Health Care Costs Associated to Type of Feeding in the First Year of Life

Background: Breastfeeding is associated with lower risk of infectious diseases, leading to fewer hospital admissions and pediatrician consultations. It is cost saving for the health care system, however, it is not usually estimated from actual cohorts but via simulation studies. Methods: A cohort of 970 children was followed-up for twelve months. Data on mother characteristics, pregnancy, delivery and neonate characteristics were obtained from medical records. The type of neonate feeding at discharge, 2, 4, 6, 9 and 12 months of life was reported by the mothers. Infectious diseases diagnosed in the first year of life, hospital admissions, primary care and emergency room consultations and drug treatments were obtained from neonate medical records. Health care costs were attributed using public prices and All Patients Refined?Diagnosis Related Groups (APR?DRG) classification. Results: Health care costs in the first year of life were higher in children artificially fed than in those breastfed (1339.5€, 95% confidence interval (CI): 903.0?1775.0 for artificially fed vs. 443.5€, 95% CI: 193.7?694.0 for breastfed). The breakdown of costs also shows differences in primary care consultations (295.7€ for formula fed children vs. 197.9€ for breastfed children), emergency room consultations (260.1€ for artificially fed children vs. 196.2€ for breastfed children) and hospital admissions (791.6€ for artificially fed children vs. 86.9€ for breastfed children). Conclusions: Children artificially fed brought about more health care costs related to infectious diseases than those exclusively breastfed or mixed breastfed. Excess costs were caused in hospital admissions, primary care consultations, emergency room consultations and drug consumptionThis research has been subsidized by the Valdecilla Health Research Institute (IDIVAL). Project awarded as the best project to be developed in Cantabria in the 19th call for research projects “Enfermería Valdecilla”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Factors associated with duration of breastfeeding in Spain: a cohort study

Background: Factors associated with duration of breastfeeding have been usually studied at specific times after birth. Little is known about how much time is added to breastfeeding by each associated factor. Methods: A cohort of 969 mother-child dyads was followed-up for twelve months at the Marqués de Valdecilla University Hospital, Spain, in 2018. Data on mother characteristics, pregnancy, delivery and children characteristics were obtained from medical records. Length of breastfeeding was reported by the mothers and recorded in paediatric medical record at hospital discharge and 2, 4, 6, 9 and 12 months of life. Factors associated with duration of breastfeeding were analysed via multivariate Weibull regression parameterized as accelerated time of failure. Results are presented as time ratios. Results: About four out of five children were breastfed at hospital discharge, although this proportion dropped to 65% in children born from smoker women, 70% in preterm children and 68% in neonates weighting less than 2500 g. Mother´s age was associated with longer breastfeeding, adding 2% more breastfeeding time per year (adjusted time ratio 1.02; 95% confidence interval 1.00, 1.04). Children born from mothers with university studies were breastfed 53% more time than those born from mothers with primary studies (adjusted time ratio 1.53; 95% confidence interval 1.21, 1.95); smoking in pregnancy decreased length of breastfeeding by 41% (adjusted time ratio 0.59; 95% confidence interval 0.46, 0.76). Other factors associated with longer breastfeeding were single pregnancy and newborn weight over 2500 g. Conclusions: Analysing factors associated with duration of breastfeeding as time parameters allows us to quantify the amount of time gained or lost by each factor, which could make it easier to evaluate the relevance of programmes directed to promote facilitating breastfeeding factors.This research has been subsidized by the Valdecilla Health Research Institute (IDIVAL). Project awarded as the best project to be developed in Cantabria in the 19th call for research projects “Enfermería Valdecilla”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Impact of Maternal Smoking on the Onset of Breastfeeding Versus Formula Feeding: A Cross-Sectional Study

This study sought to estimate the prevalence of maternal smoking and its association with exclusive breastfeeding vs. formula feeding. A cross-sectional study was performed on postpartum women at a public hospital in Spain, between January and August 2018. The main variables studied were their age, level of study, smoking habits, and chosen mode of infant feeding. In total, 948 postpartum women were included. Of these, 12.45% were smokers who smoked a mean of 7.23 cigarettes/day. Among the group of smokers, the probability of feeding the newborns with formula milk was multiplied by 2.32 ([95%CI 1.50-3.58] p < 0.001). When stratifying tobacco use into mild, moderate and severe, we found a statistically significant dose-response pattern. These associations and their statistical significance were maintained when adjusting by age and level of study. In conclusion, in the group of postpartum mothers who smoked, the probability of feeding the newborns with formula milk doubled. Our data highlight the need to improve health education programs in women of childbearing age, especially during pregnancy.This research has been subsidized by the Valdecilla Health Research Institute (IDIVAL). Project awarded as the best project to be developed in Cantabria in the 19th call for research projects “Enfermería Valdecilla”

EL ARQUETIPO FEMENINO EN TERRY Y LOS PIRATAS

Este artículo analiza los personajes femeninos principales de la serie de tiras de prensa Terry y los piratas de Milton Caniff, desde el punto de vista de su asimilación con los arquetipos femeninos del cine clásico, fundamentalmente de los años 30 y 40 del siglo XX. Se realiza una introducción comentando las características de la serie y los objetivos del artículo y se divide el artículo en cuatro secciones correspondientes a los cuatro arquetipos femeninos analizados por Nuria Bou en su libro Diosas y tumbas. Mitos femeninos en el cine de Hollywood. Cada uno de esos arquetipos corresponderá a un personaje femenino importante de la obra de Caniff, al menos durante un periodo significativo de los doce años que estuvo al frente de la serie entre 1934 y 1946. Se trata de un análisis de la relación entre el cine y el cómic clásico, aspecto poco tratado en la literatura, desde una perspectiva de género

El arquetipo femenino en Terry y los piratas

Este artículo analiza los personajes femeninos principales de la serie de tiras de prensa Terry y los piratas de Milton Caniff, desde el punto de vista de su asimilación con los arquetipos femeninos del cine clásico, fundamentalmente de los años 30 y 40 del siglo XX. Se realiza una introducción comentando las características de la serie y los objetivos del artículo y se divide el artículo en cuatro secciones correspondientes a los cuatro arquetipos femeninos analizados por Nuria Bou en su libro Diosas y tumbas. Mitos femeninos en el cine de Hollywood. Cada uno de esos arquetipos corresponderá a un personaje femenino importante de la obra de Caniff, al menos durante un periodo significativo de los doce años que estuvo al frente de la serie entre 1934 y 1946. Se trata de un análisis de la relación entre el cine y el cómic clásico, aspecto poco tratado en la literatura, desde una perspectiva de género.This paper analyses the main female characters of the newspaper comic strip Terry and the Pirates by Milton Caniff, from the point of view of their 1assimilation with the female archetypes of classic cinema, mainly from the 30s and 40s of the 20th century. Initially, the introduction comments the features of the series and the objectives of the article. Then, the paper is divided into four sections corresponding to the four feminine archetypes analysed by Nuria Bou in his book Diosas y tumbas. Mitos femeninos en el cine de Hollywood. Each of these archetypes correspond to an important female character of Caniff's work, at least during a significant period during the twelve years that he was the artist of series, between 1934 and 1946. This is an analysis of the relationship between the classic cinema and the classic comic strip, an aspect that has not been considered in the literature, from a gender perspective

Aprender a comunicar con imágenes. Uso del cómic en la educación superior como vehículo para el desarrollo de competencias multimodales

The initial training of teachers should contemplate in their programs the development of the multimodal competencies of the future teachers since they will be the ones who will promote those competencies in their students. This research has favored the creation of knowledge about the use of comics as a tool to enhance the development of multimodal communication skills in higher education. The study was carried out through an action-research process during two academic courses with the participation of 71 students in the first year and 130 in the second one. The creation of comics by students reflects their potential to develop both critical thinking skills and multimodal literacy. However, we must clarify and take into account that the creation of comics requires understanding and knowing the visual semiotics, grammar and linguistic tools of this medium. Being a complex and new process for most students, it is advisable to plan scaffolding activities in which feedback is conceived as a fundamental factor for the achievement of learning objectives.A formação inicial dos professores deve contemplar em seus programas o desenvolvimento das competências multimodais dos futuros professores, pois serão eles que, por sua vez, promoverão os de seus alunos. Esta pesquisa favoreceu a criação de conhecimento sobre o uso de histórias em quadrinhos como ferramenta para aprimorar o desenvolvimento de habilidades de comunicação multimodais no ensino superior. O estudo foi realizado através de um processo de pesquisa-ação durante dois cursos acadêmicos com a participação de 71 alunos no primeiro ano e 130 no segundo. A criação de quadrinhos pelos alunos reflete o potencial que eles têm para desenvolver tanto o pensamento crítico quanto as habilidades de alfabetização multimodal. No entanto, devemos esclarecer e levar em conta que a criação de histórias em quadrinhos requer compreensão e conhecimento da semiótica visual, gramática e ferramentas lingüísticas desse meio. Sendo um processo complexo e novo para a maioria dos estudantes, é aconselhável planejar atividades de andaimes nas quais o feedback seja concebido como um fator fundamental para a realização dos objetivos de aprendizagem.La formación inicial de maestros deberá contemplar en sus programas el desarrollo de las competencias multimodales de los futuros docentes ya que serán ellos los que a su vez promoverán las de sus alumnos. Esta investigación ha favorecido la creación de conocimiento sobre el uso del cómic como herramienta para potenciar el desarrollo de habilidades de comunicación multimodal en la educación superior. El estudio se ha llevado a cabo a través de un proceso de investigación-acción durante dos cursos lectivos con la participación de 71 alumnos en el primer curso y 130 en el segundo. La creación de cómics por parte de los alumnos refleja el potencial que tienen para desarrollar tanto competencias de pensamiento crítico como de alfabetización multimodal. No obstante, hay que aclarar y tomar en cuenta que la creación de cómics requiere entender y conocer la semiótica visual, la gramática y las herramientas lingüísticas de este medio. Al ser un proceso complejo y nuevo para la mayor parte de los alumnos, es aconsejable planificar actividades a modo de andamiaje en las que se conciba la retroalimentación como factor fundamental para el logro de los objetivos de aprendizaje

COVID-19 in a cohort of pregnant women and their descendants, the MOACC-19 study

Purpose The Mother and Child COVID-19 study is a cohort recruiting pregnant women and their children in Cantabria, North of Spain, during COVID-19 pandemic in order to ascertain consequences of SARS-CoV-2 infection on pregnant women and their descendants. This article reports the cohort profile and preliminary results as recruitment is still open.Participants Three subcohorts can be identified at recruitment. Subcohort 1 includes women giving birth between 23 March and 25 May 2020; they have been retrospectively recruited and could have been exposed to COVID-19 only in their third trimester of pregnancy. Subcohort 2 includes women giving birth from 26 May 2020 on; they are being prospectively recruited and could have been exposed to COVID-19 in both their second and third trimesters of pregnancy. Subcohort 3 includes women in their 12 week of pregnancy prospectively recruited from 26 May 2020 on; they could have been exposed to COVID-19 anytime in their pregnancy. All women are being tested for SARS-CoV-2 infection using both RT-PCR for RNA detection and ELISA for anti-SARS-CoV-2 antibodies. All neonates are being tested for antibodies using immunochemoluminiscency tests; if the mother is tested positive for SARS-CoV-2 RNA, a nasopharyngeal swab is also obtained from the child for RT-PCR analysis.Findings to date As of 22 October, 1167 women have been recruited (266, 354 and 547 for subcohorts 1, 2 and 3, respectively). Fourteen women tested positive to SARS-CoV-2 RNA by the day of delivery. All 14 children born from these women tested negative for SARS-CoV-2 RNA.Future plans Children from women included in subcohort 3 are expected to be recruited by the end of 2020. Children will be followed-up for 1 year in order to ascertain the effect that COVID-19 on their development