The research undertaken in this study utilized a case-control group nested within a prospective cohort which was followed for the first 3 months postpartum. Mothers with mastitis and their controls were requested to complete a self-report questionnaire designed to investigate the association between the potential risk factors, identified from the literature, and lactation mastitis. Logistic regression analyses of the possible risk factors were performed separately for mothers who had not breastfed previously and those mothers who had breastfed at least one infant prior to this lactation. Analysis showed blocked duct(s) and increased levels of stress were the significant predictors for mastitis in mothers who had breastfed a previous infant and blocked duct(s), restriction from a tight bra, attachment difficulties, and nipple pain during a feed were the significant predictors for mastitis in first time breastfeeding mothers.

Objective: To investigate the experiences of women participating in a cooking and nutrition component of a health promotion research initiative in an Australian Aboriginal regional community. Design: Weekly facilitated cooking and nutrition classes were conducted during school terms over 12 months. An ethnographic action research study was conducted for the programme duration with data gathered by participant and direct observation, four yarning groups and six individual yarning sessions. The aim was to determine the ways the cooking and nutrition component facilitated lifestyle change, enabled engagement, encouraged community ownership and influenced community action. Setting: Regional Bindjareb community in the Nyungar nation of Western Australia. Subjects: A sample of seventeen Aboriginal women aged between 18 and 60 years from the two kinships in two towns in one shire took part in the study. The recruitment and consent process was managed by community Elders and leaders. Results: Major themes emerged highlighting the development of participants and their recognition of the need for change: the impact of history on current nutritional health of Indigenous Australians; acknowledging shame; challenges of change around nutrition and healthy eating; the undermining effect of mistrust and limited resources; the importance of community control when developing health promotion programmes; finding life purpose through learning; and the need for planning and partnerships to achieve community determination. Conclusions: Suggested principles for developing cooking and nutrition interventions are: consideration of community needs; understanding the impact of historical factors on health; understanding family and community tensions; and the engagement of long-term partnerships to develop community determination.

Objective:The objective was to investigate changes in milk composition that reflect variations in breast permeability, milk synthesis, and immune response in women before, during, and after mastitis Methods: Mothers (n ‫؍‬ 26) were followed prospectively from day 5 postpartum to the end of their lactation. Milk from each breast, blood, 24-hour urine samples, and data on breast and systemic pathologies were collected at reference intervals during the first 3 months postpartum, daily during the occurrence of any breast inflammation, and 7 days after resolution of symptoms, and was analyzed using mixed-model analysis (repeated measures).Results: There was a significant difference in sodium (p Ͻ 0.001), chloride (p Ͻ 0.001), serum albumin (p Ͻ 0.02) and lactose (p Ͻ 0.003) in the breast with mastitis when compared with both the contralateral asymptomatic breast and "healthy" breasts. Inflammation of the whole breast was a significant predictor for a decreased glucose (p Ͻ 0.01) and hyperacute systemic symptoms predicted a decrease in milk glucose (p Ͻ 0.03) and an increased lactoferrin (p Ͻ 0.05) and sIgA (p Ͻ 0.03).Conclusions: There is an increased breast permeability, reduced milk synthesis, and increased concentration of the immune components sIgA and lactoferrin with increasing severity of breast and systemic symptoms. The changes observed in milk composition during periods of increased breast permeability cannot be solely explained by the current theory of permeability of the paracellular pathway and further research in this area is required.

This study has identified nursing students are exposed to, and feel at significant risk of, aggression and violence in the clinical setting. Providing them with an appropriate level of knowledge and self-confidence to assist in the management of the threat and actuality of such incidents is essential.

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