Breastfeeding self-efficacy of women using second-line strategies for healthy term infants in the first week postpartum : an Australian observational study

Background Breastfeeding self-efficacy (BFSE) supports breastfeeding initiation and duration. Challenges to breastfeeding may undermine BFSE, but second-line strategies including nipple shields, syringe, cup, supply line and bottle feeding may support breastfeeding until challenges are resolved. The primary aim of this study was to examine BFSE in a sample of women using second-line strategies for feeding healthy term infants in the first week postpartum. Methods A retrospective self-report study was conducted using the Breastfeeding Self-Efficacy Scale - Short Form (BSES-SF), demographic and infant feeding questionnaires. Breastfeeding women who gave birth to a singleton healthy term infant at one private metropolitan birthing facility in Australia from November 2008 to February 2009 returned anonymous questionnaires by mail. Results A total of 128 (73 multiparous, 55 primiparous) women participated in the study. The mean BSES-SF score was 51.18 (Standard deviation, SD: 12.48). The median BSES-SF score was 53. Of women using a second-line strategy, 16 exceeded the median, and 42 were below. Analyses using Kruskal-Wallis tests confirmed this difference was statistically significant (H = 21.569, p = 0.001). The rate of second-line strategy use was 48%. The four most commonly used second-line strategies were: bottles with regular teats (77%); syringe feeding (44%); bottles with wide teats (34%); and nipple shields (27%). Seven key challenges were identified that contributed to the decision to use second-line strategies, including: nipple pain (40%); unsettled infant (40%); insufficient milk supply (37%); fatigue (37%); night nursery care (25%); infant weight loss > 10% (24%); and maternal birth associated pain (20%). Skin-to-skin contact at birth was commonly reported (93%). At seven days postpartum 124 women (97%) were continuing to breastfeed. Conclusions The high rate of use of second-line strategies identified in this study and high rate of breastfeeding at day seven despite lower BFSE indicate that such practices should not be overlooked by health professionals. The design of this study does not enable determination of cause-effect relationships to identify factors which contribute to use of second-line strategies. Nevertheless, the significantly lower BSES-SF score of women using a second-line strategy highlights this group of women have particular needs that require attention.

Feeding mode of Australian infants in the first 12 months of life: An assessment against national breastfeeding indicators

Background: In 2011, Australia published a set of 6 population-level indicators assessing breastfeeding, formula use, and the introduction of soft/semisolid/solid foods. Objectives: This study aimed to report the feeding practices of Australian infants against these indicators and determine the predictors of early breastfeeding cessation and introduction of solids. Methods: Mother–infant dyads (N = 1470) were recruited postnatally in 2 Australian capital cities and regional areas of 1 state between February 2008 and March 2009. Demographic and feeding intention data were collected by self-completed questionnaire at infant birth, with feeding practices (current feeding mode, age of breastfeeding cessation, age of formula and/or solids introduction) reported when the infant was between 4 and 7 months of age, and around 13 months of age. Multiple logistic regression was used to determine the predictors of breastfeeding cessation and solids introduction. Results: Although initiation of breastfeeding was almost universal (93.3%), less than half of the infants were breastfed to 6 months (41.7%) and 33.3% were receiving solids by 4 months. Women who were socially disadvantaged, younger, less educated, unpartnered, primiparous, and/or overweight were most likely to have ceased breastfeeding before 6 months of age, and younger and/or less educated women were most likely to have introduced solid food by 4 months of age. Not producing adequate milk was the most common reason provided for cessation of breastfeeding. Conclusion: The feeding behaviors of Australian infants in the first 12 months fall well short of recommendations. Women need anticipatory guidance as to the indicators of breastfeeding success and the tendency of women to doubt the adequacy of their breast milk supply warrants further investigation.

Collaboration and Engagement Throughout The Supply Chain : The Role of Government

Collaboration is acknowledged as a key to continued growth in the Australian construction industry. Government, as a major industry client, has an important role to play with respect to fostering collaboration and ensuring the global competitiveness of the industry. The paper draws upon data collected for the Construction 2020 study and aims to demonstrate that government can a) help to break down the adversarial situation that currently exists between clients, project managers and subcontractors; and b) allow the supply chain to collaborate more effectively in terms of satisfying the relational and financial needs of all parties. Government can also provide a clear set of guidelines (backed up by a functional dispute resolution system) that will promote confidence with respect to forging relationships. Thus, the paper will discuss the way in which public policy can be more closely aligned with actual industry needs in order to promote greater collaboration.

The effect of alternate supply of shielding gases in austenite stainless steel GTA welding

Welding system has now been concentrated on the development of new process to achieve cost savings, higher productivity and better quality in manufacturing industry. Discrete alternate supply of shielding gas is a new technology that alternately supplies the different kinds of shielding gases in weld zone. As the newdevelopedmethods compared to the previous generalwelding with a mixing supply of shielding gas, it cannot only increase thewelding quality, but also reduce the energy by 20% and the emission rate of fume. As a result, under thesamewelding conditions,comparedwith thewelding by supplying pure argon, argon + 67% helium mixture by conventional method and thewelding by supplying alternately pure argon and pure helium by alternate method showed the increased welding speed. Also, the alternate method showed the same welding speed with argon + 67% helium mixture without largely deteriorating of weld penetration. The alternate method with argon and helium compared with the conventional methods of pure argon and argon + 67% helium mixture produced the lowest degree of welding distortion.

Characteristics of alternate supply of shielding gases in aluminum GMA welding

Recently, unlike conventional method in supplying shielding gas, a newly method which alternately supplies different kinds of shielding gases in weld zone is developed and partly commercialized. However, literature related to the present status of the technology in the actual weld field is very scant. To give better understand on this technology, this study was performed. Compared with conventional gas supply method, the variations of weld porosity and weld shape in aluminum welding with alternate supply method of pure argon and pure helium were compared with conventional gas supply method with pure argon and argon + 67%helium mixture, respectively. As a result, compared with the welding by supplying pure argon and argon + 67%helium mixture by conventional method, the welding by supplying alternately pure argon and pure helium, produced lower degree of weld porosity and deeper and broader weld penetration profile.

MiLK: Transforming everyday places into dynamic learning spaces with mobile and web technologies

This paper explores how game authoring tools can teach processes that transform everyday places into engaging learning spaces. It discusses the motivation inherent in playing games and creating games for others, and how this stimulates an iterative process of creation and reflection and evokes a natural desire to engage in learning. The use of MiLK at the Adelaide Botanic Gardens is offered as a case in point. MiLK is an authoring tool that allows students and teachers to create and share SMS games for mobile phones. A group of South Australian high school students used MiLK to play a game, create their own games and play each other’s games during a day at the gardens. This paper details the learning processes involved in these activities and how the students, without prompting, reflected on their learning, conducted peer assessment, and engaged in a two-way discussion with their teacher about new technologies and their implications for learning. The paper concludes with a discussion of the needs and requirements of 21st century learners and how MiLK can support constructivist and connectivist teaching methods that engage learners and will produce an appropriately skilled future workforce.

MILK : the Mobile Informal Learning Kit. Collaborating to design successful mobile learning applications

This paper suggests ways for educators and designers to understand and merge priorities in order to inform the development of mobile learning (m-learning) applications that maximise user experiences and hence learning opportunities. It outlines a User Experience Design (UXD) theory and development process that requires designers to conduct a thorough initial contextual inquiry into a particular domain in order to set project priorities and development guidelines. A matrix that identifies the key contextual considerations namely the social, cultural, spatial, technical and temporal constructs of any domain is presented as a vital tool for achieving successful UXD. The frame of reference provided by this matrix ensures that decisions made throughout the design process are attributable to a desired user experience. To illustrate how the proposed UXD theory and development process supports the creation of effective m-learning applications, this paper documents the development process of MILK (Mobile Informal Learning Kit). MILK is a support tool that allows teachers and students to develop event paths that consist of a series SMS question and answer messages that lead players through a series of checkpoints between point A and point B. These event paths can be designed to suit desired learning scenarios and can be used to explore a particular place or subject. They can also be designed to facilitate formal or informal learning experiences.