Dear Editors, Ferdos & Rahman published an article on women who are victims of intimate partner violence, based on the 2007 Bangladesh Demographic Health Survey (DHS) 1. Nevertheless, some results are not consistent with the current literature, such as malnutrition as a risk factor for all forms of violence. Interestingly, the authors themselves, acknowledged alternative explanations in their Discussion section: Ferdos & Rahman appropriately stated that the food restriction faced by Bangladeshi women was generated by economic, emotional, and psychological abuse, which may result in insufficient or inappropriate food intake among women and leading to malnutrition (measured as high or low body mass index-BMI). In that context, women deal with the incapacity to make decisions by themselves, such as choosing adequate food amount and types. However, the statistical analyses performed by the authors report findings on an opposite causal pathway: altered BMI is the risk factor for physical and/ or sexual violence (see Table 3 in the article 1). Nevertheless, these results may be biased due to lack of adjustments for unobserved confounders, i.e. other forms of violence. Violence is a latent variable, expressed by different observed behavior types, such as economic, physical, sexual, or psychological violence 2,3,4. Economic violence against women occurs when a male partner controls the family finances, deciding how money is spent or saved, forcing the woman into economic dependence 4,5. Thus, there is a link between economic violence and the availability of resources that women have access to, including food 4,5. Economic concerns could lead to family conflicts, which may end in physical/sexual violence against women 4,6. This type of relationship was shown by an experiment in Ecuador that assessed three interventions for poor households: cash transfers, transfers of food and food coupons. The results showed that, in addition to reducing the household food insecurity and poverty, the interventions reduced the violent behaviors of male partners 7. Apparently, rising economic incomes in a household reduces violence, by reduction of stress and domestic conflicts regarding poverty difficulties. It is unlikely that the women's BMI have changed in the context of the Ecuadorian study, since no intervention was oriented towards that outcome 7. Other studies have shown that increases in household income lead to decreasing couples' conflicts 8. Furthermore, other studies (including the Ecuadorian one) have shown that economic interventions for reducing household poverty also significantly increased the quantity and quality of food CARTA LETTER
Este artículo fue aprobado para publicación en el v68n3 de la Revista de la Facultad de Medicina teniendo en cuenta los conceptos de los pares evaluadores y los cambios realizados por los autores según estos conceptos. Por lo tanto, se publica la versión preliminar del artículo para su consulta y citación provisional, pero debe aclararse que esta puede diferir del documento final, ya que no ha completado las etapas finales del proceso editorial (corrección de estilo, traducción y diagramación) y solo los títulos, datos de autores, palabras clave y resúmenes corresponden a la versión final del artículo.Esta versión puede consultarse, descargarse y citarse según se indique a continuación, pero debe recordarse que el documento final (PDF, HTML y XML) puede ser diferente. Cómo citar:Sandoval-Moreno LM, Forero-Anaya B, Giraldo-Medina S, Guiral-Campo JA, Betancourt-Peña J. [Cambios fisiológicos relacionados con entrenamiento muscular respiratorio en pacientes en ventilación mecánica]. Rev. Fac. Med. 2020;68(3): In press -2020. English. doi: http://dx.doi.org/10.15446/revfacmed.v68n3.75274. -Peña J. Physiological changes associated with respiratory muscle training in patients under mechanical ventilation. Rev. Fac. Med. 2020;68(3): In press -2020. English. doi: http://dx.doi.org/10.15446/revfacmed.v68n3.75274. Revista de la Facultad de Medicina In press publication Rev. Fac. Med. P u b l i c a c i ó n a n t i c i p a d a . R e v . F a c . M e d . Tipo de artículo: Investigación original DOI: http://dx.doi.org/10.15446/revfacmed.v68n3.75274 Physiological changes associated with respiratory muscle training in patients under mechanical ventilation Cambios fisiológicos relacionados con entrenamiento muscular respiratorio en pacientes con ventilación mecánica Título corto: Cambios fisiológicos y entrenamiento muscular respiratorio.
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