Impact of education and training on type of care provided by community-based breastfeeding counselors: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Studies using community-based breastfeeding counselors (CBBCs) have repeatedly shown positive impact on breastfeeding initiation, exclusivity and duration, particularly among low-income mothers. To date, there has not been a comprehensive study to determine the impact of CBBC attributes such as educational background and training, on the type of care that CBBCs provide.</p> <p>Methods</p> <p>This was a cross-sectional study of a convenience sample of CBBCs to ascertain the influence of counselor education and type of training on type of support and proficiency of CBBCs in communities across the United States. Invitations to participate in this online survey of CBBCs were e-mailed to program coordinators of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), La Leche League, and other community-based health organizations, who in turn invited and encouraged their CBBCs to participate. Descriptive analysis was used to describe participants (N = 847), while bivariate analysis using χ²test was used to examine the differences between CBBC education, training received and breastfeeding support skills used. Multivariate logistic regression was used to assess the independent determinants of specific breastfeeding support skills.</p> <p>Results</p> <p>The major findings from the research indicate that overall, educational attainment of CBBCs is not a significant predictor for the curriculum used in their training and type of support skills used during counseling sessions, but initial training duration was positively associated with the use of many breastfeeding support skills. Another major influence of counselor support to clients is the type of continuing education they receive after their initial training, with higher likelihood of use of desirable support skills associated with counselors continuing their breastfeeding education at conferences or trainings away from their job sites.</p> <p>Conclusions</p> <p>Our results show that different programs use different training curricula to train their CBBCs varying in duration and content. Counselor education is not a significant predictor of the type of training they receive. Continuing breastfeeding education is a significant determinant of type of counseling techniques used with clients. Further research is therefore needed to critically examine the content of the various training curricula of CBBC programs. This may show a need for a standardized training curriculum for all CBBC programs worldwide to make CBBCs more proficient and efficient, ensuring successful and optimum breastfeeding experiences for mothers and their newborns.</p

Addressing post-harvest losses during traditional banana fermentation for increased food security in Southwest Uganda

Postharvest losses (PHL) destroy 20-60% of the food production in East Africa, exacerbating already severe regional food insecurity. Fermenting perishable foods such as fruits may reduce PHL while providing nutritional enrichment, improving shelf-life and food quality, and addressing seasonality in food supply. Fermented banana products have been refined and diversified in Uganda over generations to make the greatest use of available food resources, but still parts of the raw material are being lost during processing. This study aimed at exploring existing traditional methods and efficiency of fermentation of Musa (AAA-EAHB) 'Mbidde' in southwestern Uganda. The study gathered information through participatory explorations (working with brewers) on banana juice (lightly fermented beer with <1% alcohol content [n=20 brewers]), tonto (turbid beer with ~4% alcohol [n=20]), and amarwa (smoky spirit with ~ 40% alcohol [n=20]). Brewers mentioned several losses of material during harvest and processing. Harvesting bananas requires felling the plant causing ripe fruit damage, particularly during harvest for processing banana juice (loss from fresh bananas=6.4%±8.8%) or amarwa (loss=9.3%±9.5%). Second, losses occur when brewers squeeze juice from the raw banana pulp using stems of Imperata cylindrica, which is then discarded or fed to animals together with the adherent fruit pulp (losses from raw banana juice=50.6%±0.2%; from tonto 39.2%±21.4% and amarwa 47.6%±12.5%). Other causes of PHL during processing are excessive peeling for tonto processing (loss of banana flesh=18.6%±5.8%) and losses of intermediate products during distillation of amarwa (loss=75.9%±1.3%). Total losses of banana products during processing were rare and caused by sabotage (mostly by children), mistakes in the brewing process (e.g. addition of too much water), using bananas of wrong ripening stage, and equipment failure (e.g., burst or leaking drums in distillation equipment). Other non-PHL challenges include Banana Xanthomonas Wilt (BXW) and bad weather (up to 50% losses in the field). Despite the general efficiency of traditional fermentation practices, significant portions of fruit are still lost. Reduction in PHL can complement, both culturally and nutritionally, the role that fermented banana products play in Ugandan food systems and contribute to regional food security. Collaborative mechanisms for PHL reduction should target the cited sources of PHL

Forum: Teacher-Writers: Then, Now, and Next

In this article, the authors reflect upon “the teacher as writer” and describe how they see this concept and movement developing. They articulate a view of the teacher-writer as empowered advocate. Using examples from their scholarship, they illustrate how this powerful idea can transform research conducted about and with teachers. Finally, they draw attention to the potential of the teacher-writer stance as a means of resistance to current reform efforts that disempower teachers

Spitzer IRAC observations of newly-discovered planetary nebulae from the Macquarie-AAO-Strasbourg H-alpha Planetary Nebula Project

We compare H-alpha, radio continuum, and Spitzer Space Telescope (SST) images of 58 planetary nebulae (PNe) recently discovered by the Macquarie-AAO-Strasbo- urg H-alpha PN Project (MASH) of the SuperCOSMOS H-alpha Survey. Using InfraRed Array Camera (IRAC) data we define the IR colors of PNe and demonstrate good isolation between these colors and those of many other types of astronomical object. The only substantive contamination of PNe in the color-color plane we illustrate is due to YSOs. However, this ambiguity is readily resolved by the unique optical characteristics of PNe and their environs. We also examine the relationships between optical and MIR morphologies from 3.6 to 8.0um and explore the ratio of mid-infrared (MIR) to radio nebular fluxes, which is a valuable discriminant between thermal and nonthermal emission. MASH emphasizes late evolutionary stages of PNe compared with previous catalogs, enabling study of the changes in MIR and radio flux that attend the aging process. Spatially integrated MIR energy distributions were constructed for all MASH PNe observed by the GLIMPSE Legacy Project, using the H-alpha morphologies to establish the dimensions for the calculations of the Midcourse Space Experiment (MSX), IRAC, and radio continuum (from the Molonglo Observatory Synthesis Telescope and the Very Large Array) flux densities. The ratio of IRAC 8.0-um to MSX 8.3-um flux densities provides a measure of the absolute diffuse calibration of IRAC at 8.0 um. We independently confirm the aperture correction factor to be applied to IRAC at 8.0um to align it with the diffuse calibration of MSX. The result agrees with the recommendations of the Spitzer Science Center and with results from a parallel study of HII regions. These PNe probe the diffuse calibration of IRAC on a spatial scale of 9-77 arcsec.Comment: 48 pages, LaTeX (aastex), incl. 18 PostScript (eps) figures and 3 tables. Accepted by Astrophysical Journa

G313.3+00.3: A New Planetary Nebula discovered by the Australia Telescope Compact Array and the Spitzer Space Telescope

We present a new planetary nebula, first identified in images from the Australia Telescope Compact Array, although not recognized at that time. Recent observations with the Spitzer Space Telescope during the GLIMPSE Legacy program have rediscovered the object. The high-resolution radio and infrared images enable the identification of the central star or its wind, the recognition of the radio emission as thermal, and the probable presence of polycylic aromatic hydrocarbons in and around the source. These lead to the conclusion that G313.3+00.3 is a planetary nebula. This object is of particular interest because it was discovered solely through radio and mid-infrared imaging, without any optical (or near-infrared) confirmation, and acts as a proof of concept for the discovery of many more highly extinguished planetary nebulae. G313.3+00.3 is well-resolved by both the instruments with which it was identified, and suffers extreme reddening due to its location in the Scutum-Crux spiral arm.Comment: 18 pages, LaTeX (aastex), incl. 8 PostScript (eps) figures and 1 table. Accepted by ApJ (Part 1

Pentraxin-3 is a PI3K signaling target that promotes stem cell–like traits in basal-like breast cancers

Basal-like breast cancers (BLBCs) exhibit hyperactivation of the phosphoinositide 3-kinase (PI3K) signaling pathway because of the frequent mutational activation of the PIK3CA catalytic subunit and the genetic loss of its negative regulators PTEN (phosphatase and tensin homolog) and INPP4B (inositol polyphosphate-4-phosphatase type II). However, PI3K inhibitors have had limited clinical efficacy in BLBC management because of compensatory amplification of PI3K downstream signaling loops. Therefore, identification of critical PI3K mediators is paramount to the development of effective BLBC therapeutics. Using transcriptomic analysis of activated PIK3CA-expressing BLBC cells, we identified the gene encoding the humoral pattern recognition molecule pentraxin-3 (PTX3) as a critical target of oncogenic PI3K signaling. We found that PTX3 abundance is stimulated, in part, through AKT- and nuclear factor κB (NF-κB)-dependent pathways and that presence of PTX3 is necessary for PI3K-induced stem cell-like traits. We further showed that PTX3 expression is greater in tumor samples from patients with BLBC and that it is prognostic of poor patient survival. Our results thus reveal PTX3 as a newly identified PI3K-regulated biomarker and a potential therapeutic target in BLBC

Core and region-enriched networks of behaviorally regulated genes and the singing genome

Songbirds represent an important model organism for elucidating molecular mechanisms that link genes with complex behaviors, in part because they have discrete vocal learning circuits that have parallels with those that mediate human speech. We found that ~10% of the genes in the avian genome were regulated by singing, and we found a striking regional diversity of both basal and singing-induced programs in the four key song nuclei of the zebra finch, a vocal learning songbird. The region-enriched patterns were a result of distinct combinations of region-enriched transcription factors (TFs), their binding motifs, and presinging acetylation of histone 3 at lysine 27 (H3K27ac) enhancer activity in the regulatory regions of the associated genes. RNA interference manipulations validated the role of the calcium-response transcription factor (CaRF) in regulating genes preferentially expressed in specific song nuclei in response to singing. Thus, differential combinatorial binding of a small group of activity-regulated TFs and predefined epigenetic enhancer activity influences the anatomical diversity of behaviorally regulated gene networks

Redlining−associated methylation in breast tumors: the impact of contemporary structural racism on the tumor epigenome

PurposePlace-based measures of structural racism have been associated with breast cancer mortality, which may be driven, in part, by epigenetic perturbations. We examined the association between contemporary redlining, a measure of structural racism at the neighborhood level, and DNA methylation in breast tumor tissue.MethodsWe identified 80 Black and White women diagnosed and treated for a first-primary breast cancer at Emory University Hospitals (2008–2017). Contemporary redlining was derived for census tracts using the Home Mortgage Disclosure Act database. Linear regression models were used to calculate the association between contemporary redlining and methylation in breast tumor tissue. We also examined epigenetic age acceleration for two different metrics, regressing β values for each cytosine-phosphate-guanine dinucleotide (CpG) site on redlining while adjusting for covariates. We employed multivariable Cox-proportional hazards models and 95% confidence intervals (CI) to estimate the association between aberrant methylation and mortality.ResultsContemporary redlining was associated with 5 CpG sites after adjustment for multiple comparisons (FDR&lt;0.10). All genes were implicated in breast carcinogenesis, including genes related to inflammation, immune function and stress response (ANGPT1, PRG4 and PRG4). Further exploration of the top 25 CpG sites, identified interaction of 2 sites (MRPS28 and cg11092048) by ER status and 1 site (GDP1) was associated with all-cause mortality. Contemporary redlining was associated with epigenetic age acceleration by the Hannum metric (β=5.35; CI 95%=0.30,10.4) and showed positive but non-significant correlation with the other clock.ConclusionWe identified novel associations between neighborhood contemporary redlining and the breast tumor DNA methylome, suggesting that racist policies leading to inequitable social and environmental exposures, may impact the breast tumor epigenome. Additional research on the potential implications for prognosis is needed