Claibourne I. Dungy

Reliability and validity of the Romanian version of a scale to measure infant feeding attitudes and knowledge

Aim: To describe the development and testing of the Romanian version of the Iowa Infant Feeding Attitude Scale (IIFAS‐R). The original instrument has well‐established psychometrics for use in English‐speaking countries.

Validation of a Romanian scale to detect antenatal depression

The aim of this study was to develop and validate a linguistically and culturally appropriate version of the Edinburgh Postnatal Depression Scale (EPDS) for use with women attending antenatal care in Romania. We translated and tested a Romanian version of the EPDS (EPDS-R) in four hospitals in three Romanian cities: Cluj-Napoca, Satu Mare, and Sighetu-Marmatiei. The study population included third-trimester women attending antenatal clinics (n=418); 364 subjects were included in the analytic sample. We used the Center for Epidemiologic Studies Depression Scale (CES-D) as a “gold standard”. We assessed reliability, validity, and conducted sensitivity analysis to establish an EPDS-R cutpoint. We found that reliability was robust (α=0.89) and there was a significant linear relationship between EPDS-R and CES-D scores (r=0.77; p<0.001). We established an EPDS-R cutpoint of >12 to balance sensitivity and specificity. Principal component analysis revealed a two-factor solution. We detected antenatal depressive symptoms prevalence rates of 32% (CES-D) and 38% (EPDS-R). This is the first study to report exclusively on antenatal depression and the use of the EPDS in Central and Eastern Europe. The EPDS-R is easy to administer, reliable, and valid for screening depression among antenatal women in Romania.

A Structured Public Health Approach to Increasing Rates and Duration of Breastfeeding in Romania

BACKGROUND Studies indicate that since 1990, rates of breastfeeding initiation and duration in Eastern Europe, including Romania, have decreased. Most breastfeeding promotion efforts in Romania have focused on in-hospital care, with an emphasis on training clinicians. Prior studies report that about 88% of Romanian mothers initiate breastfeeding in the hospital; however, these same studies report limited breastfeeding duration. We posit that an important problem is lack of support and education in the weeks and months following the birth. The nature of this problem suggests the need for an integrated and structured public health solution. METHODS Based on our independent research, the results of an international maternal and child health (MCH) conference, and consultation with Romanian and American experts, we propose use of the public health problem-solving paradigm to support breastfeeding in Romania. RESULTS This article presents a conceptual model showing the integration of input, output, and process components and a logic model explicating possible interventions (or needs) and barriers to breastfeeding. We propose a public health solution that begins with a new MCH within the public health training structure at a major Romanian university and a summer course bringing together Romanian and American students to study MCH, including breastfeeding. CONCLUSIONS We believe that these two courses will promote enthusiasm and generate ideas to develop community-based interventions as well as policy recommendations to increase breastfeeding duration in Romania. We suggest that this public health problem-solving approach provides an integrated way of maintaining and increasing breastfeeding; furthermore, this approach could be broadly used in Eastern Europe.

Breast Feeding Preference of Hispanic and Anglo Women 1978-1985

Hispanic women of Mexican origin are one of the fastest growing minority groups in the United States, but little information is available regarding the rate of breast feeding among this group of women. The breast feeding preferences of Hispanic women delivering at a southern California university hospital were determined by retrospective analysis of birth log records from 1978 to 1985. Approximately 95 percent of the Hispanic women delivering at this institution were of Mexican origin. Hispanic women had a preference for breast feeding similar to the national average for the same time period. The rate of breast feeding among Hispanic women of Mexican descent was consistently higher than previous reports from other regions of the United States.

Securing a Faculty Position: A Practical Guide for Residents, Fellows, Junior Faculty, and Their Mentors

Applying for a faculty position can appear to be a daunting project for many residents, fellows, and junior faculty due, in large part, to the lack of readily available information on the process of interviewing and negotiating for faculty appointment in academic medicine. Although this process may seem mystifying to first-time applicants, it has a structure. This article discusses the framework of the application process and recommends an action plan from initial contact to acceptance of an offer. Each step of the process is discussed. Guidelines are provided to assist applicants and their mentors to successfully manage these important steps.

Healthy Steps: Resident’s Perceptions:

The objective of this study is to determine pediatric residents’ perception of Healthy Steps for Young Children, Healthy Steps Iowa, and Healthy Steps specialists. Twenty-nine of 37 (78%) pediatric residents participated in this survey. The Healthy Steps specialists facilitated pediatric residents’ learning of anticipatory guidance (69%), and assured the patients received information efficiently (69%). Sixty-two percent reported that the Healthy Steps specialists did not interfere with their relationship as the patient’s primary care provider. Seventy-six percent would consider using Healthy Steps specialists in their future practice. Program improvement areas include improving clinic efficiency with the incorporation of Healthy Steps specialists; increasing the pediatric residents’ awareness of family violence, mental illness, and substance abuse; and improving their method of referral to community contacts.