Programa de Pós-graduação em Nutrição e Saúde
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Navegando Programa de Pós-graduação em Nutrição e Saúde por Por Orientador "CAMPOS, Maria Raquel Hidalgo"
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Item Contagem de carboidratos e perfil metabólico de adolescentes com diabetes melito tipo 1 atendidos no Hospital das Clínicas/UFG, Goiânia(Universidade Federal de Goiás, 2012-05-10) ALBUQUERQUE, Izabela Zibetti de; STRINGHINI, Maria Luiza Ferreira; http://lattes.cnpq.br/3705544548242014; CAMPOS, Maria Raquel Hidalgo; http://lattes.cnpq.br/9910969694141110Objective: The aim of the study was evaluated the effect of carbohydrate counting, for four months, on anthropometric parameters, body composition, biochemical and food intake in adolescents with type 1 diabetes mellitus. Methods: Clinical trial, controlled and randomized study at the Clinic of Endocrinology, Hospital das Clinicas, Federal University of Goiás, with 28 patients divided into intervention group (IG - carbohydrate counting) and control (CG - no counting carbs) and monitored fortnightly. At the beginning and end of the study data were collected on: anthropometric (weight, height and waist circumference), body composition (skinfold thickness and subscapular), biochemical (fasting glucose - FPG, postprandial glucose - GPP, glycated hemoglobin - A1C, total cholesterol - TC, triglycerides - TG, high density lipoprotein - HDL-c and low density lipoprotein - LDL-c) and, fortnightly, 24-hour recalls. Statistical analysis was performed using the statistical package SPSS version 18.0. For categorical variables used the chi-square and Fisher exact test. Shapiro-Wilk test to assess the normality of continuous variables, paired t test or Wilcoxon test for intragroup analysis, and Student's t test or Mann-Whitney test for intergroup analysis. The significance level was 5%. Results: The CG increased A1C (p=0.024) and both groups decreased energy intake (CG: p=0.005; IG: p=0.002). IG decreased A1C (p=0.002), but increased the CT (p=0.009) and LDL-c (p=0.012). This group also increased the caloric intake of carbohydrates (p=0.005) and decreased caloric intake of fat (p=0.002). There were a decreased in FPG and A1C (p=0.033 and p<0.001, respectively) in IG and increased CT and LDL-c (p=0.004 and p=0.019, respectively). The mean capillary glucose pre-and post-prandial were not affected between groups (p>0.005), although the oscillation glucose was lower in IG. Conclusion: Carbohydrate counting resulted in improved glycemic control and glucose concentrations more constant. However, this practice was associated with increased CT and LDL-c. Patients who have applied this strategy increased the caloric intake of carbohydrates and decreased consumption of fat.Item Eficácia da implantação das boas práticas de preparação na qualidade microbiológica de dietas enterais de um hospital público(Universidade Federal de Goiás, 2011-03-25) ALBUQUERQUE, Marinez Ferreira Barbosa; CAMPOS, Maria Raquel Hidalgo; http://lattes.cnpq.br/9910969694141110Poor hygienic sanitary conditions in the processing of enteral diets constitutes in risks of microbial contamination, and may involve complications in patients with enteral nutrition, ranging from infections digestive up to systemic infections. For this reason is important its microbiological control, whereas individuals to whom they are intended, are more susceptible to infections. Thus, this study aimed to compare the hygienic conditions of enteral diets before and after the implementation of Good Manufacturing Practices in a public hospital in Brazil. The study was developed in the Enteral Diet Unit of the Goiânia Emergency Hospital in three stages. In stage 1 before the implantation of good practices, carried out between November and December of 2008, was diagnosed the preparation conditions of the enteral diets by systematic observation of the conduct adopted by food handlers. Was applied the check list proposed by Resolution RDC nº 63 of Agência Nacional de Vigilância Sanitária/Brazil and realized microbiological analyzes of 40 samples of each element investigated: filtered water, powdered diet, reconstituted enteral diet and food handler s hand and nasal cavity culture. The good practices were implemented in phase 2, between January and June 2009, by educational training through the Maguerez Arch technical, development of Good Manufacturing Practices Handbook and by structural changes in the Enteral Diet Unit. In stage 3, between September and November 2009, was applied again the check list and repeated all microbiological analyzes carried out in the first phase, in addition the reconstituted enteral diets were analyzed at ambient temperature at Time 0 (preparation) and 1, 2, 3, and 4 hours after preparation. Both in stage 1 and 3, viable aerobic mesophilic microorganisms, total coliforms, Escherichia coli, coagulase-positive staphylococci, Staphylococcus aureus, Salmonella sp., and Pseudomonas aeruginosa were investigated. The results were compared with standards established by the Brazilian Sanitary Surveillance Legislation. Were used the software SPSS version 17.0 and STATA version 8.0 for statistical analysis and applied the McNemar test and Fisher exact test. The implementation of good practices significantly increased conformity to checklist items from 50.8% to 78.8% (p<0.001) and reduced the prevalence of contamination in the reconstituted enteral diet from 40.0% to 15.0% (p=0.031). The enteral diet could be considered safe after up to four hours at room temperature because asceptic preparation techniques were strictly followed. A significant reduction in the presence of Escherichia coli in the food handler s nasal cavity was detected (p=0.021). Conclusion: The implementation of good manufacturing practices contributed to the improvement of the enteral diet s hygienic sanitary conditions. Continued training is recommended to improve the food handlers competenciesItem Riscos à segurança alimentar e nutricional: percepções de manipuladores de panificadoras(Universidade Federal de Goiás, 2012-05-30) FERREIRA, Ilvana Abreu de Sousa; CORREIA, Marcia Helena Sacchi; http://lattes.cnpq.br/6315630239535922; CAMPOS, Maria Raquel Hidalgo; http://lattes.cnpq.br/9910969694141110The concept of food security and nutrition was limited to supply the appropriate amount. However, it was extended also incorporating universal access to food, the nutritional aspect and therefore the issues of composition, quality and biological utilization. This security should be discussed, also because of the risks to health caused by food, since the Foodborne Diseases are gradually increasing in developing countries and developed countries. According to FAO, recognize the importance of controls in food production that includes the general principles of food hygiene and Good Manufacturing Practices (GMP) as prerequisites or as the basis for the effective deployment of the system of Hazard Analysis and Critical Control. Considering the magnitude of the industry, bakeries and pastry shops as well as other units that produce food and meals should adopt the GMP, so that food quality have produced satisfactory hygienic quality health. In this context, it is proposed to analyze the perception of risk in the health of food by food handlers in bakeries in Goiânia, Goiás and describe the facilitating factors or the difficulties of the implementation of quality programs in bakeries. This is an exploratory study employing qualitative technique of focus groups, whose interpretation was been revealed through thematic content analysis. The research was conducted with handlers of production and service units of six bakeries that produce of one network of Goiânia, Goiás. Data analysis revealed that the group has a sense of sanity to the microbiological risks of food, health risks to consumers, and revealed the effects of knowledge on hygienic handling of food. In view of the handler food safety is shared between the manipulator, the company and the consumer. So, were considered as factors that facilitate the health of food in Bakeries personal values, ethics and responsibility of each handler; recognize the company's commitment to provide the resources needed for appropriate practices and motivating role of the client with the requirement of quality products. However, point out what needs improvement, being considered complicating factors: unhealthy physical conditions, with excess heat and smoke in the environment, damaged equipment, insufficient staff and lack of adherence by all handlers of the team. Were recognized by the manipulators of inadequate care attitudes in the process of selling products, such as exposure to room temperature and inappropriate behavior of consumers.Item Qualidade Higiênico-Sanitária da Alimentação Oferecida em Escolas Públicas do Estado de Goiás(Universidade Federal de Goiás, 2011-03-31) GOMES, Nair Augusta de Araújo Almeida; MONEGO, Estelamaris Tronco; http://lattes.cnpq.br/0917323812776538; CAMPOS, Maria Raquel Hidalgo; http://lattes.cnpq.br/9910969694141110The National School Feeding Program (PNAE) is an opportunity for the government to consolidate food safety and nutrition. Such program is carried out by offering all students from Brazilian public and philanthropic schools at least a meal daily. Several studies have demonstrated that the sanitary quality of the school meals is not in accordance with the requirements of the Brazilian sanitary legislation, which could affect the food safety and therefore favor the occurrence of food-borne diseases. The aim of this study was to assess the hygienic quality of the meals served in public schools of the state of Goiás, Brazil, and compare the results with the diagnosis phase of the research conducted from 2004 to 2007. This is an observational analytical study carried out in the state of Goiás, Brazil, in 18 school food services located in the capital city, Goiânia, and in 13 surrounding municipalities, in May and June 2010. The food services were evaluated using a check list following the recommendations of the Resolution RDC no. 216/2004 of the National Agency of Sanitary Surveillance (ANVISA). Also, samples of the school meals served in these institutions were collected for microbiological analysis performed according to the methodology of the American Public Health Association, 2001. Statistical analyses were performed using the Statistical Package for the Social Sciences (version 17.0). The schools assessed partially complied with the legal requirements, since the inadequacies of the evaluated items were present in 44.9% of them in the diagnosis phase (2004 to 2007) and in 37.1% of them in the monitoring phase (2010), which could endanger the health of the students attended. The highest rates of non-compliance observed refer to personal hygiene of food handlers and building conditions. The following items assessed presented statistically significant results: absence of skin disorders and infections, participation in training programs, proper hygienic habits, proper water tanks hygiene and cleanliness, and proper destination of other wastes produced. No food analyzed presented inadequacies according to the microbiological standards established by the health legislation. Therefore, it is assumed that the heat treatment used and the short time between food preparation and distribution contributed to these results. This study evidenced the need for periodical training programs and continuous supervision carried out by nutritionists, as well as remodeling and improving the physical structure of school food services as a strategy to promote and ensure the students right to adequate and safe food.