The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants : study protocol for a randomized controlled trial

Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding. Methods/design: A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. Primary outcome: proportion of mothers exclusively breastfeeding at eight weeks after discharge. Secondary outcomes: proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be undertaken with mothers and staff. Discussion: This paper presents the rationale, study design and protocol for a RCT providing person-centred proactive telephone support to mothers of preterm infants. Furthermore, with a health economic evaluation, the cost-effectiveness of the intervention will be assessed. Trial registration: NCT01806480

Harold Pinter: A Night Out : A Study in the Political ConnotationsAnd the Abuse of Power

Harold Pinter’s A Night Out is a significant but rarely produced piece of drama. Therefore, there is very little criticism to support or contradict my argument. The reason why I chose to do my essay on this particular play is to open doors for academic research and to try and make it an equal to its sister plays. I will raise questions and topics to prove the play is worth the readers’ time and effort and that A Night Out is a sharp piece of political theatre. Although at first glance it is a simple enough story, a straightforward tale of the nasty consequences of motherly love when it is pushed to the limit, on deeper inspection, a more far reaching and complex analysis of the abuse of power can be observed. The play offers a variety of themes, including: interpersonal power struggles, failed attempts at communication, antagonistic relationships, the threat of impending or past violence, the struggle for survival or identity, domination and submission, politics, lies and verbal, physical, psychological and sexual abuse. The prevailing theme in the play is the abuse of power: powerful parties oppressing weaker ones, and the results of the oppressed party looking for a vent in someone even weaker than themselves.

Pedagoger i det sociala uppdragets gränstrakter : Att hantera familjerättsliga processer, hot och våld

Pedagogues in the borderland of their social task: dealing with family law proceedings, threats and violence Drawing upon an explorative study of family law proceedings from a school perspective, the aim of this paper is to examine the school staff’s strategies for solving or coping with problematic situations in this context. Gendered conflicts between adults and violence are extreme cases for pedagogues in school and preschool. How do the staff cope with their own and the children’s vulnerability? Based upon interviews with 22 informants, the staff’s strategies are outlined and discussed in relation to organizational and professional circumstances and intersecting social relations of power. An analytical construction of six types of proactive and reactive strategies, ranging from distance keeping to normalization of own exposure, is utilized in the analysis. Findings suggest that the staff’s strategies to handle challenging events in this context vary with the parent’s gender, class position and ethnicity. Further, it is argued that creating a sense of safety and promoting learning among the children may be obstructed by lack of support from the school’s organization, demands on staff to perform customer oriented attitudes towards parents and lack of clarity concerning the limits of the social task. Conflicts between the organization and profession on the one hand and the educational and the social task on the other hand, are thus illuminated. In conclusion, a further aim of this article is to contribute to broader discussions on men’s violence against women and children – in families as well as in workplaces and in the intersection between these two areas.