Breastfeeding Discontinuation Not Associated with Maternal Pregravid BMI But Associated with Native Hawaiian or Other Pacific Islander Race in Hawaii and Puerto Rico WIC Participants.

Objectives This study investigated the association between maternal pregravid body mass index (BMI) and breastfeeding discontinuation at 4-6 months postpartum in Hawaii and Puerto Rico participants from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods A secondary data analysis was conducted from a text message-based intervention in WIC participants in Hawaii and Puerto Rico. The analysis included 87 women from the control group who initiated breastfeeding and whose breastfeeding status was known at the end of the study when infants were 4-6 months old. Pregravid BMI and breastfeeding discontinuation were assessed using questionnaires. Results The association between pregravid BMI and breastfeeding discontinuation was not significant in the unadjusted model or in the adjusted model. Native Hawaiian or Other Pacific Islander (NHOPI) participants showed significantly increased odds of discontinuing breastfeeding (adjusted odds ratio [AOR] 7.12; 95% CI 1.34, 37.97; p = .02) compared to all the other racial/ethnic participants, as did older women ages 32-39 years versus women who were 25-31 years old (AOR 4.21; 95% CI 1.13, 15.72; p = .03). Women who took vitamins while breastfeeding had decreased odds of discontinuing breastfeeding (AOR 0.15; 95% CI 0.05, 0.46; p = .0009). Conclusions for Practice Pregravid BMI was not significantly associated with breastfeeding discontinuation at 4-6 months postpartum in women from Hawaii and Puerto Rico WIC, but NHOPIs and women who were older had higher odds of discontinuing breastfeeding. The results of this study may inform strategies for breastfeeding promotion and childhood obesity prevention but should be further investigated in larger studies. ClinicalTrials.gov Identifier: NCT02903186.

Comparison of Feeding Practices in Infants in the WIC Supplemental Nutrition Program Who Were Enrolled in Child Care as Opposed to Those with Parent Care Only.

BACKGROUND: The environment or setting to which an infant is exposed is crucial to establishing healthy eating habits and to preventing obesity. This study aimed to compare infant feeding practices and complementary food type between parent care (PC) and childcare (CC) settings among infants receiving the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). MATERIALS AND METHODS: This study sampled 105 dyads of mothers and infants between 2 to 8 months of age from a WIC office in Central Illinois. Mothers completed a cross-sectional survey to assess their infant feeding practices and demographic characteristics. CC was defined as infants receiving 10 hours or more per week of care from a nonparental caregiver. RESULTS: Almost half of the infants (44%) were enrolled in CC. Infants in CC had an average of 29 hours of care per week compared with 0.64 hours in the PC group (p<0.01). There were no differences between the two groups in age, sex, race/ethnicity, preterm birth, and birth weight. Overall, there were no significant differences in breastfeeding initiation and duration. The average age at formula introduction was earlier for PC infants (0.90 ± 1.16 months) than for CC infants (1.66 ± 1.64 months) (p = 0.03). PC infants stopped breastfeeding at 1.96 ± 1.15 months compared with 2.31 ± 1.64 months for CC infants (p = 0.080). Among complementary foods introduced to infants, the primary food type was infant cereal, followed by baby food of fruits and vegetables, 100% fruit juice, and meat-based baby food. The timing of introduction and the types of complementary foods were similar between study groups. CONCLUSIONS: CC use is not a significant influence on breastfeeding rates, introduction of complementary foods, and types of complementary foods; however, it does influence when formula is introduced. The findings support the need for infant nutrition education and breastfeeding promotion targeting WIC mothers, regardless of their pattern of CC.

Bridging community and prison for older adults: invoking human rights and elder and intergenerational family justice.

PURPOSE: Older adults in prison present a significant health and human rights challenge for the criminal justice system. To date, there is no known study that provides a comprehensive examination or portrait of older persons in prison. The purpose of this paper is to understand individual, family, system, and community vulnerabilities that can complicate successful community reintegration for these individuals. DESIGN/METHODOLOGY/APPROACH: This study provides a cross-sectional, descriptive analysis of biopsychosocial, spiritual, and prison use characteristics associated with a sample of 677 older prisoners, aged 50+, in a state-wide prison system. FINDINGS: Results indicate the extent of diversity within this population based on demographic, clinical, social, legal profiles, prison service use patterns, and professional and personal contacts. RESEARCH LIMITATIONS/IMPLICATIONS: Due to the diversity within this population, an interdisciplinary approach is needed to address the complex social and health care needs of an aging prison population and to plan for their reentry. Practical implications - These findings suggest the need for holistic prevention, assessment, and interventions to interrupt the social-structural disparities that foster and support pathways to incarceration and recidivism. ORIGINALITY/VALUE: The human rights implications for the current treatment of older adults in prison include providing in-prison treatment that promotes safety, well-being, reconciliation, and seamless bridges between prison and community for older adults and their families. The True Grit Program is presented as an example of a humanistic and holistic approach of such an approach.

Propuesta de implementación del proceso de fibromialgia. Distrito Sevilla. La fibromialgia desde Atención Primaria / Proposal for implementing the fibromyalgia process. Seville district. Fibromyalgia from primary care

El objetivo de este artículo es concienciar a la Atención Primaria, Administraciones sanitarias, ayuntamientos y Asociaciones de Fibromialgia que, es posible desarrollar el Proceso Asistencial Integrado de Fibromialgia 2005 de la Consejería de Salud de Andalucía en el Distrito Sanitario Sevilla. Los recursos humanos y materiales, casi todos existen ya, solo habría que organizarlos. La Atención Primaria juega un importante papel como puerta de entrada (AU)

This article aims to raise awareness among Primary Care, Health Authorities, Municipalities and Fibromyalgia Associations that it is possible to implement the Fibromyalgia 2005 Integrated Health Process of the Andalusion Health Department in the Seville Health District. The human and material resources, already exist, and only have to be organised. Primary Care plays an important role as gateway to this process (AU)

A naturalização dos fenômenos sobrenaturais e a construção do cérebro possuído: um estudo da medicalização do transe e da possessão no século XIX / The Naturalization of Supernatural Phenomena and the Construction of the possessed brain: a study of trance and possession medicalization in nineteenth century

Este trabalho procura discutir o modo como os fenômenos sobrenaturais foram apropriados, pela ciência, no século XlX. a teoria do magnetismo animal, criada por Mesmer, com suas variadas interpretações por várias gerações de discípulos; a construção da teoria da hipnose, com a codificação da histeria abrindo definitivamente as portas das censuras acadêmicas; e a teoria da dissociação, criada no final daquele século, demonstram diferentes explicações fisicalistas que, muitas vezes, serviram para estabelecer distâncias entre um saber popular e o conhecimento de elites profissionais. A construção do cérebro possuído, no século XlX, apoiada na nosologia da histeria, codificada pela Escola de Salpêtrière, refletiu uma importante transformação social da época, em um processo de laicização da assistencia pública, fundamental para a afirmação da psiquiatria como disciplina nascente...

This study discusses the way supernatural phenomena were enfolded by science in nineteenth century. The theory of magnetism, created by Mesmer, and its different interpretations by generations of disciples; the theory of hypnosis with hysteria codification, opening the academic censure; and the dissociation theory, created at theend of the nineteenth century, had demonstrated different efforts of finding physicals explanations, which served, in most cases, to establish distances between folk knowledge and elites of professional knowledge. The construction of the “possessed” brain, in nineteenth century, based on the hysteria nosology of Salpêtrière School,reflected an important social transformation, at that time, in a laicization process of public assistance, and an affirmation of psychiatry as a nascent discipline. Nowadays, the codification of complex mental states as trance, spiritual possession, which inhabit superstitious and popular imagination, receive a nosologic entity status from official diagnostic classification in psychiatry. Brain is mostly the reference used in the hope ofsupernatural naturalization.

Programs that mitigate the effects of poverty on children.

This article reviews six federally funded in-kind public assistance programs that are intended to mitigate the effects of poverty on low-income children by providing access to basic human necessities such as food, housing, education, and health care. The evidence suggests that, while each program can be improved, these programs do achieve their basic objectives. In general, food stamps, the Special Supplemental Food Program for Women, Infants, and Children (WIC), and school nutrition programs are successful at providing food assistance to low-income children, starting with the prenatal period and continuing through the school years. The Food Stamp Program provides food assistance nationwide to all households solely on the basis of financial need and is central to the food assistance safety net for low-income children. The WIC program has helped reduce the prevalence of iron-deficiency anemia in infants and children and has increased intakes of certain targeted nutrients for program participants. The school nutrition programs provide free or low-cost meals that satisfy the dietary goals of lunches and breakfasts to most school-age children. The Medicaid program has extended health insurance coverage to millions of low-income children. However, many children remain uninsured, and children enrolled in Medicaid do not have the same access to medical care as privately insured children. Relatively little is known about the effects of Medicaid on children's health status. For Head Start, empirical evidence suggests that participating children show enhanced cognitive, social, and physical development in the short term. Studies of the longer-term impacts of Head Start are inconclusive. Although housing assistance improves housing quality and reduces housing costs for recipients, there is a large unmet need for acceptable, affordable housing among poor families. Important gaps remain in our knowledge of the effects of these programs on the well-being of children. Questions regarding a program's effects over time on health and developmental outcomes particularly need more study.

Cornerstone: Illinois' approach to service integration.

Cornerstone is a management information system developed and implemented by the Illinois Department of Public Health as a mechanism to facilitate maternal and child health service integration. Its design features combined program registration, standardized risk assessment, automated care plan development, and consolidated referral and scheduling. Cornerstone is a flexible, PC- and local area network-based system, allowing portability across program applications and geographic areas. A wide-area network enables local agencies to share data about clients. Development of Cornerstone was a collaborative effort by potential Cornerstone users and statewide administrative staff. The standard for equipment is set at a one-to-one ratio of workstations to case managers.

Exempting the poor: the experience of Thailand.

Fee exemption schemes are widely recommended but little analysed. This paper analyses the operation of the Free Medical Care Project in Thailand, which enables those classified as poor to receive free treatment at government facilities. The paper concentrates in particular on the size and geographical distribution of the group eligible for free care, and on the extent to which the geographical distribution of the budget matches the geographical distribution of the poor. By analysing published data available at national level, information is produced on numbers of people eligible for free care, on the numbers who receive free care, and on the geographical distribution of the free medical care budget. Comments are also made on how the project appears to be operating at health facility level. The paper goes on to consider whether the equity effects of the project could be improved by reorganizing the project, and what impact reorganization might have on the costs of the project.

Program evaluation for effective resource management and accountability.

A means of determining the effectiveness of public programs as a basis for justifying resource allocation to these programs is urgently needed. Program evaluation can provide the data base required for program decision-making and modification. A ten-step model for planning and carrying out an evaluation is suggested as a guideline for program personnel who may be assigned to evaluation responsibilities. Nutrition professionals must become aware of the increasing need for evaluation and of the procedures for conducting the evaluation process within programs for which they are responsible. Failure to provide documentation of adequate, on-going evaluation of effectiveness may lead to a loss of resources for the program and, ultimately, to the demise of the nutritional care program.