Indicadores antropométricos do estado nutricional de pré-escolares em Araraquara, SP

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Associação da cárie dentária com indicadores antropométricos do estado nutricional em pré-escolares

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efficiency of cares over toothbrush storage to prevent contamination

This study evaluated the efficiency of a toothbrush holder to prevent contamination of toothbrushes used by preschool children. For that, the sample was composed by children 6 years old, enrolled in an educational and recreational center in Araraquara/SP, and divided into 3 groups: G1: same continuing routine storage toothbrushes, G2: children received only a new toothbrush holder for storage; G3: they received new toothbrushes holder for storage and solution of chlorhexidine digluconate to 0.12% to dabble in the toothbrush after use. After brushing their teeth, toothbrushes were collected for microbiological analysis. The data were analyzed using the distribution of frequencies. It was observed that, in general, higher prevalence of the microorganism in the toothbrushes was Streptococcus viridans (58.97%), followed by Estafilococcus (35.90%), the bacillus of air (28.21%) and Neisseria mucosa (5.13%). Evaluating frequency, it was noted that the contamination presented by Streptococcus is higher in G1 when compared to G2 and G3, while for Estafilococcus, the presence was more significant in G3. Thus, it was concluded that the use of new toothbrushes holder able to avoid direct contact between brushes and allow drying without smothering could be an excellent alternative to educational institutions that require the storage group.

Prevalência de cárie dentária em pré-escolares de escolas de educação infantil de Araçatuba, São Paulo

Epidemiological data on the conditions of oral health are essential for professionals in the health care plan, execute and evaluate dental programs. In Brazil, most oral health programs directs its resources to middle schools, leaving the preschool children in a secondary plan. The objective of this study was to identify the prevalence of dental caries in preschool children from 4-6 years of age from schools of child education (EMEIs) of the city of Araçatuba-SP. The study was conducted on a sample of 275 children of both genders, representative of the population of preschool children in the city of Araçatuba-SP. In order to assess the prevalence and severity of dental caries indices we used the dmft and DMFT indexes, according to the codes and standards recommended by the World Health Organization (WHO).The average dmft of 1.88 was found, comprising 78% of decayed teeth, 21% of restaured teeth and 1% with indicated extraction teeth. Regarding the permanent dentition, the average DMFT was 0.08, consisting of 71% of decayed teeth, 29% restored and 0% of missing teeth. Based on results found, there was a high caries prevalence in deciduous and permanent teeth, demonstrating the need for more dental care to the group studied.

Cognição Numérica de crianças pré-escolares brasileiras pela ZAREKI-K

The Numerical Cognition is infl uenced by biological, cognitive, educational and cultural factors. It consists of a primary system, called Number Sense that would be innate and universal, also of secondary systems: the Calculation, implied to perform mathematical operations by means of symbols or words and Number Processing, which is divided into two components, Number Comprehension, related with the understanding of numerical symbols and Number Production, which includes reading, writing and coun-ting numbers. However, studies that show the development of these functions in children of preschool age are scarce. Therefore, aims of this study were to investigate numerical cognition in preschool Brazilian children to demonstrate the construct validity of the ZAREKI-K (A Neuropsychological Battery for the Assessment of Treatment of Numbers and Calculation for preschool children). The participants were 42 children of both genders, who attended public elementary schools; the children were evaluated by this battery and WISC-III. The results indicated signifi cant differences associated with age which children of 6 years had better scores on subtests related to Number Production, Calculation and Number Comprehension, as well moderate and high correlations between some subtests of both instruments, demonstrating the construct validity of the battery. In conclusion, preliminary normative data were obtained for ZAREKI-K. The analyses suggested that it is a promising tool for the assessment of numerical cognition in preschool children.Keywords: Mathematics, number, preschoolers, working memory, Developmental Dyscalculia.

Leitura na educação infantil: implicações da Teoria Histórico-Cultural

Pós-graduação em Educação - FFC

Desenvolvimento da memória em crianças pré-escolares por meio de atividades literárias: contribuições da Teoria Histórico-Cultural

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Combined effect of anterior malocclusion and inadequate lip coverage on dental trauma in primary teeth

Objectives: The main objective of this study was to investigate whether the interaction of malocclusion (open bite or increased overjet) combined with inadequate lip coverage strengthens its association with traumatic dental injury (TDI) in the primary teeth of preschool children compared to the presence of malocclusion alone. Subjects and methods: A cross-sectional survey was conducted with 376 children aged 3659 months who attended the National Day of Childrens Vaccination. Presence of TDI, tooth discoloration, and sinus tract were evaluated in the children. Variables associated with occlusion were also evaluated. A Poisson regression analysis was performed to verify the association between the explanatory variables and TDI as well as possible interactions among the variables. Then, the prevalence ratio was calculated. Results: The prevalence of TDI was 27.7%. The maxillary central incisor was the most affected tooth, without differences between the right and left sides. Boys had more dental trauma than girls (P = 0.04). The most common TDI was crown fracture restricted to the enamel (58.4%). Children with a combination of anterior open bite or increased overjet and inadequate lip coverage presented a higher prevalence of TDI than when the malocclusions were presented alone (P < 0.05). The same trends were observed when we included, in the final adjusted model, increased overjet instead of open bite. Conclusions: Anterior malocclusions of primary teeth such as increased overjet and anterior open bite are statistically significantly associated with dental trauma only when inadequate lip coverage is also present.

Influence of nutritional variables and obesity on health and metabolism

Influence of nutritional variables and obesity on health and metabolism Obesity is a recurring theme in current scientific literature. This can easily be explained by its exponential increase in all layers of society. The popularity of this subject has also given rise to associated questions, which have achieved greater prominence in health-related publications. In order to assess what has been studied in the field of obesity and nutrition, an overview of all articles published on these subjects in some of the main Brazilian scientific journals over the past two years was performed. Among the subthemes selected for this study, those related to childhood obesity attracted attention due to their greater frequency. These were subdivided into: prevalence, intrauterine and breastfeeding influences that may lead to the development of this condition, impact on quality of life, cardiovascular system and metabolism, and possible prevention strategies. Furthermore, issues related to obesity in adults were explored, such as risk factors and new strategies for prevention, with special attention given to the many studies evaluating different aspects of bariatric surgery. Finally, the subject of malnutrition and the impact of the deficiency of specific micronutrients such as selenium, vitamin D, and vitamin B12 were assessed. Based on the results, it was possible to assess the actual importance of obesity and nutrition in health maintenance, and also the several lines of research regarding these issues. Thus, it is essential to create new methods, which must be quick and efficient, to update health professionals involved in the treatment of obesity.

Preditores da realização de consultas odontológicas de rotina e por problema em pré-escolares

OBJETIVO: Estimar a prevalência do uso de serviços odontológicos por pré- escolares e fatores associados. MÉTODOS: Estudo transversal com 1.129 crianças de cinco anos de idade da Coorte de Nascimentos de Pelotas 2004, RS, de setembro de 2009 a janeiro de 2010. Registrou-se o uso de serviço odontológico pelo menos uma vez na vida e o motivo para a primeira consulta odontológica da criança. As categorias do desfecho foram: ter feito a primeira consulta por rotina, para resolver um problema ou nunca ter ido ao dentista. Os exames bucais e as entrevistas foram realizados nos domicílios. Aspectos socioeconômicos e variáveis independentes ligadas à mãe e à criança foram analisados por meio de regressão logística multinomial. RESULTADOS: A prevalência de uso por qualquer motivo foi 37,0%. Os principais preditores para consulta de rotina foram nível econômico mais elevado, mãe com maior escolaridade e ter recebido orientação sobre prevenção. Principais preditores para consulta por problema foram ter sentido dor nos últimos seis meses, mãe com maior escolaridade e ter recebido orientação sobre prevenção. Cerca de 45,0% das mães receberam orientação de como prevenir cárie, principalmente fornecida por dentistas. Filhos de mães com história de maior aderência a programas de saúde tiveram maior probabilidade de ter feito uma consulta odontológica de rotina. CONCLUSÕES: A taxa de utilização dos serviços odontológicos por pré- escolares foi inferior às de consultas médicas (puericultura). Além da renda e da escolaridade, comportamentos maternos têm papel importante no uso por rotina. Relato de dor nos últimos seis meses e número elevado de dentes afetados por cárie, independentemente dos demais fatores, estiveram associados ao uso para resolver problema. É necessária a integração de ações de saúde bucal nos programas materno-infantis.

Laboratorial training of examiners for using a visual caries detection system in epidemiological surveys

Background: In epidemiological surveys, a good reliability among the examiners regarding the caries detection method is essential. However, training and calibrating those examiners is an arduous task because it involves several patients who are examined many times. To facilitate this step, we aimed to propose a laboratory methodology to simulate the examinations performed to detect caries lesions using the International Caries Detection and Assessment System (ICDAS) in epidemiological surveys. Methods: A benchmark examiner conducted all training sessions. A total of 67 exfoliated primary teeth, varying from sound to extensive cavitated, were set in seven arch models to simulate complete mouths in primary dentition. Sixteen examiners (graduate students) evaluated all surfaces of the teeth under illumination using buccal mirrors and ball-ended probe in two occasions, using only coronal primary caries scores of the ICDAS. As reference standard, two different examiners assessed the proximal surfaces by direct visual inspection, classifying them in sound, with non-cavitated or with cavitated lesions. After, teeth were sectioned in the bucco-lingual direction, and the examiners assessed the sections in stereomicroscope, classifying the occlusal and smooth surfaces according to lesion depth. Inter-examiner reproducibility was evaluated using weighted kappa. Sensitivities and specificities were calculated at two thresholds: all lesions and advanced lesions (cavitated lesions in proximal surfaces and lesions reaching the dentine in occlusal and smooth surfaces). Conclusion: The methodology purposed for training and calibration of several examiners designated for epidemiological surveys of dental caries in preschool children using the ICDAS is feasible, permitting the assessment of reliability and accuracy of the examiners previously to the survey´s development.

Análise da narrativa oral de pré-escolares antes e após estimulação de linguagem

OBJETIVO: Verificar as habilidades de narrativa oral em pré-escolares, antes e após estimulação de linguagem. MÉTODOS: Foram analisadas narrativas de 58 pré-escolares. O estudo foi desenvolvido em três etapas: 1. Etapa pré-estimulação (Momento 1) - os pré-escolares produziram a primeira narrativa autônoma a partir de uma sequência de figuras e a segunda narrativa autônoma após tutela do adulto; 2. Etapa de estimulação - foi realizada a leitura de histórias infantis em grupo, semanalmente, durante dez semanas; 3. Etapa pós-estimulação (Momento 2) - foi repetido o procedimento da primeira etapa. A análise dos resultados considerou: a ocorrência de eventos centrais e secundários; a conduta justificativa/explicativa, classificada segundo causas físicas, regras morais/sociais e estado interno; a expressão e retificação de falsas crenças, analisadas por meio da conduta justificativa/explicativa de estado interno. RESULTADOS: Houve aumento na ocorrência de eventos centrais no Momento 2, e após a tutela, com decréscimo de eventos secundários comparando-se os dois momentos e a presença da tutela. Em relação à conduta justificativa/explicativa, não houve diferenças para as justificativas do tipo físico, regras sociais/morais e estado interno. A conduta justificativa/explicativa do tipo estado interno foi a tipologia predominantemente encontrada em todas as narrativas. CONCLUSÃO: A leitura de histórias infantis e a tutela do adulto contribuem para o aumento da ocorrência de eventos nas narrativas autônomas. Não há variação na tipologia da conduta justificativa/explicativa nas narrativas. A tipologia de conduta justificativa/explicativa de estado interno é predominantemente utilizada pelos pré-escolares.

Peer and group relationships in preschoolers: the role of social and linguistic skills

Being able to positively interact and build relationships with playmates in preschool years is crucial to achieve positive adjustment. An update review and two studies on such topics were provided. Study 1 is observational; it investigates the type of social experience in groups (N = 443) of children (N = 120) at preschool age in child-led vs. teacher-led contexts. The results revealed that in child-led contexts children were more likely to be alone, in dyads, and in small peer groups; groups were mostly characterized by same-gender playmates who engaged in joint interactions, with few social interactions with teachers. In teacher-led contexts, on the other hand, children were more likely to be involved in small, medium and large groups; groups were mostly characterized by other-gender playmates, involved in parallel interactions, with teachers playing a more active role. The purpose of Study 2 was to describe the development of socio-emotional competence, temperamental traits and linguistic skill. It examined the role of children’s reciprocated nominations (=RNs) with peers, assessed via sociometric interview, in relation to socio-emotional competence, temperamental traits and linguistic skill. Finally, the similarity-homophily tendency was investigated. Socio-emotional competence and temperamental traits were assessed via teacher ratings, linguistic skill via test administration. Eighty-four preschool children (M age = 62.53) were recruited within 4 preschool settings. Those children were quite representative of preschool population. The results revealed that children with higher RNs showed higher social competence (tendency), social orientation, positive emotionality, motor activity and linguistic skill. They exhibited lower anxiety-withdrawal. The results also showed that children prefer playmates with similar features: social competence, anger-aggression (tendency), social orientation, positive emotionality, inhibition to innovation, attention, motor activity (tendency) and linguistic skill. Implications for future research were suggested.

Context-dependent interpretation of the conjunction 'und' in different age-groups

In contrast to formal semantics, the conjunction and is nonsymmetrical in pragmatics. The events in Marc went to bed and fell asleep seem to have occurred chronologically although no explicit time reference is given. As the temporal interpretation appears to be weaker in Mia ate chocolate and drank milk, it seems that the kind and nature of events presented in a context influences the interpretation of the conjunction. This work focuses on contextual influences on the interpretation of the German conjunction und (‘and’). A variety of theoretic approaches are concerned with whether and contributes to the establishment of discourse coherence via pragmatic processes or whether the conjunction has complex semantic meaning. These approaches are discussed with respect to how they explain the temporal and additive interpretation of the conjunction and the role of context in the interpre-tation process. It turned out that most theoretic approaches do not consider the importance of different kinds of context in the interpretation process.rnIn experimental pragmatics there are currently only very few studies that investigate the inter-pretation of the conjunction. As there are no studies that investigate contextual influences on the interpretation of und systematically or investigate preschoolers interpretation of the con-junction, research questions such as How do (preschool) children interpret ‘und’? and Does the kind of events conjoined influence children’s and adults’ interpretation? are yet to be answered. Therefore, this dissertation systematically investigates how different types of context influence children’s interpretation of und. Three auditory comprehension studies were conducted in German. Of special interest was whether and how the order of events introduced in a context contributes to the temporal read-ing of the conjunction und. Results indicate that the interpretation of und is – at least in Ger-man – context-dependent: The conjunction is interpreted temporally more often when events that typical occur in a certain order are connected (typical contexts) compared to events with-out typical event order (neutral contexts). This suggests that the type of events conjoined in-fluences the interpretation process. Moreover, older children and adults interpret the conjunc-tion temporally more often than the younger cohorts if the conjoined events typically occur in a certain order. In neutral contexts, additive interpretations increase with age. 5-year-olds reject reversed order statements more often in typical contexts compared to neutral contexts. However, they have more difficulties with reversed order statements in typical contexts where they perform at chance level. This suggests that not only the type of event but also other age-dependent factors such as knowledge about scripts influence children’s performance. The type of event conjoined influences children’s and adults’ interpretation of the conjunction. There-fore, the influence of different event types and script knowledge on the interpretation process does not only have to be considered in future experimental studies on language acquisition and pragmatics but also in experimental pragmatics in general. In linguistic theories, context has to be given a central role and a commonly agreed definition of context that considers the consequences arising from different event types has to be agreed upon.

Validation of the Asthma Predictive Index and comparison with simpler clinical prediction rules

Background The loose and stringent Asthma Predictive Indices (API), developed in Tucson, are popular rules to predict asthma in preschool children. To be clinically useful, they require validation in different settings. Objective To assess the predictive performance of the API in an independent population and compare it with simpler rules based only on preschool wheeze. Methods We studied 1954 children of the population-based Leicester Respiratory Cohort, followed up from age 1 to 10 years. The API and frequency of wheeze were assessed at age 3 years, and we determined their association with asthma at ages 7 and 10 years by using logistic regression. We computed test characteristics and measures of predictive performance to validate the API and compare it with simpler rules. Results The ability of the API to predict asthma in Leicester was comparable to Tucson: for the loose API, odds ratios for asthma at age 7 years were 5.2 in Leicester (5.5 in Tucson), and positive predictive values were 26% (26%). For the stringent API, these values were 8.2 (9.8) and 40% (48%). For the simpler rule early wheeze, corresponding values were 5.4 and 21%; for early frequent wheeze, 6.7 and 36%. The discriminative ability of all prediction rules was moderate (c statistic ≤ 0.7) and overall predictive performance low (scaled Brier score < 20%). Conclusion Predictive performance of the API in Leicester, although comparable to the original study, was modest and similar to prediction based only on preschool wheeze. This highlights the need for better prediction rules.