Najara Barbosa da Rocha

Relação entre aleitamento materno e hábitos de sucção não nutritivos

This study sought to identify the type and duration of breastfeeding received by children and establish the association with non-nutritive suction habits. A retrospective, transversal study was conducted using a questionnaire given to 330 mothers or persons responsible for 3 to 6-year-old children registered in kindergartens in Aracatuba, State of Sao Paulo, after obtaining their free and informed consent. It was revealed that 86.4% of mothers breastfed their children. With respect to duration, only 33.4% of these mothers breastfed exclusively after 6 months. The average time of exclusive breastfeeding received by children was 3.84 months and complementary breastfeeding was 11.68 months. Of this total, 53.3% reported that their infants manifested non-nutritive suction habits and of these children, 70.45% were not exclusively breastfed for the first 6 months, there being a significant association between both (p<=0.05). Pacifier use was the most frequent habit (44.4%), showing a statistically significant association with breastfeeding time (p<0.0001). It was concluded that breastfeeding was practiced, albeit for a lesser duration than considered indispensable for the babys development, there being an association between duration and type of breastfeeding and non-nutritive suction habits.

A influência da prática do aleitamento materno na aquisição de hábitos de sucção não nutritivos e prevenção de oclusopatias

OBJETIVO: Neste estudo, objetivou-se verificar a associacao entre pratica do aleitamento materno, aquisicao de habitos de succao nao nutritivos e oclusopatias. MATERIAL E METODO: Trata-se de uma pesquisa do tipo transversal, retrospectiva, na qual foram realizadas entrevistas com 330 maes de criancas de 3 a 6 anos de idade de Aracatuba-SP, apos consentimento esclarecido, utilizando-se questionario semiestruturado, testado em estudo piloto. Exames clinicos foram realizados nas criancas (n = 306) para verificacao de oclusopatias. Dois pesquisadores foram calibrados (Kappa = 0,91) para realizacao das entrevistas e exames. Os testes Qui-Quadrado (χ2) e Exato de Fischer foram utilizados para verificar associacoes, em nivel de significância de 5% (p < 0,05). Os dados foram processados no programa EpiInfo e GraphPad®. RESULTADO: A maioria das maes (86,4%) amamentou seus filhos, entretanto, apenas 33,4% delas amamentaram exclusivamente no peito ate seis meses de vida. As oclusopatias estiveram presentes em 54% das criancas e, entre estas, 83% nao foram amamentadas no peito ate seis meses de idade. Os habitos de succao nao nutritivos estiveram presentes em 53,3% (176) das criancas, sendo o uso de chupeta (31,2%), o mais prevalente. Houve associacao significante direta entre a falta de aleitamento materno total e as seguintes variaveis: presenca de oclusopatias (p < 0,0001); mordida aberta (p = 0,0001); mordida cruzada anterior (p = 0,0346); habitos de succao nao nutritivos (p < 0,0001), e uso de chupeta (p < 0,0001). A falta de aleitamento materno exclusivo esteve associada com uso de chupeta (p < 0,0001). CONCLUSAO: O aleitamento materno, alem de inumeras vantagens, exerce papel preventivo na aquisicao de habitos de succao nao nutritivos e na prevalencia de oclusopatias.

A Ótica do Usuário na Avaliação da Qualidade do Programa de Atenção Odontológica à Gestante

Departamento de Odontologia Infantil e Social Faculdade de Odontologia de Aracatuba (UNESP), Aracatuba/SP

Escolas Técnicas do SUS (ETSUS) no Brasil: regulação da integração ensino serviço e sustentabilidade administrativa

The scope of this study was to discuss the administrative sustainability of Brazils Vocational Health Schools (ETSUS) based on the principle of teaching and service integration, which brings a new dimension to healthcare work as yet unregulated by Brazilian public administration. It was a qualitative study using case study methodology. The research involved a semi-structured questionnaire given to ETSUS managers addressing institutional, administrative, and work management aspects. The sample was composed of 6 ETSUS that belong to the Network of Vocational Health Schools (RET-SUS). The ETSUS showed centralized planning and management, and decentralized implementation of their core activities. The majority did not have administrative autonomy and relied heavily on funding from the federal government. According to ETSUS managers, the lack of regulation of teaching activities by civil servants weakens the management of ETSUS. The ETSUS have managerial problems related to teaching-service integration, which has to be regulated in order to guarantee the sustainability of these schools and avoid conflicts with Brazilian legislation.

Factors affecting intention to breastfeed of a group of Brazilian childbearing women

BACKGROUND Knowing the intention of mothers is important to plan actions to improve exclusive breastfeeding rates. AIM The objective of this retrospective study was to verify the intention to breastfeed and the intended breastfeeding duration of a group of women participating in a public prenatal dental care program in the city of Araçatuba, Brazil. METHODS The records of 933 childbearing women were analyzed and their intention to breastfeed and intended breastfeeding duration were associated to womens age, ethnicity, marital status, education, employment, number of gestations, previous breastfeeding experience, previous breastfeeding guidance, presence of complications during pregnancy, and systemic diseases. Data were inserted into Epi Info 2000 and analyzed with Biostat, at a 5% level of significance, and confidence interval of 95%. FINDINGS Participants mean age was 26.1±5.9years. The majority of women (96.5%) declared their intention to breastfeed their babies. The main variables to affect the intention to breastfeed were the number of gestations (p=0.001), previous breastfeeding experience (p=0.03), and previous breastfeeding guidance (p=0.01). Intended breastfeeding duration was significantly affected by womens age (p=0.04), employment (0.02), the number of gestations (p=0.001), and previous breastfeeding experience (p=0.04). CONCLUSIONS Previous positive breastfeeding experience and guidance during prenatal examinations positively affected womens intention to breastfeed; while older, unemployed women in their second or more gestation and previous breastfeeding experience intended to breastfeed their children for longer periods of time.

Medicação intracanal sem trocas periódicas como tratamento de dente avulsionado: relato de caso

Posteriormente ao reimplante de dentes avulsionados existe a necessidade da realizacao do tratamento endodontico o mais breve possivel em casos diagnosticados com necrose pulpar. O protocolo de tratamento de dentes avulsionados envolve o uso de medicacao intracanal a base de hidroxido de calcio, entre sessoes, como um fator complementar a reducao de micro-organismos, prevencao e estabilizacao da reabsorcao radicular, inducao de formacao dentinaria e reparo dos tecidos periapicais. O objetivo deste trabalho e apresentar e discutir um protocolo de tratamento frente a reabsorcao radicular externa causado posteriormente ao reimplante de um dente avulsionado, por meio do uso de uma medicacao intracanal sem a necessidade de trocas periodicas. Paciente do genero masculino, 16 anos de idade, sofreu uma queda seguida de avulsao do dente 21. Relatou que o dente foi mantido em agua e reimplantado apos 10 minutos, sendo instalada uma contencao flexivel, a qual foi removida apenas quando se iniciou o tratamento endodontico, 9 meses apos o trauma. Ao exame radiografico, observou-se reabsorcao radicular externa a nivel medio e apical, portanto, foi definido o protocolo terapeutico com o uso de medicacao intracanal a base de hidroxido de calcio, associado ao propilenoglicol e oxido de zinco, a qual foi capaz de permanecer intracanal por um periodo superior a dois anos e estabilizar a reabsorcao radicular externa. Conclui-se que o reimplante dentario associado ao protocolo de tratamento utilizando esta medicacao intracanal sem trocas periodicas, possibilitou a manutencao do dente em funcionalidade e estetica, e evitou possiveis sequelas psicologicas. Descritores: Avulsao Dentaria; Reimplante Dentario; Reabsorcao da Raiz; Hidroxido de Calcio; Oxido de Zinco.

Longitudinal study into the determining factors of dental caries in children aged 4: socio-behavioral aspects and oral health of pregnant women

ABSTRACT ObjectiveTo analyze the influence of oral health conditions and socio-behavioral characteristics of pregnant women on the development of caries and their children’s experiences, after 4 years of follow-up.MethodsIt was conducted a longitudinal study of mother/child pairs by interview and oral clinical examination during pregnancy. Regular observations were made until the child had reached four years of age, at which time we performed a clinical examination of the children (n=73). The variables studied were: presence of caries in pregnancy (DMFT) and the child (deft), visit to the dentist, oral hygiene habits, diet, socioeconomic and behavioral factors, and were related to two study outcomes: presence of caries during the examination and experience of caries (deft≥1) in children of 4 years of age. Bivariate and logistic regression analyses were conducted with the variables (p<0.05 and 95% CI).ResultsThe average DMFT index of mothers during pregnancy was 12.09 (±2.88) and average deft index of children at 4 years was 1.79 (± 6.1). In the multiple logistic regression analysis, the presence of caries in children was associated with the presence of harmful habits (p=0.04). Caries in the child was statistically associated with brush sharing among family members (p=0.02).ConclusionThe results suggest that behavioral aspects are related to the presence and experience of caries in childhood.Indexing terms: Dental caries. Longitudinal studies. Oral health. Risk factors. Socioeconomic factors.

Desmame precoce: Falta de conhecimento ou de acompanhamento?

Departamento de Odontologia Preventiva e Social Aracatuba da Universidade Estadual Paulista (UNESP), Aracatuba/SP

The User’s View in Evaluating the Quality of the Pregnant Women Dental Care Program

Objetivo: Avaliar a percepcao das gestantes ao Programa de Atencao Odontologica a Gestante da FOA-UNESP. Metodo: A amostra compreendeu 75 gestantes, sendo utilizado um questionario com 16 questoes fechadas, contendo variaveis agrupadas nas seguintes categorias: conteudo das reunioes didatico-pedagogicas, atendimento clinico, perfil do profissional, infra-estrutura da clinica, medo/seguranca no atendimento e aprendizado. Com excecao das variaveis medo/seguranca no atendimento e aprendizado que tiveram conceitos sim e nao atribuidos, as demais tiveram conceitos de fraco a otimo atribuidos. Os questionarios foram pre-testados em um estudo piloto, e aplicados apos consentimento livre e esclarecido, em todas as gestantes que concluiram tratamento no ano de 2005 a 2006. Resultados: A maioria considerou como otimo o conteudo informativo trabalhado nas reunioes didatico-pedagogicas (81,1%), o atendimento clinico (90,6%), o profissional quanto a apresentacao pessoal, gentileza e atencao (88,7%, 96,2%, 90,6%, respectivamente), e a infra-estrutura da clinica quanto a limpeza, ventilacao e conforto (92,5%,86,8%,90,6%, respectivamente). A maioria afirmou sentir seguranca (96,2%) e nao sentir medo (86,8%) durante o tratamento, e ainda, afirmou ter aprendido conteudos ate entao desconhecidos (92,5%) nas reunioes didatico-pedagogicas do programa. Conclusao: Os servicos e acoes desenvolvidas no programa tem obtido exito, promovendo saude as gestantes e seus futuros bebes.