RESUMO
The Homa Peninsula, in southwestern Kenya, continues to yield insights into Oldowan hominin landscape behaviors. The Late Pliocene locality of Nyayanga (â¼3-2.6 Ma) preserves some of the oldest Oldowan tools. At the Early Pleistocene locality of Kanjera South (â¼2 Ma) toolmakers procured a diversity of raw materials from over 10 km away and strategically reduced them in a grassland-dominated ecosystem. Here, we report findings from Sare-Abururu, a younger (â¼1.7 Ma) Oldowan locality approximately 12 km southeast of Kanjera South and 18 km east of Nyayanga. Sare-Abururu has yielded 1754 artifacts in relatively undisturbed low-energy silts and sands. Stable isotopic analysis of pedogenic carbonates suggests that hominin activities were carried out in a grassland-dominated setting with similar vegetation structure as documented at Kanjera South. The composition of a nearby paleo-conglomerate indicates that high-quality stone raw materials were locally abundant. Toolmakers at Sare-Abururu produced angular fragments from quartz pebbles, representing a considerable contrast to the strategies used to reduce high quality raw materials at Kanjera South. Although lithic reduction at Sare-Abururu was technologically simple, toolmakers proficiently produced cutting edges, made few mistakes and exhibited a mastery of platform management, demonstrating that expedient technical strategies do not necessarily indicate a lack of skill or suitable raw materials. Lithic procurement and reduction patterns on the Homa Peninsula appear to reflect variation in local resource contexts rather than large-scale evolutionary changes in mobility, energy budget, or toolmaker cognition.
Assuntos
Hominidae , Animais , Quênia , Ecossistema , Evolução Biológica , Carbonatos , Arqueologia , FósseisRESUMO
During medical school, residency, or fellowship, many trainees struggle to balance their careers with starting a family. Some may feel the optimal time for parenthood is after completion of training, but the effect of increasing age on fertility is a real consideration for female physicians.1 Several studies have explored the impact of pregnancy and parental leave during surgical residency, yet little has been published on these topics during psychiatry training. This is surprising as psychiatry residents often address the challenges of integrating work and parenthood with their patients, yet it has not traditionally been within the culture of medicine to openly discuss this with colleagues. It is critical to address pregnancy and parenthood routinely during training and in the literature to reiterate the importance of work-life integration. In this article, we discuss current practices for psychiatry residents and advocate for the development of a standardized policy across psychiatry training programs that considers multiple aspects of childbearing including maternal mental health, family leave, and infertility.
Assuntos
Infertilidade , Internato e Residência , Psiquiatria , Humanos , Psiquiatria/educação , Feminino , Serviços de Planejamento Familiar/educação , Gravidez , Licença ParentalRESUMO
PROBLEM: Australian breastfeeding rates are low, and strategies to increase them have been inadequate. New approaches for supporting breastfeeding are required. BACKGROUND: Preliminary data suggested that Australian Breastfeeding Association members had higher exclusive breastfeeding rates than the general Australian population. The Engaging Mothers: Breastfeeding Experiences Recounted project provided an opportunity to determine which practices were influencing better breastfeeding outcomes. AIMS: (1) To determine whether Australian Breastfeeding Association volunteer trainees were positive deviants regarding breastfeeding practices, (2) to explore characteristics or behaviours underpinning beneficial breastfeeding practices and (3) to identify modifiable characteristics to inform breastfeeding promotion. METHODS: A cross-sectional, one-group survey design was used. Breastfeeding-related quantitative and qualitative data were obtained from lactation history questionnaires collected on application to train as volunteers with the Australian Breastfeeding Association (N=174), and analysed using descriptive statistics. FINDINGS: Participants in this project had higher levels of exclusive breastfeeding to around 6 months (64%) and longer duration of breastfeeding (80% to one year) than the general Australian population, going beyond World Health Organization targets. Identified modifiable factors were knowledge and motivation to breastfeed, partner and peer support, birthing outcomes, immediate skin-to-skin contact, formula supplementation and positive attitudes to breastfeeding at work and breastfeeding in public. DISCUSSION: Participants could be defined as positive deviants with positive attitudes towards breastfeeding. The personal behaviours and practices of this group may help inform future breastfeeding interventions. CONCLUSIONS: Identifying positive deviants and supporting the broader community to adopt behaviours that explain improved breastfeeding outcomes could be powerful methods to produce change.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Mães/estatística & dados numéricos , Instituições Filantrópicas de Saúde/estatística & dados numéricos , Voluntários/estatística & dados numéricos , Adulto , Austrália/epidemiologia , Aleitamento Materno/psicologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Mães/psicologia , Motivação , Cuidado Pós-Natal/métodos , Cuidado Pós-Natal/psicologia , Gravidez , Pesquisa Qualitativa , Inquéritos e Questionários , Fatores de Tempo , Voluntários/psicologia , Adulto JovemRESUMO
BACKGROUND: Debate about mother and infant bed sharing has been polarized between supporters of bed sharing and public health policies that attempt to mitigate the risk of Sudden Infant Death Syndrome. Differences in group demographics may be an important aspect in co-sleeping acceptability. RESEARCH AIMS: The first aim of this study was to investigate infant sleeping location in a dataset of mothers with strong breastfeeding outcomes. The second aim was to investigate the association between infant sleeping location and breastfeeding (exclusive breastfeeding to 6 months and total breastfeeding duration). Finally, we aimed to investigate predictors of breastfeeding duration. METHODS: Participants comprised 174 women who had applied to train as counselors with the Australian Breastfeeding Association. Data were compiled from a survey of the participants' lactation histories, including questions related to the exclusivity and duration of breastfeeding, concerns about and problems encountered during breastfeeding, type of birth, medications during birth, demographics, and infant sleeping location. The study design was a cross-sectional, one-group survey design. RESULTS: A high proportion of participants in this study bed shared and room shared: At 0-1 month (n = 58), 33% of participants bed-shared, which increased to 58% by 6-12 months (n = 80). Infants who co-slept were more likely to be exclusively breastfed at 6 months (χ2 (2, n = 116) = 4.83, p = .03) and had longer breastfeeding duration (t (62.61) = 3.81, p < .001). CONCLUSIONS: Breastfeeding targets have been difficult to achieve globally, and innovative ideas are required to improve breastfeeding outcomes through public health messaging. There was a strong association in the current study between breastfeeding outcomes and degree of closeness of the infant to the mother at night. This finding should be brought into the discourse on breastfeeding and infant sleep arrangements, accompanied by evidence-based advice about safe sleeping and the promotion of breastfeeding.
Assuntos
Aleitamento Materno/métodos , Sono/fisiologia , Fatores de Tempo , Austrália , Aleitamento Materno/estatística & dados numéricos , Estudos de Coortes , Conselheiros/psicologia , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Voluntários/psicologiaAssuntos
Aleitamento Materno/estatística & dados numéricos , Fibrose Cística/fisiopatologia , Fórmulas Infantis/administração & dosagem , Leite Humano/fisiologia , Relações Mãe-Filho , Adulto , Antibacterianos/uso terapêutico , Fibrose Cística/tratamento farmacológico , Feminino , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Período Pós-Parto , Adulto JovemRESUMO
Listeners can perceive interleaved sequences of sounds from two or more sources as segregated streams. In humans, physical separation of sound sources is a major factor enabling such stream segregation. Here, we examine spatial stream segregation with a psychophysical measure in domestic cats. Cats depressed a pedal to initiate a target sequence of brief sound bursts in a particular rhythm and then released the pedal when the rhythm changed. The target bursts were interleaved with a competing sequence of bursts that could differ in source location but otherwise were identical to the target bursts. This task was possible only when the sources were heard as segregated streams. When the sound bursts had broad spectra, cats could detect the rhythm change when target and competing sources were separated by as little as 9.4°. Essentially equal levels of performance were observed when frequencies were restricted to a high, 4-to-25-kHz, band in which the principal spatial cues presumably were related to sound levels. When the stimulus band was restricted from 0.4 to 1.6 kHz, leaving interaural time differences as the principal spatial cue, performance was severely degraded. The frequency sensitivity of cats in this task contrasts with that of humans, who show better spatial stream segregation with low- than with high-frequency sounds. Possible explanations for the species difference includes the smaller interaural delays available to cats due to smaller sizes of their heads and the potentially greater sound-level cues available due to the cat's frontally directed pinnae and higher audible frequency range.
Assuntos
Percepção Auditiva/fisiologia , Gatos/fisiologia , Animais , Limiar Auditivo , Sinais (Psicologia) , Mascaramento Perceptivo , Especificidade da Espécie , Análise e Desempenho de TarefasRESUMO
... it was horrible - a difficult, painful and agonizing process. ... Nothing I tried made it anything but torture. Finally, my son got a mouthful of blood, and I gave up. I felt like a failure. It added to my depression, made me question my ability to mother, and caused my infant to lose too much weight. (The American Dietetic Association's) position paper has no loopholes for us 'failures', no compassion for those of us too poor to rent an electric pump ... Could you please let us off the hook? (Saban, 2002, p. 24) I can't say what a devastating experience failing to breastfeed Bianca was for me. I was left feeling like I'd failed her as a mother, and even as a woman. I found it difficult to talk about, and was loath to bottle feed Bianca in public.
Assuntos
Aleitamento Materno/psicologia , Depressão Pós-Parto/psicologia , Mães/psicologia , Desmame , Adulto , Austrália , Feminino , Humanos , Lactente , Recém-Nascido , Comportamento Materno/psicologia , Mamilos , Percepção Social , Fatores de Tempo , Adulto JovemAssuntos
Transtornos da Nutrição do Lactente/prevenção & controle , Lactação/metabolismo , Leite Humano/metabolismo , Oligoelementos/administração & dosagem , Zinco/administração & dosagem , Suplementos Nutricionais , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Estado Nutricional , Oligoelementos/deficiência , Zinco/deficiênciaAssuntos
Aleitamento Materno , Suplementos Nutricionais , Transtornos da Nutrição do Lactente/prevenção & controle , Deficiência de Vitamina D/prevenção & controle , Vitamina D/administração & dosagem , Feminino , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Fenômenos Fisiológicos da Nutrição Materna , Leite Humano/efeitos dos fármacos , Período Pós-Parto/efeitos dos fármacos , Raquitismo/prevenção & controleAssuntos
Doenças Mamárias/tratamento farmacológico , Aleitamento Materno , Suplementos Nutricionais , Lecitinas/administração & dosagem , Dor/prevenção & controle , Adulto , Doenças Mamárias/complicações , Doenças Mamárias/diagnóstico , Feminino , Humanos , Recém-Nascido , Dor/etiologia , Resultado do TratamentoRESUMO
This literature review and case study answers the question: 'Do the late effects of childhood cranial radiation therapy include impacts on breastfeeding?' PubMed was searched for papers using the terms lactation and cranial radiotherapy or childhood cranial radiotherapy. The case study was written from one author's experience of helping a mother with a history of childhood cranial radiation therapy. The few available studies report a high rate of lactation failure in women who were treated with cranial radiation therapy for childhood cancer, but the exceptions indicate that lactation failure is not inevitable in this group of mothers. Breastfeeding may ameliorate some of the adverse effects of cranial radiation therapy. Health professionals caring for mothers with a history of cranial radiation therapy must balance encouraging women to breastfeed with preparing them for the possibility that they may be unable to do so.
Assuntos
Aleitamento Materno , Irradiação Craniana/efeitos adversos , Lactação/efeitos da radiação , Leite Humano/efeitos da radiação , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , Feminino , Humanos , Recém-Nascido , Cuidado Pós-Natal/métodos , Saúde da MulherAssuntos
Pancitopenia/etiologia , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/tratamento farmacológico , Vitamina B 12/uso terapêutico , Pré-Escolar , Feminino , Seguimentos , Humanos , Pancitopenia/tratamento farmacológico , Pancitopenia/fisiopatologia , Medição de Risco , Resultado do Tratamento , Deficiência de Vitamina B 12/diagnósticoRESUMO
New parents should be aware that infants' sleep is unlike that of adults and that meeting their infant's needs is likely to disrupt their own sleep. They will need to adjust their routine to manage their own sleep needs. Parental sleep patterns in the postpartum period are tied to the infant's development of a circadian sleep-wake rhythm, and the infant's feeds. Close contact with the mother and exposure to light/dark cues appear to assist in the development of the infant's circadian rhythm. The composition of breastmilk varies over the course of 24 hours and some components produced at night are likely to contribute to the infant's day/night entrainment. There is no clear evidence that using artificial feeds improves maternal sleep. Most infants need night feeds but requirements for nighttime feeds vary with the individual.
Assuntos
Ritmo Circadiano/fisiologia , Comportamento do Lactente/fisiologia , Recém-Nascido/fisiologia , Comportamento Materno/fisiologia , Período Pós-Parto/fisiologia , Sono/fisiologia , Adulto , Feminino , Humanos , Lactente , Mães , Cuidado Pós-Natal/métodosAssuntos
Aleitamento Materno/estatística & dados numéricos , Promoção da Saúde/organização & administração , Relações Mãe-Filho , Mães/estatística & dados numéricos , Obesidade/epidemiologia , Adulto , Austrália/epidemiologia , Índice de Massa Corporal , Peso Corporal/fisiologia , Aleitamento Materno/psicologia , Feminino , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Comportamento Materno , Mães/psicologia , Obesidade/psicologia , Desmame , Adulto JovemRESUMO
Endogenous corticosteroids are involved in breast development, initiation and maintenance of milk production. Animal studies have shown that exogenous corticosteroids diminish milk production and milk ejection. A high dose depot injection of triamcinolone resulted in dramatic reduction in milk production in an established lactation. Domperidone and frequent expression restored milk production. Lower dose depot injection of betamethasone into the shoulder joint did not noticeably reduce milk production.