Objetivos: identificar a prevalência do aleitamento materno na primeira hora de vida, os fatores associados e as razões para sua não ocorrência em um Hospital Amigo da Criança. Métodos: estudo transversal com 562 mães e recém-nascidos. Os dados foram obtidos entre outubro a novembro de 2011 mediante formulários de entrevista e consulta a prontuários. Modelo de Poisson foi ajustado para analisar a prevalência do aleitamento materno na primeira hora de vida em função das variáveis de exposição. Resultados: a prevalência do aleitamento materno na primeira hora de vida foi de 31%. Apenas o parto normal permaneceu no modelo final, apresentando razão de prevalência de 27% a mais em relação ao parto cesáreo (p=0,020). As razões para que 388 crianças não tenham sido amamentadas na primeira hora de vida foram classificadas em: problemas de saúde da criança (328, 84,5%), da mãe (241, 62,1%) e atraso no resultado do teste rápido anti-HIV (199, 51,2%), 11 (2,8%) não apresentaram nenhuma justificativa. Conclusões: os resultados relatados ainda estão bem abaixo das recomendações da Organização Mundial da Saúde (OMS), o que em grande parte pode ser atribuído às condições próprias de um hospital de nível terciário, cuja demanda é constituída predominantemente por casos de pacientes de médio e elevado risco obstétrico.
Objective: To describe Brazil’s historical background with regard to child development surveillance and perform a systematic review of studies published on surveillance records of child development within Child Health Handbooks. Data sources: A literature review was conducted in April of 2016 in the following electronic databases: Latin American and Caribbean Literature in Health Sciences (LILACS), the Scientific Electronic Library Online (SciELO), and the Medical Literature Analysis and Retrieval System Online (Medline). The search did not have any language or publication period restrictions, and included the bibliographic references of the selected articles. The keywords “child development and child health records,” and “child development and child health handbook” were applied. Articles were included that were original and that evaluated the use of child development surveillance tools in Brazil. Publications that were not original were excluded. The articles were selected first based on their title, then their abstracts, and finally a thorough reading. Data synthesis: The recommendation to support child development surveillance has been occurring since 1984. In 1995, developmental milestones were included in the Child’s Health Handbook, and in 2004 they became normative acts for surveillance, which should be carried out using this booklet. In the systematic review, six articles were selected in which the prevalence of child development surveillance recording ranged from 4.6 to 30.4%. This variation was due to different criteria and sample sizes as well as different methodologies employed to analyze the adequacy of filling out the handbook. Conclusions: Despite the fact that the Brazilian Ministry of Health formalized child development surveillance 32 years ago, the act of recording the surveillance in the Child Health Handbook is still deficient and irregular.
RESUMO: Introdução: O aleitamento materno exclusivo (AME), após o sexto mês de vida, como fonte alimentar única não é recomendado. Acredita-se que não é possível suprir às necessidades calórico proteicas, de ferro e vitaminas sem a devida complementação alimentar. Objetivo: Comparar a situação nutricional de crianças com AME por mais de seis mesesversuscrianças com outras práticas de amamentação. Método: Estudo transversal/exploratório com685 crianças (39 em AME > 6meses e 646com outras práticas de amamentação). Situações de déficit antropométrico foram consideradas por valores < - 2 no escore Z, anemia avaliada por hemoglobina (Hb) < 11 g/dL e níveis deficientes/baixos de vitamina A por retinol sérico < 1,05 µmol/L. Resultados: Nãoocorreram déficitsnas relações de peso/altura, peso/idade e índice de massa corporal (IMC) no grupo de crianças em AME > 6meses, enquanto no grupo de comparação esse índice foi de aproximadamente 0,5%. O déficit na relação altura/idade foi de aproximadamente 2,6% nos dois grupos. Na relação peso/altura e no IMC, os resultados variaram de 28,7 a 31,9% para excesso de peso no grupo de comparação. As médias de Hb, retinol sérico, peso e altura foram similares nos grupos. Discussão: A baixa prevalência (≤ 0,6%) de desnutrição energético proteica (DEP) nos dois grupos representa um achado, surpreendentemente, abaixo dos valores encontrados em população de referência de normalidade internacional, padrão da Organização Mundial da Saúde (OMS). Conclusão: As crianças que se mantiveram em AME após seis meses apresentaram situação nutricional equivalente àquelas com outras práticas de amamentação.
Aleitamento materno em crianças de 0 a 59 meses no Estado de Pernambuco, Brasil, segundo o peso ao nascer Breastfeeding in children from 0 to 59 months in the state of Pernambuco, Brazil, in
A cross-sectional study based on the Self Determination Theory to identify intrinsic motivation in the tutorial group scenario, and its associated factors in 276 medical students from a college in the Northeast of Brazil between October and December 2016. The Intrinsic Motivation Inventory was utilized following its adaptation and cross-cultural translation. Variables studied: age, gender, marital status, financial dependents, number of attempts at the university entrance exam for the medical course, current semester of study, previous undergraduate training, living with parents, choice of course by parental influence or pressure. Uni and multivariate Poisson analysis were carried out to assess the factors associated with intrinsic motivation; p <0.05 was considered as the significance level for statistical purposes. Average motivation score was 3.8, which indicates motivation. In 2 nd , 6 th and 10 th semester medicine students, the final model maintained as the variable associated with intrinsic motivation those who attempted the medical school entrance exam once or twice compared to those who had had three or more attempts (PR = 0.88, 95% CI (0.79-0.97), p = 0.011). In the analyses assessed by semester, in the second semester, students who had prior undergraduate training before medical school compared to those who had not was the remaining variable (PR = 0.92, 95% IC (0.87-0.97), p = 0.005). In the sixth semester, no statistically significant difference was found, and in the tenth semester the variable of those who attempted the medical school entrance exam once or twice remained (PR = 0.65, 95% IC (0.47-0.88), p = 0.006). The students seemed to be motivated in the group tutorial activity. The fewer number of medical school entry exam attempts and having previous undergraduate training were variables that showed association with intrinsic motivation.
A cross-sectional study based on the Self Determination Theory to identify intrinsic motivation in the tutorial group scenario, and its associated factors in 276 medical students from a college in the Northeast of Brazil between October and December 2016. The Intrinsic Motivation Inventory was utilized following its adaptation and cross-cultural translation. Variables studied: age, gender, marital status, financial dependents, number of attempts at the university entrance exam for the medical course, current semester of study, previous undergraduate training, living with parents, choice of course by parental influence or pressure. Uni and multivariate Poisson analysis were carried out to assess the factors associated with intrinsic motivation; p <0.05 was considered as the significance level for statistical purposes. Average motivation score was 3.8, which indicates motivation. In 2 nd , 6 th and 10 th semester medicine students, the final model maintained as the variable associated with intrinsic motivation those who attempted the medical school entrance exam once or twice compared to those who had had three or more attempts (PR = 0.88, 95% CI (0.79-0.97), p = 0.011). In the analyses assessed by semester, in the second semester, students who had prior undergraduate training before medical school compared to those who had not was the remaining variable (PR = 0.92, 95% IC (0.87-0.97), p = 0.005). In the sixth semester, no statistically significant difference was found, and in the tenth semester the variable of those who attempted the medical school entrance exam once or twice remained (PR = 0.65, 95% IC (0.47-0.88), p = 0.006). The students seemed to be motivated in the group tutorial activity. The fewer number of medical school entry exam attempts and having previous undergraduate training were variables that showed association with intrinsic motivation.
Objetivo: Analisar os fatores associados a assistência do pré-natal adequado no estado de Pernambuco. Métodos: Estudo de base populacional, observacional, de corte seccional, com objetivos descritivos e analíticos. Foram utilizados dados secundários extraído do banco de dados da IV Pesquisa Estadual de Saúde e Nutrição. Compreenderam os fatores associados as variáveis sociodemográficas, ambientais, obstétricas e biológicas. Após critérios de elegibilidade, a amostra de mães foi estimada em 880 mulheres. Resultados: Foram prevalentes as mulheres na faixa etária de 25 a 35 anos, com ensino médio completo, que não trabalhavam e com renda per capita menor que meio salário mínimo. As variáveis idade da primeira gravidez e distância à unidade de saúde mantiveram associação com adequação da assistência pré-natal. Conclusão: Conclui-se que os fatores associados a variável desfecho foram apenas idade da primeira gravidez e distância à unidade de saúde, e que os demais fatores sociodemográficos, obstétricos e biológicos, refletem a desigualdade social mostrando que os grupos socialmente mais vulneráveis recebem assistência pré-natal deficiente.
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