Community Conversation Guide: How Can Our Community Support the Breastfeeding Experience in Brookings Businesses

This forum is an opportunity for our community to come together and consider breastfeeding and support for our mothers and children with fresh eyes, fresh ideas, and a fresh conversation. Our conversation today will consider different approaches for increasing breastfeeding support in local businesses. This guide introduces the issue, explains concerns with the breastfeeding experience in Brookings businesses, and presents three approaches to improving support. These approaches are not the only possible responses to the issue. Instead, they represent different ways that our community can take action based on our priorities

Brookings Supports Breastfeeding: Using Public Deliberation as a Community-Engaged Approach to Dissemination of Research

Empirical evidence demonstrates myriad benefits of breastfeeding for mother and child, along with benefits to businesses that support breastfeeding. Federal and state legislation requires workplace support for pumping and provides protections for public breastfeeding. Yet, many are unaware of these laws, and thus, support systems remain underdeveloped. We used a community-based approach to spread awareness about the evidence-based benefits of breastfeeding and breastfeeding support. We worked to improve breastfeeding support at the local hospital, among local employers, and throughout the broader community. Our coalition representing the hospital, the chamber of commerce, the university, and local lactation consultants used a public deliberation model for dissemination. We held focus groups, hosted a public conversation, spoke to local organizations, and promoted these efforts through local media. The hospital achieved Baby-Friendly status and opened a Baby Café. Breastfeeding support in the community improved through policies, designated pumping spaces, and signage that supports public breastfeeding at local businesses. Community awareness of the benefits of breastfeeding and breastfeeding support increased; the breastfeeding support coalition remains active. The public deliberation process for dissemination engaged the community with evidence-based promotion of breastfeeding support, increased agency, and produced sustainable results tailored to the community’s unique needs

Rapid forest inventory and mapping: Monitoring forest cover and land use change

This paper discusses the research tools used to create baseline data for carbon offset mechanisms. The paper explains vegetation survey methodologies with examples of their application in a variety of contexts. These range from rapid studies using remote sensing imagery, to full multiphase survey methods. The paper gives specific examples of how these methods are used to monitor deforestation and forest regeneration

Talking about depression: a qualitative study of barriers to managing depression in people with long term conditions in primary care

<p>Abstract</p> <p>Background</p> <p>The risk of depression is increased in people with long term conditions (LTCs) and is associated with poorer patient outcomes for both the depressive illness and the LTC, but often remains undetected and poorly managed. The aim of this study was to identify and explore barriers to detecting and managing depression in primary care in people with two exemplar LTCs: diabetes and coronary heart disease (CHD).</p> <p>Methods</p> <p>Qualitative in-depth interviews were conducted with 19 healthcare professionals drawn predominately from primary care, along with 7 service users and 3 carers (n = 29). One focus group was then held with a set of 6 healthcare professionals and a set of 7 service users and 1 carer (n = 14). Interviews and the focus group were digitally recorded, transcribed verbatim, and analysed independently. The two data sets were then inspected for commonalities using a constant comparative method, leading to a final thematic framework used in this paper.</p> <p>Results</p> <p>Barriers to detecting and managing depression in people with LTCs in primary care exist: i) when practitioners in partnership with patients conceptualise depression as a common and understandable response to the losses associated with LTCs - depression in the presence of LTCs is normalised, militating against its recognition and treatment; ii) where highly performanced managed consultations under the terms of the Quality and Outcomes Framework encourage reductionist approaches to case-finding in people with CHD and diabetes, and iii) where there is uncertainty among practitioners about how to negotiate labels for depression in people with LTCs in ways that might facilitate shared understanding and future management.</p> <p>Conclusion</p> <p>Depression was often normalised in the presence of LTCs, obviating rather than facilitating further assessment and management. Furthermore, structural constraints imposed by the QOF encouraged reductionist approaches to case-finding for depression in consultations for CHD and diabetes. Future work might focus on how interventions that draw on the principles of the chronic care model, such as collaborative care, could support primary care practitioners to better recognise and manage depression in patients with LTCs.</p

Policies Aren’t Enough The Importance of Interpersonal Communication about Workplace Breastfeeding Support

Background: Formal policies can establish guidelines and expectations for workplace breastfeeding support. However, interpersonal communication between employees and managers is the context where such policies are explained, negotiated, and implemented. As such, this article focuses on interpersonal communication about breastfeeding support in the workplace.Objective: The objective of this article is to describe interpersonal communication related to workplace breastfeeding support.Methods: We conducted 3 focus groups with 23 business representatives from a rural city in the Midwest United States. Participants were recruited through the area chamber of commerce. We analyzed the transcripts of the focus groups and derived themes related to the study objective.Results: Our analysis of responses from business representatives in the focus groups revealed 3 major themes about interpersonal communication concerning breastfeeding support in the workplace: (1) interpersonal communication may be more important than written communication for enacting breastfeeding support, (2) multiple factors (age, sex, and power dynamics) complicate the interpersonal communication required to enact breastfeeding support in local businesses, and (3) positive interpersonal communication strategies may improve the success of workplace breastfeeding support. Conclusion: Interpersonal communication between employees and managers is where the specifics of workplace breastfeeding support (eg, policies) are determined and applied. Interpersonal communication about breastfeeding can be challenging due to issues such as age, sex, and power dynamics. However, positive and open interpersonal communication can enhance workplace breastfeeding support

Going home? An ethnographic study of assessment of capacity and best interests in people with dementia being discharged from hospital

Objective: To understand how, on medical wards, judgements about capacity and best interests with respect to going home are made – in line with the Mental Capacity Act 2005 – for people with dementia and how decision-making around hospital discharge for people with dementia and their families might be improved. Design: Ward-based ethnography. Observational data were captured through: detailed fieldnotes, in-depth interviews, medical-record review and focus groups. Themes and key issues identified using constant comparative analysis of 29 cases. Participants: Theoretical sampling of key stakeholders, including patients with dementia (with and without residence capacity), their relatives and a range of practitioners from the multi-disciplinary teams providing health and social care. Setting: Three hospital wards (acute and rehabilitation) in two hospitals within two NHS healthcare trusts in the North of England over a period of nine months between 2008 and 2009. Results: Analysis highlights the complexity of judgements about capacity and best interests, along with the workings of the MCA, in relation to decisions about place of residence for people with dementia facing discharge from hospital. Five key themes emerged from data: the complexity of borderline decisions; the requirement for better understanding of assessment approaches in relation to residence capacity; the need for better documentation; the importance of narrative; and the crucial relevance of time and timing in making these decisions. Conclusions: We need: more support and training for practitioners, as well as support for patients and families; clarity about the information to be imparted to the person with dementia; more advocacy for people with dementia; appropriate assessments embedded in routine clinical practice; the patient with dementia to be centre-stage in this decision-making; and properly resourced step-down or rehabilitation units to facilitate timely and good decision-making about place of residence

Policies Aren’t Enough

Background: Formal policies can establish guidelines and expectations for workplace breastfeeding support. However, interpersonal communication between employees and managers is the context where such policies are explained, negotiated, and implemented. As such, this article focuses on interpersonal communication about breastfeeding support in the workplace.Objective: The objective of this article is to describe interpersonal communication related to workplace breastfeeding support.Methods: We conducted 3 focus groups with 23 business representatives from a rural city in the Midwest United States. Participants were recruited through the area chamber of commerce. We analyzed the transcripts of the focus groups and derived themes related to the study objective.Results: Our analysis of responses from business representatives in the focus groups revealed 3 major themes about interpersonal communication concerning breastfeeding support in the workplace: (1) interpersonal communication may be more important than written communication for enacting breastfeeding support, (2) multiple factors (age, sex, and power dynamics) complicate the interpersonal communication required to enact breastfeeding support in local businesses, and (3) positive interpersonal communication strategies may improve the success of workplace breastfeeding support. Conclusion: Interpersonal communication between employees and managers is where the specifics of workplace breastfeeding support (eg, policies) are determined and applied. Interpersonal communication about breastfeeding can be challenging due to issues such as age, sex, and power dynamics. However, positive and open interpersonal communication can enhance workplace breastfeeding support