<p>Care and treatment of women with inflammatory symptoms of the breast during lactation</p><p>Inflammation of the breast during lactation causes considerable discomfort to mothers and carries a risk of early abandonment of breastfeeding. Little is known about the effects of care interventions, including acupuncture, used for these mothers or about mothers’ experiences of the complaint. Aim: to study care and treatment given at a midwife-led breastfeeding clinic to mothers with inflammatory symptoms of the breast during lactation, to gain knowledge of mothers’ experiences of being afflicted by breast inflammation and to investigate factors which may be associated with the development of breast abscess. Methods: method triangulation was used to study different aspects of the phenomenon of inflammatory symptoms of the breast during lactation; two randomised controlled trials I (n = 88) and II (n = 210), a descriptive study III (n = 210), an interview study with a Grounded Theory approach IV (n = 14), and a population-based register study V (n = 1,454,068 singleton deliveries). Results: mothers’ symptoms were more effectively relieved when acupuncture was used but acupuncture treatment did not shorten contact with health services. Nine percent (I) and 15 % (II) respectively, of mothers were prescribed antibiotics. Twelve percent experienced renewed symptoms requiring health care contact within 6 weeks (III). Seven mothers (0.1% of breastfeeding mothers) developed breast abscess, which was comparable to the figure in the population-based study (V). The presence of Group B streptococci in the breast milk was related to longer contact with health care (II). Mothers’ “will to breastfeed” may make it possible for them to withstand physical and emotional difficulties caused by the illness. Mothers considered access to clinical expertise to be an important factor in their care (IV). Primiparous mothers, those over the age of 30 years and those who give birth after 41 weeks gestation appear to be at a significantly increased risk for the development of breast abscess (V).</p><p>Conclusions: mothers’ symptoms were more effectively dissipated when acupuncture treatment was used. However, acupuncture treatment did not shorten mothers’ contact with health care services. Interventions, including acupuncture treatment for relief of symptoms may help mothers to withstand their discomfort and await the body’s own anti-inflammatory response and therefore make it possible to substantially reduce the use of antibiotic therapy for this group. The results indicate a need for a better understanding of the influence on breastfeeding of hormones administered to birthing and breastfeeding women. The availability of immediate clinical expertise is an important factor for these mothers, which health care planners should be aware of. Information on potential breastfeeding problems should be improved.</p><p>Key words: acupuncture, antibiotics, breast abscess, breastfeeding, care interventions, inflammatory symptoms, lactation mastitis</p> / <p>Vård och behandling av kvinnor med inflammation i brösten under amningsperioden</p><p>Bröstinflammation orsakar stort obehag för ammande mödrar och innebär en risk för att amning avslutas i förtid. Det finns ringa kunskap om effekterna av interventioner, inkluderande akupunktur, som används vid vård av dessa kvinnor. Det saknas även kunskap om mödrarnas upplevelser av bröstinflammation. Syfte: att studera vård och behandling av kvinnor med bröstinflammation vid en amningsmottagning ledd av barnmorskor, att utveckla kunskap om mödrars upplevelser av att vara drabbad av bröst inflammation samt att undersöka faktorer som kan ha betydelse för utvecklandet av bröstabscess. Metoder: metodtriangulering användes för att studera olika aspekter av fenomenet bröstinflammation under amningsperioden; två randomiserade kontrollerade studier I (n = 88) and II (n = 210), en deskriptiv studie III (n = 210), en intervjustudie med en grounded theory ansats IV (n = 14) och en populationsbaserat registerstudie V (n = 1 454 068 enkelbörds förlossningar). Resultat: mödrarnas symptom lindrades mer effektivt med akupunktur akupunkturbehandling men förkortade inte deras kontakt med vården. Nio procent (I) respektive 15 % (II) av mödrarna fick antibiotika. Tolv procent fick recidiv vilket föranledde kontakt med vården inom 6 veckor (III). Sju mödrar (0,1 % av ammande mödrar) utvecklade bröstabscess (II), vilket överensstämde med resultat i den populationsbaserade studien (V). Förekomsten av Grupp B streptococcer i bröstmjölken var relaterad till längre vårdkontakt (II). Mödrarnas viljan att amma kan göra det möjligt för dem att uthärda fysiska och emotionella svårigheter som sjukdomen innebär (IV). Tillgång till klinisk expertis var en viktig del av vården för dessa kvinnor. Att vara förstföderska kan innebära en något större risk för utveckling av bröstabscess. Mödrar över 30 år samt de som föder efter graviditetsvecka 41 har också en ökad risk för abscess (V).</p><p>Slutsatser: mödrarnas symptom lindrades mer effektivt när akupunktur användes. Kontakten med vården blev dock inte förkortad av akupunkturbehandling. Interventioner som inkluderar akupunkturbehandling kan tillåta mödrar att invänta kroppens anti-inflammatoriska respons och kan därför möjliggöra en avsevärd minskning av antibiotika terapi för dessa mödrar. Resultaten visar behov av att bättre förstå hur amning påverkas av hormoner administrerade till kvinnor under förlossningsarbete och amningen. Tillgång till omedelbar klinisk expertis är en viktig faktor för dessa mödrar vilket hälso- och sjukvårdsplanerare bör vara medvetna om. Förbättrad information angående potentiella amningsproblem bör eftersträvas.</p><p>Nyckelord: akupunktur, amning, antibiotika, bröstabscess, bröstinflammation, interventioner, mastit, mjölkstockning</p>

Care and treatment of women with inflammatory symptoms of the breast during lactation Inflammation of the breast during lactation causes considerable discomfort to mothers and carries a risk of early abandonment of breastfeeding. Little is known about the effects of care interventions, including acupuncture, used for these mothers or about mothers’ experiences of the complaint. Aim: to study care and treatment given at a midwife-led breastfeeding clinic to mothers with inflammatory symptoms of the breast during lactation, to gain knowledge of mothers’ experiences of being afflicted by breast inflammation and to investigate factors which may be associated with the development of breast abscess. Methods: method triangulation was used to study different aspects of the phenomenon of inflammatory symptoms of the breast during lactation; two randomised controlled trials I (n = 88) and II (n = 210), a descriptive study III (n = 210), an interview study with a Grounded Theory approach IV (n = 14), and a population-based register study V (n = 1,454,068 singleton deliveries). Results: mothers’ symptoms were more effectively relieved when acupuncture was used but acupuncture treatment did not shorten contact with health services. Nine percent (I) and 15 % (II) respectively, of mothers were prescribed antibiotics. Twelve percent experienced renewed symptoms requiring health care contact within 6 weeks (III). Seven mothers (0.1% of breastfeeding mothers) developed breast abscess, which was comparable to the figure in the population-based study (V). The presence of Group B streptococci in the breast milk was related to longer contact with health care (II). Mothers’ “will to breastfeed” may make it possible for them to withstand physical and emotional difficulties caused by the illness. Mothers considered access to clinical expertise to be an important factor in their care (IV). Primiparous mothers, those over the age of 30 years and those who give birth after 41 weeks gestation appear to be at a significantly increased risk for the development of breast abscess (V). Conclusions: mothers’ symptoms were more effectively dissipated when acupuncture treatment was used. However, acupuncture treatment did not shorten mothers’ contact with health care services. Interventions, including acupuncture treatment for relief of symptoms may help mothers to withstand their discomfort and await the body’s own anti-inflammatory response and therefore make it possible to substantially reduce the use of antibiotic therapy for this group. The results indicate a need for a better understanding of the influence on breastfeeding of hormones administered to birthing and breastfeeding women. The availability of immediate clinical expertise is an important factor for these mothers, which health care planners should be aware of. Information on potential breastfeeding problems should be improved. Key words: acupuncture, antibiotics, breast abscess, breastfeeding, care interventions, inflammatory symptoms, lactation mastitis / Vård och behandling av kvinnor med inflammation i brösten under amningsperioden Bröstinflammation orsakar stort obehag för ammande mödrar och innebär en risk för att amning avslutas i förtid. Det finns ringa kunskap om effekterna av interventioner, inkluderande akupunktur, som används vid vård av dessa kvinnor. Det saknas även kunskap om mödrarnas upplevelser av bröstinflammation. Syfte: att studera vård och behandling av kvinnor med bröstinflammation vid en amningsmottagning ledd av barnmorskor, att utveckla kunskap om mödrars upplevelser av att vara drabbad av bröst inflammation samt att undersöka faktorer som kan ha betydelse för utvecklandet av bröstabscess. Metoder: metodtriangulering användes för att studera olika aspekter av fenomenet bröstinflammation under amningsperioden; två randomiserade kontrollerade studier I (n = 88) and II (n = 210), en deskriptiv studie III (n = 210), en intervjustudie med en grounded theory ansats IV (n = 14) och en populationsbaserat registerstudie V (n = 1 454 068 enkelbörds förlossningar). Resultat: mödrarnas symptom lindrades mer effektivt med akupunktur akupunkturbehandling men förkortade inte deras kontakt med vården. Nio procent (I) respektive 15 % (II) av mödrarna fick antibiotika. Tolv procent fick recidiv vilket föranledde kontakt med vården inom 6 veckor (III). Sju mödrar (0,1 % av ammande mödrar) utvecklade bröstabscess (II), vilket överensstämde med resultat i den populationsbaserade studien (V). Förekomsten av Grupp B streptococcer i bröstmjölken var relaterad till längre vårdkontakt (II). Mödrarnas viljan att amma kan göra det möjligt för dem att uthärda fysiska och emotionella svårigheter som sjukdomen innebär (IV). Tillgång till klinisk expertis var en viktig del av vården för dessa kvinnor. Att vara förstföderska kan innebära en något större risk för utveckling av bröstabscess. Mödrar över 30 år samt de som föder efter graviditetsvecka 41 har också en ökad risk för abscess (V). Slutsatser: mödrarnas symptom lindrades mer effektivt när akupunktur användes. Kontakten med vården blev dock inte förkortad av akupunkturbehandling. Interventioner som inkluderar akupunkturbehandling kan tillåta mödrar att invänta kroppens anti-inflammatoriska respons och kan därför möjliggöra en avsevärd minskning av antibiotika terapi för dessa mödrar. Resultaten visar behov av att bättre förstå hur amning påverkas av hormoner administrerade till kvinnor under förlossningsarbete och amningen. Tillgång till omedelbar klinisk expertis är en viktig faktor för dessa mödrar vilket hälso- och sjukvårdsplanerare bör vara medvetna om. Förbättrad information angående potentiella amningsproblem bör eftersträvas. Nyckelord: akupunktur, amning, antibiotika, bröstabscess, bröstinflammation, interventioner, mastit, mjölkstockning

During this unique moment of feminist inquiry wherein breastfeeding has been a focal point of interdisciplinary research, little sociological scholarship has been presented which has centered on the various meanings that African American mothers, as a diverse group, attach to their experiences with breastfeeding and/or infant formula use. While patterns of behavior have been explored in a cross-racial context, most social science studies have not focused on how the choice between breastfeeding, using infant formula, or using a combination of the two has impacted (or has been shaped by) African American mothers’ constructs of self, motherhood/mothering, their birth experiences, and their sexuality. In order to understand the interplay of the decision-making process and these constructs, I conducted a qualitative study in which I participated in face-to-face interviews with a diverse group of thirty African-American mothers. They ranged in age from 18 years-old to 50-years-old. At the time of her interview, each mother had at least one child who was three-years-old or younger. Through our discussions, we explored how pre-pregnancy perceptions, lived experiences as a mother, familial influences, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that while African Americans mothers know that “breast is best,” that knowledge is not the only reason for their decisions. The first step in understanding why African-American mothers choose the feeding method(s) that they choose is embracing the reality that choosing is an ongoing and dynamic process which is often informed by what she does versus “is supposed to do” versus how she is portrayed weighed with the consequences of her choice(s) for herself and her family. Further, African American mothers are in the active process of negotiating an evolving definition of themselves within this post-Civil Rights, Affirmative Action context wherein choices appear abundant, but the choosing always comes with a price.

Les régions tropicales sont caractérisées par des contraintes climatiques importantes pour la production porcine pouvant induire une diminution des performances des animaux et du revenu de l'éleveur. Lorsque la température dépasse 22°C, la truie allaitante se trouve en situation de stress thermique. Elle réduit alors son ingestion d'aliment, ce qui généralement a des conséquences négatives sur ses performances de lactation et ses performances ultérieures de reproduction. Cependant, la plupart des travaux disponibles ont été réalisés en milieu tempéré avec des conditions difficilement transposables à celles rencontrées en milieu tropical humide. Les objectifs du travail de thèse sont de déterminer et de caractériser les facteurs qui affectent les performances de lactation et de reproduction des truies élevées sous un climat tropical humide. Une attention particulière a été portée sur les effets du rang de portée, du type génétique et de leurs interactions respectives avec la saison. A partir des données climatiques mesurées à proximité de l'élevage, deux saisons ont été déterminées: une saison fraîche et une saison chaude. L'hygrométrie moyenne étant comparable (i.e., environ 83%) d'une saison à l'autre, les deux saisons sont discriminées principalement par le niveau de température ambiante (23,7°C en saison fraîche et 26,0°C en saison chaude). Dans notre étude, les performances des truies ont été mesurées pendant 5 années sur deux races "extrêmes", une race dite "conventionnelle", la truie Large White (LW), et la race locale caribéenne, la truie Créole (CR). A partir de la base de données constituée, nous avons dans un premier temps étudié les effets de la saison et du rang de portée sur les performances de lactation de 106 truies LW (301 lactations). Une 2ème expérience nous a permis de prendre en considération les effets du type génétique de la truie (30 CR et 41 LW sur un total de 179 lactations) sur les performances et le comportement alimentaire en lactation. Dans une 3ème expérience, les effets du climat tropical sur les performances de reproduction ont été étudié sur 255 truies LW (1 181 saillies). Enfin, une 4ème étude a porté sur les facteurs affectant la température rectale (TR) des truies en lactation (222 lactations de 43 CR et 42 LW). Les performances des truies en lactation sont plus faibles en saison chaude qu'en saison fraîche: la consommation d'aliment des truies et la croissance de la portée sont fortement réduites et le niveau de réserves corporelles mobilisées augmente en saison chaude. La TR des truies allaitantes est plus élevée en saison chaude qu'en saison fraîche (38,9 vs. 38,6°C) et plus faible chez les multipares que chez les primipares (38,7 vs. 38,9°C). La truie CR se caractérise par un plus faible poids et une plus grande adiposité (-70 kg et + 20 mm d'épaisseur de lard à la mise bas) que la LW. Elle consomme moins d'aliment que la LW (3,4 vs. 4,8 kg/j) en relation à sa faible vitesse d'ingestion (80 vs 150 g/min). Cela se traduit par une réduction de la taille des repas des CR (390 vs. 550 g/repas), alors que le nombre de repas est semblable entre types génétiques (9,0 repas/j). La baisse d'appétit en saison chaude est plus prononcée chez les truies LW multipares que chez les primipares (-1,0 vs. -0,4 kg/j) et chez les truies LW que chez les CR (-1,0 vs. -0,5 kg/j). Les performances de reproduction mesurées après le sevrage des truies sont plus faibles en saison chaude, en particulier chez les primipares. L'intervalle sevrage-oestrus et l'intervalle sevrage saillie fécondante des truies augmentent en saison chaude, et le taux de conception est réduit pendant cette période de l'année. Les performances de reproduction des truies CR sont moins affectées par la saison, ce qui indique qu'elles pourraient mieux tolérer la chaleur. Ce résultat est conforté par une moindre augmentation de la TR en saison chaude chez les CR que les LW (+ 0,2 vs. +0,4°C). En conclusion, nos résultats contribuent de manière significative à la caractérisation des performances des truies élevées en milieu tropical humide. Dans nos conditions expérimentales, il existe une forte variabilité interindividuelle de la réponse des truies au stress thermique, dont une partie non négligeable semble être d'origine génétique (résultats préliminaires). Il semble y avoir beaucoup à espérer de programmes de sélection intégrant des critères d'adaptation aux températures élevées pour l'amélioration de la production porcine en régions tropicales humides

Dairy farming is one of the most important agricultural industries in South Africa, and thus improving the performance of dairy cows, with respect to economically important dairy traits, would be beneficial. Selection of dairy cows has traditionally been phenotypic, but new molecular techniques have made it possible to evaluate phenotypic dairy traits at the DNA level, providing the possibility of more accurate selection. The economically important dairy traits, milk production and reproductive performance, are quantitative traits, and are therefore controlled by many genes and the environment. A number of genes have been identified that have been shown to influence economically important dairy traits, including the lep gene. This gene encodes the hormone leptin, which has been proven to regulate feed intake, energy balance, fertility and immune function. A polymorphism has been identified in the lep gene, which may be associated with economically important dairy traits. This study on a South African Jersey herd investigated the possible association of the polymorphism, RFLP-Kpn 21, with milk production and reproductive performance. The lactation records of fifty Jersey cows that completed their first lactation between 1997 and 2004 were collected, and these cows were genotyped for the RFLP-Kpn 21 polymorphism, located at exon 2 of the lep gene. This involved the extraction of DNA from venous blood, using a salting out technique. The extracted DNA was amplified using PCR primers; the reverse primer included a purposeful mismatch. The role of the purposeful mismatch was to create a recognition site for a restriction enzyme (Kpn 21), thus allowing the alleles of the polymorphism to be identified through a restriction digestion protocol. Two alleles were identified, the C- and the Tallele. The genotype of each cow was identified using PAGE. The significance of the genotype effects on the milk production traits and the reproductive performance traits were estimated using the F-statistic provided by a GLM Univariate analysis. In conclusion, no significant effect of the RFLP-Kpn 21 polymorphism was found for milk yield, butterfat and protein percentage, ICP and SPC (p > 0.05), but a possible association with lactose percentage was suggested by the statistical analysis (p < 0.05). Further investigation of South African Jersey cows will be necessary in order for conclusive results to be obtained. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.

Sélectionner les animaux qui ont le plus haut niveau de production, en tenant peu compte d'autres caractères, a toujours bien fonctionné dans les conditions d'un environnement favorable (i.e. ration riche en nutriments, faible charge pathogène, thermoneutralité). Toutefois, pour de nombreuses raisons (économiques, climatiques, écologiques), les éleveurs auront sans doute de plus en plus de mal à réunir de telles conditions dans l'environnement de leur troupeau, et pourront même délibérément choisir de ne pas le faire. Sélectionner des animaux qui soient adaptés avec les conditions futures des troupeaux devient donc tout aussi important qu'adapter la conduite du troupeau en fonction des génotypes sélectionnés. Pour mieux identifier les contraintes et les opportunités d'appliquer ces deux options, nous proposons, pour la première fois dans cette thèse, un modèle animal intégrant les effets de la sélection génétique et de la conduite du troupeau. Ce modèle intègre des coefficients d'allocation de la ressource alimentaire entre les fonctions biologiques en tant que caractères héritables Il permet de simuler à court-terme les performances zootechniques et à long-terme les réponses à la sélection résultant de la transmission de ces caractères d'allocation entre générations. Le modèle a été appliqué à la chèvre laitière et se focalise sur la conduite en lactation longue (LL) d'une partie des chèvres du troupeau (conduite consistant à préserver des femelles en lactation ayant après une mise bas sans réengagement d'une nouvelle reproduction). Nous sommes partis du principe que la sélection et la conduite du troupeau influencent tous deux la façon dont chaque animal alloue ses ressources entre ses fonctions biologiques. Nous avons cherché à évaluer la portée de ce principe pour mieux comprendre le développement des interactions génotype-environnement (G x E) sur le long terme. Dans un troupeau soumis à des variations du niveau d'alimentation, différentes stratégies de sélection ciblant l'amélioration de la production laitière et de la longévité ont été simulées. En accord avec la théorie de l'allocation, les réponses à la sélection révèlent que l'amélioration de la production et de la survie doit faire face à un compromis entre ces deux caractères. Cependant, ce compromis est atténué lorsque la sélection est combinée avec la conduite en LL d'une partie du troupeau. Un tel effet de synergie entre sélection et conduite résulte d'une interaction complexe entre la dynamique individuelle de performance au cours de la LL et le renouvellement du troupeau. Ainsi, la capacité innée des chèvres à prolonger leur lactation semble pouvoir être valorisée pour améliorer la résilience du troupeau.

The objectives of the present study were to: 1) describe the gross chemical milk composition of the New Zealand sea lion (NZSLs), Phocarctos hookeri, in early lactation; 2) validate an analytical method for sea lion milk composition; 3) investigate a series of temporal, individual and dietary factors that influence the milk composition of the NZSL and; 4) investigate the temporal and spatial differences in the fatty acids signatures of sea lion milk. A comprehensive literature review revealed that data on milk composition in otariid species is either missing or limited, that to be able to fully describe their milk composition extensive sampling was required and that the temporal, maternal and offspring factors that influence milk composition in pinnipeds are poorly understood. The review identified that considerable work has been conducted to infer diet via the application of fatty acids signature analysis of milk and blubber. There are many factors (i.e. metabolism, de novo synthesis and endogenous sources) that contribute to the differences in fatty acid composition between the diet and milk or blubber. Milk samples from NZSL were used to test whether a new method would give similar results as the standard methods of milk analysis. Agreement between analytical methods for milk components was assessed using different measures of statistical fitness and the results indicated that the new method was comparable to the standard methods and applicable to the milk of sea lions, pinnipeds and to ecological studies of lactation. Milk from NZSLs was collected over a period of seven years (1997, 1999 to 2003, and 2005) in early lactation to describe the composition of milk of NZSL and to test for differences between years. The results indicated that: i) the milk protein concentration was comparable to other species of pinnipeds; ii) the milk fat concentration and the milk energy content of NZSL is the lowest reported for otariids in early lactation; however iii) the milk fat concentration was significantly different between years. These results suggested that the milk composition of NZSLs was influenced by annual changes in the environment; however, there may be other unidentified factors. Month, maternal body condition, age, body weight and length, offspring sex and age, and attendance pattern were compared with milk components. The results identified that month, maternal body condition and age significantly affected milk fat concentration. These results and the fact that maternal body condition varied significantly between years and mothers nursing male pups had lower body condition and produced milk lower in energy content suggested that local food resources along with other unidentified factors have an effect on the reproductive success of NZSLs. To test whether the fatty acid signature analysis (FASA) of lipid rich tissues (milk, blubber and serum) of otariids could be used to infer diet a mixture of vegetable oil (with distinctive fatty acid signature) was fed to 24 lactating NZSL and tissue samples were collected at different time intervals. Significant increases in the concentration of specific fatty acids in serum and milk were observed with peaks within 12hrs and 24hrs respectively of ingestion. Concentrations in milk remained elevated for up to 72hrs and there were differential rates of incorporation into milk. These findings confirm the potential of FASA to infer the composition of the diet. The variation in milk fatty acid signatures from lactating NZSL from four years (1997, 2003, 2004 and 2005) of sampling were measured in order to test whether differences occurred between years. Fatty acids signatures from five potential prey species including the commercially important arrow squid were incorporated into the analysis to associate the changes in milk fatty acids with a shift in prey choice. The results indicated that milk fatty acid signatures were different in 1997 and 2003; however, it was not possible to relate these differences to the five prey species. The variability in the annual arrow squid catch data suggested that local food resources around the Auckland Islands may also be variable. In conclusion, the milk produced by the NZSL has the lowest concentration of fat and energy in early lactation reported for any otariid species. The main factors that contributed to changes in milk quality were stage of lactation, year and maternal body condition. The yearly variation in the quality of milk appears to be a result of their lactation strategy or to variable local food conditions that also affect maternal body condition. Therefore monitoring the annual milk quality may be a means to monitor the health of a pinniped population and potential management tool for pinniped species. This thesis has shown that annual changes in the diet of NZSL can be assessed with milk fatty acid signatures.

BACKGROUND: Breastfeeding and lactation are cited as sensitive periods in the life course that contribute to the accumulation of risks or opportunities ultimately shaping vulnerability or resilience later in life. As such, breastfeeding and lactation are critical components of health equity. Despite this, Black women in the U.S. initiate and continue to breastfeed at lower rates than White women and other groups. Underlying reasons for racial inequities in breastfeeding rates are poorly understood. Exposure to racism, one manifestation of historical oppression in the U.S. has been cited as a determinant of poor health outcomes for decades but has not been extensively described in the context of breastfeeding. AIMS: To investigate the association between experiences of racism and 1.) breastfeeding initiation 2.) breastfeeding duration 3.) and the association between selected life-course factors and breastfeeding initiation and duration among participants of the Black Women’s Health Study. METHODS: This study was a prospective secondary analysis of the Black Women’s Health Study. The sample included all participants who enrolled in 1995, responded to the racism assessment in 1997 and reported the birth of a first child following the racism assessment resulting in an N=2, 995 for the initiation outcome and N= 2,392 for the duration outcome. In addition to the racism assessment, we also included life-course factors (nativity, neighborhood segregation and social mobility). For each aim, we calculated odds ratios and 95% confidence intervals using binomial and multinomial logistic regression using two models. The first adjusted for age, the second adjusted for age, BMI, education, marital status, geographic region, neighborhood SES and occupation. RESULTS: Associations between daily and institutional summary racism variables and breastfeeding initiation and duration were small and not statistically significant. Experiences of racism in the job setting was associated with lower odds of breastfeeding duration at 3-5 months compared with 3 months 95% CI [0.60, 0.98]. Experiences of racism with the police was associated with higher odds of breastfeeding initiation and duration at 3-5 months [1.01, 1.77] and at 6 months [1.10, 1.82] compared with women who did not report this experience. The participant’s nativity and the nativity of her parents were life-course factors that predicted lower odds of breastfeeding initiation and duration. Neighborhood segregation did not reach statistical significance after adjusting for covariates but results trended toward lower odds of breastfeeding initiation and duration for women who reported living in a predominately Black neighborhood (compared with White) up to age 18 and for women who reported living in a predominately Black neighborhood in 1999. CONCLUSION: Experiences of institutional racism in the job setting was associated with lower odds of breastfeeding duration. In addition to explicit experiences of racism, this study provides preliminary evidence surrounding life-course factors and breastfeeding. Individual level interventions may mitigate harmful effects of racism but structural level interventions are critical to close the gap of racial inequity in breastfeeding rates in the U.S.

Made available in DSpace on 2016-08-15T20:28:00Z (GMT). No. of bitstreams: 1 FranciscoCL_DISSERT.pdf: 1013967 bytes, checksum: a197e5825cf00fce85fcefac99ddcfcf (MD5) Previous issue date: 2015-02-27 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Trypanosomiasis by Trypanossoma vivax is exotic disease of African origin increasingly common in Brazil, where reports of outbreaks in ruminants in the semiarid northeast are associated with high mortality, decrease in productive performance and economic losses. This study aimed to evaluate the clinical, epidemiological, production and quality of milk during natural infection by T. vivax in dairy cattle in western Rio Grande do Norte and verified the effect of infection on performance in experimentally infected dairy goats. This is the first Trypanosomiasis outbreak of T. vivax in dairy cattle herd occurred in properties located in the rural municipality of Mossoró-RN. Found 42 animals with trypomastigotes of T. vivax by smear of buffy coat in 467 cattle crossbred dairy breeds. High fever, anemia, decreased milk production, unilateral and bilateral tearing were the most frequent clinical signs. All cows with the parasite had sudden drop in milk production, and the physicochemical characteristics changed values, where the averages of lactose, fat, protein and density milk group with parasite was different from the healthy group. Influence of infection by T. vivax on the lactation curve behavior and the quality of milk in experimentally infected dairy goats was studied using 20 Saanen goats second lactation divided in two groups: the infected group, consisting of ten goats infected intravenously with approximately 1.25 x 105 trypomastigotes of T. vivax and ten animals were used as control. Milk production was measured every day for 152 days, by means of hand milking and weighing of the milk. To analyze the lactation curve parameters was used Wood model. Infected goats showed high parasitemy and hyperthermia addition to significant hematocrit reduction, serum total protein, albumin, glucose, cholesterol and increase in the urea concentration. Wood model showed that there was difference (P <0.05) to increase the rate values of milk production up to the peak, decline rate of milk production after the peak, milk production day at the peak, maximum milk production at peak and persistency of lactation in goats experimentally infected group compared goats in the control group, and physico-chemical characteristics of milk as fat, nonfat dry stratum, density and protein decreased significantly (P <0.05) in the group infected goats compared goats in the control group / A tripanossomíase por Trypanossoma vivax é uma enfermidade exótica, de origem africana, cada vez mais frequente no território brasileiro, cujos relatos de surtos em ruminantes no semiárido nordestino estão associados à alta mortalidade, diminuição no desempenho produtivo e perdas econômicas. Este trabalho buscou avaliar os aspectos clínicos, epidemiológicos, produtivos e qualidade do leite durante infecção natural por T. vivax em bovinos leiteiros na região oeste do Rio grande do Norte e verificou o efeito da infecção sobre o desempenho produtivo em cabras leiteiras experimentalmente infectadas. Trata-se do primeiro surto de Tripanossomíase por T. vivax em rebanho bovino leiteiro ocorrido em propriedades localizadas na zona rural do município de Mossoró-RN. Foram encontradas 42 tripomastigotas de T. vivax pelo esfregaço da camada leucocitária em 467 bovinos de raças mestiças leiteiras. Febre alta, anemia, queda na produção de leite, lacrimejamento uni ou bilateral foram os sinais clínicos mais frequentes. Todas as vacas parasitadas tiveram queda brusca na produção de leite, e as características físico-químicas valores alterados, onde as médias dos teores de lactose, gordura, proteína e densidade do leite do grupo parasitado se mostrou diferente dos sadios. A influência da infecção por T. vivax sobre o comportamento da curva de lactação e a qualidade do leite em cabras leiteiras experimentalmente infectadas foi estudada utilizando 20 cabras da raça Saanen de segunda lactação divididos em dois grupos experimentais: o grupo infectado, constituído por dez cabras infectadas por via intravenosa com aproximadamente 1,25 x 105 tripomastigotas de T. vivax e outros dez animais foram destinados ao grupo controle. A produção do leite foi aferida diariamente durante 152 dias, mediante ordenha manual e pesagem do leite. Para análise dos parâmetros da curva de lactação, utilizou-se o modelo Wood. As cabras infectadas apresentaram altas parasitemias e hipertermia, além de redução significativa do hematócrito e dos níveis séricos de proteína total, albumina, glicose, colesterol e aumento na concentração de ureia. O modelo Wood mostrou que ocorreu diferença (P<0,05) para os valores da taxa de acréscimo da produção de leite até o pico, taxa de declínio de produção de leite após o pico, dia de produção de leite no pico, produção máxima de leite no pico e persistência da lactação no grupo de cabras infectadas experimentalmente em relação as cabras do grupo controle, e as características físico-química do leite relacionadas aos teores de gordura, ESD, densidade e proteína diminuíram significativamente (P <0,05) nas cabras do grupo infectado em relação as cabras do grupo controle

Made available in DSpace on 2016-08-15T20:31:08Z (GMT). No. of bitstreams: 1 AndrezzaKBM_DISSERT.pdf: 2145673 bytes, checksum: 7eee5441610d3202cb0ad9f1c19338c1 (MD5) Previous issue date: 2013-08-07 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present workaimed at evaluatingthe performance and yieldofcarcasscomponentsand no carcasscrossbred calvesreceivingcheese wheypowderassociated withpowdered milkduring sucklinguntil 60and 150 days, besides the realizationof economic analysisof substitution.A total of 40male calves, Holstein xwithoutdefined breed, distributed ina completely randomized designwith fourtreatments and tenreplications: whole milk(control), milk powder,milk powder80% +20% cheese wheypowder;60%milk powder+ 40%cheese wheypowder.After 60 days(suckling), 40test animalswere kept16animalsdivided into twotreatments with eight replicates: confinementandpasturewill, to evaluate the performancephaseofweaning.The developmentof the calveswas evaluated throughweeklyweighingandbodymeasurementsofwithers height, rump height, heart girthandbody length. Afterweaningweighingswere carried out fortnightlyup to 150days.To estimateconsumptionmeasurements were madedailyconsumption ofhay andconcentratedby the methodsupply /spare.The animals wereslaughteredat 60 days, where they weretakenmeasurespHand temperatureof thehot carcass, after 24 hoursofcoldcarcasses. Were also evaluatedparameters forcarcassandno carcass components.Theeconomic performance assessmentconsistedof the calculationof indicatorsof costs and revenues, andmeasuresofeconomic outcomes. All variablesweretested withTukeymean comparison, 5% probability.Theweekly consumption oftotal dry matteringestedweight gainandbody measurementsevaluatedshowed nodifferencesbetween treatments(P>.05). Therewereno significant differences (P>0.05) between treatmentsfor the variablesfor carcass traitsandnon-carcass components. The treatment containing20%cheese wheypowder+80% milk powder and40% cheese wheypowder+60% milk powder hadadditional profitof R$ 116.86and114.24respectively, principallyattributed to thefactthatspending onliquid diet. The results showthat the substitution ofwhole milkcheese wheypowder andits association withmilk powder, shownas avery feasible alternativeand not causing anany influenceon the parameters studied / No presente trabalho objetivou-se avaliar o desempenho de bezerros mestiços aleitados com soro de queijo em pó associação ao leite em pó até os 60 dias. Foram utilizados 40 bezerros machos, holandês x sem padrão racial definido, distribuídos em delineamento inteiramente casualizado com quatro tratamentos e dez repetições: leite integral (Controle); leite em pó; 80% leite em pó + 20% de soro de queijo em pó; 60% leite em pó + 40% de Soro de queijo em pó.Após a fase de aleitamento, destes 40 animaisutilizados, foram mantidos 16 bezerros distribuídos em dois tratamentos e oito repetições: confinamento e àpasto, para avaliação do desempenho na fase de desaleitamento.O desenvolvimento dos bezerros foi avaliado através de pesagens semanais e mensurações corporais de altura de cernelha, altura de garupa, perímetro torácico e comprimento do corpo. Na fase de desaleitamento as pesagens foram realizadas quinzenalmente até 150 dias de idade. Para a estimativa de consumo foram feitas medições diárias de consumo de feno e concentrado pelo método oferta/sobra. Todas as variáveis foram submetidas ao teste de comparação de médias Tukey, ao nível de 5% de probabilidade. O consumo semanal de matéria seca total ingerida não apresentou diferença entre os tratamentos (P>0,05), podendo se observar consumo crescente dos animais ao longo das semanas. Com relação ao ganho de peso os animais entraram no período experimental com pesos semelhantes (P>0,05) e ao longo desse período, os resultados apontam também que não houve diferença significativa (P>0,05), demonstrando que os tratamentos que receberam leite em pó e soro de queijo em pó associado ao leite em pó na dieta líquida não diferiu do tratamento controle. Os tratamentos também não influenciaram nenhuma das medidas corporais avaliadas. A substituição do leite integral por leite em pó, ou a associação de soro de queijo em pó ao leite em pó na substituição total do leite integral, não afetou o consumo de matéria seca, o ganho de peso e o desempenho dos animais tanto na fase de aleitamento quanto na fase de desaleitamento