Orientador: Jose Martins Filho / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T04:51:30Z (GMT). No. of bitstreams: 1 Almeida_ElaineAparecidade_M.pdf: 700336 bytes, checksum: 7031254a66c2a810c64858c8992be3a5 (MD5) Previous issue date: 2006 / Resumo: Esta pesquisa objetiva estudar a prevalência do aleitamento materno e aleitamento materno exclusivo ao nascer, aos dois, quatro e seis meses de vida dos bebês; testar a associação entre o uso de chupetas e o desmame precoce, e identificar os complementos alimentares predominantes. O estudo é do tipo longitudinal prospectivo, pois os indivíduos foram examinados ao nascer, aos dois, quatro e seis meses. Foram incluídos na pesquisa 199 binômios dos municípios de Mogi Guaçu e Estiva Gerbi, nascidos de parto vaginal ou cesáreo, com peso ao nascer entre 3000g e 3800g, sem anomalias congênitas ou asfixia perinatal, atendidos na Santa Casa de Misericórdia de Mogi Guaçu, onde o contato pele a pele e sucção na primeira hora de vida é rotina. Os dados foram coletados em prontuário médico, entrevistas e visitas domiciliares aos dois, quatro e seis meses. Os dados foram digitados em banco de dados do SPSS e analisados pelo SAS. Foram utilizados os teste de Qui quadrado e de Fisher, considerando significativo p < 0,05. O projeto de pesquisa foi submetido ao Comitê de Ética em Pesquisa da UNICAMP, que apresentou parecer positivo para sua realização. Na conclusão os índices encontrados aos dois meses foram 89,57%; aos quatro meses 91,61%; e aos seis meses 92,85% para o aleitamento materno. Para o aleitamento materno exclusivo foram 52,76%; 37,76% e 22,22% respectivamente. A chupeta se destacou na pesquisa como o fator de maior significância para o desmame precoce, ficando o leite artificial como o alimento introduzido mais precocemente na criança / Abstract: This research has as objective studying the prevalence of maternal suckling and exclusive maternal suckling when the baby is two, four and six months old, testing the association between the use of pacifiers and precocious weaning and identify the most used food complements. The study is the prospective longitudinal type, once the individuals were examined when born, then at two, four and six months old. 199 binomials from the cities of Mogi Guaçu and Estiva Gerbi were included in the research, from vaginal or cesarean birth, with birth weights between 3000g and 3800g, without congenital abnormalities or perinatal asphyxia, attended at the Santa Casa de Misericórdia de Mogi Guaçu, where the skin contact and sucking in the first hours of life is routine. The data were collected through medical records, interviews with the mothers and home visits at two, four and six months old. The data were typed at the data bank of the SPSS and analyzed by the SAS. Square Qui and Fisher tests were used, considering as significant the p < 0,05. The research project was sent to the Unicamp Research Ethic Committee which has presented positive opinion for its accomplishment. In the conclusion the indexes found were that at two months old they were 89,57%, at four months old 91,61% and at six months old 92,85% for maternal suckling. For exclusive maternal suckling they were 52,76%, 37,76% and 22,22% respectively. The pacifier was shown as the major significant factor for precocious weaning being the artificial milk the most precocious food introduced for the child / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

Orientador: Rosana de Fátima Possobon / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-23T17:31:41Z (GMT). No. of bitstreams: 1 Raven_FernandaGabrieledaCosta_M.pdf: 550713 bytes, checksum: 54c00f6eb994af5aaa305ecab1d7e8bc (MD5) Previous issue date: 2013 / Resumo: A prática do aleitamento materno é essencial para a proteção e a promoção da saúde da criança e é fundamental nos primeiros meses de vida. A amamentação contribui nutricional e imunologicamente para o desenvolvimento do lactente, prevenindo e controlando morbidades futuras. Além disso, auxilia no correto desenvolvimento facial e respiratório, além de estimular o vínculo entre mãe e filho. O aleitamento materno exclusivo é definido pela Organização Mundial de Saúde (OMS) como a oferta somente de leite, sem mesmo água ou chá, permitindo-se apenas gotas de vitaminas ou medicamentos, e deve ocorrer até o sexto mês de vida. A OMS recomenda, ainda, que o aleitamento deve ser mantido, de forma complementada, até 2 anos de idade ou mais. Entretanto, diversos fatores podem interferir na instalação e na manutenção do aleitamento, devendo ser investigados, a fim de prevenir sua influência, evitando o desmame precoce. Este estudo investigou a associação entre aleitamento materno exclusivo, nos seis primeiros meses de vida da criança, e condições socioeconômicas da mãe (escolaridade, renda, paridade, presença do companheiro, etc.), variáveis do período gestacional (início e número de consultas do pré-natal, problemas de saúde durante a gestação, tempo gestacional, etc.) e do período pós-parto (peso do bebê ao nascer, início da amamentação, permanência em alojamento conjunto, problemas de mama, se fez uso de chupeta, etc.). A amostra foi constituída por 305 crianças e suas respectivas mães, participantes do Programa de Atenção Precoce à Saúde oferecido pelo Centro de Pesquisa e Atendimento Odontológico para Pacientes Especiais (Cepae-FOP-Unicamp), no município de Piracicaba, Estado de São Paulo, Brasil. A prevalência de aleitamento materno exclusivo ao 6º mês foi de 23,9% e de desmame, 8,9%. Não foram detectadas diferenças estatisticamente significantes entre as variáveis socioeconômicas, demográficas e relacionados ao pré e pós-parto. Houve associação significativa entre abandono do aleitamento materno exclusivo e uso de chupeta (p = 0,0085; OR= 0,45; IC 95%: 0,25-0,80). Conclui-se que, para esta amostra, o uso da chupeta foi fator de risco para a manutenção do aleitamento materno exclusivo / Abstract: The practice of breastfeeding is essential for the protection and promotion of child health and is essential in the first months of life. Breastfeeding contributes to nutritional and immune development in infants, preventing and controlling morbidity future. Additionally, it assists in the correct breathing and facial development, and stimulate the connection between mother and child. Exclusive breastfeeding is defined by the World Health Organization (WHO) as the offer only milk, not even water or tea, allowing only vitamin drops or medications, and should occur until the sixth month of life. WHO also recommends that breastfeeding should be maintained as supplemented, up to 2 years of age or older. However, several factors may interfere with the installation and maintenance of breastfeeding, these factors should be investigated in order to prevent their influence, avoiding premature weaning. This study investigated the association between exclusive breastfeeding for the first six months of a child's life, and socioeconomic status of the mother (education, income, parity, presence of a partner, etc.). Variables of the gestational period (beginning and number of queries prenatal health problems during pregnancy, gestational age, etc..) and postpartum (baby's weight at birth, breastfeeding initiation, stay in rooming-in unity, breast problems, if made use of pacifiers, etc.). The sample consisted of 305 children and their mothers who participated in a Research and Dental Treatment Center for Special Patients (Cepae-FOP-Unicamp), in Piracicaba, State of São Paulo, Brazil. The prevalence of exclusive breastfeeding at 6 months was 23.9% and weaning, 8.9%. There were no statistically significant differences between the socioeconomic, demographic, and related to pre-and postpartum. There was a significant association between interruption of exclusive breastfeeding and pacifier use (p = 0.0085 OR = 0.45 95% CI: 0.25 to 0.80). We conclude that, for this sample, pacifier use was a risk factor for the maintenance of exclusive breastfeeding / Mestrado / Odontologia em Saude Coletiva / Mestra em Odontologia em Saúde Coletiva

Master of Science / Department of Animal Sciences and Industry / Michael E. Dikeman / Vitamin A (VA) restriction during finishing has been shown to increase marbling in cattle. However, little work has been done to look at the effects that VA restriction might have on color shelf-life and sensory traits of beef. This study involved 48 calves either early-weaned at 137 + 26 d or traditionally-weaned at 199 + 26 d and supplemented with either 15,400 IU/kg dry matter of VA or restricted to no supplemental VA during the finishing phase. Cattle were harvested in two groups, and carcass data were obtained after chilling. Strip loins and shoulder clods were retrieved, vacuum packaged, and cut into steaks after 14 d of aging. Visual and instrumental color scores for 7 d of retail display, thiobarbituric acid reactive substances (TBARS) values, trained sensory panel scores, and Warner-Bratzler shear force (WBSF) values were obtained. The only differences associated with weaning group were that L* values were lower (P < 0.05) on d 4 to 6 for Triceps brachii (TB) steaks from traditionally-weaned calves restricted in VA than early-weaned calves supplemented with high VA. Both Longissimus lumborum (LL) and TB steaks from calves supplemented with high VA had darker, more tan (P < 0.05) color scores after 4 d of display in PVC packaging than steaks from calves restricted in VA. Also, a*, b* and saturation index values were lower (P < 0.05) in LL steaks for the high VA treatment than those from the no supplemental VA treatment. There was less lipid oxidation (P < 0.05), as reported by TBARS, in both muscles from calves restricted in VA than muscles from calves supplemented with high VA. No treatment effects were found for WBSF values for either muscle, and no differences existed in sensory panel traits of the TB steaks. Sensory panel scores were less desirable (P < 0.05) for myofibrillar tenderness and connective tissue amount in LL steaks from calves fed high VA than steaks from calves restricted in VA. Dietary VA restriction during finishing has potential to increase color shelf-life and reduce lipid oxidation, with no negative effects on cooked meat sensory attributes.

The goal of a cow-calf producer is to produce a calf each year per cow. Research suggests that first year heifers struggle breeding back with their second calf because of the adjustments to new range/main herd conditions and the partitioning of nutrients between gaining weight, milk production, and gestation. This study was conducted at the V-V ranch at the University of Arizona for five years and looked at the effects on young cows when calves were weaned from first year heifers at 80 days rather than 205 days. Early weaning allows for gestational benefits because they are given the opportunity to adapt to herd conditions by applying feed resources to the in utero fetus and their own body condition rather than lactation. All first year heifers were included over three years, and were randomly assigned to two groups, normal weaning (NW) or early weaning (EW). This resulted in 122 heifers in the group whose calves were EW and 119 heifers in the group whose calves were NW. Heifers that were in the EW group bred back at a 27% higher rate in their second year, and had 15% greater longevity in the herd. Calves that were in utero when the nursing calves were early weaned were 16.4 kg heavier at weaning. Part of this was due to the age of the calf and part to gestational health. Early weaning was an effective strategy for improving reproductive performance of first year heifers as well as their survival rate in the herd to 5 years of age. It also resulted in improved performance for their in utero calves.

<p><i>In utero </i>heat stress (<b>IUHS</b>) is a major concern for realizing full production potential in the swine industry. Postnatal phenotypes, such as growth performance, post-absorptive metabolism, and stress response, are negatively altered in pig offspring that have been exposed to IUHS. With current trends in global temperatures predicting a continuation of increased temperatures, it is necessary to further investigate mechanisms driving these altered postnatal phenotypes and to find mitigation strategies to combat the negative effects of IUHS. In a first study, postnatal consequences of IUHS in pigs were evaluated and a mitigation strategy was tested. A second study was conducted to investigate the HPA axis response to a stress challenge in IUHS pigs. The first study found decreased average daily gain in IUHS pigs, and that providing a nutrient-dense diet did not rescue this lost productivity due to a decrease in feed intake for this diet. These results show the importance of maintaining beneficial gestation environments to avoid IUHS and the need to continue looking for alternative strategies to mitigate negative effects of IUHS. In the second study, IUHS pigs had a decreased change in cortisol response (<b>Δ CORT</b>) from baseline when subjected to a corticotropin-releasing hormone (<b>CRH</b>) challenge at 10 wk of age, and 15 wk old pigs had a decreased Δ CORT response when subjected to a dexamethasone suppression test and a CRH challenge as well as decreased glucocorticoid receptor expression in both the hypothalamus and anterior pituitary when compared to 10 wk old pigs. These results show changes in HPA axis function as young pigs mature and that particular focus may need to be put on IUHS pigs at a young age when they might be more vulnerable to negative impacts of stress. Overall, these studies show that IUHS causes a variety of negative postnatal effects in offspring and that a better understanding of mechanisms driving these changes along with developing alternative strategies to combat the incidence of these negative postnatal effects remains of paramount importance for the swine industry.</p>

For this study 14 lambs were obtained, which were split into two groups; a control group (CON) and a group that was supplemented Reed Sedge Peat (RSP). We wanted to test whether RSP could decrease stress at weaning, increase immune response and also increase digestibility of the animal. Lambs were subjected to an ACTH challenge 48 hours post weaning. After weaning (d 28 of study) 10 of the lambs (5 CON; 5 RSP) also underwent a digestibility challenge. We found that there was no difference (P = 0.8764) within cortisol concentration during the weaning portion of the study between the two treatment groups. During the ACTH challenger there was a difference between RSP group and CON, where RSP had a decrease in cortisol concentration (P = 0.0892). There was no difference in blood cell parameters, except for SEG, % (P = 0.0890) where RSP had greater % of SEG than CON group. Within the digestibility trail there was a decrease in digestibility within the RSP group compared to CON, within DM, OM, NDF and ADF (P = 0.0458; P = 0.0430; P = 0.0509; P = 0.0786; respectively).

Holmström, M & Jangvert, M Protokolliserad urträning från respirator. Att ha en plan är viktigare än hur den ser ut och en plan fungerar bara om du använder den. Examensarbete i omvårdnad 15 högskolepoäng. Malmö högskola: Hälsa och samhälle. Utbildningsområde omvårdnad 2011.Respiratorbehandling är en livsavgörande behandlingsinsats för kritisk sjuka in-tensivvårdspatienter. När patienten börjar tillfriskna från sin underliggande sjukdom trappas respiratorbehandlingen ut. Urträning – ”weaning” från respiratorn kan göras på olika sätt. Protokolliserad urträning har i flera studier visats förkorta respiratortiden men används inte överallt. Syftet med denna litteraturstudie var att studera standardiserade protokoll utformade för att underlätta weaning och andra faktorer av betydelse för en fungerande weaning. Vad utmärker de protokoll som visats underlätta weaning? Vad krävs förutom protokoll för att underlätta weaning? Efter att inklusionskriterier och exklusionskriterier utarbetats valdes tio artiklar inom aktuellt område ut - nio kvantitativa och en kvalitativ - från en litteratursökning i PubMed och Cinahl. Artiklarna granskades, analyserades och gemensamma teman för respektive artikel identifierades och omformulerades till rubriker som innehållet infogades under. Resultatet av denna litteraturstudie visade att utformningen av weaningprotokollet verkar vara mindre väsentligt än att det verkligen finns ett protokoll att arbeta efter. Ett protokolliserat arbetssätt är dock inte enda lösningen – målmedveten utbildning krävs för att ett nytt arbetssätt ska fungera. / Holmström, M & Jangvert, M Protocolized weaning from the ventilator. To have a plan is more important than how it is constructed and a plan only works if you use it.Degree Project, 15 Credit Points. Malmö University: Health and Society, Department of Nursing, 2011.Ventilator treatment is lifesaving for the most critically ill patients in an intensive care unit. However, when the patient recovers from illness, ventilator treatment is withdrawn. The process of weaning the patient from the ventilator can be done in different ways. Protocolized weaning has in several studies been shown to shorten the duration of mechanical ventilation but is not the standard of care in all intensive care units. The aim of the present study was to investigate standardized wea-ningprotocols. What parameters define the protocols that can be shown to shorten weaning? Since many factors might be presumed to influence weaning, the aim of the present study was also to determine other possibly important factors than the protocols themselves. Ten studies – nine with a quantitative approach and one with a qualitative approach – were found in a literature search in Pubmed and Cinahl. The studies were analyzed and topics were identified and used for structuring the data from the studies. The conclusion of the present study was that the design of the weaningprotocol seems less important than the existence of protocolized weaning. However, protocolized weaning as such was not enough for success – ambitious education on the usage of the protocol was essential for a suc-cessful weaningprotocol.

Breastfeeding offers significant benefits to the breastfed infant as well as the breastfeeding woman. The World Health Organization now recommends exclusive breastfeeding until six months, followed by supplementation and continued breastfeeding to two years or more. Around the world, public health programs endeavour to promote breastfeeding through educational programs. In Brazil, such programming is widespread, and yet less than 30% of women in São Paulo breastfeeding exclusively even to four months post-partum. This study uses a qualitative-quantitative bio-experiential approach to explore the way that stressful experiences and circumstances in the lives of low-income women from the Eastern Zone of São Paulo, Brazil, influence their decision to wean or supplement their infant before 12 weeks post-partum. Sixty-five first-time mothers participated in a 12-week longitudinal study of life stressors and breastfeeding practice. Participants were asked to complete one pre-partum and six post-partum interviews. Narrative and biological data were collected from each participant at each interview. Statistical analysis revealed that among these participants the breastfeeding hormone oxytocin did not mediate breastfeeding duration. Oxytocin appeared to act as a biomarker of stressful experience, while Epstein-Barr Virus antibody titre, a commonly used biological measure of psychosocial stress, did not. Unplanned pregnancy, older age and higher mean oxytocin level were statistically associated with weaned outcome at 12 weeks. Unplanned pregnancy, older age, higher mean oxytocin level, higher mean satisfaction score regarding financial situation and lower mean satisfaction score regarding interpersonal factors were associated with decreased duration of any breastfeeding. Unplanned pregnancy, older age and lower mean satisfaction score regarding interpersonal factors were associated with decreased duration of exclusive breastfeeding. Ethnographic analysis revealed that the effect of unplanned pregnancy may be connected to the discourse of the self-sacrificial, child-centric “good mother.” Exclusive breastfeeding was seen as a hallmark of this idealised maternal type. Single women with unplanned pregnancies expressed a great deal of ambivalence towards their own maternity and toward the somewhat unobtainable good mother ideal, especially with relation to the physical and psychological challenges breastfeeding. Women’s ambivalence appeared to influence their decisions to supplement or wean their infants by or before 12 weeks post-partum.

This thesis examines breastfeeding, weaning, and the post-weaning diets of 18 adults (18y+) and two subadults (aged 10y – 14y) from the rural Imperial Roman (1st – 4th c. CE) site of Vagnari, located in southern Italy. The investigation used a new method to sample dentine sections that accounts for the oblique nature of dentine development and allowed for the assignment of age categories to diagenetically altered teeth without visible dentine lines. The results indicate Vagnari children were weaned by ~3.5y, and that some males appear to have been breastfed longer than females. Despite the similar ages-at-weaning across the sample, the individuals in this study demonstrated a variety of weaning rates (i.e., speeds or paces), post-weaning dietary trends, and changes in diet across the life course. Some individuals (n = 6) appear to have been weaned rapidly, marked by significant removal of breastmilk prior to 2.5y, with small amounts of breast milk remaining in the diet until ~3.5y. Other children (n = 9) were weaned gradually, with slow, consistent removal of breastmilk until as late as 5.0y. Throughout and after the weaning period, children were fed a diet based on C3 plants and terrestrial proteins such as wheat, goat/sheep, and their by-products. A comparison of early life dentine and adult bone collagen signals for 14 individuals revealed changes in diet with increasing age, in which most people had increased access to higher terrestrial food sources such as pork and/or small amounts of marine food later in life. However, there was notable variation in dietary trends and practices across the sample, suggesting diverse dietary patterns among people from Vagnari. / Thesis / Master of Arts (MA) / In this thesis, I used samples from tooth dentine to analyze longitudinal stable isotope data for breastfeeding, weaning, and post-weaning dietary signals in a sample of 20 individuals from the Roman Imperial estate of Vagnari (1st – 4th c. CE) located in southern Italy. On average, children were weaned by ~3.5 years of age. Despite the similar age-at-weaning across the sample, individuals exhibited different weaning patterns and diversity in early life dietary practices at Vagnari. During and after weaning, the isotope data indicate that children were fed with C3 plants (e.g., wheat) and terrestrial proteins such as sheep/goat and pig. I analyzed childhood and adult diet by comparing dentine stable isotope data to bone collagen results from a sub-sample of 14 individuals. There was variability between the childhood dentine data and the adult bone collagen data, where individuals appeared to eat more pork and small amounts of fish later in life. This is the first study to explore breastfeeding and weaning practices of rural Roman children in southern Italy using stable isotope analysis of tooth dentine.

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