The effects of exclusive versus non-exclusive breastfeeding on specific infant morbidities in Conakry

Background:This study examines the effect of exclusive versus non-exclusive breastfeeding on specific infant morbidities from birth to nine months, in Conakry (Guinea). Methods:A cross-sectional study was conducted on 1,167 mother-infant pairs who visited one of 20 immunization centres in Conakry for vaccination between the 45th and 270th days of the child’s life. Two data sources were used: the infant health book and an orally administered questionnaire completed with the mother. Data analyses included univariate cross-tabulations and multivariate logistic regression models to estimate the effect of breastfeeding on infant morbidity. Results:Exclusive breastfeeding decreased with the infant’s age. At six months of age, the proportion of infants who were exclusively breastfed was only 15.5%. After adjusting for the infant’s age, and the interaction between the type of breastfeeding and the infant’s age, exclusive breastfeeding significantly protected the infants against many of the studied morbidities (OR: 0.28, CI: 0.15-0.51) and specifically against diarrhoea (OR: 0.38; 95% CI: 0.17 – 0.86), respiratory infections (OR: 0.27; 95% CI: 0.14 – 0.50), and low growth rate (OR: 0.11; 95% CI: 0.02 – 0.46), but not for otitis, urinary infection, or meningitis. Conclusion:This investigation confirmed the protective effects of exclusive breastfeeding on some specific infant’s morbidities during the first nine months of life. The results of this study are of great importance for the development of an information program designed to encourage the exclusive breastfeeding among the mothers of Conakry, Guinea

The relationship between productivity and tree-ring growth in boreal coniferous forests

Peer reviewe

Relación entre los factores que determinan los síntomas depresivos y los hábitos alimentarios en adultos mayores de México Relationship between determining factors for depressive symptoms and for dietary habits in older adults in Mexico

OBJETIVO: Determinar los factores comunes asociados tanto con los hábitos alimentarios de los adultos mayores que viven en la comunidad como con los síntomas depresivos. MÉTODOS: Se efectuó un análisis secundario de los datos provenientes de México, D.F., del estudio multicéntrico Salud, Bienestar y Envejecimiento (SABE) realizado entre 1999 y 2000. Se estudiaron las siguientes variables: presencia o ausencia de síntomas depresivos, según la escala de depresión geriátrica de Yesavage (EDG); el estado cognoscitivo, según la puntuación obtenida en una versión modificada del examen mínimo del estado mental de Folstein (EMEM abreviado); y la funcionalidad, mediante el índice de actividades básicas de la vida diaria de Katz. A las personas que obtuvieron una suma total de 12 puntos o menos en el EMEM abreviado se les aplicó el cuestionario sobre actividades funcionales o de Pfeffer, para evaluar su capacidad de realizar las actividades cotidianas. Mediante autoinforme se obtuvo información acerca de las características materiales, físicas, psicológicas y sociales relacionadas con la compra, la preparación y el consumo de los alimentos y del estado de la salud bucal en los últimos 12 meses. Con las variables asociadas significativamente con el resultado de la EDG se realizó un análisis de regresión multifactorial, se elaboraron diversos modelos y se utilizaron las variables asociadas significativamente en un análisis de regresión lineal multifactorial por pasos para conocer el conjunto que mejor explicaba el resultado obtenido con la EDG. RESULTADOS: La edad promedio de los participantes fue de 64,4 ± 8,6 años y la prevalencia de síntomas depresivos fue de 66%. El puntaje obtenido en la EDG mostró una asociación con la hipertensión arterial (P OBJECTIVE: To determine the factors that are commonly associated with both the dietary habits of older adults living in the community and depressive symptoms in this group. METHODS: Secondary analysis of data on Mexico City obtained by means of the multicenter study on Health, Well-being, and Aging (Salud, Bienestar y Envejecimiento, SABE) that was carried out in 1999 and 2000. The following variables were examined: presence or absence of depressive symptoms, according to Yesavage’s Geriatric Depression Scale (GDS); mental status, as reflected by the score obtained on a modified, shortened version of Folstein’s Mini-mental State Examination (MMSE); and functional capacity, as measured by Katz’ Index of Independence in Activities of Daily Living. Those whose score on the shortened MMSE was 12 points or less were asked to respond to the Pfeffer Functional Activities Questionnaire, which was used to assess their ability to perform the basic activities of daily living. Information was obtained through self-report on the material, physical, psychological, and social aspects of purchasing, preparing, and consuming food products and of oral health status during the most recent 12-month period. Variables that were significantly associated with the results obtained on the GDS were included in a multivariate regression analysis; several statistical models were created, and variables that were shown to be statistically significant in the stepwise multivariate linear regression were used to determine the best-fitting explanatory model for the results obtained on the GDS. RESULTS: The average age of study participants was 64.4 ± 8.6 years, and the prevalence of depressive symptoms was 66%. The score obtained on the GDS showed a significant association with the presence of arterial hypertension (P < 0.01), but not with the self-reported presence of diabetes, neoplasia, stroke, lung disease or heart disease. However, the use of dental prostheses (P < 0.01), urinary incontinence (P < 0.01), and falls (P < 0.01) were significantly associated with the results on the GDS. The intake of milk products, meat, fish, fowl, fruit, and vegetables was significantly lower in the group that had depressive symptoms. An inverse correlation was detected between the score obtained on the GDS on the one hand, and the number of complete meals consumed during the day (P < 0.01) and total fluid intake (P < 0.01) on the other. The determining factors that were most closely associated with these results were, in addition to the presence of arterial hypertension, the presence of cognitive impairment (P < 0.01), difficulty performing the basic activities of daily living (P = 0.03) and the instrumental activities of daily living (P < 0.01), poor mobility (P < 0.01), difficulty using the telephone (P < 0.01), and the self-perception of having poor memory (P < 0.01), of having insufficient resources with which to live (P < 0.01), and of having poor oral health (P < 0.01). These variables explained 31% of the variance seen in the R² values linked to the SDG variables that were incorporated into the final explanatory model. CONCLUSION: A number of determining factors for depressive symptoms and the results obtained on the GDS resemble the factors that determine poor dietary habits among older adults. The potential existence of common causative mechanisms calls attention to the need for designing interventions aimed at preventing both types of problems and their negative consequences. These results confirm the need to take dietary habits and other parameters into account when studying depression in older adults

Exponential increases in the prevalence of disability in the oldest old: a Canadian national survey.

BackgroundAs most studies generally treat all 85+ year-olds as a homogeneous group, little is known about the specific disabilities of the oldest old population, those aged 90 and older.ObjectiveTo estimate age-specific prevalence of disability in activities of daily living for older Canadians, including the oldest old, those aged 90 and older.MethodsCross-sectional national survey with a representative sample of noninstitutionalized Canadians aged between 50 and 104 years old (n = 28,406). Disability was self-reported and defined as needing assistance to perform self-care and domestic life activities.ResultsThe prevalence of disability increased with age, and the rise appeared exponential when considering the oldest old. At age 90, the highest estimated rates of disability were reported for housekeeping (50%), shopping (45%) and transportation (44%), and 21% reported requiring assistance for washing themselves. Compared to the 85-89 age group, the estimated proportion of people reporting disability in the 95+ age group approximately triples for self-care activities and doubles for domestic life activities.ConclusionEven if we knew that disability increases with age, we can now state that it increases at an accelerated rate beyond age 85. Grouping people aged 85+ into one category leads to substantial underestimates of disability in the oldest old. Accurate estimates are necessary for adequate allocation of care and rehabilitation resources for a rapidly expanding age group

Exponential Increases in the Prevalence of Disability in the Oldest Old: A Canadian National Survey

BACKGROUND: As most studies generally treat all 85+ year-olds as a homogeneous group, little is known about the specific disabilities of the oldest old population, those aged 90 and older. OBJECTIVE: To estimate age-specific prevalence of disability in activities of daily living for older Canadians, including the oldest old, those aged 90 and older. METHODS: Cross-sectional national survey with a representative sample of non-institutionalized Canadians aged between 50 and 104 years old (n=28,406). Disability was self-reported and defined as needing assistance to perform self-care and domestic life activities. RESULTS: The prevalence of disability increased with age, and the rise appeared exponential when considering the oldest old. At age 90, the highest estimated rates of disability were reported for housekeeping (50%), shopping (45%), and transportation (44%) and 21% reported requiring assistance for washing themselves. Compared to the 85-89 age group, the estimated proportion of people reporting disability in the 95+ age group approximately triples for self-care activities and doubles for domestic life activities. CONCLUSION: Even if we knew that disability increases with age, we can now state that it increases at an accelerated rate beyond age 85. Grouping people aged 85+ into one category leads to substantial underestimates of disability in the oldest-old. Accurate estimates are necessary for adequate allocation of care and rehabilitation resources for a rapidly expanding age group

Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent napi/027 strain. Clinical Infectious Diseases, 45(Supplement 2):Si12-Si21

A series of measures were implemented, in a secondary/tertiary-care hospital in Quebec, to control an epidemic of nosocomial Clostridium difficile-associated disease (n-CDAD) caused by a virulent strain; these measures included the development of a nonrestrictive antimicrobial stewardship program. Interrupted time-series analysis was used to evaluate the impact of these measures on n-CDAD incidence. ), but implementation of the antimicrobial stewardship program was followed by P p .63 a marked reduction in incidence ( ). This suggests that nonrestrictive measures to optimize antibiotic P p .007 usage can yield exceptional results when physicians are motivated and that such measures should be a mandatory component of n-CDAD control. The inefficacy of infection control measures targeting transmission through hospital personnel might be a result of their implementation late in the epidemic, when the environment was heavily contaminated with spores

Éveil à la lecture et à l’écriture dans les services de garde en milieu scolaire : engagement et ouverture face aux livres

Le présent article traite de l’éveil à la lecture et à l’écriture (ÉLÉ). À travers un programme d’ÉLÉ dans les services de garde en milieu scolaire (SGMS) conçu et expérimenté pendant une année auprès d’enfants de maternelle, cette recherche consiste à présenter les résultats des effets de ce programme quant à l’engagement et à l’ouverture que les enfants manifestent lors de l’activité d’éveil. Plus spécifiquement, nous comparons des groupes de milieux défavorisés et favorisés à l’entrée en classe maternelle et à la fin de l’année scolaire. Certains enfants ayant été exposés aux activités du programme ÉLÉ-SGMS et d’autres non (N total = 556). Les analyses quantitatives effectuées permettent de penser que le programme d’ÉLÉ a eu des effets significatifs sur l’engagement et l’ouverture face aux livres auprès de la population exposée au programme par rapport à celle non exposée.This article focuses on children’s early introduction to reading and writing (early literacy: EL) in in-school daycare. Following the implementation of an in-school daycare EL program designed and tested for a year with kindergarten children, the objective of this article is to present the program’s effects on the engagement and openness that the children showed during discovery activities. Specifically, we compare underprivileged and privileged groups at the entry into kindergarten and at the end of the school year, with some children having been exposed to the activities of the EL program and others not (total N = 556). The quantitative analyses performed suggest that the EL program had significant effects on engagement in and openness to books for the population exposed to the program compared to the population that was not exposed.El presente artículo trata de la iniciación de la lectura y de la escritura (ELE, por su sigla en francés). Por medio de un programa de ELE en los servicios de guardería escolar concebido y puesto a prueba durante un año en niños de nivel preescolar, el objetivo del artículo es presentar los resultados de los efectos de este programa en relación con el compromiso y la apertura que los niños manifiestan en el momento de la actividad de iniciación. Más específicamente, comparamos dos grupos de contextos vulnerables y no vulnerables al inicio y al final del preescolar. Algunos niños fueron expuestos a las actividades de este programa de ELE y otros no (N total = 556). Los análisis cuantitativos sugieren que el programa ELE tuvo efectos significativos sobre el compromiso y apertura hacia los libros de la población expuesta al programa en comparación con aquella que no estuvo (N total = 556)