Initial breastfeeding attitudes and practices of women born in Turkey, Vietnam and Australia after giving birth in Australia

BACKGROUND: Cultural variations exist in the proportion of women who breastfeed. For some cultural groups, migration to a new country is associated with a reduction in the initiation and duration of breastfeeding. This paper describes the initial breastfeeding attitudes and practices of women born in Vietnam, Turkey and Australia who gave birth in Australia. METHODS: The study included 300 women: 100 hundred Turkish-born, 100 Vietnamese-born and 100 Australian-born women who had given birth in a large public, tertiary referral maternity hospital between January 1998 and May 1999 in Melbourne, Australia. Women were interviewed in hospital, between 24 hours after the birth and discharge from hospital. Data were collected using a structured questionnaire with some open-ended questions. Only women who had a normal vaginal birth and who gave birth to a healthy baby were included in the study. RESULTS: Almost all Turkish women initiated breastfeeding (98%) compared with 84% of Australian women. Vietnamese women had the lowest rate of breastfeeding initiation (75%), perceived their partners to be more negative about breastfeeding and did not value the health benefits of colostrum to the same extent as the other two groups. Forty percent of Vietnamese women gave their baby formula in hospital. The results of this study add to the previously reported finding that immigrant Vietnamese women have low breastfeeding rates compared with other groups. CONCLUSION: Despite the Baby Friendly status of the hospital where the study was conducted, major differences were found in breastfeeding initiation. Future research should develop and test interventions aimed at increasing breastfeeding initiation in Vietnamese women where initiation is low

Ringing up about breastfeeding: a randomised controlled trial exploring early telephone peer support for breastfeeding (RUBY) - trial protocol

BACKGROUND: The risks of not breastfeeding for mother and infant are well established, yet in Australia, although most women initiate breastfeeding many discontinue breastfeeding altogether and few women exclusively breastfeed to six months as recommended by the World Health Organization and Australian health authorities. We aim to determine whether proactive telephone peer support during the postnatal period increases the proportion of infants who are breastfed at six months, replicating a trial previously found to be effective in Canada. DESIGN/METHODS: A two arm randomised controlled trial will be conducted, recruiting primiparous women who have recently given birth to a live baby, are proficient in English and are breastfeeding or intending to breastfeed. Women will be recruited in the postnatal wards of three hospitals in Melbourne, Australia and will be randomised to peer support or to 'usual' care. All women recruited to the trial will receive usual hospital postnatal care and infant feeding support. For the intervention group, peers will make two telephone calls within the first ten days postpartum, then weekly telephone calls until week twelve, with continued contact until six months postpartum. Primary aim: to determine whether postnatal telephone peer support increases the proportion of infants who are breastfed for at least six months. HYPOTHESIS: that telephone peer support in the postnatal period will increase the proportion of infants receiving any breast milk at six months by 10% compared with usual care (from 46% to 56%).Outcome data will be analysed by intention to treat. A supplementary multivariate analysis will be undertaken if there are any baseline differences in the characteristics of women in the two groups which might be associated with the primary outcomes. DISCUSSION: The costs and health burdens of not breastfeeding fall disproportionately and increasingly on disadvantaged groups. We have therefore deliberately chosen trial sites which have a high proportion of women from disadvantaged backgrounds. This will be the first Australian randomised controlled trial to test the effectiveness and cost effectiveness of proactive peer telephone support for breastfeeding. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12612001024831

Extragalactic H_2O masers and X-ray absorbing column densities

Having conducted a search for the 22 GHz water vapor line towards galaxies with nuclear activity, large nuclear column densities or high infrared luminosities, we present H_2O spectra for NGC2273, UGC5101 and NGC3393 with isotropic luminosities of 7, 1500, and 400 L_sun. The H_2O maser in UGC5101 is by far the most luminous yet found in an ultraluminous infrared galaxy. NGC3393 reveals the classic spectrum of a `disk maser', represented by three distinct groups of Doppler components. As in all other known cases except NGC4258, the rotation velocity of the putative masing disk is well below 1000 km/s. Based on the literature and archive data, X-ray absorbing column densities are compiled for the 64 galaxies with reported maser sources beyond the Magellanic Clouds. For NGC2782 and NGC5728, we present Chandra archive data that indicate the presence of an active galactic nucleus in both galaxies. The correlation between absorbing column and H_2O emission is analyzed. There is a striking difference between kilo- and megamasers with megamasers being associated with higher column densities. All kilomasers (L_H_2O < 10 L_sun) except NGC2273 and NGC5194 are Compton-thin, i.e. their absorbing columns are < 10^24 cm^-2. Among the H_2O megamasers, 50% arise from Compton-thick and 85% from heavily obscured (> 10^23 cm^-2) active galactic nuclei. These values are not larger but consistent with those from samples of Seyfert 2 galaxies not selected on the basis of maser emission. The similarity in column densities can be explained by small deviations in position between maser spots and nuclear X-ray source and a high degree of clumpiness in the circumnuclear interstellar medium.Comment: 16 pages, 7 figures, 5 tables. Accepted for publication in A&

Factors associated with breastfeeding at six months postpartum in a group of Australian women

BACKGROUND: Despite high levels of breastfeeding initiation in Australia, only 47 percent of women are breastfeeding (exclusively or partially) six months later, with marked differences between social groups. It is important to identify women who are at increased risk of early cessation of breastfeeding. METHODS: Data from the three arms of a randomised controlled trial were pooled and analysed as a cohort using logistic regression to identify which factors predicted women continuing to feed any breast milk at six months postpartum. The original trial included 981 primiparous women attending a public, tertiary, women's hospital in Melbourne, Australia in 1999–2001. The trial evaluated the effect of two mid-pregnancy educational interventions on breastfeeding initiation and duration. In the 889 women with six month outcomes available, neither intervention increased breastfeeding initiation nor duration compared to standard care. Independent variables were included in the predictive model based on the literature and discussion with peers and were each tested individually against the dependent variable (any breastfeeding at six months). RESULTS: Thirty-three independent variables of interest were identified, of which 25 qualified for inclusion in the preliminary regression model; 764 observations had complete data available. Factors remaining in the final model that were positively associated with breastfeeding any breast milk at six months were: a very strong desire to breastfeed; having been breastfed oneself as a baby; being born in an Asian country; and older maternal age. There was an increasing association with increasing age. Factors negatively associated with feeding any breast milk at six months were: a woman having no intention to breastfeed six months or more; smoking 20 or more cigarettes per day pre-pregnancy; not attending childbirth education; maternal obesity; having self-reported depression in the six months after birth; and the baby receiving infant formula while in hospital. CONCLUSION: In addition to the factors commonly reported as being associated with breastfeeding in previous work, this study found a negative association between breastfeeding outcomes and giving babies infant formula in hospital, a high maternal body mass index, and self-reported maternal depression or anxiety in the six months after the baby was born. Interventions that seek to increase breastfeeding should consider focusing on women who wish to breastfeed but are at high risk of early discontinuation

Birthplace in New South Wales, Australia: an analysis of perinatal outcomes using routinely collected data

BACKGROUND: The outcomes for women who give birth in hospital compared with at home are the subject of ongoing debate. We aimed to determine whether a retrospective linked data study using routinely collected data was a viable means to compare perinatal and maternal outcomes and interventions in labour by planned place of birth at the onset of labour in one Australian state. METHODS: A population-based cohort study was undertaken using routinely collected linked data from the New South Wales Perinatal Data Collection, Admitted Patient Data Collection, Register of Congenital Conditions, Registry of Birth Deaths and Marriages and the Australian Bureau of Statistics. Eight years of data provided a sample size of 258,161 full-term women and their infants. The primary outcome was a composite outcome of neonatal mortality and morbidity as used in the Birthplace in England study. RESULTS: Women who planned to give birth in a birth centre or at home were significantly more likely to have a normal labour and birth compared with women in the labour ward group. There were no statistically significant differences in stillbirth and early neonatal deaths between the three groups, although we had insufficient statistical power to test reliably for these differences. CONCLUSION: This study provides information to assist the development and evaluation of different places of birth across Australia. It is feasible to examine perinatal and maternal outcomes by planned place of birth using routinely collected linked data, although very large data sets will be required to measure rare outcomes associated with place of birth in a low risk population, especially in countries like Australia where homebirth rates are low

A descriptive study of mastitis in Australian breastfeeding women: incidence and determinants

<p>Abstract</p> <p>Background</p> <p>Mastitis is one of the most common problems experienced by women who are breastfeeding. Mastitis is an inflammation of breast tissue, which may or may not result from infection. The aims of this paper are to compare rates of mastitis in primiparous women receiving public hospital care (standard or birth centre) and care in a co-located private hospital, and to use multivariate analysis to explore other factors related to mastitis.</p> <p>Methods</p> <p>Data from two studies (a randomised controlled trial [RCT] and a survey) have been combined. The RCT (Attachment to the Breast and Family Attitudes to Breastfeeding, ABFAB) which was designed to test whether breastfeeding education in mid-pregnancy could increase breastfeeding duration recruited public patients at the Royal Women's Hospital at 18–20 weeks gestation. A concurrent survey recruited women planning to give birth in the Family Birth Centre (at 36 weeks gestation) and women in the postnatal wards of Frances Perry House (private hospital). All women were followed up by telephone at 6 months postpartum. Mastitis was defined as at least 2 breast symptoms (pain, redness or lump) AND at least one of fever or flu-like symptoms.</p> <p>Results</p> <p>The 6 month telephone interview was completed by 1193 women. Breastfeeding rates at 6 months were 77% in Family Birth Centre, 63% in Frances Perry House and 53% in ABFAB. Seventeen percent (n = 206) of women experienced mastitis. Family Birth Centre and Frances Perry House women were more likely to develop mastitis (23% and 24%) than women in ABFAB (15%); adjusted odds ratio (Adj OR) ~1.9. Most episodes occurred in the first 4 weeks postpartum: 53% (194/365). Nipple damage was also associated with mastitis (Adj OR 1.7, 95% CI, 1.14, 2.56). We found no association between breastfeeding duration and mastitis.</p> <p>Conclusion</p> <p>The prevention and improved management of nipple damage could potentially reduce the risk of lactating women developing mastitis.</p> <p>Trial registration</p> <p>Trial registration (ABFAB): Current Controlled Trials ISRCTN21556494</p

Supernova rates from the Southern inTermediate Redshift ESO Supernova Search (STRESS)

To measure the supernova (SN) rates at intermediate redshift we performed the Southern inTermediate Redshift ESO Supernova Search (STRESS). Unlike most of the current high redshift SN searches, this survey was specifically designed to estimate the rate for both type Ia and core collapse (CC) SNe. We counted the SNe discovered in a selected galaxy sample measuring SN rate per unit blue band luminosity. Our analysis is based on a sample of ~43000 galaxies and on 25 spectroscopically confirmed SNe plus 64 selected SN candidates. Our approach is aimed at obtaining a direct comparison of the high redshift and local rates and at investigating the dependence of the rates on specific galaxy properties, most notably their colour. The type Ia SN rate, at mean redshift z=0.3, amounts to 0.22^{+0.10+0.16}_{-0.08 -0.14} h_{70}^2 SNu, while the CC SN rate, at z=0.21, is 0.82^{+0.31 +0.30}_{-0.24 -0.26} h_{70}^2 SNu. The quoted errors are the statistical and systematic uncertainties. With respect to local value, the CC SN rate at z=0.2 is higher by a factor of ~2 already at redshift, whereas the type Ia SN rate remains almost constant. This implies that a significant fraction of SN Ia progenitors has a lifetime longer than 2-3 Gyr. We also measured the SN rates in the red and blue galaxies and found that the SN Ia rate seems to be constant in galaxies of different colour, whereas the CC SN rate seems to peak in blue galaxies, as in the local Universe. SN rates per unit volume were found to be consistent with other measurements showing a steeper evolution with redshift for CC SNe with respect to SNe Ia. Finally we have exploited the link between star formation (SF) and SN rates to predict the evolutionary behaviour of the SN rates and compare it with the path indicated by observations.Comment: Accepted for publication in A&A; 25 pages (including on line material), 13 figure

A statewide review of postnatal care in private hospitals in Victoria, Australia

<p>Abstract</p> <p>Background</p> <p>Concerns have been raised in Australia and internationally regarding the quality and effectiveness of hospital postnatal care, although Australian women receiving postnatal care in the private maternity sector rate their satisfaction with care more highly than women receiving public maternity care. In Victoria, Australia, two-thirds of women receive their maternity care in the public sector and the remainder in private health care sector. A statewide review of public hospital postnatal care in Victoria from the perspective of care providers found many barriers to care provision including the busyness of postnatal wards, inadequate staffing and priority being given to other episodes of care; however the study did not include private hospitals. The aim of this study was replicate the review in the private sector, to explore the structure and organisation of postnatal care in private hospitals and identify those aspects of care potentially impacting on women's experiences and maternal and infant care. This provides a more complete overview of the organisational structures and processes in postnatal care in all Victorian hospitals from the perspective of care providers.</p> <p>Methods</p> <p>A mixed method design was used. A structured postal survey was sent to all Victorian private hospitals (n = 19) and key informant interviews were undertaken with selected clinical midwives, maternity unit managers and obstetricians (n = 11). Survey data were analysed using descriptive statistics and interview data analysed thematically.</p> <p>Results</p> <p>Private hospital care providers report that postnatal care is provided in very busy environments, and that meeting the aims of postnatal care (breastfeeding support, education of parents and facilitating rest and recovery for women following birth) was difficult in the context of increased acuity of postnatal care; prioritising of other areas over postnatal care; high midwife-to-woman ratios; and the number and frequency of visitors. These findings were similar to the public review. Organisational differences in postnatal care were found between the two sectors: private hospitals are more likely to have a separate postnatal care unit with single rooms and can accommodate partners' over-night; very few have a policy of infant rooming-in; and most have well-baby nurseries. Private hospitals are also more likely to employ staff other than midwives, have fewer core postnatal staff and have a greater dependence on casual and bank staff to provide postnatal care.</p> <p>Conclusions</p> <p>There are similarities and differences in the organisation and provision of private postnatal care compared to postnatal care in public hospitals. Key differences between the two sectors relate to the organisational and aesthetic aspects of service provision rather than the delivery of postnatal care. The key messages emerging from both reviews is the need to review and monitor the adequacy of staffing levels and to develop alternative approaches to postnatal care to improve this episode of care for women and care providers alike. We also recommend further research to provide a greater evidence-base for postnatal care provision.</p

Exploring the views and experiences of callers to the PANDA Post and Antenatal Depression Association Australian National Perinatal Depression Helpline: A cross-sectional survey

Background Anxiety and depression are common in the perinatal period. Telephone interventions, including telephone peer support and counselling, have been developed to support those experiencing perinatal mental illness. PANDA Post and Antenatal Depression Association provides support to women and men experiencing perinatal mental illness via the Australian National Perinatal Depression Helpline, encompassing both volunteer peer support and professional counselling. This study aimed to explore the experiences of callers to the Helpline. Methods A cross-sectional survey design was used. All new callers from 1st May to 30th September 2013 were invited to participate. The survey, adapted from a previous survey of PANDA callers, included 23 questions using Likert-type scales, demographic and open-ended questions. Thematic network analysis was undertaken for responses to open-ended questions. Results 124 responses were received (124/405; 30 % response). The majority of callers had called the Helpline regarding themselves (90 %), with over one third (33 %) of all callers seeking crisis support and help. Ninety-nine per cent of respondents ‘agreed’ or ‘strongly agreed’ that staff and/or volunteers understood their concerns, and 97 % ‘agreed’ or ‘strongly agreed’ that overall PANDA had helped them. Callers described the PANDA service as uniquely tailored to the perinatal period, providing accessible, non-judgemental understanding and support, with a global theme from open-ended comments describing PANDA as ‘a safe space to be heard and receive support without judgement’. Recommendations for service changes included increased hours of availability. Conclusions Callers reported positive experiences of accessing support from the PANDA National Perinatal Depression Helpline. The Helpline was described as an accessible and acceptable telephone support for individuals experiencing perinatal mental illness. Recommendations for changes to the service included an increase in hours of operation to enable greater responsiveness at times of need, reduced waiting times, and access to continuity with the same volunteer and/or telephone counsellor. The findings of the study will be useful in informing future service provision, review, and implementation

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente