Limited Amount of Formula May Facilitate Breastfeeding: Randomized, Controlled Trial to Compare Standard Clinical Practice versus Limited Supplemental Feeding.

OBJECTIVES: Breastfeeding is known to reduce infant morbidity and improve well-being. Nevertheless, breastfeeding rates remain low despite public health efforts. Our study aims to investigate the effect of controlled limited formula usage during birth hospitalisation on breastfeeding, using the primary hypothesis that early limited formula feeds in infants with early weight loss will not adversely affect the rate of exclusive or any breastfeeding as measured at discharge, 3 and 6 months of age. MATERIAL AND METHODS: We randomly assigned 104 healthy term infants, 24 to 48 hours old, with ≥ 5% loss of birth weight to controlled limited formula (CLF) intervention (10 ml formula by syringe after each breastfeeding, discontinued at onset of lactation) or control group (standard approach, SA). Groups were compared for demographic data and breastfeeding rates at discharge, 3 months and 6 months of age (p-values adjusted for multiple testing). RESULTS: Fifty newborns were analysed in CLF and 50 in SA group. There were no differences in demographic data or clinical characteristics between groups. We found no evidence of difference between treatment groups in the rates of exclusive as well as any breastfeeding at discharge (p-value 0.2 and >0.99 respectively), 3 months (p-value 0.12 and 0.10) and 6 months of infants' age (p-value 0.45 and 0.34 respectively). The percentage weight loss during hospitalisation was significantly higher in the SA group (7.3% in CLF group, 8.4% in SA group, p = 0.002). CONCLUSION: The study shows that controlled limited formula use does not have an adverse effect on rates of breastfeeding in the short and long term. Larger studies are needed to confirm a possible potential in controlled limited formula use to support establishing breastfeeding and to help to improve the rates of breastfeeding overall. TRIAL REGISTRATION: ISRCTN registry ISRCTN61915183.

Effectiveness of a prevention campaign on HIV/AIDS knowledge among adolescents in Eastern Slovakia.

OBJECTIVES: The aim of this manuscript was to evaluate results of the questionnaire given to young people before and after the prevention campaign to determine whether the prevention campaign improved HIV/AIDS-related knowledge of young people. METHODS: A total of 533 students completed the pre-test and 496 students completed the post-test. Questionnaire was used as pre/post testing tool. Construct validity and measurement scale were assessed using the factor analysis. Rasch scaling was used to establish common scale for pre/post test and to transform raw score into the interval scale. A non-parametric Mann-Whitney U test was used to compare knowledge in pre-test and post-test. RESULTS: Students increased their knowledge of HIV/AIDS (Pearson's measure of effect size r = 0.74) and the risk of acquiring HIV infection (r = 0.68) statistically significantly (p = 0.001). Girls (risk estimation: r = 0.78, knowledge: r = 0.81) improved much more than boys (risk estimation: r = 0.57, knowledge: r = 0.62). CONCLUSIONS: This study suggests that, for the selected sample, the prevention campaign was an effective tool to increase young people's knowledge of HIV/AIDS. The authors recommend dividing and tailoring interventions by gender to achieve even more efficient preventive future interventions.

Regional socioeconomic indicators and ethnicity as predictors of regional infant mortality rate in Slovakia.

OBJECTIVE: Exploring the associations of regional differences in infant mortality with selected socioeconomic indicators and ethnicity could offer important clues for designing public health policy measures. METHODS: Data included perinatal and infant mortality in the 79 districts of the Slovak population in 2004. Linear regression was used to analyse the contribution of education, unemployment, income and proportion of Roma population on regional differences in perinatal and infant mortality rates. RESULTS: All the explored socioeconomic indicators and ethnicity individually contributed significantly to both perinatal and infant mortality, with the exception of income. In the model exploring the influence of all these variables together on perinatal and infant mortality, only the effect of the proportion of Roma population remained significant. This model explained 34.9% of the variance for perinatal and 36.4% of the variance for infant mortality. CONCLUSIONS: Living in Roma settlements indicates an accumulation of socioeconomic disadvantage. Health literacy, health-related behaviour and many other factors might contribute to the explanation of the differences in infant mortality, and a better understanding of these processes might help us to design tailored interventions.

Natural and man-made health hazards in rural Slovakia.

CONTEXT: There is little information on health situation of the people of rural Slovak Republic. The rural environment is often a mixture of natural and man-made hazards, which under some conditions, might turn to be a health risk to humans. PURPOSE: The aim of this study was to compare two regions of the Slovak Republic, two different hazards (natural and man-made), two different methods of health outcome measurement (routine statistics and individual diary based data). METHODS: Ecological study design with focus on cancer incidence analysis was employed in case of natural hazard analysis. Standardized incidence ratios (SIR) were calculated and are presented in paper. Observational study design was employed to study rural gardening practices and their impact on health. FINDINGS: Statistically significant differences in SIR were found in rural areas of Spis-Gemer Region (SGR) among males for lip, oral cavity and larynx (1.60, CI 95% 1.12-2.34), respiratory (1.25, CI 95% 1.01-1.55) and digestive organ cancers (1.22, CI 95% 1.01-1.47); hematopoetic cancers are significantly elevated among males in rural areas as well (1.58, CI 95% 1.05-2.39). Pesticide use (83.1% of gardeners use pesticides) without any protective equipment is still widespread among gardeners in rural Slovak Republic (16.9%). The produced fruits and vegetables are substantial part of total fruit and vegetable consumption (51% in summer and 42.7% in winter season) increasing the risk of exposure to pesticides. CONCLUSION: Our study shows that on ecological level, mortality and morbidity statistics could be used to assess human health status in linkage to broad exposure measures (urban-rural); on dose response level (arsenic in soil) this method lacks sensitivity. Health survey and diary method on the other hand are useful tools in analysis of rural health especially with respect to man-made hazards.