Addition of açai oil during the close-up dry period of Holstein cows improves colostrum quality and immune responses of their calves.

This study evaluated of the effects of açai oil during the close-up dry period of Holstein cows on colostrum quality, as well as on the immune and antioxidant responses of their calves. Sixteen multiparous cows were assigned randomly to two treatments: 1) CONTROL (n = 8) - 4.48% of soybean oil/concentrate; 2) AÇAI (n =8) - 4.48% of açai oil/concentrate. Cows fed with açai oil had greater (P≤0.04) colostrum concentrations of immunoglobulins (Ig) G (1st and 2nd milking), IgG heavy chains, IgA (only at 1st milking), alpha-lactalbumin (1st milking), total protein, and antioxidant capacity against peroxyl radicals (only at 1st milking). Cows fed with açai oil had greater serum concentrations of globulin (only on the day of calving) and total protein (only on the day of calving) (P = 0.03). Calves born of cows fed with açai oil had greater serum concentrations of total protein (only 24 and 48 h after calving) and serum concentration of IgG heavy chain (only 24 h after calving) and globulin (only 24 and 48 h after calving) (P = 0.01). These data suggest that the addition of açai oil in the cow feed during the close-up dry period boosted immunity in their calves by altering the composition of colostrum.

A Qualitative Study of US Women's Perspectives on Confidence for Physiologic Birth in the Birth Center Model of Prenatal Care.

INTRODUCTION: The purpose of this study was to increase understanding of the components of the US birth center model of prenatal care and how the birth center prenatal care model contributes to birthing people's confidence for physiologic childbirth. METHODS: This was a qualitative descriptive study using semistructured interviews with individuals who gave birth in freestanding birth centers. Birthing people were recruited from freestanding birth centers in a Midwestern US state and were between the ages of 18 and 42, were English-speaking, and had experienced a birth center birth within the previous 6 months. Interviews were transcribed and analyzed using Glaser's constant comparative method. RESULTS: Twelve women who gave birth in birth centers, representing urban and rural settings, participated. Four core categories were identified encompassing the components of birth center prenatal care and how the birth center model contributes to women's confidence for physiologic birth: birth center culture and processes, midwifery model of care within the birth center, internal influences, and outside influences. DISCUSSION: Women who gave birth in birth centers believed that the birth center culture and environment, the midwifery model of care in the birth center, internal influences including the belief that birth is a normal physiologic process, and outside influences including family support and positive birth stories contributed to their confidence for physiologic birth.

The changing incidence of childhood-onset type 1 diabetes in Wales: Effect of gender and season at diagnosis and birth.

AIMS: Determinants of the changing incidence of childhood-onset type 1 diabetes remain uncertain. We determined the recent time-trend of type 1 diabetes incidence in Wales and explored the role of vitamin D by evaluating the influence of season both at diagnosis and at birth. METHODS: Data from all Welsh paediatric units 1990-2019, and from primary care to determine ascertainment. RESULTS: Log-linear modelling indicated a non-linear secular trend in incidence with peak and subsequent decline. The peak occurred around June 2010: 31∙3 cases/year/100,000 children aged < 15y. It occurred earlier in children younger at diagnosis and earlier in boys. There were more cases in males aged <2y and >12y but more in females aged 9-10 y. More were diagnosed in winter. Also, children born in winter had less risk of future diabetes. CONCLUSIONS: The risk of developing type 1 diabetes before age 15y in Wales is no longer increasing. The data on season are consistent with a preventative role for vitamin D both during pregnancy and later childhood. Metereological Office data shows increasing hours of sunlight since 1980 likely to increase vitamin D levels with less diabetes. Additional dietary supplementation with vitamin D might further reduce the incidence of type 1 diabetes.

Effects of late-gestation heat stress independent of reduced feed intake on colostrum, metabolism at calving, and milk yield in early lactation of dairy cows.

The objective of this study was to differentiate the effects of acute heat stress (HS) from those of decreased dry matter intake (DMI) during the prepartum period on metabolism, colostrum, and subsequent production of dairy cows. Holstein dairy cows (n = 30) with similar parity and body weight were randomly assigned to 1 of 3 treatments on 45 d before calving: (1) cooled (CL, n = 10) conditions with ad libitum feed intake, (2) HS conditions with ad libitum feed intake (n = 10), and (3) pair-fed cooled (CLPF, n = 10) with reduced DMI similar to the HS group while housed under cooled conditions. The reduction in the amount of feed offered to the CLPF cows was calculated daily as the percentage decrease from the average DMI of HS cows relative to the CL cows. For CLPF and CL cows, barns provided shade, sprinklers, and fans, whereas the HS cows were provided only with shade. Cows in all groups received individually the same total mixed ration. Cows were dried off 60 d before the expected calving. Cows in the HS group and, by design, the CLPF cows had reduced DMI (~20%) during the experiment. Heat stress decreased gestation length, first colostrum yield, and calf birth weight compared with CL and CLPF cows. Milk yield decreased 21% (5 kg) in the HS and 8% (2 kg) in CLPF cows, indicating that reduced feed intake during late gestation accounted for 60% of the total reduced milk yield. The CLPF cows exhibited an elevated NEFA concentration compared with the CL and HS cows. The HS cows had a greater mRNA abundance of HSP70 in the peripheral blood leukocytes at 21 d prepartum compared with the other groups. At calving, the mRNA abundance of HSP70 was greater in HS cows, followed by CLPF, compared with the CL cows. In conclusion, HS during the late gestation period caused metabolism and production differences, which were only partially attributed to reduced feed intake in dairy cows.

Birth as a neuro-psycho-social event: An integrative model of maternal experiences and their relation to neurohormonal events during childbirth.

BACKGROUND: Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose a model demonstrating how neurohormonal processes, in particular oxytocinergic mechanisms, not only control the physiological aspects of labor and birth, but also contribute to the subjective psychological experiences of birth. In addition, sensory information from the uterus as well as the external environment might influence these neurohormonal processes thereby influencing the progress of labor and the experience of birth. METHODOLOGY: In this new model of childbirth, we integrated the findings from two previous systematic reviews, one on maternal plasma levels of oxytocin during physiological childbirth and one meta-synthesis of women´s subjective experiences of physiological childbirth. FINDINGS: The neurobiological processes induced by the release of endogenous oxytocin during birth influence maternal behaviour and feelings in connection with birth in order to facilitate birth. The psychological experiences during birth may promote an optimal transition to motherhood. The spontaneous altered state of consciousness, that some women experience, may well be a hallmark of physiological childbirth in humans. The data also highlights the crucial role of one-to-one support during labor and birth. The physiological importance of social support to reduce labor stress and pain necessitates a reconsideration of many aspects of modern maternity care. CONCLUSION: By listening to women's experiences and by observing women during childbirth, factors that contribute to an optimized process of labor, such as the mothers' wellbeing and feelings of safety, may be identified. These observations support the integrative role of endogenous oxytocin in coordinating the neuroendocrine, psychological and physiological aspects of labor and birth, including oxytocin mediated. decrease of pain, fear and stress, support the need for midwifery one-to-one support in labour as well as the need for maternity care that optimizes the function of these neuroendocrine processes even when birth interventions are used. Women and their partners would benefit from understanding the crucial role that endogenous oxytocin plays in the psychological and neuroendocrinological process of labor.

Effects of antenatal hypnosis on maternal salivary cortisol during childbirth and six weeks postpartum-A randomized controlled trial.

BACKGROUND: Cortisol has been used to capture psychophysiological stress during childbirth and postpartum wellbeing. We explored the effect of a brief antenatal training course in self-hypnosis on salivary cortisol during childbirth and 6 weeks postpartum. METHODS: In a randomized, controlled trial conducted at Aarhus University Hospital Skejby Denmark during the period January 2010 until October 2010, a total of 349 healthy nulliparous women were included. They were randomly allocated to a hypnosis group (n = 136) receiving three one-hour lessons in self-hypnosis with additional audio-recordings, a relaxation group (n = 134) receiving three one-hour lessons in various relaxation methods with audio-recordings for additional training, and a usual care group (n = 79) receiving ordinary antenatal care only. Salivary cortisol samples were collected during childbirth (at the beginning of the pushing state, 30 minutes, and 2 hours after childbirth), and 6 weeks postpartum (at wake up, 30 minutes after wake up, and evening). Cortisol concentrations were compared using a linear mixed-effects model. Correlations between cortisol concentrations and length of birth, experienced pain and calmness during birth were examined by a Spearman rank correlation test. FINDINGS: During childbirth, week correlations were found between cortisol concentrations 30 minutes after childbirth and length of birth. In the beginning of the pushing state and 2 hours after childbirth, we found a tendency towards higher cortisol concentrations in the hypnosis group compared to the other two groups (hypnosis versus relaxation p = 0.02 and 0.03, hypnosis versus usual care p = 0.08 and 0.05). No differences were observed in cortisol concentrations between the groups 30 minutes after childbirth (hypnosis versus relaxation p = 0.08, hypnosis versus usual care 0.10) or 6 weeks postpartum (hypnosis versus relaxation: p = 0.85, 0.51, and 0.68, hypnosis versus usual care: p = 0.85, 0.93, and 0.96). CONCLUSION: Antenatal hypnosis training may increase the release of cortisol during childbirth with no long-term consequences. Further research is needed to help interpret these findings.

Impact of macronutrient supplements on later growth of children born preterm or small for gestational age: A systematic review and meta-analysis of randomised and quasirandomised controlled trials.

BACKGROUND: Nutritional supplements may improve short-term growth of infants born small (preterm or small for gestational age), but there are few data on long-term effects and concerns that body composition may be adversely affected. Effects also may differ between girls and boys. Our systematic review and meta-analysis assessed the effects of macronutrient supplements for infants born small on later growth. METHODS AND FINDINGS: We searched OvidMedline, Embase, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews from inception to January 30, 2020, and controlled-trials.com, clinicaltrials.gov, and anzctr.org.au on January 30, 2020. Randomised or quasirandomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born small and growth was assessed after discharge. Primary outcome was body mass index (BMI) in childhood. Data were pooled using random-effect models. Outcomes were evaluated in toddlers (< 3 years), childhood (3 to 8 years), adolescence (9 to 18 years), and adulthood (>18 years). Forty randomised and 2 quasirandomised trials of variable methodological quality with 4,352 infants were included. Supplementation did not alter BMI in childhood (7 trials, 1,136 children; mean difference [MD] -0.10 kg/m2, [95% confidence interval (CI) -0.37 to 0.16], p = 0.45). In toddlers, supplementation increased weight (31 trials, 2,924 toddlers; MD 0.16 kg, [0.01 to 0.30], p = 0.03) and length/height (30 trials, 2,889 toddlers; MD 0.44 cm, [0.10 to 0.77], p = 0.01), but not head circumference (29 trials, 2,797 toddlers; MD 0.15 cm, [-0.03 to 0.33], p = 0.10). In childhood, there were no significant differences between groups in height (7 trials, 1,136 children; MD 0.22 cm, [-0.48 to 0.92], p = 0.54) or lean mass (3 trials, 354 children; MD -0.07 kg, [-0.98 to 0.85], p = 0.88), although supplemented children appeared to have higher fat mass (2 trials, 201 children; MD 0.79 kg, [0.19 to 1.38], p = 0.01). In adolescence, there were no significant differences between groups in BMI (2 trials, 216 adolescents; MD -0.48 kg/m2, [-2.05 to 1.08], p = 0.60), height (2 trials, 216 adolescents; MD -0.55 cm, [-2.95 to 1.86], p = 0.65), or fat mass (2 trials, 216 adolescents; MD -1.3 5 kg, [-5.76 to 3.06], p = 0.55). In adulthood, there also were no significant differences between groups in weight z-score (2 trials, 199 adults; MD -0.11, [-0.72 to 0.50], p = 0.73) and height z-score (2 trials, 199 adults; MD -0.07, [-0.36 to 0.22], p = 0.62). In subgroup analysis, supplementation was associated with increased length/height in toddler boys (2 trials, 173 boys; MD 1.66 cm, [0.75 to 2.58], p = 0.0003), but not girls (2 trials, 159 girls; MD 0.15 cm, [-0.71 to 1.01], p = 0.74). Limitations include considerable unexplained heterogeneity, low to very low quality of evidence, and possible bias due to low or unbalanced followup. CONCLUSIONS: In this systematic review and meta-analysis, we found no evidence that early macronutrient supplementation for infants born small altered BMI in childhood. Although supplements appeared to increase weight and length in toddlers, effects were inconsistent and unlikely to be clinically significant. Limited data suggested that supplementation increased fat mass in childhood, but these effects did not persist in later life. PROSPERO registration: CRD42019126918.

Physiotherapists' and midwives' views of increased inter recti abdominis distance and its management in women after childbirth.

BACKGROUND: Physiotherapists and midwives in primary healthcare often encounter women with an increased separation between the two rectus abdominis muscle bellies after pregnancy, a so-called increased inter recti distance (IRD). There are few studies on the contribution of increased IRD to the explanation of post-partum health complaints, and very little guidance in the literature for health professionals on the management of increased IRD. The aim of this study was to describe how physiotherapists and midwives in primary healthcare perceive the phenomenon of increased IRD and its management in women after childbirth. METHODS: A purposeful sampling approach was used to select physiotherapists and midwives working in primary healthcare in three large county council healthcare organisations in Sweden having experience of encountering women with increased IRD after pregnancy. Sixteen physiotherapists and midwives participated in focus group discussions. Four focus groups with four participants in each were undertaken. A semi-structured topic guide was used to explore responses to the research questions and the discussions were analysed using qualitative content analysis. RESULTS: We identified an overarching theme: Ambivalence towards the phenomenon increased IRD and frustration over insufficient professional knowledge. The theme included three categories: Uncertainty concerning the significance of increased IRD as a causal factor for functional problems; perceived insufficient professional knowledge base for the management of increased IRD; and lack of inter-professional collaboration and teamwork in the management of patients with increased IRD. Due to sparse and somewhat contradictory research findings and absence of clinical guidelines, the health professionals lacked basic preconditions for applying an evidence-based practice concerning increased IRD. They obtained their information about increased IRD from the media and fitness coaches, and hence were somewhat unsure about what to believe regarding the phenomenon. CONCLUSIONS: There was no consensus among the health professionals on how to best approach increased IRD in the clinical setting. Our findings stress the importance of more research to increase the professional knowledge base among physiotherapists and midwives. The findings highlight the urgent need for policies and clinical guidelines advising health professionals in the management of increased IRD and for facilitating inter-professional collaboration and teamwork.

Why do women assume a supine position when giving birth? The perceptions and experiences of postnatal mothers and nurse-midwives in Tanzania.

BACKGROUND: Before the advent of Western medicine in Tanzania, women gave birth in an upright position either by sitting, squatting or kneeling. Birthing women would hold ropes or trees as a way of gaining strength and stability in order to push the baby with sufficient force. Despite the evidence supporting the upright position as beneficial to the woman and her unborn child, healthcare facilities consistently promote the use of the supine position. The purpose of this study was to explore the perceptions and experiences of mothers and nurse-midwives regarding the use of the supine position during labour and delivery. METHODS: We used a descriptive qualitative design. We conducted seven semi-structured interviews with nurse-midwives and two focus group discussions with postnatal mothers who were purposively recruited for the study. Qualitative content analysis guided the analysis. RESULTS: Four themes emerged from mothers' and midwives' description of their experiences and perceptions of using supine position during childbirth. These were: women adopted the supine position as instructed by midwives; women experience of using alternative birthing positions; midwives commonly decide birthing positions for labouring women and supine position is the best-known birthing position. CONCLUSION: Women use the supine position during childbirth because they are instructed to do so by the nurse-midwives. Nurse-midwives believe that the supine position is the universally known and practised birthing position, and prefer it because it provides flexibility for them to continuously monitor the progress of labour and assist delivery most efficiently. Mothers in this study had no other choice than to labour and deliver their babies in the supine position as instructed because they trusted midwives as skilled professionals who knew what was best given the condition of the mother and her baby.

[Midwives' feelings about the post-partum care of women with severe mental illness: A qualitative analysis]. / Ressenti des sages-femmes dans la prise en charge en suites de couche des patientes avec troubles psychiques sévères : une analyse qualitative.

BACKGROUND: A significant proportion of women with Severe Mental Illness (SMI) will become mothers during their reproductive life. These pregnancies are, however, more at risk of psychiatric, obstetrical and neonatal complications (increased risks of post-partum depression, relapse, suicide, gestational diabetes, placental abnormalities or low birth weight). Midwives often feel isolated and resourceless when taking care of these women. Specialized units such as mother-infant psychiatric units or the Transversal Unit of Perinatal Care (UTAP) in the Grenoble Alpes University Hospital (CHUGA) enhance the coordination between psychiatric and obstetrical teams and have shown effectiveness in improving maternal and child outcomes. OBJECTIVES: i) to assess midwives' feelings about the postpartum care of women with SMI; ii) to determine UTAP's impact on this feeling and its determinants; iii) to look for unmet needs. METHODS: This study is a prospective, exploratory, qualitative analysis. Twenty midwives from Grenoble Alpes University Hospital who took care of one of the selected patients participated in this study. Two women had schizophrenia and one bipolar disorder. Interviews realized with a semi-structured guide were fully transcribed, anonymized and thematically analyzed. Topics have been structured according to the number of occurrences to build a thematic tree. RESULTS: Midwives felt insecure and resourceless when the postpartum care was unclear, insufficiently anticipated and in case of a danger for the women or the children. They felt uneasy when not feeling able to provide usual care to these patients (due to lack of specific knowledge about SMI and to the impossibility to consider their patient otherwise than through their pathology). Midwives felt at ease and secure when the postpartum care was anticipated. UTAP was identified as a resource for midwives. Specific training and improvements in the organization of the pre and post-natal care could improve midwives' feelings when taking care of women with SMI.

Pattern of milk yield and immunoglobulin concentration and factors associated with colostrum quality at the quarter level in dairy cows after parturition.

First colostrum yield and constituents as well as milk yield during established lactation vary considerably among mammary quarters in dairy cows. However, data on the development of milk yield, IgG concentration, and their distribution per quarter within cows during the first milkings after calving are scarce. We analyzed milk production and IgG concentration at the individual quarter level in 29 multiparous Holstein cows during the first 5 milkings after calving. Cow- and calf-related factors (time interval between calving and first milking, parity number, previous lactation yield, gestation length, dry period length, sex, and birth weight of the calf) potentially affecting first colostrum quality and quantity were assessed. Milking of first colostrum was carried out between 30 and 180 min after parturition. Further milkings were performed twice daily. Quarter milk yield varied between 0.1 and 5.5 kg at the first milking and between 1.4 and 5.1 kg at the fifth milking relative to parturition. Quarter IgG concentration ranged between 18.8 and 106.0 mg/mL at the first milking and between 0.8 and 46.1 mg/mL at the fifth milking. Distribution of milk yield and IgG concentration among quarters was not entirely repeatable during the first 5 successive milkings after parturition; that is, the ranking of quarters changed (intraclass correlation coefficients for quarter milk yield and IgG concentration: 0.64 and 0.79, respectively). The average hourly milk production increased in all quarters, ranging from 0.02 to 0.26 kg/h between the first 2 milkings up to 0.11 to 0.45 kg/h between the fourth and fifth milkings. First colostrum yield was not affected by any of the evaluated cow- and calf-related factors. Quarter colostrum IgG concentration was higher in cows with a higher previous lactation yield, whereas a lower colostrum IgG content was observed in cows with a longer gestation period and consequently heavier calves. In conclusion, milk yield and IgG concentration of individual quarters varied considerably, and their distribution among quarters within cows was moderately repeatable in consecutive milkings and changed partially over time. The decline of IgG concentration was independent of the concomitant increase in milk secretion, with changes occurring at different rates in individual quarters. Our results confirm the independence of the single mammary quarters at the onset of lactation despite an identical exposure to endocrine stimuli.

Practices During Preparturition and Normal Delivery Care in a Maternity Hospital in Southern Brazil

Abstract This study aimed to evaluate the practices of hospital care during pré parturition and normal delivery in a maternity hospital in Southern Brazil. A cross-sectional and quantitative study performed with 82 postpartum women. Results were evaluated for the total number of postpartum women and in two groups according to hospital delivery time (≤ 8 and > 8 hours). Chi-square and Fisher Exact tests were used. with a significance level of 5%. Percentages of useful practices were: oral diet (23.2%), freedom of position and movement (90.2%), non-pharmacological methods to alleviate pain (64.6%), companion in prepartum (62.1%) and parturition (42.5%) and partogram (62.2%). Harmful practices: enema (3.7%), trichotomy (3.7%), lithotomy position (92.7%) and Kristeller maneuver (20.7%). Practices used inappropriately: amniotomy (4.9%), oxytocin (41.5%), analgesia (1.2%) and episiotomy (36.6%). The hospital labor time above 8 hours was associated with offering oral diet (p < 0.001), use of non-pharmacological methods for pain relief (p < 0.01), oxytocin infusion (p = 0.01) and episiotomy (p < 0.01). The delivery care with minimum intervention compatible with the recommendations is still a challenge.

A comprehensive review on scientific evidence-based effects (including adverse effects) of yoga for normal and high-risk pregnancy-related health problems.

Women undergo distinct physiological changes and stress during pregnancy that are accompanied by various physical and psychological demands. Yoga is a complementary therapy that is commonly used by pregnant women and recommended by healthcare professionals. Thus, it is very important to know its evidence based effects, including adverse effects from all types of research. A comprehensive literature search in PubMed/Medline electronic database from inception to 23 September 2017 was performed using the keywords "yoga for pregnancy". In total, 137 articles published since 1979 were available. Of the 137 articles, 53 articles were included for the review. This comprehensive review suggests that yoga could be considered as an evidence-based complementary therapy in improving both physical and psychological wellbeing in pregnant women during pregnancy (normal and high-risk), childbirth, and post-partum. However, types, duration, and frequency of yoga practices varied among the studies and the exact mechanisms behind the effects of yoga are less understood and need to be explored.

Effects of acupressure on the childbirth satisfaction and experience of birth: A randomized controlled trial.

BACKGROUND: Complementary and alternative medicines have been used to increase comfort and relaxation in mothers during labor. Comforting and preparing the mother in labor can create a positive birth experience. The aim of this study was to evaluate the effect of acupressure on childbirth satisfaction and the experience of giving birth in women with full-term pregnancy, before the onset of labor. METHODS: In 2016, a randomized clinical trial study was conducted in Shahid Akbar Abadi Hospital, Tehran, Iran, enrolling 120 pregnant women at 39-40 gestational weeks with no signs of the onset of labor. They were divided randomly into acupressure, sham acupressure, and control groups. Acupressure points including SP6, BL 60, and BL 32 were pressured bilaterally. Interventions were performed by the researcher, the mother and her relative (husband). Childbirth satisfaction was measured 24 h after delivery. The collected data were analyzed by SPSS software and comparing tests were Chi-squared, Kruskal-Wallis, ANOVA tests (P ≤ 0.05). RESULTS: The total childbirth satisfaction did not differ significantly among the three groups (P = 0.460), but the acupressure group had a higher level of satisfaction than the other two groups. Moreover, statistical tests regarding the expectations of the childbirth experience showed a significant difference among the groups (P = 0.033). The actual birth was closest to the expectations of subjects in the acupressure group. CONCLUSION: This study demonstrated that acupressure may be used as a method in order to attempt to provide a good birth experience and satisfaction of childbirth.

The challenge of large litters on the immune system of the sow and the piglets.

The use of hyperprolific sow lines has increased litter size considerably in the last three decades. Nowadays, in some countries litters can reach up to 18-20 piglets being a major challenge for the sow's physiology during pregnancy, parturition and lactation. The increased number of piglets born per litter prolongs sensibly the duration of farrowing, decreases the piglets' average weight at birth and their vitality, increases the competition for colostrum intake and can affect negatively piglets' survival. This review aims to describe how large litters can affect the immune system of the sow and the piglets and proposes measures to improve this condition.

Effects of supplementing a Saccharomyces cerevisiae fermentation product during the periparturient period on the immune response of dairy cows fed fresh diets differing in starch content.

The objective of this study was to evaluate the effects of supplementing a Saccharomyces cerevisiae fermentation product (SCFP; NutriTek, Diamond V, Cedar Rapids, IA) during the periparturient period (d -28 ± 3 to 44 ± 3 relative to calving) on mRNA abundance of genes in the rumen epithelium, inflammation indicators, oxidative status, and adaptive immunity of dairy cows fed diets with different starch content after calving. From d 28 ± 3 (± standard deviation) before the expected calving date to calving, Holstein cows (n = 38) received a common basal controlled-energy close-up diet (1.43 Mcal/kg, net energy for lactation; 13.8% starch) with (SCFP; n = 19) or without (CON; n = 19) SCFP, and cows within each treatment (CON or SCFP) were fed either a low- (LS; 22.1% starch) or high-starch (HS; 28.3% starch) diet from d 1 to 23 ± 3 after calving (fresh period). There were 4 treatment groups: LS + CON (n = 9), LS + SCFP (n = 10), HS + CON (n = 10), and HS + SCFP (n = 9). From d 24 ± 3 to 44 ± 3 after calving, all cows were fed the HS diets (post-fresh period). Animal assignment to treatments was balanced for parity, body condition score, and expected calving date. An interaction was observed between dietary starch content and SCFP on indices of oxidative stress; plasma concentrations of total antioxidant capacity tended to be reduced on d 21 after calving for SCFP compared with CON cows when a LS fresh diet was fed, but did not differ for cows fed HS fresh diets. Regardless of starch content, SCFP supplementation increased plasma concentrations of malondialdehyde at d 21 after calving compared with CON. Supplementing with SCFP reduced serum concentrations of haptoglobin on d 7 after calving, indicating reduced inflammation, and feeding LS fresh diets reduced mRNA abundance of IL receptor associated kinase-1 in rumen tissue at d 21 after calving, suggesting reduced immune activation in rumen tissue. Other than the anti-inflammatory effects indicated by lower serum haptoglobin concentration, no other effects of treatment on adaptive immunity were detectable. These results indicate that supplementing SCFP through the transition period and feeding low-starch diets during the fresh period may reduce inflammation.

Investigating pathways linking women's status and empowerment to skilled attendance at birth in Tanzania: A structural equation modeling approach.

Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa where use of a skilled birth attendant (SBA) at delivery has remained low. Despite the recognized importance of women's empowerment as a key determinant of maternal and newborn health, evidence from sub-Saharan Africa is more limited. Using data from the 2010 Tanzania Demographic and Health Survey (n = 4,340), this study employs a robust method-structural equation modeling (SEM)-to investigate the complex and multidimensional pathways through which women's empowerment affects SBA use. The results show that women's education and household decision-making are positively associated with SBA use. However, not all empowerment dimensions have similar effects. Attitudes towards sex negotiation and violence as well as early marriage are not significant factors in Tanzania. Mediation analysis also confirms the indirect effect of education on SBA use only through household decision-making. The findings underscore the utility of structural equation modeling when examining complex and multidimensional constructs, such as empowerment, and demonstrate potential causal inference to better inform policy and programmatic recommendations.

Variations in fatty acid composition of Laoshan goat milk from partum to 135 days postpartum.

The objective of this study was to characterize the variations in fatty acid (FA) profile during 7 days of colostrum production and 5 months of mature milk production in Laoshan goats. The individual FA profiles of each sample were investigated by gas chromatography-mass spectrometry. Significant differences in FAs were found between colostrum and mature milk. The contents of saturated fatty acids (SFA), unsaturated fatty acids (UFA), monounsaturated fatty acids (MUFA), and polyunsaturated fatty acids (PUFA), and sum of C6, C8, and C10 (SC6+C8+C10 ) were all significantly affected by lactation period. Furthermore, there was no significant difference in the ratio of UFA/SFA or C18:2 (cis9, cis12-octadecadienoic acid)/C18:3 (all cis-9,12,15-octadecatrienoic acid) during the lactation period. The highest concentrations of SC6+C8+C10 , UFA, MUFA, and PUFA appeared in colostrum, but the highest SFA content was in mature milk. The highest proportions of SC6+C8+C10 and SFA were 11.32% and 79.55% on 5th day and 135th day respectively. By contrast, the lowest proportion of UFA was 20.45% on the 135th day. C14:0 (10.93%-12.87%), C16:0 (27.54%-36.65%), C18:0 (10.47%-14.59%), and C18:1 (18.80%-30.61%) were the most predominant FAs in goat milk with significant differences during the 135 days lactation period except C18:0. In conclusion, the results of this study suggest that the lactation time has a pronounced effect on the FA compositions of goat milk.

Do estimates of blood loss differ between student midwives and midwives? A multicenter cross-sectional study.

OBJECTIVE: the principal objective of this study was to assess the quality of blood loss estimates by midwives and student midwives. The secondary objectives were: to assess the intraobserver agreement of visual blood estimates and the rate of underestimation of blood loss by participants, and to estimate the sensitivity, specificity, and negative likelihood ratio of these estimates for clinically pertinent blood losses (≥ 500mL and ≥ 1000mL). DESIGN: multicenter cross-sectional study. SETTING: thirty-three French maternity units and 35 French midwifery schools participated in this study. PARTICIPANTS: volunteer French midwifery students (n = 463) and practicing midwives (n = 578). INTERVENTION: an online survey showed 16 randomly ordered photographs of 8 different simulated blood quantities (100, 150, 200, 300, 500, 850, 1000, and 1500mL) with a reference 50-mL image in each photo and asked participants to estimate the blood loss. The visual blood loss estimates were compared with Fisher's exact test. Intraobserver agreement for these estimates was assessed with a weighted kappa coefficient, and the negative predictive values (probability of no hemorrhage when visual estimate was negative) were calculated from prevalence rates in the literature. FINDINGS: of the 16,656 estimates obtained, 34.1% were accurate, 37.2% underestimated the quantity presented, and 28.7% overestimated it. Analyses of the intraobserver reproducibility between the two estimates of the same photograph showed that agreement was highest (weighted kappa ≥ 0.8) for the highest values (1000mL, 1500mL). For each volume considered, students underestimated blood loss more frequently than midwives. In both groups, the negative predictive values regarding postpartum hemorrhage (PPH) diagnosis (severe or not) were greater than 98%. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: student midwives tended to underestimate the quantity of blood loss more frequently than the midwives. Postpartum hemorrhage (≥ 500mL) was always identified, but severe postpartum hemorrhage (≥ 1000mL) was identified in fewer than half the cases. These results should be taken into account in training both student midwives and practicing professionals.