A Systematic Review of Instruments Measuring Family and Social Support of Breastfeeding Mothers

Background: Due to the low rate of breastfeeding among working mothers and support of interventions to increase the duration of breastfeeding, this systematic review conducted to evaluate psychometric properties of instruments measured mother’s perception of Breastfeeding Support. Materials and Methods: The search was carried in English language databases including Medline (via PubMed), Scopus, Cochran library and Web of Science since inception to March 2018 regarding published studies evaluating the psychometric properties of the Breastfeeding Self-Efficacy. The COSMIN checklist was used to assess the quality of related studies. Results Authors of Perceived Breastfeeding Support Assessment Tool’ (PBSAT) suggested that instrument seem to should be two factors "workplace environmental support for breast-feeding working mother" and "the available social environmental support for working mothers". Total Cronbach's alpha was 0.85. In exclusive breastfeeding social support (EBFSS) instrument, based on exploratory factor analysis, 16 items grouped into three factors "instrumental", "emotional" and "informational factors" accounted 66% of total variance. EFA were followed by confirmatory factors analysis showed Modified model was partially fitted to the data. In the Workplace Breastfeeding Support Scale (WBSS), EFA identified four dimensions of breastfeeding support at workplace. These four factors labeled "technical support", "breastfeeding-friendly environment", "facility support" and "peer support". Cronbach’s alpha was 0.77 and split-half reliability was r=0.86. In Employee Perceptions of Breastfeeding Support Questionnaire (EPBS-Q), data scaled by the Multidimensional Random Coefficients Multinomial Logit Model. A two-dimensional model (company polices/work culture and manager and her co-workers) were emerged. Cronbach’s alpha was excellent (almost 0.90). Conclusion: Four instruments found to assess breastfeeding was valid and reliable to measure breast feeding in social and workplaces

A Systematic Review of Factorial Structure of the Iowa Infant Feeding Attitude Scale (IIFAS)

Background: The attitude towards lactation is one of the best predictors of breastfeeding. Iowa Infant Feeding Attitudes Scale (IIFAS) is used to measure the attitude toward lactation. IIFAS is a valid and reliable tool but factorial structure of this tool was reported various in different studies. The aim of this study is to assess factorial structure of IIFAS. Materials and Methods: An extensive search was done in databases of databases of Medline, EMBASE, Web of Science, Scopus, Cochrane Library, and CINAHL until May 2018. Two independent researchers screened articles and in the next step, full texts of probably relevant articles were read and summarized. The quality of studies was performed by COSMIN checklist. The following keywords were used: (Iowa Infant Feeding Attitude Scale OR IIFAS) AND (Factor Analysis OR exploratory factor analysis OR confirmatory factor analysis OR Validity OR psychometric). Results: Six studies were assessed in systematic review. In Spanish version, single- factor solutions with 9 items in sample of 1,294 pregnancy women was tested and showed a satisfactory fit to the data. In Japanese version, authors provided single-factor- model with 16 items.  Factors loading were ranged from -0.06 to 0.68. Arabic version, EFA identified 6 factors with eigenvalues more than 1 explained 61% of total variance.  However, scree plot suggested unidimensional structure. In Chinese version, EFA extracted four factors and labeled "Favorable to breastfeeding", "Favorable to formula-feeding", "Convenience" and "Sociological influences". In Canadian and Singapore version, the most sense model based on EFA was a three –factors model and labeled "Favorable to breast feeding", "Convenience" and "Favorable to formula feeding". Conclusion: Four-factor model and three- factor model can be used in clinical practices and research.  There is a need to further test single-factor model

Effects of acetylation and press time on heat transfer in particleboard mat from Hornbeam wood (Carpinus betulus)

Effects of acetylation and press time on heat transfer to the core layer of particleboard mat in hot pressing were investigated. Particleboard was made using hornbeam particles. Particles were soaked in acetic anhydride for 24 hours to reach three degrees of acetylation (8, 12 and 17%). The treated particles were heated by oven at 120°C for 40, 180 and 360 minutes, respectively. Acetylated and non-treated (control) particle were blended with 10% melamine urea formaldehyde (based on the oven-dry weight of particles) and and then pressed to make boards. During pressing operation of particle mat, heat transfer to the middle layer of the mat was measured by a Cr- Ni wires thermocouple. Three press times (5, 6 and 7 minutes) were used in the manufacturing process. Results showed that increasing the degrees of acetylation, heat transfer decreased. In control samples and in low-degree modification (8%), in the early period, core temperature reached 100°C. At 12%, after 390 seconds and at the highest degree (17%) even in the longer press time (7min), the core layer temperature did not reach to 100°C

Can cardiac rehabilitation programs improve functional capacity and left ventricular diastolic function in patients with mechanical reperfusion after ST elevation myocardial infarction?: A double-blind clinical trial

BACKGROUND: Current guidelines recommend cardiac rehabilitation programs (CRP) as a means to improve functional status of patients after coronary revascularization. However, research supporting this recommendation has been limited and positive effects of CRP on diastolic function are controversial. The aim of this study was to examine the effects of an 8-week CRP on left ventricular diastolic function.    METHODS: This randomized, clinical trial included 29 men with ST elevation myocardial infarction (MI) who had received reperfusion therapy, i.e. coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). They were randomized to a training group (n = 15; mean age: 54.2 ± 9.04 years old) and a control group (n = 14; mean age: 51.71 ± 6.98 years old). Patients in the training group performed an 8-week CRP with an intensity of 60-85% of maximum heart rate. Exercise sessions lasted 60-90 minutes and were held three times a week. At the start and end of the study, all patients performed symptom-limited exercise test based on Naughton treadmill protocol. Pulsed-wave Doppler echocardiography was also used to determine peak velocity of early (E) and late (A) waves, E/A ratios, and the deceleration time of E (DT).    RESULTS: Left ventricular diastolic indices (E, A, E/A ratio, DT) did not change significantly after the CRP. Compared to baseline, patients in the training group had significant improvements in functional capacity (8.30 ± 1.30 vs. 9.7 ± 1.7) and maximum heart rate (118.50 ± 24.48 vs. 126.85 ± 22.75). Moreover, resting heart rate of the training group was significantly better than the control group at the end of the study (75.36 ± 7.94 vs. 79.80 ± 7.67; P < 0.001).    CONCLUSION: An 8-week CRP in post-MI patients revascularized with PCI or CABG led to improved exercise capacity. However, the CRP failed to enhance diastolic function.      Keywords: Cardiac Rehabilitation, Diastolic Function, Functional Capacity, Post-Myocardial Patients

Comparison of hemodynamic changes and level of spinal anesthesia in patients with hypothyroidism and control group undergoing caesarean section with spinal anesthesia: a case-control study

Introduction: Pregnancy has a significant effect on the thyroid gland and its function. Hypothyroidism in pregnancy is defined as an increase in serum TSH levels. The present study was conducted with aim to investigate the amount of hemodynamic changes and the level of spinal anesthesia in hypothyroid patients undergoing caesarean section with spinal anesthesia and comparing it with the control group.Methods: In this case-control study, 83 patients aged 18-42 years who referred to Motahari Hospital in Jahrom city for caesarean section were studied in two hypothyroid (n=42) and control (n=41) groups. The level of spinal anesthesia, systolic, diastolic and mean arterial blood pressure and heart rate were measured and recorded before the administration of anesthetic, 1, 15, 30, 45 and 60 minutes after anesthesia and at the time of entry and exit from recovery. Data analysis was done by SPSS software (version 21) and repeated measurement, Cochran, analysis of variance and chi square tests. P<0.05 was considered statistically significant.Results: There was a significant difference in the frequency of spinal anesthesia between hypothyroid patients undergoing caesarean section with spinal anesthesia and the control group (p<0.001). There was no significant difference between the groups of patients with hypothyroidism and the control group in terms of mean systolic and diastolic blood pressure before and 1 minute after anesthesia, 15, 30, 45 and 60 minutes after anesthesia and at the time of entry and exit from recovery (P<0.05).Conclusion: Although the use of spinal anesthesia in pregnant mothers with hypothyroidism reported a higher level of anesthesia during the operation compared to the control group, the difference in mean arterial pressure and heart rate was not clinically significant between the groups. Based on the present study, it seems that there is no need to change the spinal anesthesia protocol for patients with hypothyroidism