Reflections of Black Women Who Choose to Breastfeed: Influences,Challenges and Supports

Objectives

Black women continue to have the lowest rates of breastfeeding. Of those who choose to breastfeed up to half cease nursing within the first few days or months postpartum. This study identified factors that influence and challenge Black women who choose to breastfeed, and supportive strategies that facilitate successful breastfeeding experiences.

Methods

Four focus groups were conducted in 2013 with 16 self-identified Black women aged 21–46 (M = 31.35 years), with 11–18 (M = 14.94) years of education, and were either pregnant or had given birth to an infant within the prior 5 years (range of pregnancies 1–7; M = 2.44). A standard set of questions guided discussions. Data saturation occurred after three groups. All discussions were audiotaped and transcribed. Qualitative methods were used to identify categories and subthemes. Reviewers met periodically to resolve ambiguities and coding discrepancies. Member checking was conducted.

Results

Four major categories emerged: Balancing the influences: People, myths, and technology; Being in the know; Critical periods; and, Supportive Transitions. Most women experienced little help with breastfeeding from health providers or systems. More influential was the interplay of family members, myths and the internet “as my friend”. Role models and personalized support were noted as important but lacking among Black women. Patient profiling, experienced by some of the women, impacted breastfeeding choices.

Conclusions

Black women such as our participants are critical partners as we develop systems of care to decrease disparities and increase Black women’s successes in breastfeeding. Findings underscore the importance of having diverse, readily available, user-friendly, culturally sensitive options for Black women who choose to breastfeed.

     

Prevalence of metabolic syndrome with international diabetes federation criteria and ATP III program in patients 65 years of age or older

Background  

The relationship between cardiovascular factors and death can vary with age, very few studies have examined metabolic syndrome in the elderly.     

Reliability and validity of the Korean‐language version of the Communication Function Classification System in children with cerebral palsy

Purpose

The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) are useful systems for describing the broad communication function and speech intelligibility, respectively, of children with cerebral palsy (CP). The aims of this study were to determine the reliability and validity of the Korean version of the CFCS and also to investigate the association between the CFCS and the VSS and other functional classifications for children with CP.

Materials and methods

Participants were 50 children with CP (33 males, 17 females; mean age 7.2 years, range 4–16 years) recruited from a rehabilitation hospital. We analysed the interrater and intrarater reliabilities of the Korean version of the CFCS and VSS between parents, a physiatrist, and a speech–language pathologist (SLP). The social function domain of the Paediatric Evaluation of Disability Inventory was assessed to examine the concurrent validity of the CFCS and VSS.

Results

The intrarater reliabilities of the CFCS and VSS were excellent in a physiatrist (? = 0.92, ? = 0.94, respectively) and an SLP (? = 0.98, ? = 0.98) and very good in parents (? = 0.87, ? = 0.89). The interrater reliability of the CFCS and VSS was very good between the physiatrist and SLP (? = 0.87, ? = 0.89) and good between parents and the SLP (? = 0.63, ? = 0.78) and between parents and the physiatrist (? = 0.61, ? = 0.76). The CFCS and VSS were strongly related with the social function domain of Paediatric Evaluation of Disability Inventory. In addition, we found very strong associations between the VSS and CFCS.

Conclusions

The Korean version of the CFCS is a valid and reliable tool to classify communication ability and is strongly associated with the VSS, a reliable tool to classify speech intelligibility.     

A qualitative study of women's views about how health professionals communicate about infant feeding

Objective

To look at how communication by health professionals about infant feeding is perceived by first time mothers.

Design

Qualitative semi‐structured interviews early in pregnancy and 6–10 weeks after birth.

Subjects and setting

Twenty‐one white, low income women expecting their first baby were interviewed mostly at home, often with their partner or a relative.

Results

The personal and practical aspects of infant feeding which were important to women were seldom discussed in detail in ante‐natal interviews. In post‐natal interviews women described how words alone encouraging them to breastfeed were insufficient. Apprenticeship style learning of practical skills was valued, particularly time patiently spent watching them feed their baby. Women preferred to be shown skills rather than be told how to do them. Some felt pressure to breastfeed and bottle feeding mothers on post‐natal wards felt neglected in comparison. Women preferred their own decision‐making to be facilitated rather than being advised what to do. Some women experienced distress exposing their breasts and being touched by health professionals. Continuity of care and forming a personal relationship with a health professional who could reassure them were key factors associated with satisfaction with infant feeding communication.

Conclusions

The infant feeding goal for many women is a contented, thriving baby. In contrast, women perceive that the goal for health professionals is the continuation of breastfeeding. These differing goals can give rise to dissatisfaction with communication which is often seen as ‘breastfeeding centred’ rather than ‘woman centred.’ Words alone offering support for breastfeeding were often inadequate and women valued practical demonstrations and being shown how to feed their baby. Spending time with a caring midwife with whom the woman had developed a personal, continuing relationship was highly valued. Women were keen to maintain ownership, control and responsibility for their own decision‐making about infant feeding.

     

The importance of successful place integration for perceived health in very old age: a qualitative meta-synthesis

Objective  

The aim of this study was to increase our understanding of the multifaceted phenomenon of home and health, by exploring processes underlying these dynamics when living at home in very old age.     

Psychological wellbeing, physical impairments and rural aging in a developing country setting

Background  

There has been very little research on wellbeing, physical impairments and disability in older people in developing countries.     

Homeopathic medical practice: Long-term results of a cohort study with 3981 patients

Background  

On the range of diagnoses, course of treatment, and long-term outcome in patients who chose to receive homeopathic medical treatment very little is known. We investigated homeopathic practice in an industrialized country under everyday conditions.     

Forecasting the need for medical specialists in Spain: application of a system dynamics model

Background  

Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities.     

Association of osteoporotic fracture with smoking,alcohol consumption,tea consumption and exercise among Chinese nonagenarians/centenarians

Objective  

To observe the association of osteoporotic fracture with habits of smoking, alcohol consumption, tea consumption and exercise among very old people.     

Effects of apparent temperature on daily mortality in Lisbon and Oporto,Portugal

Background  

Evidence that elevated temperatures can lead to increased mortality is well documented, with population vulnerability being location specific. However, very few studies have been conducted that assess the effects of temperature on daily mortality in urban areas in Portugal.     

Health-related Quality of Life among hospitalized older people awaiting residential aged care

Background  

Health related quality of life (HRQoL) in very late life is not well understood. The aim of the present study was to assess HRQoL and health outcomes at four months follow-up in a group of older people awaiting transfer to residential aged care.     

Comparison of Arab breast cancer survivors and healthy controls for spousal relationship,body image,and emotional distress

Background  

Cultural perceptions and norms affect individuals’ psychological reactions to cancer and quality of life, but very few studies have assessed reactions to breast cancer in specific cultural groups. Such assessments are especially rare for Arab women with breast cancer.     

Prevalence and correlates of vitamin D status in African American men

Background  

Few studies have examined vitamin D insufficiency in African American men although they are at very high risk. We examined the prevalence and correlates of vitamin D insufficiency among African American men in Philadelphia.     

Exploring types of focused factories in hospital care: a multiple case study

Background  

Focusing on specific treatments or diseases is proposed as a way to increase the efficiency of hospital care. The definition of "focus" or "focused factory", however, lacks clarity. Examples in health care literature relate to very different organizations.     

Plasma very long-chain N-3 polyunsaturated fatty acids and age-related hearing loss in older adults

Objectives  

Age-related hearing loss is a common social and health problem in the older adult population. Up until now, very little scientific attention has been given to the potential role of fatty acids in agerelated hearing loss. In this study we investigated whether plasma very long-chain n-3 polyunsaturated fatty acids (PUFAs) are associated with age-related hearing loss over three years.     

Factors affecting awareness of emergency contraception among college students in Kathmandu, Nepal

Background  

In Nepal, Emergency Contraception (EC) could play a critical role in reducing unintended pregnancies, but very few people aware about it. This paper aims to investigate the level of awareness and factors influencing awareness of EC among college students.     

Survey of motivation for use of voluntary counseling and testing services for HIV in a high risk area of Shenyang, China

Background  

HIV voluntary counseling and testing (VCT) is considered an effective prevention method of HIV infection. In order to understand the VCT environment and enhance the effective delivery of VCT services in a country, an accurate assessment of the current status of VCT services is very important.     

Immune function biomarkers in children exposed to lead and organochlorine compounds: a cross-sectional study

Background  

Different organochlorines and lead (Pb) have been shown to have immunomodulating properties. Children are at greater risk for exposure to these environmental toxicants, but very little data exist on simultaneous exposures to these substances.     

The burden of community-acquired pneumonia in the elderly: the Spanish EVAN-65 Study

Background  

Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. However, population-based data are very limited and its overall burden is unclear. This study assessed incidence and mortality from CAP among Spanish community-dwelling elderly.