Food and family care during the COVID-19 pandemic: A study of women's domestic workload during the first wave in Chile.

This study aimed to explore women's perceptions of domestic work related to food and family care during the first wave of the COVID-19 pandemic in Chile and its association with sociodemographic and health variables. We conducted a cross-sectional, analytical, non-probabilistic study. A sample of 2047 women answered an online self-report survey that included a Likert scale about the perception of domestic work associated with food. The survey also included an open comment section. The survey was available between May and June 2020, during the first wave of the COVID-19 pandemic and when most of the country had some degree of mobility restriction. 70.2% of participants perceived their domestic work as "regular"; being younger, having a higher educational level, caring for children or the elderly, and having worse self-perception of mental and general health status increased the chances of having a lower perception of the burden of these tasks. In comments, women declared how heavy the domestic work was, the challenges of being together with their families and of paid job requirements, and how family demands from them increased. Most women felt that their domestic work was heavier during this pandemic period: some groups of women could be at risk of being more affected by this extra workload at home. The importance of interventions and public policies with a gender perspective becomes relevant, considering the role of women in the home and the necessity to generate a social change regarding the domestic burden associated with gender.

Family influences on food choices and nutrition: What does the literature say?

ABSTRACT The prevention of diseases related to nutrition requires an approach that considers aspects that transcend the individual level in understanding food decisions. In this context, the family as an interpersonal determinant of eating behavior is gaining importance in developing behavioral change interventions that seek better nutritional health. This manuscript aims to describe the current evidence of how family variables influence its members' food choices and nutritional status. Specifically, we present evidence on family functioning, parental feeding styles, and family meals, as they are recent topics of interest in the area. The evidence shows that a better or balanced family functioning or some of its components (communication, conflicts, cohesion, among others); a parental feeding style that demands but listens to the requirements from children; and a higher frequency of family meals are associated with a lower Body Mass Index (BMI) and healthier eating habits, especially in children and adolescents. A deep understanding of family variables could guide weight management interventions and provide information that could explain why some interventions work and others do not.

RESUMEN La prevención de enfermedades relacionadas con la nutrición requiere de un enfoque que considere aspectos que transciendan el nivel individual en el entendimiento de las decisiones alimentarias. En este contexto, la familia como un determinante interpersonal de las conductas alimentarias, está ganando importancia en el desarrollo de intervenciones de cambio conductual que buscan una mejor salud nutricional. Este artículo tiene como objetivo describir la evidencia actual de cómo variables familiares influyen en las elecciones alimentarias y el estado nutricional de sus miembros. Específicamente, presentamos evidencia sobre el funcionamiento familiar, los estilos parentales de alimentación y las comidas familiares, ya que son temas recientes de interés en el área. La evidencia muestra que un mejor o equilibrado funcionamiento familiar o de algunos de sus componentes (comunicación, conflictos, cohesión, entre otros); un estilo parental que exige, pero escucha los requerimientos de los niños; y una mayor frecuencia de comidas familiares se asocian con un menor Índice de Masa Corporal (IMC) y hábitos alimentarios más saludables, especialmente en niños y adolescentes. Una comprensión profunda de las variables familiares podría orientar las intervenciones de control de peso y brindar información que explicaría por qué algunas intervenciones funcionan y otras no.

Una aproximación a la alfabetización nutricional, evaluación del estado nutricional y calidad de la alimentación en una muestra a conveniencia de mujeres de comunas con pobreza multidimensional

RESUMEN La obesidad es factor de riesgo para las enfermedades crónicas no transmisibles. Esta condición afecta principalmente a mujeres de bajo nivel socioeconómico. La alfabetización nutricional, referida al conocimiento en alimentación y nutrición, podría estar determinando la calidad de la dieta, la que a su vez podría favorecer el desarrollo de la obesidad. Los objetivos del estudio fueron 1) Describir la alfabetización nutricional, el estado nutricional y la calidad de la alimentación, y 2) Explorar la relación entre estas tres variables, en un grupo de mujeres de comunas con pobreza multidimensional de la Región Metropolitana. Se diseñó un estudio transversal, no probabilístico, en donde participaron 122 mujeres. Se evalúo el estado nutricional mediante el cálculo del Índice de Masa Corporal, midiendo peso y talla. La calidad de la alimentación se evaluó utilizando una encuesta de tendencia de consumo alimentaria y el Índice de Alimentación Saludable, y la alfabetización nutricional, con el cuestionario Nutritional Literacy en español (NLit-S), adaptado a la población chilena. La prevalencia de obesidad fue 47,5% y el 88,5% de las mujeres presentó necesidad de cambios en su alimentación. Un 66,4% presentó una alfabetización nutricional deficiente, con más mujeres con exceso de peso en esta categoría. Dominio de etiquetado nutricional fue el que obtuvo peores resultados. Se concluye que la condición alimentaria nutricional de las mujeres de nuestro estudio sugiere un desafío para el trabajo por parte de profesionales de la salud, así como para quienes toman decisiones en alimentación y nutrición.

ABSTRACT Obesity is a risk factor for chronic non-communicable diseases. This condition mainly affects women of low socioeconomic status. Nutritional literacy, understood as knowledge of food and nutrition, could determine the quality of the diet, which in turn could cause the development of obesity. The aims were 1) To describe the nutritional literacy, nutritional status, and food quality, and 2) To explore the relationship between these three variables, in a group of women from communes with multidimensional poverty in the Metropolitan Region. We conducted a cross-sectional, non-probabilistic study in which 122 women participated. The nutritional status was evaluated by calculating the Body Mass Index using weight and height measurements. The diet quality was evaluated using a survey of food consumption trends and the Healthy Eating Index. Nutritional literacy was evaluated with the Nutritional Literacy questionnaire in Spanish adapted for the Chilean population. The prevalence of obesity was 47.5%, and 88.5% of the women presented the need for changes in their diet. 66.4% of women had low nutritional literacy, with more overweight women in this category. The nutrition labeling domain was the one with the worst results. We concluded that women's food and nutritional condition suggests a challenge for health professionals and those who make decisions about food and nutrition.

Women's perceptions about changes in food-related behaviours at home during COVID-19 pandemic in Chile.

OBJECTIVE: To explore women's perceptions of changes in specific food habits at home, specifically the food budget and shopping, and food preparation, during the COVID-19 period. DESIGN: Non-probabilistic, exploratory study. Participants completed an online self-administered questionnaire. Perceptions of food habit changes were measured on a five-point Likert scale (strongly disagree to strongly agree). Data analysis was conducted in STATA v16.0. SETTING: Chile. PARTICIPANTS: Adult women between 25 and 65 years old (n 2047). RESULTS: Of the participants, 72 % were responsible for cooking, 69 % for buying food and 85 % for child care. Difficulties in organising and doing food budget works were observed in groups with a lower educational level, lower income and single mothers with children. Younger participants, dependent workers, women from biparental families with children and those in mandatory quarantine perceived more changes in their food shopping and budget management tasks. Participants more educated, with higher income and non-mandatory quarantine perceived to cook and eat healthier. Older participants perceived minor changes in their food preparation tasks at home; in contrast, more educated women and women from biparental families with children perceived more changes. If women were in charge of the kids or grocery shopping, more food environment changes were noticed. CONCLUSIONS: Women perceived changes in their food environments. Some of these changes are perceived worse in the more vulnerable population. COVID-19 presents a challenge for the food system and gender perspectives. This information should be considered in the design of food-related interventions.

Improving antibiotic use through behaviour change: a systematic review of interventions evaluated in low- and middle-income countries.

Antibiotic resistance (ABR) has been identified as a critical threat to global health at the highest policy fora. A leading cause of ABR is the inappropriate use of antibiotics by both patients and healthcare providers. Although countries around the world have committed to developing and implementing national action plans to tackle ABR, there is a considerable gap in evidence about effective behaviour change interventions addressing inappropriate use of antibiotics in low- and middle-income countries (LMICs), where ABR is growing at an alarming rate. We conducted a systematic review to synthesize evidence about the effectiveness and cost-effectiveness of behaviour change interventions to reduce inappropriate use of antibiotics in LMICs. Three databases were searched using a set of predefined search terms and exclusion criteria. The search identified 43 relevant articles. A narrative synthesis of results was conducted using the Behaviour Change Wheel framework to categorize intervention components. The majority of the reviewed studies were set in lower-middle-income or low-income countries located in Sub-Saharan Africa or East Asia and the Pacific. Twenty-four articles evaluated multi-faceted interventions over a period of 12 months or less. Despite the widespread use of antibiotics in the community, interventions were primarily implemented in public health facilities, targeting health professionals such as doctors, nurses, and other allied medical staff. Although education for providers was the most widely used strategy for influencing antibiotic use, it was shown to be most effective when used in conjunction with training or other enabling and supportive measures to nudge behaviour. Six articles included an evaluation of costs of interventions and found a reduction in costs in inpatient and outpatient settings, and one article found a training and guidelines implementation-based intervention to be highly cost-effective. However, the small number of articles conducting an economic evaluation highlights the need for such analyses to be conducted more frequently to support priority setting in resource-constrained environments.

Understanding the food-family relationship: A qualitative research in a Chilean low socioeconomic context.

Our life is comprised of, among other things, many food and eating decisions. Therefore, we are in a constant relationship with food. Although many health providers and researchers have recommended having a positive relationship with food for better health and well-being, what the human relationship with food entails is still unclear. The aim of this study is to explore the relationship with food among families in Chile, a country that has the highest rate of obesity among OECD countries. In this qualitative study, we conducted eight focus groups in three regions of Chile (North, Center, and South). We recruited women living with their partners and children who represented the family point of view. For data analysis, we used the Atlas.ti program and conducted a thematic analysis. We found that the family relationship with food had five dimensions: (1) An identity dimension that allowed families to describe themselves or some of their family members; (2) an emotional dimension in which family expressed feelings and emotions through food; (3) a social dimension in which family members got together through food; (4) a health dimension in which family related to food to obtain benefits from it or to avoid enemy food; (5) a practical dimension in which families were organized around food tasks. Our findings show that the relationship that Chilean families have with food is a complex phenomenon. All the dimensions should be taken in consideration to create or improve interventions that seek to improve eating habits or prevent nutrition-related diseases from a family perspective.

How effective and cost-effective are behaviour change interventions in improving the prescription and use of antibiotics in low-income and middle-income countries? A protocol for a systematic review.

INTRODUCTION: Antibiotic resistance endangers effective prevention and treatment of infections, and places significant burden on patients, families, communities and healthcare systems. Low-income and middle-income countries (LMICs) are especially vulnerable to antibiotic resistance, owing to high infectious disease burden, and limited resources for treatment. High prevalence of antibiotic prescription and use due to lack of provider's knowledge, prescriber's habits and perceived patient needs further exacerbate the situation. Interventions implemented to address the inappropriate prescription and use of antibiotics in LMICs must address different determinants of antibiotic resistance through sustainable and scalable interventions. The aim of this protocol is to provide a comprehensive overview of the methods that will be used to identify and appraise evidence on the effectiveness and cost-effectiveness of behaviour change interventions implemented in LMICs to improve the prescription and use of antibiotics. METHODS AND ANALYSIS: Two databases (Web of Science and PubMed) will be searched based on a strategy developed in consultation with an essential medicines and health systems researcher. Additional studies will be identified using the same search strategy in Google Scholar. To be included, a study must describe a behaviour change intervention and use an experimental design to estimate effectiveness and/or cost-effectiveness in an LMIC. Following systematic screening of titles, abstracts and keywords, and full-text appraisal, data will be extracted using a customised extraction form. Studies will be categorised by type of behaviour change intervention and experimental design. A meta-analysis or narrative synthesis will be conducted as appropriate, along with an appraisal of quality of studies using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) checklist. ETHICS AND DISSEMINATION: No individual patient data are used, so ethical approval is not required. The systematic review will be disseminated in a peer-reviewed journal and presented at a relevant international conference. PROSPERO REGISTRATION NUMBER: CRD42017075596.

Experiencia de la práctica del kundalini yoga para el bienestar multidimensional / Experience of the practice of kundalini yoga for multidimensional well-being

Desde hace un tiempo, la medicina alternativa o complementaria ha tenido gran auge tanto en Chile como en todo Occidente. Ello se ha debido a diversos factores, desde la disconformidad de la población hacia el sistema de salud actual hasta el gran desarrollo de las comunicaciones que ha acercado a culturas que fueron muy lejanas como es la globalización, etc. El profesional de Enfermería forma parte de este cambio cultural y no puede estar ausente. Por lo anterior, conocer otras culturas médicas, técnicas sanadoras y nuevas formas en que las personas llevan su autocuidado podrá ser de gran ayuda en la práctica profesional. Dentro de este universo, el Kundalini Yoga que es una de las formas más poderosas del Yoga, busca equilibrar el cuerpo, la mente y el espíritu a través de series de ejercicios y meditación. Para conocer cómo el yoga ha afectado el bienestar multidimensional de la persona, las motivaciones y describir los efectos que tiene esta disciplina, se utilizó la Investigación Cualitativa de Trayectoria Fenomenológica, se realizaron siete entrevistas para develar las interrogantes planteadas a través del análisis de los aspectos más relevantes. En los resultados de la investigación emergieron los siguientes temas: Conociendo las motivaciones. El proceso de experimentar los cambios. Adquiriendo hábitos para un nuevo estilo de vida. Descubriendo cambios físicos. Superando problemas de salud. Potenciando el ser humano. Respirando largo y profundo. Reencontrándose con la espiritualidad. El significado de Kundalini Yoga en la vida. El resultado de este análisis reveló que la práctica regular de Kundalini Yoga para los informantes, afecta positivamente su bienestar personal y abarca todas sus dimensiones, independientemente de las motivaciones que les llevaron a su práctica, provocando cambios en el plano mental, físico, espiritual, influye positivamente en la prevención y en la restauración de la salud, los construye como seres humanos más plenos, sanos y felices a quienes, con el paso del tiempo, han adoptado esta disciplina como un estilo de vida. (AU)