The Support Needs and Current Practices of Public Health Nurses in the Republic of Ireland Who Provide Support to Breastfeeding Mothers: A Cross-Sectional Survey.

BACKGROUND: Breastfeeding continuation rates are low in Ireland. The Breastfeeding Observation and Assessment Tool (BOAT) was developed to assist public health nurses in assessing breastfeeding challenges; however, little is known of its actual usage, the level of training experienced or desired by public health nurses, or their level of confidence in the support they provide to breastfeeding mothers. RESEARCH AIM: To identify the current practices and support needs of public health nurses who provide breastfeeding support in Ireland. METHOD: An online questionnaire was devised to collect respondents' confidence with breastfeeding issues, caseload, and practices. It was distributed to public health nurses with a current child health caseload in one Community Healthcare Organization. Mann Whitney U tests were used to ascertain the relationship between public health nurses' confidence level and those with qualifications in midwifery or as an International Board Certified Lactation Consultant (IBCLC). RESULTS: The survey was completed by 66 public health nurses. Only 14 respondents (21.2%) indicated that they always used the BOAT. The most common reason for not doing so was a lack of education on its use (n = 17, 25.8%). Postholders also certified as IBCLCs were considered by participants to be the most appropriate professionals to resolve certain breastfeeding issues. Confidence levels to manage breastfeeding issues were highest among public health nurses with IBCLC credentialing (U = 12.5, p = .001) while no difference was seen when comparing those with a midwifery degree to those without (U = 184.0, p = .92). Face-to-face workshops and blended-learning approaches were ranked as the preferred formats for breastfeeding education (Median rank = 2). CONCLUSIONS: Breastfeeding education incorporating a face-to-face component is needed to support public health nurses who work with breastfeeding mothers, as is prioritization of recruitment in the community of public health nurses with IBCLC credentials.

Health cognitions mediate physical (in)activity and walking in midlife women.

This study sought to identify which of the many facilitators and barriers to physical activity (PA) and walking are most significant to changing midlife women's exercise behaviour, with a view to informing future interventions. A cross-sectional survey explored associations of PA and sedentary time with self-reported health value, health locus of control (HLOC) and physical and mental health. Open-ended questions were included to elicit barriers and facilitators to walking. A sample of 295 women, aged 35-55, was recruited via women's groups, social media, online forums, and posters in doctors' surgeries, and completed the survey online. Quantitative data were analysed using descriptive statistics, t-test, analysis of variance and regression analyses. The low activity levels reported underline the urgency of developing interventions for this population. Results suggest that the key factors associated with higher activity levels are having a more internal HLOC, better mental health and placing greater value on health. While health cognitions may therefore be one important factor to target, these must be tackled in the context of women's other barriers to and facilitators of exercise. Thematic analysis of the open-ended questions revealed that the key barrier to walking was women's busy lives and their many competing priorities and that the most important facilitators were mental health and social connection. Overall, results suggest that, rather than emphasizing physical health and activity targets, practitioners should seek to make walking more relevant to women by emphasizing mental wellbeing and self-care, and more enjoyable by focusing on social and family-based walking interventions.

Dietary cholesterol fails to stimulate the human cholesterol 7alpha-hydroxylase gene (CYP7A1) in transgenic mice.

Dietary cholesterol has been shown to have a stimulatory effect on the murine cholesterol 7alpha-hydroxylase gene (Cyp7a1), but its effect on human cholesterol 7alpha-hydroxylase gene (CYP7A1) expression in vivo is not known. A transgenic mouse strain harboring the human CYP7A1 gene and homozygous for the disrupted murine Cyp7a1 gene was created. Cholesterol feeding increased the expression of the endogenous modified Cyp7a1 allele but failed to stimulate the human CYP7A1 transgene. In transfected hepatoma cells, 25-hydroxycholesterol increased murine Cyp7a1 gene promoter activity, whereas the human CYP7A1 gene promoter was unresponsive. Electrophoretic mobility shift assays demonstrated the interaction of the liver X receptor alpha (LXRalpha): retinoid X receptor (RXR) heterodimer, a transcription factor complex that is activated by oxysterols, with the murine Cyp7a1 gene promoter, whereas no binding to the human CYP7A1 gene promoter was detected. The results demonstrate that the human CYP7A1 gene is not stimulated by dietary cholesterol in the intact animal, and this is attributable to the inability of the CYP7A1 gene promoter to interact with LXRalpha:RXR.