Tania Maria Brasil Esteves

Factors associated to breastfeeding in the first hour of life: systematic review

OBJECTIVE To identify independent risk factors for non-breastfeeding within the first hour of life. METHODS A systematic review of Medline, LILACS, Scopus, and Web of Science electronic databases, till August 30, 2013, was performed without restrictions on language or date of publishing. Studies that used regression models and provided adjusted measures of association were included. Studies in which the regression model was not specified or those based on specific populations regarding age or the presence of morbidities were excluded. RESULTS The search resulted in 155 articles, from which 18 met the inclusion criteria. These were conducted in Asia (9), Africa (5), and South America (4), between 1999 and 2013. The prevalence of breastfeeding within the first hour of life ranged from 11.4%, in a province of Saudi Arabia, to 83.3% in Sri Lanka. Cesarean delivery was the most consistent risk factor for non-breastfeeding within the first hour of life. “Low family income”, “maternal age less than 25 years”, “low maternal education”, “no prenatal visit”, “home delivery”, “no prenatal guidance on breastfeeding” and “preterm birth” were reported as risk factors in at least two studies. CONCLUSIONS Besides the hospital routines, indicators for low socioeconomic status and poor access to health services were also identified as independent risk factors for non-breastfeeding within the first hour of life. Policies to promote breastfeeding, appropriate to each context, should aim to reduce inequalities in health.

Avaliação do curso de especialização em enfermagem nas doenças infecciosas, na FIOCRUZ (1997-1999)

O estudo descreve a experiência de implantação e do desenvolvimento do Curso de Especialização em Enfermagem nas Doenças Infecciosas e sua operacionalização no âmbito do Centro de Pesquisa Clínica Evandro de Chagas, da Fundação Oswaldo Cruz, Rio de Janeiro, no período de 1997 a 1999. Objetiva mostrar, sob perspectiva histórica do Hospital e das doenças infecciosas, a experiência acumulada no processo de formação de recursos humanos. Justifica o porquê da especialização nas doenças infecciosas à medida que, nos países subdesenvolvidos e em desenvolvimento, o perfil das causas de morbimortalidade ainda são significativas. Demonstra processo de adequação do curso avaliado pelos coordenadores, corpo docente e discente, durante o seu desenvolvimento, e aborda a relevância da formação na vida pessoal e profissional de seus egressos que, na sua maioria, se inseriram no mercado de trabalho e desenvolvem ações educativas, intervindo significativamente com novas práticas nos serviços de saúde.O estudo descreve a experiencia de implantacao e do desenvolvimento do Curso de Especializacao em Enfermagem nas Doencas Infecciosas e sua operacionalizacao no âmbito do Centro de Pesquisa Clinica Evandro de Chagas, da Fundacao Oswaldo Cruz, Rio de Janeiro, no periodo de 1997 a 1999. Objetiva mostrar, sob perspectiva historica do Hospital e das doencas infecciosas, a experiencia acumulada no processo de formacao de recursos humanos. Justifica o porque da especializacao nas doencas infecciosas a medida que, nos paises subdesenvolvidos e em desenvolvimento, o perfil das causas de morbimortalidade ainda sao significativas. Demonstra processo de adequacao do curso avaliado pelos coordenadores, corpo docente e discente, durante o seu desenvolvimento, e aborda a relevância da formacao na vida pessoal e profissional de seus egressos que, na sua maioria, se inseriram no mercado de trabalho e desenvolvem acoes educativas, intervindo significativamente com novas praticas nos servicos de saude.This study describes the experience of implanting and developing the specialization course in Infectious Disease Nursing, as well as its implementation within the Evandro Chagas, clinical research center at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, from 1997 to 1999. From the historical perspective of the hospital and infectious diseases, this research aims to demonstrate the experience accumulated in the human resource formation process. It justifies a specialization course in infectious diseases to the extent that, in underdeveloped and developing countries, the profile of morbidity/mortality causes is still important. It sets forth the process of adjusting the course, evaluated by the coordinators, teaching staff and students, throughout its development, and deals with the significance of such training in the private and professional lives of its graduates, most of whom entered the labor market and are engaged in educational activities, with an expressive promotion of new practices in health services.

Profile of Brazilian smokers in the National Program for Tobacco Control

OBJECTIVE The treatment of tobacco addiction in Brazil has expanded in recent years; however, we must increase knowledge about the characteristics of individuals who adhere to cessation programs in order to adjust treatments to specific characteristics of the target population that favor success. The aim of this study was to describe the characteristics of smokers who present to Brazilian public health units seeking help to quit smoking based on the experience of a primary health care unit that covers a poor community in the city of Rio de Janeiro. METHODS Data were collected at a Teaching Health Center from January 03 2012 to January 03 2014. RESULTS Mean patient age was 49.32 ± 11.82 years, and 71% were women. About half of the participants successfully quit smoking (n=125, 51%). Higher levels of nicotine dependence were associated with lower levels of smoking cessation. There was a notable decrease in the probability of remaining smoking throughout the first month of treatment. After 3 weeks of treatment, only 19% had not quit smoking. The probability of quitting smoking decreases by 2% for every additional year of age. CONCLUSION There is a need to revise and expand current strategies to make them more effective in preventing smoking since childhood.

Fatores associados ao início tardio da amamentação em hospitais do Sistema Único de Saúde no Município do Rio de Janeiro, Brasil, 2009

This study aimed to analyze factors associated with delayed initiation of breastfeeding (lack of breastfeeding in the first hour of life). This was a cross-sectional study conducted in 2009 with 673 postpartum women at hospitals belonging to the Brazilian Unified National Health System (SUS) in the city of Rio de Janeiro, Brazil. Statistical analysis used multilevel logistic regression, with two levels (individual and hospital). Prevalence of delayed initiation of breastfeeding was 49.2%. Delivery in a Baby-Friendly Hospital (BFH) had a protective effect against late initiation of breastfeeding (OR = 0.17; 95%CI: 0.05-0.55), while cesarean section (OR = 5.95; 95%CI: 3.88-9.12) and ignorance of HIV status until delivery (OR = 2.16; 95%CI: 1.04-4.50) increased the odds of delay. Reduction in cesarean rates, adherence to protocols to prevent vertical HIV transmission, and expanded accreditation of hospitals in the BFH are important strategies to promote breastfeeding in the first hour of life.This study aimed to analyze factors associated with delayed initiation of breastfeeding (lack of breastfeeding in the first hour of life). This was a cross-sectional study conducted in 2009 with 673 postpartum women at hospitals belonging to the Brazilian Unified National Health System (SUS) in the city of Rio de Janeiro, Brazil. Statistical analysis used multilevel logistic regression, with two levels (individual and hospital). Prevalence of delayed initiation of breastfeeding was 49.2%. Delivery in a Baby-Friendly Hospital (BFH) had a protective effect against late initiation of breastfeeding (OR = 0.17; 95%CI: 0.05-0.55), while cesarean section (OR = 5.95; 95%CI: 3.88-9.12) and ignorance of HIV status until delivery (OR = 2.16; 95%CI: 1.04-4.50) increased the odds of delay. Reduction in cesarean rates, adherence to protocols to prevent vertical HIV transmission, and expanded accreditation of hospitals in the BFH are important strategies to promote breastfeeding in the first hour of life.

[Factors associated with late initiation of breastfeeding in the Brazilian Unified National Health System in the city of Rio de Janeiro, Brazil, 2009].

This study aimed to analyze factors associated with delayed initiation of breastfeeding (lack of breastfeeding in the first hour of life). This was a cross-sectional study conducted in 2009 with 673 postpartum women at hospitals belonging to the Brazilian Unified National Health System (SUS) in the city of Rio de Janeiro, Brazil. Statistical analysis used multilevel logistic regression, with two levels (individual and hospital). Prevalence of delayed initiation of breastfeeding was 49.2%. Delivery in a Baby-Friendly Hospital (BFH) had a protective effect against late initiation of breastfeeding (OR = 0.17; 95%CI: 0.05-0.55), while cesarean section (OR = 5.95; 95%CI: 3.88-9.12) and ignorance of HIV status until delivery (OR = 2.16; 95%CI: 1.04-4.50) increased the odds of delay. Reduction in cesarean rates, adherence to protocols to prevent vertical HIV transmission, and expanded accreditation of hospitals in the BFH are important strategies to promote breastfeeding in the first hour of life.This study aimed to analyze factors associated with delayed initiation of breastfeeding (lack of breastfeeding in the first hour of life). This was a cross-sectional study conducted in 2009 with 673 postpartum women at hospitals belonging to the Brazilian Unified National Health System (SUS) in the city of Rio de Janeiro, Brazil. Statistical analysis used multilevel logistic regression, with two levels (individual and hospital). Prevalence of delayed initiation of breastfeeding was 49.2%. Delivery in a Baby-Friendly Hospital (BFH) had a protective effect against late initiation of breastfeeding (OR = 0.17; 95%CI: 0.05-0.55), while cesarean section (OR = 5.95; 95%CI: 3.88-9.12) and ignorance of HIV status until delivery (OR = 2.16; 95%CI: 1.04-4.50) increased the odds of delay. Reduction in cesarean rates, adherence to protocols to prevent vertical HIV transmission, and expanded accreditation of hospitals in the BFH are important strategies to promote breastfeeding in the first hour of life.

Factores asociados con el inicio tardío de la lactancia materna en hospitales del Sistema Único de Salud en el municipio de Río de Janeiro, Brasil, 2009

This study aimed to analyze factors associated with delayed initiation of breastfeeding (lack of breastfeeding in the first hour of life). This was a cross-sectional study conducted in 2009 with 673 postpartum women at hospitals belonging to the Brazilian Unified National Health System (SUS) in the city of Rio de Janeiro, Brazil. Statistical analysis used multilevel logistic regression, with two levels (individual and hospital). Prevalence of delayed initiation of breastfeeding was 49.2%. Delivery in a Baby-Friendly Hospital (BFH) had a protective effect against late initiation of breastfeeding (OR = 0.17; 95%CI: 0.05-0.55), while cesarean section (OR = 5.95; 95%CI: 3.88-9.12) and ignorance of HIV status until delivery (OR = 2.16; 95%CI: 1.04-4.50) increased the odds of delay. Reduction in cesarean rates, adherence to protocols to prevent vertical HIV transmission, and expanded accreditation of hospitals in the BFH are important strategies to promote breastfeeding in the first hour of life.This study aimed to analyze factors associated with delayed initiation of breastfeeding (lack of breastfeeding in the first hour of life). This was a cross-sectional study conducted in 2009 with 673 postpartum women at hospitals belonging to the Brazilian Unified National Health System (SUS) in the city of Rio de Janeiro, Brazil. Statistical analysis used multilevel logistic regression, with two levels (individual and hospital). Prevalence of delayed initiation of breastfeeding was 49.2%. Delivery in a Baby-Friendly Hospital (BFH) had a protective effect against late initiation of breastfeeding (OR = 0.17; 95%CI: 0.05-0.55), while cesarean section (OR = 5.95; 95%CI: 3.88-9.12) and ignorance of HIV status until delivery (OR = 2.16; 95%CI: 1.04-4.50) increased the odds of delay. Reduction in cesarean rates, adherence to protocols to prevent vertical HIV transmission, and expanded accreditation of hospitals in the BFH are important strategies to promote breastfeeding in the first hour of life.

Evaluation of the nursing specialization course in infectious diseases at the FIOCRUZ (1997-1999)

O estudo descreve a experiência de implantação e do desenvolvimento do Curso de Especialização em Enfermagem nas Doenças Infecciosas e sua operacionalização no âmbito do Centro de Pesquisa Clínica Evandro de Chagas, da Fundação Oswaldo Cruz, Rio de Janeiro, no período de 1997 a 1999. Objetiva mostrar, sob perspectiva histórica do Hospital e das doenças infecciosas, a experiência acumulada no processo de formação de recursos humanos. Justifica o porquê da especialização nas doenças infecciosas à medida que, nos países subdesenvolvidos e em desenvolvimento, o perfil das causas de morbimortalidade ainda são significativas. Demonstra processo de adequação do curso avaliado pelos coordenadores, corpo docente e discente, durante o seu desenvolvimento, e aborda a relevância da formação na vida pessoal e profissional de seus egressos que, na sua maioria, se inseriram no mercado de trabalho e desenvolvem ações educativas, intervindo significativamente com novas práticas nos serviços de saúde.O estudo descreve a experiencia de implantacao e do desenvolvimento do Curso de Especializacao em Enfermagem nas Doencas Infecciosas e sua operacionalizacao no âmbito do Centro de Pesquisa Clinica Evandro de Chagas, da Fundacao Oswaldo Cruz, Rio de Janeiro, no periodo de 1997 a 1999. Objetiva mostrar, sob perspectiva historica do Hospital e das doencas infecciosas, a experiencia acumulada no processo de formacao de recursos humanos. Justifica o porque da especializacao nas doencas infecciosas a medida que, nos paises subdesenvolvidos e em desenvolvimento, o perfil das causas de morbimortalidade ainda sao significativas. Demonstra processo de adequacao do curso avaliado pelos coordenadores, corpo docente e discente, durante o seu desenvolvimento, e aborda a relevância da formacao na vida pessoal e profissional de seus egressos que, na sua maioria, se inseriram no mercado de trabalho e desenvolvem acoes educativas, intervindo significativamente com novas praticas nos servicos de saude.This study describes the experience of implanting and developing the specialization course in Infectious Disease Nursing, as well as its implementation within the Evandro Chagas, clinical research center at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, from 1997 to 1999. From the historical perspective of the hospital and infectious diseases, this research aims to demonstrate the experience accumulated in the human resource formation process. It justifies a specialization course in infectious diseases to the extent that, in underdeveloped and developing countries, the profile of morbidity/mortality causes is still important. It sets forth the process of adjusting the course, evaluated by the coordinators, teaching staff and students, throughout its development, and deals with the significance of such training in the private and professional lives of its graduates, most of whom entered the labor market and are engaged in educational activities, with an expressive promotion of new practices in health services.

Evaluación de la especialización en enfermería de las enfermedades infecciosas, en la FIOCRUZ (1997-1999)

O estudo descreve a experiência de implantação e do desenvolvimento do Curso de Especialização em Enfermagem nas Doenças Infecciosas e sua operacionalização no âmbito do Centro de Pesquisa Clínica Evandro de Chagas, da Fundação Oswaldo Cruz, Rio de Janeiro, no período de 1997 a 1999. Objetiva mostrar, sob perspectiva histórica do Hospital e das doenças infecciosas, a experiência acumulada no processo de formação de recursos humanos. Justifica o porquê da especialização nas doenças infecciosas à medida que, nos países subdesenvolvidos e em desenvolvimento, o perfil das causas de morbimortalidade ainda são significativas. Demonstra processo de adequação do curso avaliado pelos coordenadores, corpo docente e discente, durante o seu desenvolvimento, e aborda a relevância da formação na vida pessoal e profissional de seus egressos que, na sua maioria, se inseriram no mercado de trabalho e desenvolvem ações educativas, intervindo significativamente com novas práticas nos serviços de saúde.O estudo descreve a experiencia de implantacao e do desenvolvimento do Curso de Especializacao em Enfermagem nas Doencas Infecciosas e sua operacionalizacao no âmbito do Centro de Pesquisa Clinica Evandro de Chagas, da Fundacao Oswaldo Cruz, Rio de Janeiro, no periodo de 1997 a 1999. Objetiva mostrar, sob perspectiva historica do Hospital e das doencas infecciosas, a experiencia acumulada no processo de formacao de recursos humanos. Justifica o porque da especializacao nas doencas infecciosas a medida que, nos paises subdesenvolvidos e em desenvolvimento, o perfil das causas de morbimortalidade ainda sao significativas. Demonstra processo de adequacao do curso avaliado pelos coordenadores, corpo docente e discente, durante o seu desenvolvimento, e aborda a relevância da formacao na vida pessoal e profissional de seus egressos que, na sua maioria, se inseriram no mercado de trabalho e desenvolvem acoes educativas, intervindo significativamente com novas praticas nos servicos de saude.This study describes the experience of implanting and developing the specialization course in Infectious Disease Nursing, as well as its implementation within the Evandro Chagas, clinical research center at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, from 1997 to 1999. From the historical perspective of the hospital and infectious diseases, this research aims to demonstrate the experience accumulated in the human resource formation process. It justifies a specialization course in infectious diseases to the extent that, in underdeveloped and developing countries, the profile of morbidity/mortality causes is still important. It sets forth the process of adjusting the course, evaluated by the coordinators, teaching staff and students, throughout its development, and deals with the significance of such training in the private and professional lives of its graduates, most of whom entered the labor market and are engaged in educational activities, with an expressive promotion of new practices in health services.