O presente artigo objetiva avaliar quais os fatores de caráter biopsicossociocultural e aspectos obstétricos e assistenciais na saúde estão associados a prática de desmame precoce do aleitamento materno a fim de auxiliar nas ações frente ao tema de modo a melhorar os índices da amamentação. Trata-se de uma revisão integrativa da literatura, pesquisa descritiva, abordagem qualitativa e método dedutivo realizada a partir das bases de dados eletrônicas PubMED, MEDLINE, LILACS, BVS, BDENF e SciELO, usando os descritores “aleitamento materno/breastfeeding” e “desmame/weaning” com os operadores booleanos “e/AND”. Na busca inicial, foram encontrados 4407 artigos. Após aplicação dos critérios de elegibilidade e leitura, foram analisados 22 trabalhos. As taxas de aleitamento materno exclusivo variaram entre 14,8% e 98,1%. Os principais fatores associados ao desmame precoce foram: maior idade da criança, trabalho materno, uso de complemento lácteo no hospital, uso de chupeta, mãe com sintomas depressivos. Em contrapartida, mães com experiência anterior, apoio paterno, níveis médios e elevados de autoeficácia, estar em AME na alta hospitalar e receber apoio e incentivo profissional no pré-natal, pós-parto imediato e puerpério tardio foram fatores de proteção ao aleitamento. A amamentação é determinada por múltiplos fatores. As variáveis de caráter assistencial são um aspecto central quando se analisa o aleitamento materno e o enfoque na percepção materna se faz necessário para o estabelecimento e sucesso da amamentação por meio da compreensão dos obstáculos, incertezas e insatisfações com o processo.
Objective: To evaluate the impact of the COVID-19 pandemic on the outpatient production of pediatricians and pediatric dentists in the Brazilian Unified Health System (SUS). Methods: An ecological study was carried out with an analytical and quantitative approach, using public domain data from the Department of Informatics of the SUS. The monthly number of professionals who worked in the SUS, the number of outpatient procedures in each category and the projection of residents from zero to thirteen years old to normalize it were retrieved. Data were compared by pre-pandemic (2018-2020) and pandemic (2020-2022) periods with a significance level of 5%. Results: There was a significant reduction in the monthly number of outpatient procedures performed in the SUS by pediatricians in the first and second pandemic year of COVID-19 when compared to the pre-pandemic period (p <0.001 e 0.002, respectively). This reduction represents a median percentage reduction of -57.1% (CI95% -51.3%, -71.7%) in the first and -22.3% (CI95% -0.55%, -31.5%) in the second pandemic year. Regarding pediatric dentists, a significant reduction was observed only between the pre-pandemic period and the first pandemic year (p <0.001), representing -82.0% (CI95% -73.4%, -93.6%). Moreover, a significant, positive and moderate correlation was observed between the productivity of both professional categories in the SUS throughout the investigated period (p < 0.001, ρ = 0.744). Conclusion: The COVID-19 pandemic negatively affected the provision of specialized medical and dental outpatient care for children in the SUS.
Objective: To associate screen time with food, physical activity, sleep and sociodemographic variables in Brazilian adolescents, students of urban public institutions. Methods: Observational, cross-sectional, quantitative, analytical study approved by the Ethics Committee in Research on Human Beings of the Federal University of Sergipe (CAAE 38981320.2.0000.5546) with students from 10 to 18 years of age at a public school in a municipality in the Brazilian Northeast. A descriptive analysis of screen time, sociodemographic, economic variables, academic year, physical activity, sleep duration and daytime sleepiness was performed. Fisher's exact test and Pearson's chi-square test were used to analyze the independence hypothesis and the Mann-Whitney test to assess the hypothesis of equality of the median of two samples, in addition to simple and multiple logistic regression. Results: 364 students participated in the study. The eighth and ninth year of elementary school; the first and second years of high school made more excessive use of electronic devices. There is a greater chance of screen time higher than recommended in those with a higher socioeconomic level. High screen time was associated with the presence of daytime sleepiness, with a higher prevalence of excessive screen time in students who considered they rarely and often had sleepiness. Conclusions: The prevalence of excessive screen time was higher in adolescents considered older, when compared to younger ones and in those with better socioeconomic conditions. It is possible that screen time influences shorter sleep duration and the presence of daytime sleepiness.
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