Effects of hospital policies and practices on initiation and duration of breastfeeding.

BACKGROUND: The aim of this study was to verify if hospital policies and practices, independently of main maternal sociodemographic determinants, influence initiation and duration of breastfeeding. METHODS: The study was carried out at the Immunization Centre of Messina where all infants born in the four maternity wards of Messina are vaccinated, using a structured questionnaire, constructed in conformity with the methodology suggested by the WHO. RESULTS: Data analysis, performed by non-parametric and multivariate analysis of variance and by Kaplan-Meier curves, showed that the highest probability rate (P < 0.001) of initiation and duration of breastfeeding, independently of maternal age, parity, education levels, smoke and work was found in infants born in a University Hospital, characterized by earlier times of first suckling, longer hospital stay and higher rate of exclusive breastfeeding at discharge. CONCLUSION: Our data emphasize the role and responsibility of hospital policies and practices in the promotion, and in the duration of breastfeeding.

Eliminating congenital rubella: a seroepidemiological study on women of childbearing age and MMR vaccine coverage in newborns.

INTRODUCTION: Rubella can have particularly serious effects on the product of conception if contracted during pregnancy. Thus, the main aim of rubella vaccination programmes is to prevent infection during pregnancy. MATERIALS AND METHODS: A seroepidemiological study was conducted from July 2006 to December 2007 on 1000 women of childbearing age, 15 to 45 years old, using specific rubivirus antibody assays, IgG and IgM. A questionnaire administered at the same time allowed us to survey how much women knew about this disease. In addition, MMR vaccine coverage rates were analysed for cohorts born in the local health districts of Messina for the period 1993-2006. RESULTS: An analysis of the replies given to the questionnaire showed an estimated 42.8% of the women to have immunity from rubella, while the serological study showed an immunity coverage rate of80.6%. Vaccination coverage in the local health districts regarding the first dose of MMR was 81% (cohorts 1993-2005), while the rate was only 24% for the second dose (cohorts 1993-2002). CONCLUSIONS: Both immunity coverage in women of childbearing age and that for newborns (for the cohort considered)fall below the 95% target set by the National Elimination Plan for Measles and Congenital Rubella (PNEM). It is therefore necessary to provide women with adequate information about the risks of rubella during pregnancy and about the benefits of vaccination, as well as to recoup subjects at risk or those whose immune status is unknown. Public health authorities also need to make continued efforts to increase the number of MMR vaccinations throughout the region.

Statistics of entropy production in linearized stochastic systems.

We consider a wide class of linear stochastic problems driven off the equilibrium by a multiplicative asymmetric force. The force breaks detailed balance, maintained otherwise, thus producing entropy. The large deviation function of the entropy production in the system is calculated explicitly. The general result is illustrated using an example of a polymer immersed in a gradient flow and subject to thermal fluctuations.

Dynamical slowdown of polymers in laminar and random flows.

The influence of an external flow on the relaxation dynamics of a single polymer is investigated theoretically and numerically. We show that a pronounced dynamical slowdown occurs in the vicinity of the coil-stretch transition, especially when the dependence on polymer conformation of the drag is accounted for. For the elongational flow, relaxation times are exceedingly larger than the Zimm relaxation time, resulting in the observation of conformation hysteresis. For random smooth flows, hysteresis is not present. Yet, relaxation dynamics is significantly slowed down because of the large variety of accessible polymer configurations. The implications of these results for the modeling of dilute polymer solutions in turbulent flows are addressed.