Estudo longitudinal de fatores relacionados à cárie dentária e oclusopatias na infância

Pós-graduação em Odontologia - FOA

Observação da relação mãe-bebê pertencentes à classe trabalhadora durante o primeiro ano de vida

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

Mulher, mercado de trabalho e as configurações do seculo XX

The entrance of women in the labor market carries implications for the organization and structure of family functioning, leading to the proposition of new settings, family arrangements with direct interference in the mother-child and family dynamics.A major challenge for women is to reconcile time for household chores, academic, external work and be able to stay with their children in order to be able establish an affective bond and harmonious.In this sense, one can say that in married life the roles played by man and woman has been increasingly confused and that family configuration has been designed differently from the traditional family structure as well as the mother-child relationship is also touched by these events.

A prematuridade no discurso materno: de que se trata?

Quais os efeitos do diagnóstico de prematuridade no discurso das mães e suas repercussões na relação mãe-criança? Partindo desta questão, que surgiu na experiência psicanalítica em um hospital pediátrico, o presente estudo visa analisar os efeitos do diagnóstico de prematuridade no discurso materno a partir de entrevistas psicanalíticas preliminares com mães de crianças prematuras. Trata-se de uma pesquisa clínica qualitativa que propõe uma articulação entre clínica e teoria a partir da construção de quatro casos clínicos fundamentados pelo referencial teórico da psicanálise de Freud, Lacan e autores contemporâneos. Se no imaginário social a prematuridade é associada a dificuldades em diversos contextos da vida, a análise de cada caso revela que este diagnóstico pode ou não ser encadeado pelo sujeito aos significantes que o marcam de forma prevalente. Nesta via, a prematuridade se desloca do lugar determinante de algo que sempre marca e decide, para um lugar que só pode ser escutado no um a um. Para a análise dos casos, elencou-se a divisão mãe-mulher como operador conceitual central dada sua prevalência nos discursos, em um percurso teórico que parte da história do amor materno ao exame psicanalítico da maternidade a partir da sexualidade feminina. Tais considerações partem do mito do amor materno de Badinter, em direção à equivalência do filho como substituto da falta fálica em Freud, até à ênfase ao desejo da mulher na mãe em Lacan. A discussão apresenta os diferentes lugares atribuídos à prematuridade por cada sujeito feminino e a prevalência de impasses próprios à conjunção e disjunção mãe-mulher incidindo na relação mãe-criança

Aplicación práctica de los modelos de Mercer y Beck en las especialidades de enfermería

El vínculo afectivo es la atracción que un individuo siente por otro. La conducta de apego busca la unión emocional y seguridad del bebé hacia su madre. Distintas especialidades de enfermería indican la importancia de trabajar el vínculo afectivo, las relaciones familiares y utilizar el proceso enfermero partiendo de modelos conceptuales. Los modelos conceptuales de Mercer y Beck estudian factores a considerar en la formación y desarrollo de vínculos afectivos entre madres e hijos. Este estudio pretende desarrollar conocimientos, habilidades y actitudes que permitan una atención óptima al bebé y su familia. Analizando los elementos comunes y diferenciadores de ambos modelos y justificando la necesidad de prestar especial atención a la formación y mantenimiento del vínculo maternofilial desde la perspectiva de las diferentes especialidades de enfermería, se utiliza el proceso enfermero para la detección y resolución de problemas que afecten al vínculo afectivo y a las relaciones familiares.

Childhood Attention Problems and the Development of Comorbid Symptoms at the Transition to High School: The Mediating Role of Parent and Peer Relationships

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for the development of depression and delinquent behavior. Children and adolescents with ADHD also experience difficulty creating/maintaining high quality friendships and parent-child relationships, and these difficulties may contribute to the development of co-morbid internalizing and externalizing symptoms in adolescence. However, there is limited research examining whether high quality friendships and parent-child relationships mediate the relation between ADHD and the emergence of these co-morbid symptoms at the transition to high school. This study examines the mediating role of relationship quality in the association between ADHD and depressive symptoms/delinquent behaviors at this developmentally significant transition point. Results revealed significant indirect effects of grade 6 attention problems on grade 9 depressive symptoms through friendship quality and quality of the mother-child relationship in grade 8. Interventions targeting parent and peer relationships may be valuable for youth with ADHD to promote successful transitions to high school.

Cancro da mama vivido na relação mãe-filhos e na parentalidade

O diagnóstico de Cancro da Mama (CM) desencadeia uma crise na doente e no seu sistema familiar, levando a mudanças no seu modo de funcionamento. O presente estudo tem como objetivos analisar as mudanças percebidas, a curto e a longo prazo, na relação mãe-filhos e na parentalidade na sequência do diagnóstico de CM materno, bem como analisar de que forma “ser mãe” influenciou o modo como as pacientes lidaram com o CM. Foram entrevistadas 17 mulheres sobreviventes de CM com filhos dependentes no momento do diagnóstico através de uma entrevista semiestruturada. Os dados foram analisados segundo a Grounded Theory. Os resultados demonstraram que esta experiência desencadeia mudanças, temporárias e permanentes, nos padrões de funcionamento familiar. Perante as mudanças nos comportamentos dos filhos, as mães adotam novas estratégias para promover bem-estar nos descendentes. Após a família se conseguir descentrar da doença, as mulheres conseguem refletir sobre os contributos da vivência do CM na relação mãe-filhos. Clinicamente, estes resultados permitem conhecer as necessidades destas mães e apoiar a elaboração de programas de intervenção psicológica, capazes de responder a essas necessidades, salientando a importância de uma intervenção sistémica e que potencie a expressão emocional.

Juego y competencias emocionales: una exploración a las competencias emocionales de los niños colombianos que asisten a las ludotecas

Este trabajo tiene como objetivo describir y comparar el nivel y las diferencias de las competencias emocionales de niños que asisten a ludotecas y que no asisten. Este estudio se enmarca dentro de las investigaciones cuantitativas, con diseño no experimental descriptivo-comparativo. Para este, se tomó una muestra de 540 niños colombianos, de los cuales 249 eran niños y 287 eran niñas. Se utilizó una “Guía de Instrumentación”, la cual se divide en dos rejillas de observación, una en situación natural y la otra en situación artificial. Los resultados mostraron diferencias significativas para el componente de expresión de emociones y empatía, pero no se encontraron diferencias significativas para el componente de autorregulación. En líneas generales, esto demostraría que efectivamente las ludotecas sí tienen un efecto sobre las competencias emocionales, más específicamente en la expresión de emociones y la empatía, esto se pude dar, debido a que estos dos componentes se pueden desarrollar por medio de las interacciones sociales tempranas y el juego social; en cambio el desarrollo de la autorregulación depende más de factores personales como el temperamento y familiares como la relación madre-hijo. Por último, se requiere más estudios que den más evidencia de la relación entre las competencias emocionales y las ludotecas, de este modo, lograr que las ludotecas y las competencias emocionales sean vistas como factores claves en el desarrollo de los niños y niñas.

Abordaje psicoanalítico de la relación madre-hijo durante el embarazo y la forma en que esta afecta el desarrollo psicoafectivo del niño

Resumen Este documento hace una revisión de literatura desde un enfoque psicoanalítico sobre la relación madre – hijo durante el embarazo y la forma en que este influye en el desarrollo psíquico del bebé. Se aborda esta temática principalmente desde la visión teórica de Donald Winnicott, Wilfred Bion y Helene Deutsch para lograr un análisis más integral del vínculo madre-hijo. La elección de autores se hizo teniendo en cuenta que para cada uno de ellos este vínculo constituye una parte fundamental en el desarrollo psicoafectivo del niño, así como la importancia que le dan a la concepción y al embarazo en dicho proceso.

Ellen Key e la rete delle scuole nuove in Europa (1899-1914)

La ricerca parte dall’intento di indagare le relazioni che intrattenne Ellen Key con i fondatori delle scuole nuove in Europa a cavallo del Novecento e il contributo che lei offrì alla loro disseminazione. All’inizio del Novecento Ellen Key era al centro del dibattito pedagogico e femminista, non solo in Svezia ma in tutta l’Europa Centrale e anche in Italia, dove compì lunghi soggiorni (1900-1901 e 1906-1908). La pedagoga svedese fu un’intellettuale che sostenne strenuamente la libertà di espressione e di stampa, fu promotrice di una Carta dei diritti dei bambini e fautrice di politiche sociali per la protezione della maternità e della relazione madre-bambino. Al volgere del Ventesimo secolo si verificò l’emergere di una serie di esperimenti pedagogici innovativi che presero le mosse dalla Abbotsholme school fondata da Cecil Reddie, nel 1889, e si diffusero in Francia con la fondazione della Ecole des Roches da parte di Edmond Demolins, in Germania con le scuole di campagna (Landerziehungsheime di Ilseburg, Haubinda e Bieberstein) fondate da Hermann Lietz, la comunità scolastica di Wickersdorf e la Odenwaldschule di Paul Geheeb. Ellen Key si relazionò con questi importanti esperimenti pedagogici e, grazie ai suoi continui spostamenti, visitò alcune scuole nuove. Nello specifico la ricerca prende le mosse dall’analisi dei manoscritti e dei carteggi del fondo Ellen Key, presso la Biblioteca Reale di Stoccolma e la biblioteca privata di Ellen Key a Villa Strand. Dai documenti analizzati emerge come la scrittrice svedese, abbia assunto un ruolo di mediatrice per la disseminazione delle Scuole Nuove che nei primissimi anni del Novecento raggiunsero un elevato grado di diffusione.

Postpartum Depression: Is it a condition affecting the mother-infant interaction and the development of the child across the first year of life?

Noting that maternal depression is common during a baby's first year, this study examined the interaction of depressed and non-depressed mother-child dyads. A sample of 26 first-time mothers with postpartum depression at the third month after birth and their 3-month-old infants was compared to a sample of 25 first-time mothers with no postpartum depression at the third month after birth and their 3-month-old infants. The observations were repeated at 6 months and again at 12 months postpartum. The samples were compared for differences in mother interaction behavior, mother's infant care, mother's concern with the baby, infant behavioral difficulties, infant mental and motor development, and infant behavior with the observer. Among the findings are the following: (1) depressed mothers' interaction behavior and care of their infants are less adequate than the non-depressed mothers' interaction behavior and care of their infants at 3, 6, and 12 months postpartum; (2) infants' interaction behaviors during feeding and face-to-face interaction with depressed mothers are less adequate than infants' interactions with non-depressed mothers at 3, 6, and 12 months postpartum; (3) mother-infant interactions are less adequate in the depressed mother dyads than the non-depressed dyads at 3, 6, and 12 months postpartum; (4) depressed mothers are less concerned about their infants than non-depressed mothers at 3, 6, and 12 months postpartum; (5) infants of depressed mothers have more behavioral difficulties at 3, 6, and 12 months postpartum than infants of non-depressed mothers; (6) infants of depressed mothers had lower mental and motor development rates at 6 and 12 months postpartum than infants of non-depressed mothers; and (7) infants of non-depressed mothers behaved in a more positive way with the observer than the infants of depressed mothers. (AS)

Le développement des interactions triadiques mère-père-enfant = The development of mother-father-child triadic interactions

Cet article présente un état des lieux des recherches menées selon le paradigme de « l'alliance familiale » sur le développement des interactions triadiques mère-père-enfant lors de la transition à la parentalité. Ces recherches ont montré tout d'abord que la qualité des interactions triadiques tend à être stable au cours des deux premières années de vie de l'enfant, et qu'elle peut être anticipée durant la grossesse par l'observation d'interactions dans une simulation de jeu triadique. Ensuite, elles ont montré qu'une altération de ces interactions a une influence sur le développement de l'enfant qui se manifeste tout au long des cinq premières années, tant au niveau affectif que cognitif (par exemple : la capacité d'attention triangulaire lors des premiers mois, ou le développement de la théorie de l'esprit et les difficultés de comportements à cinq ans). Cette influence s'exerce en plus de celle d'autres variables comme la relation d'attachement mère-enfant, ou la personnalité de l'enfant lui-même évaluée selon son tempérament. La triade constitue donc un contexte de développement en soi qui doit être pris en compte dans la prise en charge et l'intervention auprès de jeunes enfants.This paper presents the main results of researches on the development of mother-father-child triadic interactions during the transition to parenthood, according to the « family alliance » model. First, these researches have shown that the quality of triadic interactions tends to be stable through the first two years, and that it can be predicted during pregnancy by observation of a simulated triadic play. Then, they have shown that disturbances in triadic interactions have an impact on several affective and cognitive developmental outcomes for the child throughout the first five years (for example, the triangular attention capacity during the first months, or the development of theory of mind and externalized behaviors at age five). This impact is specific, and triadic interactions exert an influence on the development of the child over and above other variables like the mother-child attachment relationship, or the personality of the child assessed in terms of temperament. The triad constitutes then a context of development per se which has to be taken into account when working clinically with young children.

Having a good relationship with their mother: a protective factor against sexual risk behavior among adolescent females?

STUDY OBJECTIVE: To assess whether having a good relationship with their mother was a protective factor against risky sexual behavior for female adolescents and whether it was independent of family structure. DESIGN: Cross-sectional survey of in-school adolescents aged 14-19 years. SETTING: Catalonia, in northeast Spain. PARTICIPANTS: A total of 3677 females divided according on whether they had a good (n=3335) or a bad (n=342) relationship with their mother. MAIN OUTCOME MEASURES: Rates of sexual activity and sexual behavior. RESULTS: Adolescents in the good relationship group were significantly younger, more likely to live in an intact family, to have a good relationship with their father and siblings, and to talk about sexuality and their partner with their mother. They were also less likely to have ever had sexual intercourse. Among those sexually experienced, they were significantly older at first intercourse and less likely to have multiple partners or a history of STI. After adjusting for potential confounders, females in the good relationship group were less likely to be sexually active and to have had multiple partners, independently of family structure. CONCLUSIONS: Having a good relationship with their mother is a protective factor against sexual intercourse and having multiple sexual partners independently of family structure. Communication between generations and having a good relationship with their father and siblings also play an important role.

Meaning of becoming mother and son/daughter through massage


Objective: Revealing the experience of mothers when massaging their children to know the phenomenon in the context of a mother-child healthy development. Method: This is a qualitative study with a phenomenological approach carried out with 11 women who massaged their children and answered the guiding question: What did the experience of massaging your child mean to you? Results: The experience of massaging their children meant the development of their being a mother and of being a son/daughter, in addition to developing the attachment relationship between them. The massage can operationalize this integrality, become a tool of communication, stimulation and promotion of secure attachment, by promoting the loving interaction between mother and child. Conclusion: This practice should be considered as an option in the programs that promote the comprehensive health of the mother and child.



Early dyadic patterns of mother-infant interactions and outcomes of prematurity at 18 months.

OBJECTIVE: With the increased survival of very preterm infants, there is a growing concern for their developmental and socioemotional outcomes. The quality of the early mother-infant relationship has been noted as 1 of the factors that may exacerbate or soften the potentially adverse impact of preterm birth, particularly concerning the infant's later competencies and development. The first purpose of the study was to identify at 6 months of corrected age whether there were specific dyadic mother-infant patterns of interaction in preterm as compared with term mother-infant dyads. The second purpose was to examine the potential impact of these dyadic patterns on the infant's behavioral and developmental outcomes at 18 months of corrected age. METHODS: During a 12-month period (January-December 1998), all preterm infants who were <34 weeks of gestational age and hospitalized at the NICU of the Lausanne University Hospital were considered for inclusion in this longitudinal prospective follow-up study. Control healthy term infants were recruited during the same period from the maternity ward of our hospital. Mother-infant dyads with preterm infants (n = 47) and term infants (n = 25) were assessed at 6 months of corrected age during a mother-infant play interaction and coded according to the Care Index. This instrument evaluates the mother's interactional behavior according to 3 scales (sensitivity, control, and unresponsiveness) and the child's interactional behavior according to 4 scales (cooperation, compliance, difficult, and passivity). At 18 months, behavioral outcomes of the children were assessed on the basis of a semistructured interview of the mother, the Symptom Check List. The Symptom Check List explores 4 groups of behavioral symptoms: sleeping problems, eating problems, psychosomatic symptoms, and behavioral and emotional disorders. At the same age, developmental outcomes were evaluated using the Griffiths Developmental Scales. Five areas were evaluated: locomotor, personal-social, hearing and speech, eye-hand coordination, and performance. RESULTS: Among the possible dyadic patterns of interaction, 2 patterns emerge recurrently in mother-infant preterm dyads: a "cooperative pattern" with a sensitive mother and a cooperative-responsive infant (28%) and a "controlling pattern" with a controlling mother and a compulsive-compliant infant (28%). The remaining 44% form a heterogeneous group that gathers all of the other preterm dyads and is composed of 1 sensitive mother-passive infant; 10 controlling mothers with a cooperative, difficult, or passive infant; and 10 unresponsive mothers with a cooperative, difficult, or passive infant. Among the term control subjects, 68% of the dyads are categorized as cooperative pattern dyads, 12% as controlling pattern dyads, and the 20% remaining as heterogeneous dyads. At 18 months, preterm infants of cooperative pattern dyads have similar outcomes as the term control infants. Preterm infants of controlling pattern dyads have significantly fewer positive outcomes as compared with preterm infants of cooperative pattern dyads, as well as compared with term control infants. They display significantly more behavioral symptoms than term infants, including more eating problems than term infants as well as infants from cooperative preterm dyads. Infants of the controlling preterm dyads do not differ significantly for the total development quotient but have worse personal-social development than term infants and worse hearing-speech development than infants from cooperative preterm dyads. The preterm infants of the heterogeneous group have outcomes that can be considered as intermediate with no significant differences compared with preterm infants from the cooperative pattern or the controlling pattern dyads. CONCLUSION: Among mother-preterm infant dyads, we identified 2 specific patterns of interaction that could play either a protective (cooperative pattern) or a risk-precipitating (controlling pattern) role on developmental and behavioral outcome, independent of perinatal risk factors and of the family's socioeconomic background. The controlling pattern is much more prevalent among preterm than term dyads and is related to a less favorable infant outcome. However, the cooperative pattern still represents almost 30% of the preterm dyads, with infants' outcome comparable to the ones of term infants. These results point out the impact of the quality of mother-infant relationship on the infant's outcome. The most important clinical implication should be to support a healthy parent-infant relationship already in the NICU but also in the first months of the infant's life. Early individualized family-based interventions during neonatal hospitalization and transition to home have been shown to reduce maternal stress and depression and increase maternal self-esteem and to improve positive early parent-preterm infant interactions.