Healthcare Professionals' Breastfeeding Attitudes and Hospital Practices During Delivery and in Neonatal Intensive Care Units: Pre and Post Implementing the Baby-Friendly Hospital Initiative

Background: The Baby-Friendly Hospital Initiative represents a global effort to support breastfeeding. Commitment to this program has been associated with the longer duration and exclusivity of breastfeeding and improvements in hospital practices. Further, healthcare professionals' breastfeeding attitudes have been associated with the ability to provide professional support for breastfeeding.Research aims: To determine healthcare professionals' breastfeeding attitudes and hospital practices before and after the implementation of the Baby-Friendly Hospital Initiative.Methods: Using a quasi-experimental pretest-posttest study design, healthcare professionals (N = 131) from the single hospital labor and delivery, maternity care, and neonatal intensive care were recruited before and after the Baby-Friendly Hospital Initiative intervention during 2017 and 2019. Breastfeeding attitudes with the validated Breastfeeding Attitude Questionnaire, breastfeeding-related hospital practices, and background characteristics were collected.Results: The healthcare professionals' breastfeeding attitude scores increased significantly after the implementation of the Baby-Friendly Hospital Initiative, difference = 0.16, (95% CI [0.13, 0.19]) and became breastfeeding favorable among all professional groups in each study unit. Positive changes in breastfeeding-supportive hospital practices were achieved. The infants had significantly more frequent immediate and uninterrupted skin-to-skin contact with their mothers. The rate of early breastfeeding, as well as the number of exclusively breastfed infants, increased.Conclusions: After the Baby-Friendly Hospital Initiative and Baby-Friendly Hospital Initiative for neonatal wards (Neo-BFHI) interventions were concluded, we found significant improvements in the breastfeeding attitudes of healthcare professionals and in breastfeeding-related care practices.This RCT was registered (0307-0041) with ClinicalTrials.gov on 03/03/2017.</p

Fragmentation of protonated O, O-diethyl O-aryl phosphorothionates in tandem mass spectral analysis

The gas-phase ion chemistry of protonated O,O-diethyl O-aryl phosphorothionates was studied with tandem mass spectrometric and ab initio theoretical methods. Collision-activated dissociation (CAD) experiments were performed for the [M + H]+ ions on a triple quadrupole mass spectrometer. Various amounts of internal energy were deposited into the ions upon CAD by variation of the collision energy and collision gas pressure. In addition to isobutane, deuterated isobutane C4D10 also was used as reagent gas in chemical ionization. The daughter ions [M + H - C2H4]+ and [M + H − 2C2H4]+ dominate the CAD spectra. These fragments arise via various pathways, each of which involves -y-proton migration. Formation of the terminal ions [M + H - 2C2H4 - H2O]+, [M + H − 2C2H4 − H2S]+, [ZPhOH2]+, [ZPhSH2]+, and [ZPhS]+ [Z = substituent(s) on the benzene ring] suggests that (1) the fragmenting [M + H]+ ions of O,O-diethyl O-aryl phosphorothionates have protons attached on the oxygen of an ethoxy group and on the oxygen of the phenoxy group; (2) thiono-thiolo rearrangement by aryl migration to sulfur occurs; (3) the fragmenting rear-ranged [M + H]+ ions have protons attached on the oxygen of an ethoxy group and on the sulfur of the thiophenoxy group. To get additional support for our interpretation of the mass spectrometric results, some characteristics of three protomers of O,O-diethyl O-phenyl phosphorothionate were investigated by carrying out ab initio molecular orbital calculations at the RHF/3-21G* level of theory

Perhelähtöinen hoito synnyttäneiden osastolla vanhempien ja henkilökunnan arvioimana ennen ja jälkeen Vanhemmat Vahvasti Mukaan -koulutuksen

Tutkimuksen tarkoituksena oli arvioida synnyttäneiden vuodeosaston perhelähtöisyyden toteutumista sekä vanhempien että henkilökunnan kokemana ennen ja jälkeen Vanhemmat Vahvasti Mukaan -koulutusintervention (VVM-koulutus).&nbsp; Tutkimus toteutettiin kvasikokeellisella ennen‒jälkeen-asetelmalla. Aineisto kerättiin synnyttäneiden vuodeosastolta vuosina 2016 ja 2019. Molempina mittausajankohtina vanhemmat (n=82 ja n=76) ja perheiden hoitoon osallistuva henkilökunta (n=54 ja n=36) arvioivat yksikön perhelähtöisen hoidon toteutumista FCCQ-perhelähtöisyysmittarilla, joka sisältää 20 Likert -asteikollista väittämää perhelähtöisyydestä. Mittarin korkeampi arvo kuvaa perhelähtöisempää hoitoa (min 1,0 ja max 4,0). Aineisto analysoitiin tilastollisin menetelmin.&nbsp; Vanhemmat arvioivat perhelähtöisen hoidon toteutuvan keskimäärin hyvin (ka 3,54 ja ka 3,60), samoin kuin henkilökunta (ka 3,32 ja ka 3,35). Vanhempien (p=0,376) tai henkilökunnan (p=0,377) arvioissa ei ollut tilastollisesti merkitseviä eroja.&nbsp; Synnyttäneiden vuodeosaston perhelähtöinen hoito oli lähtötilanteessa hyvällä tasolla. Vanhempien ja henkilökunnan arviot sen toteutumisesta olivat samansuuntaiset. Henkilökunnan arvio oli vanhempien arviota kriittisempi, mikä kuvastaa kykyä tunnistaa perhelähtöisiä toimintatapoja sekä toimia niiden mukaisesti. Koulutusinterventiota voi kuitenkin olla tarpeen kehittää vastaamaan paremmin synnyttäneiden vuodeosastojen tarpeisiin.&nbsp