Adopting and adapting an Internet intervention to support breastfeeding duration and breastfeeding research throughout regional Western Australia

Adopting and adapting an Internet intervention to support breastfeeding duration and breastfeeding research throughout regional Western Australia Breastfeeding is the normal and safest way to nurture an infant, and prolonged exclusive breastfeeding duration of at least six months will yield the greatest gains in optimum infant development. Despite this knowledge breastfeeding rates in Australia plummet in the postpartum period with approximately 20% of babies no longer being exclusively breastfed after one week and less than this experiencing full breastfeeding at six months. Breastfeeding duration at four and six months is currently one of the Commonwealth’s category two indicators for the progress of chronic disease, however there is limited data on regional breastfeeding rates against which comparisons can be made. Breastfeeding initiation is almost universal and what is required are interventions that promote extended duration of any or exclusive breastfeeding. Providing social, professional and lay support for women to breastfeed is important and the availability of social support is a predictive factor in both initiating and sustaining breastfeeding. Women requiring breastfeeding assistance who live in regional Australia are often challenged by the limited availability of support services and lack of family and social support networks. The opportunities for the sharing of breastfeeding knowledge are diminished with the tyranny of distance.With the advent of the Internet has been the development of many varied e-Health interventions. The use of the Internet to deliver breastfeeding information is not new, however the incorporation of Webinars, chat rooms, Web cameras and discussion forums has taken the use of the Internet to support breastfeeding to a new level. In effect a virtual community can be created in a real and isolated geographical area. This research uses a Website intervention to support breastfeeding mothers and was initially implemented in the Midwest Region of Western Australia. A success of the research has been the adoption and adaption of this intervention by other regional dieticians working state wide. Mothers recruited to the study are randomised to receive the Internet intervention or normal services already available. The primary outcome of the research is to determine the effectiveness of the intervention in supporting breastfeeding duration. Data is collected longitudinally for a 12 month period. An overarching outcome from the research will be the collection of robust regional breastfeeding data that uses nationally agreed breastfeeding definitions. This presentation will present preliminary key findings from the research. It will provide much needed contemporary regional breastfeeding data required to help support the policy recommendation that WA health services become recognised as baby friendly institutes

Dietary intake of minerals and the risk of ischemic stroke in Guangdong Province, China, 2007-2008.

Introduction: Previous studies have investigated the association between mineral intake and the risk of ischemic stroke, but results are inconsistent. We conducted a case-control study to ascertain the associations between intake of dietary potassium, calcium, magnesium, sodium, and iron and the ischemic stroke risk in the southern Chinese population.MethodsInformation on lifestyle and typical food consumption was obtained from 374 hospital inpatients with ischemic stroke and 464 hospital-based control patients. Added sodium from salt or soy sauce could not be reliably quantified, but participants were asked to characterize their diet as low in salt, normal, or high in salt. Logistic regression analyses were performed to assess possible associations between the effects of mineral intake and ischemic stroke risk. Results: The mean weekly intakes of potassium, calcium, magnesium, and iron were lower among case patients than among control patients. Sodium was an exception. Lower stroke risk was associated with higher weekly dietary calcium or magnesium levels (adjusted odds ratio, 0.32) for the highest versus lowest category of intake, and significant dose-response relationships were seen. No significant associations were found for potassium, iron, or sodium. However, patients who consumed a salty diet were more than twice as likely as those whose diet was light in salt to experience an ischemic stroke. Conclusion: The findings suggest that lowering sodium intake while maintaining high levels of dietary calcium and magnesium may help prevent ischemic stroke in southern Chinese adults

Validity of a food-frequency questionnaire for elderly men in southeast China

OBJECTIVE: To investigate the internal validity of a food-frequency questionnaire (FFQ) developed for a case-control study of prostate cancer in southeast China. DESIGN: A comprehensive questionnaire comprising a quantitative FFQ and a short food habit questionnaire (SFHQ) was developed and modified from previous cancer and nutritional studies. The Goldberg formula (ratio of energy intake (EI) to basal metabolic rate (BMR), EI/BMR) was used to assess the validity of the FFQ by making comparisons with physical activity levels. Physical activity levels were measured by the estimated total metabolic equivalents (MET) and the ratio of energy expenditure (EE) to BMR (EE/BMR). Correlation analyses were undertaken to compare the SFHQ variables with those of the quantitative FFQ. SETTING: Hangzhou, Zhejiang Province, China. SUBJECTS: A total of 404 men over 45 years old with or without prostate cancer were recruited from eight hospitals.RESULTS: The partial correlation coefficients, controlling for age and family history of prostate cancer, were moderate to high (P<0.05) for preserved foods intake, fat consumption and tea drinking variables between the SFHQ and the quantitative FFQ. The average EI/BMR was 1.72, with 76% of subjects exceeding the Goldberg cut-off value of 1.35. Apart from weight, BMI, EE/BMR and MET, there were no significant differences in characteristics between low (<1.35) and normal EI/BMR groups. CONCLUSIONS: The FFQ is demonstrated to be a valid instrument to measure energy and food intake for elderly men in southeast China

White Rice-Based Food Consumption and Ischemic Stroke Risk: A Case-Control Study in Southern China

White rice-based foods, which are high in refined carbohydrates, are widely consumed in China. A case-control study was conducted to investigate the association between white rice-based food consumption and the risk of ischemic stroke in the southern Chinese population. Information on diet and lifestyle was obtained from 374 incident ischemic stroke patients and 464 hospital-based controls. Logistic regression analyses were performed to assess the effects of rice-based foods on stroke risk. The mean weekly intake of rice foods appeared to be significantly higher in cases than in controls. Increased consumptions of cooked rice, congee, and rice noodle were associated with a higher risk for ischemic stroke after controlling for confounding factors. The corresponding adjusted odds ratios (with 95% confidence intervals) for the highest versus lowest intake level were 2.73 (1.31-5.69), 2.93 (1.68-5.13), and 2.03 (1.40-2.94), with significant dose-response relationships observed. The results provide evidence of a positive association between habitual rice food consumption and the risk of ischemic stroke in Chinese adults

Urinary incontinence in Japanese women with chronic obstructive pulmonary disease: review

The relationship between urinary incontinence and chronic obstructive pulmonary disease (COPD) among Japanese women is reviewed. The prevalence of COPD is increasing because of the aging population and the high rate of cigarette consumption. The prevalence of COPD in Japan was 16.4% for males and 5% for females aged 40 years and above in 2000. COPD is a progressive disease, which can have periods of relative stability but readily regresses. Its characteristic symptoms include cough, sputum production, dysponea and frequently urinary incontinence. The persistent cough of COPD increases intra-abdominal pressure and results in increased rates of urinary incontinence especially for female patients. The prevalence of urinary incontinence among Japanese women with chronic lung disease varied between 30.4% and 68%, which was comparatively higher than those of the general population (25-56.9%) and outpatient clients attending gynaecology clinics (27-31%). However, there is no published report specifically on the prevalence of urinary incontinence for Japanese women with COPD. As COPD is one of the causes of urinary incontinence, the obvious prevention strategy is tobacco control and early detection using screening test. Urinary incontinence should be identified and dealt with in order to improve the quality of life for COPD patients

Breastfeeding in Saudi Arabia: A review

Background: Breastfeeding is viewed as the optimal method of infant feeding that provides many benefits to both the infant and the mother. The monitoring and reporting of breastfeeding indicators are essential for any country to plan and implement effective promotion programs for sustainable breastfeeding. The aim of this review is to examine the available studies and data on breastfeeding in Saudi Arabia, and determine the potential factors that affect breastfeeding practices and duration in this country. Methods: The databases of Web of Knowledge, Science Direct and PubMed were searched using the relevant key words. Only studies that reported breastfeeding practices, rates and indicators in Saudi Arabia were included. Standard WHO definitions for breastfeeding categories were used in this review.Results: Seventeen cross-sectional studies were identified and reviewed and five stated they used standard definitions. The self-administered questionnaire as a measurement tool was the predominant method of data collection. Infants' ages range from less than six months up to five years. Initiation rates were high (mostly above 90%), but a few studies reported low rates of timely initiation (within the first hour). The exclusive breastfeeding rate could not be accurately determined as rates range from 0.8% to 43.9% among studies due to the lack of clear definitions and the nature of study design. The partial (mixed) feeding method was common and the category of 'any breastfeeding' has generally high rates. The mean duration of breastfeeding has showed a progressive decline over time from 13.4 months in 1987 to 8.5 months in 2010. Factors associated with a high prevalence of breastfeeding and longer duration include increased maternal age, low educational levels, rural residence, low income, multiparity and avoiding contraceptives. The most common reason for breastfeeding cessation was insufficient breast milk. Other reasons include sickness, new pregnancy and breastfeeding problems. Conclusions: Breastfeeding indicators in Saudi Arabia could not be monitored or compared relying on the available data because no longitudinal studies have been conducted in this country. A cohort study design would be the most appropriate procedure to rigorously assess and report valid results on breastfeeding practices and patterns in the Saudi society