Canadian Mothers More Responsive Than Cambodian Peers in a Cross-Cultural Assessment of a Breastfeeding Interaction in the First 6 Months: A Preliminary Assessment

Abstract Objectives Human milk is the sole recommended food for infants for the first 6 months of life. Although determinants and rates of exclusive breastfeeding differ greatly between high- and low-and-middle-income countries, little is known about whether breastfeeding practices, such as feeding responsiveness, differ across cultures. Responsive feeding practices are based on the cues and responses of a caregiver and infant, and are associated with more intuitive eating patterns later in life. This preliminary assessment aims to assess the responsiveness of the maternal-child interactions during breastfeeding of infants less than 6 months old cross-culturally, in both a high- and lower-middle income country. Methods This preliminary analysis includes 10 mother-infant dyads from Nova Scotia, Canada, who have been age-matched (±4 days) to 10 Cambodian dyads recruited in Kampong Thom province, Cambodia. In both settings, a breastfeeding session was video-recorded in the participant's home and videos scored using the validated, 76-item Nursing Child Assessment Satellite Training (NCAST) Caregiver/Parent-Child Interaction Feeding Scale. Results Infants were between 13 and 23 weeks old, and in both groups were 40% firstborn and 40% male. Cambodian mothers (27.3 ± 3.4 years) were significantly younger than Canadian (32.0 ± 2.3; p = 0.002), and the average length of feed in Cambodia was significantly shorter (5.5 ± 1.6 min v. 7.3 ± 1.3 min; p = 0.02). There was no significant difference between Canadian and Cambodian total NCAST scores. However, Canadian mothers scored significantly higher on three of the four maternal NCAST subscales; subscale I (sensitivity to infant's cues, p = 0.03), subscale III (social-emotional growth fostering, p = 0.01), and subscale IV (cognitive growth fostering, p = 0.02) There were no significant differences in scores for NCAST subscales measuring infant's clarity of cues or responsiveness to their mother. Conclusions These preliminary results indicate differences in feeding responsiveness on the part of mothers during breastfeeding in Canada and Cambodia and could inform future programs to optimize the maternal-child feeding interaction. Funding Sources MSVU Internal Grant, Canadian Institute for Health Research, Research Nova Scotia.

Download Full-text

Mindful Parenting, Maternal Child Feeding Style and Prescholer's Body Mass Index

Current Developments in Nutrition ◽

10.1093/cdn/nzab051_010 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 966-966

Author(s):

Rubi Casco-Ojeda ◽

Yolanda Flores-Peña ◽

Monserrat Morales-Alducin ◽

Juana Mercedes Gutiérrez-Valverde ◽

Hermelinda Avila-Alpirez ◽

...

Keyword(s):

Multiple Linear Regression Model ◽

Emotional Awareness ◽

Mindful Parenting ◽

Average Score ◽

Child Feeding ◽

Feeding Styles ◽

Feeding Style ◽

Funding Sources ◽

Significant Difference ◽

Maternal Child

Abstract Objectives To compare the dimensions and total score of Mindful Parenting (MP) according to the Maternal Child-Feeding Style (MCFS), 2) To identify the MCFS with the highest BMI average score and to verify if there are significant differences. Methods This study was of the descriptive and correlational type. The sample was determined for a multiple linear regression model with eight variables, significance of 0.5, test power of 90%, and effect size of .07. Participated, 334 dyads (mothers and her preschool child). The child attended 10 publish kindergartens in Monterrey, Nuevo Leon, México. Mothers answered the Interpersonal Mindfulness in Parenting Scale and the Caregiver's Feeding Styles Questionnaire. The preschooler's weight and height were measured. Descriptive and inferential statistics were applied. Results The MP dimension with the highest average was Emotional Awareness of the Self and the Child (Mean = 71.14, SD = 14.90), the average of the total score of MP was 69.48 (SD = 10.60). The indulgent MCFS was the most frequent 33.7% (n = 116). The authoritative MCFS presented the highest score of MP (H = 27.068, P = .001). The indulgent MCFS presented the highest average range of child's BMI (121.70) when compared against the authoritarian MCFS (102.62), a significant difference was identified (U = 5197.00, P < .05). Conclusions The authoritative MCFS had highest score of MP. Moreover the authoritative MCFS had been related to health child's BMI. It is recommended to design interventions to promote MP and authoritative MCFS. Funding Sources …

Download Full-text

“What We Are Going to Eat Today, We Are Looking for It Today”: Exploring Barriers and Enablers of Optimal Complementary Feeding in Madagascar

Current Developments in Nutrition ◽

10.1093/cdn/nzaa053_095 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 890-890

Author(s):

Hasina Rakotomanana ◽

Christine Walters ◽

Joel Komakech ◽

Deana Hildebrand ◽

Gail Gates ◽

...

Keyword(s):

Community Health ◽

Community Health Workers ◽

Complementary Feeding ◽

Health Workers ◽

Average Length ◽

Feeding Practices ◽

State University ◽

Child Feeding ◽

Funding Sources ◽

Limited Food

Abstract Objectives Complementary feeding practices in Madagascar are inadequate. The purpose of this study was to identify maternal barriers to and enablers of optimal child feeding practices in the Vakinankaratra region of Madagascar. Methods Seven focus group discussions with mothers (n = 46) who had a child aged 6–23 months and eight in-depth interviews were conducted with community health workers (6), a nurse (1), and a program field monitor (1) in Malagasy, the local language. Discussions were transcribed verbatim, then back-translated into English. The average length of the interviews was 50 minutes. The translated transcripts from the discussions and interviews were analyzed using NVivo v.12 and a thematic analysis approach was used. Results Poverty, lack of money, and limited food availability were mentioned by the mothers as obstacles to adequate complementary feeding practices. Lack of time because of work as well as heavy workload also were cited as problems. Mothers generally decide alone on what food to give to their infants, with little to no help from spouse or relatives. All mothers considered their children's health and giving them appropriate complementary foods as important. Another potential enabler was that mothers trust the community health workers and usually ask them for help and/or information on child feeding. The key informants confirmed all of the mothers’ responses. Conclusions Interventions that aim to improve feeding practices in the Vakinankaratra region should address food insecurity and improve households’ income. Strengthening the local infrastructures with the community health workers appears to be important when aiming to reinforce appropriate feeding practices. Funding Sources This study was funded by the Marilynn Thoma Chair in Human Sciences at Oklahoma State University.

Download Full-text

Dietary Diversity Measures Derived from Food Frequency Methods Are Weak Proxies for Anthropometric Indicators of Child Nutrition in East Africa (P11-111-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-111-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Lucas Gosdin ◽

Usha Ramakrishnan ◽

Amy Webb Girard

Keyword(s):

Child Nutrition ◽

Dietary Diversity ◽

Child Feeding ◽

Middle Income ◽

Food Frequency ◽

Anthropometric Indicators ◽

Young Child Feeding ◽

Child Undernutrition ◽

Funding Sources ◽

Low Middle Income Countries

Abstract Objectives The 7-item child dietary diversity score (DDS) is used widely as a metric of dietary diversity (DD) for infant and young child feeding (IYCF) in low-middle income countries. Validation of the DDS was based on mean micronutrient density adequacy and not other measures of child nutrition. We aimed to develop a measure of DD more strongly associated with anthropometric indicators of child nutrition. Methods We used data from two Tanzanian surveys, IMMANA (n = 88; ages 6–23 mo.) and the Demographic and Health Survey (DHS) (n = 9,156; ages 6–59 mo.), and two Kenyan surveys, MAMA SASHA (n = 384; age 6–12 mo.) and DHS (n = 17,509; ages 6–59 mo.). For each survey, we calculated the DDS, minimum DD, a score using all 15 items found in the standard DHS, and a yes/no indicator of animal source food (ASF) consumption. In IMMANA and MAMA SASHA, we also used a count of all unique food items consumed and based each measure on both 24-hr and 7-day recall periods. Outcome indicators were stunting, wasting, and underweight as defined by WHO. We evaluated the performance of each DD measure in identifying child undernutrition by comparing the area under the ROC curve (AUC), and estimating odds ratios using logistic regression methods. AUC = 50% is no better than random assignment. Complex survey procedures were used in all analyses and alpha was set at 0.05. Results In the DHS and MAMA SASHA data, all measures of DD had similar AUC values that did not exceed 61% when compared to the anthropometric indicators. In the IMMANA data, no measure exceeded 70% AUC for wasting, 64% for underweight, or 58% for stunting. For most DD measures, increasing the recall period to 7 days marginally improved its AUC (< 3%), while it decreased the AUC for wasting in the IMMANA data. The ASF indicator had a similar AUC to the DDS. In the Tanzania DHS, a higher DD, by all four measures, was associated with decreased odds of stunting, wasting, and underweight. In contrast, no measure of DD was associated with growth indicators for Kenya. The DD indicators based on the 15-item list and the count of unique foods were negatively associated with odds of wasting in the IMMANA data. Conclusions In two east African settings, measures of DD derived from existing food frequency questionnaires were weak proxies for measures of child undernutrition based on anthropometry. Funding Sources Innovative Methods and Metrics for Agriculture and Nutrition Actions.

Download Full-text

Extrakorporális és intrakorporális anasztomózis rövid távú eredményeinek összehasonlítása malignus daganat miatt végzett laparoszkópos jobb oldali hemikolektómia esetén

Magyar Sebészet (Hungarian Journal of Surgery) ◽

10.1556/1046.73.2020.4.3 ◽

2020 ◽

Vol 73 (4) ◽

pp. 148-152

Author(s):

Kornél Vajda ◽

László Sikorszki

Keyword(s):

Length Of Stay ◽

Gold Standard ◽

Average Length ◽

Colon Surgery ◽

Right Hemicolectomy ◽

Malignant Tumours ◽

Short Term ◽

Significant Difference ◽

Laparoscopic Assisted ◽

Laparoscopic Hemicolectomy

Összefoglaló. Bevezetés: A laparoszkópia térhódítása a jobb oldali colon műtéteknél is nyilvánvaló. Ma legtöbb helyen a laparoszkóposan asszisztált jobb oldali hemikolektómia extrakorporális anasztomózissal a gold standard. A morbiditás randomizált vizsgálatok alapján még 30% körüli. A technikai fejlődés lehetővé tette az intrakorporális anasztomózist. Célkitűzés: Retrospektív módon elemezni rosszindulatú jobb oldali vastagbéldaganat miatt végzett laparoszkópos hemikolektómiák rövid távú eredményeit a két módszer összehasonlításával. Eredmények: 2018. 01. 01. – 2019. 12. 31. között 184 jobb oldali hemikolektómiát végeztünk, ezek közül 122 történt malignus betegség miatt. 51 esetben nyitott és 71 esetben laparoszkópos műtét történt. 37 férfi (átlagéletkor: 70,59 év) és 34 nő (átlagéletkor: 72,14 év) volt. 50 esetben extrakorporális (EA) és 21 esetben pedig intrakorporális anasztomózist (IA) végeztünk. Az EA csoportban 18, míg az IA csoportban 3 szövődmény alakult ki 30 napon belül (p = 0,067). Az EA csoportból 3, az IA csoportból 1 beteget veszítettünk el 30 napon belül (p = 0,66). Az átlagos ápolási idő az EA csoportban 9,48 (5–32) nap, míg az IA csoportban 6,52 (4–19) nap volt (p = 0,001) a szövődményes esetekkel együtt. A szövődményes esetek nélkül az EA csoportban 6,35 (5–10) nap, az IA csoportban pedig 5,55 (4–8) napnak bizonyult (p = 0,09). A műtéti idő pedig az EA csoportban 147 (90–240) perc, az IA csoportban pedig 146,47 (90–265) perc volt (p = 0,11). Konklúzió: Az irodalommal összhangban azt találtuk, hogy IA esetén kevesebb a szövődmény, ezzel is összefüggésben rövidebb az átlagos ápolási idő, és a műtéti időt tekintve nincs szignifikáns különbség. Ezeket figyelembe véve az intrakorporális anasztomózis javasolható jobb oldali laparoszkópos hemikolektómia esetén. Summary. Introduction: Laparoscopy became evident for right-sided colon surgery too. Today the laparoscopic-assisted right-hemicolectomy is the gold standard with extracorporeal anastomosis. Morbidity according to randomized trials is still approximately 30%. The development of the surgical technique resulted in the creation of intracorporeal anastomosis. Our aim was to compare the short-term results of the two methods. Aim: To analyse the short-term results of right-sided hemicolectomy that were performed due to malignant tumours with the comparison of the two methods. Results: A cohort of 184 right-sided hemicolectomy were performed from 01.01.2018 to 31.12.2019 from which 122 were operated on because of a malignant disease. 51 open and 71 laparoscopic operations were performed. The average age of 37 men and 34 women were 70.59 and 72.14 years, respectively. 50 patients underwent extracorporeal (EA) anastomosis and 21 intracorporeal (IA) anastomosis. Within 30 days the number of complications were 18 in the EA group and 3 in the IA group (p = 0.067). 3 from the EA group and 1 from IA group died within 30 days (p = 0.66). The average length of stay were 9.48 days in the EA group and 6.52 days in the IA group together with the complicated cases (p = 0.001) while 6.35 days and 5.55 days without the complicated cases (p = 0.09). The average duration of operation was 147 minutes in the EA and 146.47 minutes in the IA group (p = 0.11). Conclusion: We found concordance with the literature that there are fewer complications in case of IA which might be related to shorter length of stay. There is no significant difference between the surgical times. Bearing these facts in mind, IA might be suggested for right- sided laparoscopic hemicolectomy.

Download Full-text

Efficacy and safety of doxycycline for the management of small abdominal aortic aneurysms- a meta analysis

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.126 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

A Abdul Razzack ◽

D Rocha Castellanos ◽

A Lopez Mendez ◽

M Fernando Perez Paz ◽

S Pothuru ◽

...

Keyword(s):

Meta Analysis ◽

Abdominal Aortic Aneurysms ◽

Abdominal Aortic Aneurysm Repair ◽

Mean Difference ◽

Aortic Aneurysms ◽

Efficacy And Safety ◽

Funding Sources ◽

Abdominal Aortic ◽

Significant Difference ◽

Aneurysm Repair

Abstract Funding Acknowledgements Type of funding sources: None. Background- Patients with small Abdominal Aortic Aneurysms are managed with surveillance as there is currently insufficient evidence to recommend surgical aneurysm repair. Hence, there is a dire need and interest in pharmacotherapy like tetracycline antibiotics to reduce the need for aneurysm repair. Purpose- To determine the efficacy and safety of doxycycline in the management of small abdominal aortic aneurysms. Methods- Electronic databases (PubMed, Scopus, Embase, Cochrane) were searched until 25th November 2020.The primary outcomes were the mean difference (MD) in aneurysm diameter and the odds ratio (OR) calculated to compare the number of individuals referred to Abdominal aortic aneurysm repair in each group. Results- A total of three studies with 572 participants (Doxycycline = 290; Placebo = 282 ) were included in our analysis. Average follow up was a period of 18 months. For AAA expansion, the combined results demonstrated a statistically significant mean difference in expansion rates favoring the placebo groups over the intervention (WMD-0.75, 95%CI 0.12-1.38; p = 0.02;I2 = 0%) There was no statistically significant difference in the efficacy and safety of doxycycline as opposed to placebo groups for referral to AAA surgery (OR 1.01, 95%CI 0.61-1.69; p = 0.96, I2 = 0%) and all-cause mortality(OR 0.51; 95%CI 0.18-1.43; p = 0.20, I2 =0%) Conclusion- Amongst patients with small abdominal aortic aneurysms, doxycycline did not significantly reduce aneurysm growth. Abstract Figure. A) AAA expansion B)Surgery C)Mortality

Download Full-text

Systematic review: Symptoms of parental depression and anxiety and offspring overweight

Revista de Saúde Pública ◽

10.11606/s1518-8787.2020054001731 ◽

2020 ◽

Vol 54 ◽

pp. 49

Author(s):

Paula Lobo Marco ◽

Inaê Dutra Valério ◽

Christian Loret de Mola Zanatti ◽

Helen Gonçalves

Keyword(s):

Depressive Symptoms ◽

Childhood Obesity ◽

Mental Disorder ◽

Common Mental Disorder ◽

Positive Association ◽

Depression And Anxiety ◽

Recurrent Depression ◽

Child Feeding ◽

Middle Income ◽

Symptoms Of Depression

OBJECTIVE: To evaluate the existing literature on the association between parents’ depression and anxiety and their influence on their children’s weight during childhood, identifying possible mechanisms involved in this association. METHODS: A systematic search of the literature was conducted in the PubMed, PsycINFO and SciELO databases, using the following descriptors: (maternal OR mother* OR parent* OR paternal OR father) AND (“common mental disorder” OR “mental health” OR “mental disorder” OR “depressive disorder” OR depress* OR anxiety OR “anxiety disorder”) AND (child* OR pediatric OR offspring) AND (overweight OR obes* OR “body mass index” OR BMI). A total of 1,187 articles were found after peer selection. RESULTS: In total, 16 articles that met the inclusion criteria were selected for the review. Most of them investigated depressive symptoms and only three, symptoms of maternal anxiety. The evaluated studies suggested a positive association between symptoms of maternal depression and higher risk of childhood obesity. The results diverged according to the chronicity of depressive symptoms (episodic or recurrent depression) and income of the investigated country (high or middle income). Mechanisms were identified passing by quality of parenthood, affecting behaviors related to physical activity and child-feeding, as mediators of the association. CONCLUSIONS: We conclude there is evidence of a positive relationship between the occurrence of maternal symptoms of depression and anxiety and childhood obesity. It is emphasized the need for a better understanding on the effect of depressive symptoms and the contextual factors involved in this relationship so that effective intervention strategies can be implemented.

Download Full-text

The incidence of pneumonia in the paediatric population in Poland in light of the maps of health needs

Journal of Public Health ◽

10.1007/s10389-021-01503-3 ◽

2021 ◽

Author(s):

Joanna Lange ◽

Jerzy Kozielski ◽

Kinga Bartolik ◽

Paweł Kabicz ◽

Tomasz Targowski

Keyword(s):

Average Length ◽

Age Groups ◽

Paediatric Population ◽

Incidence Rates ◽

Education Development ◽

Average Length Of Stay ◽

Significant Difference ◽

Social Fund ◽

Hospital Deaths ◽

Reported Data

Abstract In Poland, no statistical data are available concerning the analysis of the incidence of pneumonia in inpatient children. The requirement for these data results mainly from the need to prepare systemic and economic solutions. Aim This study aimed to use reported data for evaluating pneumonia incidence rates among hospitalised children and other parameters in various age groups. Subject and methods A detailed analysis was performed as part of the Operational Programme Knowledge Education Development co-financed by the European Social Fund. Services reported to the National Health Fund in 2014 were considered, including pneumonia incidence among hospitalised children and mortality in specific age groups. Results In 2014, a total of 68,543 children were hospitalised for pneumonia (68% of all hospitalisations for acute respiratory diseases). Within each of the analysed age groups, boys were hospitalised more frequently. Irrespective of the place of residence, infants were most commonly hospitalised. It was observed that there was a significant difference between the incidence rate of pneumonia among hospitalised children in all analysed groups depending on the province. The average length of stay was 7.29 days, with infants requiring the longest stays (7.96 days), and 1.8% of children were rehospitalised within 30 days due to recurrence of pneumonia. The most commonly coded pathogens responsible for pneumonia included Mycoplasma pneumoniae, Streptococcus pneumoniae and Chlamydia spp. A total of 19 inpatient hospital deaths in the course of pneumonia were reported. Conclusions Based on our findings, it is warranted to utilize epidemiological knowledge for the planning of an appropriate level of service commissioned both in outpatient and inpatient facilities as well as for the estimation of institutional and staff needs necessary to secure these services.

Download Full-text

COMPARISON OF ASCORBIC ACID CONTENT IN IMPORTED TOMATOES AND IN CULTIVARS GROWN IN NOVA SCOTIA

Canadian Journal of Plant Science ◽

10.4141/cjps87-047 ◽

1987 ◽

Vol 67 (1) ◽

pp. 331-335

Author(s):

HAK-YOON JU ◽

W. JOHN MULLIN

Keyword(s):

Ascorbic Acid ◽

Nova Scotia ◽

Vitamin C ◽

Acid Content ◽

Ascorbic Acid Content ◽

Fresh Weight ◽

Atlantic Region ◽

Significant Difference ◽

Cluster Location ◽

Greenhouse Tomatoes

The ascorbic acid (vitamin C) content of fresh imported field tomatoes and Nova Scotia greenhouse and field tomatoes was determined on a bi-weekly basis during the period of availability of each type of tomato to the Nova Scotia consumer in 1984. The average ascorbic acid contents of imported and Nova Scotia field and greenhouse tomatoes were 13.3, 16.7 and 17.7 mg 100 g−1 fresh weight, respectively. A study of nine recommended or promising field tomatoes for the Atlantic region showed significant differences in ascorbic acid content among the cultivars. The cultivar Quick Pick had the highest ascorbic acid content of 22.5 ± 1.5 mg 100 g−1, the cultivar Campbell 18 had the lowest content, 12.0 ± 2.9 mg 100 g−1. In Dombito greenhouse tomatoes the stage of maturity and the effect of cluster location were tested against ascorbic acid content. The lowest ascorbic acid content of 9.1 ± 1.0 mg 100 g−1 was found with the small green tomatoes while others from mature green to overripe contained 14.0–16.7 mg 100 g−1. Tomatoes from different cluster locations showed no significant difference in ascorbic acid content.Key words: Vitamin C, L-ascorbic acid, tomatoes

Download Full-text

757 Does Increased Sampling of Cerebrospinal Fluid from External Ventricular Drains Lead to Increased Rates of Infection?

British Journal of Surgery ◽

10.1093/bjs/znab134.575 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

B Edwards ◽

A Zolnourian ◽

D Bulters

Keyword(s):

Research Study ◽

Average Length ◽

Risk Of Infection ◽

Suspected Infection ◽

Length Of Treatment ◽

Increased Risk ◽

Significant Difference ◽

Daily Sampling ◽

Frequent Sampling ◽

Strict Protocol

Abstract Introduction External ventricular drains (EVDs) are commonly used in the management of acute hydrocephalus after subarachnoid haemorrhage (SAH). Infection is the most common complication. There remains controversy over whether frequent sampling is associated with increased risk of infection. Method Two cohorts of patients requiring EVD after SAH were retrospectively analysed for suspected and proven CSF infection. The first clinical cohort was of 50 consecutive patients with twice weekly sampling. The second group had alternate daily sampling as part of a prospective research study. Results Female to male ratio were (32:18) and (29:15) in clinical vs research group respectively. Average age of both groups was 59. Average length of treatment with EVD in both groups was 10 days. 16/50 (32%) patients had a suspected infection vs 13/44 (30%) and 8/50 (16%) had a proven infection compared to 6/44 (14%) in clinical and research groups, respectively. There was no statistically significant difference between the two groups (suspected infections p = 0.7 and proven infections p = 0.7) Conclusions Increased rates in CSF sampling in the research cohort did not result in higher rates of CSF infection. This suggests that rate of sampling, if done following a strict protocol, is not associated with increased risk of infection.

Download Full-text