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Zeleke EA, Fikadu T, Bekele M, Sidamo NB, Temesgen Worsa K. Physical activity status among adolescents in Southern Ethiopia: A mixed methods study. PLoS One 2023; 18:e0293757. [PMID: 37943792 PMCID: PMC10635445 DOI: 10.1371/journal.pone.0293757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Adolescents physical activity is associated with current and future health benefits, reduction of cardio-vascular risk factors, improved bone mineral density, and mental health. The aim of the current study is to assess physical activity status and its factors among adolescents in Arba Minch and Jinka towns, Southern Ethiopia. METHODS The study was conducted on 1255 randomly selected schools adolescents of Arba Minch and Jinka town by employing a mixed method. The qualitative data was obtained by Focus Group Discussion. Multiple linear regressions were done to identify factors affecting physical activity. Codes, sub-categories, and main categories were derived from the transcripts and presented in narrative ways to describe adolescent student's perception on physical activity, its barriers and facilitators by comparing with quantitative findings. RESULTS The mean physical activity level was 2.08 (95% CI: 2.04-2.12). A student's self-perception about being physically active, being a member of a sport or fitness team, and engaging in after-school activity to earn money, being older, sex, a self-perception of being healthy, higher levels of vegetable and fruit consumption, having someone who encouraged physical activity, perceiving one's family as being active, self-perception of not being overweight and attending schools that have a sports/playground were factors associated with physical activity. The qualitative finding showed a related finding. Poor awareness on the recommended physical activity, benefits of physical activity, lack of interest, restrictions from family members, peers and the community, uncomfortable environment were barriers to physical activity. CONCLUSION AND RECOMMENDATION The physical activity level of adolescents was low. Age, sex, a positive self-perception about PA and general health, and perception about one's family PA, healthy eating practice, and the presence of role model were associated factors. Lack of self-motivation, interest and family restrictions were barriers to physical activity. PA promotion should be made by incorporating PA into school health programs and strengthening the existing school curriculum.
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Affiliation(s)
- Eshetu Andarge Zeleke
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Flinders Health and Medical Research Institute, Discipline of Population Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Teshale Fikadu
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Muluken Bekele
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Negussie Boti Sidamo
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Kidus Temesgen Worsa
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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Investigating Maternal Perspectives of Breastfeeding Support Targeted Towards Fathers in the Milk Man Mobile App Intervention. Matern Child Health J 2023; 27:954-964. [PMID: 36920713 PMCID: PMC10115714 DOI: 10.1007/s10995-023-03616-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND The support of her infant's father is one of the most important factors influencing a mother's breastfeeding success, and an increasing number of interventions are targeted towards fathers. Engaging fathers as agents to influence a maternal behavior is potentially problematic, yet few studies report on maternal experiences. OBJECTIVE This study aims to explore mothers' perspectives of their partners' use of Milk Man, a father-focused breastfeeding smartphone app, and the acceptability of this approach. MATERIALS AND METHODS New mothers (N = 459) whose partners had access to the app completed a questionnaire at six weeks postpartum. These data were used to determine knowledge, use and perspectives of the app. A sentiment analysis was conducted on responses to an open-ended question seeking maternal perspectives of the app. RESULTS Just over a quarter of mothers (28%) had been shown something from the app, and 37% had discussed something from Milk Man with their partner. There were 162 open-ended responses related to mothers' perspectives of the app. Relevant responses (n = 129) were coded to an overall sentiment node and then to a total of 23 child nodes (sub-nodes). Most comments were positive (94), with a smaller number either negative (25) or neutral (21). Negative comments related to the usability of the app and not its intent or content. CONCLUSION Mothers found the father-focussed breastfeeding app to be acceptable. When designing interventions targeting one group to affect the behaviour of another, inclusion of measures to gain the perspectives of both should be seen as an imperative.
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3
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Nishimaki S, Yamada M, Okutani T, Hirabayashi M, Tanimura S. Breast-feeding rate comparison by parity and delivery age in Japan. Pediatr Int 2022; 64:e14943. [PMID: 34342908 DOI: 10.1111/ped.14943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/28/2021] [Accepted: 07/26/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND To examine the effects of maternal age on breast-feeding, we classified mothers who delivered vaginally aged 20-42 into 1-year age groups and investigated breast-feeding states. We also studied differences between primiparas and multiparas in breast-feeding. METHODS The subjects were 2,605 primipara mothers (age at delivery ranged from 16to 45 years; the gestational age of their infants ranged from 37 to 42 weeks, birthweight ranged from 2,501 to 4,300 g) and 3,261 multipara mothers (age 18-45 years; the gestational age of their infants ranged from 37-42 weeks, and their birthweight ranged from 2,502-4,726 g) at 12 baby-friendly hospitals in Japan. RESULTS The percentage of infants exclusively breast-fed at 1 week and 1 month after birth in the primipara mothers was 80% among mothers in their 20s but lower than 60% among mothers aged above 35. On the other hand, the percentage of infants exclusively breast-fed in the multipara mothers was almost 90% among mothers in their 20s and remained at 70% or over among mothers in their 40s. The percentage of infants exclusively breast-fed was significantly higher in the multipara mothers than in the primipara mothers in many age groups at both 1 week and 1 month of age. CONCLUSIONS The percentage of infants exclusively breast-fed rate decreased as the maternal age increased. We found that multipara mothers can breast-feed even in their 40s, but primipara mothers may encounter difficulty breast-feeding at ages above 35. Our results suggest a need to consider not only their age but number of children, i.e., breast-feeding experience, to provide effective support to breast-feeding mothers.
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Affiliation(s)
- Shigeru Nishimaki
- Department of Pediatrics, Yokohama City University Hospital, Yokohama, Japan.,Japan Breastfeeding Association, Tokyo, Japan
| | - Manabu Yamada
- Japan Breastfeeding Association, Tokyo, Japan.,Department of Obstetrics and Gynecology, Japanese Red Cross Medical Center, Shibuya, Japan
| | - Takahiro Okutani
- Japan Breastfeeding Association, Tokyo, Japan.,Department of Pediatrics, Saiseikai Hyogo-ken Hospital, Kobe, Japan
| | - Madoka Hirabayashi
- Japan Breastfeeding Association, Tokyo, Japan.,Department of Pediatrics, Osaka City Juso Hospital, Osaka, Japan
| | - Satoshi Tanimura
- Japan Breastfeeding Association, Tokyo, Japan.,Department of Obstetrics and Gynecology, Toyama Prefectural Central Hospital, Toyama, Japan
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Jayasinghe S, Herath MP, Beckett JM, Ahuja KDK, Byrne NM, Hills AP. Exclusivity of breastfeeding and body composition: learnings from the Baby-bod study. Int Breastfeed J 2021; 16:41. [PMID: 34011366 PMCID: PMC8132405 DOI: 10.1186/s13006-021-00389-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 05/06/2021] [Indexed: 01/22/2023] Open
Abstract
Background This report evaluated the breastfeeding status in a Tasmanian cohort and its effects on infant and maternal anthropometry and body composition. Methods An observational-cohort analysis of self-reported feeding data from 175 Tasmanian mother-baby dyads (recruited via in-person contact between September 2017 and October 2019), was executed. Only mothers who were ≥ 18 years of age, who had a singleton pregnancy and were able to speak and understand English, were included in the study. Infants outside a gestational age range between 37+ 0 and 41+ 6 weeks were excluded. Infant (using Air Displacement Plethysmography) and maternal body composition was assessed at 0, 3 and 6 months. Analysis of variance with relevant statistical corrections were utilised for cross-sectional and longitudinal comparisons between non-exclusively breastfed (neBF) and exclusively breastfed (eBF) groups. Results Fat-free mass was significantly higher [t = 2.27, df = 98, P = 0.03, confidence interval (CI) 0.03, 0.48] in neBF infants at 6 months (5.59 ± 0.59 vs 5.33 ± 0.50 kg) despite a higher mean fat-free mass in eBF infants at birth (2.89 ± 0.34 vs 3.01 ± 0.35 kg). Weak evidence for different fat mass index trajectories was observed for eBF and neBF infants in the first 6 months of life (ANOVA, F = 2.42, df = 1.9, P = 0.09) with an inversion in fat mass index levels between 3 and 6 months. Body Mass Index (BMI) trajectories were significantly different in eBF and neBF mothers through pregnancy and the first 6 months postpartum (ANOVA, F = 5.56, df = 30.14, P = 0.01). Compared with eBF mothers, neBF mothers retained significantly less weight (t = − 2.754, df = 158, P = 0.02, CI -6.64, − 1.09) at 3 months (0.68 ± 11.69 vs 4.55 ± 6.08 kg) postpartum. Prevalence for neBF was incrementally higher in mothers with a normal BMI compared to mothers with obesity, and mothers who underwent surgical or medical intervention during birth were less likely to exclusively breastfeed. Conclusions Infants with different feeding patterns may display varying growth patterns in early life and sustained breastfeeding can contribute to greater postpartum maternal weight loss.
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Affiliation(s)
- Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Manoja P Herath
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Jeffrey M Beckett
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia.
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Inano H, Kameya M, Sasano K, Matsumura K, Tsuchida A, Hamazaki K, Inadera H, Hasegawa T. Factors influencing exclusive breastfeeding rates until 6 months postpartum: the Japan Environment and Children's Study. Sci Rep 2021; 11:6841. [PMID: 33767216 PMCID: PMC7994576 DOI: 10.1038/s41598-021-85900-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/04/2021] [Indexed: 11/09/2022] Open
Abstract
This research aimed to examine the efficacy of the early initiation of breastfeeding within 1 h of birth, early skin-to-skin contact, and rooming-in for the continuation of exclusive breastfeeding until 6 months postpartum. The research used data from the Japan Environment and Children's Study (JECS), a nationwide government-funded birth cohort study. A total of 80,491 mothers in Japan between January 2011 and March 2014 who succeeded or failed to exclusively breastfeed to 6 months were surveyed in JECS. Multiple logistic regression model was used to analyse the data. The percentage of mothers who succeeded in exclusively breastfeeding to 6 months is 37.4%. Adjusted odds ratios were analysed for all 35 variables. Early initiation of breastfeeding (adjusted odds ratio [AOR]: 1.455 [1.401-1.512]), early skin-to-skin contact (AOR: 1.233 [1.165-1.304]), and rooming-in (AOR: 1.567 [1.454-1.690]) affected continuation of exclusive breastfeeding. Regional social capital (AOR: 1.133 [1.061-1.210]) was also discovered to support the continuation of breastfeeding. In contrast, the most influential inhibiting factors were starting childcare (AOR: 0.126 [0.113-0.141]), smoking during pregnancy (AOR: 0.557 [0.496-0.627]), and obese body type during early pregnancy (AOR: 0.667 [0.627-0.710]).
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Affiliation(s)
- Hitomi Inano
- Department of Maternal Nursing, Graduate School of Medicine and Pharmaceutical Science for Education, University of Toyama, Toyama City, 930-0194, Japan
| | - Mariko Kameya
- Department of Maternal Nursing, Graduate School of Medicine and Pharmaceutical Science for Education, University of Toyama, Toyama City, 930-0194, Japan
| | - Kyoko Sasano
- Division of Maternal Nursing, Graduate School of Medicine and Pharmaceutical Science for Research, University of Toyama, Toyama City, 930-0194, Japan
| | - Kenta Matsumura
- Toyama Regional Center for JECS, University of Toyama, Toyama City, 930-0194, Japan
| | - Akiko Tsuchida
- Toyama Regional Center for JECS, University of Toyama, Toyama City, 930-0194, Japan.,Department of Public Health, Faculty of Medicine, University of Toyama, Toyama City, 930-0194, Japan
| | - Kei Hamazaki
- Toyama Regional Center for JECS, University of Toyama, Toyama City, 930-0194, Japan.,Department of Public Health, Faculty of Medicine, University of Toyama, Toyama City, 930-0194, Japan
| | - Hidekuni Inadera
- Toyama Regional Center for JECS, University of Toyama, Toyama City, 930-0194, Japan.,Department of Public Health, Faculty of Medicine, University of Toyama, Toyama City, 930-0194, Japan
| | - Tomomi Hasegawa
- Division of Maternal Nursing, Graduate School of Medicine and Pharmaceutical Science for Research, University of Toyama, Toyama City, 930-0194, Japan.
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Magnano San Lio R, Maugeri A, La Rosa MC, Cianci A, Panella M, Giunta G, Agodi A, Barchitta M. The Impact of Socio-Demographic Factors on Breastfeeding: Findings from the "Mamma & Bambino" Cohort. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:103. [PMID: 33498814 PMCID: PMC7912184 DOI: 10.3390/medicina57020103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/31/2022]
Abstract
Background and objectives: The World Health Organization (WHO) recommends women (1) to initiate breastfeeding within one hour of birth; (2) to exclusively breastfeed for the first six months; and (3) to continue breastfeeding until two years of age. However, women do not always adhere to these recommendations, threatening the health of their children. The present study aims to evaluate breastfeeding status and the main maternal factors associated with exclusive breastfeeding for six months among women from the "Mamma & Bambino" study, a prospective cohort settled in Catania, Italy. Materials and Methods: We used data from 220 women (median age = 37 years) enrolled in the "Mamma & Bambino" cohort during prenatal obstetric counselling. Self-reported breastfeeding status was collected during the follow-up interviews at 1 and 2 years, referring to breastfeeding status (i.e., yes or no) and type of breastfeeding (i.e., exclusive or predominant). We also collected data about duration of breastfeeding to classify women into those who adhered to the WHO recommendation and those who did not. Results: In the general population, we noted that the proportion of women who have breastfed increased with increasing educational level. Accordingly, logistic regression analysis demonstrated that medium (OR = 3.171; 95% CI = 1.285-7.822; p = 0.012) and high educational levels (OR = 4.549; 95% CI = 1.525-13.570; p = 0.007) were positively associated with breastfeeding if compared to low educational level. Among women who have breastfed, instead, the proportion of adherents to the WHO recommendation was higher among those with medium-high educational level and those who were employed. In line with this, we demonstrated that full-time employment (OR = 2.158; 95% CI = 1.033-4.508; p = 0.041) and medium educational level (OR = 4.632; 95% CI = 1.227-17.484; p = 0.024) were positively associated with exclusive breastfeeding for the first six months. Conclusions: Socio-demographic factors should be taken into account through public health strategies for improving maternal knowledge about health benefits of exclusive breastfeeding.
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Affiliation(s)
- Roberta Magnano San Lio
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, via S. Sofia, 87, 95123 Catania, Italy; (R.M.S.L.); (A.M.); (M.C.L.R.); (M.B.)
| | - Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, via S. Sofia, 87, 95123 Catania, Italy; (R.M.S.L.); (A.M.); (M.C.L.R.); (M.B.)
| | - Maria Clara La Rosa
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, via S. Sofia, 87, 95123 Catania, Italy; (R.M.S.L.); (A.M.); (M.C.L.R.); (M.B.)
| | - Antonio Cianci
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Via S. Sofia, 78, 95123 Catania, Italy; (A.C.); (M.P.); (G.G.)
| | - Marco Panella
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Via S. Sofia, 78, 95123 Catania, Italy; (A.C.); (M.P.); (G.G.)
| | - Giuliana Giunta
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Via S. Sofia, 78, 95123 Catania, Italy; (A.C.); (M.P.); (G.G.)
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, via S. Sofia, 87, 95123 Catania, Italy; (R.M.S.L.); (A.M.); (M.C.L.R.); (M.B.)
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, via S. Sofia, 87, 95123 Catania, Italy; (R.M.S.L.); (A.M.); (M.C.L.R.); (M.B.)
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MacMillan KK, Lewis AJ, Watson SJ, Power J, Galbally M. Maternal psychosocial predictors of pacifier use in a mother-infant interaction task: An observational study from the MPEWS pregnancy cohort. Infant Behav Dev 2020; 61:101505. [PMID: 33197785 DOI: 10.1016/j.infbeh.2020.101505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 10/19/2020] [Accepted: 11/01/2020] [Indexed: 10/23/2022]
Abstract
The prevalence of pacifier use is high but when it occurs outside of the recommended sleep context, it becomes more controversial. Using 211 mother-infant dyads recorded as part of the Mercy Pregnancy and Emotional Wellbeing Study, we examined the maternal psychosocial predictors of pacifier use within an interaction task (i.e., ten minutes face-to-face followed by 30-minutes unstructured play). Predictors included maternal emotional availability measured with the Emotional Availability Scales; depression measured by the Structured Clinical Interview for the DSM-IV-TR Clinician Version; and maternal history of childhood trauma measured by the Childhood Trauma Questionnaire. An unadjusted odds ratio demonstrated that women classified as non-emotionally available to their infants were three-and-a-half-times more likely to use a pacifier. Multivariate logistic regression including all maternal psychosocial predictors demonstrated that even when adjusting for cessation of breastfeeding, maternal emotional availability remained the only significant predictor of pacifier use. This is the first time that predictors of pacifier use have been examined with a sample of clinically depressed women, as well as women with childhood trauma history. The results provide preliminary evidence that women who are not emotionally available might be more likely to rely on a pacifier during mother-infant interaction.
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Affiliation(s)
| | | | - Stuart J Watson
- Psychology, Murdoch University, Perth, Australia; School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Josephine Power
- School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Megan Galbally
- Psychology, Murdoch University, Perth, Australia; School of Medicine, University of Notre Dame, Fremantle, Australia; Women's Health, Genetics and Mental Health Directorate, King Edward Memorial Hospital for Women, Subiaco, Australia; Faculty of Health and Medicine Sciences, University of Western Australia, Perth, Australia
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Abstract
Despite decades of laboratory, epidemiological and clinical research, breast cancer incidence continues to rise. Breast cancer remains the leading cancer-related cause of disease burden for women, affecting one in 20 globally and as many as one in eight in high-income countries. Reducing breast cancer incidence will likely require both a population-based approach of reducing exposure to modifiable risk factors and a precision-prevention approach of identifying women at increased risk and targeting them for specific interventions, such as risk-reducing medication. We already have the capacity to estimate an individual woman's breast cancer risk using validated risk assessment models, and the accuracy of these models is likely to continue to improve over time, particularly with inclusion of newer risk factors, such as polygenic risk and mammographic density. Evidence-based risk-reducing medications are cheap, widely available and recommended by professional health bodies; however, widespread implementation of these has proven challenging. The barriers to uptake of, and adherence to, current medications will need to be considered as we deepen our understanding of breast cancer initiation and begin developing and testing novel preventives.
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Affiliation(s)
- Kara L Britt
- Breast Cancer Risk and Prevention Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.
| | - Jack Cuzick
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Kelly-Anne Phillips
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
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Stamenkovic Z, Matejic B, Djikanovic B, Bjegovic-Mikanovic V. Surprising Differences in the Practice of Exclusive Breastfeeding in Non-Roma and Roma Population in Serbia. Front Public Health 2020; 8:277. [PMID: 32714892 PMCID: PMC7342049 DOI: 10.3389/fpubh.2020.00277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Exclusive breastfeeding is essential for early childhood development, although the use of adaptive milk formulas instead of breastfeeding is widespread nowadays. This study aimed to examine the prevalence of exclusively breastfed infants under the age of 6 months in non-Roma and Roma population and factors associated with this practice. Materials and Methods: This study is a secondary analysis of the Serbian Multiple Indicator Cluster Survey investigating non-Roma and Roma infants under the age of 6 months. The study included mothers of 321 non-Roma and 164 Roma infants younger than 6 months. Univariate and multivariate logistic regression served to analyze factors associated with the practice of exclusive breastfeeding in both populations. Results: The prevalence of exclusive breastfeeding was almost the same among mothers in both non-Roma and Roma population (13.3 vs. 13%, p = 0.910). Exclusive breastfeeding was significantly more often (p < 0.001) among wealthier women, women whose newborns were over 2,500 g on birth, multipara, and women who had not established menstrual cycle among both populations. Living outside the capital significantly diminishes the chance for exclusively breastfed infants in the non-Roma community (Vojvodina: OR 0.16, CI 95% 0.03–0.92; eastern Serbia: OR 0.02, CI 95% 0.01–0.35) as well as living in the rural area (urban: OR 10.35, CI 95% 1.94–55.28). Unexpectedly, in the non-Roma population, not staying in the same room with the newborn in the maternity ward increases the chance for the baby to be exclusively breastfed (OR 7.19, CI 95% 1.80–28.68). The same pattern has been observed in Roma population. Non-Roma mothers multipara are more likely to exclusively breastfeed their children than primipara (OR 7.78, CI 95% 1.09–20.93), while among Roma mothers, the inverse association has been found although not significant (OR 0.42, CI 95% 0.14–1.23). Attending a childbirth preparation program more than 18 times increases the chances of infants being exclusively breastfed (OR 18.65, CI 95% 1.34–53.67). In the Roma population, there was no single woman that attended a childbirth preparation program. Conclusion: The pattern of exclusive breastfeeding significantly differs between non-Roma and Roma populations. Preventive work should have focus on strengthening support to mothers and medical staff in maternity wards.
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Affiliation(s)
- Zeljka Stamenkovic
- Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia
| | - Bojana Matejic
- Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia
| | - Bosiljka Djikanovic
- Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia
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Abstract
OBJECTIVE To investigate mothers' infant feeding experiences (breastfeeding/formula milk feeding) with the aim of understanding how women experience cessation of exclusive breastfeeding. DESIGN Multimethod, qualitative study; questionnaire, focus groups and interviews. SETTING Northern and Southern Tasmania, Australia. PARTICIPANTS 127 mothers of childbearing age from a broad sociodemographic context completed a questionnaire and participated in 22 focus groups or 19 interviews across Tasmania, 2011-2013. RESULTS Mothers view breastfeeding as 'natural' and 'best' and formula milk as 'wrong' and 'unnatural'. In an effort to avoid formula and prolong exclusive breastfeeding, mothers will endure multiple issues (eg, pain, low milk supply, mastitis, public shaming) and make use of various forms of social and physical capital; resources such as father/partner support, expressing breast milk, bottles and dummies. The cessation of exclusive breastfeeding was frequently experienced as unexpected and 'devastating', leaving mothers with 'breastfeeding grief' (a prolonged sense of loss and failure). CONCLUSIONS AND IMPLICATIONS For many mothers, the cessation of exclusive breastfeeding results in lingering feelings of grief and failure making it harmful to women's emotional well-being. Reframing breastfeeding as a family practice where fathers/partners are incorporated as breastfeeding partners has the potential to help women negotiate and prolong breastfeeding. Proactive counselling and debriefing are needed to assist women who are managing feelings of 'breastfeeding grief'.
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Affiliation(s)
- Jennifer Elizabeth Ayton
- School of Medicine College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Leigh Tesch
- School of Creative Arts and Media, University of Tasmania, Hobart, Tasmania, Australia
| | - Emily Hansen
- School of Social Sciences, University of Tasmania, Hobart, Tasmania, Australia
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11
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Koletzko B, Cremer M, Flothkötter M, Graf C, Hauner H, Hellmers C, Kersting M, Krawinkel M, Przyrembel H, Röbl-Mathieu M, Schiffner U, Vetter K, Weißenborn A, Wöckel A. Diet and Lifestyle Before and During Pregnancy - Practical Recommendations of the Germany-wide Healthy Start - Young Family Network. Geburtshilfe Frauenheilkd 2018; 78:1262-1282. [PMID: 30655650 PMCID: PMC6294644 DOI: 10.1055/a-0713-1058] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/22/2018] [Accepted: 08/22/2018] [Indexed: 12/11/2022] Open
Abstract
Diet and exercise before and during pregnancy affect the course of the pregnancy, the child's development and the short- and long-term health of mother and child. The Healthy Start - Young Family Network has updated the recommendations on nutrition in pregnancy that first appeared in 2012 and supplemented them with recommendations on a preconception lifestyle. The recommendations address body weight before conception, weight gain in pregnancy, energy and nutritional requirements and diet (including a vegetarian/vegan diet), the supplements folic acid/folate, iodine, iron and docosahexaenoic acid (DHA), protection against food-borne illnesses, physical activity before and during pregnancy, alcohol, smoking, caffeinated drinks, oral and dental hygiene and the use of medicinal products. Preparation for breast-feeding is recommended already during pregnancy. Vaccination recommendations for women planning a pregnancy are also included. These practical recommendations of the Germany-wide Healthy Start - Young Family Network are intended to assist all professional groups that counsel women and couples wishing to have children and during pregnancy with uniform, scientifically-based and practical information.
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Affiliation(s)
- Berthold Koletzko
- Kinderklinik und Kinderpoliklinik, Dr. von Haunersches Kinderspital, LMU – Ludwig-Maximilians-Universität, München, Germany
- Deutsche Gesellschaft für Kinder- und Jugendheilkunde e. V. (DGKJ), Berlin, Germany
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
| | - Monika Cremer
- Netzwerk Gesund ins Leben/Bundeszentrum für Ernährung (BZfE) in der Bundesanstalt für Landwirtschaft und Ernährung (BLE), Bonn, Germany
| | - Maria Flothkötter
- Netzwerk Gesund ins Leben/Bundeszentrum für Ernährung (BZfE) in der Bundesanstalt für Landwirtschaft und Ernährung (BLE), Bonn, Germany
| | - Christine Graf
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Deutsche Sporthochschule Köln, Köln, Germany
| | - Hans Hauner
- Lehrstuhl für Ernährungsmedizin, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Claudia Hellmers
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Hochschule Osnabrück, Osnabrück, Germany
- Deutsche Gesellschaft für Hebammenwissenschaft e. V. (DGHWi), Münster, Germany
| | - Mathilde Kersting
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Forschungsdepartment Kinderernährung, Klinik für Kinder- und Jugendmedizin, Universitätsklinikum der Ruhr-Universität Bochum, Bochum, Germany
| | - Michael Krawinkel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Institut für Ernährungswissenschaft, Justus-Liebig-Universität Gießen, Gießen, Germany
- Deutsche Gesellschaft für Ernährung e. V. (DGE), Bonn, Germany
| | - Hildegard Przyrembel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
| | - Marianne Röbl-Mathieu
- Mitglied der Ständigen Impfkommission am Robert Koch-Institut (STIKO), Berlin, Germany
| | - Ulrich Schiffner
- Poliklinik für Zahnerhaltung und Präventive Zahnheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
- Deutsche Gesellschaft für Kinderzahnheilkunde e. V. (DGKiZ), Würzburg, Germany
| | - Klaus Vetter
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Nationale Stillkommission, Bundesinstitut für Risikobewertung (BfR), Berlin, Germany
| | - Anke Weißenborn
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Bundesinstitut für Risikobewertung (BfR), Berlin, Germany
| | - Achim Wöckel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Frauenklinik und Poliklinik Universitätsklinikum Würzburg, Würzburg, Germany
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Mikami FCF, Francisco RPV, Rodrigues A, Hernandez WR, Zugaib M, de Lourdes Brizot M. Breastfeeding Twins: Factors Related to Weaning. J Hum Lact 2018; 34:749-759. [PMID: 29660295 DOI: 10.1177/0890334418767382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Many factors may influence a woman's decision to start and maintain breastfeeding. Research aim: This study aimed to investigate the factors associated with breastfeeding cessation in twin infants during the first 6 months after birth and to describe the main reasons for weaning cited by mothers of twins. METHODS This is a secondary data analysis of a prospective randomized trial conducted in Brazil. Data were obtained through longitudinal quantitative and qualitative self-reported interviews. One hundred twenty-eight women pregnant with twins and their 256 infants were followed for up to approximately 6 months, during which time breastfeeding data were obtained through face-to-face interviews at three different points after birth: 30 to 40 days (Time 1), 90 days (Time 2), and 180 days (Time 3). The association between weaning and the investigated factors was examined using survival analysis methodologies. RESULTS Nonexclusive breastfeeding ( p = .004, Cox proportional hazards regression model), a lack of support during the lactation period ( p = .001), difficulty breastfeeding ( p = .003), a breastfeeding duration shorter than 12 months in a previous pregnancy ( p = .001), and infants' birth weight less than 2,300 g ( p < .001) were the factors associated with breastfeeding cessation. The main reasons for weaning cited by mothers of twins were insufficient human milk supply, infants' behavior, and returning to work. CONCLUSION We have identified the factors associated with weaning in twin infants during the first 180 days of life. This knowledge can help improve strategies to increase breastfeeding rates in twins.
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Affiliation(s)
| | | | - Agatha Rodrigues
- 2 Department of Statistics, Institute of Mathematics and Statistics, São Paulo University, São Paulo, Brazil
| | | | - Marcelo Zugaib
- 1 Department of Obstetrics and Gynecology, São Paulo University Medical School, São Paulo, Brazil
| | - Maria de Lourdes Brizot
- 1 Department of Obstetrics and Gynecology, São Paulo University Medical School, São Paulo, Brazil
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Hansen E, Tesch L, Ayton J. 'They're born to get breastfed'- how fathers view breastfeeding: a mixed method study. BMC Pregnancy Childbirth 2018; 18:238. [PMID: 29914401 PMCID: PMC6006837 DOI: 10.1186/s12884-018-1827-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 05/15/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fathers' attitudes and actions can positively or negatively affect mothers' intentions to breastfeed, breastfeeding duration and exclusivity. In-depth information about fathers' perspectives on breastfeeding are largely absent in the literature about infant feeding. The objective of this research was to investigate how fathers view breastfeeding. METHODS This mixed method study recruited Tasmanian fathers with children < 24 months of age. Fathers completed a questionnaire and participated in either semi structured one-on-one or group interviews. Transcripts were analysed using a process of iterative thematic analysis. RESULTS Twenty-six fathers participated in the study. They had a mean age of 34 years and just over half were first time fathers. A total of 13 fathers lived in areas classified by SEIFA as disadvantaged. Twenty-one reported they had decided as a couple to breastfeed their current child. Fathers' views on breastfeeding are complex, multi-layered and change over time: as babies get older, as fathers get more familiar with feeding babies, when feeding practices change and when family circumstances change. Four thematic categories related to how fathers view breastfeeding were identified; Breastfeeding as healthy and natural, the value of breast feeding and breastmilk, a pragmatic approach to breastfeeding and Breastfeeding as something achieved or imposed. CONCLUSION Fathers in our study valued breastfeeding and saw it as healthy and natural for babies. However, many of the fathers in our study had seen their partners struggle with breastfeeding. As a result some also viewed breastfeeding as a potentially harmful practice for mothers. Their accounts demonstrated that breastfeeding problems affect families, not just mothers and infants. There is scope for improvement in the care of women during and after birth to reduce breastfeeding problems and for fathers to learn more about breastfeeding prior to the birth of their child.
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Affiliation(s)
- Emily Hansen
- School of Social Sciences, University of Tasmania, Private bag 22, Hobart, TAS, 7001, Australia
| | - Leigh Tesch
- School of Social Sciences, University of Tasmania, Private bag 22, Hobart, TAS, 7001, Australia
| | - Jennifer Ayton
- Public Health, College of Health and Medicine, University of Tasmania, Private Bag 135, Hobart, TAS, 7001, Australia.
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Mangrio E, Persson K, Bramhagen AC. Sociodemographic, physical, mental and social factors in the cessation of breastfeeding before 6 months: a systematic review. Scand J Caring Sci 2017; 32:451-465. [DOI: 10.1111/scs.12489] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 05/03/2017] [Indexed: 01/17/2023]
Affiliation(s)
| | - Karin Persson
- Department of Care Science; Malmö University; Malmö Sweden
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Predictors of exclusive breastfeeding duration among 6-12 month aged children in gurage zone, South Ethiopia: a survival analysis. Int Breastfeed J 2017; 12:20. [PMID: 28439290 PMCID: PMC5399807 DOI: 10.1186/s13006-017-0107-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 03/20/2017] [Indexed: 11/10/2022] Open
Abstract
Background Exclusive breastfeeding is giving only breast milk to an infant from birth up to six months of age, with the exception of medications and vitamins. For the first six months of life, breast milk alone is the ideal nourishment to meet the nutritional demand of the growing child. Although breastfeeding is a universal practice, in Ethiopia only 52% of children aged less than six months old were exclusively breastfed. The study aimed to investigate the predictors of exclusive breastfeeding duration among women who had children aged between 6–12 months in Gurage zone, South Ethiopia. Methods A mixed method cross-sectional study was conducted to assess predictors of exclusive breastfeeding duration in south Ethiopia. Eight hundred and twenty eight study participants were recruited using a multistage sampling technique for the quantitative survey. Interviewer administered close ended questionnaire was used to collect the quantitative data. Data were entered using Epi Data and analyzed using SPSS version 21. The Kaplan-Meier curve with log rank test was used to compare the survival difference due to the selected covariates. A binary and multivariable Cox regression model was used to identify the independent predictors of exclusive breastfeeding duration. Three focus group discussions were conducted to generate the qualitative data. Qualitative data is transcribed and analyzed by thematic approach using open-code software. Results The median duration of exclusive breastfeeding was six months. About 21.9% of women introduced complementary food before six months of child age. Women with education status of diploma and above (Adjusted Hazard Ratio [AHR]: 2.89, 95% CI: 1.05, 7.97), perceived inadequate breast milk (AHR: 11, 95% CI: 6.7, 18.0) and cesarean section delivery (AHR: 3.8, 95% CI: 2.0, 7.2) were more likely to cease exclusive breastfeeding before six months of child age; while women who had infant feeding counseling during postnatal care (AHR: 5.1, 95% CI: 2.5, 10.23) were less likely to cease exclusive breastfeeding before the child was six months of age. Conclusions A significant proportion of women cease exclusive breastfeeding before the recommended six months duration. Maternal education of diploma and above, perceived inadequacy of breast milk, cesarean section delivery, postnatal counseling on child feeding are factors significantly associated with the duration of exclusive breastfeeding. Encouraging behavioral change and improving communication regarding the duration of exclusive breastfeeding, and increasing the utilization of postnatal counseling about exclusive breastfeeding are recommended.
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White BK, Martin A, White JA, Burns SK, Maycock BR, Giglia RC, Scott JA. Theory-Based Design and Development of a Socially Connected, Gamified Mobile App for Men About Breastfeeding (Milk Man). JMIR Mhealth Uhealth 2016; 4:e81. [PMID: 27349756 PMCID: PMC4940606 DOI: 10.2196/mhealth.5652] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/17/2016] [Accepted: 06/04/2016] [Indexed: 01/28/2023] Open
Abstract
Background Despite evidence of the benefits of breastfeeding, <15% of Australian babies are exclusively breastfed to the recommended 6 months. The support of the father is one of the most important factors in breastfeeding success, and targeting breastfeeding interventions to the father has been a successful strategy in previous research. Mobile technology offers unique opportunities to engage and reach populations to enhance health literacy and healthy behavior. Objective The objective of our study was to use previous research, formative evaluation, and behavior change theory to develop the first evidence-based breastfeeding app targeted at men. We designed the app to provide men with social support and information aiming to increase the support men can offer their breastfeeding partners. Methods We used social cognitive theory to design and develop the Milk Man app through stages of formative research, testing, and iteration. We held focus groups with new and expectant fathers (n=18), as well as health professionals (n=16), and used qualitative data to inform the design and development of the app. We tested a prototype with fathers (n=4) via a think-aloud study and the completion of the Mobile Application Rating Scale (MARS). Results Fathers and health professionals provided input through the focus groups that informed the app development. The think-aloud walkthroughs identified 6 areas of functionality and usability to be addressed, including the addition of a tutorial, increased size of text and icons, and greater personalization. Testers rated the app highly, and the average MARS score for the app was 4.3 out of 5. Conclusions To our knowledge, Milk Man is the first breastfeeding app targeted specifically at men. The development of Milk Man followed a best practice approach, including the involvement of a multidisciplinary team and grounding in behavior change theory. It tested well with end users during development. Milk Man is currently being trialed as part of the Parent Infant Feeding Initiative (ACTRN12614000605695).
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Affiliation(s)
- Becky K White
- School of Public Health, Curtin University, Perth, Australia
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Ayton J, Hansen E. Complex young lives: a collective qualitative case study analysis of young fatherhood and breastfeeding. Int Breastfeed J 2016; 11:6. [PMID: 27042196 PMCID: PMC4818881 DOI: 10.1186/s13006-016-0066-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 03/28/2016] [Indexed: 11/13/2022] Open
Abstract
Background Of all births in Australia, 10 % are to young fathers aged less than 24 years. How young fathers experience any breastfeeding and how this is shaped by their social context is poorly understood. Our aim is to increase understanding of the lived experience of young fathers (aged less than 24 years) and to explore the way they speak about breastfeeding in the context of their lives and parenting. Methods This collective case study analysis uses qualitative data from interviews and focus groups with young fathers (aged less than 24 years) and community support staff. The research was undertaken in Tasmania, Australia, March to December 2013. Results Young fathers in our study had complex social and emotional circumstances that meant breastfeeding was not a high priority despite them valuing the health benefits of breastfeeding for their babies. If supported by peers and their community they appear to have a more positive parenting experience. Conclusion Breastfeeding although understood by the young fathers in our study as healthy and desirable is not a priority in their lives. Learning to be a parent and support their partners to breastfeed may be more effectively gained through mentoring and father-to-father localized community based support services.
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Affiliation(s)
- Jennifer Ayton
- University of Tasmania School of Social Science, Hobart, Tasmania Australia ; Menzies Institute for Medical Research, Tasmania, School of Social Science, Hobart, Tasmania Australia
| | - Emily Hansen
- University of Tasmania School of Social Science, Hobart, Tasmania Australia
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