https://repositorio.ufba.br/handle/ri/9426 2026-05-05T02:58:33Z https://repositorio.ufba.br/handle/ri/43488 Título: Análise das Conferências Nacionais de Segurança Alimentar e Nutricional no contexto de formulação de políticas públicas Autor(es): Ramos, Flávia Pascoal Primeiro Orientador: Santos, Sandra Maria Chaves dos Abstract: The research, of the exploratory type, aims to analyze the contributions generated by the National Conferences on Food and Nutrition Security (NCFNS) for the elaboration of public policies, particularly in relation to programs of interest for the promotion of Food and Nutrition Security (FNS). This is a qualitative-quantitative research, whose qualitative part was developed through semi-structured interviews with seven members and former members of the National Food and Nutrition Security Council. Data analysis was based on thematic content analysis. For the quantitative part, documentary analysis was used, whose sources of information were the final reports and normative acts (convocations acts and regulations) of the five NCFNS held in Brazil in the period from 1994 to 2015. The research was divided into three phases: the first analyzed the data from the normative acts and reports, categorizing them into five groups: G1- Characterization of conferences; G2- Form of organization; G3- Rules for deliberation; G4- Inclusive potential; and G5- Outputs of the conference process. For the second, the recommendations for FNS public policies contemplated in the reports were analyzed. The third phase was carried out in two stages: the first consisted in the identification of recommendations directed to PNAE and the second consisted in the search for legislative projects that had thematic pertinence with the demands of the NCFNS to the mentioned Program in the 24 months after each event. Main results: most of the NCFNS aimed at proposing public policies, with the III NCFNS being the most propositional; a quota system was established as of the III NCFNS, expanding the participation of traditional peoples and communities; the NCFNS mobilized a large number of participants and municipalities; regarding the nature of the recommendations, 22% met the criterion of being propositional; all the classic dimensions of FNS, were object of recommendations in the whole of the NCFNS; food availability was the dimension with most recommendations, supported by the thematic categories of agrarian reform, strengthening family of agriculture and rural Credit Stimulus; in the last NCFNS the food consumption dimension stood out; a set of NCFNS recommendations for PNAE focused on transforming it into a public policy that contributes to guaranteeing the rights of school children; legislative bills were found relevant to 41.7% of the NCFNS recommendations for PNAE, indicating that there is convergence between the NCFNS and the Brazilian legislative agenda; two laws were approved during the studied period. The results reveal that although the NCFNS declare themselves as propositional, the analysis showed a low number of recommendations for public policies. However, it was possible to identify the contributions of the NCFNS for the FNS agenda in Brazil, as well as the main recommendations for the PNAE. From all the results, it can be concluded that the NCFNS that took place constituted a social and political space of relevance for FNS the country. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Tese 2021-05-03T00:00:00Z https://repositorio.ufba.br/handle/ri/41473 Título: Estresse ocupacional, padrão alimentar e composição corporal de trabalhadores de hospital Autor(es): Lira, Carlos Rodrigo Nascimento de Primeiro Orientador: Costa, Priscila Ribas de Farias Abstract: Introduction: Occupational stress is a reality in hospitals and a global public health problem, being aggravated by precarious working conditions. Among the stages of occupational stress on workers' health, negative impacts on body composition are observed. Aim: To evaluate associations between occupational stress, dietary patterns and body composition in hospital workers. Methods: Two methodological approaches were adopted. The first was a systematic review (PROSPERO: CRD42022331846), where the search was carried out in seven databases, gray literature, manual search and contact with experts. The selection of studies occurred independently by two evaluators following the pre-established inclusion criteria. Risk of bias was assessed using the Joanna Briggs Institute checklist and certainty of evidence presented by the Recommendation Assessment, Development and Evaluation Classification. In the primary study, 218 workers from a private hospital in Santo Antônio de Jesus - Bahia, were included in the sample. Sociodemographic, occupational, lifestyle data, body composition (by bioelectrical impedance and anthropometry), food consumption and occupational stress were eliminated before and during the COVID-19 pandemic. After evaluating the normality of the data, parametric and/or non-parametric tests were used according to relevance. Furthermore, for article II, we performed Exploratory Factor Analysis to identify the dietary pattern and Structural Equation Modeling to test the desired model. In article III, in addition to descriptive and bivariate statistics, we also carried out Mixed Effects Modeling. Results: In article I, which dealt with a systematic review, we identified that 10 of the 12 studies were carried out only with health professionals. Even so, a relationship was observed between occupational stress and changes in Body Mass Index (BMI) in these workers. However, most studies presented moderate or high risk to life and low quality of evidence. In article II, we observed that three dietary patterns had a direct effect on the latent variable “occupational stressors” and, only in Pattern A (b= -0.133; p=0.185) this effect was negative. In Pattern B (b= 0.225; p=0.023) and Pattern C (b= 0.144; p=0.278) there was a direct and positive effect on the latent variable, with Pattern B being the only statistically significant one. Even so, the latent variable exerted a direct and positive mediating effect on the variables BMI (b=0.478; p<0.001), waist variations (b=0.395; p=0.001), Fat Free Mass (FFM) (b =0.440; p=0.001) and Fat Mass (FM) (b= -0.104; p=0.292). Finally, in article III, the results indicate that high demand and low control at work are risk factors for changes in BMI (p=0.023; p=0.008), MG (p=0.044; p=0.015) and FFM (p =0.054) in hospital workers over time. Conclusion: Both general occupational stress and high demand and low control at work, dimensions of the instruments evaluated separately, are risk factors for changes in BMI, MG and FFM of hospital workers. Even so, a dietary pattern with calorie-dense foods favors changes in the body composition of these workers, with occupational stressors mediating this relationship. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Tese 2024-08-02T00:00:00Z https://repositorio.ufba.br/handle/ri/40786 Título: Saúde muscular em pacientes portadores de doença renal crônica não dialítica: marcadores clínicos nutricionais e de qualidade de vida Autor(es): Gomes, Tarcisio Santana Primeiro Orientador: Medeiros, Jairza Maria Barreto Abstract: The progression of chronic kidney disease is accompanied by multiple nutritional and metabolic abnormalities, which can compromise renal function, affecting the clinical and nutritional status of these patients. Among the nutritional alterations, sarcopenia and dynapenia stand out, terms used to designate a reduction in muscle mass, muscle strength and physical performance. OBJECTIVES: To identify the association of muscle quality markers with clinical, nutritional and quality of life aspects in patients with non-dialytic chronic kidney disease. METHODS: This is a cross-sectional study conducted from January to September 2012 with patients with CKD stages 3 to 5 (stage 5 non-dialysis) who were followed at the Nutrition and Nephropathy Outpatient Clinic of the Professor Francisco de Magalhães Neto Outpatient Clinic. Adult patients (20 and <60 years) and elderly patients (≥60 years), of both sexes, with creatinine clearance between 89 and 15 ml/min/1.73m², participated in this study. Anthropometric, body composition, muscle strength, biochemical and quality of life indicators were evaluated. RESULTS: The results presented allow us to conclude that sarcopenia and dynapenia are prevalent in patients with CKD-ND and that, according to the review performed, they are prognostic of severity, including mortality. It is worth noting that muscle health indicators were associated with quality of life domains related to physical health in this population. In addition, it was observed that the phase angle and HGS measurement can be indicators to assess muscle quality in these patients. CONCLUSION: our studies reinforce the importance of monitoring nutritional indicators associated with muscle quality in order to reduce possible clinical and nutritional complications and the impact on quality of life in patients with non-dialysis-dependent chronic kidney disease. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Tese 2024-10-04T00:00:00Z https://repositorio.ufba.br/handle/ri/40080 Título: Aconselhamento em nutrição na doença inflamatória intestinal: de novos marcadores à assistência Autor(es): Passos, Rebeca Araujo Primeiro Orientador: Santos, Raquel Rocha dos Abstract: INTRODUCTION: Nutrition is an important component of the clinical care of people with Inflammatory Bowel Disease (IBD). Nutrition counseling (NC) provided by health professionals with expertise in nutrition can promote the best nutritional advances and prognoses. OBJECTIVE: To evaluate factors that may allow for more effective nutrition interventions to assist people with IBD. METHODS: This thesis consists of three methodological sections, culminating in 3 bibliographical products: 1. Systematic review of the potential of thiols as a biomarker of IBD activity, aiming to direct more assertive nutritional interventions; 2. Review of the evidence inherent to NC as a care strategy for IBD, seeking to characterize the importance and effectiveness of NC for better assistance in IBD; 3. Historical cohort study, involving adult and elderly individuals, who underwent clinical follow-up at a reference outpatient clinic for the treatment of IBD. The data contained in the participants' medical records were allocated into 2 evaluation groups, based on specialized assistance: I. group assisted by registered dietitian nutritionist (SN) and II. group not assisted by registered dietitian nutritionist (NN), and evaluated at the first and last consultations at the reference outpatient clinic for IBD care. The data were treated statistically to verify the association between clinical and nutritional variables and specialized assistance. RESULTS: The results of the investigations of this thesis are presented in the form of 3 manuscripts: 1. Thiols as a marker of inflammatory bowel disease activity: a systematic review: individual studies included in this review suggest an association between disease activity and systemic oxidation, measured by serum thiol levels; 2. Nutrition counseling in inflammatory bowel disease: a review based on WH questions: NC is an important strategy for the treatment of IBD, it must occur early and continuously. The registered dietitian nutritionist (RDN) is the professional who brings together specific skills and competencies for safe and effective NC; 3. Assistance from RDN favors better nutritional evolution of individuals with inflammatory bowel disease: Having been assisted by RDN increased the chance of using a dietary supplement (p=0.029). The SN had a lower erythrocyte sedimentation rate in the final evaluation, suggesting that it was less inflamed than the NN (P =0.042). The NN showed greater weight variation during the assessment interval. Adequate body mass index evolution was associated with RDN assistance (P=0.018). CONCLUSION: Thiols may be a good parameter for monitoring the clinical course of IBD. Specialized care from RDN may favor better clinical and nutritional evolution of people with Crohn's disease and ulcerative colitis, considering the role of RDN in effective NC, justifying the inclusion of RDN as mandatory members of multidisciplinary care teams in IBD. More robust studies may confirm these findings and direct more assertive nutritional interventions in IBD. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Tese 2024-07-29T00:00:00Z