Orientador: Antonio Carlos Pereira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-06T06:17:59Z (GMT). No. of bitstreams: 1 Cortellazzi_KarineLaura_M.pdf: 529900 bytes, checksum: 8c56ee5a9569cbb748bd11c313f2d7f3 (MD5) Previous issue date: 2006 / Resumo: O objetivo desse estudo foi relatar a prevalência de cárie dentária e de gengivite e identificar os indicadores de risco dessas doenças dentre variáveis socioeconômicas, clínicas e o gênero em pré-escolares na idade de 5 anos de Piracicaba, Brasil, em 2005. A amostra consistiu de 728 pré-escolares, de ambos os gêneros, matriculados em 22 pré-escolas públicas (n=428) e 18 pré-escolas privadas (n=300). Os exames foram realizados por um examinador previamente calibrado, no pátio das pré-escolas, sob luz natural, com auxílio de espelho bucal plano, sonda IPC, secagem e escovação prévia. A cárie dentária foi avaliada utilizando-se os índices ceod e ceos e a gengivite, pelo índice de alteração gengival. Também foi feita avaliação para lesão inicial de cárie (LI). As variáveis socioeconômicas (renda familiar mensal, número de residentes na mesma casa, escolaridade do pai e da mãe, habitação e profissão do chefe da família) foram obtidas por meio de um questionário semi estruturado enviado aos pais. Os indicadores de risco de cárie dentária e de gengivite foram determinados por meio da análise de regressão logística múltipla no nível de significância de 5%. As médias dos índices ceod e ceos foram 1,30 (dp=2,47) e 3,08 (dp=7,55) respectivamente, sendo que 62,2% das crianças estavam livres de cárie. Os indicadores de risco identificados foram escolaridade do pai abaixo do superior completo e presença de lesão inicial. A prevalência de gengivite foi de 16,6%, enquanto os indicadores de risco foram estudar em pré-escola pública, residir em casas com mais de quatro pessoas, ser do gênero masculino ou apresentar lesão de cárie inicial. Em conclusão, crianças que apresentaram lesão inicial de cárie e cujos pais tinham escolaridade abaixo do superior completo tiveram mais chance de ter cárie. Adicionalmente, estudar em pré-escola pública, residir em casas com mais de quatro pessoas, ser do gênero masculino ou apresentar lesão de cárie inicial foram indicadores de risco de gengivite / Abstract: The aim of this study was to report the dental caries and gingivitis prevalence and to identify the risk indicators of those diseases among socioeconomic, clinical variables and the gender in 5-year-old preschool children from Piracicaba, Brazil, in 2005. The sample consisted of 728 preschool children, both genders, attending 22 public (n=428) and 18 private (n=300) preschools. Clinical examination was performed by one previously calibrated examiner, at the back yard, under natural light, using dental mirror, CPI probe, air drying and previous tooth brushing. The dental caries was measured using dmft and dmfs indexes and the gingivitis, by alteration gingival index. Initial caries lesion (IL) was also evaluated. The socioeconomic variables (monthly family income, number of people living in the household, parents¿ educational level, home ownership and householder¿s occupation) were collected by means of a parental semi structured questionnaire. The risk indicators of dental caries and gingivitis were determined using multiple logistic regression analyses at 5% significance level. The mean values for dmft and dmfs indexes were 1.30 (SD=2.47) and 3.08 (SD=7.55) respectively, being 62.2% of the children were caries free. The risk indicators identified were father¿s incomplete undergraduate studies and presence of initial lesion. The prevalence of gingivitis was 16.6%, while the risk indicators were studying at public preschool, living with more than four people, being male or presenting initial caries lesion. In conclusion, children who presented initial caries lesion and whose fathers had incomplete undergraduate studies were presented more chance of caries. Moreover, studying at public preschool, living with more than four people, being male or presenting initial caries lesion were risk indicators of gingivitis / Mestrado / Cariologia / Mestre em Odontologia

Indiana University-Purdue University Indianapolis (IUPUI) / The purpose of this study was to evaluate the status of a sample of children ages 6 to 36 months with regard to prevalence of tooth decay in a community with an optimum fluoridated water supply. It was determined whether a relation existed between these data and the socioeconomic level of the family. One hundred and fifty children ages 6 to 36 months born and reared in Marion County, Indiana were examined with a dental mirror, explorer and a portable light. Parents/legal guardians of these children were given a questionnaire to obtain family history. Caries prevalence for children ages 6 to 12, 13 to 18, 19 to 24, 25 to 30, and 31 to 36 months were 4%, 0%, 22%, 23%, and 26%, respectively. Age, mother's educational attainment, and Medicaid experience remained significant predictors of caries experience: the odds of caries were 1.1 times for each monthly increase in age. Gender, father's educational attainment, family household income, and single parent status remained marginally significant predictors of caries experience. Results for similar correlation studies between caries prevalence and socioeconomic status for children ages 6 to 36 months are inconsistent. Further research is needed for children ages 6 to 36 months. Caries experience begins before age one. Patients, parents, and health care professionals need to be aware that the caries process begins at an early age, and prevention should begin as early as 6 months of age.

Indiana University-Purdue University Indianapolis (IUPUI) / Treating pediatric dental patients four years old and younger can be difficult at times due to patient behavior. Conscious sedation has been employed as a means to control pediatric dental patients for several years. Butorphanol tartrate has been used safely for pain control in pediatric patients for several years, but has never been used for sedating pediatric dental patients. The purpose of this study is to compare the behavioral and physiologic effects of conscious sedation on pediatric dental patients using intramuscular meperidine and an equipotent dosage of intramuscular butorphanol. Forty conscious sedations of ASA I pediatric dental patients between the ages of 13 and 60 months were accomplished using either 2.0 mg/kg of intramuscular meperidine or 0.03 mg/kg of intramuscular butorphanol. Each sedation was videotaped and three viewers viewed the videotapes rating them with a computer program (ACS) involving a four-code behavior rating scale. The tlrree viewers rated patient behavior for each sedation also with a form with global rating, categorical, and dichotomous scales. Physiologic signs of oxygen saturation, blood pressure, heart rate, and respiration rate were monitored at baseline and every 5 minutes during treatment. The operator also rated the sedation patient behavior with a form that had pre-treatment Frankl, post-treatment Frankl, global rating categorical, dichotomous, and sedation success rating scales. The two groups demographic data, physiologic data, ACS data, the three viewer's behavior rating form, and the operator's behavior rating form were analyzed for any statistically significant differences between the groups. The statistical analysis of the demographic data revealed a statistically significant trend in the butorphanol group toward extractions. The meperidine group had a statistically significant higher mean oxygen saturation during treatment (99.63 percent) than the butorphanol group (99.20 percent). The butorphanol group spent significantly more time in the annoyed ACS behavior rating code and showed a trend toward less time spent in the quiet ACS behavior rating code. There were no statistically significant differences in the three viewers ratings of global rating, categorical, and dichotomous scales. The operators' ratings showed the meperidine group had a statistically significant better global rating than the butorphanol group. Overall butorphanol appears to be equal clinically to meperidine in physiologic effects and patient behavior effects. No adverse effects occurred with either medication. Butorphanol may be offered as an alternative sedative agent to other narcotic sedative agents with more side effects.

This research was designed to assess 7-week-old infants' preference for infant directed and adult directed talk. (IDT and ADT) using the infant controlled habituation/dishabituation looking procedure. Infants were presented with short audio recordings of either a female or a male speaking in IDT during habituation and ADT during dishabituation or the reverse. In the control conditions, the stimulus did not change. Infants demonstrated preference for IDT over ADT in both male and female speaker conditions. They also demonstrated preference for the female speaker used in this study over the male speaker. Interactions among the dependent variables (first three looks), and the independent variables (infant gender, and style of speaking as well as infant gender, and speaker gender), suggest that the preference might not be as robust as the preference found in infants over 4 months. Evidence for discrimination between IDT and ADT was inferred from the between group demonstration of preference, but no evidence of within infant discrimination was found. Because the evidence suggests that 7-week-old infants demonstrate weaker preference for IDT over ADT than do infants of 4 months, it is assumed that infant preferences follow a developmental sequence. Thus, it is possible that developing preferences are influenced by experiential factors. / Arts, Faculty of / Psychology, Department of / Graduate

A Organização Mundial de Saúde (OMS) classifica o excesso de peso (sobrepeso e obesidade) como epidemia, uma vez que é um dos dez principais problemas de saúde atuais. Sua etiologia é multifatorial: genética, endócrina, metabólica, comportamental e ambiental. Tendo em vista estes fatores e os primeiros cinco anos de vida, cruciais para o desenvolvimento de hábitos saudáveis, é necessário conhecer o ambiente, bem como as influências a que a criança está exposta. Assim, este estudo teve como objetivo identificar, conhecer e analisar percepções e crenças de pais e educadores de pré-escolares acerca de sobrepeso e obesidade infantil. Trata-se de estudo qualitativo exploratório, realizado por meio de entrevistas semiestruturadas com quatro educadores, cinco mães e um pai de crianças de duas pré-escolas, uma pública e outra privada, localizadas em São Bernardo do Campo (SP). As entrevistas foram realizadas entre maio e dezembro de 2008. Para a análise dos dados foi utilizada a Análise Temática de Conteúdo de Bardin e o referencial da Bioecologia do Desenvolvimento Humano de Bronfenbrenner. Este propõe um sistema composto por vários níveis: micro, meso, exo e macro, além da própria criança, um sistema por si só, os quais se articulam de modo que os mais amplos vão sucessivamente englobando os menores, em um sistema de círculos concêntricos. O microssistema é o mais próximo da criança e abarca o local no qual faz as refeições, as interações com adultos e pares, as práticas e estratégias utilizadas durante os momentos de alimentação e atividade física. O mesossistema, por sua vez, consiste na interação entre os microambientes, nos quais a criança participa ativamente (família e pré-escola). O exossistema é composto da família extensa, da comunidade, da mídia, do trabalho parental, bem como pela forma de organização dos ambientes urbanos (disponibilidade de alimentos e ambientes públicos de lazer). Afeta a criança intensamente, tanto na alimentação quanto nas oportunidades para brincar e praticar atividades físicas ao ar livre. O macrossistema é constituído por práticas culturais ligadas à alimentação, influência do pertencimento social e econômico, influência do clima e da política governamental. Os entrevistados têm maior clareza acerca da influência dos componentes mais concretos de seu cotidiano. Assim, conseguem perceber, por exemplo, a influência das práticas familiares e da pré-escola, mas tem dificuldade para perceber que falta uma política de segurança que possibilite o uso dos poucos locais públicos de lazer e atividade física. Conclui-se, assim, que as crianças pré-escolares deste estudo estão expostas a muitas influências negativas nos diversos sistemas, o que pode prejudicá-las quanto à aquisição de bons hábitos alimentares e de atividade física, prejudicando-as consequentemente quanto à manutenção de um peso corporal saudável. A temática estudada tem implicações para a profissão de enfermagem em termos de assistência direta, ensino e pesquisa. Propõe-se a continuidade das pesquisas, especialmente levando-se em conta a influência de fatores relacionados ao macrossistema, que geralmente são pouco considerados na gênese do excesso de peso, mas que se revelaram importantes de acordo com os depoimentos estudados. / The World Health Organization (WHO) classifies excessive weight (overweight and obesity) as an epidemic, once it is one of nowadays main ten problems. Its etiology is multifactorial: genetic, endocrine, metabolic, behavioral and environmental. Considering these factors and a persons first years of life, which are crucial for the development of healthy habits, it is necessary to know the environment and the influences children are being exposed to. Thus, this study aims at identifying, understanding and analyzing parents and preschool educators beliefs and perceptions about childhood overweight and obesity. This is an exploratory and qualitative study which was conducted through semi-structured interviews with four educators, five mothers and one father of children from two preschools, one of which was public and the other was private, both located in São Bernardo do Campo (SP). The interviews were conducted from May to December 2008. In order to analyze the data, Bardins Thematic Content Analysis and Bronfenbrenners Bioecology and Human Development referential were used. This suggests a system composed of several levels: micro, meso, exo and macro, and also the children themselves, who represent one entire system. These levels are articulated and the widest ones successively encompass the smaller ones in a system of concentric circles. The microsystem is the closest one to the child and it encompasses the place in which the child has their meals, where they interact with adults and peers, the practices and strategies used during their feeding and physical activities. The mesosystem is the interaction between microenvironments, in which the child actively participates (family and preschool environment). The exosystem corresponds to the extended family, the community, media, parental jobs, as well as the form in which the urban environments are organized (availability of food and entertainment public places). It intensely affects children in their feeding and in the opportunities they have to play and practice outdoor physical activities. The microsystem consists of cultural practices related to feeding habits, influence of social and economic status, and to climate and political government influence. Those interviewed are more aware of the influence of more concrete components in their everyday lives. Thus, they can notice, for example, the influence of family and preschool practices. However, it is hard for them to realize they lack a security policy which allows the utilization of the few public places meant for recreation and physical activities. Therefore, it is possible to conclude that the preschool children who participated in this study are exposed to many negative influences in the various systems, which may harm their acquisition of healthy eating habits and physical activities, thus harming their maintenance of a healthy body weight. The thematic studied in this paper has implications for the nursing profession in terms of direct care, teaching and research. It is suggested that this research be continued, especially taking into account the influence of factors related to the macrosystem, which are not often taken into consideration in the overweight genesis, but which have been proven to be important according to the statements analyzed.

Diss. (sammanfattning) Uppsala : Univ., 2009. / Härtill 4 uppsatser.

The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on January 5, 2010). Vita. Thesis advisor: Dr. Judith C. Goodman. Includes bibliographical references

BACKGROUND: In children, sleep-related airway obstruction by large tonsils and adenoids can cause obstructive sleep apnea (OSA). OSA may lead to poor growth, developmental delay, behaviour or learning problems. Recent evidence also suggests that children with OSA may develop cardiovascular complications, the mechanisms perhaps involving hypoxemia, the autonomic nervous system, apneas, and arousals. Surgical removal of tonsils and adenoids (adenotonsillectomy (T&A)) usually cures pediatric OSA. To diagnose OSA at all levels of severity, polysomnography is currently the best approach. The McGill Oximetry Score (MOS) is a validated measure based on nocturnal pulse oximetry. An abnormal MOS has a 97% positive predictive value at detecting moderate-severe OSA. Because the MOS was devised by measuring frequency of desaturations (<90%) and numbers of clusters of desaturations, it is not accurate at detecting OSA in children who do not have such drops in oxygen saturation. Accordingly, other measures applicable to a wider spectrum of children should be assessed. These measures should be simpler, less cumbersome, cheaper, and more accessible than polysomnography. / OBJECTIVES: To study alternative approaches that may be used to identify moderate-severe OSA in children, two studies were conducted. We examined one subjective measure - the OSA-18 parent questionnaire - and two objective measures - pulse rate and pulse rate variability. For the OSA-18 study, the goal was to determine whether it would accurately detect children with moderate-severe OSA as indicated by an abnormal MOS. For the pulse rate and pulse rate variability study, the goal was to determine if either or both would decrease after treatment with T&A for children with moderate-severe OSA. / METHODS: For the OSA-18 study, we used a cross-sectional design that included children 1-18 years old referred to a pediatric sleep laboratory for evaluation of suspected OSA. Alongside data from the OSA-18, we analyzed demographic and medical data (from a parent questionnaire) and information regarding adenotonsillar hypertrophy. We estimated sensitivity, specificity, positive and negative predictive values as well as receiver operating curves of the OSA-18 in detecting an abnormal MOS. We also conducted univariate and multivariate logistic regression analyses, using the MOS as the dependent variable and the OSA-18 score and others (age, gender, comorbidities, race) as independent variables. For the second study, we used a retrospective before-after design to compare pulse rate and pulse rate variability as measured by nocturnal pulse oximetry pre- and post-T&A of otherwise healthy children 1-18 years old with moderate-to-severe OSA. / RESULTS: For the OSA-18 study, we studied 334 children (58% male, mean age 4.6 +/- 2.2 years). The OSA-18 had a sensitivity of 40% and a negative predictive value of 73% for detecting an abnormal MOS. In addition, the area under the receiver operating curve was 0.611. While controlling for other independent variables in the logistic regression model, for each unit increase in the OSA-18 Score, the odds of having an abnormal MOS were increased by 2%. However, for each increase in age of 1 year, the odds of having an abnormal MOS were decreased by 17%. In the pulse rate and pulse rate variability study, 25 subjects (88% male; mean age 4.3 +/- 3.6 years) were enrolled. Following T&A, pulse rate and pulse rate variability decreased in 21 of 25 and 23 of 25 children, respectively. Mean pulse rate dropped from 99.7+/-11.2 to 90.1+/-10.7 bpm, p<0.001; age-standardized pulse rate (z-score) from 0.8 (0.4, 1.5) to 0.4 (0, 0.9), p=0.04). Pulse rate variability, as measured by the standard deviation of the pulse rate decreased from 10.3 +/- 2.1 to 8.2 +/- 1.6 bpm, p<0.001. As well, OSA symptomatology, parental concern about breathing during sleep and the MOS all improved. / CONCLUSIONS: Based on the first study we conclude that among children referred to a sleep laboratory, the OSA-18 does not accurately detect which children will have an abnormal MOS. The OSA-18 should not be used in place of objective testing to identify moderate-severe OSA in children. However, from the second study we conclude that measures of the autonomic nervous system such as pulse rate and pulse rate variability, as measured by pulse oximetry, decreased following surgical treatment of moderate-severe OSA. The results of this study potentially serve as important data for further work that would determine the accuracy of pulse rate and pulse rate variability measures and their diagnostic usefulness for OSA at all levels of severity.

Dissertation (Ph.D.)-- University of Texas Southwestern Medical Center at Dallas, 2006. / Vita. Bibliography: pp. 163-184.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.