The Association between Birth Method and Successfulness of Exclusive Breastfeeding at the Time of Hospital Discharge at Wellstar Kennestone Hospital from March, 2011 through March, 2013

ABSTRACT BACKGROUND: Breastfeeding is important to children’s health and development in early years. It may also have implications for health in later life as it has been associated with some chronic non-communicable diseases including hypertension, obesity, diabetes, hypercholesterolemia, and cardiovascular diseases. The prevalence of exclusive breastfeeding in the United States is estimated to be approximately 44% for a 3-month period and 24% for a 6-month period (CDC, 2008). There are many factors that influence whether or not a mother will be successful in exclusive breastfeeding, and one factor that has been identified with the success of this is delivery method. OBJECTIVE: The purpose of this study was to determine whether or not infant delivery method is associated with exclusive breastfeeding. Additionally, other environmental and personal factors examined included: intent, infant-to-breast within two hours of birth, as well as maternal race, parity, and age. METHODOLOGY: Data were obtained from the Wellstar Kennestone Hospital Lactation Department through an agreement. The information was extracted from the patients’ medical charts between March, 2011 and March, 2013 by nurses in the lactation department. Descriptive statistical tests and univariate and multivariate logistic regression analyses were conducted to examine associations between delivery method and exclusive breastfeeding with analytic consideration given to significant environmental and personal maternal characteristics. RESULTS: There was a statistically significant association between delivery method and exclusive breastfeeding (OR= .510, 95% CI= .375-.695) after adjusting for intent, whether or not baby was put to the breast within two hours of birth, maternal race, parity, and maternal age. Mothers who delivered via cesarean section were .510 times as likely to be exclusively breastfeeding at the time of hospital discharge when compared to mothers who delivered vaginally. CONCLUSION: The results of this study indicate that there is a significant association between delivery method and exclusive breastfeeding, in that vaginally delivered babies were more likely to be exclusively breastfeeding compared to babies delivered via cesarean section. This result is consistent with other research, and it further supports recommendations for healthcare professionals to promote breastfeeding for the first six months of life. As aligned with the Baby-Friendly Hospital Initiative and WHO goals, exclusive breastfeeding should be thoroughly encouraged in addition to promoting natural (vaginal) birth options whenever possible. Further research regarding post-partum factors for both types of delivery that can lead to higher rates of exclusive breastfeeding is warranted

Evaluating the Efficacy of Point-of-Use Water Filtration Units in Fiji

Background: To develop and evaluate a strategy for reducing the prevalence and impact of waterborne disease, a water quality intervention was developed for Fiji by Give Clean Water, Inc. in partnership with the Fiji Ministry of Health. Residents were provided and trained on how to use a Sawyer® PointONE™ filter, while also being taught proper handwashing techniques. At the time of the filter installation, all households were surveyed inquiring about the prior 2- to 4-week period. Households were measured a second time between 19 and 225 days later (mean = 66 days). Results: To date, five economic and health outcomes have been tracked on 503 households to evaluate the efficacy of the intervention. When comparing baseline to follow-up among the 503 households, the 2-week diarrhea prevalence decreased in households from 17.5% at baseline to 1.8% at follow-up. Also, the 2-week prevalence of severe diarrhea decreased per household from 9.7% at baseline to 0.6% at follow-up. Finally, monthly diarrhea-related medical costs reduced by an average of Fijian (FJ) $3.54 per person, and monthly water expenses reduced by FJ$0.63 per person. All estimated values are obtained from general linear and logistic mixed-effect models, which adjusted for location, season, time to follow-up, household size, water source, and respondent changing. Changes in economic and health outcomes from installation to follow-up were statistically significant (p \u3c 0.05) in all cases, in both unadjusted and adjusted models. Conclusions: The installation of water filters shows promise for the reduction of diarrhea prevalence in Fiji, as well as the reduction of diarrhea-related medical costs and water expenses. Future work entails evaluation in other countries and contexts, long-term health monitoring, and comparison to alternative water quality interventions

n–6 fatty acid biomarkers and incident atrial fibrillation:an individual participant-level pooled analysis of 11 international prospective studies

Background: The presence of atrial fibrillation (AF) is associated with an over 2-fold increased risk of stroke, heart failure, and cardiovascular mortality. Long chain n–6 PUFAs have been suggested to have a variety of beneficial biologic effects that may reduce AF development; however, prior studies evaluating this relationship are limited. Objectives: We prospectively evaluated the association between circulating levels of linoleic acid (LA) and arachidonic acid (AA) with incident AF. Methods: We used participant-level data from a global consortium of 11 prospective cohort studies with measurements of LA and AA in adults (aged ≥18 y). Participating studies conducted de novo analyses using a prespecified analytical plan with harmonized definitions for exposures, outcomes, covariates, and subgroups. Associations were pooled using inverse-variance weighted meta-analysis. Results: Among 41,335 participants, 6173 incident cases of AF were ascertained, with median follow-up time of 14 y. In multivariable analysis, per interquintile range (difference between the 10th and 90th percentiles for each fatty acid), circulating n–6 levels were not associated with incident AF. For LA, the hazard ratio per interquintile range was 0.96 (95% confidence interval [CI]: 0.89, 1.04), and for AA, 1.02 (95% CI: 0.94, 1.10), with little evidence of heterogeneity between cohorts. Associations were similarly nonsignificant across subgroups of age, race, and biomarker fraction. Conclusions: Biomarkers of n–6 fatty acids including LA and AA are not associated with incident AF. These findings suggest that overall effects of n–6 PUFAs on influencing AF development are neutral.</p

Prostaglandin E₂ stimulates adaptive IL-22 production and promotes allergic contact dermatitis

International audienc

Omega-3 Fatty Acid Biomarkers and Incident Atrial Fibrillation

Background: The relationship between omega-3 fatty acids and atrial fibrillation (AF) remains controversial. Objectives: This study aimed to determine the prospective associations of blood or adipose tissue levels of eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) with incident AF. Methods: We used participant-level data from a global consortium of 17 prospective cohort studies, each with baseline data on blood or adipose tissue omega-3 fatty acid levels and AF outcomes. Each participating study conducted a de novo analyses using a prespecified analytical plan with harmonized definitions for exposures, outcome, covariates, and subgroups. Associations were pooled using inverse-variance weighted meta-analysis. Results: Among 54,799 participants from 17 cohorts, 7,720 incident cases of AF were ascertained after a median 13.3 years of follow-up. In multivariable analysis, EPA levels were not associated with incident AF, HR per interquintile range (ie, the difference between the 90th and 10th percentiles) was 1.00 (95% CI: 0.95-1.05). HRs for higher levels of DPA, DHA, and EPA+DHA, were 0.89 (95% CI: 0.83-0.95), 0.90 (95% CI: 0.85-0.96), and 0.93 (95% CI: 0.87-0.99), respectively. Conclusions: In vivo levels of omega-3 fatty acids including EPA, DPA, DHA, and EPA+DHA were not associated with increased risk of incident AF. Our data suggest the safety of habitual dietary intakes of omega-3 fatty acids with respect to AF risk. Coupled with the known benefits of these fatty acids in the prevention of adverse coronary events, our study suggests that current dietary guidelines recommending fish/omega-3 fatty acid consumption can be maintained.</p

The DOE Systems Biology Knowledgebase (KBase)

The U.S. Department of Energy Systems Biology Knowledgebase (KBase) is an open-source software and data platform designed to meet the grand challenge of systems biology — predicting and designing biological function from the biomolecular (small scale) to the ecological (large scale). KBase is available for anyone to use, and enables researchers to collaboratively generate, test, compare, and share hypotheses about biological functions; perform large-scale analyses on scalable computing infrastructure; and combine experimental evidence and conclusions that lead to accurate models of plant and microbial physiology and community dynamics. The KBase platform has (1) extensible analytical capabilities that currently include genome assembly, annotation, ontology assignment, comparative genomics, transcriptomics, and metabolic modeling; (2) a web-browser-based user interface that supports building, sharing, and publishing reproducible and well-annotated analyses with integrated data; (3) access to extensive computational resources; and (4) a software development kit allowing the community to add functionality to the system

Omega-3 Blood Levels and Stroke Risk:A Pooled and Harmonized Analysis of 183 291 Participants from 29 Prospective Studies

BACKGROUND: The effect of marine omega-3 PUFAs on risk of stroke remains unclear. METHODS: We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome. RESULTS: Among 183 291 study participants, there were 10 561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91]; P&lt;0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74-0.91]; P&lt;0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81-0.96]; P=0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; P=0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD. CONCLUSIONS: Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.</p

Omega-3 Blood Levels and Stroke Risk:A Pooled and Harmonized Analysis of 183 291 Participants from 29 Prospective Studies

BACKGROUND: The effect of marine omega-3 PUFAs on risk of stroke remains unclear. METHODS: We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome. RESULTS: Among 183 291 study participants, there were 10 561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91]; P&lt;0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74-0.91]; P&lt;0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81-0.96]; P=0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; P=0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD. CONCLUSIONS: Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.</p