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Cell division in Escherichia coli is intricately regulated by the MinD and MinE proteins, which form oscillatory waves between cell poles. These waves manifest as concentration gradients that reduce MinC inhibition at the cell center, thereby influencing division site placement. This study explores the plasticity of the MinD gradients resulting from the interdependent interplay between molecular interactions and diffusion in the system. Through live cell imaging, we observed that as cells elongate, the gradient steepens, the midcell concentration decreases, and the oscillation period stabilizes. A one-dimensional model investigates kinetic rate constants representing various molecular interactions, effectively recapitulating our experimental findings. The model reveals the nonlinear dynamics of the system and a dynamic equilibrium among these constants, which underlie variable concentration gradients in growing cells. This study enhances quantitative understanding of MinD oscillations within the cellular environment. Furthermore, it emphasizes the fundamental role of concentration gradients in cellular processes., (© 2024 Parada et al.)

Background and Aims: The inflammatory response in preterm parturition is regulated by the innate immune system. Toll-like receptors (TLR)-2 and TLR-4 are innate immune receptors that recognize the microorganisms most frequently involved in amniotic cavity infections, which are associated with activating the inflammatory response at the maternal-fetal interface during preterm labor. This study aimed to evaluate the expression of TLR-2 and TLR-4 in maternal neutrophils in preterm labor., Methods: A cross-sectional study was conducted in the Obstetrics Care Unit of Botucatu Medical School, UNESP, Brazil. The preterm group was composed of 20 pregnant women who presented preterm labor and preterm delivery. The control group was composed of 20 nonlaboring pregnant women matched to the preterm group by gestational age. Neutrophils were isolated from peripheral blood and TLR expressions were performed by real-time polymerase chain reaction and flow cytometry., Results: Gene expressions of TLR-2 and TLR-4 in neutrophils from the preterm group were statistically higher than expressions in neutrophils from the matched control group. The percentage of TLR-4+ neutrophils was higher in the preterm group than the matched control group, while the percentage of TLR-2+ neutrophils did not differ between groups., Conclusion: TLR-4 expression in maternal neutrophils is associated with spontaneous preterm labor., (© 2017 S. Karger AG, Basel.)

Background: The knowledge and practices of health professionals have a recognized role in behaviors related to the health of their patients. During pregnancy, this influence can be even stronger because there is frequent contact between women and doctors/nurses at periodic antenatal visits. When trained, supported and motivated, these professionals can act as health promoters. This study aimed to evaluate the effect of a focused educational intervention on improving the knowledge and practices of health professionals concerning diet and physical activity during pregnancy., Methods: A controlled, non-randomized study was performed to assess the effects of an educational intervention on the knowledge and practices of nurses and doctors who provide primary care to pregnant women. The intervention group, doctors and nurses (n = 22) from the family health units in a medium-sized city of São Paulo State, Brazil, received 16 h of training comprising an introductory course and three workshops, whereas the control group, doctors and nurses (n = 20) from traditional basic health units in Botucatu, did not. The professionals' knowledge was assessed at two time points, 1 month prior to and 1 year after the beginning of the intervention, using an ad hoc self-report questionnaire. The increases in the knowledge scores for walking and healthy eating of the intervention and control groups were calculated and compared using Student's t-test. To analyze the professionals' practice, women in the second trimester of pregnancy were asked whether they received guidance on healthy eating and leisure-time walking; 140 of these women were cared for by professionals in the intervention group, and 141 were cared for by professionals in the control group. The percentage of pregnant women in each group that received guidance was compared using the chi-square test and the Prevalence Ratio (PR), and the corresponding 95 % confidence intervals (CI) were calculated., Results: The intervention improved the professionals' knowledge regarding leisure-time walking (92 % increase in the score, p < 0.001). The women who were cared for by the intervention group were more likely to receive guidance regarding leisure-time walking (PR = 2.65; 95 % CI = 1.82-3.83) and healthy eating (PR = 1.76; 95 % CI = 1.34-2.31) when compared to the control group., Conclusion: It is possible to improve the knowledge and practices of health professionals through the proposed intervention aimed at primary health care teams providing antenatal care.

Objective: analyze the pertinence of calls made by obstetric users of the Mobile Emergency Care Service (SAMU 192) of Botucatu-SP., Method: retrospective and analytical research. All records of prehospital obstetric care delivered by the SAMU 192 in 2012 were analyzed. To be considered responsive, calls should lead to referral to a reference obstetric hospital or be classified with the colors red, orange and yellow, according to risk criteria defined by the Ministry of Health., Results: considering the two outcomes evaluated: referral to a reference hospital and risk criteria defined by the Ministry of Health, 6.7% and 75.6% of the calls were not pertinent, respectively. There was no matching between outcomes, neither variation between primiparas and multiparas as regards the call pertinence., Conclusion: this study ratifies the need for implementing a risk classification protocol in obstetrics, and support managers in the organization, qualification and effective implementation of the Rede Cegonha.

The importance of immunization among actions recommended in the prenatal period raises the possibility of protecting both the mother and the fetus against certain harmful diseases. The scope of this study was to assess the immunization coverage and associated factors of mothers whose deliveries occurred in the first half of 2012 in Botucatu, state of São Paulo. It is a cross-sectional study and data collection was performed in the two municipal maternity hospitals. Of the total births during the study period, 1318 mothers (90.3%) were included The data for the characterization of participants and their vaccination status (diphtheria, tetanus and hepatitis B) were obtained from the prenatal card, hospital records or interviews. For analysis of associated factors, the Chi-square test was used, with a 95% confidence interval and critical p of <0.05. Most of the study participants were 20 years old or more (84.4%), had seven years of schooling (69%), were monitored in prenatal care (99.2%) with seven or more appointments (88.9%). Miscarriage and infant death of 17.7% and 2.4% was recorded, respectively. Vaccination coverage was 68.4%. There was no association between sociodemographic and obstetric variables relating to prenatal care and vaccination of pregnant women.

Objective: To identify socio-demographic factors, characteristics and pregnancy complications associated with elective cesarean section., Methods: Cross-sectional study. A total of 1,295 births in the first semester of 2012 in Botucatu, São Paulo, Brazil, were evaluated in a large epidemiological study of maternal and child morbidity and mortality. This article compares women who had normal births (n = 405) with 214 undergoing elective cesarean section, defined as scheduled and without reference in hospital records or prenatal card of absolute, relative indication or any medical reason for that. Data were obtained from hospital records, prenatal card and interview with women, soon after parturition. Univariate analysis was conducted and evaluated by Fisher's exact or χ2 tests. Variables with p < 0.20 were grouped into three blocks and, by hierarchical multiple logistic regression model, the associated factors with elective cesarean section were identified, considering p < 0.05., Results: Socio-demographic variables (age ≥ 18 years, ≥ high school education, paid work and living with a partner) were independently associated with increased odds of elective cesarean section. Regardless of these, there was an association between elective caesarean section and prenatal and place of birth, with a higher chance of birth by elective caesarean section when the woman was assisted by the supplementary health network. Taking as indicators of unfavorable socioeconomic conditions the low education, the payment of prenatal and childbirth by the Unified Health System, it can be said that there was an association between elective caesarean section and better socio-economic conditions., Conclusion: Actions in the supplementary health network are required to approach the cesarean delivery rate in the municipality to the international recommendations.

This study sought to analyze the frequency of preterm births and identify the respective risk factors and their evolution over a decade (2001-2005-2010) in a city in São Paulo state. It is a time-series study using data from the Live Birth Information System. Univariate and multiple logistic regression were used to identify factors associated with preterm births, and linear regression was used to evaluate the time-series tendency of such factors in the period. To avoid underestimation, a correction factor was applied to the preterm frequencies obtained. A discrete increase in preterm birth was observed: 12.5%, 12% and 13.2%. After adjusting for confounding factors, maternal age equal to or higher than 35 years and cesarean sections were associated with higher chances for preterm births and increased over the decade. The number of births in high-risk hospitals and of women with fewer than seven prenatal consultations decreased during the period, while multiple pregnancies remained stable. Compared to vaginal births, cesarean sections doubled the chance of preterm birth. Among the five factors associated with preterm birth, three (cesarean sections, births in high-risk hospitals and fewer than seven prenatal consultations) can be modified by actions taken by health care services.

Context and Objective: Bacterial vaginosis occurs frequently in pregnancy and increases susceptibility to sexually transmitted infections (STI). Considering that adolescents are disproportionally affected by STI, the aim of this study was to evaluate the cervicovaginal levels of interleukin (IL)-1 beta, IL-6, IL-8 and bacterial sialidase in pregnant adolescents with bacterial vaginosis., Design and Setting: Cross-sectional study at mother and child referral units in Belém, Pará, Brazil., Methods: Vaginal samples from 168 pregnant adolescents enrolled were tested for trichomoniasis and candidiasis. Their vaginal microbiota was classified according to the Nugent criteria (1991) as normal, intermediate or bacterial vaginosis. Cervical infection due to Chlamydia trachomatisand Neisseria gonorrhoeae was also assessed. Cytokine and sialidase levels were measured, respectively, using enzyme-linked immunosorbent assays and MUAN conversion in cervicovaginal lavages. Forty-eight adolescents (28.6%) were excluded because they tested positive for some of the infections investigated. The remaining 120 adolescents were grouped according to vaginal flora type: normal (n = 68) or bacterial vaginosis (n = 52). Their cytokine and sialidase levels were compared between the groups using the Mann-Whitney test (P < 0.05)., Results: The pregnant adolescents with bacterial vaginosis had higher levels of IL-1 beta, IL-6 and IL-8 (P < 0.05). Sialidase was solely detected in 35 adolescents (67.2%) with bacterial vaginosis., Conclusions: Not only IL-1 beta and sialidase levels, but also IL-6 and IL-8 levels are higher in pregnant adolescents with bacterial vaginosis, thus indicating that this condition elicits a more pronounced inflammatory response in this population, which potentially increases vulnerability to STI acquisition.

Objective: To assess the health care process for women over 50 at a Family Health Unit based on the concept of programmatic vulnerability., Method: This study is inserted in the field of health care assessments. The framework proposed by Donabedian was used to analyze 90.5% of the 790 records of women registered at the unit., Results: It was observed that none of the women that did not have a diagnosed pathology attended the recommended consultations or underwent the recommended tests. Of the total number of women with hypertension or diabetes, 20.7% were registered in the Hiperdia Programme and less than 1.0% had attended the consultations and undergone the necessary tests. Only 11.9% of the women had had a gynaecological examination, a clinical breast examination and a mammography the year before data collection., Conclusion: It is concluded that women over 50 are in a situation of programmatic vulnerability in terms of the indicators established in this study. Knowledge of this reality can help nurses provide care that is best suited for this group.

Objective: To evaluate the structure, process and results of the Capillary Blood Glucose Self-monitoring Program in a Brazilian city., Method: Epidemiological, cross-sectional study. The methodological framework of Donabedian was used to construct indicators of structure, process and outcome. A random sample (n = 288) of users enrolled and 96 health professionals who worked in the program was studied. Two questionnaires were used that were constructed for this study, one for professionals and one for users, both containing data for the evaluation of structure, process and outcome. Anthropometric measures and laboratory results were collected by consulting the patients' health records. The analysis involved descriptive statistics., Results: Most of the professionals were not qualified to work in the program and were not knowledgeable about the set of criteria for patient registration. None of the patients received complete and correct orientations about the program and the percentage with skills to perform conducts autonomously was 10%. As regards the result indicators, 86.4% of the patients and 81.3% of the professionals evaluated the program positively., Conclusion: The evaluation indicators designed revealed that one of the main objectives of the program, self-care skills, has not been achieved.

Objective: The purpose of this study was to assess the cervicovaginal levels of proinflammatory cytokines in women with Chlamydia trachomatis (CT) infection in the presence of bacterial vaginosis (BV) and normal flora and to compare with those negative for CT., Materials and Methods: In this cross-sectional study, nonpregnant women were enrolled at 2 outpatient clinics and at 1 primary medical care unit in São Paulo State, Brazil. Cervicovaginal samples from 256 women with BV, of which 68 (26.6%) had concomitant CT infection and 188 (73.4%) were CT-negative, were measured for interleukin-1β (IL-1β), IL-6, and IL-8 by enzyme-linked immunosorbent assay. A matching number of samples from women with normal flora, CT-positive (n = 68) and negative (n = 188), were evaluated as control. Cytokine levels were compared by Mann-Whitney test and differences were considered significant at p < .05., Results: In CT-negative women, IL-1β was increased in BV (p < .001) when compared to normal flora, while the levels of IL-6 and IL8 were unchanged. The presence of CT infection was not associated with differences on cytokine levels in women with normal flora. However, women with BV had higher levels of IL-1β (p = .02), IL-6 (p = .02), and IL-8 (p = .03) in the presence of CT when compared to those who tested negative for CT., Conclusions: Detection of endocervical CT is associated with increased cervicovaginal IL-1β, IL-6, and IL-8 levels in women with concomitant BV but not in those with normal flora.

Objective: to analyze the production of knowledge resulting from the professional master's degree programs in Nursing and to reflect about their perspectives for the area., Method: descriptive and analytical study. Data collected from the dissertations of three educational institutions that graduated students in programs of professional master's degree in Nursing between 2006 and 2012 were included., Results: most of the 127 course completion studies analyzed were developed within hospital contexts; there was a focus on the organizational and healthcare areas, in the research fields care process and management, and predominance of qualitative studies. There are various products resulting from the course completion studies: evaluation of services/healthcare programs and development of processes, care or educational protocols., Conclusion: the programs of professional master's degree in Nursing, which are undergoing a consolidation stage, have recent production under development and there is a gap in the creation of hard technologies and innovation. They are essential for the development of innovative professional practices that articulate the healthcare and educational areas.

Objective: outline the profile of women living with the human immunodeficiency virus/aids in interior cities in São Paulo State, in the attempt to identify characteristics related to individual, social and programmatic vulnerability and to analyze the conditions in which they discovered their serological status., Method: between October 2008 and December 2010, a cross-sectional study was undertaken with 184 women attended at a specialized service. The data were collected through an interview and gynecological test, including the collection of samples for the etiological diagnosis of sexually transmissible conditions., Results: the women were predominantly white, between 30 and 49 years of age, lived with a partner, had a low education level, multiple sexual partners across the lifetime and unsafe sexual practices. The prevalence of sexually transmitted diseases corresponded to 87.0%., Conclusion: the study suggests the need to offer gynecological care in specialized services and the accomplishment of multiprofessional actions to reinforce the female autonomy in protective decision making.

Purpose: To evaluate the adequacy of gestational weight gain and to determine its association with maternal socioeconomic, demographic and nutritional factors and health care, to estimate the prevalence of low birth weight, macrosomia, preterm birth and cesarean delivery and to identify the association of these outcomes with the adequacy of weight gain., Methods: A cross-sectional study was performed in 2009/2010 to obtain socioeconomic, demographic, nutritional, dietary and physical activity data of pregnant women assisted by primary health care in a municipality of the state of São Paulo. Subsequently, data were collected from the medical records to evaluate gestational weight gain. Type of delivery, birth weight and gestational age at delivery were obtained from the Livebirths Information System. Gestational weight gain was evaluated according to the recommendations of the Institute of Medicine (2009). Associations were investigated by comparing the frequencies and by logistic regression, with excessive weight gain (yes, no) and insufficient gain (yes, no) being the dependent variables., Results: A total of 212 pregnant women were studied: 50.5% had excessive gain and 19.8% insufficient weight gain. Only prepregnancy nutritional status was associated with adequacy of weight gain: compared with normal weight, prepregnancy overweight women had a four-fold higher chance to gain excessive weight (OR 4.66, 95%CI 2.19-9.4). Nearly a third of babies were born by caesarian section, 5.7% were premature, 7.1% were underweight and 4.7% were macrosomic. There was no association between adequacy of gestational weight gain and these outcomes., Conclusion: The proportion of inadequate gestational weight gain was high. Overweight pregnant women have a four-fold higher chance to gain excessive weight, and priority should be given to actions promoting adequate prenatal weight gain.

This is a qualitative study seeking to understand Brazilian women's experience of urinary incontinence (UI) and design a representative theoretical model for the experience. Theoretical saturation occurred after analysis of the 18th non-directive interview in accordance with Grounded Theory. Two phenomena emerged: living with the challenges of UI and experiencing the hope and disappointment of rehabilitation from UI. Upon re-alignment of the components, the core category emerged, namely: between suffering and hope--rehabilitation from urinary incontinence as an intervening component. From the analysis in light of symbolic interactionism, pregnancy and vaginal birth were observed to be symbols of women's vulnerability to the suffering from living with the moral and physio-psychosocial challenges of UI. It is also inferred that the lack of consideration of the Unified Health System (SUS) in investing in the process of rehabilitation from UI may be having a negative effect on the incentive programs for promoting vaginal birth. Most of all, it reveals the ongoing suffering of women with UI, most of whom do not have access to rehabilitation due to the lack of programs geared to the real needs of these users of the Unified Health System.

Objective: To evaluate levels of proinflammatory cytokines and sialidase activity in aerobic vaginitis (AV) in relation to normal vaginal flora and bacterial vaginosis (BV)., Study Design: In this cross-sectional study, a total of 682 consecutive non-pregnant women attending the gynecology service were assessed and 408 women were included. Vaginal rinsing samples were collected from 223 women with microscopic finding of BV (n=98), aerobic vaginitis (n=25) and normal flora (n=100). Samples were tested for interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, and sialidase activity., Results: Compared to women with normal flora, vaginal levels of IL-1β were highly increased in both BV and AV (p<0.0001). Significantly higher vaginal IL-6 was detected in AV (p<0.0001) but not in BV, in relation to normal flora. Women with AV also presented increased IL-8 levels (p<0.001), while those with BV presented levels similar to normal flora. Sialidase was increased in BV and AV compared with the normal group (p<0.0001) but no difference in sialidase activity was observed between BV and AV., Conclusion: A more intense inflammatory host response occurs for AV than for BV when compared with normal flora. Furthermore, the increased sialidase activity in AV and BV indicates that both abnormal vaginal flora types can be harmful to the maintenance of a healthy vaginal environment., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

This article is part of a more comprehensive qualitative study which used grounded theory and symbolic interactionism as theoretical and methodological frameworks, resulting in the theoretical model entitled, Between suffering and hope: rehabilitation of urinary incontinence as an intervenient component. In order to communicate all the knowledge produced, part of this model is presented, and it refers to the process of coping with urinary incontinence by women without perspectives of access to surgical treatment after failure of conservative procedures. When interrelating the components (categories and subcategories) of these women's experience in order to compare and analyze them to understand their interaction, moral and psychosocial vulnerability were noticed within the experience of the group, which makes them susceptible to health risks and to compromise of their quality of life, observed in the movement of the group's experience. Research is needed to further understand experiences in which there are barriers to surgical treatment due to physicians' disbelief in its effectiveness.

Objectives: to evaluate the quality of the pre-natal care delivered in primary care, comparing the traditional model and the Family Health Strategy., Method: a service evaluation study, grounded in the public health policies. The data was obtained from interviews with managers, observation in the health centers, and analysis of patient records of pregnant women, selected at random. Differences in the indicators for structure and process were evaluated using the Chi-squared test, adopting p<0.05 as the critical value, calculation of the odds ratio, and confidence intervals of 95%., Results: Similar structures were evidenced in both models of care. Synthesis indicators for the process created in the present study, and those indicated by the public policies, indicated that the situation is more favorable in Family Health Centers. Regarding the set of activities called for in pre-natal care, the performance was flawed in both models, although it was slightly better in the Family Health Centers., Conclusion: the results indicate the need for actions to improve pre-natal care in the two models of primary care evaluated in the municipality.

Objectives: To investigate if the participation of Atopobium vaginae, Megasphaera sp. and Leptotrichia sp. in the bacterial community of bacterial vaginosis (BV) is associated with distinct patterns of this condition., Methods: In this cross-sectional controlled study, 205 women with BV and 205 women with normal flora were included. Vaginal rinsing samples were obtained for measuring the levels of pro-inflammatory cytokines and bacterial sialidases. Real-time PCR was used to quantify the BV-associated bacteria and to estimate the total bacterial load using the 16S rRNA. Principal component analysis (PCA) using the measured parameters was performed to compare the BV samples with lower and higher loads of the species of interest., Results: Higher bacterial load (p<0.001), levels of interleukin 1-β (p<0.001) and sialidase activity (p<0.001) were associated with BV. Women with BV and higher relative loads of A vaginae, Megasphaera sp. and Leptotrichia sp. presented increased sialidase activity, but unchanged cytokine levels. PCA analysis did not indicate a different pattern of BV according to the loads of A vaginae, Megasphaera sp. and Leptotrichia sp., Conclusions: Greater participation of A vaginae, Megasphaera sp. and Leptotrichia sp. in vaginal bacterial community did not indicate a less severe form of BV; moreover, it was associated with increased sialidase activity.

The objectives of this study were to describe a population of sex workers considering their sociodemographic characteristics, gyneco-obstetric history and behavioral factors, and to verify the association of these characteristics with the presence of sexually transmitted diseases. This epidemiological cross-sectional study was performed with 102 female sex workers. Data were collected using structured interviews and gold-standard exams for diagnosis of the diseases of interest. The women's mean age was 26.1 years. Most of them had attended school for nine years or more, were single and reported becoming sexually active before 15 years of age. Performing oral sex on partners was cited by 90.2% of women, and 99% reported the use of condoms at work; only 26.3% used condoms with permanent partners, and 42.2% used illicit drugs. No association was observed between sociodemographic factors, gyneco-obstetric history or behavioral factors and sexually transmitted diseases, which may have been due to their educational status and the fact that the population had very similar characteristics, thus making it difficult to determine such associations.

The aim was to evaluate the care for at-risk newborns under follow-up in their first year of life by the Growing Happily Program, developed in a city in inner São Paulo state. It is a population-based epidemiological health program evaluation study, which was based on the national guidelines of the Agenda of Commitments to Children and Child Mortality Reduction for data analysis. Results showed the program's institutional vulnerability, caused by problems related to its structure and process, with implications for its outcomes. Considering the adaptation of the criteria adopted by the Program for defining at-risk newborns, as well as the proposed interventions and strategies, in consonance with the Agenda of Commitments, the need for managers to make it a priority is appointed, by effectively including it in public health care policies to be developed in cities, in order to reverse the institutional vulnerability identified.

The aim of this study was to comprehend the experiences of family members regarding the oral health care of children. This was a qualitative study, conducted in 2007, in the health district of Ribeirão Preto, with 12 caregivers. The theoretical framework of vulnerability and the hermeneutical perspective were used. Three empirical categories were established: the meanings of oral health care, in search of the causes and prevention of oral diseases, and the reality of oral health services. Among other potentiating factors of infantile vulnerability to oral diseases, the overvaluation of biological causality, of high complexity care and of esthetic dentistry emerged, and among the protective factors, the valorization of popular knowledge and the integration of professional actions and knowledge were observed. This study indicates the necessity for a review of prevention and oral health promotion strategies and provides elements to assist health services to reorganize oral health care for children.

This study aimed to understand severe maternal morbidity from the perspective of women who experienced it. The methodological precepts of qualitative research were adopted and the Collective Subject Discourse was the methodological framework chosen. A total of 16 women who experienced severe maternal morbidity were interviewed. Results were discussed based on four themes: describing the desire and plan for having a child; acknowledging the health problem and its influence on pregnancy and on the conceptus; overcoming the initial shock postpartum, and experiencing the risk situation: desires, frustration, and overcoming. This study will contribute to qualifying nursing care, specifically acknowledging the diversity and breadth of the needs presented by women in situations of severe morbidity during the pregnancy-puerperal cycle.

This study identifies the prevalence of vaginal flora alterations in low-risk pregnant women and their association with reported symptoms and gynecological exams. This quantitative, descriptive, cross-sectional study was conducted in public primary care service units in Botucatu, SP, Brazil from 2006 to 2008 with 289 pregnant women from a stratified sample obtained by sampling by care unit. Tests of vaginal content were performed using Gram's method and testing for Trichomonas vaginalis using Diamond's medium. The prevalence of altered vaginal flora was 49.5%, of which bacterial vaginosis (20.7%), vaginal candidiasis (11.8%) and intermediate flora (11.1%) were the most frequent, not considering associations. Results revealed a high prevalence of vaginal flora alterations with little relation to symptoms, but in agreement with findings from the gynecological exams. Considering undesirable maternal and perinatal outcomes and feasible laboratory practices, the establishment of a routine for diagnosing vaginal flora alterations in low-risk pregnant women is suggested.

This study evaluated breastfeeding knowledge and practice of professionals who care for infants at health care services in a city in the interior of São Paulo, Brazil. This epidemiological study was carried out with a population of 89 nurses and physicians. Their answers to a structured questionnaire were analyzed in total and by place of work through the test for difference between proportions (Chi-square) with the level of significance at p<0.05. Data analysis was performed according to the Ministry of Health recommendations. The significant differences found for knowledge and practice, according to place of work, were restricted to certain aspects. Results of average scores were slightly better for professionals from the basic care units. Regular and poor performance were found in different studied aspects regardless of place of work, which suggest that potential educational interventions in this subject should include professionals at all levels of health care.

Anatomic and physiological alterations during pregnancy predispose pregnant women to urinary tract infections (UTI). This study aimed to identify the accuracy of the simple urine test for UTI diagnosis in low-risk pregnant women. Diagnostic test performance was conducted in Botucatu, SP, involving 230 pregnant women, between 2006 and 2008. Results showed 10% UTI prevalence. Sensitivity, specificity and accuracy of the simple urine test were 95.6%, 63.3% and 66.5%, respectively, in relation to UTI diagnoses. The analysis of positive (PPV) and negative (NPV) predictive values showed that, when a regular simple urine test was performed, the chance of UTI occurrence was small (NPV 99.2%). In view of an altered result for such a test, the possibility of UTI existence was small (PPV 22.4%). It was concluded that the accuracy of the simple urine test as a diagnostic means for UTI was low, and that performing a urine culture is essential for appropriate diagnosis.

Objectives: To study the trends and patterns of exclusive breastfeeding (EBF) for under-6-month-old infants in the city of Bauru, Brazil., Methods: Data from three methodologically equivalent cross-sectional surveys integrating the project for monitoring breastfeeding indicators in São Paulo state were compared. Infants aged zero to 6 months who attended one of the two phases of the Multivaccination Campaign in 1999, 2003 and 2006, respectively 496, 674 and 509 infants, were studied. Descriptive statistics were presented to compare the prevalence of EBF according to age (in months) and for the set of children under 6 months. The differences in prevalence were expressed in percentage and submitted to statistical tests (Pearsons chi-square and tendency), adopting p < 0.05 as the critical level. Factors associated with EBF interruption in 2006 were also studied by uni- and multivariate analysis., Results: Increase in EBF prevalence was found in under-6-month-old infants: in the 1999-2003 period, increase of 9.1%; in the 2003-2006 period, increase of 6.6%, thus reaching the annual increase rate of 2.3% in the first period and 2.2% in the second period. Significant inverse association was observed between EBF and the use of pacifiers (hazard ratio = 2.03; 95% confidence interval 1.44-2.84)., Conclusion: EBF prevalence in under-6-month-old infants in the city of Bauru, Brazil, increased almost threefold in the studied period, changing from 8.5% in 1999 to 24.2% in 2006, which represents an increase of 184.7%. The use of pacifiers was the only factor associated with greater chances of EBF interruption.

This study sheds light on the smoking pregnant women's outlook on cigarette use. The Theory of Social Representations was used as a theoretical reference. For data analysis, the Collective Subject Discourse was constructed. Of the 27 women that were interviewed, 18 had finished elementary education, 8 had completed secondary education, and one had college level education; 14 had a stable union and 6 were married. Four themes emerged from the interviews: (1) starting to smoke: a natural, social practice; (2) satisfaction versus guilt; (3) shattering news: effects of smoking on pregnancy; and (4) quitting: between will and ability. Pregnant women revealed negative ideas about smoking, considering smoking the worst of addictions and a potential cause for complications to the fetus and the mother. Smoking was represented in a prejudicial manner, disregarding the existence of treatment and the need for it. Emerging difficulties were related to quitting, for which professionals, information and adequate approaches for treatment and support for achieving success are utmost necessities.

This study aimed to evaluate care during childbirth and neonatal development in the interior of São Paulo in order to support managers responsible for formulating public policies on human development and allocating public resources to the women's healthcare. This epidemiological study focused on the evaluation of health services based on the observation of the assistance delivered by the Single Health System in 12 maternities and 134 delivers. The Brazilian Health Ministry or World Health Organization standards were adopted for comparison. The results revealed problems related to the structure of some maternities, where some well-proven practices in normal childbirth are still little used, whereas other prejudicial or ineffective ones are routinely used. Reversing this picture is essential in order to offer humanized quality care to women with consequent reductions in maternal and neonatal mortality rates, in such a way that the region achieves the millennium goals established for improving human development.

This study aimed to investigate complementary feeding practices during children's first year of life in Botucatu, SP, Brazil. Practices were described according to the age range and the breastfeeding (BF) practice. Data were collected during a multi-vaccination campaign through the interview of 1,238 individuals who accompanied children younger than one year old being vaccinated. Differences associated with the BF situation were identified by the chi-square test and Fisher's exact test. The early introduction of complementary food was observed, which led to the low frequency of exclusive breastfeeding (36.9% <4 months). Children younger than 4 months old consumed tea (30.7%); children between 4 and 6 months old consumed fruits (54.1%), soups (39.9%) and home-made food (19.2%). Juice was offered only to 15.2% of children younger than 4 months old who were completed weaned, 60% of the children was offered water. Data show that the consistence of the food consumed was inappropriate: children between 6 and 8 months old were offered the family's regular food (48.8%) and children older than 8 months (71.6%) were offered soup. Therefore, interventions focused on complementary feeding are justified on the city.

This study aimed to identify factors associated with exclusive breastfeeding (AME) and the reasons mothers presented to introduce complementary feeding in the first four months of life. A total of 380 mothers (92.2%) of children under four months old vaccinated in a Multi-vaccination Campaign were interviewed. To identify factors associated to AME, univariate and multiple logistic regressions analyses were performed. Thirty-eight percent of the children were on AME; 33.4% consumed cow milk; 29.2% tea; and 22.4% water. The mothers justified introduction of cow milk by factors related to quantity/quality of maternal milk and "necessity" of the child. The use of a pacifier (odds ratio=2.63; CI95%=1.7-4.06) and difficulty to breastfeed (odds ratio=1.57; CI95%=1.02-2.41) were associated with the absence of AME. The populational attributable risk percentage for the use of a pacifier was estimated at 46.8 %. Thus, modifiable risk factors were associated with AME interruption.

This study aimed to identify the prevalence of different types of breastfeeding and how they relate to maternal variables in the municipality of Conchas, São Paulo, Brazil, which is fully covered by the family health program. We collected information about the current eating habits of children under one year old who were attended during the 2003 Multivaccination Campaign. Associations were submitted to the chi-square test, adopting p<0.05 as the critical level. The prevalence rates for exclusive breastfeeding (EB) and predominant breastfeeding (PB) in 4-month-olds and younger were 25.4% and 44.4%, respectively, and 66.7% of the children under one were still being breastfed. Prevalence for EB in 6-month-olds and younger was heterogeneous, ranging from 7.4 to 41.2% according to the children's region of origin in the FHP. Difficulties at the beginning of breastfeeding were associated with lower prevalence rates for EB and PB. These results show a situation far from WHO recommendations and from that situation in which there is evidence that children's health receives maximum protection, reiterate the need to support mothers in the early puerperal period and demonstrate the importance of diagnoses separated per regions for actions aimed at promoting breastfeeding.

This qualitative study intends to understand the meaning of pregnancy for diabetic women. Semi-structured interviews were carried out and data were analyzed by means of the Collective Subject Discourse, identifying the following central ideas: "happiness about a desired pregnancy", "preoccupation with pregnancy and renouncement", "my pregnancy was planned", "I had other plans", "I feel what pregnant women feel", "I had many problems during pregnancy", "a child was everything that he wanted", "he didn't feel the same emotions as a woman", "I am controlling, doing everything the doctor says", "I am trying to follow a diet, but it is hard". These central ideas demonstrate that, among the diabetic pregnant women, planning and wanting the pregnancy and counting on the support of the family and/or companion were also essential for the treatment to be faced naturally and for the pregnancy to be experienced in a pleasant way.

Considering that infant mortality indicates the levels of health in the population, we have accomplished the foolwing work, which goals were to identify the causes of infancy mortality during the year of 1998 in Botucatu. The rate of infanty mortality obtained was as much as 12/1000 born alive with greater participation of the neonatal deaths-8,3/1000 born alive. Though most of deaths can be classified as reducible or partially reducible, but the necessary attention to make such reduction possible has varied. All the deaths that have occurred, 21.7% were classified as unavoidable, emphasizing that to reduce the rates of infant mortality, we must continue investing on the quality of health assistance as well as on the improvement of life conditions of the population.

Paternal participation in adolescents' pregnancy is little discussed. Although the absence of the partner is pointed out as one of the problems due to it. This research had the aim to ascertain, under the perspective of mothers who gave birth at an early age, the participation of a father during gestation, birth, and raising of his child in the first months of life. In order to record data, two categories have been devised: experiencing pregnancy and valuing a partner/father's presence and participation.

Considering that neonatal mortality is an indicator of the quality of the care provided to pregnant women, at childbirth as well as to the new born, authors developed the present study, whose aim was to analyze the neonatal mortality during the year of 1998 at the municipality Botucatu-SP. The coefficient of neonatal mortality was of 8.3/1000 born alive and the coefficient of precocious neonatal mortality was of 7.3/1000 born alive, confirming the importance of decease in the first week of life. Results showed that approximately 3/4 of the deceases can be reduced through precocious diagnosis and treatment as well as adequate care to birth or partially reduced through appropriate pregnancy control measures, evidencing that in order to decrease the rates of neonatal death, investments must be made to improve the quality of the care to pregnant women, parturients and the new born.

Adolescence is the age of crises, changes, adaptation to the new body and new attitudes towards life. If we add to this the meaning of pregnancy from personal, social and family points of view, we will understand how difficult it can be for the adolescents. The purpose of this study was to identify where the pregnant teenagers look for support. Results showed that they had family support, mainly from parents, and less frequently from the baby's father. It also showed the pregnancy acceptance, its relation to school abandonment, the girls' idealized vision of pregnancy and future expectations, the concern about biological aspects and the lack of concern about real problems.

This is a transverse-type designed study with the aim analyze maternal age as a risk factor, and as not a risk factor, through the verification of incidents during pregnancy, birth and puerperium of first time pregnant women with age equal or higher than 28 years old; as well as birth conditions and discharge of their newborns, comparing them with a group of first time pregnant women from 20 to 27 years old. The study was carried out in Botucatu, São Paulo, from January, 1990 to June, 1995. The statistical analysis, discussed at the level of 5% of significance, was developed through Mann-Whitney test, Goodman test and the evaluation of relative risk and corrected relative risk through Mantel-Haenszel technique. We concluded that maternal age equal or higher than 28 years old, is not a pregnancy, puerperal and intrapartum risk factor, although, on the other hand, it was a risk factor even after controlled parturition for the following perinatal incidents: newborn tachypnea, generalized cyanosis at birth and neonatal infection.

Introduction: The diagnosis of breastfeeding status in populations is necessary to define aims and to evaluate support and promotion programs related to this practice. Thus, the feasibility of undertaking such a diagnosis concomitantly with the National Multivaccination Campaign, was tested., Method: A simplified questionnaire was used (3 yes/no questions) to study the present feeding of 1,550 children under 1 year old (91.8% coverage) who attended the vaccination venues in August 19th, 1995. The medians and frequencies from three patterns of breastfeeding were calculated by probit analysis technique., Results: The medians were: exclusive breastfeeding = 17 days (IC: 4.6-28.7); complete breastfeeding = 64 days (IC: 53.0-74.5) and breastfeeding = 167 days (IC: 153.7-182.2). The good adjustment of three patterns was attested by R2 values and by Kolmogorov-Smirnov tests (p < 0.05)., Conclusions: The results confirmed the need for this program in the city. The simplified methodology was found to be available and is recommended for breastfeeding trend management and for studies on the impact resulting from intervention.