A Process-Oriented Breastfeeding Training Program for Healthcare Professionals to Promote Breastfeeding: An Intervention Study
BREASTFEEDING MEDICINE
Authors: Ekstrom, Anette; Kylberg, Elisabeth; Nissen, Eva
Abstract
Aim: The aim of the study was to evaluate the effects of process-oriented training in supportive breastfeeding counseling for midwives and postnatal nurses on the time lapse between the initial breastfeeding session, introduction of breastmilk substitutes and solids, and the duration of breastfeeding. Materials and Methods: Ten municipalities in Sweden were randomized to either the intervention or control groups. The intervention included a process-oriented training program for midwives and postnatal nurses in the intervention municipalities. Primiparas (n = 540) living in either an intervention or control municipality were asked to participate in a longitudinal study to evaluate the care given. Data collection for control group A (CGA) (n = 162) started before the intervention was initiated. Data for control group B (CGB) (n = 172) were collected simultaneously with the intervention group (IG) (n = 206). The mothers responded to questionnaires at 3 days, 3 months, and 9 months postpartum. Results: As a result of the process-oriented training program for midwives and postnatal nurses, the IG mothers had a significantly longer duration of exclusive breastfeeding, even if the initial breastfeeding session did not occur within 2 hours after birth, than the corresponding group of CGA mothers (p = 0.01). Fewer infants in the IG received breastmilk substitutes (in the first week of life) without medical reasons compared with the control groups (p = 0.01). The IG infants were significantly older (3.8 months) when breastmilk substitutes were introduced (after discharge from the hospital) compared with the infants in the control groups (CGA, 2.3 months, p = 0.01; CGB, 2.5 months, p = 0.03). Conclusion: A process-oriented training program for midwives and postnatal nurses was associated with a reduced number of infants being given breastmilk substitutes during the 1st week without medical reasons and delayed the introduction of breastmilk substitutes after discharge from the hospital.
Concentration and distribution of mercury in drainage catchment sediment and alluvial soil of China
JOURNAL OF GEOCHEMICAL EXPLORATION
Authors: Wang, Xueqiu; Liu, Xuemin; Han, Zhixuan; Zhou, Jian; Xu, Shanfa; Zhang, Qin; Chen, Haijie; Bo, Wei; Xia, Xing
Abstract
The China Geochemical Baselines (CGB) project provides nation-wide catchment sediment/alluvial soil geochemical baseline data for 76 elements including Hg from 3382 top (0-25 cm) and 3380 deep sediment/alluvial soil samples (under a depth of 100 cm) at 3382 sampling sites, corresponding to a sampling density of about 1 site per 3000 km(2). Mercury was determined by cold vapour generation atomic fluorescence spectrometry (AFS) under strict quality control using field duplicates, standard reference materials and analytical replicate samples. The 25th percentile is at 13 and 11 mu g/kg in top and deep sediment/alluvial soil samples, respectively; these concentrations are close to the crustal abundance in China. The median Hg value is at 26 and 18 mu g/kg in top and deep sediment/alluvial soil samples, respectively; the 75th percentile is 56 mu g/kg in top and 36 mu g/kg in deep sediment/alluvial soil samples. Mercury concentrations at the 50th (26 mu g Hg/kg) and 75th (56 mu g Hg/kg) percentiles exhibit systematic enrichment in the near-surface material. The Hg distribution maps show distinct increasing trends from northern to southern and from western to eastern China, which are primarily related to the distribution of parent rocks, including rocks associated with mineral resources of Hg, Sb, Au, As, Pb-Zn, and climate, resulting in different soil types, as well as to population density with accompanying industrial development. Anomalous Hg concentrations in top sediment/alluvial soil samples above the 85th percentile (87 mu g/kg) occur mainly in south and south-west and sparsely in north and east China; they most likely have a dual origin, natural and human-induced, with the latter having a greater contribution because of the intense industrial activities, and particularly mercury emissions from Hg, Sb, As, Au, Pb-Zn mining, coal combustion, and production of batteries, fluorescent lamps, thermometers and cement. The spatial distribution map of Hg ratios of top to deep sediment/alluvial soil samples displays higher values, suggesting that top samples are most likely polluted from human activities in the highly populated urban areas of eastern China. About 6.86% and 3.52% of top and deep sediment/alluvial soil samples, respectively, have Hg concentrations higher than the soil contamination limit of 150 mu g/kg set by the National Environmental Standards for Heavy Metals of the People's Republic of China. (C) 2015 Elsevier B.V. All rights reserved,