ALEXANDRA VALERIA MARIA BRENTANI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Association between maternal lifestyle and preschool nutrition(2016) NOBRE, Erica Bezerra; BRENTANI, Alexandra Valeria Maria; FERRARO, Alexandre ArchanjoIntroduction: Many of the health behaviors involved in the emergence of chronic non-communicable diseases (CNCD) are originated in childhood under parental influence. Mothers are the ones most involved in the education and health care of children. Lifestyle (LS) is a social determinant of health. Very few studies tried to understand the influence of maternal LS on child nutrition. Objective: To verify the association between maternal behavioral and non-behavioral LS and nutritional aspects in preschool children. Method: From January 2010 to December 2010, we performed a cross-sectional study with 255 mothers of preschool children who were residents of five different sub-districts in southwestern Sao Paulo. A proportional stratified random sample was selected using two layers (""schools"" and ""children""). From the mother, sociodemographic and LS information were collected. From the child, data on anthropometry, sedentary behavior and food intake were collected. The association was calculated using chi-square test and logistic regression. Results: Children who ate minimally processed food were born from mothers with more socially aware non-behavioral LS, while children that ate more processed food were born from mothers with more consumerist non-behavioral LS. No association was found between nutritional characteristics of preschoolers and types of maternal behavioral LS. Children presenting ""sedentary behavior"" and the habit of eating ""ultra-processed foods"" had 113% and 84% higher chances, respectively, of being born to mothers that belonged to the ""consumerist"" cluster. Conclusion: Mothers living a consumerist lifestyle can promote negative influences on child nutrition.
- Rollout of community-based family health strategy (programa de saude de familia) is associated with large reductions in neonatal mortality in Sao Paulo, Brazil(2016) BRENTANI, Alexandra; GRISI, Sandra Josefina Ferraz Ellero; TANIGUCHI, Mauro T.; FERRER, Ana Paula Scoleze; BOURROUL, Maria Lucia de Moraes; FINK, GuntherRationale: Several recent studies suggest that Brazil's Estrategia Saude de Familia (Family Health Strategy-FHS) has contributed to declines in mortality at the national and regional level. Comparatively little is known whether this approach is effective in urban populations with relatively easy access to health services. Objectives: To use detailed medical data collected as part of Sao Paulo's Western Region project to examine whether the FHS program had an impact on child health in Sao Paulo, Brazil. Results: No associations were found between FHS and birth weight (OR 1.03, 95% CI 0.93-1.29), gestational length (OR 0.98, 95% CI 0.83-1.15) or stillbirth (OR 1.51, 95% CI 0.75-3.03). FHS eligibility was associated with a 42% reduction in the odds of child mortality (OR 0.58, 95% CI 0.34, 0.91), with largest effect sizes for the early neonatal period (OR 0.18, 95% CI 0.04-0.79). Conclusions: Community based health delivery platforms may be a highly effective way to reduce neonatal mortality in urban areas of low and middle income countries, even when access to general health services is almost universal. (C) 2016 The Authors.
- Maternal depression and child development: Evidence from Sao Paulo's Western Region Cohort Study(2016) BRENTANI, Alexandra; FINK, GuntherIntroduction: While a growing body of evidence has investigated the relationship between maternal mental health and child development, evidence on children's early life outcomes remains mixed. We analyze the empirical relationship between maternal depression and children's development at age one using data from the Sao Paulo Western Region Cohort project. Method: Seven hundred and ninety-eight (798) mother-child dyads living in the Butanta-Jaguare region of Sao Paulo were assessed through a home visit between January and March 2015. Maternal mental health was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Mothers were classified as ""possibly depressed"" if their EPDS score was between 10 and 13 and as ""likely depressed"" if their EPDS score was >13. The child outcomes analyzed were height, weight, and overall development as assessed by the Ages and Stages Questionnaire (ASQ). Height and weight were age-normalized using WHO growth standards. Stunting was defined as height-for-age z-score (HAZ) < -2. Obesity was defined as body mass index z-score (BMIZ) > 2. Adjusted and unadjusted linear regression models were used to assess the associations between Edinburgh scores and child outcomes. Results: No association was found between maternal depression variables and children's height, weight, stunting, and obesity. Positive associations were found between possible depression and ASQ (delta = 0.33; 95CI 0.11-0.54; p-value< 0.01); no associations were found between likely depression and any of the outcomes analyzed. Conclusion: The results from this study suggest that symptoms of maternal depression are not associated with delays in child development in the study setting analyzed. Further research will be needed to understand this lack of association: while it is possible that caregivers' mental health did not affect caregiving behavior, it is possible that the effect of maternal depression can vary according to timing, persistence, and intensity. It is also possible that the EPDS instrument may fail to identify mothers with clinical depression, or that children with depressed mothers get increased support from other family members or public early childhood focused programs.
- Georeferenced and secure mobile health system for large scale data collection in primary care(2016) SA, Joao H. G.; REBELO, Marina S.; BRENTANI, Alexandra; GRISI, Sandra J. F. E.; IWAYA, Leonardo H.; SIMPLICIO JR., Marcos A.; CARVALHO, Tereza C. M. B.; GUTIERREZ, Marco A.Introduction: Mobile health consists in applying mobile devices and communication capabilities for expanding the coverage and improving the effectiveness of health care programs. The technology is particularly promising for developing countries, in which health authorities can take advantage of the flourishing mobile market to provide adequate health care to underprivileged communities, especially primary care. In Brazil, the Primary Care Information System (SIAB) receives primary health care data from all regions of the country, creating a rich database for health-related action planning. Family Health Teams (FHTs) collect this data in periodic visits to families enrolled in governmental programs, following an acquisition procedure that involves filling in paper forms. This procedure compromises the quality of the data provided to health care authorities and slows down the decision-making process. Objectives: To develop a mobile system (GeoHealth) that should address and overcome the aforementioned problems and deploy the proposed solution in a wide underprivileged metropolitan area of a major city in Brazil. Methods: The proposed solution comprises three main components: (a) an Application Server, with a database containing family health conditions; and two clients, (b) a Web Browser running visualization tools for management tasks, and (c) a data-gathering device (smartphone) to register and to georeference the family health data. A data security framework was designed to ensure the security of data, which was stored locally and transmitted over public networks. Results: The system was successfully deployed at six primary care units in the city of Sao Paulo, where a total of 28,324 families/96,061 inhabitants are regularly followed up by government health policies. The health conditions observed from the population covered were: diabetes in 3.40%, hypertension (age >40) in 23.87% and tuberculosis in 0.06%. This estimated prevalence has enabled FHTs to set clinical appointments proactively, with the aim of confirming or detecting cases of non-communicable diseases more efficiently, based on real-time information. Conclusion: The proposed system has the potential to improve the efficiency of primary care data collection and analysis. In terms of direct costs, it can be considered a low-cost solution, with an estimated additional monthly cost of U$ 0.040 per inhabitant of the region covered, or approximately U$ 0.106 per person, considering only those currently enrolled in the system.