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The diets of 75 two year old children, participating in the Virginia Beach WIC Program, were evaluated twice. They were analyzed using a 24 hour dietary recall (WIC 329), and again using a computer program (Nutritionist I) for RDA. Diets were examined for the nutrients calcium, protein, vitamin A, vitamin C, and iron found in the four food groups on the WIC 329. Each food group and corresponding nutrient was identified with varying degrees of success.The protein and calcium assessment were accurate. Under the conditions of this study, several recommendations can be made. The milk group heading could state that one cup of fluid milk provides 310 IU vitamin A. The vitamin A rich foods yield 6000 IU rather than 4000-5000 IU as indicated on the WIC 329. For vitamin C, only 3/4 serving is required to satisfy the RDA rather than the stated full serving. Iron values could be documented on the WIC 329 for the meat, vitamin A, vitamin C, and bread/cereal group. Iron fortified cereals, supplying at least 45% RDA, could be a separate subgroup to reflect the higher iron content. A truncated regression formula was developed to estimate nutritional status. A ceiling of 150% RDA was used to prevent skewing of nutrients. Use of the regression formula instead of the WIC 329 resulted in a 67% improvement of estimating nutritional status. / Master of Science

The purpose of this research was to examine food security for people with prediabetes participating in the Supplemental Nutrition Assistance Program (SNAP), focusing on their food choice decisions and coping strategies over a 30-day benefit cycle that potentially increases the risk of Type 2 diabetes. A cross-sectional, quantitative design based on food choice process model constructs was used. SNAP participants (n = 36) with prediabetes, aged 21â??70 years, were recruited as outpatients from Bronx Lebanon Hospital and completed self-reported questionnaires on demographics and health, food security, and food frequency. Descriptive statistics, Pearson chi square tests, and regression analysis were performed using SPSS. Also, independent t test, and Levene's test were used for ad hoc analysis to assess variation of food choice decisions over 30 days. Of the sample, 5% had low and 95% very low food secure status. Food security status did not predict coping strategies (p = .724); however, food security status and type of coping strategy had a moderate relationship (p < 0.01; r =.60). Food choices of 11 food categories changed over a 30-day cycle with greatest variation for Week 1, compared to Weeks 2â??4 (p < .005). Use of coping strategies to minimize hunger was limited. Very low food security associated with certain coping strategies disrupted eating patterns. Disrupted eating patterns affect food variation over time, increasing the intake of non-nutrient-dense foods and the risk of obesity and Type 2 diabetes. The implications for positive social change include the potential to change SNAP's benefit allotments, make nutrition education mandatory, and create a nutrition package, thereby lowering food insecurity and the risk of Type 2 diabetes.

Because children eat better when their parents use appropriate feeding practices, this study examined WIC participation and parental knowledge about child feeding practices. A Child Feeding Questionnaire was developed to evaluate parental knowledge about these feeding practices. The questions evaluated parents' knowledge about their responsibilities and the responsibilities of their children in feeding situations, the role of parental modeling when eating, appropriate snack habits, management of dislikes/picky eating, and the use of coercive feeding practices. The directors of four WIC clinics, with clients of differing sociodemographic status, agreed to participate in the study. The questionnaire was tested with and revised following work with clients in two of the four WIC clinics. The questionnaire was then administered to 403 parents during WIC certification visits. Cronbach Alpha reliability measures indicated that the reliability of the instrument was low. Therefore, no real conclusions could be drawn from the results. However, the data analyses did suggest some possible findings that would need additional study to verify their existance. ANOVA measures indicated that increased length of WIC participation was not associated with an increase in the total number of correct responses. Parental responds suggested that the majority of respondents understood the responsibility of parents for deciding what foods to offer (88.3), and when to offer food (71.7 %), the importance of healthy snacks in the diet of children (79.4 %), the need to set a good parental example with eating (92.6 %), and the importance of exposing children to foods that the children dislike (80.1%). However, one-third of the parents did not agree or know that children should be resonsible for deciding how much to eat when foods are being offered. In addition, the majority of parents (68.7 %) indicated that it was acceptable to substitute a food for one that is disliked by children. With respect to the use of coercive feeding strategies to get children to eat, parental responses reflected that many parents (46.7 %) did not feel that the use of rewards to get children to eat was not advisable. Based on the researcher's professional knowledge that WIC staff generally provide only nutrition information related to immediate problems, it was recommended that WIC staff members who provide nutrition education might serve the participants better if the education that they provided was directed at broader nutrition issues that parents face in guiding their children to eat well. Perhaps this education will indirectly alleviate immediate nutritional needs of the individual child and prevent the occurance of other nutrition problems. This would require additional study for verification. / Department of Home Economics

O objetivo deste estudo foi comparar a eficácia anestésica da articaína 4%, da lidocaína 2%, ambas associadas à epinefrina 1:100.000, e da bupivacaína 0.5%, associada à epinefrina 1:200.000, durante pulpectomia em pacientes com pulpite irreversível em molares inferiores. Cento e cinco voluntários do Setor de Urgência da Faculdade de Odontologia da Universidade de São Paulo receberam, aleatoriamente, 3,6mL de um dos anestésicos locais para o convencional bloqueio do nervo alveolar inferior (BNAI). No caso de falha do BNAI, foram administrados 3,6mL da mesma solução como injeção complementar no ligamento periodontal. O sinal subjetivo de anestesia do lábio, a presença de anestesia pulpar e ausência de dor durante a pulpectomia foram avaliados, respectivamente, por indagação ao paciente, por meio do aparelho estimulador pulpar elétrico (pulp tester) e por uma escala analógica verbal. A análise estatística foi realizada por meio dos testes Qui-quadrado, Kruskal Wallis e Razão de Verossimilhanças. Foi adotado nível de significância de 0,05 (P <= 0,05). Todos os pacientes reportaram anestesia no lábio após o BNAI. A lidocaína apresentou valores superiores (42,9%) para a anestesia pulpar após o BNAI e após a injeção no ligamento periodontal (61,5%). A bupivacaína apresentou valores superiores para a analgesia (80%) após o BNAI e a lidocaína (92,3%) após a injeção no ligamento periodontal. Após a falha do BNAI, a dor na câmara pulpar foi a mais frequente para articaína e lidocaína e na dentina para a bupivacaína e após a falha da injeção no ligamento periodontal, a dor foi similar para articaína nas diferentes regiões; câmara, canal e dentina; para a bupivacaína foi mais frequente na dentina e para a lidocaína no canal. No entanto, essas diferenças não foram estatisticamente significantes. Portanto as três soluções anestésicas locais se comportam de forma semelhante e não apresentam efetivo controle da dor no tratamento da pulpite irreversível em molares inferiores. / The aim of this study was to compare the anesthetic efficacy of 4% articaine and 2% lidocaine both associated with 1:100,000 epinephrine and 0.5% bupivacaine associated with 1:200,000 epinephrine in patients with irreversible pulpitis of the mandibular molars during a pulpectomy procedure. One hundred and five volunteers from the Emergency Center of the School of Dentistry at University of São Paulo randomly received 3.6 mL of local anesthetic as a conventional inferior alveolar nerve block (IANB). The subjective signal of lip numbness, pulpal anesthesia and the absence of pain during the pulpectomy procedure were, respectively, evaluated by questioning the patient, stimulation using an electric pulp tester and a verbal analogue scale. Statistical analysis was performed using the chi-square test, Kruskal Wallis and likelihood rations. The level for significance of differences was P <= .05. All patients reported the subjective signal of lip numbness after the application of either IANB. Lidocaine showed higher values for pulpal anesthesia after the IANB (42.9%) and after injection in the periodontal ligament (61.5%). Bupivacaine presented higher values for analgesia after the IANB (80,0%) and lidocaine after injection in the periodontal ligament (92,3%). After the failure of the IANB, the pain in the pulp chamber was the most frequent to articaine and lidocaine and bupivacaine for dentin and after the failure of the periodontal ligament injection, the pain was equal to articaine in different regions, chamber, canal and dentin; for bupivacaine was greater in dentin and lidocaine was higher in the channel. However, these differences were not statistically significant. So the three local anesthetic solutions behave similarly and not present any effective pain control in the treatment of irreversible pulpitis in mandibular molars.

Submitted by JOSIANE SANTOS DE OLIVEIRA (josianeso) on 2018-09-26T14:29:28Z No. of bitstreams: 1 Vítor Hugo Hoffmann da Costa_.pdf: 5158714 bytes, checksum: 90537d9a457113d3412237b91e5abeae (MD5) / Made available in DSpace on 2018-09-26T14:29:28Z (GMT). No. of bitstreams: 1 Vítor Hugo Hoffmann da Costa_.pdf: 5158714 bytes, checksum: 90537d9a457113d3412237b91e5abeae (MD5) Previous issue date: 2018-04-16 / Nenhuma / Este trabalho propõe um modelo informacional para dar suporte ao processo de faturamento e de prestação de contas dos serviços realizados pelos hospitais para os beneficiários das operadoras de planos de saúde. O modelo informacional proposto visa a permitir o controle dos dados em tempo hábil, sendo baseado nos conceitos de Intercâmbio Eletrônico de Dados. A pesquisa que sustenta o modelo é qualitativa, estruturada segundo o método de Design Research. As fontes de informação incluem especialistas gestores de hospitais ou de operadoras de planos de saúde, além de publicações acadêmicas, normas e documentos técnicos. A coleta de dados foi realizada por meio de entrevistas semiestruturadas, observações in loco e análise documental, e a extração de informação foi realizada por meio de Análise de Conteúdo. Como resultado, foram identificados: os impactos dos modelos de remuneração na relação entre hospitais e operadoras de planos de saúde; as informações, regras, parâmetros e a periodicidade necessária para implementar o novo modelo informacional proposto de suporte ao faturamento; e os impactos potenciais do modelo informacional proposto no processo de faturamento, na visão de hospitais e operadoras de planos de saúde. / The aim of this study is to recommend an informational model to support the billing and accountability process of the services performed by hospitals for beneficiaries of healthcare plan companies. The proposed informational model aims at allowing the control of the data in a timely manner, being based on the concepts of Electronic Data Interchange. This is a qualitative research which used Design Research method. Sources of information include specialist managers of hospitals or healthcare plan companies, as well as academic publications, standards and technical documents. Data collection was performed through semi-structured interviews, on-site observations and documentary analysis, and the extraction of information was performed through Content Analysis. As a result, were identified: the impacts of compensation models on the relationship between hospitals and healthcare plan companies; information, rules, parameters and periodicity required to implement the new informational model proposed to support billing; and potential impacts of the informational model proposed in the billing process, in the view of hospitals and healthcare plan companies.

Made available in DSpace on 2016-04-29T14:16:43Z (GMT). No. of bitstreams: 1 Veronica Fernandes de Jesus.pdf: 2246563 bytes, checksum: a6a38f3cb645758b90b2381313bf9fd5 (MD5) Previous issue date: 2015-08-13 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The Family Grant Program, created in October 2003, proposed the joint monetary benefit to the effectiveness of complementary programs, with the official objective of promoting capacity building and promoting the empowerment process of the beneficiary families. The purpose of this study is to analyze the proposed complementary actions, especially in actions directed to vocational training and integration into the labor market at the local level, identifying the potential and obstacles of this process in the city of Salvador / BA . The methodological approach of research in qualitative research techniques employed documentary research, semi-structured interviews with the PBF team managers and other municipal representatives and the beneficiary families of PBF / O Programa Bolsa Família, criado em outubro de 2003, propõe a articulação do benefício monetário à efetivação de programas complementares, com o objetivo oficial de promover o desenvolvimento de capacidades e de fomentar o processo de autonomização das famílias beneficiárias. O objetivo desta proposta de estudo será de analisar as ações complementares, principalmente nas ações direcionadas à capacitação profissional e inserção no mercado de trabalho no plano local, identificando as potencialidades e os entraves deste processo no município de Salvador / BA. A investigação de abordagem metodológica em pesquisa qualitativa empregou técnicas de pesquisa documental, entrevistas semi estruturadas junto à equipe de gestores do PBF além de outros representantes do município bem como as famílias beneficiárias do PBF

Made available in DSpace on 2016-04-26T20:20:50Z (GMT). No. of bitstreams: 1 Gabriela Moccia de Oliveira Cruz.pdf: 991501 bytes, checksum: b0724c8c231be3472426ecc3fbae0b4f (MD5) Previous issue date: 2012-05-11 / The focus of this study is the supplemental legislative competence of the municipalities, specifically. The municipal jurisdiction has two foci of activity: the matters of exclusive competence and matters of concurrent jurisdiction, ie, those that are shared by the local entity with the Union and the States. For the exercise of the concurrent jurisdiction, the Federal Constitution provides in article 24, a rule: the general norms are edited by the Union and are supplemented by the States and Federal District. Although article 24 did not mention the municipalities, the entity was awarded by the supplemental legislative competence in the article 30, II, which gives it permission to complement Federal and State laws as appropriate . We follow analyzing the interpretations offered by the Brazilian courts and the specialized doctrine. Settled this discussion, we depart for the analysis of four cases: the straw burning of sugar cane, the free distribution of plastic bags in the supermarkets, the entry of people wearing helmets in public places or open to the public, and accessibility at commercial establishments. Despite the usual centralization of decisions in the framework of the Union, which depreciates municipal activity in the analyzed cases, we identified a trend of reorientation of this interpretation by the Brazilian courts and doctrine that confirms what we defend: a stronger role of the municipality in the Federation, because it is the closest political entity of the society / O foco desse estudo é especificamente a atuação legislativa suplementar dos Municípios. A competência municipal tem dois focos de atuação: as matérias de competência exclusiva do ente local e as matérias de competência concorrente, ou seja, aquelas que são por ele compartilhadas com a União e os Estados. Para o exercício das competências concorrentes, a Constituição Federal estabelece, no seu artigo 24, uma regra: as normas gerais serão editas pela União e a suplementação dessas normas fica a cargo dos Estados e do Distrito Federal. Apesar do artigo 24 não incluir os Municípios, o ente foi contemplado com a competência legislativa suplementar no artigo 30, inciso II da Constituição Federal, que lhe dá permissão para suplementar legislação Federal e Estadual no que couber . Discutimos o tema a partir do estudo da origem da federação, da análise histórica da Federação brasileira e da organização municipal no Brasil e de conceitos trazidos pela Constituição Federal de 1988, que alçou o Município a ente federado. Seguimos analisando as interpretações oferecidas pelos Tribunais brasileiros e pela doutrina especializada. Assentada essa discussão, partiremos para análise de quatro casos concretos: a queima da palha da cana-de-açúcar em alguns municípios do interior paulista, a distribuição gratuita de sacolas plásticas em supermercados, a entrada de pessoas usando capacetes em locais públicos ou abertos ao público e da acessibilidade nos grandes estabelecimentos comerciais das municipalidades. Apesar da centralização costumeira de decisões no âmbito da União que desprestigia a atuação municipal nos casos analisados, identificamos uma tendência de reorientação dessa interpretação pelos Tribunais brasileiros e doutrina que vai ao encontro do que defendemos: uma atuação mais contundente dos Municípios na Federação, por ele ser o locus político mais próximo da sociedade

O estudo Judicialização dos planos e seguros de saúde coletivos no Tribunal de Justiça de São Paulo trata das ações judiciais relacionadas a planos e seguros de saúde coletivos, julgadas pela segunda instância do Tribunal de Justiça de São Paulo nos anos de 2013 e 2014. São descritas e analisadas as demandas levadas ao Poder Judiciário pelos consumidores de planos de saúde. Os conflitos envolvem coberturas, reembolso, aposentados e demitidos, reajustes aplicados sobre a mensalidade, cancelamento de contrato e descredenciamento de hospitais. Também são analisados o comportamento e as argumentações da Justiça nas decisões. Conclui-se pela necessidade de aprimoramento da regulamentação e da fiscalização das atividades dos planos e seguros de saúde / The Judicialization of plan and collective health insurance study at the Court of Law of Sao Paulo treats legal actions related to plans and collective health insurances judged by the Court of Law of São Paulo of Second Instance in 2013 and 2014. It was described and analyzed the demands referred to Judiciary branch by health plan consumers. The conflicts involve coverage, reimbursement, retired and dismissed people, readjustments applied on the monthly payment, contract cancelling and hospital loss of accreditation. It is also analyzed the behavior and arguments of Justice on decisions. It is evidenced the need of improving the regulation and supervision of health plans and insurances

O objetivo deste estudo foi comparar a eficácia anestésica da articaína 4%, da lidocaína 2%, ambas associadas à epinefrina 1:100.000, e da bupivacaína 0.5%, associada à epinefrina 1:200.000, durante pulpectomia em pacientes com pulpite irreversível em molares inferiores. Cento e cinco voluntários do Setor de Urgência da Faculdade de Odontologia da Universidade de São Paulo receberam, aleatoriamente, 3,6mL de um dos anestésicos locais para o convencional bloqueio do nervo alveolar inferior (BNAI). No caso de falha do BNAI, foram administrados 3,6mL da mesma solução como injeção complementar no ligamento periodontal. O sinal subjetivo de anestesia do lábio, a presença de anestesia pulpar e ausência de dor durante a pulpectomia foram avaliados, respectivamente, por indagação ao paciente, por meio do aparelho estimulador pulpar elétrico (pulp tester) e por uma escala analógica verbal. A análise estatística foi realizada por meio dos testes Qui-quadrado, Kruskal Wallis e Razão de Verossimilhanças. Foi adotado nível de significância de 0,05 (P <= 0,05). Todos os pacientes reportaram anestesia no lábio após o BNAI. A lidocaína apresentou valores superiores (42,9%) para a anestesia pulpar após o BNAI e após a injeção no ligamento periodontal (61,5%). A bupivacaína apresentou valores superiores para a analgesia (80%) após o BNAI e a lidocaína (92,3%) após a injeção no ligamento periodontal. Após a falha do BNAI, a dor na câmara pulpar foi a mais frequente para articaína e lidocaína e na dentina para a bupivacaína e após a falha da injeção no ligamento periodontal, a dor foi similar para articaína nas diferentes regiões; câmara, canal e dentina; para a bupivacaína foi mais frequente na dentina e para a lidocaína no canal. No entanto, essas diferenças não foram estatisticamente significantes. Portanto as três soluções anestésicas locais se comportam de forma semelhante e não apresentam efetivo controle da dor no tratamento da pulpite irreversível em molares inferiores. / The aim of this study was to compare the anesthetic efficacy of 4% articaine and 2% lidocaine both associated with 1:100,000 epinephrine and 0.5% bupivacaine associated with 1:200,000 epinephrine in patients with irreversible pulpitis of the mandibular molars during a pulpectomy procedure. One hundred and five volunteers from the Emergency Center of the School of Dentistry at University of São Paulo randomly received 3.6 mL of local anesthetic as a conventional inferior alveolar nerve block (IANB). The subjective signal of lip numbness, pulpal anesthesia and the absence of pain during the pulpectomy procedure were, respectively, evaluated by questioning the patient, stimulation using an electric pulp tester and a verbal analogue scale. Statistical analysis was performed using the chi-square test, Kruskal Wallis and likelihood rations. The level for significance of differences was P <= .05. All patients reported the subjective signal of lip numbness after the application of either IANB. Lidocaine showed higher values for pulpal anesthesia after the IANB (42.9%) and after injection in the periodontal ligament (61.5%). Bupivacaine presented higher values for analgesia after the IANB (80,0%) and lidocaine after injection in the periodontal ligament (92,3%). After the failure of the IANB, the pain in the pulp chamber was the most frequent to articaine and lidocaine and bupivacaine for dentin and after the failure of the periodontal ligament injection, the pain was equal to articaine in different regions, chamber, canal and dentin; for bupivacaine was greater in dentin and lidocaine was higher in the channel. However, these differences were not statistically significant. So the three local anesthetic solutions behave similarly and not present any effective pain control in the treatment of irreversible pulpitis in mandibular molars.