Professional breastfeeding support for first-time mothers: a multicentre cluster randomised controlled trial.

OBJECTIVE: To evaluate the effect of two postnatal professional support interventions on the duration of any and exclusive breastfeeding. DESIGN: Multicentre, three-arm, cluster randomised controlled trial. POPULATION: A cohort of 722 primiparous breastfeeding mothers with uncomplicated, full-term pregnancies. METHODS: The three study interventions were: (1) standard postnatal maternity care; (2) standard care plus three in-hospital professional breastfeeding support sessions, of 30-45 minutes in duration; or (2) standard care plus weekly post-discharge breastfeeding telephone support, of 20-30 minutes in duration, for 4 weeks. The interventions were delivered by four trained research nurses, who were either highly experienced registered midwives or certified lactation consultants. MAIN OUTCOME MEASURES: Prevalence of any and exclusive breastfeeding at 1, 2, and 3 months postpartum. RESULTS: Rates of any and exclusive breastfeeding were higher among participants in the two intervention groups at all follow-up points, when compared with those who received standard care. Participants receiving telephone support were significantly more likely to continue any breastfeeding at 1 month (76.2 versus 67.3%; odds ratio, OR 1.63, 95% confidence interval, 95% CI 1.10-2.41) and at 2 months (58.6 versus 48.9%; OR 1.48, 95% CI 1.04-2.10), and to be exclusively breastfeeding at 1 month (28.4 versus 16.9%; OR 1.89, 95% CI 1.24-2.90). Participants in the in-hospital support group were also more likely to be breastfeeding at all time points, but the effect was not statistically significant. CONCLUSIONS: Professional breastfeeding telephone support provided early in the postnatal period, and continued for the first month postpartum, improves breastfeeding duration among first-time mothers. It is also possible that it was the continuing nature of the support that increased the effectiveness of the intervention, rather than the delivery of the support by telephone specifically.

The perceptions of obese school children in Hong Kong toward their weight-loss experience.

Most studies related to addressing weight management of obese children have focused on understanding the perceptions of parents and health professionals. This study identifies the factors that obese children who have tried to lose weight perceive as affecting their efforts. This descriptive qualitative study has sought to identify factors affecting obese children's weight-loss decision making and process and to explore the development of an effective weight-loss program. This study screened 603 primary school children equivalent to U.S. Grades 5 and 6 of age 10-12. Seventy-nine out of 93 obese children who had been trying on their own to lose weight for at least 1 month formed 6 focus groups. Four themes were identified: Making the decision, self-efficacy, social influences, and environmental constraints. The results suggest that the design of a weight-loss program for obese children should include the contribution of family members, school, and health professionals.

Cross-cultural validity and measurement invariance of the social physique anxiety scale in five European nations.

The cross-cultural generalizability of the social physique anxiety scale (SPAS) was evaluated using confirmatory factor analysis (CFA) in five European nations: Britain, Estonia, Spain, Sweden, and Turkey. Motl and Conroy's (2000) methods were used to develop modified versions of the scale within each sample based on the original 12-item version. Pending the satisfactory fit of the CFAs of the modified models within each sample, it was expected that the measurement parameters and mean values of these models would be equivalent across samples in multisample CFAs. An eight-item version of the SPAS exhibited a good fit with data from the British, Estonian, and Swedish samples, and a seven-item version fitted the data well in the Spanish and Turkish samples. The eliminated items were also influenced by a method effect associated with the item wording. Multisample analyses revealed that factor loadings were equivalent across samples. Tests of latent means revealed that British and Spanish participants reported the highest levels of SPA, with Estonian participants reporting the lowest. Results indicate that the SPAS is generalizable across these cultures, although subtle variations existed in the Spanish and Turkish samples. Researchers are advised to follow these procedures to develop a valid version of the SPAS appropriate for their sample.

Social identity in adolescence.

Social identity theory (SIT) was used to investigate the effects of social categorization on adolescents' intergroup behaviour. One hundred and forty-nine male adolescents aged 14-15 years made comparisons between an ingroup and an outgroup along a series of dimensions. Participants displayed consistent ingroup-favouring behaviour in their ratings: the ingroup was associated to a greater extent than the outgroup with positively valued dimensions, and to a lesser extent with negatively valued dimensions. Those participants who demonstrated the most discrimination reported highest levels of ingroup identification. The utility of applying predictions from SIT to the study of adolescence is discussed.

Mothers' perceptions of childhood immunizations in First Nations communities of the Sioux Lookout Zone.

OBJECTIVE: Low uptake of childhood immunizations is a problem in many First Nations communities. This article describes the results of a study that examined mothers' perceptions of childhood immunizations and the factors that influence uptake. METHOD: Person-centred interviews focussing on childhood immunizations and child health were conducted with 28 mothers of young children in two First Nations communities in the Sioux Lookout Zone. Content analysis was applied to the interview data and patterns and themes were developed. RESULTS: Data analysis identified four key factors as negatively influencing immunization uptake: knowledge barriers, the influence of others, vaccine barriers, and missed opportunities. CONCLUSIONS: Further research with Elders and community members along with culturally sensitive education initiatives are required to address low immunization uptake. Changes in health professionals' behaviours may serve to reduce missed opportunities.

Social categorization, self-esteem, and the estimated musical preferences of male adolescents.

The authors investigated the intergroup processes of male adolescents within the context of social identity theory (SIT; H. Tajfel, 1978; H. Tajfel & J. C. Turner, 1979). The participants were English male adolescents (age = 14-15 years). They estimated in-group and out-group musical preferences and evaluated the in-group and out-group along a series of scales. The results showed in-group favoritism effects along the musical preference and evaluative dimensions. The participants reported greater liking for the in-group. Compared with the out-group, they associated the in-group more with positively stereotyped music and less with negatively stereotyped music. Compared with the out-group, they rated the in-group as more fun, more masculine, more sporty, less boring, less snobbish, and less weird. The participants with lower levels of self-esteem showed greater differentiation between groups and greater derogation of the out-group. The results supported the predictions of SIT and demonstrated the applicability of SIT for the study of adolescent behavior.

Effect of monensin on milk production of Holstein-Friesian dairy cows.

We examined the effects of monensin on feed intake and milk production in Holstein-Friesian cows receiving a total mixed rations in two experiments. In experiment 1, 60 individually fed cows consumed, during wk 7 to 26 of lactation, 1 kg/d of supplement containing either 0, 150,300, or 450 mg of monensin. In experiment 2, 98 group-fed cows also received 1 kg/d of a supplement with either 0 or 300 mg/d of monensin for two consecutive lactations. In lactations 1 and 2, treatment started at wk 8 and 3 wk prior to calving, and continued for 32 wk. In experiment 1, 150, 300, and 450 mg of monensin/d produced a small decrease in feed intake and milk yield responses of 2.8, 2.5 and 1.5 kg/d, respectively. In experiment 2, milk yield responses of 0.8 and 1.1 kg/d were recorded in lactations 1 and 2. Milk fat and milk protein content declined in experiments 1 and 2, lactations 1 and 2 by 0.46, 0.38 and 0.27%, and 0.16, 0.16 and 0.11%, respectively. Yield of milk constituents was unaffected. Efficiency of milk production was increased by 5% in experiment 1. In experiment 2, lactation 2, monensin decreased beta-hydroxybutyrate and acetoacetate but increased blood glucose concentration.

Preparation of triazolo[1,5-c]pyrimidines as potential antiasthma agents.

With the use of the human basophil histamine release assay, 5-aryl-2-amino[1,2,4]triazolo[1,5-c]pyrimidines were found to be active as mediator release inhibitors. These compounds were prepared by reacting arylamidines with sodium ethyl formylacetate or with ethyl propiolate to give pyrimidinones. Treatment with phosphorus oxychloride gave a chloropyrimidine, which was converted to a hydrazinopyrimidine with hydrazine. Cyclization, using cyanogen bromide, gave the triazolo[1,5-c]pyrimidines, after a Dimroth rearrangement. Following a structure-activity evaluation, the 5-[3-(trifluoromethyl)phenyl]-2-amino (8-10), 5-(3-bromophenyl)-2-amino (8-13), 5-[3-(difluoromethoxy)-phenyl]-2-amino (8-11), and 5-(4-pyridinyl)-2-amino (6-7) compounds were found to have the best activity. They were chosen for further pharmacological and toxicological study.

The epidemiology of mumps in southern Alberta 1980-1982.

The full spectrum of mumps in Southern Alberta was studied over the years 1980-1982. In the community, a random sample of 3,497 children was tested for prevalence of immunity to mumps. The 1,816 who were not immune were retested after one year. The incidence of new immunity was 16.5%. Most seroconverters had no illness suggestive of mumps. History of previous mumps or immunization were found to be unreliable predictors of serologic immune status. In the family study, information was obtained on 342 cases diagnosed as mumps by family physician recorders. The overall complication rate was 10.8% and the secondary attack rate within families was 11.7%. Hospital records of all 25 patients admitted in Calgary with mumps during the same period were analyzed. Estimated costs of unopposed mumps over 20 years compared with the estimated costs of vaccination showed that a vaccination program could give a benefit-cost ratio between 6.4 and 247. These studies show that mumps is a mild disease with relatively few serious complications or sequelae. Even so, there would be definite medical and economic benefit with immunization. A low-cost addition of mumps vaccine to the immunization program would be justified.

Adolescent lumbar disc prolapse.

87 adolescents with lumbar disc prolapse treated from 1978 to 1985 were reviewed. The clinical pattern was different from that usually seen in adults, as 41 patients had no leg pain; and signs of neurologic deficit were often absent. Nonoperative treatment was successful in 57/61 patients, and 26 patients underwent discectomy with eventual return to full activity in 23 patients.

Imidazo[1,5-d][1,2,4]triazines as potential antiasthma agents.

By using inhibition of histamine release from antigen-challenged, sensitized human basophils as a means of identifying a potentially prophylactic drug for the treatment of asthma, a series of substituted imidazo[1,5-d][1,2,4]triazines were found, which were active. These compounds were prepared by treating imidazolecarboxaldehydes with excess Grignard agent and then oxidizing the resulting alcohols to ketones with Jones reagent. Pyrolysis of a mixture of ketone and methyl carbazate at 200 degrees C in diphenyl ether produced the desired imidazo[1,5-d][1,2,4]triazines. Those compounds with the greatest basophil activity were tested for in vivo activity in the mouse passive cutaneous anaphylaxis (PCA) and the guinea pig passive anaphylaxis tests. The best compounds, 1-ethyl-8-methyl-6-propylimidazo[1,5-d][1,2,4]triazin-4(3H)- one (4-17) and 1,8-dimethyl-6-propylimidazo[1,5-d][1,2,4]triazin-4-(3H)-one (4-16) were chosen for further study.

Capgras' syndrome: outmoded term for changeling delusions?

A case of so-called Capgras' syndrome occurring in an elderly woman showing several degenerative conditions is presented as a basis for questioning the value of preserving this diagnostic term. It is pointed out that the concept of the changeling has ancient provenance in man's thought down the ages, and that its occurrence in psychosis does not justify its ascription as a syndrome. 'Changeling' or 'imposture' are terms which describe this kind of delusion usually occurring in underlying schizophrenic, affective and organic syndromes.

Pharmacokinetic studies with benoxaprofen in man: prediction of steady-state levels from single-dose data.

1 Plasma levels of benoxaprofen were measured in eight subjects 2-168 h after a single oral dose of 100 mg. Pharmacokinetic parameters were estimated by the NON-LIN computer programme using the two-compartment open model. Mean half-lives of absorption, distribution and elimination were respectively 0.4, 4.8 and 37.6 hours. Volumes of distribution were 6.8 and 3.2 litres for the central and peripheral compartments respectively. 2 Eleven subjects in groups of three or four were given 25 mg/day, 50 mg/day or 100 mg two times daily for 11 days. Their plasma levels were compared with those predicted from the above parameters, which were adjusted for individual body weights and elimination half-lives. Steady-state plasma levels were predicted in each case, and a resonable degree of accuracy (mean 91%) achieved. 3 There was no tendency for observed and predicted levels to diverge as the dose was increased, and there was no evidence of any change in the disposition of benoxaprofen on repeated dosing. 4 The pharmacokinetic parameters were used to predict steady state plasma levels for various dosage regimens.