scholarly journals Feeding practices and early weaning in the neonatal period: a cohort study

2021 ◽  
Vol 55 ◽  
pp. 63
Author(s):  
Josilene Maria Ferreira Pinheiro ◽  
Taiana Brito Menêzes Flor ◽  
Mayara Gabrielly Germano de Araújo ◽  
Ana Márcia Soares Fernandes Xavier ◽  
Amanda Michelly Braga da Mata ◽  
...  

OBJECTIVE To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period. METHODS Cohort study, which we collected socioeconomic, demographic, health care and feeding data from 415 mother/child binomials born in four public maternity hospitals in Natal/Brazil. They were followed-up at 48 hours, 7 and 28 days after birth. The association was established using Pearson’s Chi-square test and Poisson’s regression, after adjusting it to other variables. RESULTS The prevalence of mixed breastfeeding in the first 2 days was 47,2% and early weaning in 7 and 28 days was 8,4% and 16,2% in that order. The main reasons for mixed breastfeeding and early weaning were: colostrum deficiency (33.8%), difficulty in latching/sucking (23.5%) and “little milk” (70.0%). The use of formula/milk/porridge remained associated with maternal age ≤ 20 years (RR = 0.64; 95%CI: 0.47–0.86), age 20–29 years (RR = 0,70; 95%CI: 0,57–0,87), primiparity (RR = 1.37; 95%CI: 1.11–1.60) and cesarean delivery (RR = 1.20; 95%CI: 1.00–1.45) at 2 days; absence of paternal support (RR = 4.98; 95%CI: 2.54–9.79) and pacifier use (RR = 3.21; 95%CI: 1.63–6.32) at 7 days; and only pacifier use (RR = 2.48; 95%CI: 1.53–4.02) at 28 days. CONCLUSIONS Early weaning was associated with maternal and health care factors, thus suggesting the need to readjust good practices and educational actions to achieve the exclusive offer to the maternal breast in the neonatal period.

Author(s):  
Dhaval Dalal ◽  
Kamalpriya Thiyagarajan ◽  
Humeshwari Nipane ◽  
Vijaykumar Gawali

Background: COVID-19 has brought psychological disorders that affect health care workers and the general public. Hence it is important to have necessary counselling to address the psychological, social aspects of the pandemic to ensure psychological well-being of especially Health-care Workers and preserve their innate and acquired immunity.Methods: The study was planned as single centre retrospective study and conducted between April and June 2020 at dedicated COVID-19 hospital in India. Front-line HCWs more than 18 years, of any gender working in COVID-19 hospital and willing to participate for the study were enrolled in the study. Study included two questionnaires, generalized anxiety disorder scale, and socio-demographics and COVID-19 related awareness questionnaire. Measurements were taken pre and post the psychological counselling intervention.Results: As per generalized anxiety disorder (GAD) scale people suffering from moderate anxiety disorder dropped from 19% (pre counselling) to 5% (post counselling) and severe cases dropped from 14% (pre counseling) to 2% (post counseling), there was statistically significant difference observed due to psychological intervention in GAD scale (Chi square test-10.794, p value=3.67E-27). Socio demographics and COVID-19 related awareness questionnaire results were statistically significant (Chi square test-11.945, p value=6.91E-33).Conclusions: Counselling interventions based on scientific data offered in groups by investigator with an accurate knowledge of the COVID-19 and its manifestation increased the confidence of health care workers (HCWs) and reduced anxiety level. This was translated into the full availability of HCWs on the clinical study site, although medical services were disrupted while other hospitals were starving due to lack of staff.


2020 ◽  
Author(s):  
Huanyuan Luo ◽  
Songqiao Liu ◽  
Yuancheng Wang ◽  
Penelope A. Phillips-Howard ◽  
Yi Yang ◽  
...  

Objectives To determine the age-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China. Design and setting This is a retrospective, multi-center cohort study performed at twenty-four hospitals in Jiangsu, China. Participants From January 10 to March 15, 2020, 625 patients with COVID-19 were involved. Results Of the 625 patients (median age, 46 years; 329 [52.6%] males), 37 (5.9%) were children (18 years or less), 261 (40%) young adults (19-44 years), 248 (39.7%) middle-aged adults (45-64 years), and 79 (12.6%) elderly (65 years or more). The incidence of hypertension, coronary heart disease, chronic obstructive pulmonary disease, and diabetes comorbidities increased with age (trend test, P < .0001, P = 0.0003, P < .0001, and P < .0001 respectively). Fever, cough, and shortness of breath occurred more commonly among older patients, especially the elderly, compared to children (Chi-square test, P = 0.0008, 0.0146, and 0.0282, respectively). The quadrant score and pulmonary opacity score increased with age (trend test, both P < .0001). Older patients had significantly more abnormal values in many laboratory parameters than younger patients. Elderly patients contributed the highest proportion of severe or critically-ill cases (33.0%, Chi-square test P < 0.001), intensive care unit (ICU) (35.4%, Chi-square test P < 0.001), and respiratory failure (31.6%, Chi-square test P = 0.0266), and longest hospital stay (21 days, ANOVA-test P < 0.001). Conclusions Elderly (≥65) patients with COVID-19 had the highest risk of severe or critical illness, intensive care use, respiratory failure, and the longest hospital stay, which may be due partly to that they had higher incidence of comorbidities and poor immune responses to COVID-19.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Manuela Filipec ◽  
Gordana Brumini

Abstract Background Electronic health record can facilitate everyday clinical practice of physiotherapists. The aim of this study is to determine attitude of physiotherapists towards implementation of information technology in their work and the differences in attitude in relation to gender, age, level of education and type of health institutions. Methods This study is a cross-sectional survey of Croatian physiotherapists. The questionnaire ″Attitude of physiotherapists towards implementation of electronic health record included 12 items scored on a Likert-type scale from 1 to 5 and presented the award values as “Disagree”, “Neither agree nor disagree” and “Agree”. Croatian physiotherapists were (n = 267) recruited from 13 health care institutions. For analysis chi square test, t-test, one-way analysis of variance and as a post-hoc Tukey test were used. Results Explanatory factorial analysis confirmed two factors: Satisfaction in the work of physiotherapists using computers (SAT) and Necessity of computers in the work of physiotherapists (NEC). Most physiotherapists agree on (SAT) (47.9%) and on (NEC) (51.3%). Male physiotherapists were significantly more likely to disagree with statements related to SAT (p < 0.001) and NEC (p = 0.035) than female physiotherapists. Physiotherapists aged between 46 and 55 years were significantly more like to disagree on NEC in comparison to all the other groups of participants (p < 0.001). Physiotherapists with secondary school degree were significantly more like to disagree on NEC as compared with participants with bachelor’s degree (p = 0.009), as well as in comparison with physiotherapists with a university degree (p = 0.002). Most of the physiotherapists who are employed in Clinical hospitals and in the Speciality hospital agree with that statement (all p > 0.05). Conclusion The attitude of Croatian physiotherapists towards electronic health record differs according to the age, gender, level of education and type of health care institutions. This finding can facilitate implementation of electronic health record in physiotherapy. Trial registration Not applicable.


Author(s):  
Gustavo Antonio Raimondi ◽  
Yahn Rezende de Abreu ◽  
Isadora Meirelles Borges ◽  
Gabriel Benjamin Macedo da Silva ◽  
Wallisen Tadashi Hattori ◽  
...  

Abstract Introduction: The Brazilian National Curriculum Guidelines (NCG) for undergraduate courses in Medicine since 2014 have highlighted the need to include gender and sexuality in the medical school curricula, aiming at better care for people. Method: Thus, the objective is to identify and analyze the approach of gender and sexuality in the Curriculum Pedagogical Projects (CPP) of the medical courses of the Federal Institutions of Brazil. This is a cross-sectional study of descriptive and documentary analysis, carried out through the analysis of CPP, of the undergraduate medical courses of the Federal Universities of Brazil. Data were obtained from the website of the undergraduate medical course of each higher education institution. In addition, emails were sent to the coordinators of these courses to obtain the updated CPPs. For the quantitative analysis, an initial description of the sample was performed followed by a statistical analysis using the chi-square test to assess whether or not there was an association between the presence of gender and / or sexuality debate in CPP, with the publication of the 2014 NCG and with the Brazilian geographic region, as well as between the nature of the curricular unit (compulsory or complementary / optional) and the perspective of the approach. The documentary analysis was used for the qualitative analysis with the content analysis technique, through the thematic analysis method. Results: It was found that 48 (69.56%) of the 69 analyzed CPP discuss the topics gender and / or sexuality in one or more subjects offered by the course. There is a predominance of the sexuality topic, of compulsory curricular units (88.32% of 137 curricular units) and an approach beyond the exclusively biological perspective (63.5% of 48 CPPs and 62.04% of curricular units). No statistical significance was evidenced by the chi-square test. Regarding the documentary analysis, two categories were constructed: “gender and sexuality associated with a biological perspective”, “gender and sexuality associated with a predominantly broader perspective or social determinants in health”. It was observed that the first category predominates in curricular units associated with organs, systems or life cycles of the human being, while the second, to social and human sciences applied to health and Primary Health Care. Conclusions: We conclude there is a significant number of CPPs and, consequently, also of curricular units that have a perspective beyond the exclusively biological approach. Nevertheless, there is difficulty with comprehensive health care that may be related to a selective visibility to pathology and technical aspects of medical practice and a difficulty in effectively promoting an interdisciplinary dialogue between the biological, exact and human sciences as proposed by the NCG.


2019 ◽  
Vol 6 (3) ◽  
pp. 13
Author(s):  
Arantika Meidya Pratiwi

<p>Result of SDKI 2012 show that MMR in Indonesia is 359 deaths per 100,000 live births. This result show that Indonesia still far from the target SDGs (Suitable Development Goals), who reducing the Maternal Mortality Rate (MMR) to 70 per 100,000 live birth. One of the breakthrough programs of the Ministry of Health in an effort to accelerate the reduction in maternal mortality is to increase contraceptive after childbirth. The coverage of contraceptive after childbirth in Indonesia is still far from what is expected, from the 2013 Riskesdas data the coverage of contraceptive after childbirth in Indonesia was only 59.6%. Papua became a province with the lowest coverage of only 26%. The purpose of this study was to determine the relationship between postpartum health care and contraceptive after childbirth in Indonesia. This study using  secondary data from "2013 Basic Health Research" conducted by the Health Research and Development Institute. The 2013 Riskesdas survey uses a cross sectional design. The results of the Chi-Square test showed that there were 0,0001, which meant that there was a relationship between postpartum health care and contraceptive after childbirth in Indonesia. While the results of the analysis of OR values were 1.595, which means that mothers who received health care during the postpartum were 1.6 times more likely to use contraceptive after childbirth.</p>


Author(s):  
Vijayakumar M. ◽  
Jeshtin M.

Background: Construction sector is a thriving industry which comprises most of the unorganized workers and providing widespread opportunities for employment of most of the poorest and marginalized sections of society in India. The workers are more susceptible to various occupational hazards due to working conditions in dusty environment. This study is proposed to identify the morbidity pattern, availability and usage of safety measures, health care seeking behaviour and health care facilities at the quarry site.Methods: A cross sectional study was conducted among the stone quarry workers of Maduranthakam area in Kancheepuram district from February 2018 to May 2018. The sample size was calculated as 94 and five quarries were selected randomly. The study tool was interview based semi structured questionnaire and clinical examination. Appropriate descriptive and inferential statistics like Chi square test, Fischer’s exact test was done to determine significant association (p<0.05).Results: The common morbidities among the participants were abdominal conditions (54%), injuries (34%) and musculoskeletal disorders (27%). One in five individuals had respiratory problems and those with breathing difficulty had decreased peak expiratory flow rate. Usage of personal protective equipments is low and about 63.8% of them were using government health care facilities.Conclusions: Increasing demand for stone and aggregates has led to extensive stone quarrying operations. Awareness and enforcement of personal protective equipment, vaccination against diseases like tetanus, periodic health check- ups should be enforced for people working in quarries.


2020 ◽  
Vol 12 (02) ◽  
pp. 186
Author(s):  
Wahyuningsih . ◽  
Rismawati . ◽  
Rina Harwati

ABSTRAKPemberian ASI eksklusif adalah bayi hanya diberi ASI saja, tanpa tambahan cairan lain seperti susu formula, air jeruk, madu, air teh, air putih dan tanpa tambahan makanan padat seperti pisang, pepaya, bubur susu, biskuit, bubur nasi dan tim selama 6 bulan. Rendahnya cakupan keberhasilan pemberian ASI Ekslusif pada bayi, dipengaruhi banyak hal, diantaranya rendahnya pengetahuan dan kurangnya informasi pada ibu dan keluarga mengenai pentingnya pemberian ASI Ekslusif, tata laksana rumah sakit ataupun tempat bersalin yang tidak memberlakukan rooming-in, fasilitas kesehatan memberikan susu formula kepada bayi baru lahir, banyak ibu bekerja yang menganggap repot menyusui sambil bekerja. Di Puskesmas Wonogiri II cakupan pemberian ASI eksklusif sampai bulan Oktober 2010 sebanyak 87% dari 72 ibu menyusui bayi 0-6 bulan (Puskesmas Wonogiri II, 2020). Bidan berpendapat pengetahuan ibu tentang ASI eksklusif dimulai sejak ibu hamil, sehingga saat ibu melahirkan ibu sudah banyak pengetahuan, sudah siap memberikan ASI eksklusif sehingga cakupan pemberian ASI eksklusif meningkat. Tujuan penelitian ini adalah untuk mengetahui hubungan tingkat pendidikan dengan pengetahuan ibu hamil tentang ASI eksklusif. Metode penelitian yang digunakan adalah survey analitik  dengan pendekatan cross sectional. Jumlah sampel 72 dengan tehnik sampling yang digunakan yaitu total sampling menggunakan kuesioner terbuka 25 item soal untuk menilai pengetahuan ibu hamil tentang ASI eksklusif. Analisa data menggunakan uji chi square untuk menguji hipotesa. Hasil penelitian tidak ada hubungan yang signifikan antara tingkat pendidikan dengan pengetahuan ibu hamil tentang ASI eksklusif. Kesimpulan pengetahuan ibu hamil tentang ASI eksklusif tidak hanya dipengaruhi oleh pendidikan.Kata Kunci : Tingkat pendidikan, Pemgetahuan, ASI eksklusif. RELATIONSHIP OF EDUCATION LEVEL WITH EXCLUSIVE BREASTFEEDING KNOWLEDGE IN PREGNANT WOMEN IN WONOGIRI II PRIMARY HEALTH CARE ABSTRACTExclusive breastfeeding means if the baby is only breastfed, without the addition of other fluids such as formula milk, lemon juice, honey, tea water, water and no added solid foods such as bananas, papaya, milk porridge, biscuits, rice porridge and the team for 6 months. The low coverage of the success of exclusive breastfeeding in infants is influenced by many things, including low knowledge and lack of information to mothers and families about the importance of exclusive breastfeeding, hospital management or delivery centers which often do not apply rooming-in, health facilities provide formula milk to newborns, many working mothers find it difficult to breastfeed while working. At the Puskesmas Wonogiri II, coverage of exclusive breastfeeding until October 2010 was 87% of 72 mothers breastfeeding infants 0-6 months. Midwives are of the opinion that the mother's knowledge of exclusive breastfeeding should start from the time the mother is pregnant, so that when the mother gives birth, the mother has a lot of knowledge, is ready to provide exclusive breastfeeding so that the coverage of exclusive breastfeeding increases. The purpose of this study was to determine the relationship between education level and knowledge of pregnant women about exclusive breastfeeding. The research method used was an analytic survey with a cross sectional approach. The are72 sample with total sampling technique used, and using an open questionnaire with 25 items to assess the knowledge of pregnant women about exclusive breastfeeding. Data analysis used the chi square test to test the hypothesis. The results of the study there was no significant relationship between the level of education and knowledge of pregnant women about exclusive breastfeeding. Conclusion, knowledge of pregnant women about exclusive breastfeeding is not only influenced by education. Keyword: Education level, knowledge, exclusive breastfeeding


2021 ◽  
Vol 4 (6) ◽  
pp. 43-59
Author(s):  
Adetoun A.O. ◽  
Olanrewaju A.I. ◽  
Temidayo O.A. ◽  
Oluwasayo B.O.

Background and Aim: Healthcare workers are at risk of infections from blood-borne pathogens due to percutaneous injuries from sharps, mucous membrane and skin exposures to contaminated blood and bodily fluids. The study, therefore, investigated exposure to occupational-related blood and fluids infections, accidental injuries and precaution practices among health care workers in a tertiary hospital in South-West, Nigeria. Methods: The study utilised a cross-sectional research design requiring a structured questionnaire to elicit data from medical doctors, nurses and laboratory scientists/technologists. Through the convenience sampling technique, 266 respondents were selected for the study. Non-parametric descriptive statistics were used to analyse the data with the level of significance of the chi-square test put at 5%. Results: The overwhelming majority (76%) of the health care workers at the hospital are of the female gender. The study found that the majority of the respondents (92%) were trained on infection control in the course of their career while virtually all of them (98%) had never contracted an occupational-related infection. Recapping of used needles accounted for 24.4% of activity that predisposed the workers to accidental injuries. Also, there was a significant association between the recapping of needles and the occurrence of accidental injuries (P.V. = 0.000). Meanwhile, the incidence of unreported injuries stood at 70.3% as all the reasons given were significant (P.V. = 0.000) using a one-sample chi-square test. Conclusion: It has been established that prevention practices like training in infection control, adherence to clear work procedures and guidelines, post-exposure prophylaxis and use of personal protective equipment were associated with contraction of occupational-related infections. Moreover, while recapping of used needles was a usual practice in the hospital, it was, however, associated with cases of accidental injuries among most health care workers. Unfortunately, most cases of injuries were unreported due to certain significant reasons.


Author(s):  
Chinmay N. Gokhale ◽  
Smita S. Chavhan ◽  
Balkrishna B. Adsul ◽  
Maharudra A. Kumbhar ◽  
Kirti V. Kinge ◽  
...  

Background: India was one of the leaders in terms of COVID-19 cases across year 2020. Hypothyroidism is one of the common morbidities that may influence prognosis of infectious diseases. However, some previously published literature had suggested that hypothyroidism may not be affecting outcomes of COVID-19 disease. Objective of this study was to analyze the outcomes of COVID-19 patients with pre-existing hypothyroidism and further suggesting determinants of worse outcomesMethods: This retrospective cohort study was carried out at one of largest Dedicated COVID-19 Hospital in Mumbai, India. Of the 16306 patients that got admitted at this hospital in year 2020, all those having hypothyroidism were included. Bivariate analysis was performed using Chi-square test and Multivariate analysis was performed using multiple logistic regression.Results: A total of 251 patients were having pre-existing hypothyroidism (1.54%). More females had hypothyroidism (73.7%) while death rate was more in males (26.3%). ICU admissions (27.5%) and death proportions (18.3%) were significantly more in hypothyroidism. Diabetes and hypertension were common concomitant Co-morbidities and odds ratios for death for diabetes group, hypertension group and diabetes+hypertension group were 4.9, 8.1 and 4.4 respectively in comparison to those having exclusive hypothyroidism.Conclusions: This study deals with an important topic of co-existing Hypothyroidism in COVID-19 patients and we can conclude that patients with Hypothyroidism must be considered to be at risk of severe outcomes. Furthermore, age, male gender and presence of concomitant Co-morbidities increase the risk of worse outcome.


2020 ◽  
Vol 1 (1) ◽  
pp. 31-50
Author(s):  
Haile Abebe ◽  
◽  
Belay Assefa ◽  

An appropriate diet is critical in the growth and development of children especially in the first two years of life. Poor complementary feeding of children aged 6 months - 23 months contributes to the characteristics negative growth trends and deaths observed in developing countries. Therefore, this study aimed to assess determinants and current level of optimal complementary feeding practices among mothers of children aged 6 months to 23 months in Ambo town, Oromia Region. The study used cross sectional study design and targeted 336 mothers with children 6 months - 23 months olds. Information from the respondents were collected using standard questionnaire. Data entry and analysis was done using SPSS version 21.0 windows statistical software. All (100%) the children 6 months - 8 months old had received solid, semi-solid/soft foods. The minimum meal frequency was attained by 88.3% (95% CI 84.3-91.4) whereas the minimum dietary diversity was attained by 17.9% (95% CI 14.1-22.5). The minimum acceptable diet was attained by 15.4% (95% CI 11.9-19.8). Maternal knowledge on: importance of breastfeeding (87.3%); age of introduction of complementary foods (85.4%) and correct meal frequency for age (74.5%) was high. On the contrary, knowledge on the importance of enriching complementary foods (34.5%) was low. Mothers who knew the importance of a diverse diet were likely (chi-square test; p=0.001) to feed their children on a diverse diet. On the other hand, mothers who knew the importance of enriching complementary foods were likely to feed their children on a minimum acceptable diet (chi-square test; p = 0.007) and maternal knowledge on enriching complementary foods (OR = 3.41, p = 0.040) were significant predictors of consumption of Vitamin A rich foods, minimum meal frequency and minimum acceptable diet, respectively. Behaviour change and communication involving all the stakeholders in infant and young child feeding should be emphasized. Messages on appropriate feeding practices should include importance of dietary diversity


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