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This cross-sectional study aimed to assess whether levels of anxiety, perceived stress, and self-perception of happiness during the Covid-19 pandemic were lower among Tai Chi (TC) practitioners. An online questionnaire was applied from September 2020 to November 2021 through email list and instant messaging application "WhatsApp". In total 368 individuals, 341 of whom did not practice TC, coming from a university and sports academies and 27 TC practitioners from the Brazilian Society of TC and Oriental Culture were included. Sociodemographic, mental health, habits related to physical activity and the State Anxiety Inventory (STAI), Perceived Stress Scale (PSS14) and the Andrews Faces Scale were collected to assess level of state-anxiety, perceived-stress, and self-perception of happiness, respectively. Each independent variable with the outcome variables (severe anxiety level, severe stress level, moderate/severe stress level and self-perception of happiness) were analyzed for simple and multiple logistic regression model. Individuals who do not practice TC are more likely to have a severe level of anxiety (OR=3.55; CI95%CI: 1.37-9.20) and a moderate/severe level of stress (OR=2.60; 95%CI: 1.07-6.35), p<0.05. TC practitioners are more likely to perceive themselves as happy than non-practitioners (OR=3.18; 95%CI: 1.16-8.71), p<0.05. Do not practice regular physical activity (OR=2.88; 95%CI:1.50-4.34); (OR=1.7; 95%CI: 95%: 1.09-2.74) and being young were associated with high levels of stress, p<0.05. The TC practice during the pandemic promoted lower level of perceived stress, state anxiety and greater self-perception of happiness, showing the importance of TC practice and maintaining the frequency of physical activity during the pandemic.

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Resumo Após 15 anos de promulgação da política nacional, muitas unidades de saúde ainda não implantaram as Práticas Integrativas e Complementares em Saúde. As razões para esse afastamento da Atenção Primária à Saúde na Região Metropolitana de Goiânia-GO, Brasil, ainda são desconhecidas. Assim, este estudo objetiva compreender como os gerentes percebem as dificuldades de implantação e implementação das Práticas Integrativas e Complementares em Saúde na Atenção Primária à Saúde. Trata-se de um estudo qualitativo, descritivo e exploratório, realizado com 24 gerentes de unidades básicas de saúde mediante entrevistas semiestruturadas e analisadas segundo a estrutura de conteúdo de Bardin. Os gerentes imputam a impossibilidade da oferta a fatores como sobrecarga do trabalho, falta de apoio financeiro, material e organizacional por parte das secretarias de Saúde, preconceito, infraestrutura inadequada, inexistência de recurso financeiro e insuficiência de formação em serviço. Portanto, concluímos que a implementação das Práticas Integrativas e Complementares em Saúde é incipiente na Atenção Primária à Saúde por conta, principalmente, de barreiras estruturais, organizacionais, culturais e educacionais. Esses resultados podem colaborar na resolução desses obstáculos, para que as Práticas Integrativas e Complementares em Saúde possam ser oferecidas aos usuários do Sistema Único de Saúde de forma mais equânime.

Abstract After 15 years of promulgating the national policy, many health units still have not implemented the Integrative and Complementary Practices. The reasons for this departure from Primary Health Care in the Metropolitan Region of Goiania-GO, Brazil, remain unknown. Thus, this study aims to understand how managers perceive the difficulties of implementing and implementing Integrative and Complementary Health Practices in Primary Health Care. This qualitative, descriptive, and exploratory study was carried out with 24 managers of basic health units through semi-structured interviews, transcribed and analyzed according to Bardin's content structure. Managers attribute the absence of Integrative and Complementary Practices in Primary Health Care to factors such as work overload, lack of support from the health secretariats, prejudice, inadequate infrastructure, lack of financial resources, and insufficient in-service training. Therefore, we conclude that Integrative and Complementary Practices are absent from Primary Health Care, mainly due to structural and organizational barriers. These results may imply the resolution of these obstacles so that Integrative and Complementary Practices can be offered to users of the Unified Health System more equitably.

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Este estudo teve como objetivo sistematizar os resultados das pesquisas que investigaram a relação entre a prática de TC e a saúde de indivíduos com Hipertensão Arterial Sistêmica (HAS) e Diabetes Mellitus (DM). Realizou-se uma revisão integrativa da literatura e foram realizadas buscas nas bases de dados PubMed, SciELO, LILACS e BVS. Foram incluídos estudos publicados nos últimos 20 anos em inglês, português e espanhol, que discorreram sobre a temática da prática de TC em indivíduos com HAS e DM. Foram excluídos estudos que não atenderam a temática proposta, não disponíveis na íntegra, duplicatas, revisões, anais de congresso, literatura cinzenta e livros. Foram identificados 21 estudos, com delineamentos diversos, realizados em sua maioria na China (n=12), que demonstraram o impacto positivo do engajamento na prática de TC na saúde de indivíduos com HAS e DM, como redução da pressão arterial, controle glicêmico e lipídico. Foram descritos também benefícios em outros aspectos físicos e psicossociais importantes para a manutenção do bem-estar e melhor qualidade de vida. Alguns estudos não descreveram resultados significantes associados à prática de TC . Em contrapartida, a maior parte dos estudos revisados relataram benefícios à saúde de indivíduos com HAS e DM associados à prática de Tai Chi.

This study aimed to systematize the results of research that investigated the relationship between the practice of TC and the health of individuals with Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM). This is an integrative review in whicha search was conducted in the PubMed, SciELO, LILACS, and BVS databases. Studies published in the last 20 years, in English, Portuguese and Spanish, which discussed the theme of the practice of Tai Chi in individuals with SAH and DM, were included. Studies that did not meet the proposed theme, not available in full, duplicates, reviews, conference proceedings, gray literature and books were excluded. Twenty-one studies were identified, with different designs, carried out mostly in China (n=12), which demonstrated the positive impact of engaging in this bodily practice on the health of hypertensive and diabetic patients, such as blood pressure reduction, glycemic and lipid control. Benefits in other physical and psychosocial aspects that are important for the maintenance of well-being and better quality of life were also described. Some studies did not describe significant results associated with the practice of CT. In contrast, most of the studies reviewed reported health benefits for individuals with SAH and DM associated with the practice of Tai Chi.

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This intervention follow-up study evaluated anxiety and stress levels and self-perceived happiness of individuals linked to the health field who did not practice Tai Chi and compared these variables before and after practicing this art. One hundred twenty-three participants were subdivided into two groups: G1) Older health professionals (n=41) and G2) Younger pre-university students interested in the health field (n=82). Participants received a 60-minute Tai Chi class. The Perceived Stress Scale (PSS-14) was applied before the practice, and the State-Trait Anxiety Inventory (STAI) and Andrews Face Scale were used before and after the class. Generalized linear models and the Bowker symmetry test were applied for data analysis. 46.3% and 30.5% of participants in G1 and G2 had mild stress levels, and 43.9% and 46.3% had moderate stress levels, respectively. After practicing Tai Chi, both groups presented significantly lower mean anxiety scores. In G1, 31.7% of participants went from moderate to mild anxiety levels after practice, 19.5% from severe to moderate, and 7.3% from severe to mild. In G2, 28.2% of participants went from moderate to mild anxiety levels after practice, 18.3% from severe to moderate, and 6.1% from severe to mild. Furthermore, 100.0% of individuals in G1 and 96.3% in G2 were happy after the class. Tai Chi was effective in reducing anxiety levels and improving self-perceived happiness.

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A Síndrome da Morte Súbita do Lactente é definida como a morte de qualquer lactente com menos de um ano de idade, sendo a posição de dormir, em posição prona, é o mais importante fator de risco. Assim, a divulgação maciça dos fatores de risco para essa síndrome é fundamental para que principalmente as mães saibam seus fatores e consigam evitar esse acidente. Dessa forma, o objetivo desse estudo foi verificar o conhecimento das mães sobre os fatores de risco e de proteção sobre a síndrome da morte súbita do lactente e sua associação às condições socioeconômicas e demográficas. Participaram 502 mães de crianças que estiveram presentes na vacinação da poliomielite. Foram coletadas informações socioeconômicas, demográficas e o conhecimento das mães sobre os fatores associados à síndrome. Realizado teste qui-quadrado, para associar a variável dependente (número de acerto das mães) com as independentes (socioeconômicas e demográficas). Foi utilizada análise de variância (ANOVA) para idade, renda e grau de escolaridade e modelo linear generalizado, para exclusão social. A maioria das mães (72,34%) relatou já ter ouvido falar sobre a síndrome, porém, apenas 51,9% sabia descrevê-la. Houve associação entre menor acerto nas questões (p=0,0001) e nunca ter ouvido falar sobre a síndrome. Mães que não ouviram falar e acertaram menos questões moravam em bairros com índice de exclusão social pior do que as que já ouviram falar. Conclui-se que, mães que nunca ouviram falar sobre a síndrome e consequentemente acertaram menos questões, moravam em bairros com índice de exclusão social pior do que as que já ouviram falar sobre a síndrome. Entretanto, dentre todos os fatores relacionados à síndrome, a posição de dormir foi aquela com maior número de acerto pelas mães.

Sudden Infant Death Syndrome is defined as the death of any infant under one year of age, with a sleeping position, in the prone position, being the most important risk factor. Thus, the massive dissemination of risk factors for this syndrome is fundamental so that mothers, specifically, would know these factors and be able to avoid this accident. Therefore, the objective of this study was to verify the knowledge of mothers about the risk and protective factors for sudden infant death syndrome and its association with socioeconomic and demographic conditions. 502 mothers of children who went for a polio vaccination participated. Socioeconomic and demographic information and mothers' knowledge of factors associated with the syndrome were collected. A chi-square test was performed to associate the dependent variable (number of mothers' correct answers) with the independent variables (socioeconomic and demographic data). Analysis of variance (ANOVA) was used for age, income, and level of education and a generalized linear model for social exclusion. Most mothers (72.34%) reported having heard about the syndrome; however, only 51.9% knew how to describe it. There was an association between lower accuracy in the questions (p=0.0001) and never having heard about the syndrome. Mothers who had not heard about it and got fewer questions right lived in neighborhoods with a worse social exclusion index than those who had already heard about it. It is concluded that mothers who had never heard about the syndrome and consequently answered fewer questions correctly, lived in neighborhoods with a worse social exclusion index than those who had already heard about the syndrome. However, among all the factors related to the syndrome, the sleeping position was the one with the highest number of correct answers by the mothers.

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Resumo Este artigo explora sentidos e significados do trabalho odontológico no SUS, no contexto da relação profissional-paciente. Pesquisa qualitativa com 20 cirurgiões-dentistas que atuavam em um município paulista de médio porte, abordada por meio de três grupos focais, com a pergunta disparadora "Qual é o sentido ou significado do seu trabalho, aqui na prefeitura, para você?". O material foi áudio-gravado, transcrito na íntegra e analisado pelo método de análise de conteúdo temática. Procedemos a realização de leitura flutuante, categorização e discussão dos achados junto aos pares de pesquisadores para validação final. Como resultados, aponta-se a construção das categorias 1) Estranheza às necessidades percebidas pelos pacientes e a consequente medicalização da vida, e 2) Poder e consumo como significados da prática. O trabalho do cirurgião dentista, nesse contexto, evidenciou as diferenças entre as necessidades percebidas pelo paciente e aquelas que o dentista considera. Além disso, revelou o poder que emana da assimetria entre paciente e profissional como dificultador da produção de autonomia do paciente. Tais significações parecem trazer sofrimento para esses profissionais no seu trabalho. Concluiu-se que há necessidade de reflexão sobre o trabalho em saúde como forma de se evitar sofrimento, e que a prática desses dentistas é carregada de sentidos e significados.

Abstract This study explores the senses and meanings attributed to dental work in the Brazilian National Health System (SUS) focusing on dentist-patient relations. A qualitative research was conducted with 20 dentists working in a medium-sized municipality in São Paulo, divided into three focus groups and asked the guiding question "What sense or meaning do you attribute to your work here in the city?" Data were audio-recorded, fully transcribed, and analyzed using thematic content analysis. Floating reading, categorization, and peer discussion of the findings were performed for the final validation, resulting in two categories: 1) Strangeness to patients' needs and the subsequent medicalization of life, and 2) Power and consumption as meanings of practice. In this context, the dental practices showed the differences between patients' needs and those considered relevant by dentists. It also showed the power imbalance between patients and professionals as a hindrance to patients' autonomy. Such meanings seem to cause suffering to these professionals. In conclusion, reflections on health work are paramount to avoid suffering and understand that the practice of these dentists bears many senses and meanings.

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ABSTRACT: This study aimed to know perception of the marital subsystem (parents) and to understand the dynamics of the family system in offer of pacifiers. Ten couples, parents of children between 4 and 7 years old, were interviewed by means of a semi-structured script of questions about the offer of pacifiers for their children. Answers by qualitative method of content analysis, using predefined categories of the General Systems Theory (homeostasis, circularity, globality, non- summativity, morphogenesis and equifinality). Pacifier offer reestablished the Homeotasis related to adaptation of mother in postpartum period; in introduction of artificial nipples due to allergy to breast milk and to avoid thumb sucking. Circularity occurred in paternal support to stimulate breastfeeding and in offer of pacifier to reduce the dependence of baby regarding the mother. Globality occurred when offer of pacifier softened mastitis and colic of baby. Non-somivity was evidenced in the mother's attitude in controlling behavior of children with offer of pacifier. Morphogenesis predominated in influence of extern al systems (health, school, kinship, marketing and social media) on family decision to offer pacifiers. Offer of pacifiers interfe red in Equifinality, favoring the organization of family system in face of complications in breastfeeding. Offer of pacifier sought to meet emergency needs of baby, although there was a perception of consequences for child's health in long term. General Theory of Systems allowed verifying the dynamics of family system, which can be applied by health professionals in order to understand the factors involved in offer of pacifiers.

RESUMEN: Este estudio tuvo como objetivo conocer la percepción del subsistema conyugal (padres) y comprender la dinámica del sistema familiar en la oferta de chupetes. Se entrevistó a diez parejas, padres de niños entre 4 y 7 años, mediante un guión semiestructurado de preguntas sobre la oferta de chupetes para sus hijos. Respuestas por método cualitativo de análisis de contenido, utilizando categorías predefinidas de la Teoría General de Sistemas (homeostasis, circularidad, globalidad, no sumatividad, morfogénesis y equifinalidad). La oferta de chupete restableció la Homeotasis relacionada con la adaptación de la madre en el puerperio; en la introducción de pezones artificiales por alergia a la leche materna y para evitar chuparse el dedo. Ocurrió circularidad en el apoyo paterno para estimular el amamantamiento y en la oferta del chupete para reducir la dependencia del bebé con respecto a la madre. La globalidad ocurrió cuando la oferta del chupete suavizó la mastitis y el cólico del bebé. La no somividad se evidenció en la actitud de la madre en el control de la conducta de los niños con oferta de chupete. Predominó la morfogénesis en la influencia de los sistemas externos (salud, escuela, parentesco, marketing y redes sociales) en la decisión familiar de ofrecer chupetes. La oferta de chupetes interfirió en la Equifinalidad, favoreciendo la organización del sistema familiar frente a las complicaciones en la lactancia. La oferta del chupete buscó atender las necesidades de emergencia del bebé, aunque hubo una percepción de consecuencias para la salud del niño a largo plazo. La Teoría General de Sistemas permitió verificar la dinámica del sistema familiar, que puede ser aplicada por los profesionales de la salud para comprender los factores involucrados en la oferta de chupetes.

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This study evaluated patients´ anxiety levels related to dental radiographic examinations in addition to dentists' perception and management. Salivary alpha-amylase (sAA) activity of 47 patients was measured before and after exposure to radiographic examinations to assess their anxiety level and compared using Wilcoxon test. Mann-Whitney test assessed the sAA activity related to sex, type of examination, and previous experience with radiographic examinations. 50 dentists were interviewed using a semi-structured script containing open-ended questions perception on their patients' anxiety. Before the radiographic examination, sAA activity was significantly higher for women (p ≤0.05). SAA activity significantly increased after the examination for men, patients of both sexes with no previous experience and for those who underwent CBCT (p≤0.05). Anxiety was reported to be observed in adult patients' speech and pediatric patients' behavior. Dental radiographic examinations may be a source of anxiety for women before the examination. After the examination, men, patients with no previous experience, and those subjected to CBCT present higher anxiety levels. Dentists perceive anxiety in adult and pediatric patients differently.

Este estudio evaluó los niveles de ansiedad en los pacientes relacionados con exámenes radiográficos dentales, además de la percepción y el manejo de los dentistas. Se midió la actividad de la alfa-amilasa salival (sAA) de 47 pacientes antes y después de la exposición a exámenes radiográficos para evaluar su nivel de ansiedad y se comparó mediante la prueba de Wilcoxon. La prueba de Mann-Whitney evaluó la actividad de la sAA relacionada con el sexo, el tipo de examen y la experiencia previa con exámenes radiográficos. Se entrevistó a 50 dentistas utilizando un guión semiestructurado de preguntas abiertas sobre la percepción de la ansiedad de sus pacientes. Antes del examen radiográfico, la actividad de la sAA era significativamente mayor para las mujeres (p≤0.05). La actividad de SAA aumentó significativamente después del examen para los hombres, pacientes de ambos sexos sin experiencia previa y para los que se sometieron a CBCT (p≤0.05). Se informó que se observa ansiedad en el habla de los pacientes adultos y en el comportamiento de los pacientes pediátricos. Los exámenes radiográficos dentales pueden ser una fuente de ansiedad para las mujeres antes del examen. Tras la exploración, los hombres, los pacientes sin experiencia previa y los sometidos a CBCT presentan niveles de ansiedad más elevados. Los dentistas perciben la ansiedad en los pacientes adultos y pacientes pediátricos de manera diferente.

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Aim: The present study sought to investigate dental caries experience and its association with sociodemographic, postnatal and breastfeeding variables in children in the agerange from 6 to 71 months of age, in the Xingu Indigenous Park, Mato Grosso, Brazil. Methods: This was an analytical cross-sectional study that used secondary data pertaining to 402 indigenous children of the Low, Middle and Eastern Xingu regions, who participated in the Oral Health Epidemiological Survey in 2013. The dependent variable was dental caries, dichotomized by the median (dmf-t≤1 and dmf-t>1). The data of independent variables were obtained by means of instruments of the Local Health Information System of the Xingu Indigenous Special Sanitary District (DSEI). Raw analyses were performed to test the association of the independent variables with the dependent variable. The variables were tested in the multiple logistic regression model. Results: The mean value of the dmf-t index was 2.60 and the prevalence of affected children was 51%. In the multiple analysis, only children older than 36 months (OR: 6.64; CI95%: 4.11 to 10.73) and those that were breastfed for a longer period of time (OR: 1.88; CI95%: 1.16 to 3.02) showed significant association with the dmf-t>1 index. Conclusion: Childhood dental caries among indigenous children was associated with age and breastfeeding prolonged for over 26 months, therefore, pointing out the need to offer dental follow-up care at earlier ages

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It is well recognized that pacifier habit leads to occlusal and orofacial functional changes in children. However, the effects of the interruption of prolonged pacifier habit on the development of the dento-facial complex has not yet been fully characterized. Thus, the aim of this study was to investigate the influence of pacifier removal on aspects of oro-dentofacial morphology and function in preschool children. For that, a pacifier group (n = 28) and a control group (n = 32) of 4-year-old children with and without pacifier habit, respectively, were followed up by a group of dentists and speech therapists at baseline, 6 and 12 months after habit removal. Bite force and lip pressure were assessed using digital systems, and the evaluation of breathing and speech functions was performed using validated protocols, together with the measurements of dental casts and facial anthropometry. The Two-way mixed model ANOVA was used in data analysis. After 12 months, a decrease in malocclusion frequency was observed in pacifier group. Additionally, a change over time was observed in facial, intermolar and palate depth measurements, as well in bite and lip forces and speech function scores, increasing in both groups (p < 0.01). The upper and lower intercanine widths and breathing scores differed between groups at baseline and changed over time reducing the differences. The presence of speech distortions was more frequent in the pacifier group at baseline and decreased over time (p < 0.05). The interruption of pacifier habit improved the maxillary and mandibular intercanine widths, as well as the breathing and speech functions, overcoming the oro-dentofacial changes found. Trial Registration: This clinical trial was registered in the Brazilian Clinical Trials Registry (ReBEC; http://www.ensaiosclinicos.gov.br/), protocol no. RBR-728MJ2.

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OBJECTIVE: To investigate association between parental locus of control (belief of individuals about what or who has control of the events of their lives) and bottle feeding habits among children from 3 to 5 years of age. METHODOLOGY: Parental locus of control validated in Brazil, and semi-structured questionnaire to obtain sociodemographic, health, and oral habit behaviors was applied to mothers of 992 preschool children. Outcome variable "use of feeding bottle" was studied according to the time of its use (≤36 months and >36 months). Simple logistic regression models were adjusted and raw odds ratios were estimated for variables of distal blocks, which contemplated parental locus of control, socioeconomic characteristics of family, and maternal habits. In the intermediate block, the variables for conditions of the child's birth and place of health care attendance during the prenatal period and early childhood were included. In the proximal block, the time of breastfeeding and pacifier use were reported. Variables were analyzed from the distal to the proximal block, and the individual analyses that presented p≤0.20 remained in each model; included in the subsequent block were the variables with p≤0.10, because this was a study of prevention. RESULTS: Longer time of feeding bottle use was associated with the internal parental locus of control, mothers older than 31 years of age, white race, premature children, who used pacifiers and are treated in the private health system. CONCLUSIONS: Children who maintained the habit of feeding bottle use for a longer time were those whose mother presented an internal locus of control.

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OBJECTIVE: To analyze the scientific literature on Baby-Led Weaning with an integrative literature review to identify risks and benefits. DATA SOURCE: The databases used were: National Library of Medicine (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde), US National Library of Medicine (PubMed), and Virtual Health Library (BVS - Biblioteca Virtual em Saúde) in December 2017. The inclusion criteria established were publications in English with the descriptor "baby-led weaning" in the heading, abstract, or keywords, classified as original articles, of primary nature, and available online and in full. We excluded review articles, editorials, letters to the editor, critical commentaries, and books on the subject, as well as articles not available in full and duplicates. DATA SUMMARY: We identified 106 articles, of which 17 met the selection criteria. The Baby-Led Weaning method was significantly associated with the baby's satiety, the start of complementary feeding, and adequacy of weight gain. On the other hand, choking and the intake of micronutrients were negatively associated, however with no statistical differences. CONCLUSIONS: Despite the benefits found, the risks still deserve attention and should be investigated with longitudinal randomized controlled studies to ensure the safety of the method when practiced exclusively.

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O objetivo foi identificar o impacto da depressão pós-parto no aleitamento materno e no desenvolvimento infantil. Tratou-se de uma Revisão Integrativa de Literatura realizada a partir da busca de artigos nas bases de dados Pubmed e Biblioteca Virtual em Saúde. Inicialmente foram encontrados 1.413 artigos, entretanto, após aplicação dos critérios de exclusão, foram selecionados oito artigos. A sintomatologia da depressão pós-parto materna pode ter implicações no aleitamento materno e, também, implicações duradouras no desenvolvimento infantil, que podem estender-se até a vida adulta. A literatura evidenciou que intervenções precoces e preventivas envolvendo mães com sintomas sugestivos de depressão pós-parto são necessárias e reduzem o impacto deste quadro no aleitamento materno e no desenvolvimento infantil, principalmente se forem identificadas e tratadas no período pré-natal. Os profissionais de saúde são uma rede de apoio essencial na identificação e encaminhamento de mães com sinais sugestivos de depressão pós-parto para avaliação,tratamento e rede de apoio.(AU)

The objective was to identify the impact of postpartum depression on breastfeeding and child development. This was an Integrative Literature Review based on the search articles in the Pubmed and Virtual Health Library databases. Initially, 1413 articles were found, however, after applying the exclusion criteria, eight articles were selected. Symptoms of maternal postpartum depression may fave implications for breastfeeding as well as lasting implications for child development, wich may extend into adulthood. The literature has shown that early and preventive interventions involving mothers with symptoms suggestive of postpartum depression are necessary and reduce the impact of this condition on breastfeeding and child development, especially if they are identified and treated in the prenatal period. Health professionals are an essential support network in the identification and referral of mothers with signs suggestive of postpartum depression for evaluation, treatment and support network.(AU)

El objetivo fue identificar el impacto de la depresión posparto en la lactancia materna y el desarrollo infantil. Esta fue uma Revisión Integral de Literatura basada en la búsqueda de artículos em las bases de datos Pubmed y Biblioteca Virtual em Salud. Inicialmente, se encontraron 1413 artículos, sin embargo, después de aplicar los criterios de exclusión, se seleccionaron ocho artículos . Los sintomas de la depresión pós-parto materna pueden tener implicaciones para la lactancia materna, así como implicaciones duraderas para el deserrollo infantil, que puedem extenderse hasta la edad adulta. La literatura ha demostrado que las intervenciones tempranas y preventivas que involucran a madres con síntomas sugestivos de depresión posparto son necesarias y reducen el impacto de esta afección en la lactancia materna y el desarrollo infantil, especialmente si se identifican y tratan en el período prenatal. Los profesionales de la salud son una red de apoyo esencial en la identificación y derivación de madres con signos que sugieren depresión posparto para evaluación,tratamento y red de apoyo.(AU)

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ABSTRACT Objective: To analyze the scientific literature on Baby-Led Weaning with an integrative literature review to identify risks and benefits. Data source: The databases used were: National Library of Medicine (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde), US National Library of Medicine (PubMed), and Virtual Health Library (BVS - Biblioteca Virtual em Saúde) in December 2017. The inclusion criteria established were publications in English with the descriptor "baby-led weaning" in the heading, abstract, or keywords, classified as original articles, of primary nature, and available online and in full. We excluded review articles, editorials, letters to the editor, critical commentaries, and books on the subject, as well as articles not available in full and duplicates. Data summary: We identified 106 articles, of which 17 met the selection criteria. The Baby-Led Weaning method was significantly associated with the baby's satiety, the start of complementary feeding, and adequacy of weight gain. On the other hand, choking and the intake of micronutrients were negatively associated, however with no statistical differences. Conclusions: Despite the benefits found, the risks still deserve attention and should be investigated with longitudinal randomized controlled studies to ensure the safety of the method when practiced exclusively.

RESUMO Objetivo: Analisar a literatura científica referente ao desmame guiado pelo bebê (Baby-Led Weaning) por meio de revisão integrativa de literatura a fim de identificar riscos e benefícios. Fonte de dados: As bases de dados utilizadas foram: National Library of Medicine (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), US National Library of Medicine (PubMed) e Biblioteca Virtual em Saúde (BVS); e a busca foi realizada em dezembro de 2017. Os critérios de inclusão estabelecidos foram publicações em inglês com o descritor "baby-led weaning" no título, resumo ou palavras-chave em artigos classificados como originais de natureza primária, disponibilizados online e na íntegra. Excluíram-se artigos de revisão, editoriais, cartas ao editor, comentários críticos e livros abordando o assunto, assim como artigos não disponíveis na íntegra e duplicatas. Síntese dos dados: Identificaram-se 106 artigos, dos quais 17 faziam parte do critério de seleção. O método Baby-Led Weaning teve associação significativa com a saciedade do bebê, início da alimentação complementar e adequação de ganho de peso. Já o engasgo e a ingestão de micronutrientes foram associados negativamente, contudo sem diferenças estatísticas. Conclusões: Apesar dos benefícios apontados, os riscos ainda merecem atenção por meio de pesquisas longitudinais controladas e randomizadas para fornecer mais segurança para a sua prática de forma exclusiva.

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It has been postulated that oral health-related quality of life (OHRQoL) may be affected by the sense of coherence (SOC), but there are no epidemiological studies investigating this association in Brazilian adults. The present study was conducted among adults of a mid-sized Brazilian city, with the aim of looking into this association. The probability sampling consisted of 342 adults aged 35-44 years old, from a mid-sized Brazilian city, who were examined at their homes for caries (Decayed, Missing and Filled Teeth [DMFT] Index) and periodontal disease (Community Periodontal Index - CPI), according to WHO criteria. The questionnaire applied included demographic factors, socioeconomic information, use of dental services, behavior, SOC and the Oral Health Impact Profile (OHIP). The OHIP outcome, measured by prevalence of the impact, was analyzed by binary logistic regression using a hierarchical approach, a conceptual model, and a 5% significance level. A total of 67.9% of the respondents had one or more impacts on OHRQoL, and 54.4% showed a high SOC. The impact on OHRQoL was more prevalent in adults who had a manual occupation (PR = 2.47, 95%CI 1.24-4.93), those who perceived the need for dental treatment (PR = 2.93, 95%CI 1.67-5.14), and those who had untreated caries (PR = 1.93, 95%CI 1.07-3.47). Those with a low SOC had a twofold higher prevalence of impact on OHRQoL (PR = 2.19, 95%CI 1.29-3.71). This impact on OHRQoL was associated with a low SOC, even after adjusted by socioeconomic, behavioral and clinical factors. Future studies should consider the SOC in determining the oral health impact on quality of life.

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O objetivo desse artigo foi identificar os tratamentos sugeridos na literatura para tratamento de lesão e dor mamilar durante o aleitamento materno. Trata-se de uma Revisão Integrativa de Literatura, realizada na base de dados Pubmed e LILACS, onde foi encontrado oito artigos. A maioria dos estudos adotou a correção da pega associados ao uso de pomadas a base de lanolina para o tratamento da dor e trauma mamilar. Outros tratamentos indicados incluíram o uso leite materno além de medicamentos tópicos e orais, porém observou-se que somente houve evidência estatisticamente significante o uso de lanolina. Conclusão: A correção da pega e o uso da lanolina mostraram serem eficazes para o tratamento da dor e fissura mamária.(AU)

The objective of this article was to identify the treatments suggested in the literature for the treatment of nipple injury and pain during breastfeeding. It is an Integrative Review of Literature, carried out in the Pubmed database and LILACS, where eight articles were found. Most studies have adopted the correction of the handle associated with the use of lanolin-based ointments for the treatment of pain and nipple trauma. Other indicated treatments included the use of breast milk in addition to topical and oral medications, but it was observed that there was only statistically significant use of lanolin. Conclusion: Handle correction and lanolin use have been shown to be effective for the treatment of breast pain and fissure.(AU)

El objetivo de este artículo fue identificar los tratamientos sugeridos en la literatura para el tratamiento de la lesión del pezón y el dolor durante la lactancia. Es una Revisión Integrativa de Literatura, realizada en la base de datos Pubmed y LILACS, donde se encontraron ocho artículos. La mayoría de los estudios han adoptado la corrección del mango asociada con el uso de ungüentos a base de lanolina para el tratamiento del dolor y el traumatismo del pezón. Otros tratamientos indicados incluyeron el uso de leche materna además de medicamentos tópicos y orales, pero se observó que solo había un uso estadísticamente significativo de lanolina. Conclusión: la corrección del mango y el uso de lanolina han demostrado ser efectivos para el tratamiento del dolor y la fisura en los senos.(AU)

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Impact of maternal self-efficacy and associatedfactors on maintaining exclusive breastfeeding in the city of Piracicaba-SP: Cohort study

Impacto da autoeficácia materna e fatores associadosna manutenção do aleitamento materno exclusivo nomunicípio de Piracicaba-SP: Estudo de Coorte

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We evaluated the association between quality of life, family cohesion and sociodemographic factors of beneficiary families of the BolsaFamília Program (PBF). This was an analytical, cross-sectional study with exploratory methodology. The sample was composed of 385 respondents. The dependent variable was the quality of life (WHOQOL-BREF), and the independent variables were sociodemographic characteristics, self-rated health, family cohesion and adaptability (FACES III). The best quality of life was associated with an age younger than or equal to 36 years (OR = 2.15), higher educational level (OR = 1.54), good/very good health (OR = 6.39), not having current health problem (OR = 5.68), no treatment (OR = 1.76), moderate (OR = 3.39) and high (OR = 3.66) family cohesion and moderate adaptability (OR = 2.23). Individuals from families with moderate and high family cohesion were more likely to have a better quality of life than those from families with low cohesion. The male volunteers were 3.54 times more likely to have a better quality of life. It was concluded that moderate and high levels of cohesion may impact positively to the quality of life of persons receiving the PBF, indicating that social programs should seek to strengthen these dynamics.

Avaliou-se a associação entre qualidade de vida, coesão familiar e fatores sociodemográficos de famílias beneficiárias do Programa Bolsa Família (PBF). Estudo transversal, analítico e de caráter exploratório com amostra representativa de 385 entrevistados. A variável dependente foi a qualidade de vida (WHOQOL-BREF), e as variáveis independentes quantificadas em características sociodemográficas, autopercepção sobre saúde, coesão e adaptabilidade familiar (FACES III). A melhor qualidade de vida associou-se com idade menor ou igual a 36 anos (OR = 2,15), maior nível educacional (OR = 1,54), boa/muito boa saúde (OR = 6,39), não ter problema de saúde atual (OR = 5,68), sem tratamento (OR = 1,76), moderada (OR = 3,39) e alta (OR = 3,66) coesão familiar e moderada adaptabilidade (OR = 2,23). Indivíduos provenientes de famílias com moderada e alta coesão familiar tiveram mais chance de ter uma melhor qualidade de vida do que aqueles vindos de famílias com baixa coesão. Os voluntários do sexo masculino tiveram 3,54 vezes mais chance de apresentar uma melhor qualidade de vida. Concluiu-se que níveis moderados e altos de coesão podem impactar positivamente uma melhor qualidade de vida das pessoas beneficiárias do PBF, indicando que as ações sociais devem buscar o fortalecimento dessa dinâmica.

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BACKGROUND: As sex estimation is an important step to delineate the biological profile, the development of tools employing anatomical structures which may maintain their integrity even after extreme events, such as the maxillary sinus, become useful for forensic identification. Thus, the aim in the present study was to develop and validate a formula for sex estimation through measurements in the maxillary sinuses in a Brazilian population, using cone beam computed tomography (CBCT) scans. MATERIAL AND METHODS: Linear and volumetric measurements in the maxillary sinus were performed bilaterally in 94 CBCT scans from 45 males (mean age 25.2 ± 0.79) and 49 females (mean age 23.7 ± 0.50). The OnDemand 3D software was employed for linear measurements (height, length and width of, and the largest distance between the right and left maxillary sinuses), while the ITK-SNAP 3.0 segmentation software was used to acquire the volume. The data obtained was applied to a mathematical model for sex estimation. To validate the developed formula, another sample composed of 60 CBCT images of Brazilian individuals was tested. RESULTS: Overall, maxillary sinuses' measurements were significantly higher in males, without statistically significant differences between the right and left sides within each group. The most dimorphic measurement was the height, with an accuracy of 77.7% regarding sex estimation. The formula created lead to a sex estimation of 87.8% for females and 80% for males, with an overall accuracy of 84%. When the formula validity was tested in another sample, it showed an accuracy of 82.4%. CONCLUSION: The formula developed through measurements in the maxillary sinus using CBCT scans showed an accuracy of 84% for sex estimation and can be applied as a complementary method for human identification in the Brazilian population.

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Objetivo:O objetivo deste estudo foi conhecer a conduta para as prescrições de antimicrobianos pelos cirurgiões-dentistas (CDs) da rede pública, de um município de médio porte do interior do estado de São Paulo. Métodos: todos CDs da rede pública do município de Piracicaba, São Paulo, foram convidados a participar (n = 79). A coleta de dados foi realizada em 2015, por meio de uma entrevista, questionário estruturado, como entrevista, nas unidades de saúde. O questionário continha questões sobre as características dos CDs, condições clínicas e sistêmicas que levariam ou não a prescrição de antibiótico, droga de escolha e forma de prescrição. Foi realizada a análise descritiva, utilizando o programa SPSS® (Statistical Package for the Social Sciences) versão 20.0 para Microsoft Windows.Resultados: no total, 74 CDs aceitaram participar da pesquisa, e 68,9% (n = 51) relataram prescrever antimicrobianos para abscesso localizado, alveolite seca, pulpite aguda. Situações sistêmicas que necessitam de profilaxia antibiótica eram desconhecidas pelos CDs, sendo que 56,8% (n = 42) não sabiam a conduta correta com a prescrição em casos de pacientes que fazem uso de bisfosfonatos e 35,0% (n = 26) após a quimioterapia. A droga de escolha de 97,3% dos CDs foi a amoxicilina. Conclusão: os resultados obtidos pelos relatos das condutas terapêuticas permitiram concluir que houve um excesso de prescrição de antibióticos, inclusive para situções clínicas que não havia necessidade, sendo o mais receitado a amoxicilina. Deve-se pensar no desenvolvimento de estratégias públicas de educação permanente, voltadas para os profissionais de odontologia, para o controle da resistência bacteriana. (AU)

Aim: This study sought to comprehend the conduct of antimicrobial prescriptions by dental surgeons (DSs) of the public network of a mid-sized municipality in the countryside of the state of São Paulo. Methods: All DSs of the public network of Piracicaba, São Paulo, were invited to participate (n = 79). Data collection was performed in 2015, through an interview, structured questionnaire, as an interview, in the health units. The questionnaire contained questions about the characteristics of DSs, clinical and systemic conditions that would or would not lead to antibiotic prescription, drug of choice, and prescription form. The descriptive analysis was performed using the SPSS ® software (Statistical Package for the Social Sciences) version 20.0 for Microsoft Windows. Results: A total of 74 DSs chose to participate in the study, and 68.9% (n = 51) reported prescribing antimicrobials for localized abscesses, dry alveolitis, and acute pulpitis. Systemic conditions requiring antibiotic prophylaxis were unknown by the DSs, and 56.8% (n = 42) did not know the correct conduct to be taken with the prescription in cases of patients taking bisphosphonates and 35.0% (n = 26) after chemotherapy. The drug of choice for 97.3% of the DSs was amoxicillin. Conclusion:The results from the reports of the therapeutic procedures led to the conclusion that there was an excess of antibiotic prescriptions, even for clinical situations that were not necessary, with amoxicillin being the most commonly prescribed. The development of public strategies of permanent education, aimed at dental professionals, to control bacterial resistance should be considered. (AU)

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