Protection, promotion and support of breast-feeding in Europe: progress from 2002 to 2007.

Objective To assess progress in the protection, promotion and support of breast-feeding in Europe. Design Data for 2002 and 2007 were gathered with the same questionnaire. Of thirty countries, twenty-nine returned data for 2002, twenty-four for 2007. Results The number of countries with national policies complying with WHO recommendations increased. In 2007, six countries lacked a national policy, three a national plan, four a national breast-feeding coordinator and committee. Little improvement was reported in pre-service training; however, the number of countries with good coverage in the provision of WHO/UNICEF courses for in-service training increased substantially, as reflected in a parallel increase in the number of Baby Friendly Hospitals and the proportion of births taking place in them. Little improvement was reported as far as implementation of the International Code on Marketing of Breastmilk Substitutes is concerned. Except for Ireland and the UK, where some improvement occurred, no changes were reported on maternity protection. Due to lack of standard methods, it was difficult to compare rates of breast-feeding among countries. With this in mind, slight improvements in the rates of initiation, exclusivity and duration were reported by countries where data at two points in time were available. Conclusions Breast-feeding rates continue to fall short of global recommendations. National policies are improving slowly but are hampered by the lack of action on maternity protection and the International Code. Pre-service training and standard monitoring of breast-feeding rates are the areas where more efforts are needed to accelerate progress

Investigation Into the Pharmacist’s Role in Breastfeeding Support in the “Roma B” Local Health Authority in Rome

Background: Breastfeeding is the biological norm for feeding infants and a public health strategy with such a significant impact on the health of the population in the short, medium, and long terms that it should be considered a priority. A pharmacy can be a place for breastfeeding support, since it is open 24 hours a day and is easily accessible. Objective: The main objective of our fact-finding investigation into the breastfeeding support role of pharmacists in the “Roma B” Local Health Authority was to understand how often pharmacists came into contact with nursing mothers, and if pharmacists felt the need to have a greater knowledge of issues regarding breastfeeding. Methods: This survey was done by administering 144 questionnaires (to 1 pharmacist per pharmacy) with items about the support and the protection of breastfeeding and lactation, the perceived need for specific training courses, and openness to establishing virtuous network mechanisms with stakeholders who work in breastfeeding in that geographical area. Results: Our survey shows that mothers come to pharmacies for advice about various health problems. Although pharmacists had little knowledge about breastfeeding, they were interested in participating in a training course. Ninety percent of them declared their interest in collaborating with local breastfeeding stakeholders. Conclusions: The role of the pharmacist in the protection, promotion, and support of breastfeeding has become increasingly important, along with the awareness of being competent and ethical on issues about breastfeeding

Effectiveness of the Baby Friendly Community Initiative in Italy : a non-randomised controlled study

Objective To assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months. Design Controlled, non-randomised trial. Setting 18 Local Health Authorities in 9 regions of Italy. Participants 5094 mother/infant dyads in 3 cohorts were followed up to 12 months after birth in 3 rounds of data collection: at baseline, after implementation of the intervention in the early intervention group and after implementation in the late intervention group. 689 (14%) dyads did not complete the study. Intervention Implementation of the 7 steps of the BFCI. Main outcome measures The rate of exclusive breast feeding at 6 months was the primary outcome; breast feeding at discharge, 3 and 12 months was also measured. Results The crude rates of exclusive breast feeding at discharge, 3 and 6 months, and of any breast feeding at 6 and 12 months increased at each round of data collection after baseline in the early and late intervention groups. At the end of the project, 10% of infants were exclusively breast fed at 6 months and 38% were continuing to breast feed at 12 months. However, the comparison by adjusted rates and logistic regression failed to show statistically significant differences between groups and rounds of data collection in the intention-to-treat analysis, as well as when compliance with the intervention and training coverage was taken into account. Conclusions The study failed to demonstrate an effect of the BFCI on the rates of breast feeding. This may be due, among other factors, to the time needed to observe an effect on breast feeding following this complex intervention

IMAgiNE EURO: Data for action on quality of maternal and newborn care in 20 European countries during the COVID-19 pandemic

A summary of the findings in the Supplement, highlighting the heterogeneity in reported quality of maternity care and inequalities within and between countries in the European region

A Continuing Investigation and Comparison of Chinese & American Climate Change Views I

Color poster with text, images, charts, photographs, and graphs.The importance of the roles of China and the United States cannot be overstated regarding the development/implementation of international climate change mitigation policies. Surveys were conducted in China and the U.S. in 2015 (N=7,556) and 2017 (N=7,415) to investigate people’s support for an international climate treaty. A climate change acceptance/knowledge/concern score (from -10 to 10) was calculated for respondents in both years using a set of eight questions from the survey. In both 2015 and 2017, scores for Chinese were on average higher than Americans, while the American scores were more variable. Largely due to an increase in concern among U.S. respondents in 2017, the difference in American and Chinese mean scores decreased compared to 2015.Two additional questions were used to explore support for an international climate treaty. One question was unconditional, while the other was conditional on nonparticipation of the other country. Responses from both nations indicate a significant withdraw of support for the conditional question. However, Chinese respondents showed significantly greater support in both years compared to Americans. Like the climate change score, US unconditional and conditional treaty support increased in 2017 with little change in China, decreasing the gap between American and Chinese respondents.University of Wisconsin--Eau Claire Office of Research and Sponsored Program

A Continuing Investigation and Comparison of Chinese & American Climate Change Views II

Color poster with text, images, charts, photographs, and graphs.Climate change is one of the most important, challenging and costly issues of our time. Because of the global causes/consequences of climate change, international cooperation is essential in implementing and financing successful mitigation policy action. The willingness of citizens across nations to incur the costs of reducing GHG is an important component of achieving meaningful policy success. The United States and China are of particular interest in international climate negotiations because of their significant greenhouse gas emissions and dominant economies. Surveys were conducted in China and the U.S. in 2015 (N=7,556) and 2017 (N=7,415) to investigate their citizens’ willingness-to-pay (WTP) for climate change policy action to reduce GHG emissions. In this study we employ contingent valuation analysis to estimate WTP. Our results show a significantly higher mean WTP among Chinese respondents compared to Americans in purchasing power parity terms in both 2015 and 2017. Our results also show a greater mean WTP in 2017 compared to 2015 in both countries. Regression analysis reveals similar results for 2015 and 2017; variables describing climate change acceptance, knowledge, and concern correlate with WTP for climate action in both countries. Political affiliation also influences WTP among Americans in both years. Advancing upon last year’s presentation on this topic, we are undertaking a more detailed examination into the determining factors of the increased WTP from 2015 to 2017, in both countries.University of Wisconsin--Eau Claire Office of Research and Sponsored Program

A Continuing Investigation and Comparison of Chinese & American Climate Change Views III

Color poster with text, images, charts, photographs, and graphs.As the world’s two largest economies and greenhouse gas polluters, China and the United States are key players in international climate change negotiations. However, public views of climate change in these nations are diverse and complex and may often be uninformed or misinformed. To better understand climate change views in the US and China, we use survey data collected in 2015 (N=7,556) and 2017 (N=7,415) to analyze responses to the question “what comes to mind when you hear the words ‘climate change’?” We manually coded open-ended responses to examine respondents’ perceptions related to the consequences of climate change, and actions or solutions to address it. We also probed who they assigned responsibility for climate change to, and what groups they projected negativity toward. Quantitative correlations will be drawn between coded open-ended responses and other variables from our survey including calculated climate change acceptance/knowledge/concern scores and support for international climate treaties. Preliminary results indicate that Chinese respondents very rarely mentioned actions, solutions, or assignment of responsibility, focusing mostly on consequences of climate change. Americans mentioned politics much more frequently than Chinese and projected negativity toward opposing groups. But they also mentioned actions or solutions to mitigate climate change.University of Wisconsin--Eau Claire Office of Research and Sponsored Program

Value of Including the Children's Experience for Improving Their Rights During Hospitalization : Protocol for the VoiCEs Project

Background: Users' feedback is a key asset for organizations that want to improve their services. Studying how organizations are enabling their users to participate in evaluation activities is particularly important, especially when there are vulnerable or disadvantaged people, and the services to be evaluated can be life-changing. This is the case in the coassessment by pediatric patients experiencing hospital stay. The international literature reports a few attempts and several challenges in systematically collecting and using the pediatric patient experience with respect to hospitalization, to undertake quality improvement actions.Objective: This paper describes the research protocol of a European project intended to develop and implement a systematic pediatric patient-reported experience measures (PREMs) observatory that will be shared by 4 European children's hospitals in Finland, Italy, Latvia, and the Netherlands.Methods: The VoiCEs (Value of including the Children's Experience for improving their rightS during hospitalization) project uses a participatory action research approach, based on a mixture of qualitative and quantitative methods. It consists of 6 different phases, including a literature review, an analysis of the previous experiences of pediatric PREMs reported by project partners, a Delphi process, a cycle of focus groups or in-depth interviews with children and their caregivers, a series of workshops with interactive working groups, and a cross-sectional observational survey. The project guarantees the direct participation of children and adolescents in the development and implementation phases of the project.Results: The expected results are (1) a deeper knowledge of published methodologies and tools on collecting and reporting pediatric patients' voice; (2) lessons learnt from the analysis of previous experiences of pediatric PREMs; a consensus reached through a participatory process (3) among experts, (4) pediatric patients and caregivers about a standard set of measures for the evaluation of hospitalization by patients; (5) the implementation of a European observatory on pediatric PREMs; and (6) the collection and comparative reporting of the pediatric patients' voice. In addition, the project is aimed at studying and proposing innovative methodologies and tools for capturing the pediatric patients' feedback directly, avoiding the intermediation of parents/guardians.Conclusions: Over the last decade, the collection and use of PREMs have gained importance as a research field. Children and adolescents' perspectives have also been increasingly taken into consideration. However, to date, there are limited experiences regarding the continuous and systematic collection and use of pediatric PREMs data for implementing timely improvement actions. In this perspective, the VoiCEs project provides room for innovation, by contributing to the creation of an international, continuous, and systematic pediatric PREMs observatory that can be joined by other children's hospitals or hospitals with pediatric patients, and foresees the return of usable and actionable data in benchmarking.International Registered Report Identifier (IRRID): DERR1-10.2196/42804(JMIR Res Protoc 2023;12:e42804) doi: 10.2196/42804Peer reviewe

Climate change alters stoichiometry of phosphorus and nitrogen in a semiarid grassland

Nitrogen (N) and phosphorus (P) are essential nutrients for primary producers and decomposers in terrestrial ecosystems. Although climate change affects terrestrial N cycling with important feedbacks to plant productivity and carbon sequestration, the impacts of climate change on the relative availability of N with respect to P remain highly uncertain. In a semiarid grassland in Wyoming, USA, we studied the effects of atmospheric CO2 enrichment (to 600 ppmv) and warming (1.5/3.0°C above ambient temperature during the day/night) on plant, microbial and available soil pools of N and P. Elevated CO2 increased P availability to plants and microbes relative to that of N, whereas warming reduced P availability relative to N. Across years and treatments, plant N : Pratios varied between 5 and 18 and were inversely related to soil moisture. Our results indicate that soil moisture is important in controlling P supply from inorganic sources, causing reduced P relative to N availability during dry periods. Both wetter soil conditions under elevated CO2 and drier conditions with warming can further alter N : P. Although warming may alleviate N constraints under elevated CO2, warming and drought can exacerbate P constraints on plant growth and microbial activity in this semiarid grassland