An interpretive phenomenological analysis of the experiences of mothers who continue to breastfeed despite facing difficulties.

BACKGROUND: Breastfeeding offers many health benefits to mother and infant. PROBLEM: Breastfeeding difficulties are common and are linked with postnatal distress. AIM: To explore the lived experiences of breastfeeding continuation despite facing difficulties. METHODS: Qualitative semi-structured interviews were conducted with eight women who had experienced breastfeeding difficulties yet continued breastfeeding. Interviews were analysed using Interpretative Phenomenological Analysis (IPA). FINDINGS: The first superordinate theme, 'Radical acceptance of the imperfect' included sub-themes of: 'Taking it day-by-day', 'Breastfeeding takes a community', and, 'Finding what works for you'. The second superordinate theme, 'Determination and persistence' included sub-themes of: 'Adopting a headstrong attitude' and 'Transient challenges versus lifelong achievement'. DISCUSSION: Participants found radical acceptance of breastfeeding as an imperfect, variable process which enabled them to sustain breastfeeding despite challenges. Participants proactively drew on social and personal resources to navigate guidance and to find solutions which worked for their individual circumstances. Finally, open-mindedness, optimism, self-compassion, and being headstrong and determined were all personal qualities which facilitated breastfeeding during exceptionally difficult moments on their breastfeeding journey. CONCLUSION: Recommendations are made for healthcare professionals: to provide emotional counselling during routine care (with an aim to instil breastfeeding self-efficacy) and to encourage breastfeeding advocacy among fathers and the maternal social support network (with an aim to further scaffold successful breastfeeding). Recommendations are also made for mothers: to develop and refine maternal confidence, patience, flexibility, self-compassion, and trust.

mHealth App for Risk Assessment of Pigmented and Nonpigmented Skin Lesions-A Study on Sensitivity and Specificity in Detecting Malignancy.

BACKGROUND: With the advent of smartphone devices, an increasing number of mHealth applications that target melanoma identification have been developed, but none addresses the general context of melanoma and nonmelanoma skin cancer identification. INTRODUCTION: In this study a smartphone application using fractal and classical image analysis for the risk assessment of skin lesions is systematically evaluated to determine its sensitivity and specificity in the diagnosis of melanoma and nonmelanoma skin cancer along with actinic keratosis and Bowen's disease. MATERIALS AND METHODS: In the Department of Dermatology, Catharina Hospital Eindhoven, The Netherlands, 341 melanocytic and nonmelanocytic lesions were imaged using SkinVision app; 239 underwent histopathological examination, while the rest of 102 lesions were clinically diagnosed as clearly benign and not removed. The algorithm has been calibrated using the images of the first 233 lesions. The calibrated version of the algorithm was used in a subset of 108 lesions, and the obtained results were compared with the medical findings. RESULTS: On the 108 cases used for evaluation the algorithm scored 80% sensitivity and 78% specificity in detecting (pre)malignant conditions. DISCUSSION: Although less accurate than the dermatologist's clinical eye, the app may offer support to other professionals who are less familiar with differentiating between benign and malignant lesions. CONCLUSION: An mHealth application for the risk assessment of skin lesions was evaluated. It adds value to diagnosis tools of its type by taking into consideration pigmented and nonpigmented lesions all together and detecting signs of malignancy with high sensitivity.