ABSTRACT
INTRODUCCIÓN: La lactancia materna tiene importantes beneficios para la salud poblacional. Los objetivos de este estudio son: a) conocer la prevalencia y duración de la lactancia materna y lactancia materna exclusiva; b) analizar las razones de no inicio y de abandono de la lactancia materna, y c) describir los factores asociados a la lactancia materna exclusiva y con su mantenimiento durante 6meses. MATERIAL Y MÉTODOS: Estudio transversal a partir de datos basales de la cohorte ELOIN, obtenidos por cuestionario epidemiológico. Se estudió una muestra de 2.627 niños de 4años nacidos en 2008-2009 de la Comunidad de Madrid. Se utilizaron modelos de regresión logística. RESULTADOS: La prevalencia de lactancia materna exclusiva y lactancia materna fue del 77,6 y del 88%, respectivamente; la lactancia materna exclusiva a los 6 meses fue del 25,4%, y la lactancia materna a los 2 años, del 7,7%. Las razones principales de finalización de la lactancia fueron la producción insuficiente de leche (36%) y la incorporación al trabajo (25,9%). Las variables asociadas con el inicio o mantenimiento de la lactancia materna exclusiva fueron: madre de más de 35años, estatus económico medio-alto, extranjera con menos de 10 años de residencia en España y haber participado en taller de lactancia tras el parto. CONCLUSIONES: La prevalencia de lactancia materna en la Comunidad de Madrid no alcanzó en 2008-2009 las recomendaciones internacionales. Es necesario intensificar estrategias de promoción, protección y apoyo a la lactancia materna, incluyendo su monitorización periódica
INTRODUCTION: Breastfeeding has important benefits for population health. The aims of this study are: (I) to determine the prevalence and duration of breastfeeding and exclusive breastfeeding; (II) analyse the reasons for not starting or abandoning of breastfeeding, and (III) describe the factors associated with the initiation and duration of exclusive breastfeeding. MATERIAL AND METHODS: Cross sectional study using the baseline data of the ELOIN cohort, obtained using an epidemiological questionnaire. A sample of 2,627 children born in 2008-2009 from the Community of Madrid was studied. Logistic regression models were used. RESULTS: Prevalence of exclusive breastfeeding and breastfeeding was 77.6% and 88% respectively; prevalence of exclusive breastfeeding at 6 months 25.4%, and prevalence of breastfeeding at 2 years was 7.7%. The most common reasons for abandoning breastfeeding were insufficient milk (36%), and incorporation to work (25.9%). The variables associated with starting or maintaining of exclusive breastfeeding were: mother older than 35 years, medium-high economic status, foreigner residing in Spain less than 10 years, and having participated in a breastfeeding workshop. CONCLUSIONS: Breastfeeding prevalence in the Community of Madrid did not reach the international recommendations in 2008-2009. It is necessary to intensify strategies for breastfeeding promotion, protection, and support, including their periodic monitoring
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Young Adult , Breast Feeding/statistics & numerical data , Maternal Behavior/psychology , Cross-Sectional Studies , Retrospective Studies , Spain/epidemiology , Time Factors , Urban HealthABSTRACT
INTRODUCTION: Breastfeeding has important benefits for population health. The aims of this study are: (i)to determine the prevalence and duration of breastfeeding and exclusive breastfeeding; (ii)analyse the reasons for not starting or abandoning of breastfeeding, and (iii)describe the factors associated with the initiation and duration of exclusive breastfeeding. MATERIAL AND METHODS: Cross sectional study using the baseline data of the ELOIN cohort, obtained using an epidemiological questionnaire. A sample of 2,627 children born in 2008-2009 from the Community of Madrid was studied. Logistic regression models were used. RESULTS: Prevalence of exclusive breastfeeding and breastfeeding was 77.6% and 88% respectively; prevalence of exclusive breastfeeding at 6months 25.4%, and prevalence of breastfeeding at 2years was 7.7%. The most common reasons for abandoning breastfeeding were insufficient milk (36%), and incorporation to work (25.9%). The variables associated with starting or maintaining of exclusive breastfeeding were: mother older than 35years, medium-high economic status, foreigner residing in Spain less than 10 years, and having participated in a breastfeeding workshop. CONCLUSIONS: Breastfeeding prevalence in the Community of Madrid did not reach the international recommendations in 2008-2009. It is necessary to intensify strategies for breastfeeding promotion, protection, and support, including their periodic monitoring.
Subject(s)
Breast Feeding/statistics & numerical data , Maternal Behavior , Adult , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Maternal Behavior/psychology , Retrospective Studies , Spain , Time Factors , Urban Health , Young AdultABSTRACT
Introducción y objetivos: Dada la gran prevalencia de obesidad infantil en España, se analiza su evolución entre 2006-2007 y 2011-2012, junto con dieta, hábitos de sueño y sedentarismo en la población de 5-14 años y la percepción parental del exceso de peso infantil. Métodos: La muestra procede de las Encuestas Nacionales de Salud de 2006-2007 (n = 5.590) y 2011-2012 (n = 3.601). Las encuestas se realizaron mediante entrevista telefónica a los padres/tutores por personal entrenado. La información sobre peso y talla es la declarada por los encuestados, y se aplicaron los puntos de corte de sobrepeso/obesidad de la International Obesity Task Force. Resultados: La prevalencia de exceso de peso fue del 30,1% en 2006-2007 y del 29,7% en 2011-2012, y la de obesidad, del 9,6 y el 9% respectivamente. La percepción errónea del exceso de peso pasó del 60,8 al 71,4% (p < 0,001). La ingesta diaria de verdura aumentó un 7,8% y la de refrescos y aperitivos disminuyó. Esta caída fue mayor en menores de clase social baja, que también redujeron el consumo de dulces y comida rápida. Mientras el cumplimiento de las recomendaciones sobre horas de sueño disminuyó un 5%, el de las relativas al tiempo máximo de actividad sedentaria no varió. Conclusiones: Las altas cifras de obesidad y sobrepeso infantil permanecieron estables en España entre 2006-2007 y 2011-2012. El error perceptivo del exceso de peso aumentó entre los padres. Aunque disminuyó el consumo de refrescos y aperitivos, se observó un bajo cumplimiento de las recomendaciones dietéticas y las relativas a horas de sueño y ocio sedentario (AU)
Introduction and objectives: Due to the high prevalence of childhood obesity in Spain, we analyzed changes in its prevalence from 2006 to 2007 and from 2011 to 2012, as well as diet, sleep, and sedentary habits in 5- to 14-year-olds and parental misperceptions about their children's excess weight. Methods: The sample was from the Spanish National Health Surveys for 2006 to 2007 (n = 5590) and for 2011 to 2012 (n = 3601). Data were collected by trained personnel through telephone interviews with parents/guardians. Weight and height were self-reported and the International Obesity Task Force cutpoints were used to define overweight and obesity. Results: The prevalence of childhood excess weight was 30.1% from 2006 to 2007 and 29.7% from 2011 to 2012, while that of childhood obesity was 9.6% and 9%, respectively. Parental misperception of childhood excess weight increased from 60.8% to 71.4% (P < .001). Daily consumption of vegetables increased by 7.8%, while that of soft drinks and snacks decreased. This decrease was greatest in children from families with a low socioeconomic status, who also decreased their consumption of sweets and fast food. Adherence to sleep recommendations decreased by 5%, but adherence to recommended sedentary time did not change. Conclusions: High childhood overweight and obesity rates remained stable in Spain from 2006 to 2007 and from 2011 to 2012, but there was an increase in parental misperception of childhood excess weight. Despite reduced consumption of soft drinks and snacks, there was low adherence to dietary recommendations, hours of sleep, and sedentary habits (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Overweight/epidemiology , Pediatric Obesity/epidemiology , Weight Perception , Feeding Behavior , Nutrition Surveys/statistics & numerical data , Body Mass IndexABSTRACT
BACKGROUND: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12 months, as compared with usual care. METHODS/DESIGN: Design: pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. SCOPE: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). POPULATION: patients aged 65-74 years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3 months). SAMPLE SIZE: n = 400 (200 per study arm). INTERVENTION: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. OUTCOMES: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. STATISTICAL ANALYSIS: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. DISCUSSION: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. TRIAL REGISTRATION: Clinicaltrials.gov, NCT02866799.
Subject(s)
Chronic Disease/drug therapy , Drug Prescriptions/statistics & numerical data , Drug Prescriptions/standards , Patient-Centered Care/statistics & numerical data , Patient-Centered Care/standards , Primary Health Care/statistics & numerical data , Primary Health Care/standards , Aged , Aged, 80 and over , Female , Humans , Male , Multimorbidity , Outcome Assessment, Health Care , Polypharmacy , SpainABSTRACT
INTRODUCTION AND OBJECTIVES: Due to the high prevalence of childhood obesity in Spain, we analyzed changes in its prevalence from 2006 to 2007 and from 2011 to 2012, as well as diet, sleep, and sedentary habits in 5- to 14-year-olds and parental misperceptions about their children's excess weight. METHODS: The sample was from the Spanish National Health Surveys for 2006 to 2007 (n=5590) and for 2011 to 2012 (n=3601). Data were collected by trained personnel through telephone interviews with parents/guardians. Weight and height were self-reported and the International Obesity Task Force cutpoints were used to define overweight and obesity. RESULTS: The prevalence of childhood excess weight was 30.1% from 2006 to 2007 and 29.7% from 2011 to 2012, while that of childhood obesity was 9.6% and 9%, respectively. Parental misperception of childhood excess weight increased from 60.8% to 71.4% (P<.001). Daily consumption of vegetables increased by 7.8%, while that of soft drinks and snacks decreased. This decrease was greatest in children from families with a low socioeconomic status, who also decreased their consumption of sweets and fast food. Adherence to sleep recommendations decreased by 5%, but adherence to recommended sedentary time did not change. CONCLUSIONS: High childhood overweight and obesity rates remained stable in Spain from 2006 to 2007 and from 2011 to 2012, but there was an increase in parental misperception of childhood excess weight. Despite reduced consumption of soft drinks and snacks, there was low adherence to dietary recommendations, hours of sleep, and sedentary habits.
Subject(s)
Parents/psychology , Pediatric Obesity/epidemiology , Adolescent , Attitude to Health , Carbonated Beverages/statistics & numerical data , Child , Child, Preschool , Fast Foods/statistics & numerical data , Feeding Behavior/psychology , Female , Healthy Lifestyle , Humans , Male , Overweight/epidemiology , Patient Compliance , Perception , Prevalence , Sedentary Behavior , Sleep/physiology , Socioeconomic Factors , Spain/epidemiologyABSTRACT
Child maltreatment is a major public health problem that has a serious impact on the health and development of children. Reports estimate that at least 55 million children in Europe may experience maltreatment during childhood. It may have a significant negative effect on children’s developmental progress and result in dysfunction during their life-course. Preventing child maltreatment would therefore contribute to preventing a much broader range of difficulties in adult life and enhance children’s long-term social development and physical and mental well-being. The financial costs of maltreatment are high for society, warranting increased investment in preventive and therapeutic strategies from early childhood. The key message to policy-makers and members of civil society is that child maltreatment is not inevitable: it can be prevented by taking a multisectoral, multifactorial public health approach to prevention. This handbook sets out the steps that can be taken when developing an action plan to prevent child maltreatment. It is intended for use alongside other resources developed by the WHO Regional Office for Europe and has been developed to assist countries to implement the European child maltreatment prevention action plan 2015–2020.
Subject(s)
Child , Child Abuse , National Health ProgramsABSTRACT
OBJECTIVE: The objective of this study was to investigate whether pressure hypersensitivity over deep tissues is a feature of acute inversion ankle sprain. DESIGN: This is a cross-sectional study. SETTING: No study has previously investigated peripheral and central sensitization mechanisms in a clinical acute pain model such as inversion ankle sprain. PATIENTS: Twenty individuals with unilateral inversion ankle sprain (10 women/10 men, age: 31 ± 7 years) and 19 comparable healthy controls (11 women/8 men, age: 30 ± 6 years) participated in this study. OUTCOMES: Pressure pain thresholds (PPTs) over anterior talofibular, calcaneofibular, and deltoid ligaments; the lateral and medial malleolus; the tibialis anterior muscle; second metacarpal; and median, radial, and ulnar nerves were bilaterally assessed. RESULTS: The analysis of variance (ANOVA) revealed that PPT levels over the affected anterior talofibular (P = 0.048) and calcaneofibular (P = 0.002) ligaments, and over the affected lateral malleolus (P < 0.001) were lower compared with the non-affected side within patients and both sides in controls. The patients also showed bilateral lower PPT levels over the deltoid ligament than controls (P < 0.05). No significant differences for PPT over the medial malleolus; the second metacarpal; the tibialis anterior muscle; and the median, ulnar, radial nerves were found. Significant negative correlations between intensity of ongoing pain and PPT over the anterior talofibular and deltoid ligaments were found: the higher the pain intensity, the lower the PPT. CONCLUSIONS: This study showed the presence of localized pressure pain hypersensitivity over ankle ligaments in patients with unilateral acute inversion ankle sprain, confirming the presence of localized peripheral sensitization.
