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161.
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Problem

Supplementation of breastfed babies is common during the hospital stay.

Background

The Baby Friendly Hospital Initiative (BFHI) optimises practices to support exclusive breastfeeding, yet supplementation is still prevalent.

Objective

To determine predictors for supplementation in a cohort of breastfed babies in a Baby-Friendly hospital.

Methods

Electronic hospital records of 1530 healthy term or near term singleton infants and their mothers were examined retrospectively and analysed to identify factors associated with in-hospital supplementation using Poisson regression (unadjusted and adjusted).

Findings

Fifteen percent of breastfed infants were supplemented during their hospital stay. Analysis by multivariable Poisson regression found that supplementation was independently associated with overweight (reference normal weight) (aRR [adjusted relative risk] = 1.46; 95% CI: 1.11–1.93); primiparity (aRR = 1.40; 95% CI: 1.09–1.80); early term gestation (37–376 weeks, aRR = 2.79; 95% CI: 1.88–4.15; 38–386 weeks, aRR = 2.03, 95%CI: 1.46–2.82); birthweight less than 2500 grams (reference 3000–3499 grams) (aRR = 3.60; 95% CI: 2.32–5.60) and use of postpartum uterotonic (aRR = 2.47; 95% CI: 1.09–5.55). Greater than 65 minutes of skin-to-skin contact at birth reduced the risk of supplementation (aRR = 0.66; 95% CI; 0.48–0.92).

Conclusion

These identified predictors for supplementation, can inform the development of interventions for mother-infant pairs antenatally or in the early postpartum period around increased breastfeeding education and support to reduce supplementation. It may also be possible to reduce supplementation through judicious use of postpartum uterotonics and facilitation of mother-infant skin-to-skin contact at birth for greater than one hour duration.  相似文献   
164.
We seek to explain the development of the educational gap between children in “out‐of‐home care” (CLA), children deemed in social need (CIN), and other pupils. A cohort of 642,805 pupils aged 16 in 2013 was used to chart the educational progress of the full cohort, the CLA (n = 6,236), the CIN in 2012 or 2013 but not CLA (n = 20,384), and a sample individually matched with the CLA (n = 11,084). At age 7, attainment of the CLA and CIN was approximately 1 standard deviation lower than the cohort average and predicted attainment at 16. At this point, the persistent “CIN” (those with earlier and persistent needs) had the lowest attainment relative to others, and this declined further during secondary school. Those entering care before or during primary school had very low attainment at age 7, but their relative attainment did not decline. Attainment of CLA and CIN at age 16 likely reflects early environment, special educational needs, and poor relationships with secondary school. Policy, research, and intervention should focus on CIN as well as CLA, do so before entry to care, and take account of the onset of, and probable reasons for, educational difficulties.  相似文献   
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The Tea Party Movement (TPM) burst onto the political scene following the 2008 elections. Early on, the movement attracted broad public support and seemed to tap into a variety of cultural concerns rooted in the changing demographic, political, and economic face of the nation. However, some observers questioned whether the Tea Party represented anything more than routine partisan backlash. And what had started as a seemingly grassroots movement that changed the face of American politics in the 2010 election was reduced to being mainly a caucus within Congress by 2012. In this article, we examine the cultural and political dimensions of Tea Party support over time. Using polling data from North Carolina and Tennessee and quantitative media analysis, we provide new evidence that cultural dispositions in addition to conservative identification were associated with TPM favorability in 2010; that these dispositions crystallized into shared political positions in 2011; and that by 2012 little distinguished TPM adherents from other conservatives.  相似文献   
167.
The purpose of this research was to examine governance in the New Zealand outdoor activity sector. We conducted 35 interviews with key personnel from organisations with responsibility for national co-ordination, education, and membership services. Using Brandsen and Pestoff’s (Public Manag Rev 8(4):493–501, 2006) co-processes framework, we describe and analyse governance of the outdoor sector. In so doing, we provide insight into the challenges facing this complex sector with regard to funding and stakeholder relationships, programme delivery, and personality conflicts. We also contribute by highlighting some of the shortcomings of the co-processes model, and offer constructively critical insights for its development.  相似文献   
168.
Indigenous Australians are among the most unhealthy populations in the world and yet they reside in a country where the non‐Indigenous population enjoys high standards of well‐being. Education has been identified as the key mechanism for closing this equity gap. At school commencement many Indigenous children are already at risk of disengagement. This four‐year longitudinal study of two Indigenous boys from a socially marginalised community examined key factors affecting transitional trajectories into school. While child characteristics affected level of achievement the critical factors in sustaining positive educational engagement were social support, school practices, inclusion of family and positive expectation.  相似文献   
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Changes in gay and bisexual men’s connectedness to the gay community are related to the declining public visibility of HIV/AIDS and greater acceptance for homosexuality and bisexuality in mainstream society. Little work, however, has focused on perceived acceptance for subgroups within the gay community or broader society. Using interviews (n = 20) and a survey (n = 202) of gay and bisexual men in a mid-sized Canadian city, we find perceived hierarchies of acceptance for the various subgroups as well as an age effect wherein middle-aged men perceive the least acceptance for all groups. These differences are linked with the uneven impact of social, political, and institutional changes relevant to gay and bisexual men in Canada.  相似文献   
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