The impact of implementation of the Breastfeeding Friendly Primary Care Initiative on the prevalence rates of breastfeeding and causes of consultations at a basic healthcare center.

OBJECTIVE: To compare the prevalence rates of breastfeeding and the principal causes of consultations at the infant and neonatal clinic of a basic healthcare center in the city of Rio de Janeiro, before and after its being accredited by the Breastfeeding Friendly Primary Care Initiative. METHODS: Information was analyzed from 121 and 200 children followed-up at the healthcare center before and after certification, respectively. Type of feeding was classified as exclusive breastfeeding, predominant breastfeeding or breastfeeding, and the 10th International Classification of Diseases was used to classify the complaints causing consultations. RESULTS: A statistically significant increase was observed in the prevalence of exclusive breastfeeding, both among those less than 4 months old (68 vs. 88%; p < 0.0001) and among children aged from 4 to 6 months (41 vs. 82%; p < 0.0001). Furthermore, an impressive increase was observed in the prevalence of breastfeeding in children more than 6 months old, especially those aged 9 to 12 months (24 vs. 82%; p < 0.0001). After certification, there was also a reduction in the number of consultations motivated by some type of disease among infants more than 4 months old. CONCLUSION: Implementation of the Breastfeeding Friendly Primary Care Initiative proved to be an important strategy for increasing the rate of breastfeeding and reducing consultations due to disease among infants less than one year old cared for at this health center.

Impacto da implementação da Iniciativa Unidade Básica Amiga da Amamentação nas prevalências de aleitamento materno e nos motivos de consulta em uma unidade básica de saúde / The impact of implementation of the Breastfeeding Friendly Primary Care Initiative on the prevalence rates of breastfeeding and causes of consultations at a basic healthcare center

OBJETIVO: Comparar as prevalências de aleitamento materno e das queixas principais nas consultas de puericultura de uma unidade básica de saúde do município do Rio de Janeiro, nos períodos pré e pós-certificação da Iniciativa Unidade Básica Amiga da Amamentação. MÉTODOS: Foram analisadas informações de 121 e 200 crianças assistidas pela unidade antes e após sua certificação, respectivamente. Classificou-se o tipo de alimentação em aleitamento materno exclusivo, aleitamento materno predominante e aleitamento materno, e utilizou-se a 10ª Classificação Internacional de Doenças para categorização das queixas que motivaram as consultas de puericultura. RESULTADOS: Observou-se um aumento estatisticamente significativo da prevalência de aleitamento materno exclusivo tanto nos menores de 4 meses (68 versus 88 por cento; p < 0,0001) quanto entre as crianças com idade entre 4 e 6 meses (41 versus 82 por cento; p < 0,0001). Além disso, foi expressivo o aumento da prevalência de aleitamento materno em crianças maiores de 6 meses, especialmente entre os 9 e 12 meses de vida (24 versus 82 por cento; p < 0,0001). Houve, também, diminuição nas consultas motivadas por alguma doença após a certificação da unidade nos lactentes com mais de 4 meses. CONCLUSÃO: A implantação da Iniciativa Unidade Básica Amiga da Amamentação mostrou-se estratégia importante para o aumento das taxas de aleitamento materno e para a diminuição de consultas motivadas por doenças nos lactentes menores de 1 ano assistidos nesta unidade.

OBJECTIVE: To compare the prevalence rates of breastfeeding and the principal causes of consultations at the infant and neonatal clinic of a basic healthcare center in the city of Rio de Janeiro, before and after its being accredited by the Breastfeeding Friendly Primary Care Initiative. METHODS: Information was analyzed from 121 and 200 children followed-up at the healthcare center before and after certification, respectively. Type of feeding was classified as exclusive breastfeeding, predominant breastfeeding or breastfeeding, and the 10th International Classification of Diseases was used to classify the complaints causing consultations. RESULTS: A statistically significant increase was observed in the prevalence of exclusive breastfeeding, both among those less than 4 months old (68 vs. 88 percent; p < 0.0001) and among children aged from 4 to 6 months (41 vs. 82 percent; p < 0.0001). Furthermore, an impressive increase was observed in the prevalence of breastfeeding in children more than 6 months old, especially those aged 9 to 12 months (24 vs. 82 percent; p < 0.0001). After certification, there was also a reduction in the number of consultations motivated by some type of disease among infants more than 4 months old. CONCLUSION: Implementation of the Breastfeeding Friendly Primary Care Initiative proved to be an important strategy for increasing the rate of breastfeeding and reducing consultations due to disease among infants less than one year old cared for at this health center.

Heart rate and energy expenditure during garbage collection in Rio de Janeiro, Brazil

Physiological workload is used to estimate the physical demand of tasks in the workforce, but limited information is available for the various work activities in developing countries. Eighty-three randomly selected male workers participated in the present study, aimed at assessing the physiological workload of garbage collection (GC) in Rio de Janeiro, Brazil. Heart rate (HR) was obtained on four consecutive workdays. Energy expenditure (EE) was extrapolated from heart rate data based on individual laboratory-established heart rate/oxygen consumption curve in 70 workers. Mean HR during GC was 104.0 ± 11.7bpm (± SD), representing 56.9 ± 7.5 percent of maximum heart rate. EE was 1608.3 ± 738.5kcal for an average of 293.1 ± 103.9 minutes of work per day. Based on all measurements, work in garbage collection in Rio de Janeiro can be considered excessively heavy. These data emphasize the need to develop appropriate classification of workload to be used in health-related research and in the development of maximum acceptable work time in association with the physiological workload, particularly in developing countries.

A carga de trabalho fisiológica é utilizada para estimar a demanda física de uma tarefa na população de trabalhadores adultos; no entanto, nos países em desenvolvimento há poucos dados disponíveis sobre as diversas atividades ocupacionais. Oitenta e três trabalhadores masculinos participaram neste estudo, com o objetivo de avaliar a carga fisiológica do trabalho de coleta de lixo domiciliar no Município do Rio de Janeiro, Brasil. A freqüência cardíaca foi medida em quatro dias de trabalho consecutivos. O gasto energético foi extrapolado a partir da freqüência cardíaca, com base em dados individuais obtidos em laboratório para a curva de freqüência cardíaca/consumo de oxigênio em 70 trabalhadores. A freqüência cardíaca média durante a coleta de lixo era 104,0 ± 11,7bpm, o que representa 56,9 ± 7,5 por cento da freqüência cardíaca máxima. O gasto energético era de 1.608,3 ± 738,5kcal para uma média de 293,1 ± 103,9 minutos de trabalho por dia. Com base em todas as medidas, o trabalho de coleta de lixo domiciliar pode ser classificado como excessivamente pesado. Os dados destacam a necessidade de se desenvolver uma classificação apropriada do trabalho, a ser utilizada em pesquisas sobre saúde do trabalhador e para definir cargas máximas de horas de trabalho em relação à carga de trabalho fisiológica, particularmente nos países em desenvolvimento.

Heart rate and energy expenditure during garbage collection in Rio de Janeiro, Brazil.

Physiological workload is used to estimate the physical demand of tasks in the workforce, but limited information is available for the various work activities in developing countries. Eighty-three randomly selected male workers participated in the present study, aimed at assessing the physiological workload of garbage collection (GC) in Rio de Janeiro, Brazil. Heart rate (HR) was obtained on four consecutive workdays. Energy expenditure (EE) was extrapolated from heart rate data based on individual laboratory-established heart rate/oxygen consumption curve in 70 workers. Mean HR during GC was 104.0 +/- 11.7 bpm (+/- SD), representing 56.9 +/- 7.5% of maximum heart rate. EE was 1608.3 +/- 738.5 kcal for an average of 293.1 +/- 103.9 minutes of work per day. Based on all measurements, work in garbage collection in Rio de Janeiro can be considered excessively heavy. These data emphasize the need to develop appropriate classification of workload to be used in health-related research and in the development of maximum acceptable work time in association with the physiological workload, particularly in developing countries.