Dietary patterns in pregnancy and birth weight

OBJECTIVE To analyze if dietary patterns during the third gestational trimester are associated with birth weight.METHODS Longitudinal study conducted in the cities of Petropolis and Queimados, Rio de Janeiro (RJ), Southeastern Brazil, between 2007 and 2008. We analyzed data from the first and second follow-up wave of a prospective cohort. Food consumption of 1,298 pregnant women was assessed using a semi-quantitative questionnaire about food frequency. Dietary patterns were obtained by exploratory factor analysis, using the Varimax rotation method. We also applied the multivariate linear regression model to estimate the association between food consumption patterns and birth weight.RESULTS Four patterns of consumption – which explain 36.4% of the variability – were identified and divided as follows: (1) prudent pattern (milk, yogurt, cheese, fruit and fresh-fruit juice, cracker, and chicken/beef/fish/liver), which explained 14.9% of the consumption; (2) traditional pattern, consisting of beans, rice, vegetables, breads, butter/margarine and sugar, which explained 8.8% of the variation in consumption; (3) Western pattern (potato/cassava/yams, macaroni, flour/farofa/grits, pizza/hamburger/deep fried pastries, soft drinks/cool drinks and pork/sausages/egg), which accounts for 6.9% of the variance; and (4) snack pattern (sandwich cookie, salty snacks, chocolate, and chocolate drink mix), which explains 5.7% of the consumption variability. The snack dietary pattern was positively associated with birth weight (β = 56.64; p = 0.04) in pregnant adolescents.CONCLUSIONS For pregnant adolescents, the greater the adherence to snack pattern during pregnancy, the greater the baby’s birth weight.

Influence of the support offered to breastfeeding by maternity hospitals

ABSTRACT OBJECTIVE To evaluate whether the support offered by maternity hospitals is associated with higher prevalences of exclusive and predominant breastfeeding. METHODS This is a cross-sectional study including a representative sample of 916 infants less than six months who were born in maternity hospitals, in Ribeirao Preto, Sao Paulo, Southeastern Brazil, 2011. The maternity hospitals were evaluated in relation to their fulfillment of the Ten Steps to Successful Breastfeeding. Data were collected regarding breastfeeding patterns, the birth hospital and other characteristics. The individualized effect of the study factor on exclusive and predominant breastfeeding was analyzed using Poisson multiple regression with robust variance. RESULTS Predominant breastfeeding tended to be more prevalent when the number of fulfilled steps was higher (p of linear trend = 0.057). The step related to not offering artificial teats or pacifiers to breastfed infants and that related to encouraging the establishment of breastfeeding support groups were associated, respectively, to a higher prevalence of exclusive (PR = 1.26; 95%CI 1.04;1.54) and predominant breastfeeding (PR = 1.55; 95%CI 1.01;2.39), after an adjustment was performed for confounding variables. CONCLUSIONS We observed a positive association between support offered by maternity hospitals and prevalences of exclusive and predominant breastfeeding. These results can be useful to other locations with similar characteristics (cities with hospitals that fulfill the Ten Steps to Successful Breastfeeding) to provide incentive to breastfeeding, by means of promoting, protecting and supporting breastfeeding in maternity hospitals.

Um retrato do Empreendedorismo em Malanje-Angola: análise de negócios criados entre 2008-2012

Dissertação de Mestrado em Empreendedorismo e Internacionalização apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Empreendedorismo e Internacionalização, sob orientação de Professora Doutora Celsa Maria Carvalho Machado e Mestre Maria Luísa Verdelho Alves

Detection of Astrovirus-like in diarrhoeic stool and its coexistence with Rotavirus

A clinical case is described in this paper in that a 5-month old baby girl severely malnourished and dehydrated presented a prolonged acute diarrhoea. No enteropathogenic bacteria or parasites were demonstrated. Virological study by electron microscopy (EM) showed that the patient shed both astrovirus-like and rotavirus in the watery stool as long as 12 days after the onset. Immune electron microscopy (IEM) performed with the patient serum revealed clumps of both viruses. It is suggest that this may be a case of mixed infection due to astrovirus-like and rotavirus.

Estudo sobre a qualidade da autorregulação do bebé na situação face-to-face-still-face com o pai

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção do grau de Mestre em Ciências da Educação Especialidade Intervenção Precoce

Laboratory acquired infection by the virus SP H 114202 (Arenavirus: Arenaviridae): clinical and laboratory findings

Here in is described the clinical and laboratorial findings of a laboratory-acquired infection caused by the virus SP H 114202 (Arenavirus, family Arenaviridae) a recently discovered agent responsible for a viral hemorrhagic fever. The patient was sick for 13 days. The disease had an abrupt onset characterized by high fever (39ºC.), headache, chills and myalgias for 8 days. In addition, on the 3rd day, the patient developed nauseas and vomiting, and in the 10th, epigastralgia, diarrheia and gengivorrhagia. Leucopenia was seen within the 1 st week of onset, with counts as low as 2,500 white cells per mm³. Counts performed after the 23th day of the onset were within normal limits. With the exception of moderate lymphocitosis, no changes were observed in differential counts. An increase in the liter of antibodies by complement fixation, neutralization and ELISA (IgM) was detected. Suckling mice and baby hamsters were inoculated intracerebrally with 0.02 ml of blood samples collected in the 2nd and 7th days of disease. Attempts to isolate the virus were also made in Vero cells. No virus was isolated. This virus was isolated before in a single occasion in São Paulo State, in 1990, from the blood of a patient with hemorrhagic fever with a fatal outcome. The manipulation of the virus under study, must be done carefully, since the transmission can occur through aerosols.

Descifrando la reestructuración técnica del profesional de la información con las argumentaciones de la economía global

This paper addresses the issue of restructuring the information professional in the global economy. This restructuring is justified by a tripartite explanation: the redesign understood as innovation and disciplinary change, the reorganization of institutions conditioned by the development of information technology and economic deflation interpreted as eliminating jobs. To understand this restructuring scenario multigenerational work contexts information services are also addressed. These work contexts represent a search for understanding and to overcome common referential differences, by baby boomer practitioners and digital natives. The issue of tension and challenge between the specific technical skills and flexibility to adapt to ever-changing organizations is another topic for reflection and serves to point out new paths for the restructuring of the information professional.

Mental health promotion during pregnancy and early childhood : an action- research project in primary health care

ABSTRACT – Background: Primary Health Care (PHC) is usually the first contact with the health system, and health professionals are key mediators for enabling citizens to take care of their health. In Portugal, great improvements have been achieved in the biometric indicators of maternal and child health during the last decades. Nevertheless, scant attention has been paid to the mental health dimension, in spite of the recognition of its importance, being pregnancy and early childhood crucial opportunities in the lifecycle for mental health promotion, especially in the early years of life, with a strong impact in the health of the child. The impact of early attachment between mother and baby on maternal and child health has long been recognized. This attachment can be influenced by some factors, as the mother’s emotional adjustment. Attention to these factors may facilitate implementation of both positive conditions and preventative measures. Family support during the transition to parenthood has been highlighted as an effective measure and PHC professionals are in a privileged position as information sources as well as mediators. Aims: The project we present describes an action-research process developed together among academic researchers and health professionals to embrace these issues. We intend to enable health professionals to support families in the transition to parenthood thereby promoting children’s mental health. Approach: The project is driven by a participatory approach intended to lead to reorganization of health care during pregnancy and early childhood. Effective change happens when those involved are interested and motivated, what makes their participation so important. Reflection about current practices and needs, and knowledge about evidence-based interventions have been guiding the selection of changes to introduce in clinical practice for family support and development of parenthood skills and self-confidence. Development: We summarize the main steps in development: the initial assessment and the picture taken from the community under study; the decision making process; the training programme of PHC professionals in action; the review of the protocols of maternal consultation, home visits and antenatal education; the implementation planning; the plan for evaluation the effectiveness of the changes introduced in the delivery of maternal and child health care units. The already developed work has shown that motivation, leadership and organizational issues are decisive for process development.-------------------------- RESUMO - Os Cuidados de Saúde Primários são habitualmente o primeiro contacto com o sistema de saúde e os profissionais de saúde são mediadores chave na capacitação dos cidadãos para cuidarem da sua saúde. Em Portugal, nas últimas décadas, têm-se alcançado grandes melhorias nos indicadores biométricos de saúde materno-infantil. Contudo, tem-se dedicado pouca atenção à dimensão de saúde mental, apesar do reconhecimento da sua importância. A gravidez e primeira infância têm sido apontadas como uma oportunidade crucial no ciclo de vida para a promoção da saúde mental. É dado especial enfoque aos primeiros tempos de vida, dado o forte impacto na saúde da criança. O impacte da vinculação precoce entre a mãe e o bebé na saúde da mãe e da criança há muito que é reconhecido. Esta vinculação pode ser influenciada por vários factores, nomeadamente pelo ajustamento emocional da mãe. A focalização nestes aspectos pode facilitar a criação de condições favoráveis e a implementação de medidas preventivas. O suporte familiar durante o período de transição para a parentalidade tem sido enfatizado como uma medida eficaz e os Cuidados de Saúde Primários estão numa posição privilegiada como fontes de informação e como mediadores. O projecto que apresentamos descreve um processo de investigação- acção desenvolvido em parceria entre investigadores académicos e profissionais de saúde para abordar os aspectos referidos. Pretende-se capacitar os profissionais de saúde para apoiarem as famílias na transição para a parentalidade, promovendo assim a saúde mental das crianças. O projecto baseia-se numa abordagem participativa, direccionada para a reorganização dos cuidados durante a gravidez e primeiros tempos de vida. A mudança efectiva acontece quando os envolvidos estão interessados e motivados, o que torna a sua participação tão importante. A reflexão acerca das práticas e necessidades actuais e o conhecimento acerca de intervenções baseadas na evidência têm guiado a selecção das alterações a introduzir na prática clínica, no sentido de promover o suporte familiar e o desenvolvimento de competências parentais e auto-confiança. Neste artigo, apresentamos as etapas principais do desenvolvimento do projecto: avaliação inicial da comunidade em estudo; processo de tomada de decisão; programa de formação dos profissionais dos Cuidados de Saúde Primários; revisão dos protocolos da consulta de saúde materna, visita domiciliária e educação pré-natal; planeamento da implementação; plano de avaliação da efectividade das alterações introduzidas na prestação de cuidados. O trabalho já desenvolvido tem mostrado que a motivação, liderança e aspectos

Mother-to-child transmission of different HIV-1 subtypes among ARV Naïve infected pregnant women in Nigeria

The rate of mother-to-child transmission (MTCT) of HIV as well as the implications of the circulating multiple subtypes to MTCT in Nigeria are not known. This study was therefore undertaken to determine the differential rates of MTCT of HIV-1 subtypes detected among infected pregnant women before ARV intervention therapy became available in Nigeria. Twenty of the HIV-positive women who signed the informed consent form during pregnancy brought their babies for follow-up testing at age 18-24 months. Plasma samples from both mother and baby were tested for HIV antibody at the Department of Virology, UCH, Ibadan, Nigeria. All positive samples (plasma and peripheral blood mononuclear cells - PBMCs) were shipped to the Institute of Tropical Medicine, Antwerp, Belgium, where the subtype of the infecting virus was determined using the HMA technique. Overall, a mother-to-child HIV transmission rate of 45% was found in this cohort. Specifically, 36.4%, 66.7% and 100% of the women infected with HIV-1 CRF02 (IbNg), G and B, respectively, transmitted the virus to their babies. As far as it can be ascertained, this is the first report on the rate of MTCT of HIV in Nigeria. The findings reported in this paper will form a useful reference for assessment of currently available therapeutic intervention of MTCT in the country.

Health survey on the Ilha da Conceição, state of Rio de Janeiro: I. Study design and report of selected demographic and environmental characteristics

During July and August of 1968, a Health survey was conducted on the Ilha da Conceição, an area of Niterói containing approximately one thousand households. The survey was conducted by students from the Universidade Federal Fluminense and the University of Maryland, and was under the supervision of faculty of the Department of Tropical Medicine at U.F.F. and from the Department of Preventive Medicine at the University of Maryland, Baltimore, Maryland, U.S.A. The survey was focused on a 25 percent random sample of the households on the island. Information was obtained from a responsible adult at each Household for completion of a Health questionnaire. Physical measurements, as well as laboratory study information were obtained from, all children in these households. A number of environmental sanitation problems were identified on the Ilha da Conceição. In addition, the survey indicated that approximately half the children had not been adequately immunized against diphteria, pertussis and typhoid. Preventable communicable diseases were the major cause of reported deaths which had occurred in infants ou Household members. The Health of the population on the Ilha da Conceição could well be enhanced by the development of an intelligence system indicating the immunization status of all children in the area. In addition a Health education program for the residents could well be beneficial for improvement of sanitary conditions on the island, as well as maternity and well baby care.

Health survey on the Ilha da Conceição, state of Rio de Janeiro, II: selected health characteristics in children

As part of the health survey on the Ilha da Conceição, a 25 percent random sample of households was identified and a health guestionnaire completed at 236 households. These households contained 536 children, of whom 239 were under age six. Prenatal care had been obtained by 70 percent of the mothers during the pregnancies of the youngest children and 83 percent of these children had been born in hospital. The use of available health facilities was reported more frequently for the younger children in comparison to the older children. Over 90 percent of the children had been vaccinated against one or more diseases but only 50 to 60 percent of the children had complete vaccination against pertussis, diphtheria and tetanus. Almost two-thirds of the stool specimens from the children revealed evidence of parasites and were most commonly found in children two to three years of age. Low hemoglobin values were found commonly under age three and hemoglobin leveis ábove 12 grams were not commonly found until age six. Compared with a North American standard for height and weight, proportionately more children on the Ilha da Conceição were found below the 25th and 3rd percentiles. These findings suggest that an improved health status for the children on the Ilha da Conceição would result from a household health record maintained at the island clinic including current information on vaccination status of all children, and a health education program focused on expectant mothers and the well baby clinic program.

The avirulence of the cultivated PF strain of Trypanosoma cruzi: V - the evaluation of parasitologic tests after vaccination of different animal species

After vaccination with the live PF strain of Trypanosoma cruzi, 194 blood cultures were performed in 143 mice, 9 dogs, 5 Cebus monkeys and 7 human subjects. Some of these blood cultures were simultaneously done with xenodiagnosis, subinoculation in baby mice and/or culture of viscerae. The trypanosomes isolated from the few positive cases (6,1%) were incapable of infecting baby mice were considered as cases of immunotolerance. All the other tests were negative.

Speed and rhythm in organizations: How do different generations cope with speed and rhythm at work?

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Disseminated cutaneous sporotrichosis in a patient with AIDS: report of a case

We describe a case report of disseminated cutaneous sporotrichosis as the initial presentation of AIDS in a 24-year-old HIV-positive male patient. He presented multiple ulcerated skin lesions distributed over the face, thorax, legs and arms. Biopsy of one of the cutaneous lesions was suggestive of sporotrichosis and culture isolated Sporothrix schenckii. Itraconazole was started and the lesions progressively resolved after 15 days of medication. The patient was discharged with this medication but he did not return for follow-up. He died three months later in another hospital. Therapy of sporotrichosis in HIV-infected patients remains unclear and the response to therapy is variable. Itraconazole is highly concentrated in the skin and is one of the options for treatment of disseminated sporotrichosis.

Percepção da experiência de parto e qualidade da interacção mãe-bebé

Dissertação de Mestrado apresentada ao ISPA - Instituto Universitário