Depresión materna como mediadora en el desarrollo de sobrepeso y obesidad infantil: una revisión integrativa / Maternal depression as a mediator in the development of childhood overweight and obesity: an integrative review

Introducción: la depresión materna interfiere en la crianza y la alimentación de los hijos a través de conductas de alimentación infantil. Objetivo: examinar cómo la depresión materna predispone al desarrollo de sobrepeso y obesidad infantil. Metodología: revisión integrativa empleando la metodología de Whittemore y Knafl, y la declaración PRISMA, en PubMed y CONRICyT, utilizando los descriptores "depression", "depressive symptoms","mothers" y "childhood obesity", e incluyendo artículos con metodología cuantitativa publicados entre 2013 y 2020 cuyos indicadores fueran peso y conductas en la población infantil. Resultados: en 22 artículos se identificaron vías conductuales, como conductas maternas de alimentación, estilos de alimentación, prácticas de alimentación infantil, inseguridad alimentaria y recurrencia de la depresión. Conclusión: seis vías conductuales poco aptas para la alimentación y el desarrollo se identificaron como mediadoras entre la depresión y el aumento de peso infantil.

Introduction: Maternal depression interferes with raising and feeding children through infant feeding behaviors. Objective: To examine how maternal depression predisposes to the development of childhood overweight and obesity. Methods: An integrative review with the Whittemore & Knafl methodology and the PRISMA background in PubMed and CONRICyT, using descriptors "depression","depressive symptomatology","mothers" and "childhood obesity". Articles with a quantitative methodology, from 2013 to 2020, with analysis of weight or behavior indicators in the child population were included. Results: In 22 articles, behavioral pathways were identified, such as: maternal eating behaviors, feeding styles, feeding practices, food insecurity and recurrence of depression. Conclusions: Six behavioral pathways unsuitable for eating and development were identified as mediators between depression and infant weight gain.

Violence against health personnel before and during the health contingency COVID-19. / Violencia contra el personal de salud antes y durante la contingencia sanitaria COVID-19.

BACKGROUND: Violence against health personnel is an understudied phenomenon in Mexico, which has increased during periods of health contingency. OBJECTIVE: To identify the prevalence and type of violence against health professionals before and during the COVID-19 health contingency and determine the characteristics of the worker with the highest exposure. MATERIAL AND METHODS: Cross-sectional descriptive study, carried out during April of 2020, in 562 health workers, who answered a sociodemographic identification card and a questionnaire to know the characteristics, types and consequences of aggression before and during the contingency, through an electronic and anonymous platform. A non-probabilistic sampling (snowball) was used in different states of Mexico. RESULTS: 47.7% of the participants experienced aggressions, 12.8% verbal type and 34.9% verbal/physical aggressions during the last year, where women showed to be more attacked (chi squared = 12.12, p = 0.000). During health contingency, 16.8% perceived aggression, 13.2% verbal type and 3.6% verbal/physical aggression, with nurses being the most attacked (chi squared = 5.57, p = 0.018). A logistic regression model confirmed that being a woman and belonging to nursing profession has, respectively as far as 2.5 and 3 times more risk of suffering violence. CONCLUSIONS: Violence against health personnel requires immediate strategies, especially in critical periods in the community, where aggressions occur inside and outside of hospitals, which have an impact on worker's safety and health institutions.

INTRODUCCIÓN: la violencia hacia el personal de salud es un fenómeno poco estudiado en México, el cual se ha incrementado durante periodos de contingencia sanitaria. OBJETIVO: identificar la prevalencia y el tipo de violencia hacia el personal de salud antes y durante la contingencia sanitaria por COVID-19 y determinar las características laborales del trabajador en mayor exposición. MATERIAL Y MÉTODOS: estudio descriptivo transversal, llevado a cabo en abril de 2020, en 562 trabajadores de la salud, quienes contestaron una cédula de datos sociodemográficos y un cuestionario para indagar características, tipos y consecuencias de las agresiones, antes y durante la contingencia, mediante una plataforma electrónica y anónima. Se empleó un muestreo no probabilístico (en bola de nieve) en distintas entidades de México. RESULTADOS: 47.7% de los participantes experimentó agresiones, 12.8% de tipo verbal y 34.9% verbal/física durante el último año; las mujeres fueron las más agredidas (chi cuadrada = 12.12, p = 0.000). Durante la contingencia sanitaria 16.8% recibió agresión, 13.2% de tipo verbal y 3.6% verbal/física, siendo las enfermeras las más agredidas (chi cuadrada = 5.57, p = 0.018), información que se confirmó mediante un modelo de regresión logística donde ser mujer y pertenecer a enfermería, respectivamente representó hasta 2.5 y 3 veces mayor riesgo de sufrir violencia. CONCLUSIONES: la violencia hacia el personal sanitario requiere estrategias inmediatas, especialmente en periodos críticos en la comunidad, donde las agresiones se presentan dentro y fuera de hospitales, lo cual repercute en la seguridad de los trabajadores e instituciones sanitarias.

Maternal Eating and Physical Activity Strategies and their Relation with Children's Nutritional Status / Estratégias maternas referentes à alimentação e à atividade física e sua relação com o estado nutricional dos filhos / Estrategias Maternas de Alimentación y Actividad Física y su Relación con el Estado Nutricional de los Hijos

OBJECTIVES: to describe the maternal eating and physical activity strategies (monitoring, discipline, control, limits and reinforcement) [MEES]; to determine the relation between MEES and the child's nutritional status [body mass index (BMI) and body fat percentage (BFP)]; to verify whether the MEES differ according to the child's nutritional status. METHOD: participants were 558 mothers and children (3 to 11 years of age) who studied at public schools. The Parental Strategies for Eating and Activity Scale (PEAS) was applied and the child's weight, height and BFP were measured. For analysis purposes, descriptive statistics were obtained, using multiple linear regression and the Kruskal-Wallis test. RESULTS: the highest mean score was found for reinforcement (62.72) and the lowest for control (50.07). Discipline, control and limits explained 12% of the BMI, while discipline and control explained 6% of the BFP. Greater control is found for obese children (χ2=38.36, p=0.001) and greater reinforcement for underweight children (χ2=7.19, p<0.05). CONCLUSIONS: the mothers exert greater control (pressure to eat) over obese children and greater recognition (congratulating due to healthy eating) in underweight children. Modifications in parental strategies are recommended with a view to strengthening healthy eating and physical activity habits. .

OBJETIVOS: descrever as estratégias maternas referentes à alimentação e à atividade física (monitoramento, disciplina, controle, limites e reforço), determinar a relação entre as estratégias maternas referentes à alimentação e à atividade física e o estado nutricional da criança (índice de massa corporal e porcentagem de gordura corporal) e verificar se as estratégias maternas diferem de acordo com o estado nutricional da criança. MÉTODO: participaram 558 mães e filhos (3 a 11 anos), estudantes em escolas públicas. A Escala Estratégias Parentais referentes à Alimentação e à Atividade foi aplicada, e o peso, a altura e a porcentagem de gordura corporal da criança foram medidos. Para a análise, foram obtidas estatísticas descritivas e foram aplicados a regressão linear múltipla e o teste de Kruskal-Wallis. RESULTADOS: o reforço apresentou a média mais alta (62,72) e o controle, a mais baixa (50,07). Disciplina, controle e limites representaram 12% do índice de massa corporal, e disciplina e controle, os 6% da porcentagem de gordura corporal. O maior controle é exercido em crianças que apresentam obesidade (χ2=38,36, p=0,001), e o maior reforço, em crianças com baixo peso (χ2=7,19, p<0,05). CONCLUSÕES: mães exercem maior controle (pressão para comer) sobre crianças obesas e concedem maior reconhecimento (elogio por uma alimentação saudável) às crianças com baixo peso. Recomenda-se que as estratégias parentais sejam modificadas, a fim de fortalecer hábitos saudáveis de alimentação e atividade física. .

OBJETIVOS: describir las estrategias maternas de alimentación y actividad física (monitoreo, disciplina, control, límites y reforzamiento) [EMAA]; Determinar la relación de EMAA con el estado nutricional del hijo [índice de masa corporal (IMC) y porcentaje de grasa corporal (PGC)]; Verificar si las EMAA son diferentes de acuerdo al estado nutricional del hijo. MÉTODO: participaron 558 madres e hijos (3 a 11 años) estudiantes de escuelas públicas. Se aplicó la Escala Estrategias Parentales de Alimentación y Actividad (PEAS), se midió peso, talla y PGC del hijo. Para el análisis se obtuvieron estadísticas descriptivas, se aplicó regresión lineal múltiple y prueba de Kruskal Wallis. RESULTADOS: reforzamiento presentó la media más alta (62.72) y control la más baja (50.07). Disciplina, control y límites explicaron 12% del IMC, disciplina y control el 6% del PGC. Se ejerce mayor control en hijos con obesidad (χ2=38.36, p=0.001) y mayor reforzamiento en hijos con bajo peso (χ2=7.19, p<0.05). CONCLUSIONES: las madres ejercen mayor control (presión para comer) en hijos con obesidad y otorgan mayor reconocimiento (felicitar por comer saludable) en hijos con bajo peso. Se recomienda modificar las estrategias parentales para fortalecer hábitos saludables de alimentación y actividad física. .

Maternal Eating and Physical Activity Strategies and their Relation with Children's Nutritional Status.

OBJECTIVES: to describe the maternal eating and physical activity strategies (monitoring, discipline, control, limits and reinforcement) [MEES]; to determine the relation between MEES and the child's nutritional status [body mass index (BMI) and body fat percentage (BFP)]; to verify whether the MEES differ according to the child's nutritional status. METHOD: participants were 558 mothers and children (3 to 11 years of age) who studied at public schools. The Parental Strategies for Eating and Activity Scale (PEAS) was applied and the child's weight, height and BFP were measured. For analysis purposes, descriptive statistics were obtained, using multiple linear regression and the Kruskal-Wallis test. RESULTS: the highest mean score was found for reinforcement (62.72) and the lowest for control (50.07). Discipline, control and limits explained 12% of the BMI, while discipline and control explained 6% of the BFP. Greater control is found for obese children (χ²=38.36, p=0.001) and greater reinforcement for underweight children (χ²=7.19, p<0.05). CONCLUSIONS: the mothers exert greater control (pressure to eat) over obese children and greater recognition (congratulating due to healthy eating) in underweight children. Modifications in parental strategies are recommended with a view to strengthening healthy eating and physical activity habits.