Speech therapy in food transition from probe to breast in newborn in kangaroo method

Objetivo: Verificar a relação entre idade gestacional e tempo de intervenção fonoaudiológica para início da alimentação via oral, quando utilizada a técnica de transição alimentar da sonda direta para o peito. Métodos: Trata-se de um estudo do prontuário médico/fonoaudiológico de 38 recém-nascidos de risco em Unidade Canguru. Foram coletados os seguintes dados: idade gestacional ao nascimento e corrigida, dias de vida, peso ao nascimento e atual, tipo e duração da intervenção fonoaudiológica, volume de dieta por sonda. Utilizou-se o tempo de uso de antibióticos e o suporte ventilatório como critérios de divisão dos recém-nascidos em dois grupos (G1 e G2). Na análise estatística, aplicou-se o teste não paramétrico de Mann-Whitney e o coeficiente de correlação de Pearson. Resultados: O tempo de intervenção para os recém-nascidos que receberem alta fonoaudiológica não apresentou resultados significativos entre os grupos (G1= 9,35 dias e G2= 10,12 dias), embora a hipótese inicial deste estudo fosse a de que os recém-nascidos do G1 necessitariam de menor período de atendimento fonoaudiológico que os do G2. Houve diferença estatisticamente significativa para o peso ao nascimento, entre G1 (1563,53 g) e G2 (1409,62 g). Conclusão: Quando utilizada a técnica de transição alimentar da sonda direta para o peito, em recém-nascidos de risco com média de idade gestacional semelhante e mesmo tempo de intervenção fonoaudiológica, os bebês demonstraram aptidão para coordenar os movimentos de sucção/respiração/deglutição, e consequentemente, a amamentação efetiva em seio materno exclusivo. _________________________________________________________________________________________ ABSTRACT: Purpose: Verify the relationship between gestational age and duration of speech therapy to start oral feeding, when used the technique of feeding transition of the probe directly to the chest. Methods: This is a study of newborn medical/speech records of 38 risk in Kangaroo unit. Were collected: gestational age at birth and corrected days of life, birth weight and current, type and duration of speech therapy, enteral feeding volume. We used time use of antibiotics and ventilatory support as criteria for division of newborns into two groups (G1 and G2). At the statistical analysis was applied the nonparametric test of Mann-Whitney and the Pearson’s correlation coefficient. Results: Intervention time for newborns were discharged speech showed no significant results between groups (G1 = 9.35 days and G2 = 10.12 days), although the initial hypothesis of this study was that the newborn G1 would require fewer days of speech therapy than the G2. There was statistically significant difference in birth weight between G1 (1563.53 g) and G2 (1409.62 g). Conclusion: It was observed that both groups started speech therapy and oral feeding practically medium of similar gestational ages and both speech intervention, demonstrating ability to coordinate sucking movements/breathing/swallowing, and consequently the effective and exclusive breastfeeding

Food consumed outside the home in Brazil according to places of purchase

ABSTRACT OBJECTIVE This study aims to describe the places of purchase of food consumed outside the home, characterize consumers according to the places of consumption, and identify the food purchased by place of consumption in Brazil. METHODS We have used data from the Pesquisa de Orçamento Familiar (Household Budget Survey) of 2008-2009 with a sample of 152,895 subjects over 10 years of age. The purchase of food outside the home was collected from the records of all expenditures made in seven days. The places of purchase were grouped according to their characteristics: supermarket, bakery, street food, restaurant, snack bar, fruit shop, and other places. The types of food were grouped into nine categories, considering the nutritional aspects and the marketing characteristics of the item. We have estimated the frequency of purchase in the seven groups of places in Brazil and according to gender and type of food purchased per place. We have calculated the average age, income and years of education, as well as the per capita expenditure according to places of purchase of food consumed outside the home. RESULTS The purchase of food outside the home was reported by 41.2% of the subjects, being it greater among men than women (44% versus 38.5%). Adults had a higher frequency (46%) than teenagers (37.7%) and older adults (24.2%). The highest frequency of places of purchase were snack bar (16.9%) and restaurant (16.4%), while the fruit shop (1.2%) presented the lowest frequency. Sweets, snack chips and soft drinks were the most purchased items in most places. Average expenditure was higher for restaurant (R$33.20) and lower for fruit shop (R$4.10) and street food (R$5.00). CONCLUSIONS The highest percentage of food consumed outside the home comes from snack bars and restaurants, pointing to important places for the development of public policies focused on promoting healthy eating

Social determinants of leprosy in a hyperendemic State in North Brazil

OBJECTIVE To identify the socioeconomic, demographic, operational, and health service-related factors associated with the occurrence of leprosy in a hyperendemic State in North Brazil. METHODS This is an ecological study based on secondary data from the Sistema de Informações de Agravos de Notificação in municipalities of the State of Tocantins from 2001 to 2012. Units of analysis were the 139 municipalities of the State. Negative binomial log linear regression models were used to estimate incidence rate ratios. RESULTS In bivariate analysis, the incidence rate ratios were significantly higher for municipalities with higher income ratio of the poorest 20.0% (1.47; 95%CI 1.19–1.81) and better Municipal Human Development Index (1.53; 95%CI 1.14–2.06). In multivariate analysis, the incidence rate ratios were significantly higher in municipalities with higher proportion of immigrants (1.31; 95%CI 1.11–1.55) and higher proportion of households with waste collection (1.37; 95%CI 1.11–1.69). There was a significant reduction in the incidence rate ratio with increased coverage of the Bolsa Família Program (0.98; 95%CI 0.96–0.99). CONCLUSIONS Control programs need to focus on activities in municipalities of greater social vulnerability with intersectoral investment for the improvement of the living conditions of the population.OBJETIVO Identificar fatores socioeconômicos, demográficos, operacionais e de serviços de saúde associados à ocorrência da hanseníase em um estado hiperendêmico do norte do Brasil. MÉTODOS Estudo ecológico com dados secundários do Sistema de Informações de Agravos de Notificação em municípios do estado do Tocantins de 2001 a 2012. As unidades de análise foram os 139 municípios do estado. Modelos de regressão log linear binomial negativa foram utilizados para estimar as razões de taxas de incidência. RESULTADOS Na análise bivariada, a razão de taxa de incidência foi significativamente maior para os municípios com maior razão de renda dos 20,0% mais pobres (1,47; IC95% 1,19–1,81) e melhor Índice de Desenvolvimento Humano Municipal (1,53; IC95% 1,14–2,06). Na múltipla, a razão de taxa de incidência foi significativamente superior em municípios com maior concentração de imigrantes (1,31; IC95% 1,11–1,55) e proporção de domicílios com coleta de lixo (1,37; IC95% 1,11–1,69). Houve redução significativa da razão de taxa de incidência com o aumento da cobertura do programa bolsa família (0,98; IC95% 0,96–0,99). CONCLUSÕES Os programas de controle precisam focar as atividades em municípios de maior vulnerabilidade social com investimentos intersetoriais para a melhoria das condições de vida da população