Breastfeeding in South Gloucestershire: Mothers' early experiences of infant feeding

Executive SummaryIntroduction• This research about mothers’ early experiences of infant feeding was developed following discussions about South Gloucestershire’s public health priorities for breastfeeding; current services supporting breastfeeding; and relatively low breastfeeding continuation rates.Background and context• Breastfeeding is recognised as the optimal way to feed infants from birth and exclusive breastfeeding is recommended until about six months of age, with the introduction of complementary feeding when babies are developmentally ready, usually around six months. • The support, promotion and protection of breastfeeding is a national and local priority. In 2014/15, initiation of breastfeeding in South Gloucestershire, was 77.1% while continuation was 47.8%. The Joint Strategic Needs Assessment in 2016, highlighted the need to obtain the views of mothers on their experience of support for breastfeeding. Research question• The research question was: What are the experiences of mothers (with a focus on support) in South Gloucestershire in relation to infant feeding in the first 6-8 weeks? Methods• The research design adopted a purposive sampling strategy, based on criteria sampling, with mothers that had; experience of breastfeeding in the first 6-8 weeks of their baby’s life, a baby up to 6 months of age and were engaged with a Children’s Centre. We recruited mothers who met all three criteria. • Support for the research was obtained from Midwifery, Health Visiting and Children’s Centres managers. Baby and Me groups were visited to invite participation; 53 mothers expressed an interest and 24 mothers selected randomly were interviewed. An information sheet, consent form and interview schedule were developed.• NVivo was used to support data management and analysis in which themes were identified. Data protection requirements were adhered to throughout the research. The research had ethical approval from both South Gloucestershire Council and the University of the West of England. The findingsFindings from this project suggest that there are three ‘critical stages’ in supporting a mother to breastfeed and in her experience of breastfeeding; within these the main themes emerging from this research are discussed: • Support before birth: o Preparation antenatally for breastfeeding does not prepare women for the reality.o Many mothers would have liked information about expressing milk and bottle-feeding before they become mothers. • Support around the time of the birth:o In hospital, after the birth, some mothers receive conflicting messages and don’t always feel supported.o Birth experience can influence early experiences of breastfeeding.• Support once at home:o On return home, Health Visitors are generally perceived as supportive although contact can be minimal.o Breastfeeding support groups suit some women but are not available when needed.o Family, friends and other networks are a key source of support and advice for many motherso Many women seek support from other sources including online groups and apps although telephone helplines were not much used.Recommendations A number of recommendations are made; these are mainly directed towards South Gloucestershire Council but are also of relevance to the wider partnership of health and community and voluntary sector agencies. Recommendations concern the promotion and protection of breastfeeding; the mental and emotional health and wellbeing of women; consistent evidence-based personal and timely support; mothers awareness of differing professional roles; evaluation of breastfeeding groups and; consistent approach to signposting women to websites, apps and social media; and quality assurance of resources and workforce development

Traditional Owners of the Great Barrier Reef: the next generation of Reef 2050 actions

In short, this Report: Confirms that there are two options for progressing the integration of Traditional Owner interests in the Reef 2050 Plan. Option 1 (Business As Usual) represents a continuation of the current approach of Government-based review and refinement of the (now 23) Traditional Owner actions in the Reef 2050 Plan. Option 2 (Towards Genuine Co-governance) represents Government taking a far more negotiated approach at the GBR-wide level (and subsequently down to local scales) that applies the principles of Free Prior and Informed Consent. Based on extensive engagement concerning the aspirations of Traditional Owners and their support organisations across the GBR, the overwhelming stated desire and demand is for genuine partnership in the overarching governance of the Reef and far deeper ownership of, and participation in, its active day to day management (Option 2). There is an unambiguous view that the foundations set in the Reef 2050 Plan (Option 1), while a step in the right direction, simply reflect Traditional Owner aspirations in someone else’s planning. Meanwhile, a consistent message from Traditional Owners, fuelled by their existing and emerging rights in sea country, is that this more passive form of involvement cannot continue into the future; that a genuine form of agreement making and active implementation (from GBR to local scales) must emerge

The Grizzly, October 18, 1985

Limerick: The Main Objective - Calm • Typesetting Equipment Offers New Experience • Letters: Ex-Rover Responds; Some Housing Needs Help; Reply for Sluggo • Financial Aid Striving to the Top • Search of Success Finds Bravo • Look Out for the Candid Cameras • Sorority Pledging Sees Light Through Tunnel • Field Hockey Battles Tough Competition • Booters Find Easier Times • Ultimate Frisbee is Here • Doleniak: Flying Higher Through the Sky • Grizzlies are Defeated • Campus Security Noteshttps://digitalcommons.ursinus.edu/grizzlynews/1148/thumbnail.jp

So many filters, so little time : the development of a search filter appraisal checklist

Objectives: The authors developed a tool to assess the quality of search filters designed to retrieve records for studies with specific research designs (e.g., diagnostic studies). Methods: The UK InterTASC Information Specialists' Sub-Group (ISSG), a group of experienced health care information specialists, reviewed the literature to evaluate existing search filter appraisal tools and determined that existing tools were inadequate for their needs. The group held consensus meetings to develop a new filter appraisal tool consisting of a search filter appraisal checklist and a structured abstract. ISSG members tested the final checklist using three published search filters. Results: The detailed ISSG Search Filter Appraisal Checklist captures relevance criteria and methods used to develop and test search filters. The checklist includes categorical and descriptive responses and is accompanied by a structured abstract that provides a summary of key quality features of a filter. Discussion: The checklist is a comprehensive appraisal tool that can assist health sciences librarians and others in choosing search filters. The checklist reports filter design methods and search performance measures, such as sensitivity and precision. The checklist can also aid filter developers by indicating information on core methods that should be reported to help assess filter suitability. The generalizability of the checklist for non-methods filters remains to be explored.The work of InterTASC members, including the ISSG, is funded through the UK National Institute for Health Research Health Technology Assessment Programm

A collaboratively produced model of service design for children and young people with common mental health problems

Background: Little is known about the effectiveness of, and implementation complexities associated with, service delivery models for children and young people (CYP) experiencing ‘common’ mental health problems such as anxiety, depression, behavioural difficulties and self-harm. This paper outlines how a model for high-quality service design for this population group was developed by identifying available services, their effectiveness, cost-effectiveness and acceptability, and the barriers and enablers to access. Methods: Sequential, mixed-methods design, combining evidence syntheses (scoping and integrative reviews of the international literature) with primary research (a collective case study in England and Wales). Data from these two elements were collaboratively synthesised in a subsequent model-building phase. Results: The scoping review yielded a service model typology. The integrative review found effectiveness evidence only for four models: collaborative care (the only service model to also have cost-effectiveness evidence), outreach approaches, brief intervention services and an organisational framework called ‘Availability, Responsiveness and Continuity’. No service model seemed more acceptable than others. Three case study themes were identified: pathways to support; service engagement; and learning and understanding. The model-building phase identified rapid access, learning self-care skills, individualised support, clear information, compassionate and competent staff and aftercare planning as core characteristics of high-quality services. These characteristics were underpinned by four organisational qualities: values that respect confidentiality; engagement and involvement; collaborative relationships; and a learning culture. Conclusions: A consistent organisational evidence-base for service design and delivery in CYP’s mental health spanning many years appears to have had little impact on service provision in England and Wales. Rather than impose – often inflexible and untested – specific local or national models or frameworks, those commissioning, designing and delivering mental health services for CYP should (re)focus on already known, fundamental components necessary for high-quality services. These fundamental components have been integrated into a collaboratively produced general model of service design for CYP with common mental health problems. While this general model is primarily focused on British service provision, it is broad enough to have utility for international audiences

The Grizzly, November 22, 1985

From Damp to Bone Dry? • UCFL Takes to the Air: Or Visa Versa • It\u27s all Greek to me • The Descent on the Skunks of Ursinus • Editorial: Yale Conference a Learning Experience • Letter: Munchies Mandate • Who\u27s Who Honors Ursinus • How to Deal with Terrorists? • Two Truman Scholars • In Search of Success: Marivi Relova Brings Good Things to GE • Communication a Must • Bears Bounce Dickinson • Booters Find Cold Times in New Hampshire • Soccer Seniors Will be Missed • Coach B. is Back • Lady Bears Hope to Improve Behind Letuakas • Season Tips Off Tonight • Gymnasts Spring into Season • Alercio Faces J Board • Myrin Stacks Up • Fields Should be Ready in Spring • Immersion as Opposed to Voyeurism in Summer Study in France • Smokeless Tobacco Still Burns • Women\u27s Studies Added to Goal No. 9 • Eating Healthy at College Essential • Open Dialogs: Middle Class on Welfare?; Mercy Killing as a Solution; Birth Defects Popular With Geneticists • Ursinus College: The Marriage Factoryhttps://digitalcommons.ursinus.edu/grizzlynews/1153/thumbnail.jp