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Determine which elements of a lactating patient’s clinical presentation, including breast pump use and symptoms, are associated with a diagnosis of nipple thrush.

Drawing on agency theory and transaction cost analysis, this study investigates the impact of refranchising and buybacks of downstream retail units by franchising firms on shareholder value (i.e., stock returns). It further evaluates the contingency role of firm and industry factors in shaping this impact. An event study analysis over the years 2001-2020 confirms that both refranchising and buybacks positively affect stock returns. However, notable impact differences emerge between the two types of strategic decisions. For refranchising, firms with lower royalty rates, smaller returns-on-assets (ROA), and higher trade credit provided generate higher stock returns. Whereas, for buybacks, firms with higher royalty rates derive more value in stock markets. Analysis further shows that investors judge refranchising (buybacks) less (more) favorably in munificent industries, but industry dynamism has no effect on the stock returns generated from these moves. Together, the study offers important implications for franchising theory and retail practice in marketing., Author(s): Anna Sadovnikova [sup.1] , Manish Kacker [sup.2] , Saurabh Mishra [sup.3] Author Affiliations: (1) grid.260185.8, 0000 0004 0484 1579, Leon Hess Business School, Monmouth University, , 400 Cedar Avenue, [...]

Milk production by dairy cows is sensitive to increased levels of stress hormones such as glucocorticoids (GC) that also regulate the transcription of several genes required for milk synthesis. Whereas previous studies identified that an exogenous GC such as dexamethasone (DEX) transiently suppresses milk yield in several species without any pronounced effect on milk protein or fat percentage, the mechanism underlying this effect has not been established. In this study we sought to establish changes within the mammary glands of non-pregnant dairy cows in their second lactation (n = 3-4; 648-838 kg) following a single dose of exogenous DEX. Changes in the udder were monitored by serial biopsy of alternating quarters, concurrent with quarter-level monitoring of milk yield and composition. Dexamethasone increased serum glucose levels from 12-36 h (p

Lactose is the primary carbohydrate in the milk of most mammals and is unique in that it is only synthesized by epithelial cells in the mammary glands. Lactose is also essential for the development and nutrition of infants. Across species, the concentration of lactose in milk holds a strong positive correlation with overall milk volume. Additionally, there is a range of examples where the onset of lactose synthesis as well as the content of lactose in milk varies between species and throughout a lactation. Despite this diversity, the precursors, genes, proteins and ions that regulate lactose synthesis have not received the depth of study they likely deserve relative to the significance of this simple and abundant molecule. Through this review, our objective is to highlight the requirements for lactose synthesis at the biochemical, cellular and temporal levels through a comparative approach. This overview also serves as the prelude to a companion review describing the dietary, hormonal, molecular, and genetic factors that regulate lactose synthesis.

Milk is critical for the survival of all mammalian offspring, where its production by a mammary gland is also positively associated with its lactose concentration. A clearer understanding of the factors that regulate lactose synthesis stands to direct strategies for improving neonatal health while also highlighting opportunities to manipulate and improve milk production and composition. In this review we draw a cross-species comparison of the extra- and intramammary factors that regulate lactose synthesis, with a special focus on humans, dairy animals, and rodents. We outline the various factors known to influence lactose synthesis including diet, hormones, and substrate supply, as well as the intracellular molecular and genetic mechanisms. We also discuss the strengths and limitations of various in vivo and in vitro systems for the study of lactose synthesis, which remains an important research gap.

Objectives: Physicians may be asked to prescribe, recommend, or discuss foods, herbs, and medications for low milk supply. It is unclear how factors such as education, experience, and regulations influence clinical practice. The objective was to document physicians' clinical practice surrounding pharmacologic, nutritional, and herbal products for the management of low milk supply. Methods: Physicians from two Facebook groups completed an anonymous, online survey about their clinical use of pharmaceutical, supplemental, and nutritional substances perceived to increase milk production. The association between practice patterns and lactation medicine expertise or country for different perceived galactagogues was determined. Results: A total of 307 physicians completed the primary portion of the survey. There was no difference in the proportion of physicians in Canada or the United States (U.S.) who were defined as lactation medicine experts. Canadian physicians were more likely to prescribe metformin, levothyroxine, and domperidone for low milk supply compared with U.S.-based physicians. Canadians and experts were more likely than U.S.-based and nonexpert physicians, respectively, to include herbs in their practice. Patient request, personal and clinical experience, and lack of education, research, or access were frequently selected as reasons for or against using a specific substance. Conclusions: The U.S. Food and Drug Administration ban on domperidone affects low milk supply management in North America. Though Canadian physicians prescribed domperidone without limitations, U.S. physicians were less likely to incorporate it into clinical practice. Despite a lack of evidence, physicians in North America frequently used herbs and foods to increase milk production. [ABSTRACT FROM AUTHOR]

Background: Nipple–areolar complex (NAC) conditions affect reproductive-age women, yet it is not known how care of NAC complaints is distributed among medical specialties. There is a need to characterize all NAC conditions, including their treatment and the care team involved in their clinical management, of nonlactating and lactating patients to determine care gaps. Materials and Methods: This was a retrospective cohort study of reproductive-age females who presented to a large tertiary health system with an NAC complaint between 2015 and 2020. Data about the symptoms, diagnosis, specialty providing care, diagnostic considerations, and treatments were collected. Results: Nipple pain, dermatitis, and thrush were the most common diagnoses among 407 encounters (215 patients). Lactating patients represented half (204, 50%) of the study sample. Benign breast conditions like obstructed ductal openings, accessory nipples, nipple growth, inverted nipples, and chronic and bacterial infections represented a third of all encounters. Primary care physicians (167, 41%) and obstetricians (105, 26%) provided most of the care and referred a third and quarter of patients, respectively, to another provider. Conclusion: The care of patients with NAC complaints is not limited to obstetricians. Internal medicine, family medicine, emergency medicine, and obstetrician-gynecology, dermatology, and surgery resident physicians should receive training in benign breast conditions and clinical lactation. [ABSTRACT FROM AUTHOR]

Many businesses increasingly use strategic partnerships to manage corporate environmental agendas. However, how value is created in green partnerships remains largely unexplored. To address this gap, the authors examine the effects of announcements of green partnerships (marketing versus technology) on shareholder value. It is argued that in green partnerships firms leverage marketing and technology-related capabilities for value-enhancing purposes. The results show that announcements of green marketing partnerships have an immediate positive and significant effect on shareholder value, whereas announcements of green technology partnerships produce an immediate negative and significant effect. Nevertheless, green technology partnerships can accrue positive returns, but over a longer-term (1 year) period. In 'dirtier' industries, it is more difficult to generate positive returns to green partnerships. Counterintuitively, though, in high-polluting industries, firms having a history of positive environmental performance experience lower financial gains from announcements of green partnerships than firms that were less environmentally responsible in the past., Author(s): Anna Sadovnikova [sup.1] , Ashish Pujari [sup.2] Author Affiliations: (1) 0000 0001 2167 853Xgrid.263791.8Department of Economics, South Dakota State University, 57007, Brookings, SD, USA (2) 0000 0004 1936 8227grid.25073.33DeGroote [...]

As technology for remote learning advances, it is critical to understand how public health internship preceptors or faculty can provide engaging virtual experiential learning experiences for pre-professionals. We aimed to examine whether a virtual internship offered through a breastfeeding education company engaged learners to develop public health skills resulting in products beneficial for the internship site and learner. We provided a menu of tools to consider when developing virtual experiential opportunities. Master of Public Health students seeking dual-degrees in dietetics, nursing, and social work participated. Value of the interprofessional team, engagement, knowledge attainment, and translational skills were assessed through diverse modalities including surveys, oral communication, and products relevant to the internship site and interns' academic program. Interns indicated that they valued the internship team and felt the team valued each intern's opinion. Interns developed products useful to the internship site, suggesting active engagement in the virtual experience. Interns' breastfeeding knowledge developed as the internship progressed demonstrated through oral communication as the content conveyed and discussed by interns advanced in cognitive level. The most frequently practiced translational skills reported by interns were research and communication. Virtual experiential learning can be hands-on resulting in professional skill development. This work aides in the understanding of how to feasibly implement an engaging remote internship. [ABSTRACT FROM AUTHOR]