Suchergebnisse

"Robinson details the life and times of France-Albert René (1935-2019), the second post-independence leader of Seychelles who oversaw the nation's transition to democracy after over a decade of his brutal dictatorship. René's career was Seychelles' history over the forty-three years from independence in 1976 until his peaceful death. Having presented himself as a socialist during the Cold War, he transitioned to build Africa's most successful relationship with international lenders including the IMF and developed Seychelles as a major offshore tax haven. He also sustained and cultivated Seychelles' position as a Western tourism-based economy. Robinson outlines not only René's use of political violence and extrajudicial killing, but also his unique relationship with transnational organised crime including his links with the New York mafia, Italian organised crime interests and even helping to arm the Rwandan genocide. Nevertheless, René - a white leader of an African nation - avoided the self-isolation of Rhodesia and South Africa, endowed racial harmony, enabled women to advance politically and socially, and left Seychelles with high incomes, currency convertibility and robust human and physical infrastructure. An essential read for anyone with an interest in the history of Seychelles, which will also be of great value to scholars of postcolonial states, African studies, microstates, and the Indian Ocean region"--

Abstract
Objective
To evaluate racial disparities in breastfeeding rates in patients with heart disease.

Study Design
Retrospective cohort of pregnant patients with maternal cardiac disease managed by a Cardio-Obstetrics program. Patients self-identifying as Non-Hispanic Black (NHB) and Non-Hispanic White (NHW), who attended ≥ 1 prenatal visit at the Cardio-Obstetrics Program and delivered at the same hospital between March 2015 and June 2019 were included. The primary outcome was breastfeeding rate at discharge from the delivery-associated hospitalization. Secondary outcomes included breastfeeding intent on admission and breastfeeding rates at the postpartum visit among patients who initiated breastfeeding.

Results
138 pregnant patients with cardiac disease were included: 58 (42%) NHB and 80 (58%) NHW patients. Parity, marital status and insurance were statistically different between groups. NHB patients were more likely to have government insurance compared to NHW patients (77.6% vs. 40%; p < 0.001). There was a significant difference in the intent to breastfeed upon admission for the delivery-associated hospitalization (74.2% NHB vs. NHW 91.3%; p = 0.01), but not at hospital discharge (84.5% NHB vs. 93.8% NHW; p = 0.08). However, breastfeeding rates were significantly lower among NHB patients at the postpartum visit among the entire cohort (38.2% in NHB vs. 61.1% in NHW women; p = 0.036) and among those who initiated breastfeeding (35.3% NHB vs. 61.1% NHW, p = 0.018).

Conclusions
Despite similar breastfeeding rates at hospital discharge, NHB patients with maternal cardiac disease were less likely to intend to breastfeed at admission and/or continue breastfeeding by the postpartum visits. Qualitative studies understanding these differences are crucial to improve breastfeeding rates, especially for NHB patients with maternal cardiac disease.