Evolution of Socioeconomic Conditions and Its Relation to Spatial-Temporal Changes of Giardiasis and Helminthiasis in Amazonian Children.

This study analyzed the evolution of socioeconomic, sanitary, and personal factors as well as spatiotemporal changes in the prevalence of helminthiasis and giardiasis in urban Amazonian children between 2003 and 2011. Child age, lack of sanitation, and lack of access to bottled water were identified as significant associated factors for helminthiasis and giardiasis. There was an overall improvement in socioeconomic and sanitary conditions in the city resulting in decreased helminth prevalences from 12.42 to 9.63% between 2003 and 2010, but the prevalence increased to 15.03% in 2011 due to migratory movement and unstable sanitary conditions. As for Giardiasis, socioeconomic and environmental changes were not enough to reduce prevalence (16% in 2003 and 23% in 2011). Spatial analysis identified a significant cluster for helminthiasis in an area of poor housing conditions. Control programs in the Amazon need to target high-risk areas focusing changes in sanitation, water usage, and health education.

Rocking and pacifiers: two comforting interventions for heelstick pain.

The effects of behavioral interventions in reducing the stress of infant pain are not well documented. Two comfort interventions, rocking and pacifiers, were compared with routine care administered to 60 newborn infants randomly assigned to the three conditions following a neonatal screening heelstick. Heart rate, state of arousal, and crying were recorded continuously. Both pacifiers and rocking reduced crying, but pacifiers predominantly produced sleep states and rocking predominantly produced alert states. Pacifiers reduced heart rate levels significantly more than did rocking. Thus, newborns clearly benefit from both comforting methods. Several mechanisms are proposed to account for these findings.

Soothing pain-elicited distress in infants with swaddling and pacifiers.

The effectiveness of pacifiers and swaddling in reducing pain-induced distress was compared in 2-week-old infants who underwent heel-sticks and 2-month-old infants who received injections. Crying, state, and heart rate were measured on 32 infants at each age during baseline, the stress of heel-stick or injection, and during 3-min soothing intervention and postintervention periods. At 2 weeks, infants' HR levels and crying declined significantly more rapidly in the pacifier than in the swaddling condition. At 2 months, both conditions produced similar rates of decline in HR and crying. At both ages, infants in the pacifier group spent significantly more time in an alert state than did swaddled infants. Following termination of the intervention at both ages, HR and crying tended to rebound more in the pacifier than in the swaddling group. Swaddling and pacifiers thus reduce pain-elicited distress differently.