Regarding the socioeconomic factors related to breast- feeding, it is important to highlight the influence of work factors as being determinant of the adherence to initial exclusive breastfeeding among Chinese women who res- ide in Spain. This consideration is evident after adjusting for those variables associated with the work status of the women studied (paid work outside the home, the intention of going back to work, the type of work and the estimated time for going back to work after giving birth), which, as a result, meant that the differences pre- viously observed regarding the country of origin stopped being significant, indicating that an over adjustment in the model may have occurred.
7 Lee mas
studies do not permit adequately clarifying if a given factor was present before or after abandonment of breastfeeding or in general of the event studied. Establishing if a factor is present before en- ding EB is one of the indispensable conditions to involve it in the underlying mechanisms that determine its duration. This way, the factors involved in the underlying mechanisms can be of interest for an intervention aimed at promoting and protecting EB. But, when this cannot be established reliably, an intervention interes- ted in said factor may have its effectiveness compromised. Among the quantitative designs that permit establishing if a factor antecedes an event of interest, there are case and control studies and cohort studies. Cohort studies have an advantage over case and control studies in that measurements of EB duration are made through prospective methods and, thus, avoid bias in the infor- mation that can compromise the validity of the results. Other ele- ments that can be of great help in identifying factors, understan- ding underlying mechanisms to an event and design, implement, and evaluate interventions are the qualitative methods, used as sole methodology or in combination with quantitative methods. Design and evaluation of the effectiveness and cost-effectiveness of potential interventions to prolong the duration of EB: The effectiveness of an intervention of promotion may vary widely. In general, its success is quite linked to its planning before imple- menting it. Thus, interventions that have been subjected to a com- prehensive planning process prior to their implementation are the most successful 13 . Several theoretical models exist to offer support
6 Lee mas
lacerations would cause intense pain, making them feel both unfortunate and guilty for not being able to breastfeed their children. They state that in spite of having been prepared by nature to lactate their babies, these very babies injured them so that they could not offer the nourishment the baby needed at that moment; that feeling of guilt irritated them and made them feel like «bad mothers». They also commented that as much as they insisted on breastfeeding, the milk would not come out and the pain was increasingly acute. The mothers assured that the most painful moment was breastfeeding the baby and not childbirth. The following testimony states how a woman perceives the dual feeling of wanting and not being able to breastfeed the baby:
10 Lee mas
Introduction: To describe the trend of exclusive breastfeeding (EBF) until sixth month of life in Chile before and after the implementation of the parental postnatal law in children treated in the public health system. Material and Method: An observational and population-based study, using the EBF data up to the sixth month obtained from monthly statistical records (MSR), available at the Department of Information and Statistics on Health of children treated in the public health system. Prevalence and weighted prevalence were determined by region and country. Cumulative percentage variation (PV) and annual percentage variation (APV) of prevalence were analyzed using a linear regression model in the period before (2008-2011) and after (2011-2013) of the implementation of the law. Results: The highest prevalence of EBF was observed in 2008 (49.1%) and 2009 (45.1%) and the lowest in 2011 (41.1%). The Antofagasta (33.6%) and Atacama Region (31.6%) had the lowest weighted prevalence of the period. A negative APV was observed in the period 2008-2011 and a positive APV in the period 2011-2013 in all regions and in the country, except for the B. O´Higgins Region. Conclusions: The enactment of the law that increases EBF until 24 weeks of life reverses the decreasing tendency previosly observed until the sixth month. This could encourage other govern- ments to invest resources and efforts in early childhood by providing equity and health.
6 Lee mas
The World Health Organization recommends exclusive breastfeeding for the first six months of age (1). The benefits of breastfeeding are widely described in the scientific literature. According to the recent UpToDate systematic review (2), breastfeeding is proved to provide direct benefits to mothers and babies both in the short and long term. Among the most relevant short term benefits are the prevention of acute infectious processes such as gastrointestinal and respiratory diseases (3, 4). Among the long term benefits are improvements in the child’s neurological development, both on a cognitive level (5, 6), as well as for the development of linguistic skills (7) and is associated with a decreased risk of chronic diseases such as asthma (8).
18 Lee mas
It is also important to highlight that, although a high percentage of the women were found to have good levels of knowledge and attitudes, a significant percentage of these (42%) considered that babies should be breastfed only for the first six months. This is far from the timespan considered ideal by the World Health Organization and this lack of clarity among the Colombian population, is corroborated by a qualitative study involving pregnant women, nursing mothers, and carers of under two-year-olds in the municipalities of Caldas, Colombia, where most of their lack of knowledge and skills were found to involve the ideal time for exclusive breastfeeding and weaning (Benjumea et al., 2013).
26 Lee mas
45,3% of the students surveyed were not aware that all women produce milk after giv- ing birth. 63,7 % thought that it was necessary to supplement breastfeed with bottle-feed. 60,7% believed that mothers milk was not always suitable for feeding newborns. A pa- rameter that a considerable number of stu- dents did not know was the advised duration for breastfeeding. Only 15,3% answered up to two years of age (recommended by the WHO). To the question “What do you think is the most important thing when a child is born?, 71.7% of adolescents indicated the correct option that the newborn must remain with his mother after childbirth. However, the 74,8% of the participants did not know how often a newborn should be fed. Table 2 shows the percentage of correct answers regarding knowledge items in the two study groups (EG and CG) separately.
12 Lee mas
be assessed using the computer-assisted system for ma- ternal monitoring and education and feedback about weight gain will be provided. Second, at each midwife visit pregnant women will receive advice about at least two of following nutrition messages (previously defined as more relevant by health professionals in a qualitative study): avoid the consumption of sugar-sweetened bever- ages (including fruit juice); restrict the consumption of white bread to two pieces/day; replace fatty meats (pork, veal, lamb) by lean meat (poultry, turkey) and fish; eat a variety of vegetables and fruits each day (at least 5 por- tions), in place of foods higher in fat and calories; ante- natal breastfeeding promotion; invitation to physical activity classes. Third, midwife will refer pregnant women to dietitian according to defined criteria: gain more than 3 kg at the first trimester independently of their baseline nutritional status; gain more than 3, 2 and 1.5 kg at the second and third trimesters for normal, overweight and obese pregnant women at baseline, respectively. ii. A physical activity program for pregnant women of moderate-intensity exercise lasting 60 min and performed three times per week will be delivered at each PHCC supervised by licensed physical activity instructors. Each session will consist of 30 min of aer- obic exercise of moderate-intensity (walking, dancing),
6 Lee mas
4 others, proteins with antimicrobial components such as secretory immunoglobulin A (IgA), lysozyme, and Lf; the last one has immune- modulating properties in addition to its well-known anti-infective properties. Oligosaccharides in human milk inhibit bacterial adhesion, further protecting against pathogens. Nucleotides and cytokines of human milk, also assist with T-cell maturation and immune system modulation, evidenced by, e.g., the more robust immune response that breastfed infants exhibit after vaccination. Human milk also promotes healthful gastrointestinal microbiota (Zivkovic et al., 2011), and can actively stimulate development of the newborn’s host defenses to provide continued mucosal protection after breastfeeding. Several components of human milk such as growth factors, interleukin-10 (IL-10) and also Lf can reduce the inflammatory response to stimuli in the newborn intestine (Petit, 2008; Walker, 2010). Lf as a functional human milk ingredient has been demonstrated to increase the resistance of newborns to infections and also has many biological activities that are essential for an adequate health of infants. Recently, Lf has taken more attention in regarding with some healthy activities like its role in the improvement of bone health, cancer prevention and its role as transcription factor. Lf is also able to enter a cell and to activate the transcription of specific DNA sequences and this Lf- DNA interaction is reported to be responsible for antiviral activity (Adlerova et al, 2008).
181 Lee mas
epithelium, making the cells less susceptible to malig- nant transformation, and prolonged breastfeeding, which may lower the periodic influence of estrogen/ progesterone on breast tissue and thus protect against BC. In addition, the strong exfoliation of breast tissue during lactation and the massive epithelial apoptosis at the end of breastfeeding could contribute to decrease the risk of cancer by excreting cells with initial DNA damage from the breast ductal tissue. These results are particularly important to young women for whom aggressive tumors are more likely and less responsive to treatment.
11 Lee mas
Introduction: Breastfeeding (BF) can be a protective factor against obesity and its associated metabo- lic complications. Objective: To determine the association between breastfeeding history and present obesity, metabolic syndrome (MS) and insulin resistance (IR). Patients and Methods: Cross-sectio- nal study in 20 public schools in Santiago, Chile. Anthropometry and blood pressure were assessed. Blood lipids, glucose, insulin and HOMA index were measured in a fast blood sample. Parents answe- red a survey on BF. MS was defined according to Cook´s criteria and IR as HOMA > 90 th percentile.
9 Lee mas
Interpretación: La tabla N° 41 demuestra un nivel de deficiencia en cuanto a la confianza del personal del Hotel San Agustín Exclusive, en diferencia a sus principales competidores, asimismo, en la posición de la empresa en internet y la tecnología que utiliza para facilitar las actividades en el rubro; mostrando cualidades superiores respecto al precio de sus tipo de habitaciones por noche, ya que mediante el instrumento de observación, se fue testigo de las ventas promocionales que ofrece el hotel al momento de atender el teléfono o mediante la página del mismo hotel como booking.com.
122 Lee mas
The variation in organochlorine pesticide levels by breastfeeding time has also been demonstrated by Enna- ceur and Driss (2013), who analyzed pp’DDE, pp’DDT, HCB, HCH and dieldrin for 10 months in breast milk samples from women in Tunisia; a gradual decrease in concentrations of pp’DDE and pp’DDT was observed. Meanwhile Waliszewski et al. (2009) studied such varia- tions over a shorter period of 4–30 days of initial breast- feeding and also found a decrease in values of b-HCH, pp’DDE and pp’DDT. By contrast, Yu et al. (2007) found Fig. 1 pp’DDE levels versus days of lactation
5 Lee mas
“I would say that more than support, it is coherence or consistency in the same discourse. I mean, what happe- ned to me was that shift change came and we had a diffe- rent vision. Another midwife would come and say to me “no, it does not matter, relax, and do not feed anything (breast)”... Then another person would come and say to me “no, let us try”... I lacked coherence..., a consistency with something, especially in this matter... Try to support the mother that if she needs psychological support give it to her, talk more with her, about what happens to the baby, about breastfeeding. They lost the kind of integrity that considers the whole mother-child relationship which is established through breastfeeding” (E6).
7 Lee mas
2 Feeding on demand 0.72 (0.45) 0.68 (0.47) 0.78 (0.42) 0.77 (0.43) 0.420 0.75 (0.44) 0.68 (0.47) 0.345 3 Increased morbimortality risk with exclusive formula feeding 0.64 (0.48) 0.68 (0.47) 0.56 (0.50) 0.59 (0.50) 0.319 0.72 (0.45) 0.56 (0.50) 0.032 4 Breastfeeding when cesarean section 0.84 (0.37) 0.84 (0.37) 0.76 (0.43) 1.00 (0.00) 0.041 0.86 (0.35) 0.82 (0.39) 0.405 5 Way to feed with formula 0.68 (0.47) 0.62 (0.49) 0.68 (0.47) 1.00 (0.00) 0.002 0.69 (0.46) 0.67 (0.47) 0.734 6 Breastfeeding and phototherapy 0.77 (0.42) 0.78 (0.42) 0.76 (0.43) 0.77 (0.43) 0.950 0.72 (0.45) 0.84 (0.37) 0.047 7 First feed in the delivery room 0.83 (0.38) 0.84 (0.37) 0.78 (0.42) 0.86 (0.35) 0.608 0.84 (0.37) 0.82 (0.39) 0.660 8 Breastfeeding in very premature infants 0.94 (0.23) 0.92 (0.27) 0.98 (0.16) 1.00 (0.00) 0.206 0.93 (0.26) 0.96 (0.19) 0.289 9 Clinical case of a newborn not demanding breastmilk 0.50 (0.50) 0.49 (0.50) 0.44 (0.50) 0.68 (0.48) 0.172 0.49 (0.50) 0.51 (0.50) 0.818 10 Prolonged breastfeeding 0.64 (0.48) 0.58 (0.50) 0.73 (0.45) 0.82 (0.39) 0.041 0.64 (0.48) 0.65 (0.48) 0.954 11 Clinical case of low weight gain as a single finding in a breastfed child 0.80 (0.40) 0.78 (0.42) 0.78 (0.42) 0.91 (0.29) 0.379 0.82 (0.39) 0.77 (0.42) 0.387 12 Breastfeeding and complementary feeding 0.66 (0.47) 0.60 (0.49) 0.76 (0.43) 0.82 (0.39) 0.045 0.63 (0.48) 0.70 (0.46) 0.376 13 difference from foremilk and hindmilk 0.57 (0.50) 0.58 (0.50) 0.54 (0.50) 0.59 (0.50) 0.879 0.61 (0.49) 0.52 (0.50) 0.251 14 Recognize a por breastfeeding latch 0.81 (0.40) 0.82 (0.39) 0.73 (0.45) 0.91 (0.29) 0.223 0.82 (0.39) 0.79 (0.41) 0.635 15 WHO recommendations on breastfeeding 0.84 (0.37) 0.80 (0.40) 0.88 (0.33) 1.00 (0.00) 0.046 0.84 (0.37) 0.84 (0.37) 0.991 16 Most important action in a nursing mother with cracked nipples (4 options) 0.83 (0.38) 0.82 (0.39) 0.83 (0.38) 0.91 (0.29) 0.570 0.83 (0.38) 0.83 (0.38) 0.968 17 Clinical case of a growth spurt (4 options) 0.60 (0.49) 0.55 (0.50) 0.56 (0.50) 0.91 (0.29) 0.006 0.58 (0.50) 0.62 (0.49) 0.563
11 Lee mas
170. Les Parties sont en désaccord en ce qui concerne les droits que peuvent générer les autres formations maritimes. Concernant Quitasueño, leurs divergences sont telles que les droits générés par cette formation feront l’objet d’une section distincte (paragraphes 181-183 ci-dessous). Le Nicaragua soutient que les cayes d’Alburquerque, les cayes de l’Est-Sud-Est, Roncador, Serrana, Serranilla et Bajo Nuevo tombent toutes sous le coup de l’exception prévue au paragraphe 3 de l’article 121 de la CNUDM ; autrement dit, il s’agirait de rochers ne générant aucun droit à un plateau continental ou à une zone économique exclusive. Il fait valoir que les for- mations en question doivent être considérées séparément et que l’on ne saurait étendre la portée géographique des droits qu’elles génèrent en mer en les considérant comme un groupe, compte tenu surtout de la distance considérable qui les sépare. Il conteste par ailleurs ce qu’il tient pour une tentative, de la part de la Colombie, de donner à ces îles une taille dispro- portionnée, en se servant des dimensions des bancs et des basses sur les- quels elles reposent. Selon lui, seules les formations individuelles qui restent découvertes à marée haute peuvent générer des droits à des espaces maritimes et, dans chaque cas, la portée de ces droits est fonction des dimensions de l’île et non de ses liens avec d’autres formations maritimes.
197 Lee mas
Factor II. There was no significant difference between U.S. and international students (P = 0.347) with regard to knowledge about breastfeeding basics. Students from either group had nearly identical mean factor scores. On the other hand, significant difference was found between students who were 18-19 and those who were 23-30 (P < 0.001) and also these 31 and over (P < 0.001) with lowest mean scores in 18 to 19 groups. Those 20-22 had the lower mean score than those 23-30 (P < 0.001), and those over 31 (P < 0.001). Finally, those 23- 30 had significantly lower scores than those over 31 (P < 0.001). Females had significantly higher scores than males (P < 0.001). On the contrary, there was no significant difference in race for this factor (P = 0.011). Married students had significantly higher scores than single students (P < 0.001). Significantly lower scores were observed for students that did not know if they were breastfed as children compare to those who were breastfed (P < 0.001) and also those that were not (P < 0.001). Those who had breastfed a child themselves had significantly higher scores than those women who had no prior experience (P < 0.001) (Table 19 and Table 20).
44 Lee mas
for control of hypertension, is mainly eliminated be used with caution. Thus, contraindications should through glomerular filtration. This medication is also be assessed on a per patient basis, with the benefits known to be accumulated in milk (milk-to-plasma and risks to both the mother and infant weighed. The ratio of about 2). In addition to its relatively high presence of adverse events reported in the literature, excretion into milk, immaturity of renal function of or the theoretical risks of adverse events does not the infant was probably one of the contributing automatically suggest contraindication, although a factors to the toxicity in this case. Also, meperidine cautious approach may be required (e.g. monitoring administered to mothers after delivery, and pre- the infant for physical / behavioural changes). sumably excreted into milk, reportedly caused neuro- Risk assessment of maternal drug treatment during behavioral depression in the breastfed infants, com- breastfeeding is further complicated by lack of data pared to morphine . Thus, although some drugs on long-term adverse outcomes in the infants. Such are taken safely by lactating women, some result in effects may include behavioral and subtle cognitive significant exposures and toxicity in the infants. changes that may become overt only later in the Most recommendations on the safety of medica- infant’s life. This is a concern, especially for psycho- tions during lactation are based on theoretical risks, active medications, even without apparent immediate case reports, or single case studies that measured clinical effects. Without the data, it is impossible to breast milk or infant serum drug levels. Although a interpret and assess clinical significance of any handful of prospective, cohort studies exist, there is amounts of drug excreted into milk, and ingested by an overall lack of published information confirming the infant.
12 Lee mas
The present work is developed in the EXCLUSIVE CAR Automotive Workshop, in charge of providing mechanical services in general, where activities are carried out that generate hazardous waste exposing workers to risk factors, the objective of this study is to analyze the Occupational Risks in the Waste handling in the automotive workshop to minimize risks and reduce occupational accidents in the company, the field research method is used, through the survey it is determined that 87.5% of the workers surveyed indicate that they have no knowledge of the occupational hazards to which you are exposed when handling hazardous waste and carrying out work activities, it is proposed to control the exposure to waste by means of a Risk Management Plan on the handling of waste for the automotive workshop based on legal technical requirements , with a total cost of $ 22,703.00.
73 Lee mas
Applications use resources to give users service. These applications may require the exclusive use of resources. The use of protocols that guarantee mutual exclusion pro- vides a solution of this problem. Several authors proposed different options using the shared-memory or message-passing model (, , , , ). In distributed sys- tems, applications need resources too, but there may be two different options: some processes compete and some processes collaborate to give users service. There may also be another situation where a resource can be shared by processes with common property, i.e., they belong to the same group or they will not be in conflict while us- ing the resource. Processes with different properties must use the resource in exclusive mode. For example, database applications require a mutual exclusion property for data inserting operation and concurrency property for data selecting operation. This situ- ation is similar to the readers-writers problem (multiple readers-single writer). This type of problem is solved by using protocols that guarantee group mutual exclusion (GME). Properties of mutual exclusion and concurrency are important at the time of the design.
10 Lee mas