Determinants of breastfeeding initiation among mothers in Kuwait

<p>Abstract</p> <p>Background</p> <p>Exclusive breastfeeding is recommended as the optimal way to feed infants for the first six months of life. While overall breastfeeding rates are high, exclusive breastfeeding is relatively uncommon among Middle Eastern women. The objective of this study was to identify the incidence of breastfeeding amongst women in the six governorates of Kuwait and the factors associated with the initiation of breastfeeding.</p> <p>Methods</p> <p>A sample of 373 women (aged 17-47 years), recruited shortly after delivery from four hospitals in Kuwait, completed a structured, interviewer-administered questionnaire. Multivariate logistic regression analysis was used to identify those factors independently associated with the initiation of breastfeeding.</p> <p>Results</p> <p>In total, 92.5% of mothers initiated breastfeeding and at discharge from hospital the majority of mothers were partially breastfeeding (55%), with only 30% of mothers fully breastfeeding. Prelacteal feeding was the norm (81.8%) and less than 1 in 5 infants (18.2%) received colostrum as their first feed. Only 10.5% of infants had been exclusively breastfed since birth, the remainder of the breastfed infants having received either prelacteal or supplementary infant formula feeds at some time during their hospital stay. Of the mothers who attempted to breastfeed, the majority of women (55.4%) delayed their first attempt to breastfeed until 24 hours or more after delivery. Breastfeeding at discharge from hospital was positively associated with paternal support for breastfeeding and negatively associated with delivery by caesarean section and with the infant having spent time in the Special Care Nursery.</p> <p>Conclusions</p> <p>The reasons for the high use of prelacteal and supplementary formula feeding warrant investigation. Hospital policies and staff training are needed to promote the early initiation of breastfeeding and to discourage the unnecessary use of infant formula in hospital, in order to support the establishment of exclusive breastfeeding by mothers in Kuwait.</p

Accretion in the Early Kuiper Belt II. Fragmentation

We describe new planetesimal accretion calculations in the Kuiper Belt that include fragmentation and velocity evolution. All models produce two power law cumulative size distributions, N_C propto r^{-q}, with q = 2.5 for radii less than 0.3-3 km and q = 3 for radii exceeding 1-3 km. The power law indices are nearly independent of the initial mass in the annulus, the initial eccentricity of the planetesimal swarm, and the initial size distribution of the planetesimal swarm. The transition between the two power laws moves to larger radii as the initial eccentricity increases. The maximum size of objects depends on their intrinsic tensile strength; Pluto formation requires a strength exceeding 300 erg per gram. Our models yield formation timescales for Pluto-sized objects of 30-40 Myr for a minimum mass solar nebula. The production of several `Plutos' and more than 10^5 50 km radius Kuiper Belt objects leaves most of the initial mass in 0.1-10 km radius objects that can be collisionally depleted over the age of the solar system. These results resolve the puzzle of large Kuiper Belt objects in a small mass Kuiper Belt.Comment: to appear in the Astronomical Journal (July 1999); 54 pages including 7 tables and 13 figure

Key Scientific Issues in the Health Risk Assessment of Trichloroethylene

Trichloroethylene (TCE) is a common environmental contaminant at hazardous waste sites and in ambient and indoor air. Assessing the human health risks of TCE is challenging because of its inherently complex metabolism and toxicity and the widely varying perspectives on a number of critical scientific issues. Because of this complexity, the U.S. Environmental Protection Agency (EPA) drew upon scientific input and expertise from a wide range of groups and individuals in developing its 2001 draft health risk assessment of TCE. This scientific outreach, which was aimed at engaging a diversity of perspectives rather than developing consensus, culminated in 2000 with 16 state-of-the-science articles published together as an Environmental Health Perspectives supplement. Since that time, a substantial amount of new scientific research has been published that is relevant to assessing TCE health risks. Moreover, a number of difficult or controversial scientific issues remain unresolved and are the subject of a scientific consultation with the National Academy of Sciences coordinated by the White House Office of Science and Technology Policy and co-sponsored by a number of federal agencies, including the U.S. EPA. The articles included in this mini-monograph provide a scientific update on the most prominent of these issues: the pharmacokinetics of TCE and its metabolites, mode(s) of action and effects of TCE metabolites, the role of peroxisome proliferator–activated receptor in TCE toxicity, and TCE cancer epidemiology

An Evaluation of Porcine Epidemic Diarrhea Virus Survival in Individual Feed Ingredients in the Presence or Absence of a Liquid Antimicrobial

Background: Contaminated complete feed and porcine plasma are risk factors for PEDV introduction to farms and a liquid antimicrobial has been proven useful for reducing risk. This study provides information on the survivability of PEDV across common swine feed ingredients in the presence or absence of the liquid antimicrobial.Results: Eighteen ingredients commonly included in commercial swine diets were selected, including 3 grain sources (corn, soybean meal (SBM), dried distillers grains with solubles (DDGS)), 5 porcine by-products (spray-dried plasma, purified plasma, intestinal mucosa, meat and bone meal and red blood cells (RBCs)), 3 vitamin/trace mineral (VTM) mixes (sow, nursery, finishing), 2 fat sources (choice white grease and soy oil), 3 synthetic amino acids (lysine HCL, D/L methionine, threonine), as well as limestone and dry choline chloride. Complete feed and stock PEDV served as controls. Thirty grams of each ingredient were inoculated with 2 mL PEDV. A matched set of samples were treated with the formaldehyde-based liquid antimicrobial SalCURB® (LA). All samples (n = 320) were stored outdoors under winter time ambient conditions for 30 days. Samples were submitted on 1, 7, 14 and 30 days post-inoculation (DPI) and tested by PCR and virus isolation (VI). All VI-negative samples were tested by swine bioassay. Viable PEDV was detected by VI or swine bioassay at 1, 7, 14 and 30 DPI from SBM, DDGS, meat & bone meal, RBCs, lysine HCL, D/L methionine, choice white grease, choline chloride, complete feed and stock virus control and at 7 DPI in limestone and at 14 DPI in threonine. Supplementary testing of complete feed and SBM indicated viable virus out to 45 and 180 DPI, respectively. All other samples were negative by VI and bioassay. In contrast, treatment with LA inactivated PEDV across all ingredients on 1 DPI and induced RNA reduction over time.Conclusions: Under the conditions of this study, PEDV viability in feed was influenced by ingredient with extended survival in SBM. Furthermore, LA treatment rendered virus inactive, independent of ingredient type

Evidence from Detrital Zircon Ages for Middle Pennsylvanian Uplift and Drainage in the Source Area of the Chariton Conglomerate and Marmaton Group Sandstones, Southern Iowa and Northern Missouri

The Chariton Conglomerate is a quartz/limestone conglomerate of Middle Pennsylvanian age sparsely exposed in southern Iowa and northern Missouri. In Iowa it is characterized by quartz granules and rounded crinoid columnals. The objective of this study was to use detrital zircon ages to determine the provenance of the Chariton Conglomerate and possibly associated Marmaton Group sandstone beds. Detrital zircon ages were obtained for five conglomerate and two sandstone beds of the Chariton Conglomerate in Iowa, three conglomerate beds of the Chariton Conglomerate in Missouri, and two sandstone beds of the Marmaton Group in Iowa. According to the Kolmogorov-Smirnoff Test, the 12 detrital zircon age spectra were statistically indistinguishable, consistent with a common provenance for all beds. The combined age spectrum (879 zircons) showed both a young cluster (1.1 % of zircons) in the range 320-364 Ma (Late Devonian Period - Late Mississippian Subperiod) and a much older cluster (0.3% of zircons) in the range 3198-3269 Ma (Paleoarchean - Mesoarchean Eras). The Devonian Period - Mississippian Subperiod (318--416 Ma) and the Paleoarchean-Mesoarchean Eras (2800-3600 Ma) accounted for 2.8% and 3.6% of zircon ages, respectively. A model consistent with the above ages and the paleocurrent directions in the Chariton Conglomerate is an Early - Middle Pennsylvanian river originating in the Devonian - Mississippian crystalline rocks of New England and entering Minnesota - Wisconsin from the northeast to collect sediments from crystalline rocks of Paleoarchean - Mesoarchean age. However, a Middle Pennsylvanian uplift in the Minnesota - Wisconsin region is also required to produce the headwaters necessary for the production of quartz granules, which is consistent with the model of hotspot epeirogen

Breastfeeding duration in mothers who express breast milk: a cohort study

BACKGROUND: The expression of breast milk allows a mother to be away intermittently from her infant while continuing to breastfeed. The aim of this study was to investigate the association between expression of breast milk and breastfeeding duration METHODS: A cohort study of 12 months duration. The mothers were recruited from two public maternity hospitals in Perth, Australia between mid-September 2002 and mid-July 2003. While in hospital, participating mothers completed a questionnaire that included questions on how they were feeding their newborn. Telephone interviews conducted at regular periods monitored changes in infant feeding practices, including expression of breast milk. Multivariate Cox regression analysis was used to explore the association between breast milk expression and the duration of any breastfeeding. RESULTS: A total of 587 mothers, or 55% of those eligible, participated in the study. Of these 93.5% were breastfeeding at discharge from hospital. Mothers who expressed breast milk (at one or more time periods) were less likely to discontinue any breastfeeding before six months (Relative Risk 0.71, 95% CI 0.52, 0.98) than those who had never expressed milk. CONCLUSION: This study found that mothers who express breast milk are more likely to breastfeed to six months (any breastfeeding). While further research is required in different cultures to confirm these results, the appropriate use of expressed breast milk may be a means to help mothers to achieve six months of full breastfeeding while giving more lifestyle options

Theory-Based Design and Development of a Socially Connected, Gamified Mobile App for Men About Breastfeeding (Milk Man)

BACKGROUND: Despite evidence of the benefits of breastfeeding, <15% of Australian babies are exclusively breastfed to the recommended 6 months. The support of the father is one of the most important factors in breastfeeding success, and targeting breastfeeding interventions to the father has been a successful strategy in previous research. Mobile technology offers unique opportunities to engage and reach populations to enhance health literacy and healthy behavior. OBJECTIVE: The objective of our study was to use previous research, formative evaluation, and behavior change theory to develop the first evidence-based breastfeeding app targeted at men. We designed the app to provide men with social support and information aiming to increase the support men can offer their breastfeeding partners. METHODS: We used social cognitive theory to design and develop the Milk Man app through stages of formative research, testing, and iteration. We held focus groups with new and expectant fathers (n=18), as well as health professionals (n=16), and used qualitative data to inform the design and development of the app. We tested a prototype with fathers (n=4) via a think-aloud study and the completion of the Mobile Application Rating Scale (MARS).RESULTS: Fathers and health professionals provided input through the focus groups that informed the app development. The think-aloud walkthroughs identified 6 areas of functionality and usability to be addressed, including the addition of a tutorial, increased size of text and icons, and greater personalization. Testers rated the app highly, and the average MARS score for the app was 4.3 out of 5. CONCLUSIONS: To our knowledge, Milk Man is the first breastfeeding app targeted specifically at men. The development of Milk Man followed a best practice approach, including the involvement of a multidisciplinary team and grounding in behavior change theory. It tested well with end users during development. Milk Man is currently being trialed as part of the Parent Infant Feeding Initiative (ACTRN12614000605695)

Freshwater composition of the waters off southeast Greenland and their link to the Arctic Ocean

Author Posting. © American Geophysical Union, 2009. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 114 (2009): C05020, doi:10.1029/2008JC004808.The freshwater composition of waters on the southeast Greenland shelf and slope are described using a set of high-resolution transects occupied in summer 2004, which included hydrographic, velocity, nutrient, and chemical tracer measurements. The nutrient and tracer data are used to quantify the fractions of Pacific Water, sea ice melt, and meteoric water present in the upper layers of the East Greenland Current (EGC) and East Greenland Coastal Current (EGCC). The EGC/EGCC system dominates the circulation of this region and strongly influences the observed distribution of the three freshwater types. Sea ice melt and meteoric water fractions are surface intensified, reflecting their sources, and generally increase southward from Denmark Strait to Cape Farewell, as well as shoreward. Significant fractions of Pacific Water are found in the subsurface layers of the EGCC, supporting the idea that this inner shelf branch is directly linked to the EGC and thus to the Arctic Ocean. A set of historical sections is examined to investigate the variability of Pacific Water content in the EGC and EGCC from 1984 to 2004 in the vicinity of Denmark Strait. The fraction of Pacific Water increased substantially in the late 1990s and subsequently declined to low levels in 2002 and 2004, mirroring the reduction in Pacific Water content reported previously at Fram Strait. This variability is found to correlate significantly with the Arctic Oscillation index, lagged by 9 years, suggesting that the Arctic Ocean circulation patterns bring varying amounts of Pacific Water to the North Atlantic via the EGC/EGCC.This work was funded by National Science Foundation grant OCE- 0450658. D. Sutherland also received support from the Woods Hole Oceanographic Institution Academic Programs Office