Assessment of social psychological determinants of satisfaction with childbirth in a cross-national perspective

<p>Abstract</p> <p>Background</p> <p>The fulfilment of expectations, labour pain, personal control and self-efficacy determine the postpartum evaluation of birth. However, researchers have seldom considered the multiple determinants in one analysis. To explore to what extent the results can be generalised between countries, we analyse data of Belgian and Dutch women. Although Belgium and the Netherlands share the same language, geography and political system and have a common history, their health care systems diverge. The Belgian maternity care system corresponds to the ideal type of the medical model, whereas the Dutch system approaches the midwifery model. In this paper we examine multiple determinants, the fulfilment of expectations, labour pain, personal control and self-efficacy, for their association with satisfaction with childbirth in a cross-national perspective.</p> <p>Methods</p> <p>Two questionnaires were filled out by 605 women, one at 30 weeks of pregnancy and one within the first 2 weeks after childbirth either at home or in a hospital. Of these, 560 questionnaires were usable for analysis. Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004–2005. Satisfaction with childbirth was measured by the Mackey Satisfaction with Childbirth Rating Scale, which takes into account the multidimensional nature of the concept. Labour pain was rated retrospectively using Visual Analogue Scales. Personal control was assessed with the Wijma Delivery Expectancy/Experience Questionnaire and Pearlin and Schooler's mastery scale. A hierarchical linear analysis was performed.</p> <p>Results</p> <p>Satisfaction with childbirth benefited most consistently from the fulfilment of expectations. In addition, the experience of personal control buffered the lowering impact of labour pain. Women with high self-efficacy showed more satisfaction with self-, midwife- and physician-related aspects of the birth experience.</p> <p>Conclusion</p> <p>Our findings focus the attention toward personal control, self-efficacy and expectations about childbirth. This study confirms the multidimensionality of childbirth satisfaction and demonstrates that different factors predict the various dimensions of satisfaction. The model applies to both Belgian and Dutch women. Cross-national comparative research should further assess the dependence of the determinants of childbirth satisfaction on the organisation of maternity care.</p

Irregular breakfast eating and health status among adolescents in Taiwan

BACKGROUND: Regular breakfast eating (RBE) is an important contributor to a healthy lifestyle and health status. The aims of the present study were to evaluate the relationships among irregular breakfast eating (IRBE), health status, and health promoting behavior (HPB) for Taiwanese adolescents. METHODS: A cross-sectional, descriptive design was used to investigate a cluster sample of 1609 (7(th )-12(th )grade) adolescents located in the metropolitan Tao-Yuan area during the 2005 academic year. The main variables comprised breakfast eating pattern, body weight, and health promoting behaviors. Data were collected by a self-administered questionnaire. RESULTS: A total of 1609 participants were studied, 64.1% in junior high school and 35.9% in high school, boys (47.1%) and girls (52.9%) ranging in age from 12–20 years. Of the total participant population, 28.8% were overweight and nearly one quarter (23.6%) reported eating breakfast irregularly during schooldays. The findings indicated that adolescents with RBE had a lower risk of overweight (OR for IRBE vs. RBE = 1.51, 95% CI: 1.12, 2.04), and that the odds of becoming overweight were 51% greater for IRBE than for RBE even after controlling for demographical and HPB variables. IRBE also was a strong indicator for HPB. However, the profile of the high-risk IRBE group was predominantly junior high schoolchildren and/or children living without both parents. CONCLUSION: This study provides valuable information about irregular breakfast eating among adolescents, which is associated with being overweight and with a low frequency of health promoting behavior. School and family health promotion strategies should be used to encourage all adolescents to eat breakfast regularly

Sn-Beta zeolites with borate salts catalyse the epimerization of carbohydrates via an intramolecular carbon shift

Carbohydrate epimerization is an essential technology for the widespread production of rare sugars. In contrast to other enzymes, most epimerases are only active on sugars substituted with phosphate or nucleotide groups, thus drastically restricting their use. Here we show that Sn-Beta zeolite in the presence of sodium tetraborate catalyses the selective epimerization of aldoses in aqueous media. Specifically, a 5 wt% aldose (for example, glucose, xylose or arabinose) solution with a 4:1 aldose:sodium tetraborate molar ratio reacted with catalytic amounts of Sn-Beta yields near-equilibrium epimerization product distributions. The reaction proceeds by way of a 1,2 carbon shift wherein the bond between C-2 and C-3 is cleaved and a new bond between C-1 and C-3 is formed, with C-1 moving to the C-2 position with an inverted configuration. This work provides a general method of performing carbohydrate epimerizations that surmounts the main disadvantages of current enzymatic and inorganic processes.National Science Foundation (U.S.). Materials Research Science and Engineering Centers (Program) (Award DMR-0819762)DuPont MIT Alliance (Graduate Research Fellowship)National Institutes of Health (U.S.) (Grant EB-001960)National Institutes of Health (U.S.) (Grant EB-002026)National Science Foundation (U.S.). Graduate Research Fellowship Program (Grant 1122374

Pain acceptance and personal control in pain relief in two maternity care models: a cross-national comparison of Belgium and the Netherlands

<p>Abstract</p> <p>Background</p> <p>A cross-national comparison of Belgian and Dutch childbearing women allows us to gain insight into the relative importance of pain acceptance and personal control in pain relief in 2 maternity care models. Although Belgium and the Netherlands are neighbouring countries sharing the same language, political system and geography, they are characterised by a different organisation of health care, particularly in maternity care. In Belgium the medical risks of childbirth are emphasised but neutralised by a strong belief in the merits of the medical model. Labour pain is perceived as a needless inconvenience easily resolved by means of pain medication. In the Netherlands the midwifery model of care defines childbirth as a normal physiological process and family event. Labour pain is perceived as an ally in the birth process.</p> <p>Methods</p> <p>Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004-2005. Two questionnaires were filled out by 611 women, one at 30 weeks of pregnancy and one within the first 2 weeks after childbirth either at home or in a hospital. However, only women having a hospital birth without obstetric intervention (N = 327) were included in this analysis. A logistic regression analysis has been performed.</p> <p>Results</p> <p>Labour pain acceptance and personal control in pain relief render pain medication use during labour less likely, especially if they occur together. Apart from this general result, we also find large country differences. Dutch women with a normal hospital birth are six times less likely to use pain medication during labour, compared to their Belgian counterparts. This country difference cannot be explained by labour pain acceptance, since - in contrast to our working hypothesis - Dutch and Belgian women giving birth in a hospital setting are characterised by a similar labour pain acceptance. Our findings suggest that personal control in pain relief can partially explain the country differences in coping with labour pain. For Dutch women we find that the use of pain medication is lowest if women experience control over the reception of pain medication and have a positive attitude towards labour pain. In Belgium however, not personal control over the use of pain relief predicts the use of pain medication, but negative attitudes towards labour.</p> <p>Conclusions</p> <p>Apart from individual level determinants, such as length of labour or pain acceptance, our findings suggest that the maternity care context is of major importance in the study of the management of labour pain. The pain medication use in Belgian hospital maternity care is high and is very sensitive to negative attitudes towards labour pain. In the Netherlands, on the contrary, pain medication use is already low. This can partially be explained by a low degree of personal control in pain relief, especially when co-occurring with positive pain attitudes.</p

Prevalence and energy intake from snacking in Brazil: analysis of the first nationwide individual survey

BACKGROUND/OBJECTIVES: Snacking has increased globally. We examine snacking patterns and common snack foods in Brazil. SUBJECTS/METHODS: Data from the first of two non-consecutive food diaries from 34,003 individuals (aged ≥10 years) in the first Brazillian nationally representative dietary survey (2008-2009) were used. Meals were defined as the largest (kcal) eating event reported during select times of the day (Breakfast, 6am-10am; Lunch, 12pm-3pm; Dinner, 6pm-9pm); all other eating occasions were considered snacks. We estimate daily energy intake, percent consuming, number of daily snacks, and per capita and per consumer energy from snacks (kcal/d, kcal/snack, and % of daily energy from snacks). RESULTS: 74% of Brazilians (≥10 years) snacked, reporting an average 1.6 snacks/d. 23% of the sample were heavy snackers (≥3 snacks/d). Snacking accounted for 21% of daily energy intake in the full sample, but 35.5% among heavy snackers. Compared to non-snackers (1548 kcal/d), light (1-2 snacks/d) and heavy snackers consumed more daily energy (1929 and 2334 kcal/d, respectively). By time of day, the largest percent of persons reported afternoon/early evening snacking (3:01-5:59 pm, 47.7%). Sweetened Coffee & Tea, Sweets & Desserts, Fruit, Sugar-Sweetened Beverages (SSB), and high-calorie Salgados (Fried/baked dough with Meat/Cheese/Vegetable) were the top 5 most commonly consumed snacks. Differences were observed by age groups. Trends in commercial sales were observed, especially for SSB’s. CONCLUSIONS: Many commonly consumed snack foods in Brazil are classified, in the US, as being high in solid fats and added sugars (SoFAS). The public health impact of snacking in Brazil requires further exploration

Phase-change materials for non-volatile photonic applications

Phase change materials (PCM) provide a unique property combination. Upon the transformation from the amorphous to the crystalline state, their optical properties change drastically. Short optical or electrical pulses can be utilized to switch between these states, making phase change materials attractive for photonic applications. We review recent developments of PCMs and evaluate the potential for all-photonic memories. Towards this goal, the progress as well as existing challenges to realize waveguides with stepwise adjustable transmission is presented. Colour-rendering and nano-pixel displays form another interesting application. Finally, nanophotonic applications based on plasmonic nanostructures are introduced. They provide reconfigurable, non-volatile functionality enabling manipulation and control of light. Requirements and perspectives to successfully implement PCMs in emerging areas of photonics are discussed