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2.
Int J Equity Health ; 20(1): 260, 2021 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-34930273

RESUMO

BACKGROUND: Because breastfeeding offers short- and long- term health benefits to mothers and children, breastfeeding promotion and support is a public health priority. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are thought to be contained in breastmilk of mothers with history of COVID-19 infection or vaccination. WHO recommends direct breastfeeding as the preferred infant feeding option during the COVID-19 pandemic, even among women with COVID-19; but conflicting practices have been adopted, which could widen existing inequities in breastfeeding. This study aims to describe how information about breastfeeding was communicated in Mexican media during the pandemic and assess Mexican adults' beliefs regarding breastfeeding among mothers infected with COVID-19. METHODS: We conducted a retrospective content analysis of media coverage on breastfeeding in Mexico between March 1 and September 24, 2020, excluding advertisements. For the content analysis, we performed both a sentiment analysis and an analysis based on strengths, weaknesses, opportunities, and threats (SWOT) for breastfeeding promotion. Additionally, we conducted a descriptive analysis of nationally representative data on adults' beliefs about breastfeeding from the July 2020 round of the ENCOVID-19 survey in Mexico and stratified the results by gender, age, and socioeconomic status. RESULTS: A total of 1014 publications on breastfeeding were identified on the internet and television and in newspapers and magazines. Most information was published during World Breastfeeding Week, celebrated in August. The sentiment analysis showed that 57.2% of all information was classified as positive. The SWOT analysis indicated that most information focused on current actions, messages, policies, or programs that enable breastfeeding (i.e., strengths) or those not currently in place but that may enable breastfeeding (i.e., opportunities) for breastfeeding promotion. However, ENCOVID-19 survey results showed that 67.3% of adults living in households with children under 3 years of age believe that mothers with COVID-19 should not breastfeed, and 19.8% do not know whether these mothers should breastfeed. These beliefs showed differences both by gender and by socioeconomic status. CONCLUSIONS: While the Mexican government endorsed the recommendation on breastfeeding during the COVID-19 pandemic, communication was sporadic, inconstant and unequal across types of media. There was a widespread notion that mothers with COVID-19 should not breastfeed and due to differences on beliefs by socioeconomic status, health inequities could be exacerbated by increasing the risk of poorer breastfeeding practices and preventing vulnerable groups from reaping the short and long-term benefits of breastfeeding.


Assuntos
COVID-19 , Pandemias , Adulto , Aleitamento Materno , Criança , Pré-Escolar , Comunicação , Feminino , Desigualdades de Saúde , Humanos , Lactente , México , Mães , Estudos Retrospectivos , SARS-CoV-2 , Análise de Sentimentos
3.
Res Sq ; 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34031652

RESUMO

BACKGROUND: Breastfeeding offers short- and long- term health benefits to mothers and children and constitutes a priority for public health. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are presumably contained in breastmilk of mothers with history of COVID-19 infection or vaccination. Direct breastfeeding is the preferred infant feeding option during the pandemic, but conflicting practices have been adopted, which could widen existing disparities in breastfeeding. This study aims to describe how was information about breastfeeding communicated in Mexican media during the pandemic and assess Mexican adults' beliefs regarding breastfeeding among mothers infected with COVID-19. METHODS: A retrospective content analysis of media coverage on breastfeeding in Mexico between March 1 and September 24, 2020, excluding advertisements, was done. For the content analysis, both a sentiment analysis and an analysis based on strengths, weaknesses, opportunities and threats for breastfeeding promotion were performed. Also, we incorporated a descriptive analysis from the July 2020 wave of the ENCOVID-19 survey, which included questions on beliefs about breastfeeding. This information was stratified by gender, age, and socioeconomic status. RESULTS: 1014 publications on breastfeeding were identified in internet, newspapers, TV, and magazines. Most information was published during World Breastfeeding Week, celebrated in August. Based on the sentiment analysis, 57.2% of all information was classified as positive, and based on the SWOT analysis, most information was classified either as strengths or opportunities for breastfeeding promotion. However, the ENCOVID-19 data showed that 67.3% of people living in households with children under 3 years of age believe that mothers with COVID-19 should not breastfeed, and 19.8% stated that they simply didn't know. These beliefs showed differences both by gender and by socioeconomic status. CONCLUSIONS: While the Mexican government endorsed the recommendations on breastfeeding during the COVID-19 pandemic, communication of those messages was sporadic, inconstant and unequal across types of media. Moreover, there were also negative messages for breastfeeding circulating on the media. There continues to be a widespread notion that mothers with COVID-19 should not breastfeed and, due to differences on beliefs by socioeconomic status, health inequities could be exacerbated.

4.
Respir Res ; 21(1): 311, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33238993

RESUMO

BACKGROUND: Sexual function is often affected in patients suffering from chronic diseases especially chronic obstructive pulmonary disease (COPD). However, the effect of COPD on sexual satisfaction is underappreciated in clinical practice. The aim of this study is to evaluate the impact of COPD on patient's sexuality and the explanatory variables of sexual dissatisfaction. METHODS: Questionnaires were emailed to participants and they submitted their responses on the Santé Respiratoire France website. Data about sexual well-being (Arizona Sexual Experience Scale, ASEX), Quality of life (VQ11), anxiety, depression (Hospitalized anxiety and depression, HAD) and self-declared COPD grade were collected. RESULTS: Seven hundred and fifty one subjects were included and were characterized as follows: women-51%, mean age-61 years, in a couple-62% and 70%-retired. Every grade of COPD was represented. Out of 751 participants, 301 participants (40%) had no sexual activity and 450 (60%) had sexual activity. From the 450 participants, 60% needed to change their sexual life because of their disease (rhythm, frequency and position). Subjects often used medications to improve sexual performance (43% used short-acting bronchodilator and 13% -specific erectile dysfunction drugs). ASEX questionnaire confirmed patients' dissatisfaction (diminution of sexual appetite for 68% and sexual desire for 60%) because of breathlessness and fatigue. Eighty one percent of the responders had an altered quality of life (VQ11 mean score 35) and frequent suspected anxiety or depression (HAD mean score 10.8). Ninety percent declared that sexual dysfunction had never been discussed by their doctors, while 36% of patients would have preferred to undergo a specialized consultation. CONCLUSION: Sexual dysfunction is frequent among COPD patients and leads to an altered well-being, however being a cultural taboo, it remains frequently neglected. Sexual guidance should be a part of patient's consultations improve quality of sexual life.


Assuntos
Efeitos Psicossociais da Doença , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/psicologia , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Qualidade de Vida/psicologia , Comportamento Sexual/fisiologia , Disfunções Sexuais Fisiológicas/fisiopatologia , Inquéritos e Questionários
6.
Digit Health ; 6: 2055207620909291, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32206330

RESUMO

Breastfeed4Ghana was a social media-based campaign implemented to address identified gaps in the protection, promotion, and support of breastfeeding in Ghana. This paper describes the process of campaign materials development and testing to ensure their cultural and content appropriateness. The 60 campaign materials, each consisting of an image and text message, underwent a process of creation, testing, revision, and finalization. Existing research evidence and infant and young child feeding communication tools that were culturally relevant for Ghana were used to develop the materials. All materials were tested and finalized through an iterative process that incorporated input from six focus group discussions (FGDs) with mothers, and content and technical experts. The materials were revised to ensure scientific accuracy, understandability, and cultural appropriateness of the messages, as well as alignment of the messages with the images. Finalized materials were reviewed and approved by the Ghana Food and Drugs Authority. Analysis for this paper involved summarizing and categorizing the types and sources of input as well as the research team's responses to the input received. The 60 campaign materials received a total of 132 inputs. Most inputs came from FGDs (78.4%); and most inputs were on the campaign material images. The evidence-informed process of materials creation, use of multiple input sources, and a broad-based iterative process allowed the creation of 60 evidence-based and culturally appropriate materials for a breastfeeding social media campaign in Ghana. This paper could serve as a guide for other social media campaign efforts looking to develop culturally appropriate materials.

7.
Respir Med Res ; 76: 4-9, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31254946

RESUMO

INTRODUCTION: The impact of fractional exhaled nitric oxide (FENO) on the management of chronic cough (CC) is still inconclusive. The aim of the present study was to assess whether FENO is a good tool to predict the response to inhaled corticosteroids (ICS) in patients with CC. METHODS: Patients, referred for investigation of CC, had a FENO measurement determined as part of their first-line assessment. A methacholine test was performed as part of a second-line assessement. Patients were assigned to two groups according to their FENO values: a high FENO level group (â°¥25 ppb) and a normal FENO level group (<25 ppb). RESULTS: One hundred patients were included in the study. High FENO levels were found in 25 patients (25%). The proportion of patients who responded to ICS was significantly greater in the high FENO group compared to the normal FENO level group (86.4% vs 46.3%, P<0.05). FENO is a good tool to predict ICS response in patients with high FENO levels but a response to ICS cannot be ruled out in patients with normal FENO levels. In patients with normal FENO values, a methacholine test could be an interesting tool for a second-line assessment. Among the 13 patients with a positive methacholine test result, 11 responded to ICS whilst 2 did not. Of the patients with a negative methacholine test result, 3 responded to ICS whilst 13 did not. CONCLUSION: FENO may be a more reliable predictor of ICS response when used as part of a multi-step assessment procedure.


Assuntos
Corticosteroides/administração & dosagem , Tosse/diagnóstico , Tosse/tratamento farmacológico , Expiração/fisiologia , Óxido Nítrico/análise , Administração por Inalação , Adulto , Idoso , Testes Respiratórios/métodos , Testes de Provocação Brônquica , Doença Crônica , Tosse/metabolismo , Tosse/patologia , Monitoramento de Medicamentos/métodos , Feminino , França , Humanos , Masculino , Cloreto de Metacolina/farmacologia , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
9.
Rev Esp Sanid Penit ; 20(3): 87-94, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30908571

RESUMO

OBJECTIVES: To assess the consumption of ultra-processed foods among inmates in a women's prison in the State of São Paulo, Brazil. METHODS: We conducted a cross-sectional study in 2012/2013 with 1,013 female inmates. A structured interview questionnaire was used to collect socio-demographic, self-reported morbidity and healthy lifestyles and health-related behaviors data. The inmates' usual diet was assessed with a food frequency questionnaire. Foods were classified as either natural or minimally processed, processed or ultra-processed. RESULTS: Inmates age ranged from 18 to 65 years, 51.7% were black, 80.3% had children, 69.5% smoked, 47% were overweight/obese and half of them had high blood triglycerides. The prevalence of daily consumption of natural or minimally processed foods (rice, beans and cassava flour) was 87.7%. The prevalence of daily consumption of green leafy and other vegetables was 63.7%. Almost two-thirds reported consuming milk and fried chicken frequently. A high prevalence of daily consumption of ultra-processed foods was observed in this study. Hot dog bread and sweet bread with margarine were consumed by 86.5% of the interviewees on a daily basis; sugar sweetened beverages by 68.4%, and biscuits as well as candies by 77.1%. CONCLUSIONS: The women's diet in the prison is of low quality, and may lead to metabolic alterations, obesity and other comorbidities. It is recommended that the prison's Food Evaluation Committee considers improvements to the quality of the prisoners' diets.


Assuntos
Dieta/estatística & dados numéricos , Prisioneiros/estatística & dados numéricos , Adolescente , Adulto , Idoso , Brasil , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Comportamentos Relacionados com a Saúde , Estilo de Vida Saudável , Humanos , Pessoa de Meia-Idade , Prisões , Autorrelato , Adulto Jovem
10.
J Health Commun ; 23(1): 40-51, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29236569

RESUMO

Rates of breastfeeding initiation and duration among women who attend the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are dramatically lower than nonparticipants. Innovative solutions are needed to improve breastfeeding rates in this population. The Lactation Advice through Texting Can Help (LATCH) study was one such approach, designed to augment and reinforce the WIC breastfeeding peer counseling process. The purpose of the present study was to examine engagement via two-way text messaging in a sample of women attending the WIC breastfeeding peer counseling program and enrolled in LATCH. The objectives were to: (1) describe text message engagement in the context of LATCH; and (2) assess the association between engagement variables and exclusive breastfeeding status. Text messaging data were first coded qualitatively by two independent researchers and engagement variables created. An analysis of engagement was conducted using descriptive statistics for normally distributed data and binary logistic regression. In the multivariable model, intensity of engagement during the first 2 weeks post partum was the single strongest predictor of exclusive breastfeeding status. LATCH is an innovative intervention designed to enhance the capacity of breastfeeding peer counselors and holds much potential for improving exclusive breastfeeding rates in this population.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Aconselhamento/métodos , Lactação , Envio de Mensagens de Texto , Feminino , Humanos , Recém-Nascido , Gravidez
11.
Child Care Health Dev ; 44(1): 4-11, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29235169

RESUMO

BACKGROUND: Chile Crece Contigo (ChCC) is defined as a comprehensive, intersectoral, and multicomponent policy that aims to help all children reach their full potential for development, regardless of their socio-economic status. METHODS: This case study was developed on the basis of grey literature review and key informants' interviews. RESULTS: ChCC behaves as a complex adaptive system that combines universal and targeted benefits for the more vulnerable starting since gestation and until the children are 4 years old. Three key ministries are involved in ChCC management: health, education, and social development. Studies show adequate programme implementation and positive effects of ChCC on child development. In addition, it was found that the more families use ChCC benefits and the longer the subsystem has been operating in the commune, the greater the positive effects. CONCLUSIONS: Strong political support based on principles of equity and child rights combined with strong evidence and funding commitment from government has been central to emergence, scaling up, and sustainability of ChCC. Further sustainability of ChCC will rely on firmly establishing a well-trained and compensated cadre of early child development professionals and paraprofessionals as well as an improved management and evaluation decentralized system.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Educação em Saúde/organização & administração , Implementação de Plano de Saúde , Política de Saúde , Desenvolvimento Infantil , Educação Infantil , Proteção da Criança , Pré-Escolar , Chile , Implementação de Plano de Saúde/organização & administração , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
12.
Child Care Health Dev ; 44(1): 50-61, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29235170

RESUMO

BACKGROUND: There is still limited knowledge regarding the translation of early child development (ECD) knowledge into effective policies and large-scale programmes. A variety of frameworks that outline the key steps in scaling up exist, but we argue that taking a complex adaptive systems (CAS) approach assists in understanding the complex, dynamic processes that result in programmes being taken to scale. OBJECTIVES: The objective of this study is to examine the process of scaling up four major country-level ECD programmes through the application of a CAS framework. METHODS: Nine key informants with a deep knowledge of how each ECD programme was established and brought to scale were interviewed via Skype or phone by using open-ended interviews. The interviews were tape recorded and then transcribed verbatim for subsequent coding by using CAS domains. The coding and integration of the results to identify unique and common CAS scaling up features across the case studies involved an iterative process of reaching consensus. RESULTS: The scaling up of all four programmes behaved as a CAS including as follows: (i) positive feedback loops (five themes) and negative feedback loops (two themes); (ii) scale-free networks (two themes); (iii) phase transitions (four themes); (iv) path dependence (two themes); and (v) emergent behaviour (six themes). Five additional themes were identified for sustainability, which was repeatedly mentioned as an important consideration when deciding how to scale up programmes. CONCLUSIONS: CAS analysis is likely to improve our understanding of how effective ECD programmes become scaled up. Prospective CAS implementation research is needed to continue advancing the knowledge in the field.


Assuntos
Serviços de Saúde da Criança , Atenção à Saúde/organização & administração , Implementação de Plano de Saúde/organização & administração , Política de Saúde , Criança , Desenvolvimento Infantil , Serviços de Saúde da Criança/organização & administração , Serviços de Saúde da Criança/normas , Pré-Escolar , Chile , Atenção à Saúde/normas , Prática Clínica Baseada em Evidências , Pesquisa sobre Serviços de Saúde , Humanos , Índia , Objetivos Organizacionais , Desenvolvimento de Programas , Estudos Prospectivos , Pesquisa Qualitativa , África do Sul
13.
Rev. esp. sanid. penit ; 20(3): 88-96, 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-179553

RESUMO

Objetivo: Evaluar el consumo de alimentos ultra-procesados entre las reclusas en una prisión femenina en el Estado de São Paulo, Brasil. Métodos: Se realizó un estudio transversal en 2012/2013 con 1.013 reclusas. El instrumento de recolección de datos contempló cuestiones sociodemográficas, morbilidad referida y acciones de prevención, indicadores relacionados al estilo de vida y comportamientos de salud. El consumo de alimentos se verificó de acuerdo con el grado de procesamiento de los alimentos: in natura o mínimamente procesados, procesados y ultraprocesados. Resultados: La edad varió de 18 a 65 años, el 51,7% eran negras, el 80,3% tenían hijos, el 69,5% fumaban, el 47% tenía sobrepeso/obesidad y la mitad de ellas tenían hipertrigliceridemia. La prevalencia de consumo diario de alimentos naturales o mínimamente procesados (arroz, frijoles y harina de mandioca) fue del 87,7%. La prevalencia de consumo diario de hojas verdes y otros vegetales fue del 63,7%. Alrededor de dos tercios reportaron consumir frecuentemente leche y pollo frito. Se observó una alta prevalencia de consumo diario de alimentos ultra-procesados en este estudio. El pan de perro caliente o "hot dog" y el pan dulce con margarina fueron consumidos por el 86,5% de las entrevistadas, refrescos por el 68,4%, galletas y dulces por el 77,1%. Conclusiones: El alimento servido en la cárcel es de baja calidad, y puede llevar a cambios metabólicos, obesidad y otras comorbilidades. Se recomienda que el Comité de Evaluación de Alimentos de la cárcel considere la mejora de la calidad de los alimentos servidos


Objectives: To assess the consumption of ultra-processed foods among inmates in a women's prison in the State of São Paulo, Brazil. Methods: We conducted a cross-sectional study in 2012/2013 with 1,013 female inmates. A structured interview questionnaire was used to collect socio-demographic, self-reported morbidity and healthy lifestyles and health-related behaviors data. The inmates' usual diet was assessed with a food frequency questionnaire. Foods were classified as either natural or minimally processed, processed or ultra-processed. Results: Inmates age ranged from 18 to 65 years, 51.7% were black, 80.3% had children, 69.5% smoked, 47% were overweight/obese and half of them had high blood triglycerides. The prevalence of daily consumption of natural or minimally processed foods (rice, beans and cassava flour) was 87.7%. The prevalence of daily consumption of green leafy and other vegetables was 63.7%. Almost two-thirds reported consuming milk and fried chicken frequently. A high prevalence of daily consumption of ultra-processed foods was observed in this study. Hot dog bread and sweet bread with margarine were consumed by 86.5% of the interviewees on a daily basis; sugar sweetened beverages by 68.4%, and biscuits as well as candies by 77.1%. Conclusions: The women's diet in the prison is of low quality, and may lead to metabolic alterations, obesity and other comorbidities. It is recommended that the prison's Food Evaluation Committee considers improvements to the quality of the prisoners' diets


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Alimentação Coletiva , Alimentos Industrializados , Necessidades Nutricionais , Prisões/estatística & dados numéricos , Brasil/epidemiologia , Estudos Transversais , Qualidade dos Alimentos
14.
Obes Rev ; 18 Suppl 2: 28-38, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28741904

RESUMO

BACKGROUND: Addressing childhood obesity in Latin America requires a package of multisectoral, evidence-based policies that enable environments conducive to healthy lifestyles. OBJECTIVE: Identify and examine key elements to translating research into effective obesity policies in Latin America. METHODS: We examined obesity prevention policies through case studies developed with an expert in the specific policy. Policies were selected based on their level of implementation, visibility and potential impact to reduce childhood obesity. They include: (i) excise taxes on sugar sweetened beverages and energy-dense foods; (ii) front-of-package food label legislation; (iii) trans fatty acids removal from processed foods; and (iv) Ciclovías recreativas or 'open streets'. Case studies were coded to identify components that explained successful implementation and sustainability using the Complex Adaptive Health Systems framework. RESULTS: The analysis identified key elements for effective and sustainable policy, including evidence justifying policy; evidence-based advocacy by civil society; political will; and legislation and skillful negotiations across government, academia, the private sector and civil society. Scientific evidence and evaluation played an important role in achieving tipping points for policies' launch and sustain effective implementation. CONCLUSIONS: Well-coordinated, intersectoral partnerships are needed to successfully implement evidence-based anti-obesity policies. Prospective policy research may be useful for advancing knowledge translation.


Assuntos
Rotulagem de Alimentos , Programas Governamentais , Política Nutricional , Obesidade Infantil/prevenção & controle , Bebidas , Criança , Humanos , América Latina , Estudos Prospectivos , Edulcorantes , Impostos
15.
Rev Mal Respir ; 34(5): 535-543, 2017 May.
Artigo em Francês | MEDLINE | ID: mdl-28578989

RESUMO

INTRODUCTION: We studied the pattern changes over time of medication prescriptions for COPD and their conformity with French and international recommendations using data from patients in the prospective French cohort "Initiatives BPCO". METHOD: Eight hundred and forty-six patients have been included during a first period from August, 2001 till May 2006 (n=425) and a second period from June, 2006 till June, 2012 (n=421). The pivotal date was based on the tiotropium availability in France. RESULTS: During period 1, we recruited older patients (average 65 vs 64 years), less often women (19 vs 26 %) and having less severe airflow obstruction (mean FEV1 48 vs 54 %). The ICS prescriptions decreased in mild COPD, but there was no change for inhaled long-acting beta-2 agonist (LABA) (68 %). The use of LABA+LAMA association without ICS increased from 0.9 to 7 %, but remained lower than the fixed LABA+ICS association (26 %), less often prescribed than the triple association LABA+ICS+LAMA (32.5 % in period 2). The use of long-acting bronchodilators increased from 68 to 80 % between both periods. Vaccinations and rehabilitation remained insufficiently prescribed. LAMA had been added but did not appear to replace other drugs.


Assuntos
Broncodilatadores/uso terapêutico , Antagonistas Muscarínicos/administração & dosagem , Antagonistas Muscarínicos/farmacocinética , Padrões de Prática Médica/tendências , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Administração por Inalação , Idoso , Disponibilidade Biológica , Broncodilatadores/farmacocinética , Preparações de Ação Retardada , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/metabolismo
16.
Soc Sci Med ; 182: 106-116, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28437693

RESUMO

RATIONALE: In the United States rates of exclusive breastfeeding duration remain exceedingly low. Exclusive breastfeeding is a complex learned behavior that is influenced by social cognitive, interpersonal, and structural factors. Interventions are needed that address factors at multiple levels of the social-ecological model. This study was designed to examine the social cognitive predictors of exclusive breastfeeding behavior in a sample of low-income women attending the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counseling program and enrolled in the Lactation Advice Through Texting Can Help (LATCH) study. OBJECTIVES: The objectives were to examine whether: (1) the theoretical model, the Health Action Process Approach (HAPA), fit the data well; (2) planning mediated the effect of intentions and maintenance self-efficacy on exclusive breastfeeding; and (3) recovery self-efficacy mediated the association between maintenance self-efficacy and exclusive breastfeeding behavior. METHODS: Outcome expectancies, action self-efficacy and intentions were assessed prenatally at baseline in N = 119 participants. Maintenance self-efficacy, planning, recovery self-efficacy and breastfeeding behavior were measured at two weeks post partum. Structural equation modeling with mean and variance adjusted Weighted Least Squares estimation was used to examine the applicability of the HAPA model to the data. RESULTS: Phase specific self-efficacy and planning significantly predicted exclusive breastfeeding status. Planning and recovery self-efficacy mediated the association between maintenance self-efficacy and exclusive breastfeeding. Planning did not emerge as a mediator between intentions and behavior. CONCLUSION: These results demonstrate the utility of the HAPA model in predicting exclusive breastfeeding behavior among low-income women attending WIC. LATCH is a theoretically sound text messaging intervention that can be used to augment and reinforce the WIC breastfeeding peer counseling process.


Assuntos
Aleitamento Materno/psicologia , Intenção , Comportamento Social , Adulto , Feminino , Humanos , Autoeficácia , Apoio Social , Inquéritos e Questionários , Estados Unidos
17.
Allergy ; 72(1): 137-145, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27501862

RESUMO

BACKGROUND: Some studies suggest that asthma-COPD overlap syndrome (ACOS) is associated with worse outcomes than chronic obstructive pulmonary disease (COPD). The goal of this study was to further explore the clinical characteristics and survival of patients with ACOS identified in a real-life cohort of patients with COPD. METHODS: Data from the French COPD cohort 'INITIATIVES BronchoPneumopathie Chronique Obstructive' (n = 998 patients) were analyzed to assess the frequency of ACOS defined as a physician diagnosis of asthma before the age of 40 years and to analyze its impact. Univariate analyses were performed to assess the relationship between ACOS and sociodemographic characteristics, risk factors (smoking, occupational exposure, atopic diseases), symptoms (chronic bronchitis, dyspnea-modified Medical Research Council scale and baseline dyspnea index), quality of life (QoL), mood disorders, exacerbations, comorbidities, lung function, prescribed treatment, and survival. RESULTS: ACOS was diagnosed in 129 patients (13%). In multivariate analyses, ACOS was associated negatively with cumulative smoking (odds ratio [OR]: 0.992; 95% CI 0.984-1.000 per pack-year) and positively with obesity: OR: 1.97 [1.22-3.16], history of atopic disease (hay fever: OR: 5.50 [3.42-9.00] and atopic dermatitis: OR 3.76 [2.14-6.61]), and drug use (LABA + ICS: 1.86 [1.27-2.74], antileukotrienes 4.83 [1.63-14.34], theophylline: 2.46 [1.23-4.91], and oral corticosteroids: [2.99;.1.26-7.08]). No independent association was found with dyspnea, QoL, exacerbations, and mortality. CONCLUSIONS: Compared to 'pure' COPD patients, patients with ACOS exhibit lower cumulative smoking, suffer more from obesity and atopic diseases, and use more asthma treatments. Disease severity (dyspnea, QoL, exacerbations, comorbidities) and prognosis (mortality) are not different from 'pure' COPD patients.


Assuntos
Asma/complicações , Asma/diagnóstico , Fenótipo , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Idoso , Asma/tratamento farmacológico , Asma/epidemiologia , Estudos de Coortes , Comorbidade , Diagnóstico Diferencial , Progressão da Doença , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Qualidade de Vida , Fatores de Risco , Inquéritos e Questionários , Avaliação de Sintomas , Síndrome
18.
Asian Pac J Cancer Prev ; 17(6): 2953-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27356717

RESUMO

BACKGROUND: Breast Cancer (BCa) is the most common malignant tumour in Mexican women. In BCa, several studies have linked ß2-adrenergic receptor activation with increased tumour growth and progression as related with Epinephrine-NorEpinephrine (E-NE) stimulation. The aim of this study was to describe Beta-Blocker (BB) treatment related with reduction of the risk of metastasis in Mexican patients with BCa. MATERIALS AND METHODS: We collected data of 120 patients seen at the High-Specialty Naval General Hospital in Mexico City (HOSGENAES), all of these with a histopathological diagnosis of BCa. Four groups of patients were divided as follows: without Systemic Arterial Hypertension (SAH); with SAH treatment with non-selective BB; with SAH treatment with selective BB, and with SAH treatment with other antihypertensive drugs. Chi-square, Mantel- Haenszel, Student t, and ANOVA tests were performed for data analysis. RESULTS: On average, patients were 54.8±11.8 years of age. Risk factors such as smoking and consuming alcohol exhibited a frequency of 33 and 36.5% respectively. Clinical stages III- IV were found in 50% of patients, while, 30% of patients had arterial hypertension (n=29 and N=96, respectively) and 17.5% used BB. One hundred percent of patients with arterial hypertension treated with BB for ß1 - and ß2 -adrenergic-receptors did not present metastasis globally, but patients treated with ß1 BB presented 30% of metastasis while patients treated with no BB or without SAH had around 70% of metastasis. CONCLUSIONS: In Mexican patients with BCa and SAH treated with non-selective (ß1- and ß2-adrenergic receptors) BB, a decrease in the risk for metastasis was observed at the time of diagnosis.


Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Lobular/tratamento farmacológico , Hipertensão/tratamento farmacológico , Comportamento de Redução do Risco , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/uso terapêutico , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/secundário , Carcinoma Lobular/secundário , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Hipertensão/patologia , Metástase Linfática , México , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico
20.
J Phys Condens Matter ; 26(45): 455602, 2014 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-25318982

RESUMO

We studied the effect of carbon substituted by boron on polycrystalline samples of SmNiC(2) in the B content range 0 ⩽ x ⩽ 0.200. The structural parameters were determined from x-ray measurements by Rietveld analysis. The structural analysis shows that the cell volume increases as the B content increases indicating that the substitution produces an internal pressure. The samples were studied by resistance as a function of temperature from room temperature down to 2 K. The transition temperature of the charge density wave, TCDW = 148 K, decreases with an increment of B until the transition vanishes in the resistance measurements. At the same time, the ferromagnetic transition temperature changes showing a tiny dome with the B content, with a maximum transition temperature of ∼ 23.1 K. In addition, the resistance behaviour above the charge density wave is linear in temperature and this behaviour persists until the charge density wave disappears, suggesting that the system is a non-Fermi liquid. The resulting temperature--boron content phase--diagram indicates a quantum critical behaviour.

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