Early breastfeeding cessation: validation of Breastfeeding Assessement Score (BAS) on an Italian validation cohort of women

Introduction The World Health Organization recommends exclusive breastfeeding for the first 6 months of life because of the numerous benefits of breastfeeding for the mother and the child 2,3. A prognostic approach to identify the mothers at risk of early breastfeeding cessation is needed to provide preventive support to these women. The BAS1, elaborate in Kansas, is a score useful for this approach. Aim of the study To assess the accuracy of the BAS1, in an Italian validation cohort of women. Methods This is a bicentric, prospective study. Italian and healthy mothers who gave birth to a single child from 25th June 2008 to 15th January 2009, with a gestational age of at least 35 weeks, were included. Exclusion criteria, on the convenience sample, were: mothers with a non-Italian background, preterm delivery (<35 weeks) or twin birth.The authors have calculated the BAS on 386 women just before hospital discharge, at least 48 hours post-delivery age, in Mangiagalli and in S. Gerardo hospitals. The primary outcome measured was how many women stopped the breastfeeding, and it was assessed using structured follow-up telephone interviews after 4 weeks. The predictive value of the BAS1 is ok, if it identifies the 80% of the women that stop to breastfeed. This study was carried out from 25th June 2008 to 15th February 2009. Results For a cut point of 8, recommended by the authors of the BAS1, 119 mother-infant pairs were categorized at high risk to early breastfeeding cessation, with a RR 5,24. The BAS has a sensibility of 0.69, a specificity of 0.79, a positive predictive value of 43% and a negative predictive value of 91%. Conclusions / discussion The intrinsic properties of the BAS1 are strong, but the study cannot validate this score because in the studied population, there is a low sensibility versus the authors expectation. Practical relevance Italian midwives need to individualize the mothers at risk of early breastfeeding cessation, for a special support. Research implications This study confirms the necessity to identify a score for the Italian population

ALLATTAMENTO AL SENO: VALIDAZIONE DEL BREASTFEEDING ASSESSMENT SCORE RIDOTTO, SU UN GRUPPO DI PUERPERE ITALIANE.

TITLE. Breastfeeding: validation of a reduced Breastfeeding Assessment Score (BAS) in a group of Italian women. AIM AND OBJECTIVE. To assess the accuracy of a reduced Breastfeeding Assessment Score (BAS) in a group of Italian women; the reduced BAS considers only 5 of the 8 original BAS items studied, those not indicating a pathology. BACKGROUND. The WHO and many Professional Organizations recommend exclusive breastfeeding for the first 6 months of life because of its many benefits for mother and child. A prognostic approach that identifies mothers at increased risk of early breastfeeding cessation is needed in order to provide preventive support. The BAS, elaborated in Kansas, is useful to this approach. DESIGN. This is a descriptive, prospective study. This study involves two Italian hospitals. METHOD. We included healthy Italian mothers who gave birth from July 7, 2008 to January 15, 2009. The exclusion criteria on the convenience sample were: non-Italian nationality, birth under 36 wks and twin birth. The authors calculated a reduced BAS (\u201creduced\u201d because the original 8 items studied by Hall, were reduced to 5) 48 hours after birth. After 4 weeks a structured follow-up telephone interview was carried out: the primary outcome was breastfeeding cessation (including mixed feeding). RESULTS. We recruited 386 women, with 6 lost during follow-up. Out of 380 women, 127 (33.4%) stopped breastfeeding. With a cut off point of 8, the reduced BAS sensitivity was 52.0%, which increased to 77.9% by using a cut-off point of 9. We also calculated a modified BAS with different age categories, which is adequate based on the Italian situation: in this case sensitivity was 70.1%. This study suggests that a reduced BAS with a different cut-off point or modified with a different age classification is useful in identifying Italian mothers who will discontinue breastfeeding, as in both cases sensitivity does increase. RELEVANCE TO CLINICAL PRACTICE. Italian midwives could use this modified BAS to identify mothers at increased risk of early breastfeeding cessation needing special support

Le disposizioni degli insegnanti rispetto all’atmosfera morale scolastica: Uno studio empirico

Commencing with the definition of school moral atmosphere, this essay presents first results of an empirical research which aims to investigate the attitudes of aspiring, in-training, and in-service teachers. The study was conducted by means of a questionnaire entitled, Che cosa è bene, che cosa è male. La scuola e la sfida dell’educazione morale, which involved 763 participants. These included 224 aspirating teachers who participated in pre-F.I.T. training programs at the Universities of Parma and Sassari, 397 in-training teachers who underwent training in Special Needs Education at the Universities of Messina and Parma, and 142 in-service teachers from the provinces of Messina, Reggio Emilia and Parma. Data analyses were conducted through factorial and cluster analyses. Results of the cluster analyses revealed three different attitudes of teachers: first, one generally institutional, a second, more undecided in nature, and a third, which was mostly communicative in nature.Il contributo intende presentare i primi risultati di uno studio empirico sull’atteggiamento che insegnanti, aspiranti, in formazione e in servizio, sviluppano e hanno sviluppato rispetto all’atmosfera morale scolastica. L’indagine ha previsto la somministrazione del questionario Che cosa è bene, che cosa è male. La scuola e la sfida dell’educazione morale, e ha coinvolto 763 soggetti, di cui 224 aspiranti insegnanti coinvolti nei percorsi formativi pre-F.I.T. nelle Università di Messina, Parma e Sassari, 397 insegnanti in formazione iscritti ai corsi di Specializzazione per le attività di sostegno didattico agli alunni con disabilità nelle stesse università, e 142 insegnanti in servizio nella scuola secondaria di I grado delle province di Messina, Reggio Emilia e Parma. Le analisi sono state condotte attraverso l’applicazione della analisi fattoriale e della cluster analysis. Grazie a queste ultime, emergono tre disposizioni che gli insegnanti indagati hanno rispetto all’atmosfera morale scolastica: una prima tendenzialmente istituzionalista, una seconda di natura più indecisa e una terza maggiormente dialogante

Rotational States of Magnetic Molecules

We study a magnetic molecule that exhibits spin tunneling and is free to rotate about its anisotropy axis. Exact low-energy eigenstates of the molecule that are superpositions of spin and rotational states are obtained. We show that parameter $\alpha = 2(\hbar S)^2/(I\Delta)$ determines the ground state of the molecule. Here $\hbar S$ is the spin, $I$ is the moment of inertia, and $\Delta$ is the tunnel splitting. The magnetic moment of the molecule is zero at $\alpha \alpha_c$. At $\alpha \to \infty$ the spin of the molecule localizes in one of the directions along the anisotropy axis.Comment: 4 pages, 3 figure

University climate in distance education contexts: developing an assessment instrument

The article presents the validation of an instrument for the assessment of students’ perception of the university climate in distance education settings. Also in such contexts, students establish relationships with classmates and teachers, and feel the atmosphere, the sense of belonging to an institution and to a community of learners. For teachers, however, it is difficult to understand how students perceive these dynamics. Therefore, the University Climate Questionnaire for Distance Education Contexts (UCliQ-DE), composed of 22 items, has been developed and validated through factorial analysis and reliability studies among a population of freshmen in an Italian BA program in Educational Sciences. It was concluded that the UCliQ-DE is a valid and reliable assessment tool, and that it yields five interpretable factors: the perception of the relationships among students, the sense of belonging to the academic community, the previous expectations about the online university climate, the perception of the relationships between students and teachers, and the awareness of the potential limits of online interactions

Electron transport through single Mn12 molecular magnets

We report transport measurements through a single-molecule magnet, the Mn12 derivative [Mn12O12(O2C-C6H4-SAc)16(H2O)4], in a single-molecule transistor geometry. Thiol groups connect the molecule to gold electrodes that are fabricated by electromigration. Striking observations are regions of complete current suppression and excitations of negative differential conductance on the energy scale of the anisotropy barrier of the molecule. Transport calculations, taking into account the high-spin ground state and magnetic excitations of the molecule, reveal a blocking mechanism of the current involving non-degenerate spin multiplets.Comment: Accepted for Phys. Rev. Lett., 5 pages, 4 figure

What information is available to women regarding coronavirus and childbirth in Italy? A mixed-methods exploration of the web during the COVID-19 lockdown

Problem: The world is fighting against the COVID-19 pandemic and an infodemic; Italy is one of the most severely affected countries. Background: The internet represents a popular source of health information. In Italy, its use amongst pregnant women and new mothers has increased during the lockdown. No research has examined the nationally accessible information related to childbirth in these unprecedented circumstances. Aim: To explore online information accessible to Italian users concerning childbirth and coronavirus-related issues. Methods: A mixed methods exploration of the web was conducted involving searches on Google, peer discussion forums and midwifery association webpages. Data were analysed both quantitatively and qualitatively. A cross-consultation analysis of themes was performed to identify macro categories of information. Findings: A total of 720 results from free searches, 635 interventions from 97 forums and 68 posts from four midwifery association webpages were analysed. Informative/divulging sources were the most prevalent in Google; pregnancy-related topics appeared more in discussion forums and midwifery association webpages. ‘Prevention’; ‘risks and outcomes’; ‘users’ experiences’ and ‘reorganisation of maternity services’ represent the cross-consultation categories of information. Discussion: Google emerges as the main contributor to the infodemic; national systems of alert and ranking of web sources are needed. Women’s pragmatic needs are more likely to be addressed by peer-discussion forums and midwifery association webpages during and after COVID-19. Conclusion: This is the first study to investigate childbirth-related web information during COVID-19 in Italy; findings may impact on education, research and practice

Prevalence and management of familial hypercholesterolemia in patients with coronary artery disease: The heredity survey

Background and aims Familial hypercholesterolemia (FH) is a genetic disorder characterized by high levels of low density lipoprotein cholesterol (LDL-C) predisposing to premature cardiovascular disease. Its prevalence varies and has been estimated around 1 in 200\u2013500. The Heredity survey evaluated the prevalence of potential FH and the therapeutic approaches among patients with established coronary artery disease (CAD) or peripheral artery disease (PAD) in which it is less well documented. Methods Data were collected in patients admitted to programs of rehabilitation and secondary prevention in Italy. Potential FH was estimated using Dutch Lipid Clinic Network (DLCN) criteria. Potential FH was defined as having a total score 65 6. Results Among the 1438 consecutive patients evaluated, the prevalence of potential FH was 3.7%. The prevalence was inversely related to age, with a putative prevalence of 1:10 in those with 8) had the highest percentages of patients after an ACS (75% vs 52.5% in the whole study population). At discharge, most patients were on high intensity statin therapy, but despite this, potential FH group still had a higher percentage of patients with LDL-C levels not at target and having a distance from the target higher than 50%. Conclusions Among patients with established coronary heart disease, the prevalence of potential FH is higher than in the general population; the results suggest that a correct identification of potential FH, especially in younger patients, may help to better manage their high cardiovascular risk

No evidence of association between prothrombotic gene polymorphisms and the development of acute myocardial infarction at a young age

Background : we investigated the association between 9 polymorphisms of genes encoding hemostasis factors and myocardial infarction in a large sample of young patients chosen because they have less coronary atherosclerosis than older patients, and thus their disease is more likely to be related to a genetic predisposition to a prothrombotic state Methods and Results : this nationwide case-control study involved 1210 patients who had survived a first myocardial infarction at an age of 45 years who underwent coronary arteriography in 125 coronary care units and 1210 healthy subjects matched for age, sex, and geographical origin. None of the 9 polymorphisms of genes encoding proteins involved in coagulation (G-455A -fibrinogen: OR, 1.0; CI, 0.8 to 1.2; G1691A factor V: OR, 1.1; CI, 0.6 to 2.1; G20210A factor II: OR, 1.0; CI, 0.5 to 1.9; and G10976A factor VII: OR, 1.0; CI, 0.8 to 1.3), platelet function (C807T glycoprotein Ia: OR, 1.1; CI, 0.9 to 1.3; and C1565T glycoprotein IIIa: OR, 0.9; CI, 0.8 to 1.2), fibrinolysis (G185T factor XIII: OR, 1.2; CI, 0.9 to 1.6; and 4G/5G plasminogen activator inhibitor type 1: OR, 0.9; CI, 0.7 to 1.2), or homocysteine metabolism (C677T methylenetetrahydrofolate reductase: OR, 0.9; CI, 0.8 to 1.1) were associated with an increased or decreased risk of myocardial infarction Conclusions : this study provides no evidence supporting an association between 9 polymorphisms of genes encoding proteins involved in hemostasis and the occurrence of premature myocardial infarction or protection against it