Breastfeeding Promotion in German Maternity Hospitals and Consecutive Rates of Exclusive Breastfeeding During the First 4 Months of Life – The Prospective SuSe II Study

Abstract Objectives The implementation of the “10 Step” programme of WHO/UNICEF for breastfeeding promotion (BFP) in maternity hospitals is considered as a key for long-term breastfeeding success of mothers worldwide. The objective of this work was to determine whether this expectation also holds true for Germany. Methods The nationwide SuSe II study (2017–19) is a combination of a cross-sectional survey in maternity hospitals and a prospective follow-up of mother-infant pairs (0.5, 2, 4, 6, 12 months postpartum (pp)) recruited in the participating hospitals. All German maternity hospitals were invited to complete an online questionnaire assessing BFP based on the 10 Steps. Mothers reported if they were breastfeeding and if the infant received any other fluid or food. Relevant factors for exclusive breastfeeding (EBF) during the first 4 months pp were determined in 5 multivariable models with variable selection through backward elimination according to the likelihood ratio. Results One hundred and three hospitals (15% out of 692) recruited 929 mothers (33% of eligible mothers) who had tried to breastfeed, with a compliance of about 90%. During hospital stay, 74% of mothers exclusively breastfed, 77% at discharge, 74% 2 weeks, 70% 2 months and 58% 4 months pp. Hospitals had implemented between 2 and 10 Steps (median 7). Until 4 months pp, the rate of EBF was higher, if mothers had given birth in hospitals with a high BFP (≥9 Steps) compared to medium (6–8 Steps) or low promotion (≤5 Steps). Even after adjusting for potential confounders, high BFP compared to medium and low promotion significantly increased the modeled odds of mothers for EBF during hospital stay (p = 0.000), at discharge (p = 0.005) and 2 months pp (p = 0.002). Maternal breastfeeding experience and absence of a pacifier significantly increased the modeled odds of mothers for EBF at all 5 time points pp. Conclusions Implementation of at least 9 of the 10 Steps for BFP in hospitals was related to mothers' breastfeeding success in the first 2 months. It is noteworthy that this association was found even at the high level of BFP in hospitals and the high initial breastfeeding rates in the SuSe II study. Funding Sources Funding: Federal Ministry of Food and Agriculture Client: German Society for Nutrition.

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Evaluation of Knowledge, Attitudes, and Practices about Exclusive Breastfeeding among Women in Italy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16122118 ◽

2019 ◽

Vol 16 (12) ◽

pp. 2118 ◽

Cited By ~ 3

Author(s):

Diana Cascone ◽

Davide Tomassoni ◽

Francesco Napolitano ◽

Gabriella Di Giuseppe

Keyword(s):

Hospital Stay ◽

Exclusive Breastfeeding ◽

Hospital Admissions ◽

Educational Interventions ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Policy Makers ◽

Campania Region ◽

Face To Face ◽

Attitudes And Practices

Background: The aim of this study was to assess the level of knowledge, attitudes and behaviors of women about breastfeeding in Italy. Methods: A cross-sectional survey was carried out between January and June 2016 in the Campania Region among mothers who were going to six public vaccination centers. Data were collected by two researchers through face to face interviews. Results: Two thirds of the women had heard on exclusive breastfeeding (64.6%) and the 71% of them knew that exclusive breastfeeding should be practiced for at least six months. Nearly all mothers had breastfed their child (93.2%), but only 33.3% of them had practiced exclusive breastfeeding for at least six months. Women who agree that breastfeeding creates a positive relationship between the mother and the child, who practiced exclusive breastfeeding during the hospital stay, and who had received breastfeeding advice at hospital discharge were more likely to practice exclusive breastfeeding for at least six months. Conclusions: The results of this survey may be helpful to policy makers and managers when planning educational interventions on breastfeeding both during pregnancy and during hospital admissions for delivery. Indeed, there is a need to increase efforts to make mothers aware of health benefits of breastfeeding for themselves and their offspring during their hospital stay after delivery. This research has the potential to increase exclusive breastfeeding rates and subsequent maternal and child health outcomes.

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A Preliminary Assessment of Novel Coronavirus (COVID-19) Knowledge and Perceptions in Nigeria

10.1101/2020.04.11.20061408 ◽

2020 ◽

Cited By ~ 9

Author(s):

P.O. Olapegba ◽

O. Ayandele ◽

S.O. Kolawole ◽

R. Oguntayo ◽

J.C. Gandi ◽

...

Keyword(s):

Study Data ◽

Common Source ◽

Chinese Government ◽

Snowball Sampling ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Traditional Media ◽

Cross Sectional ◽

Novel Coronavirus ◽

High Level

AbstractThis study assessed knowledge and perceptions about COVID-19 among the general public in Nigeria during the initial week of the pandemic lockdown in the country. From March 28 to April 4, 2020, this cross-sectional survey used an anonymous online questionnaire to collect data from respondents within Nigeria. Purposive and snowball sampling techniques were used to recruit 1357 respondents, aged 15-70 years, from 180 cities and towns within Nigeria. Study data were analysed using descriptive statistics. Approximately more than half (57.02%) of the respondents were male with high level of education (48.86% bachelor’s degree or higher). Approximately half of the respondents (46.94%) opined that COVID-19 was “a biological weapon designed by the Chinese government.” About 94% of the respondents identified “contact with airborne droplets via breathing, sneezing, or coughing” as the most common mode of transmission; most respondents associated COVID-19 with coughing (81.13%), shortness of breath (73.47%) and fever (62.79%). “Regular hand washing and social distancing” was selected by most respondents (94.25%) as a way of preventing infection whereas 11.86% reported “consuming gins, garlic, ginger, herbal mixtures and African foods/soups” as preventive measures against COVID-19. Majority of the respondents (91.73%) thought COVID-19 is deadly; and most respondents (84.3%) got 4 or more answers correctly. It was also observed that the traditional media (TV/Radio) are the most common source of health information about COVID-19 (93.5%). Findings revealed that Nigerians have relatively high knowledge, mostly derived from traditional media, about COVID-19. Their perceptions of COVID-19 bear implications across public health initiatives, compliance with precautionary behavior as well as bilateral relations with foreign nations. Evidence-based campaign should be intensified to remove misconceptions and promote precautionary measures.

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COVID-19 Knowledge and Perceptions in Nigeria

10.31234/osf.io/j356x ◽

2020 ◽

Cited By ~ 7

Author(s):

Peter O. Olapegba ◽

Olusola Ayandele ◽

Samson Olowo Kolawole ◽

Rotimi Oguntayo ◽

Joshua Chiroma Gandi ◽

...

Keyword(s):

Study Data ◽

Common Source ◽

Chinese Government ◽

Snowball Sampling ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Traditional Media ◽

Cross Sectional ◽

Precautionary Measures ◽

High Level

This study assessed knowledge and perceptions about COVID-19 among the general public in Nigeria during the initial week of the pandemic lockdown in the country. From March 28 to April 4, 2020, this cross-sectional survey used an anonymous online questionnaire to collect data from respondents within Nigeria. Purposive and snowball sampling techniques were used to recruit 1357 respondents, aged 15-70 years, from 180 cities and towns within Nigeria. Study data were analysed using descriptive statistics. Approximately more than half (57.02%) of the respondents were male with high level of education (48.86% bachelor’s degree or higher). Approximately half of the respondents (46.94%) opined that COVID-19 was “a biological weapon designed by the Chinese government.” About 94% of the respondents identified “contact with airborne droplets via breathing, sneezing, or coughing” as the most common mode of transmission; most respondents associated COVID-19 with coughing (81.13%), shortness of breath (73.47%) and fever (62.79%). “Regular hand washing and social distancing” was selected by most respondents (94.25%) as a way of preventing infection whereas 11.86% reported “consuming gins, garlic, ginger, herbal mixtures and African foods/soups” as preventive measures against COVID-19. Majority of the respondents (91.73%) thought COVID-19 is deadly; and most respondents (84.3%) got 4 or more answers correctly. It was also observed that the traditional media (TV/Radio) are the most common source of health information about COVID-19 (93.5%). Findings revealed that Nigerians have relatively high knowledge, mostly derived from traditional media, about COVID-19. Their perceptions of COVID-19 bear implications across public health initiatives, compliance with precautionary behavior as well as bilateral relations with foreign nations. Evidence-based campaign should be intensified to remove misconceptions and promote precautionary measures.

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Biographic Characteristics and Factors Perceived as Affecting Female and Male Careers in Academic Surgery: The Tenured Gender Battle to Make It to the Top

European Surgical Research ◽

10.1159/000446874 ◽

2016 ◽

Vol 57 (3-4) ◽

pp. 139-154 ◽

Cited By ~ 1

Author(s):

Laura Schwarz ◽

Sonia Sippel ◽

Andrew Entwistle ◽

Anna Kathrin Hell ◽

Sarah Koenig

Keyword(s):

Career Guidance ◽

Work Satisfaction ◽

Attrition Rate ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Professional Career ◽

Academic Surgery ◽

Female Surgeons ◽

High Degree

Purpose: Given the high attrition rate in the field of academic surgery, we aimed to characterise the professional and personal situations of female and male academic surgeons as well as to gather data on their respective perceptions of career advancement and work satisfaction. Methods: We conducted a cross-sectional survey in Germany, inviting all identifiable academically highly qualified female surgeons and their male counterparts in a 1:2 ratio to participate. An anonymous 103-item online questionnaire was designed and the data collected between July and September 2014. Results: The questionnaire was sent to 93 female and 200 male surgeons, of whom 63 women (67.7%) and 70 men (35.0%) replied. The average age was 47.5 and 47.1 years, respectively. Respondents identified ‘high degree of expertise', ‘ambition', and ‘clarity of one's professional aims' as important factors affecting professional career development. Both groups felt ‘workload', ‘working hours/shifts', and ‘gender' to be a hindrance, the latter of significantly greater importance to female surgeons. The mean work satisfaction scores were high in both female (69.5%) and male (75.7%) surgeons. The predictors ‘support from superiors' (standardised β coefficient = 0.41) and ‘manual aptitude' (β = 0.41) contributed incrementally to the variance in ‘high degree of work satisfaction' (90-100%) observed for female surgeons. However, childcare provided by ‘kindergarten/crèche/after-school care' had the greatest negative predictive value (β = -1.33). Conclusions: Although there are many parallels, female faculty members experience the culture of academic surgery to some extent differently from their male counterparts, especially when impacted by parenthood and childcare. Faculty development programmes need to develop strategies to improve perceived equality in career opportunities by respecting individuals' requirements as well as offering gender-appropriate career guidance.

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COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116076 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6076

Author(s):

Hasan S. Alamri ◽

Wesam F. Mousa ◽

Abdullah Algarni ◽

Shehata F. Megahid ◽

Ali Al Bshabshe ◽

...

Keyword(s):

Health Care ◽

Saudi Arabia ◽

Health Care Workers ◽

Psychological Impact ◽

Psychological Outcomes ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Care Workers ◽

The Impact

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.

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Hidden bedside rationing in the Netherlands: a cross-sectional survey among physicians in internal medicine

BMC Health Services Research ◽

10.1186/s12913-021-06229-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ursula W. de Ruijter ◽

Hester F. Lingsma ◽

Willem A. Bax ◽

Johan Legemaate

Keyword(s):

Internal Medicine ◽

The Netherlands ◽

Patient Choice ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Physician Characteristics ◽

Distribution Of Resources ◽

Healthcare Rationing ◽

Do So

Abstract Background Healthcare rationing can be defined as withholding beneficial care for cost reasons. One form in particular, hidden bedside rationing, is problematic because it may result in conflicting loyalties for physicians, unfair inequality among patients and illegitimate distribution of resources. Our aim is to establish whether bedside rationing occurs in the Netherlands, whether it qualifies as hidden and what physician characteristics are associated with its practice. Methods Cross-sectional online questionnaire on knowledge of -, experience with -, and opinion on rationing among physicians in internal medicine within the Dutch healthcare system. Multivariable ordinal logistic regression was used to explore relations between hidden bedside rationing and physician characteristics. Results The survey was distributed among 1139 physicians across 11 hospitals with a response rate of 18% (n = 203). Most participants (n = 129; 64%) had experience prescribing a cheaper course of treatment while a more effective but more expensive alternative was available, suggesting bedside rationing. Subsequently, 32 (24%) participants never disclosed this decision to their patient, qualifying it as hidden. The majority of participants (n = 153; 75%) rarely discussed treatment cost. Employment at an academic hospital was independently associated with more bedside rationing (OR = 17 95%CI 6.1–48). Furthermore, residents were more likely to disclose rationing to their patients than internists (OR = 3.2, 95%CI 2.1–4.7), while salaried physicians were less likely to do so than physicians in private practice (OR = 0.5, 95%CI 0.4–0.8). Conclusion Hidden bedside rationing occurs in the Netherlands: patient choice is on occasion limited with costs as rationale and this is not always disclosed. To what extent distribution of healthcare should include bedside rationing in the Netherlands, or any other country, remains up for debate.

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Perioperative nutrition care and dietetic practices in the scope of bariatric surgery in Saudi Arabia using adapted protocols for evaluation

SAGE Open Medicine ◽

10.1177/20503121211036136 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110361

Author(s):

Elham Abbas Aljaaly

Keyword(s):

Bariatric Surgery ◽

Saudi Arabia ◽

Care Process ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Nutrition Risk ◽

Nutrition Care ◽

Management Protocol ◽

Perioperative Nutrition

Objectives: This study evaluates the availability of perioperative nutritional care protocols and the practices of bariatric registered dietitians in Saudi Arabia. The primary outcomes of the study were conducted using an adapted American survey “with permission.” Methods: A cross-sectional survey of a selected 32 dietitians providing bariatric services completed a self-administered online questionnaire from 12 hospitals in Jeddah, Saudi Arabia. Results: All surveyed dietitians were females, mainly Saudi nationals (93.9%, n = 30), and accredited by the Saudi Commission for Health Specialties (93.8%, n = 30). Only 37.5% (n = 6) of the dietitians were specialized in bariatric surgery. Perioperative common practices of dietitians included a conduct of screening for nutrition risk before (44%, n = 14) and after surgery (62.5%, n = 20) and applied a nutrition management protocol that is mainly based on the application of nutrition care process (62.5%, n = 20). Dietitians (81%, n = 26) reported the importance of having standardized protocols for nutritional management of patients undoing bariatric surgery, where 69% (n = 22) confirmed the availability of pre-operative written protocols in hospitals and 75% (n = 24) confirmed the existence of post-operative protocols. Pre-operative practices included using approaches for weight loss before surgery, for example, very low and low-calorie diet. Dietitians (25%, n = 8) see two to ten patients per month. The sleeve gastrectomy procedure is the most often performed surgery. Conclusion: This is the first study to evaluate the perioperative nutrition care protocols and practices related to bariatric surgery in Saudi Arabia. Perioperative bariatric protocols are available, but some dietitians are not aware of their availability and contents. Researchers emphasize the importance of creating national protocols by the Saudi Credentials Body to standardize practices within the field.

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Vaccination knowledge, attitudes and practices in patients with HIV: a cross-sectional survey

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.824 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Rousset ◽

G Voglino ◽

E Boietti ◽

A Corradi ◽

M R Gualano ◽

...

Keyword(s):

Public Health ◽

Infectious Diseases ◽

Health System ◽

Vaccination Coverage ◽

Public Health System ◽

Cross Sectional Survey ◽

Hiv Patients ◽

Cross Sectional ◽

Contagion Risk ◽

High Level

Abstract Background Infectious diseases are more common and severe in patients with HIV, which show different response to vaccines and a diminished protection. It is therefore very important to assess knowledge and attitudes towards vaccination in people with HIV, since precise vaccination coverage and vaccine hesitancy are not well established in this subgroup of patients. Methods A sample of 119 patients with HIV completed a cross-sectional survey. Patients were recruited during their routine medical examination at the infectious diseases clinic in Turin. The survey explored these main areas: demographics and history of HIV infection, vaccination history, attitudes towards vaccination, confidence in the public health system, contagion risk and disease seriousness perception. In this preliminary phase descriptive analysis were conducted. Results Preliminary data show that mean age of the participants was 49.51 years, 80% were males. The median of HIV infection duration was 10 years, while the median of the lymphocyte count was 762.50 cells/mm3. The disease with the highest vaccination coverage was tetanus (88.7%), considered a serious or very serious disease by 85.6% of the participants, despite low or very low contagion risk perception (84.1%). The disease with the lowest vaccination coverage was Herpes Zoster (7.3%), despite high or very high seriousness perception (70%). Furthermore, 99.1% of the participants showed high or very high confidence toward public health system professionals, and the majority of them (59.5%) stated that vaccines are more useful for the community than for the single person. Conclusions Vaccination coverage is still not fully satisfactory regarding diseases considered infrequent or mild. Considering the high level of confidence toward the public health system that has emerged, it is necessary to implement informative and operative strategies about vaccination for European HIV patients, which are particularly at risk regarding infectious diseases. Key messages Vaccination coverage and risk perception in HIV patients is not satisfactory for many diseases and an effort to implement informative strategies in Europe is needed. The role of vaccination in preventing infectious diseases in HIV patients should be recognized and strengthened by relying on the high level of confidence toward European public health systems.

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Analyzing Predictors of Control Measures and Psychosocial Problems Associated with COVID-19 Pandemic: Evidence from Eight Countries

Behavioral Sciences ◽

10.3390/bs11080106 ◽

2021 ◽

Vol 11 (8) ◽

pp. 106

Author(s):

Sheikh Saifur Rahman Jony ◽

Ubydul Haque ◽

Nathaniel J. Webb ◽

Emily Spence ◽

Md. Siddikur Rahman ◽

...

Keyword(s):

Psychological Health ◽

Age Groups ◽

Psychosocial Problems ◽

Relevant Information ◽

The United States ◽

Control Measures ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Primary Determinant

COVID-19 has harshly impacted communities globally. This study provides relevant information for creating equitable policy interventions to combat the spread of COVID-19. This study aims to predict the knowledge, attitude, and practice (KAP) of the COVID-19 pandemic at a global level to determine control measures and psychosocial problems. A cross-sectional survey was conducted from July to October 2020 using an online questionnaire. Questionnaires were initially distributed to academicians worldwide. These participants distributed the survey among their social, professional, and personal groups. Responses were collected and analyzed from 67 countries, with a sample size of 3031. Finally, based on the number of respondents, eight countries, including Bangladesh, China, Japan, Malaysia, Mexico, Pakistan, the United States, and Zambia were rigorously analyzed. Specifically, questionnaire responses related to COVID-19 accessibility, behavior, knowledge, opinion, psychological health, and susceptibility were collected and analyzed. As per our analysis, age groups were found to be a primary determinant of behavior, knowledge, opinion, psychological health, and susceptibility scores. Gender was the second most influential determinant for all metrics except information about COVID-19 accessibility, for which education was the second most important determinant. Respondent profession was the third most important metric for all scores. Our findings suggest that greater encouragement from government health authorities and the promotion of health education and policies are essential in the dissemination of COVID-19-awareness and increased control of the spread of COVID-19.

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Prevalence and determinant factors of exclusive breastfeeding practices among mothers in Marrakesh province, Morocco: A cross- sectional survey

Mediterranean Journal of Nutrition and Metabolism ◽

10.3233/mnm-200517 ◽

2021 ◽

pp. 1-11

Author(s):

Soufiane El Moussaoui ◽

Kamal Kaoutar ◽

Ahmed Chetoui ◽

Abdeslam El Kardoudi ◽

Fatiha Chigr ◽

...

Keyword(s):

Exclusive Breastfeeding ◽

Multivariate Logistic Regression ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

Breastfeeding Practices ◽

Survey Report ◽

Duration Of Breastfeeding ◽

Breastfeeding Practice

BACKGROUND: Exclusive breastfeeding is the best form of nutrition for infants during the first 6 months of life. Nevertheless, the practice of breastfeeding is currently declining throughout the world. OBJECTIVE: The objective of this study was to assess the prevalence of exclusive breastfeeding (EBF) practice and its associated factors among mothers living in Marrakesh province, Morocco. METHODS: The data were collected using an interviewer administered questionnaire. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with exclusive breastfeeding practice. RESULTS: Prevalence of exclusive breastfeeding was 50.2%. Mothers with age more than 30 years, residing in rural area, receiving counseling related breastfeeding during antenatal follow up and having knowledge about duration of breastfeeding were more likely to practice exclusive breastfeeding than their counterparts. CONCLUSION: Although the prevalence of breastfeeding in Marrakesh was higher than the last national survey report but it is still insufficient. These findings have to stress authorities and deciders to sensitize mothers and future mothers to increase exclusive breastfeeding practice notably through the involvement of health professionals.

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