Parent’s experiences of feeding their preterm infant in Neonatal Units in Sweden. : Ethnographic design

Introduction: Studies have shown that having a preterm infant may cause stress and powerlessness for parents. It is important to support parents around the feeding situation, and that the Neonatal Intensive Care Unit (NICU) has appropriate space and place to help the family to bond to each other. For the healthcare professionals it is important to promote skin-to-skin contact and breastfeeding; particularly for preterm infants. There are many studies on parent’s experiences of NICUs and a few studies on parent’s experiences of feeding their infant in the NICU. Objective: The objective of this study was to explore parents experiences of feeding their infant in the NICU. Design: The study was conducted using an ethnographic design. Results: A global theme of ‘The journey in feeding’ was developed from four organising themes: ‘Ways of infant feeding’; ‘Environmental influences’; ‘Relationships’ and ‘Emotional factors’. These themes illustrate the challenges mothers reported with different methods of feeding. The environment had a big impact on parent’s experiences of infant feeding. Some mothers felt that breastfeeding seemed unnatural because their infant was so tiny but breastfeeding and skin-to-skin contact helped them to bond to their infant. The mothers thought it was difficult to keep up with the milk production by only pumping. Routines were not inviting parents to find their own rhythm. They also felt stressed about the weighing. Healthcare professionals had positive and negative influences on the parents. Conclusions: This study demonstrates that while all parents expressed the wish to breastfeed, their ‘journey in feeding’ was highly influenced by method of feeding, environmental, relational and emotional factors. The general focus upon routines and assessing milk intake generated anxiety and reduced relationality. Midwives and neonatal nurses need to ensure that they emphasise and support the relational aspects of parenting and avoid over-emphasising milk intake and associated progress of the infant

Eficiência da magic formula de value investing no mercado brasileiro

O objetivo deste trabalho é realizar procedimento de back-test da Magic Formula na Bovespa, reunindo evidências sobre violações da Hipótese do Mercado Eficiente no mercado brasileiro. Desenvolvida por Joel Greenblatt, a Magic Formula é uma metodologia de formação de carteiras que consiste em escolher ações com altos ROICs e Earnings Yields, seguindo a filosofia de Value Investing. Diversas carteiras foram montadas no período de dezembro de 2002 a maio de 2014 utilizando diferentes combinações de número de ativos por carteira e períodos de permanência. Todas as carteiras, independentemente do número de ativos ou período de permanência, apresentaram retornos superiores ao Ibovespa. As diferenças entre os CAGRs das carteiras e o do Ibovespa foram significativas, sendo que a carteira com pior desempenho apresentou CAGR de 27,7% contra 14,1% do Ibovespa. As carteiras também obtiveram resultados positivos após serem ajustadas pelo risco. A pior razão retorno-volatilidade foi de 1,2, comparado a 0,6 do Ibovespa. As carteiras com pior pontuação também apresentaram bons resultados na maioria dos cenários, contrariando as expectativas iniciais e os resultados observados em outros trabalhos. Adicionalmente foram realizadas simulações para diversos períodos de 5 anos com objetivo de analisar a robustez dos resultados. Todas as carteiras apresentaram CAGR maior que o do Ibovespa em todos os períodos simulados, independentemente do número de ativos incluídos ou dos períodos de permanência. Estes resultados indicam ser possível alcançar retornos acima do mercado no Brasil utilizando apenas dados públicos históricos. Esta é uma violação da forma fraca da Hipótese do Mercado Eficiente.

Teste de eficiência da magic formula de value investing para o mercado brasileiro de ações

O objetivo desse trabalho é realizar um procedimento de back-test da Magic Formula no IBX-100, a fim de reunir evidencias sobre a eficiência de tal metodologia no processo de seleção das melhores ações e formação de carteiras que superem o desempenho do IBX-100 no longo prazo. Desenvolvida por Joel Greenblatt, a Magic Formula é uma metodologia de formação de carteiras que consiste em escolher ações com altos ROICs e Earnings Yields, seguindo a filosofia de Value Investing. Diversas carteiras foram montadas no período de janeiro de 2000 a junho de 2015 utilizando diferentes combinações de número de ativos por carteira e períodos de permanência. Nem todas as carteiras apresentaram retornos superiores ao índice de mercado. Aparentemente, as carteiras com mais ações e períodos de permanência mais longos apresentam desempenho superior às carteiras menores e com rotatividade maior (períodos de permanência mais curtos). A carteira de 10 ações, com período de permanência de 1 ano, apresentou o maior CAGR dentre todas as outras (17,77%), superando o CAGR de 13,17% do IBX-100 no mesmo período. Esse resultado foi superior mesmo quando ajustado ao risco. Independentemente do período de permanência e número de ações, todas as carteiras apresentaram riscos sistemáticos menores do que o índice IBX-100 (todos os betas foram significativos e menores do que 1). Por outro lado, os alfas das carteiras foram muito baixos e, raramente, significativos, sugerindo que a gestão ativa de acordo com os critérios da Magic Formula não adiciona retornos substancialmente maiores do que o retorno relacionado à variações de mercado.

The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil

EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002

Project Pró-Natal: population-based study of perinatal and infant mortality in Natal, Northeast Brazil

RAMOS, Ana Maria de Oliveira et al. Project Pró-Natal: population-based study of perinatal and infant mortality in Natal, Northeast Brazil. Pediatric and Developmental Pathology, v.3, n.1, p.29-35, 2000

Analysis of biological tissues in infant chest for the development of an equivalent radiographic phantom

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

Social support and infant malnutrition: a case-control study in an urban area of Southeastern Brazil

The relationship between malnutrition and social support was first suggested in the mid-1990s. Despite its plausibility, no empirical studies aimed at obtaining evidence of this association could be located. The goal of the present study was to investigate such evidence. A case-control study was carried out including 101 malnourished children (weight-for-age National Center for Health Statistics/WHO 5th percentile) aged 12-23 months, who were compared with 200 well-nourished children with regard to exposure to a series of factors related to their social support system. Univariate and multiple logistic regressions were carried out, odds ratios being adjusted for per capita family income, mother's schooling, and number of children. The presence of an interaction between income and social support variables was also tested. Absence of a partner living with the mother increased risk of malnutrition (odds ratio 2.4 (95 % CI 1.19, 4.89)), even after adjustment for per capita family income, mother's schooling, and number of children. The lack of economic support during adverse situations accounted for a very high risk of malnutrition (odds ratio 10.1 (95 % CI 3.48, 29.13)) among low-income children, but had no effect on children of higher-income families. Results indicate that receiving economic support is an efficient risk modulator for malnutrition among low-income children. In addition, it was shown that the absence of a partner living with the mother is an important risk factor for malnutrition, with an effect independent from per capita family income, mother's schooling, and number of children.

Identificação de dificuldades no início do aleitamento materno mediante aplicação de protocolo

Objetivo: dimensionar o grupo de mães/recém-nascidos com necessidades especiais de apoio para um início bem sucedido do aleitamento materno, mediante aplicação de protocolo preconizado pelo UNICEF, e verificar práticas assistenciais associadas com dificuldades no aleitamento materno. Metodologia: trata-se de um estudo transversal, descritivo. A amostra foi constituída de 50 binômios mãe/recém-nascido, selecionados mediante sorteio, em maternidade que atende ao parto de baixo risco pelo SUS. Utilizando protocolo para observação e avaliação de mamada, foram registrados os comportamentos de cada dupla, computando-se a freqüência de comportamentos desfavoráveis ao aleitamento materno. A seguir, foram criados escores (bom, regular, ruim) para avaliar cada aspecto da mamada observada. Investigou-se também a associação entre determinadas práticas assistenciais e escores desfavoráveis. Adotou-se p < 0,05 como nível crítico. Resultados: a freqüência de binômios que apresentaram comportamentos sugestivos de sérias dificuldades (escore ruim) com o início do aleitamento materno variou entre 2% e 22%, conforme o aspecto da mamada avaliada. As dificuldades mais presentes foram a má posição corporal da mãe e do bebê durante a mamada e a inadequação da interação mãe/neonato. Tais dificuldades foram significativamente mais freqüentes quando o parto foi cirúrgico (p< 0,05). O uso de fórmula láctea e/ou soro glicosado também associou-se com piores escores em alguns aspectos da mamada. Conclusões: a aplicação do protocolo para a observação e avaliação de mamada identificou alta prevalência de binômios mãe/bebê com comportamentos sugestivos de dificuldades com o início da amamentação, em especial quando o parto foi cirúrgico e quando foram oferecidos suplementos ao neonato.

Nitrosyl ruthenium complexes with general formula [RuCl3,(NO)(P-P)] (P-P={PPh(2)(CH2)(n)PPh(2)},n=1-3 and {PPh(2)-CH=CH-PPh(2)}). X-ray structure of [RuCl3(NO){PPh(2)(CH2)(3)PPh(2)}]

Ruthenium(II) complexes with general formula [RuCl3(NO)(P-P)] were obtained in the solid state, where P-P = PPh(2)(CH2)(n)PPh(2) (n = 1-3) and PPh(2)-CH = CH-PPh(2). The P-31 NMR spectra of these compounds measured in CH2Cl2 showed only singlets, consistent with a fac configuration containing two equivalent phosphorus atoms, However the X-ray diffraction data show that the [RuCl3(NO){PPh(2)(CH2)(3)PPh(2)}] complex crystallizes in a met configuration, where one of the phosphorus atoms is trans to the NO group, in a slightly distorted octahedral geometry. Copyright (C) 1996 Elsevier B.V. Ltd

Caries and its association with infant feeding and oral health-related behaviours in 3-4-year-old Brazilian children

Objectives: To investigate the relationships between socio-demographic factors, infant feeding habits, oral hygiene and the prevalence and patterns of caries in Brazilian 3-4-year-olds. Methods: Systematic random sampling was used to select children enrolled in municipal nurseries in Araraquara, Brazil, in 1998. Clinical examinations were carried out by one examiner using dmft and dmfs indices and WHO criteria. Questionnaires for information related to the socio-demographic background, oral hygiene and dietary history of the children were completed by their mothers. Results: Caries was seen in 46% of the children; 17% of them had the more extensive pattern involving molars and incisors. Social class, mother's education, and age at which breast-feeding terminated showed statistically significant associations with caries. Feeding bottles with added sugars were still being given to 80% of the children. When the significant variables were taken into account only age at which breast-feeding terminated showed a significant relationship to the pattern of disease. Children who were never breast-fed or were breast-fed beyond the age of 24 months had a higher prevalence of the more extensive pattern of caries. Conclusions: The association between the length of time a mother breast-feeds and extensive caries should be a consideration in any local infant feeding policies or health promotion strategies. The duration for appropriate breast- or bottle-feeding should be emphasised.

Growth and developmental outcomes of the extremely preterm infant

Objetive: To provide information for pediatricians and neonatologists to create realistic outcome expectations and thus help plan their actions. Sources of data: Searches were made of the Cochrane Library, MEDLINE, and Lilacs databases. Summary of the findings: The assessment of growth and development over the first 2-3 years must adjust chronological age with respect of the degree of prematurity. There is special concern regarding the prognoses of small for gestational age preterm infants, and for those with bronchopulmonary dysplasia. Attention must be directed towards improving the nutrition of extremely low birth weight infants during their first years of life; these infants have high prevalence levels of failure to catch-up on growth, diseases and rehospitalizations during their first 2 years. They are frequently underweight and shorter than expected during early childhood, but delayed catch-up growth may occur between 8 and 14 years. Extremely low birth weight infants are at increased risk of neurological abnormalities and developmental delays during their first years of life. Educational, psychological, and behavioral problems are frequent during school years. Teenage and adult outcomes show that although some performance differences persist, social integration is not impaired. Conclusions: The growth and neurodevelopment of all ELBW infants must be carefully monitored after discharge, to ensure that children and their families receive adequate support and intervention to optimize prognoses. Copyright © 2005 by Sociedade Brasileira de Pediatria.

A dimension formula for reduced plethysms

The boson calculus formalism is used to construct realizations of basis states of irreducible representations of unitary groups taking as a paradigm the interacting boson models of atomic nuclei. These realizations, together with a theorem on plethysms for obtaining branching rules, allowed us to obtain a dimension formula for reduced plethysms. © 2005 IOP Publishing Ltd.

Dental caries experience in children attending an infant oral health program

Aim: To investigate: a) caries experience in 5 year-old children and its relationship to the caries risk evaluation made before 1 year of age; b) compliance of parents to an infant oral health program as well as the abandonment reasons. Methods: Group A (GA) - 242 children (60-71 months old) who stayed in the program and had been enrolled since their first year of life underwent a clinical examination according to the WHO's criteria; their parents/caregivers were interviewed to ascertain their compliance to the program. Group B (GB) - parents of 60 children, who had dropped out of the program, were interviewed to check the reasons of withdrawing. The caries risk classification was based on the file at the first appointment. Chi-square test was used (α=0.05) for statistical analyses. Results: Most of the children were free of caries (71.1%). Caries risk evaluation showed low sensibility (34.3%, 95% CI = 22.4-46.1) and high specificity (74.4%, 95% CI = 67.6-81.2) to caries experience. Sixty-two mothers (25.6%) reported difficulty to follow the guidelines. The main reason for dropping out was changing to similar health services (40.0%). Conclusions: Caries risk in the first year of life was not efficient to predict dental caries experience at 5 years of age. Educational practice should be improved to increase the compliance of the parents to the program.