Non-Donors of Organs and Tissues Due to Medical Refusal in a Transplant Referral Service.

BACKGROUND: Obtaining organs for transplants through a deceased donor occurs exclusively through donation. However, some open protocols with potential donors do not become effective donors due to medical refusal. Our aim was to identify the profile of non-donors of organs and tissues due to medical refusal in a state reference service for transplants. METHODS: This is a cross-sectional study with retrospective data collection from medical records of patients who died and had a protocol opened to evaluate brain death and procurement of organs and tissues in 2019. RESULTS: The sample consisted of 27 patients, the majority of whom were female, aged over 71 years, had primary education, and were married. The main causes of medical refusal were age above the recommended age and septicemia. Brain death was mostly confirmed within 12 hours, and the main cause of hospitalization was a vascular event. CONCLUSIONS: Identifying the profile of non-donors due to medical refusal is necessary for services to identify possible misattributed medical contraindications and thus contribute to reducing the disproportion between supply and demand for organs and tissues for transplants.

Exclusive breastfeeding duration within a cohort of indigenous Terena living in the urban area of Campo Grande, Central-West Region, Brazil.

In Brazil, current information about breastfeeding indicators among indigenous living in the urban areas is lacking. This article describes the duration of exclusive breastfeeding and its associations with mother and child characteristics in a cohort of Terena infants. The study enrolled infants born between June 2017 to July 2018 (n = 42) and living in villages of the urban area of Campo Grande, Mato Grosso do Sul State, Brazil. Information was collected in four time-points. Variables on maternal sociodemographics and on maternal and child health characteristics were collected, respectively, during the antenatal and the first-month interviews. Variables on breastfeeding practices and bottle use were collected during the first-, six- and 12-month interviews. Associations were examined using Wilcoxon, Kruskal-Wallis, Pearson's chi-square, and Fisher's exact tests. The prevalence of exclusive breastfeeding duration to the ages of three and six months were, respectively, 50% and 11.9%. Compared to infants never introduced to bottles during the first three months of life, those bottle-fed had lower median duration of exclusive breastfeeding (15 versus 150 days) and lower prevalence of exclusive breastfeeding duration to the age of three months (22.7% versus 80%). Most Terena infants fell short of meeting the international recommended duration of exclusive breastfeeding until six months of age and suggested the negative impact of bottle use in the duration of exclusive breastfeeding.

Global legislation regulating the donation, procurement and distribution processes of organs and tissues from deceased donors for transplants: A scoping review.

Introduction: Organ transplantation is one of the most successful advances in modern medicine. However, a legal system is necessary for its practice to be free from ethical flaws and to respect donors, recipients, and family members. Objective: To map the global legislation regulating the donation, capture and distribution processes of organs and tissues from deceased donors for transplants. Method: A scoping review according to the Joanna Briggs Institute was conducted in the following databases: Medline, CINAHL, Virtual Health Library, SCOPUS, Web of Science, Science Direct, and EMBASE, as well as gray literature, and reported according to the PRISMA extension for scoping reviews. Results: We identified 3302 records, of which 77 were analyzed which enabled mapping the type of consent adopted and the existence of current legislation for harvesting organs and tissues after circulatory and brain death. Conclusion: Opt-out consent predominates in Europe, and there is harvesting after brain and circulatory death. Opt-out predominates in the Americas, while Opt-in and harvesting of organs and tissues after brain death predominate in Asia and Oceania. The procurement of organs and tissues from deceased donors is practically non-existent in Africa.

Exclusive breastfeeding duration within a cohort of indigenous Terena living in the urban area of Campo Grande, Central-West Region, Brazil / Duração do aleitamento materno exclusivo em uma coorte de indígenas Terena residentes na zona urbana de Campo Grande, Região Centro-oeste do Brasil / Duración de la lactancia materna exclusiva en una cohorte de indígenas Terena que viven en el área urbana de Campo Grande, región Centro-oeste de Brasil

Abstract In Brazil, current information about breastfeeding indicators among indigenous living in the urban areas is lacking. This article describes the duration of exclusive breastfeeding and its associations with mother and child characteristics in a cohort of Terena infants. The study enrolled infants born between June 2017 to July 2018 (n = 42) and living in villages of the urban area of Campo Grande, Mato Grosso do Sul State, Brazil. Information was collected in four time-points. Variables on maternal sociodemographics and on maternal and child health characteristics were collected, respectively, during the antenatal and the first-month interviews. Variables on breastfeeding practices and bottle use were collected during the first-, six- and 12-month interviews. Associations were examined using Wilcoxon, Kruskal-Wallis, Pearson's chi-square, and Fisher's exact tests. The prevalence of exclusive breastfeeding duration to the ages of three and six months were, respectively, 50% and 11.9%. Compared to infants never introduced to bottles during the first three months of life, those bottle-fed had lower median duration of exclusive breastfeeding (15 versus 150 days) and lower prevalence of exclusive breastfeeding duration to the age of three months (22.7% versus 80%). Most Terena infants fell short of meeting the international recommended duration of exclusive breastfeeding until six months of age and suggested the negative impact of bottle use in the duration of exclusive breastfeeding.

Resumo No Brasil, não há informações atuais sobre indicadores de aleitamento materno entre indígenas residentes em áreas urbanas. O objetivo deste estudo foi descrever a duração do aleitamento materno exclusivo e suas associações com características maternas e infantis em uma coorte de lactentes Terena. O estudo incluiu crianças nascidas de junho de 2017 a julho de 2018 (n = 42) e residentes em povoados da zona urbana de Campo Grande, Mato Grosso do Sul, Brasil. As informações foram coletadas em quatro momentos. Variáveis sociodemográficas maternas e características de saúde materno-infantil foram coletadas durante o pré-natal e o primeiro mês de entrevistas, respectivamente. As variáveis sobre práticas de amamentação e uso de mamadeira foram coletadas durante as entrevistas realizadas no primeiro mês, seis meses e 12 meses. As associações foram examinadas pelos testes de Wilcoxon, Kruskal-Wallis, qui-quadrado de Pearson e exato de Fisher. As prevalências de duração do aleitamento materno exclusivo até os três e seis meses de idade foram, respectivamente, de 50% e 11,9%. Em relação aos bebês que nunca foram introduzidos à mamadeira durante os três primeiros meses de vida, aqueles que usaram mamadeira tiveram menor duração média de amamentação exclusiva (15 versus 150 dias) e menor prevalência de duração de amamentação exclusiva até os três meses de idade (22,7% versus 80%). A maioria dos lactentes Terena não atingiu a duração recomendada internacionalmente para o aleitamento materno exclusivo até os seis meses, sugerindo um impacto negativo do uso da mamadeira na duração do aleitamento materno exclusivo.

Resumen En Brasil no existe información actual sobre los indicadores de lactancia materna entre los indígenas que viven en áreas urbanas. El objetivo de este estudio fue describir la duración de la lactancia materna exclusiva y sus asociaciones con las características maternas e infantiles en una cohorte de lactantes Terena. Este estudio incluyó a niños nacidos entre junio de 2017 y julio de 2018 (n = 42) y que vivían en aldeas del área urbana de Campo Grande, Mato Grosso do Sul, Brasil. La información se recopiló en cuatro momentos. Las variables sociodemográficas maternas y las características de salud materno-infantil durante la atención prenatal y el primer mes de entrevistas, respectivamente, se recogieron para este estudio. Las variables sobre prácticas de lactancia materna y alimentación con biberón fueron recolectadas de las entrevistas realizadas en el primer mes, seis meses y 12 meses. Las asociaciones pasaron por las pruebas de Wilcoxon, de Kruskal-Wallis, el chi-cuadrado de Pearson y la prueba exacta de Fisher. La prevalencia de duración de la lactancia materna exclusiva fue del 50% hasta los tres meses de edad y del 11,9% hasta los seis meses. En comparación con los bebés que no utilizaron biberón durante los primeros tres meses de vida, los que usaron biberón tuvieron una duración promedio más corta de lactancia materna exclusiva (15 versus 150 días) y una menor prevalencia de lactancia materna exclusiva hasta los tres meses de edad (22,7% versus 80%). La mayoría de los bebés Terena no alcanzaron la duración recomendada internacionalmente para la lactancia materna exclusiva hasta los seis meses, lo que sugiere un impacto negativo de la alimentación con biberón en la duración de la lactancia materna exclusiva.

Public health policies for children and youth with special health care needs in OECD member countries and Brazil: A scoping review protocol.

BACKGROUND: Because public health policies lay down guidelines for health promotion in specific populations, a review of policies devised for children and youth with special health care needs (CYSHCN) can reveal the actual degree of priority assigned to this population segment, while also highlighting relevant policies in this field. OBJECTIVE: To map the available evidence of public health policies for CYSHCN in member countries of the Organization for Economic Cooperation and Development (OECD) and Brazil. METHOD: A scoping review protocol was developed as per the Joanna Briggs Institute (JBI) manual and the Preferred Reporting Items for Systematic Review and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR) checklist, for application to the Web of Science (WoS), Scopus, PubMed, and Embase databases;to theLatin American and Caribbean Literature in Health Sciences (LILACS)multilingual thesaurus; and to gray literature.The review will map the principal documents (irrespective of time frame or language) addressing public health policies for CYSHCN up to 19 years old. The research protocol has been registered on the Open Science Framework platform (identifier 10.17605/OSF.IO/UW5BH:DOI). RESULTS AND CONCLUSION: Tables, maps, charts, and/or graphs accompanied by descriptive texts will be employed to present the results to the research question and provide answers to it. Use of both open-access software IRaMuTeQ for similitude analysis and word clouds is also planned. This protocol is expected to reveal policies that meet the specific needs of this vulnerable population segment and highlight examples of good practices or current gaps.

Polyphenols and ω-3 PUFAs: Beneficial Outcomes to Obesity and Its Related Metabolic Diseases.

Obesity is associated with the leading causes of death in the worldwide. On the other hand, the intake of vegetables, fruits and fish is related to the reduction of obesity and other metabolic syndromes. This review aims to highlight the role of ingestion of polyphenols and omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in reducing obesity and related metabolic diseases (RMDs). The consumption of vegetables, fish and by-products rich in polyphenols and α-linolenic acid (ALA), as well as oils rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are associated with a decrease in obesity and its RMDs in consumers. Furthermore, we discussed the adequate amount of extracts, powder, polyphenols, ω-3 PUFAs administrated in animal models and human subjects, and the relevant outcomes obtained. Thus, we appeal to the research institutions and departments of the Ministries of Health in each country to develop a food education joint project to help schools, businesses and families with the aim of reducing obesity and other metabolic diseases.