Recent Intervention Research Articles

Knowledge, attitude, and practice regarding dengue vaccine: a baseline study of community members and health providers in Indonesia.

Despite recent behavioral interventions aimed at reducing the burden of dengue, persistent unfavorable related behaviors in the Indonesian community suggest that vaccination could be effective. However, before this is implemented nationally, public perception and acceptance of the vaccine should be assessed in addition to health providers' points of view. This study aimed to assess the knowledge, attitudes, and practices (KAP) of community members and health providers in Indonesia. A cross-sectional survey was conducted in six districts of three Indonesian provinces. Respondents included both community members and health providers living within the territory of the selected primary health care centers. Pretested questionnaires were used to gather information on the sociodemographic characteristics and KAPs regarding dengue vaccines. An independent t-test was performed to compare the mean KAP scores between community members and health providers, while a logistic regression analysis was used to identify the predictors in each domain. Only 18.5% of health providers possessed high knowledge of the dengue vaccine versus only 12.5% of community members. Approximately one-third of the health providers versus one-fourth of community members displayed a high to moderate score for attitudes about dengue vaccines. Dengue vaccination practices demonstrated a more favorable score for both health providers and community members at 59.1% and 41.1%, respectively. No individual sociodemographic characteristics were associated with KAPs; rather, only education was correlated with better dengue vaccination practices. We also found that good knowledge of dengue was the only factor associated with all domains. Our findings highlight the urgent need to deliver educational interventions to health providers and community members in Indonesia to improve their awareness of dengue vaccines.

Elevated Perspectives: Unraveling Cardiovascular Dynamics in High-Altitude Realms.

High-altitude regions pose distinctive challenges for cardiovascular health because of decreased oxygen levels, reduced barometric pressure, and colder temperatures. Approximately 82 million people live above 2400 meters, while over 100 million people visit these heights annually. Individuals ascending rapidly or those with pre-existing cardiovascular conditions are particularly vulnerable to altitude-related illnesses, including Acute Mountain Sickness (AMS) and Chronic Mountain Sickness (CMS). The cardiovascular system struggles to adapt to hypoxic stress, which can lead to arrhythmias, systemic hypertension, and right ventricular failure. Pathophysiologically, high-altitude exposure triggers immediate increases in cardiac output and heart rate, often due to enhanced sympathetic activity. Over time, acclimatisation involves complex changes, such as reduced stroke volume and increased blood volume. The pulmonary vasculature also undergoes significant alterations, including hypoxic pulmonary vasoconstriction and vascular remodelling, contributing to conditions, like pulmonary hypertension and high-altitude pulmonary edema. Genetic adaptations in populations living at high altitudes, such as gene variations linked to hypoxia response, further influence these physiological processes. Regarding cardiovascular disease risk, stable coronary artery disease patients generally do not face significant adverse outcomes at altitudes up to 3500 meters. However, those with unstable angina or recent cardiac interventions should avoid high-altitude exposure to prevent exacerbation. Remarkably, high-altitude living correlates with reduced cardiovascular mortality rates, possibly due to improved air quality and hypoxia-induced adaptations. Additionally, there is a higher incidence of congenital heart disease among children born at high altitudes, highlighting the profound impact of hypoxia on heart development. Understanding these dynamics is crucial for managing risks and improving health outcomes in high-altitude environments.

Parenteral lipid nutrition in congenital gastrointestinal malformation operated cases

Background: Congenital gastrointestinal malformation (CGIM) cases require immediate surgical correction after birth and proper nutrition to meet energy demands. Among the macronutrients, lipids are considered the major energy source, playing a vital role in parenteral nutrition. However, the time of their initiation remains unclear. We compared the data of CGIM cases where lipids were given from the first post-surgical day to those where parenteral lipids were initiated on the second or third day of surgery and then reevaluated them on the seventh day of parenteral nutrition.Methods: We collected the data of patients who had undergone surgical correction for CGIM and were kept on parenteral nutrition including lipids from day 1 of surgery labeling them as group 1. Group 2 comprised of neonates having lipid parenteral nutrition started from day 2 or 3 of surgery. Both groups were reevaluated on the 7th day of parenteral nutrition. Statistical analysis was performed.Results: Group 1 had higher total bilirubin (TB) statistically significant (p-value=0.0299), as well as lower lipase (p-value=0.0286), and lower total lipids (p-value=0.0365). The values were lower of triglycerides (p-value=0.0365), and total lipids (p-value=0.0365), on day 1. Comparing both groups, all biochemical parameters were found to be statistically significant.Conclusion: Lipid deficiency and overload should be carefully evaluated, especially in neonates having undergone recent surgical interventions, which increase their nutritional demands. No adverse effects were seen in our study related to parenteral lipid emulsion administration in post-surgical congenital gastrointestinal malformation cases. Early initiation of parenteral lipid regimens can provide better outcomes.Keywords: Congenital gastrointestinal malformations; Intravenous lipid emulsions; Parenteral nutrition; Gestational age; Milk formula

Palliative Care Referral Patterns and Implications for Standardization in Cardiac ICU.

Evidence suggests that pediatric palliative care involvement (PPC) is beneficial to medically complex patients. Historically, PPC involvement has been overlooked or delayed and varies by institution but PPC awareness has increased in cardiovascular ICUs (CVICU) and so we investigated frequency and timeliness of PPC referral for patients dying in ICU. Retrospective study of pediatric cardiac patients experiencing death in ICU to review PPC presence and timing of initial PPC, most recent PPC, and interventions, therapies, CPR, and presence of do-not-resuscitate DNR discussion. Fifty-four patients died during a 5-year period aged 11d-17y (54% male). PPC involvement occurred in 40/54 (74%). Of those patients without PPC, the Center to Advance Palliative Care (CAPC) guidelines would have supported PPC in 11/14 (79%). DNR discussion was more likely in PPC patients (63% vs 14%; p = 0.0011), though often only on DOD. Comparing prior to DOD, PPC patients were still more likely to have DNR discussion (55% vs 0%; p = 0.0003). PPC patients were no less likely to have CPR on DOD (28% vs 43%, p = 0.29). PPC occurred frequently in patients experiencing death in CVICU. However, frequently the initial PPC occurred within a week or day of death. Patients without PPC would often qualify under published guidelines. Standardization, timing, and patient identification for PPC will expand efficacy in CVICU.

Neurosurgical Procedures in Patients Requiring Extracorporeal Membrane Oxygenation.

Extracorporeal membrane oxygenation (ECMO) is often withheld in patients with significant neurologic injury or recent neurosurgical intervention due to perceived futility. Studies of neurosurgical interventions before or during ECMO are limited to case reports or single-center series, limiting generalizability, and outcomes in this population are unknown. We therefore sought to report the outcomes of ECMO patients with acute neurosurgical interventions at four high-volume ECMO and comprehensive stroke centers. Retrospective case series. Four academic tertiary referral hospitals in the United States. Adults (n = 24) having undergone neurosurgical procedures before or during ECMO. None. We retrospectively reviewed adults at four institutions who had undergone neurosurgical procedures immediately before or during ECMO from 2015 to 2023. The primary outcome was survival to hospital discharge. Secondary outcomes included favorable neurologic outcome (Cerebral Performance Category 1 or 2) and neurosurgical complications. Twenty-four of 2957 ECMO patients (0.8%) were included. Primary indications for neurosurgical intervention included traumatic brain (n = 8) or spinal (n = 3) injury, spontaneous intracranial hemorrhage (n = 6), and acute ischemic stroke (n = 5). Procedures included extraventricular drain (EVD) and/or intracranial pressure monitor placement (n = 10), craniectomy/craniotomy (n = 5), endovascular thrombectomy (n = 4), and spinal surgery (n = 3). Fifteen patients (63%) survived to hospital discharge, of whom 12 (80%) were discharged with favorable neurologic outcomes. Survival to discharge was similar for venoarterial and venovenous ECMO patients (8/12 vs. 7/12; p = 0.67) and those who had neurosurgery before vs. during ECMO (8/13 vs. 7/11; p = 0.92). One patient (4%) experienced a neurosurgical complication, a nonlethal tract hemorrhage from EVD placement. Survival to discharge was similar for neurosurgical and nonneurosurgical ECMO patients at participating institutions (63% vs. 57%; p = 0.58). Patients with acute neurologic injury can feasibly undergo neurosurgery during ECMO or can undergo ECMO after recent neurosurgery. Larger studies are needed to fully understand risks for bleeding and other procedure-related complications.

Knowledge, attitudes, and practices regarding malaria transmission and prevention in an indigenous Maijuna community: a qualitative study in the Peruvian Amazon

BackgroundPeru is a low-endemic transmission area for malaria, where the majority (84%) of incident malaria cases are localized to the department of Loreto, which is composed of several geographically isolated rural communities. Recent intervention efforts targeting at-risk Indigenous populations that live in riverine communities in Loreto place emphasis on preventive behaviours to decrease transmission. However, malaria related behaviour change is often dependent upon local knowledge, beliefs, and practices, especially in areas where malaria is viewed an embedded and unavoidable aspect of life.MethodsThis exploratory case study used semi-structured interviews conducted in Spanish between February and March of 2019 to examine the knowledge, attitudes, and practices related to malaria prevention among the Indigenous Maijuna people of Sucusari, Loreto, Peru. Participants who consented were also administered a rapid diagnostic test (RDT) upon the time of interview.ResultsA total of 33 community members were interviewed, and 31 were tested via malaria rapid diagnostic tests, with RDT filter paper subsequently tested using PCR. All test results were negative for malaria. Themes that emerged included: varying knowledge of methods to prevent malaria, reports of observed changes in malaria incidence over time, confusion surrounding malaria transmission, treatment-seeking as a common behaviour, the belief that medications are effective, and the acceptance of bed nets which were viewed as a lifestyle norm.ConclusionThese shared narratives should be used as a foundation for further studies and health interventions among communities in the Peruvian Amazon with limited access to health services where culturally resonant, community-based health programming is essential to improving health. Takeaways regarding confusion surrounding malaria transmission should also be considered.

Ain’t I a Migrant?: Global Blackness and the Future of Migration Studies

In the wake of recent interventions to better connect the subfields of international migration and race and ethnicity through a sociology of racialized immigration, we push this further by arguing for the necessity of a global Blackness perspective on global migration. Such a focus does not just reflect the role of race in the dynamics of migration, and vice versa, but more importantly shifts assumptions about this relationship. So, it is not enough to say that race matters in migration but rather that blackness and Black lives matter in how migration unfolds. Using global blackness as a starting point in our analyses of migration reveals a clearer and closer entanglement of race, racism, colonialism, and migration. We argue that global Blackness structures notions of who migrates and under what conditions, as well as our ideas regarding migrants and their descendants and use the examples of New York City, Paris, and France as paradigmatic sites for understanding this relationship.

The Struggle Over Mobility Narratives: How Senegalese Activists use Alternative Information Campaigns to Contest EU Externalization

For nearly two decades the European Union and its member states have invested in migration awareness and information campaigns (MICs) in West Africa to prevent unwanted migration. While a growing body of migration scholarship has critically engaged with the larger-scale, European-funded MICs in Africa, local activist-led campaigns have received less attention. The article addresses this gap by focusing on campaigns organized by a local, activist-led organization in Dakar, Senegal. Building on ethnographic fieldwork, the article shows how activist-led MICs use counternarratives and action repertories entangled in and motivated by recent externalization interventions in Senegal and the EU–Africa borderlands. By situating these “ripple effects” of externalization locally and exploring their repercussions, the article illustrates how migrant experiences, border control, and violence become catalysts for collective action. The activist-led MICs in Senegal can be understood as activities that fundamentally challenge the political premises and outcomes of EU–Africa migration governance, including European-driven MICs. This perspective enriches our understanding of MICs in West Africa and the local ripple effects of externalization, underscoring local actors’ proactive role in trying to contest and reshape Eurocentric migration narratives and policies.

Desirability in Real-World Blended Care for Psychosis: Insights from the Development and Pilot Study of Digital NAVIGATE

<p>Blended care, a psychosocial intervention merging face-to-face therapy with digital tools, holds significant potential for enhancing psychosis treatment outcomes by extending access and increasing patient engagement with therapeutic materials. Recent blended care interventions for psychosis were solely developed within controlled research conditions, and an attempt to transition one of these interventions into real-world practice yielded inadequate engagement and effectiveness. This suggests that the development context of blended care may significantly impact its implementation potential. This study represents the first attempt to both develop and research a blended care intervention in a real-world setting, directly addressing the specific challenges and unmet needs within NAVIGATE, a coordinated speciality care program for individuals who have experienced a first-episode psychosis. Both clients and practitioners agreed on the potential benefits of integrating digital tools into NAVIGATE, and clients expressed a willingness to adopt them once available. However, when the digital program became available, clients' actual desire to incorporate it into their usual care was unexpectedly low. We observed a strong correlation between clients' expressed desire to use Digital NAVIGATE before engaging with it and their subsequent engagement with the digital tools. These findings highlight a distinction between clients’ attitudes towards digital tools adaptation before being offered to use them, and their actual intention and desire to utilize such tools during the treatment they receive. These findings underscore the need to reassess current frameworks for developing and implementing digital mental health tools, particularly within existing mental health programs.</p>

Recent Interventions for Acute Suicidality Delivered in the Emergency Department: A Scoping Review

Introduction: Suicidality is a growing problem in the US, and the emergency department (ED) is often the front line for the management and effective treatment of acutely suicidal patients. There is a dearth of interventions that emergency physicians may use to manage and effectively treat acutely suicidal patients. To the extent that recently described interventions are available for ED personnel, no review has been conducted to identify them. This scoping review is intended to fill this gap by systematically reviewing the literature to identify recently described interventions that can be administered in the ED to reduce symptoms and stabilize patients. Methods: We conducted a search of PubMed, SCOPUS, and CINAHL in January 2024 to identify papers published between 2013–2023 for original research trialing recent interventions for the effective treatment of suicidality in the ED. We assessed 16 full-text articles for eligibility, and nine met inclusion criteria. Included studies were evaluated for features and characteristics, the fit of the intervention to the ED environment, and interventional efficacy. Results: Four studies assessed the efficacy of a single dose of the anesthetic/analgesic agent ketamine. Three studies assessed the efficacy of a brief psychosocial intervention delivered in the ED, two of which paired this intervention with the provision of follow-up care (postcard contact and referral assistance/case management, respectively). The remaining two studies trialed a brief, motivational interviewing-based intervention. Included studies had strong experimental designs (randomized controlled trials) but small sample sizes (average 57). Among the interventions represented across these nine studies, a single dose of ketamine and the brief psychosocial intervention Crisis Response Planning (CRP) show promise as ED-appropriate interventions for suicidality. Ketamine and CRP demonstrated the strongest fit to the ED environment and most robust efficacy findings. Conclusion: This review identified one drug (ketamine) and four unique psychological/behavioral interventions that have been used to treat acute suicidality in the ED. There is currently insufficient evidence to suggest that these interventions will prove efficacious and well-suited to be delivered in the ED environment. Future studies should continue to test these interventions in the ED setting to determine their feasibility and efficacy.

Role of caregivers being trained in assisting in end of life care - Latin American perspective.

Palliative care in Latin America is evolving, but training for informal caregivers remains underexplored. This review summarizes recent interventions to educate or train caregivers in end-of-life care. The literature search identified three interventions published by 2023, two with reception evaluations, all with small sample sizes and no control groups. Needs of caregivers have been more frequently described and include training on aspects of the disease, nursing skills, how to handle patients´ and own emotions; help in navigating the complex healthcare systems in Latin America; help in conversations about the end of life and dying, still taboos in the region; help in finding additional caregivers or other types of support to make the caregiving role sustainable over time for the caregiver. Interventions mainly focused on emotional support and identifying additional caregivers without guilt; two included nursing skills training. There are very few formal interventions described and evaluated to assist caregivers in end-of-life care in Latin America described in the literature. This illustrates the rather invisible but very important role of these important stakeholders in the care for patients. Multidimensional interventions should be developed and evaluated to support caregivers.

Investigation and Conservation: Assessing the Impact of Recent Interventions at the Theatre of Smyrna (Modern Izmir)

ABSTRACT Many ancient theatres as places of performance have outstanding universal value as ‘venues’ that have witnessed physical and socio-economical changes through time. Various scales of modern interventions have affected them and in Turkey the authorities mostly interprete them as a resource of socio-economic value. This paper aims to examine recent efforts to understand the cultural importance of the Smyrna theatre and to assess contemporary approaches to its conservation, reuse, and management. International documents on ancient places of performance, assessment of modern interventions are reviewed and the phases of discovery and rediscovery described. Four aspects describe its cultural significance: Understanding the Place, Interpreting the Place, Preserving the Spirit of the Place, and Managing the Place. Interpretation of the theatre is still in progress, though limited by a focus on its potential us by the local authorities. Its spirit as a place of performance has not been preserved but is in high demand, and its management has deficiencies, although to some extent this is being addressed by the local authorities of the port city of Izmir.

Unintended consequences of health and safety interventions in fisheries

AbstractFishing communities globally continue to face poor health and safety outcomes, driving the expansion of fisheries occupational health and safety (OHS) interventions. However, narrowly focused OHS interventions that neglect the social and structural determinants of health may have unintended consequences. We illustrate this problem through a case study from the UK where a recent OHS intervention, the introduction of compulsory medical certificates to all commercial fishers, led to unforeseen negative impacts. Through analysis of data from interviews, focus groups and a participatory workshop in Cornwall, UK, we highlight three key findings. First, while seeking to improve safety at sea, the regulatory change actually had negative consequences for fishers' health, their access to healthcare and potentially even their safety. Second, a mismatch between the requirements of the regulation and fishers' lived experience undermined the efforts of health promotion and outreach activities. Third, a failure to account for the implications for different sectors of the fleet has contributed to mistrust that may have ramifications for future fisheries governance activity. Our research brings to the fore important implications for the design of OHS regimes in fisheries. These include the broadening of OHS approaches to consider fishers' wider health and well‐being; engagement of fishers in the development and implementation of OHS interventions to account for their lived experiences of health and safety at sea and better integrate their knowledge; support for bottom‐up fisher‐led initiatives aimed at managing health and safety at sea; and improved coordination between agencies responsible for different areas of fisheries governance.

Vitamin D and muscle health: insights from recent studies.

The purpose of this review is to critically evaluate the effects of vitamin D on muscle mass and physical/muscle function in middle-aged and older adults, based on recent human studies, including cross-sectional, observational, and intervention studies. Vitamin D, beyond its well established role in bone health, has shown potential in influencing muscle physiology, making it a nutrient of interest in the context of sarcopenia and related chronic conditions. The review states how vitamin D affects muscle function, emphasizing its role in muscle cell proliferation, differentiation, and key signaling pathways. Additionally, the review of recent human studies revealed an inconsistent relationship between vitamin D and sarcopenia and related indices, with mixed results regarding muscle mass and strength. Variability in supplementation dose, duration, and baseline 25-hydroxyvitamin D levels may contribute to these inconsistencies. While animal studies indicate vitamin D's effectiveness in muscle growth, cross-sectional, observational, and intervention studies do not show clear benefits of maintaining efficient vitamin D levels on muscle mass or function in humans. Although vitamin D impacts muscle health, it is insufficient alone, emphasizing the need for a multifaceted approach to sarcopenia prevention and management.

Social dimensions of climate‐induced flooding in Jakarta (Indonesia): The role of non‐point source pollution

AbstractBecause of its low‐lying location, urbanization, and inadequate infrastructure, Jakarta (Indonesia) has experienced an increase in annual flooding events, rising from an average of five significant floods per year in the 1990s to over 20 annually (2010–2020). With climate change exacerbating extreme weather events, Jakarta encounters escalating risks of flooding. Although the recurrent flooding is exacerbated by non‐point source (NPS) of pollution such as urban runoff and agricultural discharge that contribute to 40% of total pollutants leading to flood‐related issues in Jakarta, none has investigated this research gap. To reflect its novelty, this work explores the implications of climate change on the annual flooding in Jakarta by focusing on NPS and analyzes their impacts from social perspectives. This work also underscores the implications of flooding on livelihoods, health, and social cohesion in Jakarta. Focus group discussion with affected residents was used to shed light on the coping strategies employed in response to recurrent floods, ranging from community‐based initiatives to reliance on informal networks. The empirical findings show that the implications of flooding extend beyond physical damages. Displacement of communities, loss of livelihoods, disruption of essential services, and increased health risks are among the social impacts experienced by local residents. Vulnerable populations, including low‐income communities residing in informal settlements, bear their consequences. Economic losses from flooding amount to USD 500 million annually, impacting over 1 million residents. However, recent interventions have led to a 15% reduction in peak flood levels and a 20% reduction in flood duration in affected areas. Community resilience has also improved, with a 25% increase in flood insurance coverage and a 20% rise in community response initiatives. Overall, this study highlights that climate change exacerbates annual flooding in Jakarta, significantly impacting vulnerable communities through NPS pollution. Addressing the challenges requires integrated approaches combining effective pollution control, resilient infrastructure, and community engagement to mitigate social and long‐term environmental impacts.Practitioner Points Climate‐induced flooding disproportionately affects vulnerable communities in Jakarta. Non‐point source pollution from urban runoff contributes to the severity of flooding in Jakarta. Waterborne diseases, disruption of livelihoods, and reduced access to clean water are major concerns identified in the study. The study highlights the importance of community‐based adaptation strategies to mitigate the impact of flooding and pollution.

Online Prosumers and Penal Policy Formation in an Age of Digital Polarization and Populism: An Exploratory Study

This article explores the influence of right-wing social media users on penal policy formation processes. Through a passive digital ethnography approach, the study examines online debates preceding and following recent legislative interventions adopted in Italy by the new right-wing government in power since late 2022, namely the criminalization of unauthorized rave parties and the punitive approach to migration management. The article discusses the role of social media users as prosumers, who both consume and produce content, and shows how social media platforms amplify political polarization by promoting selective exposure to like-minded viewpoints and facilitating the spread of divisive content. It also showcases how prosumers contribute to the propagation of punitive narratives and engage in direct interactions with populist leaders through social media platforms. Conversely, political leaders—specifically Italy’s Prime Minister Giorgia Meloni in this case study—use these platforms to disseminate their narratives and create support for their penal policies, employing fear-mongering tactics and simplistic messaging. Our findings suggest that, while social media platforms have transformed political discourse, in the Italian scenario their direct influence on penal policy making from the ground-up remains limited. Instead, traditional top-down channels continue to dominate the process of penal policy formation.

The Late Holocene evolution of the Adra Delta subaqueous system (Northern Alboran Sea): Seismic-stratigraphic and geomorphic evidence of millennial scale climatic and anthropic effects

The formation and development of a small Mediterranean deltaic system are investigated through a primary seismic stratigraphic interpretation of a high-resolution seismic profile network, combined with multiple bathymetric data (including multibeam bathymetric imagery) and collated with shallow sediment cores collected with a vibro-corer device.The submarine delta of the Adra River is divided into a basal patchy seismic unit and five wedge-shaped younger seismic units that are related to the Holocene highstand stabilization. Limited age control indicates that the two uppermost seismic units are very recent, most likely related to a dearth of fluvial fluxes led by channel deviations and by sediment retention. The formation of the three older seismic units is correlated to three humid periods during the Middle Holocene, Late Holocene and Little Ice Age, under a general context of progressive aridification of southeastern Iberia.The stacking patterns and spatial distribution of individual seismic units document a history of episodic progradation of successive prodeltaic lobes, with a long-term evolution mediated by climatically-induced changes in the river basin and more recent anthropogenic interventions. Overall, the subaqueous deltaic system registers the complete modification of a deltaic system that evolves from a fluvial-dominated delta to recent wave-dominated wedges. In between, the deltaic system exhibits a progressive asymmetric character, due to the instauration of Atlantic waters on the shelf and their subsequent eastward redistribution. The Adra deltaic system is proposed as an outstanding example of a small deltaic system that reacts almost immediately to the complex interaction between natural changes in the system and anthropogenic interventions in the drainage basin.

Lifestyle Factors and Stroke Prevention: From the Individual to the Community.

The overwhelming majority of stroke burden can be prevented through the pillars of lifestyle medicine: diet, exercise, sleep, substance abuse, stress management, and healthy relationships. Among these, diet confers the greatest attributable risk. Despite abundant data and integration of lifestyle medicine within major stroke prevention guidelines, several barriers to effective implementation remain. These include lack of emphasis in medical education, integration in hospital certification metrics, reimbursement from medical insurance, and health policy that inadequately addresses social determinants of health. However, both top-down and bottom-up solutions introduced within the last few years are helping to break down these barriers. This review highlights recent literature and interventions that are closing the gap between the theory and practice of stroke prevention through lifestyle risk factors from a US perspective. By strategically targeting the various institutional barriers, it is possible and essential to substantially reduce stroke burden.

Reliability and validity of the German version of the Iowa infant feeding attitude scale (IIFAS-G) and relations to breastfeeding duration and feeding method

BackgroundPublic health initiatives (e.g., the Baby Friendly Hospital Initiative) have led to an increase in breastfeeding rates worldwide. However, as (exclusive) breastfeeding duration is still below WHO recommendations, it is crucial to understand the factors that influence decisions on breastfeeding practice. Modifiable psychological factors such as intention to breastfeed have therefore become targets of recent interventions. As the intention to breastfeed is among the strongest predictors of breastfeeding duration, reliable tools for measuring the intention to breastfeed are needed. The Iowa Infant Feeding Attitude Scale (IIFAS) measures attitudes towards infant feeding and is used in various languages and across different cultural contexts. However, there has been no German version of the IIFAS (IIFAS-G) so far. The aim of this study was to investigate reliability, validity, and associations of the IIFAS-G with feeding method and breastfeeding duration.MethodsBetween August and November 2022, a total of 353 mothers (Mage = 35 years, SDage = 4.2 years) of singleton infants (47.3% female (1 undetermined), Mage = 10.8 months, SDage = 4.7 months, age range: 3-547 days; 90.4% living in Switzerland) participated in an online survey. The IIFAS-G was administered as a part of a larger study on early child development and infant feeding method.ResultsThe translated IIFAS-G showed unsatisfactory model fit for the two factor 17-item solution. Four items showed low factor loadings. After item reduction, a 13-item two factor solution showed satisfactory model fit (CFI = 0.92, TLI = 0.90, RMSEA = 0.07) and high internal consistency (Cronbach’s α = 0.85). The IIFAS-G score was higher for mothers who exclusively breastfed their infants compared to mothers who additionally or exclusively fed infant formula. Moreover, mothers with higher IIFAS-G scores were less likely to stop breastfeeding their child over the course of 1.5years (HR = 0.87).ConclusionA shorter two-factor IIFAS-G is proposed to investigate attitudes towards breastfeeding and formula feeding in German-speaking mothers.

Nurturing creative confidence and learner empathy

As a contemporary and boundary spanning approach, design thinking is gaining traction in higher education, but it has not yet been established in academic staff development. The aim of this study is to reflect on a recent staff development intervention on blended learning course design, aimed at promoting a ‘design thinking mindset’ among university lecturers. By analysing empirical data gathered through participant interactions, we discuss the implications and potential of design thinking for academic staff development. Data analysis shows an increased awareness of the complex and diverse student body, a recognition for interdisciplinary collaboration, mentoring and reflective thinking. Additionally, it is highlighted that adopting design thinking is not without challenges, which include the need for continued practice, securing departmental buy-in and upscaling initiatives. The findings emphasise the importance of creating a ‘safe’ space to experiment, modelling a designing-on-the-go approach, focusing on the iterative processes of (re)design, providing scaffolding for learning, making design thinking processes explicit, building a community of practice, regular feedback and maintaining the balance between playfulness and reflection. Success of such an intervention will rely on balancing the development of design thinking skills, a design thinking mindset and creative confidence.