Rita de Cassia Coelho de Almeida Akutsu

In Brazil, Community Restaurants (CRs) are regarded as an essential public initiative to expand food access for groups experiencing severe social vulnerability. This cross-sectional study analyzed the strategic effect of CRs as an indirect mechanism to ensure food availability in municipalities with more than 100,000 inhabitants, located in the North and Northeast regions of the country, using the CR evaluation matrix system of structural and process indicators as proxies to classify units as “not very effective,” “effective,” or “very effective,” rather than direct outcome impacts. Of the 94 CRs assessed (North: n = 23; Northeast: n = 71), most were rated as effective or very effective (95.6% in the North, 95.8% in the Northeast), with only one CR in Pará and three in the northeast (two in Bahia and one in Sergipe) classified as not very effective. The North region showed strong performance in financial resources, monitoring, location, physical structure, menu planning, incorporation of regional foods, volume of meals served to the attending public, and intersectoral actions. The Northeast excelled in financial resources, food security, physical structure, menu planning, and integration of regional foods, though it scored lower in education and volume of meals served to the attending public. This study represents the first structured application of the Oliveira matrix in the North and Northeast, providing new evidence on regional disparities and management challenges. These findings underscore CR’s strategic effectiveness in supporting regional efforts to improve food access and mitigate food and nutritional insecurity in historically vulnerable regions. However, outcome indicators such as dietary diversity, nutritional adequacy, and user health outcomes were not assessed. Future studies should incorporate these measures, alongside longitudinal designs and onsite evaluations, to better understand the broader impact of CRs on food and nutrition security.

OBJETIVO: Analisar a conformidade entre a organização da Rede Alyne e a realidade observada nos serviços de atenção à saúde da gestante com síndromes hipertensivas na cidade de Manaus, Amazonas. MÉTODO: Estudo qualitativo, descritivo e observacional, com base em visitas técnicas a unidades de saúde que integram os diferentes níveis de atenção do SUS: Unidade de Saúde da Família, Policlínica, Distrito de Saúde, Maternidade e Hospital Universitário. A análise foi orientada por parâmetros normativos do Ministério da Saúde e da Portaria GM/MS nº 5.350/2024. RESULTADOS: Identificaram-se fragilidades na articulação entre os níveis de atenção, insuficiência de protocolos operacionais e lacunas na contrarreferência. Apesar de avanços estruturais e normativos, persistem desafios relacionados à comunicação intersetorial e à gestão territorial do cuidado. CONCLUSÃO: A Rede Alyne representa avanço na normatização do cuidado materno, porém sua efetivação prática ainda demanda investimento em integração, qualificação das equipes e monitoramento contínuo das ações assistenciais.

Industry 5.0 involves the integration of advanced technologies, collaboration between humans and intelligent machines, resilience and sustainability, all of which are essential for the advancement of the food services industry. This analysis reviews the scientific literature on Industries 4.0 and 5.0 technologies, whether experimental or implemented, focused on producing large meals in food service. The review has been conducted through a systematic search, covering aspects from consumer ordering and the cooking process to distribution while considering management, quality control, and sustainability. A total of thirty-one articles, published between 2006 and 2025, were selected, with the majority focusing on Industry 5.0 (71%) and a significant proportion on testing phases (77.4%). In the context of Food Service Perspectives, the emphasis has been placed on customer service (32.3%), highlighting the use of Artificial Intelligence (AI)-powered robots for serving customers and AI for service personalization. Sustainability has also received attention (29%), focusing on AI and machine learning (ML) applications aimed at waste reduction. In management (22.6%), AI has been applied to optimize production schedules, enhance menu engineering, and improve overall management. Big Data (BD) and ML were utilized for sales analysis, while Blockchain technology was employed for traceability. Cooking innovations (9.7%) centered on automation, particularly the use of collaborative robots (cobots). For Quality Control (6.4%), AI, along with the Internet of Things (IoT) and Cloud Computing, has been used to monitor the physical aspects of food. The study underscores the importance of strategic investments in technology to optimize processes and resources, personalize services, and ensure food quality, thereby promoting balance and sustainability.

Background: Food and Nutrition Security (FNS) policies in Brazil aim to ensure a broad spectrum of rights and were formulated based on the complex relationship among the State, Society, and Market in the capitalist order. The human right to adequate food (HRAF) is reflected in the guidelines of the National School Feeding Program (Programa Nacional de Alimentação Escolar—PNAE), which is implemented and monitored by the National Education Development Fund (Fundo Nacional de Desenvolvimento da Educação—FNDE). The PNAE consolidates part of the strategies adopted by the Brazilian State to combat hunger among children and adolescents and promote healthy habits by offering food in schools. However, there is no recent evaluation on the aspects of management, financing, and monitoring of the PNAE in the Brazilian Federal District. Objective: This study aims to contribute to the debate on health promotion and the right to adequate food by analyzing documents and legislation in force until 2024 related to the PNAE, as well as those that maintain a correlation with food and nutritional security policies in Brazil, verifying the scope and guarantee of rights and their applicability based on a critical analysis of the selected database. Methods: Brazilian official documents and legislation related to FNS and school meals were reviewed for inclusion in the database. The historical-dialectical materialist method was employed for content analysis, and the analyzed documents underwent a critical reading and the coding process, grouping common themes, utilizing MaxQda^® software for support. Results: The word cloud (20 words) shows that the document groups emphasize food as a right, with 6038 occurrences found and relating to the “rights” approach with 2365 occurrences found, highlighting words related to FNS policies. Public actions to achieve health and food supply were expressed through the words “public” (381 occurrences) and “DHAA” (510 occurrences). The code cloud highlights social control as the most frequently attributed code in the set of documents, with 105 codified segments, indicating that democratic control and societal participation are crucial for achieving the PNAE’s objectives. Conclusions: The analyses underscored the importance of social control, as evidenced by the exploration of the research corpus and demonstrated in the code cloud. The role of monitoring and social control falls to the School Feeding Council (CAE), being the body responsible for verifying compliance with the Program’s objectives, enabling the adoption of timely measures to correct the PNAE’s course and contribute to achieving its objectives.

Background: Occupational or work-related stress remains a persistent challenge in nursing, often intensified by sociodemographic factors. In Brazil’s Northeast, particularly in Aracaju, Sergipe, public hospital nurses face unique stressors shaped by regional socioeconomic conditions. Objective: This cross-sectional exploratory study aimed to examine the relationship between perceived work-related stress and the sociodemographic profiles of nursing professionals in three public hospitals in Aracaju. Methods: Data were collected via an online questionnaire incorporating the Perceived Stress Scale (PSS-10) and sociodemographic items. Results: Among 440 participants—comprising nurses (42%), nursing technicians (38.2%), nursing assistants (8.9%), and specialists (10.9%)—moderate to high stress levels were most prevalent among nursing technicians and assistants. Elevated stress was notably associated with adult women working in high-complexity sectors (e.g., pediatrics, obstetrics, ICU), particularly those without partners, earning low incomes, and with over ten years of professional experience. Conclusions: The findings highlight a vulnerable subgroup within the nursing workforce and underscore the need for targeted interventions to mitigate occupational stress in public healthcare settings. This study contributes region-specific insights into the intersection of stress and sociodemographic factors, offering a foundation for future policy and support strategies.

Fundo: O presente estudo tem como objetivo identificar e mapear investigações relacionadas ao aconselhamento de gestantes com alto risco obstétrico, fundamentado em evidências científicas. Métodos: Realizou-se uma busca nas bases de dados PubMed, Embase, BVS e Lilacs, abrangendo estudos primários e literatura cinzenta que tratassem de indicadores, crenças e aspectos éticos relacionados à Medicina Baseada em Evidências (MBE) no contexto de gestantes de alto risco. A pesquisa incluiu estudos realizados em diversos ambientes de saúde, em diferentes idiomas, sem restrição quanto à data de publicação. Os títulos, resumos e artigos completos foram avaliados segundo critérios de inclusão por dois revisores independentes. Os dados extraídos foram analisados de forma quantitativa, enquanto os dados qualitativos foram submetidos a uma análise descritiva de conteúdo. Os resultados foram apresentados em tabelas e formato narrativo. Resultados: Das 2.033 publicações selecionadas, sete foram consideradas elegíveis para leitura integral. Quatro desses artigos foram incluídos para contextualizar o mapeamento de critérios e crenças éticas relevantes para a pesquisa. Apesar de abordarem temas distintos, todos os artigos enfatizam a importância do aconselhamento de saúde durante a gestação, destacando a necessidade de um pré-natal mais humanizado e menos medicalizado, que possibilite à mulher tomar decisões informadas sobre sua saúde e a de seu filho. Conclusão: Os resultados indicam que o aconselhamento baseado em informações precisas é crucial para que as gestantes possam tomar decisões alinhadas com os princípios éticos, a MBE e crenças que respeitem sua autonomia e dignidade.

Community Restaurants (CRs), part of the Brazilian government’s Popular Restaurant Program (PRP), provide free and/or affordable nutritionally balanced meals as an essential strategy to meet the most vulnerable population’s basic needs and rights. This cross-sectional study evaluated the effectiveness of these CRs’ proposed objectives in cities with ≥100,000 inhabitants in Brazil’s northern and northeastern regions—Brazil’s most vulnerable and historically unequal regions. Effectiveness was assessed using a CR evaluation matrix-based indicator system to classify CRs as “not very effective”, “effective”, or “very effective”. Among the 94 CRs assessed (north: n = 23, 24.5%; northeast: n = 71, 75.5%), most were classified as “effective” or “very effective”, except for the northern states of Amapá and Tocantins, whose only CR was rated as “not very effective” and the northeastern state of Sergipe, which had a PR considered “not very effective”. State-operated CRs predominated (north: 82.6%; northeast: 76.1%) and primarily operated Monday to Friday (north: 87.0%; northeast: 59.2%), with 35.2% of the northeast CRs operating daily, serving lunch as the main meal (100%). Average daily meal counts were 486.5 (north) and 926.9 (northeast), and the average meal offering time was from 10:55 am to 1:21 pm in the north and from 10:35 am to 2:00 pm in the northeast region, with costs averaging USD 0.27 and USD 0.20, respectively. All CRs employed a nutritionist as a technical manager responsible for menu planning and demonstrated compliance with essential infrastructure criteria, including regular waste collection, water supply, and proximity to public transport. Most were in areas with sanitary sewage coverage (north: 91.3%; northeast: 98.6%) and had monitoring mechanisms (91.3% north; 94.4% northeast) and prioritization systems for vulnerable populations (north: 73.9%; northeast: 80.0%). These findings indicate that CRs in these regions effectively strive to address food security goals, demonstrating tangible outcomes that benefit society.

The food environment plays a crucial role in shaping people’s eating habits and, in and around schools, this influence becomes even more critical due to the time students spend daily in these spaces. This study aimed to analyze the food and consumer environments inside and around federal institutes in Bahia, Brazil. Ecological study and audit methodologies were combined, with all the 35 federal institutes in Bahia as the sample universe. To delimit the food environment around the school, the establishments were mapped in a 1000 m buffer, with the school as the centroid. The geographic coordinates of schools and food outlets were initially obtained using Google Maps and later confirmed on-site. The data were collected in WGS 84 and converted to UTM zone 23S SIRGAS 2000. To map the consumer environment, establishments found in a 250 m buffer and also canteens within schools were audited, using the ESAO-r instrument that considers the availability and prices of healthy and unhealthy foods; availability of nutritional information near the point of purchase or on the menu; and presence of internal marketing of healthy and unhealthy foods. The healthy meal–restaurant index (HMRI) was also measured. This index ranges from 0 to 8 points and positively scores items related to healthy consumption and fails to score those related to unhealthy consumption and behavior. The establishments were grouped into four categories (healthy, unhealthy, mixed, and supermarkets). The surrounding area with four or more unhealthy establishments within the 250 m buffer was considered a food swamp. Descriptive analyses were carried out with frequency measurements, measures of central tendency (mean and median), and dispersion (standard deviation). Around the analyzed schools, 732 food establishments were identified, 73.8% (n = 540) formal and 26.2% (n = 192) informal. Considering the characteristics of existing commerce, there was a predominance of snack bars (45%), grocery stores (23%), and bars (7.8%), with a smaller number of supermarkets identified (4.1%). School canteens were found in 20 schools analyzed and only 15% had a variety of healthy foods. When evaluating the availability of healthy foods, a median HMRI of 3 (1–7) was observed. When analyzing this index according to the type of establishment, it was found that fruit and vegetables presented higher values (HMRI = 7; P25–P75: 4–8) compared to large chain supermarkets (HMRI = 5; P25–P75: 2–6; p < 0.001) and local markets (HMRI = 4; P25–P75: 2–5; p < 0.001). From the analysis of the food and consumer environments, it was possible to make inferences about the quality of the food offered to students in these locations, as well as the potential health outcomes arising from this exposure and the need to carry out food education activities and nutritional activities.

Deserts, swamps and food oases terms have been used to characterize the food environment according to the identified food availability. Food swamps are defined as neighborhoods with a predominance of food establishments selling ultra-processed foods compared to establishments selling healthy options. In contrast, food oases are areas with easy access to healthy and nutritious foods, such as fruits, vegetables, and other fresh foods. Food deserts describe densely populated urban areas where residents face difficulty obtaining healthy food. In this context, this work aimed to map deserts, swamps, and food oases around federal schools in Bahia, Brazil, emphasizing the importance of implementing the Brazilian National School Feeding Program (PNAE) in these schools, to guarantee food security and nutrition. An ecological study was carried out in all 35 federal schools in Bahia, Brazil, using an 800 m buffer analysis, with the school as the centroid. The geographic coordinates of schools and food establishments were initially obtained using Google Maps and later confirmed onsite. To evaluate food deserts and swamps, the methodology proposed by the CDC was used and the Modified Retail Food Environment Index (mRFEI) was calculated; when the result was equal to zero, the surrounding area was considered a food desert and values between 0.01 and 20 determined food swamps; for values above 20, the neighborhood was classified as mixed. Food oases were considered regions containing at least one supermarket within the analyzed buffer. Descriptive analyses were carried out with frequency measurements, measures of central tendency (mean and median) and dispersion (standard deviation). The food environment of schools was compared considering the number of students impacted, the area where the school was located (urban or rural) and the size of the municipalities. The average number of food establishments found was 22.39 (±13.03), with the highest averages for snack bars (7.33 ± 4.43), grocery stores (5.83 ± 4.09) and restaurants (2.94 ± 2.19). Food deserts and mixed environments were identified in 40% of the sample, while swamps represented 20% and oases 65%. An association was observed between food deserts and social vulnerability, making it necessary to emphasize the importance of adequate implementation of the PNAE in these schools to reduce food and nutritional insecurity, guaranteeing the human right to adequate and healthy food and providing better nutrition and health perspectives within the school environment and impact on students’ lives through food and nutrition education actions, which are also part of the context of PNAE activities.