scholarly journals Six-month exclusive breastfeeding and the impact of COVID-19 on breastfeeding practice in Hong Kong: A mixed-methods study

2021 ◽  
Author(s):  
John Kwan ◽  
Jimsyn Jia ◽  
Ka-man Yip ◽  
Hung-kwan So ◽  
Sophie SF Leung ◽  
...  
Keyword(s):  
Hong Kong ◽  
Mixed Methods ◽  
Exclusive Breastfeeding ◽  
Public Hospital ◽  
Positive Impact ◽  
World Health ◽  
Breastfeeding Support ◽  
The Past ◽  
The Impact ◽  
Breastfeeding Practice

Abstract Background The World Health Organization recommends exclusive breastfeeding (EBF) for an infant’s first six months. Therefore, various policies were implemented to support breastfeeding in Hong Kong in the past decade. Meanwhile, the COVID-19 pandemic brought new challenges and opportunities to breastfeeding practices. This study aimed to identify the associated factors of six-month EBF, and to evaluate the impact of COVID-19 on breastfeeding practice. Methods This study was conducted using a mixed-methods approach. An electronic questionnaire was distributed to members of breastfeeding or parenting groups who have had breastfeeding experience in the past 10 years. Exploratory factor analysis with principal components analysis was used to identify the factors representing breastfeeding support from family and friends. Stepwise binary logistic regression analyses with forward (conditional) selection were conducted to examine factors associated with six-month EBF both in general and during the pandemic period. A thematic analysis was conducted using both deductive and inductive approaches. Results The study included 793 participants. Giving birth in a public hospital (AOR 2.015, 95% CI 1.440 to 2.821, p < 0.001) and breastfeeding support from family and friends (AOR 1.309, 95% CI 1.102 to 1.555, p = 0.002) were significantly associated with six-month EBF even during COVID-19. Our qualitative results indicated a high prevalence of breastfeeding problems in both public and private maternity wards, suggesting that neonatal support for breastfeeding in Hong Kong were generally insufficient and ineffective. Conclusions Giving birth in a public hospital and having breastfeeding support from family and friends were associated with six-month EBF. Furthermore, COVID-19 in Hong Kong had an overall positive impact on six-month EBF. Further studies should investigate the impact of hospital practice and the COVID-19 pandemic on breastfeeding behaviours.

scholarly journals The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Walusa Assad Gonçalves-Ferri ◽  
◽  
Fábia Martins Pereira-Cellini ◽  
Kelly Coca ◽  
Davi Casale Aragon ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
World Health ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Maternity Services ◽  
Community Needs ◽  
Care Services ◽  
Skin Contact ◽  
Health Organization ◽  
The Impact

Abstract Background The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. Results The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.

Customer satisfaction with sommelier services of upscale Chinese restaurants in Hong Kong

2019 ◽  
Vol 31 (4) ◽  
pp. 532-554 ◽  
Author(s):  
Tommy Lau ◽  
Man Lai Cheung ◽  
Guilherme D. Pires ◽  
Carol Chan
Keyword(s):  
Hong Kong ◽  
Customer Satisfaction ◽  
Service Quality ◽  
Customer Loyalty ◽  
Positive Impact ◽  
Partial Least Square ◽  
Least Square ◽  
Survey Method ◽  
Content Type ◽  
The Impact

Purpose The abolishment of the wine tax in Hong Kong has led to increased wine consumption and increased demand for wine-related professionals, such as sommeliers. Yet the importance of sommeliers’ value-adding performance in the context of upscale Chinese restaurants has not been examined. To address this gap, the SERVQUAL framework is adopted to examine the influence of sommeliers’ service quality (SQ) on customer satisfaction (CS) and loyalty in the context of upscale Chinese restaurants in Hong Kong. Design/methodology/approach The survey method is used to collect data from 302 units of the population of interest, partial least square-structural equation modelling (PLS-SEM) is used to test the links between constructs. Findings Four of the seven dimensions of sommeliers’ service quality, namely, empathy, tangibles, credibility and assurance, have a significant positive impact on customer satisfaction and customer loyalty, whereas the impact of perceived value and responsiveness on customer satisfaction and customer loyalty is positive but only marginally significant. Reliability has a weak and non-significant impact on customer satisfaction and customer loyalty. Research limitations/implications Examining a small number of upscale Chinese restaurants in Hong Kong limits generalisation of the findings to other contexts. Replication of the research in different contexts will enhance generalizability. In terms of implications, the discussion highlights the importance of sommeliers’ service performance on customers’ SQ perceptions SQ, CS and loyalty, all of which are important variables for restaurateurs. Originality/value To the best of the authors’ knowledge, this is the first study of the influence of the quality of sommelier’s SQ on CS and loyalty in upscale Chinese restaurants in Hong Kong. Given the lack of attention to this service role in the literature, the study contributes theory from which further understanding can develop.

scholarly journals Changes in Catastrophic Health Expenditures Depending on Health Policies in Turkey

2021 ◽  
Vol 8 ◽  
Author(s):  
Guvenc Kockaya ◽  
Gülpembe Oguzhan ◽  
Zafer Çalşkan
Keyword(s):  
Health Services ◽  
Health Expenditure ◽  
Positive Impact ◽  
Health Expenditures ◽  
Catastrophic Health Expenditure ◽  
Health Policies ◽  
World Health ◽  
Positive Health ◽  
Catastrophic Health Expenditures ◽  
The Impact

Without any financial protection out of pocket health expenses are essential both because their increase causes difficulties in accessing higher quality health services for households and more importantly because it complicates access to most basic health services. As a result of the Health Transformation Program in practice in the Turkish healthcare system since 2003, significant changes have been done in all layers of the health system. Turkish Statistics Institute (TurkStat) publishes the ratio of households that bear catastrophic health expenditures since 2002. According to TurkStat data, the ratio of households with catastrophic expenditure has fallen from 0.81% in 2002 to 0.17% in 2011 with the health transformation project. However, it has started to rise since 2012 and has reached 0.31% in 2014. This study aims to evaluate the expenditure items that may have caused the rise of the ratio of households with catastrophic health expenditures since 2012, which had previously dropped with the Health Transformation Program that has caused fundamental changes in health policies. Methodology and definitions presented in the article named “Distribution of health payments and catastrophic expenditures: Methodology” by Ke Xu published by the World Health Organization in 2005 have been used. Percentages of health expenditure items among the total expenditure of households with positive health expenditure and households with catastrophic health expenditure between 2007 and 2014 have been evaluated using descriptive analysis. Findings have been interpreted in light of the health policies in practice between 2007 and 2014. An overview of the impact of the health policies reveals that medicine expenditures have decreased both for household and public health expenditures. Despite the impact of policies on the pharmaceutical industry was criticized by the industry, the positive impact can be seen by the decrease in the spending on medicine for households spending on health. Hospital service with positive health expenditure is seen to decrease health expenditure. The reasons for the increase in households with catastrophic health expenditure need further research. As a result, the study strives to discuss the possible policy reasons for the observed effects.

Contribution of the co.LAB Framework to the Collaborative Design of Serious Games: Mixed-Methods Validation Study (Preprint)

2021 ◽  
Author(s):  
Dominique Jaccard ◽  
Laurent Suppan ◽  
Félicia Bielser
Keyword(s):  
Mixed Methods ◽  
Game Design ◽  
Serious Games ◽  
Positive Impact ◽  
Serious Game ◽  
Multidisciplinary Design ◽  
Design Teams ◽  
Design And Development ◽  
Significant Difference ◽  
The Impact

BACKGROUND Multidisciplinary collaboration is essential to the successful development of serious games, albeit difficult to achieve. The co.LAB serious game design framework was created to support collaboration within serious game multidisciplinary design teams. Its use has not yet been validated in a naturalistic context. OBJECTIVE The objective of this study was to perform a first assessment of the impact of the co.LAB framework on collaboration within multidisciplinary teams during serious game design and development. METHODS This was a mixed-methods study based on two serious game design projects in which the co.LAB framework was used. The first phase was qualitative and carried out using a general inductive approach. To this end, all members of the first serious game project team who used the co.LAB framework were invited to take part in a focus group session (N=6). Results inferred from qualitative data were then used to define a quantitative instrument (questionnaire) which was designed according to the Checklist for Reporting Results of Internet E-Surveys. Members of both project teams (N=11) were then asked to answer the questionnaire. Quantitative results were reported as median [Q1;Q3] and appropriate non-parametric tests used to assess for between group differences. Finally, results gathered through the qualitative and quantitative phases were integrated. RESULTS In both phases, the participation rate was 100%. Verbatim transcripts were classified into 4 high level themes: influence on collaborative dimensions; impact on project course, monitoring and efficiency; qualitative perceptions of the framework; and influence of team composition on the use of the framework. Accordingly, the web-based questionnaire was then developed according to Burhardt's seven dimensions of collaboration. In both projects, the co.LAB framework had a positive impact on most dimensions of collaboration during the multidisciplinary design and development of serious games. When all collaborative dimensions were aggregated, the overall impact of the framework was rated on a scale from "-42" to "+42" (very negative to very positive). The overall score was 23 [20;27], with no significant difference between groups (P=.58). Most respondents also believed that all serious game design teams should include a member possessing a significant expertise in serious game design frameworks to guide the development process. CONCLUSIONS The co.LAB framework has a positive impact on collaboration within serious game development teams. However, expert guidance seems necessary to maximize development efficiency. Whether such guidance can be provided by means of a collaborative web platform remains to be determined.

scholarly journals Evaluation of the impact of breastfeeding support groups in primary health centres in Andalusia, Spain: a study protocol for a cluster randomized controlled trial (GALMA project)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Isabel Rodríguez-Gallego ◽  
Fatima Leon-Larios ◽  
Cecilia Ruiz-Ferrón ◽  
Maria-de-las-Mercedes Lomas-Campos
Keyword(s):  
Support Groups ◽  
Exclusive Breastfeeding ◽  
Intervention Group ◽  
World Health ◽  
Control Group ◽  
Breastfeeding Initiation ◽  
Primary Health ◽  
Breastfeeding Rate ◽  
Breastfeeding Rates ◽  
The Impact

Abstract Background In 2003, the World Health Organization recommended exclusive breastfeeding (EB) during the newborn’s first 6 months of life and, if possible, during the first 2 years. However, EB rates resist these recommendations. In developed countries, only 1 out of 3 babies is breastfed during its first 6 months of life, and great differences between areas and countries can be observed. Only 35% of the newborns receive breastfeeding at 3–4 months of age. There are diverse strategies described in the literature that have proven their efficiency in improving breastfeeding rates. It has also been proven that professional support is an effective tool to extend any kind of breastfeeding; besides, it has been observed that mother-to-mother support also increases breastfeeding initiation, sustainment, and exclusive duration. The overall aim of the study is to assess the impact of the support groups on the sustainment of exclusive breastfeeding until 6 months after birth. Methods/design This study is a cluster-random multicentric clinical trial with a control group and an intervention group, without blinding because it is impossible to mask the intervention. A randomization by centres of primary health (clusters) will be carried out. The women allocated to the intervention or control group will be randomized with a simple randomization sampling. The participants’ breastfeeding rate will be followed up at the first 10 days, and at 2, 4, and 6 months of their newborn’s life. Discussion There is a need to assess the impact of mother support groups on exclusive breastfeeding. This study aims to analyse the outcomes related to the support received and to identify what should the structure of these groups be; in other words, to describe factors related to a better breastfeeding experience in order to help women increase breastfeeding rates. Trial registration The trial is prospectively recorded at the ISRCTN registry (Trial ID: ISRCTN17263529). Date recorded: 17/06/2020.

scholarly journals Active Learning via Problem-Based Collaborative Games in a Large Mathematics University Course in Hong Kong

2019 ◽  
Vol 9 (3) ◽  
pp. 172
Author(s):  
Fridolin Sze Thou Ting ◽  
Wai Hung Lam ◽  
Ronnie Homi Shroff
Keyword(s):  
Hong Kong ◽  
Active Learning ◽  
Collaborative Learning ◽  
Learning Outcomes ◽  
Conceptual Understanding ◽  
Positive Impact ◽  
Tertiary Education ◽  
Background Knowledge ◽  
Learning Platform ◽  
The Impact

Research has demonstrated the positive impact of active learning on students’ learning outcomes, particularly in science, technology, engineering and mathematics (STEM) fields. However, few studies have explored the impact of active learning via problem-based collaborative games in large mathematics classes in the context of Asian tertiary education. This study assesses the effects of active learning on students’ learning outcomes using class test scores and the calculus concept inventory (CCI) to test the conceptual understanding of the basic principles of differential calculus, in a first year calculus course in Hong Kong. Three hypotheses were tested to determine the effects of game-based collaborative learning on learning mathematics among students. Active learning through a problem-based collaborative learning methodology was employed, using Kahoot!, a game-based learning platform. Results supported all three hypotheses, demonstrating a statistically significant increase in students’ conceptual understanding and examination performance, based upon their individual perceptions of active engagement and time spent in active learning. Our results indicated that active learning “levels the playing field”, in the sense that students with less pre-requisite background knowledge, using a problem-based collaborative learning methodology, were relatively more inclined to catch up or even exceed the performance of students with a stronger prerequisite background knowledge, at the end of the course.

The sustainability of enterprise education: a case study in Hong Kong

2007 ◽  
Vol 49 (2) ◽  
pp. 138-152 ◽  
Author(s):  
Christina Wai Mui Yu ◽  
Thomas Wing Yan Man
Keyword(s):  
Hong Kong ◽  
Local Community ◽  
Positive Impact ◽  
Extended Period ◽  
Education Programme ◽  
Three Dimensions ◽  
Systematic Research ◽  
Content Type ◽  
Enterprise Education ◽  
The Impact

PurposeThe purpose of this paper is to introduce a case of an increasingly popular enterprise education programme in Hong Kong called the Teen Entrepreneurs Competition (TEC) and to examine its sustainability in different dimensions.Design/methodology/approachPost‐activity evaluation feedback was obtained from the participants and the stakeholders of the activity. Three systematic research studies were also conducted for investigating the impact of entrepreneurial characteristics and social interaction on the participants throughout TEC.FindingsParticipants and stakeholders generally provided positive feedback towards TEC. The research findings also showed that TEC was able to draw a positive impact on developing the participants' entrepreneurial characters and in turn made TEC sustainable on the provision of an enterprise education programme in the local community.Research limitations/implicationsIt is suggested that the sustainability of TEC is attributed to three dimensions, namely, opportunities for individual comprehensive understanding, context for collaborative learning, and network for institutional support.Practical implicationsSuggestions on how to further strengthen the sustainability of enterprise education programmes through these three dimensions are provided, for example, maximising individuals' practical experience, improving the quality of collaboration and developing a closer working relationship with various stakeholders.Originality/valueEnterprise education is recognised to have a significant influence on the development of entrepreneurial knowledge, skills and attitudes for youths. In order to widen the impact of enterprise education in society, it is necessary to sustain such enterprise education programmes over an extended period of time.

The Impact of Unions on Pay Levels in Lower-Skilled Jobs

2001 ◽  
Vol 176 ◽  
pp. 76-90 ◽  
Author(s):  
John Forth ◽  
Neil Millward
Keyword(s):  
Private Sector ◽  
Minimum Wage ◽  
Trade Union ◽  
Trade Unions ◽  
Positive Impact ◽  
Employee Relations ◽  
The Past ◽  
Sphere Of Influence ◽  
The Impact

The decline in trade union influence over the past two decades raises the question of whether pay levels in lower-skilled jobs now lie outside the unions' sphere of influence, as tacitly acknowledged by their acceptance and later endorsement of the principle of the statutory minimum wage. This article examines pay levels among lower-skilled jobs in the private sector in Britain using the Workplace Employee Relations Survey of 1998. It shows that trade unions still had a positive impact upon pay levels in lower-skilled jobs and identifies those forms of unionism associated with the largest premiums. However, the article also shows that the activities of trade unions did little to counteract the forces generating the lowest levels of pay.

scholarly journals Familiar but neglected: identification of gaps and recommendations to close them on exclusive breastfeeding support in health facilities in Malawi

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Alinane Linda Nyondo-Mipando ◽  
Mai-Lei Woo Kinshella ◽  
Sangwani Salimu ◽  
Brandina Chiwaya ◽  
Felix Chikoti ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Qualitative Data ◽  
Health Workers ◽  
Newborn Care ◽  
Health Systems Strengthening ◽  
World Health ◽  
Standards Of Care ◽  
Routine Practice ◽  
Breastfeeding Support ◽  
Care Assessment

Abstract Background Exclusive breastfeeding is widely accepted as a key intervention with proven efficacy for improving newborn survival. Despite international commitments and targets to support and promote breastfeeding, there are still gaps in meeting and maintain coverage in many sub-Saharan African countries. This paper aimed to triangulate the perspectives of health workers, mothers, and their family members with facility assessments to identify gaps to improve breastfeeding support in in Malawi. Methods The study on breastfeeding barriers and facilitators was conducted in 2019 at one tertiary hospital and three secondary-level hospitals in Malawi. We conducted 61 semi-structured interviews with health workers, postnatal mothers, grandmothers, aunts, and fathers. In 2017, we carried out a neonatal care facility assessment using the World Health Organization (WHO) Integrated Maternal, Neonatal, and Child Quality of Care Assessment and Improvement Tool. Qualitative data were analysed using a thematic analysis approach within the Systems Framework for Health Policy. Results The district-level hospitals rated high with an average score of 4.8 out of 5 across the three facilities indicating that only minor improvements are needed to meet standards of care for early and exclusive breastfeeding. However, the score fell to an average of 3.5 out of 5 for feeding needs with sick neonates indicating that several improvements are needed in this area. The qualitative data demonstrated that breastfeeding was normalized as part of routine newborn care. However, the focus on routine practice and reliance on breastfeeding knowledge from prenatal counselling highlights inequities and neglect in specialized care and counselling among vulnerable mothers and newborns. Revitalisation of breastfeeding in Malawian facilities will require a systems approach that reinforces policies and guidelines; contextualises knowledge; engagement and empowerment of other relatives to the baby and task-sharing among health workers. Conclusions Breastfeeding is accepted as a social norm among health workers, mothers, grandmothers, aunts, and fathers in Malawi, yet vulnerable groups are underserved. Neglect in breastfeeding support among vulnerable populations exacerbates health inequities. Health systems strengthening related to breastfeeding requires a concerted effort among health workers, mothers, grandmothers, aunts, and fathers while remaining grounded in contexts to support family-centered hospital care.

scholarly journals Determinants of breastfeeding practice in Pujehun district, southern Sierra Leone: a mixed-method study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Dorothee van Breevoort ◽  
Francesca Tognon ◽  
Arne Beguin ◽  
Amara S. Ngegbai ◽  
Giovanni Putoto ◽  
...  
Keyword(s):  
Breast Milk ◽  
Sierra Leone ◽  
Exclusive Breastfeeding ◽  
Mixed Method ◽  
Critical Role ◽  
World Health ◽  
Mixed Method Study ◽  
Breastfeeding Rate ◽  
Breastfeeding Practice ◽  
Determinants Of Breastfeeding

Abstract Background It is well established that exclusive breastfeeding can play a critical role in reducing child morbidity and mortality. Limited research has been done thus far on the practice and perceptions of breastfeeding in Sierra Leone, where more than 10 % of children die before the age of five. This study aimed to gain understanding into and explore both matters in order to develop recommendations for effective strategies to promote breastfeeding practice in Pujehun District, Southern Sierra Leone. Methods This exploratory mixed-method study included a cross-sectional survey of 194 mothers, semi-structured interviews and focus group discussions. Logistic regression analysis was used calculated odds ratios of factors associated with primarily breastfeeding practice, defined as ‘Children under six months of age who are fed with breast milk only and children older than six months of age that were exclusively breastfed up to six months’, based on recall from birth. Exclusive breastfeeding rate was based on breastfeeding practice 24 h prior to the survey. Qualitative data was analysed through a deductive approach, using a pre-determined framework on determinants of breastfeeding. Results This study revealed an exclusive breastfeeding rate of 62.8% (95% CI 53.9, 71.7); dropping from 74% in the 0–1-month age group to 33% in the 4–5 months group. Triangulation of qualitative and quantitative data revealed enabling factors for primarily breastfeeding practice included mothers receiving support during their first breastfeed, pregnant women being provided with information on the benefits of the practice, counselling by nurses, support from husbands, and women’s awareness of how their friends and family members fed their own babies. The main barriers were a lack of encouragement by husbands, women’s perception that their infants’ stools were abnormal or that they were not producing enough breast milk. Conclusions Although the exclusive breastfeeding may have risen over recent years, a gap remains compared to World Health Organization recommendations. According to the breastfeeding determinants identified in this study, promotion of counselling by a nurse, encouragement of husbands’ support, and improve knowledge of mothers on breastfeeding are recommended to be incorporated in the design of future health programs.

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