Introdução: Dentre as carências nutricionais de maior relevância destacam-se, neste estudo, anemia e deficiência de vitamina A, que constituem as principais preocupações das políticas públicas, na área de alimentação e nutrição. Apesar de medidas de prevenção e controle já terem sido implantadas no Brasil há algum tempo, suas prevalências continuam elevadas, com profundas repercussões na saúde infantil. Assim, embora reconhecidos como problemas de saúde pública e bastante explorados, politicamente, ainda há espectros de interesse epidemiológico a serem investigados. Objetivo: Analisar os determinantes da anemia e da deficiência de vitamina A (DVA), bem como a presença concomitante dessas duas carências nutricionais em crianças brasileiras. Métodos: Reanálise dos dados da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS) de 2006, abrangente inquérito das condições de saúde de mulheres e crianças brasileiras cuja 3ª edição incorporou a avaliação dos níveis de hemoglobina e vitamina A. Essa reanálise baseou-se numa amostra probabilística complexa com representação nacional, o que permitiu descrever a situação de anemia e DVA nas macrorregiões brasileiras e suas áreas urbanas e rurais. O presente estudo incluiu a análise de 3.417 crianças de 6 a 59 meses. Anemia foi definida como hemoglobina (Hb) <11g/dL, determinada pelo método da cianometa-hemoglobina. DVA foi definida como retinol sérico <0,7mol/L, avaliado por cromatografia líquida de alta eficiência. Para expansão da amostra utilizaram-se critérios adotados pela PNDS. As variáveis respostas foram presença de anemia, de DVA e carência concomitante de DVA e anemia, enquanto as explanatórias, analisadas considerando-se três dimensões, foram vinculação aos processos estruturais da sociedade (variáveis socioeconômicas e ambientais); ao ambiente imediato da criança (variáveis maternas, de segurança e consumo alimentar); e individual (características biológicas da criança). A força de associação entre as variáveis respostas e as explanatórias foi avaliada pelo odds ratio (OR), tanto na análise univariada (OR bruta) quanto na múltipla (OR ajustada), com nível de significância de 5%. Resultados: Determinantes da anemia: A prevalência de anemia no País foi de 20,5%. Na análise múltipla, permaneceram associadas à anemia residir no Nordeste [OR: 3,45; IC: 2,21-5,40] Sudeste [OR: 2,55; IC: 1,60-4,06] e Sul [OR: 2,22; IC: 1,39-3,55]; na zona urbana [OR: 2,01; IC: 1,35-3,00]; e ter insegurança alimentar grave [OR: 1,78; IC: 1,00-3,16], destacando-se como proteção ter mãe com 5 a 8 anos de estudo [OR: 0,62; IC: 0,41-0,92] e consumir carne pelo menos uma vez na semana [OR: 0,45; IC: 0,22-0,93]. Determinantes da DVA: A prevalência de DVA no País foi de 17,5%. Após ajuste para as variáveis de confusão, permaneceram associadas ao DVA residir no Nordeste [OR: 1,77; IC: 1,16-2,77] e Sudeste [OR: 1,74; IC: 1,16-2,72]; na zona urbana [OR: 1,29; IC: 0,91-1,87]; e ter mãe com idade 36 anos [OR: 3,14; IC: 1,48-7,09], considerando-se proteção consumir carne pelo menos uma vez na semana [OR: 0,19; IC: 0,09-0,40]. Determinantes da DVA e da anemia: A prevalência concomitante de DVA e anemia foi de 3,9%, sem associação entre elas (p>0,05). As variáveis estatisticamente associadas (p<0,05) com DVA e anemia na análise múltipla foram residir no Sudeste [OR: 4,28; IC: 1,96-11,68] e Nordeste [OR: 2,92; IC: 1,31-7,96]; na zona urbana [OR: 3,66; IC: 1,46-12,30]; e ter insegurança alimentar grave [OR: 3,64; IC: 1,41-8,84]; revelando-se proteção ter idade 2 anos de idade [OR: 0,51; IC: 0,26-0,99]; e consumir carne pelo menos uma vez na semana [OR: 0,04; IC: 0,00-0,23]. Conclusões: Os resultados mostram redução importante na prevalência de anemia e DVA infantil no Brasil, embora, de acordo com o critério de importância epidemiológica da Organização Mundial da Saúde (OMS), continuem como problema moderado de saúde pública. Apesar das fortes evidências de que a DVA contribui para o desenvolvimento da anemia, constatou-se baixa prevalência concomitante dessas duas carências nutricionais entre as crianças brasileiras, e sem associação entre elas. Entretanto, anemia e DVA apresentam determinantes comuns (residir em macrorregiões menos e mais desenvolvidas e em área urbana), que reiteram o caráter trans-social dessas carências estudadas. O fato de terem como determinante a insegurança alimentar e como proteção consumir carne pelo menos uma vez por semana reforça a determinação social dessas deficiências nutricionais, embora a insegurança alimentar não tenha se associado à DVA. Os resultados evidenciaram como principais determinantes da anemia e da DVA aqueles relacionados aos processos estruturais da sociedade e do ambiente imediato da criança e não os individuais. Constatou-se, também, que as estratégias governamentais têm contribuído para a prevenção e controle dessas carências nutricionais no País, porém, sinaliza-se a necessidade de expansão da estratégia governamental no sentido de prevenção e controle da DVA, até então restrita a áreas de risco (região Nordeste e áreas pobres da região Sudeste). / Introduction: Among the most relevant nutritional deficiencies, anemia and vitamin A deficiency stand out, constituting the main concerns of public policy in food and nutrition area. Even though prevention and control measures have already been implemented in Brazil some time ago, their prevalence remains high, with profound effects on child health. Thus, in spite of recognized as problems of public health and plenty explored, politically, there are still spectra of epidemiological interest to be investigated. Objective: To analyze the determinants of anemia, vitamin A deficiency (VAD), as well as these two concomitant nutritional deficiencies in Brazilian children. Methods: Reanalysis of data from the National Survey on Demography and Health of Women and Children (PNDS) of 2006, comprehensive survey of health of women and children in Brazil, whose 3rd edition incorporated the evaluation of hemoglobin and vitamin A levels. This reanalysis was based on a complex random sampling with national representation, which allowed describing the situation of VAD and anemia in Brazilian regions and their urban and rural areas. This study included analysis of 3.417 children aged from 6 to 59 months. Anemia was defined as hemoglobin (Hb) <11g/dL, determined by cyanometahemoglobin method. VAD was set as serum retinol <0.7 mol/L, evaluated by high performance liquid chromatography. To expand the sample, the criteria adopted by PNDS were used. The variable responses were presence of anemia, VAD and concomitant deficiency of VAD and anemia, while the explanatory, analyzed considering three dimensions, were link to the structural processes of society (socioeconomic and environmental variables), to the immediate environment of the child (maternal variables, of safety and food consumption); and individual (biological characteristics of the child). The strength of association between the response and the explanatory variables was evaluated by odds ratio (OR), both in univariate (crude OR) and in multiple analysis (adjusted OR), with a significance level of 5%. Results: Determinants of anemia: The prevalence of anemia in the Country was 20.5%. In multiple analysis, remained associated with anemia living in the Northeast [OR: 3,45, CI; 2,21-5,40], Southeast [OR: 2,55; CI: 1,60-4,06] and South [OR:2,22;IC:1,39-3,55]; in urban area [OR: 2,01; CI: 1,35-3,00], and having severe food insecurity [OR: 1,78; CI :1,00-3,16], highlighting as protection having a mother with 5 to 8 years of study [OR: 0,62; CI: 0,41-0,92] and consuming meat at least once a week [OR: 0,45; CI: 0,22-0,93]. Determinants of VAD: The prevalence of VAD in the Country was 17.5%. After adjustment for confounding variables, remained associated with DVA living in the Northeast [OR: 1,77; CI: 1,16-2,77] and Southeast [OR: 1,74; CI: 1,16-2,72]; in urban area [OR: 1,29; CI: 0,91-1,87]; and having a mother aged 36 years [OR: 3,14; CI :1,48-7,09], considering protection to consume meat at least once a week [OR: 0,19; CI: 0,09-0,40]. Determinants of anemia and VAD: The concomitant prevalence of VAD and anemia was 3.9%, with no association between them (p>0,05). Variables statistically associated (p <0.05) with VAD and anemia in multiple analysis were living in the Southeast [OR: 4,28; CI: 1,96-11,68] and Northeast [OR: 2,92; IC: 1,31-7,96]; in urban area [OR: 3,66; CI: 1,46-12,30], and having severe food insecurity [OR: 3,64; CI: 1,41-8,84]; revealing protection being 2 years old [OR: 0,51; CI: 0,26-0,99] and consuming meat at least once a week [OR: 0,04; CI: 0,00-0,23]. Conclusions: The results show a significant reduction in the prevalence of child anemia and VAD in Brazil, although according to the criterion of epidemiological importance of the World Health Organization (WHO), they continue as a moderate public health problem. Despite strong evidences that VAD contributes to the development of anemia, it was verified a low prevalence of these two concomitant nutritional deficiencies among Brazilian children, and no association between them. However, anemia and VAD present common determinants (living in macro-regions less and more developed and in urban areas), reaffirming the transocial character of these nutritional deficiencies. The fact they have as a determinant food insecurity and as protection consuming meat at least once a week reinforce the social determination of these nutritional deficiencies, although food insecurity was not associated with VAD. The results showed as major determinants of anemia and VAD, those related to structural processes of society and the immediate environment of the child and not the individuals. It was also verified that government strategies have contributed to the prevention and control of these nutritional deficiencies in the Country, but it is signalized the need for expansion of the government\'s strategy for prevention and control of VAD, so far restricted to high-risk areas (Northeast and poor areas of the Southeast).

Assessment is necessary in many programs to be certain that expected outcomes are being met. Without curriculum evaluation, higher education faculty would be unaware if students are competent in the skills and knowledge that the faculty thought they were teaching. New curriculum competencies related to dietetics are introduced every five to seven years from the Commission on Accreditation for Dietetics Education (CADE). CADE establishes the minimum requirements of foundation knowledge, skills, and competencies for institutions to train entry level dietitians. Even though a variety of criteria have been proposed to evaluate curricula, no common model or format is used because of the differences in each program, college, or university. The purpose of this study is to evaluate North Dakota State University's (NDSU) dietetics program through students' understanding and knowledge as demonstrated by the change in pretest and post-test scores to ensure they are meeting competencies. The Dietetics Program Assessment Test is made up of questions contributed by each instructor in the dietetics program at NDSU regarding their particular area of expertise. The effectiveness was assessed by comparing students' Dietetics Program Assessment pretest scores, taken during sophomore year, with their post-test scores, taken during senior year. This evaluation was used to determine if pretest scores predict program course grades or if high pretest results indicate a more successful student. Therefore, the scores could be used as a selection criterion for acceptance into the dietetics program if there is a strong correlation. Results from students in the Coordinated Program in Dietetics (CPD) were compared to those in the Didactic Program in Dietetics (DPD) and those not accepted into either program to see if there is a difference between the groups. The test was also divided into dietetics core content areas (community nutrition, medical nutrition therapy/clinical, food service, basic nutrition/lifespan, and management) to see if there was an area in which students were scoring poorly. Pretests were taken by 122 pre-dietetics students; of these, 46 were admitted into the CPD, 29 were admitted into the DPD, and 47 were not admitted into either program. A paired t-test found there to be a significant difference (p<0.0001) between individual mean pretest scores and post-test scores, which means students' knowledge about the area of dietetics had greatly improved through courses throughout each program. A t-test found there was not a significant difference between either the pretest scores (p=0.9847) or the post-test scores (p=0.4263) of those in the CPD and DPD programs. In all of the core dietetics content areas the average percentage of correct questions improved from the pretest to the post-test, and each content area had a similar improvement, roughly a 25 percentage point increase. Using an exact Kendall's Tau Test to examine the association between pretest score and final course grades, no significant difference was found in all of the core dietetics courses expect for Food Selection and Preparation Principles (HNES 261) (p=0.0324). In conclusion, since no one content area on the post-test appears to be lacking more than any other, it would appear that the students are learning from all courses. Due to the lack of association between all core dietetics course grades and pretest scores along with the small sample size, pretest scores should not currently be used alone or as one of the selection criterion for admittance into either dietetics programs.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 5 uppsatser.

No description available.

Contexte : L’insécurité alimentaire des ménages, c’est-à-dire un accès insuffisant aux aliments découlant de contraintes financières, peut affecter la qualité de l’alimentation. Toutefois, cette association est peu étudiée chez les nouveaux demandeurs d’aide alimentaire. Objectifs : Quantifier les associations entre la sécurité alimentaire et la qualité de l’alimentation des nouveaux demandeurs d’aide alimentaire au Québec. Méthodes : Il s’agit d’une analyse de données transversales de l’étude Parcours, demander de l’aide alimentaire et après? auprès de 1001 participants interviewés entre 2018 et 2020. Le statut de sécurité alimentaire a été évalué via le Module d’enquête sur la sécurité alimentaire des ménages. La qualité de l’alimentation, estimée à partir d’un questionnaire de fréquence alimentaire, a été déclinée en cinq variables : trois patrons alimentaires reflétant une alimentation de meilleure qualité (désignée prudent) et de moindre qualité (respectivement western et snack foods), un score de variété alimentaire et la fréquence de consommation de repas. Des régressions multivariées et logistiques ont été effectuées sur 987 participants avec des données complètes. Résultats : L’étude montre une association négative entre la gravité de l’insécurité alimentaire et le patron prudent, une association positive entre la gravité de l’insécurité alimentaire et le patron snack foods, un risque plus élevé de sauter des repas et d’avoir un faible score de variété. Conclusion : Il existe un gradient de qualité de l’alimentation selon le statut de sécurité alimentaire des nouveaux demandeurs d’aide alimentaire. Des inégalités sociales en alimentation existent, même au sein d’une population très vulnérable à l’insécurité alimentaire. / Context: Household food insecurity, i.e an insufficient or uncertain access to foods because of financial difficulties, can affect dietary quality. However, little is known about this association among new food aid users. Objectives: To quantify the associations between food security status and dietary quality of new food aid users. Methods: This is a cross-sectional analysis of data from the Pathways, asking for food aid and then? study, including 1001 participants interviewed between 2018 and 2020. Household food security status was assessed through the Household Food Security Survey Module. Dietary quality, assessed through a food frequency questionnaire, was broken down into five variables: three dietary patterns reflecting a diet of better quality (named prudent) and poorer quality (named western and snack foods, respectively), a dietary variety score and meal consumption frequency. Multivariable regression and logistic regression analyses were performed on 987 participants with complete data. Results: This study shows a negative association between gravity of food insecurity and prudent dietary pattern, a positive association between gravity of food insecurity and snack foods dietary pattern and higher odds of skipping meals and having a lower dietary variety among individuals in food insecure households. Conclusion: There is a gradient of dietary quality according to food security status among new food aid users in Quebec. Social inequalities in diet exist even among a subgroup of very vulnerable individuals living in food insecurity.

No description available.