The Resurgence of Breastfeeding, 1975-2000

Annotated and edited transcript of a Witness Seminar held on 24 April 2007. Introduction by Professor Rima Apple, University of Wisconsin-Madison.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2009.©The Trustee of the Wellcome Trust, London, 2009.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 24 April 2007. Introduction by Professor Rima Apple, University of Wisconsin-Madison.Annotated and edited transcript of a Witness Seminar held on 24 April 2007. Introduction by Professor Rima Apple, University of Wisconsin-Madison.Annotated and edited transcript of a Witness Seminar held on 24 April 2007. Introduction by Professor Rima Apple, University of Wisconsin-Madison.Annotated and edited transcript of a Witness Seminar held on 24 April 2007. Introduction by Professor Rima Apple, University of Wisconsin-Madison.As breast-milk substitutes became iAs breast-milk substitutes became increasingly sophisticated and heavily marketed in the mid-twentieth century, bottle-feeding became regarded worldwide as safe, convenient, normal and even preferable to breastfeeding. From 1975, research conducted in the developing world, particularly Gambia, began to converge with work on immunology and child psychology to reassert the value of mothers’ own milk. At the same time, growing understanding of physiology, reproductive and developmental biology shifted interest from the composition of infant formulae to the biology of infant feeding. Insights from comparative zoology, dairy science and animal husbandry, shared with research in human lactation and ‘naturalization’ of childbirth all helped to de-medicalize infant feeding. Chaired by Professor Lawrence Weaver, this Witness Seminar was attended by representatives from women’s groups, pressure groups and international organizations, including Baby Milk Action, IBFAN, La Leche League, the National Childbirth Trust, WHO and UNICEF, as well as paediatricians, obstetricians, physiologists, nutritional scientists, zoologists, psychologists and members of industry. The discussion addressed the critical events, scientific advances, and social and political steps that drove the resurgence of breastfeeding, focusing not only on the nutritional science but also on the social context in which the changes took place. Participants included: Mr James Akre, Professor Elizabeth Alder, Mrs Phyll Buchanan, Professor Forrester Cockburn, Ms Rosie Dodds, Mrs Jill Dye, Professor Fiona Dykes, Ms Hilary English, Miss Chloe Fisher, Professor Anna Glasier, Professor Lars Hanson, Dr Elisabet Helsing, Dr Edmund Hey, Professor Peter Howie, Professor Alan McNeilly, Professor Kim Michaelsen, Mrs Rachel O’Leary, Ms Gabrielle Palmer, Professor Malcolm Peaker, Dr Ann Prentice,Professor Mary Renfrew, Mrs Patti Rundall, Ms Ellena Salariya, Dr Felicity Savage, Professor Roger Short, Dr Mary Smale, Dr Alison Spiro, Dr Penny Stanway, Dr Tilli Tansey, Mrs Jenny Warren, Mr John Wells, Professor Brian Wharton, Professor Roger Whitehead, Dr Anthony Williams, Miss Carol Williams and Dr Michael Woolridge. Crowther S M, Reynolds L A, Tansey E M. (eds) (2009) The resurgence of breastfeeding, 1975–2000, Wellcome Witnesses to Twentieth Century Medicine, vol. 35. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Patience Capital and the Demise of the Aristocracy

We model the decision problem of a parent who chooses an occupation and invests in the patience of her children. The two choices complement each other: patient individuals choose occupations with a steep income profile; a steep income profile, in turn, leads to a strong incentive to invest in patience. In equilibrium, society becomes stratified along occupational lines. The most patient people are those in occupations requiring the most education and experience. The theory can account for the demise of the British land-owning aristocracy in the nineteenth century, when rich landowners proved unable to profit from new opportunities arising with industrialization, and were thus surpassed by industrialists rising from the middle classes.discount factor; patience; British aristocracy; Industrial Revolution; capital accumulation; income distribution

Crossing Borders for Reproductive Care: A Systematic Review and Meta-Synthesis of Intended Parents' Experiences

This item is only available electronically.Cross border reproductive care (CBRC) is a growing global phenomenon where individuals travel abroad seeking assisted and third-party reproductive services. Infertility rates are rising, and the increased accessibility of travel has produced global 'hubs' where intended parents seek fertility treatment to fulfil their parenthood desires. While CBRC has faced social commentary fraught with ethical and moral debate, less attention has been paid to exploring intended parents’ experiences, with much of this understanding remaining fragmented and providing only a partial account of CBRC. Consequently, this research explored intended parents’ experiences embarking on their treatment abroad, their care overseas and their navigation of ethical concerns, by systematically reviewing and synthesising existing CBRC qualitative literature. Seven databases were searched, with 24 included studies synthesised using a meta-aggregative approach following screening and quality appraisal. Key findings concerning the experience of CBRC included: exhaustion of local options for family formation; varied care and assistance from local clinicians; a reliance on peer support to facilitate CBRC; trust as core to the experience of care abroad; overall satisfaction with care abroad; and dissatisfying aspects of overseas care. Additionally, key findings relating to intended parents’ navigation of ethics included: disillusion with and rejection of the exploitation discourse; and attempts to identify, minimise and avoid exploitation. Going beyond the scope of discrete studies, the findings from this meta-synthesis reveal the overall landscape of CBRC and helps inform future practice for all stakeholders, including policy makers and clinicians, to maximise support and positive outcomes throughout the CBRC experience.Thesis (B.PsychSc(Hons)) -- University of Adelaide, School of Psychology, 202

Consequences of female night shift work for fertility, assisted conception and fetal development

It is estimated that 1 in 7 women in paid employment in Australia are working at night, on either permanent or rotating shift rosters. Night shift work can disrupt circadian rhythms, contributing to cardiometabolic disturbance, psychosocial stress, and could potentially affect human reproductive health. This thesis investigated whether female night shift workers were more likely to require fertility treatment to achieve a first birth and whether this reflected specific reproductive health problems. The thesis then examined whether this combination of patient and treatment factors contributed to adverse perinatal outcomes, specifically congenital urogenital anomalies, in the first births of night shift workers when compared to non-shift workers. An initial step entailed a review of the literature concerning night shift work and female fertility, miscarriage and perinatal outcomes, resulting in a published manuscript focusing on fertility (including time to pregnancy, menstrual irregularity and endometriosis) and miscarriage. This manuscript represents a multidisciplinary project in which a complex literature is critiqued and summarised. It also provided an overview of current clinical guidance and policies in place internationally. Australian research on shift work has been constrained by the absence of a tool to assess this exposure on a large scale. Accordingly, a shift work job-exposure matrix specific to occupations in Australia was developed using established methods. The job-exposure matrix was applied to a large population-based cohort of births produced via linkage of routine perinatal registries with fertility clinic data. These included the South Australian Perinatal Statistics Collection, the South Australian Birth Defects Register and data from the two clinics registered to provide fertility treatment in South Australia between 1986–2002. This allowed identification of primiparous women with probable exposure to light at night during night shift work, forming the basis for two subsequent studies of reproductive function and treatment outcomes. One study considered the use of fertility treatment among night shift workers. The analysis indicated that a higher proportion of women in occupations likely to involve night shift conceived their first birth with fertility treatment, compared to their unexposed counterparts in paid employment (OR = 1.25, 95% CI 1.09–1.43). However, this was attenuated when adjusted for age (OR = 1.10, 95% CI 0.95–1.26). Among those who accessed treatment, night shift workers were more likely to be diagnosed with menstrual irregularity (OR = 1.42, 95% CI 1.05–1.91) and endometriosis (OR = 1.34, 95% CI 1.00–1.80). A second study examined the associations of night shift work, subfertility and fertility treatment with urogenital anomalies occurring in first births. This outcome was pre-specified based on plausible mechanisms linking circadian rhythms to perturbed maternal endocrinology and subsequent fetal exposures in utero. Results indicated that singleton births to primiparous night shift workers, conceived using fertility treatment, were more likely to have a urogenital anomaly, compared to those of non-shift workers who conceived using fertility treatment (OR = 1.80, 95% CI 0.94–3.46). The effect was greater among multiple births (OR = 2.94, 95% CI 1.26-6.85). This finding was not related to differences in the type of fertility treatment received by night shift workers compared to other women who did not work night shift. The outcome was also specific to fertility treatment, and did not extend to naturally conceived singleton or multiple births to night shift workers in the general population, for which there was no significant association. Further analysis indicated an ordering of risk, whereby the greatest risk of urogenital anomalies occurred among births that were jointly exposed to maternal night shift work and fertility treatment (OR for singletons = 2.11, 95% CI 1.17–3.79), an additive interaction. This thesis represents the first research to investigate the use of fertility treatment among female night shift workers and whether this contributes to congenital anomalies in offspring. The finding that night shift workers were more likely to conceive their first birth using fertility treatment is potentially a consequence of a higher prevalence of menstrual irregularities and endometriosis. Alternatively it may reflect psychosocial effects of night shift work, or a combination of these factors, on women’s age of first childbearing. A subgroup of women who undertake night shift work may be most susceptible to the effects of circadian disruption on their fertility, either directly or through exacerbation of underlying fertility problems, which contribute to adverse outcomes for offspring conceived using fertility treatment. Future research concerning night shift work, infertility, and recourse to fertility treatment would benefit from inclusion of all women who undergo fertility treatment, regardless of whether a birth was achieved. Despite this limitation, the depth and breadth of information in this large population-based cohort has enabled the first steps towards identifying requirements for fertility treatment by night shift workers and demonstrated a combined impact of patient and treatment factors on fetal development.Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School and School of Public Health, 201

The resurgence of breastfeeding, 1975–2000

As breast-milk substitutes became increasingly sophisticated and heavily marketed in the mid-twentieth century, bottle-feeding became regarded worldwide as safe, convenient, normal and even preferable to breastfeeding. From 1975, research conducted in the developing world, particularly Gambia, began to converge with work on immunology and child psychology to reassert the value of mothers’ own milk. At the same time, growing understanding of physiology, reproductive and developmental biology shifted interest from the composition of infant formulae to the biology of infant feeding. Insights from comparative zoology, dairy science and animal husbandry, shared with research in human lactation and ‘naturalization’ of childbirth all helped to de-medicalize infant feeding. Chaired by Professor Lawrence Weaver, this Witness Seminar was attended by representatives from women’s groups, pressure groups and international organizations, including Baby Milk Action, IBFAN, La Leche League, the National Childbirth Trust, WHO and UNICEF, as well as paediatricians, obstetricians, physiologists, nutritional scientists, zoologists, psychologists and members of industry. The discussion addressed the critical events, scientific advances, and social and political steps that drove the resurgence of breastfeeding, focusing not only on the nutritional science but also on the social context in which the changes took place. Participants included: Mr James Akre, Professor Elizabeth Alder, Mrs Phyll Buchanan, Professor Forrester Cockburn, Ms Rosie Dodds, Mrs Jill Dye, Professor Fiona Dykes, Ms Hilary English, Miss Chloe Fisher, Professor Anna Glasier, Professor Lars Hanson, Dr Elisabet Helsing, Dr Edmund Hey, Professor Peter Howie, Professor Alan McNeilly, Professor Kim Michaelsen, Mrs Rachel O’Leary, Ms Gabrielle Palmer, Professor Malcolm Peaker, Dr Ann Prentice,Professor Mary Renfrew, Mrs Patti Rundall, Ms Ellena Salariya, Dr Felicity Savage, Professor Roger Short, Dr Mary Smale, Dr Alison Spiro, Dr Penny Stanway, Dr Tilli Tansey, Mrs Jenny Warren, Mr John Wells, Professor Brian Wharton, Professor Roger Whitehead, Dr Anthony Williams, Miss Carol Williams and Dr Michael Woolridge

Representing and Inferring Visual Perceptual Skills in Dermatological Image Understanding

Experts have a remarkable capability of locating, perceptually organizing, identifying, and categorizing objects in images specific to their domains of expertise. Eliciting and representing their visual strategies and some aspects of domain knowledge will benefit a wide range of studies and applications. For example, image understanding may be improved through active learning frameworks by transferring human domain knowledge into image-based computational procedures, intelligent user interfaces enhanced by inferring dynamic informational needs in real time, and cognitive processing analyzed via unveiling the engaged underlying cognitive processes. An eye tracking experiment was conducted to collect both eye movement and verbal narrative data from three groups of subjects with different medical training levels or no medical training in order to study perceptual skill. Each subject examined and described 50 photographical dermatological images. One group comprised 11 board-certified dermatologists (attendings), another group was 4 dermatologists in training (residents), and the third group 13 novices (undergraduate students with no medical training). We develop a novel hierarchical probabilistic framework to discover the stereotypical and idiosyncratic viewing behaviors exhibited by the three expertise-specific groups. A hidden Markov model is used to describe each subject\u27s eye movement sequence combined with hierarchical stochastic processes to capture and differentiate the discovered eye movement patterns shared by multiple subjects\u27 eye movement sequences within and among the three expertise-specific groups. Through these patterned eye movement behaviors we are able to elicit some aspects of the domain-specific knowledge and perceptual skill from the subjects whose eye movements are recorded during diagnostic reasoning processes on medical images. Analyzing experts\u27 eye movement patterns provides us insight into cognitive strategies exploited to solve complex perceptual reasoning tasks. Independent experts\u27 annotations of diagnostic conceptual units of thought in the transcribed verbal narratives are time-aligned with discovered eye movement patterns to help interpret the patterns\u27 meanings. By mapping eye movement patterns to thought units, we uncover the relationships between visual and linguistic elements of their reasoning and perceptual processes, and show the manner in which these subjects varied their behaviors while parsing the images

Interaction Between Convection and Pulsation

This article reviews our current understanding of modelling convection dynamics in stars. Several semi-analytical time-dependent convection models have been proposed for pulsating one-dimensional stellar structures with different formulations for how the convective turbulent velocity field couples with the global stellar oscillations. In this review we put emphasis on two, widely used, time-dependent convection formulations for estimating pulsation properties in one-dimensional stellar models. Applications to pulsating stars are presented with results for oscillation properties, such as the effects of convection dynamics on the oscillation frequencies, or the stability of pulsation modes, in classical pulsators and in stars supporting solar-type oscillations.Comment: Invited review article for Living Reviews in Solar Physics. 88 pages, 14 figure