社会正义的实现:从“排斥冶走向“包容性政策冶

我国社会政策经历过一个建构与重构的过程,但排斥性是一以贯之的主基调.随着人类从工业社会逐步迈入后工业社会,基于差异承认与平等实现而形成的二维正义观登场.而现行社会政策既无法体现对差异的尊重,也无法保证平等实现,从而呈现出对正义的偏离.只有建立起包容性社会政策,尊重个体差异,同时保证多元主体享有共同福利的机会和水平,才能实现正义.     

Effect of immediate and continuous mother–infant skin-to-skin contact on breastfeeding self-efficacy of primiparous women: A randomised control trial

ObjectiveTo evaluate the effect of mother–infant immediate skin-to-skin contact on primiparous mother's breastfeeding self-efficacy.Study designA randomised control trial.SettingsThe study was conducted in Omolbanin obstetrics hospital (large tertiary hospital), Mashhad, Iran.Participants114 18–35 year-old primiparous, Iranian, healthy and full term mothers who anticipated normal vaginal delivery and intended to breastfeed their babies.InterventionSkin-to-skin contact immediately after birth and then controlling breastfeeding self-efficacy at 28 days postpartum.Main outcome measureMaternal breastfeeding self-efficacy at 28 days postpartum and success in first breastfeeding and mean time of first breastfeeding initiation.ResultsA total of 92 mother–infant dyads (47 dyads in skin-to-skin care skin-to-skin contact group and 45 dyads in routine care group) were monitored and analysed. In skin-to-skin contact group, breastfeeding self-efficacy was 53.42 ± 8.57 SD as compared to 49.85 ± 5.50 SD in routine care group which is significantly higher in skin-to-skin contact group (p = 0.0003).Successful breastfeeding initiation rate was 56.6% in skin-to-skin contact group as compared to 35.6% in routine care group (p = 0.02).Time to initiate first feed was 21.98 ± 9.10 SD min in SSC group vs. 66.55 ± 20.76 min in routine care group (p < 0.001).ConclusionMother–infant immediate skin-to-skin contact is an easy and available method of enhancing maternal breastfeeding self-efficacy. High breastfeeding self-efficacy increases exclusive breastfeeding duration.     

Breastfeeding experiences and perspectives among women with postnatal depression: A qualitative evidence synthesis

BackgroundStudies show that postnatal depression affects around 10–16% of women globally. It is associated with earlier cessation of breast feeding, which can negatively impact infants’ long-term development. Mechanisms underpinning associations between mental health and women’s decision to commence and continue to breastfeed are complex and poorly understood.AimThe aim of this review was to investigate breastfeeding experiences, perspectives, and support needs of women with postnatal depression. No previous reviews were identified which had addressed this aim.MethodA systematic search was conducted of six databases to identify relevant qualitative studies. Six included studies were critically appraised and synthesised using thematic synthesis.FindingsFive themes were identified: (1) desire to breastfeed and be a ‘good mother’, (2) struggles with breastfeeding, (3) mixed experiences of support from healthcare professionals, (4) importance of practical and social support, (5) support for mental health and breastfeeding. Most women with postnatal depression expressed strong intentions to breastfeed, although some perceived ‘failure’ to breastfeed triggered their mental health problems. Practical and non-judgemental support for their mental health needs and for successful breastfeeding from healthcare professionals, family and friends are needed.ConclusionMost women with postnatal depression desired to breastfeed but experienced breastfeeding difficulties that could impact on their mental health. By offering women with postnatal depression tailored and timely support, healthcare professionals could help women minimize breastfeeding problems which could consequently impact on their mental well-being and ensure they and their infants have opportunity to benefit from the advantages that breastfeeding offers.     

Navigating infant feeding supports after migration: Perspectives of Arabic and Chinese mothers and health professionals in Australia

Optimal feeding practices can establish lifelong, transgenerational and global health benefits. Migration and cultural factors impact infant feeding practices and the support mothers receive for optimal infant feeding. This qualitative study explored support for infant feeding among Arabic and Chinese speaking migrant mothers in Australia.Semi-structured focus groups were conducted in language with 24 Arabic and 22 Chinese-Mandarin speaking migrant mothers with children under five years of age. Individual interviews were conducted in English with 20 health professionals working with Arabic or Chinese speaking migrant families. Data were thematically analysed using the framework method.Traditional family networks and trusted bi-cultural doctors were influential infant feeding supports for mothers. Health professionals perceived maternal and child health services to be poorly understood, and some mothers who accessed services felt they were not always culturally sensitive. Mothers sought additional information and support through online sources and peers. Both mothers and health professionals recognised the challenges of managing conflicting infant feeding advice and seeking best-practice support.The findings of this study highlight opportunities for health professionals to better support migrant mothers’ infant feeding practices, for example through engaging families and working with doctors. There is a need for greater cultural sensitivity within maternal and child health services and culturally relevant programs to support healthy infant feeding practices among migrant communities.     

建筑物区分所有权及专有权的概念辨析

建筑物区分所有权制度是近现代社会发展起来的一项新型不动产所有权制度。专有所有权是业主对其建筑物专有部分享有的专有、使用、收益和处分的权利,其性质为对空间的所有权。     

Factors associated with early cessation of breastfeeding in women with gestational diabetes mellitus

AimTo determine factors associated with early cessation of breastfeeding (≤3 months) in women with recent gestational diabetes mellitus (GDM).MethodsA cross-sectional online survey of women aged ≥18 years, diagnosed with GDM in 2010 and registered with the National Diabetes Services Scheme in Australia. The 59 questions examined breastfeeding duration, intention, attitudes, exclusivity and support.Results738 women completed the survey (15% response rate). Data was analysed for 729 eligible respondents. Of these 97% reported ‘ever’ breastfeeding and 19% had breastfed for ≤3 months. Cessation of breastfeeding at or before 3 months was associated with breastfeeding problems at home [adjusted odds ratio 8.01, 95% confidence interval (4.57, 14.05)], return to work prior to three months [OR 3.39 (95% CI 1.53, 7.55)], inadequate breastfeeding support [OR 1.88 (95% CI 1.10, 3.22)], caesarean delivery [OR 1.70 (95% CI 1.04, 2.76)], low socioeconomic status (SEIFA 1 unit increase) [OR 0.89 (95% CI 0.81, 0.97)] and BMI (2 unit increase) [OR 1.08 (95% CI 1.01, 1.57)]. Being married or de facto [OR 0.14 (95% CI 0.03, 0.62)] was a protective against early cessation of breastfeeding.ConclusionStrategies to improve breastfeeding duration in women with GDM need to address those most at risk of early cessation and provide appropriate postpartum breastfeeding support in this group.     

Impact of support networks for breastfeeding: A multicentre study

Background

The rates of breastfeeding worldwide are slowly improving since 1996. Europe is still trailing behind the global breastfeeding incidence and prevalence rates. Thus, breastfeeding promotion, protection, prolongation and support have become an important challenge as breastfeeding sharply decreases in the first six months of life.

Breastfeeding interventions in Kansas: A qualitative process evaluation of program goals and objectives

Across the state of Kansas, eighteen public health departments received funding through the 2011 Breastfeeding Grant Initiative to start a breastfeeding intervention. The main objective of this study was to evaluate the progress toward program goals and objectives. This study was a process evaluation. Qualitative data were collected from recipient health departments at two time-points during the program year. Structured, open-ended questions were asked through telephone interviews. This study examined: (1) progress toward program goals and objectives, (2) problems encountered during implementation, and (3) evaluation measures employed to assess program impact. All health departments reported making significant progress toward program goals and objectives and reported successful collaboration with other healthcare providers. The use of breast pumps, educational classes, and professional training of staff were reported as providing the best outcome in the promotion of breastfeeding. The majority of respondents did not measure program impact. From a public health perspective, it is important that infants receive breast milk for the first six months of life. It appears that goals and objectives set a priori guided health departments with the administration of their breastfeeding program. Results may be used to enhance and sustain delivery of breastfeeding support programs in Kansas communities.     

Developing and testing a mobile application for breastfeeding support: The Milky Way application

BackgroundSupporting women to continue breastfeeding is a global challenge. The Milky Way Program is an effective face to face intervention to increase breastfeeding rates up to six months postpartum. The sustainability and access to the Milky Way Program could be enhanced by transforming it into a mobile application allowing women to access relevant information from their own place at a convenient time.AimTo explore the process of transforming the Milky Way Program into an acceptable and usable mobile health application.MethodStakeholders including multidisciplinary researchers and end-users designed the application based on the Milky Way Program by using Persuasive System Design principles. A mixed-method approach was used in the development and evaluation process. Seven women were recruited through convenience sampling to pilot test the application. The women’s feedback was collected through an online survey six weeks after birth and individual interviews at four months postpartum.FindingsWomen in the pilot study reported that the breastfeeding application was well designed, easy to use, interactive, reassuring and evidence-based with credible sources of information.ConclusionThe Persuasive System Design model combined with end-user engagement can feasibly inform the development of an acceptable and usable mobile health application for breastfeeding based on a proven clinical intervention. Further rigorous testing is required to evaluate the effectiveness of the application on breastfeeding initiation and duration.