingestão dietética e características clínicas e demográficas foi avaliada pela análise de variância. A ingestão de energia e macronutrientes dos pacientes foi comparada com a necessidade nutricional, utilizando intervalo de confiança de 95%. O Cancer Appetite and Symptom Questionnaire (CASQ) e o European Organization for Research and Treatment of Cancer (EORTC QLQ C-30) foram utilizados para avaliar apetite/sintomas e qualidade de vida, respectivamente. As propriedades psicométricas dos instrumentos foram estimadas. Elaborou-se modelo de equações estruturais. Resultados Participaram do estudo 772 pacientes oncológicos (63,1% mulheres). Observou-se relação significativa entre ingestão dietética e atividade laboral, classe econômica, especialidade do diagnóstico, tipo de tratamento e estado nutricional. O consumo de energia e macronutrientes dos pacientes esteve abaixo do recomendado. Tanto o CASQ quando o EORTC QLQ C-30 foram refinados para bom ajustamento aos dados. No modelo estrutural, comprometimento do apetite, maior acometimento por sintomas, presença de metástase, ser mulher e pertencer às classes econômicas mais altas foram características que contribuíram significativamente para o comprometimento da qualidade de vida dos pacientes oncológicos. Conclusão A ingestão dietética dos pacientes oncológicos não atingiu os níveis recomendados. Diferentes características impactaram na qualidade de vida dos pacientes e devem ser consideradas em protocolos clínicos e epidemiológicos.

Dieta y ejercicio. Control y regulación en los discursos de profesionales de las expresiones motrices / Diet and Exercise. Control and Regulation of the Motor Expression Professionals' Speeches

Resumen Antecedentes: este artículo es producto de la investigación denominada Memorias a sol y a sombra. Recuperación de la experiencia en profesionales de las expresiones motrices (2014 - 2015), llevada a cabo con 20 egresados y egresadas del Instituto de Educación Física, de la Universidad de Antioquia (Medellín - Colombia). Objetivo: el objetivo de una de las perspectivas abordadas en el estudio fue caracterizar la cultura corporal de quienes ejercen en distintos escenarios de la educación física, el deporte, la recreación y afines y, específicamente, en este acercamiento se trata de identificar, en los discursos de estos profesionales de las expresiones motrices, las preocupaciones relativas a los hábitos alimentarios, la dietética y la nutrición, como mediadores de la salud -dimensión de la cultura corporal-, y revelar su potencial regulador del sujeto. Materiales y métodos: se fundamenta en la etnografía reflexiva, apoyada con entrevistas, registros visuales, observaciones y talleres e implementada con profesionales de las expresiones motrices, de la ciudad de Medellín. Resultados: el estudio permitió comprender la función de control de las orientaciones provenientes de la dietética en la doble vía: maestro-alumno, la recurrencia a los saberes del campo disciplinar de la Nutrición, en los discursos de los profesionales de las expresiones motrices, y la complejidad que entraña el acatamiento del deber ser, manifiesto en los hábitos alimentarios.

Abstract Background: This article is a product from the research named, On Sun and Shade Memories. This is a recovery from the experience of The Motor expressions stages (2014 - 2015), performed with 20 graduates of the Institute of Physical Education of the University of Antioquia (Medellín - Colombia). Objective: The aim of one of the perspectives addressed in the study, was to characterize the body culture of those who practice physical education, sports, recreation and related areas in different stages, and specifically, this approach is to identify the motor expression professionals' speech, the concerns about eating habits, dietetics and nutrition as mediators of health-body culture dimension- and to reveal individual's regulatory potential. Materials and Methods: Based on reflexive ethnography, supported by interviews, visual records, observations and workshops implemented with motor expression professionals from the city of Medellín. Results: The study allowed us to understand the control function of guidance coming from dietetics and nutrition in two ways: teacher-student, the recurrence to the knowledge on the nutrition and dietetics fields, from the speech of motor expressions' professionals and the complexity of compliance with what it should be, manifested in eating habits.

Caracterización de estudiantes de nutrición de la Universidad del Mar de Talca según composición de capital cultural y social / Characterization of nutrition students of the Universidad del Mar of Talca according to cultural and social capital composition

Considering the increase in higher education institutions that offer the Nutrition program and the paradigm shift in the healthcare area oriented to a bio psychosocial approach, which can be understood as a holistic look at the principal actors in the educational process and whose development is not only technical and professional, but also educational. The aim of this article was to describe the composition of the cultural and social capital of the students enrolled in the Nutrition and Dietetics program at the University del Mar of Talca. This was a quantitative, non-experimental, cross-sectional and descriptive study; a survey with close ended question was applied to 45 students. The descriptive statistics results were analyzed using SPSS v.20 and indicated the composition of cultural and social capital of the universe of this study, allowing characterization of each individual whose program training implies a search for social mobility, security, notions of self-expression, and valoric composition proper to modernity.

Considerando el incremento de instituciones de educación superior que ofertan la Carrera de Nutrición, y el cambio paradigmático en el área de salud orientado a un enfoque biopsicosocial, el que podemos entender como una mirada holística hacia los actores en este proceso educativo, cuyo desarrollo no es sólo técnico y profesional, sino también formativo; el presente artículo pretende describir la composición del capital cultural y social de estudiantes de la carrera de Nutrición y Dietética de la Universidad del Mar de Talca. Estudio cuantitativo, no experimental, transversal y descriptivo, con muestra de 45 estudiantes a quienes se les aplicó un cuestionario con preguntas cerradas. Los resultados analizados con estadística descriptiva y utilizando el programa SPSS v.20, indican que la composición del capital cultural y social de los sujetos, permite caracterizar a un estudiante cuya formación disciplinar implica una búsqueda de movilidad social, seguridad, generando nociones de autoexpresión, y una composición valórica muy propia de la modernidad.

Qualidade da dieta de pré-escolares beneficiados pelo Programa Bolsa Família, segundo a situação de Segurança Alimentar do domicílio / Diet quality of preschool children benefited by the ?Bolsa Família? Program according to the household food security status

benefited by the ?Bolsa Família? Program in Viçosa, Minas Gerais state, according to the food (in)security status of their households. Methods: A cross-sectional study was conducted with informed participation of the heads of households of 242 preschool children, aged 2-6 years, of both sexes, living in the urban area of the previously mentioned municipality. The Brazilian Food Insecurity Scale was used for the evaluation of food (in)security, while the Diet Quality Index, adapted to the Brazilian reality, was used for dietary assessment. Statistical analysis was performed by the Sigma Statistic software for Windows, version 3.5, using the Mann-Whitney and the Kruskal Wallis (p< 0.05) tests. Results: We found prevalence of 27.3% and 72.6% for food security and insecurity, respectively. According to the classification of the Diet Quality Index, the average score was 63.27 ± 7.94 for those under food security, 63.38 ± 8.06 for mild insecurity, 62.42 ± 8.10 for moderate insecurity, and 60.84 ± 7.39 for severe insecurity. No significant difference between the scores of the Diet Quality Index was found according to the classification of food (in)security, but it is worth mentioning that all the children (secure and insecure) investigated were below the recommended level for the intake of cereals, vegetables, fruits, and dairy products. Conclusions: These findings underscore the importance of using the Brazilian Food InsecurityScale along with another instrument capable of identifying, besides food (in)security, nutrition insecurity related to diet quality, so that action can be taken to improve nutrition and prevent nutritional disorders among children.

Objetivo: O objetivo deste artigo é avaliar a qualidade da alimentação de pré-escolares beneficiados pelo Programa Bolsa Família (PBF), do município de Viçosa-MG, segundo a situação de (in)segurança alimentar do domicílio. Métodos: Estudo transversal, com participação consentida pelos responsáveis de 242 pré-escolares, com idade entre 2 e 6 anos, de ambos os sexos, residentes da zona urbana do município. Para avaliaçãoda (in)segurança alimentar, utilizou-se a Escala Brasileira de Insegurança Alimentar (EBIA), e para avaliação da dieta, utilizou-se o Índice de Qualidade da Dieta (IQD), adaptado à realidade brasileira. A análise estatística foi realizada por meio do software Sigma Statistic for Windows versão 3.5 e utilizaram-se os testes de Mann-Whitney e Kruskal Wallis, sendo significante quando p<0,05. Resultados: A prevalência de segurança alimentar encontrada foi de 27,3%, enquanto a de insegurança, 72,6%. Segundo classificação do IQD, a média de pontos foi de 63,27±7,94 para aqueles em segurança alimentar; 63,38±8,06, em insegurança leve; 62,42±8,10, em insegurança moderada, e 60,84±7,39, em insegurança grave. Não foi encontrada diferença significante entre a pontuação do IQD, segundo a classificação de (In)Segurança Alimentar, mas ressalta seque todas as crianças (seguras e inseguras) apresentaram consumo abaixo do recomendado de cereais, hortaliças, frutas e leite e derivados. Conclusões: Isso ressalta a importância de se utilizar a EBIA junto a outro instrumento capaz de identificar, além de (in)segurança alimentar, a insegurança nutricional relacionada à qualidade da dieta, para que seja possível adotar medidas a fim de melhorar a alimentação e prevenir distúrbios nutricionais.

Aproximaciones cualitativas al estudio de obesidad: nuevas contribuciones a la comprensión de la nutrición humana / Qualitative approaches to studying obesity provide a fresh contribution towards understanding human nutrition

La obesidad se constituye en un problema de salud pública profusamente evidenciado epidemiológica y clínicamente, que tiende a aumentar en diferentes regiones del mundo. Ante esta situación, en el escrito se propone asumir la necesidad de ahondar también en las características cualitativas necesarias para tener una perspectiva completa sobre las dimensiones psicológicas, sociales y culturales de un fenómeno complejo y multicausal, en el marco general e interdisciplinario de la salud y de los estudios de la nutrición humana. De tal modo, se muestra la reciente inclusión de las aproximaciones cualitativas en los estudios sobre alimentación y nutrición humana. Seguidamente, se plantean ejemplos de esta inclusión centrados en la problemática emergente de obesidad y sobrepeso, se enfatiza en el imperativo de avanzar hacia la comprensión de la experiencia humana de la obesidad a partir de la aproximación contextual y del reconocimiento de la vivencia específica de los sujetos en dicha condición. Finalmente, se asume que los estudios cualitativos permiten un acercamiento a nuevos elementos sociales y culturales, favorecen la ampliación del espectro de comprensión habitual del fenómeno y ofrecen contribuciones significativas, tanto para la caracterización de la problemática como para el diseño e implementación de acciones que contribuyan a su resolución, aprovechando la labor interdisciplinar, así como la utilización rigurosa y creativa de metodologías y técnicas propias de los enfoques cualitativos.

It has been epidemiologically and clinically demonstrated that obesity constitutes a main public health problem worldwide. This paper poses the need for assuming the qualitative characteristics necessary for a complete perspective regarding the psychological, social and cultural dimensions of such complex phenomenon within a framework of interdisciplinary healthcare and nutritional studies. Including qualitative approaches when studying human nutrition and food specifically focuses on the growing problem of obesity and being overweight and emphasises the need to move towards understanding human obesity from a contextual approach and recognising the specific experience of the obese. It has been assumed that qualitative studies will provide a fresh approach to social and cultural elements, thereby increasing understanding obesity from a medicine-based approach and making a significant contribution to problem characterisation and designing and introducing action aimed at its resolution which has been based on interdisciplinary dialogue and the rigorous and creative use of qualitative approaches' methodologies and techniques.

Concepciones curriculares del Programa de Nutrición y Dietética en la Universidad Nacional de Colombia (1965-2013) / The Universidad Nacional de Colombia's Nutrition and Dietetics Programme's curricular concepts (1965-2013)

Las concepciones curriculares que han orientado el programa de Nutrición y Dietética de la Universidad Nacional de Colombia se encuentran implícitas en los documentos de reforma curricular, elaborados en diferentes momentos desde la creación del programa. El presente documento pretende aportar una revisión documental en torno a los factores que influyeron en la construcción de los diseños curriculares adelantados en el programa hasta el presente, en la concepción del proceso alimentario y nutricional como objeto de estudio de la profesión, y su incidencia en el proceso formativo de Nutricionistas Dietistas de esta alma máter.

The curricular concepts which have guided the Universidad Nacional de Colombia's Nutrition and Dietetics Programme have been implicit in curriculum reform documents issued since the programme's inception. This paper was aimed at providing a literature review concerning the pertinent factors influencing an approach to curriculum design to date regarding an understanding of food and nutrition as an object of study for our profession and its impact on dietician/nutritionist training/education at the university.

Assessing the Value of a Nutrition and Dietetic Service Website.

Background: The Leicestershire dietetic service developed a website (www.lnds.nhs.uk) in 2004 with three levels of access; for the public, health care professionals (HCPs) and dietitians. Over 450 resources are available on the site. The website has never been evaluated, though is perceived as being used frequently by dietitians. Access to nutrition websites has increased over recent years. Marquis et al. and Buttriss [1,2] have discussed how nutrition websites are used by dietitians and the public and how and why their popularity has increased. The study aimed to explore the value attached to the department website, the costs of running it and make recommendations for future development of the website. Methods: The researcher developed a Survey Monkey (www.surveymonkey.com) questionnaire, containing 12 questions to assess how visitors used the website and what they viewed. This was attached to the website for 6 weeks in spring 2013. Local Health Information Services (HIS) and Google Analytics information was available to look at retrospective website activity. Information on departmental printing costs was available to see if this had reduced over the time the website had been live. Results: Fifty four website users responded to the online questionnaire and indicated that this sample of users visited the website regularly and could find the information they were looking for. On a scale of 1-5, with 5 being a very positive response, the average rating for useful information was 4.19 and the average rating from users for the quality of the information was 4.27. The retrospective information showed that users, repeat users and pages viewed had increased steadily over the last 3 years. Unique visitors had increased from 7986 in 2011 to 10641(predicted in 2013) and return visitors had increased from 50.9% in 2011 to 57.6% (predicted) in 2013. The website users were a range of patients/public, HCPs and dietitians and although most users were from the UK there was an increasing worldwide audience. The printing budget had reduced over recent years while the number of dietetic staff employed and patients seen had increased between 2010 and 2012. Discussion: The results of the online questionnaire and Google Analytics data provided information that indicated the range of visitors valued the website and could mostly find what they were looking for. Improvements were identified e.g. a better search facility and consideration given to setting up Facebook/Twitter accounts to allow user experience to be captured on an on-going basis. The website was a very cost effective way of providing, accessible, evidence based, patient centred resources when compared with other ways of providing dietary information to patients and HCPs in Leicestershire. Conclusions: The website was valued and should be maintained with consideration given to the improvements recommended.