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Trends and determinants of early initiation of breastfeeding in Indonesia: A multivariate decomposition analysis

by Siti Nurokhmah, Lucinda Middleton, Judhiastuty Februhartanty, Aryono Hendarto

Background

Early initiation of breastfeeding (EIBF) is key to reducing neonatal morbidity and mortality, however, little is known about the determinants of the trends of EIBF prevalence in Indonesia. This study aims to assess the contributing factors to the changes in the prevalence of EIBF between 2007 and 2017.

Methods

We analysed data from the 2007, 2012, and 2017 Indonesia Demographic and Health Surveys to estimate the trends in EIBF. A multivariate logistic decomposition model was fitted to examine variables associated with changes in the percentage of EIBF from 2007 to 2017. The contributing factors to changes in EIBF prevalence were categorized into either compositional or behavioural changes, with each of them divided into portions or percentages of contribution (pct) of the independent variables. The former refers to the changes in the distribution of samples, while the latter refers to the changes in the behavioural responses toward EIBF in both surveys. All analyses accounted for the complex study design and potential confounding factors.

Results

An increase in the prevalence of EIBF from 49.9% to 56.5% was recorded between 2012 and 2017, with an overall increase of 16.9 percentage points from 2007 to 2017. At the aggregate level, the compositional differences did not significantly contribute to the changes in the percentage of EIBF, while 98.3pct (p Conclusions

Almost half of the newborns experienced delayed breastfeeding initiation despite the improvement in the prevalence of EIBF. Therefore, further research and interventions on behaviour change in mother’s attitudes towards EIBF, especially among those undergoing caesarean delivery, living in Kalimantan or Sulawesi, and from wealthier households, are recommended to close this gap.

Scabies outbreak management in refugee/migrant camps in Europe 2014-2017: a retrospective qualitative interview study of healthcare staff experiences and perspectives

Por: Richardson · N. A. · Cassell · J. A. · Head · M. G. · Lanza · S. · Schaefer · C. · Walker · S. L. · Middleton · J.
Objectives

Provide insights into the experiences and perspectives of healthcare staff who treated scabies or managed outbreaks in formal and informal refugee/migrant camps in Europe 2014–2017.

Design

Retrospective qualitative study using semistructured telephone interviews and framework analysis. Recruitment was done primarily through online networks of healthcare staff involved in medical care in refugee/migrant settings.

Setting

Formal and informal refugee/migrant camps in Europe 2014–2017.

Participants

Twelve participants (four doctors, four nurses, three allied health workers, one medical student) who had worked in camps (six in informal camps, nine in formal ones) across 15 locations within seven European countries (Greece, Serbia, Macedonia, Turkey, France, the Netherlands, Belgium).

Results

Participants reported that in camps they had worked, scabies diagnosis was primarily clinical (without dermatoscopy), and treatment and outbreak management varied highly. Seven stated scabicides were provided, while five reported that only symptomatic management was offered. They described camps as difficult places to work, with poor living standards for residents. Key perceived barriers to scabies control were (1) lack of water, sanitation and hygiene, specifically: absent/limited showers (difficult to wash off topical scabicides), and inability to wash clothes and bedding (may have increased transmission/reinfestation); (2) social factors: language, stigma, treatment non-compliance and mobility (interfering with contact tracing and follow-up treatments); (3) healthcare factors: scabicide shortages and diversity, lack of examination privacy and staff inexperience; (4) organisational factors: overcrowding, ineffective interorganisational coordination, and lack of support and maltreatment by state authorities (eg, not providing basic facilities, obstruction of self-care by camp residents and non-governmental organisation (NGO) aid).

Conclusions

We recommend development of accessible scabies guidelines for camps, use of consensus diagnostic criteria and oral ivermectin mass treatments. In addition, as much of the work described was by small, volunteer-staffed NGOs, we in the wider healthcare community should reflect how to better support such initiatives and those they serve.

Career optimism and job‐related well‐being of Australian nurses during COVID‐19: A cross‐sectional study

Abstract

Background

Australia has been confronted with a severe nursing deficit, making it difficult to maintain a strong healthcare workforce capable of meeting the mounting demands of healthcare organizations.

Aims

This study aimed to understand how personal and organizational resources influence career optimism and job-related affective well-being of Australian nurses during a pandemic using the Conservation of Resource Theory.

Methods

A cross-sectional online survey was emailed to 123 Australian nurses from January to February 2021. The survey consisted of self-reported measures, including mindfulness, career optimism, job-related affective well-being, personal and job resources measures, and the Dirty Dozen scale. Correlations, independent sample t-test, and a series of hierarchical regressions were conducted on the cross-sectional data with SPSS Version 27. The STROBE checklist was used to report the results.

Results

Findings suggested that mindfulness, perceived supervisor support, and job autonomy were significant predictors of job-related well-being, whereas mindfulness, perceived supervisor support, and opportunities for professional growth contributed more to career optimism of nurses during a health crisis. Male nurses in this study reported significantly higher mindfulness, career optimism, and job-related well-being levels than female nurses.

Linking Evidence to Action

Developing mindfulness among nurses, allocating organizational resources to facilitate more supervisor support, and providing job autonomy may enhance career optimism and job-related well-being of nursing staff who work in disruptive and high-demand work environments such as those experienced during the COVID-19 health crisis. Supervisors should also facilitate and encourage nurses to reflect and be mindful of their behaviors with their peers and patients which can help to reduce exploitative or arrogant behaviors in the workplace.

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