Breast-feeding initiation and exclusive breast-feeding in rural Vietnam

OBJECTIVE: To investigate the initiation of breast-feeding and exclusive breast-feeding within the first week after delivery for women in rural Vietnam. DESIGN: An interviewer-administered survey was conducted on a sample of rural women who gave birth during August-October 2002. SETTING: Quang Xuong District, Thanh Hoa Province of Vietnam. SUBJECTS: Four hundred and sixty-three women participated in the study, of whom 181 delivered at the district hospital (39.1%), 229 at a commune health centre (49.5%) and 53 at home attended by a traditional birth attendant (11.4%). RESULTS: Although the initiation and exclusive breast-feeding rates were relatively high at 98.3% and 83.6% respectively, the premature introduction of complementary food was a great concern. Logistic regression analysis showed that, together with socio-cultural determinants such as feeding preferences of the husband and maternal grandmother, feeding practices of friends, factors relating to delivery methods, delivery locations and health problems could influence the initiation rate and breast-feeding patterns. CONCLUSIONS: To promote breast-feeding practices of rural mothers, health education on breast-feeding should take into account local socio-cultural features in addition to improving the counselling skills of health workers.     

Breast-feeding and feeding practices of infants in a developing country: a national survey in Lebanon

OBJECTIVE: Breast-feeding (BF) provides the ideal food for the healthy growth and development of infants. The prevalence of BF in Lebanon shows mixed results. The present study was the first large-scale, extensive survey on BF parameters in Lebanon that aimed to explore demographic, socio-economic and other fundamental issues associated with the initiation and duration of BF by Lebanese mothers.DESIGN: The survey was cross-sectional in design and administered over 10 months.SETTING: Information on all variables was collected from mothers at health centres.SUBJECTS: Two-stage sampling was conducted to select participants. A total of 1,000 participants were randomly selected. A consent form was provided to each participant. Data were collected from 830 of these.RESULTS: Almost all mothers were Lebanese, married and had given birth in a hospital. About a third stated that breast milk was the first food introduced after birth. Although 55.9% started breast-feeding their newborns within a few hours after birth, and 18.3% within half an hour, 21.2% replied that they initiated BF a few days after birth. Only 4.6% of the mothers replied that they never breast-fed their infant. Timing of initiation of BF was associated with the type of delivery (vaginal/Caesarean section) and hospital-related factors (rooming-in, night feedings and frequency of mother-infant interaction). Of the mothers who breast-fed exclusively beyond 6 months, 86.7% had initiated BF a few hours following delivery, while only 13.3% had initiated BF a few days later. Compared with the exceptionally high proportion of BF initiation, exclusivity of BF was low, dropping to 52.4% at 1 month. Exclusivity of BF was also associated with place of residence (urban/rural) and negatively associated with educational level of the mother. Duration of BF was inversely associated with the use of pain killers during delivery and maternal education. Rural mothers and those who practised exclusive BF maintained BF for a longer duration.CONCLUSION: Initiation rates of BF are very high in Lebanon but rates of exclusive BF are low and duration of BF is short. Future research targeting the factors associated with BF, with particular emphasis on exclusivity, is needed. For the 95.4% of mothers who initiated BF, an ecological perspective on intervention aimed at women and their social support system is required to improve duration and exclusivity.     

Development and simulated validation of a food-frequency questionnaire for the Colombian population

OBJECTIVE: To develop a food-frequency questionnaire (FFQ) useful for ranking of nutrient intakes. DESIGN: Subjects consuming their regular diet completed 7 days of weighed intake registry (7-WIR). Foods for the FFQ were selected by stepwise multiple regression. The FFQ was then completed for each subject using data on individual food consumption from the 7-WIR. The correlation and agreement between the extrapolated FFQ and the 7-WIR data were assessed using Spearman's rank correlation coefficients (rS) and Bland and Altman's limits of agreement (LOA). SETTING: Bucaramanga, Colombia. SUBJECTS: We studied 97 randomly selected 20-40-year-old subjects. RESULTS: Sixty foods were selected for the FFQ. The 7-WIR and the extrapolated FFQ intake estimates correlated well. rS was 0.58 for energy, 0.53 for carbohydrate, 0.50 for total fat, and 0.48 for protein. For micronutrients, rS varied from 0.46 (manganese) to 0.71 (vitamin B12). FFQ average intake estimates were 83%, 80%, 86.2% and 86.4% of 7-WIR estimates for energy, carbohydrate, total fat and protein, respectively. LOA for these nutrients ranged between 45% and 165%. FFQ micronutrient intakes were on average 96% (median) of those from the 7-WIR, and the median lower and upper LOA were 50% and 203%. However, there was no indication that the degree of agreement varied with the level of intake. CONCLUSIONS: According to our simulated validation, this FFQ may be useful to rank subjects by nutrient intake. Its validity against standard independent measurements and its applicability to other subsets of the Colombian population should be carefully considered.     

Rethinking research in breast-feeding: a critique of the evidence base identified in a systematic review of interventions to promote and support breast-feeding

OBJECTIVE: To appraise critically the relevance and value of the evidence base to promote and support the duration of breast-feeding, with a specific focus on disadvantaged groups. DESIGN: A systematic review was conducted of intervention studies relevant to enhancing the duration of breast-feeding; topics included public health, public policy, clinical issues, and education, training and practice change. A systematic search was conducted. Eighty studies met the inclusion criteria. Data were systematically extracted and analysed. Full results and recommendations are reported elsewhere. Here a critique of the evidence base--topics, quality and gaps--is reported. RESULTS: Many studies were substantially methodologically flawed, with problems including small sample sizes, inconsistent definitions of breast-feeding and lack of appropriate outcomes. Few were based on relevant theory. Only a small number of included studies (10%) were conducted in the UK. Very few targeted disadvantaged subgroups of women. No studies of policy initiatives or of community interventions were identified. There were virtually no robust studies of interventions to prevent and treat common clinical problems, or of strategies related to women's health issues. Studies of health professional education and practice change were limited. Cost-effectiveness studies were rare. CONCLUSIONS: Policy goals both in the UK and internationally support exclusive breast-feeding until 6 months of age. The evidence base to enable women to continue to breast-feed needs to be strengthened to include robust evaluations of policies and practices related to breast-feeding; a step change is needed in the quality and quantity of research funded.     

Knowledge of dietary and behaviour-related determinants of non-communicable disease in urban Senegalese women

OBJECTIVE: To assess knowledge of dietary and behaviour-related determinants of non-communicable disease (NCD) of urban Senegalese women. DESIGN: A cross-sectional, population study using an interviewer-administered knowledge questionnaire, developed and validated for this study. The questionnaire consisted of 24 items with six scores measuring knowledge of: (1) diet- and behaviour-related causes of NCD; (2) diet quality-NCD relationship; (3) fruit and vegetable link with NCD; (4) health consequences of obesity; (5) causes of cardiovascular disease (CVD); and (6) causes of certain cancers. SUBJECTS: A random sample of 301 women aged 20-50 years. RESULTS: The knowledge scores developed suggest that the health consequences of obesity (mean score of 65.4%) were best understood followed by causes of CVD (mean score of 60.6%), because obesity, smoking, high blood cholesterol and dietary fat were well recognised as risk factors for CVD. Subjects scored least for their knowledge of the protective effect of fruit and vegetables (mean score of 19.9%). Knowledge of causes of certain cancers (mean score of 36.1%) was also low. Women who worked outside the home had better knowledge for two scores but otherwise no relationship was found between knowledge and literacy, formal education or body mass index. CONCLUSIONS: Findings suggest reasonable overall knowledge concerning diet and behaviour with NCD, especially given the relatively new context of the obesity epidemic in Senegal. However, there was poor knowledge of the benefit of eating fruit and vegetables and other preventable causes of certain cancers. Education targeting the benefits of vegetables and fruit may have the greatest impact on NCD prevention.     

Survival of the western pond turtle (Emys marmorata) in an urban California environment

The western pond turtle Emys (formerly Clemmys) marmorata is declining throughout its range, primarily due to loss of habitat via urbanization and conversion to agriculture. Urban waterways present several important challenges to freshwater turtle populations, but they also present an opportunity to maintain declining species in a ubiquitous habitat that has high public visibility. The arboretum waterway on the University of California, Davis campus is an example of an extensively altered urban habitat that supports a relatively large E. marmorata population. Over the last 6 years, we monitored the turtle population inhabiting the arboretum waterway to determine the demographic health of the population, and the challenges and opportunities that urban environments pose for pond turtles. Since 1993, the naturally existing arboretum pond turtle population has declined by approximately 40% and has shown little natural recruitment. During this time, we also introduced 31 headstarted turtles into the arboretum. Headstarting is the process of raising juveniles in captivity until they have outgrown their period of greatest vulnerability to predators, and then releasing them into the wild. Our headstarting results demonstrate that this contentious strategy is a viable option for adding young turtles to the population, although it does not address the causes of decline. Over the course of our study, we encountered nine species of non-native turtles in the waterway, and these appear to be a serious threat to the native species. As more habitat becomes urbanized, it is increasingly important to understand how freshwater turtles, such as E. marmorata, adapt to urban waterways and the impact of non-native turtles on native turtle species. Our strong feeling is that urban waterways can provide habitat for viable populations of freshwater turtles and showcase them to the public, but both the aquatic and terrestrial habitat must be managed according to the biological requirements of individual species.     

Edaphic factors as determinants for the distribution of intrinsic antibiotic resistance in a cowpea rhizobia population

 A large collection of cowpea rhizobia strains was obtained from soil samples collected from either a semi-arid or a tropical rain forest area located at about the same latitude in the north-eastern region of Brazil and evaluated for their intrinsic antibiotic resistance to eight commercial antibiotics. The aim of this study was to correlate antibiotic resistance of native rhizobia strains to edaphic-climatic factors as a way to establish suitable inoculants for specific areas. A large diversity regarding intrinsic antibiotic resistance was found, and 17 clusters were identified as varying from sensitive to gradually resistant up to 500 μg·ml^–1 of the antibiotics tested. Clustering analysis did not show any pattern related to the geographic region where isolates have been obtained. On the other hand, an increase in the antibiotic-resistant rhizobia population was associated with an increase in soil P and Al contents. lsolates which were sensitive to spectinomycin, ampicillin, streptomycin, chloramphenicol and tetracycline were present at higher rates in soils devoid of Al. Rhizobia bacteria producing mucus type I (fluid and capable of spreading over the solid media) were found preferentially in soil with Al concentrations up to 36 mg·kg^–1, diminishing quickly at higher levels. Received: 2 May 1997     

The assessment of point and diffuse metal pollution of soils from an urban geochemical survey of Sheffield, England

Abstract. A model of soil variability as a continuous background process with superimposed point contamination was applied to 569 measurements of metal concentrations (Cr, Ni and Pb) in the topsoils of Sheffield, England. Robust estimators of the variogram were shown to be required to describe spatial variation of the metal concentrations at most sampled locations. This is diagnostic of the presence of a contaminant process. Values of the standardized kriging error from the cross‐validation of each datum were used to identify spatial outliers for each metal. The ordinary kriged estimates of Cr, Ni and Pb were mapped after removing the outliers to estimate the background variation. Each of the 35 spatial outliers that occured in gardens have concentrations exceeding their Soil Guideline Value for residential land use with plant uptake, highlighting a potentially significant exposure pathway. The frequent observation of coal and furnace waste at these sites suggests that their dispersal, following domestic use and industrial processes, respectively, represents a significant point contaminant process. There was no evidence for spatial clustering of the point process. However, the spatial outliers of Cr and Ni showed a significant association with disturbed sites identified from historical land use maps, in part due to their prevalence in areas of historical steel manufacture. The magnitude of diffuse pollution for each metal in the urban soil was estimated by removing the spatial outliers and comparing robust measures of location with those from a survey of soils developed over the same parent materials in adjacent rural and peri‐urban environments. The Winsorized mean Pb concentrations in urban topsoil (203 mg kg^?1) were twice the value in the rural environment (101 mg kg^?1), highlighting a very substantial diffuse Pb load to urban soils. The equivalent estimated diffuse components in urban soils for Cr and Ni were, respectively, 25% and 14% higher than the rural soils.     

A comparative study of methods for diagnosis of obesity in an urban mixed-race population in Minas Gerais, Brazil

BACKGROUND: Obesity is defined as an excess of total body fat and may be assessed by different methods. The objective of the present study was to establish the discriminatory power of anthropometric data in determining obesity. METHODS: The subjects comprised 685 individuals, aged 20-79 years, sampled from a population-based survey. The following indicators were used: body mass index (BMI), waist circumference (WC) and total body fat percentage estimated with both Siri's equation (%BF Siri) and foot-to-foot bioelectrical impedance analysis (%BF BIA). Sensitivity and specificity of different cut-off points for each method were determined using %BF BIA as reference. RESULTS: Of 685 participants, 57.6% were aged >/= 40 years, 69.9% were women and 72.6% self-referred themselves as non-white. To classify obesity based on sex and age among women aged 0.05). Classifying according to skin colour did not change cut-off points in any indicator. CONCLUSION: BMI and WC better discriminate obesity among women and men aged >/= 40 years from a mixed-race population.     

Features of airborne breathable particulate in a remote rural and in an urban area

In order to define the atmosphere pollution role in the lung cancer etiology it is necessary to carefully measure the composition of airborne pollutants. The evaluation of atmosphere pollution by analytic electron microscopy technique has made it possible to analyze the morphology and composition of airborne breathable particulate and to characterize the sources. The comparative study of a rural area and a downtown area in Rome has shown qualitative and quantitative differences in the pollution pattern. In the urban area the data we have obtained point out motor vehicle traffic as the greatest source of pollution. A large amount of heavy metals and mineral fibers, potentially noxious for health, was observed.     

The impact of sport-hunting on the population dynamics of an African lion population in a protected area

Between 1999 and 2004 we undertook an ecological study of African lions (Panthera leo) in Hwange National Park, western Zimbabwe to measure the impact of sport-hunting beyond the park on the lion population within the park, using radio-telemetry and direct observation. 34 of 62 tagged lions died during the study (of which 24 were shot by sport hunters: 13 adult males, 5 adult females, 6 sub-adult males). Sport hunters in the safari areas surrounding the park killed 72% of tagged adult males from the study area. Over 30% of all males shot were sub-adult (<4 years). Hunting off-take of male lions doubled during 2001-2003 compared to levels in the three preceding years, which caused a decline in numbers of adult males in the population (from an adult sex ratio of 1:3 to 1:6 in favour of adult females). Home ranges made vacant by removal of adult males were filled by immigration of males from the park core. Infanticide was observed when new males entered prides. The proportion of male cubs increased between 1999 and 2004, which may have occurred to compensate for high adult male mortality.     

Salt exploitation and landscape structure in a breeding population of the threatened bluethroat (Luscinia svecica) in salt-pans in western France

The Guérande salt-pans represent the main French breeding area of bluethroat, a migrating passerine. Salt exploitation has created a geometrical artificial landscape in which we investigated factors influencing spatial distribution and breeding success of this species using a Geographical Information System. We compared data for four sites in these salt-pans, for three zones in the most densely populated site, and for 2500 m² grid cells defined for this same site. This study showed the influence of (1) the level of salt exploitation activity, (2) the density of bank intersections, (3) the extent of area covered by Suaeda vera bushes and (4) the structural heterogeneity. The continued management of these salt-pans enhanced bird breeding success. Thus, traditional salt exploitation contributes directly to the conservation of bluethroat, considered as an endangered species in Europe.