Fengereverett4623

Many women seek lactation consultant support in the postpartum period. Lactation consultant support in community or clinical settings is often assumed to extend breastfeeding duration, improve breastfeeding experiences, and be well-received. Few studies have assessed women's perceptions of the support they received, nor have perceptions been examined in relationship to breastfeeding outcomes and maternal well-being. Our objective was to characterize the lactation consultant support women received and examine how women's perceptions about the support related to their breastfeeding outcomes, anxiety and depressive symptoms, and parenting stress.

This observational, cross-sectional study examined receipt of postpartum lactation consultant support among 210 US women. Perceptions of lactation consultant support were examined in relation to breastfeeding outcomes, anxiety and depressive symptoms, and parenting stress to explore outcomes of negative versus positive lactation consultant support experiences, using linear and proportional hazards regression.

While overall perceptions of lactation consultant support were positive for most recipients (71%, n = 98), 29% (n = 40) reported negative perceptions of lactation consultant support. Negative perceptions were associated with lower breastfeeding self-efficacy (β =  - 11.7, 95% CI - 17.3, - 6.0), a less successful breastfeeding experience (β =  - 19.5, CI - 27.8, - 11.3), greater general anxiety (β = 6.5, CI 2.1, 10.9), and shorter total duration of milk production (HR = 0.39, 95% CI 0.18, 0.84). Perceptions were not associated with depressive symptoms or parenting stress.

Findings highlight the importance of ensuring that postpartum breastfeeding support provided by lactation consultants is perceived as positive by women.

Findings highlight the importance of ensuring that postpartum breastfeeding support provided by lactation consultants is perceived as positive by women.

The United States has experienced a rising incidence of maternal deaths, including those attributable to obstetric hemorrhage (OBH). In response, the National Partnership for Maternal Safety developed a standardized OBH Consensus Bundle with the goal of universal adoption. In 2016 a large western Pennsylvania health system adopted the OBH Consensus Bundle across its 8 obstetrical units, with the goal to improve maternal outcomes.

Gap analysis was used to identify differences between existing OBH protocols and the OBH Consensus Bundle from January to June 2016. Identified gaps as well as existing practices of success were used to systematically develop and implement a standardized system-wide OBH improvement initiative. Hospitals were then categorized by annual birth volume as high (> 2000), medium (500-2000), and low (< 500) with analysis performed across these groups to identify potential trends.

All hospitals had individual successes as well as gaps that were used to direct the system-wide OBH ithese lessons described may provide a useful framework for other hospitals and health systems as they implement their own safety bundles.

To advocate perspectives to strengthen existing healthcare systems to prioritize maternal health services amidst and beyond the COVID-19 pandemic in low- and middle income countries.

COVID-19 directly affects pregnant women causing more severe disease and adverse pregnancy outcomes. The indirect effects due to the monumental COVID-19 response are much worse, increasing maternal and neonatal mortality.

Amidst COVID-19, governments must balance effective COVID-19 response measures while continuing delivery of essential health services. Using the World Health Organization's operational guidelines as a base, countries must conduct contextualized analyses to tailor their operations. Evidence based information on different services and comparative cost-benefits will help decisions on trade-offs. Situational analyses identifying extent and reasons for service disruptions and estimates of impacts using modelling techniques will guide prioritization of services. Ensuring adequate supplies, maintaining core interprimary healthcare system linked to specialist care and accessible to all segments of the population including marginalized subgroups is of paramount importance. Systematic approaches to digital health care solutions to bridge gaps in service is imperative. Future pandemic preparedness programs must include action plans for resilient maternal health services.A halophilic PAHs-degrading strain, Martelella AD-3, was previously isolated from highly saline petroleum-contaminated soil. In this study, label-free proteomics were performed to identify differentially expressed proteins (DEPs) under Group P (phenanthrene +5% salinity) and Group G (glycerol +1% salinity), which would help to reveal the mechanism of phenanthrene degradation and salt tolerance. DOX inhibitor A total of 307 up-regulated DEPs were found in Group P, including 17 phenanthrene degradation proteins. Among these phenanthrene-degrading proteins, the ferredoxin of aromatic ring-hydroxylating dioxygenase (RHD) was up-regulated by 110-fold and gentisate 1,2-dioxygenases (GDOs) were only expressed in Group P. Besides, we also found nine high salt stress response proteins, including ectoine synthase and transport protein of compatible (osmoprotectant) solutes, were differentially up-regulated. These results indicate that strain AD-3 mainly relied on RHD and dihydrodiol dehydrogenase to degrade phenanthrene, and accumulated compatible solutes for resistance to salt stress. This study provides strong theoretical guidance for understanding the degradation of phenanthrene by strain AD-3 in high salt environments.This work aimed to evaluate the residual action of five insecticides on larvae and adults of the predators Chrysoperla externa (Hagen) and Eriopis connexa (Germar). The insecticides gamma-cyhalothrin, imidacloprid+beta-cyfluthrin, methomyl, thiamethoxam, and thiamethoxam+lambda-cyhalothrin were sprayed in pod bean plants until the point of runoff. Weekly, at 3, 10, 17, 24, and 31 days, first instar larvae and adults of both predators were exposed to leaves containing dry residues of the insecticides. Based on the mortality observed throughout the bioassays, the insecticides were classified according to the scale of the residual effects proposed by the International Organization for Biological and Integrated Control (IOBC). Except for thiamethoxam+lambda-cyhalothrin, which was moderately persistent (class 3) to larvae of C. externa and E. connexa, all other tested insecticides were persistent (class 4) to larvae of both species. Gamma-cyhalothrin, imidacloprid + beta-cyfluthrin, and methomyl were persistent (class 4) to C.