Thesis--University of Oklahoma. / Bibliography: leaves 70-75.

Nutrition of children of each age has its particular aspects. For the new born and infantile age it is mainly breast-feeding that is very significant. Nutrition with breast milk is ideally balanced, ensures the intake of high-quality nutrition that is well tolerated by the young organism and ensures the optimal growth and psychological development of the child. Thanks to its composition, breast milk increases the protective impact on the child with respect to infections and creates a natural bond between the mother and the child. In the Thesis, I was trying to look up decisive moments in the infantile nutrition concept both in this country and worldwide and to map the issue of breast feeding and formula feeding since the end of the Second World War up to the present. Also, I wanted to emphasize the irreplaceability of breast milk as wel as supplementing of artificial milks with probiotics, prebiotics, synbiotics and their importance in the nutrition of children. Objective No. 1 of the Thesis has been to look up the key points in the infantile nutrition concept in the world since the beginning of the nineteenth century and since 1945 until this day in the Czech Republic. Objective No. 2 has been to prove that infantile formula nutrition has been focusing also on the immunological aspect apart from the nutritional ones. Objective No. 3 has been to create and aducational program proposal, which can serve as a practical guide for the application of theoretical data in clinical practice. Data necessary to achieve the determined objectives have been acquired by studing, analyses and comparison of available written documents relating to the natural and formula nutrition of infants. Most of these documents have been intended for the educational purposes at secondary school and universities in the Czech Republic. Also, data heve been taken from publications for parents and broad public published since 1945 until this day. By way of illustration, certain charts containing schemes of artificial nutrition corresponding to the time of creation have been used. On these schemes I wanted to show the chages in the concepts brought about by the development not only in the knowledge and thinking of people dealing with the nutrition of infants but also in the new possibilities and technology of the food processing industry.

Cette thèse porte sur les discours relatifs à l’allaitement maternel dans les forums de discussion sur Internet. L’enjeu est d’aborder les pratiques discursives des participants au regard des discours d’experts en la matière, qu’ils soient d’ordre institutionnels, relèvent de l’édition ou de la presse grand public de vulgarisation de la puériculture, ou d’associations de promotion de l’allaitement maternel. Nous avons choisi comme approche pour cette démarche une construction conceptuelle empruntée à Antonio Negri et Michael Hardt, l’aliénation autonome. Pouvant être définie comme le processus supposant autant l’interaction de chacun des membres de la société au travers d’appareils disciplinaires, certes plus diffus et plus nombreux que dans la société de contrôle, mais bien existants et actifs, que la conformation individuelle de chacun au discours social dominant, cette construction conceptuelle, appliquée aux discours relatifs à l’allaitement maternel, permet de mettre en évidence les rapports entre le discours des experts et celui des internautes sur les forums de discussion. La première partie est consacrée à un examen des travaux à la fois sur l’allaitement maternel et sur Internet et à l’élaboration de ce cadre théorique centré sur le concept d’aliénation autonome. La seconde partie est une analyse des discours relatifs à l’allaitement maternel, tels qu’on peut les trouver dans l’édition, la presse spécialisée, les publications institutionnelles et celles des associations de promotion de l’allaitement maternel, afin de dégager les différentes thématiques de ce discours. Elles servent de référentiel pour l’analyse du discours des internautes dans la troisième partie. Cette analyse a été réalisée conjointement à partir des données fournies par le logiciel d’analyse lexicométrique « Pistes » et grâce à la méthode d’analyse de contenu. Reprenant les thèmes et arguments du discours dominant sur l’allaitement maternel, interprétant les réalités auxquelles ils sont confrontés en fonction des éléments discursifs qui leur sont ainsi fournis, les internautes incarnent ici le concept d’aliénation autonome. Mais à travers certaines résistances qui parviennent à s’exprimer contre la « doxa de l’allaitement maternel », ils illustrent aussi une autre conceptualisation d’Antonio Negri et de Michael Hardt : celle de « multitude ». / This thesis concerns the discourses about breast feeding in the Internet chat rooms. The aim is to focus on the discursive practices of the participants from the expert discourses viewpoint. The concerned discourses can be institutional ones, publishing ones, from baby care popularization popular press or from associations promoting breast feeding. We chose to approach the point with a conceptual construction borrowed to Antonio Negri and Michael Hardt : the autonomous alienation. This conceptual construction that can be defined as a process with the interaction of each society member through disciplinary apparatus that are - it is true -more diffuse and numerous than in the control society but real and active, as well as the individual conformation of each one to the prevailing social discourse, applied to breast feeding discourse allows to put into relieve the links between the expert discourses and the one of net surfers in chat rooms. The first part is dedicated not only to an exam of the works on breast feeding on the Internet but also to the elaboration of the theorical frame focused on the autonomous alienation concept. The second part is an analysis of the breast feeding discourses that we can find in publishing business, specialized newspapers, institutional publications and the publications of associations promoting breast feeding. The goal is to put into relieve the different themes that will be used as references for the discourse analysis of net surfers in the third part. This analysis is based on data from the word count analysis software called “Pistes” and also owing to the content analysis method.If we look at the themes and arguments of the main discourse about breast feeding that interprets the realities they are confronted to, according to the discursive elements that are given to them, net surfers represent here the autonomous alienation concept. But through some resistances that can be expressed against the “breast feeding doxa”, they also represent another conceptualization of Antonio Negri and Michael Hardt : the “multitude” one.

The purpose of the study was to determine if mothers who breast-feed their babies for nine months and longer experience problems when weaning. This research also determines the type of problems and weaning practices used by those mothers. In this descriptive study, data was collected from 150 mothers by means of questionnaires and interviews. The subjects were mothers who breast-fed their children for nine months or longer, who attended antenatal and postnatal clinics at Coronation Hospital. Reasons for weaning were inter alia the belief that the baby was old enough to be weaned. The results revealed that 42 (31,34%) of the respondents experienced problems during weaning. The problems included, among others, guilt feelings in the mother. Mothers use harsh methods of weaning such as sending a child away to a relative. There is minimal involvement of health workers in the health education of mothers on weaning. / Health Studies / M.A. (Nursing Science)

Made available in DSpace on 2015-07-22T20:49:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-09-29 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução: O leite materno constitui-se no melhor alimento para o lactente, sendo alimento que possue nutrientes essenciais para o crescimento e desenvolvimento ideal da criança. Diminue os riscos de doenças infecciosas, respiratórias e gastrointestinais, como também de obesidade entre outros benefícios de ordem emocional e psicológica. Muitos são os fatores de risco que levam ao desmame precoce, alguns destes fatores estão relacionados à mãe, à criança, ao ambiente e fatores circunstanciais. A amamentação depende, portanto, de condições ambientais, as quais podem ser favorecidas pelo trabalho de orientação de educadoras de creches. Objetivo: Identificar e analisar os principais determinantes que influenciam na duração do aleitamento materno exclusivo e aleitamento materno de crianças atendidas em berçários de creches públicas e filantrópicas de São Paulo. Métodos: Estudo transversal, com 270 crianças de 4 a 29 meses de idade, frequentadoras de 8 creches do Município de São Paulo. Foram realizadas entrevistas com as mães utilizando um questionário estruturado e pré-codificado desenvolvido e previamente testado para coletar os dados individuais da criança, visando conhecer sua condição de saúde e nutrição. Foram abordados indicadores maternos, demográficos, clínicos, epidemiológicos, sócio-econômicos e ambientais. O aleitamento materno foi avaliado a partir de perguntas coletadas no questionário. Os dados foram analisados utilizando o método de Mann Whitney/Wilcoxon (Kruskal – Wallis) e modelos de sobrevida (Kaplan Meier e regressão multipla de Cox). Resultados: A duração média de aleitamento materno exclusivo foi de 79,1 ± 55,6 dias e de aleitamento materno de 185,3 ± 174,2 dias. Na análise multivariada para o aleitamento materno exclusivo foram encontrados os seguintes fatores de risco associados ao desmame precoce: o uso de chupeta, internação prévia e mãe que trabalha fora de casa. Para o aleitamento materno foram encontrados os seguintes fatores de risco: uso de chupeta e mãe que trabalha fora de casa. Conclusão: Os resultados obtidos demonstram que é preciso continuar com o incentivo e apoio ao aleitamento materno principalmente o aleitamento materno exclusivo até os seis meses de idade. As creches podem e devem aliar-se a essa proposta, já que podem colaborar de maneira direta com alguns dos fatores determinantes do aleitamento materno, uma vez que são lugares apropriados para difundir mensagens de educação nutricional e orientações para mães e cuidadores de crianças menores de três anos. / FAPESP: 2005/02597-0 / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2013-01-07T15:55:07Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 5.pdf: 880331 bytes, checksum: 1137d1950575e17cc24ef7d1d574a7ef (MD5) Previous issue date: 2006 / Consiste no estudo histórico do processo da institucionalização médica no Brasil e de suas conseqüentes influências no espaço urbano do Rio de Janeiro escravista. O período estudado, concentrado entre os anos 1850 a 1871, foi marcado pelo importante crescimento urbano do Rio de Janeiro e pela criação das primeiras faculdades de Medicina do Brasil, entre elas a Faculdade de Medicina do Rio de Janeiro em 1832. A pesquisa foi norteada por construir uma reflexão a respeito do paradigma social que envolveu o chamado aleitamento mercenário e a preocupação dos intelectuais cariocas em formar no Brasil uma sociedade que se aproximasse do modelo de civilização europeu.

Introdução: Devido à fatores hormonais e mecânicos, a gestação e o parto provocam alterações que podem gerar disfunções do assoalho pélvico (DAP). Os estudos sobre as DAP no puerpério a curto prazo são escassos e fazem uso assistemático de métodos avaliativos. Objetivo: Identificar e avaliar as DAP no pós-parto imediato, um mês e três meses após o parto, comparando parto vaginal (PV), cesárea eletiva (CE) e cesárea intraparto (CI). Métodos: Estudo observacional longitudinal que avaliou mulheres até 48 horas (fase 1); um mês (fase 2) e três meses após o parto (fase 3). Utilizou-se o International Consultation on Incontinence Questionnaire (ICIQ-SF); o Índice de Incontinência Anal (IA) de Jorge-Wexner; a Escala Análoga Visual (EVA) para dor pélvica; o Pelvic Organ Prolapse Quantification system (POP-Q) e a perineometria dos Músculos do Assoalho Pélvico (MAP), além de questionário estruturado. Resultados: Foram avaliadas 227 pacientes na fase 1 (141 realizaram PV; 28 realizaram CI e 58 realizaram CE); 79 na fase 2 e 41 na fase 3. O escore do ICIQ-SF, índice de IA, EVA e perineometria não apresentaram diferenças significativas em relação ao tipo de parto. O ponto distal do colo uterino apresentou-se mais prolapsado no grupo PV. Conclusão: O tipo de parto não foi um fator significante para o desenvolvimento das DAP no pós-parto a curto prazo. Foi identificado que ocorreu recuperação fisiológica na funcionalidade dos MAP e piora na sustentação da parede vaginal anterior e no impacto da incontinência urinária na qualidade de vida ao longo dos três meses. / Introduction: Due to mechanical and hormonal factors, pregnancy and childbirth triggers changes that can lead to pelvic floor dysfunction (PFD). PFD studies in the immediate postpartum period are scarce and do unsystematic use of evaluation methods. Objective: To identify and evaluate the immediate, one month and three months postpartum PFD, comparing vaginal delivery (VD), elective cesarean (ECS) and cesarean indicating (ICS) during labor. Methods: This was a longitudinal observational study that assessed postpartum women after up to 48 hours (phase 1); one month (phase 2) and three months (phase 3). The study used the International Consultation on Incontinence Questionnaire (ICIQ-SF); Jorge-Wexner's Anal Incontinence (AI) score; the Visual Analogue Scale (VAS) for pelvic pain; the Pelvic Organ Prolapse Quantification System (POP-Q); and a Pelvic Floor Muscles (PFM) perineometer, as well as a structured questionnaire. Results: A total of 227 patients were assessed in phase 1 (141 had VD, 28 ICS and 58 ECS); 79 in phase 2 and 41 in phase 3. The ICIQ-SF, AI, VAS and perineometer index did not present significant differences in relation to the type of delivery. The distal point of the cervix presented more prolapse in VD. Conclusion: The type of delivery was not a significant factor for the development of postpartum PFD in the short term. The study found that there was physiological recovery of the functionality of PFM and worsening prolapse of the anterior vaginal wall and urinary incontinence over the three months.

The object of this study was to find out, what the by breast cancer affected women know about the protective effect of the breast-feeding, how long they were breast-feeding and whether they know the risk factors of the forming of this sickness. The further object was to find out which knowledge the puerperas have about the protective effect of the breast-feeding, how long they plan to breast-feed and when, from who and which information they obtain about the breast-feeding. On the basis of dialogues was found out that the women with breast cancer know very little about the protective effect of the breast-feeding. Most of them never obtained information from anybody, only some of them heard or read about the protective effect of the breast-feeding. The relationship between the breast-feeding and cancer occurrence was approved, as only one of the women breast fed for more than a year. There is a minimal knowledge of women about the risk factors. Generally, they showed three risk factors which means that the knowledge is deficient and that the education in field of precaution is necessary. In the second part of the research it was found out that the education about breast-feeding is insufficient in the maternity hospital. The hospital nurses provide information about the breast-feeding technique and the care about breasts only. The women obtained information about the protective effect of the breast-feeding at the antenatal courses, some of them from web sites or print media. The puerperas plan to breast-feed for 11.5 months on an average which shows a very positive attitude to the breast-feeding of the children.

Pesquisa descritiva com abordagem qualitativa, cujo objeto foi o processo de cuidar da mulher que escolhe desmamar precocemente com ênfase nas relações que se estabelecem entre a cliente e a enfermeira. Tomou como objetivos identificar quais as estratégias utilizadas pelas enfermeiras para se comunicarem com as mulheres que escolhem desmamar precocemente; discutir a relação interpessoal no processo do cuidar entre a enfermeira e analisar o cuidado da enfermeira à mulher que escolhe desmamar precocemente sob a ótica da teoria de Peplau. A pesquisa foi realizada com nove enfermeiras que realizam consulta de enfermagem no núcleo materno infantil, das Unidades Básicas de Saúde do município do Rio de Janeiro. Os dados foram coletados através de entrevista semi estruturada e analisados pelo método de análise de conteúdo de Bardin. Foram evidenciadas três categorias: 1) Os determinantes do relacionamento interpessoal das enfermeiras cuidando da mulher que escolhe desmamar precocemente, cujas subcategorias expressaram os significados do aleitamento materno atribuído pelas enfermeiras, os conflitos da mulher no processo do aleitamento materno e os sentimentos das enfermeiras quando a mulher escolhe desmamar precocemente; 2) Estratégias de comunicação das enfermeiras ao cuidar da mulher que escolhe desmamar precocemente, cujas subcategorias evidenciaram a comunicação não verbal e a associação da comunicação não verbal à comunicação verbal; 3) Contradições a enfermeiras no processo de cuidar da mulher que escolhe desmamar precocemente. Os resultados evidenciaram que as enfermeiras possuem em importante papel de apoio a mulher no processo da amamentação, e constroem o cuidado de enfermagem dentro da relação interpessoal, usando os recursos da comunicação não verbal e em associação a verbal. Através da Teoria do Relacionamento Interpessoal de Peplau, foi revelado que há contradições no cuidado das enfermeiras diante da escolha da mulher pelo desmame precoce, por priorizarem suas concepções e valores comparados aos da mulher. / Descriptive research with qualitative approach, which object was the process of taking care of woman that chooses to wean precociously with emphasis in the relationships that settle down between the customer and the nurse. It took as objectives to identify which strategies that were used by nurses to communicate with the women that choose to wean precociously; to discuss the interpersonal relationship in the process of take care among the nurse and to analyze the care of the nurse to the woman that chooses to wean precociously on the optics of Peplaus theory. The research was accomplished with nine nurses that accomplish nursing consultation in the infantile maternal nucleus, of the Basic Units of Health of the municipal district of Rio de Janeiro. The data was collected through semi- structured interview and analyzed by Bardins method of analysis of content. Three categories were evidenced: 1) the determinant of the nurses' interpersonal relationship taking care of woman that chooses to wean precociously, whose subcategories expressed the meanings of maternal breast-feeding attributed by the nurses, the woman's conflicts in the process of maternal breast-feeding and the nurses' feelings when the woman chooses to wean precociously; 2) communication strategies of the nurses when taking care of woman that chooses to wean precociously, whose subcategories evidenced the non-verbal communication and the association of the non-verbal communication to the verbal communication; 3) contradictions to nurses in the process of taking care of the woman that chooses to wean precociously. The results evidenced that the nurses possess an important support paper to woman in the process of breast-feeding, and they build the nursing care inside the interpersonal relationship, using the resources of non-verbal communication and in association of the verbal communication. Through the Interpersonal Relationships Theory of Peplau, it was revealed that there are contradictions in the nurses' care before the woman's choice for the precocious weans, because they prioritize your conceptions and values compared to the womans.

Pesquisa descritiva com abordagem qualitativa, cujo objeto foi o processo de cuidar da mulher que escolhe desmamar precocemente com ênfase nas relações que se estabelecem entre a cliente e a enfermeira. Tomou como objetivos identificar quais as estratégias utilizadas pelas enfermeiras para se comunicarem com as mulheres que escolhem desmamar precocemente; discutir a relação interpessoal no processo do cuidar entre a enfermeira e analisar o cuidado da enfermeira à mulher que escolhe desmamar precocemente sob a ótica da teoria de Peplau. A pesquisa foi realizada com nove enfermeiras que realizam consulta de enfermagem no núcleo materno infantil, das Unidades Básicas de Saúde do município do Rio de Janeiro. Os dados foram coletados através de entrevista semi estruturada e analisados pelo método de análise de conteúdo de Bardin. Foram evidenciadas três categorias: 1) Os determinantes do relacionamento interpessoal das enfermeiras cuidando da mulher que escolhe desmamar precocemente, cujas subcategorias expressaram os significados do aleitamento materno atribuído pelas enfermeiras, os conflitos da mulher no processo do aleitamento materno e os sentimentos das enfermeiras quando a mulher escolhe desmamar precocemente; 2) Estratégias de comunicação das enfermeiras ao cuidar da mulher que escolhe desmamar precocemente, cujas subcategorias evidenciaram a comunicação não verbal e a associação da comunicação não verbal à comunicação verbal; 3) Contradições a enfermeiras no processo de cuidar da mulher que escolhe desmamar precocemente. Os resultados evidenciaram que as enfermeiras possuem em importante papel de apoio a mulher no processo da amamentação, e constroem o cuidado de enfermagem dentro da relação interpessoal, usando os recursos da comunicação não verbal e em associação a verbal. Através da Teoria do Relacionamento Interpessoal de Peplau, foi revelado que há contradições no cuidado das enfermeiras diante da escolha da mulher pelo desmame precoce, por priorizarem suas concepções e valores comparados aos da mulher. / Descriptive research with qualitative approach, which object was the process of taking care of woman that chooses to wean precociously with emphasis in the relationships that settle down between the customer and the nurse. It took as objectives to identify which strategies that were used by nurses to communicate with the women that choose to wean precociously; to discuss the interpersonal relationship in the process of take care among the nurse and to analyze the care of the nurse to the woman that chooses to wean precociously on the optics of Peplaus theory. The research was accomplished with nine nurses that accomplish nursing consultation in the infantile maternal nucleus, of the Basic Units of Health of the municipal district of Rio de Janeiro. The data was collected through semi- structured interview and analyzed by Bardins method of analysis of content. Three categories were evidenced: 1) the determinant of the nurses' interpersonal relationship taking care of woman that chooses to wean precociously, whose subcategories expressed the meanings of maternal breast-feeding attributed by the nurses, the woman's conflicts in the process of maternal breast-feeding and the nurses' feelings when the woman chooses to wean precociously; 2) communication strategies of the nurses when taking care of woman that chooses to wean precociously, whose subcategories evidenced the non-verbal communication and the association of the non-verbal communication to the verbal communication; 3) contradictions to nurses in the process of taking care of the woman that chooses to wean precociously. The results evidenced that the nurses possess an important support paper to woman in the process of breast-feeding, and they build the nursing care inside the interpersonal relationship, using the resources of non-verbal communication and in association of the verbal communication. Through the Interpersonal Relationships Theory of Peplau, it was revealed that there are contradictions in the nurses' care before the woman's choice for the precocious weans, because they prioritize your conceptions and values compared to the womans.