The Impact of Prenatal Education on Behavioral Changes Toward Breast Feeding and Smoking Cessation in a Healthy Start Population

Background and Objectives: Prenatal education represents an important part of maternal prenatal care in Western countries. In Romania, prenatal education is of recent interest but there is no official information about prenatal courses and their impact on prenatal care and patients in Romania. Material and methods: A prospective study based on the STROBE statement was designed in order to assess the prenatal education delivered in our unit. The study group included women who gave birth at Bucur Maternity, “Saint. John” Hospital, Bucharest, Romania and attended the prenatal courses, compared with a control group (women who gave birth in our unit but did not attend the prenatal lecture). Patients’ perception about the impact of prenatal education was collected by applying a questionnaire. Results: The analysis included 89 women who fulfilled the questionnaire online. In our study, 62 women (69.7%) attended the prenatal education classes and represented the study group while 27 women (30.3%) constituted the control group. Women who attended the prenatal lecture recognized the utility of the topic regarding newborn care (90.3%), while women from the control group did not consider it useful (n = 55.6%), χ2 = 18.412, p < 0.001. Patients from the study group admitted the importance of the topics (93.5%) from the lectures about breast feeding, while the percentage of these women from the control group is significantly lower (55.6%) χ2 = 27.867, p < 0.001. Conclusions: The benefits of prenatal education were recognized by women who attended the prenatal lecture, while women who did not participate underestimated the utility of the topics. Further actions are required to inform mothers about the necessity of antenatal education.

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A 7-month inhalation toxicology study in C57BL/6 mice demonstrates reduced pulmonary inflammation and emphysematous changes following smoking cessation or switching to e-vapor products

Toxicology Research and Application ◽

10.1177/2397847321995875 ◽

2021 ◽

Vol 5 ◽

pp. 239784732199587

Author(s):

Ashutosh Kumar ◽

Ulrike Kogel ◽

Marja Talikka ◽

Celine Merg ◽

Emmanuel Guedj ◽

...

Keyword(s):

Smoking Cessation ◽

Cigarette Smoke ◽

Pulmonary Inflammation ◽

Clinical Signs ◽

Inhalation Study ◽

Toxicology Study ◽

Nasal Tissue ◽

Product Switching ◽

The Impact

Cigarette smoking causes serious diseases, including lung cancer, atherosclerotic coronary artery disease, peripheral vascular disease, chronic bronchitis, and emphysema. While cessation remains the most effective approach to minimize smoking-related disease, alternative non-combustible tobacco-derived nicotine-containing products may reduce disease risks among those unable or unwilling to quit. E-vapor aerosols typically contain significantly lower levels of smoke-related harmful and potentially harmful constituents; however, health risks of long-term inhalation exposures are unknown. We designed a 7-month inhalation study in C57BL/6 mice to evaluate long-term respiratory toxicity of e-vapor aerosols compared to cigarette smoke and to assess the impact of smoking cessation (Cessation group) or switching to an e-vapor product (Switching group) after 3 months of exposure to 3R4F cigarette smoke (CS). There were no significant changes in in-life observations (body weights, clinical signs) in e-vapor groups compared to the Sham Control. The 3R4F CS group showed reduced respiratory function during exposure and had lower body weight and showed transient signs of distress post-exposure. Following 7 months of exposure, e-vapor aerosols resulted in no or minimal increase in pulmonary inflammation, while exposure to 3R4F CS led to impairment of lung function and caused marked lung inflammation and emphysematous changes. Biological changes observed in the Switching group were similar to the Cessation group. 3R4F CS exposure dysregulated the lung and nasal tissue transcriptome, while these molecular effects were substantially lower in the e-vapor group. Results from this study demonstrate that in comparison with 3R4F CS, e-vapor aerosols induce substantially lower biological responses including pulmonary inflammation and emphysematous changes, and that complete switching from CS to e-vapor products significantly reduces biological changes associated with CS in C57BL/6 mice.

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CHANGING PRESCRIBING CULTURE – A FOCUS ON CODEINE POSTPARTUM

Archives of Disease in Childhood ◽

10.1136/archdischild-2016-311535.2 ◽

2016 ◽

Vol 101 (9) ◽

pp. e2.12-e2 ◽

Cited By ~ 2

Author(s):

Noor Al-Adhami ◽

Karen Whitfield ◽

Angela North

Keyword(s):

Breast Feeding ◽

Medical Staff ◽

Successful Outcome ◽

Postpartum Women ◽

Limited Data ◽

Training And Education ◽

Key Stakeholders ◽

Postpartum Analgesia ◽

The Impact ◽

Breast Fed

AimTo eliminate the prescribing of codeine and codeine combination products postpartum to improve safety in breast fed infants.Concerns have been raised over the use of codeine and codeine combination products during breast feeding after the death of a neonate whose mother had been prescribed codeine postpartum. High concentrations of morphine were found in the infant's blood and this was attributed to the mother being a CYP2D6 ultrafast metaboliser.1 MethodsThe evidence surrounding the safety of codeine and codeine combination products in children, during the postpartum period and specifically for breast fed infants was collated. The evidence was presented to key stakeholders including obstetricians, midwives, safety and quality representatives, nurse unit managers and acute pain team representatives. Postpartum analgesia was discussed and an agreed protocol developed. Training and education sessions were undertaken to obstetric medical and nursing staff.ResultsThe evidence that was presented to key stakeholders included:▸ Reports over the safety concerns surrounding the use of codeine and codeine combination products during breast feeding▸ Guidelines and contraindications about the use of codeine in children that had been issued by international regulatory bodies (US Food and Drug Administration and European Medicines Agency).▸ Recommendations from the Australian Medicines Handbook to avoid in breast feeding2 ▸ Recommendations from Hale's Medications and Mothers Milk that reported limited data and had made a recent re-classification from L3 (limited data–probably compatible) to L4 (limited data–possibly hazardous).3 Before presenting the evidence to key stakeholders and undertaking training to nursing and medical staff, more than 90% of postpartum women were prescribed a codeine containing product as part of their ‘as required’ analgesic regimen.Since the intervention, codeine combination products have now been almost completely eliminated on medication charts for postpartum women (less than 5%). Those that are prescribed are ceased once highlighted to medical staff. The obstetric pharmacist now presents a session on postpartum analgesia at every new resident medical officer orientation outlining suitable medications to prescribe. In addition all new pharmacists to the women's and new born's team receive training about postpartum analgesia.ConclusionThis study highlights the impact that can be achieved when health care professionals work together to change the culture and prescribing habits in a hospital setting, to enhance patient safety. Evaluating the evidence and presenting to stakeholders as well as providing ongoing training and education to medical, nursing and pharmacy staff are all essential to a successful outcome.

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Nipple Confusion

PEDIATRICS ◽

10.1542/peds.92.2.300 ◽

1993 ◽

Vol 92 (2) ◽

pp. 300-301

Author(s):

DOREN FREDRICKSON

Keyword(s):

Breast Feeding ◽

Statistical Power ◽

White Women ◽

Small Sample Size ◽

False Negative ◽

Small Sample ◽

Bottle Feeding ◽

Feeding Duration ◽

Breast Feed ◽

The Impact

To the Editor.— I wish to comment on the study reported by Cronenwett et al,1 which was a fascinating prospective study among married white women who planned to breast-feed. Women were randomly selected to perform either exdusive breast-feeding or partial breast-feeding with bottled human milk supplements to determine the impact of infant temperament and limited bottle-feeding on breast-feeding duration. The authors admit that small sample size and lack of statistical power make a false-negative possible.

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Intracellular and plasma cytokine profile in neonates born to non-atopic parents: the impact of breast feeding

European Journal of Pediatrics ◽

10.1007/s00431-004-1463-4 ◽

2004 ◽

Vol 163 (7) ◽

Cited By ~ 4

Author(s):

Florence Kanakoudi-Tsakalidou ◽

Vasiliki Drossou-Agakidou ◽

Chariklia Noutsia ◽

Vasiliki Tzimouli ◽

Anna Taparkou ◽

...

Keyword(s):

Breast Feeding ◽

Cytokine Profile ◽

Plasma Cytokine ◽

The Impact

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The impact of smoking and smoking cessation on disease outcomes in ulcerative colitis: a nationwide population-based study

Alimentary Pharmacology & Therapeutics ◽

10.1111/apt.15390 ◽

2019 ◽

Vol 50 (5) ◽

pp. 556-567 ◽

Cited By ~ 5

Author(s):

Jonathan Blackwell ◽

Sonia Saxena ◽

Christopher Alexakis ◽

Alex Bottle ◽

Elizabeth Cecil ◽

...

Keyword(s):

Ulcerative Colitis ◽

Smoking Cessation ◽

Population Based ◽

Population Based Study ◽

Disease Outcomes ◽

The Impact

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The Impact of Prolonged Breast-Feeding on Birth Intervals and on Postpartum Amenorrhoea

Nutrition and Human Reproduction ◽

10.1007/978-1-4684-0790-7_11 ◽

1978 ◽

pp. 179-195 ◽

Cited By ~ 8

Author(s):

Jeroen K. Van Ginneken

Keyword(s):

Breast Feeding ◽

Birth Intervals ◽

The Impact

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Telephone based smoking cessation intervention for adults with serious mental illness during the COVID-19 pandemic

Tobacco Use Insights ◽

10.1177/1179173x211065989 ◽

2021 ◽

Vol 14 ◽

pp. 1179173X2110659

Author(s):

Heather Leutwyler ◽

Erin Hubbard

Keyword(s):

Mental Illness ◽

Smoking Cessation ◽

San Francisco ◽

Serious Mental Illness ◽

Smoking Cessation Intervention ◽

Smoking Cessation Counseling ◽

Cessation Intervention ◽

Data Collection And Analysis ◽

Readiness To Quit ◽

The Impact

Background The high rates of smoking in adults with serious mental illness (SMI) increases risk for COVID-19 infection. The purpose of this paper is to present the results of a smoking cessation intervention that was adapted to be offered by phone during a Shelter in Place (SIP) period in San Francisco, California, at the beginning of the COVID-19 pandemic. Methods During the SIP, we offered counseling sessions by phone to five participants. At the end of each session, we assessed readiness to quit, tobacco cessation or reduction, and inquired about the impact of the shelter in place on smoking habits and mental health. Grounded theory guided data collection and analysis. Results The categories that emerged around barriers and facilitators for smoking cessation were COVID-19–related stressors, having purpose, structure and feelings of connections, and the importance of quitting aides for smoking cessation. Conclusion Offering telephone based smoking cessation counseling to adults with SMI while they shelter in place may improve their readiness to quit.

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