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Background: It has been reported that preterm infants may experience feeding difficulties in complementary food introduction. There is a lack of a comprehensive summary of the current evidence of the difficulties in complementary food introduction of preterm infants and how to intervene or solve these difficulties. So the purpose of this review is to systematically analyze the difficulties and solutions in the existing literature on it. Methods: A literature search was conducted in PubMed, Web of Science, Cochrane library and Scopus databases for the studies about complementary feeding in preterm infants. The time range of the search was from January 2012 to December 2021. Included studies were summarized and organized into two perspectives: (1) the difficulties of complementary feeding in preterm infants; (2) related factors influencing feeding difficulties and possible interventions. Results: A total of 6 articles were included in the systematic review ultimately. Three studies were cross-sectional study and the other three were longitudinal study. The current evidence demonstrated that feeding problems such as vomiting, gagging, food refusal, and chewing and swallowing difficulty might occur in complementary foods introduction in preterm infants. And preterm infants were more likely to experience these difficulties than full-term infants. Possible causes of these feeding difficulties include endotracheal intubation, gastric tube feeding, formula feeding, neonatal surgery, parenteral nutrition, etc. However, the available literatures do not provide specific intervention methods or guidelines to facilitate the complementary feeding in preterm infants. Conclusions: More experiments are needed to explore appropriate interventions to solve the problems and facilitate complementary feeding in preterm infants during infancy, and promote catch-up growth and develop good eating habits for preterm infants.

Understanding the main factors influencing energy intensity in China is important to reduce total energy consumption and protect the environment. Based on the OECD–WTO Database of Trade in Value-Added, we subdivide the secondary sector and employ the LMDI method to analyze how much changes in industrial structure and intra-industry energy intensity contribute to the overall change in energy intensity. The results prove that the change in intra-industry energy intensity is the main factor that influences the overall change in energy intensity in recent years. Furthermore, we use firm-level energy consumption data that cover various regions, scales and kinds of energy consumption, and employ firm fixed effects regression to analyze intra-industry influencing factors and find that the scale effect exists for coal, oil and electricity efficiency; foreign-invested firms have lower energy intensity; and firms in coal-rich areas have higher coal intensity. Our results show that if firms’ energy intensity decreases to the level of firms with lower energy intensity within the industry, total energy consumption will decrease considerably without changing the output or industry structure. This paper will give implications for developing countries, where it is difficult to make industrial structural changes to reduce energy consumption.

To improve the development level of intelligent dance education and choreography network technology, the research mainly focuses on the automatic formation system of continuous choreography by using the deep learning method. Firstly, it overcomes the technical difficulty that the dynamic segmentation and process segmentation of the automatic generation architecture in traditional choreography cannot achieve global optimization. Secondly, it is an automatic generation architecture for end-to-end continuous dance notation with access to temporal classifiers. Based on this, a dynamic time-stamping model is designed for frame clustering. Finally, it is concluded through experiments that the model successfully achieves high-performance movement time-stamping. And combined with continuous motion recognition technology, it realizes the refined production of continuous choreography with global motion recognition and then marks motion duration. This research effectively realizes the efficient and refined production of digital continuous choreography, provides advanced technical means for choreography education, and provides useful experience for school network choreography education.

Maternal nutrition during pregnancy plays a vital role in foetal growth and development. The present study aimed to describe the diet quality of pregnant women and explore the association between maternal diet and the prevalence of low birth weight (LBW) and small for gestational age (SGA). A total of 3 856 participants from a birth cohort in Beijing, China were recruited between June 2018 and February 2019. Maternal diet in the 1st and 2nd trimesters was assessed by inconsecutive 2-day 24-hour dietary recalls. The Chinese diet balance index for pregnancy (DBI-P) was used to assess the diet quality of the participants. Multivariate logistic regressions were performed to explore the independent effects of DBI-P components on LBW and SGA. The prevalence of LBW and SGA was 3.8% and 6.0%, respectively. Dietary intakes of the participants were imbalanced. The proportions of participants having insufficient intake of vegetables (87.3% and 86.6%), dairy (95.9% and 96.7%), and aquatic foods (80.5% and 85.3%) were high in both trimesters. The insufficiency of fruit intake was more severe in the 2nd trimester (85.2%) than in the 1st trimester (22.5%) (P0.05). After adjusting for potential confounders, the intake of fruits and dairy in the 2nd trimester was negatively associated with the risk of LBW (OR=0.850, 95% CI: 0.723-0.999) and SGA (OR=0.885, 95% CI: 0.787-0.996), respectively. The diet of Beijing pregnant women was imbalanced. Higher consumption of fruits and dairy products in the 2nd trimester was associated with lower risks of LBW and SGA. Sufficient consumption of fruits and dairy products in pregnancy may be suggested, in an attempt to prevent the occurrence of LBW and SGA.

Background Health benefits of fruit and vegetable have been well recognized. However, insufficient consumption of fruit and vegetable is prevalent among toddlers, and has become a global public health issue. Maternal feeding practices are potential factors influencing toddlers’ dietary intake, including fruit and vegetable intake. This study was conducted to explore the influence of maternal feeding practices on toddlers’ fruit and vegetable consumption in Ireland. Methods A follow-up to the DIT-Coombe Hospital birth cohort was conducted. Mothers in the original cohort were invited to participate in the present follow-up study by phone. A questionnaire assessing maternal feeding behavior and the child’s 3-day food diary was sent to mothers who agreed to take part in the present study by post, together with a self-addressed stamped envelope. Results There were 193 mother-children pairs included in the analysis, and the mean age of children was 2.4 (SD 0.7) years old. Toddlers’ mean daily intakes of vegetable and fruit were 67.57 (SD 45.95) g and 213.35 (SD 170.78) g, respectively. Logistic regression analyses showed that maternal practice of breastfeeding for more than 4 weeks was positively associated with fruit (OR = 2.93, 95% CI: 1.29–6.64) and vegetable (OR = 1.95, 95% CI: 1.00–3.81) intake or the contribution of fruit (OR = 2.62, 95% CI: 1.19–5.80) and vegetable (OR = 2.02, 95% CI: 1.02–3.99) to the total diet. Letting the child eat with other family members was associated with high vegetable intake (OR = 5.45, 95%CI: 1.69–17.61) and high contribution of vegetable to total diet (OR = 3.78, 95% CI: 1.04–13.82). Not being too worried about the child’s refusal to eat was positively associated with toddlers’ vegetable intake (OR = 2.10, 95%CI: 1.09–4.05). Conclusions To increase children’s fruit and vegetable intake, and develop good eating habits, parents should eat with their toddlers, be patient and not put much pressure on their children in the context of meal feeding.

Background Coronavirus Disease 2019 (COVID-19) has spread worldwide. The safety of breastfeeding of SARS-CoV-2-positive women has not yet reached a consensus among the scientific community, healthcare providers, experts in lactation care, health organizations and governments. This study was conducted to summarize the latest evidence about the safety of breastfeeding among suspected/confirmed infected mothers and to summarize the recommendations on breastfeeding during COVID-19 from different organizations. Methods A comprehensive literature review of publications about the safety of breastfeeding among SARS-CoV-2-infected mothers was conducted. Scientific databases were searched up to 26 May 2021. The evidence was summarized into five perspectives according to a framework proposed by van de Perre et al. with certain modifications. Moreover, websites of different health organizations were visited to gather the recommendations for breastfeeding. Results The current evidence demonstrated that the majority of infants breastfed by infected mothers were negative for SARS-CoV-2. Breast milk samples from suspected/infected mothers mainly demonstrated negative results in SARS-CoV-2 viral tests. There was insufficient evidence proving the infectivity of breast milk from infected mothers. Recent studies found other transmission modalities (e.g., milk containers, skin) associated with breastfeeding. Specific antibodies in the breast milk of infected mothers were also found, implying protective effects for their breastfed children. According to van de Perre’s criteria, the breast milk of infected mothers was unlikely to transmit SARS-CoV-2. Owing to the low quality of the current evidence, studies with a more robust design are needed to strengthen the conclusion regarding the safety of breastfeeding. Further studies to follow up the health status of infants who were directly breastfed by their suspected/infected mothers, to collect breast milk samples at multiple time points for viral tests and to examine specific antibodies in breast milk samples are warranted. Current recommendations on breastfeeding during COVID-19 from different organizations are controversial, while direct breastfeeding with contact precautions is generally suggested as the first choice for infected mothers. Conclusions This review determined the safety of breastfeeding and identified the focus for further research during the COVID-19 pandemic. Recommendations on breastfeeding are suggested to be updated in a timely manner according to the latest evidence.

Background Most studies of associations between parental support behaviours for physical activity (PA) and children’s moderate-to-vigorous physical activity (MVPA) have been conducted in developed countries, and they have focused on maternal or parental support behaviours. Children’s MVPA time (i.e., weekdays vs. weekends) has not been adequately differentiated. This paper investigated the associations of paternal and maternal support behaviours for PA with the proportion of children who met the MVPA recommendations on weekdays and weekends in China. Methods Cross-sectional data of 517 father–child dyads and 1422 mother–child dyads were analysed. The children recorded PA diaries on 7 consecutive days to assess their MVPA time. The father or mother completed a questionnaire concerning their support for children’s PA. Multivariate logistic regression was used to investigate the independent effects of paternal and maternal support behaviours for PA on whether children met the MVPA recommendations for weekdays, weekends, and the whole week. Results Significantly fewer children met the MVPA recommendations on weekends (37.8%) than on weekdays (62.8%). Higher paternal (odds ratio [OR] = 1.098, 95% confidence interval [CI]: 1.009–1.195) and maternal (OR = 1.076, 95% CI: 1.021–1.134) total support behaviour scores were associated with higher odds of children meeting the MVPA recommendations on weekends, after controlling for covariates. Paternal PA knowledge-sharing with the child was positively associated with children meeting the MVPA recommendations on weekends (OR = 1.319, 95% CI: 1.055–1.649); it tended to be associated with children meeting the MVPA recommendations on weekdays and throughout the week, although these associations were not statistically significant. Maternal reservation of PA time for the child was positively associated with a higher likelihood of children meeting the MVPA recommendations on weekdays (OR = 1.160, 95% CI: 1.025–1.313), weekends (OR = 1.241, 95% CI: 1.097–1.403), and throughout the week (OR = 1.214, 95% CI: 1.076–1.369). Conclusions Paternal and maternal support behaviours for PA should be enhanced on weekends to increase children’s MVPA. Fathers should share PA knowledge with children and mothers should reserve PA time for children every day.

Databases of PubMed, Scopus, and China National Knowledge Infrastructure (CNKI) were used to search relevant articles on sexual and reproductive health (SRH) in China published from 2005 to the present (2021), based on the World Health Organization’s (WHO) Operational Framework on Sexual Health and Its Linkages to Reproductive Health. The following results were found. (a) SRH education and information among the Chinese were insufficient, in particular regarding contraception, pregnancy, and sexually transmitted diseases (STDs). Adolescents, migrants, and the rural population had insufficient knowledge of SRH. (b) Fertility care services were mainly available in large cities, in urban areas, and for married couples. Services targeted for rural-to-urban migrants, rural residents, and the disabled and elderly are needed. (c) A total of 22.4% of youths aged 15–24 had premarital sexual intercourse, and the age of first sexual intercourse was decreasing. Risky sexual behaviors included multiple partners, casual and commercial sex, and having sex after drinking alcohol. (d) The contraceptive practice rate of women aged 15–49 in China was higher than the world’s corresponding figure. However, contraceptive use among young people was low (only 32.3% among unmarried women). (e) Unmarried pregnancy induced by low contraceptive practice is a critical issue in China. (f) Induced abortion was the major consequence of unmarried pregnancy. The rate of induced abortion among the general population in 2016 was 28.13‰, and the rate among unmarried women was increasing annually. (g) There were 958,000 HIV-infected cases in China as of October 2019. Sexual transmission was the major transmission route of HIV-AIDS. More men than women were infected. Men having sex with men comprised the high-risk group of sexual transmission of HIV-AIDS. (h) Gender-based violence including intimate partner violence (IPV), sexual violence, sexual coercion, and child sexual abuse (CSA) might be underreported in China, since many victims were afraid to seek help as well as due to limited services. Legal and regulatory measures should therefore be taken to prevent and reduce gender-based violence. For future perspectives of SRH in China, it is important to pay attention to SRH education and services. An up-to-date national survey on SRH is needed to reflect the current situation and to capture changes over the past decade. Most of the current research has been conducted among adolescents, and more studies are needed among other groups, such as the disabled, the elderly, and homosexual populations.

The use of lifelogging device in dietary assessments can reduce misreporting and underreporting, which are common in the previous studies conventional methods. We performed the first study in Chinese children (primary school Grade 4) that applied the wearable cameras in assisting dietary recall. Children (n = 52) wore the wearable cameras (Narrative Clip 2) for seven consecutive days, during which they completed a 3-day 24-h dietary recall at home. Then children modified their dietary recalls at school by reviewing the photos taken by the wearable camera at school, with the assistance of the investigator, and generated the camera-assisted 24-h dietary recalls. Compared with camera-assisted dietary recalls, 8% (n = 160) and 1% (n = 11) of food items were underreported (i.e. not reported at all) and misreported (i.e. reported in an incorrect amount) by dietary recalls without camera-assistance, respectively. Dietary recalls without camera assistance underestimated daily energy intake by 149 ± 182 kcal/d (8%) in comparison to the camera-assisted dietary recalls. Foods consumed on the snacking occasions (40%) were more likely to be underreported than those consumed at main meals (P

Haze pollution is an increasingly serious problem in China. Based on the PM 2.5 data from 283 prefecture-level cities in China, we combine the stochastic impacts by regression on population, affluence, and technology (STIRPAT) model and environmental Kuznets curve (EKC) hypothesis and use a geographically weighted regression (GWR) method to evaluate the effects of different factors influencing haze pollution in different regions. Nighttime light data from NOAA was used in place of gross domestic product (GDP) in a robustness test. From a global analysis perspective, the EKC is established, and the inflection point is approximately 40000 yuan per capita; however, the GWR estimate is better than the ordinary least squares (OLS) estimate with an improvement in R 2 from 0.20 to 0.75. The GWR estimation results show that different environmental protection inputs have different effects in different regions: 1. Technical inputs tend to increase productivity rather than reduce emissions in most areas except Guangdong and Jiangsu. 2. The industrial output values in Guangxi and Yunnan have a greater impact on pollution than those in other regions. 3. In the central and eastern regions with dense populations, comprehensive public transportation can effectively reduce haze pollution. In terms of environmental protection measures, park green areas can reduce pollution, and due to the current status of industrial waste recovery in China, increasing the recovery rate of industrial waste is not conducive to reducing pollution. This article analyzes different causes of haze in different regions and provides suggestions for implementing different environmental policies in different regions.

Background The exclusive breastfeeding rate in Ireland is very low with extremely slow annual growth. The population of immigrants in Ireland is increasing. Improving exclusive breastfeeding practice among immigrants may contribute to the overall improvement of exclusive breastfeeding rates in Ireland. This study was conducted to elicit suggestions on improving exclusive breastfeeding rate for the first 6 months among Chinese immigrants in Ireland. Methods Fourteen semi-structured in-depth interviews were conducted with Chinese immigrant mothers residing in Ireland, who breastfed exclusively for 4 to 6 months. Interviews were recorded and transcribed in Chinese. Data were analyzed using a qualitative thematic analysis. Themes were developed through categorization of codes and via in-depth discussion between two researchers. Results Themes generated from the thematic content analysis were: 1) suggestions for new mothers: being strong mentally and getting support from family and friends; 2) suggestions for employers: creating a supportive workplace by setting up private rooms and breastmilk storage facilities; 3) suggestions for healthcare professionals: advocating breastfeeding in the hospital and addressing cultural differences by recruiting multilingual staff; 4) suggestions for the government: promoting breastfeeding by initiating societal and policy changes. Conclusions The key findings emerging from this study may be considered in the development of breastfeeding promotion strategies in Ireland. Our findings could also have implications for other English-speaking countries with low rates of exclusive breastfeeding.

The identification of rare haplotypes may greatly expand our knowledge in the genetic architecture of both complex and monogenic traits. To this aim, we developed PERHAPS (Paired-End short Reads-based HAPlotyping from next-generation Sequencing data), a new and simple approach to directly call haplotypes from short-read, paired-end Next Generation Sequencing (NGS) data. To benchmark this method, we considered the APOE classic polymorphism (*1/*2/*3/*4), since it represents one of the best examples of functional polymorphism arising from the haplotype combination of two Single Nucleotide Polymorphisms (SNPs). We leveraged the big Whole Exome Sequencing (WES) and SNP-array data obtained from the multi-ethnic UK BioBank (UKBB, N=48,855). By applying PERHAPS, based on piecing together the paired-end reads according to their FASTQ-labels, we extracted the haplotype data, along with their frequencies and the individual diplotype. Concordance rates between WES directly called diplotypes and the ones generated through statistical pre-phasing and imputation of SNP-array data are extremely high (>99%), either when stratifying the sample by SNP-array genotyping batch or self-reported ethnic group. Hardy-Weinberg Equilibrium tests and the comparison of obtained haplotype frequencies with the ones available from the 1000 Genome Project further supported the reliability of PERHAPS. Notably, we were able to determine the existence of the rare APOE*1 haplotype in two unrelated African subjects from UKBB, supporting its presence at appreciable frequency (approximatively 0.5%) in the African Yoruba population. Despite acknowledging some technical shortcomings, PERHAPS represents a novel and simple approach that will partly overcome the limitations in direct haplotype calling from short read-based sequencing.

High consumption of ultra-processed foods (UPF) increases the risks of non-communicable diseases and all-cause mortality in adulthood, and the risk of early childhood caries. Limited evidence about factors influencing children’s consumption of UPF exists. This study was conducted to assess the prevalence of UPF consumption among children less than three years of age, and identify its associations with caregivers’ emotional and instrumental feeding, and children’s emotional eating. A cross-sectional study was conducted in Shijiazhuang, Hebei Province, China. Caregivers caring for children aged 6–36 months (n = 408) were recruited. Caregivers’ emotional and instrumental feeding practices and children’s emotional eating were assessed by the Parents’ Feeding Practices Scale for Infant and Young Child and Children’s Eating Behaviour Questionnaire, respectively. Children’s UPF consumption was assessed by a validated Food Frequency Questionnaire. Of the children, 86.8% consumed UPF. The highest percentage of UPF consumed was pastries (63.5%), followed by solid or semi-solid dairy products (58.8%), and reconstituted meat products (56.4%). Caregivers’ emotional and instrumental feeding was positively associated with children’s consumption of UPF (OR = 1.59, 95%CI: 1.01, 2.49), a higher frequency of UPF consumption weekly (OR = 1.80, 95%CI: 1.35, 2.39), and a larger amount of UPF consumption weekly (OR = 1.85, 95% CI: 1.38, 2.49). Children’s higher frequency of emotional undereating was associated with their UPF consumption (OR = 1.61, 95%CI: 1.07, 2.42) and a higher frequency of UPF consumption weekly (OR = 1.33, 95%CI: 1.03, 1.73). Children’s emotional undereating significantly mediated the associations between caregivers’ emotional and instrumental feeding and children’s consumption of reconstituted meat products. Caregivers should be educated to avoid emotional and instrumental feeding practices, and cultivate children’s good eating habits to improve children’s diet quality.

Background: Most studies about parental support behaviors for physical activity (PA) on children’s moderate-to-vigorous intensity physical activity (MVPA) were conducted in developed countries, and most of them focused on mother’s or parent’s (with no differentiation between father’s or mother’s) support behaviors. Besides, children’s MVPA time interval was not differentiated adequately. This paper aimed at investigating the associations between paternal and maternal support behaviors for PA, and children’s MVPA on weekdays, weekends and the whole week in China.Methods: Cross-sectional data of 517 father-child dyads and 1,422 mother-child dyads were analyzed. Children’s consecutive 7-day PA diary were recorded to assess their MVPA time, and MVPA time on weekdays, weekends and the whole week were further calculated, respectively. Father or mother completed a questionnaire on their support behaviors for children’s PA. Multivariate logistic regression was conducted to investigate the independent effect of paternal and maternal support behaviors for PA on children’s meeting MVPA recommendation on weekdays, weekends and the whole week, respectively.Results: The proportion of children’s meeting MVPA recommendation on weekends (37.8%) was significantly lower than that on weekdays (62.8%). Higher paternal (OR[95%CI]:1.098[1.009,1.195]) and maternal (OR[95%CI]:1.076[1.021,1.134]) total scores of support behaviors for PA were associated with children’s higher odds of meeting MVPA recommendation on weekends, after controlling for covariates. Paternal sharing PA knowledge with child was significantly associated with children’s meeting MVPA recommendation on weekends (OR[95%CI]:1.319[1.055,1.649]), and marginally associated with children’s meeting MVPA recommendation on weekdays (OR[95%CI]:1.220[0.974,1.528], P=0.084) and on the whole week (OR[95%CI]:1.218[0.977,1.519], P=0.080). Maternal reserving PA time for child was associated with children’s higher likelihood of meeting MVPA recommendation on weekdays (OR[95%CI]:1.160[1.025,1.313]), weekends (OR[95%CI]:1.241[1.097,1.403]) and the whole week (OR[95%CI]:1.214[1.076,1.369]), respectively.Conclusions: On weekends, paternal and maternal total support behaviors for PA deserves more practices for promoting children’s MVPA. To promote children’s MVPA on weekdays, weekends and the whole week, father’s sharing PA knowledge with child and mother’s reserving PA time for child are recommended. Longitudinal researches are needed to verify the effect of paternal and maternal support behaviors on children’s MVPA.

Fat-soluble vitamins during pregnancy are important for fetal growth and development. The present study aimed at exploring the association between vitamin A, E and D status during pregnancy and birth weight. A total of 19 640 women with singleton deliveries from a retrospective study were included. Data were collected by the hospital electronic information system. Maternal serum vitamin A, E and D concentrations were measured during pregnancy. Logistic regression was performed to estimate the association between the vitamin status and low birth weight (LBW) or macrosomia. Women with excessive vitamin E were more likely to have macrosomia (OR 1·30, 95 % CI 1·07, 1·59) compared with adequate concentration. When focusing on Z scores, there was a positive association between vitamin E and macrosomia in the first (OR 1·07, 95 % CI 1·00, 1·14), second (OR 1·27, 95 % CI 1·11, 1·46) and third (OR 1·28, 95 % CI 1·06, 1·54) trimesters; vitamin A was positively associated with LBW in the first (OR 1·14, 95 % CI 1·01, 1·29), second (OR 1·31, 95 % CI 1·05, 1·63) and third (OR 2·00, 95 % CI 1·45, 2·74) trimesters and negatively associated with macrosomia in the second (OR 0·79, 95 % CI 0·70, 0·89) and third (OR 0·77, 95 % CI 0·62, 0·95) trimesters. The study identified that high concentrations of vitamin E are associated with macrosomia. Maintaining a moderate concentration of vitamin A during pregnancy might be beneficial to achieve optimal birth weight. Further studies to explore the mechanism of above associations are warranted.

Human milk (HM) is dynamic and shows a high inter- and intra-individual variability. To characterize HM with precision, it is necessary to understand the factors that modulate its composition. The objective of this narrative review is to summarize the maternal, infant and methodological factors that affect HM composition. We searched SCOPUS and PubMed databases for articles related to factors that are known to or could potentially influence HM composition and volume across lactation periods. Our comprehensive review encompasses various maternal-, infant-related, and methodological factors that modulate aspects of HM composition including macro- and micronutrients, vitamins and minerals, as well as volume. The most profound changes were observed in HM lipids and lipophiles. Evidence exists for many of the infant-related factors known to affect the nutritive and non-nutritive components of HM (e.g., birth weight, gestational age, infant age/stage of lactation). In contrast, less is known with respect to maternal factors; where there is either limited research or conflicting evidence (e.g., maternal lifestyle, obstetric history, medical conditions), except for the mother's diet, for which there is a relatively well-established understanding. Equally, although many of the methodological factors (e.g., HM sampling, handling and analytics) are known to impact HM composition, few studies have investigated this as a primary outcome, making it an important area of future research in HM. Here we propose a systematic capture of numerous maternal- and infant-related characteristics to facilitate associative comparisons of HM data within and across studies. Additionally, it would be prudent to standardize the methodological aspects known to affect HM composition in analytics, not only for HM lipids and lipophiles, but also for those nutrients whose variability is yet less well-understood. Defining the factors determining HM composition with accuracy will open perspectives for maternal intervention to optimize milk composition for specific needs of infants.

International students may have difficulties in dietary acculturation. This study aimed to evaluate the knowledge, attitude and practices (KAP) of diet and health during the acculturation of international students. A cross-sectional survey was conducted among a convenience sample of 473 international students in Dublin. Knowledge, attitude and practices towards diet and health were evaluated by a questionnaire with open- and closed-ended questions. It was found that 45.3% of participants had a broad concept of a healthy diet, while few knew its specific contents. Furthermore, 75.3% of participants could explain the term functional food, and among them, 62.1% knew the appropriate definition of functional food. Participants who perceived their health very good and excellent were more likely to believe that their health status was determined by their own control. The consumption rate of functional food varied among regions and South and Central America students had the highest usage rate (44.5%) and Asian students had the highest daily usage rate (52.7%). Participants who were younger, single, from African and South and Central American countries, or who were in Ireland for less than one year were more likely to report dietary change after immigration. In conclusion, insufficient knowledge and self-perception towards diet and health as well as unhealthily dietary changes exist among international students living in Dublin.

Background: The exclusive breastfeeding rate in Ireland is very low with extremely slow annual growth. The population of immigrants in Ireland is increasing. Improving exclusive breastfeeding practice among immigrants may contribute to the overall improvement of exclusive breastfeeding rates in Ireland. This study was conducted to elicit recommendations on improving exclusive breastfeeding rate for six months among Chinese immigrants in Ireland.Methods: Fourteen semi-structured in-depth individual interviews were conducted with Chinese immigrant mothers resident in Ireland, who breastfed exclusively for four to six months.Results: Themes generated from thematic content analyses were 1) recommendation for mothers: improve self-intention to breastfeed exclusively and self-efficacy, be financially secure before pregnancy, and obtain breastfeeding information proactively. 2) Recommendation for family members, employers and colleagues, and health care professionals: family members should offer sufficient support. Employers should provide hygienic places for breastmilk storage, and set up breastfeeding rooms and nurseries. Irish hospitals need to advocate exclusive breastfeeding, recruit and train multilingual health care professionals, and combine breastfeeding knowledge with practice in the prenatal education. 3) Recommendation for the government: set up breastfeeding rooms and dedicated rooms for breastfeeding groups, and increase the publicity and visibility of breastfeeding in multiple languages. An independent welfare policy for immigrants was also recommended.Conclusions: The key findings emerging from this study may be considered in the development of breastfeeding promotion strategies in Ireland. Our findings could also have implications for other English-speaking countries with low rates of exclusive breastfeeding.

BackgroundMigration to another country has a potential influence on breastfeeding practices. A significant difference in breastfeeding rates between Irish nationals and non-nationals has been reported. This study was conducted to explore breastfeeding practices of the Chinese in Ireland, one of the largest Irish ethnic groups, and to explore the influence of living in Ireland on breastfeeding practices. This is the first and the only migration study so far on breastfeeding practices among the Chinese in Ireland.MethodsA sequential explanatory mixed methods approach was adopted. The first phase was a cross-sectional self-administered retrospective mailed survey, to explore breastfeeding practices and determinants of breastfeeding among a convenience sample of Chinese mothers living in Ireland (n = 322). Recruitment was conducted in the Dublin metropolitan area, with the application of the snowball technique to increase sample size. The second phase consisted of seven semi-structured focus groups (n = 33) conducted in Dublin, to explore the influence of living in Ireland on breastfeeding among Chinese mothers who had given birth in Ireland. Quantitative data were analyzed by univariate and multivariate logistic regression analyses, and informed the qualitative data collection. Qualitative data were analyzed by thematic content analyses, to explain and enrich the qualitative results.ResultsThe breastfeeding initiation rate among Chinese immigrants to Ireland who gave birth in Ireland (CMI) (75.6%) was high and close to that of Chinese immigrant mothers who gave birth in China (CMC) (87.2%). However, giving birth in Ireland was independently associated with a shorter duration of breastfeeding (ConclusionMigration to Ireland was found to be associated with a shorter duration of breastfeeding of the Chinese. Culturally sensitive and language-specific education and support of breastfeeding is needed for the Chinese mothers living in Ireland. The mixed methods design presented here might serve as a template for future migration research on breastfeeding.

OBJECTIVES: Maternal nutrition during pregnancy plays a vital role in fetal growth and development. Dietary index eliminates the need for complex nutrient calculations and assess dietary quality as a whole. The present study was conducted to evaluate maternal dietary quality using specific dietary index for Chinese pregnant women, and to explore the association between maternal diet and the prevalence of low birth weight (LBW) and small for gestational age (SGA). METHODS: A birth cohort was conducted in Beijing, China (n = 3871) between June 2018 and February 2019. Maternal diet in the 1st and 2nd trimesters was assessed by inconsecutive 2-day 24-hour dietary recalls. The Chinese Diet Balance Index for Pregnancy (DBI-P) was used to assess participants’ dietary quality. Multivariate logistic regressions were performed to explore the independent effects of DBI components on LBW and SGA. RESULTS: The prevalence of LBW and SGA was 3.8% and 6.0%, respectively in the present study. There existed an unbalanced diet, especially high insufficient intake of vegetables (87.3% and 86.6%), dairy (95.9% and 96.6%), and aquatic foods (80.5% and 85.4%) in both the 1st and 2nd trimesters. Adequate fruits consumption was higher in the 1st trimester (76.7%) than that in the 2nd trimester (15.5%). The intake of cereals was negatively associated with the risk of LBW (OR = 0.944, 95% CI: 0.893–0.997), and the intake of dairy and dairy products was negatively associated with the risk of SGA (OR = 0.874, 95% CI: 0.773–0.987) in the 2(nd) trimester, after adjusting for potential confounders. CONCLUSIONS: Diet quality of Chinese pregnant women in Beijing was unbalanced, in particular high insufficiency in dairy products and vegetables. Pregnant women should pay attention to the adequate intakes of cereals and dairy products in mid-pregnancy, in order to prevent the occurrence of LBW and SGA. FUNDING SOURCES: This study was funded by the National Natural Science Foundation of China and the Peking University Research Initiation Fund.

This study was conducted to explore the associations between maternal feeding practices, mealtime emotions, as well as maternal food neophobia and toddlers&rsquo, food neophobia in Ireland. A follow-up to the Technological University Dublin (DIT)-Coombe Hospital birth cohort was conducted. Mothers in the original cohort were invited to the present study by telephone calls. Postal questionnaires with stamped addressed envelopes were distributed to those who agreed to participate in the study. Toddler food neophobia was assessed by the modified version of the Child Food Neophobia Scale (CFNS). There were 205 participants included in this study, with a median score of child food neophobia of 12. A higher degree of child food neophobia (score &gt, 12) was positively associated with the maternal practice of coaxing the children to eat at refusal (OR (Odds Ratio) = 2.279, 95% CI: 1.048&ndash, 4.955), unpleasant emotions at mealtime (e.g., stressful or hectic for mothers, or tearful for children) (OR ranged between 1.618 and 1.952), and mothers&rsquo, own degree of food neophobia (OR = 1.036, 95% CI: 1.001&ndash, 1.072). Mothers who were not worried when confronted with child&rsquo, s food refusal was negatively associated with toddlers&rsquo, food neophobia (OR = 0.251, 95% CI: 0.114&ndash, 0.556). This study suggests the maternal practices of responsive feeding, being calm and patient with the toddlers, and creating a positive atmosphere at mealtime.

Introduction: Migration to another country may induce changes in infant feeding practices especially where such practices differ considerably between the two countries. This study was undertaken to compare the infant feeding practices between Chinese mothers who gave birth in Ireland (CMI) with immigrant Chinese mothers who gave birth in China (CMC), and to examine the factors that influence these practices. Methods: A cross-sectional self-administrated survey was conducted among a convenience sample of 322 Chinese mothers living in Ireland. Data were obtained from mailed questionnaires. Infant feeding practices between CMC and CMI were compared by Chi-square or independent sample t-test. Binary logistic regression analyses were further performed to test the differences in infant feeding practices between two groups, after controlling for potential socio-demographic confounders. Results: High breastfeeding initiation rates were found in both groups (CMC: 87.2%; CMI: 75.6%); however sharp reductions in breastfeeding rates at 3 months (49.1%) and 6 months (28.4%) were found among CMI but not CMC (P < 0.05). Introduction of water within 1 week after childbirth was common for CMC in comparison with CMI. CMI were more likely than CMC to introduce infant formula to their child within the first 4 months after childbirth. The timing of introduction of rice porridge, vegetables, fruits and meats did not differ between CMC and CMI. Conclusions: Cultural and perceptional factors, and changes caused by migration contribute to the decline in breastfeeding duration among CMI. Language-specific breastfeeding support and education among Chinese mothers in Ireland is needed, in particular to encourage mothers to breastfeed for 6 months or more.

Table S1. Comparison of characteristics among women remained in the present study and those who missed Q2 data. Table S2. Food List in the food frequency questionnaire (FFQ) of BIGCS. Table S3. List of food items included in the 30 main food groups. Table S4 The ratios of between-cluster variance to within-cluster variances for each food group across clusters from two to six. Table S5. Frequencies of weekly intake of 30 food groups assessed with a self-administered food frequency questionnaire across the six dietary patterns identified among 7352 pregnant Chinese women from the Born in Guangzhou Cohort Study. Table S6. Characteristics of the participants across the six dietary patterns identified by cluster analysis. Table S7. Associations between dietary patterns and preterm delivery. (DOCX 54Â kb)

This paper describes a program of brief, universal, positive psychology-based interventions to increase targeted behaviors that enhance family relationships, developed and delivered to over 1500 participants using a community-based participatory approach. The cluster-randomized design combined interventions based on one of three themes (gratitude, hope, or open-mindedness) in one of two structures (intervention, or intervention with planning). The latter structure supplemented with materials and exercises derived from the Health Action Process Approach model of behavior change. Planning was more effective in increasing attitude and intention to perform behaviors, frequency of the targeted behaviors, and family health and happiness (Cohen’s ds: 0.10–0.16, p

To the Editor: In 2014, a serious Ebola virus disease (EVD) outbreak occurred in West Africa (1). In a study on EVD-related perceptions, 85% of US respondents mistakenly believed that EVD could be transmitted through airborne droplets from patients’ sneezes or coughs (2). EVD-related panic was reported in the United States (3) and the United Kingdom (4). During November 15–December 20, 2014, we conducted a cross-sectional survey of 1,295 undergraduate students in Guangzhou, China, where the population of immigrants from Africa is high, who had heard of EVD (Technical Appendix). Our aim was to measure students’ anticipated negative emotional responses and avoidance activities (dependent variables) to a possible outbreak of EVD (5). We constructed scales for the dependent and independent variables to assess EVD-related perceptions: 1) misconceptions/knowledge about transmission modes, 2) scenarios of an EVD outbreak in Guangzhou (chances, severity, control), 3) efficacy of preventive measures and self-protection, and 4) public stigma toward EVD survivors. MLwiN 2.30 (Centre for Multilevel Modeling, University of Bristol, Bristol, UK) was used for multilevel regression analyses (Technical Appendix). We analyzed data from 1,155 (89.2%) students who have heard of EVD. To the example of 2–3 EVD cases detected in Guangzhou, 31.0% showed >4 types of anticipated negative emotions (e.g., fear, panic, worry); 59.5% showed >3 types of anticipated unnecessary avoidance. Most (80.0%) indicated >1 misconception regarding transmission mode (e.g., believed it was droplet or waterborne) but knew that direct contact with the corpse of an infected person (69.0%) and body fluids (81.4%) could lead to infection and perceived EVD as fatal (85.6%,) and highly infectious (81.6%). About half of respondents believed that effective treatment and a vaccine were unavailable (51.9% and 59.1%, respectively); 22.2% anticipated EVD outbreaks among Africans in Guangzhou (during the next 12 months). Many students perceived severe consequences if a small EVD outbreak occurred in Guangzhou and believed an outbreak would have a high fatality rate (70.5%), EVD is highly infectious (65.4%), an outbreak would be of long duration (47.5%), and the number of infected persons would be high (39.9%); 52.5%–79.2% of respondents lacked confidence in the government’s ability to control an outbreak (e.g., ability to provide adequate vaccines, medication, protective gear). Half or more of respondents believed that restricting travel by Africans to and from Africa and avoiding visiting African-inhabited areas were effective means of prevention. About 40% were confident that they could protect themselves or family members from EVD (Technical Appendix Tables 1, 2). Older age, female sex, longer school years, and rural origin were associated with negative emotional responses, avoidance, or both (Technical Appendix Table 3). In multivariate analyses that adjusted for significant background variables, we found positive associations between both dependent variables and the following independent variables: perceived fatality of EVD, perceived nonavailability of treatment, misconceptions regarding modes of transmission, perceived severity of a Guangzhou outbreak, perceived efficacy of restricting Africans’ travel, perceived efficacy of avoiding African-inhabited areas, and public stigma toward EVD survivors. Confidence in governmental control was negatively associated with both dependent variables. Some variables were positively associated with emotional response but not avoidance (perceived irreversible harm, perceived chance of outbreak in Guangzhou and in other parts in China, perceived self-efficacy for protection); 2 variables (perceived nonavailability of vaccine and knowledge of transmission mode) were positively associated with avoidance measures but not with emotional responses (Table). Table Factors associated with anticipated responses to EVD, adjusted for sociodemographic variables, Guangzhou, China, 2014* Because EVD causes serious physical harm, negative emotional responses and unnecessary avoidance practices were anticipated. Such negative community responses might cause individual and societal harm, as witnessed during the epidemic of severe acute respiratory syndrome (6). Misconceptions concerning transmission modes were prevalent and significantly correlated with both dependent variables. More than 80% of respondents perceived that the virus was highly infectious, another significant factor. About 20% of participants believed that an EVD outbreak would occur in Guangzhou in the next year. Among all participants, many anticipated severe outcomes but were not confident that the government was prepared for and could control such an outbreak. The concentration of immigrants from Africa in this region might have increased perceived chances of an EVD outbreak and thus lead to avoidance of this population. The high percentages of those who believed that restricting Africans’ travel was effective also might result in discrimination. Public stigmatization toward EVD survivors, another significant factor, was a prominent attitude (7,8). Fear, misconceptions, and perceived likelihood of EVD to cause death may lead to patient stigmatizing, which could hinder case detection and patients’ service seeking. The relationship between stigmatization and EVD-related perceptions should be investigated. The study’s limitations included the inability to assess real responses, inability to generalize findings to all university students and the general public, and the use of scales that had not been validated. Also, some students might have given exaggerated responses. In summary, misconceptions and perceptions regarding EVD may result in negative community responses in Guangzhou. Health education is needed to clarify that EVD is not airborne or waterborne or highly infectious and that avoidance is not an effective preventive measure. In addition, the government should start developing and publicizing its preparedness plans. Technical Appendix. Detailed methods and background variables of the study participants in Guangzhou, China, the frequency distribution of items related to Ebola virus disease (EVD), associations between sociodemographic factors and anticipated responses to an EVD outbreak, and univariate associations between independent variables and anticipated responses to EVD by participants. Click here to view.(269K, pdf)

Objective The relationship between dietary patterns and gestational weight gain (GWG) in different pregnancy stages has rarely been reported among the Asian population. The aim of this study was to examine the relationship between dietary patterns and GWG in Chinese pregnant women. Methods Participants were women from the Born in Guangzhou Cohort Study who completed a validated food frequency questionnaire at 24 to 27 wk gestation (N = 5733). Dietary patterns were generated by cluster analysis. Maternal prepregnancy weight was self-reported; weights during pregnancy were extracted from medical records. Regression analyses were performed to test the associations between dietary patterns and total GWG and GWG rates (linear regression), and the adequacy of GWG (logistic regression). Results According to food consumption frequency, six dietary patterns were generated: “richer in cereals,” “richer in vegetables,” “richer in meats,” “richer in fruits,” “richer in fish, beans, nuts, and yogurt,” and “richer in milk and milk powder.” Compared with women following the richer in cereals pattern, those who followed the richer in fruits pattern had a significantly higher GWG (β = 0.592; 95% confidence interval [CI], 0.166–1.018) and total rate of GWG; those who followed the richer in fish, beans, nuts, and yogurt” pattern had a greater GWG rate in the second trimester, and also had a decreased risk for inadequate GWG (odds ratio, 0.797; 95% CI, 0.638–0.997). Conclusion Consuming a variety of foods and frequent consumption of fruits during pregnancy contributes to a more rapid increase in GWG among pregnant women in China. Findings may be useful in pregnancy weight monitoring.

Introduction Capacity building approaches are useful in large-scale community-based health promotion interventions. However, models to guide and evaluate capacity building among social service agency staff in community settings are rare in the literature. This paper describes the development and evaluation of a 1-day (7 h) train-the-trainer (TTT) workshop for the “Enhancing Family Well-Being Project”. The workshop aimed at equipping staff from different community agencies with the knowledge and skills to design, implement, and evaluate positive psychology-based interventions for their clients in Sham Shui Po, an over-crowded and low-income district in Hong Kong. Methods The current TTT extended and improved on our previous successful model by adding research and evaluation methods (including the Logic Model, process evaluation, and randomized controlled trial), which are important to plan and evaluate the community interventions. Evaluation of the TTT was guided by the Integrated Model of Training Evaluation and Effectiveness (IMTEE), with quantitative and qualitative methods. Quantitative data were collected from pretraining (T1), post-training (T2), and 6-month (T3) and 12-month (T4) follow-up surveys. Qualitative data were collected from four focus groups of agency staff after the intervention. Results Ninety-three staff from 30 community agencies attended the training, and 90 completed the baseline survey. Eighty-eight, 63, and 57 staff performed the evaluations at T2, T3, and T4, respectively. Agency staff were satisfied with the TTT. Immediate enhancement of knowledge, self-efficacy, and positive attitudes toward the training content was found at T2 (Cohen’s d ranged from 0.24 to 1.22, all p

Background: Psychological factors are important in influencing breastfeeding practices. This retrospective study explored knowledge and attitudes related to breastfeeding of Chinese mothers living in Ireland. Methods. A cross-sectional self-administrated survey written in Chinese was distributed to a convenience sample of 322 immigrant Chinese mothers mainly via Chinese supermarkets and Chinese language schools in Dublin, with the involvement of the snowball method to increase sample size. Maternal breastfeeding knowledge and attitudes were described, their associations with socio-demographic variables were explored by Chi-square analysis, and their independent associations with breastfeeding behaviours were estimated by binary logistic regression analyses. Results. In spite of considerable awareness of the advantages of breastfeeding (mean score = 4.03 0.73), some misconceptions (e.g. 'mother should stop breastfeeding if she catches a cold') and negative attitudes (e.g. breastfeeding inconvenient, embarrassing, and adverse to mothers' figure) existed, especially among the less educated mothers. Cultural beliefs concerning the traditional Chinese postpartum diet were prevalent, particularly among those who had lived in Ireland for a shorter duration (P = 0.004). Psychological parameters had strong independent associations with breastfeeding practices in this study. Those who had lower awareness score (OR = 2.98, 95% CI: 1.87-4.73), more misconceptions and negative attitudes (P < 0.05), and weaker cultural beliefs (P < 0.05) were less likely to breastfeed. Conclusions. Findings highlight a need to focus resources and education on correcting the misconceptions identified and reversing the negative attitudes towards breastfeeding among Chinese mothers in Ireland, in particular those with primary/secondary level of education. Mothers' cultural beliefs should also be acknowledged and understood by healthcare providers. © 2010 Zhou et al; licensee BioMed Central Ltd., published_or_final_version