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CONTEXT: Of the members of a family, the mother is without doubt the most important one, which provides justification for including an evaluation of her mental health as one of the variables to be considered as determining factors in each child's level of development. OBJECTIVE: To assess the impact of the application of Neurolinguistic Programming (NLP) on child development, home environment and maternal mental health. DESIGN: Randomised controlled trial. SETTING: The study included children enrolled in the municipal day care center of a shantytown in the City of São Paulo. PARTICIPANTS: 45 pairs of mothers and respective children between 18 and 36 months of age. MAIN MEASUREMENTS: Children's development (Bayley scales); home environment variation (HOME); and maternal mental health (SRQ). Comparison between before and after the intervention was made in terms of children's psychomotor development, home environment and maternal mental health. INTERVENTION: Application of the NLP technique to the experimental group and comparison with a control group. 1--Experimental (EG), consisting of 23 children submitted to intervention by NLP; and 2--Control (CG), with 22 children with no intervention. Length of intervention: 15 sessions of NLP. RESULTS: 37 children remained in the study (EG = 10, CG = 27). Variations in mental development (OR 1.21, IC 95% 0.0 to 23.08) in their home environment (Wilcoxon): p = 0.96 (before) and p = 0.09 (after); in maternal mental health: p = 0.26, 2 df. CONCLUSIONS: There was a trend that indicated positive effects on the home environment from the intervention.

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The objective of this study is to assess the anthropometric evolution of children who had been assisted by the Malnourished Children's Recuperation Program in the town of Embu, as well as to analyze some variables that interfered in this evaluation. The study included 233 children aged under five, enrolled in the program from January 1984 to December 1985. 201 (86,3%) were undernourished grade II and 32 (13,7%) grade III, according to Gomez. The percentage increase of Weight in relation to Age (W/A) and Height in relation to Age (H/A) - outcome variables, in the first and last examinations in the program - were analyzed, using the multiple linear regression. Younger children and in worse nutritional conditions showed higher W/A and H/A increases. Low birth weight, more frequent examinations, and longer stay in the program were associated to lower W/A increases. The presence of chronical pathologies jeopardized the H/A rate increases. This result strengthens the importance of developing programs for the assistance of undernourished children, due to higher risk of morbi-mortality in this group, mainly in younger children and with worse nutritional conditions.

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Mothers of malnourished children were evaluated by psychologist, nutritionist, social worker and pediatrician with the objective of verifying in which ways the psychological, social and nutritional aspects interact. All mothers were from the low socioeconomic level, with extremely low family incomes, lower school levels were predominant,with 57.6% up to 4 years of formal education; 27.3% of the mothers were single, 48.5% single with male partners, 18.2% married and 6% separated. Main personality traits found: immaturity, difficulties in relationships, low self-regard, feelings of insufficiency/inferiority, aggressiveness. The intellectual level was average or below average in 82.6%. Concerning food preparation,we observed that 80% were disorganized and showed poor hygiene, 64% did not show interest, 77% wasted foodstuffs, 61.9% were insecure in handling foods and 37% prepared foods with inadequate aspect and consistency. Results confirm that social aspects effectively are a risk factor for malnutrition in families from the low socioeconomic level. Other aspects are also very relevant, since certain characteristics of the mothers personality disturb her performance and determine external disorder and absence of interest during preparation of meals, an activity directly related to child care.

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Colostrum of high and low (LSEL) socioeconomic level adolescent mothers was analyzed to determine the potential influence of adolescence on colostrum's chemical composition. Concentrations of total fat, energy, total protein, immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin G and fatty acids were compared to those of adult mothers. The colostrum of adolescent mothers showed significantly higher levels of IgA and IgM compared to that of adults. Concentrations of lauric, myristic, and palmitic acids were lower in the group of LSEL adolescents, when compared to those of adult mothers of the same socioeconomic level, probably due to lower lipogenic activity in the former. High levels of stearic and oleic acids were found in LSEL adolescents in comparison to LSEL adults, despite similar dietary habits. Our results show that breast-feeding by adolescent mothers of any socioeconomic level is as indicated as that by adult mothers.

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The levels of certain components, notably total protein, total fat, energy, and fatty acids, of mature milk from 48 adolescent and 44 adult mothers was studied. These two groups were subdivided into high and low socioeconomic level (SEL). All mothers were primiparous, eutrophic, and with term pregnancy; and their newborns weighted over 2500 g at birth. The age factor appeared to have significant influence on the concentration of total protein, with higher levels in the group of adolescent mothers possibly as a compensatory mechanism to maintain the caloric value of the milk. The fatty acid content was altered significantly by the SEL probably due to the direct effect of maternal diet. The milk in adolescent mothers of low SEL demonstrated higher concentration of lauric and myristic acids, while the milk in low SEL adults contained higher proportions of linoleic and linolenic acids. The milk in adult mothers of high SEL demonstrated higher concentrations of palmitic, palmitoleic, and oleic acids. The different feeding habits of two socioeconomic groups may explain these results. The regular intake of soya oil, corn oil, and margarine by the urban population in general resulted in higher levels of linoleic acid in the milk of all groups studied.

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We have studied the alkaline ribonuclease (RNase) activity in maternal serum and serum of full-term small- (T-SGA), full-term appropriate- (T-AGA) and preterm appropriate-for-gestational age (PT-AGA) newborns. A significantly lower level of RNase was observed in T-AGA and T-SGA newborns on the 30th day of age and in PT-AGA newborns on the 15th and 30th days of age, as compared to other T-AGA, T-SGA and PT-AGA groups of infants at birth. RNase activity was significantly higher in cord blood than in the maternal blood in all categories studied. Moreover, in preterm newborns, RNase activity in cord blood was significantly higher in those presenting a lower gestational age. We did not observe any significant difference in RNase levels in the cord blood of newborns from the 3 categories studied. The same results were observed concerning maternal blood. We, therefore, conclude that RNase activity in cord blood or in maternal blood is not a very satisfactory indicator of fetal malnutrition.

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The effect of protein-calorie malnutrition during gestation on the brain amino acids of rat pups was studied following nutritional recovery during lactation. The brain amino acids of rat pups born to dam rats malnourished during gestation were studied after these rat pups received proper nutrition during lactation. Pregnant rats were fed a 1% protein diet with total caloric intake restricted to half that of controls. After birth, the offspring of rats fed on deficient diets were nurtured up to the 28th day postpartum by foster mothers receiving adequate diets. At this time, the offspring were killed. The control group consisted of offspring from pregnant rats fed a diet with adequate protein (21%) and calories during the entire gestation and lactation period. Quantitation of brain amino acids in the pups at 28 days postpartum showed lower concentrations of essential and nonessential amino acids in the rats malnourished during gestation. Concentrations of histidine, glycine, and alpha-aminobutyric acid were all reduced. These findings demonstrate that the brains of rat pups malnourished during gestation show persistent decreases in specific brain amino acids after adequate postpartum nutrition.

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Rats were submitted to protein-calorie deprivation during different periods of gestation and the body weight and mortality of offspring were evaluated at 0, 28 and 90 days of age. The body weight was considered adequate (n) when the values were up to 2 SD below the mean values of control animals, or inadequate (d) when the values were below 2 SD. Rats of the control group (C) were fed ad libitum (protein 21%), and the rats of the experimental groups were fed during all gestational period (D), during the first half (D1) or second half of pregnancy (D2), with a diet containing 1% of protein, and the intake reduced to 50%. Significant differences were observed in the ponderal evolution for all experimental groups. Group D was the most damaged, with the greatest ponderal deficiency and the greatest mortality rates. Similar behavior was observed for D2. Group D1 was similar to C with the best results and the lowest mortality rate.

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Rats were submitted to protein-caloric deprivation during different periods of gestation. Maternal body weight gain, duration of pregnancy and number of offspring were evaluated. Rats of the control group (C) were fed ad libitum (protein 21%), and rats of the experimental groups were fed during all gestational period (D), during the first half (D1) or second half of pregnancy (D2) with a diet containing 1% of protein, and the intake was reduced to 50%. We concluded that malnutrition during pregnancy induced lower maternal weight (C greater than D1 greater than D2 greater than D) and lower number of offspring ( [C = D1] greater than D2 greater than D). No differences were observed in the duration of pregnancy in all groups studied.

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An attempt was made to point out the alterations in serum calcium, phosphorus and magnesium, during gestation in female rats fed ad libitum normal diets (protein content, 21%), a protein-calorie deficient diet (protein content, 1%) in a quantity equal to half of that given to normal rats. As the data revealed, in the control group of pregnant rats a significant increase in calcium on the 17th and 19th days was observed, as well as a decrease at the end of gestation. The values remained at higher levels in this group than those detected in the control non-pregnant rats. The above-mentioned increase was not observed in the undernourished pregnant rats, which showed an evident decrease. The behavior of phosphorus in the control pregnant rats was similar to calcium behavior, but this "ion" had not suffered the influence of malnutrition when isolatedly imposed. With regard to magnesium, we noticed that throughout the experiment serum concentration was not influenced either by malnutrition or by gestation. Malnutrition itself was the greatest responsible factor as judged by the differences observed among the groups.

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