No description available.

It is widely accepted that breast milk is the optimal source of infant nutrition. Despite the World Health Organization (WHO) recommendation of exclusive breastfeeding for the first 6 months of infant life, many women discontinue breastfeeding as a result of perceived difficulties. Nipple pain is a highly prevalent, significant reason for breastfeeding cessation. Among the numerous interventions for nipple pain, the application of lanolin is commonly recommended, with endorsement by Health Canada, The La Leche League, and International Board Certified Lactation Consultants. The few studies that have evaluated the effectiveness of lanolin on nipple pain have lacked methodologic rigor, and are thus not reliable or generalizable. As such, the purpose of this trial was to rigourously evaluate the effect of lanolin for the treatment of nipple pain among breastfeeding women. This single-site randomized controlled trial (RCT) compared the application of lanolin (treatment) to usual postpartum care (not applying lanolin) for the treatment of nipple pain. The primary outcome for this trial was the effect on pain severity, as measured by a numeric rating scale (NRS) at 4 days post-randomization. Of 186 participants, 93 were randomized to the treatment group and 93 to the usual care group. At 4 and 7 days post-randomization there were no statistically significant differences in pain scores between groups. It is noteworthy that by 7 days post-randomization there were clinically relevant decreases in nipple pain in both groups. However, there were no statistically significant differences between groups for other outcomes, including pain measured with the short-form McGill Pain Questionnaire, breastfeeding duration, breastfeeding exclusivity, and breastfeeding self-efficacy. Despite these findings, women in the treatment group were significantly more satisfied receiving lanolin for their nipple pain than those receiving usual care. Since the use of lanolin is no more effective than applying nothing to the nipples for the management of nipple pain, the widespread use of lanolin is questionable. Further research is required on the role of interventions to prevent nipple pain and damage, and the effect of anticipatory guidance on improving breastfeeding outcomes for those experiencing nipple pain in the early postpartum period.

No description available.

No description available.

The enteric pathogen Escherichia albertii represents an emerging food safety challenge. It has been mistakenly identified as Hafnia alvei, Shigella, or as a member of the Enteropathogenic E. coli (EPEC). Isolates of certain strains of the organism are known to possess genes encoding pathogenesis factors capable of inducing attaching/effacing (A/E) lesions, cytolethal distending toxin and a variant Shiga toxin. The pathogen has been isolated from infants and adults and has been identified as a causative agent from an outbreak of foodborne disease occurring in an industrialized nation. Recent reports have detailed the ability of this pathogen to survive on ground beef and to resist several classes of therapeutic antibiotics. The objectives of this study were to: (i) determine the efficacy of E. albertii isolates to survive lactic acid exposure as a function of solution pH, and (ii) verify its inactivation in ground beef according to the USDA recommendations for in-home preparation. Rifampicin resistant (RifR) isolates of E. albertii (ATCC 9194, 19982, 10457) were obtained according to published methods. Thermal resistance of parent and RifR isolates were compared in vitro at 55 °C to confirm no significant differences in tolerance to heat as a result of antibiotic resistance capacity. Tolerance to food grade lactic acid (Purac, Olathe, KS) (3.0% w/v) at differing pH levels (3.0, 4.0, 5.0, 7.0) was examined in physiological saline at 35 °C. Finally, ground beef patties (80% lean) inoculated with individual RifR isolates were cooked to internal temperatures of 62, 71, or 76 °C to determine resistance of different internal temperatures. Experiments comparing the in vitro tolerances of parent and RifR E. albertii isolates indicated no differences between parent and mutant with regards to heat and lactic acid challenge. E. albertii inactivation in lactic acid increased as the pH of the solution was decreased; maximum reduction at pH 3.0 was at 30 min and maximum reduction for pH 4.0 at 2.5 hours. Changes in populations of E. albertii at pH 5.0 were not different than that at pH 7.0. Cooking of beef to 62 °C internal temperature produced reductions of all RifR isolates to non-detectable levels.

Falls are a relatively frequent occurrence amongst older people. Rates of falls amongst patients in subacute care are substantially higher than amongst people living in the community. Falls have been reported to cause physical and psychological injury, increase the likelihood of being discharged to nursing home, and are associated with longer lengths of stay in hospital. Thus, minimisation of falls in the subacute hospital setting is of high public health importance. (For complete abstract open document)

Thesis (Ph. D.)--University of Wyoming, 2006. / Title from PDF title page (viewed on Nov. 27, 2007). Includes bibliographical references (p. 33-36).

Thesis (LL. M.)--Judge Advocate General's School, [1968] / Date from JAG School Library Catalog. Typescript. Includes bibliographical references. Also issued in microfiche.

Thesis (doctoral)--Georg-August-Universität zu Göttingen.

Thesis (doctoral)--Universität Bern.