No abstract available. / Thesis (M.A.)-University of Natal, Durban, 2003.

Thesis (Ph.D.)--Pardee Rand Graduate School, 2007. / Title from title screen (viewed on June 13, 2008). Includes bibliographical references.

Thesis--Copenhagen. / Summary in Danish. Includes bibliographical references (p. 175-191).

Thesis--Copenhagen. / Summary in Danish. Bibliography: p. 175-191.

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 137-143).

Thesis (MVoeding)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Objectives and scope of investigation Following the 1996 recommendations of a FAO/WHO expert panel for the development of food-based dietary guidelines (FBDGs) unique and specific to the needs of the populations of different countries, a South African FBDG Working Group was formed and ultimately also a Paediatric FBDG (PFBDG) Working Group with the task of the latter being the development of FBDGs for children younger than 7 years. A set of preliminary PFBDGs, chosen to address the most pressing paediatric public health issues, namely protein-energy malnutrition, micronutrient deficiencies and infectious diseases, were formulated for each age group sub-category (0-6 months, 6-12 months and 1-7 years). The following set of preliminary PFBDGs for the age group 6-12 months were approved by the Working Group to be subjected to consumer testing: • Enjoy time with your baby • From six months start giving your baby small amounts of solid foods • Gradually increase your baby’s meals to five times a day • Keep breast feeding your baby • Offer your baby clean, safe water regularly • Teach your baby to drink from a cup • Take your baby to the clinic every month Assessment of the consumer’s comprehension, interpretation of the proposed guidelines, and ability to apply them, was considered essential before the PFBDGs could be finalised, disseminated to the consumer, and implemented as an educational tool for health professionals and community workers. This study was also the first in which PFBDGs were tested, and was intended to be a pilot study for further testing of PFBDGs for this age category in other parts of the country, adapted for different circumstances. The investigation was conducted among women who were mothers or caregivers to infants 6-12 months of age in the Afrikaans-, English- and Xhosa-speaking communities of the greater Oudtshoorn area, including Bongulethu, Bridgeton and Toekomsrus and its adjacent rural areas of Dysselsdorp, Calitzdorp, Uniondale, Ladismith and Zoar. Methodology The study was designed to be an observational, descriptive and cross-sectional study. Qualitative data was collected from a sample of 64 volunteers who took part in ten focus group discussions each attended by between 3 and 11 participants. Group discussions were recorded on videotape and quantitative and qualitative questionnaires measured pre-discussion knowledge and comprehension of guidelines, perceived hindrances to compliance with guidelines and perceived importance of guidelines as well as socio-demographic data. Results and conclusions With this study, useful and enlightening information was obtained which met the research objectives. Participants discussed the guidelines in depth and information obtained from the questionnaires were found to support what was said during the discussions. Body language or non-verbal communication as observed, and recorded on videotape, also complemented the information gained from the discussions. Summarily it can be said that the guidelines were well-received and perceived as important by the majority of respondents, although some of the guidelines were initially not well-understood without explanation. Furthermore, the fact that the applicability of the guideline on prolonged breast feeding seems to be the most problematic, is a cause for concern. In view of the results obtained in this study, it can be concluded that PFBDGs will have to be supported by extensive and appropriate educational material to be effective when introduced to the public. The findings of this study will be submitted to the PFBDG Working group for consideration before finalisation of the guidelines for the age group 6-12 months. / AFRIKAANSE OPSOMMING: Doelwitte en omvang van die studie Na aanleiding van die 1996 aanbevelings van ‘n VLO/WGO paneel van kenners vir die ontwikkeling van voedselgebaseerde dieetriglyne (VGDR) wat uniek en spesifiek gerig is tot die behoeftes van die bevolkings van verskillende lande, is ‘n Suid-Afrikaanse VGDR Werkgroep gevorm en uiteindelik ook ‘n Pediatriese VGDR (PVGDR) Werkgroep met die opdrag van laasgenoemde om VGDRe te ontwikkel vir kinders jonger as 7 jaar. ‘n Stel voorlopige Pediatriese VGDRe, gekies om die mees dringende pediatriese publieke gesondheidsvraagstukke, naamlik proteïn-energie wanvoeding, mikronutriënttekorte en infektiewe siektetoestande aan te spreek, is geformuleer vir elke ouderdomsgroep subkategorie (0-6 maande, 6-12 maande en 1-7 jaar). Die volgende stel voorlopige PVGDRe vir die ouderdomsgroep 6-12 maande is deur die Werkgroep goedgekeur om aan verbruikerstoetsing te onderwerp: • Geniet tyd saam met jou baba • Begin vanaf ses maande om jou baba klein hoeveelhede vaste kos te gee • Vermeerder jou baba se maaltye geleidelik na vyf keer per dag • Hou aan om jou baba te borsvoed • Bied gereeld vir jou baba skoon, veilige drinkwater aan • Leer jou baba om uit ‘n koppie te drink • Neem jou baba elke maand kliniek toe Evaluering van die verbruiker se begrip, interpretasie van die riglyne en die vermoë om die riglyne te implementeer, is as noodsaaklik beskou voordat die PVGDRe gefinaliseer kon word, vrygestel kon word aan die publiek, en aan professionele- en gemeenskapsgesondheidswerkers beskikbaar gestel kon word as ‘n onderrighulpmiddel. Hierdie studie was die eerste waarin PVGDRe getoets is en dit is bedoel as ‘n voorloperstudie vir verdere toetsing van PVGDRe vir hierdie ouderdomskategorie in ander dele van die land en aangepas vir ander omstandighede. Die ondersoek is gedoen onder vroue wat moeders of versorgers van babas van 6-12 maande was in die Afrikaans- Engels- en Xhosasprekende gemeenskappe van die groter Oudtshoorn area wat Bongulethu, Bridgton en Toekomsrus insluit asook die nabygeleë plattelandse gemeenskappe van Dysselsdorp, Calitzdorp, Uniondale, Ladismith en Zoar. Metodiek Die studie is ontwerp om ‘n waarnemende en beskrywende analise van ‘n deursnee van die studiepopulasie moontlik te maak. Kwalitatiewe data is verkry van ‘n proefmonster van 64 vrywilligers wat deelgeneem het aan tien fokusgroep besprekings wat elk deur 3 tot 11 persone bygewoon is. Groepbesprekings is op videoband opgeneem en kwantitatiewe en kwalitatiewe vraelyste het voorbesprekings kennis en begrip van die voorgestelde riglyne, vermeende verhindering tot uitvoering van die riglyne en vermeende belangrikheid van riglyne sowel as sosio-demografiese inligting gemeet. Resultate en gevolgtrekkings Met hierdie studie is bruikbare en verhelderende inligting verkry wat beantwoord het aan die doelwitte van die studie. Deelnemers het die riglyne in diepte bespreek en dit is bevind dat inligting wat van die vraelyste verkry is, ook dit bevestig het wat gedurende die sessies bespreek is. Lyftaal en nie-verbale kommunikasie soos waargeneem en soos op videoband vasgelê, het ook die inligting ondersteun wat van die besprekingsessies verkry is. Opsommend kan gesê word dat die riglyne goed ontvang is en as belangrik beskou is deur die meerderheid van respondente. Sommige van die riglyne was nie vir deelnemers goed verstaanbaar sonder meegaande verduideliking nie. Verder is die feit dat die toepasbaarheid van die riglyn met betrekking tot ‘n verlengde tydperk van borsvoeding voorgekom het as die mees problematiese, ‘n rede tot kommer In die lig van die resultate van hierdie studie, kan daar tot die slotsom gekom word dat PVGDRE ondersteun sal moet word deur omvattende en gepaste onderrigmateriaal om effektief te kan wees wanneer dit aan die publiek bekend bekend gestel word. Die bevindings van hierdie studie sal aan die Pediatriese VGDR Werkgroep voorgelê word vir oorweging voordat riglyne vir die ouderdomsgroep 6-12 maande gefinaliseer word.

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)

Introdução: Recém-nascidos prematuros são considerados vulneráveis às complicações da prematuridade, incluindo o insulto neurológico e os déficits a longo prazo no crescimento e no desenvolvimento. Objetivo: Investigar o desenvolvimento psicomotor e o crescimento de crianças prematuras, nascidas com muito baixo peso, aos 8 e 18 meses de idade corrigida, comparando com seus pares nascidos de termo; e verificar a relação do crescimento com os resultados do desenvolvimento. Método: Estudo de coorte prospectivo, incluindo 83 recém-nascidos com peso de nascimento≤1500g e idade gestacional≤32 semanas, e um grupo controle de 52 crianças nascidas de termo saudáveis. A Alberta Infant Motor Scale (AIMS) e a Escala Brunet-Lèzini (EBL) foram utilizadas para avaliar o desenvolvimento aos 8 e 18 meses de idade (corrigida para a prematuridade - ICo). Medidas antropométricas foram coletadas para avaliar o crescimento nas duas faixas etárias. Resultados: Aos 8 meses de ICo, os prematuros pontuaram significativamente inferior no escore bruto da AIMS (p=0,001). Aos 18 meses, pontuaram significativamente inferior na subescala em pé da AIMS (p=0,040) e apresentaram pobre desenvolvimento psicomotor na EBL (p=0,006). O estado nutricional apresentou diferenças significativas entre os grupos, nas duas faixas etárias (p<0,001). Ocorreu correlação positiva do estado nutricional dos prematuros com a AIMS (r=0,395; p<0,001) e com a EBL (r=0,346; p<0,01) aos 8 meses de ICo; e do perímetro cefálico com a AIMS (r=0,282; p<0,05) aos 18 meses de ICo. Conclusões: Crianças prematuras, nascidas com muito baixo peso, aos 8 e 18 meses de ICo, apresentaram diferenças significativas no desenvolvimento e no padrão de crescimento, quando comparadas aos seus pares de termo. Os resultados demonstram o impacto do crescimento junto ao desenvolvimento, reforçando a importância do acompanhamento multidisciplinar dessa população de risco. / Introduction: Preterm infants are considered vulnerable to the prematurity complications, including the neurological insult and the deficits in the long term growth and development. Objective: To investigate the psychomotor development and growth of preterm infants born with very low weight, at 8 and 18 months corrected age, compared with their peers born at term; and to verify the growth relation with the development results. Methods: A prospective cohort study including 83 infants with birth weight≤1500g and gestational age≤32 weeks, and a control group of 52 healthy term born children. Alberta Infant Motor Scale (AIMS) and Brunet-Lèzini scale (EBL) were used to evaluate the development at 8 and 18 months of age (corrected for prematurity-CA). Anthropometric measurements were collected to evaluate the growth in both age groups. Results: At 8 months of CA, premature infants scored significantly lower in gross score of the AIMS (p=0.001). At 18 months, they scored significantly lower on the standing up subscale from AIMS (p=0.040) and exhibited poor psychomotor development in the EBL (p=0.006). The nutritional status showed significant differences between the groups, in both age groups (p<0.001). There was a positive correlation of nutritional status of preterm infants with the AIMS (r=0.395; p<0.001) and with the EBL (r=0.346; p<0.01) at 8 months of CA; and the head circumference at birth with the AIMS (r=0.282; p<0.05) at 18 months of CA. Conclusions: Preterm infants born with very low birth weight, at 8 and 18 months of CA, showed significant differences in the development and growth pattern, when compared with their peers born at full term. The results demonstrate the impact of growth on the development, reinforcing the importance of monitoring this at risk population.

Introdução: Recém-nascidos prematuros são considerados vulneráveis às complicações da prematuridade, incluindo o insulto neurológico e os déficits a longo prazo no crescimento e no desenvolvimento. Objetivo: Investigar o desenvolvimento psicomotor e o crescimento de crianças prematuras, nascidas com muito baixo peso, aos 8 e 18 meses de idade corrigida, comparando com seus pares nascidos de termo; e verificar a relação do crescimento com os resultados do desenvolvimento. Método: Estudo de coorte prospectivo, incluindo 83 recém-nascidos com peso de nascimento≤1500g e idade gestacional≤32 semanas, e um grupo controle de 52 crianças nascidas de termo saudáveis. A Alberta Infant Motor Scale (AIMS) e a Escala Brunet-Lèzini (EBL) foram utilizadas para avaliar o desenvolvimento aos 8 e 18 meses de idade (corrigida para a prematuridade - ICo). Medidas antropométricas foram coletadas para avaliar o crescimento nas duas faixas etárias. Resultados: Aos 8 meses de ICo, os prematuros pontuaram significativamente inferior no escore bruto da AIMS (p=0,001). Aos 18 meses, pontuaram significativamente inferior na subescala em pé da AIMS (p=0,040) e apresentaram pobre desenvolvimento psicomotor na EBL (p=0,006). O estado nutricional apresentou diferenças significativas entre os grupos, nas duas faixas etárias (p<0,001). Ocorreu correlação positiva do estado nutricional dos prematuros com a AIMS (r=0,395; p<0,001) e com a EBL (r=0,346; p<0,01) aos 8 meses de ICo; e do perímetro cefálico com a AIMS (r=0,282; p<0,05) aos 18 meses de ICo. Conclusões: Crianças prematuras, nascidas com muito baixo peso, aos 8 e 18 meses de ICo, apresentaram diferenças significativas no desenvolvimento e no padrão de crescimento, quando comparadas aos seus pares de termo. Os resultados demonstram o impacto do crescimento junto ao desenvolvimento, reforçando a importância do acompanhamento multidisciplinar dessa população de risco. / Introduction: Preterm infants are considered vulnerable to the prematurity complications, including the neurological insult and the deficits in the long term growth and development. Objective: To investigate the psychomotor development and growth of preterm infants born with very low weight, at 8 and 18 months corrected age, compared with their peers born at term; and to verify the growth relation with the development results. Methods: A prospective cohort study including 83 infants with birth weight≤1500g and gestational age≤32 weeks, and a control group of 52 healthy term born children. Alberta Infant Motor Scale (AIMS) and Brunet-Lèzini scale (EBL) were used to evaluate the development at 8 and 18 months of age (corrected for prematurity-CA). Anthropometric measurements were collected to evaluate the growth in both age groups. Results: At 8 months of CA, premature infants scored significantly lower in gross score of the AIMS (p=0.001). At 18 months, they scored significantly lower on the standing up subscale from AIMS (p=0.040) and exhibited poor psychomotor development in the EBL (p=0.006). The nutritional status showed significant differences between the groups, in both age groups (p<0.001). There was a positive correlation of nutritional status of preterm infants with the AIMS (r=0.395; p<0.001) and with the EBL (r=0.346; p<0.01) at 8 months of CA; and the head circumference at birth with the AIMS (r=0.282; p<0.05) at 18 months of CA. Conclusions: Preterm infants born with very low birth weight, at 8 and 18 months of CA, showed significant differences in the development and growth pattern, when compared with their peers born at full term. The results demonstrate the impact of growth on the development, reinforcing the importance of monitoring this at risk population.

Orientador: Rosana de Fatima Possobon, Antonio Bento Alves de Moraes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T07:14:07Z (GMT). No. of bitstreams: 1 Brasileiro_AlineAlves_M.pdf: 1472520 bytes, checksum: e726dece31cec4c7d998871f078a52db (MD5) Previous issue date: 2008 / Resumo: O objetivo deste estudo foi verificar a manutenção da amamentação natural no período de retorno da mãe ao trabalho, comparando mães participantes do Grupo de Incentivo ao Aleitamento Materno Exclusivo, com mães não participantes do referido grupo. Foi realizado um estudo de intervenção não randomizado, por meio de inquérito entre mães que voltaram a trabalhar após o parto, participantes e não participantes de um grupo de incentivo ao aleitamento materno exclusivo. A amostra consistiu de 200 díades mãe-lactente com idade entre 6 e 10 meses de vida. Para avaliar fatores associados ao retorno ao trabalho, os resultados foram analisados por meio dos testes estatísticos Qui-Quadrado e Exato de Fisher. A idade média da época em que a mãe retornou ao trabalho foi de 3,64 e 4,20 meses após o parto para as mães do Grupo Externo e do Grupo Interno, respectivamente. Foi observada diferença estatística para introdução precoce de outro tipo de leite (p>0001), água (p>0001), chá (p>0001), suco de frutas (p>0001), papa de frutas (p=0016) e papa salgada (p=0023) quando comparados os dois grupos. O Grupo Interno manteve a amamentação exclusiva por mais tempo após o retorno ao trabalho. A manutenção do aleitamento materno exclusivo independe da época de retorno da mãe ao trabalho, da jornada diária, da distância entre mãe-criança, da presença de creche interna ou externa, o nível do cargo ocupado pela mãe e a utilização do posto de coleta de leite materno. Como fator protetor da prática do aleitamento materno exclusivo, aponta-se a utilização do descanso de 30 minutos por turno trabalhado. O apoio foi um fator importante para a manutenção do aleitamento materno exclusivo entre as mulheres trabalhadoras / Abstract: The objective of this study was to verify the maintenance of natural breastfeeding in the period of return of the mother to work, comparing mothers participants of the encouragement Group for the Exclusive Breastfeeding, with mothers not participants of the group. A non-randomized study of intervention was performed through survey among mothers who returned to work after childbirth, participants and non-participants of a group to encourage exclusive breastfeeding. The sample consisted of 200 pain mother-infant aged between 6 and 10 months of life. To avaliate factors associated with the return to work, the results were analyzed by means of statistical tests chi-square and Fisher's Exact. The average age of time when the mother returned to work was 3.64 and 4.20 months after delivery for mothers of the Foreign Group and Internal Group, respectively. Statistical difference was observed for early introduction of another type of milk (p> 0001), water (p> 0001), tea (p> 0001), fruit juice (p> 0001), Pope of fruit (p = 0016) and pope salt (p = 0023) comparing the two groups. The Internal Group maintained the exclusive breastfeeding for a longer time after the return to work. The maintenance of exclusive breastfeeding independs on the time of return of the mother to work, the daily journey, the distance between mother-child, the presence of internal or external day care, level of the position held by the mother and the use of the place of collection of milk. As protective factor of the practice of exclusive breastfeeding, there are the uses of the rest of 30 minutes per shift worked. The support was an important factor for the maintenance of exclusive breastfeeding among women workers / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente