Unveiling the voices: Exploring perspectives and experiences of women, donors, recipient mothers and healthcare professionals in human milk donation: A systematic review of qualitative studies.

OBJECTIVES: This study aims to examine and synthesise the views and experiences of women, donors, recipient mothers and healthcare professionals regarding human milk donation or sharing. METHODS: The Joanna Briggs Institute (JBI) meta-aggregative approach to systematic reviews of qualitative studies was adopted. Six databases, MEDLINE, CINAHL, Embase, PsycINFO, Web of Science and Scopus were searched. English written qualitative studies from database inception to February 2024 were included. The JBI Critical Appraisal Checklist for Qualitative Research was used to appraise the collected research evidence. RESULTS: A total of 629 papers were screened, and 41 studies were included in the review. Six key findings were synthesised. (i) Donors, recipients and their families all benefit from milk donation. (ii) Motivation to receive or donate breast milk. (iii) Awareness and participation are affected by formal vs. informal sharing, mothers' personal experiences and external factors. (iv) Concerns about disease transmission, jealousy, bonding and traits. (v) Challenges encountered by donors, recipient mothers, staff and milk banks (vi) Suggestions for promoting human milk donation. DISCUSSION: Stakeholders of human milk donation, including donors, recipient mothers, healthcare professionals, and human milk bank representatives, face various physical, mental and practical challenges. Informal sharing complements formal donations and contributes to improved breastfeeding rates. Advocacy and education efforts are still needed to increase participation and safety levels. The major limitation of the study is the inadequate search on views of immediate family members.

Exploring South Asian women's perspectives and experiences of maternity care services: A qualitative evidence synthesis.

BACKGROUND: The United Nations Women and other sources have highlighted the poor maternal and neonatal care experienced by South Asian women, emphasizing the need to understand the cultural factors and specific experiences that influence their health-seeking behavior. This understanding is crucial for achieving health equity and improving health outcomes for women and infants. OBJECTIVES: This study aims to examine and synthesize qualitative evidence on the perspectives and experiences of South Asian women regarding maternity care services in destination countries. METHODS: A systematic review was conducted using the Joanna Briggs Institute's approach. Eight databases were searched for studies capturing the qualitative views and experiences of South Asian women - Medline, EMBASE, CINAHL Plus, Global Health, Scopus, PsycInfo, British Nursing Index and the Applied Social Science Index and Abstracts. Qualitative and mixed method studies written in English are included. The methodological quality of the included studies was assessed using the JBI's QARI checklist for qualitative studies and the MMAT checklist for mixed-methods studies. RESULTS: Fourteen studies, including twelve qualitative and two mixed-methods studies, were identified and found to be of high methodological quality. The overarching theme that emerged was "navigating cross-cultural maternity care experiences." This theme encapsulates the challenges and complexities faced by South Asian women in destination countries, including ethnocultural and religious differences, communication and language barriers, understanding different medical systems, and the impact of migration on their maternity care experiences. CONCLUSIONS: South Asian migrant women often have expectations that differ from the services provided in destination countries, leading to challenges in their social relationships. Communication and language barriers pose additional obstacles that can be addressed through strategies promoting better communication and culturally sensitive care. To enhance the utilization of maternity healthcare services, it is important to address these factors and provide personalized, culturally sensitive care for South Asian migrant women.

The Influence of the Baby-Friendly Hospital Initiative and Maternity Care Practices on Breastfeeding Outcomes.

BACKGROUND: The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991 to promote breastfeeding through hospital policy. Researchers have reported breastfeeding improvements after hospitals became "Baby-Friendly." In Hong Kong, the first public hospital was designated as a Baby-Friendly Hospital in 2016. RESEARCH AIM: To examine the influence of the BFHI on breastfeeding by comparing breastfeeding outcomes in a study cohort recruited before the implementation of the BFHI and a cohort recruited after its implementation. METHODS: This was a quasi-experimental interrupted time-series design. Two cohorts of mother-infant pairs (N = 2369) were recruited immediately postpartum from four public hospitals in Hong Kong and followed up prospectively. Comparisons were made in five of the BFHI steps experienced in both cohorts and the duration of any and exclusive breastfeeding. RESULTS: A higher proportion of participants from the post-implementation cohort breastfed and breastfed exclusively at all follow-up periods. Participants in the pre-BFHI cohort, on average experienced 3.10 (SD = 1.42) of the BFHI steps, whereas the participants in the post-BFHI cohort experienced 3.59 (1.09) of the BFHI steps. Half of the participants discontinued any breastfeeding by 13 weeks in the pre-BFHI cohort; more than half in the post-BFHI cohort were still breastfeeding at 6 months postpartum (p < .001). Giving only human milk in the first 48 hr of delivery and not providing pacifiers or bottles were associated with lower risk of not exclusive breastfeeding in both cohorts. CONCLUSION: Implementation of the BFHI was associated with improvements in breastfeeding practices and outcomes.

A multi-centric study on validation of the Fear Scale for COVID-19 in five Arabic speaking countries.

BACKGROUND: The Eight-item Fear Scale is a unidimensional scale evaluating the perceived feelings of fear associated with the thought of the coronavirus. AIM: The Arabic version of this scale did not exist; hence, this study aimed to translate and evaluate the psychometric properties of the Fear Scale in participants aged 18 years and above in five Arabic countries: Egypt, Lebanon, Libya, Saudi Arabia, and Sudan by using a cross-sectional survey design. METHOD: The English version of the COVID-19 Fear Scale was translated into Arabic following the guidelines and disseminated through social media. Factorial and convergent validity and internal reliability were evaluated. RESULTS: The total number of participants was 2783; the majority was young (41.9%) and female (60.5%). Fear scores were moderate in four countries and severe in Egypt. The scale showed good structural validity, with the items explaining up to 70% of the variance. The scale items correlated significantly with the total scores, and the Cronbach alpha was above 0.9. CONCLUSION: The study concluded that the Arabic Fear Scale is a psychometrically robust scale that can be used to evaluate the perceived feelings of fear with the thought of the coronavirus or pandemic in general.

Accessing health care: Experiences of South Asian ethnic minority women in Hong Kong.

The aim of the present qualitative study was to understand the experiences of South Asian ethnic minority women in accessing health-care services in Hong Kong, a Chinese-oriented society. Levesque's framework (2013) was adopted to conduct and analyze focus group discussions among 30 South Asian women aged between 21 and 72 years, who came from India, Nepal, and Pakistan. The overarching theme was identified as disengagement between South Asian women and the health-care system, with the following five themes: attitude and awareness, sociocultural factors, time constraints, financial burdens, and inadequate interaction. These were linked to barriers affecting South Asian women's ability to access health care, the common challenges encountered being those related to language, culture, and communication. Lengthy waiting periods discourage these women from seeking health care in Hong Kong. Enhancing accessibility to appropriate health-care-related information and culturally-informed patient-provider interaction can improve knowledge, trust, and satisfaction among these women, thereby enhancing their engagement with the health-care system.

A Mobile App for Identifying Individuals With Undiagnosed Diabetes and Prediabetes and for Promoting Behavior Change: 2-Year Prospective Study.

BACKGROUND: To decrease the burden of diabetes in society, early screening of undiagnosed diabetes and prediabetes is needed. Integrating a diabetes risk score into a mobile app would provide a useful platform to enable people to self-assess their risk of diabetes with ease. OBJECTIVE: The objectives of this study were to (1) assess the profile of Diabetes Risk Score mobile app users, (2) determine the optimal cutoff value of the Finnish Diabetes Risk Score to identify undiagnosed diabetes and prediabetes in the Chinese population, (3) estimate users' chance of developing diabetes within 2 years of using the app, and (4) investigate high-risk app users' lifestyle behavior changes after ascertaining their risk level from the app. METHODS: We conducted this 2-phase study among adults via mobile app and online survey from August 2014 to December 2016. Phase 1 adopted a cross-sectional design, with a descriptive analysis of the app users' profile. We used a Cohen kappa score to show the agreement between the risk level (as shown in the app) and glycated hemoglobin test results. We used sensitivity, specificity, and area under the curve to determine the optimal cutoff value of the diabetes risk score in this population. Phase 2 was a prospective cohort study. We used a logistic regression model to estimate the chance of developing diabetes after using the app. Paired t tests compared high-risk app users' lifestyle changes. RESULTS: A total of 13,289 people used the app in phase 1a. After data cleaning, we considered 4549 of these as valid data. Most users were male, and 1811 (39.81%) had tertiary education or above. Among them, 188 (10.4%) users agreed to attend the health assessment in phase 1b. We recommend the optimal value of the diabetes risk score for identifying persons with undiagnosed diabetes and prediabetes to be 9, with an area under the receiver operating characteristic curve of 0.67 (95% CI 0.60-0.74), sensitivity of 0.70 (95% CI 0.58-0.80), and specificity of 0.57 (95% CI 0.47-0.66). At the 2-year follow-up, people in the high-risk group had a higher chance of developing diabetes (odds ratio 4.59, P=.048) than the low-risk group. The high-risk app users improved their daily intake of vegetables (baseline: mean 0.76, SD 0.43; follow-up: mean 0.93, SD 0.26; t81=-3.77, P<.001) and daily exercise (baseline: mean 0.40, SD 0.49; follow-up: mean 0.54, SD 0.50; t81=-2.08, P=.04). CONCLUSIONS: The Diabetes Risk Score app has been shown to be a feasible and reliable tool to identify persons with undiagnosed diabetes and prediabetes and to predict diabetes incidence in 2 years. The app can also encourage high-risk people to modify dietary habits and reduce sedentary lifestyle.

Effect of a hospital policy of not accepting free infant formula on in-hospital formula supplementation rates and breast-feeding duration.

OBJECTIVE: To investigate the effect of public hospitals in Hong Kong not accepting free infant formula from manufacturers on in-hospital formula supplementation rates and breast-feeding duration. DESIGN: Prospective cohort study. SETTING: In-patient postnatal units of four public hospitals in Hong Kong. SUBJECTS: Two cohorts of breast-feeding mother-infant pairs (n 2560). Cohort 1 (n 1320) was recruited before implementation of the policy to stop accepting free infant formula and cohort 2 (n 1240) was recruited after policy implementation. Participants were followed prospectively for 12 months or until they stopped breast-feeding. RESULTS: The mean number of formula supplements given to infants in the first 24 h was 2·70 (sd 3·11) in cohort 1 and 1·17 (sd 1·94) in cohort 2 (P<0·001). The proportion of infants who were exclusively breast-fed during the hospital stay increased from 17·7 % in cohort 1 to 41·3 % in cohort 2 (P<0·001) and the risk of breast-feeding cessation was significantly lower in cohort 2 (hazard ratio=0·81; 95 % CI 0·73, 0·90). Participants who non-exclusively breast-fed during the hospital stay had a significantly higher risk of stopping any or exclusive breast-feeding. Higher levels of formula supplementation also increased the risk of breast-feeding cessation in a dose-response pattern. CONCLUSIONS: After implementation of a hospital policy to pay market price for infant formula, rates of in-hospital formula supplementation were reduced and the rates of in-hospital exclusive breast-feeding and breast-feeding duration increased.

Gustatory Evaluation of Still and Carbonated Waters: A Preference Rating Study.

We studied the sensory preference for six still waters and four carbonated waters, nonflavored, by 11 tasting experts (4 women and 7 men). Five tasters rated the still waters, four tasters rated the carbonated water, and seven tasters rated twice on each of the still waters when evaluated with a dry red wine. All ratings were performed through answering a set of questions regarding the specific taste and/or smell of the waters. All tasters and the statistician were blinded to the water brands during rating and analysis. Multidimensional preference analysis and correspondence analysis were used to portray the underlying sensory preference. Still waters with higher mineral content tended to be less favorable for drinking purposes. On the other hand, carbonated waters with more minerals (but not over a certain limit) were favorable, and still waters with higher mineral content were preferable as mouth cleaners for red wine. The methodology can be carried to the food and beverage industries, to the functional foods industry, and to medical research where the preference of patients toward certain medications is of interest.