Evaluation of environmental features that support breastfeeding: A photovoice study.

The United Kingdom (UK) has some of the lowest breastfeeding rates in the world, and Stoke-on-Trent has some of the lowest breastfeeding rates and highest infant mortality rates in the UK. Vicarious experience of formula feeding, formula feeding culture, and a lack of physical environments to support breastfeeding are known barriers to uptake and maintenance. Improving physical environments and increasing the visibility of breastfeeding in public would help to challenge these barriers. This research employs a participatory approach to understand the facilitators and barriers to breastfeeding in public. Nine breastfeeding peer supporters were recruited as co-researcher for a photovoice study. Co-researchers collated images of features in environments which they felt either supported or acted as a barrier to public breastfeeding. An analysis workshop was held to review the data collected and produce collaboratively agreed findings. Various environmental features were highlighted as facilitators to breastfeeding including family rooms, welcoming signage, supportive staff members, and displays of information about breastfeeding. In addition, poorly designed family rooms, lack of inclusivity within breastfeeding spaces, breastfeeding spaces within toilets and a lack of information were barriers to public breastfeeding. This research illustrates that while some environments are well designed to support breastfeeding many others are not. Environments often lack basic provision and/or make token gestures towards breastfeeding support, such as welcome signage, without providing the infrastructure needed to support breastfeeding. More education about breastfeeding friendly spaces and resources for putting this information into practice are needed for environment owners, managers, and policy makers.

Leishmania donovani donavani antigens recognized by Kala-azar patient sera and identification of cross-reacting antigens to Chagas' disease

L. donovani antigens were analyzed by a direct agglutination test (DAT), by ELISA using intact promastigotes and by the SDS-PAGE immunoperoxidase technique (SGIP). Sera of Chagas' disease patients cron-reacted in the ELISA and SGIP but not in the DAT. Trypsin treatment of the parasites removed concanavalin A-binding sites but not epitopes for antibodies present in Chagas' disease and in leishmaniasis sera, as seen in the SGIP. Eight bands were revealed after incubation of the gel sections with Kala-azar or Chagas' disease sera, three of which were common to both sera. The major antigenic component recognized by leishmaniasis sera was a glycoprotein of 57 KD, and the major cross-reacting protein recognized by Chagas' disease sera was a glycoprotein doublet of 71.5-68KD