Objective: To explore factors that interact and shape the meaning and experience of mothers of HIV-exposed children in relation to replacing breastfeeding by infant formula. Method: A qualitative study was carried out with 23 mothers living with HIV, whose children were up to 18 months of age and under follow-up in a specialized care service. Symbolic Interactionism, semi-structured interviews and content analysis were adopted as theoretical framework. Results: The social symbols of breastfeeding, the (un)availability of the milk formula and the (lack of)support of health professionals influenced the mothers’ experience with formula feeding. Social, cultural and economic constraints have proved capable of undermining the conditions necessary for the replacement of breastfeeding. Final considerations: The availability of infant formula, access to lactation inhibitor and quality of health services still represent challenges to eradicate new HIV infections in children.

Background Among the treatments for type 1 diabetes mellitus (T1DM), Continuous Subcutaneous Insulin Infusion (CSII) is a device that infuses insulin through the subcutaneous tissue in an uninterrupted manner and that comes closest to the physiological secretion of insulin. The use of CSII can provide the family with greater security and children and adolescents have more autonomy in relation to the treatment of T1DM. There is a lack of reviews that systematically gather the mounting evidence about the use of CSII in children and adolescents with T1DM. Therefore, the aim of this review was to group and describe primary and secondary studies on the use of CSII in children and adolescents with T1DM. Methods A systematic mapping review was performed based on searches in the following databases: PubMed, Embase, CINAHL, Lilacs and PsycINFO, using a combination of descriptors and keywords. The screening of the studies was carried out with the aid of the Rayyan software and reading in full was conducted independently by two reviewers. The data extraction of the studies was performed using an extraction tool adapted and validated by researchers specialized in diabetes. The data were analyzed according to the content analysis technique. The map from geocoding of the studies was produced using the ArcGis 10.5 software. Results A total of 113 studies were included in the review, including primary studies, literature reviews and gray literature publications. The content analysis of the results of the studies allowed for the identification of four categories: 1) metabolic control; 2) support networks; 3) benefits of using CSII; and 4) challenges of using CSII, each category having its respective subcategories. The review also made it possible to conduct a rigorous mapping of the literature on the use of CSII considering the location of development and the design of the studies. Conclusions The use of CSII should be indicated by health professionals able to prepare children, adolescents, and their families for the treatment of T1DM, and, despite being a technological device, it may not be suitable for the entire pediatric population.

Durante o envelhecimento a convivência com animais de estimação pode ajudar a pessoa idosa a atravessar situações difíceis, tornando os animais de estimação um suporte social. O objetivo do estudo foi conhecer a prevalência de idosos em convívio com animais de estimação e sua associação com características sociodemograficas e de saúde. Estudo transversal de base populacional. A coleta de dados ocorreu por meio de inquérito domiciliar com idosos de 60 anos ou mais, residentes na área urbana do município de Bagé, RS, no ano de 2008. A variável dependente foi convivência com animais de estimação e as independentes incluíram características sociodemograficas e de saúde. Foram realizadas análises descritivas e bivariadas, para verificar as associações foi utilizado o teste de exato de Fisher para heterogeneidade. O nível de significância estatístico utilizado foi de 5% para testes bicaudais. Todas análises foram realizadas no programa Stata versão 14.0. A amostra foi de 1.593 idosos. A prevalência geral de convívio com animais de estimação foi de (69,0%; IC 95%: 66,6; 71,2). As variáveis associadas com o desfecho foram: sexo masculino (72%), menor faixa etária (60 a 74 anos - 72,9%), viver com companheiro (72,9%), não morar sozinho, não receber aposentadoria (72,9%) e não ter referido queda no último ano (70,7%). Encontrou-se uma elevada prevalência de idosos em convívio com animais de estimação, contudo mais estudos são necessários para melhor compreender como a convivência com os animais se reflete em melhorias de saúde para a população idosa.

PurposeThe dairy industry needs to make important decisions regarding its supply chain. In a context with many available suppliers, deciding which of them will be part of the supply chain and deciding when to buy raw milk is key to the supply chain performance. This study aims to propose a mathematical model to support milk supply decisions. In addition to determining which producers should be chosen as suppliers, the model decides on a milk pickup schedule over a planning horizon. The model addresses production decisions, inventory, setup and the use of by-products generated in the raw milk processing.Design/methodology/approachThe model was formulated using mixed integer linear programming, tested with randomly generated instances of various sizes and solved using the Gurobi Solver. Instances were generated using parameters obtained from a company that manufactures dairy products to test the model in a more realistic scenario.FindingsThe results show that the proposed model can be solved with real-world sized instances in short computational times and yielding high quality results. Hence, companies can adopt this model to reduce transportation, production and inventory costs by supporting decision making throughout their supply chains.Originality/valueThe novelty of the proposed model stems from the ability to integrate milk pickup and production planning of dairy products, thus being more comprehensive than the models currently available in the literature. Additionally, the model also considers by-products, which can be used as inputs for other products.