Bibliography: leaves 148-163.

Bibliography: leaves 148-163. / xix, 163, [43] leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2001

This study investigated the relationship between stress and pain crisis incidence in pediatric Sickle Cell Anemia (SCA). It was hypothesized that SCA children were exposed to higher levels of stress than healthy children. It was also hypothesized that a significant positive correlation existed between level of stress and pain crisis incidence both within and between years. The sample consisted of 20 Black elementary school children with SCA. There were 12 female and 8 male children. The period of investigation included the calendar years 1983 and 1984. Pain crisis incidence was determined through parent interviews and verified by a review of medical records.

While sickle cell disease (SCD) primarily affects those of African heritage, Latinos, the second most commonly affected group, are often not included in studies of youth with SCD. The purpose of this mixed methods study was to complete the linguistic translation validation of the PedsQL SCD Module, a recently validated disease specific quality of life (QOL) instrument, for use in Spanish speaking parents and youth with SCD (Aim 1). Using this instrument, QOL of Latino and African American youth with SCD who participated in an NIH funded study to improve adherence to hydroxyurea therapy (R21 NR013745) were compared (Aim 2) and factors associated with QOL examined (Aim 3). For Aim 1, 10 Latino youth with SCD (n = 5 age, 8-12 years; n = 5 age, 13-18 years) and their parents completed a demographic survey, Spanish version of PedsQL SCD Module and an audio-taped cognitive interview. Across age groups, all reported that the translated PedsQL Sickle Cell Disease Module was easy to understand and had minimal suggestions for further improvement. For Aims 2 and 3, secondary baseline data from 28 youth (mean age 13.6  2.4 years) with sickle cell disease and their parents who participated in the HABIT feasibility trial were analyzed using descriptive statistics, Wilcoxon Signed Rank and Mann-Whitney test, and linear regression modeling. Latino youth reported higher QOL scores than non-Latino youth for all QOL measures except for the Worry II subscale of the disease-specific QOL measure while Latino parents reported higher QOL scores than non-Latino parents for all subscales except for three: the disease-specific Worry I, Worry II, and Communication I subscales. Poorer disease specific QOL was predicted by greater youth-parent discordance regarding sickle cell disease responsibility for parents (β = -3.07, p = 0.04) but not youth. Poorer disease-specific QOL was predicted by greater number of both emergency room visits during the prior year for both youth (β = -2.89, p = 0.005 [self-report]; β = -5.07, p = 0.002 [electronic medical records]) and parents (β = -3.41, p = 0.002 [self-report]; β = -6.93, p = <0.001 [electronic medical records]) and hospitalizations during the prior year (youth β = -5.72, p = <0.001 [self-report]; β = -7.56, p = 0.03 [electronic medical records]; parents β = -6.48, p = <0.001 [self-report]; β = -9.16, p = 0.02 [electronic medical record]). Based on these findings, greater youth-parent discordance regarding sickle cell family responsibility and greater utilization of emergency rooms and/or hospitals were associated with poorer disease-specific QOL.

The aims of the present studies were to determine the magnitude of iron deficiency anemia among preschool children in Northern Ethiopia and to evaluate different control strategies. The cross-sectional study showed that anemia was highly prevalent (42%) and that iron deficiency was the commonest cause of anemia. However, the iron deficiency was not due to lack of iron in the diet but to its poor availability and to other non-dietary risk factors. Unsafe water, mother's illness, older child (24--60 months), family not having food reserves and family income below poverty-line were predictors of anemia. Hookworm and malaria were rare and did not account for the anemia. In the iron pot study three types of Ethiopian foods were cooked in three types of pots (iron, aluminum and clay) and assessed for their total and available iron. After adjusting for cooking time and moisture, there were significantly higher total and available iron in all the three types of foods when cooked in iron pots compared to the aluminum or clay pots. The study also showed that the hemoglobin status and length of children improved significantly when they consumed food cooked in iron pots. In the third study, a randomized, placebo-controlled, and double-blind trial, both iron and vitamin A supplemented children showed increased hemoglobin levels. Combined iron and vitamin A supplementation showed the highest rise. Iron-supplemented children showed increase in length, but no increase in weight. They also showed lower rates of c-reactive protein positivity and decreases in the prevalence and frequency of diarrhea. A single dose of vitamin A did not result in any increase in length or weight but a decrease in the prevalence and frequency of diarrhea was observed. Children supplemented with iron only or vitamin A only showed higher ARI rates, but those children who received combined iron and vitamin A showed significantly lower ARI rates. Iron supplementation did not have any effect on either zinc

The purpose of this quasi-experimental study was to measure the effectiveness of a grocery store tour that emphasized sources of iron-rich, kid-friendly foods on the participants’ knowledge about dietary iron and iron-rich food sources. A second purpose was to determine if, three months after the grocery store tour, the serum iron levels of the children who had previously been identified by the WIC (Supplemental Women, Infants, and Children) program as being low was higher as compared to the serum iron levels of the control group. Ten parents of children with low iron levels participated in this study, 5 in the control group and 5 in the treatment group. Data collection took place for this research study over the course of three months. The results of this study indicated that the grocery store intervention seemed to have no impact on the children’s hemoglobin levels. The results of this study also indicated that the grocery store tour intervention seemed to have no impact on children’s consumption of iron rich foods. However, the grocery store tour intervention did have a positive impact on parents’ knowledge of iron rich foods and their ability to use unit pricing. / Department of Family and Consumer Sciences

Made available in DSpace on 2015-01-26T13:21:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-04-30Bitstream added on 2015-01-26T13:30:40Z : No. of bitstreams: 1 000797017.pdf: 589739 bytes, checksum: b01c89457a2793444e6965350ef2ed28 (MD5) / Objetivo: identificar a prevalência de anemia e fatores associados a esse agravo em crianças assistidas por creches públicas, com vistas a propor protocolo clínico de enfermagem e de organização dos serviços de atenção primária à saúde para ações de vigilância nutricional. Método: realizou-se um estudo epidemiológico, transversal. A amostra de estudo foi intencional e formada por 221 crianças entre seis meses e seis anos de idade, matriculadas em três creches públicas do município de Guararapes (SP), situado na região noroeste do Estado de São Paulo. A amostra do sangue capilar (punção digital) coletada de cada criança participante foi processada em hemoglobinômero portátil, considerando-se anemia valores de hemoglobina inferiores a 11g/dl. O estado nutricional global foi avaliado a partir dos indicadores: altura para idade, peso para alturae IMC para idade, expressos em escores-Z, utilizando-se como referência o padrão da Organização Mundial de Saúde-2006. Foram adotadas duas classificações nutricionais: a preconizada pelo Sistema de Vigilância Nutricional do Ministério da Saúde para a atenção individual à criança e a recomendada pela Organização Mundial de Saúde para estudos epidemiológicos. Dados socioeconômicos das famílias e demográficos maternos e paternos foram coletados através dos prontuários individuais das crianças e por meio de questionário enviado aos pais. Realizou-se análise descritiva e tabulações cruzadas entre presença de anemia e fatores de interesse, com significância avaliada pelo teste qui-quadrado. Resultados: a média de concentração de hemoglobina foi 10,8 g/dl (DP=1,38). A prevalência de anemia foi 51,1%; senda que 42,1% apresentaram a forma leve e 9,0% moderada. A frequência de crianças com baixa estatura foi 6,7%. Segundo o índice IMC/idade, 32,6% das crianças apresentavam alguma situação envolvendo excesso de peso: risco de sobrepeso ... / Objective: To identify the prevalence of anemia and factors associated with this disease under attended by public nursery children, with a view to proposing clinical nursing protocol and organization of primary health care services to provide nutrition surveillance. Method: The authors conducted an epidemiological, cross-sectional study. The study sample was intentional and formed by 221 children between six months and six years of age, enrolled in three public kindergartens in the municipality of Guararapes (SP), located in the northwestern region of São Paulo. The sample of capillary blood (fingerstick) collected from each participating child was processed on laptop hemoglobinometer, considering anemia hemoglobin below 11g/dl. The overall nutritional status was assessed from indicators: height for age, weight for height and BMI for age expressed as Z-scores, using as reference the standard of the World Health Organization, 2006. Two nutritional classifications were adopted: advocated by Nutritional Surveillance System of the Ministry of Health for individual attention to the child and recommended by the World Health Organization for epidemiological studies. Socioeconomic and demographic data on the families maternal and paternal were collected through the individual records of children and by means of a questionnaire sent to parents. A descriptive analysis and cross-tabulations between anemia and the factors of interest, with significance evaluated by chi- square test.Results: The mean hemoglobin concentration was 10.8 g / dl (SD = 1.38). The prevalence of anemia was 51.1 %, 42.1 % showed the path to take shape and moderate 9.0 %. The frequency of children with short stature was 6.7%. According to the BMI index / age, 32.6 % of children had some situation involving overweight: risk of overweight (24 %), overweight (7.2%) and obesity (1.4%). You can check inverse linear association between child's age and anemia: ...

Orientador: Maria Antonieta de Barros Leite Carvalhaes / Coorientador: Vera Lúcia Pamplona Tonete / Banca: Sílvia Justina Papini / Banca: Débora Falleiros de Mello / Resumo: Objetivo: identificar a prevalência de anemia e fatores associados a esse agravo em crianças assistidas por creches públicas, com vistas a propor protocolo clínico de enfermagem e de organização dos serviços de atenção primária à saúde para ações de vigilância nutricional. Método: realizou-se um estudo epidemiológico, transversal. A amostra de estudo foi intencional e formada por 221 crianças entre seis meses e seis anos de idade, matriculadas em três creches públicas do município de Guararapes (SP), situado na região noroeste do Estado de São Paulo. A amostra do sangue capilar (punção digital) coletada de cada criança participante foi processada em hemoglobinômero portátil, considerando-se anemia valores de hemoglobina inferiores a 11g/dl. O estado nutricional global foi avaliado a partir dos indicadores: altura para idade, peso para alturae IMC para idade, expressos em escores-Z, utilizando-se como referência o padrão da Organização Mundial de Saúde-2006. Foram adotadas duas classificações nutricionais: a preconizada pelo Sistema de Vigilância Nutricional do Ministério da Saúde para a atenção individual à criança e a recomendada pela Organização Mundial de Saúde para estudos epidemiológicos. Dados socioeconômicos das famílias e demográficos maternos e paternos foram coletados através dos prontuários individuais das crianças e por meio de questionário enviado aos pais. Realizou-se análise descritiva e tabulações cruzadas entre presença de anemia e fatores de interesse, com significância avaliada pelo teste qui-quadrado. Resultados: a média de concentração de hemoglobina foi 10,8 g/dl (DP=1,38). A prevalência de anemia foi 51,1%; senda que 42,1% apresentaram a forma leve e 9,0% moderada. A frequência de crianças com baixa estatura foi 6,7%. Segundo o índice IMC/idade, 32,6% das crianças apresentavam alguma situação envolvendo excesso de peso: risco de sobrepeso ... / Abstract: Objective: To identify the prevalence of anemia and factors associated with this disease under attended by public nursery children, with a view to proposing clinical nursing protocol and organization of primary health care services to provide nutrition surveillance. Method: The authors conducted an epidemiological, cross-sectional study. The study sample was intentional and formed by 221 children between six months and six years of age, enrolled in three public kindergartens in the municipality of Guararapes (SP), located in the northwestern region of São Paulo. The sample of capillary blood (fingerstick) collected from each participating child was processed on laptop hemoglobinometer, considering anemia hemoglobin below 11g/dl. The overall nutritional status was assessed from indicators: height for age, weight for height and BMI for age expressed as Z-scores, using as reference the standard of the World Health Organization, 2006. Two nutritional classifications were adopted: advocated by Nutritional Surveillance System of the Ministry of Health for individual attention to the child and recommended by the World Health Organization for epidemiological studies. Socioeconomic and demographic data on the families maternal and paternal were collected through the individual records of children and by means of a questionnaire sent to parents. A descriptive analysis and cross-tabulations between anemia and the factors of interest, with significance evaluated by chi- square test.Results: The mean hemoglobin concentration was 10.8 g / dl (SD = 1.38). The prevalence of anemia was 51.1 %, 42.1 % showed the path to take shape and moderate 9.0 %. The frequency of children with short stature was 6.7%. According to the BMI index / age, 32.6 % of children had some situation involving overweight: risk of overweight (24 %), overweight (7.2%) and obesity (1.4%). You can check inverse linear association between child's age and anemia: ... / Mestre

Orientadores: Valdemiro Carlos Sgarbieri, Emilio Carlos Elias Baracat / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos / Made available in DSpace on 2018-08-03T18:06:44Z (GMT). No. of bitstreams: 1 Simoes_MiriamCorreadeCarvalho_D.pdf: 1345494 bytes, checksum: 47c222f69a8d8d2bde7025f385f72617 (MD5) Previous issue date: 2003 / Resumo: A anemia ferropriva, desordem nutricional mais prevalente em todo o mundo, acomete principalmente crianças menores de cinco anos como resultado do balanço negativo prolongado de ferro ou por falha do organismo em atender às necessidades fisiológicas aumentadas. A importância como problema de saúde pública está baseada em suas conseqüências para a saúde, entre elas, a diminuição da resposta imune, especialmente a celular, pode interferir negativamente na instalação e na evolução de processos infecciosos, representando assim, fator de risco para o desenvolvimento da pneumonia, principal causa de hospitalização devido às infecções respiratórias agudas (IRA). Esforços substanciais têm ocorrido para se implementar programas para reduzir a deficiência de ferro e a anemia ferropriva, sendo a suplementação uma importante estratégia para a prevenção e o tratamento da anemia em todo o mundo. O sulfato ferroso, apesar de ser um dos compostos mais utilizados na suplementação, devido ao baixo custo e a oferta, pode causar efeitos gastrointestinais indesejáveis. Neste sentido, o sangue bovino, por apresentar ferro hematínico de alta biodisponibilidade, por ser encontrado abundantemente em nosso país e por representar custo favorável, pode representar uma alternativa para a suplementação de ferro no tratamento da anemia. Deste modo, no presente trabalho, foi realizado um estudo prospectivo, de intervenção, tipo ensaio clínico, com o objetivo de avaliar a resposta terapêutica ao uso do suplemento de ferro hematínico, proveniente de sangue bovino (grupo experimental-G1), em crianças de 1 a 5 anos de idade internadas com pneumonia aguda e anemia, e compará-la ao esquema com utilização de sulfato ferroso (grupo controle-G2). Na admissão dos pacientes, foram coletados dados sócioeconômicos (escolaridade da mãe, renda familiar e renda per capita); realizada avaliação antropométrica (peso, estatura) e coleta de sangue para avaliação de dados hematimétricos. O diagnóstico de anemia foi realizado utilizando-se parâmetros hematimétricos associados, sendo esta diagnosticada quando 2 ou 3 dos parâmetros apresentavam-se alterados: Hemoglobina (<11g/dL), RDW (>14,5%) e VCM (<73fL para Idade <3 anos ou VCM<75fL para Idade ³3 anos). Outros parâmetros como ferro sérico, capacidade total de ligação de ferro, ferritina sérica, saturação de transferrina e reticulócitos, também foram analisados. Das 184 crianças, consecutivamente admitidas no período de agosto 2001 a julho de 2002, foram selecionadas 119, utilizando-se critérios de exclusão e inclusão, sendo 61 (51,3%) do sexo masculino e 58 (48,7%) do sexo feminino. A prevalência total de anemia foi de 57,1%. As crianças foram aleatoriamente distribuídas em dois grupos, experimental e controle. Após a alta hospitalar ao grupo experimental (n=33) prescreveu-se suplemento de ferro e ao grupo controle (n=35) prescreveu-se sulfato ferroso por um período de 60 dias. Após 7(T1), 30(T2) e 60(T3) dias, as crianças retornaram para avaliação clínica e da dieta e coleta de sangue. A distribuição dos pacientes nos dois grupos foi homogênea, em relação às variáveis: estado nutricional, idade, escolaridade da mãe, renda per capita e níveis hematimétricos. A análise de variância (ANOVA) para medidas repetidas mostrou que os dois grupos responderam de maneira semelhante quanto à evolução dos parâmetros hematimétricos, apresentando diferença significativa para todos os tempos, não havendo diferença significativa entre os grupos. A dieta apresentou adequação calórica e protéica e déficit de ferro para os dois grupos. A presença de efeitos adversos foi significativamente maior para o grupo controle. Tais resultados apontam para a viabilidade de se utilizar o suplemento de ferro hematínico, proveniente de sangue bovino, no tratamento da anemia em crianças, destacando-se, menor prevalência de efeitos adversos, menor prescrição de ferro, baixo custo e boa aceitação / Abstract: Iron deficiency and iron deficiency anemia are considered the major public health problems and the most common nutritional deficiency around the world due to their high prevalence, effects on development and growth, resistance to infections and association with the mortality of infants younger than 2 years. Etiologic factors include insufficient intake or assimilation of iron from the diet or dilution of body iron by rapid growth. In addition, iron deficiency may be associated with impaired cellular immunity and altered behavior. It can interfere in the infectious processes installation, representing a risk factor for the development of pneumonia, the main cause of hospitalization in the acute respiratory infections (ARI). Substantial efforts have been made to implement programs to reduce iron deficiency and iron deficiency anemia. Iron supplementation is an important strategy to prevent and to treat this type of anemia all over the world. Ferrous sulfate is the more used component for iron supplementation, due to low cost and good availability, but it can cause undesirable gastrointestinal effects. Other form of iron supplementation is the bovine blood, a high bio-available heme iron, which can be easily found at our country and has also a favorable cost. The present work, a prospective study of intervention, was accomplished with the objective of evaluating the therapeutic answer to the use of heme iron supplement coming from bovine blood (experimental group-G1) in hospitalized children of 1 to 5 years of age with acute pneumonia and anemia and to compare it to the use of ferrous sulfate (control group-G2). Socioeconomic data (mother's educational levels, family and per capita income), anthropometric evaluation of nutritional status (weight, height) and blood sampling for hematological index evaluation were performed at the patients' admission. Anemia diagnosis was accomplished when at least 2 of 3 blood parameters were altered: Hemoglobin (<11g/dL), RDW (>14.5%) and VCM (<73fL for age <3 years or VCM <75fL for age >3 years). Other parameters as serum iron, total iron binding capacity, serum ferritin, transferrin saturation and reticulocitose were also analyzed. From a total of 184 children, consecutively admitted in the period from August 2001 to July 2002, using exclusion and inclusion approaches, 119 were selected, 61 (51.3%) male and 58 (48.7%) female. Total prevalence of anemia was 57,1%. Children were distributed by chance in two groups, experimental and control. It was prescribed heme iron supplement to the experimental group (n=33) and ferrous sulfate to the control group (n=35) after hospital discharge by a period of 60 days. After 7, 30 and 60 days, the children came back for clinical and diet evaluation and blood sampling. Patient¿s distribution was homogeneous in the two groups, in relation to the variables nutritional state, age, mother's educational levels, per capita income and hematological blood levels. Variance analysis (ANOVA) for repeated measures resulted that the two groups were similar in the increase of the hematological parameters. Calories and proteins in the diet were satisfactory but the amount of iron was insufficient for the two groups. Presence of adverse effects was significantly bigger for the control group. Based on these results it can be concluded the viability of using heme iron supplement coming from bovine blood, in the treatment of the anemia in children, standing out, smaller prevalence of adverse effects, smaller iron prescription, low cost and good acceptance / Doutorado / Doutor em Alimentos e Nutrição

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