The effect of a breastfeeding support programme on breastfeeding duration and exclusivity: a quasi-experiment.

BACKGROUND: Breastfeeding has important positive long-term health consequences for infants and mothers. The World Health Organization recommends that all infants should be exclusively breastfed for six months or longer, and advises continuation of breastfeeding for two years or beyond. However, these recommendations are not met in many countries. This study examined whether a comprehensive, evidence-based breastfeeding intervention, the Breastfeeding Support Programme (BSP), promotes prolonged duration and exclusivity of breastfeeding among its participants. METHODS: A quasi-experimental design was used to compare breastfeeding duration and exclusivity in the BSP group (N = 66) to breastfeeding duration and exclusivity in a control group (N = 72). Participants who followed the BSP were provided with 6 consults delivered by a lactation consultant. The consults started during pregnancy and continued up until 10 weeks after delivery. Participants in the control group did not follow the BSP. Pretest and posttest questionnaires were administered through the internet. A Cox proportional hazards regression analysis was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for cessation of any and exclusive breastfeeding, while controlling for differences at baseline. RESULTS: The effect of the BSP on survival rates for any and exclusive breastfeeding were significant while controlling for differences between the two groups at baseline (respectively HR = 0.34, p < .001 [95% CI = 0.18-0.61] and HR = 0.46, p < .001 [95% CI = 0.29-0.72]). Among mothers in the BSP group there was on average 66% less risk of cessation of any breastfeeding and on average 54% less risk of cessation of exclusive breastfeeding at any point in time compared to those in the control group. CONCLUSIONS: The BSP appears to be an effective means to delay cessation of any and exclusive breastfeeding cessation and therefore to increase breastfeeding duration and exclusivity. This is an important finding, because earlier cessation of breastfeeding than desired is a common problem in many countries. Future research into the effectiveness of the BSP could consider random assignment to conditions and test the effectiveness of the intervention in other populations to investigate further whether wide-scale implementation of this intervention could be useful to promote breastfeeding.

Positive effects of indoor environmental conditions on students and their performance in higher education classrooms: A between-groups experiment.

This study explores if multiple alterations of the classrooms' indoor environmental conditions, which lead to environmental conditions meeting quality class A of Dutch guidelines, result in a positive effect on students' perceptions and performance. A field study, with a between-group experimental design, was conducted during the academic course in 2020-2021. First, the reverberation time (RT) was lowered in the intervention condition to 0.4 s (control condition 0.6 s). Next, the horizontal illuminance (HI) level was raised in the intervention condition to 750 lx (control condition 500 lx). Finally, the indoor air quality (IAQ) in both conditions was improved by increasing the ventilation rate, resulting in a reduction of carbon dioxide concentrations, as a proxy for IAQ, from ~1100 to <800 ppm. During seven campaigns, students' perceptions of indoor environmental quality, health, emotional status, cognitive performance, and quality of learning were measured at the end of each lecture using questionnaires. Furthermore, students' objective cognitive responses were measured with psychometric tests of neurobehavioural functions. Students' short-term academic performance was evaluated with a content-related test. From 201 students, 527 responses were collected. The results showed that the reduction of the RT positively influenced students' perceived cognitive performance. A reduced RT in combination with raised HI improved students' perceptions of the lighting environment, internal responses, and quality of learning. However, this experimental condition negatively influenced students' ability to solve problems, while students' content-related test scores were not influenced. This shows that although quality class A conditions for RT and HI improved students' perceptions, it did not influence their short-term academic performance. Furthermore, the benefits of reduced RT in combination with raised HI were not observed in improved IAQ conditions. Whether the sequential order of the experimental conditions is relevant in inducing these effects and/or whether improving two parameters is already beneficial, is unknown.

From the laboratory to pharmaceutical care research--Part I.

In pharmaceutical care research (PCR) a mass of robust general rules has not yet been found. Consequently, the challenge of PCR is that mainly through induction researchers have to study objects which are learning and which are open to environmental influences and, by doing so, researchers have to contribute to both theory and practice. Therefore the characteristics reductionism, repeatability and refutability originated from natural sciences cannot be applied to PCR on a 1:1 basis. PCR should be imitable, defensible, consistent and relevant in order to enable other researchers to agree or disagree with the conclusions and to stimulate new research.

The work at the pharmacy: Sweden and The Netherlands compared.

At pharmacy Orden in Apeldoorn (the Netherlands) a change in the flow of filling a prescription was made, introducing the 'counter model': one person fills the prescription at the counter and is checked by another person. This change was mainly inspired by the actual working situation in Sweden. A comparison was made between pharmacy Orden and pharmacy Ekorren (Sweden) with respect to working systems, communication patterns, time spending and perceptions of the personnel. At pharmacy Orden fewer communication disturbances occurred and less advice was required to fill a prescription than at pharmacy Ekorren. The time to fill a prescription was almost two minutes shorter at pharmacy Orden. The personnel at both pharmacies was satisfied with the physical and psychological workload. The technicians at pharmacy Ekorren felt subordinate to their higher educated prescriptionist colleagues in filling a prescription.

APOM-project: a first study of pharmacy organization and management.

In 1994, a Ph.D.-study started regarding pharmacy, organization and management (APOM) in the Netherlands. The APOM-project deals with the structuring and steering of pharmacy organization. This article describes a summary of the theoretical background of the project and the empirical results of a pilot study (n = 24). No generalization to the population of pharmacies in the Netherlands was made. Three mixes of objectives in pharmacy organization were theoretically postulated; the product mix, the process mix, and the customer mix. Mainly, the purpose of the pilot study was method selection. Additionally, it was studied if thought and action of pharmacy managers corresponded, and, if theoretical pharmacy mixes corresponded with the empirical pharmacy mixes. Two methods were selected to be applied in a survey. Thought and action did not correspond for most pharmacy managers. Thought related to customer and product mainly, and action related to process and customer mainly.

APOM-project: a survey of pharmacy organization and management.

In 1994, a Ph.D-study started regarding pharmacy, organization and management (APOM) in the Netherlands. The APOM-project deals with the structuring and steering of pharmacy organization. This article describes the summary of the empirical results of a survey in a relatively large sample (n = 169). Generalization to the population of pharmacies in the Netherlands was made. Thought results comprised a total number of seven clusters of priorities of pharmacy mixes. Most pharmacy managers were observed with product and customer activities in the first position; pharmaceutical and customer activities were perceived as the most important. Action results comprised a total number of five clusters of activities of pharmacy mixes. Most pharmacy managers were observed with product and process activities in the first position; pharmaceutical and process activities were performed most frequently. The results showed that the traditional conception of the work in the community pharmacy is still vividly present.

APOM-project: managing change to the customer in community pharmacy practice.

In 1994, a Ph.D.-study started regarding pharmacy, organization and management (APOM) in the Netherlands. This article describes the final phase of the study in community pharmacy practice: managerial problems in change to the customer and the difference between supported pharmacy managers and independent ones. It appeared that pharmacy managers experienced problems with the formulation and use of aims, norms, and measurements. Although many organizations operating in the pharmaceutical sector are a good source for new ideas, they lack to have the proper support for these problems. The difference between supported and independent pharmacy managers was minimal in the change to the customer. Pharmacy managers are in need of micro-instrumentalization: aims, norms, and monitor instruments for customer activities applicable at their own pharmacy. Moreover, pharmacy managers will have to learn how to deal with the tension between money and care in order to improve the 'grip' on their organization.