Current studies on two separate topics: breastfeeding postpartum length of hospital stay

IN THIS COLUMN, THE AUTHOR EXAMINES RECENT RESEARCH ON TWO SEPARATE TOPICS: 1) breastfeeding; 2) postpartum length of hospital stay. Recent studies suggest long-term effects of breastfeeding that benefit both mother and infant. Benefits include a reduced risk of breast cancer in breastfeeding mothers and a reduced level of total and LDH cholesterol in adults who were breastfed as infants. Infants of mothers with maternal asthma had lower rates of asthma if the mother breastfed. In a study of women in the United States who planned to breastfeed, those mothers who breastfed exclusively and planned to breastfeed more than three months were more likely to achieve their goals than mothers who planned to combine breast and human-milk substitute feeds and to breastfeed less than three months.In a Canadian study, shortened postpartum stays led to increased re-admission to hospital for mothers with cesarean births. In contrast, in a Massachusetts study, shortened postpartum stays did not lead to an increase in infant visits for urgent care. However, the Massachusetts study did not reflect a decrease in maternity-related costs associated with shortened length of postpartum stay.     

Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum

Although breastfeeding is known to be beneficial to both mother and infant, many women encounter barriers to breastfeeding, even after successful breastfeeding initiation, which may put them at greater risk for early cessation of breastfeeding. The objectives of this study were to conduct a secondary analysis of data from a longitudinal study of postpartum depression to (a) examine factors related to very early discontinuation of breastfeeding (at 2 weeks postpartum) following hospital discharge and (b) identify women's reasons for very early cessation of breastfeeding. The results of this study support findings from previous research. Having a perceived support system, whether it is personal or professional, may have an effect on both the initiation and duration of breastfeeding. Educating expectant and new mothers, especially women who encounter multiple barriers and are at risk for very early cessation of breastfeeding, of the benefits of breastfeeding and supporting them in developing efficient techniques and problem-solving skills can help increase the duration of breastfeeding.     

Development and testing of a prenatal breastfeeding education intervention for Hispanic women

Many immigrant Hispanic women in the United States choose to bottle-feed rather than breastfeed. This article describes an intervention that was developed and tested in a two-step process. Two studies were undertaken. First, a qualitative inquiry explored the breastfeeding beliefs, attitudes, meanings, and practices of Hispanic women. Results informed the design of a culturally appropriate prenatal breastfeeding education intervention. Secondly, the researchers undertook a quantitative study of the intervention's success in increasing breastfeeding duration among Hispanic women. Methodology and findings of this study have implications for future interventions that promote breastfeeding.     

Beginning teacher attrition: a question of identity making and identity shifting

While there is discrepancy about the actual percentage of early career teachers that leave teaching in their first five years, one consistent discovery in a number of countries is that attrition is high for early career teachers. I became curious about early career teacher attrition as I watched colleagues leave the profession that they thought was a lifelong calling. In order to inquire into this phenomenon, I moved through a three-stage research process. First, I engaged in writing a series of stories about my experiences as a beginning teacher. Using autobiographical narrative inquiry, I then inquired into the stories in order to retell them looking for resonances across the stories. Secondly, I conducted a review of the literature, analyzing the studies to identify how the problem of early career teacher attrition was conceptualized. I identified two dominant problem frames: a problem frame situated within the individual and a problem frame situated in the context. Lastly, I offered a different conceptualization of the phenomenon of early career teacher attrition that draws on my autobiographical narrative inquiry and the literature review. I frame the problem of teacher attrition, not as a personal or a contextual problem frame, but as a problem of teacher identity making and identity shifting.     

Effects of a prenatal care intervention for adolescent mothers on birth weight, repeat pregnancy, and educational outcomes at one year postpartum

About one-third of adolescent mothers receive inadequate prenatal care, and babies born to young mothers are more likely to be of low birth weight. The objective of this study is to evaluate a peer-centered prenatal care program for adolescent mothers. Pregnant adolescents were randomly assigned to an experimental or control group in a mastery modeling peer-support intervention designed to improve long- and short-term perinatal outcomes. A sample of 282 urban pregnant adolescents (94% African American, 4% Caucasian, 2% other) participated in the study. Participants were recruited from five clinics located mainly in Detroit, Michigan. Participants in the experimental group received care in a small group setting and learned to perform critical measurements with a peer partner during prenatal visits. Participants in the control group received individual prenatal care in the same clinics. Outcome measures included birth weight, years of schooling completed at one year postpartum, planned and unplanned pregnancy at one year postpartum, and employment and school attendance at one year postpartum. Mothers in the experimental group had a lower rate of low birth weight (6.6% vs. 12.5%, p=0.08). The rate of unplanned pregnancy was also lower for adolescents in the experimental group (13.4% vs. 15.9%), although this difference was not statistically significant. Adolescents who participated in the intervention were more likely to have continued their education during the pregnancy and the postpartum year. The mastery modeling, peer-centered, prenatal care program produced some positive pregnancy outcomes for adolescent mothers.     

Dropouts and turnover: The synthesis and test of a causal model of student attrition

The purpose of this research is to investigate the determinants of student attrition in institutions of higher education. A causal model was developed which synthesized research findings on turnover in work organizations and on student attrition. Questionnaires were distributed to university freshmen (N = 1,171). The data was analyzed using multiple regression and path analysis. The regressions produced anR ² = .36 for females and .27 for males. Findings indicate that three surrogate measures for pay were significantly related to intent to leave for both sexes and that the theories and determinants developed in research on turnover are useful in studies of student attrition.Paper presented at the Annual Meeting of American Educational Research Association, San Francisco, April 1979.     

Student attrition,intentions, and confidence: Interaction effects in a path model

A causal model of student attrition developed by the author (Bean, 1981) was reduced to 10 independent variables. Background variables were excluded from the analysis. The sample was partitioned into high- and low-confidence men and women based on interaction effects. The model was estimated using a sample of 1,574 college freshmen. TheR ² for dropout ranged from .42 to .50. Based on the effects coefficients, the overall ranking of the independent variables in influencing dropout in descending order of importance was as follows: intent to leave; grades; opportunity to transfer; practical value; certainty of choice; loyalty; family approval; courses; student goals; and major and job certainty.     

Potential impact of the validated Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A clinical vignette study

BackgroundThe validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) in children <3 years old with intracranial injury.ObjectiveTo explore the impact of PredAHT on clinicians’ AHT probability estimates and child protection (CP) actions, and assess inter-rater agreement between their estimates and between their CP actions, before and after PredAHT.Participants and SettingTwenty-nine clinicians from different specialties, at teaching and community hospitals.MethodsClinicians estimated the probability of AHT and indicated their CP actions in six clinical vignettes. One vignette described a child with AHT, another described a child with non-AHT, and four represented “gray” cases, where the diagnosis was uncertain. Clinicians calculated the PredAHT score, and reported whether this altered their estimate/actions. The ‘think-aloud’ method was used to capture the reasoning behind their responses. Analysis included linear modelling, linear mixed-effects modelling, chi-square tests, Fisher’s exact tests, intraclass correlation, Gwet’s AC₁ coefficient and thematic analysis.ResultsOverall, PredAHT significantly influenced clinicians’ probability estimates in all vignettes (p < 0.001), although the impact on individual clinicians varied. However, the influence of PredAHT on clinicians’ CP actions was limited; after using PredAHT, 9/29 clinicians changed their CP actions in only 11/174 instances. Clinicians’ AHT probability estimates and CP actions varied somewhat both before and after PredAHT. Qualitative data suggested that PredAHT may increase clinicians’ confidence in their decisions when considered alongside other associated clinical, historical and social factors.ConclusionsPredAHT significantly influenced clinicians’ AHT probability estimates, but had minimal impact on their CP actions.     

Explorations of crystallized intelligence: Completion tests,cloze tests,and knowledge

An attempt is made to reconcile two historically important tools for the assessment of intelligence and the prediction of academic achievement with extant theories of verbal–crystallized–knowledge aspects of adult abilities. A study of 167 adults ranging in age from 18 to 69 reasserts the importance of individual differences in completion test and cloze test performance in accounting for both measures of crystallized intelligence (Gc) and four scales of knowledge (biology, U.S. history, U.S. literature, and technology). The completion tests were found to account for all of the variance in Gc and knowledge that the cloze tests accounted for, and resulted in incremental predictive validity for both domains. In addition, completion and cloze tests were found to have a suppressor effect on the relationship between Gc and Age. We note that C. Spearman's [The nature of “Intelligence” and the principles of cognition. New York: MacMillan (1927).] assertion, namely that the completion test had higher correlations with intelligence than any other measure. Our results suggest that abstract reasoning may be far less useful in predicting learning and performance than the completion test is.     

Acceptability of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals

The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) based on combinations of six clinical features: head/neck bruising; apnea; seizures; rib/long-bone fractures; retinal hemorrhages. We aimed to determine the acceptability of PredAHT to child protection professionals. We conducted qualitative semi-structured interviews with 56 participants: clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom. Interviews were recorded, transcribed and imported into NVivo for thematic analysis (38% double-coded). We explored participants’ evaluations of PredAHT, their opinions about the optimal way to present the calculated probabilities, and their interpretation of probabilities in the context of suspected AHT. Clinicians, child protection social workers and police thought PredAHT would be beneficial as an objective adjunct to their professional judgment, to give them greater confidence in their decisions. Lawyers and pathologists appreciated its value for prompting multidisciplinary investigations, but were uncertain of its usefulness in court. Perceived disadvantages included: possible over-reliance and false reassurance from a low score. Interpretations regarding which percentages equate to ‘low’, ‘medium’ or ‘high’ likelihood of AHT varied; participants preferred a precise % probability over these general terms. Participants would use PredAHT with provisos: if they received multi-agency training to define accepted risk thresholds for consistent interpretation; with knowledge of its development; if it was accepted by colleagues. PredAHT may therefore increase professionals’ confidence in their decision-making when investigating suspected AHT, but may be of less value in court.     

Education for all and attrition/retention of new teachers: A trajectory study in Chile

This article centres on teacher retention and its importance for achieving quality education for all. It analyses the state of early career teaching attrition and turnover in Chile over a ten-year period, and goes on more closely to the study of new teacher trajectories over their first two years of teaching. In line with literature on issues of retention/attrition it considers the impact of school conditions and changes in professional satisfaction and self-efficacy perceptions in the early years of teaching. Data sources include econometric analysis of existing databases as well as surveys, interviews and narratives. Quantitative results indicate high attrition rates of early career teachers in Chile, and teacher narratives show “critical” as well as “protective” conditions that foreshadow decisions to leave or the stay in the profession.     

#6: no separation of mother and baby with unlimited opportunity for breastfeeding

In this position paper-one of six care practice papers published by Lamaze International and reprinted here with permission-the value of keeping mothers and their babies together from the moment of birth is discussed and presented as an evidenced-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. Babies held skin-to-skin with their mothers cry less often, breathe easier, and stay warmer than babies who are separated from their mothers. They also instinctively attach to the breast and begin breastfeeding, usually within one hour of birth. The advantages of rooming-in for mother and baby are also discussed. The accompanying commentary-written by two leading professionals in the field of maternity care and pediatrics-provides further evidence to support the practice of keeping mothers and their babies together after birth. Lamaze International encourages women to give birth in settings that do not separate mothers and babies after birth.     

Childbirth education for multiple pregnancy: part 2: intrapartum and postpartum considerations

Women with a multiple pregnancy can expect a different labor and birth course than those with a singleton pregnancy. While the postpartum period is similar to that of families with a singleton, it is likely to be more hectic in families with multiple infants. In addition, a multiple pregnancy increases both maternal and neonatal risks; therefore, women with a multiple pregnancy may experience slight differences in care due to these potential risks, including additional monitoring and treatment. This article discusses the intrapartum and postpartum considerations families with a multiple pregnancy/birth may experience. This information is provided so that the childbirth educator can incorporate this content into courses, as appropriate, and assist families with a multiple pregnancy to anticipate a realistic birth and postpartum experience.     

Sensory processing disorder in a primate model: evidence from a longitudinal study of prenatal alcohol and prenatal stress effects

Disrupted sensory processing, characterized by over- or underresponsiveness to environmental stimuli, has been reported in children with a variety of developmental disabilities. This study examined the effects of prenatal stress and moderate-level prenatal alcohol exposure on tactile sensitivity and its relationship to striatal dopamine system function in thirty-eight 5- to 7-year-old rhesus monkeys. The monkeys were from four experimental conditions: (a) prenatal alcohol exposed, (b) prenatal stress, (c) prenatal alcohol exposed + prenatal stress, and (d) sucrose controls. Increased D(2) receptor binding in the striatum, evaluated using positron emission tomography neuroimaging, was related to increased withdrawal (aversion) responses to repetitive tactile stimuli and reduced habituation across trials. Moreover, prenatal stress significantly increased overall withdrawal responses to repetitive tactile stimulation compared to no prenatal stress.     

Access,attrition, test scores,and grades of college entrants and persisters: 1965–1973

This study contrasts the distributions of indices of academic abilities and achievements of entering freshmen classes and of classes at the end of the first year of college over an eight-year period. The data reported are based on two groups of students: one comprised of all students who completed the ACT Assessment Program and subsequently enrolled in college, and the other group comprised of all students in the first group completing their first year of college. Data collected show a decline in ACT test scores, an increase in the high school grades of college entrants, and the stability of test scores and increases in college grades of freshmen completing their first year of college.Presented at the American Association of Collegiate Registrars and Admissions Officers National Conference, Minneapolis, Minnesota, April, 1975.     

关于转基因问题的争论与思考

现今,在世界范围的研究领域中有多于100种农作物已被进行转基因改造,与转基因有关的食品多达7000种,包括婴儿食品、巧克力、冷冻甜品等。转基因作物能更好地抗病虫害、抗干旱、抗寒冷、抗盐碱、抗除草剂、提高产量等。此外,利用转基因技术还可以有选择地培育有利于人体健康和抗病作用的动植物新品种,为人类提供大量功能保健食品。而随着人类社会的不断发展,人口数量飞速增长和自然资源严重减少和匮乏之间的矛盾如何解决?本文通过对转基因食品的发展、对转基因食品安全性的评价和管理,以及转基因食品所引发的争论进行探讨和思考,以期能更科学地认识转基因食品。     

Becoming,being and unbecoming an early childhood educator: a phenomenological case study of teacher attrition

This article reports on a phenomenological case study that explored the blossoming and wilting of an early childhood educator's career commitment and her eventual decision to leave the field. Spanning a 7-year period, the study employs representation and analysis of metaphors as heuristic tools to illuminate the lived experience of becoming, being and unbecoming an early childhood educator. The study highlights the need to explore further the interplay between personal, relational and contextual influences if we are to develop a more comprehensive understanding of staff attrition.     

Perinatal experiences: the association of stress, childbearing, breastfeeding, and early mothering

The support of women and their families through childbirth, breastfeeding, and early parenting experiences are often treated as separate areas of maternity care. In fact, growing evidence, as cited in this article, links their intertwined impact on the health of mothers, infants, and their families.