Introduction Optimal child growth requires adequate energy and nutrient intake, absence of disease and appropriate care Poor living conditions, including household food insecurity, low parental education, lack of access to quality health care and an unhealthy living environment are among the main determinants of stunted growth Poverty has a more detrimental effect on linear growth than on body weight (1) Child stunting is associated with higher morbidity and mortality, shorter height in adulthood, lower educational achievement, and reduced productivity in adulthood Child growth patterns are therefore strong predictors of future human capital and social progress and of the health of future generations (1-4) Estimates indicate that in 2005, one-third of all children less than 5 years of age (or approximately 178 million children) in low- and middle-income countries were stunted (5) Projections of current trends to 2015 point to declines in the prevalence of both stunting (6) and underweight (5) among children, although such declines will still fall short of the 50% reduction in undernutrition established as an indicator for fulfilling the first Millennium Development Goal (MDG- 1), (7) to eradicate hunger Of 70 low- or middle-income countries that conducted two or more surveys between 1971 and 1999, 42 showed a decline in child stunting, 17 showed no major change over the period, and 11 (9 of them in Africa) showed an increase (8) In Brazil, three national health and nutrition surveys conducted between 1974-75 and 1996 have pointed to declining trends in child stunting prevalence (9,10) An analysis of data from 47 low- and middle-income countries showed pronounced within-country socioeconomic inequalities in child stunting, particularly in Latin America and the Caribbean (11) Brazil ranked fifth among these 47 countries in terms of such inequality (11) We are unaware of studies from low- or middle-income countries on how social inequalities in child stunting are evolving over time We have taken advantage of a Demographic and Health Survey carried out in Brazil in 2006-07 to assess trends in child stunting and in related socioeconomic disparities over the past three decades The Brazilian government has prioritized the elimination of hunger and poverty (12) since 2003, and recent reports (13) suggest that redistributive policies have successfully redressed one of the most skewed income distributions in the world (14) Because child stunting is a sensitive indicator of living conditions, we believe that the effectiveness of redistributive policies can be accurately assessed by studying the social distribution of child stunting over time Methods Data sources Four national household surveys were carried out in Brazil over a period of 33 years: Estudo Nacional de Despesa Familiar [National Study on Family Expenditures] in 1974-75; Pesquisa Nacional de Saude e Nutricao [National Health and Nutrition Survey] in 1989; and two Demographic and Health Surveys, in 1996 and 2006-07, respectively Nationwide probability house hold samples were obtained in each survey using similar census-based, multistage, stratified, cluster sampling procedures The sampling schemes, variables, and data collection procedures are described elsewhere (15-17) In the four surveys, the height of all children aged 0-59 months living in the sampled households was measured Children living in the sparsely populated rural areas of the Northern region, who comprise 3% of the country's child population, were only included in the most recent survey Analyses were repeated after removing these children from the 2006-07 sample, but the results were virtually identical to those presented below, which apply to the entire sample of children studied in each survey In the four surveys, trained personnel measured the recumbent length of children aged up to 23 months and the standing height of older children …

Narrowing Socioeconomic Inequality in Child Stunting: The Brazilian Experience, 1974-2007/reduction Des Inegalites Socioeconomiques En Termes De Retard De Croissance Des Enfants : Experience Du Bresil, 1974-2007/reduccion De la Desigualdad Socioeconomica En Materia De Retraso del Crecimiento Infantil: La Experiencia del Brasil, 1974-2007

A taxa de mortalidade infantil (referente as criancas menores de um ano) caiu muito nas
ultimas decadas no Brasil. Gracas as acoes de diminuicao da pobreza, ampliacao da cobertura da
Estrategia Saude da Familia e a outros fatores, os obitos infantis diminuiram de 47,1 a cada mil
nascidos vivos, em 1990, para 15,6 em 2010 (IBGE, 2010). Entretanto, a meta de garantir a toda
crianca brasileira o direito a vida e a saude ainda nao foi alcancada, pois persistem desigualdades
regionais e sociais inaceitaveis. Alem disso, 68,6% das mortes de criancas com menos de um ano
acontecem no periodo neonatal (ate 27 dias de vida), sendo a maioria no primeiro dia de vida.
Assim, um numero expressivo de mortes por causas evitaveis por acoes dos servicos de saude –
tais como a atencao pre-natal, ao parto e ao recem-nascido (RN) – faz parte da realidade social
e sanitaria de nosso Pais.

Saúde da criança: crescimento e desenvolvimento

Introducao: Realizou-se uma pesquisa em municipios da Regiao de Saude de Sao Miguel do Oeste no estado de Santa Catarina, sobre Internacoes por Condicoes Sensiveis a Atencao Primaria, consideradas como um problema de saude publica. A Lista Brasileira de Internacoes por Condicoes Sensiveis a Atencao Primaria elenca doencas que nao deveriam gerar internacoes, e sim, ter resolubilidade na Atencao Primaria. Objetivos: Caracterizar o perfil das Internacoes por Condicoes Sensiveis a Atencao Primaria e outras variaveis no Sistema Unico de Saude de municipios de abrangencia da Regiao de Saude de Sao Miguel do Oeste / SC. Metodologia ou Descricao da Experiencia: A pesquisa foi realizada no Sistema de Informacao Hospitalar-SUS (SIH-SUS) que gerencia as autorizacoes de internacoes hospitalares ocorridas no pais (DATASUS, 2012) no âmbito do SUS. Atraves do SIH-SUS disponibilizados pelo site do DATASUS foi realizada coleta de dados das ICSAPs dos municipios de Bandeirante, Barra Bonita, Belmonte, Descanso, Guaraciaba, Sao Miguel do Oeste e Paraiso. Os dados foram coletados no periodo de Agosto 2009 a Julho de 2010 conforme as variaveis: sexo, faixa etaria, media de permanencia, valor do total gasto e numero de internacoes das ICSAPs. Resultados: Destacaram-se cinco patologias com maior numero de internacoes. Dentre elas encontrou-se a asma, diabetes mellitus, diarreia e gastroenterite, insuficiencia cardiaca e pneumonia. O municipio de Belmonte apresentou um total de 205 internacoes, dentre as internacoes ocorridas 9% foram por ICSAP, em Descanso 755 pessoas estiveram internadas e dentre elas 12% foram por ICSAP, em Paraiso das 266 internacoes 17% foram por ICSAP, em Sao Miguel do Oeste das 2.662 internacoes, 22% foram por ICSAP, em Bandeirante das 246 internacoes, 20% foram por ISCAP, no municipio de Barra Bonita no total de 191 internacoes 19% (foram por ICSAP e em Guaraciaba das 987 internacoes ocorridas 28% foram por ICSAP. Conclusao ou Hipoteses: As ICSAP geram internacoes que poderiam ser prevenidas com acoes oportunas em tempo adequado. Considerando que o estudo analisou somente cinco das setenta e quatro patologias descritas na Lista Brasileira, estima-se que tenha ocorrido no periodo, um numero ainda maior de internacoes por ICSAP. Espera-se que os resultados obtidos, reforcem a importância das acoes desenvolvidas na Atencao Primaria.

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Internações por condições sensíveis à Atenção Primária

Objective to identify the challenges pediatric nursing workers face as a result of the COVID-19 pandemic. Method qualitative study, using a semi-structured electronic form applied to nursing workers from pediatric services in the state of Rio de Janeiro, Brazil. Data were submitted to lexicographic analysis using the Interface de R pour Analyses Multidimensionnelles de Textes et de Questionnaires, Word Cloud technique, and Similitude Analysis. Results different challenges concerning the COVID-19 pandemic were reported, including the need to promote comprehensive and quality care while being concerned with protecting oneself and others, with an emphasis on fear. A lack of protective equipment, training, diagnostic tests, and knowledge/information concerning the disease was also reported, in addition to a reduced number of nursing workers and a lack of appreciation for the profession. Conclusion managerial guidelines need to be adopted for properly allocating human and material resources in the health field, including the pediatric services, in addition to providing training on standard precautions. Actions to encourage, value, motivate, and support the nursing staff are needed during and after the pandemic to protect the physical and mental health of these professionals.

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Challenges faced by pediatric nursing workers in the face of the COVID-19 pandemic.

Robots are no longer confined to factories; they are progressively spreading to urban, social and assistive domains. In order to become handy co-workers and helpful assistants, they must be endowed with quite different abilities from their industrial ancestors. Research on service robots aims to make them intrinsically safe to people, easy to teach by non-experts, able to manipulate not only rigid but also deformable objects, and highly adaptable to non-predefined and dynamic environments. Robots worldwide will share object and environmental models, their acquired knowledge and experiences through global databases and, together with the internet of things, will strongly change the citizens’ way of life in so-called smart cities. This raises a number of social and ethical issues that are now being debated not only within the Robotics community but by society at large.

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Service Robots for Citizens of the Future

Resumo Avaliou-se o estado nutricional e sua associacao com os habitos alimentares de criancas escolares que frequentam a rede publica de ensino do municipio de Campina Grande, Paraiba. Estudo transversal, realizado com 1081 criancas de 5 a 10 anos. Analisaram-se os indices antropometricos estatura/idade (E/I) e Indice de Massa Corporal/idade (IMC/I), e os habitos alimentares dos escolares. Verificaram-se prevalencias de deficit de estatura, sobrepeso e obesidade de 2,4%, 12,3% e 9,2%, respectivamente. O E/I apresentou-se com media inferior (p = 0,029) nas criancas que indicaram quase nunca tomar cafe da manha (-0,130 ± 1,053 Escore-z) em comparacao com as que faziam essa refeicao todas ou na maioria das vezes (0,183 ± 0,912 Escore-z), associacao similar foi observada quando a merenda escolar nao era consumida (p = 0,001). Para o IMC/I, criancas com habito de fazer todas as refeicoes apresentaram menor media (p = 0,034); resultado similar foi observado em relacao ao habito de tomar cafe da manha em que menor media foi constatada entre as criancas com esse costume (p = 0,020). Conclui-se que o estado nutricional dos escolares e marcado por altas taxas de sobrepeso/obesidade. Sugere-se que os prejuizos no estado nutricional estejam relacionados ao nao consumo do cafe da manha e da alimentacao oferecida na escola.

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Estado nutricional e hábitos alimentares de escolares de Campina Grande, Paraíba, Brasil

Resumo Objetivo: descrever as causas de internacoes nas criancas brasileiras menores de cinco anos relatadas na literatura. Metodos: trata-se de uma revisao sistematica de artigos publicados entre 2008 e 2015, a partir das bases eletronicas Medline e Lilacs; os estudos foram avaliados criticamente, utilizando-se um instrumento validado. Resultados: foram incluidos 11 artigos, quatro ecologicos e sete transversais; doencas do aparelho respiratorio (n=5), infeccoes parasitarias (n=4) e afeccoes perinatais (n=2) foram as causas gerais de internacoes mais frequentes nos artigos revisados; nos estudos que analisaram as condicoes sensiveis, pneumonias (n=6), gastroenterites (n=5) e asma (n=5) foram as causas mais apontadas. Conclusao: doencas respiratorias, parasitarias e perinatais citam-se entre as principais causas de internacoes nas criancas brasileiras; pneumonias, gastroenterites e asma constituem as causas mais importantes de internacoes que sao preveniveis, trataveis no nivel primario de atencao a saude.

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Internações das crianças brasileiras menores de cinco anos: revisão sistemática da literatura

Resumo O Programa Nacional de Alimentacao Escolar (PNAE) representa uma estrategia importante de promocao da alimentacao saudavel. Objetivou-se realizar uma analise sumaria das pesquisas avaliativas sobre o PNAE. Pesquisa bibliografica do periodo de 2010 a 2015 nas bases de dados Bireme e SciELO. Foram selecionados 12 artigos vinculados a area, dos quais oito analisaram a insercao do nutricionista no PNAE; sete, a aquisicao de alimentos da agricultura familiar; cinco, a implantacao dos Conselhos de Alimentacao Escolar; cinco, a execucao dos cardapios; e quatro, os recursos financeiros destinados ao PNAE. Apontam-se problemas na atuacao do nutricionista e dos Conselhos de Alimentacao Escolar, na aquisicao de alimentos da agricultura familiar e na composicao dos cardapios (baixo conteudo de frutas e hortalicas). Destaca-se a necessidade de maior atencao relacionada a execucao do PNAE, de maneira a garantir uma alimentacao escolar dentro de principios que promovam a seguranca alimentar e nutricional. Novos estudos avaliativos sobre o Programa sao fundamentais para o fornecimento de subsidios aos gestores publicos com fins de aprimorar a sua execucao.

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Avaliação do Programa Nacional de Alimentação Escolar: revisão da literatura

CONTEXT AND OBJECTIVE: Hospitalizations due to primary care-sensitive conditions constitute an important indicator for monitoring the quality of primary healthcare. This study aimed to describe hospitalizations due to primary care-sensitive conditions found among children under five years of age (according to their age and sex), in two cities in Paraiba, Brazil. DESIGN AND SETTING: Cross-sectional study carried out in the municipalities of Cabedelo and Bayeux, in Paraiba, Brazil. METHODS: Data were collected from four public pediatric hospitals in Paraiba that receive children from these municipalities. Hospital admission authorizations were consulted to gather information on the children’s profile and the characteristics of their hospitalizations. Differences in the causes of admissions and the respective lengths of hospital stay length were analyzed according to age group and sex. RESULTS: The proportion of hospital admissions due to primary care-sensitive conditions was 82.4%. The most frequent causes were: bacterial pneumonia (59.38%), infectious gastroenteritis and its complications (23.59%) and kidney and urinary tract infection (9.67%). Boys had higher frequency of hospitalizations due to primary care-sensitive conditions than girls. The median hospitalization due to primary care-sensitive conditions was found to be four days. The duration of hospital stays due to primary care-sensitive conditions was significantly longer than those due to conditions that were not sensitive to primary care. CONCLUSIONS: High rates of hospital admissions due to primary care-sensitive conditions were highlighted, especially among children of male sex, with long periods of hospitalization.

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Hospitalizations due to primary care-sensitive conditions among children under five years of age: cross-sectional study.

Weight/height and weight/age anthropometric statistics are important, respectively, for identifying incipient changes in weight and alterations in nutritional status at an early stage. The scope of this study was to analyze weight/height- and weight/age-associated factors in preschool children. This is a cross-sectional study with a probabilistic sample scrutinizing 299 children enrolled in municipal daycare centers. Information was obtained through interviews with mothers together with a questionnaire analyzing socioeconomic, maternal and child information. Weight and height/stature of children were measured according to recommendations of the World Health Organization. The results showed that none of the maternal variables was associated with the nutritional status of children and that only birth weight among child variables revealed any association with weight/height (p = 0.0030) and weight/age scores (p = 0.0018). The block of socioeconomic variables, in turn, proved to be the most representative variation factor of results, especially in the weight/age index. The importance of birth weight in the weight/height and weight/age of children, as well as the socioeconomic conditions notably in weight/age indices, was clearly revealed.

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Erika Morganna Neves de Araujo

Papers

Estado nutricional e hábitos alimentares de escolares de Campina Grande, Paraíba, Brasil

Internações das crianças brasileiras menores de cinco anos: revisão sistemática da literatura

Avaliação do Programa Nacional de Alimentação Escolar: revisão da literatura

Hospitalizations due to primary care-sensitive conditions among children under five years of age: cross-sectional study.

Índices antropométricos de crianças assistidas em creches e sua relação com fatores socioeconômicos, maternos e infantis