Effectiveness of biological nurturing on early breastfeeding problems: a randomized controlled trial.

BACKGROUND: Biological nurturing is a neurobehavioral approach to breastfeeding support that encourages women to breastfed in a relaxed, laidback position. This approach has the potential to reduce breast problems (e.g., sore nipples), making good latch easier and thus facilitating the initiation of exclusive breastfeeding. However, its effects have not been adequately investigated in a real-life situation. The aim of this randomized controlled trial was to assess the effectiveness of biological nurturing, compared to usual hospital practices, on the frequency of breast problems and on the prevalence of exclusive breastfeeding at discharge from the maternity ward, after 1 week, and at one and 4 months. METHODS: Open randomized parallel controlled trial carried out in a third level maternity ward (IRCCS Burlo Garofolo, Trieste, Italy) between March and December 2018. Two-hundred eight women who planned to give birth at the hospital and who expressed the intention to breastfeed were enrolled during pregnancy and randomized to receive breastfeeding support following either the biological nurturing approach or the usual care protocol based on the WHO/UNICEF 20-h course, in use at the hospital. The primary study outcome was the incidence of breast problems during hospital stay, defined as the presence of one or more of the following outcomes, collected separately: sore nipples, cracked nipples, engorgement and mastitis. The primary analysis was performed by intention to treat. The follow up lasted 4 months. RESULTS: One hundred eighty eight out of 208 women (90.3%) were included in the analysis, 90 allocated to the biological nurturing group and 98 to the usual care group. At discharge from the maternity ward, biological nurturing significantly reduced the risk of breast problems (Relative risk [RR] 0.56, 95% Confidence Interval [CI] 0.40, 0.79), including cracked (RR 0.42, 95% CI 0.24, 0.74) and sore nipples (RR 0.59, 95% CI 0.40, 0.88). No statistically significant difference was observed for exclusive breastfeeding at discharge and up to 4 months. No adverse events occurred. CONCLUSIONS: The biological nurturing approach applied in the real-life situation of a third level hospital was effective in preventing breast problems. TRIAL REGISTRATION: Clinicaltrials.gov NCT03503500. Date of First Submission: 28 March 2018.

[The effort of being male: a survey on gender and burnout]. / La fatica di essere maschio: un'indagine su genere e burnout.

INTRODUCTION: Stress at work affects more than 40 million people in the European Union - around 22% of workers - and is the second most reported work-related health problem. Gender does not seem to be a constant predictive factor for burnout: some studies showed that women suffer more from burnout than males, other studies proved that males report higher burnout scores while others did not detect any difference at all. These results may be due to gender-related stereotypes, or could even reiflect the preponderance of a specific gender in some jobs. OBJECTIVES: To determine whether gender might be among the relevant variables in job burnout studies. METHOD: In 2008-2009 a study on burnout was carried out in a Healthcare Trust in northern Italy. The Job Content Questionnaire (JCQ) and the Maslach Burnout Inventory (MBI) were distributed to physicians, administrative staff and auxiliary personnel of hospital departments and local services. RESULTS: A total of l, 604 JCQ's and 1,604 MBI's were analysed, corresponding to 37% of the distributed tests. Results of logistic regression showed that gender, shift work and a low score in relationships with superiors were significantly associated with burnout. Considering the tasks of physicians and nurses, the burnout frequency was 3.78% for physicians and 1.97% for nurses, with higher percentages in males than in females. Women with children reported an average burnout frequency that was lower than the average of the whole population studied while men with children had a double burnout frequency compared to the average. CONCLUSIONS: Male gender is significantly associated with a burnout condition. Moreover, our findings have shown that physicians experience an excess burnout compared to nurses although this excess did not achieve statistical significance when taking into account distribution according to gender in the two professions.

Development and validation of predictive MoSaiCo (Modello Statistico Combinato) on emergency admissions: can it also identify patients at high risk of frailty?

The prospective historical cohort study develops and validates a method of identifying patients at high risk of emergency admission to hospital in the population of the Province of Ravenna (no. = 296 641). The main outcome measure is: emergency hospital admission analyzed using multivariate logistic regression (MoSaiCo - Modello Statistico Combinato). To validate the findings, the coefficients for 30 most powerful variables found on half of the population (derivation data set) were then applied to the rest of the population (validation data set). The key predicting factors included some demographic variables, social variables, clinical variables and use of health/social services. Discriminatory power and validation both reached good results. Risk score increases when variables indicating the individual vulnerability raise. The predictive frailty risk resulting from MoSaiCo allows to stratify the population, to organize care services, to provide a practical planning tool in the field of case management and management of frail patients.

[Occupational accidents among immigrant women in the Italian North-Eastern regions (Veneto and Friuli Venezia Giulia)]. / Gli infortuni sul lavoro tra le donne immigrate nelle regioni del Nord-Est (Veneto e Friuli Venezia Giulia).

OBJECTIVES: to describe occupational accidents among foreign women working in two regions of North-Eastern Italy, in the perspective of a desirable prevention policy. SETTING AND DESIGN: frequency distribution of occupational accidents among foreign women covered by the National Institute for Insurance against Work Accidents (INAIL) in 2000. PARTICIPANTS: foreign female workers employed in two regions of North-Eastern Italy. MAIN OUTCOME MEASURES: frequency distribution of work accidents. RESULTS: 1003 occupational accidents to foreign female workers occurred in Veneto and 383 in Friuli Venezia Giulia. The most frequent places of origin of injured workers in Friuli Venezia Giulia (borderline region with Slovenia) were former Yugoslavia (113) and Albania (28). In Veneto, corresponding countries of origin were Africa (156), Romania (84) and Albania (80).