Práticas e crenças populares associadas ao desmame precoce

Objetivo: Compreender a interferência das práticas e crenças populares no desmame precoce em puérperas assistidas na Estratégia Saúde da Família.Metodologia: Estudo descritivo, de abordagem qualitativa, realizado de abril a maio de 2016, com 12 puérperas cadastradas na unidade de Atendimento Multiprofissional Especializado (AME) Saúde da Família, através de entrevista semiestruturada. Os dados foram analisados por análise de conteúdo temática.Resultados: As mulheres compreendem a importância da amamentação exclusiva, porém o retorno ao trabalho e estudo e algumas crenças e tabus como, por exemplo, acreditar que o leite é fraco, dificuldade de pega, e alterações estéticas das mamas, levam ao desmame ou a inclusão de outros alimentos antes dos seis meses de vida da criança. A maioria não recebeu orientação profissional durante o pré-natal sobre amamentação e, as que receberam, reportaram a figura do enfermeiro como agente facilitador.Conclusão: É importante a desmistificação e favorecimento da prática do aleitamento materno exclusivo pelo tempo mínimo estabelecido.Objetivo: Comprender la influencia de las prácticas y creencias populares en el destete precoz de puérperas que asistían al programa Estratégia Saúde da Família.Metodología: Estudio descriptivo con enfoque cualitativo, el cual se llevó a cabo entre abril y mayo de 2016 con 12 puérperas registradas en la unidad de Atendimento Multiprofissional Especializado (AME) Saúde da Família, a partir de entrevistas semiestructuradas. Los datos se analizaron mediante el análisis de contenido temático.Resultados: Las mujeres participantes en nuestro estudio comprendieron la importancia de la lactancia materna exclusiva. Sin embargo, factores como el retorno al trabajo o al estudio, las creencias y tabúes —como creer que la leche materna no es suficiente—, la dificultad de agarre y el temor por las alteraciones estéticas de los senos llevan al destete o a la inclusión de otros alimentos en la dieta antes de los primeros seis meses de vida del niño. La mayoría de las puérperas no recibió orientación profesional sobre la lactancia materna durante el control prenatal; aquellas que obtuvieron orientación informaron que la figura del enfermero fue un agente facilitador.Conclusión: Es necesario desmitificar la lactancia materna exclusiva y promover que esta práctica se lleve a cabo durante un tiempo determinado.Objective: To understand the effect of popular beliefs and practices on early weaning of puerperal women attending the Estratégia Saúde da Família program.Methodology: This is a descriptive qualitative study, conducted from April to May 2016 with 22 puerperal women enrolled in the Atendimento Multiprofissional Especializado (AME) Saúde da Família. Data were collected through semi-structured interviews and they were analyzed using content analysis.Results: Women who participated in this study understood the importance of exclusive breastfeeding. Nevertheless, factors such as return to work/school, beliefs and taboos (for instance, some mothers believe that breast milk is insufficient), latching problems, and fear for breast changes lead to weaning or to include other foods during first six months of the childʼs life. Most puerperal women did not receive expert guidance on breastfeeding during antenatal care. Those who do received guidance regarded the figure of the nurse as a facilitating agent.Conclusion: It is necessary to demystify exclusive breastfeeding and to promote this practice to be possible for a certain period of time

Differences in autophagy marker levels at birth in preterm vs. term infants.

BACKGROUND Preterm infants are susceptible to oxidative stress and prone to respiratory diseases. Autophagy is an important defense mechanism against oxidative-stress-induced cell damage and involved in lung development and respiratory morbidity. We hypothesized that autophagy marker levels differ between preterm and term infants. METHODS In the prospective Basel-Bern Infant Lung Development (BILD) birth cohort we compared cord blood levels of macroautophagy (Beclin-1, LC3B), selective autophagy (p62) and regulation of autophagy (SIRT1) in 64 preterm and 453 term infants. RESULTS Beclin-1 and LC3B did not differ between preterm and term infants. However, p62 was higher (0.37, 95% confidence interval (CI) 0.05;0.69 in log2-transformed level, p = 0.025, padj = 0.050) and SIRT1 lower in preterm infants (-0.55, 95% CI -0.78;-0.31 in log2-transformed level, padj < 0.001). Furthermore, p62 decreased (padj-value for smoothing function was 0.018) and SIRT1 increased (0.10, 95% CI 0.07;0.13 in log2-transformed level, padj < 0.001) with increasing gestational age. CONCLUSION Our findings suggest differential levels of key autophagy markers between preterm and term infants. This adds to the knowledge of the sparsely studied field of autophagy mechanisms in preterm infants and might be linked to impaired oxidative stress response, preterm birth, impaired lung development and higher susceptibility to respiratory morbidity in preterm infants. IMPACT To the best of our knowledge, this is the first study to investigate autophagy marker levels between human preterm and term infants in a large population-based sample in cord blood plasma This study demonstrates differential levels of key autophagy markers in preterm compared to term infants and an association with gestational age This may be linked to impaired oxidative stress response or developmental aspects and provide bases for future studies investigating the association with respiratory morbidity

Factors associated with mortality in a neonatal intensive care unit

Aims: To describe the factors associated with mortality of newborns hospitalized in a Neonatal Intensive Care Unit in the period from 2012 to 2015. Methods: This was a descriptive, quantitative study of secondary data, correlated with the causes of death and hospitalization according to classification by ICD-10.&nbsp; The categorical variables were presented in absolute and relative frequencies, with measurements of central tendency and dispersion. Evaluation of the factors associated with neonatal death was made by the logit model of analysis with correction of robust errors by the statistical program Stata 12.0, considering values of p&lt;0.05 and interval of confidence of 95%.&nbsp; Results: Of the 563 newborns, 58.6% were of the male sex; 89.0% were early newborns, 73.0% were premature. 181 newborns died (32.3%). The main causes of hospitalization were: difficulties during birth, conditions of birth and immaturity (45.0%), pathologies associated with the respiratory system (21.1%), congenital malformations (9.7%). The main causes of death were: septicemia of the NB (40.4%), respiratory discomfort of the NB (22.4%). The significant associations for mortality were the use of ventilatory supports: Mechanical Ventilation (p=0.001), Hallo (p=0.000), CPAP (p=0.000), VNI (p=0.005). Conclusions: The major risk factors for neonatal mortality were associated with septicemia and use of mechanical ventilation

Popular beliefs and practices related to early weaning

Objective: To understand the effect of popular beliefs and practices on early weaning of puerperal women attending the Estratégia Saúde da Família program. Methodology: This is a descriptive qualitative study, conducted from April to May 2016 with 22 puerperal women enrolled in the Atendimento Multiprofissional Especializado (AME) Saúde da Família. Data were collected through semi-structured interviews and they were analyzed using content analysis. Results: Women who participated in this study understood the importance of exclusive breastfeeding. Nevertheless, factors such as return to work/school, beliefs and taboos (for instance, some mothers believe that breast milk is insufficient), latching problems, and fear for breast changes lead to weaning or to include other foods during first six months of the childʼs life. Most puerperal women did not receive expert guidance on breastfeeding during antenatal care. Those who do received guidance regarded the figure of the nurse as a facilitating agent. Conclusion: It is necessary to demystify exclusive breastfeeding and to promote this practice to be possible for a certain period of time

Práticas e crenças populares associadas ao desmame precoce

Objective: To understand the effect of popular beliefs and practices on early weaning of puerperal women attending the Estratégia Saúde da Família program.Methodology: This is a descriptive qualitative study, conducted from April to May 2016 with 22 puerperal women enrolled in the Atendimento Multiprofissional Especializado (AME) Saúde da Família. Data were collected through semi-structured interviews and they were analyzed using content analysis.Results: Women who participated in this study understood the importance of exclusive breastfeeding. Nevertheless, factors such as return to work/school, beliefs and taboos (for instance, some mothers believe that breast milk is insufficient), latching problems, and fear for breast changes lead to weaning or to include other foods during first six months of the childʼs life. Most puerperal women did not receive expert guidance on breastfeeding during antenatal care. Those who do received guidance regarded the figure of the nurse as a facilitating agent.Conclusion: It is necessary to demystify exclusive breastfeeding and to promote this practice to be possible for a certain period of time.Objetivo: Compreender a interferência das práticas e crenças populares no desmame precoce em puérperas assistidas na Estratégia Saúde da Família.Metodologia: Estudo descritivo, de abordagem qualitativa, realizado de abril a maio de 2016, com 12 puérperas cadastradas na unidade de Atendimento Multiprofissional Especializado (AME) Saúde da Família, através de entrevista semiestruturada. Os dados foram analisados por análise de conteúdo temática.Resultados: As mulheres compreendem a importância da amamentação exclusiva, porém o retorno ao trabalho e estudo e algumas crenças e tabus como, por exemplo, acreditar que o leite é fraco, dificuldade de pega, e alterações estéticas das mamas, levam ao desmame ou a inclusão de outros alimentos antes dos seis meses de vida da criança. A maioria não recebeu orientação profissional durante o pré-natal sobre amamentação e, as que receberam, reportaram a figura do enfermeiro como agente facilitador.Conclusão: É importante a desmistificação e favorecimento da prática do aleitamento materno exclusivo pelo tempo mínimo estabelecido.Objetivo: Comprender la influencia de las prácticas y creencias populares en el destete precoz de puérperas que asistían al programa Estratégia Saúde da Família.Metodología: Estudio descriptivo con enfoque cualitativo, el cual se llevó a cabo entre abril y mayo de 2016 con 12 puérperas registradas en la unidad de Atendimento Multiprofissional Especializado (AME) Saúde da Família, a partir de entrevistas semiestructuradas. Los datos se analizaron mediante el análisis de contenido temático.Resultados: Las mujeres participantes en nuestro estudio comprendieron la importancia de la lactancia materna exclusiva. Sin embargo, factores como el retorno al trabajo o al estudio, las creencias y tabúes —como creer que la leche materna no es suficiente—, la dificultad de agarre y el temor por las alteraciones estéticas de los senos llevan al destete o a la inclusión de otros alimentos en la dieta antes de los primeros seis meses de vida del niño. La mayoría de las puérperas no recibió orientación profesional sobre la lactancia materna durante el control prenatal; aquellas que obtuvieron orientación informaron que la figura del enfermero fue un agente facilitador.Conclusión: Es necesario desmitificar la lactancia materna exclusiva y promover que esta práctica se lleve a cabo durante un tiempo determinado

The association of exhaled nitric oxide with air pollutants in young infants of asthmatic mothers

Abstract Background Exhaled nitric oxide is a marker of airway inflammation. Air pollution induces airway inflammation and oxidative stress. Little is known about the impact of air pollution on exhaled nitric oxide in young infants. Methods The Breathing for Life Trial recruited pregnant women with asthma into a randomised controlled trial comparing usual clinical care versus inflammometry-guided asthma management in pregnancy. Four hundred fifty-seven infants from the Breathing for Life Trial birth cohort were assessed at six weeks of age. Exhaled nitric oxide was measured in unsedated, sleeping infants. Its association with local mean 24-h and mean seven-day concentrations of ozone, nitric oxide, nitrogen dioxide, carbon monoxide, sulfur dioxide, ammonia, particulate matter less than 10 μm (PM10) and less than 2.5 μm (PM2.5) in diameter was investigated. The air pollutant data were sourced from local monitoring sites of the New South Wales Air Quality Monitoring Network. The association was assessed using a ‘least absolute shrinkage and selection operator’ (LASSO) approach, multivariable regression and Spearman’s rank correlation. Results A seasonal variation was evident with higher median exhaled nitric oxide levels (13.6 ppb) in warmer months and lower median exhaled nitric oxide levels (11.0 ppb) in cooler months, P = 0.008. LASSO identified positive associations for exhaled nitric oxide with 24-h mean ammonia, seven-day mean ammonia, seven-day mean PM10, seven-day mean PM2.5, and seven-day mean ozone; and negative associations for eNO with seven-day mean carbon monoxide, 24-h mean nitric oxide and 24-h mean sulfur dioxide, with an R-square of 0.25 for the penalized coefficients. These coefficients selected by LASSO (and confounders) were entered in multivariable regression. The achieved R-square was 0.27. Conclusion In this cohort of young infants of asthmatic mothers, exhaled nitric oxide showed seasonal variation and an association with local air pollution concentrations

Clinical and lung function outcomes in a cohort of children with severe asthma

BACKGROUND: Uncontrolled severe asthma in children is burdensome and challenging to manage. This study aims to describe outcomes in children with uncontrolled severe asthma managed in a nurse-led severe asthma clinic (SAC). METHODS: This retrospective analysis uses data collected from children referred by a paediatric respiratory specialist to a nurse-led SAC for uncontrolled severe asthma between 2014 and 2019. The pre-clinical assessments included a home visit to assess modifiable factors that could be addressed to improve control. A comprehensive lung function analysis was conducted at each visit. Interventions were personalised and included biologic agents. Statistical analysis was performed using nonparametric, two-tailed Mann-Whitney U-test, the parametric Student’s t-test, or analysis of variance (ANOVA) as appropriate. RESULTS: Twenty-three children with a median age of 12 years were seen once, and 16 were followed up. Compared to a non-asthmatic (NA) and asthmatic (A) age-matched cohort, children with severe asthma (SA) had a lower FEV1, and FVC% predicted before and after bronchodilator inhalation, and a higher mean Lung Clearance Index [LCI] (10.5 [SA] versus 7.3 [NA] versus 7.6 [A], p = 0.003). Almost 80% of children with SA had an abnormal LCI, and 48% had a reduced FEV1% at the first SAC visit. Asthma control and FEV1% predicted significantly improved at a follow-up visit, while LCI remained abnormal in the majority of children (83%). CONCLUSION: Over time, many children with severe asthma showed improved clinical outcomes and lung function while lung ventilation inhomogeneities persisted. Future appropriately controlled studies are required to determine if a nurse-led multidisciplinary SAC is associated with better outcomes