Three experiments examined auditory-visual integration of temporal relations by infants. In the first experiment infants of 3, 6 and 10 months of age were placed midway between two flashing visual displays. Tones, temporally synchronized to one of the visual displays, emanated from concealed speakers placed midway between the visual displays directly in front of the infants. The visual displays, and corresponding tones differed in temporal rate by a factor of four. No evidence was found for differential looking to the sound-specified visual pattern in any of the three age levels tested. The 3-month-olds showed a strong right-looking bias regardless of visual pattern or temporal rate of the tone, while the 10-month-olds preferred to look at the fast visual pattern regardless of position or tone rate. Both of these biases impaired the effectiveness of the simultaneous presentation paradigm to detect differential looking related to auditory-visual synchrony. Experiments II and III used an habituation methodology which eliminated any effects of position and rate bias. Only 4-month-old infants were tested. In each experiment, one group of infants was first presented with temporally synchronous auditory and visual signals during habituation trials and then nonsynchronous signals during recovery trials. Two other groups of infants, one in each experiment, received the opposite sequence. In Experiment II the auditory and visual signals were spatially congruous, but they were separated by 90° in Experiment III. Since the pulse rate of the visual stimuli was changed for the nonsynchronous trials, a control group was tested which received only the light during habituation and recovery trials. Both groups initially presented with synchronous signals showed habituation and recovery. Neither group presented with nonsynchronous stimuli during habituation trials demonstrated recovery and only the group with the spatially separated sources habituated. The results suggest that 4-month-old infants are able to coordinate the temporal relations between auditory and visual signals. / Arts, Faculty of / Psychology, Department of / Graduate

The child's understanding of open systems, as exemplified by an ecosystem and a socio-economic system, was assessed in a Piagetian type interview with 8 males and 8 females in each of grades 3, 5, 7, 9, 11 and first year post-secondary (n=96). Since Piagetian theory has been based on tasks using mainly inanimate, physical content, the generalizability of Piagetian stages and sequences to the two open systems content domains was tested. Tasks assessing the four concrete operations examined were repeated in each of the physical, the bio-ecological and the societal domains. Typical stage and sequence patterns were observed in all three domains. Post-concrete operations were represented by three formal operations in the physical domain and four systemic operations in each of the open systems domains. Logical and philosophical arguments for the qualitative difference between formal and systemic logic were presented. Three blind judges reached spontaneous agreement on 84.6% of the scores assigned for the systemic task protocols. A scalogram analysis and comparisons of the differences between pass/fail proportions indicated that the systemic operations of systems synthesis and transitive recycling were more difficult than the formal operational tasks by a Guttman step of the same size as that between the formal and concrete stages. A cluster analysis showed those most difficult systemic tasks to be grouped as if they were a part of a separate structure d'ensemble. Further analyses indicated that the greater difficulty of these two systemic operations could not be attributed to the greater un-familiarity of the task contents. Systemic task success rates were zero for respondents below grade 9 (14 years) and consistently fell far below formal task success rates for same aged peers'. The most difficult systemic operations satisfied the criteria for membership in a fifth stage as well as any other Piagetian operations do for their imputed stage membership. Nevertheless, an alternative interpretation construing systemic operations as post-concrete developments parallel and complementary to formal operations could not be ruled out. The implications of the findings for the areas of cognitive development, social development and social psychology were discussed. / Arts, Faculty of / Psychology, Department of / Graduate

This study describes ways that parents attempt to help their preschool children with asthma meet their basic human needs. Information about such parental guidance is lacking in the literature and yet parents need assistance from health professionals about how to accomplish the task of rearing their chronically ill children. Ten couples with asthmatic preschool children from the Lower Mainland region of British Columbia were identified and interviewed in their homes. The couples were asked about the actions they took to help their preschool children with asthma meet their basic human needs and the ways they perceived asthma and its treatment affecting their efforts to help these children. An Interview Guide was developed based on the University of British Columbia's Model for Nursing. It is a model with a basic human needs and systems theory framework. All interviews with the couples were audiotaped and later analyzed for content of their communications. The analysis revealed 17 specific helpful actions common to all of the couples, and additional emotions, decisions, and physical efforts to normalize their asthmatic children's and family's daily lives. It was concluded that the couples in this study assumed the responsibilities of helping their preschool children, sick or well, meet their needs to grow and develop according to parental tasks. The intensity of the helping behaviours tended to increase during the children's asthmatic attacks. There are implications for health professionals for developing programs to assist parents to acquire the knowledge, skills and attitudes: to facilitate the growth and development of their children with a chronic disease such as asthma. / Applied Science, Faculty of / Nursing, School of / Graduate

Orientador: Marines Nobre dos Santos Uchoa / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-27T07:50:05Z (GMT). No. of bitstreams: 1 Monteiro-Oliveira_MarcelaPinto_D.pdf: 1338284 bytes, checksum: ffd883f94e84a177b8c0612ef47d0772 (MD5) Previous issue date: 2015 / Resumo: Este estudo transversal objetivou investigar a relação entre o estado nutricional, cárie dental, exposição diária ao açúcar e fatores sociais, assim como a presença de biofilme visível em 303 pré-escolares de 3 a 5 anos da cidade de Teresina-PI. A cárie dental foi determinada por meio do critério da Organização Mundial de Saúde (OMS) incluindo lesões iniciais de mancha branca (LMB). O peso e altura corporais foram mensurados e o Índice de massa corporal (IMC) obtido foi plotado em diagrama segundo gênero e faixa etária para obter-se o ranking do percentil segundo o Centers for Disease Control and Prevention (CDC). Os dados de exposição diária ao açúcar (líquido, sólido e total) foram obtidos pelo diário de dieta, usando-se a média de exposição diária de 72 horas. A presença de biofilme dental clinicamente visível nos incisivos superiores foi também registrada. Os fatores comportamentais e socioeconômicos foram coletados por meio de uma entrevista com as mães ou responsáveis pelas crianças. Os dados foram analisados por meio do teste qui quadrado seguido de regressão logística múltipla (? = 0,05, intervalo de confiança = 95%). Os resultados mostraram que 10,6% das crianças eram malnutridas, 17,2% tinham baixo peso, 44,9% apresentaram peso normal, 15,5% tinham sobrepeso e 11,9% eram obesos; 24,8% estavam livres de cárie e 75,2% apresentavam cárie precoce da infância (CPI). A média do ceo-s + LMB foi 10,8 (+ 11,2). Crianças com experiência de cárie apresentaram 0,3 mais chance de serem obesas do que aquelas livres de cárie (p = 0,0049). Da mesma forma, aquelas que consumiam líquidos açucarados mais de 2 vezes por dia apresentaram 2,7 mais chance de serem obesas (p = 0,0339). Nenhuma associação foi encontrada ente cárie e sobrepeso (p = 0,3640) e a presença de biofilme dental (p= 0,3190). Crianças que apresentaram o hábito de dormir com a mamadeira mostraram 2,3 vezes mais chance de terem baixo peso do que aquelas sem esse hábito (p = 0,0174). O gênero feminino apresentou a probabilidade 0,3 vezes maior de serem malnutridas do que o masculino (p = 0,00797). Além disso, pré-escolares com a presença de biofilme dental tiveram 3,1 vezes mais chance de serem malnutridas do que aquelas sem biofilme visível (p = 0,0247). Este estudo mostrou que houve relação entre experiência de cárie, consumo de líquidos açucarados e obesidade. Também mostrou relação entre o uso da mamadeira noturna e baixo peso na infância. Fatores socioeconômicos não foram relacionados ao estado nutricional da criança / Abstract: This cross-sectional study aimed to investigate the relationship among body mass index (BMI), dental caries, sugar exposure and social factors, as well as the presence of visible biofilm in 303 three-to-five-year-old preschoolers in the city of Teresina-PI, Brazil. Dental caries was recorded according to the World Health Organization criteria (WHO) + early caries lesions (ECL). Body weight/height was determined and BMI was calculated. Data regarding the sugar exposure was recorded using the mean exposure of 72-hour recall diet frequency chart. The presence of clinically visible dental biofilm on maxillary incisors was also recorded. Behavioral and social economic status of the study subjects were assessed using an interview applied to the mother. Data were analyzed by chi-square test followed by multiple logistic regression analysis (? = 0.05, confidence interval = 95%). The results showed that 10.6% of the children were malnourished, 17.2% were underweight, 44.9% had health weight, 15.5% were at risk of overweight, and 11.9% were obese; 24.8% were caries free and 75.2% had early childhood caries (ECC). The mean dmfs score was 10.8 (± 11.2). Preschool children with ECC were 0.3 times more likely to be obese than caries free children (p = 0.0049). In the same way, those who consumed liquid sugar more than 2 times a day, were 2.7 times more likely to be obese (p = 0.0339). No association was found between overweight and caries (p=0.3640) and dental biofilm (p= 0.3190). Preschool children who slept with a bottle were 2.3 times more likely to have underweight than children who did not sleep with a bottle (p = 0.0174). Female preschool children were 0.3 times more likely to be malnourished than boys (p = 0.00797). Moreover, preschool children with presence of dental biofilm were 3.1 times more likely to be malnourished than children with absent biofilm (p = 0.0247). In conclusion, our results suggest that preschool children having early childhood caries and a high liquid sugar consumption were more likely to be obese and those who were bottle fed during the night showed a higher chance of having underweight / Doutorado / Odontopediatria / Doutora em Odontologia

No description available.

INTRODUÇÃO: A doença diarreica aguda é a segunda causa de morte em crianças abaixo de 5 anos de idade. No Brasil, entre 2003 e 2009, a diarreia aguda foi responsável por cerca de 100.000 internações por ano, e por 4% das mortes em crianças abaixo de 5 anos de idade. O rotavírus é a principal etiologia de diarreia aguda grave no mundo todo, sendo responsável por 40% das internações por diarreia aguda, e 29% de todas as mortes por diarreia aguda. A vacina monovalente (RV1) contra o rotavírus foi introduzida no Programa Nacional de Imunizações em 2006. OBJETIVOS: Verificar o impacto da vacina monovalente contra rotavírus nas consultas de pronto-socorro e internações por doença diarreica aguda em crianças menores de 5 anos de idade, verificar a positividade do exame \"pesquisa de rotavírus nas fezes\", e verificar a presença ao ausência de imunidade de rebanho. METODOLOGIA: Foi realizado um estudo ecológico retrospectivo no Hospital Universitário da Universidade de São Paulo. O período foi dividido em pré-vacina (2003 a 2005) e pós-vacina (2007 a 2009). Foram incluídas todas as crianças abaixo de 5 anos que passaram em consulta no pronto-socorro e verificado o diagnóstico do atendimento e internação através de registro eletrônico. Foram obtidas as taxas de consultas no pronto-socorro e internações por doença diarreica aguda, foram selecionadas as crianças não vacinadas para cálculo da imunidade de rebanho, e verificado se houve coleta do exame pesquisa de rotavírus nas fezes. A redução nas taxas foi obtida através da fórmula: redução (%) = (1 - odds ratio) x 100. RESULTADOS: No período pré-vacina a taxa de consultas por diarreia aguda foi de 85,8 consultas por 1.000 consultas gerais, no período pós vacina a taxa de consultas por diarreia aguda foi 80,9 por 1.000, e a redução foi 6% (IC 95%, 4% a 9%, p < 0,001), chegando a 40% (IC 95%, 36% a 44%, p<0,001) nos meses de maio e junho. A taxa de internação por diarreia aguda era 40,8 internações por 1.000 e caiu para 24,9 por 1.000, redução de 40% (IC 95%, 22% a 54%, p < 0,001), chegando a 82% (IC 95%, 62% a 92%, p < 0,001) nos meses de maio e junho. Nas crianças não vacinadas não houve redução na taxa de consultas de pronto-socorro (IC 95%, -4% a 5%, p=0,903), e não se pode afirmar se houve redução ou aumento das internações por diarreia aguda (IC 95%, -212% a 35%, p=0,381). Houve queda da positividade do exame pesquisa de rotavírus em 2009 (redução de 70%, IC 95%, 26% a 88%, p=0,007). CONCLUSÕES: Após a introdução da vacina contra rotavírus (RV1) houve uma redução de 6% nas consultas por diarreia aguda no pronto-socorro, de 40% nas internações por diarreia aguda e de 70% na positividade do exame pesquisa de rotavírus nas fezes. Não foi detectada imunidade de rebanho / INTRODUCTION: Acute diarrheal disease is the second cause of death in children under five years. In Brazil, from 2003 to 2009, acute diarrhea was responsible for nearly 100,000 deaths per year and 4% of the deaths in children under five years. Rotavirus is the leading cause of severe acute diarrhea worldwide, accounting for 40% of hospital admissions and 29% of all the acute diarrhea-related deaths. In 2006, the rotavirus monovalent vaccine (RV1) was added to the Brazilian National Immunization Program. OBJECTIVES: To analyze the impact of the RV1 on Emergency Department (ED) visits and hospital admissions for acute diarrhea, the rates of positivity of the stool rotavirus tests and the presence or absence of herd immunity. METHODS: A retrospective ecologic study at the University Hospital, University of Sao Paulo. The study analyzed two periods: the pre-vaccine (2003-2005) and the post-vaccine (2007-2009) periods. We screened the main diagnosis of all ED attendances and hospital admissions of children under five years in an electronic registry system database and calculated the rates of ED visits, hospital admissions and positivity of the stool rotavirus test in patients with acute diarrhea. Herd immunization was evaluated in non-vaccinated children. The reduction rate was analyzed according to the formula: reduction (%) = (1- odds ratio) x 100. RESULTS: The rates of ED visits for acute diarrhea was 85.8 and and 80.9 per 1,000 total ED visits in the pre and post vaccination periods, respectively, resulting in 6% reduction (95% CI, 4% to 9%, p< 0.001) in the overall period and reaching 40% reduction on May and June. The rates of hospital admissions for acute diarrhea was 40.8 per 1,000 in the pre-vaccine period and dropped to 24.9 per 1,000 hospitalizations, resulting in 40% reduction (95% CI, 22% to 54%, p < 0.001) in the overall period and 82% (95% CI, 62% to 92%, p < 0.001) on May and June. Among non-vaccinated children, no reduction on ED visits was observed (95% CI, -4% to 5%, p=0.903), while an increase or reduction in the hospitalization rates could not be determined (95% CI, -212% to 35%, p=0.381). There was a decrease in the positivity of the stool rotavirus tests in 2009 (70% reduction, 95% CI, 26% to 88%, p=0.007). CONCLUSIONS: The introduction of the RV1 vaccine resulted in 6% reduction in the ED visits and 40% reduction in hospital admissions for acute diarrhea, and 70% reduction in the rates of positive stool rotavirus tests. No herd immunity was observed

INTRODUÇÃO: A doença diarreica aguda é a segunda causa de morte em crianças abaixo de 5 anos de idade. No Brasil, entre 2003 e 2009, a diarreia aguda foi responsável por cerca de 100.000 internações por ano, e por 4% das mortes em crianças abaixo de 5 anos de idade. O rotavírus é a principal etiologia de diarreia aguda grave no mundo todo, sendo responsável por 40% das internações por diarreia aguda, e 29% de todas as mortes por diarreia aguda. A vacina monovalente (RV1) contra o rotavírus foi introduzida no Programa Nacional de Imunizações em 2006. OBJETIVOS: Verificar o impacto da vacina monovalente contra rotavírus nas consultas de pronto-socorro e internações por doença diarreica aguda em crianças menores de 5 anos de idade, verificar a positividade do exame \"pesquisa de rotavírus nas fezes\", e verificar a presença ao ausência de imunidade de rebanho. METODOLOGIA: Foi realizado um estudo ecológico retrospectivo no Hospital Universitário da Universidade de São Paulo. O período foi dividido em pré-vacina (2003 a 2005) e pós-vacina (2007 a 2009). Foram incluídas todas as crianças abaixo de 5 anos que passaram em consulta no pronto-socorro e verificado o diagnóstico do atendimento e internação através de registro eletrônico. Foram obtidas as taxas de consultas no pronto-socorro e internações por doença diarreica aguda, foram selecionadas as crianças não vacinadas para cálculo da imunidade de rebanho, e verificado se houve coleta do exame pesquisa de rotavírus nas fezes. A redução nas taxas foi obtida através da fórmula: redução (%) = (1 - odds ratio) x 100. RESULTADOS: No período pré-vacina a taxa de consultas por diarreia aguda foi de 85,8 consultas por 1.000 consultas gerais, no período pós vacina a taxa de consultas por diarreia aguda foi 80,9 por 1.000, e a redução foi 6% (IC 95%, 4% a 9%, p < 0,001), chegando a 40% (IC 95%, 36% a 44%, p<0,001) nos meses de maio e junho. A taxa de internação por diarreia aguda era 40,8 internações por 1.000 e caiu para 24,9 por 1.000, redução de 40% (IC 95%, 22% a 54%, p < 0,001), chegando a 82% (IC 95%, 62% a 92%, p < 0,001) nos meses de maio e junho. Nas crianças não vacinadas não houve redução na taxa de consultas de pronto-socorro (IC 95%, -4% a 5%, p=0,903), e não se pode afirmar se houve redução ou aumento das internações por diarreia aguda (IC 95%, -212% a 35%, p=0,381). Houve queda da positividade do exame pesquisa de rotavírus em 2009 (redução de 70%, IC 95%, 26% a 88%, p=0,007). CONCLUSÕES: Após a introdução da vacina contra rotavírus (RV1) houve uma redução de 6% nas consultas por diarreia aguda no pronto-socorro, de 40% nas internações por diarreia aguda e de 70% na positividade do exame pesquisa de rotavírus nas fezes. Não foi detectada imunidade de rebanho / INTRODUCTION: Acute diarrheal disease is the second cause of death in children under five years. In Brazil, from 2003 to 2009, acute diarrhea was responsible for nearly 100,000 deaths per year and 4% of the deaths in children under five years. Rotavirus is the leading cause of severe acute diarrhea worldwide, accounting for 40% of hospital admissions and 29% of all the acute diarrhea-related deaths. In 2006, the rotavirus monovalent vaccine (RV1) was added to the Brazilian National Immunization Program. OBJECTIVES: To analyze the impact of the RV1 on Emergency Department (ED) visits and hospital admissions for acute diarrhea, the rates of positivity of the stool rotavirus tests and the presence or absence of herd immunity. METHODS: A retrospective ecologic study at the University Hospital, University of Sao Paulo. The study analyzed two periods: the pre-vaccine (2003-2005) and the post-vaccine (2007-2009) periods. We screened the main diagnosis of all ED attendances and hospital admissions of children under five years in an electronic registry system database and calculated the rates of ED visits, hospital admissions and positivity of the stool rotavirus test in patients with acute diarrhea. Herd immunization was evaluated in non-vaccinated children. The reduction rate was analyzed according to the formula: reduction (%) = (1- odds ratio) x 100. RESULTS: The rates of ED visits for acute diarrhea was 85.8 and and 80.9 per 1,000 total ED visits in the pre and post vaccination periods, respectively, resulting in 6% reduction (95% CI, 4% to 9%, p< 0.001) in the overall period and reaching 40% reduction on May and June. The rates of hospital admissions for acute diarrhea was 40.8 per 1,000 in the pre-vaccine period and dropped to 24.9 per 1,000 hospitalizations, resulting in 40% reduction (95% CI, 22% to 54%, p < 0.001) in the overall period and 82% (95% CI, 62% to 92%, p < 0.001) on May and June. Among non-vaccinated children, no reduction on ED visits was observed (95% CI, -4% to 5%, p=0.903), while an increase or reduction in the hospitalization rates could not be determined (95% CI, -212% to 35%, p=0.381). There was a decrease in the positivity of the stool rotavirus tests in 2009 (70% reduction, 95% CI, 26% to 88%, p=0.007). CONCLUSIONS: The introduction of the RV1 vaccine resulted in 6% reduction in the ED visits and 40% reduction in hospital admissions for acute diarrhea, and 70% reduction in the rates of positive stool rotavirus tests. No herd immunity was observed

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Thesis (M.S.)--University of Michigan, 1984.