Efeitos da estimulação da sucção não nutritiva com dedo enluvado na transição alimentar em recém-nascido prematuro de muito baixo peso

Objetivos analisar os efeitos da estimulação da sucção não nutritiva com a técnica do dedo enluvado, sobre o início e a transição alimentar da via gástrica para a via oral em prematuros de muito baixo peso. Métodos estudo aleatório, prospectivo, longitudinal, experimental e controlado, que incluiu 40 prematuros internados na UTI Neonatal do Hospital de Clínicas, com idade gestacional £ 32 semanas e peso de nascimento £ 1500g, clinicamente estáveis. Os prematuros foram distribuídos aleatoriamente, por meio de sorteio, em 2 grupos: grupo controle, sem SNN e grupo experimental, com SNN com dedo enluvado, 3 vezes ao dia, 3 dias na semana. Foram avaliados critérios quanto ao escore da avaliação da prontidão para início da alimentação oral, intercorrências durante a sucção nutritiva (SN) e o tempo de transição alimentar. Resultados quando comparado o grupo experimental em relação ao grupo controle observou-se um escore significantemente maior na avaliação da prontidão para início da alimentação via oral, uma menor frequência de sinais de estresse durante a sucção nutritiva e um menor tempo de transição alimentar da via gástrica para via oral. Conclusão a estimulação da sucção não nutritiva com a técnica do dedo enluvado melhorou a prontidão do prematuro para início da alimentação via oral, diminuiu a frequência dos sinais de estresse durante a alimentação via oral e reduziu o tempo de transição alimentar no grupo experimental quando comparado ao grupo controle

The Formation of the First Massive Black Holes

Supermassive black holes (SMBHs) are common in local galactic nuclei, and SMBHs as massive as several billion solar masses already exist at redshift z=6. These earliest SMBHs may grow by the combination of radiation-pressure-limited accretion and mergers of stellar-mass seed BHs, left behind by the first generation of metal-free stars, or may be formed by more rapid direct collapse of gas in rare special environments where dense gas can accumulate without first fragmenting into stars. This chapter offers a review of these two competing scenarios, as well as some more exotic alternative ideas. It also briefly discusses how the different models may be distinguished in the future by observations with JWST, (e)LISA and other instruments.Comment: 47 pages with 306 references; this review is a chapter in "The First Galaxies - Theoretical Predictions and Observational Clues", Springer Astrophysics and Space Science Library, Eds. T. Wiklind, V. Bromm & B. Mobasher, in pres

Risk Factors for Type 2 Diabetes Mellitus in Children

This study investigates risk factors for type 2 diabetes mellitus in a population of children in public schools, Fortaleza, CE, Brazil. A total of 727 children aged 6 to 11 years old from 12 schools were evaluated between March and June 2008. A form addressing socio-demographic data, body mass index, blood pressure, capillary blood glucose and waist circumference was applied. A total of 54.1% of the children were female, 21.7% were overweight, 6.6% were obese, 27% had central obesity, 6.2% showed altered capillary glucose, and 17% high blood pressure. In relation to risk factors, 53.4% presented no risk factors; 24.3% had at least one factor and 18.8% two risk factors. Nurses can intervene in schools through educational health programs encouraging the adoption of healthy habits and identifying children at risk of type 2 diabetes mellitus.El estudio tuvo como objetivo identificar factores de riesgo para diabetes mellitus tipo 2 en una población de niños de escuelas públicas de Fortaleza, Brasil. Fueron evaluadas 727 niños de 6 a 11 años, de 12 escuelas, en los meses de marzo a junio de 2008. Fue aplicado un formulario abordando aspectos sociodemográficos, índice de masa corporal, presión arterial, glucemia capilar y, circunferencia de la cintura. Fue identificado que 54,1% de los sujetos eran del sexo femenino, 21,7% tenían exceso de peso, 27% obesidad central, 6,2% alteraciones en la glucemia y 17,9% presión arterial elevada. En relación a los factores de riesgo, 53,4% no lo presentaban, 24,3% tenían por lo menos un factor y 18,8% dos factores. La enfermería puede actuar en las escuelas por medio de acciones de educación en salud, incentivando la adopción de hábitos de vida saludables y identificando niños con riesgo para diabetes mellitus tipo 2.O estudo teve como objetivo identificar fatores de risco para diabetes mellitus tipo 2 numa população de crianças de escolas públicas de Fortaleza, CE, Brasil. Foram avaliadas 727 crianças de 6 a 11 anos de 12 escolas, nos meses de março a junho de 2008. Foi aplicado formulário abordando aspectos sociodemográficos, índice de massa corporal, pressão arterial, glicemia capilar e circunferência da cintura. Dos sujeitos, 54,1% eram do sexo feminino, 21,7% tinham excesso de peso, 27% obesidade central, 6,2% alterações glicêmicas e 17,9% pressão arterial elevada. Em relação aos fatores de risco, 53,4% não apresentavam, 24,3% tinham pelo menos um fator e 18,8%, dois. A enfermagem pode atuar nas escolas por meio de ações de educação em saúde, incentivando a adoção de hábitos de vida saudáveis e na identificação de crianças com risco para diabetes mellitus tipo 2

How are gender equality and human rights interventions included in sexual and reproductive health programmes and policies: A systematic review of existing research foci and gaps

The importance of promoting gender equality and human rights in sexual and reproductive health (SRH) programmes and policies has been affirmed in numerous international and regional agreements, most recently the 2030 Agenda for Sustainable Development. Given the critical role of research to determine what works, we aimed to identify research gaps as part of a broader priority setting exercise on integrating gender equality and human rights approaches in SRH programmes and policies. A systematic literature review of reviews was conducted to examine the question: what do we know about how research in the context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research. We searched three databases for reviews that addressed the research question, were published between 1994-2014, and met methodological standards for systematic reviews, qualitative meta-syntheses and other reviews of relevance to the research question. Additional grey literature was identified based on expert input. Articles were appraised by the primary author and examined by an expert panel. An abstraction and thematic analysis process was used to synthesize findings. Of the 3,073 abstracts identified, 56 articles were reviewed in full and 23 were included along with 10 from the grey literature. The majority focused on interventions addressing gender inequalities; very few reviews explicitly included human rights based interventions. Across both topics, weak study designs and use of intermediate outcome measures limited evidence quality. Further, there was limited evidence on interventions that addressed marginalized groups. Better quality studies, longer-term indicators, and measurement of unintended consequences are needed to better understand the impact of these types of interventions on SRH outcomes. Further efforts are needed to cover research on gender equality and human rights issues as they pertain to a broader set of SRH topics and populations.Scopu