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Lifelong eating behaviours are established in childhood. Improving parents' food literacy skills is essential, as parents play a fundamental role in establishing their children's healthy eating behaviours and preferences for nutritious food. This paper describes the development and evaluation of an innovative program that combines food literacy with positive parent feeding practices, targeting parents in disadvantaged areas of Western Australia. The Food Sensations® for Parents five‐week program was delivered to participants from community‐based parenting organisations during 2020 and 2021. Formative research and a pre‐post evaluation design were adopted. Pre‐ and post‐evaluation data were collected from 224 participants (96% female). There was a statistically significant improvement in the mean score for 13 food literacy behaviours, 10 positive parenting feeding practices and a mean increase in parents' daily vegetable intake of 1/3 serve. Participants reported significantly greater net improvements in food literacy behaviours than feeding practices, the largest being the Use a nutrition information panel to make food choices(33.1%). Multivariate logistic regression analyses found English as a first language, being older than 35, and from a higher Socio‐Economic Index for Areas resulted in a higher likelihood of positive changes in behaviours and practices. The findings indicate that the program is effective in improving the frequency of use of food literacy behaviours, positive parenting feeding practices and increasing vegetable consumption. Analysing improvements in food literacy behaviours and feeding practices provides clarity on what change can be expected with a five‐week parent program.

IMPORTANCE: Despite a lack of effectiveness data in humans, tecovirimat was widely prescribed to people with HIV (PWH) with mpox during the 2022 mpox epidemic, particularly PWH with low CD4+ T-cell counts or severe mpox clinical manifestations. OBJECTIVE: To evaluate if PWH with mpox who were treated with tecovirimat within 7 days of symptom onset were less likely to have mpox disease progression. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included PWH diagnosed with mpox at 4 hospitals in Atlanta, Georgia, between June 1 and October 7, 2022. Patients were grouped according to whether they were treated with tecovirimat within 7 days of mpox symptom onset (early tecovirimat cohort) or they did not receive tecovirimat or received the drug 7 or more days after symptom onset (late or no tecovirimat cohort). Multivariable logistic regression models were used to identify factors associated with progression of mpox disease. The 2 cohorts were then matched 1:1 using propensity scores based on the identified factors, and mpox disease progression was compared. EXPOSURES: Treatment with tecovirimat within 7 days of mpox symptom onset. MAIN OUTCOME AND MEASURES: Progression of mpox disease, defined as the development of at least 1 severe mpox criterion established by the US Centers for Disease Control and Prevention, after symptom day 7. RESULTS: After propensity score matching, a total of 112 PWH were included in the analysis; 56 received tecovirimat within 7 days of mpox symptom onset (early tecovirimat group) and 56 were either treated later or did not receive tecovirimat (late or no tecovirimat group). In the early tecovirimat group, the median (IQR) age was 35 (30-42) years; 54 individuals (96.4%) were cisgender men, 46 (82.1%) were Black individuals, and 10 (17.9%) were individuals of other races (American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, or White) or unknown race. In the late or no tecovirimat group, the median (IQR) age was 36 (32-43) years; 54 (96.4%) were cisgender men, 49 (87.5%) were Black individuals, and 7 (12.5%) were individuals of other races or unknown race. Mpox disease progression occurred in 3 PWH (5.4%) in the early tecovirimat group and in 15 PWH (26.8%) in the late or no tecovirimat group (paired odds ratio, 13.00 [95% CI, 1.71-99.40]; P = .002). CONCLUSION AND RELEVANCE: Results of this cohort study support starting tecovirimat in all PWH as soon as an mpox diagnosis is suspected. Additional research is warranted to confirm these findings.

The COVID‐19 pandemic has seen evidence and advice evolve quickly. Since the start of the pandemic there has been confusion and concern about breastfeeding and COVID‐19, and advice for this group has at times been contradictory. The volume of information on social media has exacerbated this. This study aimed to understand breastfeeding‐related COVID‐19 information sharing on social media during the global and Australian vaccine roll‐out. The CrowdTangle platform was used to source data from December 2020 to December 2021. Posts were categorised to intent and source and mapped to a timeline of pandemic‐related events and announcements. Descriptive analysis was used to understand data distribution patterns and qualitative analysis for post‐intent. A total of 945 posts were included. Post‐interactions ranged from 0 to 6500. Vaccine‐related posts were the highest in number and increased over time. Non‐profit organisations shared the highest number of posts (n= 241), but interactions were highest with personal and government accounts. Peaks in posts and interactions mapped to key pandemic‐related announcements and events. These results describe the breastfeeding and COVID‐19 related content shared on Facebook over 13 months, and the associated interactions. Breastfeeding is an important public health issue and breastfeeding women have experienced conflicting and confusing breastfeeding‐related information during the COVID‐19 pandemic. Better understanding of social media usage, and the monitoring of changes in usage, as an emergency unfolds, can help target communications. This article adds to the evidence in understanding user reactions to COVID‐19 related breastfeeding information on social media. Social listening is an important part of health communication and infodemic management. Understanding how users react to and engage with COVID‐19 related breastfeeding information on social media can help to understand how the general public perceives and responds to health advice and other information being shared.

Developing acute hepatitis B in immunocompetent non-responders to hepatitis B vaccination has been rarely reported. We report such a case in a 79 year old heterosexual male. There is evidence that tenofovir disoproxil/emtricitabine as primary prophylaxis can prevent acquisition of hepatitis B. In the current era of HIV pre-exposure prophylaxis (PrEP) with tenofovir disoproxil/emtricitabine, there is dual benefit of preventing HIV and hepatitis B. We discuss the importance of considering tenofovir disoproxil/emtricitabine pre-exposure prophylaxis in those hepatitis B vaccination non-responders at high risk of acquiring hepatitis B.

AbstractThis paper presents a new perspective on the role of the artifact in knit design research. The artifact is presented as a stimulus for interdisciplinary research where practice based enquiry provides only part of the required methodological approach. Reporting on a major collaboration between the curator of the Oriental Collection at The Royal Armories, Leeds, and researchers from the School of Design at The University of Leeds, this paper pursues two key trajectories. Firstly, the paper outlines how the artifact can be used as a design stimulus for interdisciplinary collaboration. This is assessed across multiple stages of design and through the production of several perspectives on key thematic ideas. Secondly, the paper reports on how collaboration, specifically in the development of these alternative perspectives, can lead to materials innovation. These two points of discussion are contextualized with reference to interior architectural installation, Inflection, and supported by analysis of The Knitting Machine, Cocoonand knitted exterior installation Configure. Findings highlight how the use of artifacts enables practitioners to adapt thinking using material practice in order to generate new knowledge.

AbstractIt is widely acknowledged that textile processing is increasingly unsustainable, for example textile dyeing is experiencing a rising use of water. It is imperative to investigate alternative strategies to colouration and whilst there is no single resolution to the problem, using design intelligence from diverse design specialisms, in this instance knitted fabric design, can offer a realistic framework within which to develop solutions.Following established design methodologies, successful knit design requires knowledge of materials, process, technology and aesthetics which is utilised in unique combinations to create a specified product. Disrupting this approach to design through the application of innovative technologies or removing the concept of designing for a specified product, this unique body of knowledge can question wider societal problems, including textile coloration, and determine a range of solutions through knitted fabric design practice.The paper will report on the development of sustainable textile coloration through innovative lighting technologies. New research explores the breadth of colour gamut achievable with a limited palette of yarn (so minimising dyeing) when recognised optical effects, for example optical mixing, are observed in different lighting conditions. The iterative design/research methodology used exploits the materiality and structural knowledge inherent in knitted fabrics and allows the creation of unique fabrics, which would be unachievable in any other medium, to test ideas abductively. A feature of this methodology is an acceptance of unexpected outcomes that challenge the concept of designing for a specified product. The fabrics produced are not in themselves functional, except as a communication tool for the knowledge revealed through the design research.

Background:Students and clinicians are challenged to locate evidence to answer clinical questions. Searching experiences include frustration with words to query databases, lack of searching skills, lack of confidence in nursing databases, and questioning how many databases to search. To implement practice change based on best available evidence, search strategies need to be efficient and effective.Method:We replicated the systematic review by Stillwell, Vermeesch, and Scott, which used a specific search, with a sensitive search to compare search strategies to answer the clinical question.Results:The specific search produced 5,108 articles, with eight being relevant; whereas the sensitive search produced 11,362 articles with nine being relevant.Conclusion:The sensitive search located the same eight studies and one additional study. If PubMed instead of MEDLINE had been used in the specific search, the results would have been identical. The sensitive search located the same eight studies and one additional study. If PubMed instead of MEDLINE had been used in the specific search, the results would have been identical. [[J Nurs Educ. 2020;59(1):22–25.]

Background: An unmet need for contraception is associated with unintended pregnancy and adverse maternal and childhood outcomes. Family planning counselling is linked with reduced unmet need for contraception. However, evidence is lacking in Ethiopia on the impact of integrated family planning counselling on the unmet need for contraception. This study aimed to examine the association between family planning counselling and the unmet need for contraception in Ethiopia. Methods: We used community-based prospective cohort study data from a nationally representative survey conducted by Performance Monitoring for Action Ethiopia between 2019 and 2020. Women who had received three maternal and child health (MCH) services (n = 769) - antenatal care (ANC), facility delivery and child immunisation - were included in this study. The primary exposure variable was family planning counselling provided during the different MCH services. A weighted modified Poisson regression model was used to estimate the adjusted relative risk (aRR) of the unmet need for contraception. Results: The prevalence of family planning counselling during ANC, prior to discharge, and child immunisation was 22%, 28%, and 28%, respectively. Approximately one-third (34%) of the women had an unmet need for contraception. Family planning counselling prior to discharge from the facility was associated with reductions in the unmet need for contraception (aRR 0.88; 95% CI 0.67, 1.16). The risk of unmet need for contraception was 31% (aRR 0.69; 95% CI 0.48, 0.98) less likely among women who had received family planning counselling during child immunisation services. However, family planning counselling during ANC was associated with an increased unmet need for contraception (aRR 1.24; 95% CI 0.93, 1.64). Conclusion: Strongest evidence was observed for moderate associations between reductions in the unmet need for contraception and family planning counselling during the provision of child immunisation services in Ethiopia.

We assess the productivity, outcomes, and experiences of participants in the National Institutes of Health/National Heart, Lung, and Blood Institute–funded K12 institutional research training programs in emergency care research.

AbstractBackground:Approximately one in five Western women who breastfeed are likely to experience acute mastitis. This study investigated the incidence and risk factors of acute mastitis in a cohort of Iranian women.Subjects and Methods:Subjects were 672 participants of the Shiraz Infant Feeding Study conducted between June 2014 and March 2015. Mothers were recruited from the maternity ward and followed up at 1, 3, 4, and 6 months postpartum to obtain information on their breastfeeding practices and experiences. The occurrence of acute mastitis in the first 26 weeks postpartum was self-reported and the occurrence of acute mastitis in the first 4 weeks and between 5 and 12 weeks postpartum was treated as separate outcomes. The risk factors for acute mastitis were explored using multivariable logistic regression analysis.Results:In total, 130 mothers (19.3%, 95% confidence interval: 16.3–22.3%) experienced at least one episode of acute mastitis. Having expressed breast milk and use of a pacifier were significantly associated with acute mastitis in both the first 4 weeks and between 5 and 12 weeks postpartum. Persistent problems with cracked or sore nipples, or engorged breasts, and a reduction in breastfeeding were associated with acute mastitis between 5 and 12 weeks.Conclusions:The incidence of acute mastitis experienced by this cohort of Iranian women is similar to that reported for women in Western countries. The risk factors of acute mastitis identified in this study are potentially modifiable and could be prevented or ameliorated with adequate support and anticipatory guidance provided in the early postpartum period.

Evaluating complex health promotion interventions that use mobile apps requires comprehensive and adaptive evaluation plans. As mobile usage becomes increasingly sophisticated and personalised, broad evaluation plans are important in determining the impact and efficacy of a mobile health (mHealth) app. Evaluation should consider user feedback and outcome measures, as well as examine elements such as the robustness of the technology, the intervention principles and engagement strategies, and the interaction of the user with the technology. This paper introduces four mHealth evaluation models and tools and describes the evaluation plan that has been developed for Milk Man, a breastfeeding app targeting new and expectant fathers. Milk Man is a socially connected, gamified app that is being tested in a large Randomised Control Trial (RCT). While there is a need for mobile apps to be evaluated in adequately powered RCTs, trialling mobile apps over a long period of time presents challenges. Incorporating robust evaluation design will help ensure that technological performance, app intervention principles, as well as health and behavioural outcomes are measured. The detail and scope of the Milk Man app evaluation plan will ensure the findings add to the evidence base and have broad relevance to health promotion practitioners. Evidence about the efficacy of mHealth interventions is an emerging area and appropriate evaluation skills are needed. This paper illustrates an evaluation planning approach for mHealth interventions that could be adapted for use by health promotion practitioners and researchers. Mobile interventions are increasingly being incorporated into health promotion programs. As a result, practitioners are required to develop appropriate evaluation plans. This paper describes a number of evaluation tools and models, and provides a case study of the evaluation plan developed for the Milk Manapp. The examples discussed can provide guidance for practitioners seeking to develop mHealth interventions.

Objective:To explore factors associated with sugar‐sweetened beverage (SSB) consumption in Australia. Methods:Pooled data from Western Australian (WA) and South Australian (SA) 2009 and 2012 nutrition monitoring survey series interviews of 2,832 WA and 10,764 SA adults aged 18 to 64 years. Demographic data were collected and independent samples t‐test, analysis of variance, multiple logistic regression performed. Results:Obese participants were more likely to consume SSB than healthy weight participants (SA: OR=1.77; 95% CI 1.56–2.02; WA: OR=1.53; 1.05–2.24). SA obese participants consumed more SSB per day (152.0 mL; 140.7–163.5) than healthy weight (80.1 mL; 73.2–88.2; p<0.001) and overweight participants (106.9 mL; 99.0, 114.8; p<0.001). Males were more likely to consume SSB than females (SA: OR 1.80; 1.35–2.40; WA: 1.81; 1.64–2.00). WA participants who didn't think about the healthiness of food (4.55; 2.71–7.64) and bought meals away from home the day prior (1.55; 1.15–2.09) were more likely to consume SSB. SA adults rating their health highest were less likely to consume SSB (0.62; 0.54–0.72). Conclusions:SSB consumers are more likely to be male, have little interest in health, or have purchased a meal away from home. Implications:Increasing awareness of the adverse health effects of consumption may be a first step in curbing SSB intake.

To explore factors associated with sugar‐sweetened beverage (SSB) consumption in Australia.

Objective:Functional data analysis (FDA) is a forecasting approach that, to date, has not been applied to obesity, and that may provide more accurate forecasting analysis to manage uncertainty in public health. This paper uses FDA to provide projections of Body Mass Index (BMI), overweight and obesity in an Australian population through to 2019. Methods:Data from the South Australian Monitoring and Surveillance System (January 2003 to December 2012, n=51,618 adults) were collected via telephone interview survey. FDA was conducted in four steps: 1) age‐gender specific BMIs for each year were smoothed using a weighted regression; 2) the functional principal components decomposition was applied to estimate the basis functions; 3) an exponential smoothing state space model was used for forecasting the coefficient series; and 4) forecast coefficients were combined with the basis function. Results:The forecast models suggest that between 2012 and 2019 average BMI will increase from 27.2 kg/m2to 28.0 kg/m2in males and 26.4 kg/m2to 27.6 kg/m2in females. The prevalence of obesity is forecast to increase by 6–7 percentage points by 2019 (to 28.7% in males and 29.2% in females). Conclusions:Projections identify age–gender groups at greatest risk of obesity over time. The novel approach will be useful to facilitate more accurate planning and policy development.

AbstractBackground:Mastitis is a painful problem experienced by breastfeeding women, especially in the first few weeks postpartum. There have been limited studies of the incidence of mastitis from traditionally breastfeeding societies in South Asia. This study investigated the incidence, determinants, and management of mastitis in the first month postpartum, as well as its association with breastfeeding outcomes at 4 and 6 months postpartum, in western Nepal.Subjects and Methods:Subjects were a subsample of 338 mothers participating in a larger prospective cohort study conducted in 2014 in western Nepal. Mothers were interviewed during the first month postpartum and again at 4 and 6 months to obtain information on breastfeeding practices. The association of mastitis and determinant variables was investigated using multivariable logistic regression, and the association with breastfeeding duration was examined using Kaplan–Meier estimation.Results:The incidence of mastitis was 8.0% (95% confidence interval, 5.1%, 10.8%) in the first month postpartum. Prelacteal feeding (adjusted odds ratio = 2.76; 95% confidence interval, 1.03, 7.40) and cesarean section (adjusted odds ratio = 3.52; 95% confidence interval, 1.09, 11.42) were associated with a higher likelihood of mastitis. Kaplan–Meier estimation showed no significant difference in the duration of exclusive breastfeeding among the mothers who experienced an episode of mastitis and those who did not.Conclusions:Roughly one in 10 (8.0%) women experienced mastitis in the first month postpartum, and there appeared to be little effect of mastitis on breastfeeding outcomes. Traditional breastfeeding practices should be encouraged, and the management of mastitis should be included as a part of lactation promotion.

Functional data analysis (FDA) is a forecasting approach that, to date, has not been applied to obesity, and that may provide more accurate forecasting analysis to manage uncertainty in public health. This paper uses FDA to provide projections of Body Mass Index (BMI), overweight and obesity in an Australian population through to 2019.

Local governments are uniquely placed to influence the food environment of their communities through healthy eating policies (HEPs) but very few have done so. Using a community-based participatory approach, Healthy Eating Local Policies and Programs built the capacity of South Australian local governments to develop and implement a HEP by leading the development of a HEP framework then mentoring local governments to develop their own local policy tailored to their community. Over a 2-year period, 31 of the 68 local governments worked towards developing a HEP, with 14 receiving endorsement by December 2013. Local governments are ready to model healthy eating practices and adopt healthy eating policy that supports the health of their communities. A HEP developed using a participatory approach and with the flexibility to be tailored to local preferences and demographics appears feasible, although the process may be lengthy. This process and outcome appears applicable and transferable to other local governments. As local governments take up their responsibilities in promoting health and wellbeing, HEPs provide important structural mechanisms to enable councils to facilitate healthy eating in their local communities. Local governments are uniquely placed to influence the food environment of their communities through healthy eating policies (HEPs) but few have done so. Using a community-based participatory approach, the capacity of 31 South Australian local governments to develop and implement a HEP was increased with 14 endorsed policies. HEPs provide important structural mechanisms to enable local governments to facilitate healthy eating.

Although the addition of the HCV NS3/4A protease inhibitors boceprevir and telaprevir to pegylated interferon (peginterferon) alfa plus ribavirin has improved sustained virological response (SVR) in treatment-naive and treatment-experienced patients infected with hepatitis C virus (HCV) genotype 1, the regimens have a high pill burden and are associated with increased rates and severity of adverse events, such as anaemia and rash. The efficacy and safety of the combination of simeprevir, a one pill, once-daily, oral HCV NS3/4A protease inhibitor, plus peginterferon alfa 2a plus ribavirin were assessed in treatment-naive patients with HCV genotype 1 infection.

Pegylated interferon (peginterferon) alfa 2a or 2b plus ribavirin regimens were the standard of care in patients with hepatitis C virus (HCV) infection, but the sustained virological response can be suboptimum in patients with HCV genotype 1 infection. The efficacy, safety, and tolerability of the combination of simeprevir, a one-pill, once-daily, oral HCV NS3/4A protease inhibitor versus placebo, plus peginterferon alfa 2a or 2b plus ribavirin was assessed in treatment-naive patients with HCV genotype 1 infection.

Women who are breastfeeding have increased requirements for energy and nutrients. Nutritional requirements for lactation have been the subject of several international reports and are included in general nutrient requirements documents, including those of the USA, Australia, European Union and WHO. Recommendations are made for all pregnant women to take folic acid prior to becoming pregnant and during the first trimester of the pregnancy and iodine supplementation is recommended in Australia and many other countries during pregnancy and lactation. The current WHO/ICCIDD/UNICEF recommendation for daily iodine intake (250 g for lactating mothers) has been selected to ensure that iodine deficiency does not occur in the postpartum period and that the iodine content of the milk is sufficient for the infants iodine requirement. While recommendations for nutritional supplements during pregnancy are specific, recommendations are usually less specific for lactation. The aim of this study was to review the use of supplements during lactation and to document the use of nutritional supplements in a cohort of mothers who are breastfeeding in Perth, Western Australia. A literature search was undertaken of reviews published between January 2000 and May 2011 and further analysis was undertaken of supplement usage in the Perth Infant Feeding Survey. In the USA the limited data that is available suggest that supplement use during lactation is dependent on demographic, sociologic, and economic factors and that more women take supplements during pregnancy than during lactation. Data from the NHANES III study show that ethnicity and income predicted iron supplementation during lactation, with 77 of non-Hispanic white women reporting supplement use compared with 41 of non-Hispanic black or Mexican American women. Multivitamin-multimineral use was the most frequently reported dietary supplement (33). In a cohort study of postpartum mothers in Australia the use of supplements fluctuated between 40 to 30, with 35 still taking supplements a year after birth. During their pregnancy 78 of mothers took a folic acid supplement and 21 took an iron supplement. Mothers who took supplements were more likely to continue breastfeeding. More studies are needed to document supplement use by lactating mothers in different cultures and countries.

Objective: To review the effect of pacifier use in healthy term infants on breastfeeding duration and the risk of Sudden Infant Death Syndrome (SIDS). Design: Two systematic reviews were conducted of published studies (meta-analysis, Systematic Literature Reviews (SLRs), Randomised Controlled Trials (RCTs), cohort, case-control or cross-sectional studies). Electronic databases were searched for articles that assessed the effect of infant pacifier use on the risk of SIDS and/or on breastfeeding outcomes. Retrieved articles were assessed for validity and quality using the Dietitians Association of Australia (DAA) Quality Criteria Checklist and the NHMRC Evidence Hierarchy before being included in the review. Results: The initial search of the databases resulted in 68 references on the use of pacifiers and SIDS; three articles (1 meta-analysis, 1 SLR, 1 narrative review) received a positive rating according to the DAA checklist. The three publications consistently found pacifier use at last sleep was associated with a significant reduction in the risk of SIDS and to a lesser extent, routine pacifier use also provided a significant reduction in the risk. Searching the electronic databases for use of pacifiers and breastfeeding duration resulted in 188 publications and four of these publications were retrieved for analysis (1 Cochrane review, 1 SLR, 1 meta-analysis, 1 cohort study). The epidemiological evidence found pacifier use reduced the duration of any, full and exclusive breastfeeding, but this effect was not significant in four out of the five RCTs analysed in the Cochrane review and the SLR. Conclusion: The present review provides evidence of the association between pacifier use during the postnatal period and a decreased risk of SIDS whilst also drawing attention to the negative association between early pacifier use and reduced duration of breastfeeding (any, full and exclusive). This is the first review to emphasise the U-shaped effect of pacifiers on infant health. When assessing the totality of the evidence the results indicate that pacifiers should be advised against in the first month of life, but after the first month pacifier use may reduce the probability of SIDS.

The article presents highlights of the activities during the opening of the Visitors Pavilion at the National Butterfly Center on October 28, 2010. The ribbon-cutting ceremony was led by North American Butterfly Association (NABA) president Jeffrey Glassberg, National Butterfly Center Advisory Committe co-chairpersons Jose Amador and Margarette McAllen. It recounts events and setbacks that preceded the ceremony since acquiring the land on the Lower Rio Grande Valley, until construction in 2004 by architects Wendy Evans Joseph and Chris Cooper.

There are many differences in diet and lifestyle across Europe that may influence the development of the infant gut microbiota. This work aimed to assess the impact of geographic area, mode of delivery, feeding method, and antibiotic treatment on the fecal microbiota of infants from 5 European countries with different lifestyle characteristics Sweden, Scotland, Germany, Italy, and Spain.

There are many differences in diet and lifestyle across Europe that may influence the development of the infant gut microbiota. This work aimed to assess the impact of geographic area, mode of delivery, feeding method, and antibiotic treatment on the fecal microbiota of infants from 5 European countries with different lifestyle characteristics: Sweden, Scotland, Germany, Italy, and Spain. Fecal samples from 606 infants (age 6 weeks) recruited within the European project INFABIO were analyzed by fluorescent in situ hybridization combined with flow cytometry using a panel of 10 rRNA targeted group- and species-specific oligonucleotide probes. Information on factors potentially affecting gut microbiota composition was collected with questionnaires and associations were evaluated with multivariate analyses. The Bifidobacteriumgenus was predominant (40% average proportion of total detectable bacteria), followed by Bacteroides(11.4%) and enterobacteria (7.5%). Northern European countries were associated with higher proportions of bifidobacteria in infant feces, whereas a more diverse microbiota with more bacteroides characterized southern countries. Bifidobacteria dominated the microbiota of breast-fed infants, whereas formula-fed babies had significantly higher proportions of Bacteroidesand members of the Clostridium coccoidesand Lactobacillusgroups. Newborns delivered by cesarean section or from mothers treated with antibiotics perinatally had lower proportions of Bacteroidesand members of the Atopobiumcluster. Delivery mode and feeding method influenced the fecal microbiota of European infants at 6 weeks, as expected, but the effect of country of birth was more pronounced, with dominant bifidobacteria in northern countries and greater early diversification in southern European countries.

To compare the sources of information about breastfeeding given to Aboriginal and nonAboriginal mothers in Australia. Cohort studies were undertaken on two groups of mothers who gave birth in the Perth metropolitan area; the Perth Infant Feeding Study and the Perth Aboriginal Breastfeeding Study Similar questions were asked . of 556 non-Aboriginal and 425 Aboriginal mothers. Aboriginal mothers were more likely (88%) to be given a pamphlet about breastfeeding than nonAboriginal mothers (56%). On the other hand, they were far less likely to receive any other form of education about breastfeeding. Aboriginal mothers were less likely to have discussed potential infant feeding methods with the baby's father prior to delivery. Aboriginal mothers are less likely to participate in health promotion activities about breastfeeding. There is a need to improve and increase antenatal breastfeeding information for Aboriginal Australian mothers. The young age at which many Aboriginal mothers give birth suggests that health promotion for motherhood could usefully be given to senior high school students.

The purpose of this study is to review demographics and examine and stratify risk factors related to the outcome of operatively treated iliac vascular injuries. We conducted a retrospective review of 78 cases of iliac vessel injury. Patients with blunt and penetrating injury had statistically similar length of hospital stay and intensive care unit stay, incidence of shock, and mortality. Shock on admission and bleeding hematoma are linked, and shock increased mortality with an odds ratio of 5.2 (P= 0.002). A review of operative technique and outcome demonstrated a low mortality of 25 per cent in arterial bypass of an isolated arterial injury versusa mortality of 83 per cent in the combined injury group. Patients treated with primary repair of venous injuries had a lower incidence of shock and mortality compared with patients treated with venous ligation. We conclude that, if matched for severity of injury and physiologic instability, the mechanism of injury does not affect mortality. Shock is the most significant prognostic factor for mortality. Operative management must be based on presence of shock.

A prospective study of 556 women from Perth, Western Australia, and 503 women from the Darling Downs area, Queensland, Australia, was conducted to identify factors associated with the abandonment of breastfeeding prior to hospital discharge. In total, 88% ofwomen initiated breastfeeding, but 5% discontinued breastfeeding while still in the hospital. Discontinuation of breastfeeding prior to discharge was associated with a number of psychosocial factors, namely, infant feeding method being chosen after becoming pregnant, a perception by the mother that the infant%’s father either preferred formula feeding or was ambivalent about how the infant was fed, and whether the mother's own mother had ever breastfed. Judicious questioning prenatally regarding a woman's commitment to, social support for, and prior exposure to breastfeeding will help identify thosewomen most at risk of abandoning breastfeeding prematurely. Such women should be targeted for additional support while in the hospital.

Presents information on the attractions of Leeuwin-Naturaliste Ridge in Western Australia. Location of the ridge; History of the ridge; Amalgation of several wildlife protection agencies for the ridge.

Placentas either in situ or mechanically separated from their uterine beds were surveyed by scanning electron microscopy to determine the changing relationship of the placenta to its uterine bed with special reference to alteration in the decidua basalis accompanying parturition.

• The clinical efficacy of an acellular pertussis vaccine containing lymphocytosis-promoting factor, filamentous hemagglutinin, agglutinogens, and the 69-kd outer membrane protein, combined with diphtheria and tetanus toxoids and adsorbed onto an aluminum salt, was assessed in a household contact study. The occurrence of pertussis 7 to 30 days following home exposure among 62 previously vaccinated children was compared with that among 62 unvaccinated children similarly exposed. Classic whooping cough was diagnosed in 43 unimmunized children, and 1 vaccinated child experienced a 5-week illness that was probably pertussis (efficacy, 98%; 95% confidence interval, 84% to 99%). A few children in each group incurred respiratory illnesses that may have represented mild, atypical pertussis; including these as probable pertussis, vaccine efficacy was 81% (95% confidence interval, 64% to 90%). It is concluded that prior immunization with this four-component pertussis vaccine combined with diphtheria and tetanus toxoids is highly efficacious in preventing pertussis.(AJDC. 1990;144:899-904)

In this in vitro autoradiographic study of ANP-binding sites in fetal rats, 125I-ANP bound to receptors in certain developing neural crest derivatives, including the boundary caps, dorsal root ganglia, and Schwann cells of peripheral nerves. Within the spinal cord, ANP receptors were localized in the roof plate and floor plate. The developing meningeal layer of the CNS, blood vessels, lung, liver, and wall of the herniated gut were also labeled. The topographical and temporal correlation of the appearance of ANP receptors with the developmental processes of the targets suggests that ANP in the fetus is multifunctional, and may be involved in diverse events such as gliogenesis, formation of axonal pathways or surfactant production.

The development of immunoreactive atrial natriuretic peptide (ANP) was studied in fetal hearts of spontaneously hypertensive (SHR) and compared to normotensive Wistar-Kyoto (WKY) rats. While SHR fetal hearts were noticeably less developed than those of WKY at 10 and 11 days gestation, both strains showed ANP immunoreactive cells in some but not all primitive heart tubes. At 12 days additional ANP immunoreactive cells appeared in formative trabeculae of the ventricle and atrium. ANP cells were also observed in the myogenic layer of the truncus and bulbus arteriosus and their derivatives from 11 through 16 days, but not at 18 days. In both strains, there were more ANP cells in the left ventricle than in right beginning at day 13. There were no obvious strain differences in the developmental pattern and timing of ANP producing cells. However, on the day of birth, staining was reduced in hearts from some WKY newborn pups compared with hearts from SHR newborns and ventricular staining was reduced in both strains when compared to fetal hearts. These observations indicate that ANP is one of the earliest peptide hormones produced and that the predisposition to genetic hypertension does not appear to influence the development of ANP.