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Objective: To identify determinants of the initiation and duration of breastfeeding amongst Australian women.Methods: A prospective cohort study of 556 women in Perth, Western Australia and 503 women from the Darling Downs area, Queensland, Australia.Results: Breastfeeding at discharge was most strongly associated with perceived paternal support of breastfeeding with an adjusted odds ratio of 9.13 (95% CI 4.83-17.26), using multivariate logistic regression analysis. Duration of breastfeeding was most strongly associated with the length of time a mother intended to breastfeed with an adjusted relative risk of 4.18 (95% CI 2.81-6.22) for > or = 4 months relative to < 4 months.Conclusions: Interventions which aim to increase the length of time a woman intends to breastfeed, and which highlight the role of the father in successful breastfeeding, are recommended to help achieve recommended targets for breastfeeding initiation and duration. [ABSTRACT FROM AUTHOR]

Australian governments routinely monitor population household food insecurity (FI) using a single measure-'running out of food at least once in the previous year'. To better inform public health planning, a synthesis of the determinants and how they influence and modify each other in relation to FI was conducted. The analysis used data from the Health & Wellbeing Surveillance System cross-sectional dataset. Weighted means and multivariable weighted logistic regression described and modelled factors involved in FI. The analysis showed the direction and strength of the factors and a path diagram was constructed to illustrate these. The results showed that perceived income, independent of actual income was a strong mediator on the path to FI as were obesity, smoking and other indicators of health status. Eating out three or more times a week and eating no vegetables more strongly followed FI than preceded it. The analysis identified a range of factors and demonstrated the complex and interactive nature of them. Further analysis using propensity score weighted methods to control for covariates identified hypothetical causal links for investigation. These results can be used as a proof of concept to assist public health planning., Competing Interests: The authors declare no conflict of interest. A.D. and C.P. worked for the Department of Health, Western Australia. The founding sponsors had no role in the design of the study; in the analyses or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Background: Very few Australian infants are exclusively breastfed to 6 months as recommended by the World Health Organization. There is strong empirical evidence that fathers have a major impact on their partner's decision to breastfeed and continuation of breastfeeding. Fathers want to participate in the breastfeeding decision making process and to know how they can support their partner to achieve their breastfeeding goals. The aim of the Parent Infant Feeding Initiative (PIFI) is to evaluate the effect on duration of any and exclusive breastfeeding of three breastfeeding promotion interventions of differing intensity and duration, targeted at couples but channelled through the male partner. The study will also undertake a cost-effectiveness evaluation of the interventions., Methods/design: The PIFI study is a factorial randomised controlled trial. Participants will be mothers and their male partners attending antenatal classes at selected public and private hospitals with maternity departments in Perth, Western Australia. Fathers will be randomly allocated to either the usual care control group (CG), one of two medium intensity (MI1 and MI2) interventions, or a high intensity (HI) intervention. MI1 will include a specialised antenatal breastfeeding education session for fathers with supporting print materials. MI2 will involve the delivery of an antenatal and postnatal social support intervention delivered via a smartphone application and HI will include both the specialised antenatal class and the social support intervention. Outcome data will be collected from couples at baseline and at six and 26 weeks postnatally. A total of 1600 couples will be recruited. This takes into account a 25% attrition rate, and will detect at least a 10% difference in the proportion of mothers breastfeeding between any two of the groups at 26 weeks at 80% power and 5% level of significance, using a Log-rank survival test. Multivariable survival and logistic regression analyses will be used to assess the effect of the treatment groups on the outcomes after adjusting for covariates., Discussion: The PIFI study will be the first Australian study to provide Level II evidence of the impact on breastfeeding duration of a comprehensive, multi-level, male-partner-focused breastfeeding intervention. Unique features of the intervention include its large sample size, delivery of two of the interventions by mobile device technology, a rigorous assessment of intervention fidelity and a cost-effectiveness evaluation., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12614000605695. Registered 6 June 2014.

For infants' optimal growth and development, the introduction of nutritionally suitable solid foods at the appropriate time is essential. However, less attention has been paid to this stage of infant life when compared with studies on breastfeeding initiation and duration. The practice of introducing solid foods, including the types of foods given to infants, in the Asia Pacific region was reviewed. In total nine studies using the same questionnaire on infant feeding practices were analysed to gain a better understanding of trends in the introduction of solid foods in this region. All studies showed less than optimal duration of exclusive breastfeeding indicating an earlier time of introduction of solid foods than recommended by the WHO. Most mothers commonly used rice or rice products as the first feed. In many studies, the timing of introducing solid foods was associated with breastfeeding duration. Compared with the Recommended Nutrient Intakes for infants aged above six months, rice/rice products are of lower energy density and have insufficient micronutrients unless they have been fortified. Although the timing of introducing solid foods to infants is important in terms of preventing later health problems, the quality of the foods should also be considered. Recommendations to improve the introduction of solid foods include measures to discourage prelacteal feeding, facilitating breastfeeding education and providing better information on healthier food choices for infants.

This study recorded maternal perceptions of preschool children's weight in Chinese mothers living in Australia and China. A survey was undertaken of 1951 mothers living in Chengdu and Wuhan, China and 89 Chinese mothers living in Perth, Australia. All participants were mothers with children aged 2-4 years. The children's weight and height were measured and their weight status were classified using the International Obesity Task Force 2012 revised international child body mass index cut-offs. The prevalence of overweight or obese in children was 16.7% in China and 8% in Australia. The overall percentages of correct maternal perception of the child's weight were 35% in underweight children, 69.2% in normal weight children but only 10.8% in overweight/ obese children. Among the overweight/obese children, only 14% in Australia and 10.8% in China were classified as overweight/obese by their mothers. Within the group of underweight children, normal weight mothers (p=0.004) and mothers with older age children (p=0.015) were more likely to correctly classify children's weight status. A higher percentage of overweight/obese mothers (p=0.002) and mothers who over-estimated her own weight status (p<0.001) have correct perception of the weight status of their overweight/obese children, compared to their counterparts. There was a high prevalence of incorrect maternal perception of preschool children's weight status in Chinese mothers, especially those with overweight/obese children. To address the obesity epidemic in children, future health promotion programs should put improved efforts to educate parents about obesity and its health consequences in order to reduce misperceptions.

This study describes Japanese mothers' knowledge and attitudes towards breastfeeding using the Iowa Infant Feeding Attitudes Scale (IIFAS). A cross-sectional survey of 1,612 mothers was conducted in Japan in 2007. The participants were recruited at the free health checks conducted for infants at 18 months of age. The survey was self-administered using the Japanese version of the IIFAS. Descriptive statistics were used to summarise sample characteristics and IIFAS score followed by multiple logistic regression to identify association between total IIFAS score and breastfeeding duration. While the IIFAS showed that the majority recognized some benefits of breastfeeding, their overall knowledge and attitudes towards breastfeeding were neutral and more positive towards the use of infant formula. It is important to provide accurate prenatal education that focuses on methods and long-term benefits of infant feeding to mothers, family and health professionals.

This study aimed to translate and validate a Chinese (simplified) version of the Iowa Infant Feeding Attitude Scale (IIFAS) and compare the infant feeding attitudes of Chinese mothers living in Perth Australia and in Chengdu P.R. China. A survey was undertaken on 200 Chinese mothers living in Perth and 1620 mothers living in Chengdu. The simplified Chinese version of IIFAS had a moderate level of internal consistency with a Cronbach's alpha of 0.69 for mothers in Australia and 0.55 for mothers in China. The mean IIFAS scores in both country groups lay in the range of 'neutral breastfeeding attitudes'. Higher IIFAS scores were significantly associated with the likelihood of both breastfeeding initiation (OR: 3.85; CI: 2.49-5.96; p<0.001) and longer (>=8 months) breastfeeding duration (OR: 2.52; CI: 1.87-3.40; p<0.001). Chinese mothers in Perth (mean IIFAS score=60.0±6.3) tended to have more positive attitudes towards breastfeeding than mothers in Chengdu (mean IIFAS score=57.7±5.1, p<0.001), and had a longer duration of 'any breastfeeding' (10.0±6.2 months in Perth compared to 7.4±4.3 months in Chengdu, p<0.001). In conclusion, higher scores on the IIFAS in simplified Chinese are associated with breastfeeding initiation and duration in Chinese populations.

Aim: To determine the effect of mothers receiving health promotion material and education antenatally and/or postnatally on breastfeeding outcomes in Perth, Western Australia., Methods: A 12-month longitudinal study was conducted in two public maternity hospitals in Perth, Western Australia, between 2002 and 2003. Data were collected on a consecutive sample 587 mothers., Results: The results showed that mothers who received an individual consultation or were involved in a discussion on breastfeeding antenatally with hospital staff were approximately 55% less likely to cease fully breastfeeding (HR 0.44; 95% CI 0.24-0.88) before 6 months, and 50% less likely to cease any breastfeeding before 12 months postnatally (HR 0.51; 95% CI 0.28-0.92). In the postnatal period, mothers who received instruction on positioning and attachment of the infant to the breast while in hospital were approximately 30% less likely to cease fully breastfeeding before 6 months (HR 0.66; 95% CI 0.45-0.99)., Conclusion: The results of this study suggest a positive association between receiving individualized breastfeeding information in both the antenatal and postnatal period, and breastfeeding outcomes., (© 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.)

Background:   Alcoholic liver disease (ALD) is an important contributor to the total burden of alcohol-related harm; however, the morbidity of different types of ALD in Australia has not been described. The aim of this study was to investigate recent trends in hospital admission rates among alcoholic liver cirrhosis, alcoholic hepatic failure and alcoholic hepatitis in Australia, as well as the mortality of ALD., Method:   This is a population-based cohort study including the total 15+ years Australian population. Data were obtained from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare., Main Outcome Measures: (i) trend of standardized mortality rates and trend of standardized hospital admission rates for males and females for 1993/1994-2004/2005 (fiscal year), (ii) relative risk of alcoholic liver cirrhosis, alcoholic hepatic failure and alcoholic hepatitis hospital admissions for 1999/2000-2004/2005., Results:   The mortality rate of ALD decreased significantly. Significant increases in hospital admissions for alcoholic hepatic failure among older adults and alcoholic hepatitis among younger age groups were observed. There is a significant 10-fold increase in the risk of hospital admissions of alcoholic cirrhosis in 2002/2003 for the 20-29 years population., Conclusion:   Reductions in overall ALD mortality observed are likely the result of advances in disease management. Significant increase in hospital admissions suggests an increase in the prevalence of ALD among the Australian population. Dramatic increases in hospital admissions for alcoholic cirrhosis in 2002/2003 for the 20-29 years population may have been due to an increase in screening of alcohol-related harms in primary care settings., (© 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.)

The role of calcium in the prevention of bone loss in later life has been well established but little data exist on the adequacy of calcium intakes in elderly Australian women. The aim of this study was to compare the dietary intake including calcium of elderly Australian women with the Australian dietary recommendation, and to investigate the prevalence of calcium supplement use in this population. Community-dwelling women aged 70-80 years were randomly recruited using the Electoral Roll for a 2-year protein intervention study in Western Australia. Dietary intake was assessed at baseline by a 3-day weighed food record and analysed for energy, calcium and other nutrients. A total of 218 women were included in the analysis. Mean energy intake was 7,140 ± 1,518 kJ/day and protein provided 19 ± 4% of energy. Mean dietary calcium intake was 852 ± 298 mg/day, which is below Australian recommendations. Less than one quarter of women reported taking calcium supplements and only 3% reported taking vitamin D supplements. Calcium supplements by average provided calcium 122 ± 427 mg/day and when this was taken into account, total calcium intake increased to 955 ± 504 mg/day, which remained 13% lower than the Estimated Average Requirement (EAR, 1,100 mg/day) for women of this age group. The women taking calcium supplements had a higher calcium intake (1501 ± 573 mg) compared with the women on diet alone (813 ± 347 mg). The results of this study indicate that the majority of elderly women were not meeting their calcium requirements from diet alone. In order to achieve the recommended dietary calcium intake, better strategies for promoting increased calcium, from both diet and calcium supplements appears to be needed.

Objective: To develop nutrition criteria consistent with Australian dietary guidelines encouraging fruit and vegetable consumption for branding recipes with the Go for 2&5 campaign message., Design: Dietary policies, guidelines, food selection guides, nutrient targets, existing consumer education programs' nutrition criteria, food habits, and eating styles were reviewed to develop nutrition criteria, which were then used to assess 128 recipes., Setting: Perth, Australia., Analysis: Recipes were analyzed then assessed against criteria for fat, sodium, fiber, energy, added sugar, fruit, vegetables, cereal, and dairy content/per serving., Results: Recipe nutrition criteria were devised, and 128 contemporary industry recipes were evaluated according to developed nutrition criteria. Recipe categories included main meals; light meals (includes breakfast); soups; salads; side dishes; snacks (includes drinks); desserts; bakery; and basic ingredients (eg, stocks, dips, and sauces). Nearly three quarters failed. Excess fat (45%) and sodium (30%) and inadequate cereal (24%) were the main reasons. Only minor modifications were required to meet criteria., Conclusions and Implications: "Healthful" recipes promoting fruits and vegetables were often high in fat and sodium and low in cereal content. Nutrition criteria developed for this study provided a practical way of assessing specific meals and snacks according to the dietary guidelines, making them suitable for nutrition promotions.

Exclusive breastfeeding for the first 6 months of life is recommended as the optimal way to feed infants. This paper reviews the measurement of exclusive breastfeeding in Australian studies over the past 10 years. Only half the studies identified that claimed to measure exclusive breastfeeding used a definition consistent with the World Health Organisation. Three studies used 24-h or 7-day recall indicators that have been shown to produce overestimations of the prevalence of exclusive breastfeeding. Measurement of exclusive breastfeeding with a valid and consistent definition is vital for monitoring rates and trends, for comparison between different studies and countries and to reach conclusions on various health benefits. Any future measurement of exclusive breastfeeding in Australia should use the World Health Organisation definition and the 24 h recall study design should not be used for this purpose.

Aim: This study investigated the relationships between alcohol consumption and breastfeeding initiation and duration., Design and Setting: A 12-month longitudinal study was conducted in two public hospitals in Perth, Australia between September 2002 and July 2003., Intervention: Participating mothers completed a self-administered baseline questionnaire. Follow-up telephone interviews were conducted at 4, 10, 16, 22, 32, 40 and 52 weeks., Main Outcome Measures: Association of the relationships between alcohol consumption and breastfeeding initiation and duration., Results: After 6 months of follow-up, women who consumed alcohol at levels of more than two standard drinks per day were almost twice as likely to discontinue breastfeeding than women who drank below these levels (HR 1.9, 95% CI 1.1, 3.0)., Conclusion: Consuming alcohol in excess of two standard drinks per day during lactation was found to be independently associated with shorter breastfeeding duration, even after consideration of previously identified predictors of breastfeeding duration. Guidelines that provide direction on safe alcohol consumption for lactating mothers may help support extended breastfeeding duration.

Alcohol enters breastmilk by passive diffusion and levels are reflected in maternal blood within 30 to 60 minutes of ingestion. If not timed appropriately, drinking alcohol throughout the period of lactation can negatively impact on lactation performance and the mental development of the infant. The aim of this study was to explore the drinking patterns of pregnant, lactating and other Australian women of child bearing age using the 1995 and 2001 National Health Survey Confidentialised Unit Record Files. Alcohol consumption was categorised according to Guideline 11 from the National Health and Medical Research Council (NHMRC) current Australian Alcohol Guidelines, which state that if pregnant or lactating women choose to drink, over a week, they should have fewer than 7 standard drinks. Despite a low intake by most pregnant and lactating women from both surveys, approximately 16.4% and 1.3% (95% Confidence Interval (CI 7.0-23.2) of pregnant women from the 1995 and 2001 NHS respectively, and 13% and 16.8% (95% CI -6.5 - -1.1) of lactating mothers from the 1995 NHS and 2001 NHS respectively, were drinking above this national guideline. There were significantly more pregnant women in the 1995 NHS, and lactating women in the 20091 NHS, exceeding this recommendation. Pregnancy and lactation are vulnerable times of infant growth and development. There is a definite need in Australia for improved antenatal, and maternal and child health programs that address this significant public health issue.

Objectives: To determine applicability of the Japanese-translated versions of the Ben-Tovim Walker Body Attitudes Questionnaire (BAQ) and the Attention to the Body Shape Scale (ABS) in Japanese males and females., Methods: The translated questionnaires were administered to Japanese living in Japan (84 males, 139 females) and also to 68 Japanese males living in Australia. The results were compared with 72 Australian males using the English version and also with previous results using Australian females., Results: Alpha levels from the two questionnaires ranged 0.70 to 0.87. Japanese groups showed significant (p<0.05) differences in the scores obtained from the BAQ compared to Australian males. The inter-subscale correlations for the BAQ were comparable regardless of ethnicity. Both questionnaires also correlated with the 26-item Eating Attitudes Test scores (p<0.01)., Discussion: The current study suggests that both BAQ and ABS are adequate for use in Japanese males and females to assess their body attitudes.

Background: Drinking alcohol during pregnancy can cause many birth defects and developmental disabilities. There is considerable information available for pregnant women regarding the dangers of drinking alcohol during this time. Postpartum many women enter the period of lactation, which can last for several months to years. However information regarding safe levels of alcohol consumption during lactation is limited despite potential harmful effects on infant development and maternal lactational performance., Methods: A descriptive study using qualitative methods. Data was collected in focus groups interviews conducted from February 2004 to December 2005. Women eligible to participate in the focus groups were currently breastfeeding or had been breastfeeding within the previous 12 months., Results: Seventeen women aged 28 to 41 years participated in postpartum focus groups. The mothers were largely unaware of the effects of alcohol on breastfeeding performance and the development of the infant. The majority of the women in the focus groups expressed concern at the lack of information available regarding "safe" alcohol consumption practices during lactation and reported being more diligent during pregnancy with regard to abstaining from alcohol., Conclusion: There is a variable level of knowledge regarding consuming alcohol and breastfeeding among Australian mothers. The majority of participants were aware of the recommendations regarding alcohol during pregnancy and felt that a similar level of information was required to provide direction and support during lactation.

This cross-sectional study aimed to determine ethnic and environmental influences on the relationship between BMI and percentage body fat, using a sample of 144 Japanese and 140 Australian-Caucasian men living in Australia, and eighty-eight Japanese men living in Japan. Body composition was assessed by anthropometry using standard international methods (International Society for the Advancement of Kinanthropometry protocol). Body density was predicted using Durnin and Womersley's (1974) equation, and percentage body fat was calculated from Siri's (1961) equation. Significant (P<0.05) ethnic differences in stature, body mass and BMI were observed between Japanese and Australian men, but no ethnic differences were observed in their percentage body fat and height-corrected sum of skinfold thicknesses. No differences were found in the BMI-percentage body fat relationship between the Japanese subjects living in Australia and in Japan. Significant (P<0.05) ethnic differences in the BMI-percentage body fat relationship observed from a comparison between pooled Japanese men (aged 18-40 years, BMI range 16.6-32.8 kg/m2) and Australians (aged 18-39 years, BMI range 16.1-31.4 kg/m2) suggest that Japanese men are likely to have a greater percentage body fat than Australian men at any given BMI value. From the analyses, the Japanese men were estimated to have an equivalent amount of body fat to the Australian men at BMI values that were about 1.5 units lower than those of the Australians (23.5 kg/m2 and 28.2 kg/m2, respectively). It was concluded that Japanese men have greater body fat deposition than Australian-Caucasians at the same BMI value. Japanese men may therefore require lower BMI cut-off points to identify obese individuals compared with Australian-Caucasian men.

Background: Regular identification of factors that predict a woman's infant feeding choice is important so that breastfeeding promotion interventions can be targeted at those women least likely to breastfeed. The objective of this study was to compare determinants of breastfeeding at discharge from hospital in 2002/2003 with those reported for 1992/1993., Methods: Women participating in two longitudinal infant feeding studies in Perth, Australia, completed a baseline questionnaire just before, or shortly after, discharge from hospital. Data collected included infant feeding method and socio-demographic, biomedical, and psychosocial factors known, or suspected, to be related to the initiation of breastfeeding. Multivariate logistic regression was used to identify independent predictors of "any" and "exclusive" breastfeeding at hospital discharge in both studies., Results: Although maternal age, level of education, and family income were independent predictors of breastfeeding at hospital discharge in the first study, no association was found between these factors and breastfeeding at hospital discharge in the second study. In both studies, a woman who perceived her husband to prefer breastfeeding was significantly more likely to leave hospital breastfeeding, and to be exclusively breastfeeding, than a woman who perceived her husband to prefer formula feeding. The strongest predictor in both studies for a woman to not be exclusively breastfeeding at hospital discharge was having an infant who had been admitted to the special care nursery after delivery., Conclusions: Given the importance of psychosocial factors to breastfeeding initiation, interventions that aim to increase breastfeeding initiation rates should be targeted on the basis of parental attitudes to breastfeeding rather than on sociodemographic factors. Similarly, interventions that aim to increase exclusive breastfeeding should address biomedical factors that hinder a woman's ability to establish exclusive breastfeeding.

Aims: The perceptions that teachers, parents and health professionals have on the relative importance of different aspects of quality of life (QOL) for the adolescent with a chronic illness were explored using a three-round Delphi study., Methods: The first round questionnaire identified the level of importance each panel attached to 16 aspects relating to QOL. Panellists were also encouraged to provide additional comments on why they felt a particular item was important. In round two, panellists were asked to prioritize the items in order of importance, whereas round three attempted to achieve consensus among each of the three panels., Results: Differences between and within panels in the prioritization of items in round one and round two were evident. However, consensus was achieved in round three, except for the prioritization of very important items by the panel of teachers. Items identified by all three panels as extremely important included the adolescent's attitude, family relationships and friendships with the same age group. Themes to emerge from the qualitative responses to the open-ended questions included the perception of the chronically ill adolescent 'not wanting to be different' and the importance of a 'positive attitude'. The majority of participants also perceived adolescents with a chronic illness as having worse QOL than their healthy counterparts., Conclusions: By increasing the awareness among the different groups of the impact of chronic illness on various aspects of adolescent QOL, the overall care and support of those adolescents could be improved. Further studies should also be undertaken to explore the views of the chronically ill adolescents themselves.

The acquisition of information technology and research skills is fundamental for all students in Public Health because of its fundamental emphasis on population studies. In the Curtin University, Division of Health Sciences the School of Public Health has the responsibility of introducing communication and IT skills to all students, both undergraduate and postgraduate. A special program of information technology skills is offered. The age of the Internet has meant added temptation for students in terms of plagiarism and all students and staff must be aware of their ethical obligations in this area. The advent of flexible learning strategies will provide many opportunities for Schools of Public Health, both in the education of their students and in the continuing education of public health practitioners. APACPH member institutions could usefully pool their resources to develop flexible learning resources.

There has been rapid development in the Asia-Pacific region, leading to improvements in the food supply and nutrition. The high prevalence of low birth weight has been a problem in many countries and continues to be a problem in some parts of the region. In the past few years an epidemic of obesity and chronic disease has emerged. The fetal origins hypothesis links the high prevalence of low birth weight and recent increasing obesity to explain the emerging epidemic of chronic disease. One public health strategy to challenge this epidemic is the promotion of breastfeeding of all infants. Breastfeeding has been shown to protect against childhood obesity, and is "dose related", that is, the longer an infant is breastfed, the lower the risk of obesity.

Duration of breastfeeding was studied in 556 women delivering at 2 maternity hospitals in Perth, Australia. At discharge 83.8% of women were breastfeeding their infants, including 6% who were giving complementary feeds. At 3 and 6 months, 61.8% and 49.9%, respectively, were still breastfeeding. In a Cox survival analysis of factors associated with duration of breastfeeding a positive association was found with maternal education, age and intended duration of breastfeeding. Male infants were more likely to be weaned before female infants and women whose partners were unemployed, or did not have a preference for breastfeeding, breastfed for shorter duration. There is still a need for programmes which support and encourage breastfeeding, focusing particularly on younger, less well-educated women who intend to breastfeed for less than the recommended 4-6 months.

Objective: To identify factors that influence a woman's decision to breast-feed., Methodology: Five hundred and fifty-six women were recruited from the maternity wards of two Perth hospitals. Data were collected from a self-administered questionnaire completed by participants prior to discharge. Logistic regression analysis was used to determine factors influencing the initiation of breast-feeding., Results: At discharge from hospital 83.8% of women were breast-feeding, including 6% who were giving complementary formula feeds. After controlling for potentially confounding demographic and biomedical factors, the father's reported preference for breast-feeding was found to be the most important factor influencing a woman's decision to breast-feed (OR 10.18)., Conclusion: Fathers participate in and influence the choice of infant feeding method and should be included in breast-feeding discussions.

Blood pressures were measured in 326 boys and 309 girls, 12 to 14 yr of age, who attended schools in six rural towns with water sodium levels ranging from 1.46 to 9.69 mmol/L. Although there were significant differences between mean blood pressure levels in children living in the six towns, they did not appear to result from differences in water sodium levels. Children who lived on farms and who drank low-sodium rain water did not have lower blood pressures than children who lived in the towns. The estimated intake of sodium from drinking water in the towns varied between 1.5 and 11.6 mmol/day and represented between 1.2% and 10.4% of the estimated daily sodium intake. No effect of water sodium level on urinary sodium excretion was found. Blood pressure levels showed significant positive relationships with pulse rate, body height and weight, Quetelet's index, mid-upperarm circumference, and triceps skinfold thickness. Diastolic blood pressures in girls were inversely related to the measure of physical activity. Control of these variables, where relevant, by covariance analysis did not uncover any relationship between water sodium level and blood pressure.

Wernicke's encephalopathy (WE) is a serious disease resulting from excessive alcohol intake. As well as the disastrous consequences for the individual, patients with WE place a heavy burden for continuing care on the community. Australia appears to have a higher rate of WE than other western countries, probably due to differences in the consumption patterns of alcoholic beverages. Unlike most other western countries, Australia does not fortify flour with thiamin. On the other hand the USA does fortify flour and has higher thiamin intakes and lower rates of WE. In Australia it has been proposed that thiamin be added to alcoholic beverages. Given that technical problems related to stability, taste and absorption can be solved, the fortification of a substance which is potentially harmful, raises serious problems for health educators. The labeling of alcoholic beverages as 'vitamin enriched' could result in changes in the community's beliefs about alcohol and in increased alcohol consumption. The nutrition and education implications of this proposal are discussed. The conclusion is drawn that Australia should follow the example of other western countries and fortify flour with thiamin.