Residing in socioeconomically deprived neighborhoods may pose substantial physiological stress, which can then lead to higher allostatic load (AL), a marker of biological wear and tear that precedes disease. The aim of the present study was to map the current evidence about the relationship between neighborhood socioeconomic deprivation and AL. A scoping review approach was chosen to provide an overview of the type, quantity, and extent of research available. The review was conducted using three bibliographic databases (PubMed, SCOPUS, and Web of Science) and a standardized protocol. Fourteen studies were identified. Studies were predominantly from the USA, cross-sectional, focused on adults, and involved different races and ethnic groups. A wide range of measures of AL were identified: the mode of the number of biomarkers per study was eight but with large variability (range: 6–24). Most studies (n = 12) reported a significant association between neighborhood deprivation and AL. Behaviors and environmental stressors seem to mediate this relationship and associations appear more pronounced among Blacks, men, and individuals with poor social support. Such conclusions have important public health implications as they enforce the idea that neighborhood environment should be improved to prevent physiological dysregulation and consequent chronic diseases.

ObjectiveTo describe how Italian medical societies interact with pharmaceutical and medical device industries through an analysis of the information available on their websites.DesignCross sectional study.SettingItaly.Participants154 medical societies registered with the Italian Federation of Medical-Scientific Societies.Main outcome measuresIndicators of industry sponsorship (presence of industry sponsorship in the programme of the last medical societies’ annual conference; presence of manufacturers’ logos on the homepage; presence of industry sponsorship of satellite symposia during the last annual conference).Results131 Italian medical societies were considered. Of these, 4.6% had an ethical code covering relationships with industry on their websites, while 45.6% had a statute that mentioned the issue of conflict of interest and 6.1% published the annual financial report. With regard to industry sponsorship, 64.9% received private sponsorship for their last conference, 29.0% had manufacturers’ logos on their webpage, while 35.9% had industry-sponsored satellite symposia at their last conference. The presence of an ethical code on the societies’ websites was associated with both an increased risk of industry sponsorship of the last conference (relative risk (RR) 1.22, 95% CIs 1.01 to 1.48 after adjustment) and of conferences and/or satellite symposia (RR 1.22, 95% CIs 1.02 to 1.48 after adjustment) but not with the presence of manufacturers’ logos on the websites (RR 1.79, 95% CIs 0.66 to 4.82 after adjustment). No association was observed with the other indicators of governance and transparency.ConclusionsThis survey shows that industry sponsorship of Italian medical societies’ conferences is common, while the presence of a structured regulatory system is not. Disclosure of the amount of industry funding to medical societies is scarce. The level of transparency therefore needs to be improved and the whole relationship between medical societies and industry should be further disciplined in order to avoid any potential for conflict of interest.

Background Early breastfeeding practices are important determinants of later breastfeeding behaviors and can be influenced by multiple factors. Despite the Baby-Friendly Hospital Initiative reported positive influence on breastfeeding initiation, its influence on the association between maternal country of birth and first day in-hospital breastfeeding has not been examined. Research aims To determine (1) if association between maternal country of birth and first day in-hospital exclusive breastfeeding exists in Portugal and (2) if any association is affected by giving birth in a Baby-Friendly Hospital. Methods Data were drawn from baMBINO—a longitudinal, 2017–2019 nationwide study designed to assess the perinatal health and healthcare experiences of migrant and native Portuguese women. Data from participants ( N = 5,340) were collected during their hospital stay from 32 maternity units. Missing data were handled through multiple imputation. After stratifying by Baby-Friendly Hospital Initiative accreditation, a multivariate logistic regression was performed. Results First day in-hospital exclusive breastfeeding rates were high among both migrant and native participants (89.2% vs. 87.4%). Migrants were more likely to exclusively breastfeed when compared to natives ( OR = 1.19, 95% CI [1.00, 1.41]). In non-Baby-Friendly Hospitals, a positive association was found between participants from Eastern European countries (a OR = 2.46, 95% CI [1.27, 4.78]) and first day in-hospital exclusive breastfeeding. In accredited hospitals, maternal country of birth did not influence exclusive breastfeeding during the first 24 hr. Conclusions The Baby-Friendly Hospital Initiative attenuates differences between migrant and native participants, promoting optimal breastfeeding practices among natives.

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Background Breastfeeding provides benefits for children, mothers, society and the environment. The promotion of optimal breastfeeding, from an early stage in life is, therefore, a public health priority. Infant feeding can be influenced by maternal country of birth. However, studies carried out in European settings point to inconsistent findings. This study aims to compare first day in-hospital exclusive breastfeeding among migrant and native women in Portugal. Methods This study is based on a national project on perinatal health among migrants and natives in Portugal (baMBINO). Out of 39 public maternity units in mainland Portugal, 32 were enrolled. Women aged 18 years old or older with a live birth were recruited. The final sample included 5109 participants (2431 natives and 2678 migrants). Logistic regression was used to assess the association between maternal country of birth and in-hospital exclusive breastfeeding. Results Migrant participants included women from Portuguese-speaking African countries (PSAC) (49,7%), Brazil (18%), Eastern Europe (10.2%), other European countries (9.6%), Asia (5.5%) and other countries (7.0%). No differences were found between migrants and natives, with the exception of women from PSAC who were more likely to exclusively breastfeed during the first day of hospital stay (aOR 1.34 CI95% 1.05-1.72), irrespective of maternal age, education, parity, type of pregnancy, reproductive assistance, tobacco use, gestational age, newborn birth weight, mode of delivery and antenatal care. Conclusions In Portugal, women from PSAC are more likely to exclusively breastfeed their babies during the first day of hospital stay when compared to native women. Strategies to maintain healthy breastfeeding practices in this population are fundamental. Key messages Women from PSAC are more likely to breastfeed exclusively in the first day after delivery than Portuguese natives. They should be supported in the maintenance of optimal breastfeeding practices.

Background The International Code of Marketing of Breast-Milk Substitutes is a global public health policy aiming to protect breastfeeding from the influence of human-milk substitutes marketing. Brazil is one of the few countries substantially implementing it. Most countries adopted selected provisions, including Portugal. Research Aim To explore whether Brazilians’ perspectives about breastfeeding intention and practice are influenced by human-milk substitutes marketing upon migration to Portugal. Methods A qualitative, prospective, cross-sectional survey design was conducted in Brazil and Portugal (2018–2019). Qualitative semi-structured interviews were performed with native ( n = 16) and immigrant ( n = 15) Brazilians. Women aged 18 or above, mothers of 0–12 month infants, and without contraindications to breastfeed, were eligible for the study. Heterogeneity sampling was employed based on socioeconomic status and infants’ age. Content analysis was conducted using NVivo. Results Brazilian immigrants were more aware of the potential negative influence of human-milk substitutes marketing than natives. Sociocultural factors contributed to Brazilian immigrants being less permeable to the influence of human-milk substitutes marketing in the host country, where a less protective breastfeeding environment was perceived. Conclusions Sociocultural factors including breastfeeding promotion strategies and a strong breastfeeding culture in the home country appear to play a protective role on breastfeeding intention and practice among Brazilians migrating to Portugal.