Exclusive breastfeeding frequency at 30 days of life: review of longitudinal studies

A nutrição adequada no início da vida pode afetar o desenvolvimento e a sobrevivência infantil, por isso a adesão às práticas de aleitamento materno e o seu monitoramento regular tornam-se essenciais. Este artigo objetiva realizar uma revisão integrativa da literatura sobre a frequência do aleitamento materno exclusivo (AME) aos 30 dias de vida, divulgada em estudos longitudinais. Para isso, foram identificados artigos nas bases de dados PubMed e LILACS. A combinação dos termos de pesquisa foi “estudo prospectivo” e “aleitamento materno”. A busca limitou-se aos artigos em inglês, espanhol e português, e compreendeu as publicações entre os anos 2015 e 2020. Foram selecionados 17 estudos originais. Apesar das diferenças metodológicas entre eles, em relação ao tipo e tamanho de amostra, a definição do AME e método de mensuração, os resultados indicam alta taxa de início da amamentação (≥86%) e ampla variação da ocorrência de AME aos 30 dias (4,5%-86%), com declínio substancial (<60%) em 63% dos locais investigados. Esses resultados distam do cumprimento da recomendação da Organização Mundial da Saúde de AME até o sexto mês, e indicam a necessidade de investigações, com metodologia padronizada, para comparação dentro dos e entre os países, visando ao planejamento de ações para incentivo da amamentação.Early life feeding can affect children’s development and survival. Adherence to breastfeeding practices and regular monitoring is essential. This study aims an integrative review of longitudinal studies on the frequency of exclusive breastfeeding (EBF) at 30 days of life. Articles were retrieved from the PubMed and LILACS databases. The combination of descriptors used was: “prospective study” and “breast feeding.” The search was limited to articles published between 2015 and 2020 in English, Spanish, and Portuguese. We selected 17 original studies. Despite their methodological differences regarding sample size and type, follow-up period, and EBF definition and measurement method, results indicated a high rate of breastfeeding initiation (≥86%) and a wide variation in the occurrence of EBF at 30 days (4.5% - 86%) with substantial decline (<60%) in 63% of the investigated areas. These results are far from complying with the recommendation from the World Health Organization of maintaining EBF up to the sixth month of children’s life and point to the need for further investigations with a standardized methodology for comparisons within and between countries, aiming at planning actions which support breastfeeding

Elaboración de un manual de procesos del área de farmacia en el Hospital Pediátrico Alfonso Villagómez de la ciudad de Riobamba.

Se elaboró un Manual de Procesos para el Área de Farmacia del Hospital Pediátrico Alfonso Villagómez Román de la ciudad de Riobamba, con la finalidad de garantizar en cada uno de los procedimientos realizados la seguridad al paciente, se contó con la colaboración del Bioquímico Farmacéutico encargado y el personal que labora en la farmacia, realizando una socialización y especificando la información que se manejara en la guía, basada en la Norma Técnica de Seguridad al Paciente y la Guía de Autolevantamiento de Procesos del Ministerio de Salud Pública del Ecuador, donde la ficha de caracterización contiene cada actividad que se realiza en la farmacia y su procedimiento a seguir mediante la utilización de un diagrama de flujo elaborado en el programa Bizagi el cual indica de manera concisa la labor de cada profesional, al diseñar este manual de procesos se determina que cada uno de los procedimientos establecidos cuentan con sus propias actividades y obligaciones, en donde el personal de farmacia involucrado tiene en cuenta el rol que desempeña dentro de su organización. En conclusión, el Manual de Procesos propuesto se convertirá en una herramienta útil en la inducción y capacitación para el nuevo personal que ingresa a la farmacia del hospital, fortaleciendo al personal de farmacia en el desempeño de sus funciones, con el fin de proporcionar eficiencia, eficacia y seguridad en la atención al paciente. Se recomienda realizar las modificaciones necesarias al manual de procesos, como resultado de la mejora o cambios q puedan ocurrir en el establecimiento de salud.A Process Manual was developed for the pharmacy área of the Pediatrics Hospital “Alfonso Villagómez Román” located in Riobamba city. The main purpose of this Process Manual is to ensure patient safety in each of the procedures carried out. The Pharmaceutics Biochemist in charge as well as the personnel working in the pharmacy; collaborated in the process of socialization and the specification of the information to be held in the guide. The information of this guide is base don the Technical Regulations of Patient Safety, and the Self-management Process Guide of the Ministry of Public Health of Ecuador. The file card of characterization of this guide; contains each activity carried out in the pharmacy and its procedure by using a flow chart designed in the program Bizagi, which indicates in a concise way the work of each professional. When designing this Manual Process it is determined that each of the established procedures count on their own activities and obligations, the manual specifies where the pharmacy personnel envolved takes into account the role they play in their organization. To conclude, the Process Manual proposed will become a useful tool for induction and training of the new personnel in the performance of their duties in order to provide efficiency, effectiveness and safety in patient care. It is recommended to make the necessary modifications to the manual process, as result of the improvement or changes that may take place in the health care institution

Breastfeeding practices and head circumference in young children: a systematic review

OBJECTIVE: To review observational studies on the association between breastfeeding (BF) practices and head circumference (HC) of children < 2 years old. METHODS: A systematic review was conducted using the following electronic databases of ​​health sciences: PubMed, Latin American and Caribbean Literature in Health Sciences (Lilacs), Web of Science and Scopus. We selected observational studies published in any language from January 01, 2010 to November 19, 2021, from different populations that investigated the association between BF practice and HC among healthy children <2 years old. Titles and abstracts were screened independently by two evaluators. RESULTS: From the 4229 articles identified, 24 were included in this review: 6 cross-sectional, 17 longitudinal, and 1 case-control. The studies varied in their definition of the variables for BF and in reporting its practice, frequency, duration, and feeding method. Regarding HC, the authors analyzed the mean differences, abnormal values ​​(z-score above + 2SD or below -2SD according to the World Health Organization (WHO) growth standards, 2007), and longitudinal growth parameters. The findings of this review suggest that BF may have a positive relationship with HC at the beginning of life. CONCLUSIONS: Our findings suggest that BF, especially exclusive BF, may play a protective role against abnormal HC values in young children. However, more robust evidence with standardized BF indicators and WHO growth standards (2007) are required

Prevalence and predictors of breastfeeding in the MINA-Brazil cohort

OBJECTIVE: To describe the prevalence and factors associated with exclusive (EBF) and continued breastfeeding (BF) practices among Amazonian children. METHODS: Data from 1,143 mother-child pairs recorded on the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) birth cohort were used. Information on EBF and BF was collected after childbirth (July 2015–June 2016) and during the follow-up visits at 1 and 6 months postpartum, 1, 2, and 5 years of age. For longitudinal analysis, the outcomes were EBF and BF duration. Probability of breastfeeding practices were estimated by Kaplan-Meier survival analysis. Associations between baseline predictors variables and outcomes among children born at term were assessed by extended Cox regression models. RESULTS: EBF frequencies (95% confidence interval [95%CI]) at 3 and 6 months of age were 33% (95%CI: 30.2–36.0) and 10.8% (95%CI: 8.9–12.9), respectively. Adjusted hazard ratio for predictors of early EBF cessation were: being a first-time mother = 1.47 (95%CI: 1.19–1.80), feeding newborns with prelacteals = 1.70 (95%CI: 1.23–2.36), pacifier use in the first week of life = 1.79 (95%CI: 1.44–2.23) or diarrhea in the first two weeks of life = 1.70 (95%CI: 1.15–2.52). Continued BF frequency was 67.9% (95%CI: 64.9–70.8), 29.3% (95%CI: 26.4–32.4), and 1.7% (95%CI: 0.9–2.8) at 1, 2 and 5 years of age, respectively. Adjusted hazard ratio for predictors of early BF cessation were: male sex = 1.23 (95%CI: 1.01–1.49), pacifier use in the first week of life = 4.66 (95%CI: 2.99–7.26), and EBF less than 3 months = 2.76 (95%CI: 1.64–4.66). CONCLUSIONS: EBF and continued BF duration among Amazonian children is considerably shorter than recommendations from the World Health Organization. Significant predictors of breastfeeding practices should be considered for evaluating local strategies to achieve optimal breastfeeding practices

Engineered ferritin for lanthanide binding

Ferritin H-homopolymers have been extensively used as nanocarriers for diverse applications in the targeted delivery of drugs and imaging agents, due to their unique ability to bind the transferrin receptor (CD71), highly overexpressed in most tumor cells. In order to incorporate novel fluorescence imaging properties, we have fused a lanthanide binding tag (LBT) to the C-terminal end of mouse H-chain ferritin, HFt. The HFt-LBT possesses one high affinity Terbium binding site per each of the 24 subunits provided by six coordinating aminoacid side chains and a tryptophan residue in its close proximity and is thus endowed with strong FRET sensitization properties. Accordingly, the characteristic Terbium emission band at 544 nm for the HFt-LBT Tb(III) complex was detectable upon excitation of the tag enclosed at two order of magnitude higher intensity with respect to the wtHFt protein. X-ray data at 2.9 Å and cryo-EM at 7 Å resolution demonstrated that HFt-LBT is correctly assembled as a 24-mer both in crystal and in solution. On the basis of the intrinsic Tb(III) binding properties of the wt protein, 32 additional Tb(III) binding sites, located within the natural iron binding sites of the protein, were identified besides the 24 Tb(III) ions coordinated to the LBTs. HFt-LBT Tb(III) was demonstrated to be actively uptaken by selected tumor cell lines by confocal microscopy and FACS analysis of their FITC derivatives, although direct fluorescence from Terbium emission could not be singled out with conventional, 295–375 nm, fluorescence excitation

El uso de sondas de alimentación en pacientes con demencia avanzada: revisión bibliográfica

Debido a la abundante controversia en el uso de sondas de alimentación en pacientes con demencia avanzada, los objetivos de esta revisión bibliográfica es conocer el uso de sondas de alimentación, su efectividad, beneficios, inconvenientes y alternativas de alimentación en estos pacientes. La metodología de búsqueda fue llevada a cabo en las bases de datos PubMed, Cochrane, Dialnet, ScienceDirect y Google Académico. Se seleccionaron los artículos donde la muestra fuesen humanos, a texto completo, en inglés o castellano, la edad de la muestra fuera más de 65 años y un rango de antigüedad de diez años. Como resultado se seleccionaron un total de 36 artículos. Las conclusiones finales de nuestra revisión bibliográfica se resumen en que sigue habiendo una lucha entre ciencia y bioética, ya que, a pesar de no haber ningún tipo de evidencia científica sobre la mejora del estado general de salud de un paciente con demencia avanzada, se sigue haciendo uso de esta técnica.<br /

Optical simulation of a central receiver system : comparison of different software tools

ABSTRACT: Heliostat field layout design is a critical task in solar tower power plant construction due to its impact in the final plant efficiency and cost. The complexity of these systems and the high number of parameters to define during the field design stage demand the use of suitable simulation tools to compare different design options and evaluate the final performance of the heliostat field. This work concerns a comparison of some of the most common tools used for the heliostat field layout design and analysis, aiming to help Concentrating Solar Power researchers and industry by providing more information regarding the tools comparative results and features. A brief review of available tools is presented, including an extended description of some of them - Tonatiuh, SolTrace, TracePro and CRS4-2. A qualitative comparison of these four tools is performed focusing on functionality and usability. A quantitative comparison is done providing simulation results for a test-case, the SPSS-CRS facility located at Plataforma Solar de Almeria in Spain. In general, the results for total power and maximum irradiance are in good agreement across most tools. The total power values are very close for Tonatiuh, SolTrace and CRS4-2. Apart from the designer preferences, the choice of the most suitable tool depends on the specific application and requirements.info:eu-repo/semantics/publishedVersio

Understanding the journey of patients with depression in Brazil: A systematic review

Despite having an organized mental health law and policy, a majority of patients with depression remain underreported and undertreated in Brazil. The study aimed to quantitatively map and identify the deficiencies in patient journey touchpoints in terms of awareness, screening, diagnosis, treatment, adherence, and control for depression in Brazil using a semi-systematic approach highlighting the knowledge gaps in the existing literature. A structured search of Embase, MEDLINE, and BIOSIS databases was conducted to identify the relevant studies published in English, Portuguese, and Spanish from 2006 to 2021. An unstructured search was also conducted on Google or government websites with no restrictions. To address the data gaps, anecdotal data were also considered. Weighted or simple means were calculated for the pooled data. Of 3175 articles retrieved, 10 articles met the inclusion criteria. Synthesized evidence indicates that the pooled prevalence of depression in Brazil ranged from 4.1% to 21.8%; 42.4% of patients had awareness of depression, 37.5% underwent screening, 18.7% had a diagnosis, and 54.4% received treatment. No data on adherence and control were available. The study findings highlight the need for more research to accurately estimate the common patient journey touchpoints for depression to achieve better clinical outcomes in Brazil

Análisis de eslabones de la cadena de suministro de la papa en el Perú

El Perú se conoce como uno de los países productores de papa, cuenta con una variedad de aproximadamente 3,500 tipos de papa y la producción está presente en 19 regiones del país, la producción es mayoritariamente para consumo local y poco para exportación. El objetivo de la investigación fue analizar los eslabones de la cadena de suministro de la papa en el Perú. El tipo de investigación fue aplicada, de enfoque cualitativo y de diseño fenomenológico. Las técnicas utilizadas fueron las entrevistas y el análisis documentario. Como resultado se obtuvo un análisis de los ítems de: planeación, producción, inventario y distribución. La investigación concluyó que es necesario identificar los procesos y los actores participantes en la cadena de suministro para obtener mejores resultados, uno de los procesos recomendables es la industrialización y participación en proyectos gubernamentales que hagan sostenible el sector agrícola en especial los tubérculo