A influência de fatores sociodemográficos na ocorrência de cárie em crianças brasileiras de baixa renda / The influence of sociodemographic factors on the occurrence of caries in Brazilian children of low-income

Trata-se de um estudo transversal conduzido em uma população de 308 crianças, entre 6 e 8 anos de idade, frequentadoras de uma escola municipal de Recife/PE. Objetivou-se identificar a influência de fatores sociodemográficos, práticas alimentares e de higiene oral e acesso aos serviços de saúde bucal na gravidade da cárie dentária em crianças. Considerou-se como gravidade de cárie ceo-d maior ou igual à média encontrada na amostra estudada (ceo-d ≥ 3). A análise de regressão logística mostrou que crianças cujas mães tinham idade entre 20 e 30 anos, não receberam orientação sobre higiene bucal no pré-natal e apresentaram mais de 10 dentes afetados por cárie tiveram uma chance de 2,0 a 2,5 vezes maior de apresentar o índice ceo-d ≥ 3. As crianças que não tiveram a higiene bucal realizada após a ingestão de leite industrializado/suco/chá no primeiro ano de vida e foi referido dor/sangramento/trauma como motivo do primeiro atendimento odontológico tiveram chance de 2,0 e 3,0 vezes maior de apresentar o desfecho de interesse, respectivamente. Assim, a gravidade de cárie na população estudada mostrou-se associada à idade e experiência de cárie materna, à ocorrência de orientação sobre saúde oral do bebê durante o pré-natal, aos hábitos de higiene bucal adotados no primeiro ano de vida e ao acesso da criança aos serviços odontológicos (AU).

This is a cross-sectional study conducted in a population of 308 children aged 6 to 8 years old, attending a public school in Recife/PE that had the objective to identify the influence of sociodemographic factors, diet and oral hygiene habits, and access to oral health services in the severity of dental caries in children. Caries severity was considered as those with dmft index greater than or equal to the mean found for the studied sample (dmft ≥3). The logistic regression analysis showed that children whose mothers were aged between 20 and 30 years old, had not received oral hygiene counseling during prenatal care and had more than 10 teeth affected by caries had a chance 2.0 to 2.5 times higher to have dmft ≥3. Children who had no oral hygiene performed after drinking formula milk/juice/tea during the first year of life and was referred pain/bleeding/trauma as a reason for the first dentistry attendance had a chance 2.0 and 3.0 times higher to have the outcome of interest, respectively. Thus, the severity of caries in the studied population was associated with maternal age and caries experience, the occurrence of counseling on infant's oral health during prenatal care, oral hygiene habits adopted in the first year of life, and access to children's dental services (AU).

Influence of preeclampsia and gestational obesity in maternal and newborn levels of vitamin D.

BACKGROUND: In recent years, a high prevalence of vitamin D deficiency amongst pregnant women and newborns has been observed throughout several regions of the world, especially in the presence of preeclampsia (PE) or obesity (OB). The aim of this study was to investigate whether nonobese and obese preeclamptic pregnant women and their newborns have low 25(OH)D compared with nonobese and obese nonpreeclamptic pregnant women; and to verify whether the maternal level of this vitamin correlates with the newborns' level. METHODS: This is a cross-sectional study conducted with 179 pregnant women recruited immediately before delivery, divided into four groups: PE(+)/OB(-); PE(+)/OB(+); PE(-)/OB(+); and PE(-)/OB(-), with gestational age ≥ 34 weeks. Maternal peripheral blood and newborns umbilical cord blood were collected and 25(OH)D levels were measured by chemiluminescence (LIAISON®). RESULTS: Infants born to preeclamptic mothers had a lower median 25(OH)D level than those born to nonpreeclamptic mothers (p < 0.01). Obese pregnant women and their newborns had higher frequencies of 25(OH)D deficiency, but the difference with respect to nonobese pregnant women and their newborns was not significant. The vitamin D status of preeclamptic obese women was not worse than that of their nonobese counterparts. Newborns and maternal 25(OH)D levels were significantly correlated (p = 0.01). Obesity weakened this correlation. CONCLUSIONS: Preeclamptic women and their newborns presented higher frequencies of 25(OH)D deficiency, but 25(OH)D levels were not significantly influenced by obesity. Obese pregnant women transferred less 25(OH)D to their fetuses.

Vigilância do desenvolvimento infantil: práticas de enfermeiras após capacitação / Surveillance of child development: practices of nurses after training / Vigilancia del desarrollo infantil: prácticas de enfermeras luego de capacitación

Este estudo objetivou avaliar a percepção de enfermeiras em relação à sua prática na atenção à saúde da criança, após a capacitação em vigilância do desenvolvimento infantil, no contexto da Atenção Integrada às Doenças Prevalentes na Infância. Pesquisa exploratória, com abordagem qualitativa realizada de junho a agosto de 2009, mediante entrevista com onze enfermeiras participantes de oficinas de capacitação realizadas em João Pessoa - Paraíba, Brasil. Identificaram-se, a partir da análise temática, três categorias: fragilidades na vigilância do desenvolvimento infantil antes da capacitação; olhar qualificado, pós-capacitação: empoderamento e motivação profissional; e novo agir na vigilância do desenvolvimento infantil. A capacitação mostrou-se como potente estratégia para qualificação profissional e mudança de atitudes da enfermeira na atenção primária, motivando as enfermeiras a novo agir frente à vigilância do desenvolvimento infantil.

The aim of this study was to evaluate the perception of nurses regarding their practice in child care after training in child development surveillance, in the context of the Integrated Care for Childhood Prevalent Diseases. An exploratory study, using a qualitative approach, was developed between June and August 2009, by means of interviews with 11 nurses who participated in training workshops developed in João Pessoa, Paraíba, Brazil. The thematic analysis helped identify three categories: weaknesses in child development surveillance before training; post-training qualified perspective: professional motivation and empowerment; and a new behavior in child development surveillance. The training was considered to be a powerful strategy for professional qualification and for changing the attitude of primary care nurses, motivating nurses to adopt a new behavior in child development surveillance.

Estudio que objetivó evaluar la percepción de enfermeras en relación a su práctica en la atención de salud del niño luego de capacitación en vigilancia del desarrollo infantil, en el contexto de la Atención Integrada a las EnfermedadesPrevalentes en la Infancia. Investigación exploratoria, de abordaje cualitativo, realizada entre junio y agosto de 2009 mediante entrevistas con once enfermeras que participaron de talleres de capacitación, realizados en João Pessoa, Paraíba, Brasil. Se identificaron, a partir del análisis temático, tres categorías: fragilidades en la vigilancia del desarrollo infantil antes de la capacitación; visión calificada post capacitación: empoderamiento y motivación profesional; y nueva actuación en la vigilancia del desarrollo infantil. La capacitación se mostró como estrategia poderosa para la calificación profesional y cambio de actitudes de las enfermeras en la atención primaria, motivándolas a tomar nuevas acciones para la vigilancia del desarrollo infantil.

[Mental and motor development at 24 months of full-term low birthweight infants]. / Desenvolvimento mental e motor aos 24 meses de crianças nascidas a termo com baixo peso.

The objective of this study was to compare the development at 24 months of 152 full-term infants, born with low (<2500g) and appropriate birth weight (3000 to 3499g), paired in a proportion of 1:1 by sex and age. Mental and motor development were assessed through the Bayley scale. A variety of sociodemographic and environmental stimulation conditions were also assessed. The infants born with low weight had on average significantly lower mental and motor indexes than those born with appropriate weight (p<0.001), with a difference of 9.1 and 10.2 points, respectively. The multiple linear regression analysis showed that socioeconomic conditions and environmental stimulation explained 11% and 12% of the variation of mental index, and 12% and 9% of motor development, respectively. All together, they explained 23% and 21% of the variation of these indexes. Low birth weight influenced only 3% of the variation of mental index and 5% of motor index.